Examining Electronic Health Records to Investigate Sex Differences in Oral Diseases and Conditions

OBJECTIVES: Sexual dimorphism has been shown to influence disease predisposition and/or progression, although population-based studies in dental, oral, and craniofacial (DOC) diseases and conditions are limited. This study aimed to identify sex-based differences in DOC diseases/conditions using two large health data repositories. METHODS: Retrospective cross-sectional study of health record data obtained from adult participants (> 18 years old) in the NIH All of Us Research Program (n = 254,700) and the BigMouth Data Repository (n ≈ 4.7 million). The number of males and females presenting each selected condition in each database was recorded. Sex-specific association analysis for each condition was performed using chi-square tests (α ≤ 0.0002). Female-to-male odds ratio (OR) and confidence intervals were also calculated. RESULTS: Significant sex-related differences were found for 61/87 concepts (70%), with 33 concepts (54%) showing female bias and 28 (46%) showing male bias (p ≤ 0.0002). Analysis of BigMouth data showed sex bias for 90/230 (39%) concepts investigated, of which 87 (97%) showed female bias and 3 (3%) showed male bias (p ≤ 0.0002). CONCLUSIONS: This study provides evidence of sex bias in numerous oral and dental conditions in the populations studied. Additional studies in other populations might provide further insight into the role of sexual dimorphism in these conditions.