Physical activity and periodontitis among US adults

Abstract Aim Periodontitis is a chronic inflammatory disease and leading cause of tooth loss among US adults. Beyond smoking and socioeconomic factors, modifiable lifestyle behaviors affecting systemic inflammation may influence periodontal health. Physical activity reduces inflammation, yet its association with periodontitis remains inconsistent. This study examined this relationship using nationally representative US data. Subject and methods We analyzed cross-sectional data from the National Health and Nutrition Examination Survey 2009 to 2014 among 6590 adults aged 20 years or older with complete data; pregnant individuals and those with diabetes were excluded. Physical activity was self-reported and categorized as none, moderate, or heavy. Periodontitis was defined using Centers for Disease Control and Prevention and American Academy of Periodontology criteria. Multivariable logistic regression examined associations, adjusting for demographic, socioeconomic, and behavioral factors. Results Overall, 31.2% of participants had periodontitis. In unadjusted analyses, both moderate and heavy physical activity were associated with lower odds of periodontitis compared with no activity. After full adjustment for age, sex, race/ethnicity, education, income, body mass index, smoking, and alcohol use, moderate physical activity remained significantly associated with lower odds of periodontitis (odds ratio [OR] = 0.72; 95% confidence interval [CI] 0.63–0.83), whereas the association for heavy activity was attenuated and not statistically significant (OR = 0.89; 95% CI 0.77–1.03). Conclusion Moderate physical activity was independently associated with lower prevalence of periodontitis among US adults. These findings support the potential role of regular physical activity as part of broader lifestyle strategies for periodontal health, though longitudinal studies are needed to clarify causality.