Network Analysis of Health Behaviours Associated With Periodontitis in Chinese Adults

Effective prevention of periodontitis requires addressing multiple modifiable health behaviours (MHBs). This study aimed to examine how MHBs interact and to identify the key behaviours that could serve as targets for intervention.

We analysed data from a large, population-based survey using questionnaires conducted in China during 2021-2023. Logistic regression was used to examine associations between self-reported periodontitis and multiple MHBs. Network analysis was applied to assess interrelationships among MHBs and identify central MHBs.

Among 85,483 participants, 12.8% reported periodontitis. Ten MHBs were associated with self-reported periodontitis. Ever smoking, ever drinking, unhealthy bedtime, frequent consumption of sugar-sweetened snacks and beverages, insufficient vegetable or fruit intake and toothbrushing less than twice daily were linked to higher prevalence, while insufficient physical activity, no daily flossing and absence of annual dental checkups were linked to lower prevalence. Network analysis identified ever smoking, ever drinking, toothbrushing frequency and dental checkups as the most central behaviours, with variations observed across different subgroups.

This study identified key MHBs and revealed differences in central behaviours across subgroups. Ever smoking, ever drinking, toothbrushing frequency and annual dental checkups may represent priority targets for tailored prevention strategies. Future research is warranted to inform integrated interventions.