Unpacking the association between chewing capacity and gallstone prevalence: a cross-sectional analysis of NHANES...

Gallstone disease has been identified as a prevalent clinical entity in emergency general surgery, and tooth loss is considered as a potential risk factor for gallstone disease, the relationship between chewing capacity and gallstone formation remains unexplored. As traditional tooth counts inadequately assess chewing capacity, we employ functional tooth units (FTUs), a validated biomechanical metric, to investigate the chewing capacity-gallstone association through multivariate epidemiological analysis.

This study used data from the National Health and Nutrition Examination Survey (NHANES) 2017-2020. Chewing capacity was evaluated based on the number of FTU, which were defined as pairs of opposing natural and artificial teeth. Gallstone status was determined based on abdominal sonography. Logistic regression analyses, subgroup analyses and restricted cubic spline regression, were conducted to assess the association between impaired chewing capacity (ICC) and gallstones.

An association between FTU and the risk of gallstones was detected (OR = 0.90, 95% CI 0.85-0.96), suggesting protective roles of more FTUs. Significant increase in the risk of gallstones in ICC was observed (OR = 1.81, 95% CI 1.27-2.57). Subgroup analyses demonstrated consistent results in all subgroups, except for individuals aged>65, male, white, education (Grades 0 - 12, High school or equivalent), drinking, Normal weight, Overweigh, and diabetes. Restricted cubic spline regression analysis demonstrated the risk of gallstones increased with FTUs decreases, particularly FTU≤6.

This population-based study revealed a significant link between the ICC and a higher prevalence of gallstones, which suggests that maintaining functional teeth may be a protective factor. Prospective studies are needed to elucidate the causal mechanisms and explore potential intervention strategies.