Serum Calcium and Periodontal Disease Progression in Community-Dwelling Elderly

Some reports have been supportive of the significant role played by dietary calcium in the aetiology and progression of periodontitis. However, virtually no study has addressed the issue of serum calcium-periodontal relationship in non-institutionalized elderly. Objective: To assess the effect of serum calcium on the progression of periodontal disease in community-dwelling elderly. Methods: Clinical attachment levels of 266 Japanese subjects aged 70 years were recorded at baseline and annually for 6 consecutive years. Periodontal progression (PEVENT) was defined as the number of teeth that showed additional attachment loss of≥3mm in a given subject during the follow-up period. The number of PEVENT was calculated accordingly for each subject. The levels of serum calcium, albumin, total protein, cholesterol, triglyceride, blood sugar, creatinine, rheumatoid factor (RF), immunoglobulin (IgG, IgA and IgM), smoking habits, socio-economic status and basal metabolic index (BMI) were obtained at baseline. Results: 4.1% of the sample presented with no PEVENT (PEVENT=0), 54.1% with 1-10 PEVENT (PEVENT=1), 36.1% with 11-20 PEVENT (PEVENT=2) and 5.7% with >20 PEVENT (PEVENT=3). Out of the variables measured at baseline serum calcium, IgG, IgA, RF, smoking and BMI were associated with PEVENT at P≤0.30 and thus were included in a multinomial logistic regression analysis. The relationships between these variables and PEVENT were assessed at 3 levels where PEVENT=0 was the comparison group. Serum calcium was the only variable that was significantly associated with PEVENT at all 3 levels (P=0.01, 0.02 and 0.002, respectively) after controlling for serum markers, smoking and BMI. In subjects with low serum calcium, the relative risks for PEVENT were 200, 143 and 5000, respectively, at PEVENT=1, 2 and 3 levels. Conclusion: Serum calcium may be considered a risk factor for periodontal disease progression in community-dwelling elderly. This study was supported by grant-in-aid from the Ministry of Health and Welfare, Japan.