Due to the low incidence rate of oral cancer, studies have not been able to conduct quality studies to prove the association between the two, however future larger studies may aid in the identification of individuals at a higher risk.Systemic implications
Periodontal disease (PD) can be described as an inflammatory condition affecting the supporting structures of the teeth. Studies have shown that PD is associated with higher levels of systemic inflammatory markers such as Interleukin-6 (IL-6), C-Reactive Protein (CRP) and Tumor Necrosis Factor (TNF). To compare, elevated levels of these inflammatory markers are also associated with cardiovascular disease and cerebrovascular events such as ischemic strokes.The presence of a wide spectrum inflammatory oral diseases can increase the risk of an episode of stroke in an acute or chronic phase. Inflammatory markers, CRP, IL-6 are known risk factors of stroke. Both inflammatory markers are also biomarkers of PD and found to be an increased level after daily activities, such as mastication or toothbrushing, are performed. Bacteria from the periodontal pockets will enter the bloodstream during these activities and the current literature suggests that this may be a possible triggering of the aggravation of the stroke process.Other mechanisms have been suggested, PD is a known chronic infection. It can aid in the promotion of atherosclerosis by the deposition of cholesterol, cholesterol esters and calcium within the subendothelial layer of vessel walls. Atherosclerotic plaque that is unstable may rupture and release debris and thrombi that may travel to different parts of the circulatory system causing embolization and therefore, an ischemic stroke.
Gingival diseases - Non dental biofilm induced
Genetic/developmental disorders
Specific infections
Inflammatory and immune conditions
Reactive processes
Neoplasms
Endocrine, nutritional and metabolic
Traumatic lesions
Gingival pigmentation.Periodontitis

Necrotizing periodontal diseases
Necrotizing Gingivitis
Necrotizing Periodontitis
Necrotizing Stomatitis
Periodontitis as a manifestation of systemic disease
PeriodontitisOther conditions affecting the periodontium
(Periodontal Manifestations of Systemic Diseases and Developmental and Acquired Conditions)

Systemic disease of conditions affecting the periodontal support tissues
Other Periodontal Conditions
Periodontal abscesses
Endodontic- periodontal lesions
Mucogingival deformities and conditions
Gingival Phenotype
Gingival/Soft Tissue Recession
Lack of Gingiva
Decreased Vestibular Depth
Aberrant Frenum/muscle position
Gingival Excess
Abnormal Color
Condition of the exposed root surface
Traumatic occlusal forces
Primary Occlusal Trauma
Secondary Occlusal Trauma
Tooth and prosthesis related factors
Localized tooth-related factors
Localized dental prostheses-related factorsPeri-implant diseases and conditions

Peri-implant health
Peri-implant mucositis
Peri-implantitis
Peri-implant soft and hard tissue deficiencies

Staging
The goals of staging periodontitis is to classify the severity of damage and assess specific factors that may affect management.According to the 2017 classification, periodontitis is divided into four stages; after considering a few factors such as:

Amount and percentage bone loss radiographically
Clinical attachment loss, probing depth
Presence of furcation
Vertical bony defects
History of tooth loss related to periodontitis
Tooth hypermobility due to secondary occlusal trauma

Grading
According to the 2017 classification, the grading system for periodontitis consists of three grades:
Grade A: Slow progression of disease; no evidence of bone loss over last five years
Grade B: Moderate progression; < 2mm of bone loss over last five years
Grade C: Rapid progression or future progression at high risk; ≥ 2mm bone loss over five yearsRisk factors affecting which grade a person is classified into include:
Smoking
Diabetes

Prevention
Daily oral hygiene measures to prevent periodontal disease include:

Brushing properly on a regular basis (at least twice daily), with the person attempting to direct the toothbrush bristles underneath the gumline, helps disrupt the bacterial-mycotic growth and formation of subgingival plaque.