Associations Between Periodontitis and Chronic Obstructive Pulmonary Disease: The 2010 to 2012 Korean National Health and Nutrition Examination Survey

Background: The aim of this study is to examine whether oral hygiene and self-care, particularly in periodontal health, are associated with chronic obstructive pulmonary disease (COPD) in the Korean population. Methods: Data from the Korean National Health and Nutrition Examination Survey from 2010 to 2012 were used to assess the community periodontal index (CPI) of 5,878 participants (normal lung function: n = 5,181; obstructive spirometric pattern: n = 697) aged >= 40 years, who underwent spirometry. Results: Participants with COPD brushed their teeth less frequently and used the following less frequently: 1) dental floss and/or interdental brush; 2) mouthwash; and 3) electric toothbrush (P <0.001). Prevalence of periodontitis in patients with COPD (58.1%) was significantly higher than in those without COPD (34.0%, P <0.001). Number of teeth was significantly lower in patients with COPD compared with controls. Decayed-missing-filled tooth index was significantly lower in patients with COPD. This study shows risk of COPD by periodontal severity. Periodontitis (CPI 3 and 4) was associated in males with COPD after adjustment for: 1) age; 2) income; 3) education; 4) smoking; 5) alcohol consumption; 6) exercise; 7) body mass index; 8) toothbrushing frequency; 9) diabetes mellitus; and 10) number of teeth (CPI 3: relative risk [RR] = 1.38, 95% confidence interval [CI] = 1.12 to 2.05; CPI 4: RR = 1.23, 95% CI = 1.06 to 1.56). Conclusion: Findings of this cross-sectional study suggest that COPD in males may be associated with severe periodontitis and indicates the importance of promoting dental care in patients with COPD.