Periodontal inflammatory disease is associated with the risk of Parkinson's disease: a population-based retrospective matched-cohort study

Dental Scaling Decreases the Risk of Parkinson's Disease: A Nationwide Population-Based Nested Case-Control Study

The protective effect of dental scaling in Parkinson’s disease (PD) remains inconclusive. The aim of this study was to analyze the association between dental scaling and the development of PD. A retrospective nested case-control study was performed using the National Health Insurance Research Database of Taiwan. The authors identified 4765 patients with newly diagnosed PD from 2005 to 2013 and 19,060 individuals without PD by matching sex, age, and index year. In subgroup 1, with individuals aged 40–69 years, individuals without periodontal inflammatory disease (PID) showed a protective effect of dental scaling against PD development, especially for dental scaling over five consecutive years (adjusted odds ratio = 0.204, 95% CI = 0.047–0.886, p = 0.0399). In general, the protective effect of dental scaling showed greater benefit for individuals with PID than for those without PID, regardless of whether dental scaling was performed for five consecutive years. In subgroup 2, with patients aged ≥70 years, the discontinued (not five consecutive years) scaling showed increased risk of PD. This was the first study to show that patients without PID who underwent dental scaling over five consecutive years had a significantly lower risk of developing PD. These findings emphasize the value of early and consecutive dental scaling to prevent the development of PD.

Patients with chronic periodontitis present increased risk for primary Sjögren syndrome: a nationwide population-based cohort study

Many reports have mentioned the association between chronic periodontitis (CP) and primary Sjögren syndrome (pSS). However, no cohort study has been performed for the risk of pSS in patients with CP. In this study, we evaluated the risk of pSS from CP exposure in a nationwide population-based cohort study in Taiwan. We studied the claims data of Taiwanese population from 2001 to 2012. We identified 76,765 patients with CP from the National Health Insurance Database in Taiwan. We also selected 76,765 controls that were randomly frequency matched by age, sex, and index year from the general population. We analyzed the risk of pSS by using Cox proportional hazards regression models including sex, age, and comorbidities. In this study, 76,765 patients with CP (mean age: 40.8 years) and 76,765 controls (mean age: 41.0 years) were followed-up for 8.54 and 8.49 years, respectively. A total of 869 cases of pSS were identified in CP cohort and 483 cases in non-CP cohort. Multivariate Cox regression analysis indicated that the incidence rate of pSS was significantly higher in CP cohort than those who in non-CP cohort (adjusted HR: 1.79, 95% CI [1.60–2.00]). Taken together, this nationwide retrospective cohort study demonstrated that the risk of pSS was significantly higher in patients with CP than in the general population. The association between CP and pSS was significant in the female group.

Increased risk of periodontitis in patients with psoriatic disease: a nationwide population-based retrospective cohort study

Aims

Periodontitis and psoriatic disease, including psoriasis (PS) and psoriatic arthritis (PsA), share the common risk factors and co-morbidities. However, the risk of periodontitis in patients with psoriatic disease still needs further investigation. This study was a nationwide population-based retrospective cohort study assessing the risk of periodontitis from psoriatic disease exposure.

Materials and Methods

Patients with newly diagnosed psoriatic disease from 2003 to 2012 were identified from the Taiwanese National Health Insurance Research Database. The 1:4 ratio propensity score matched controls were selected from no psoriatic disease participations. The subsequent risk of periodontitis was evaluated in exposure and comparison groups. Multiple Cox proportional hazard models were used for the estimation.

Results

A total of 3,487 psoriatic disease patients and 13,948 controls were identified. Incidence rate of periodontitis was higher in patients with PsA. The adjusted hazard ratio (aHRs) for moderate/severe periodontitis were 0.85 (95% CI [0.65-1.11]) in PS group and 1.66 (95% CI [0.99-2.78]) in PsA group. The aHRs of PsA were increased over time, aHRs was changed from 0.65 (0-11 months from index date) to 1.34 (≥12 months from index date) in all types of periodontitis and from 1.09 to 1.79 in moderate/severe periodontitis group, respectively.

Conclusions

The increased risk of periodontitis was observed, especially the association between PsA and moderate/severe periodontitis. The patients with psoriatic disease should receive regular periodontal evaluation.