Can periodontal health determinants predict future self-rated health?

The aim of this study was to determine the correlation between periodontal health determinants and self-rated health.

This was a nested analytical cohort study conducted in the years 2015-19 which is a part of Nationwide survey conducted by 8020 Promotion foundation in Japan.

Only the dentate patients >20 years of age at their initial visit and who gave informed consent were recruited for the study. In this study, the data from the patients regarding their self-rated health was determined each year and was correlated with the periodontal health parameters, recorded in penultimate year(s). Primary analysis included correlation of 1-year lagged periodontal health parameters with current self-reported health. A total of 9306 data-pairs were included from 4 different cohort-year pairs, which included 2710, 2473, 2172, and 1952 observations pairs from 2015 to 16, 2016 to 17, 2017 to 18, and 2018 to 19, respectively. Sensitivity analysis was done by using 4-year cohort model and 3-year lagged data pairing and included 2429 and 4787 observation-pairs, respectively. Periodontal health parameters used in the study included bleeding on probing, clinical attachment level, and periodontal pocket depth. In addition, data on various covariates, self-reported data about bleeding on brushing and swollen gums was also collected using a questionnaire. For both the primary analysis and the sensitivity analysis for 3-year lagged data-pairs, multi-level logistic regression analysis was used and both the crude and adjusted odds ratios were calculated. For the sensitivity analysis of 4-year cohort-model, an ordered logistic regression analysis was used.

In primary analysis, adjusted odds ratio depicted a statistically significant correlation between poor-SRH with self-reported bleeding gums (OR = 1.329, CI = 1.209-1.461), swollen gums (OR = 1.402, CI = 1.260-1.559) and for the cohort of patients with CAL ≥ 7 mm (OR = 1.154, CI = 1.022-1.304). These findings were consistent for both of the sensitivity analyses. In accordance, again a significant correlation was found between poor-SRH and self-reported bleeding gums, (4-year follow-up: OR = 1.569, CI = 1.312-1.876; 3-year lagged model: OR = 1.462, CI = 1.237-1.729) and self-reported swollen gums (4-year follow-up: OR = 1.457, CI = 1.91-1.783; 3-year lagged model: OR = 1.588, CI = 1.315-1.918) Among the clinical parameters, only the cohort with maximum probing depth of ≥7 mm showed significant correlation with future poorer SRH in a 3-year lagged model (OR = 1.290, CI = 1.002-1.661).

Periodontal health is helpful in determining future self-rated health. The correlation between self-rated health and self-reported bleeding and swollen gums were found to be statistically significant even after adjustment was done for various covariates that may impact the self-rated health.