Association of Tooth Loss with New-Onset Parkinson’s Disease: A Nationwide Population-Based Cohort Study
Table 2
Risk of new-onset Parkinson’s disease according to oral health disease and oral hygiene care.
Event rate (%), (95% CI)
Unadjusted model
Multivariable adjusted (1)
Multivariable adjusted (2)
Multivariable adjusted (3)
HR (95% CI)
value
HR (95% CI)
value
HR (95% CI)
value
HR (95% CI)
value
Presence of periodontal disease
No
0.79 (0.74, 0.84)
1 (ref)
0.125
1 (ref)
0.104
1 (ref)
0.103
1 (ref)
0.232
Yes
0.68 (0.59, 0.77)
0.89 (0.77–1.03)
0.88 (0.76–1.03)
0.88 (0.76–1.03)
0.91 (0.78–1.06)
Frequency of tooth brushings (times/day)
0-1
1.05 (0.93, 1.20)
1 (ref)
0.014
1 (ref)
0.793
1 (ref)
0.775
1 (ref)
0.652
2
0.86 (0.79, 0.93)
0.83 (0.71–0.96)
1.02 (0.88–1.19)
1.02 (0.88–1.19)
1.04 (0.89–1.21)
≥3
0.59 (0.53, 0.65)
0.58 (0.50–0.69)
<0.001
0.93 (0.78–1.10)
0.370
0.93 (0.78–1.10)
0.384
0.95 (0.80–1.12)
0.531
for trend
<0.001
0.267
0.277
0.399
Dental clinic visits for any causes
No
0.83 (0.77, 0.89)
1 (ref)
0.008
1 (ref)
0.169
1 (ref)
0.180
1 (ref)
0.640
Yes
0.70 (0.64, 0.76)
0.86 (0.76–0.96)
0.92 (0.82–1.04)
0.92 (0.82–1.04)
0.97 (0.85–1.11)
Competent dental care
No
0.84 (0.79, 0.89)
1 (ref)
<0.001
1 (ref)
0.136
1 (ref)
0.139
1 (ref)
0.436
Yes
0.57 (0.50, 0.65)
0.69 (0.60–0.80)
0.90 (0.78–1.04)
0.90 (0.78–1.04)
0.94 (0.79–1.11)
Number of tooth loss
0
0.70 (0.65, 0.75)
1 (ref)
0.083
1 (ref)
0.789
1 (ref)
0.754
1 (ref)
0.765
1–7
0.80 (0.71, 0.90)
1.13 (0.98–1.29)
0.98 (0.86–1.12)
0.98 (0.85–1.12)
0.98 (0.85–1.12)
8–14
2.20 (1.66, 2.92)
2.94 (2.20–3.93)
<0.001
1.34 (0.99–1.80)
0.055
1.33 (0.99–1.79)
0.059
1.32 (0.98–1.78)
0.068
≥15
3.77 (2.88, 4.94)
4.76 (3.60–6.29)
<0.001
1.40 (1.05–1.87)
0.022
1.39 (1.04–1.86)
0.025
1.38 (1.03–1.85)
0.029
for trend
<0.001
0.032
0.038
0.043
Event rates were reported as 10-year event rates (%). Regression methods of Fine and Gray for competing risk data (death is a competing event for Parkinson’s disease) were used. Multivariable model (1) was adjusted for age, sex, income level, regular physical activity, alcohol intake, smoking status, body mass index (kg/m2), hypertension, diabetes mellitus, dyslipidemia, renal disease, and history of malignancy. Multivariable model (2) was adjusted for the variables listed above as well as for systolic blood pressure, fasting blood glucose level, aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transferase, and proteinuria. Multivariable model (3) was adjusted for the variables listed above as well as for the presence of periodontal disease, frequency of tooth brushings, dental clinic visits for any causes, competent dental care, and the number of tooth loss except regarding the independent variable. CI, confidence interval and HR, hazard ratio.
