A silent killer- Periodontal disease linked to startling mortality risks in new study

Periodontal disease, a common inflammatory condition affecting the tissues surrounding the teeth, has been linked to various systemic diseases. Previous studies have suggested associations between PD and increased mortality, but robust evidence has been lacking. This study aimed to investigate the relationship between PD and mortality more thoroughly, considering demographic, lifestyle, clinical measurements, and comorbidities.

The study included 15,030 adult participants recruited from six NHANES cycles (1999-2014). Baseline clinical periodontal examinations were conducted by trained and calibrated examiners. Participants were followed up until December 2019, resulting in a median follow-up period of 9 years. All-cause and cause-specific mortality were modeled using multivariable Cox proportional hazards and Fine-Gray models to account for competing risks. Adjustments were made for demographic variables, lifestyle factors, clinical measurements, and comorbidities.

• The study revealed that individuals with periodontal disease had a 22% higher risk of all-cause mortality compared to those without PD (adjusted hazard ratio [HR]: 1.22, 95% confidence interval [CI]: 1.12-1.31).

• The risks were even more pronounced for specific causes of death among participants with severe PD.

• For cardiovascular diseases (CVD), the sub-distribution hazard ratio (SHR) was 1.38 (95% CI: 1.16-1.64).

• For respiratory diseases, the SHR was 1.62 (95% CI: 1.07-2.45), and for diabetes-related mortality, the SHR was 1.68 (95% CI: 1.12-2.53).

These findings highlight the significant impact of severe periodontal disease on mortality risk. The elevated risks for all-cause mortality, as well as specific causes like CVD, respiratory diseases, and diabetes, suggest that PD may exacerbate underlying conditions or contribute to systemic inflammation, leading to worse health outcomes. The results emphasize the importance of oral health care and periodontal disease management in reducing overall mortality risk.

This large-scale, prospective study provides strong evidence that severe periodontal disease is associated with increased risks of all-cause and cause-specific mortality among US adults. These findings underscore the critical need for integrating oral health into general health care practices to mitigate the adverse outcomes associated with periodontal disease.

Reference:

Larvin, H., Baptiste, P. J., Gao, C., Muirhead, V., Donos, N., Pavitt, S., Kang, J., & Wu, J. (2024). All‐cause and cause‐specific mortality in US adults with periodontal diseases: A prospective cohort study. Journal of Clinical Periodontology. https://doi.org/10.1111/jcpe.14002