Association of Tooth Loss with New-Onset Parkinson’s Disease: A Nationwide Population-Based Cohort Study

Abstract

Introduction. Tooth loss is associated with poor oral hygiene. During insufficient oral sanitation, focal infection and inflammation can occur and these reactions may induce systemic inflammation. Systemic inflammatory reaction may be related to the degeneration of dopamine neurons in the substantia nigra. We hypothesized that tooth loss is related to increased risk of new-onset Parkinson’s disease. Methods. Between 2003 and 2006, we included 153,165 participants from the national health insurance system-health screening cohort in Korea. The incidence of new-onset Parkinson’s disease was defined as International Classification of Diseases-10 code “G20,” accompanying the prescription records for any anti-Parkinson’s disease medication. Results. Approximately 19.9% of the included participants had periodontal disease. After a median duration of 10.4 years, 1,227 (0.8%) cases of new-onset Parkinson’s disease were noted. The number of tooth loss was positively related to an increased risk of new-onset Parkinson’s disease. Contrastingly, the frequency of tooth brushings and dental clinic visits for any causes as well as competent dental care were negatively related to the development of new-onset Parkinson’s disease. In multivariable analysis, the number of tooth loss (≥15) was positively related to new-onset Parkinson’s disease development (hazard ratio: 1.38, 95% confidence interval (1.03–1.85), p=0.029, p for trend = 0.043) after adjusting variables. Conclusion. Our study demonstrated that the number of tooth loss was positively correlated with a higher risk of new-onset Parkinson’s disease development in a longitudinal study setting. Increased number of tooth loss may be an important risk indicator of new-onset Parkinson’s disease.

Evaluation of the association between periodontitis and risk of Parkinson’s disease: a nationwide retrospective cohort study

“…The number of Parkinson’s patients visiting dental clinics to be treated with complete dentures is increasing 11 . Previous report showed that the number of tooth loss was positively correlated with a higher risk of development of newly onset Parkinson's disease in a longitudinal study setting 12 . Increased susceptibility to periodontitis in Parkinson’s disease is reported in the individuals with Parkinson’s disease 11 .…”

Association between Findings in Oral Health Screening and Body Mass Index: A Nation-Wide Longitudinal Study

“…Periodontitis is defined as an inflammatory disease of the supporting tissues of teeth caused by specific microorganisms or groups of specific microorganisms, resulting in progressive destruction of the periodontal ligament and alveolar bone with periodontal pocket formation, gingival recession, or both [ 5 ]. Emerging evidence suggests that poor oral health and periodontitis can influence the initiation and/or progression of various diseases such as cancer, cardiovascular disease, metabolic disease, and degenerative diseases [ 6 , 7 , 8 , 9 ]. On the other hand, behaviors improving oral health may reduce the risk of medical illnesses [ 10 , 11 ].…”

Neuroinflammation: A Distal Consequence of Periodontitis

“…A subsequent population-based cohort study from the same group noted that dental scaling over 5 consecutive years has a protective effect against development and progression of PD in patients with and without periodontal disease (Chen et al 2018). Another group found a positive correlation between an increase in tooth loss and the development of new-onset PD in a longitudinal study (Woo et al 2020). Studies reported by these groups showed for the first time that oral dysbiosis and poor oral health might predispose patients to developing PD.…”