1
|
Brooks CV, Maupomé G. Social support associated with restorative treatment, professionally applied fluoride and flossing: A cross-sectional analysis including recent immigrants from Central America and Mexico in the Midwest USA. Community Dent Oral Epidemiol 2024; 52:187-195. [PMID: 37779340 PMCID: PMC10939981 DOI: 10.1111/cdoe.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/08/2023] [Accepted: 09/20/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVES This study examined how Mexican and Central American immigrants' social support was associated with three selected dental outcomes among recent immigrants, prior to the 2020 COVID-19 pandemic. METHODS Using baseline wave data from the 2017-2022 VidaSana study about the health and social networks of Mexican and Central American immigrants living in Indiana, this study utilized logistic and ordinal logistic regression to predict lifetime fluoride use, lifetime dental restoration and flossing frequency, across levels of social support and differences between Mexican and Central American immigrants. RESULTS Data from 547 respondents were included in the present analysis (68% women; mean age 34.4 years [SD 11.2]; Central American 42%; Mexican 58%). Results show a high level of social support was associated with increased probability of fluoride use, dental restoration and higher flossing frequency for Mexican immigrants. However, social support for Central American immigrants was associated with a decreased likelihood of fluoride use, more infrequent flossing, and had no significant association with dental restorations experience. What would be a negative association between Central American immigrants and dental restoration was accounted for by education level and never having been to a dentist. CONCLUSIONS While higher social support was linked to beneficial outcomes for oral health in Mexican immigrants, the opposite was found in Central Americans. These findings highlighted the complexities of social relationships among new immigrants, and potential heterogeneity within the Hispanic population, particularly regarding social and behavioural measures as they pertain to oral health. Further research is needed to identify the underlying mechanisms producing both differences in social support and oral health outcomes.
Collapse
Affiliation(s)
- Caroline V. Brooks
- Indiana University, Department of Sociology, 1020 E. Kirkwood Ave., Bloomington, IN 47405, USA
| | - Gerardo Maupomé
- Indiana University-Purdue University Indianapolis, Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd., Indianapolis, IN 46202, USA
| |
Collapse
|
2
|
Shing TL, Preisser JS, Sotres-Alvarez D, Divaris K, Beck JD. Patterns of site-level periodontal disease and within-mouth correlation among older adults in the Hispanic Community Health Study/Study of Latinos. Community Dent Oral Epidemiol 2023; 51:927-935. [PMID: 36036459 PMCID: PMC9971328 DOI: 10.1111/cdoe.12789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 08/03/2022] [Accepted: 08/15/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Clinical measures of periodontal disease such as attachment loss (CAL) and probing depth (PD) vary considerably between and within individuals with periodontitis and are known to be influenced by person-level factors (e.g. age and race/ethnicity) as well as intraoral characteristics (e.g. tooth type and location). This study sought to characterize site-level disease patterns and correlations using both person-level and intraoral factors through a model-based approach. METHODS This study used full-mouth, six sites per tooth, periodontal examination data collected from 2301 Hispanic/Latino adults aged 60-74 years in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). The presence of site-level CAL ≥3 mm and PD ≥4 mm was estimated using generalized estimating equations (GEE), explicitly modelling pairwise periodontal site correlations, while adjusting for number of teeth, sex and Hispanic/Latino background. Subsequently tooth- and tooth-site patterns of intraoral CAL ≥3 mm and PD ≥4 mm were estimated and visualized in the HCHS/SOL population. RESULTS The findings showed that posterior sites had the highest odds of CAL ≥3 mm and PD ≥4 mm. Sites located in the interproximal space had higher odds of PD ≥4 mm but lower odds of CAL ≥3 mm than non-interproximal sites. Mexicans had the lowest odds of CAL ≥3 mm among all Hispanic/Latino backgrounds. While Mexicans had lower odds of PD ≥4 mm than Central Americans and Cubans, they had higher odds than Dominicans and Puerto Ricans. Site-level proportions and pairwise correlations of PD ≥4 mm were generally smaller than those of CAL ≥3 mm. CONCLUSIONS The patterns of site-level probabilities of clinical measures of periodontal disease can be defined based on tooth, site and individual-level characteristics. Intraoral correlation patterns, while complex, are quantifiable. The risk factors for site-level CAL ≥3 mm may differ from those of PD ≥4 mm. Likewise, participant risk factors for site-level clinical measures of periodontal disease are distinct from those that affect individual-level periodontitis prevalence. Future epidemiological investigations should consider model-based approaches when examining site-level disease probabilities to identify intra-oral patterns of periodontal disease and make inferences about the larger population.
Collapse
Affiliation(s)
- Tracie L Shing
- Department of Biostatistics, Gillings School of Global Public Health University of North Carolina, Chapel Hill, North Carolina, USA
| | - John S Preisser
- Department of Biostatistics, Gillings School of Global Public Health University of North Carolina, Chapel Hill, North Carolina, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kimon Divaris
- Division of Pediatric and Public Health, Adams School of Dentistry University of North Carolina, Chapel Hill, North Carolina, USA
| | - James D Beck
- Division of Comprehensive Oral Health/Periodontology, Adams School of Dentistry University of North Carolina, Chapel Hill, North Carolina, USA
| |
Collapse
|
3
|
Laniado N, Khambaty T, Hua S, Kaplan R, Llabre MM, Schneiderman N, Singer RH, Qi Q, Cai J, Finlayson TL, Whalen AM, Isasi CR. Periodontal disease and incident prediabetes and diabetes: The Hispanic Community Health Study/Study of Latinos. J Clin Periodontol 2022; 49:313-321. [PMID: 35112368 PMCID: PMC8934300 DOI: 10.1111/jcpe.13599] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 01/02/2023]
Abstract
AIM To examine whether baseline periodontal disease is independently associated with incident prediabetes and incident diabetes in Hispanics/Latinos in the United States. MATERIALS AND METHODS This study examined 7827 individuals, 18-74 years of age without diabetes, from the Hispanic Community Health Study/Study of Latinos. Participants received a full-mouth periodontal examination at baseline (2008-2011), and the disease was classified using the Centers for Disease Control and Prevention/American Academy of Periodontology case definitions. At Visit 2 (2014-2017), incident prediabetes and diabetes were assessed using multiple standard procedures including blood tests. Multivariable survey Poisson regressions estimated the rate ratio (RR) and 95% confidence intervals (CIs) of incident prediabetes and incident diabetes associated with periodontal disease severity. RESULTS Among the individuals without prediabetes or diabetes at baseline, 38.8% (n = 1553) had developed prediabetes and 2.2% (n = 87) had developed diabetes after 6 years. Nineteen percent (n = 727) of individuals with prediabetes at baseline developed diabetes after 6 years. Adjusting for all potential confounders, no significant association was found between periodontal disease severity and either incident prediabetes (RR: 0.93; 95% CI: 0.82-1.06) or incident diabetes (RR: 0.99; 95% CI: 0.80-1.22). CONCLUSIONS Our findings suggest that among a diverse cohort of Hispanic/Latino individuals living in the United States, there was no association between periodontal disease severity and the development of either prediabetes or diabetes during a 6-year follow-up period.
Collapse
Affiliation(s)
- Nadia Laniado
- Albert Einstein College of Medicine, Jacobi Medical Center Department of Dentistry, 1400 Pelham Parkway South, Bronx, New York 10461
| | | | - Simin Hua
- Albert Einstein College of Medicine, Bronx NY
| | | | | | | | | | - Qibin Qi
- Albert Einstein College of Medicine, Bronx NY
| | - Jianwen Cai
- University of North Carolina at Chapel Hill, Chapel Hill NC
| | | | | | | |
Collapse
|
4
|
Shaharyar SA, Bernabé E, Delgado-Angulo EK. The Intersections of Ethnicity, Nativity Status and Socioeconomic Position in Relation to Periodontal Status: A Cross-Sectional Study in London, England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910519. [PMID: 34639818 PMCID: PMC8508573 DOI: 10.3390/ijerph181910519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 09/29/2021] [Accepted: 10/02/2021] [Indexed: 11/16/2022]
Abstract
The role of migration as a social determinant of periodontitis has been overlooked. Intersectionality theory could help understand how immigration status interacts with other social determinants of health to engender inequalities in periodontitis. The objective of the present study was to evaluate whether ethnicity, nativity status and socioeconomic position intersect to structure social inequalities in periodontal status. Data from 1936 adults in a deprived and multi-ethnic area of London were analysed. The numbers of teeth with probing depth and clinical attachment loss were determined from clinical examinations. A matrix with 51 intersectional strata, defined according to ethnicity, nativity status and education, was created. A cross-classified multilevel analysis, with participants clustered within intersectional social strata, was performed to assess the extent to which individual differences in periodontal measures were at the intersectional strata level. A complex pattern of social inequalities in periodontal status was found, which was characterised by high heterogeneity between strata and outcome-specificity. The variance partition coefficient of the simple intersectional model, which conflated additive and interaction effects, indicated that 3-5% of the observed variation in periodontal measures was due to between-stratum differences. Moreover, the percentual change in variance from the simple intersectional to the intersectional interaction model indicated that 73-74% of the stratum-level variance in periodontal measures was attributed to the additive effects of ethnicity, nativity status and education. This study found modest evidence of intersectionality among ethnicity, nativity status and education in relation to periodontal status.
Collapse
Affiliation(s)
- Syeda Ammara Shaharyar
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK; (S.A.S.); (E.K.D.-A.)
| | - Eduardo Bernabé
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK; (S.A.S.); (E.K.D.-A.)
- Correspondence: ; Tel.: +44-(0)-20-3299-3022
| | - Elsa Karina Delgado-Angulo
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK; (S.A.S.); (E.K.D.-A.)
- Departamento Académico de Odontología Social, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| |
Collapse
|
5
|
Periodontal Disease and Incident CKD in US Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos. Kidney Med 2021; 3:528-535.e1. [PMID: 34401720 PMCID: PMC8350839 DOI: 10.1016/j.xkme.2021.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Rationale & Objective Recent studies suggest that periodontal disease may be associated with incident chronic kidney disease (CKD). However, studies have focused on older populations, and US Hispanics/Latinos were not well represented. Study Design Observational cohort. Setting & Participants We analyzed data from the Hispanic Community Health Study/Study of Latinos who completed a baseline visit with a periodontal examination and a follow-up visit, and did not have CKD at baseline. Predictors Predictors included ≥30% of sites with clinical attachment loss ≥3 mm, ≥30% of sites with probing depth ≥4 mm, percentage of sites with bleeding on probing, and absence of functional dentition (<21 permanent teeth present). Outcomes Outcomes were incident low estimated glomerular filtration rate (eGFR) (eGFR <60 mL/min/1.73 m2 and decline in eGFR ≥1 mL/min/year); incident albuminuria (urine albumin:creatinine ratio [ACR] ≥30 mg/g); and change in eGFR and ACR. Analytic Approach Poisson and linear regression. Results For the sample (n = 7.732), baseline mean age was 41.5 years, 45.2% were male, 11.7% had ≥30% of sites with clinical attachment loss ≥3 mm, 5.1% had ≥30% of sites with probing depth ≥4 mm, 30.7% had ≥50% of sites with bleeding on probing, and 16.2% had absent functional dentition. During a median follow-up of 5.9 years, 149 patients developed low eGFR and 415 patients developed albuminuria. On multivariable analysis, presence versus absence of ≥30% of sites with probing depth ≥4 mm and absence of functional dentition were each associated with increased risk for incident low eGFR (incident density ratio, 2.31; 95% CI, 1.14-4.65 and 1.65, 95% CI, 1.01-2.70, respectively). None of the other predictors were associated with outcomes. Limitations Only a single kidney function follow-up measure. Conclusions In this cohort of US Hispanics/Latinos, we found that select measures of periodontal disease were associated with incident low eGFR. Future work is needed to assess whether the treatment of periodontal disease may prevent CKD.
Collapse
|
6
|
Akinkugbe AA, E Sarah R, Richard S, Tracy F, Marston Y, Nadia L, Shirley B, Linda K. Perceived dental care need and actual oral health status in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Public Health Dent 2020; 80:259-270. [PMID: 32662151 PMCID: PMC10890782 DOI: 10.1111/jphd.12376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 03/02/2020] [Accepted: 05/01/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To evaluate the performance of subjective self-assessment of dental care need with objective oral disease status in a sample of Hispanics/Latinos. METHODS Data from 13,561 participants of the 2008-2011 Hispanic Community Health Study/Study of Latinos were analyzed using complex survey procedure in SAS 9.4. Subjective self-reports of types of dental care needed (check-up or cleaning, teeth filled, teeth pulled, gum treatment, denture repair) were validated against objectively determined oral disease status [dental decay, periodontitis, bleeding on probing (BOP) and count of missing teeth]. RESULTS Individuals who reported needing a cleaning/checkup were twice as likely to present with BOP upon oral examination (POR = 2.01, 95% CI: 1.54, 2.63). Similarly, individuals who reported needing gum treatment were more likely to present with periodontitis (POR = 1.96, 95% CI: 1.71, 2.24) and BOP (POR = 2.70, 95% CI: 2.37, 3.07) upon oral examination. In multivariable prediction modeling, demographic factors and subjective dental care measures were associated with the respective oral disease states. Moreover, the sensitivity, specificity, and area under the ROC curve for the count of missing teeth were, respectively, 77 percent, 57 percent, and 0.84, while the positive predictive value (PPV) was 26 percent. CONCLUSIONS In bivariate analysis, self-reported type of dental care needed appear indicative of actual oral disease state and may be of value for the surveillance of oral diseases when clinical measures are unattainable. In multivariable prediction modeling, these subjective measures had low PPVs thus limiting the generalizability of our findings. Nonetheless, validation and refinement of these constructs in other populations is warranted.
Collapse
Affiliation(s)
- Aderonke A Akinkugbe
- Department of Dental Public Health and Policy, Virginia Commonwealth University, School of Dentistry, Richmond, VA, USA
- Institute for Inquiry, Innovation and Inclusion, Virginia Commonwealth University, Richmond, VA, USA
| | - Raskin E Sarah
- Institute for Inquiry, Innovation and Inclusion, Virginia Commonwealth University, Richmond, VA, USA
- L. Douglas Wilder School of Government and Public Affairs, Virginia Commonwealth University, Richmond, VA, USA
| | - Singer Richard
- Nova Southeastern University, College of Dental Medicine, Ft. Lauderdale, FL
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL
| | - Finlayson Tracy
- School of Public Health, San Diego State University, San Diego, CA
| | - Youngblood Marston
- Collaborative Studies Coordinating Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | - Kaste Linda
- College of Dentistry, University of Illinois, Chicago, IL
| |
Collapse
|
7
|
Silveira ML, Dye BA, Iafolla TJ, Adesanya MR, Boroumand S, Youngblood ME, Salazar CR, Finlayson TL, Khambaty T, Beaver SM, Isabel Garcia A. Cultural factors and oral health-related quality of life among dentate adults: Hispanic community health study/study of Latinos. ETHNICITY & HEALTH 2020; 25:420-435. [PMID: 29343079 PMCID: PMC6148392 DOI: 10.1080/13557858.2018.1427219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 12/15/2017] [Indexed: 06/07/2023]
Abstract
Objective: Research on the relationships between acculturation, ethnic identity, and oral health-related quality of life (OHRQOL) among the U.S. Hispanic/Latino population is sparse. The aim of this study is to examine the association between acculturation, ethnic identity, and OHRQOL among 13,172 adults in the 2008-2011 Hispanic Community Health Study/Study of Latinos (HCHS/SOL).Design: Participants self-reported their acculturation (immigrant generation, birthplace, residence in the U.S., language, and social acculturation), ethnic identity (sense of belonging and pride), and four OHRQOL measures. Key socio-demographic, behavioral, and oral health outcomes were tested as potential confounders.Results: Overall, 57% of individuals experienced poor OHRQOL in at least one of the domains examined. In multivariable analyses, some elements of higher acculturation were associated with greater food restriction and difficulty doing usual jobs/attending school, but not associated with pain or difficulty chewing, tasting, or swallowing. While sense of belonging to one's ethnic group was not associated with poor OHRQOL, low sense of pride was associated with food restriction. Socio-behavioral characteristics were significant effect modifiers.Conclusion: This study contributes to the understanding of the role of Hispanic/Latino's cultural factors in OHRQOL perception and can inform targeted strategies to improve OHRQOL in this diverse population.
Collapse
Affiliation(s)
- Marushka L. Silveira
- National Institute of Dental and Craniofacial Research,
National Institutes of Health, Building 31, Room 5B55, 31 Center Dr, Bethesda, MD
– 20892
| | - Bruce A. Dye
- National Institute of Dental and Craniofacial Research,
National Institutes of Health, Building 31, Room 5B55, 31 Center Dr, Bethesda, MD
– 20892
| | - Timothy J. Iafolla
- National Institute of Dental and Craniofacial Research,
National Institutes of Health, Building 31, Room 5B55, 31 Center Dr, Bethesda, MD
– 20892
| | - Margo R. Adesanya
- National Institute of Dental and Craniofacial Research,
National Institutes of Health, Building 31, Room 5B55, 31 Center Dr, Bethesda, MD
– 20892
| | - Shahdokht Boroumand
- National Institute of Dental and Craniofacial Research,
National Institutes of Health, Building 31, Room 5B55, 31 Center Dr, Bethesda, MD
– 20892
| | - Marston E. Youngblood
- University of North Carolina at Chapel Hill, Collaborative
Studies Coordinating Center, 123 West Franklin Street, Suite 450, Chapel Hill, NC
– 27516
| | - Christian R. Salazar
- Department of Epidemiology and Health Promotion, New York
University College of Dentistry, 433 1 Ave, 7 floor, New
York, NY 10010
| | - Tracy L. Finlayson
- San Diego State University, Graduate School of Public
Health, 5500 Campanile Drive, San Diego, CA – 92182-4162
| | - Tasneem Khambaty
- University of Maryland, Baltimore County (UMBC), Department
of Psychology, 1000 Hilltop Circle, Math/Psychology 326, Baltimore, MD 21250
| | - Shirley M Beaver
- University of Illinois at Chicago, College of Dentistry,
Department of Periodontics, 801 S. Paulina street, Chicago, IL – 60077
| | - A. Isabel Garcia
- University of Florida, College of Dentistry, Health Science
Center, Room D4-6B, 1395 Center Drive, Gainesville, FL – 32610
| |
Collapse
|
8
|
Laniado N, Badner VM, Sanders AE, Singer RH, Finlayson TL, Hua S, Kaste LM, Isasi CR. Social capital and periodontal disease in Hispanic/Latino adults in the United States: Results from the Hispanic Community Health Study/Study of Latinos. J Clin Periodontol 2020; 47:542-551. [PMID: 31998991 DOI: 10.1111/jcpe.13262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/18/2019] [Accepted: 01/26/2020] [Indexed: 11/26/2022]
Abstract
AIMS To examine the association of social capital with periodontal disease severity. MATERIALS AND METHODS We analysed data obtained from 3,994 men and women aged 18-74 years in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study (HCHS/SOL SCAS). From 2008 to 2011, dentists assessed periodontitis status with a full-mouth periodontal examination. Periodontitis was classified using standardized case definitions. Multivariable logistic regression estimated odds of moderate-severe periodontitis associated with two measures of social capital: structural support (Social Network Index) and functional support (Interpersonal Support Evaluation List). RESULTS For US-born participants, for each additional person in their social network, the adjusted odds of moderate-severe periodontitis was reduced 17% (OR = 0.83, 95% CI = 0.71, 0.96). However, no association was found between functional support and periodontal disease severity. CONCLUSIONS Greater structural social support was associated with a lower prevalence of moderate-severe periodontitis in US-born Hispanics/Latinos. These findings suggest that US-born Hispanics/Latinos with less social support represent a vulnerable segment of the population at high-risk group for periodontal disease.
Collapse
Affiliation(s)
- Nadia Laniado
- Department of Dentistry, Albert Einstein College of Medicine, Bronx, New York.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Victor M Badner
- Department of Dentistry, Jacobi Medical Center/North Central Bronx Hospital, Bronx, New York
| | - Anne E Sanders
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Richard H Singer
- Department of Orthodontics, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida
| | - Tracy L Finlayson
- Division of Health Management and Policy, School of Public Health, San Diego State University, San Diego, California
| | - Simin Hua
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Linda M Kaste
- College of Dentistry and School of Public Health, University of Illinois at Chicago, Chicago, Illinois
| | - Carmen R Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| |
Collapse
|
9
|
Akinkugbe AA, Barritt AS, Cai J, Offenbacher S, Thyagarajan B, Khambaty T, Singer R, Kallwitz E, Heiss G, Slade GD. Periodontitis and prevalence of elevated aminotransferases in the Hispanic Community Health Study/Study of Latinos. J Periodontol 2019; 89:949-958. [PMID: 29717494 DOI: 10.1002/jper.17-0579] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 02/07/2018] [Accepted: 02/26/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) prevalence is greater among Hispanics/Latinos than other racial/ethnic groups and prevalence is further reported to vary among Hispanic/Latino background groups. Experimental animal and human studies demonstrate associations between periodontitis and NAFLD, not yet reported among Hispanics/Latinos. This study examined periodontitis as a novel risk factor that may contribute to the burden of NAFLD among Hispanics/Latinos. METHODS Data came from 11,914 participants of the Hispanic Community Health Study/Study of Latinos. Periodontitis was defined as the extent (none, < 30%, ≥30%) of periodontal sites with clinical attachment level (CAL) of ≥3 mm or probing pocket depth (PD) of ≥4 mm. Elevated serum transaminases indicative of suspected NAFLD were defined as having alanine aminotransferase levels (ALT) > 40 IU/L or aspartate aminotransferase (AST) > 37 IU/L for men and ALT > 31 IU/L or AST > 31 IU/L for women. Survey-logistic regression models estimated prevalence odds ratios (POR) and 95% confidence intervals (CI) for the association between periodontitis and suspected NAFLD. RESULTS The overall age-standardized percentage of study participants with < 30% of sites with CAL ≥3 mm or PD ≥4 mm was 53.5% and 58.6%, respectively, while participants with ≥30% sites with CAL ≥3 mm or PD ≥4 mm comprised 16% and 5.72%, respectively. The overall age-standardized prevalence (95% CI) of suspected NAFLD was 18.1% (17.1-19.0). For the entire cohort, we observed a dose-response (i.e. graded) association between PD ≥4 mm and the prevalence odds of suspected NAFLD, whereby participants with < 30% affected had a crude POR = 1.19 (95% CI: 1.03, 1.38) while participants with ≥30% affected had a crude POR = 1.39 (95% CI: 1.02, 1.90). These crude estimates were attenuated toward the null and rendered non-significant upon covariate adjustment. No differences were found by Hispanic/Latino background group. CONCLUSION Previously reported associations between periodontitis and NAFLD were marginal to null in this study of a diverse group of Hispanics/Latinos.
Collapse
Affiliation(s)
- Aderonke A Akinkugbe
- Oral Health Services Research Core, School of Dentistry, Virginia Commonwealth University, Richmond, VA
| | - A Sidney Barritt
- Department of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Steven Offenbacher
- Department of Periodontology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Tasneem Khambaty
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD
| | - Richard Singer
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.,College of Dental Medicine, Nova Southeastern University, Ft. Lauderdale, FL
| | - Eric Kallwitz
- Department of Medicine, Loyola University Medical Center, Maywood, IL
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Gary D Slade
- Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| |
Collapse
|
10
|
Floríndez LI, Floríndez DC, Floríndez FM, Como DH, Pyatak E, Baezconde-Garbanati L, Polido JC, Cermak SA. Oral Care Experiences of Latino Parents/Caregivers with Children with Autism and with Typically Developing Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2905. [PMID: 31416123 PMCID: PMC6721061 DOI: 10.3390/ijerph16162905] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/03/2019] [Accepted: 08/09/2019] [Indexed: 12/17/2022]
Abstract
As a result of various barriers, several pediatric populations are at risk for poor oral health, including children with disabilities and children from under-represented populations, such as Latinos. To this end, this study aimed to better understand the factors that affect the oral health experiences of 32 Latino parents/caregivers from 18 families (n = 8 with a typically developing child and n = 10 with a child with Autism). Using a qualitative descriptive methodology, each family was interviewed twice. Interviews were audio-recorded, transcribed verbatim, and coded thematically to identify the individual, social, systemic, and culturally rooted factors contributing to oral health disparities in the families. The three themes that arose were "Why would I want to start trouble?": Latino parents' dissatisfaction with dental treatments, costs, and fear of the dentist and health care providers because of their ethnic minority status as key factors inhibiting receipt of dental care; "We have to put our children first": prioritizing the oral care activities of their children over their own individual oral care needs; and "We always keep baking soda around": familial and cultural influences on oral care habits. Understanding the oral health beliefs and experiences of Latino parents and caregivers of children with and without autism is critical for developing targeted prevention and intervention programs and reducing oral health disparities.
Collapse
Affiliation(s)
- Lucía I Floríndez
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA.
| | | | | | - Dominique H Como
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Elizabeth Pyatak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | | | - Jose C Polido
- Division of Dentistry, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - Sharon A Cermak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| |
Collapse
|
11
|
Celeste RK, Oliveira SC, Junges R. Threshold-effect of income on periodontitis and interactions with race/ethnicity and education. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22:e190001. [PMID: 30652730 DOI: 10.1590/1980-549720190001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 03/21/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The aims of this study were to explore the shape of the relationship of income and education with periodontal health, and to assess the interactions between them and race/ethnicity. METHOD Individual level data from the Brazilian National Oral Health Survey in 2010 (Pesquisa Nacional de Saúde Bucal-SB Brasil 2010) were obtained for 9,779 subjects. Relations between per capita income and education with periodontal health were smoothed using Locally Weighted Scatter-plot Smoother (Lowess) technique. Multivariable logistic regression was used to assess independent effects of income, education, race/ethnicity adjusted for age, sex and time since last dental appointment. RESULTS Prevalence of adults with moderate to severe and severe periodontitis was 17.6 and 6.5%, respectively. The relationship between periodontal health and income was curvilinear, showing a threshold of no relationship for income levels higher than US$ 600/month. In multivariable analysis, after controlling for covariates, only income was significantly associated with periodontal health. There was no significant interaction of income with race or education, neither between race and education. CONCLUSION The relation between periodontal health and income was curvilinear and indicated the presence of a threshold, supporting income transfer programs. Beyond the threshold, only education presented a negative linear relationship with moderate to severe periodontitis.
Collapse
Affiliation(s)
- Roger Keller Celeste
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil
| | - Sara Cioccari Oliveira
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.,Department of Dental Material Sciences, Academic Centre for Dentistry Amsterdam, Vrije University and University of Amsterdam - Amsterdam, The Netherlands
| | - Roger Junges
- Department of Oral Biology, Faculty of Dentistry, University of Oslo - Oslo, Norway
| |
Collapse
|
12
|
Lopez-Owens M, Starkey K, Gil C, Armenta K, Maupomé G. The VidaSana Study: Recruitment Strategies for Longitudinal Assessment of Egocentric Hispanic Immigrant Networks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2878. [PMID: 30558280 PMCID: PMC6313685 DOI: 10.3390/ijerph15122878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/04/2018] [Accepted: 12/10/2018] [Indexed: 12/27/2022]
Abstract
We disseminate the recruitment strategies used in the five-year VidaSana study (started in 2017) in the Midwest region of the United States, targeting recently arrived Hispanic immigrants. VidaSana aims to follow immigrants within six months of arrival for 24 months to (1) characterize features of networks (personal and community) that improve or undermine dental health; and (2) further refine methods to quantify the evolution of egocentric networks, using social network methodology. We implemented several strategies to promote and recruit potential participants into the study. We collaborate with agents serving Indiana's Hispanic communities using three levels of visibility. The broad level includes radio advertisements, TV interviews, newspaper advertisements, and targeted Facebook advertisements. Intermediate level visibility includes posting flyers in schools, employment agencies, immigrant welcome centers, and Hispanic businesses; making announcements at church/temple and school events; tabling at community, church and school events; and a pervasive adaptation of our strategies to the requirements of our partners. Lastly, the individualized level includes direct referrals by partners through word of mouth. From the initial 13 months of recruitment (494 screened contacts and 202 recruited participants), the most successful recruitment strategies appear to be a combination of intermediate- and individual-level strategies; specifically, face-to-face recruitment at school events, direct referrals from our community partners, and tabling at community/school/church events. The current interim findings and future final findings will help guide recruitment and retention strategies for studies focused on immigrants in the current climate of heightened immigration regulations and enforcement.
Collapse
Affiliation(s)
- Mariana Lopez-Owens
- Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University-Purdue University Indianapolis. Indianapolis, IN 46202, USA.
| | - Kristen Starkey
- Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University-Purdue University Indianapolis. Indianapolis, IN 46202, USA.
| | - Cindy Gil
- Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University-Purdue University Indianapolis. Indianapolis, IN 46202, USA.
| | - Karla Armenta
- Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University-Purdue University Indianapolis. Indianapolis, IN 46202, USA.
| | - Gerardo Maupomé
- Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University-Purdue University Indianapolis. Indianapolis, IN 46202, USA.
- Indiana University Network Science Institute, Bloomington, IN 46202, USA.
| |
Collapse
|
13
|
Pietropaoli D, Del Pinto R, Ferri C, Wright JT, Giannoni M, Ortu E, Monaco A. Poor Oral Health and Blood Pressure Control Among US Hypertensive Adults. Hypertension 2018; 72:1365-1373. [DOI: 10.1161/hypertensionaha.118.11528] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Davide Pietropaoli
- From the Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Italy (D.P., R.D.P., C.F., M.G., E.O., A.M.)
| | - Rita Del Pinto
- From the Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Italy (D.P., R.D.P., C.F., M.G., E.O., A.M.)
| | - Claudio Ferri
- From the Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Italy (D.P., R.D.P., C.F., M.G., E.O., A.M.)
| | - Jackson T. Wright
- Division of Nephrology and Hypertension, University Hospitals Cleveland Medical Center, Case Western Reserve University, OH (J.T.W.)
| | - Mario Giannoni
- From the Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Italy (D.P., R.D.P., C.F., M.G., E.O., A.M.)
| | - Eleonora Ortu
- From the Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Italy (D.P., R.D.P., C.F., M.G., E.O., A.M.)
| | - Annalisa Monaco
- From the Department of Life, Health, and Environmental Sciences, San Salvatore Hospital, University of L’Aquila, Italy (D.P., R.D.P., C.F., M.G., E.O., A.M.)
| |
Collapse
|
14
|
Finlayson TL, Lemus H, Becerra K, Kaste LM, Beaver SM, Salazar CR, Singer RH, Youngblood ME. Unfair Treatment and Periodontitis Among Adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Racial Ethn Health Disparities 2018; 5:1093-1106. [PMID: 29327269 PMCID: PMC6760848 DOI: 10.1007/s40615-017-0459-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 12/01/2017] [Accepted: 12/28/2017] [Indexed: 10/18/2022]
Abstract
This study investigates how perceived unfair treatment, towards self and observed towards others due to ethnicity, is associated with periodontitis among diverse Hispanic/Latino adults, accounting for sociodemographic, health behavior, and acculturation factors. Baseline (2008-2011) dental and survey data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multicenter epidemiologic study, were analyzed (N = 12,750). Crude and adjusted prevalence ratios and confidence limits were estimated. Half (49%) reported never being treated unfairly, while 41% reported they were sometimes, and 10% reported it often/always. One third (32%) never saw others treated unfairly, while 42% reported it sometimes, and 26% reported it often/always. In the final fully adjusted model, the prevalence of periodontitis was higher among adults who were as follows: non-Dominican, older, male, had a past year dental visit, current and former smokers, and among those who observed unfair treatment towards others. Lower prevalence was associated with higher income, higher educational attainment, less than full-time employment, reporting experiencing unfair treatment, higher acculturation scores, and having health insurance. Perceived unfair treatment towards self was negatively associated with periodontitis prevalence, while observed unfair treatment towards others was positively associated with the outcome among diverse Hispanics/Latinos. The associations between unfair treatment and periodontitis warrant further exploration.
Collapse
Affiliation(s)
| | | | - Karen Becerra
- Gary and Mary West Senior Dental Center, San Diego, CA, USA
| | | | | | | | - Richard H Singer
- Nova Southeastern University, Ft. Lauderdale, FL, USA and Univesity of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL, USA
| | | |
Collapse
|
15
|
Singer RH, Stoutenberg M, Feaster DJ, Cai J, Hlaing WM, Metsch LR, Salazar CR, Beaver SM, Finlayson TL, Talavera G, Gellman MD, Schneiderman N. The association of periodontal disease and cardiovascular disease risk: Results from the Hispanic Community Health Study/Study of Latinos. J Periodontol 2018. [PMID: 29542123 DOI: 10.1002/jper.17-0549] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Current evidence suggests that periodontal disease (PD) is associated with a significant increased risk of atherosclerotic cardiovascular disease (CVD) independent of known confounders. PD is a chronic oral disease with significant variation in prevalence demonstrated among Hispanic/Latino subgroups. The purpose of this study was to investigate the associations between PD and CVD risk and variations with sex, age, and Hispanic/Latino background. METHODS The sample included 7379 participants aged 30 to 74 years, from the Hispanic Community Health Study/Study of Latinos (2008 to 2011). We assessed CVD risk by the Framingham 10-year general CVD risk score (FGRS). PD severity classification was based on calibrated measurements of gingival recession and probing depth. Multivariable sequential linear models for complex sample design assessed FGRS by PD severity, Hispanic/Latino background, and covariates. RESULTS The prevalence of moderate and severe PD combined was 46%. For women and men with severe PD, the combined prevalence of moderate and high CVD risk was 44% and 85%, respectively. The FGRS observed for women (5.1% [95% CI: 4.1%, 6.0%], p < 0.001) and men 10.8% (95% CI [9.2%, 12.3%], p < 0.001) with severe PD were 56% and 134% greater than those without PD, respectively. Dominican women and men with moderate or severe PD, aged 60 to 69 years, exhibited the greatest CVD risks (FGRS = 15.1%, 95% CI [7.8%, 22.5%]) and (FGRS = 40.2%, 95% CI [30.2%, 50.3%]), respectively. CONCLUSIONS Moderate and severe PD were associated with significant CVD risk with marked sex disparity and heterogeneity by Hispanic/Latino background.
Collapse
Affiliation(s)
- Richard H Singer
- University of Miami, Miller School of Medicine, Department of Public Health Sciences, Miami, FL.,Nova Southeastern University, College of Dental Medicine, Ft. Lauderdale, FL
| | - Mark Stoutenberg
- University of Miami, Miller School of Medicine, Department of Public Health Sciences, Miami, FL
| | - Daniel J Feaster
- University of Miami, Miller School of Medicine, Department of Public Health Sciences, Miami, FL
| | - Jianwen Cai
- University of North Carolina, Gillings School of Global Public Health, Collaborate Studies Coordinating Center, Department of Biostatistics, Chapel Hill, NC
| | - WayWay M Hlaing
- University of Miami, Miller School of Medicine, Department of Public Health Sciences, Miami, FL
| | - Lisa R Metsch
- Columbia University, Mailman School of Public Health, Department of Sociomedical Sciences, New York, NY
| | - Christian R Salazar
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, New York, NY
| | - Shirley M Beaver
- University of Illinois at Chicago College of Dentistry, Chicago, IL
| | - Tracy L Finlayson
- San Diego State University, Graduate School of Public Health, San Diego, CA
| | - Gregory Talavera
- San Diego State University, Graduate School of Public Health, San Diego, CA
| | - Marc D Gellman
- University of Miami, Department of Psychology, Miami, FL
| | | |
Collapse
|
16
|
Salazar CR, Laniado N, Mossavar-Rahmani Y, Borrell LN, Qi Q, Sotres-Alvarez D, Morse DE, Singer RH, Kaplan RC, Badner V, Lamster IB. Better-quality diet is associated with lower odds of severe periodontitis in US Hispanics/Latinos. J Clin Periodontol 2018; 45:780-790. [PMID: 29779261 PMCID: PMC6023728 DOI: 10.1111/jcpe.12926] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/09/2018] [Accepted: 05/13/2018] [Indexed: 11/28/2022]
Abstract
AIM We investigated the cross-sectional association between diet quality and severe periodontitis in a sample of diverse Hispanics from the Hispanic Community Health Study/Study of Latinos. MATERIALS AND METHODS A total of 13,920 Hispanic/Latinos aged 18-74 years of different heritages underwent a full-mouth oral examination and completed two 24-hr dietary recalls during 2008-2011. Severe periodontitis was defined as having ≥30% tooth sites with clinical attachment loss ≥5 mm. Diet quality was assessed using the Alternative Healthy Eating Index (AHEI-2010). We evaluated the association of diet quality with severe periodontitis adjusting for age, sex, nativity status, income, education, last dental visit, current insurance, cigarette smoking, diabetes, and energy intake. RESULTS Relative to those at the lowest quartile of diet quality, individuals at the highest quartile had significantly lower odds of severe periodontitis (adjusted OR = 0.57, 95% CI: 0.39-0.82), with evidence of a dose-response relationship across AHEI quartiles. Among AHEI-2010 components, higher consumption of whole grains and fruits, and lower consumption of red/processed meats were associated with lower odds of severe periodontitis. CONCLUSION Better-quality diet was associated with lower prevalence of severe periodontitis although the causal pathways need to be clarified in future work.
Collapse
Affiliation(s)
- Christian R. Salazar
- Department of Epidemiology and Health Promotion, NYU College of Dentistry, New York, NY
| | - Nadia Laniado
- Department of Dentistry, Jacobi Medical Center, Bronx, NY
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Luisa N. Borrell
- Department of Epidemiology & Biostatistics, Graduate School of Public Health and Health Policy, City University of New York, New York, NY
| | - Qibin Qi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC
| | - Douglas E. Morse
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Richard H Singer
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Robert C. Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Victor Badner
- Department of Dentistry, Jacobi Medical Center, Bronx, NY
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Ira B. Lamster
- Stony Brook University, School of Dental Medicine, Stony Brook, NY
| |
Collapse
|
17
|
Ortiz AP, González D, Vivaldi-Oliver J, Castañeda M, Rivera V, Díaz E, Centeno H, Muñoz C, Palefsky J, Joshipura K, Pérez CM. Periodontitis and oral human papillomavirus infection among Hispanic adults. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2018; 5:128-133. [PMID: 29555599 PMCID: PMC5886954 DOI: 10.1016/j.pvr.2018.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/12/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Research on the association between periodontitis and oral human papilloma virus (HPV) infection is inconsistent. The cross-sectional association of severe periodontitis with oral HPV infection was investigated in a sample of Hispanic adults. METHODS Data from the 2014-2016 San Juan Overweight Adults Longitudinal Study (n = 740) was analyzed. Periodontitis assessment and self-collection of oral HPV samples followed the National Health and Nutrition Examination Survey methodology. Periodontitis was defined using the Centers of Disease Control and Prevention/American Academy of Periodontology definition. HPV typing was performed using polymerase chain reaction. Multivariate logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS 5.7% of participants had oral HPV infection and 20.3% had severe periodontitis. Adults with severe periodontitis had higher odds of oral HPV infection than those with none/mild disease (OR=2.9, 95% CI: 1.0-8.4, p < 0.05) in multivariable analysis. Adults with clinical attachment loss≥ 7 mm and pocket depth PD≥ 6 mm had 2- to 3-fold higher odds of HPV infection. CONCLUSIONS Severe periodontitis was positively associated to oral HPV infection. Longitudinal evaluation of periodontal inflammation's role in acquisition and persistence of oral HPV infection is needed, as periodontitis screening could identify individuals at increased risk of HPV-related oral malignancies.
Collapse
Affiliation(s)
- Ana Patricia Ortiz
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, 00936-5067 San Juan, Puerto Rico; Cancer Control and Population Sciences Program, Puerto Rico Comprehensive Cancer Center, University of Puerto Rico, San Juan, Puerto Rico.
| | - Daisy González
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, 00936-5067 San Juan, Puerto Rico
| | - José Vivaldi-Oliver
- Center for Clinical Research and Health Promotion, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Maira Castañeda
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, 00936-5067 San Juan, Puerto Rico
| | - Vivian Rivera
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, 00936-5067 San Juan, Puerto Rico
| | - Elba Díaz
- Center for Clinical Research and Health Promotion, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Hilmaris Centeno
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, 00936-5067 San Juan, Puerto Rico
| | - Cristina Muñoz
- Cancer Control and Population Sciences Program, Puerto Rico Comprehensive Cancer Center, University of Puerto Rico, San Juan, Puerto Rico
| | - Joel Palefsky
- Department of Infectious Diseases, School of Medicine, University of California, San Francisco (UCSF), United States
| | - Kaumudi Joshipura
- Center for Clinical Research and Health Promotion, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Cynthia M Pérez
- Cancer Control and Population Sciences Program, Puerto Rico Comprehensive Cancer Center, University of Puerto Rico, San Juan, Puerto Rico
| |
Collapse
|
18
|
Garcia D, Tarima S, Glasman L, Cassidy LD, Meurer J, Okunseri C. Latino Acculturation and Periodontitis Status Among Mexican-Origin Adults in the United States: NHANES 2009-2012. FAMILY & COMMUNITY HEALTH 2017; 40:112-120. [PMID: 28207674 PMCID: PMC5321569 DOI: 10.1097/fch.0000000000000142] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study examined the association between Latino acculturation indicators (language and citizenship/nativity status) and periodontitis using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2012. Descriptive statistics and logistic regression analyses were performed and all analyses were adjusted for the complex survey design. Results showed that 63.2% of participants had periodontitis: 9.4% mild, 37.9% moderate, and 16% severe. Language was significantly associated with periodontitis after adjusting for age, educational level, gender, usual source of care, flossing, smoking, and glycohemoglobin level (P = .02). Dental public and private health efforts should implement culturally tailored oral health promotion education efforts for this population.
Collapse
Affiliation(s)
- Dina Garcia
- Iowa Institute for Oral Health Research, The University of Iowa
College of Dentistry, Iowa City, IA
| | - Sergey Tarima
- Institute for Health & Society, Medical College of
Wisconsin, Milwaukee, WI
| | - Laura Glasman
- Center for AIDS Intervention Research Department of Psychiatry and
Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Laura D. Cassidy
- Institute for Health & Society, Medical College of
Wisconsin, Milwaukee, WI
| | - John Meurer
- Institute for Health & Society, Medical College of
Wisconsin, Milwaukee, WI
| | - Christopher Okunseri
- Department of Clinical Services, Marquette University School of
Dentistry, Milwaukee, WI
| |
Collapse
|
19
|
Akinkugbe AA, Sanders AE, Preisser JS, Cai J, Salazar CR, Beck JD. Environmental tobacco smoke exposure and periodontitis prevalence among nonsmokers in the hispanic community Health Study/Study of Latinos. Community Dent Oral Epidemiol 2016; 45:168-177. [PMID: 27978596 DOI: 10.1111/cdoe.12275] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 11/20/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To describe self-reported exposure to environmental tobacco smoke (ETS) and its association with periodontitis prevalence in a diverse group of Hispanics/Latinos. METHODS Data came from 8675 lifetime nonsmokers in the 2008-2011 Hispanic Community Health Study/Study of Latinos. Exposure to ETS was self-reported, while periodontitis was defined using the Centers for Disease Control and Prevention-American Academy of Periodontology criteria and the proportion of sites affected by clinical attachment level of ≥3 mm or pocket depth of ≥4 mm. Survey logistic regression estimated prevalence odds ratios (POR) and 95% confidence intervals (CI). In addition, we assessed whether greater hours of exposure to ETS in the past year was associated with greater periodontitis prevalence, and lastly, we conducted a simple sensitivity analysis of ETS misclassification. RESULTS Age-standardized prevalence estimates (95% CI) for ETS exposure and periodontitis were 57.6% (55.9, 59.4) and 39.8% (38.1, 41.4), respectively. After adjusting for confounders and periodontitis risk factors, we estimated an overall adjusted POR (95% CI) for the ETS-periodontitis association as 1.09 (0.95-1.26) with a confidence limit ratio (CLR) of 1.34. This association varied in magnitude by Hispanic/Latino background, ranging from 1.04 (0.75, 1.43 with a CLR = 1.91) among Central Americans to 1.76 (1.16, 2.66 with a CLR = 2.29) in Puerto Ricans. CONCLUSIONS Previously reported associations between ETS and periodontitis appear weak in this study. However, the magnitude of the association differs according to Hispanic/Latino background.
Collapse
Affiliation(s)
- Aderonke A Akinkugbe
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anne E Sanders
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John S Preisser
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christian R Salazar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - James D Beck
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
20
|
Wilson FA, Wang Y, Stimpson JP, McFarland KK, Singh KP. Use of dental services by immigration status in the United States. J Am Dent Assoc 2015; 147:162-9.e4. [PMID: 26562731 DOI: 10.1016/j.adaj.2015.08.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 08/12/2015] [Accepted: 08/17/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is limited research with mixed findings comparing differences in oral health outcomes and the use of dental services by immigration status. The authors conducted a study by reviewing nationally representative data to describe differences in dental care among noncitizens, naturalized citizens, and US-born citizens in the United States. METHODS The authors used nationally representative data from the 2008-2012 Medical Expenditure Panel Survey to examine dental care for US-born citizens, naturalized citizens, and noncitizens 18 years and older. Total analytical sample size was 98,107 adults. They used multivariate logistic regression to model dental service use adjusting for confounding factors. RESULTS Naturalized citizens and noncitizens were significantly less likely to have at least 1 dental visit within 12 months (39.5% and 23.1%, respectively) compared with US-born citizens (43.6%; P < .001). Among users, a smaller proportion of comprehensive examination visits were for naturalized citizens and noncitizens (75.9% and 71.4%, respectively) compared with US-born citizens (82.8%; P < .01). Noncitizen visits to dentists were also more likely to involve tooth extraction compared with those of US-born citizens (11.3% versus 8.8%; P < .01). Multivariate logistic regression suggests both non- and naturalized citizens had lower adjusted odds of having a comprehensive examination compared with US-born citizens during a visit (P < .01). CONCLUSIONS Noncitizens and naturalized citizens had a lower rate of dental service use, and noncitizens were more likely to have had tooth extraction compared with US-born citizens. PRACTICAL IMPLICATIONS Increased outreach efforts tailored to noncitizens and naturalized citizens who are at high risk of experiencing dental problems are needed, particularly to address misperceptions on the necessity of preventive dental visits.
Collapse
|
21
|
Schneiderman N, Chirinos DA, Avilés-Santa ML, Heiss G. Challenges in preventing heart disease in hispanics: early lessons learned from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Prog Cardiovasc Dis 2014; 57:253-61. [PMID: 25212986 PMCID: PMC4252509 DOI: 10.1016/j.pcad.2014.08.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The challenge of preventing cardiovascular disease (CVD) in US Hispanics depends upon being able to understand and communicate about the diversity within this population in terms of environmental exposures, health behaviors, socio-cultural experiences and genetic background to CVD risk factor profiles and disease burdens. Recent publications from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) launched by the National Institutes of Health (NIH) have begun to accomplish this task. In this article we review some of the HCHS/SOL findings concerning cardiometabolic and other CVD risk factors and relate them to the need for increased access to health care and attention to lifestyle variables including nutrition. A major challenge that needs to be accomplished is to alert our lawmakers, public health officials, health care providers and the Hispanic population at large about how to lighten the CVD risk factor and disease burdens now carried by our Hispanic population.
Collapse
Affiliation(s)
- Neil Schneiderman
- Department of Psychology and Behavioral Medicine Research Center, University of Miami, Miami, FL.
| | - Diana A Chirinos
- Department of Psychology and Behavioral Medicine Research Center, University of Miami, Miami, FL
| | - M Larissa Avilés-Santa
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Gerardo Heiss
- Department of Epidemiology, UNC at Chapel Hill, Chapel Hill, NC
| |
Collapse
|