Abstract
BACKGROUND: Periodontitis is a chronic inflammatory disease associated with oxidative stress. The Oxidative Balance Score (OBS) is a composite measure of dietary and lifestyle factors that reflect the balance between pro-oxidants and antioxidants. Recently, there has been growing interest in research examining the connection between oxidative balance scores (OBS) and periodontitis. However, the nature of this relationship, particularly whether it follows a linear or non-linear pattern, remains unclear. This study aimed to explore association between OBS and periodontitis using data from the National Health and Nutrition Examination Survey (NHANES 2009-2014.). METHODS: We conducted a cross-sectional study using data from NHANES 2009-2014. A total of 10,714 participants with a mean age of 32.60 years (SD = 24.91) were included in this study. Periodontitis was defined based on clinical periodontal examinations, and OBS was calculated using dietary and lifestyle factors. A generalized additive model was used to explore the nonlinear relationship between OBS and periodontitis. A two-piecewise linear regression model was employed to identify the threshold effect of OBS on periodontitis. RESULTS: The study found a nonlinear relationship between OBS and periodontitis. When OBS was less than 16, the odds ratio (OR) for periodontitis was 0.74 (95% CI: 0.50-1.09, P = 0.13). However, when OBS was greater than 16, the OR for periodontitis significantly decreased to 0.14 (95% CI: 0.09-0.20, P < 0.001). The threshold effect of OBS on periodontitis was identified at 16. CONCLUSION: This study demonstrates a nonlinear relationship between OBS and periodontitis, with a significant reduction in the risk of periodontitis when OBS exceeds 16.