Respiratory diseases-including COPD, asthma, sleep apnoea, pneumonia, and COVID-19-represent a significant burden on global health, particularly in ageing populations. Periodontal disease (PD), a common chronic inflammatory condition, has been increasingly implicated in systemic disease through biological pathways such as persistent low-grade inflammation, oral-respiratory bacterial transmission, and shared risk factors including smoking and socioeconomic disadvantage. A recent review by Herrera et al. (2023) underscored these potential associations, but large-scale, longitudinal evidence remains limited.
This study will utilise the UK Biobank to investigate whether indicators of poor periodontal health-such as self-reported oral condition (painful gum, bleeding gum, tooth loose), or the deterioration of oral condition over time-are prospectively associated with the risk of developing respiratory diseases. Outcome events will be identified via linked hospital, primary care, and mortality records in the UK Biobank.
The study will address the following research questions:
1. Is PD associated with increased incidence of respiratory disease?
2. Do these associations persist after adjusting for key confounders such as smoking and socioeconomic status?
3. Are associations modified by age, sex, or genetic susceptibility?
Survival analysis techniques, including Cox proportional hazards models, will be employed to assess risk over time. The findings may enhance our understanding of the oral-respiratory health connection and inform integrated approaches to chronic disease prevention.