Park Yehyun, Park Jung-Hyun, Leem Gwang Hyun, Song Tae-Jin
Division of Gastroenterology, Department of Internal Medicine, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, South Korea.
Department of Oral and Maxillofacial Surgery, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, South Korea.
Am J Gastroenterol. 2025 Jan 17. doi: 10.14309/ajg.0000000000003326.
Periodontitis and other oral health indicators are reportedly related to systemic inflammation. Our study aimed to investigate a possible association of oral health status (periodontitis and number of missing teeth) and oral hygiene behaviors (frequency of tooth brushing, dental visit, and dental scaling) with the risk of inflammatory bowel disease (IBD) incidence.
Using the Korean National Health Insurance Database, we conducted a nationwide, population-based cohort study involving participants from the 2003 national health screening program. We followed these individuals until December 2020 or the occurrence of censoring events. Crohn's disease (CD) and ulcerative colitis (UC) were defined by disease classification codes from the International Classification of Diseases-10 and national codes for rare intractable disease. The occurrence of IBD was analyzed using the Cox proportional hazard model, with propensity score matching performed to balance baseline characteristics between participants with and without periodontitis.
Our analysis involved a total of 2,272,012 participants with a median follow-up period of 17.0 years. The incidence rates for CD and UC were 11.6 and 32.4 per 100,000 person-years, respectively. In multivariable analysis after propensity score matching, the presence of periodontitis was associated with an increased risk of both CD (adjusted hazard ratio [aHR] 1.32, 95% confidence interval [CI] 1.14-1.52, P < 0.001) and UC (aHR 1.21, 95% CI 1.10-1.32, P < 0.001). Conversely, frequent tooth brushing ≥3 times a day was associated with a reduced risk of CD (aHR 0.81, 95% CI 0.65-0.99, P = 0.049), but no significant association was observed with UC.
Periodontitis may augment the risk of incidence for CD and UC. This association underscores the potential significance of periodontal health in the context of IBD, emphasizing the importance of comprehensive oral hygiene practices and potential preventive strategies to reduce the risk of CD and UC incidence.
据报道，牙周炎和其他口腔健康指标与全身炎症有关。我们的研究旨在调查口腔健康状况（牙周炎和缺牙数量）以及口腔卫生行为（刷牙频率、看牙医次数和洗牙）与炎症性肠病（IBD）发病风险之间可能存在的关联。
利用韩国国民健康保险数据库，我们开展了一项全国性的基于人群的队列研究，研究对象来自2003年全国健康筛查项目的参与者。我们对这些个体进行随访，直至2020年12月或审查事件发生。克罗恩病（CD）和溃疡性结肠炎（UC）根据《国际疾病分类-10》中的疾病分类代码以及罕见难治性疾病的国家代码进行定义。使用Cox比例风险模型分析IBD的发生情况，并进行倾向得分匹配以平衡有牙周炎和无牙周炎参与者之间的基线特征。
我们的分析共纳入2272012名参与者，中位随访期为17.0年。CD和UC的发病率分别为每10万人年11.6例和32.4例。在倾向得分匹配后的多变量分析中，牙周炎的存在与CD（调整后风险比[aHR]1.32，95%置信区间[CI]1.14 - 1.52，P < 0.001）和UC（aHR 1.21，95% CI 1.10 - 1.32，P < 0.001）的发病风险增加相关。相反，每天刷牙≥3次与CD发病风险降低相关（aHR 0.81，95% CI 0.65 - 0.99，P = 0.049），但与UC未观察到显著关联。
牙周炎可能会增加CD和UC的发病风险。这种关联强调了牙周健康在IBD背景下的潜在重要性，凸显了全面口腔卫生措施以及潜在预防策略对于降低CD和UC发病风险的重要性。
