Association between periodontal disease and prostatic disease: a systematic review and meta-analysis of observational studies.

OBJECTIVE

Current research highlights periodontal disease as a systemic inflammatory condition that may influence extra-oral diseases such as prostatic diseases, which prompted us to explore the potential association. To evaluate whether periodontal disease is associated with an increased risk of prostatic disease, including prostate cancer, benign prostatic hyperplasia (BPH), and prostatitis.

METHODS

A systematic search of observational studies concerning the relationship between periodontal disease and prostatic disease was performed in online databases PubMed, Embase, Web of Science, Scopus, CENTRAL, CNKI, and WanFang. Searches were conducted from database inception to 31 July 2025. Pooled hazard ratio (HR) or odds ratio (OR) with 95% confidence intervals (CIs) were synthesized. Subgroup analysis was used to detect the origin of heterogeneity, sensitivity analysis was employed to evaluate the robustness of the results, and publication bias analyses were also performed. R software was used to perform statistical analyses.

RESULTS

Sixteen studies that met the preset criteria were included in this study. In the pooled analysis, periodontal disease was associated with increased risk of prostate cancer (HR = 1.23, 95%CI: 1.16-1.29, p < 0.001) or BPH (OR = 1.55, 95%CI: 1.41-1.70, p < 0.001). Sensitivity analysis confirmed the robustness of the results. No obvious publication bias was found in the meta-analysis. Only one cohort study reported that chronic periodontitis increases the risk of prostatitis (HR = 2.521, 95%CI: 1.685-4.005, p < 0.001). The effect of periodontal treatment on prostatic disease is still unclear.

CONCLUSIONS

The systematic review and meta-analysis identified an observational association between periodontal disease and increased risks of prostate cancer and BPH. Because all included studies were observational, these results indicate association rather than causation, and further prospective and mechanistic studies are required to clarify temporality and causality.