Association of human papillomavirus infection with increased new-onset periodontitis risk: A multi-center retrospective cohort study.

backgroundHuman papillomavirus (HPV) is implicated in oncogenesis and inflammatory processes, yet its role in periodontitis remains poorly defined.

methodsWe conducted a retrospective cohort study using the US Collaborative Network of the TriNetX platform. Adults (≥18 years) with at least two healthcare encounters were selected. The HPV-positive group, identified via ICD-10 codes from 2005 to 2018, was 1:1 propensity score-matched with HPV-negative controls after excluding individuals with prior periodontitis, cancer, or insufficient follow-up. New-onset periodontitis was defined using ICD-10 criteria, and hazard ratio estimates were derived using Cox proportional hazards models. Sensitivity analyses were performed with varying wash-out periods (12-36 months) and follow-up durations (5-15 years), while stratified analyses assessed differences by age, sex, race, and key comorbidities.

resultsAfter matching (n = 272,332 per group), the baseline characteristics were balanced. HPV-positive patients had significantly higher periodontitis risk, with a hazard ratio (HR) = 3.00 (95% CI: 2.67-3.37). Sensitivity analyses showed consistent findings. Age-stratified HRs were 3.74 (95% CI: 3.28-4.26) for 18-64 years old and 1.79 (95% CI: 1.13-2.84) for ≥65 years old. In racial stratification, White and Asian HPV patients presented significant risk of periodontitis.

conclusionHPV infection is associated with a markedly increased risk of periodontitis. These findings support enhanced periodontal screening for HPV-positive patients and warrant further investigation into the viral mechanisms driving chronic oral inflammation. PLAIN LANGUAGE SUMMARY: Human papillomavirus (HPV) is well known for its link to certain cancers, but scientists are now investigating whether it might also play a role in gum disease. In this study, researchers analyzed health records from a large U.S. database to find out if people diagnosed with HPV were more likely to later develop periodontitis. They compared more than 270,000 adults with HPV with a similar group without the virus, making sure that both groups were alike in terms of age, health conditions, and other factors. The results showed that people with HPV had about three times the risk of developing periodontitis. This connection remained strong even when the researchers looked at different age groups, timeframes, and health backgrounds. Younger adults and those who were White or Asian showed particularly high risks. These findings suggest that HPV may play a role in long-term gum inflammation and damage. Although the study does not prove cause and effect, it highlights the need for more research and suggests that people with HPV might benefit from regular dental checkups to catch and manage gum disease early.