Abstract

BackgroundPeriodontal infection induces inflammation, which may increase the risk of tumor-promoting effects. The aim of this study was to assess the association between periodontitis and all-cause mortality, and all-cancer and specific cancers’ mortality in a health examination cohort of the elderly in the communities.MethodsA dataset of health examinations for the elderly with cause of death from 2005 to 2012 was obtained from the Department of Health, Taipei City Government. We enrolled 82,548 study participants with 262,035 visits. A Cox proportional hazards model and Cox frailty model were used for calculating the hazard ratios under different periodontal status by using SAS and Rstudio.ResultsBeing male, elderly, having a low education level, and smoking were risk factors for mortality in this retrospective elderly community cohort study. Participants with periodontitis followed across time had significantly higher hazard ratios (HRs) for all-cause mortality and all-cancer mortality (HR = 1.092, 95% confidence interval (CI):1.038 to 1.149, HR = 1.114, 95% CI:1.032 to 1.203, respectively) in the Cox frailty models after adjusting for age, marital status, education level, sex, and smoking status. After adjusting for age and sex, the hazard ratio was 1.185 (95% CI: 1.027 to 1.368) for lung cancer mortality, and 1.340 (95% CI: 1.019 to 1.762) for prostate cancer mortality in the periodontitis group with each visit.ConclusionsThe findings indicated that being male, having a low education level, and daily smoking were risk factors for mortality, and showed mixed evidence that periodontal disease is associated with all-cause, all-cancer and specific-cancer mortality including lung and prostate cancer. We suggest the importance of regular health screening in order to achieve early disease detection and lower mortality risk.

Highlights

  • Periodontal infection induces inflammation, which may increase the risk of tumor-promoting effects

  • Association between periodontal status and risk of specific cancer mortality Comparing mortality of lung cancer in the periodontitis group to the healthy periodontium group, the hazard ratio was 1.185 after adjusting for age and sex in a multivariate Cox frailty model (Table S1)

  • The present findings show that dental plaque and gingival inflammation are associated with all-cancer mortality [33]

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Summary

Introduction

Periodontal infection induces inflammation, which may increase the risk of tumor-promoting effects. The aim of this study was to assess the association between periodontitis and all-cause mortality, and all-cancer and specific cancers’ mortality in a health examination cohort of the elderly in the communities. In 2010, severe periodontitis was the sixth most prevalent condition globally [14]. The prevalence of periodontitis significantly increased from 11.5% in 1997 to 19.59% in 2013 in Taiwan. The pattern of mean age for periodontitis decreased from 1997 to 2013 (mean age ± standard deviation: 54.46 ± 14.47 and 45.51 ± 16.58 years old, respectively) [16]. Severe periodontitis is related to poor oral health conditions which can lead to tooth loss, unclear speaking, difficulty chewing and swallowing, poor nutrition, and poor quality of life [19]

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