Study Exposures

Self-reported oral health indicators were used as surrogates for periodontal disease (Abbood et al. 2016). Participants were asked if they had any of a number of dental problems. Bleeding gums and painful gums were used as surrogates for mild to moderate periodontal disease, while self-reported loose teeth were indicative of severe periodontal disease (Larvin et al. 2021). In cases of multiple responses, the most severe indicator was used as the primary surrogate for periodontal disease. Participants who did not report any of the oral health indicators were deemed to have no history of periodontal disease and were periodontally healthy at baseline.

Obesity status was quantified by BMI. A BMI of 18.5 to 24.9 kg/m² was classified as normal weight, 25 to 29.9 kg/m² as overweight, and ≥30 kg/m² as obese (World Health Organization 2020).