Association of dental diseases with pulmonary outcomes in a multicenter cohort of adolescents and young adults with CF.

CF is associated with multiple risk factors for caries and gingivitis, which in turn are potential risk factors for poor lung health, mediated through aspiration of dysbiotic oral microbiota. Nonetheless, the association between dental diseases and respiratory outcomes in CF has not previously been evaluated. Here, we report the baseline cross-sectional associations between dental diseases (caries and gingivitis) and respiratory outcomes (FEV1 and the respiratory domain of the CFQ-R) modeled using linear regression with adjustment for appropriate covariates from an ongoing multicenter, prospective cohort study enrolling people with CF ages 12 to 30. Among 203 participants (mean (SD) age at enrollment of 18.7 (5.0) years, 86% on elexacftor-tezacaftor-ivacaftor or ivacaftor)), we found that ≥3 surfaces with untreated caries was associated with a mean decrement of -0.88 (95% CI -1.61, -0.16, p = 0.02) in FEV1 z score compared to no untreated caries, and a mean decrement of -11.7 (95% CI -20.7, -2.7, p = 0.01) in the CFQ-R respiratory domain. We did not observe an association between gingivitis and respiratory outcomes. Our results suggest that poor oral health could be a modifiable risk factor for worse lung health in CF, and that prevention and treatment of dental caries could potentially improve respiratory health in adolescents and young adults with CF, even in the post-modulator era.