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Montero E, Bujaldón R, Montanya E, Calle-Pascual AL, Rojo-Martínez G, Castaño L, Franch-Nadal J, Delgado E, Chaves F, Alonso B, Sanz M, Herrera D. Cross-sectional association between severe periodontitis and diabetes mellitus: A nation-wide cohort study. J Clin Periodontol 2024; 51:368-379. [PMID: 38140803 DOI: 10.1111/jcpe.13937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 11/25/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023]
Abstract
AIM To evaluate the cross-sectional association between severe periodontitis and diabetes mellitus (DM), in a representative sample of Spanish population. MATERIALS AND METHODS The di@bet.es epidemiological study is a population-based cohort study aimed to determine the prevalence and incidence of DM in the adult population of Spain. The at-risk sample at the final examination (2016-2017) included 1751 subjects who completed an oral health questionnaire. This questionnaire, together with demographic and risk factors, had been previously validated to build an algorithm to predict severe periodontitis in the Spanish population. Logistic regression models were used to evaluate the association between severe periodontitis and DM with adjustment for confounding factors. RESULTS In total, 144 subjects developed DM, which yielded 8.2% cumulative incidence. Severe periodontitis was detected in 59.0%, 54.7% or 68.8% of the subjects depending on three different selected criteria at the 2016-2017 exam. All criteria used to define severe periodontitis were associated with DM in unadjusted analysis, but the magnitude of the association decreased after adjusting for significant confounders. The criteria '≥50% of teeth with clinical attachment loss ≥5 mm' presented an odds ratio of 4.9 (95% confidence interval: 2.2-10.7; p ≤ .001) for DM. CONCLUSIONS Severe periodontitis is associated with DM in the Spanish population.
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Affiliation(s)
- Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
- Working Group "Diabetes and Periodontal Diseases" of the Spanish Society of Diabetes (SED) and the Spanish Society of Periodontology (SEPA), Spain
| | - Rocío Bujaldón
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Eduard Montanya
- Bellvitge Hospital-IDIBELL, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Alfonso L Calle-Pascual
- Medical School, University Complutense, Madrid, Spain
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Gemma Rojo-Martínez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- UGC Endocrinología y Nutrición, Hospital regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
| | - Luis Castaño
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Cruces University Hospital, Biocruces Bizkaia Health Research Institute, Endo-ERN, UPV/EHU, Barakaldo, Spain
- Spanish Biomedical Research Network in Rare Disease (CIBERER), Madrid, Spain
| | - Josep Franch-Nadal
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- EAP Raval Sud, Catalan Institute of Health, GEDAPS Network, Primary Care, Research Support Unit (IDIAP-Jordi Gol Foundation), Barcelona, Spain
| | - Elías Delgado
- Department of Endocrinology and Nutrition, Central University Hospital of Asturias/University of Oviedo, Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain
| | - Felipe Chaves
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
- Genomic and Genetic Diagnosis Unit, Research Foundation of Valencia University Clinical Hospital-INCLIVA, Valencia, Spain
| | - Bettina Alonso
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
- Working Group "Diabetes and Periodontal Diseases" of the Spanish Society of Diabetes (SED) and the Spanish Society of Periodontology (SEPA), Spain
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Self-Perception of Periodontal Health and Associated Factors: A Cross-Sectional Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082758. [PMID: 32316219 PMCID: PMC7215350 DOI: 10.3390/ijerph17082758] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 04/13/2020] [Indexed: 12/18/2022]
Abstract
The aim of this cross-sectional study was to explore sociodemographic, behavioral, and clinical factors associated with self-awareness of periodontal health. Data were collected from a representative sample of 736 adults (25–75 years old) in a city of Northern Italy who self-assessed gingival bleeding, oral malodor, and tooth mobility in a questionnaire and who underwent clinical periodontal examination and organoleptic evaluation. Approximately 50% of the subjects were aware of their actual gingival health status and oral odor. The logistic regression analysis revealed that females presented higher odds of correctly perceiving their gingival conditions and mouth odor, while those who were older and smokers had a greater probability of being less objective in reporting them. Tooth type and position in the dental arches were positively associated with self-perception of tooth mobility. These findings reflected a low level of self-awareness that may influence oral care-seeking behavior. Subjects may be unconcerned about their periodontal health condition or lack enough knowledge to be aware of it. This points to the need for planning strategies to improve education and knowledge about periodontal health, which, by enhancing self-perception of periodontal symptoms, could help everyone to seek treatment in the initial stage of the disease.
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Montero E, La Rosa M, Montanya E, Calle‐Pascual AL, Genco RJ, Sanz M, Herrera D. Validation of self‐reported measures of periodontitis in a Spanish Population. J Periodontal Res 2019; 55:400-409. [DOI: 10.1111/jre.12724] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/29/2019] [Accepted: 11/25/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Eduardo Montero
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - Martina La Rosa
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - Eduard Montanya
- Bellvitge Hospital‐IDIBELL Barcelona Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) Barcelona Spain
- Department of Clinical Sciences University of Barcelona Barcelona Spain
| | - Alfonso L. Calle‐Pascual
- Medical School. University Complutense Madrid Spain
- Endocrinology and Nutrition Department Hospital Clínico Universitario San Carlos Madrid Spain
| | | | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
| | - David Herrera
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group University Complutense Madrid Spain
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Carra MC, Gueguen A, Thomas F, Pannier B, Caligiuri G, Steg PG, Zins M, Bouchard P. Self-report assessment of severe periodontitis: Periodontal screening score development. J Clin Periodontol 2018; 45:818-831. [DOI: 10.1111/jcpe.12899] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Maria Clotilde Carra
- Department of Periodontology; Service of Odontology; Rothschild Hospital, AP-HP; Paris France
- U.F.R. of Odontology; Paris 7-Denis Diderot University; Paris France
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Alice Gueguen
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Frédérique Thomas
- Centre d'Investigations Préventives et Cliniques (IPC); Paris France
| | - Bruno Pannier
- Centre d'Investigations Préventives et Cliniques (IPC); Paris France
- Department of Cardiology; Georges Pompidou European Hospital, AP-HP; Paris France
- Medicine Faculty; Paris 5-Descartes University; Paris France
| | | | - Philippe Gabriel Steg
- INSERM-Unité 1148; Paris France
- French Alliance for Cardiovascular Trials (FACT); Département Hospitalo-Universitaire FIRE; Hôpital Bichat; Assistance Publique-Hôpitaux de Paris; Paris France
- Université Paris-Diderot; Sorbonne-Paris Cité; Paris France
- Royal Brompton Hospital; Imperial College; London UK
| | - Marie Zins
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Philippe Bouchard
- Department of Periodontology; Service of Odontology; Rothschild Hospital, AP-HP; Paris France
- U.F.R. of Odontology; Paris 7-Denis Diderot University; Paris France
- EA 2496, Paris 5-Descartes University; Paris France
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Han K, Park JB. Association between oral health behavior and periodontal disease among Korean adults: The Korea national health and nutrition examination survey. Medicine (Baltimore) 2017; 96:e6176. [PMID: 28207558 PMCID: PMC5319547 DOI: 10.1097/md.0000000000006176] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
This study was performed to assess the association between oral health behavior and periodontal disease using nationally representative data.This study involved a cross-sectional analysis and multivariable logistic regression analysis models using the data from the Korean National Health and Nutrition Examination Survey. A community periodontal index greater than or equal to code 3 was used to define periodontal disease.Adjusted odds ratios and their 95% confidence intervals of periodontitis for the toothbrushing after lunch group and the toothbrushing before bedtime group were 0.842 (0.758, 0.936) and 0.814 (0.728, 0.911), respectively, after adjustments for age, sex, body mass index, drinking, exercise, education, income, white blood cell count, and metabolic syndrome. Adjusted odds ratios and their 95% confidence intervals of periodontitis for the floss group and the powered toothbrush group after adjustment were 0.678 (0.588, 0.781) and 0.771 (0.610, 0.974), respectively.The association between oral health behavior and periodontitis was proven by multiple logistic regression analyses after adjusting for confounding factors among Korean adults. Brushing after lunch and before bedtime as well as the use of floss and a powered toothbrush may be considered independent risk indicators of periodontal disease among Korean adults.
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Affiliation(s)
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Kim HD, Shin MS, Kim HT, Kim MS, Ahn YB. Incipient periodontitis and salivary molecules among Korean adults: association and screening ability. J Clin Periodontol 2016; 43:1032-1040. [DOI: 10.1111/jcpe.12607] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2016] [Indexed: 12/23/2022]
Affiliation(s)
- Hyun-Duck Kim
- Department of Preventive and Social Dentistry; School of Dentistry; Seoul National University; Seoul Korea
- Dental Research Institute; School of Dentistry; Seoul National University; Seoul Korea
| | - Myung-Seop Shin
- Department of Preventive and Social Dentistry; School of Dentistry; Seoul National University; Seoul Korea
| | - Hyun-Tae Kim
- Department of Preventive and Social Dentistry; School of Dentistry; Seoul National University; Seoul Korea
| | - Mi-Sun Kim
- Department of Preventive and Social Dentistry; School of Dentistry; Seoul National University; Seoul Korea
| | - Yoo-Been Ahn
- Department of Preventive and Social Dentistry; School of Dentistry; Seoul National University; Seoul Korea
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Garcia RI, Compton R, Dietrich T. Risk assessment and periodontal prevention in primary care. Periodontol 2000 2016; 71:10-21. [DOI: 10.1111/prd.12124] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2015] [Indexed: 11/28/2022]
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Kim HD, Sukhbaatar M, Shin M, Ahn YB, Yoo WS. Validation of periodontitis screening model using sociodemographic, systemic, and molecular information in a Korean population. J Periodontol 2015; 85:1676-83. [PMID: 24965062 DOI: 10.1902/jop.2014.140061] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This study aims to evaluate and validate a periodontitis screening model that includes sociodemographic, metabolic syndrome (MetS), and molecular information, including gingival crevicular fluid (GCF), matrix metalloproteinase (MMP), and blood cytokines. METHODS The authors selected 506 participants from the Shiwha-Banwol cohort: 322 participants from the 2005 cohort for deriving the screening model and 184 participants from the 2007 cohort for its validation. Periodontitis was assessed by dentists using the community periodontal index. Interleukin (IL)-6, IL-8, and tumor necrosis factor-α in blood and MMP-8, -9, and -13 in GCF were assayed using enzyme-linked immunosorbent assay. MetS was assessed by physicians using physical examination and blood laboratory data. Information about age, sex, income, smoking, and drinking was obtained by interview. Logistic regression analysis was applied to finalize the best-fitting model and validate the model using sensitivity, specificity, and c-statistics. RESULTS The derived model for periodontitis screening had a sensitivity of 0.73, specificity of 0.85, and c-statistic of 0.86 (P <0.001); those of the validated model were 0.64, 0.91, and 0.83 (P <0.001), respectively. CONCLUSIONS The model that included age, sex, income, smoking, drinking, and blood and GCF biomarkers could be useful in screening for periodontitis. A future prospective study is indicated for evaluating this model's ability to predict the occurrence of periodontitis.
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Affiliation(s)
- Hyun-Duck Kim
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
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Impact of periodontal disease on outcomes in diabetes. Contemp Clin Trials 2015; 41:93-9. [PMID: 25623292 DOI: 10.1016/j.cct.2015.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 01/16/2015] [Accepted: 01/19/2015] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The prevalence of periodontal disease (POD) among adults aged 30years and older in the United States is reported to be more than 47%, with higher prevalence seen among patients with diabetes mellitus (DM). POD has been associated with systemic inflammation, a known risk factor for cardiovascular and bone disease, both of which are more common in patients with DM. However, there is mixed evidence that treatment of POD reduces inflammation, improves DM control, and reduces DM complications. Our study objectives are to assess factors associated with POD in patients with DM and determine the impact of POD treatment on inflammation and bone turnover biomarkers associated with complications of DM. METHODS In this pilot study, we will first recruit 200 patients with DM to complete a 48-item investigator-administered questionnaire designed to assess socio-economic status, oral health status, adequacy of oral care, glycemic control and presence of DM complications. Responses will be verified by individual chart review. Then, using a crossover design, a subgroup of 24 subjects with responses suggestive of POD will be assigned to undergo POD treatment for three months followed by three months of routine dental care (group 1) or be followed for three months during routine dental care then receive POD treatment for three months (group 2). Outcome measures will be collected before and after POD treatment and include glycemic control and inflammatory and bone turnover biomarkers. RESULTS We hypothesize that the prevalence of POD among DM patients will be associated with inadequate glycemic control and greater DM complications.
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Zhan Y, Holtfreter B, Meisel P, Hoffmann T, Micheelis W, Dietrich T, Kocher T. Prediction of periodontal disease: modelling and validation in different general German populations. J Clin Periodontol 2014; 41:224-31. [DOI: 10.1111/jcpe.12208] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Yiqiang Zhan
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
| | - Birte Holtfreter
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
| | - Peter Meisel
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
| | - Thomas Hoffmann
- Department of Periodontology; Medical Faculty Carl Gustav Carus; Dresden Germany
| | | | - Thomas Dietrich
- Department of Oral Surgery; School of Dentistry; University of Birmingham; Birmingham UK
| | - Thomas Kocher
- Unit of Periodontology; University Medicine; Ernst-Moritz-Arndt University Greifswald; Greifswald Germany
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Wu X, Weng H, Lin X. Self-reported questionnaire for surveillance of periodontitis in Chinese patients from a prosthodontic clinic: a validation study. J Clin Periodontol 2013; 40:616-23. [PMID: 23557490 DOI: 10.1111/jcpe.12103] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 01/18/2013] [Accepted: 02/27/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Xiayi Wu
- Guanghua School and Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Haiyan Weng
- Guanghua School and Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Xuefeng Lin
- Guanghua School and Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
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Jung SH, Ryu JI, Jung DB. Association of total tooth loss with socio-behavioural health indicators in Korean elderly. J Oral Rehabil 2010; 38:517-24. [PMID: 21118289 DOI: 10.1111/j.1365-2842.2010.02178.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study examined the association between total tooth loss, and socio-behavioural factors and general health indicators in elderly Koreans using national databases. Cross-sectional data for this study were from the third Korean National Health and Nutrition Examination Survey (KNHANES III), which was conducted among non-institutionalised civilians by the Korean Ministry of Health and Welfare in 2005. KNHANES III used a stratified, multistage probability sampling design on a representative of total South Korean population, according to geographical areas, age and sex groups. Among them, 1091 subjects aged 65 years and above were identified as potential participants in this study. The dependent variable in this study was the self-reported total tooth loss. The independent variables consisted of the following four categories: demographic information, socio-behavioural factors, psychological factors and general health indicators. The data were weighted to adjust for the sampling complexity, and SPSS version 14 for Windows software was used for data analysis. There were significant differences in total tooth loss odds according to the socio-behavioural backgrounds (education and smoking), psychological conditions (perceived oral health) and general health status (diabetes and body mass index as underweight). This suggests that the total tooth loss is associated with the socio-economic status, health-related behaviour and general health. However, more extensive longitudinal data and research will be needed to better explain the relationship between the total tooth loss and these variables.
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Affiliation(s)
- S H Jung
- Department of Preventive and Public Health Dentistry, Gangneung-Wonju National University, Gangneung, Korea
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