Preterm birth and birth weight extremes are associated with periodontal disease and tooth loss in the ARIC study

To investigate whether preterm birth (PTB) and extreme birth weights are associated with the prevalence of periodontal disease and tooth loss later in life, we conducted a cross-sectional analysis of 6152 adults (62.3 ± 5.6 years) from the Atherosclerosis Risk in Communities (ARIC) study, who underwent a periodontal examination at Visit 4 (1996–1998). Preterm birth (PTB) (< 37 weeks) and birth weight categories (low birth weight (LBW) < 2.5 kg and high birth weight (HBW) > 4.0 kg) were self‑reported. Periodontal status was assessed via clinical examination and classified using the Periodontal Profile Class (PPC). Multivariable logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) for prevalent periodontal disease (PD) and tooth loss, adjusting for sociodemographic, behavioral, and cardiovascular risk factors. LBW and PTB were associated with increased odds of PD (OR = 1.57, 95% CI 1.15–2.16 and OR = 1.52, 95% CI 1.02–2.27, respectively), but not with tooth loss. Conversely, HBW was not associated with PD but was linked to greater odds of tooth loss (OR = 1.49, 95% CI 1.06–2.07). Adverse birth outcomes are associated with periodontal health in later life, supporting life-course approaches to risk assessment and prevention in both oral and systemic health.