Goals Identify the association between periodontal diseases (gingivitis and periodontitis) and chronic diseases, including cardiovascular diseases, cardiometabolic diseases, autoimmune diseases and mental illnesses. Retrospective cohort design. IQVIA Medical Research Data-UK configuration between January 1, 1995 and January 1, 2019. Participants 64,379 adult patients with a diagnosis of periodontal disease recorded by a general practitioner (exposed patients) were matched with 251,161 unexposed patients by age, sex, deprivation and date of registration. Main outcome measures Logistic regression models accounting for clinically important covariates were performed to estimate the adjusted OR (aOR) of having chronic diseases at baseline in the exposed compared to the unexposed group. Incidence rates were then provided for each outcome of interest, followed by calculation of adjusted HRs using a Cox regression model to describe the risk of outcome development in each group. Results The average age at entry into the cohort was 45 years and the median follow-up was 3.4 years. At study entry, the exposed cohort was more likely to have a diagnosis of cardiovascular disease (aOR 1.43, 95% CI 1.38 to 1.48), cardiometabolic disease (aOR 1.16, 95% CI %: 1.13 to 1.19), autoimmune disease (aOR 1.33, 95% CI: 1.28 to 1.37), and mental illness (aOR 1.79, 95% CI: 1.75 to 1.83) compared to the non-exposed group. During follow-up of people without pre-existing outcomes of interest, the exposed group had an increased risk of developing cardiovascular disease (HR 1.18, 95% CI 1.13 to 1.23), cardiometabolic disease (HR 1.07 ; 95% CI: 1.03 to 1.10), autoimmune disease (HR 1.33, 95% CI: 1.26 to 1.40), and mental illness (HR 1.37, 95% CI: 1.33 to 1.42) compared to the unexposed group. Conclusions In this cohort, periodontal diseases appeared to be associated with an increased risk of developing cardiovascular, cardiometabolic, autoimmune, and mental diseases. Periodontal diseases are very common; Therefore, increased risk of other chronic diseases represents a substantial public health burden. |
Comments
A study led by the University of Birmingham shows an increased risk of patients developing diseases including mental illness and heart conditions if they have a medical history of periodontal (gum) disease entered by their GP.
Experts carried out the first study of its kind from GP records of 64,379 patients who had a recorded history of periodontal disease entered by the GP, including gingivitis and periodontitis (the condition that occurs if periodontal disease gums are left untreated and can lead to tooth loss). Of these, 60,995 had gingivitis and 3,384 had periodontitis.
The records of these patients were compared with those of 251,161 patients who had no history of periodontal disease.
- Across all cohorts, the average age was 44 years and 43% were men, while 30% were smokers.
- Body mass index (BMI), ethnicity and levels of deprivation were also similar between the groups.
The researchers examined the data to establish how many of the patients with and without periodontal disease develop cardiovascular disease (eg, heart failure, stroke, vascular dementia), cardiometabolic disorders (eg, high blood pressure, type 2 diabetes) , autoimmune diseases (e.g., arthritis, type 1 diabetes, psoriasis), and mental illnesses (e.g., depression, anxiety, and serious mental illness) over an average follow-up of about three years.
From the research, published in the journal BMJ Open, the team found that patients with a recorded history of periodontal disease at the start of the study were more likely to continue and be diagnosed with one of these additional conditions within an average of three years, compared to those in the cohort without periodontal disease at the beginning of the investigation.
The results of the study showed, in patients with a recorded history of periodontal disease at the start of the study, the increased risk of developing a mental illness was 37%, while the risk of developing an autoimmune disease increased by 33%, and the The risk of developing cardiovascular disease increased by 18%, while the risk of having a cardiometabolic disorder increased by 7% (with a much greater increased risk for type 2 diabetes at 26%).
Co-lead author Dr Joht Singh Chandan, from the Institute of Applied Health Research at the University of Birmingham, said: “Poor oral health is extremely common, both here in the UK and around the world. When poor oral health progresses, it can lead to a substantially reduced quality of life. However, until now, not much has been known about the association of poor oral health and many chronic diseases, particularly mental illnesses.
We therefore conducted one of the largest epidemiological studies of its kind to date, using UK primary care data to explore the association between periodontal disease and several chronic conditions.
We found evidence that periodontal disease appears to be associated with an increased risk of developing these associated chronic diseases. "Given that periodontal diseases are very common, an increased risk of other chronic diseases may represent a substantial public health burden."
