We aimed to investigate the association between blood pressure (BP) and tooth loss and the mediation effect of age. A cross-sectional study from a reference dental hospital was conducted from September 2017 to July 2020. Single measures of BP were taken via an automated sphygmomanometer device. Tooth loss was assessed through oral examination and confirmed radiographically. Severe tooth loss was defined as 10 or more teeth lost. Additional study covariates were collected via sociodemographic and medical questionnaires. A total of 10,576 patients were included. Hypertension was more prevalent in severe tooth loss patients than nonsevere tooth lost (56.1% vs. 39.3%, p < 0.001). The frequency of likely undiagnosed hypertension was 43.4%. The adjusted logistic model for sex, smoking habits and body mass index confirmed the association between continuous measures of high BP and continuous measures of tooth loss (odds ratio (OR) = 1.05, 95% CI: 1.03–1.06, p < 0.001). Age mediated 80.0% and 87.5% of the association between periodontitis with both systolic BP (p < 0.001) and diastolic BP (p < 0.001), respectively. Therefore, hypertension and tooth loss are associated, with a consistent mediation effect of age. Frequency of undiagnosed hypertension was elevated. Age, gender, active smoking, and BMI were independently associated with raised BP.
Periodontitis is greatly related to worse perceived oral health-related quality of life (OHRQoL), yet this association has never been explored using radiographically screened periodontal bone loss. Here we have radiographically screened patients for periodontitis via a validated method and assessed its association with measures of OHRQoL. From a total of 10,267 participants (6,112 females and 4,155 males), self-reported general health questionnaire, body mass index, self-reported oral health behaviours, panoramic x-rays and the oral health impact profile (OHIP-14) were gathered. Radiographically screened periodontitis was measured through a radiographic-based periodontal bone loss (R-PBL) approach. We compared the respective variables according to the R-PBL status and explored using multiple logistic regression adjusted for the significant variables. Overall, patients with periodontitis shown significantly different sociodemographic, health measures and oral hygiene characteristics. All domains of the OHIP-14 were significantly worsened in the periodontitis group, and further confirmed through adjusted logistic regression (p<0.001). Active smoking, number of missing teeth, sex and age were the most impactful variables in this relationship. Our results demonstrate the existence of a link between radiographically screened periodontitis and OHRQoL, mostly upheld by active smoking, number of missing teeth, sex and age.
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