Abstract
Aim
To evaluate the association between periodontal disease and all‐cause mortality in a longitudinal cohort study over 50 years.
Materials and Methods
Participants (N = 1156) in the Veterans Affairs Dental Longitudinal Study, aged 25–85 years at enrollment in 1968, received comprehensive medical and oral exams approximately every 3 years through 2007. Periodontal status was defined using person‐level, mean whole‐mouth radiographic alveolar bone loss (ABL) scores using a five‐point Schei ruler, each unit representing 20% increments of ABL. Time‐varying Cox regression models estimated hazard ratios (HRs) for the association between continuous and categorical ABL and mortality, adjusting for covariates.
Results
Each one‐unit increase in mean ABL score was associated with a 14% increase in the hazard of mortality (adjusted HR = 1.14, 95% confidence interval [CI] 1.02, 1.27). When assessed categorically, HRs for average scores of 2 to <3 and 3 to ≤5 showed increasing associations with hazard of mortality, relative to 0 to <1 (adjusted HR = 1.17, 95% CI 0.94, 1.46; and HR = 1.65, 95% CI 0.94, 2.85, respectively). By contrast, we observed null associations for average scores of 1 to <2 relative to 0 to <1 (adjusted HR = 1.00, 95% CI 0.86, 1.17).
Conclusions
Time‐varying periodontal status assessed using radiographic ABL was positively associated with all‐cause mortality even after confounder adjustment.