Predicted vitamin D status and incidence of tooth loss and periodontitis.

OBJECTIVE Vitamin D insufficiency is highly prevalent, with particular subgroups at greater risk (e.g. the elderly and those with darker skin). Vitamin D insufficiency may partly explain US racial/ethnic disparities in the prevalence of periodontitis and tooth loss. We evaluated the association between a predictor score of plasma 25-hydroxyvitamin D (25(OH)D) and incidence of periodontitis and tooth loss. DESIGN Detailed biennial questionnaires were collected on medical history, lifestyle practices and incident periodontitis and tooth loss. The predictor score was derived from variables known to influence circulating concentrations of plasma 25(OH)D and validated against plasma concentrations among a sub-sample. Multivariable Cox proportional-hazards models with time-varying covariates estimated the association between the predicted 25(OH)D score and time until first tooth loss. SUBJECTS A total of 42,730 participants of the Health Professionals Follow-Up Study aged 40-75 years at baseline were followed from 1986 to 2006. SETTING USA, representing all fifty states and the District of Columbia. RESULTS We observed 13,581 incident tooth loss events from 539,335 person-years. There was a dose-dependent significant inverse association across quintiles of the predicted 25(OH)D score and incidence of tooth loss. In multivariable analyses, the highest quintile of the updated predicted 25(OH)D score compared with the lowest was associated with a 20% lower incidence of tooth loss (hazard ratio = 0.80, 95 % CI 0.76, 0.85; P value for trend <0.001); UV-B was also independently associated. Results for the predicted 25(OH)D score and periodontitis were similar. CONCLUSIONS These results are suggestive of an association between predictors of vitamin D and lower incidence of tooth loss and periodontitis.