Statin use and risk of periodontitis in US adults: A population-based cross-sectional study

Periodontitis is a chronic inflammatory disease and a leading cause of tooth loss among adults. Beyond their lipid-lowering effects, statins exhibit anti-inflammatory and bone-regenerative properties that may influence periodontal health; however, the existing evidence remains inconsistent. This study aimed to examine the association between statin use and periodontitis in a nationally representative US cohort. Data were obtained from 10,714 adults aged ≥30 years who participated in the 2009 to 2014 National Health and Nutrition Examination Survey. Statin use and duration were determined from prescription medication records, and periodontitis was defined according to the Centers for Disease Control and Prevention and the American Academy of Periodontology criteria. Weighted logistic regression models were applied to assess the association between statin use and periodontitis while adjusting for demographic, socioeconomic, lifestyle, and metabolic factors. Subgroup analyses were performed based on statin type and duration of use. After the application of survey weights, the findings were representative of 144.1 million US adults, with an overall periodontitis prevalence of 37.96%. In the fully adjusted model, statin use was significantly associated with a reduced risk of periodontitis (adjusted odds ratio [OR] = 0.83, 95% confidence interval [CI]: 0.69-0.98, P = .038). This inverse association was more pronounced among overweight individuals (OR = 0.73, 95% CI: 0.56-0.95, P = .031), long-term statin users (>5 years; OR = 0.77, 95% CI: 0.61-0.98, P = .039), and users of atorvastatin (OR = 0.68, 95% CI: 0.48-0.97, P = .037). Statin use was independently associated with a lower risk of periodontitis among US adults. This protective association was particularly evident in long-term users and individuals taking atorvastatin, supporting the hypothesis that the pleiotropic anti-inflammatory effects of statins may provide periodontal benefits. These findings suggest a potential role for statins in host-modulation therapy; however, prospective studies are required to establish causality.