Association of periodontitis, tooth loss, and self-rated oral health with circadian syndrome in US adults: a cross-sectional population study.

Abstract

Background: This study was to investigate associations of periodontitis, tooth loss and self-rated oral health with circadian syndrome.

Methods: Data regarding periodontitis, dentition, oral health questionnaire and circadian syndrome of 30-85 years old participants from US National Health and Nutrition Examination Survey 2005-2020 were analyzed. Periodontitis questions for periodontitis and dentition status were validated. Weighted multivariable logistic regression analyses were used.

Results: Weighted prevalence of circadian syndrome and stage II-IV periodontitis was 33.29% and 88.87%, respectively. When compared with stage I periodontitis, stage II periodontitis was significantly associated with greater circadian syndrome prevalence after adjustment (odds ratio (OR) and 95% confidence interval (CI): Stage II: 1.35 (1.03, 1.76), P = 0.032; Stage III: 1.30 (0.97, 1.73), P = 0.069; Stage IV: 1.17 (0.82, 1.65), P = 0300). Stage II periodontitis was significantly associated with greater prevalence of lower high-density lipoprotein cholesterol (HDL) and elevated triglycerides and stage III and stage IV periodontitis were significantly associated with greater hypertension prevalence. A 1 tooth increase in the number of missing teeth was associated with a 1% increase in circadian syndrome and its components of obesity, elevated fasting plasma glucose (FPG) and short sleep. Poor or fair self-rated oral health showed a specificity of > 70% for periodontitis and lack of functional dentition. Meanwhile, poor or fair self-rated oral health had relatively higher levels of sensitivity for stage II-IV periodontitis (35%), stage III-IV periodontitis (46%), stage IV periodontitis (60%) and lacking functional dentition (56%). When compared to excellent self-rated oral health, good, fair and poor self-rated oral health were significantly associated with higher circadian syndrome prevalence (OR and 95% CI: Very good: 1.13 (0.97, 1.32), P = 0.120; Good: 1.34 (1.14, 1.57), P < 0.001; Fair: 1.41 (1.16, 1.71), P = 0.001; Poor: 1.63 (1.32, 2.03), P < 0.001). Additionally, participants with worse self-rated oral health had significantly higher prevalence of elevated FPG, hypertension, low HDL, elevated triglycerides, short sleep and depression.

Conclusions: Periodontitis, tooth loss and worse self-rated oral health were associated with circadian syndrome in US adults. Self-rated oral health may be a simple question to indicate oral and systemic health.