Self-reported oral health issues may elevate the risk of developing autoimmune diseases, according to findings from a large prospective UK Biobank study.
Investigators included 451,404 participants without an autoimmune disease diagnosis at baseline. Oral health was assessed using a questionnaire, with participants classified as having self-reported oral health issues if they reported painful, bleeding gums; mouth ulcers; toothache; dentures; or loose teeth. The investigators used linked health records to evaluate 39 autoimmune diseases.
About 39% of the participants reported at least one oral health issue. The participants reporting any oral health issues had an 11% higher adjusted odds of developing any autoimmune disease compared with those reporting none. Among the individual oral health issues examined, painful gums showed the strongest association followed by mouth ulcers and toothache.
The investigators also reported an incremental association between the number of oral health issues and autoimmune disease risk. Seven autoimmune diseases were significantly associated with any self-reported oral health issue after correction for multiple comparisons: primary biliary cholangitis, rheumatism, lichen planus, Sjögren's disease, pernicious anemia, rheumatoid arthritis, and psoriasis.
The study had limitations, including reliance on self-reported oral health at a single baseline assessment, the potential for residual confounding and reverse causation, and possible limits to generalizability because UK Biobank participants tend to be healthier and more socioeconomically advantaged compared with the general population. The investigators cautioned that because of the observational nature of their study, they were not able to establish causality or a microbiome-mediated mechanism.
"[O]ral health indicators may serve as clinically relevant markers of autoimmune disease risk,” wrote lead study author Dongwon Yoon, PharmD, PhD, of the Laboratory of Epidemiology and Population Sciences at the National Institute on Aging of the National Institutes of Health, and colleagues.
The investigators called for studies incorporating objective periodontal measures and microbiome data to clarify potential mechanisms and determine whether improving oral health could influence autoimmune disease development.
The study was supported by the Intramural Research Program. The study authors reported no conflicts of interest.
Source: BMC Oral Health