Self-reported oral health is associated with systemic health outcomes and all-cause mortality

医学 全国健康与营养检查调查 危险系数 优势比 糖尿病 比例危险模型 全国健康访谈调查 骨质疏松症 全国死亡指数 逻辑回归 前瞻性队列研究 队列研究 队列 内科学 疾病 自评健康 置信区间 老年学 环境卫生 人口 内分泌学
作者
Yau‐Hua Yu,Bjørn Steffensen,Daniel I. Chasman,Julie E. Buring
出处
期刊:Journal of the American Dental Association [Elsevier BV]
卷期号:155 (3): 233-243.e8 被引量:3
标识
DOI:10.1016/j.adaj.2023.11.006
摘要

Abstract

Background

Self-reported oral health questions (OHQs) are used commonly for epidemiologic surveillance of periodontal disease (PD). The authors' objective was to investigate how OHQs are associated with well-established systemic comorbidities of PD and their impact on all-cause mortality. The authors hypothesized that OHQs exhibit associations with systemic comorbidities similar to PD.

Methods

Two independent data sets were used to achieve these objectives: the Women's Health Study, a prospective cohort of women 45 years or older with self-reported information on PD, OHQs, cardiovascular disease, diabetes, and osteoporosis in various timeframes (continuous from 1992) and the National Health and Nutrition Examination Survey (NHANES), with data on OHQs and linked mortality (1999-2018). The authors applied multivariate logistic regression models and Cox proportional hazard regression survival analyses to test their hypotheses.

Results

The Women's Health Study participants who reported having PD until 2006 were more likely to later report deteriorating oral health, bone loss around their teeth, or periodontal treatment in 2018. Self-rated fair or poor oral health was independently associated with increased risk of cardiovascular disease (odds ratio, 1.39; 95% CI, 1.14 to 1.69; P < .001), diabetes (odds ratio, 1.21; 95% CI, 1.02 to 1.43; P = .028), and osteoporosis (odds ratio, 1.60; 95% CI, 1.38 to 1.84; P < .001). National Health and Nutrition Examination Survey participants who self-rated fair or poor oral health had higher risks of all-cause mortality (hazard ratio, 1.18; 95% CI, 1.02 to 1.37; P = .027).

Conclusions

Self-reported oral health had a similar magnitude of associations with systemic comorbidities as established with PD previously. Moreover, self-rated fair or poor oral health, suboptimal dental visits, or infrequent flossing were associated with increased all-cause mortality.

Practical Implications

These results support the use of OHQs in assessing systemic connections, especially when clinical dental access is limited. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT00000479.
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