Is COPD associated with periodontal disease? A population-based study in Spain

Ana Lopez-de-Andrés,1 Luis Vazquez-Vazquez,2 Maria A Martinez-Huedo,3 Valentín Hernández-Barrera,1 Isabel Jimenez-Trujillo,1 Miguel A Tapias-Ledesma,1 Javier de Miguel-Diez,4,5 Rodrigo Jiménez-García1 1Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Spain; 2Human Anatomy and Embryology Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Alcorcón, Spain; 3Preventive Medicine, La Paz University Hospital, Madrid, Spain; 4Respiratory Department, Gregorio Marañon General University Hospital, Medical School, Complutense University, Madrid, Spain; 5Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain Background: Periodontal disease is more prevalent and more severe among men and women suffering from chronic obstructive pulmonary disease (COPD) compared with healthy adults. The objectives of this paper were to assess the association between periodontal disease and COPD, controlling the effect of sociodemographic characteristics, oral health status, lifestyle variables, and comorbidities. Second, we identified which of the variables analyzed were independently associated with periodontal disease among COPD sufferers.Methods: This descriptive study was done with data from the National/European Health Interview Surveys, conducted in years 2006, 2011/12, and 2014 in Spain. We included subjects ≥40 years of age. COPD status was self-reported. One non-COPD patient was matched by age, gender, and the year of survey for each COPD case. The presence of periodontal disease was defined using the answers “my teeth bleed spontaneously or while brushing” or/and “my teeth move” to the question: “Do you suffer of any of these dental and oral disorders or diseases?” Independent variables included demographic, socioeconomic, and health care-related variables, oral health status, and presence of comorbidities.Results: The prevalence of periodontal disease was higher among COPD patients than their matched non-COPD controls (26.5% vs 22.2%; P<0.001). Adjusted odds ratio (AOR) of periodontal disease for subjects with COPD was 1.21 (95% CI: 1.12–1.30). Suffering mental disorders (AOR: 1.61; 95% CI: 1.32–1.97) was positively associated with higher risk of periodontal disease. Older age, having a private dental health insurance, and university education were variables associated with lower rates of periodontal disease.Conclusion: Prevalence of periodontal disease was higher among those with COPD compared to non-COPD controls. Dentists and physicians should increase their awareness with their COPD patients, especially those who are younger, with lower education, and suffer depression and/or anxiety. Keywords: periodontal disease, COPD, survey, educational leve