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Updated: Oct 10, 2025

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Published on: December 31, 2017
Low ambient temperature as a novel risk factor of oral diseases: A time-series study
Yifeng Qian1, Ya Gao2, Binxin Cai3
1Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai JiaoTong University, Shanghai, China; National Center for Stomatology, Shanghai, China; National Clinical Research Center for Oral Diseases, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai, China.
Background:
The seasonal variation of oral diseases has been observed in life, but the influences of oral diseases associated with non-optimal ambient temperature were unknown.
Objective:
To examine whether non-optimum ambient temperature is associated with increased risks of oral diseases.
Methods:
We conducted a time series study based on outpatient data from the Shanghai Health Information Center, containing all public hospitals in Shanghai from 2016 to 2019. Generalized additive models with distributed lagged nonlinear models were applied to fit the data.
Result:
A total of 3,882,636 outpatient cases of oral diseases were collected. Low temperature (<7 °C) posed increased risks for oral diseases. Daily temperature above 7 °C had no effect on oral diseases. The excess risks were present on the lag 1 day and lasted till lag 7 day. Relative to referent temperatures, the cumulative risks of total oral diseases, pulpitis, periodontitis, gum pain, stomatitis, and glossitis at extreme low temperature (-3 °C, 1st percentile) over lag 0-7 day were 1.92 (95% confidence interval, CI: 1.40, 2.63), 2.40 (95% CI: 1.78, 3.25), 1.62 (95% CI: 1.15, 2.29), 1.75 (95% CI: 1.08, 2.83), 1.81 (95% CI: 1.30, 2.53), and 2.22 (95% CI: 1.23, 3.99). These associations were larger in patients who were above age 60.
Conclusion:
This study provided novel epidemiological evidence that low ambient temperature may increase the risks of oral diseases. The temperature thresholds for eight oral diseases range from 3 to 7 °C. The excess risks could last for 7 days and were larger in older patients.
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