Relationships between periodontitis, tooth loss, and metabolic syndrome indicators

Background: This study investigates how poor oral health impacts metabolic alterations, specifically evaluating the effects of periodontitis and tooth loss, either individually or in combination, on the number of metabolic syndrome (MetS) indicators. Methods: A cross-sectional study was conducted with 1281 individuals aged 18 and older, attending public health clinics. Physical exams and laboratory tests were performed to diagnose and determine MetS indicators as defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and the Joint Interim Statement (JIS). Oral exams assessed tooth loss and periodontitis severity. Multinomial regression analysis was used, and adjusted prevalence ratios (PR_adjusted) with 95% confidence intervals (95%CI) were calculated. Results: MetS prevalence ranged 32.3–40.7%. Periodontitis distribution was no (n = 202), mild (stage I; n = 7), moderate (stage II; n = 649), severe (stage III/IV; n = 412). Multinomial regression models revealed that periodontitis occurrence and severity, along with tooth loss, were independently associated with MetS, with stronger associations in individuals with 4 to 5 negative metabolic indicators (PR_adjusted for periodontitis = 2,09; [95%CI:1.20–3.67]; PR_adjusted for severe periodontitis = 2.11; [95%CI:1.04–4.29]; PR_adjusted for tooth loss = 2.13; [95%CI:1.38–3.28]). The combined effect of periodontitis and tooth loss significantly increased the likelihood of having 4 to 5 MetS indicators (PR_adjusted = 3.59; [95%CI:1.47–8.78]; PR_adjusted = 5.58; [95%CI:2.45–12.75] for NCEP-ATP III and JIS criteria, respectively). Conclusions: Periodontitis and tooth loss are positively associated with MetS, with stronger associations observed in individuals with more severe metabolic alterations. The combined presence of these oral conditions increases the likelihood of greater metabolic impairment. Plain Language Summary: This study examines the impact of poor oral health on metabolic syndrome (MetS). It finds that both periodontitis and tooth loss are associated with a higher number of MetS indicators. These associations are particularly stronger in individuals with more severe metabolic alterations. Additionally, individuals with both periodontitis and tooth loss are more likely to exhibit metabolic dysfunctions, including hypertension, hyperglycemia, obesity, and dyslipidemia. This highlights the critical need for integrated care addressing both periodontal and metabolic health in clinical practice.