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Tan J, Lamont GJ, Sekula M, Hong H, Sloan L, Scott DA. The transcriptomic response to cannabidiol of Treponema denticola, a phytocannabinoid-resistant periodontal pathogen. J Clin Periodontol 2024; 51:222-232. [PMID: 38105008 DOI: 10.1111/jcpe.13892] [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: 05/12/2023] [Revised: 09/14/2023] [Accepted: 09/26/2023] [Indexed: 12/19/2023]
Abstract
AIM The use of cannabis, which contains multiple antimicrobials, may be a risk factor for periodontitis. We hypothesized that multiple oral spirochetes would be phytocannabinoid-resistant and that cannabidiol (CBD) would act as an environmental stressor to which Treponema denticola would respond transcriptionally, thereby providing first insights into spirochetal survival strategies. MATERIALS AND METHODS Oral spirochete growth was monitored spectrophotometrically in the presence and absence of physiologically relevant phytocannabinoid doses, the transcriptional response to phytocannabinoid exposure determined by RNAseq, specific gene activity fluxes verified using qRT-PCR and orthologues among fully sequenced oral spirochetes identified. RESULTS Multiple strains of oral treponemes were resistant to CBD (0.1-10 μg/mL), while T. denticola ATCC 35405 was resistant to all phytocannabinoids tested (CBD, cannabinol [CBN], tetrahydrocannabinol [THC]). A total of 392 T. denticola ATCC 35405 genes were found to be CBD-responsive by RNAseq. A selected subset of these genes was independently verified by qRT-PCR. Genes found to be differentially activated by both methods included several involved in transcriptional regulation and toxin control. Suppressed genes included several involved in chemotaxis and proteolysis. CONCLUSIONS Oral spirochetes, unlike some other periodontal bacteria, are resistant to physiological doses of phytocannabinoids. Investigation of CBD-induced transcriptomic changes provided insight into the resistance mechanisms of this important periodontal pathogen. These findings should be considered in the context of the reported enhanced susceptibility to periodontitis in cannabis users.
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Affiliation(s)
- Jinlian Tan
- Department of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky, USA
| | - Gwyneth J Lamont
- Department of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky, USA
| | - Michael Sekula
- Department of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky, USA
- Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky, USA
| | - HeeJue Hong
- Department of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky, USA
| | - Lucy Sloan
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, Kentucky, USA
| | - David A Scott
- Department of Oral Immunology and Infectious Diseases, University of Louisville, Louisville, Kentucky, USA
- Center for Microbiomics, Inflammation and Pathogenicity, University of Louisville, Louisville, Kentucky, USA
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2
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Portilio MN, Prado MC, Rigo L. Is drug use associated with the presence of periodontitis and oral lesions? A meta-analysis. J Periodontal Implant Sci 2023; 53:53.e52. [PMID: 38014773 DOI: 10.5051/jpis.2302920146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/28/2023] [Accepted: 10/05/2023] [Indexed: 11/29/2023] Open
Abstract
PURPOSE This systematic review investigated whether drug use is associated with the presence of oral lesions and periodontitis. METHODS A search was performed for studies that analyzed the presence of periodontitis and/or oral lesions in users of crack, cocaine, and/or marijuana in the PubMed, Scopus, and Web of Science databases. Observational studies in English, Spanish, or Portuguese, without limitation of year, age, and sex, were included. Studies that did not evaluate periodontitis and oral lesions according to the eligibility criteria were excluded. Two authors independently performed study selection and data extraction using a standardized form. The risk of bias of studies included in the meta-analysis was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The meta-analysis included studies that investigated the association of drug use with the outcome. RESULTS The initial search resulted in 9,279 articles, from which 16 studies with 15,434 participants were included in the review and 8 studies were included in the meta-analysis. Most studies that evaluated periodontitis in drug users and non-users found a positive association in users. Most studies that analyzed oral lesions reported a higher prevalence, association, or risk of oral lesions in drug users than in non-users. A critical evaluation identified a need to improve the control and reporting of confounding factors in studies on this topic. An association was found between periodontitis and the use of crack, cocaine, and/or marijuana (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.04-3.27; P=0.04) and between oral lesions and the use of these drugs (OR, 2.13; 95% CI, 1.58-2.86; P<0.001). CONCLUSIONS Drug users are more likely to develop oral lesions and periodontitis than non-users. However, the results should be interpreted with caution, considering the heterogeneity and quality of the studies included in the analysis.
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Affiliation(s)
| | - Mayara Colpo Prado
- Graduate Program in Dentistry, ATITUS Education, Passo Fundo, RS, Brazil
| | - Lilian Rigo
- Graduate Program in Dentistry, ATITUS Education, Passo Fundo, RS, Brazil.
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3
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Stephenson L, Grabowski M, van den Heuvel C, Humphries M, Byard RW. Success of Low Aromatic Fuel in Preventing Gasoline Sniffing Deaths. Am J Forensic Med Pathol 2022; 43:354-358. [PMID: 35970515 DOI: 10.1097/paf.0000000000000786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Gasoline (petrol) sniffing is a form of volatile substance misuse that is particularly prevalent within Australian indigenous communities. Although epidemiological studies have shown that gasoline sniffing has decreased over recent years, rates of gasoline sniffing deaths have not been widely reported. Therefore, a study was undertaken to assess the association between the implementation of low aromatic fuel (LAF) and gasoline sniffing deaths. All cases of fatal gasoline sniffing in South Australia between 2000 and 2019 were identified from the Toxicology Database and autopsy reports at Forensic Science South Australia. Furthermore, previous studies of gasoline sniffing deaths were assessed to provide historical context and approximate rates of gasoline sniffing deaths before the current study. The rate of gasoline sniffing deaths decreased significantly ( P = 0.039) over the study period concomitant to an increase in the number of LAF sites nationally. Although not supported by findings of statistical significance because of the small number of cases, this study provides further supportive evidence for the effectiveness of LAF by showing a significant associated decrease in local rates of gasoline sniffing deaths.
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Affiliation(s)
| | | | | | - Melissa Humphries
- School of Mathematical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
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4
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Quaranta A, D'Isidoro O, Piattelli A, Hui WL, Perrotti V. Illegal drugs and periodontal conditions. Periodontol 2000 2022; 90:62-87. [PMID: 36183328 PMCID: PMC9828249 DOI: 10.1111/prd.12450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
In recent years, the practice of dentistry and periodontology has become complicated by several risk factors, including the treatment of an increasing number of patients with substance use disorder. This review presents an update in the current literature of the impact of illegal drug use on periodontal conditions and their possible effect as risk factors or indicators. The main illegal drugs that may have an impact on periodontal health and conditions are described, including their effect, medical manifestations, risks, and the overall effect on oral health and on the periodontium. Where available, data from epidemiologic studies are analyzed and summarized. The clinical management of periodontal patients using illegal drugs is reported in a comprehensive approach inclusive of the detection of illicit drug users, screening, interviewing and counseling, the referral to treatment, and the dental and periodontal management. With regard to the impact of illegal substance use on periodontal conditions, there is moderate evidence that regular long-term use of cannabis is a risk factor for periodontal disease, manifesting as a loss of periodontal attachment, deep pockets, recessions, and gingival enlargements. Limited evidence also shows that the use of cocaine can cause a series of gingival conditions that mostly presents as chemical induced-traumatic lesions (application of cocaine on the gingiva) or necrotizing ulcerative lesions. There is a scarcity of data regarding the impact of other drug use on periodontal health. There is evidence to suggest that regular long-term use of cannabis is a risk factor for periodontal disease and that the use of cocaine can cause a series of periodontal conditions. The dental treatment of subjects that use illegal substances is becoming more common in the daily clinical practice of periodontists and other dental clinicians. When the clinicians encounter such patients, it is essential to manage their addiction properly taking into consideration the impact of it on comprehensive dental treatment. Further studies and clinical observations are required to obtain sound and definitive information.
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Affiliation(s)
- Alessandro Quaranta
- School of DentistryUniversity of SydneySydneyNew South WalesAustralia,Smile Specialists SuiteNewcastleNew South WalesAustralia
| | | | - Adriano Piattelli
- Dental SchoolSaint Camillus International University for Health Sciences (Unicamillus)RomeItaly,Casa di Cura Villa SerenaCittà Sant'Angelo, PescaraItaly
| | - Wang Lai Hui
- Smile Specialists SuiteNewcastleNew South WalesAustralia
| | - Vittoria Perrotti
- Department of Medical, Oral and Biotechnological Sciences (DSMOB)University of Chieti‐PescaraChietiItaly
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5
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Scott D, Dukka H, Saxena D. Potential Mechanisms Underlying Marijuana-Associated Periodontal Tissue Destruction. J Dent Res 2022; 101:133-142. [PMID: 34515556 PMCID: PMC8905217 DOI: 10.1177/00220345211036072] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
While definitive evidence awaits, cannabis is emerging as a likely risk factor for periodontal tissue destruction. The mechanisms that underlie potential cannabis-induced or cannabis-enhanced periodontal diseases, however, remain to be elucidated. Herein, we 1) examine insights obtained from the endocannabinoid system, 2) summarize animal models of exposure to cannabinoid receptor agonists and antagonists, 3) review the evidence suggesting that cannabis and cannabis-derived molecules exert a profound influence on components of the oral microbiome, and 4) assess studies indicating that marijuana and phytocannabinoids compromise the immune response to plaque. Furthermore, we address how knowledge of cannabinoid influences in the oral cavity may be exploited to provide potential novel periodontal therapeutics, while recognizing that such medicinal approaches may be most appropriate for nonhabitual marijuana users. The suspected increase in susceptibility to periodontitis in marijuana users is multifaceted, and it is clear that we are only beginning to understand the complex toxicological, cellular, and microbial interactions involved. With marijuana consumption increasing across all societal demographics, periodontal complications of use may represent a significant, growing oral health concern. In preparation, an enhanced research response would seem appropriate.
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Affiliation(s)
- D.A. Scott
- Oral Immunology and Infectious
Diseases, School of Dentistry, University of Louisville, Louisville, KY,
USA
- D.A. Scott, School of Dentistry,
University of Louisville, 501 S. Preston St, Louisville, KY 40292,
USA.
| | - H. Dukka
- Diagnosis and Oral Health, School
of Dentistry, University of Louisville, Louisville, KY, USA
| | - D. Saxena
- Molecular Pathobiology, College
of Dentistry, New York University, New York, USA
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6
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Chaffee BW, Couch ET, Vora MV, Holliday RS. Oral and periodontal implications of tobacco and nicotine products. Periodontol 2000 2021; 87:241-253. [PMID: 34463989 PMCID: PMC8444622 DOI: 10.1111/prd.12395] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tobacco use contributes to more mortality and morbidity globally than any other behavioral risk factor. Adverse effects do not spare the oral cavity, with many oral diseases more common, and treatments less successful, in the tobacco-using patient. Many of the oral health effects of cigarette smoking are well established, but other forms of tobacco, including cigars and smokeless tobacco, merit dental professionals' attention. Recently, an expanding variety of new or emerging tobacco and/or nicotine products has been brought to market, most prominently electronic cigarettes, but also including heated tobacco and other noncombustible nicotine products. The use of cannabis (marijuana) is increasing and also has risks for oral health and dental treatment. For the practicing periodontist, and all dental professionals, providing sound patient recommendations requires knowledge of the general and oral health implications associated with this wide range of tobacco and nicotine products and cannabis. This review provides an overview of selected tobacco and nicotine products with an emphasis on their implications for periodontal disease risk and clinical management. Also presented are strategies for tobacco use counselling and cessation support that dental professionals can implement in practice.
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Affiliation(s)
- Benjamin W. Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Elizabeth T. Couch
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Manali V. Vora
- Division of Periodontology, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA
| | - Richard S. Holliday
- NIHR Clinical Lecturer in Restorative Dentistry, School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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7
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Hill B, Mugayar LRF, da Fonseca MA. Oral Health Implications of Risky Behaviors in Adolescence. Dent Clin North Am 2021; 65:669-687. [PMID: 34503660 DOI: 10.1016/j.cden.2021.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adolescence is a time for new discoveries, which may lead teens to engage in impulsive behaviors. Although social media and the Internet have brought great benefits to the world, they can also have a negative influence on adolescents, facilitating their engagement in risky behaviors. Positive parenting and healthy friendships in adolescence have a protective effect against sensation-seeking behaviors. Dental practitioners also have a significant role in steering young patients toward healthy behaviors. They play an essential role in the early recognition, initiation of appropriate interventions, and referrals for treatment of youth at risk.
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Affiliation(s)
- Brittaney Hill
- Department of Pediatric Dentistry, College of Dentistry, University of Illinois Chicago, 801 South Paulina Street, Suite 250 (MC-850), Chicago, IL 60612, USA
| | - Leda R F Mugayar
- Department of Pediatric Dentistry, College of Dentistry, University of Illinois Chicago, 801 South Paulina Street, Suite 250 (MC-850), Chicago, IL 60612, USA
| | - Marcio A da Fonseca
- Department of Pediatric Dentistry, College of Dentistry, University of Illinois Chicago, 801 South Paulina Street, Suite 250 (MC-850), Chicago, IL 60612, USA.
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8
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Gu Z, Singh S, Niyogi RG, Lamont GJ, Wang H, Lamont RJ, Scott DA. Marijuana-Derived Cannabinoids Trigger a CB2/PI3K Axis of Suppression of the Innate Response to Oral Pathogens. Front Immunol 2019; 10:2288. [PMID: 31681262 PMCID: PMC6804395 DOI: 10.3389/fimmu.2019.02288] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 09/10/2019] [Indexed: 12/18/2022] Open
Abstract
Cannabis use is an emergent risk factor for periodontitis, a chronic bacterial-induced disease of the supporting structures of the teeth. However, the mechanisms by which marijuana exposure predisposes to periodontal tissue destruction have yet to be elucidated. Therefore, we examined the influence of physiologically relevant doses of major marijuana-derived phytocannabinoid subtypes (cannabidiol [CBD]; cannabinol [CBN]; and tetrahydrocannabinol [THC], 1.0 μg/ml) on the interactions of three ultrastructurally variant oral pathogens, Porphyromonas gingivalis, Filifactor alocis, and Treponema denticola with the immune system. CBD, CBN, and THC each suppressed P. gingivalis-induced IL-12 p40, IL-6, IL-8, and TNF release while enhancing the anti-inflammatory cytokine, IL-10, from human innate cells. Similar phenomena were observed in F. alocis- and T. denticola-exposed human monocytes and human gingival keratinocytes. Higher phytocannabinoid doses (≥5.0 μg/ml) compromised innate cell viability and inhibited the growth of P. gingivalis and F. alocis, relative to unexposed bacteria. T. denticola, however, was resistant to all cannabinoid doses tested (up to 10.0 μg/ml). Pharmaceutical inhibition and efficient gene silencing indicated that a common CB2/PI3K axis of immune suppression is triggered by phytocannabinoids in vitro. This pathway does not appear to perpetuate through the canonical GSK3β-dependent cholinergic anti-inflammatory pathway, the predominant endogenous inflammatory control system. In a repetitive, transient oral infection model, CBD also suppressed P. gingivalis-induced innate immune markers in wild-type mice, but not in CB2−/− mice. If such phenomena occur in humans in situ, environmental cannabinoids may enhance periodontitis via direct toxic effects on specific oral bacteria; by compromising innate cell vitality; and/or through a suppressed innate response to periodontal pathogens involving a CB2/PI3K signaling lineage.
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Affiliation(s)
- Zhen Gu
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Shilpa Singh
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Rajarshi G Niyogi
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Gwyneth J Lamont
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Huizhi Wang
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - Richard J Lamont
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
| | - David A Scott
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, Louisville, KY, United States
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9
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Chisini LA, Cademartori MG, Francia A, Mederos M, Grazioli G, Conde MCM, Correa MB. Is the use of Cannabis associated with periodontitis? A systematic review and meta-analysis. J Periodontal Res 2019; 54:311-317. [DOI: 10.1111/jre.12639] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/25/2018] [Accepted: 12/21/2018] [Indexed: 01/07/2023]
Affiliation(s)
- Luiz A. Chisini
- Graduate Program in Dentistry; Federal University of Pelotas; Pelotas RS Brazil
- Graduate Program in Dentistry; University of Vale do Taquari; Lajeado RS Brazil
| | | | | | - Matias Mederos
- School of Dentistry; University of the Republic; Montevideo Uruguay
| | | | - Marcus C. M. Conde
- Graduate Program in Dentistry; University of Vale do Taquari; Lajeado RS Brazil
| | - Marcos B. Correa
- Graduate Program in Dentistry; Federal University of Pelotas; Pelotas RS Brazil
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10
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Mofidi A, Fang D, Flores-Mir C. Cannabis and periodontal harm: How convincing is the association? Oral Dis 2018; 25:350-352. [PMID: 30240507 DOI: 10.1111/odi.12980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Amirsalar Mofidi
- Periodontal Graduate Program, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Dongdong Fang
- Periodontal Graduate Program, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Carlos Flores-Mir
- Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
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11
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Figueiredo DDR, Bastos JL, Peres KG. Association of adverse oral health outcomes with socioeconomic inequalities and dental needs in Brazilian adolescents. CAD SAUDE PUBLICA 2017. [PMID: 28640329 DOI: 10.1590/0102-311x00165415] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to explore the relations between adverse oral outcomes and socioeconomic, demographic, and self-rated oral health variables and to describe their distribution. Principal component analysis was conducted on data from adolescents in the Brazilian National Oral Health Survey (N = 5,445). Higher loadings were found for crowding (0.6), maxillary and mandibular irregularities (0.5), and count of communitary periodontal index (CPI) sextants with bleeding and dental calculus (0.5). The mean rates for periodontal and occlusal disorders were at least two times higher in adolescents from lower income families and those reporting the need for dental prostheses, as well as those dissatisfied with their dental and overall oral health. Increased mean rates of occlusal disorders were associated with schooling delay and history of toothache in the previous six months. The mean scores suggested accumulation of at least one of the negative oral health indicators in the lower income strata, among adolescents with schooling delay, and in those reporting dental needs. The results suggest priorities for planning and monitoring as a function of oral health requirements.
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Affiliation(s)
| | | | - Karen Glazer Peres
- Universidade Federal de Santa Catarina, Florianópolis, Brasil.,Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
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12
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Baghaie H, Kisely S, Forbes M, Sawyer E, Siskind DJ. A systematic review and meta-analysis of the association between poor oral health and substance abuse. Addiction 2017; 112:765-779. [PMID: 28299855 DOI: 10.1111/add.13754] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/08/2016] [Accepted: 01/02/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Substance use disorders are associated commonly with comorbid physical illness. There are fewer data on dental disease in these conditions, in spite of high rates of dry mouth (xerostomia), as well as the associated indirect or life-style effects such as poverty and lack of access to care. We compared the oral health of people with substance use disorders (SUDs) with non-using controls. METHOD This was a systematic search for studies from the last 35 years of the oral health of people reporting SUDs. We used MEDLINE, PsycInfo, OVID, Google Scholar, EMBASE and article bibliographies. Results were compared with the general population. Oral health was assessed in terms of dental caries and periodontal disease using the following standardized measures: the mean number of decayed, missing and filled teeth (DMFT) or surfaces (DMFS) and probing pocket depth. Non-carious tooth loss was assessed clinically. RESULTS We identified 28 studies that had sufficient data for a meta-analysis, comprising 4086 SU patients and 28 031 controls. People with SUD had significantly higher mean scores for DMFT [mean difference = 5.15, 95% confidence interval (CI) = 2.61-7.69 and DMFS (mean difference = 17.83, 95% CI = 6.85-28.8]. They had more decayed teeth but fewer restorations, indicating reduced access to dental care. Patients with SUD also exhibited greater tooth loss, non-carious tooth loss and destructive periodontal disease compared to controls. CONCLUSION Patients with substance use disorders have greater and more severe dental caries and periodontal disease than the general population, but are less likely to have received dental care.
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Affiliation(s)
- Hooman Baghaie
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
| | - Steve Kisely
- School of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - Malcolm Forbes
- School of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,School of Medicine, The University of Melbourne, Melbourne, VIC, Australia
| | - Emily Sawyer
- James Cook University, Townsville, QLD, Australia
| | - Dan J Siskind
- School of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
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13
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de Silva AM, Martin-Kerry JM, McKee K, Cole D. Caries and periodontal disease in Indigenous adults in Australia: a case of limited and non-contemporary data. AUST HEALTH REV 2017; 41:469-478. [DOI: 10.1071/ah15229] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 06/26/2016] [Indexed: 02/05/2023]
Abstract
Objective The aim of the present study was to identify all evidence about the prevalence and severity of clinically measured caries and periodontal disease in Indigenous adults in Australia published in peer-reviewed journals and to summarise trends over time. In addition, we examined whether the studies investigated associations between putative risk factors and levels of caries and periodontal disease. Methods PubMed was searched in September 2014, with no date limitations, for published peer-reviewed articles reporting the prevalence rates and/or severity of caries and periodontal disease in Indigenous adults living in Australia. Articles were excluded if measurement was not based on clinical assessment and if oral disease was reported only in a specific or targeted sample, and not the general population. Results The search identified 18 papers (reporting on 10 primary studies) that met the inclusion criteria. The studies published clinical data about dental caries and/or periodontal disease in Australian Indigenous adults. The studies reported on oral health for Indigenous adults living in rural (40%), urban (10%) and both urban and rural (50%) locations. Included studies showed that virtually all Indigenous adults living in rural locations had periodontal disease. The data also showed caries prevalence ranged from 46% to 93%. Although 10 studies were identified, the peer-reviewed literature was extremely limited and no published studies were identified that provided statistics for a significant proportion of Australia (Victoria, Tasmania, Queensland or the Australian Capital Territory). There were also inconsistencies in how the data were reported between studies, making comparisons difficult. Conclusions This review highlights a lack of robust and contemporary data to inform the development of policies and programs to address the disparities in oral health in Indigenous populations living in many parts of Australia. What is known about the topic? Many studies report that Indigenous people in Australia have poorer general health compared with non-Indigenous people. What does this paper add? This paper documents the available caries and periodontal disease prevalence and experience for Indigenous adults in Australia published in peer-reviewed journals. It demonstrates significant limitations in the data, including no data in several large Australian jurisdictions, inconsistency with reporting methods and most data available being for Indigenous adults living in rural locations. Therefore, the oral health data available in the peer-reviewed literature do not reflect the situation of all Indigenous people living in Australia. What are the implications for practitioners? It is important for oral health practitioners to have access to current and relevant statistics on the oral health of Indigenous Australians. However, we have highlighted significant evidence gaps for this population group within the peer-reviewed literature and identified the limitations of the available data upon which decisions are currently being made. This paper also identifies ways to capture and report oral health data in the future to enable more meaningful comparisons and relevance for use in policy development.
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14
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Shariff JA, Ahluwalia KP, Papapanou PN. Relationship Between Frequent Recreational Cannabis (Marijuana and Hashish) Use and Periodontitis in Adults in the United States: National Health and Nutrition Examination Survey 2011 to 2012. J Periodontol 2016; 88:273-280. [PMID: 27718772 DOI: 10.1902/jop.2016.160370] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Recreational use of cannabis, following its legalization in some countries, poses emergent oral and periodontal health concerns. The objective of this study is to examine the relationship between frequent recreational cannabis (FRC) (marijuana and hashish) use and periodontitis prevalence among adults in the United States. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) 2011 to 2012 were analyzed. Primary outcome (periodontitis) was defined using the Centers for Disease Control and Prevention/American Academy of Periodontology classification as well as continuous measurements of probing depth (PD) and clinical attachment loss (AL). Exposure of interest was self-reported cannabis use, defined as "FRC use" versus "non-FRC use." Bivariate and multivariable regression models were performed using the entire analytical sample (model 1) as well as those who had never used tobacco (never-users) (model 2). RESULTS Of 1,938 participants with available cannabis use data and essential covariates, 26.8% were FRC users. Mean number of sites per participant with PD ≥4, ≥6, and ≥8 mm and AL ≥3, ≥5, and ≥8 mm was significantly higher among FRC users than among non-FRC users (mean difference in number of PD sites: 6.9, 5.6, and 5.6; P <0.05; mean difference in number of AL sites: 12.7, 7.6, and 5.6; P <0.05). Average AL was higher among FRC users than among non-FRC users (1.8 versus 1.6 mm; P = 0.004). Bivariate analysis revealed positive (harmful) association between FRC use and severe periodontitis in the entire sample (odds ratio [OR]: 1.7, 95% confidence interval [CI]: 1.3 to 2.4; P = 0.002) as well as in never-smokers (OR: 2.0, 95% CI: 1.2 to 3.5; P = 0.01). This association was retained in multivariable models adjusted for demographics (age, sex, race/ethnicity, and income level), alcohol and tobacco use, diabetes mellitus, and past periodontal treatment (model 1: adjusted OR [aOR]: 1.4, 95% CI: 1.1 to 1.9; P = 0.07; model 2: aOR: 1.9, 95% CI: 1.1 to 3.2; P = 0.03). CONCLUSION FRC use is associated with deeper PDs, more clinical AL, and higher odds of having severe periodontitis.
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Affiliation(s)
- Jaffer A Shariff
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, NY
| | - Kavita P Ahluwalia
- Division of Behavioral Sciences, Section of Population Oral Health, Columbia University College of Dental Medicine
| | - Panos N Papapanou
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, NY
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