Research on the comorbidity of periodontitis and tooth loss and its association with accelerated biological aging

YU Xiao; ZHANG Yi; LU Xiu-zhen; SUN Ying; CHEN Xin

doi:10.19749/j.cn.cjgd.1672-2973.2025.05.005

Abstract：Objective To investigate the comorbidity of periodontitis and tooth loss,examines its potential association with accelerated biological aging,and discusses preventive strategies aimed at mitigating age-related decline from the perspective of oral health.Methods A total of 2,842 individuals aged 60 years and older were selected as study participants based on cross-sectional data from the United States National Health and Nutrition Examination Survey(NHANES)conducted between 2009 and 2014.The prevalence of periodontitis and tooth loss was assessed using oral examination data.Two biological aging markers were computed from blood biochemical test results:phenotypic age,calculated using the Levine method,and biological age,derived via the Klemera-Doubal method.Data on relevant covariates were collected through questionnaire interviews and physical examinations.logistic regression analysis was used to investigate the relationship between periodontitis,tooth loss and accelerated biological aging,and interaction tests were used to investigate the synergistic harmful effects of periodontitis and tooth loss on biological aging.Results The detection rate of periodontitis,tooth loss and comorbidities was 63.9%87.6%and 58.8%respectively.The analysis found that there was no correlation between mild periodontitis and the two biological aging indicators,while moderate and severe periodontitis was significantly associated with accelerated biological aging(P＜0.05),and the heavier the degree of periodontitis,the greater the risk of accelerated biological aging.There was always a significant correlation between tooth loss and phenotypic age acceleration(P＜0.05),whereas biological aging was observed only in the population group of more severe tooth loss(number of tooth lost＞8,OR=1.55,95%CI:1.02～2.36,P=0.042).The phenoage acceleration(95%CI:1.18～2.51,P=0.005),biological age acceleration(95%CI:1.09～2.45,P=0.020)were 1.72 times and 1.63 times higher than those of oral health population.Moreover,there was an interaction between periodontitis and tooth loss(P interaction＜0.05).In the population with periodontitis,the number of tooth loss further increased the risk of accelerated biological aging(P＜0.05).Conclusion This study confirmed the association between periodontitis and tooth loss and accelerated biological aging,suggesting that maintaining periodontal health in elderly people can be used as a personalized prevention and treatment strategy for biological aging.