Association of internal exposure of cadmium and lead with periodontal disease: a study of the Fourth Korean National Health and Nutrition Examination Survey

Aims This study was performed to examine the association of the internal exposure of cadmium and lead with periodontitis in a representative sample of adults, who were involved in the Fourth Korea National Health and Nutrition Examination Survey (KNHANES). Materials and methods One thousand nine hundred and sixty-six subjects over the age of 19 who participated in KNHANES were examined. Cadmium (Cd) and lead (Pb) exposure were grouped into three categories: low (<25th percentile), middle (25th75th percentile) and high (=75th percentile). The periodontal status was assessed by the Community Periodontal Index. The multivariate logistic regression analysis was performed to get the adjusted odds ratio (OR), and subgroup analysis was also performed. All analyses considered a complex sampling design. Results The multivariate logistic regression analysis revealed associations of Cd with periodontitis. Subjects with a high Cd had a 1.57 (95% CI: 1.03-2.38) times higher OR for periodontitis than those with a low Cd. In the subgroup analysis, the association of Pb and Cd with periodontitis was different according to the strata of gender and smoking. Conclusions High Cd could be associated with periodontitis in females and current smokers, and middle Pb showed associations in females and non-smokers among a representative sample of adults in Korea.