Relationship between oral health and glaucoma traits in the United Kingdom

Lee, Rachel H., Kang, Jae H., Wiggs, Janey L., Wagner, Siegfried K., Khawaja, Anthony P. and Pasquale, Louis R. , the Modifiable Risk Factors for Glaucoma Collaboration, the UK Biobank Eye and Vision Consortium and the International Glaucoma Genetics Consortium Collaborators (2024) Relationship between oral health and glaucoma traits in the United Kingdom. Journal of Glaucoma, 33 (6), 400-408. (doi:10.1097/IJG.0000000000002370).

Abstract

Precis: in this cross-sectional analysis of UK Biobank participants, we find no adverse association between self-reported oral health conditions and either glaucoma or elevated intraocular pressures.

Purpose: poor oral health may cause inflammation, which accelerates the progression of neurodegenerative diseases. We investigated the relationship between oral health and glaucoma.

Patients: United Kingdom Biobank participants.

Methods: this is a cross-sectional analysis of participants categorized by self-reported oral health status. Multivariable linear and logistic regression models were used. Primary analysis examined the association with glaucoma prevalence. Secondary analyses examined associations with IOP, macular retinal nerve fiber layer (mRNFL), and ganglion cell inner plexiform layer (mGCIPL) thicknesses, and interaction terms with multitrait glaucoma polygenic risk scores (MTAG PRS) or intraocular pressure (IOP) PRS.

Results: a total of 170,815 participants (34.3%) reported current oral health problems, including painful or bleeding gums, toothache, loose teeth, and/or denture wear. A In all, 33,059, 33,004, 14,652, and 14,613 participants were available for analysis of glaucoma, IOP, mRNFL, and mGCIPL, respectively. No association between oral health and glaucoma was identified [odds ratio (OR): 1.04, 95% CI: 0.95-1.14]. IOPs were slightly lower among those with oral disease (-0.08 mm Hg, 95% CI: -0.15, -0.009); specifically, among those with loose teeth ( P =0.03) and denture-wearers ( P <0.0001). mRNFL measurements were lower among those with oral health conditions (-0.14 μm, 95% CI: -0.27, -0.0009), but mGCIPL measurements ( P =0.96) were not significantly different. A PRS for IOP or glaucoma did not modify relations between oral health and IOP or glaucoma ( P for interactions ≥​​​​0.17).

Conclusions: self-reported oral health was not associated with elevated IOP or an increased risk of glaucoma. Future studies should confirm the null association between clinically diagnosed oral health conditions and glaucoma.

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Contributors

Author: Roxana Carare

Author: Sarah Ennis

Author: Jane Gibson

Author: Andrew J. Lotery

Author: Jay Self

Author: Irene Stratton

Author: Andrew J. Lotery

Author: Angela J. Cree

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