Impact of periodontal treatment on systemic health

Background + Aims

• The study investigates the association between periodontal diseases and chronic obstructive pulmonary disease (COPD), motivated by emerging evidence suggesting a potential link between oral health and respiratory conditions.
• Periodontal diseases, characterised by inflammation and infection of the gums, may contribute to systemic inflammation, which is also a key feature of COPD.
• Utilising data from the UK Biobank, the researchers aimed to explore this relationship through two sequential clinical studies: a cross-sectional study assessing the association with airflow limitation, a hallmark of COPD, and a prospective cohort study examining the incidence of COPD in individuals with periodontal diseases. The findings are expected to enhance understanding of the interplay between oral and respiratory health, potentially informing preventive strategies.
• The aim of the study is to investigate the association between periodontal diseases and chronic obstructive pulmonary disease (COPD) using data from the UK Biobank. Specifically, the researchers sought to determine whether periodontal diseases are linked to airflow limitation and to assess the risk of incident COPD among individuals with periodontal conditions.

Materials + Methods

• The research utilised a cross-sectional study and a prospective cohort study design, adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The study included 502,413 participants aged 40-69 years from the UK Biobank, recruited between April 2007 and December 2010.
• Participants self-reported dental symptoms, including painful gums, bleeding gums, and loose teeth, to determine the presence of periodontal diseases.
• Logistic regression was employed in the cross-sectional study to evaluate the association between periodontal diseases and airflow limitation. Cox proportional hazard models were used in the prospective cohort study to assess the risk of incident COPD.
• The cross-sectional study analysed data from 495,610 participants, while the cohort study included 379,266 participants with a median follow-up period of 12.68 years.
• Airflow limitation was defined using the forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) ratio, with a cut-off of <0.7. The incidence of COPD was monitored over the follow-up period.
• Multivariable analyses were conducted to adjust for potential confounders, including age, sex, smoking status, and diabetes mellitus.

Results

• The study included 495,610 participants in the cross-sectional study and 379,266 in the cohort study, with mean ages of 56.54 and 56.22 years, respectively.
• In the cross-sectional study, 18.0% of participants were identified as having a high risk of periodontal diseases, while 17.8% were identified in the cohort study.
• The adjusted logistic regression analysis revealed a significant association between the high risk of periodontal diseases and airflow limitation, with an odds ratio (OR) of 1.036 (95% CI: 1.015–1.059).
• In the cohort study, the presence of periodontal diseases was associated with an elevated risk of incident COPD, with a hazard ratio (HR) of 1.248 (95% CI: 1.174–1.326).
• The association between periodontal diseases and COPD incidence was consistent across various subgroups, including age (≤65 or >65 years), sex, smoking status, and diabetes mellitus (DM).
• Sensitivity analyses confirmed the robustness of the findings, supporting the association between periodontal diseases and both airflow limitation and COPD incidence.

Limitations