Department of Oral and Cranio-maxillofacial Surgery, Ninth People's Hospital Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.
National Clinical Research Center for Oral Diseases, Ninth People's Hospital Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Shanghai, 200011, China.
Aging Clin Exp Res. 2020 Nov;32(11):2375-2382. doi: 10.1007/s40520-019-01446-6. Epub 2020 Feb 4.
Poor oral health is a risk indicator of poor quality of life and mortality. However, whether these associations remain potent in elderly subjects after adequately considering the confounding factors is not yet clearly elucidated. The present study aimed to investigate the associations between periodontal disease and tooth loss and total mortality and cardiovascular disease (CVD) outcomes in the elderly > 75 years old.
A total of 1385 individuals, receiving periodontal treatment in Shanghai, participated in this retrospective study. Data on oral status were obtained from radiographs to calculate the proportion of residual bone. The information about mortality was collected from the Shanghai Municipal Center for Disease Control and Prevention (SCDC). Univariate Cox proportional hazards model, multivariable-adjusted model, and competing risk hazard model were used to analyze the association between periodontal disease or tooth loss and mortality.
Those with severe periodontitis were associated with higher risk of total mortality than healthy individuals [hazard ratio (HR) = 1.48, 95% confidence interval (95% CI) 1.11-1.98]. Further, missing teeth increased the risk of total mortality (HR = 1.02, 95% CI 1.01-1.03). However, no significant difference was detected in the association between periodontitis or tooth loss and CVD mortality. In competing risk hazard model, an increased risk was observed for other-cause mortality, not CVD mortality, in those with severe periodontitis and missing teeth.
Periodontal diseases and tooth loss were the potential predictors of total mortality even after adjustment for confounding factors. However, these were not independent indicators for CVD mortality.
口腔健康状况不佳是生活质量和死亡率低的风险指标。然而，在充分考虑混杂因素后，这些关联在老年人中是否仍然强烈，目前尚不清楚。本研究旨在调查牙周病和牙齿缺失与 75 岁以上老年人总死亡率和心血管疾病（CVD）结局之间的关系。
共有 1385 名在上海接受牙周治疗的患者参与了这项回顾性研究。口腔状况数据从射线照片中获得，以计算残留骨的比例。死亡率信息从上海市疾病预防控制中心（SCDC）收集。使用单变量 Cox 比例风险模型、多变量调整模型和竞争风险风险模型来分析牙周病或牙齿缺失与死亡率之间的关系。
与健康个体相比，患有严重牙周炎的个体总死亡率风险更高[风险比（HR）=1.48，95%置信区间（95%CI）1.11-1.98]。此外，缺牙增加了总死亡率的风险（HR=1.02，95%CI 1.01-1.03）。然而，牙周炎或牙齿缺失与 CVD 死亡率之间没有显著差异。在竞争风险风险模型中，对于严重牙周炎和缺牙的个体，其他原因导致的死亡率风险增加，而不是 CVD 死亡率。
即使在调整混杂因素后，牙周病和牙齿缺失仍然是总死亡率的潜在预测因素。然而，这些并不是 CVD 死亡率的独立指标。
