Alcohol consumption is associated with periodontitis. A systematic review and meta-analysis of observational studies

OBJECTIVE: To determine whether alcohol consumption is associated with the risk of periodontitis. BASIC RESEARCH DESIGN: Systematic review and meta-analysis of observational studies performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. METHOD: PubMed and Scopus were searched for eligible articles published in English from inception till November 2018. The quality of studies was assessed by the Newcastle Ottawa Scale. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated for the risk of periodontitis associated with highest versus lowest/non-alcohol in a random effects meta-analysis model. Heterogeneity and sensitivity were investigated in meta regression analysis. A funnel plot was used to assess publication bias. RESULTS: Twenty-nine observational studies were included. One study with two separate datasets was considered as two separate studies for analysis. Alcohol consumption was significantly associated with the presence of periodontitis (OR = 1.26, 95% CI= 1.11-1.41). Significant heterogeneity (I2=71%) was present in the overall analysis, primarily attributable to sampling cross-sectional studies (I2=76.6%). A funnel plot and Egger tests (p=0.0001) suggested the presence of publication bias. CONCLUSION: Alcohol consumption was associated with increased occurrence of periodontitis and should be considered as a parameter in periodontal risk assessment. Publication bias should be explored in future studies.