Periodontal Disease Was Mildly Associated With an Increased Mortality in 88,882 Men.
We sought to investigate the association between periodontal disease (PD) and total and cardiovascular (CV) mortality in a large cohort of men. Methods: Of 104,388 men in the Physician s Health Study enrollment cohort, 88,882 who had no history of cancer, myocardial infarction, stroke or liver disease and provided information on PD were included in this analysis. A total of 10,264 patients reported history of PD. Results: During a mean follow-up of 5 years, 2,921 patients died, from which 1,461 had a CV death. The crude, age adjusted RR, showed an association between PD and total mortality (RR=1.31, C.I. 1.2-1.4, p<0.0001). Men with PD were more likely to have history of diabetes, hypertension, stable angina, diabetes, and past or current smoking, all with p<0.001. The association between PD and total mortality was substantially attenuated after adjustment for potential confounders (RR=1.14, C.I. 1.02-1.26, p=0.02). Smoking appeared to be an effect modifier because the crude RR between PD and mortality in current or past smokers (RR=1.33, C.I. 1.2-1.5, p<0.0001) was not significantly attenuated after adjustment for potential confounders (RR=1.25, C.I. 1.1-1.4, p<0.0005). A similar association was found with CV mortality, see ⇓table. Conclusion: This prospective cohort study suggests that PD is associated with increased mortality, particularly among smokers. However, whether this mild association is real or only due to residual confounding remains to be clarified.⇓