Lower intradaily rest-activity variability is associated with severe periodontitis: A cross-sectional...

Behavioral research on periodontitis has largely emphasized sleep duration and activity volume, whereas the 24-hour temporal organization of movement and rest remains understudied. We examined wrist-accelerometry-derived intradaily variability (IV) in relation to severe periodontitis.

This cross-sectional study included 4,631 adults aged 30 years or older from the National Health and Nutrition Examination Survey 2011-2014. Participants had wrist-accelerometry data and an evaluable full-mouth periodontal examination. Severe periodontitis was defined using the Centers for Disease Control and Prevention/American Academy of Periodontology surveillance definition. Survey-weighted logistic regression with marginal standardization estimated adjusted prevalence measures.

Severe periodontitis was identified in 507 participants (survey-weighted prevalence, 7.69%). In the fully adjusted model, standardized prevalence was 7.41% when IV was set to the analytic-cohort mean and 5.83% when IV was set to the mean plus 1 standard deviation. The adjusted marginal prevalence ratio was 0.786 (95% confidence interval, 0.696-0.889), and the prevalence difference was - 1.58% points (95% confidence interval, - 2.32 to - 0.85). Quartile results were broadly inverse but not strictly monotonic, and the restricted cubic spline showed no statistical evidence of nonlinearity.

Higher IV was cross-sectionally associated with a lower standardized prevalence of severe periodontitis, although the absolute difference was modest.

The findings do not establish temporal direction or support clinical intervention; longitudinal studies are needed to determine whether IV adds information beyond established periodontal risk indicators.