Increased risk of dry eye disease in Taiwanese patients with chronic periodontitis: A nationwide population-based cohort study

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Available online 26 December 2025

Journal of Dental SciencesAuthor links open overlay panel, , , AbstractBackground/purpose

Dry eye disease (DED) is an extremely common ocular disease worldwide. Inflammation plays a significant role in the development and the progression of DED as well as chronic periodontitis (CP). The association between DED and CP is worth for further investigation.

Materials and methods

A retrospective cohort study was conducted by using Taiwanese Longitudinal Health Insurance Database. A total of 81996 patients who were newly diagnosed with CP from 2001 to 2012 were selected. A 1:1 propensity-matched controls without any type of periodontal diseases were selected with randomly frequency matched from the general population. The risk of DED was analyzed by Cox proportional hazards regression models, including sex, age, monthly income, urbanization, and comorbidities.

Results

CP group exhibited a significantly increased risk of DED (relative risk: 2.62, 95 % confidence interval (CI): 2.52–2.73) as compared with non-CP group. Multivariate Cox regression analysis indicated that the incidence rate of DED was significantly higher in CP group than those who in non-CP group (adjusted hazard ratio: 2.61, 95 % CI: 2.51–2.72). Female patients had a 2.09-fold higher risk of DED than male patients (95 % CI: 2.01–2.17, P < 0.001). The cumulative incidence of CP patients with DED was significantly higher than that in control subjects (log rank test, P < 0.001).

Conclusion

Taken together, this nationwide retrospective cohort study indicates that the risk of DED is significantly higher in Taiwanese patients with CP than in those without CP. In addition, female patients with CP are more likely to have DED.

Keywords

Dry eye disease

Chronic periodontitis

Nationwide population

Cohort study

Taiwan

© 2025 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.Vé

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