Metabolic syndrome/lifestyle diseases such as hypertension, diabetes mellitus and obesity are associated with overactive bladder (OAB) and other lower urinary tract symptoms (LUTS). Chronic periodontitis, the leading cause of tooth loss in the elderly, is also associated with metabolic syndrome/lifestyle diseases. However, few studies have examined the relationship between tooth loss/chronic periodontitis and LUTS/OAB. This study aimed to determine the relationship between LUTS/OAB and tooth loss.

Individuals aged >40 years who had not been treated for LUTS, and who had lost teeth due to chronic periodontitis were enrolled in the study. 
Participants were divided into two groups: the OAB group and non-OAB group according to the Overactive Bladder Symptom Score (OABSS). Individuals with tooth loss from dental caries or external trauma, LUTS due to neurological disease, and males with a prostate size >30g were excluded. OAB was defined as a score ≥2 on OABSS item Q3 (urgency) and a total score ≥3. Multivariate analysis was conducted to assess the relationship between the number of lost teeth and symptoms of LUTS/OAB. All participants provided written informed consent.

A total of 232 participants (OAB group: n=103, non-OAB group: n=129) were enrolled. Their mean age was 70.1±10.5 years and 65.7±10.9 years in the OAB group and non-OAB group, respectively (P=0.001). The number of remaining teeth was 12.8±8.8 and 21.5±8.5 in the OAB group and non-OAB group, respectively (P<0.001). There was a statistically significant inverse association between the number of remaining teeth and each of the OABSS items and the total OABSS (daytime frequency: r=-0.416, P<0.001; nighttime frequency: r=-0.525, P<0.001; urinary urgency: r=-0.474, P<0.001; urgency incontinence: r=-0.290, P<0.001; total OABSS: r=-0.572, P<0.001). The number of remaining teeth was also significantly associated with the voided volume (r=0.303, P<0.001), and maximum flow rate (r=0.219, P<0.001), but was not significantly associated with residual urine volume (r=-0.125, P=0.06). There was a significant inverse association between the number of remaining teeth and serum C-reactive protein (CRP) level (r=-0.264, P<0.001). With the exception of urgency incontinence, serum CRP level was significantly associated with each OABSS item and the total OABSS (daytime frequency: r=0.152, P=0.02; nighttime frequency: r=0.247, P<0.001; urinary urgency: r=0.262, P<0.001; urgency incontinence: r=0.115, P=0.08; total OABSS: r=0.270, P<0.001). Multivariate analysis revealed that the number of lost teeth was an independent risk factor for OAB (odds ratio: 1.08, 95% confidence interval:1.04-1.14, P<0.001).

OAB was correlated with the tooth loss and systemic, chronic inflammation. In addition, the severity of OAB was correlated with the tooth loss; thus future studies should focus on the utility of oral care as a means to prevent OAB.

In this study, it was suggested that there is a relationship between the number of remaining teeth and LUTS including OAB.