Abstract
BackgroundThis cross-sectional study performed to clarify the relationship between periodontal disease and non-communicable diseases (NCDs), such as obesity, diabetes mellitus, impaired glucose tolerance (IGT), chronic obstructive pulmonary disease (COPD), and atherosclerotic cardiovascular disease (ASCVD) by introducing dental examinations into the annual health examinations conducted by Japanese companies, and to highlights the importance of a medical system that connects dental and medical professionals.MethodsA total of 1.022 Hitachi Ltd. employees were enrolled in this cross-sectional study. We examined correlations and odds ratios (ORs) between the dental and overall health of employees using stratification and multiple logistic regression analyses based on the periodontal health indicators, general health indicators, and occlusal force.ResultsThe adjusted OR of PPD for obesity (OR, 1.42; 95% confidence interval [CI], 1.09–1.84; p = 0.009), IGT (OR, 1.48; 95% CI, 1.00–2.20; p = 0.049), and COPD (OR, 1.38; 95% CI, 1.02–1.88; p = 0.038) significantly differed. The adjusted OR of body mass index (OR, 1.28; 95% CI 1.15–1.42; p < 0.001), haemoglobin A1C (HbA1c) (OR, 4.34; 95% CI, 1.89–9.98; p < 0.001), fasting blood glucose (FBG) levels (OR, 1.08; 95% CI 1.04–1.11; p < 0.001), postbronchodilator forced expiratory volume in one second/forced vital capacity ratio (%FEV1) (OR, 0.95; 95% CI 0.91–1.00; p = 0.031) and smoking (OR, 2.32; 95% CI 1.62–3.33; p < 0.001) for severe periodontal disease also significantly differed. Occlusal force was significantly reduced in employees aged 50–59 years compared to those aged 40–49 years. Both PPD, HbA1c, FBG levels were significantly associated with occlusal force among employees with moderate/severe periodontitis. PPD was significantly associated with occlusal force among employees with and moderate COPD, and ASCVD. %FEV1 was significantly associated with occlusal force among employees with IGT.ConclusionsThis cross-sectional study revealed mutual relationships among periodontal disease, NCDs, and occlusal force on Japanese corporate workers. We demonstrated that a comprehensive, regional healthcare system centred on annual integrated dental and physical health examinations in the workplace will benefit employees and positively impact corporate health insurance.
Highlights
This cross-sectional study performed to clarify the relationship between periodontal disease and noncommunicable diseases (NCDs), such as obesity, diabetes mellitus, impaired glucose tolerance (IGT), chronic obstructive pulmonary disease (COPD), and atherosclerotic cardiovascular disease (ASCVD) by introducing dental examinations into the annual health examinations conducted by Japanese companies, and to highlights the importance of a medical system that connects dental and medical professionals
The periodontal disease screening in this study was conducted by 15 dental hygienists belonging to the LION Foundation for Dental Health (LDH) and 5 periodontists belonging to the Department of Periodontal Disease Treatment, Faculty of Dentistry, Osaka University
The effect of systemic disease on periodontal disease status revealed that a high body mass index (BMI) (OR, 1.28; 95% confidence intervals (CI), 1.15– 1.42; p < 0.001), haemoglobin A1C (HbA1c) (OR, 4.34, 95% CI, 1.89–9.98, p < 0.001), fasting blood glucose (FBG) (OR, 1.08; 95% CI, 1.04–1.11; p < 0.001), and smoking (OR, 2.32; 95% CI, 1.62–3.33; p < 0.001; Model 2) significantly increased with worse periodontal disease
Summary
This cross-sectional study performed to clarify the relationship between periodontal disease and noncommunicable diseases (NCDs), such as obesity, diabetes mellitus, impaired glucose tolerance (IGT), chronic obstructive pulmonary disease (COPD), and atherosclerotic cardiovascular disease (ASCVD) by introducing dental examinations into the annual health examinations conducted by Japanese companies, and to highlights the importance of a medical system that connects dental and medical professionals. Obesity, which is closely related to diabetes, is a chronic inflammatory disease characterized by constant oxidative stress. Elevated fatty acid levels increase oxidative stress in monocyte macrophages, dysregulating the production of adiponectin and other adipocytokines [7]. These inflammatory- and lipid peroxidation-related diseases increase susceptibility to bacterial infections and might promote the progression of periodontal disease [8]. Most epidemiological studies have been conducted in countries other than Japan; the diabetes and obesity metrics indicated by these studies might not necessarily represent a comprehensive global perspective, given the differences in standards of disease severity among races [9, 10]. Obesity is defined at a relatively lower threshold of BMI ≥ 25 kg/m2 by the Japan Society for the Study of Obesity because obesity complications occur at a lower BMI in the Japanese population than in the European and North American populations [11]
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