Increased risk for tooth extraction in primary hyperparathyroidism and hypercalcemia: a population study

Area of Science:

• Endocrinology
• Oral Health
• Public Health

Background:

• Primary hyperparathyroidism (pHPT) is a common endocrine disorder.
• Dental comorbidities associated with pHPT require further investigation.
• Understanding oral health impacts is crucial for comprehensive patient care.

Purpose of the Study:

• To analyze dental comorbidities in patients with untreated primary hyperparathyroidism (pHPT).
• To compare dental outcomes between pHPT patients and a matched general population cohort.
• To identify risk factors for dental issues within the pHPT population.

Main Methods:

• Retrospective cohort study comparing 982 pHPT patients (undergoing parathyroidectomy) with 2944 controls.
• Dental data (tooth extractions, periodontal interventions, visits) obtained from Swedish registries (3 years pre-surgery).
• Poisson regression models used to analyze incidence rate ratios (IRRs), with subgroup analysis based on serum calcium levels.

Main Results:

• Overall tooth extractions, periodontal interventions, and dental visits were similar between cohorts.
• pHPT patients in the highest serum ionized calcium quartile (≥1.51 mmol/L) showed an increased risk of tooth extraction (IRR 1.85).
• Female gender was an independent risk factor for increased tooth extraction (IRR 1.341).

Conclusions:

• A significant association exists between primary hyperparathyroidism and increased tooth loss, especially with elevated serum calcium.
• Heightened awareness of dental comorbidities in pHPT patients is recommended for early detection and prevention.
• This highlights the importance of integrating oral health assessments into the management of primary hyperparathyroidism.