title: Predicted vitamin D status and incidence of tooth loss and periodontitis.
abstract: OBJECTIVE
  Vitamin D insufficiency is highly prevalent, with particular subgroups at greater risk (e.g. the elderly and those with darker skin). Vitamin D insufficiency may partly explain US racial/ethnic disparities in the prevalence of periodontitis and tooth loss. We evaluated the association between a predictor score of plasma 25-hydroxyvitamin D (25(OH)D) and incidence of periodontitis and tooth loss.
  
  
  METHODS
  Detailed biennial questionnaires were collected on medical history, lifestyle practices and incident periodontitis and tooth loss. The predictor score was derived from variables known to influence circulating concentrations of plasma 25(OH)D and validated against plasma concentrations among a sub-sample. Multivariable Cox proportional-hazards models with time-varying covariates estimated the association between the predicted 25(OH)D score and time until first tooth loss.
  
  
  METHODS
  A total of 42,730 participants of the Health Professionals Follow-Up Study aged 40-75 years at baseline were followed from 1986 to 2006.
  
  
  METHODS
  USA, representing all fifty states and the District of Columbia.
  
  
  RESULTS
  We observed 13,581 incident tooth loss events from 539,335 person-years. There was a dose-dependent significant inverse association across quintiles of the predicted 25(OH)D score and incidence of tooth loss. In multivariable analyses, the highest quintile of the updated predicted 25(OH)D score compared with the lowest was associated with a 20% lower incidence of tooth loss (hazard ratio = 0.80, 95 % CI 0.76, 0.85; P value for trend <0.001); UV-B was also independently associated. Results for the predicted 25(OH)D score and periodontitis were similar.
  
  
  CONCLUSIONS
  These results are suggestive of an association between predictors of vitamin D and lower incidence of tooth loss and periodontitis.
authors.affiliation: 1 Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Monik
authors.initials: M
authors.lastname: Jimenez
authors.affiliation: 2 Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Giovannucci
authors.affiliation: 3 Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Krall Kaye
authors.affiliation: 4 University of Puerto Rico School of Dentistry, San Juan, Puerto Rico.
authors.forename: Kaumudi J
authors.initials: KJ
authors.lastname: Joshipura
authors.affiliation: 5 Department of Oral Surgery, The School of Dentistry, University of Birmingham, St Chad's Queensway, Birmingham B4 6NN, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Dietrich
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000453:epidemiology*; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016388:Tooth Loss / Q000453:epidemiology*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014807:Vitamin D / Q000008:administration & dosage / Q000097:blood*; D014808:Vitamin D Deficiency / Q000453:epidemiology*
chemical_list: D014807:Vitamin D