Department of Family Medicine, Healthcare System Gangnam Center Seoul National University Hospital, Seoul, Republic of Korea; Department of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Family Medicine, Uijeongbu Eulji Medical Center, Eulji University, Gyeonggi-do, Republic of Korea.
J Am Med Dir Assoc. 2023 Dec;24(12):1924-1930.e3. doi: 10.1016/j.jamda.2023.08.011. Epub 2023 Sep 12.
To investigate the associations of dental diseases and oral hygiene care with the risk of dementia.
Retrospective longitudinal cohort study.
We conducted a population-based study of individuals in the Korean National Health Insurance System. A total of 2,555,618 participants who underwent cardiovascular and dental screenings in 2008 were included.
Dental diseases including periodontal diseases, dental caries, and tooth loss were assessed by dentists. Information on oral hygiene care, including professional dental cleaning and the frequency of tooth brushing, was collected using a self-administered questionnaire. Study outcomes were all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD).
Periodontal diseases [adjusted hazard ratio (aHR) 1.07, 95% CI 1.04-1.09], dental caries (aHR 1.03, 95% CI 1.00-1.05), and 8-14 missing teeth (aHR 1.07, 95% CI 1.02-1.12) were associated with an increased risk of all-cause dementia. In contrast, either professional dental cleaning or frequent tooth brushing were associated with decreased risks of all-cause dementia (aHR 0.91, 95% CI 0.89-0.93 each; aHR 0.83, 95% CI 0.80-0.86 for both). The increased risks by dental diseases were reduced by oral hygiene care: periodontal diseases with professional dental cleaning (aHR 0.94, 95% CI 0.91-0.98) or tooth brushing ≥2 times/day (aHR 0.97, 95% CI 0.94-1.00) and 1 to 7 missing teeth with professional dental cleaning (aHR 0.94, 95% CI 0.89-0.98) or tooth brushing ≥2 times/day (aHR 0.92, 95% CI 0.89-0.95). Consistent results were noted for AD and VaD and in various subgroup analyses.
Periodontal disease, dental caries, and a high number of missing teeth were independently associated with a higher risk of dementia. Conversely, improved oral hygiene care, such as professional dental cleaning and frequent tooth brushing, may modify the risk of dementia associated with dental diseases.
探讨口腔疾病和口腔卫生保健与痴呆风险的关系。
回顾性纵向队列研究。
我们进行了一项基于人群的研究，纳入了参加韩国国家健康保险系统心血管和牙科筛查的 2555618 名参与者。
由牙医评估牙周疾病、龋齿和牙齿缺失等口腔疾病。使用自我管理问卷收集有关口腔卫生保健的信息，包括专业洁牙和刷牙频率。研究结果为全因痴呆、阿尔茨海默病（AD）和血管性痴呆（VaD）。
牙周疾病（调整后的危险比[aHR]1.07，95%置信区间[CI]1.04-1.09）、龋齿（aHR 1.03，95% CI 1.00-1.05）和 8-14 颗缺失牙齿（aHR 1.07，95% CI 1.02-1.12）与全因痴呆风险增加相关。相比之下，专业洁牙或频繁刷牙与全因痴呆风险降低相关（aHR 分别为 0.91，95% CI 0.89-0.93；两者的 aHR 为 0.83，95% CI 0.80-0.86）。口腔疾病的风险增加可以通过口腔卫生保健来降低：牙周疾病进行专业洁牙（aHR 0.94，95% CI 0.91-0.98）或每天刷牙≥2 次（aHR 0.97，95% CI 0.94-1.00）以及 1-7 颗缺失牙齿进行专业洁牙（aHR 0.94，95% CI 0.89-0.98）或每天刷牙≥2 次（aHR 0.92，95% CI 0.89-0.95）。AD 和 VaD 的结果一致，且在各种亚组分析中也是如此。
牙周疾病、龋齿和大量牙齿缺失与痴呆风险增加独立相关。相反，改善口腔卫生保健，如专业洁牙和经常刷牙，可能会改变与口腔疾病相关的痴呆风险。
