{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T07:27:47Z","timestamp":1771399667033,"version":"3.50.1"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oral Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Peptic ulcer disease (PUD) remains a significant public health issue, with established risk factors including Helicobacter pylori infection, nonsteroidal anti-inflammatory drugs (NSAID) use, and lifestyle factors. Emerging evidence suggests a link between poor oral health and systemic diseases, yet its association with PUD is understudied, particularly in Central and Eastern Europe. This study aimed to investigate the relationship between oral health status and the presence of PUD in a nationally representative Hungarian population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using cross-sectional data from the 2,019 European Health Interview Survey in Hungary (EHIS), we analyzed oral health indicators (decayed teeth, bleeding gums, loose teeth, tooth extractions, dental restorations, and self-perceived oral health) and constructed a composite oral health status via exploratory factor analysis. Multivariable logistic regression assessed the association between oral health and self-reported PUD, adjusting for sociodemographic, lifestyle, mental health, and comorbidity factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Active dental and periodontal disease (OR\u2009=\u20091.54, 95% CI: 1.07\u20132.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017) and a history of dental and periodontal disease (OR\u2009=\u20092.17, 95% CI: 1.01\u20134.67,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047) were significantly associated with higher odds of self-reported PUD. Older age, female sex, smoking, depression, and selected comorbidities were also associated with PUD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Poor oral health, particularly indicators of active periodontal disease, was independently associated with PUD in this nationally representative cross-sectional sample. These findings suggest a potential connection between oral health status and gastrointestinal health, which warrants further investigation in longitudinal studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/froh.2026.1739255","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T06:54:10Z","timestamp":1771397650000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between oral health status and peptic ulcer disease: evidence from a nationally representative survey in Hungary"],"prefix":"10.3389","volume":"7","author":[{"given":"Battamir","family":"Ulambayar","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Faculty of Health Sciences, University of Debrecen","place":["Debrecen, Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amr Sayed","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Faculty of Health Sciences, University of Debrecen","place":["Debrecen, Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Attila Csaba","family":"Nagy","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Faculty of Health Sciences, University of Debrecen","place":["Debrecen, Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1007\/s11938-020-00277-z","article-title":"Burden of gastroduodenal diseases from the global perspective","volume":"18","author":"Milivojevic","year":"2020","journal-title":"Curr Treat Options Gastro"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e0271284","DOI":"10.1371\/journal.pone.0271284","article-title":"Quality of care of peptic ulcer disease worldwide: a systematic analysis for the global burden of disease study 1990\u20132019","volume":"17","author":"Abbasi-Kangevari","year":"2022","journal-title":"PLoS One"},{"key":"B3","year":""},{"key":"B4","doi-asserted-by":"publisher","first-page":"e0325821","DOI":"10.1371\/journal.pone.0325821","article-title":"Global burden and risk factors of peptic ulcer disease between 1990 and 2021: an analysis from the global burden of disease study 2021","volume":"20","author":"Hao","year":"2025","journal-title":"PLoS One"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.3390\/jcm13041063","article-title":"The prevalence, etiology and treatment of gastroduodenal ulcers and perforation: a systematic review","volume":"13","author":"Amalia","year":"2024","journal-title":"JCM"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2225","DOI":"10.3390\/ph3072225","article-title":"Nonsteroidal anti-inflammatory drug-induced gastroduodenal bleeding: risk factors and prevention strategies","volume":"3","author":"Venerito","year":"2010","journal-title":"Pharmaceuticals"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2034","DOI":"10.2174\/1381612824666180510092303","article-title":"Lifestyle and peptic ulcer disease","volume":"24","author":"Yegen","year":"2018","journal-title":"CPD"},{"key":"B8","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1016\/j.amjmed.2023.11.022","article-title":"Oral health and cardiovascular disease","volume":"137","author":"Hopkins","year":"2024","journal-title":"Am J Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"S1968","DOI":"10.4103\/jpbs.jpbs_469_24","article-title":"Diabetes and oral health: advancements in prevention, screening and treatment of periodontal diseases","volume":"16","author":"Parihar","year":"2024","journal-title":"Journal of Pharmacy and Bioallied Sciences"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1854","DOI":"10.3390\/biomedicines12081854","article-title":"Oral health and \u201cmodern\u201d digestive diseases: pathophysiologic and etiologic factors","volume":"12","author":"Rotaru","year":"2024","journal-title":"Biomedicines"},{"key":"B11","doi-asserted-by":"publisher","first-page":"105213","DOI":"10.1016\/j.jdent.2024.105213","article-title":"The impact of oral diseases on respiratory health and the influence of respiratory infections on the oral microbiome","volume":"148","author":"Gupta","year":"2024","journal-title":"J Dent"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e70052","DOI":"10.1002\/mco2.70052","article-title":"Connection between oral health and chronic diseases","volume":"6","author":"Fu","year":"2025","journal-title":"MedComm"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1522892","DOI":"10.3389\/fdmed.2025.1522892","article-title":"Addressing disparities in oral health access and outcomes for aging adults in the United States","volume":"6","author":"Lowenstein","year":"2025","journal-title":"Front Dent Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"4387","DOI":"10.3390\/ijerph17124387","article-title":"Analysis of the relation between periodontitis and chronic gastritis\/peptic ulcer: a cross-sectional study using KoGES HEXA data","volume":"17","author":"Byun","year":"2020","journal-title":"IJERPH"},{"key":"B15","doi-asserted-by":"publisher","first-page":"42","DOI":"10.5539\/gjhs.v4n2p42","article-title":"Association between periodontal disease and peptic ulcers among Japanese workers: mY health up study","volume":"4","author":"Kaneto","year":"2012","journal-title":"Glob J Health Sci"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1263365","DOI":"10.3389\/fendo.2023.1263365","article-title":"Cardiovascular disease and risk factors in adults with diabetes mellitus in Hungary: a population-based study","volume":"14","author":"Ulambayar","year":"2023","journal-title":"Front Endocrinol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e0301466","DOI":"10.1371\/journal.pone.0301466","article-title":"Role of oral health in heart and vascular health: a population-based study","volume":"19","author":"Ghanem","year":"2024","journal-title":"PLoS One"},{"key":"B18","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/j.jad.2008.06.026","article-title":"The PHQ-8 as a measure of current depression in the general population","volume":"114","author":"Kroenke","year":"2009","journal-title":"J Affect Disord"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1016\/j.sapharm.2020.07.027","article-title":"Issues and recommendations for exploratory factor analysis and principal component analysis","volume":"17","author":"Schreiber","year":"2021","journal-title":"Res Soc Admin Pharma"},{"key":"B20","author":"Costello","year":""},{"key":"B21","volume-title":"Stata Statistical Software","year":"2023"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e0207373","DOI":"10.1371\/journal.pone.0207373","article-title":"Association of gastric and duodenal ulcers with anthropometry and nutrients: korean national health and nutrition examination survey (KNHANES II-IV) 2001\u20132009","volume":"13","author":"Lee","year":"2018","journal-title":"PLoS One"},{"key":"B23","doi-asserted-by":"publisher","first-page":"899","DOI":"10.53555\/jptcp.v30i19.3769","article-title":"Exploring the associations of age, sex, and blood group with peptic ulcer disease: a comprehensive study of frequency, clinical manifestations, risk factors, and ulcer types","volume":"30","author":"Zahir","year":"2023","journal-title":"JPTCP"},{"key":"B24","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1093\/ageing\/27.4.427","article-title":"Characteristics of Helicobacter pylori-negative and -positive peptic ulcer disease","volume":"27","author":"Kemppainen","year":"1998","journal-title":"Age Ageing"},{"key":"B25","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s12876-022-02130-2","article-title":"The global, regional and national burden of peptic ulcer disease from 1990 to 2019: a population-based study","volume":"22","author":"Xie","year":"2022","journal-title":"BMC Gastroenterol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1136\/gut.36.6.819","article-title":"Prevalence and incidence of peptic ulcer disease in a Danish county\u2013a prospective cohort study","volume":"36","author":"Rosenstock","year":"1995","journal-title":"Gut"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1465452","DOI":"10.3389\/fpubh.2024.1465452","article-title":"Smoking-attributable peptic ulcer disease mortality worldwide: trends from 1990 to 2021 and projections to 2046 based on the global burden of disease study","volume":"12","author":"Li","year":"2024","journal-title":"Front Public Health"},{"key":"B28","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1136\/gut.52.2.186","article-title":"Risk factors for peptic ulcer disease: a population based prospective cohort study comprising 2416 Danish adults","volume":"52","author":"Rosenstock","year":"2003","journal-title":"Gut"},{"key":"B29","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.jpsychores.2005.08.009","article-title":"The role of psychosocial factors in peptic ulcer disease: beyond Helicobacter pylori and NSAIDs","volume":"60","author":"Jones","year":"2006","journal-title":"J Psychosom Res"},{"key":"B30","doi-asserted-by":"publisher","first-page":"372","DOI":"10.3892\/ijmm.2014.1786","article-title":"Cigarette smoking and gastrointestinal diseases: the causal relationship and underlying molecular mechanisms (review)","volume":"34","author":"Li","year":"2014","journal-title":"Int J Mol Med"},{"key":"B31","doi-asserted-by":"publisher","first-page":"3374","DOI":"10.1111\/j.1572-0241.2000.03347.x","article-title":"The effects of alcohol consumption upon the gastrointestinal tract","volume":"95","author":"Bujanda","year":"2000","journal-title":"Am J Gastroenterol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1186\/s12876-016-0554-9","article-title":"Perceived stress as a risk factor for peptic ulcers: a register-based cohort study","volume":"16","author":"Deding","year":"","journal-title":"BMC Gastroenterol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1128\/CMR.00054-05","article-title":"Pathogenesis of Helicobacter pylori infection","volume":"19","author":"Kusters","year":"2006","journal-title":"Clin Microbiol Rev"},{"key":"B34","doi-asserted-by":"publisher","first-page":"34","DOI":"10.7704\/kjhugr.2025.0004","article-title":"Nonsteroidal anti-inflammatory drug-induced peptic ulcer disease","volume":"25","author":"Ko","year":"2025","journal-title":"Korean J Helicobacter Up Gastrointest Res"},{"key":"B35","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1097\/MOG.0b013e32833e91eb","article-title":"NSAID-induced gastrointestinal and cardiovascular injury","volume":"26","author":"Ng","year":"2010","journal-title":"Curr Opin Gastroenterol"},{"key":"B36","doi-asserted-by":"publisher","first-page":"e3797","DOI":"10.1097\/MD.0000000000003797","article-title":"The association between peptic ulcer disease and ischemic stroke: a population-based longitudinal study","volume":"95","author":"Cheng","year":"2016","journal-title":"Medicine (Baltimore)"},{"key":"B37","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1097\/MEG.0b013e328346a559","article-title":"Risk of acute myocardial infarction and stroke after discharge from in-hospital care due to complicated and uncomplicated peptic ulcer disease","volume":"23","author":"Sadr-Azodi","year":"2011","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"e87952","DOI":"10.1371\/journal.pone.0087952","article-title":"Peptic ulcer disease risk in chronic kidney disease: ten-year incidence, ulcer location, and ulcerogenic effect of medications","volume":"9","author":"Liang","year":"2014","journal-title":"PLoS One"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1111\/jcpe.12015","article-title":"Effect of periodontal therapy on prevention of gastric H elicobacter pylori recurrence: a systematic review and meta-analysis","volume":"39","author":"Bouziane","year":"2012","journal-title":"J Clinic Periodontology"},{"key":"B40","doi-asserted-by":"publisher","first-page":"e49","DOI":"10.1038\/ctg.2013.14","article-title":"A prospective study of periodontal disease and risk of gastric and duodenal ulcer in male health professionals","volume":"5","author":"Boylan","year":"2014","journal-title":"Clin Transl Gastroenterol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/1498525","article-title":"Integrative analysis of deregulated miRNAs reveals candidate molecular mechanisms linking H. pylori infected peptic ulcer disease with periodontitis","volume":"2022","author":"Li","year":"2022","journal-title":"Dis Markers"},{"key":"B42","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1099\/jmm.0.079491-0","article-title":"Detection of Helicobacter pylori DNA in inflamed dental pulp specimens from Japanese children and adolescents","volume":"64","author":"Ogaya","year":"2015","journal-title":"J Med Microbiol"},{"key":"B43","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/j.archoralbio.2010.06.018","article-title":"Presence of Helicobacter pylori in supragingival dental plaque of individuals with periodontal disease and upper gastric diseases","volume":"55","author":"Silva","year":"2010","journal-title":"Arch Oral Biol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1111\/j.1523-5378.2007.00471.x","article-title":"Oral health Status and oral hygiene practices of patients with peptic ulcer and how these affect Helicobacter pylori eradication from the stomach","volume":"12","author":"Namiot","year":"2007","journal-title":"Helicobacter"},{"key":"B45","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1186\/s40001-025-02669-2","article-title":"Increased risk of peptic ulcer following periodontitis: a systematic review and meta-analysis","volume":"30","author":"Motaghi","year":"2025","journal-title":"Eur J Med Res"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.3109\/00365529108998615","article-title":"Dental plaque: a permanent reservoir of Helicobacter pylori?","volume":"26","author":"Desai","year":"1991","journal-title":"Scand J Gastroenterol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1902\/jop.2006.050163","article-title":"Are dental plaque, poor oral hygiene, and periodontal disease associated with Helicobacter pylori infection?","volume":"77","author":"Anand","year":"2006","journal-title":"J Periodontol"}],"container-title":["Frontiers in Oral Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/froh.2026.1739255\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T06:54:11Z","timestamp":1771397651000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/froh.2026.1739255\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,18]]},"references-count":47,"alternative-id":["10.3389\/froh.2026.1739255"],"URL":"https:\/\/doi.org\/10.3389\/froh.2026.1739255","relation":{},"ISSN":["2673-4842"],"issn-type":[{"value":"2673-4842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,18]]},"article-number":"1739255"}}