Multimorbidity, Polypharmacy, and Periodontal Disease Burden in a University Dental Setting: A Cross-Sectional Study

Aim: To investigate multimorbidity and polypharmacy in periodontal patients and determine whether increasing numbers of documented systemic diseases and medications are associated with periodontal disease burden. Methods: This cross-sectional study included 116 patients with periodontitis treated in a university dental setting. Systemic conditions and medications were classified according to ICD-10 and ATC systems. Multimorbidity was defined as ≥2 systemic conditions and polypharmacy as ≥5 medications. Associations of the number of documented systemic diagnoses and medications with mean clinical attachment level (CAL), percentage of sites with probing pocket depth (PPD) ≥ 6 mm, and bleeding on probing (BOP) were examined using multivariable linear regression adjusted for age, sex, and current smoking. Results: Participants had a mean age of 63.1 ± 11.2 years; 52.6% were female, and 25.9% were current smokers. Multimorbidity was present in 56.9% and polypharmacy in 24.1%. Periodontitis was predominantly advanced (Stage I/II, 13.8%; Stage III, 65.5%; Stage IV, 20.7%). After adjustment, neither the number of documented systemic diagnoses nor the number of medications was significantly associated with mean CAL, percentage of sites with PPD ≥ 6 mm, or BOP (all p > 0.20). Sensitivity analyses using categorical definitions of multimorbidity and polypharmacy yielded consistent results. Increasing age, male sex, and current smoking were associated with higher mean CAL, while current smoking was also associated with a higher percentage of sites with PPD ≥ 6 mm. Conclusions: Multimorbidity and polypharmacy were common in this periodontal cohort, but increasing numbers of documented systemic diagnoses and medications were not significantly associated with greater periodontal disease burden after adjustment for age, sex, and current smoking. These findings suggest that simple counts of diagnoses or medications may not adequately capture aspects of systemic health relevant to periodontal disease.