Periodontitis, Edentulism, and Accelerated Biological Aging: A Population‐Based Study of Epigenetic Clocks
Yi‐Ning Chen, Lu Wang, Mario Romandini, Dominique S. MichaudABSTRACT
Aim
To examine whether periodontitis and its ultimate sequela (edentulism) are associated with accelerated epigenetic aging in older adults.
Methods
A total of 1 926 adults aged ≥ 50 years with DNA‐methylation (DNAm) and oral health data from the NHANES 1999–2002 cycles were included. Periodontitis (stages/grades) and edentulism were classified using the 2018 AAP/EFP framework via the ACES system. Epigenetic age acceleration was estimated using genome‐wide DNAm for four clocks: HannumAge, HorvathAge, PhenoAge, and GrimAge2Mort. Survey‐weighted linear regression models, adjusted for relevant confounders, assessed the relationship between periodontal status and epigenetic age acceleration.
Results
In fully adjusted models, Stage III–IV periodontitis was associated with higher biological age acceleration compared with healthy/gingivitis/Stage I for three of the four clocks examined: PhenoAge +2.12 years (95% CI 0.64–3.59), HannumAge +1.48 years (0.34–2.62), and GrimAge2Mort +1.35 years (0.52–2.63). Associations with edentulism were stronger in 3 of the clocks: HorvathAge +1.31 years (0.00–2.62), HannumAge +1.92 years (0.72–3.12), and GrimAge2Mort +1.77 years (0.90–2.65). Accelerated aging was also observed in individuals with Grade B/C periodontitis for HorvathAge (+1.04 years; 0.35–1.72), HannumAge (+0.93 years; 0.26–1.60), and GrimAge (+0.55 years; 0.03 = 1.07), when compared with health/gingivitis/Grade A. Associations were also observed between mean interproximal CAL and age acceleration in all four clocks.
Conclusion
Severe and higher‐grade periodontitis, as well as edentulism, are associated with higher epigenetic aging acceleration, suggesting that these oral conditions may reflect—or potentially contribute to—systemic biological aging.