Prospective Study of Oral Health and Risk of Primary Open-Angle Glaucoma in Men: Data from the Health Professionals Follow-up Study.
Pasquale Louis R, Hyman Leslie, Wiggs Janey L, Rosner Bernard A, Joshipura Kaumudi, McEvoy Mark, McPherson Zachary E, Danias John, Kang Jae H
AI Summary
This study found recent tooth loss, especially with periodontal disease, was associated with increased primary open-angle glaucoma risk in men. This suggests a potential oral-systemic link to glaucoma, needing further confirmation.
Abstract
Purpose
Tooth loss or periodontal disease is associated with systemic endothelial dysfunction, which has been implicated in primary open-angle glaucoma (POAG). The relationship between oral health and POAG has received limited attention. Thus, we evaluated the association between oral health history and risk of POAG and POAG subtypes.
Design
Prospective cohort study.
Participants
Health Professionals Follow-up Study participants (40 536 men) followed biennially from 1986 to 2012. At each 2-year risk period, eligible participants were aged 40+ years, were free of POAG, and reported eye examinations.
Methods
By using validated questions, we updated participants' status on number of natural teeth, teeth lost, periodontal disease with bone loss, and root canal treatments.
Main outcome measures
During follow-up, 485 incident cases of POAG were confirmed with medical records and classified into subtypes defined by intraocular pressure (IOP; ≥ or <22 mmHg) or visual field (VF) loss pattern at diagnosis (peripheral loss only or early paracentral loss). Multivariable relative risks (MVRRs) and 95% confidence intervals (CIs) were estimated.
Results
Number of natural teeth, periodontal disease, and root canal treatment were not associated with POAG. However, compared with no report of tooth loss, a report of losing teeth within the past 2 years was associated with a 1.45-fold increased risk of POAG (95% CI, 1.06-1.97); in particular, a report within the past 2 years of both losing teeth and having a prevalent diagnosis of periodontal disease was associated with a 1.85-fold increased risk of POAG (95% CI, 1.07-3.18). The associations with recent tooth loss were not significantly different for the POAG subtypes (P for heterogeneity ≥0.36), although associations were strongest in relation to the POAG subtypes with IOP <22 mmHg (MVRR, 1.93; 95% CI, 1.09-3.43) and early paracentral VF loss (MVRR, 2.27; 95% CI, 1.32-3.88).
Conclusions
Although the number of natural teeth was not associated with risk of POAG, recent tooth loss was associated with an increased risk of POAG. Because these findings may be due to chance, they need confirmation in larger studies.
MeSH Terms
Shields Classification
Key Concepts4
In a prospective cohort study of 40,536 men, a report of losing teeth within the past 2 years was associated with a 1.45-fold increased risk of primary open-angle glaucoma (POAG) (95% CI, 1.06-1.97) compared with no report of tooth loss.
In a prospective cohort study of 40,536 men, a report within the past 2 years of both losing teeth and having a prevalent diagnosis of periodontal disease was associated with a 1.85-fold increased risk of primary open-angle glaucoma (POAG) (95% CI, 1.07-3.18).
In a prospective cohort study of 40,536 men, associations between recent tooth loss and primary open-angle glaucoma (POAG) were strongest in relation to POAG subtypes with intraocular pressure (IOP) <22 mmHg (MVRR, 1.93; 95% CI, 1.09-3.43) and early paracentral visual field (VF) loss (MVRR, 2.27; 95% CI, 1.32-3.88).
In a prospective cohort study of 40,536 men, the number of natural teeth, periodontal disease, and root canal treatment were not associated with primary open-angle glaucoma (POAG).
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