Obstructive airway disease and edentulism in the atherosclerosis risk in communities (ARIC) study

Abstract

ObjectivesWe examined the potential association between prior chronic obstructive pulmonary disease (COPD) and edentulism, and whether the association varied by COPD severity using data from the Dental Atherosclerosis Risk in Communities Study.DesignCross-sectional.SettingCommunity dwelling subjects from four US communities.Participants and measurementsCases were identified as edentulous (without teeth) and subjects with one or more natural teeth were identified as dentate. COPD cases were defined by spirometry measurements that showed the ratio of forced expiratory volume (1 s) to vital capacity to be less than 0.7. The severity of COPD cases was also determined using a modified Global Initiative for Chronic Obstructive Lung Disease classification criteria (GOLD stage I–IV). Multiple logistic regression was used to examine the association between COPD and edentulism, while adjusting for age, gender, centre/race, ethnicity, education level, income, diabetes, hypertension, coronary heart disease and congestive heart failure, body mass index, smoking, smokeless tobacco use and alcohol consumption.Results13 465 participants were included in this analysis (2087 edentulous; 11 378 dentate). Approximately 28.3% of edentulous participants had prior COPD compared with 19.6% among dentate participants (p<0.0001). After adjustment for potential confounders, we observed a 1.3 (1.08 to 1.62) and 2.5 (1.68 to 3.63) fold increased risk of edentulism among GOLD II and GOLD III/IV COPD, respectively, as compared with the non-COPD/dentate referent. Given the short period of time between the measurements of COPD (visit 2) and dentate status (visit 4) relative to the natural history of both diseases, neither temporality nor insight as to the directionality of the association can be ascertained.ConclusionsWe found a statistically significant association between prior COPD and edentulism, with evidence of a positive incremental effect seen with increasing GOLD classification.

Comorbid depression/anxiety and teeth removed: Behavioral Risk Factor Surveillance System 2010

“…For this study, the selection of the dichotomy at 6+ teeth removed was based on methodology of the National Oral Health Surveillance System's use of ‘Lost 6 or more teeth’ in data presentation at http://www.cdc.gov/nohss/ , and the potential miscount of teeth removed for reasons other than caries or periodontal disease such as for orthodontic treatment, impactions, or lack of space. The dichotomy of edentulism and any teeth present was used in many research designs and was also used in this study design.…”

Complete Edentulism and Comorbid Diseases: An Update

“…Offenbacher et al, 45 in a cross-sectional study of 13,465 patients age 45 to 64 (of whom 2084 were completely edentulous) found that 28.3% of the edentulous patient cohort had COPD vs. 19.6% of the dentate patients. The risk (OR) of development of COPD in denture wearers was 1.3 times higher for GOLD stage 2 and 2.5 times higher for GOLD stage 3 COPD.…”

Periodontitis and airflow limitation in older Swedish individuals

“…An association between periodontitis and COPD has been reported (Barros, Suruki, Loewy, Beck, & Offenbacher, 2013; Offenbacher, Beck, Barros, Suruki, & Loewy, 2012; Scannapieco & Ho, 2001; Takeuchi et al, 2019). Periodontitis is a multifactorial inflammatory disease associated with dysbiotic dental plaque biofilms and characterized by progressive destruction of the tooth‐supporting structures (Papapanou et al, 2018).…”