{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:36:58Z","timestamp":1791211018506,"version":"4.1.0"},"reference-count":59,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"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>(1) Background: Benzene, environmental pollutant, is linked to various adverse health effects, but its impact on oral health remains under-explored. This study examines the association between blood benzene levels and periodontitis, a progressive oral inflammatory condition, using a nationally representative sample of U.S. adults. (2) Methods: Cross sectional data from the 2013\u20132014 National Health and Nutrition Examination Survey (NHANES) were analyzed. Periodontitis was defined per CDC\/AAP. Three weighted multivariable logistic regression models determined the association between blood benzene levels and periodontal severity, adjusting for potential confounders. A structural equation modeling (SEM) analysis evaluated cotinine, smoking biomarker, as a mediator in the relationship between benzene and severe periodontitis. (3) Results: The ordinal logistic regression showed a statistically significant association (AOR = 2.0, p = 0.02) between blood benzene levels and periodontal severity. A one unit increase in blood benzene was associated twice the odds of progressing to a higher category of periodontitis. Benzene exposure was significantly linked to severe periodontitis (AOR = 2.9, p = 0.001). SEM analysis indicated cotinine mediates the relationship between blood benzene and sever periodontitis. (4) Conclusions: This study provides evidence that higher blood benzene levels are associated with severe periodontitis. The findings suggest that cotinine, a biomarker of smoking, mediates the relationship between benzene exposure and severe periodontitis.<\/jats:p>","DOI":"10.3390\/ijerph22060853","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T09:22:41Z","timestamp":1748596961000},"page":"853","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association Between Blood Benzene Levels and Periodontal Disease in a Nationally Representative Adult U.S. Population"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2357-7818","authenticated-orcid":false,"given":"Basel","family":"Hamoud","sequence":"first","affiliation":[{"name":"Ministry of Health, Kuwait City 15462, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3098-9039","authenticated-orcid":false,"given":"Meshari","family":"Alfailakwi","sequence":"additional","affiliation":[{"name":"Ministry of Health, Kuwait City 15462, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hessah","family":"Aljalahmah","sequence":"additional","affiliation":[{"name":"Ministry of Health, Kuwait City 15462, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatema","family":"Almael","sequence":"additional","affiliation":[{"name":"Ministry of Health, Kuwait City 15462, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Alsaeedi","sequence":"additional","affiliation":[{"name":"Ministry of Health, Kuwait City 15462, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Saleh","sequence":"additional","affiliation":[{"name":"Ministry of Health, Kuwait City 15462, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0376-0996","authenticated-orcid":false,"given":"Bushra","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Dental Medicine, Tufts University, Boston, MA 02111, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hend","family":"Alqaderi","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Dental Medicine, Tufts University, Boston, MA 02111, USA"},{"name":"Dasman Diabetes Institute, Kuwait City 15462, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17038","DOI":"10.1038\/nrdp.2017.38","article-title":"Periodontal diseases","volume":"3","author":"Kinane","year":"2017","journal-title":"Nat. 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