Severe Periodontitis Tracked With Faster Biological Aging in NHANES Analysis

Edited by Hygienetown staff

Adults with severe periodontitis showed higher epigenetic age acceleration than adults with healthy gums or early-stage disease, according to a population-based study published Sept. 23 in the Journal of Periodontal Research.

The analysis drew on 1,926 adults aged 50 and older from the 1999–2002 NHANES cycles who had both DNA methylation data and oral health examinations. Periodontitis was classified by stage and grade under the 2018 AAP/EFP framework using the ACES system, and biological age acceleration was estimated with four epigenetic clocks: HannumAge, HorvathAge, PhenoAge, and GrimAge2Mort.

In fully adjusted models, stage III to IV periodontitis was associated with higher age acceleration on three of the four clocks compared with participants who were healthy or had gingivitis or stage I disease. PhenoAge showed the largest difference at 2.12 years, with a 95% confidence interval of 0.64 to 3.59. HannumAge showed 1.48 years and GrimAge2Mort 1.35 years.

Edentulism produced stronger associations on three clocks. HannumAge registered 1.92 years, GrimAge2Mort 1.77 years, and HorvathAge 1.31 years.

Grade B and C disease also tracked with acceleration relative to health, gingivitis, or grade A, at 1.04 years on HorvathAge and 0.93 years on HannumAge.

Mean interproximal clinical attachment loss was associated with age acceleration on all four clocks.

Researchers in the Department of Public Health and Community Medicine at Tufts University School of Medicine conducted the study, with a collaborator at Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. Estimates came from survey-weighted linear regression models adjusted for confounders.

The design is cross-sectional, so it establishes association rather than direction. The authors wrote that these oral conditions may reflect, or potentially contribute to, systemic biological aging, leaving open which way the relationship runs. The confidence interval for the edentulism association on HorvathAge reached zero at its lower bound, and the exposures were measured in survey cycles now more than two decades old.

Sources:
Journal of Periodontal Research, “Periodontitis, Edentulism, and Accelerated Biological Aging: A Population-Based Study of Epigenetic Clocks,” published online Sept. 23, 2026: doi.org/10.1111/jre.70163
PubMed record, PMID 42775949: pubmed.ncbi.nlm.nih.gov/42775949