A cross-sectional study of relationships between periodontal disease and general health: The Hitachi Oral Healthcare Survey

Abstract

Background: This cross-sectional study performed to clarify the relationship between periodontal disease and non-communicable diseases (NCDs), such as obesity, diabetes mellitus, impaired glucose tolerance (IGT), chronic obstructive pulmonary disease (COPD), and atherosclerotic cardiovascular disease (ASCVD) by introducing dental examinations into the annual health examinations conducted by Japanese companies, and to highlights the importance of a medical system that connects dental and medical professionals.

Methods: A total of 1.022 Hitachi Ltd. employees were enrolled in this cross-sectional study. We examined correlations and odds ratios (ORs) between the dental and overall health of employees using stratification and multiple logistic regression analyses based on the periodontal health indicators, general health indicators, and occlusal force.

Results: The adjusted OR of PPD for obesity (OR, 1.42; 95% confidence interval [CI], 1.09-1.84; p = 0.009), IGT (OR, 1.48; 95% CI, 1.00-2.20; p = 0.049), and COPD (OR, 1.38; 95% CI, 1.02-1.88; p = 0.038) significantly differed. The adjusted OR of body mass index (OR, 1.28; 95% CI 1.15-1.42; p < 0.001), haemoglobin A1C (HbA1c) (OR, 4.34; 95% CI, 1.89-9.98; p < 0.001), fasting blood glucose (FBG) levels (OR, 1.08; 95% CI 1.04-1.11; p < 0.001), postbronchodilator forced expiratory volume in one second/forced vital capacity ratio (%FEV₁) (OR, 0.95; 95% CI 0.91-1.00; p = 0.031) and smoking (OR, 2.32; 95% CI 1.62-3.33; p < 0.001) for severe periodontal disease also significantly differed. Occlusal force was significantly reduced in employees aged 50-59 years compared to those aged 40-49 years. Both PPD, HbA1c, FBG levels were significantly associated with occlusal force among employees with moderate/severe periodontitis. PPD was significantly associated with occlusal force among employees with and moderate COPD, and ASCVD. %FEV₁ was significantly associated with occlusal force among employees with IGT.

Conclusions: This cross-sectional study revealed mutual relationships among periodontal disease, NCDs, and occlusal force on Japanese corporate workers. We demonstrated that a comprehensive, regional healthcare system centred on annual integrated dental and physical health examinations in the workplace will benefit employees and positively impact corporate health insurance.

Keywords: Cross-sectional; General health; Health check; Occlusal force; Periodontal disease.

Fig. 1

Flowchart of study participants in the HTC-OHC survey

Fig. 2

Effects of periodontal disease indicators on risk of diabetes, obesity, IGT, COPD, and ASCVD. Model 1 (M1) is the reference model based on healthy employees with HbA1c < 5.7. Model 2 (M2) is M1 adjusted for age, and Model 3 (M3) is M1 adjusted for age and smoking status. Multiple logistic regression analysis was used to obtain the odds ratio. The number of patients with disease is as follows: Diabetes; n = 87, Obesity; n = 348, IGT; n = 117, COPD (moderate); n = 464, ASCVD; n = 93. Markers indicate estimated odds ratio (OR). Vertical ranges indicate 95% confidence interval (CI).TN; Number of teeth

Fig. 3

Effects of BMI, FBG, %FEV1, CAVI, smoking, and HbA1c on severe periodontal disease. Model 1 (M1) is the reference model based on healthy employees with HbA1c < 5.7. Model 2 (M2) is M1 adjusted for age. Model 3 (M3) is M1 adjusted for age and smoking status. Multiple logistic regression analysis was used to obtain the odds ratio. Severe periodontal disease; n = 349. Markers indicate the estimated odds ratio (OR). Vertical ranges indicate the 95% confidence interval (CI)

Fig. 4

Changes in number of teeth and occlusal force with advancing age. a Number of teeth stratified by age (n = 1,022 employees). Mean numbers of employees in each age group were as follows: 20 s (n = 3), 30 s (n = 102), 40 s (n = 382), 50 s (n = 315), 60 s (n = 174), 70 s (n = 47). b Occlusal force stratified by age (n = 764 employees). Mean numbers of employees in each age group were as follows: 20 s (n = 3), 30 s (n = 83), 40 s (n = 270), 50 s (n = 241), 60 s (n = 132), 70 s (n = 35). Data are shown as means ± SE. Kruskal–Wallis test with post hoc Bonferroni test was used for multiple comparisons across the six groups. NS, not significant