{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T05:00:58Z","timestamp":1780290058698,"version":"3.54.0"},"reference-count":41,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The contribution of oral inflammatory conditions to systemic disease burden remains underexplored within multimorbidity frameworks. Emerging evidence suggests that periodontal inflammation may play a role in the clustering of chronic diseases, yet few studies have evaluated this at a population level using robust datasets. The aims of this study were to investigate whether periodontal diseases are associated with Multiple long-term conditions (MLTCs) burden and severity in two population-based cohorts and to examine whether systemic inflammatory biomarkers mediate these associations. Materials and Methods: We analyzed two population-based cohorts: the UK Biobank (UKB; n = 500,612) and the US National Health and Nutrition Examination Survey (NHANES; n = 10,714). MLTCs were defined as the coexistence of \u22652 chronic diseases. Associations between periodontal diseases and MLTCs were assessed using multivariable logistic and multinomial logistic regression. Causal mediation analyses examined the contribution of systemic inflammatory markers. Results: Approximately half of all participants had MLTCs. The prevalence of periodontal diseases was 17.8% in UKB (self-reported symptoms), and 42.3% in NHANES (clinically assessed). Periodontal diseases were independently associated with greater odds of MLTCs in both UKB (OR 1.12; 95% CI 1.10\u20131.14) and NHANES (OR 1.22; 95% CI 1.09\u20131.37). Associations were stronger among adults aged \u2264 60 years. A consistent dose-response relationship was observed between periodontal status and the number and severity of chronic conditions, as well as inflammatory-related MLTCs. Mediation analyses suggested partial effects through white blood cell count, neutrophils, and C-reactive protein. Conclusions: Periodontal inflammation is independently associated with greater multimorbidity burden, particularly in younger adults. Systemic inflammation may offer a plausible biological link, and these findings position oral health as an underrecognized and modifiable target in multimorbidity prevention and management frameworks, warranting prospective investigation.<\/jats:p>","DOI":"10.3390\/jcm15114029","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T13:12:08Z","timestamp":1779455528000},"page":"4029","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oral Health, Inflammation, and the Burden of Multiple Long-Term Conditions: Cross-Sectional Analyses from UK Biobank and NHANES"],"prefix":"10.3390","volume":"15","author":[{"given":"Nisachon","family":"Siripaiboonpong","sequence":"first","affiliation":[{"name":"Periodontology Unit, UCL Eastman Dental Institute, London WC1E 6BT, UK"},{"name":"Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok 10120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanie","family":"Suvan","sequence":"additional","affiliation":[{"name":"Oral Sciences Research Group, Glasgow Dental School, School of Medicine, Dentistry & Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow G2 3JZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Sharma","sequence":"additional","affiliation":[{"name":"Periodontal Research Group, Institute of Clinical Sciences, University of Birmingham and Birmingham Community Healthcare NHS Foundation Trust, Birmingham B5 7EG, UK"},{"name":"NIHR Birmingham Biomedical Research Centre in Inflammation, Birmingham B15 2TH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attawood","family":"Lertpimonchai","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok 10120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1088-2046","authenticated-orcid":false,"given":"Crystal","family":"Marruganti","sequence":"additional","affiliation":[{"name":"Unit of Periodontology, Endodontology, and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8654-935X","authenticated-orcid":false,"given":"Francesco","family":"D\u2019Aiuto","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust, London W6 8RF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","unstructured":"Mercer, S., Furler, J., Moffat, K., Fischbacher-Smith, D., and Sanci, L. 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