{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:29:51Z","timestamp":1790281791504,"version":"4.1.0"},"reference-count":43,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2019,3,3]],"date-time":"2019-03-03T00:00:00Z","timestamp":1551571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Xerostomia (dry mouth) is the cardinal symptom of Sj\u00f6gren\u2019s syndrome (SS), which is an autoimmune disease involving the exocrine glands and other organs. Xerostomia may predispose patients to periodontal disease (PD) and an association between SS and PD has been reported. This association may be bidirectional; therefore, we conducted this study to investigate the risk of SS in patients with PD using data from the National Health Insurance Research Database of Taiwan. A total of 135,190 patients were enrolled in our analysis. In all, 27,041 patients with PD were matched by gender, age, insured region, urbanization and income, with cases and controls in a 1:4 ratio. Both groups were followed and the risks of SS were calculated by Cox proportional hazards regression. Finally, 3292 (2.4%) patients had newly diagnosed SS. Patients with PD had a significantly higher risk of subsequent SS (903 (3.3%) vs. 2389 (2.2%), adjusted hazard 1.47, 95% confidence interval: 1.36\u20131.59). In conclusion, patients with PD had an approximately 50% increased risk of subsequent SS. Physicians should be aware of the symptoms and signs of SS in patients with PD.<\/jats:p>","DOI":"10.3390\/ijerph16050771","type":"journal-article","created":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T05:45:36Z","timestamp":1551678336000},"page":"771","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Association between Periodontal Disease and Subsequent Sj\u00f6gren\u2019s Syndrome: A Nationwide Population-Based Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4630-8724","authenticated-orcid":false,"given":"Chien-Yu","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu City 30071, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien-Fu","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Dentistry and Oral Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 33004, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3868-085X","authenticated-orcid":false,"given":"Jui-Ming","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 33004, Taiwan"},{"name":"Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng-Chang","family":"Chuang","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 33004, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1677-8901","authenticated-orcid":false,"given":"Wei-Te","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu City 30071, Taiwan"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence Yu-Min","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City 30071, Taiwan"},{"name":"Department of Medical Science &amp; Institute of Bioinformatics and Structural Biology, National Tsing Hua University, Hsinchu City 30071, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chin","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu City 30071, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren-Jun","family":"Hsu","sequence":"additional","affiliation":[{"name":"Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan"},{"name":"Cancer Medicine Center of Buddhist Hualien Tzu Chi Hospital, Tzu Chi University, Hualien 97002, Taiwan"},{"name":"Department of Pathology and Graduate Institute of Pathology and Parasitology, The Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"191","DOI":"10.7150\/ijms.17718","article-title":"Reviewing primary sjogren\u2019s syndrome: Beyond the dryness\u2014From pathophysiology to diagnosis and treatment","volume":"14","author":"Both","year":"2017","journal-title":"Int. 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