Risk of Peripheral Arterial Occlusive Disease with Periodontitis and Dental Scaling: A Nationwide Population-Based Cohort Study

Abstract

Periodontitis (PD) is a common oral disease associated with various other diseases, particularly those affecting the cardiovascular system. This study explored whether peripheral artery occlusive disease (PAOD) is associated with PD and dental scaling. This study was a retrospective cohort study design from 2000 to 2018. The study population was newly diagnosed with periodontitis. The comparison group was defined as never diagnosed with periodontitis. The outcome variable was defined with the diagnosis of peripheral arterial occlusive disease (PAOD). The propensity score matching was performed by age, sex, comorbidities, and dental scaling between the two groups. Kaplan–Meier analysis was used to calculate the cumulative incidence of PAOD among the two groups. To perform the independent risk of the PAOD group, the multivariate Cox proportional hazard model was used to estimate the hazard ratios. First, 792,681 patients with PD and 458,521 patients with no history of PD were selected from Taiwan’s Longitudinal Health Insurance Database, which comprises the data of two million beneficiaries. After propensity score matching between the PD and non-PD groups for age, sex, comorbidities, and dental scaling, 357,106 patients in each group were analyzed for PAOD risk. The incidence density, relative risk, and cumulative incidence of PAOD were higher in the PD group than in the non-PD group. After adjusting for all variables, the risk of PAOD for the PD group was greater than for the non-PD group (adjusted hazard ratio = 1.03; 95% CI, 1.01–1.06). Undergoing at least one dental scaling procedure reduced the risk of PAOD. Age over 65 years was also a risk factor. In conclusion, patients with PD have an increased risk of PAOD. In addition, our results can lead to increased attention to oral hygiene, as dental scaling has a trend towards a lower risk of PAOD.

An updated review on the link between oral infections and atherosclerotic cardiovascular disease with focus on phenomics

“…Interestingly, another recent powerful population-based cohort study showed that the risk for peripheral artery occlusive disease, a condition with similar atherosclerosis pathogenesis, was increased in patients that had periodontal disease. This same study also found that patients undergoing at least one dental scaling procedure, a treatment for periodontal disease, had lower risk of peripheral artery occlusive disease ( Yeh et al, 2022 ).…”

Integrated strategies for the clinical correlation, prevention and management of chronic oral infections, wounds and arteriosclerotic occlusion in lower extremities

“…Because it causes chronic ischaemia, ASO, which is defined by atherosclerotic plaque accumulation that results in arterial stenosis and occlusion, is extremely common and poses a major risk to limb viability 3 . The pathophysiology of atherosclerosis, which underpins not just ASO but also coronary artery disease and hypertension, has been linked to the adoption of lifestyles burdened with excessive intakes of salt, sugar and fat in addition to smoking habits 4,5 …”

“…3 The pathophysiology of atherosclerosis, which underpins not just ASO but also coronary artery disease and hypertension, has been linked to the adoption of lifestyles burdened with excessive intakes of salt, sugar and fat in addition to smoking habits. 4,5 When ASO first appears, it may just be weariness. However, it can quickly advance to critical limb ischaemia, which is indicated by skin pallor, thicker nails and pain at rest.…”

Evaluation of the Risk Factors for Cellulitis among Patients with Peripheral Artery Disease

“…Peripheral artery occlusion disease (PAOD), also known as peripheral artery disease (PAD), is a manifestation of atherosclerosis that causes the narrowing or occlusion of the arterial lumen. Blood flow and perfusion are impaired in the area of the distal part of the affected arteries [ 1 ]. Figures on the prevalence of PAOD vary with diagnostic criteria and the study population.…”

“…Symptoms of PAOD in the male population were reported to be more severe than in the female population [ 6 ]. The diagnosis of PAD was also presented in the previous study [ 1 ].…”