Associations of periodontal disease and tooth loss with all-cause and cause-specific mortality in the Sister Study

J Clin Periodontol. 2021 Dec;48(12):1597-1604. doi: 10.1111/jcpe.13557. Epub 2021 Oct 17.

Abstract

Aim: Studies have found that periodontal disease and tooth loss are associated with increased mortality; however, associations with cause-specific mortality and all-cause mortality within specific subgroups have not been thoroughly investigated.

Materials and methods: We examined the association of self-reported periodontal disease and disease/decay-related tooth loss with subsequent all-cause and cause-specific mortality in the Sister Study, a prospective cohort study of 50,884 women aged 35-74 years at baseline, whose sister was diagnosed with breast cancer. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the associations were calculated with adjustment for relevant confounders.

Results: With a mean follow-up of 10.9 years (range 0.1-14.3), 2058 women died. Participants with periodontal disease had a slightly higher rate of all-cause mortality (HR = 1.08, 95% CI 0.98-1.19), while participants with tooth loss had an increased rate of all-cause mortality (HR = 1.15, 95% CI 1.05-1.26). For cause-specific mortality, women with tooth loss had increased rates of death from circulatory system diseases, respiratory system diseases, and endocrine/metabolic diseases. Results varied in stratified models, but no heterogeneity across strata was found.

Conclusions: In this large prospective study, periodontal disease and tooth loss were associated with all-cause and certain specific cause-specific mortality outcomes.

Keywords: all-cause mortality; cause-specific mortality; periodontal disease; tooth loss.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Cause of Death
  • Female
  • Humans
  • Periodontal Diseases* / complications
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Tooth Loss* / complications
  • Tooth Loss* / epidemiology