Could periodontitis be associated with overall and cancer-specific mortality risk; a 35-year Swedish cohort study

Many studies have shown a link between inflammation and increased morbidity and mortality. We evaluated the association between baseline periodontitis, medication purchases, and mortality in a 35-year follow-up.  Materials and methods: The sample and data are from a long-term follow-up of a random sample, from the greater region of Stockholm, Sweden, 1985 to 2017. The sample comprised 1,643 participants, initially clinically examined in 1985, and found to either have (n = 286) or not have (n = 1,357) periodontitis. Swedish national population and patient registers from 1985 to 2017 were used for analyses. Descriptive statistics, Chi2-test, Kaplan-Meier and Coxs proportional hazard regression models were used in the analyses. The outcome variable in the Kaplan-Meier and Cox's regression analyses was time to death.  Results: Periodontitis at baseline showed a positive association with all-cause and, particularly, with cancer-specific mortality and a poorer survival distribution. In addition, having lost two or more teeth at the age of 30-40 years, a higher dental calculus or gingival index at baseline, were identified as risk factors for overall mortality among the participants. In addition, alimentary tract and metabolism medications, systemic hormones, and antineoplastic and immunomodulating agents were associated with higher mortality risk.  Conclusion: This study found that periodontitis diagnosed 35 years earlier was associated with an earlier death when compared with the then periodontally healthy participants.