{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:36:43Z","timestamp":1788561403989,"version":"build-2803163510"},"reference-count":53,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC113-2629-B-532-001"],"award-info":[{"award-number":["NSTC113-2629-B-532-001"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC112-2314-B-038-141"],"award-info":[{"award-number":["NSTC112-2314-B-038-141"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC111-2320-B-532-001-MY3"],"award-info":[{"award-number":["NSTC111-2320-B-532-001-MY3"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Both atopic dermatitis (AD) and periodontitis are common chronic inflammatory diseases. However, the association between AD and periodontitis remains poorly understood. This study aimed to evaluate the effects of dental scaling (DS) on the risk of AD among patients with periodontitis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>In this retrospective cohort study using health insurance data, we identified individuals aged \u226520 years with periodontitis and a matched cohort without a history of periodontitis in Taiwan from 2011 to 2015. Age- and sex-matching was applied to select controls (ratio\u2009=\u20091:1). Both cohorts were followed until the end of 2017 to monitor atopic dermatitis (AD) incidence. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for AD risk associated with periodontitis were estimated using multivariate Cox regression. Among patients with periodontitis, we compared the risk of AD between those who received DS and those who did not.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>During the follow-up period, patients with periodontitis had an increased risk of AD compared with those without periodontitis (HR 2.47, 95% CI 2.25\u20132.71). The association between periodontitis and increased risk of AD was significant in men (HR 2.68, 95% CI 2.33\u20133.08), women (HR 2.35, 95% CI 2.07\u20132.66), and people in every age group. Among patients with periodontitis (n\u2009=\u200938,943), DS was associated with a reduced risk of AD (HR 0.33, 95% CI 0.30\u20130.37), and there was a dose-response relationship (p\u2009&lt;\u20090.0001). The beneficial effects of DS on the risk of AD were observed across subgroups. The risk of AD was lowest in patients with periodontitis who received DS more than four times compared with those without DS (HR 0.14, 95% CI 0.08\u20130.25).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In conclusion, our study revealed a significant association between periodontitis and increased risk of atopic dermatitis in Taiwanese adults. Moreover, regular dental scaling may lower this risk, underscoring the value of integrating oral care into managing systemic inflammation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0333877","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T17:29:21Z","timestamp":1760549361000},"page":"e0333877","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk of atopic dermatitis in periodontitis patients with and without dental scaling: A retrospective cohort study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2350-4634","authenticated-orcid":true,"given":"Ming-Che","family":"Chiang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuen-Chau","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Yen","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Chieh","family":"Yeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chen","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ta-Liang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6694-0730","authenticated-orcid":true,"given":"Chien-Chang","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"issue":"10247","key":"pone.0333877.ref001","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/S0140-6736(20)31286-1","article-title":"Atopic dermatitis","volume":"396","author":"SM Langan","year":"2020","journal-title":"Lancet"},{"issue":"12","key":"pone.0333877.ref002","doi-asserted-by":"crossref","DOI":"10.2340\/00015555-3510","article-title":"Prevalence and Incidence of Atopic Dermatitis: A Systematic Review","volume":"100","author":"S Bylund","year":"2020","journal-title":"Acta Derm Venereol"},{"issue":"14","key":"pone.0333877.ref003","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1056\/NEJMra1011040","article-title":"Filaggrin mutations associated with skin and allergic diseases","volume":"365","author":"AD Irvine","year":"2011","journal-title":"N Engl J Med"},{"issue":"2","key":"pone.0333877.ref004","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2332\/allergolint.13-RAI-0564","article-title":"New insights into atopic dermatitis: role of skin barrier and immune dysregulation","volume":"62","author":"DYM Leung","year":"2013","journal-title":"Allergol Int"},{"issue":"5","key":"pone.0333877.ref005","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1111\/bjd.15390","article-title":"The role of the skin microbiome in atopic dermatitis: a systematic review","volume":"177","author":"RD Bjerre","year":"2017","journal-title":"Br J Dermatol"},{"issue":"1","key":"pone.0333877.ref006","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jaci.2018.11.015","article-title":"The microbiome in patients with atopic dermatitis","volume":"143","author":"AS Paller","year":"2019","journal-title":"J Allergy Clin Immunol"},{"issue":"5","key":"pone.0333877.ref007","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1001\/jamadermatol.2014.3324","article-title":"Association of Vitiligo and Alopecia Areata With Atopic Dermatitis: A Systematic Review and Meta-analysis","volume":"151","author":"GC Mohan","year":"2015","journal-title":"JAMA Dermatol"},{"issue":"1","key":"pone.0333877.ref008","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s13223-021-00597-4","article-title":"Atopic dermatitis and risk of autoimmune diseases: a systematic review and meta-analysis","volume":"17","author":"Z Lu","year":"2021","journal-title":"Allergy Asthma Clin Immunol"},{"issue":"1","key":"pone.0333877.ref009","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/prd.12002","article-title":"Inflammatory and immune pathways in the pathogenesis of periodontal disease","volume":"64","author":"A Cekici","year":"2014","journal-title":"Periodontol 2000"},{"issue":"3","key":"pone.0333877.ref010","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1038\/s41368-019-0064-z","article-title":"The cytokine network involved in the host immune response to periodontitis","volume":"11","author":"W Pan","year":"2019","journal-title":"Int J Oral Sci"},{"key":"pone.0333877.ref011","doi-asserted-by":"crossref","unstructured":"Isola G, Polizzi A, Serra S, Boato M, Sculean A. Relationship between periodontitis and systemic diseases: a bibliometric and visual study. Periodontol 2000. 2025 Jan 8. https:\/\/doi.org\/10.1111\/prd.12621","DOI":"10.1111\/prd.12621"},{"issue":"5","key":"pone.0333877.ref012","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/j.ahj.2007.06.037","article-title":"The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: a meta-analysis","volume":"154","author":"AA Bahekar","year":"2007","journal-title":"Am Heart J"},{"issue":"1","key":"pone.0333877.ref013","doi-asserted-by":"crossref","DOI":"10.1136\/bmjdrc-2016-000326","article-title":"Periodontitis as a possible early sign of diabetes mellitus","volume":"5","author":"WJ Teeuw","year":"2017","journal-title":"BMJ Open Diabetes Res Care"},{"issue":"4","key":"pone.0333877.ref014","doi-asserted-by":"crossref","first-page":"101498","DOI":"10.1016\/j.jebdp.2020.101498","article-title":"Periodontitis May Be Associated With Respiratory Diseases Such as Asthma, COPD, and Pneumonia","volume":"20","author":"N Kelly","year":"2020","journal-title":"J Evid Based Dent Pract"},{"issue":"5","key":"pone.0333877.ref015","article-title":"Periodontitis in established rheumatoid arthritis patients: a cross-sectional clinical, microbiological and serological study","volume":"14","author":"M de Smit","year":"2012","journal-title":"Arthritis Res Ther"},{"issue":"31","key":"pone.0333877.ref016","article-title":"Poor oral health is associated with asthma, allergic rhinitis, and atopic dermatitis in Korean adolescents: A cross-sectional study","volume":"99","author":"JH Wee","year":"2020","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"pone.0333877.ref017","doi-asserted-by":"crossref","first-page":"19461","DOI":"10.1038\/s41598-020-76532-1","article-title":"Identification of oral symptoms associated with atopic dermatitis in adolescents: Results from the Korea national representative survey 2009-2017","volume":"10","author":"J-S Shim","year":"2020","journal-title":"Sci Rep"},{"key":"pone.0333877.ref018","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s12901-018-0062-3","article-title":"Allergic rhinitis and periodontitis among Korean adults: results from a nationwide population-based study (2013-2015)","volume":"18","author":"E-J Kim","year":"2018","journal-title":"BMC Ear Nose Throat Disord"},{"key":"pone.0333877.ref019","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1016\/j.jaci.2011.03.023","article-title":"Can oral pathogens influence allergic disease?","volume":"127","author":"SJ Arbes","year":"2011","journal-title":"J Allergy Clin Immunol"},{"issue":"5","key":"pone.0333877.ref020","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1111\/j.1601-0825.2010.01784.x","article-title":"Mechanisms involved in the association between periodontal diseases and cardiovascular disease","volume":"17","author":"R Teles","year":"2011","journal-title":"Oral Dis"},{"issue":"5","key":"pone.0333877.ref021","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1111\/clr.14405","article-title":"Effect of Nonsurgical Mechanical Debridement With or Without Chlorhexidine Formulations in the Treatment of Peri-Implant Mucositis. A Randomized Placebo-Controlled Clinical Trial","volume":"36","author":"G Isola","year":"2025","journal-title":"Clin Oral Implants Res"},{"issue":"6","key":"pone.0333877.ref022","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/j.amjmed.2011.10.034","article-title":"The association of tooth scaling and decreased cardiovascular disease: a nationwide population-based study","volume":"125","author":"Z-Y Chen","year":"2012","journal-title":"Am J Med"},{"key":"pone.0333877.ref023","article-title":"Risk of Periodontitis in People With Atopic Dermatitis: Real-World Evidences","author":"S-C Yang","year":"2025","journal-title":"Oral Dis"},{"issue":"1","key":"pone.0333877.ref024","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1159\/000533434","article-title":"Systemic Type 2 Inflammation-Associated Atopic Dermatitis Exacerbates Periodontitis","volume":"185","author":"Y Liu","year":"2024","journal-title":"Int Arch Allergy Immunol"},{"issue":"12","key":"pone.0333877.ref025","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1111\/jcpe.13372","article-title":"Risk of dementia in patients with periodontitis and related protective factors: A nationwide retrospective cohort study","volume":"47","author":"C-Y Lee","year":"2020","journal-title":"J Clin Periodontol"},{"key":"pone.0333877.ref026","doi-asserted-by":"crossref","first-page":"2085","DOI":"10.2147\/CIA.S228324","article-title":"Risk Of Urticaria In Geriatric Stroke Patients Who Received Influenza Vaccination: A Retrospective Cohort Study","volume":"14","author":"F Lam","year":"2019","journal-title":"Clin Interv Aging"},{"key":"pone.0333877.ref027","doi-asserted-by":"crossref","first-page":"1210449","DOI":"10.3389\/fphys.2023.1210449","article-title":"Role of oxidative stress in the relationship between periodontitis and systemic diseases","volume":"14","author":"J Shang","year":"2023","journal-title":"Front Physiol"},{"key":"pone.0333877.ref028","first-page":"931083","article-title":"Systemic oxidative stress biomarkers in chronic periodontitis: a meta-analysis","volume":"2014","author":"Z Liu","year":"2014","journal-title":"Dis Markers"},{"key":"pone.0333877.ref029","doi-asserted-by":"crossref","first-page":"2721469","DOI":"10.1155\/2016\/2721469","article-title":"Oxidative Stress in Atopic Dermatitis","volume":"2016","author":"H Ji","year":"2016","journal-title":"Oxid Med Cell Longev"},{"issue":"3","key":"pone.0333877.ref030","doi-asserted-by":"crossref","first-page":"196","DOI":"10.3390\/antiox9030196","article-title":"Oxidative Stress and Atopic Dermatitis","volume":"9","author":"L Bertino","year":"2020","journal-title":"Antioxidants (Basel)"},{"issue":"2","key":"pone.0333877.ref031","first-page":"72","article-title":"Prevalence of periodontal disease, its association with systemic diseases and prevention","volume":"11","author":"MA Nazir","year":"2017","journal-title":"Int J Health Sci (Qassim)"},{"issue":"2","key":"pone.0333877.ref032","first-page":"122","article-title":"Atopic dermatitis and dental manifestations","volume":"152","author":"C Perugia","year":"2017","journal-title":"G Ital Dermatol Venereol"},{"issue":"6","key":"pone.0333877.ref033","first-page":"48","article-title":"The Association Between Oral Health and Skin Disease","volume":"13","author":"P Macklis","year":"2020","journal-title":"J Clin Aesthet Dermatol"},{"issue":"7","key":"pone.0333877.ref034","article-title":"C-Reactive Protein (CRP) and its Association with Periodontal Disease: A Brief Review","volume":"8","author":"T Bansal","year":"2014","journal-title":"J Clin Diagn Res"},{"issue":"12","key":"pone.0333877.ref035","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/j.jamda.2013.05.009","article-title":"Proinflammatory cytokines, aging, and age-related diseases","volume":"14","author":"M Michaud","year":"2013","journal-title":"J Am Med Dir Assoc"},{"issue":"21","key":"pone.0333877.ref036","doi-asserted-by":"crossref","first-page":"15592","DOI":"10.3390\/ijms242115592","article-title":"Association of Periodontitis and Atopic Dermatitis with the Levels of IL-13, IL-31, and TSLP in the Gingival Crevicular Fluid","volume":"24","author":"C Jim\u00e9nez","year":"2023","journal-title":"Int J Mol Sci"},{"key":"pone.0333877.ref037","doi-asserted-by":"crossref","first-page":"424","DOI":"10.2174\/1874210601812010424","article-title":"Oral Aspects Identified in Atopic Dermatitis Patients: A Literature Review","volume":"12","author":"ADT Oliveira","year":"2018","journal-title":"Open Dent J"},{"issue":"8","key":"pone.0333877.ref038","doi-asserted-by":"crossref","first-page":"2867","DOI":"10.3390\/ijms21082867","article-title":"Skin Barrier Abnormalities and Immune Dysfunction in Atopic Dermatitis","volume":"21","author":"G Yang","year":"2020","journal-title":"Int J Mol Sci"},{"key":"pone.0333877.ref039","article-title":"Filaggrin gene defects and risk of developing allergic sensitisation and allergic disorders: systematic review and meta-analysis","volume":"339","author":"RAHM van den Oord","year":"2009","journal-title":"BMJ"},{"issue":"3","key":"pone.0333877.ref040","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1111\/j.1398-9995.2010.02493.x","article-title":"Mutations in the filaggrin gene in Han Chinese patients with atopic dermatitis","volume":"66","author":"H Zhang","year":"2011","journal-title":"Allergy"},{"issue":"6","key":"pone.0333877.ref041","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1038\/sj.jid.5701208","article-title":"Filaggrin expression in oral, nasal, and esophageal mucosa","volume":"128","author":"A De Benedetto","year":"2008","journal-title":"J Invest Dermatol"},{"issue":"3","key":"pone.0333877.ref042","doi-asserted-by":"crossref","first-page":"152","DOI":"10.2478\/folmed-2014-0022","article-title":"Subgingival microbial profile and production of proinflammatory cytokines in chronic periodontitis","volume":"56","author":"VT Dosseva-Panova","year":"2014","journal-title":"Folia Med (Plovdiv)"},{"issue":"4","key":"pone.0333877.ref043","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/jcpe.12381","article-title":"Java project on periodontal diseases: periodontal bone loss in relation to environmental and systemic conditions","volume":"42","author":"A Amaliya","year":"2015","journal-title":"J Clin Periodontol"},{"issue":"9","key":"pone.0333877.ref044","doi-asserted-by":"crossref","first-page":"16106","DOI":"10.1038\/nmicrobiol.2016.106","article-title":"Whole metagenome profiling reveals skin microbiome-dependent susceptibility to atopic dermatitis flare","volume":"1","author":"KR Chng","year":"2016","journal-title":"Nat Microbiol"},{"issue":"8","key":"pone.0333877.ref045","article-title":"Inverse Association Between the Skin and Oral Microbiota in Atopic Dermatitis","volume":"139","author":"W Li","year":"2019","journal-title":"J Invest Dermatol"},{"issue":"14","key":"pone.0333877.ref046","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1093\/eurheartj\/ehy836","article-title":"Improved oral hygiene care attenuates the cardiovascular risk of oral health disease: a population-based study from Korea","volume":"40","author":"S-Y Park","year":"2019","journal-title":"Eur Heart J"},{"key":"pone.0333877.ref047","article-title":"Effect of professional mechanical plaque removal on secondary prevention of periodontitis and the complications of gingival and periodontal preventive measures: consensus report of group 4 of the 11th European Workshop on Periodontology on effective prevention of periodontal and peri-implant diseases","author":"M Sanz","year":"2015","journal-title":"J Clin Periodontol"},{"key":"pone.0333877.ref048","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.c2451","article-title":"Toothbrushing, inflammation, and risk of cardiovascular disease: results from Scottish Health Survey","volume":"340","author":"C de Oliveira","year":"2010","journal-title":"BMJ"},{"issue":"8","key":"pone.0333877.ref049","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1902\/jop.2003.74.8.1231","article-title":"Antimicrobial periodontal treatment decreases serum C-reactive protein, tumor necrosis factor-alpha, but not adiponectin levels in patients with chronic periodontitis","volume":"74","author":"Y Iwamoto","year":"2003","journal-title":"J Periodontol"},{"issue":"1","key":"pone.0333877.ref050","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/pai.13335","article-title":"Global differences in atopic dermatitis","volume":"32","author":"NHA Suaini","year":"2021","journal-title":"Pediatr Allergy Immunol"},{"issue":"3","key":"pone.0333877.ref051","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/s13555-021-00516-w","article-title":"Epidemiology and Characterization of Atopic Dermatitis in East Asian Populations: A Systematic Review","volume":"11","author":"J Cheng","year":"2021","journal-title":"Dermatol Ther (Heidelb)"},{"issue":"6","key":"pone.0333877.ref052","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1111\/1346-8138.14881","article-title":"Dietary habits in adult Japanese patients with atopic dermatitis","volume":"46","author":"M Ito","year":"2019","journal-title":"J Dermatol"},{"issue":"3","key":"pone.0333877.ref053","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/1346-8138.12065","article-title":"Consensus guidelines for the management of atopic dermatitis: an Asia-Pacific perspective","volume":"40","author":"D Rubel","year":"2013","journal-title":"J Dermatol"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0333877","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T17:29:30Z","timestamp":1760549370000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0333877"}},"subtitle":[],"editor":[{"given":"Andrej M","family":"Kielbassa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,10,15]]},"references-count":53,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,15]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0333877","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,15]]}}}