Supplementary Material for: Association between self-reported oral health and Parkinson's disease: evidence from UK biobank

Abstract
Objectives
Oral health problem is prevalent in the elderly population which is also at high risk of Parkinson’s disease (PD). However, the association between self-reported oral health and PD is still unclear. We aimed to explore the association between baseline self-reported oral health (mouth ulcers, painful gums, bleeding gums, loosen teeth, toothache, dentures) and future incidence of PD.
Methods
Participants were enrolled in the UK biobank from 2006 to 2010 and those without PD at baseline were included in the current study. We used Cox regression analysis to explore the question and adjusted for age, sex, body mass index, smoking, drinking, ethnicity, education, socioeconomic status, and average total household income before tax.
Results
We included 421180 participants with a mean age of 56.26 years old and 46.5% of them were male. And 2339 participants were diagnosed with PD in the follow-up. Mouth ulcers, loosen teeth, dentures, toothache, and bleeding gums were not related to the risk of PD. Painful gums were related to a higher risk of PD (HR: 1.39, 95%CI: 1.12-1.72, P = 0.003), and similar results were reached after adjusting for gene risk (HR: 1.39, 95%CI: 1.12-1.73, P = 0.003), or source of diagnosis (HR: 1.39, 95%CI: 1.12-1.72, P = 0.002), and time of diagnosis (HR: 1.29, 95%CI: 1.03-1.63, P = 0.02).
Conclusions
Our study has demonstrated a substantial correlation between painful gums and elevated susceptibility to PD, underscoring the potential advantages of implementing oral health interventions for decreasing the risk of PD.

摘要
研究目的
口腔健康问题在老年人群中普遍存在，而该人群同时也是帕金森病（PD）的高风险群体。然而，自我报告的口腔健康状况与PD之间的关联尚不清楚。本研究旨在探讨基线时自我报告的口腔健康状况（口腔溃疡、牙龈疼痛、牙龈出血、牙齿松动、牙痛、义齿佩戴情况）与未来帕金森病发病风险之间的关联。

研究方法
本研究的研究对象于2006年至2010年纳入英国生物样本库（UK Biobank），且基线时未患PD的个体被纳入本次研究。我们采用Cox回归分析探讨上述关联，并针对年龄、性别、体质量指数、吸烟、饮酒、种族、教育水平、社会经济地位以及税前家庭平均总收入进行了校正。

研究结果
本研究共纳入421180名研究对象，平均年龄为56.26岁，其中男性占比46.5%。随访期间共有2339名研究对象被确诊为PD。口腔溃疡、牙齿松动、义齿佩戴、牙痛以及牙龈出血与PD发病风险无显著关联。牙龈疼痛与PD发病风险升高相关（风险比（Hazard Ratio, HR）：1.39，95%置信区间（95% Confidence Interval, 95%CI）：1.12~1.72，P=0.003）；在校正基因风险（HR：1.39，95%CI：1.12~1.73，P=0.003）、诊断来源（HR：1.39，95%CI：1.12~1.72，P=0.002）以及诊断时间（HR：1.29，95%CI：1.03~1.63，P=0.02）后，上述结果仍保持一致。

研究结论
本研究证实牙龈疼痛与PD易感性升高存在显著相关性，强调了开展口腔健康干预以降低PD发病风险的潜在应用价值。