Periodontal disease increases the risk for onset of systemic comorbidities in dental hospital attendees: An 18-year retrospective cohort study

Background Periodontal disease closely links to various systemic diseases. This l8-year retrospective cohort study investigated whether poor periodontal condition may increase the risk for onset of systemic comorbidities. Methods A total of 488 individual dental folders from 17 400 dental hospital attendees registered from 1996 to 1998 were randomly selected, and these participants were free of diabetes, cardiovascular disease, chronic obstructive pulmonary disease, cancer, stroke, cognitive impairment, hypertension, and dyslipidemia in the Clinical Management System. The records of periodontal examination and orthopantomogram on the first registration were obtained, and full-mouth bone level (BL) was measured. Onsets of the eight comorbidities concerned above until 2016 were retrieved from the system. Results The participants with worse periodontal status on their first registration had significantly higher numbers of the eight comorbidities/mortality during the 18-year follow-ups than their counterparts (P < 0.05). BL presented as bone loss/age was independently correlated to the comorbidity profiles in two multivariate models (0 to 1 versus >= 2; 0 to 2 versus >= 3) after adjusting for age and sex (odds ratio [OR] = 1.87; OR = 2.18, P < 0.05), highlighting that the individuals with more bone resorption exhibited a greater number of the comorbidities as compared with their counterparts. Moreover, those with onsets of more comorbidities showed worse periodontal conditions according to four parameters employed (community periodontal index, BL, bone loss/age and number of remaining teeth) (P < 0.05). Conclusions Within the limitations of this 18-year retrospective cohort study, our findings provide the first evidence that periodontal disease experience to some extent reflects the host susceptibility to onset of common systemic comorbidities. Further studies with larger sample sizes and appropriate adjustment of critical confounders are highly warranted to substantiate the current observation.