Association between skull bone mineral density and periodontitis: evidence from the National Health and Nutrition Examination Survey (2011-2014)

Background and ObjectiveBone mineral density (BMD) and periodontitis have been the subject of many studies. However, the relationship between skull (including mandible) BMD and periodontitis has not been extensively studied. An objective of this cross-sectional study was to examine the relationship between skull BMD and periodontitis using data from the National Health and Nutrition Examination Surveys (NHANES) for 2011-2012 and 2013-2014. Materials and MethodsFrom 19,931 participants, 3,802 were screened and included with no missing values in the study. We examined the distribution of variables by grouping the skull BMD levels into quartiles. Periodontitis is defined by the Centers for Disease Control and Prevention (CDC) and the American Periodontal Association (AAP) in 2012. An interaction test was conducted using stratified and adjusted logistic regression models, and multivariate logistic regression analysis was performed, along with curve fitting and a threshold effect analysis were performed on the relationship between skull BMD and periodontitis. ResultsThe results showed a negatively relationship between skull BMD and the risk of periodontitis. Although the inflection point was found (the skull BMD= 2.89g/cm2), it was not statistically significant, indicating that the skull BMD and periodontitis are linearly related, which 1 unit increase in the skull BMD (g/cm2) was associated with a 30% (OR=0.70; CI=0.57, 0.87; p=0.0010) reduction in the risk of periodontitis events. ConclusionsPeriodontal disease may be related to low skull BMD, for those people, oral hygiene and health care should be more closely monitored. Validation of our findings will require further research.