Impacto do estado periodontal e perda dentária na incidência e mortalidade por câncer de pulmão e doenças cardiovasculares: evidências de uma coorte prospectiva de idosos

Abstract

Periodontitis is one of the major causes of tooth loss, with its prevalence increasing as the population ages. The association between periodontitis and tooth loss with systemic conditions has been widely studied based on the hypothesis that inflammatory processes and microbial dissemination can impact general health. In this context, lung cancer and cardiovascular diseases, which are chronic non-communicable inflammatory conditions, may be linked to oral health. This study aimed to evaluate the influence of periodontal condition and tooth loss on lung cancer incidence and mortality outcomes, cerebrovascular, cardiovascular, and all-cause mortality outcomes, in elderly participants in the “Health, Aging and Body Composition” (Health ABC) cohort. The Health ABC study followed individuals aged 70 to 79 over 16 years. Detailed data on periodontal parameters were collected in the 2nd and 3rd follow-up years, along with information on the number of teeth considered the main exposure variables. The hazard ratio (HR) was calculated using Cox regression. Independent adjusted models were constructed for each primary exposure (α<5%). Participants were grouped according to the outcome presentation over the 16- year follow-up. Multivariate analyses demonstrated that patients with at least 10% of sites with PD≥6mm had 2.82 (95%CI 1.31–6.05) and 3.08 (95%CI 1.27– 7.46) times higher HRs of developing and dying from lung cancer, respectively. The number of teeth was inversely associated with lung cancer incidence (HR: 0.96, 95%CI 0.93–0.99) and mortality (HR: 0.96, 95%CI 0.92–0.99). Severe tooth loss and a lower number of teeth were associated with cardiovascular incidence and mortality and all-cause mortality. Furthermore, higher mean PD and at least 10% of sites with PD≥4mm (HR: 1.22; 95%CI 1.04–1.44) and ≥5mm (HR: 1.26; 95%CI 1.02–1.56) were significantly associated with all-cause mortality. The presence of at least 10% of sites with PD≥5mm was also associated with cerebrovascular mortality (HR: 2.10; 95%CI 1.19–3.71). These results demonstrate that the presence of severe periodontal parameters and tooth loss is associated with an increased risk of developing lung cancer and cardiovascular diseases, as well as with mortality.