Prospective Study of Oral Health and Risk of Primary Open-Angle Glaucoma in Men

Abstract

Purpose Tooth loss or periodontal disease is associated with systemic endothelial dysfunction, which has been implicated in primary open-angle glaucoma (POAG). The relationship between oral health and POAG has received limited attention. Thus, we evaluated the association between oral health history and risk of POAG and POAG subtypes. Design Prospective cohort study Participants Health Professionals Follow-up Study participants (40,536 men) followed biennially from 1986 to 2012. At each 2-year risk period, eligible participants were 40+ years old, free of POAG, and reported eye examinations. Methods Using validated questions, we updated participants' status on number of natural teeth, teeth lost, periodontal disease with bone loss and root canal treatments. Main Outcome Measures During follow-up, 485 incident cases of POAG were confirmed with medical records and classified into subtypes defined by intraocular pressure (IOP) (≥ or < 22 mm Hg) or by visual field (VF) loss pattern at diagnosis (peripheral loss only or early paracentral loss). Multivariable relative risks (MVRR) and 95% confidence intervals (CIs) were estimated. Results Number of natural teeth, periodontal disease or root canal treatment were not associated with POAG. However, compared to no report of tooth loss, a report of losing teeth within the past 2 years was associated with a 1.45 fold increased risk of POAG (95% CI=1.06, 1.97); in particular, a report within the past 2 years of both losing teeth and having a prevalent diagnosis of periodontal disease was associated with 1.85 fold increased risk of POAG (95% CI=1.07, 3.18). The associations with recent tooth loss was not significantly different for the POAG subtypes (p for heterogeneity ≥ 0.36), although associations were strongest in relation to the POAG subtypes with IOP < 22 mm Hg (MVRR = 1.93, 95% CI=1.09, 3.43) and with early paracentral VF loss (MVRR = 2.27, 95% CI=1.32, 3.88). Conclusion While the number of natural teeth was not associated with risk of POAG, recent tooth loss was associated with an increased risk of POAG. Because these findings may be due to chance, they need confirmation in larger studies.

Automated Process Incorporating Machine Learning Segmentation and Correlation of Oral Diseases with Systemic Health

“…We report significant correlations between an MGI of 4 and swollen joints and a family history of eye diseases. We also found a significant correlation between an MGI of 1 and optic nerve exam abnormalities, reported for the first time in an Indian population (Table 3), which is in agreement with established links between oral and opthalmologic health measured in other populations [21], [22]. We did not find significant correlations between periodontal disease and cardiovascular health.…”

“…In the same study, low BMI was significantly associated with decreased prevalence of periodontal disease among young American adults [20]. Separate studies of thousands of American adults found that recent tooth loss was significantly correlated with primary open-angle glaucoma and that periodontal disease was significantly correlated with macular degeneration in adults under the age of 60 [21], [22]. In various populations in India, periodontal disease has been found to be highly prevalent and significantly correlated with older age, coronary artery disease, tobacco use, smoking, and lower socioeconomic status [23], [24].…”

Cross‐sectional association between oral health and retinal microcirculation

“…Further, endothelial dysfunction is associated with impaired flow‐mediated vasodilatation, for example with effects on the blood flow to the optic nerve (Fadini et al., ; Su et al., ). While self‐reported periodontal disease was not associated, an association between self‐reported recent tooth losses with an increased risk of primary open‐angle glaucoma was shown previously (Pasquale et al., ).…”

SIRT6 overexpression inhibits cementogenesis by suppressing glucose transporter 1

“…Periodontitis is a chronic inflammatory condition associated with many systemic diseases (LaMonte et al, ; Pasquale et al, ), and the limitations of periodontal regeneration largely depend on the regenerative potential on the root surface (Bosshardt, ). Root cementum plays a critical role in achieving the attachment of periodontal ligament fiber to the root surface (Ripamonti, ).…”