{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:53:44Z","timestamp":1760144024439,"version":"build-2065373602"},"reference-count":44,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T00:00:00Z","timestamp":1710115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research Foundation of Korea funded by the Ministry of Education","award":["2021R1I1A1A01059868","RS-2023-00262087"],"award-info":[{"award-number":["2021R1I1A1A01059868","RS-2023-00262087"]}]},{"name":"Korea Health Technology R&amp;D Project through the Korea Health Industry Development Institute (KHIDI)","award":["2021R1I1A1A01059868","RS-2023-00262087"],"award-info":[{"award-number":["2021R1I1A1A01059868","RS-2023-00262087"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The aim of this study was to evaluate the association of oral health status and habits with the occurrence of ankylosing spondylitis (AS) in a nationwide population-based cohort in a longitudinal setting. Methods: A total of 2,415,963 individuals aged 40\u201379 years who underwent oral health examinations were included from the National Health Insurance Service-National Health Screening (NHIS-HEALS) cohort of Korea between 2003 and 2004. The occurrence of AS was analyzed according to the oral health status and oral hygiene habits. Results: Among 2,271,221 of the participants, AS occurred in 6366 (0.3%) participants over 16.7 years. The likelihood of AS was higher in participants who had periodontitis (hazard ratio [HR]: 1.33, 95% confidence interval [CI]: 1.20\u20131.46, p &lt; 0.0001) and more missing teeth (HR: 1.68, 95% CI: 1.42\u20131.99, p &lt; 0.0001). However, better oral hygiene habits such as frequent tooth brushing (HR: 0.77, 95% CI: 0.71\u20130.83, p &lt; 0.0001) and a history of dental scaling within the last year (HR 0.88, 95% CI 0.82\u20130.95, p = 0.001) were associated with a lower occurrence of AS. Conclusions: Periodontitis and an increased number of missing teeth could be related to the occurrence of late-onset AS. Improved oral hygiene care may attenuate the likelihood of late-onset AS.<\/jats:p>","DOI":"10.3390\/jcm13061606","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T07:25:32Z","timestamp":1710141932000},"page":"1606","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Improved Oral Health Is Associated with a Lower Risk of Late Onset Ankylosing Spondylitis: A Nationwide Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6414-9187","authenticated-orcid":false,"given":"Min Kyung","family":"Chung","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0345-2278","authenticated-orcid":false,"given":"Yoonkyung","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul 07985, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5297-5059","authenticated-orcid":false,"given":"Jung-Hyun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul 07985, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gwang Hyun","family":"Leem","sequence":"additional","affiliation":[{"name":"Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9937-762X","authenticated-orcid":false,"given":"Tae-Jin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul 07804, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1038\/nrrheum.2017.56","article-title":"Pathogenesis of ankylosing spondylitis\u2014Recent advances and future directions","volume":"13","author":"Ranganathan","year":"2017","journal-title":"Nat. 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