Exercise intensity and periodontitis: a narrative review

Periodontitis is a prevalent chronic inflammatory disease that affects the tooth-supporting tissues and is associated with systemic conditions. Regular physical activity is recognized for its role in preventing and managing chronic diseases, with potential benefits for periodontal health. This review aimed to examine the influence of varying exercise intensities on the inflammatory response in periodontitis. A literature review was conducted using the PubMed database, employing the descriptors “periodontitis” and “physical activity”. Original articles published between 2019 and 2025, in English, Portuguese, and Spanish, open access, were included; reviews and duplicates were excluded. The analysis comprised clinical and experimental studies, without a specific geographic focus, involving adults, athletes, and animal models, with varying sample sizes. Evidence suggests that regular exercise, particularly moderate aerobic activity, reduces inflammatory markers and tissue damage in animal models and patients with type 2 diabetes, promoting periodontal health. Conversely, elite athletes under intense training often exhibit compromised periodontal conditions, indicating that excessive exertion may negatively impact oral health. Outcomes are influenced by exercise intensity, type, and factors such as oral hygiene, with leisure-time physical activity showing superior outcomes compared to occupational physical activity. The review concludes that moderate-to-vigorous exercise intensities may mitigate periodontitis signs, while excessive intensities may increase risk. Further research is needed to elucidate the underlying mechanisms and contextual factors, to develop tailored preventive strategies.