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Systemic inflammation and the relationship between periodontitis, edentulism, and all‐cause mortality: A 17‐year prospective cohort study
Author(s) -
Winning Lewis,
Patterson Christopher C.,
Linden Katie,
Cullen Kathy M.,
Kee Frank,
Linden Gerard J.
Publication year - 2021
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.13510
Subject(s) - periodontitis , medicine , hazard ratio , proportional hazards model , edentulism , confounding , cohort study , confidence interval , systemic inflammation , prospective cohort study , cohort , tooth loss , inflammation , dentistry , oral health
Aim The aim was to investigate the role of systemic inflammation in the relationship between periodontitis, edentulism, and all‐cause mortality in a group of men in Northern Ireland aged 58–72 years. Materials and methods A representative sample of 1558 men had a detailed dental examination between 2001 and 2003. The primary end point was death from any cause. Cox's proportional hazards model was used to assess the longitudinal relationship between periodontitis, edentulism, and all‐cause mortality. Accelerated failure time modelling was performed to investigate the mediating role of systemic inflammation. Results Mean age of the men at baseline was 64.3 (standard deviation 2.9) years. During a median follow‐up of 17 years, 500 (32.1%) men died. After adjustment for confounding variables, compared to men with no/mild periodontitis, edentulous men had a hazard ratio for all‐cause mortality of 1.52 (95% confidence interval [CI] 1.16–1.99) p < .01 and for those with severe periodontitis, it was 1.34 (95% CI 1.06–1.70) p = .01. Systemic inflammation accounted only for a minor mediating pathway effect of 10%. Conclusions There was evidence in this group of men that those who were edentulous or had severe periodontitis had a significantly increased risk of all‐cause mortality. Systemic inflammation was not a major explanatory mediator of this association.