Identification of oral symptoms associated with atopic dermatitis in adolescents: Results from the Korea national representative survey 2009-2017

Abstract

The relationship between oral health and atopic dermatitis (AD) remains unclear. Here we investigated the association between oral health status and AD using data from 634,299 subjects in the Korean Youth Risk Behavior Survey (KYRBS). Participants with oral symptoms were defined as those with any of following: sensitive teeth, toothache, bleeding gums or gum pain, and dry mouth. Current AD was determined by the question if participant had been diagnosed with AD from doctor within the past 12 months. We estimated the odds ratio (OR) for AD diagnosis according to the presence of oral symptoms. The OR for current AD, which is a dependent variable, was significantly increased in participants with oral symptoms, which are independent variables, in an adjusted model (OR, 1.27; 95% confidence interval [CI], 1.26-1.29; P < 0.001). In detailed analyses, all four oral symptoms were significantly associated with AD diagnosis: sensitive teeth (OR, 1.21; CI, 1.19-1.23; P < 0.001), bad breath (OR, 1.18; CI, 1.17-1.20; P < 0.001), toothache (OR, 1.18; CI, 1.16-1.20; P < 0.001), and bleeding gums (OR, 1.14; CI, 1.12-1.16; P < 0.001). In the presence of oral symptoms, the ORs for having two or more allergic diseases (AD, allergic rhinitis, and/or asthma) were higher than that of AD alone. In this study, oral symptoms appeared to be associated with AD in Korean adolescences.

Figure 1

Risk for allergic diseases according to the presence of oral symptoms. When adjusted for confounders using model 2 (age, sex, region of residence, family income, smoking, stress, daily tooth brushing frequency, teeth scaling experience, soda/soft drink consumption, and snack foods consumption), the odds ratio (ORs) of current atopic dermatitis (AD) were significantly higher in those with oral symptoms than in those without such symptoms. The ORs increased with the combination of other allergic diseases, such as allergic rhinitis (AR) and/or asthma, compared to current AD alone. For all OR values, P < 0.001. A P-value less than 0.008 is significant after Bonferroni correction for multiple comparison. Abbreviations: AD, atopic dermatitis; AR, allergic rhinitis.

Figure 2

Schematic diagram of self-reported oral symptoms and each corresponding oral condition. We inferred the corresponding oral conditions from each survey question, and each OR value of current AD diagnosis was significantly higher for all four oral symptoms. ^*Adjusted for age, sex, region of residence, family income, smoking, stress, daily tooth brushing frequency, teeth scaling experience, soda/soft drink consumption, and snack foods consumption. ^†P < 0.001. Abbreviations: AD, atopic dermatitis; OR, odds ratio.