Journal List > J Korean Acad Oral Health > v.37(3) > 1057562

Jin, Kim, An, Im, Song, and Choi: Relationship between periodontal status and chronic obstructive pulmonary disease

Abstract

Objectives

The aim of this study was to examine the relationship between periodontal health and chronic obstructive pulmonary disease (COPD) in a Korean population.

Methods

The Community Periodontal Index (CPI) data of 7,264 subjects, aged over 25 years, who participated in the Fourth Korea National Health and Nutrition Examination Survey was used to assess the periodontal status of the population. Severity of COPD in the subjects was classified according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) definition.

Results

Subjects with more severe COPD were more likely to have severe periodontal disease. After adjustment for gender, age, monthly income, education, economic activity, and occupation, the odds ratio of COPD was 1.18 (95% Confidence interval [CI], 0.63-2.21) for severe periodontal disease in the study sample. When stratified by smoking status, the odds ratio of current smokers was 0.92 (95% CI, 0.41-2.05) and that of non-smokers was 1.29 (95% CI, 0.64-2.59).

Conclusions

Periodontal health was not significantly related to the severity of the COPD, even though smoking was a common risk factor. This is the first study examining the relationship between periodontal health and COPD in a Korean population. Studies that further investigate the causal relationship between the two are recommended.

References

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Table 1.
Criteria used for the diagnosis of COPD
COPD stage FEV1/FVC FEV1/Predictred FEV1
Normal to at risk ≥70% ≥80%
Mild <70% ≥80%
Moderate <70% ≥30% and <80%
Severe <70% <30%

Base on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometry guidelines

6) .

Table 2.
Demographic distribution according to periodontitis
Non-periodontitis (n=5,093) Periodontitis (n=2,171) P-value
Age (yrs, mean±SD) 35.60±0.21 43.75±0.26 <0.001*
Gender <0.001
Male 1,990 (48.1) 1,240 (64.5)
Female 3,103 (51.9) 931 (35.5)
Education (yrs) <0.001
<6 314 (5.4) 271 (11.3)
6-8 473 (8.4) 329 (14.9)
9-11 2,202 (43.5) 907 (42.6)
≥12 2,084 (42.6) 653 (31.1)
Occupation <0.001
Non-manual 2,331 (48.3) 896 (44.4)
Manual 1,069 (20.8) 749 (34.0)
Non-economic activity 1,636 (21.3) 505 (6.7)
Income states <0.001
Low 1,132 (22.3) 605 (27.1)
Milddle-low 1,195 (23.3) 499 (26.8)
Milddle-high 1,325 (26.9) 499 (24.2)
High 1,358 (27.5) 458 (21.8)
Marital status <0.001
Married 4,045 (77.2) 1,853 (84.4)
Divorced 358 (6.5) 192 (8.7)
Unmarried 686 (16.3) 123 (6.9)
Region 0.289
Metropolitan 2,351 (47.4) 1,023 (48.9)
City 1,913 (38.1) 741 (34.7)
Rural 829 (14.5) 407 (16.3)
BMI
Normal 3,384 (65.8) 1,338 (61.4) 0.026
Overweight 1,471 (29.7) 729 (34.1)
Obese 228 (4.5) 95 (4.5)
Smoking status <0.001
Current smoker 1,155 (27.1) 797 (41.2)
Non-smoker 3,920 (72.9) 1,369 (58.9)
Number of cigarettes smoked in a day among current smokers 16.35±9.04 18.76±9.33 0.003*
WBC 6.27±0.04 6.74±0.06 <0.001*

BMI, body mass index; WBC, white blood cell. The data were analysed by complex samples. *P-value obtained from t-test.

P-value obtained from chi-square test.

Table 3.
Periodontal disease and dental behavior distribution according to COPD status
Non-COPD COPD severity
COPD P-value* Mild Moderate Severe P-value
CPI code
Normal 1,437 (20.3) 49 (18.5) <0.001 16 (26.9) 31 (67.8) 2 (5.2) <0.001
Gingival bleeding 515 (6.9) 25 (7.9) 9 (37.7) 14 (58.8) 2 (3.5)
Calculus 2,964 (42.3) 103 (31.5) 29 (25.8) 67 (69.3) 7 (4.9)
Shallow periodontal pocket 1,644 (24.1) 90 (28.8) 37 (46.1) 51 (52.3) 2 (1.6)
Deep periodontal pocket 406 (6.3) 31 (13.3) 9 (29.2) 19 (56.2) 3 (14.7)
Frequency of daily toothbrushing
≤2 3,433 (50.5) 164 (60.3) 0.006 51 (33.1) 102 (60.2) 11 (6.7) 0.035
≥3 3,516 (49.5) 129 (39.7) 48 (35.9) 76 (60.8) 5 (3.4)
Dental visit (1 yr)
Yes 2,203 (33.8) 93 (32.4) 0.752 37 (45.3) 48 (45.6) 8 (9.2) 0.085
No 4,728 (65.9) 198 (67.2) 62 (29.1) 128 (67.3) 8 (3.6)

*P-value obtained from complex samples crosstabs for comparing the distribution of periodontitis between non-COPD group and COPD group.

P-value obtained from complex samples crosstabs for comparing the distribution of periodontitis among different COPD group.

Table 4.
Relationship between periodontal health and chronic obstructive pulmonary disease
Crude OR 95% CI Adjust OR* 95% CI
Periodontitis severity
Normal 1.00 1.00
Gingival bleeding 1.26 0.70-2.25 0.96 0.07-1.80
Calculus 0.82 0.53-1.27 0.74 0.46-1.17
Shallow periodontal pocket 1.32 0.84-2.06 0.79 0.50-1.25
Deep periodontal pocket 2.31 1.27-4.19 1.18 0.63-2.21

OR, odds ratio; CI, 95% confidence intervals. *Gender, age, monthly income, education, economic activity, occupation, WBC and smoking status.

Table 5.
Adjusted odds ratios (OR) and 95% confidence intervals of COPD in relation to periodontal health and stratification of smoking status
Crude OR 95% CI Adjusted OR* 95% CI
Current smoker
Normal (CPI 0) 1.00 1.00
Gingival bleeding (CPI 1) 0.77 0.21-2.81 0.58 0.15-2.20
Calculus (CPI 2) 0.84 0.43-1.64 0.66 0.33-1.32
Shallow periodontal pocket (CPI 3) 1.69 0.89-3.23 0.88 0.44-1.74
Deep periodontal pocket (CPI 4) 2.12 1.00-4.49 0.92 0.41-2.05
Non-smoker
Normal (CPI 0) 1.00 1.00
Gingival bleeding (CPI 1) 1.36 0.75-2.45 1.30 0.72-2.35
Calculus (CPI 2) 1.02 0.67-1.56 0.93 0.60-1.42
Shallow periodontal pocket (CPI 3) 1.04 0.63-1.70 0.83 0.50-1.38
Deep periodontal pocket (CPI 4) 1.71 0.87-3.35 1.29 0.64-2.59

Non-smoker; ex-smoker and never smoker. OR, odds ratio; CI, 95% confidence intervals. *Gender, age, monthly income, education, economic activity, occupation and WBC.

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