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Fleming E, Taylor GW, Neighbors HW. Systemic racism and racial inequities in periodontal health: The long journey from upstream determinants to downstream treatment. Periodontol 2000 2024. [PMID: 38501675 DOI: 10.1111/prd.12559] [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: 10/28/2023] [Accepted: 01/11/2024] [Indexed: 03/20/2024]
Abstract
Racial disparities in the prevalence of periodontal disease are consistent and persistent. The epidemiology of periodontal disease demonstrates racial inequities: non-Hispanic Black (14.7%), Mexican American (13.4%), and other Hispanic adults (7.8%) experience a higher prevalence of severe periodontal disease than non-Hispanic White adults (5.9%). Epidemiologic and clinical research on periodontal health suffers from the same problem that has plagued the health equity movement, an over emphasis on describing racial inequities coupled with few interventions that reduce racial health inequity. Over the decades that racial inequities in periodontal disease have been observed, many have argued that systemic racism is the fundamental driver of racial health inequity. This paper interrogates the roles of systemic racism, dental education, clinical treatment, and patient behavior in periodontal disease. We describe how, together, these mechanisms contribute to racial disparities in periodontal outcomes. However, it is insufficient for oral health equity scientists to only describe and discuss the negative effects of systemic racism. The imperative is to create antiracist strategies designed to eliminate systemic racism. Health equity scientists must also specify how dental systems operate in a racist manner and create effective clinical strategies designed to reduce racial disparities in periodontal disease.
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Affiliation(s)
- Eleanor Fleming
- Department of Dental Public Health, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - George W Taylor
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Harold Woody Neighbors
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Cozier YC, Heaton B, Robles Y, C Bond J, I Garcia R, Coogan P, Rosenberg L. Perceived racism associated with declines in self-rated oral health among U.S. Black women. Ann Epidemiol 2023; 84:54-59. [PMID: 37244316 PMCID: PMC10525027 DOI: 10.1016/j.annepidem.2023.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 05/29/2023]
Abstract
PURPOSE Racial disparities in oral health are well-documented. Stress has been associated with both perceived racism and oral health, yet little research has directly investigated the association between perceived racism and oral health. METHODS We used data from the Black Women's Health Study, a longitudinal cohort study that includes a geographically diverse sample of Black women across the United States. Perceived exposure to racism was assessed via two scales, one assessing lifetime exposure and one everyday exposure. Self-rated oral health was subsequently assessed over multiple time points. We used Cox proportional hazard models to calculate adjusted incidence rate ratios estimating the association between higher levels of perceived racism and incident "fair" or "poor" oral health, and explored potential effect measure modification using stratified models. RESULTS The adjusted incidence rate ratios (n = 27,008) relating perceived racism to incident fair or poor oral health were 1.50 (95% confidence interval 1.35, 1.66) comparing the highest quartile of everyday racism to the lowest and 1.45 (95% confidence interval 1.31, 1.61) for the highest score of lifetime racism compared to the lowest. We did not see evidence of effect modification. CONCLUSIONS Higher levels of perceived racism documented in 2009 were associated with declines in self-rated oral health from 2011 to 2019.
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Affiliation(s)
- Yvette C Cozier
- Slone Epidemiology Center at Boston University, Boston, MA; Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Brenda Heaton
- Department of Epidemiology, Boston University School of Public Health, Boston, MA; Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, MA.
| | - Yvonne Robles
- Slone Epidemiology Center at Boston University, Boston, MA
| | - Julia C Bond
- Department of Epidemiology, Boston University School of Public Health, Boston, MA; Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, MA
| | - Raul I Garcia
- Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, MA
| | | | - Lynn Rosenberg
- Slone Epidemiology Center at Boston University, Boston, MA
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Kim S, Kwon YS, Hong KH. What Is the Relationship between the Chewing Ability and Nutritional Status of the Elderly in Korea? Nutrients 2023; 15:2042. [PMID: 37432195 DOI: 10.3390/nu15092042] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 04/12/2023] [Accepted: 04/21/2023] [Indexed: 07/12/2023] Open
Abstract
This study aims to determine the relationship between chewing ability and the nutritional status of the elderly in Korea. This study utilized the data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2013-2018 for persons who were ≥65 years of age. Of the 7835 subjects, 43.2% had chewing difficulty. Compared to the normal group, the chewing difficulty group had more stress, lower exercise frequency, less snack intake, a lower frequency of eating out, and a higher proportion of food insecurity. The chewing difficulty group had significantly lower food intake compared to the normal group, including various food groups such as cereals and grain, potatoes, fruits, meat, and milks and dairy products. The intake of fresh fruits was 24.5% lower and the intake of plant food (fresh fruits and nonstarchy vegetables) was 17.8% lower in the chewing difficulty group compared to the normal group. In addition, the intake of most nutrients (carbohydrates, fat, calcium, phosphorus, sodium, potassium, vitamin A, riboflavin, niacin, and vitamin C) was significantly lower in the chewing difficulty group than in the normal group. The chewing difficulty was significantly associated with undernutrition (OR = 1.63). In conclusion, chewing ability is closely related to food and nutrient intake among the elderly, which can decrease the quantity and quality of diet and is also related to undernutrition. Therefore, it is necessary to develop customized nutrition programs and aging-friendly food products that consider the chewing ability of the elderly.
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Affiliation(s)
- Sohye Kim
- Nutrition Care Services, Seoul National University of Bundang Hospital, Seongnam 13620, Republic of Korea
- Department of Medical Nutrition, Graduate School of East-West Science, Kyung Hee University, Yongin 17104, Republic of Korea
| | - Yong-Seok Kwon
- Department of Agro-Food Resources, National Institute of Agricultural Sciences, Wanju 55365, Republic of Korea
| | - Kyung Hee Hong
- Department of Food Science and Nutrition, Dongseo University, Busan 47011, Republic of Korea
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Fernando C, Ha DH, Do LG, Tadakamadla SK. Socioeconomic Status and Toothbrushing in Indigenous and Non-Indigenous Australian Children. JDR Clin Trans Res 2023; 8:139-147. [PMID: 35360957 DOI: 10.1177/23800844221086205] [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] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Dental caries in children is a multifactorial and complex condition. Toothbrushing helps maintain good oral hygiene and delivers fluoride. However, determinants of toothbrushing could vary based on Indigenous status. OBJECTIVE This study aimed to assess the association between socioeconomic status and adequate toothbrushing practice (brushing twice or more a day) in Indigenous and non-Indigenous Australian children. METHODS Data were acquired from the National Child Oral Health Survey (NCOHS) 2012 to 2014. NCOHS administered questionnaires to parents of a representative sample of 24,215 Australian children aged 5 to 14 y recruited using a complex sampling method. Data on the frequency of toothbrushing and socioeconomic status were collected through the questionnaires. Statistical analysis was conducted progressively from bivariate to multivariable regression modeling, stratified by Indigenous status. RESULTS Just over half of Indigenous children and over two-thirds of non-Indigenous children reported adequate toothbrushing. The prevalence of adequate brushing (twice or more a day) was 42% (95% confidence interval [CI], 1.10-1.84) higher among children with an overseas-born parent than those with Australian-born parents. Among non-Indigenous children, sex and age, parents' country of birth, number of children in the family, and other family socioeconomic indicators (education, income, private health insurance) were associated with adequate toothbrushing. The prevalence of adequate brushing was 1.09 (95% CI, 1.03-1.15) and 1.15 (95% CI, 1.10-1.21) times higher when their parent possessed vocational training and tertiary education, respectively, compared to those children whose parents had school-level education. CONCLUSIONS There were differences in patterns of socioeconomic disparities for toothbrushing practices between Indigenous and non-Indigenous Australian children. KNOWLEDGE TRANSFER STATEMENT To promote positive toothbrushing practices in children, dental clinicians and public health professionals must be aware of the determinants of toothbrushing practices. Socioeconomic disparities in toothbrushing frequency were more apparent in non-Indigenous children. These results will help develop population-specific interventions that tackle the determinants to help improve oral hygiene behavior in Indigenous and non-Indigenous children.
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Affiliation(s)
- C Fernando
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - D H Ha
- School of Dentistry, The University of Queensland, Brisbane, Australia
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - L G Do
- School of Dentistry, The University of Queensland, Brisbane, Australia
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - S K Tadakamadla
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Khajavi A, Radvar M, Moeintaghavi A. Socioeconomic determinants of periodontitis. Periodontol 2000 2022; 90:13-44. [PMID: 35950737 DOI: 10.1111/prd.12448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Amin Khajavi
- Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Radvar
- Department of Periodontology, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Moeintaghavi
- Department of Periodontology, Mashhad University of Medical Sciences, Mashhad, Iran
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Koffi-Coulibaly NT, Pockpa ZAD, Mobio GS, Struillou X, Soueidan A. Prevalence and risk indicators for severe periodontitis in Côte d’Ivoire. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2022; 14:7-12. [PMID: 35919450 PMCID: PMC9339718 DOI: 10.34172/japid.2022.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022]
Abstract
Background The present study evaluated the prevalence of severe periodontitis (SP) and determined the possible relevant risk factors among patients referred to the Periodontology Department at the Dental Care Center of the Odontostomatology Training and Research Unit of Abidjan, in Côte d’Ivoire.
Methods This retrospective observational study was based on 1087 patients data aged 18‒80 years, who were treated in the periodontology department from December 2008 to December 2018. Severe periodontitis (stages III or IV) was defined as interdental clinical attachment loss (CAL)>5 mm at two non-adjacent teeth. Two groups were considered: patients with severe periodontitis (test) or without severe periodontitis (control). Differences between the two groups were tested using the chi-squared test and ANOVA. Furthermore, logistic regression analysis was used to model the relationship between the severity of periodontitis and covariables as potential risk indicators. Results 43.4% of patients had severe periodontitis with a mean CAL of 6.89 mm. SP was associated with age (P=0.004), socioeconomic status (P=0.005), smoking habits (P=0.000), brushing frequency (P=0.000), the number of mobile teeth (P<0.001), and the number of lost teeth (P<0.001). Logistic regression analysis showed that having at least five mobile teeth (OR= 4.11, 95% CI: 2.95‒5.73) and/or five missing teeth (OR=2.60, 95% CI: 1.85‒3.66) were independent risk indicators for severe periodontal disease.
Conclusion This Ivorian sample presented a high prevalence of severe periodontal diseases. Therefore, proper public health measures would allow early detection, with targeted and effective treatment of the Ivorian population.
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Affiliation(s)
| | | | - Gnaba Samson Mobio
- Department of Periodontology, Dental College, Felix Houphouet Boigny University, Cote d’Ivoire
| | - Xavier Struillou
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes, France
| | - Assem Soueidan
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes, France
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Koffi-Coulibaly NT, Pockpa ZAD, Mobio GS. Prevalence and severity of periodontitis among adults in Côte d’Ivoire according to the new EFP/AAP periodontal disease classification. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2021; 13:76-83. [PMID: 35919678 PMCID: PMC9327475 DOI: 10.34172/japid.2021.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/25/2021] [Indexed: 11/09/2022]
Abstract
Background To describe the prevalence and severity of periodontitis in patients attending the Periodontics Service of the Cocody University Hospital at Abidjan. Methods This retrospective observational study reviewed records of patients aged 20-80 years who attended the Periodontics Service between January 2014 and December 2018. Periodontitis was diagnosed, according to the 2018 EFP/AAP new classification of Periodontal and Peri-Implant Diseases and Conditions. Chi-square test, 1-factor Anova test, and logistic regression were performed for analysis. Results A total number of 596 patients were included. The mean age was 44.94 ± 14.34 years and 59.20% of were males. 2 (0.40%) patients were classified as Stage I, 221 (37.08%) as Stage II, and 373 (62.58%) as Stage III/V; the extent of periodontitis was generalized in 39.77% of patients. PD ≥ 6 mm, missing teeth ≥ 5 and mobile teeth were present in 47.15%, 26.35% and 25.50% of the sample, respectively.Severity of periodontitis were associated with age (p < 0.001), socio-economic status (p=0.001), diabetes (p < 0.001), missing teeth (p < 0.001) and smoking (p=0.009). Age (OR= 1.59, 95% CI: 1.11-2.26) and missing teeth (OR= 2.31, 95% CI: 1.08-4.89) were identified as independent risks indicators. Conclusion The prevalence and severity of periodontitis were high. Risks indicators identified may allow early detection and management of groups at high risk in Côte d’Ivoire.
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Affiliation(s)
| | | | - Gnaba Samson Mobio
- Department of Periodontology, Dental College, Felix Houphouet Boigny University, Cote d’Ivoire
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Greater inequalities in dental caries treatment than in caries experience: a concentration index decomposition approach. BMC Oral Health 2021; 21:564. [PMID: 34749711 PMCID: PMC8573976 DOI: 10.1186/s12903-021-01935-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 10/25/2021] [Indexed: 12/04/2022] Open
Abstract
Background The aim of the current study was to (a) measure the socioeconomic inequalities in oral health and examine whether the inequalities are greater in disease experience or in its treatment and to (b) decompose the factors that influence oral health inequalities among the adults of Guangdong Province. Methods A cross-sectional study was conducted among 35- to 44-year-old and 65- to 74-year-old adults in Guangdong Province. All participants underwent oral health examinations and answered questionnaires about their oral health. We measured the concentration indices of the DMFT and its separate components, namely, decayed teeth (DT), missing teeth (MT), and filled teeth (FT), to explore the inequalities in oral health status; then, we analysed its decomposition to interpret the factors that influence the inequalities. Results The results showed that significant inequality was concentrated on FT (CI = 0.24, 95% CI = 0.14/0.33, SE = 0.05). The concentration indices for the DMFT (CI = 0.02, 95% CI = 0.02/0.06, SE = 0.02) and MT (CI = 0.02, 95% CI 0.03/0.08, SE = 0.03) were small and close to zero, while the concentration for DT (CI = − 0.04, 95% CI = − 0.01/0.02, SE = 0.03) was not statistically significant. The results from the decomposition analysis suggested that a substantial proportion of the inequality was explained by household income, high education level, regular oral examination and type of insurance (5.1%, 12.4%, 43.2%, − 39.6% (Urban Employee Basic Medical Insurance System) and 34.5% (New-Type Rural Medical Collaboration System), respectively). Conclusions The results indicated greater inequalities in dental caries than in caries experience. Among the included factors, household income, high education level, and regular oral health examinations had the greatest impact on the inequalities in the number of FT. In addition, the current medical insurance systems, including the Urban Employee Basic Medical Insurance System, Urban Resident Basic Medical Insurance System, and the New-Type Rural Medical Collaboration System, have not been effectively used in oral treatment. Policy-making and the implementation of interventions for tackling socioeconomic oral health inequalities should focus on reducing the burden of treatment and providing greater access to dental care for low-income groups. Welfare policies are skewed towards rural areas and low-income people.
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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.
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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
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Muralikrishnan M, Sabbah W. Is Racial Discrimination Associated with Number of Missing Teeth Among American Adults? J Racial Ethn Health Disparities 2021; 8:1293-1299. [PMID: 33051748 PMCID: PMC8452587 DOI: 10.1007/s40615-020-00891-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/18/2020] [Accepted: 10/04/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The objectives of this study are to assess the association of racial discrimination with tooth loss among American adults and whether this relationship, if existed, explains ethnic differences in tooth loss. METHODS Data is from the Behavioural Risk Factor Surveillance System (BRFSS) 2014, a cross-sectional survey of a nationally representative sample of American adults. The survey included data on sociodemographic characteristics, behaviour, health insurance and number of missing teeth. The survey also included questions on whether a person was treated differently because of his/her race. Logistic regression analysis was conducted to assess the relationship between tooth loss and indicators of discrimination. We also examined the relation between ethnicity and indicators of discrimination. RESULTS The analysis included 4858 participants aged 18 to 44 years. Tooth loss (> one tooth) was reported by 26% of participants. Among those reporting discrimination at healthcare facility, there was 141% increase in tooth loss compared to those not reporting discrimination. Discrimination at work and emotional impact of discrimination were both significantly associated with tooth loss in the partially adjusted models. Accounting for discrimination slightly attenuated ethnic differences in too loss. Black Americans had significantly higher odds for reporting all types of discrimination used here. CONCLUSION This study demonstrated a potential role for discrimination in tooth loss among American adults. Discrimination could also explain part of ethnic inequalities in oral health.
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Affiliation(s)
- Malini Muralikrishnan
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, 2nd Floor Dental Extension, Bessemer Road, Denmark Hill, London, SE5 9RS, UK
| | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, 2nd Floor Dental Extension, Bessemer Road, Denmark Hill, London, SE5 9RS, UK.
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Srinarupat J, Oshiro A, Zaitsu T, Prasertsom P, Niyomsilp K, Kawaguchi Y, Aida J. Inequalities in Periodontal Disease According to Insurance Schemes in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5945. [PMID: 34206095 PMCID: PMC8199551 DOI: 10.3390/ijerph18115945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 01/06/2023]
Abstract
Few studies have considered the effects of insurance on periodontal disease. We aimed to investigate the association between insurance schemes and periodontal disease among adults, using Thailand's National Oral Health Survey (2017) data. A modified Community Periodontal Index was used to measure periodontal disease. Insurance schemes were categorized into the Universal Coverage Scheme (UCS), Civil Servant Medical Benefit Scheme (CSMBS), Social Security Scheme (SSS), and "others". Poisson regression was applied to estimate the prevalence ratios (PRs) of insurance schemes for periodontal disease, with adjustment for age, gender, residential location, education attainment, and income. The data of 4534 participants (mean age, 39.6 ± 2.9 years; 2194 men, 2340 women) were analyzed. The proportions of participants with gingivitis or periodontitis were 87.6% and 25.9%, respectively. In covariate adjusted models, lowest education (PRs, 1.03; 95% CI, 1.01-1.06) and UCS (PRs, 1.05; 95% CI, 1.02-1.08) yielded significantly higher PRs for gingivitis, whereas lowest education (PRs, 1.20; 95% CI, 1.05-1.37) and UCS (PRs, 1.17; 95% CI, 1.02-1.34) yielded substantially higher PRs for periodontitis. Insurance schemes may be social predictors of periodontal disease. For better oral health, reduced insurance inequalities are required to increase access to regular dental visits and utilization in Thailand.
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Affiliation(s)
- Jarassri Srinarupat
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (J.S.); (T.Z.); (Y.K.); (J.A.)
- Bureau of Dental Health, Department of Health, Ministry of Public Health, Nonthaburi 11000, Thailand; (P.P.); (K.N.)
| | - Akiko Oshiro
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (J.S.); (T.Z.); (Y.K.); (J.A.)
| | - Takashi Zaitsu
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (J.S.); (T.Z.); (Y.K.); (J.A.)
| | - Piyada Prasertsom
- Bureau of Dental Health, Department of Health, Ministry of Public Health, Nonthaburi 11000, Thailand; (P.P.); (K.N.)
| | - Kornkamol Niyomsilp
- Bureau of Dental Health, Department of Health, Ministry of Public Health, Nonthaburi 11000, Thailand; (P.P.); (K.N.)
| | - Yoko Kawaguchi
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (J.S.); (T.Z.); (Y.K.); (J.A.)
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan; (J.S.); (T.Z.); (Y.K.); (J.A.)
- Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Miyagi 980-8575, Japan
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Global Prevalence of Periodontal Disease and Lack of Its Surveillance. ScientificWorldJournal 2020; 2020:2146160. [PMID: 32549797 PMCID: PMC7275199 DOI: 10.1155/2020/2146160] [Citation(s) in RCA: 168] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/23/2020] [Accepted: 04/28/2020] [Indexed: 01/09/2023] Open
Abstract
Background Periodontal disease is a public health problem and is strongly associated with systemic diseases; however, its worldwide distribution is not fully understood. Objective To evaluate global data of periodontal disease: (1) among adolescents, adults, and older population and (2) in low-, middle-, and high-income countries. Methods This ecological study included data of periodontal disease from the World Health Organization's data bank which are based on the Community Periodontal Index of Treatment Needs (CPITN code: 0 = no disease; 1 = bleeding on probing; 2 = calculus; 3 = periodontal pocket (PD) 4-5 mm; 4 = PD (6+ mm). Age- and income-related periodontal disease inequalities were evaluated across the globe. Results Compared with 9.3% of adults and 9.7% of older persons, 21.2% of adolescents had no periodontal disease (P = 0.005). Nearly 18.8% of adolescents compared with 8.9% of adults and 5% of older persons had bleeding on probing (P ≤ 0.001). Similarly, 50.3% of adolescents, 44.6% of adults, and 31.9% older persons demonstrated the occurrence of calculus (P = 0.01). On the other hand, older persons had the highest prevalence of PD 4-5 mm and PD 6+ mm than adults and adolescents (P ≤ 0.001). The distribution of periodontitis (CPITN code 3 + 4) in adults differed significantly in low- (28.7%), lower-middle- (10%), upper-middle- (42.5%), and high-income countries (43.7%) (P = 0.04). However, no significant differences in periodontitis (CPITN code 3 + 4) were observed in adolescents and older persons in low- to high-income countries. Conclusions Within the limitations of data, this study found that the distribution of periodontal disease increases with age. Periodontitis was the most common in older persons and in population from high-income countries.
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Cozier YC, Heaton B, Bethea TN, Freudenheim JL, Garcia RI, Rosenberg L. Predictors of self-reported oral health in the Black Women's Health Study. J Public Health Dent 2020; 80:70-78. [PMID: 31840825 PMCID: PMC7227786 DOI: 10.1111/jphd.12351] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 11/21/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To describe the self-reported oral health of participants in the Black Women's Health Study (BWHS), a national cohort of 59,000 Black women, and to assess factors associated with this self-report. METHODS Annual follow-up of the BWHS cohort occurs via surveys. The 2011 questionnaire included oral health self-report items, on which 38,573 respondents had complete data. Sample characteristics were summarized using descriptive statistics. We assessed correlations with several covariates by estimating odds ratios using multivariable-adjusted logistic regression models. RESULTS Those who reported fair or poor oral health were more likely to report current smoking, recent tooth loss, diabetes or hypertension diagnoses, lower education levels, obesity, and higher parity. Few factors were related to self-reported gum disease with bone loss. CONCLUSIONS The oral health of US Black women is poorly understood. Correlates of oral health in the BWHS are largely consistent with what has been observed in other populations.
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Affiliation(s)
| | - Brenda Heaton
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Traci N. Bethea
- Slone Epidemiology Center, Boston University, Boston, MA, USA
| | - Jo L. Freudenheim
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Raul I. Garcia
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Lynn Rosenberg
- Slone Epidemiology Center, Boston University, Boston, MA, USA
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14
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Hagenfeld D, Zimmermann H, Korb K, El-Sayed N, Fricke J, Greiser KH, Kühnisch J, Linseisen J, Meisinger C, Schmitter M, Kim TS, Becher H. Periodontal Health and Use of Oral Health Services: A Comparison of Germans and Two Migrant Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16163000. [PMID: 31434329 PMCID: PMC6720619 DOI: 10.3390/ijerph16163000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/15/2019] [Accepted: 08/18/2019] [Indexed: 01/19/2023]
Abstract
A cross-sectional study was performed with 251 individuals, consisting of 127 Germans, 68 migrants from Turkey, and 56 resettlers (migrants from the former Soviet Union with German ancestors) to compare periodontal health status, with a special focus on associations with lifestyle and anthropometric factors, and use of dental health services. Maximal pocket depth was used as a clinical surrogate marker for periodontitis. Other variables were obtained by questionnaires administered by a Turkish or Russian interpreter. The age- and sex-adjusted prevalence of periodontitis was significantly higher in Turks (odds ratio (OR) 2.84, 95% CI = 1.53–5.26) and slightly higher in resettlers (OR = 1.33, 95% CI = 0.71–2.49). These differences are partly explained by a differential distribution of known risk factors for periodontitis. A full model showed a higher prevalence of maximal pocket depth above 5 mm in Turks (OR = 1.97, 95% CI = 0.99–3.92). Use of oral health services was significantly lower in the two migrant groups. Individuals who reported regular visits to a dentist had significantly less periodontitis, independent of migrant status. A reasonable conclusion is that, since oral health causes major chronic diseases and has a major effect on total health system expenditures, public health efforts both generally and specifically focused on migrant groups are warranted.
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Affiliation(s)
- Daniel Hagenfeld
- Section of Periodontology, Department of Conservative Dentistry, University of Heidelberg, 69120 Heidelberg, Germany
- Department of Periodontology and Restorative Dentistry, University-Hospital of Münster, 48149 Münster, Germany
| | - Heiko Zimmermann
- Institute of Global Health, University of Heidelberg, 69120 Heidelberg, Germany
| | - Katja Korb
- Department of Orthodontics, University of Heidelberg, 69120 Heidelberg, Germany
| | - Nihad El-Sayed
- Section of Periodontology, Department of Conservative Dentistry, University of Heidelberg, 69120 Heidelberg, Germany
| | - Julia Fricke
- Division of Cancer Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, 10117, Berlin, Germany
| | - Karin Halina Greiser
- Division of Cancer Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany
| | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, Ludwig-Maximilians-University of Munich, 80336 München, Germany
| | - Jakob Linseisen
- German Research Center for Environmental Health, Institute of Epidemiology II, Helmholtz Zentrum München, D-85764 Neuherberg, Germany
| | - Christa Meisinger
- German Research Center for Environmental Health, Institute of Epidemiology II, Helmholtz Zentrum München, D-85764 Neuherberg, Germany
| | - Marc Schmitter
- Department of Prosthodontics, University of Würzburg, 97070 Würzburg, Germany
| | - Ti-Sun Kim
- Section of Periodontology, Department of Conservative Dentistry, University of Heidelberg, 69120 Heidelberg, Germany
| | - Heiko Becher
- Institute of Global Health, University of Heidelberg, 69120 Heidelberg, Germany.
- Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
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15
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Fauroux MA, Germa A, Tramini P, Nabet C. Prosthetic treatment in the adult French population: Prevalence and relation with demographic, socioeconomic and medical characteristics. Rev Epidemiol Sante Publique 2019; 67:223-231. [PMID: 31204147 DOI: 10.1016/j.respe.2019.04.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 04/05/2019] [Accepted: 04/10/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND The aim of this study was to estimate the prevalence of dental prosthetic treatment and to investigate the demographic, social, economic and medical factors associated with the use of fixed and removable dentures in a representative sample of adults living in France. METHODS The data were obtained from the 2002-2003 Decennial Health Survey, a cross-sectional study of a representative sample of the population living in France, which included 29,679 adults. Information was collected by interview. The variables collected were fixed denture, removable denture, age, gender, number of children, area of residence, nationality, educational attainment, family social status, employment status, annual household income per capita, supplementary insurance, chronic disease, eyesight problems/glasses, hearing problems/hearing aids. Multinomial logistic regression models were used to study the relationship between prosthetic treatment and demographic, socioeconomic and medical characteristics unadjusted, adjusted for age and adjusted for all the characteristics. RESULTS The prevalence of prosthetic treatment was 34.6% (95% confidence interval (CI): [34.1; 35.2]) for fixed prosthetic dentures and 13.8% (95% CI: [13.4; 14.2]) for removable prosthetic dentures. We showed a gradient between educational attainment and removable dentures; the odds ratio adjusted for all the variables (aOR) associated with no or primary education compared to post-secondary education was 2.56; 95% CI: [2.09; 3.13]. When annual household income per capita was low, subjects were less likely to report fixed dentures (aOR=0.68; 95% CI: [0.62; 0.75]) than those with high annual household income per capita. Individuals without insurance less often reported fixed dentures than those with private insurance. Those reporting chronic disease were less likely to report fixed dentures (aOR=0.87; 95% CI: [0.79; 0.95]) but more likely to report removable dentures (aOR=1.29; 95% CI: [1.17; 1.43]) than those without chronic disease. CONCLUSION This study reveals social, economic and medical inequalities in fixed and removable prosthetic treatment among adults in France.
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Affiliation(s)
- M-A Fauroux
- EA4203 Bio-nano laboratory, faculty of dentistry of Montpellier, 545, avenue du Pr JL Viala, 34193 Montpellier cedex 5, France.
| | - A Germa
- Faculty of dentistry of Paris Descartes, 92120 Montrouge, France; Inserm, UMR1153, obstetrical, perinatal, and pediatric epidemiology (EPOPE) Team, Epidemiology and Biostatistics, Sorbonne Paris Cité Research Center, 75004 Paris, France.
| | - P Tramini
- EA2415 clinical research university institute (IURC), faculty of dentistry of Montpellier, 545, avenue du Pr JL Viala, 34193 Montpellier cedex 5, France.
| | - C Nabet
- Inserm UMR 1027, faculty of dentistry of Toulouse, Toulouse university, 3, chemin des Maraîchers, 31062 Toulouse cedex 09, France.
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16
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Gerlovin H, Michaud DS, Cozier YC, Palmer JR. Oral Health in Relation to Pancreatic Cancer Risk in African American Women. Cancer Epidemiol Biomarkers Prev 2019; 28:675-679. [PMID: 30923045 DOI: 10.1158/1055-9965.epi-18-1053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 11/19/2018] [Accepted: 01/14/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Incidence of pancreatic cancer is higher in African Americans than in U.S. whites. We hypothesized that poor oral health, disproportionately common in African Americans and associated with increased risk of pancreatic cancer in several studies of predominantly white populations, may play a role in this disparity. METHODS We examined the relation of self-reported measures of oral health (periodontal disease and adult tooth loss) in relation to pancreatic cancer incidence in the prospective Black Women's Health Study (BWHS). Cox proportional hazard analyses were used to calculate HRs of pancreatic cancer for women with periodontal disease, tooth loss, or both, relative to women who reported neither. Multivariable models adjusted for age, cigarette smoking, body mass index (BMI), type 2 diabetes, and alcohol consumption. RESULTS Participants aged 33 to 81 were followed for an average of 9.85 years from 2007 through 2016, with occurrence of 78 incidence cases of pancreatic cancer. Multivariable HRs for pancreatic cancer incidence were 1.77 [95% confidence interval (CI) 0.57-5.49] for periodontal disease with no tooth loss, 2.05 (95% CI, 1.08-3.88) for tooth loss without report of periodontal disease, and 1.58 (95% CI, 0.70-3.57) for both tooth loss and periodontal disease. The HR for loss of at least five teeth, regardless of whether periodontal disease was reported, was 2.20 (95% CI, 1.11-4.33). CONCLUSIONS The poor oral health experienced by many African Americans may contribute to their higher incidence of pancreatic cancer. IMPACT Future research will assess associations between the oral microbiome and pancreatic cancer risk in this population.
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Affiliation(s)
- Hanna Gerlovin
- Slone Epidemiology Center at Boston University, Boston, Massachusetts.,Boston University School of Public Health, Boston, Massachusetts
| | - Dominique S Michaud
- Department of Public Health and Community Medicine, Tufts University Medical School, Boston, Massachusetts
| | - Yvette C Cozier
- Slone Epidemiology Center at Boston University, Boston, Massachusetts.,Boston University School of Public Health, Boston, Massachusetts
| | - Julie R Palmer
- Slone Epidemiology Center at Boston University, Boston, Massachusetts. .,Boston University School of Public Health, Boston, Massachusetts
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17
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Gonzalez-Navarro B, Pintó-Sala X, Corbella E, Jané-Salas E, Miedema MD, Yeboah J, Shea S, Nasir K, Comin-Colet J, Corbella X, Lopez-López J, Blumenthal RS, Blaha MJ, Cainzos-Achirica M. Associations between self-reported periodontal disease, assessed using a very short questionnaire, cardiovascular disease events and all-cause mortality in a contemporary multi-ethnic population: The Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2018; 278:110-116. [PMID: 30265891 DOI: 10.1016/j.atherosclerosis.2018.09.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS Periodontal disease (PD) is believed to be associated with cardiovascular disease (CVD) events. Nevertheless, the additive prognostic value of PD for the prediction of CVD events beyond traditional risk factors is unclear, particularly when self-reported using a short questionnaire. METHODS In the community-based, multicenter, prospective, Multi-Ethnic Study of Atherosclerosis (MESA), PD was assessed at baseline using a two-item questionnaire. We used Cox proportional hazards regression models to evaluate the independent associations between self-reported PD and coronary heart disease (CHD), CVD events, and all-cause death. In addition, the area under the receiver-operator characteristic curve (AUC) was calculated for each of the study endpoints, for models including traditional CVD risk factors alone and models including traditional CVD risk factors plus information on PD. Subgroup analyses were performed stratifying by age and tobacco use. RESULTS Among the 6640 MESA participants, high education level, high income, and access to healthcare were more frequent among individuals who self-reported PD. In multivariable analyses, null associations were observed between self-reported PD and incident CVD events, CHD events, and all-cause mortality; and self-reported PD did not improve risk prediction beyond traditional CVD risk factors in terms of AUC, for any of the three study endpoints. Subgroup analyses were consistent with the overall results. CONCLUSIONS Our findings suggest that the prevalence of self-reported PD may be strongly influenced by educational status and other socioeconomic features. In this context, self-reported PD does not improve CVD risk assessment when evaluated using a brief questionnaire. Future studies should prioritize objective, dental health-expert assessments of PD.
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Affiliation(s)
- Beatriz Gonzalez-Navarro
- Oral Health and Masticatory System Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Odonto-Stomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Xavier Pintó-Sala
- Cardiovascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Emili Corbella
- Cardiovascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Enric Jané-Salas
- Oral Health and Masticatory System Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Odonto-Stomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Steve Shea
- Departments of Medicine and Epidemiology, Columbia University, New York, NY, USA
| | | | - Josep Comin-Colet
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Xavier Corbella
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jose Lopez-López
- Oral Health and Masticatory System Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Odonto-Stomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain; Dental Hospital Barcelona University (HOUB), University of Barcelona, Barcelona, Spain
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Miguel Cainzos-Achirica
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain; RTI Health Solutions, Pharmacoepidemiology and Risk Management, Barcelona, Spain.
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18
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Shim SH, Han DH. Association between height and periodontitis in Korean adults: Results from KNHANES IV and V. J Periodontal Res 2017; 53:345-352. [PMID: 29159808 DOI: 10.1111/jre.12519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Evidence shows that a short stature in adulthood is associated with chronic diseases. However, few studies have investigated the association between height and periodontitis. The purpose of this study was to examine the relationship between adult height and periodontitis and to assess the roles of covariates in different birth cohorts of Korea. MATERIAL AND METHODS This was a cross-sectional study using the data from the 4th and 5th Korea National Health and Nutritional Examination Survey. The subjects were grouped into 2 birth cohorts based on their historical and social context: born from 1946 to 1962 and from 1963 to 1978. The dependent variables were periodontitis and severe periodontitis, while the independent variable was the height quartile. Demographic factors (age and gender), socioeconomic position (own education, region and income), health behaviors (frequency of daily tooth brushing and smoking) and medical status (diabetes) were included. Logistic regression analyses estimated the association of adult height with periodontitis after sequential adjustments. RESULTS The sample size of the final analysis was 18 010. The shortest quartile was associated with severe periodontitis (OR = 1.55, 95% CI 1.11-2.16) in the 1963-1978 birth cohort. The association remained after full adjustment in the 1963-1978 birth cohort (OR = 1.41, 95% CI 1.01-1.97). CONCLUSION Our study shows that there is an inverse association between height and severe periodontitis only in the younger Korean birth cohort. Our results support the impact of height, as an early childhood environmental indicator, on severe periodontitis in adulthood.
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Affiliation(s)
- S-H Shim
- Department of Dental Hygiene, Kyungbok University, Namyangju, Korea
| | - D-H Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
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19
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Heaton B, Gordon NB, Garcia RI, Rosenberg L, Rich S, Fox MP, Cozier YC. A Clinical Validation of Self-Reported Periodontitis Among Participants in the Black Women's Health Study. J Periodontol 2017; 88:582-592. [PMID: 28088874 PMCID: PMC5556388 DOI: 10.1902/jop.2017.160678] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND There is a paucity of data on the validity of self-report of periodontal disease in African Americans. The Black Women's Health Study (BWHS), a United States national cohort study of 59,000 black women followed via mailed questionnaires since 1995, offered the opportunity to clinically validate self-reported periodontitis among a sample of participants. METHODS Oral health questionnaires were sent to study participants residing in Massachusetts. Respondents living in the Boston metro area were invited for clinical examination. Self-reports were compared with clinical data obtained from the 77 women (mean age: 59 years) who were examined. The authors examined the predictive ability of individual and combined questionnaire items with respect to clinical periodontal disease severity. Validation parameters were calculated for each question, and receiver operating characteristic statistics were generated to compare questionnaire items. RESULTS Periodontitis prevalence in the validation sample was 24% for severe periodontitis and 61% for moderate disease. Performance of individual questionnaire items with respect to predicting periodontitis was better for severe compared with moderate disease. Combinations of questionnaire items improved the predictive ability with respect to severe disease beyond that of individual questionnaire items. CONCLUSIONS Prevalence of severe periodontitis was similar to other age-comparable populations, without regard for race or sex, whereas prevalence of total periodontitis (moderate and severe) among women of similar age and/or race was much higher. Predictive ability of questionnaire items assessed in the BWHS was similar to that in other studies.
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Affiliation(s)
- Brenda Heaton
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA
| | - Nicholas B. Gordon
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA
| | - Raul I. Garcia
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA
| | | | - Sharron Rich
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA
| | - Matthew P. Fox
- Department of Epidemiology, School of Public Health, Boston University
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20
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Kwon SH, Park HR, Lee YM, Kwon SY, Kim OS, Kim HY, Lim YS. Difference in food and nutrient intakes in Korean elderly people according to chewing difficulty: using data from the Korea National Health and Nutrition Examination Survey 2013 (6th). Nutr Res Pract 2017; 11:139-146. [PMID: 28386387 PMCID: PMC5376532 DOI: 10.4162/nrp.2017.11.2.139] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/14/2016] [Accepted: 01/04/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND/OBJECTIVES Chewing difficulty is a factor contributing to a poor nutritional status in the elderly. The aim of this study was to examine disparities in food and nutrition intakes among Korean elderly people with and without chewing difficulty. SUBJECTS/METHODS This study utilized data from the sixth Korea National Health and Nutrition Examination Survey conducted in 2013. The study subjects included males and females over 65 years of age who were not required to adhere to a special diet due to disease or sickness. They were divided into groups according to their chewing ability. Those who found chewing “very difficult” or “difficult”, were combined to form the chewing difficulty group. Similarly, those who found chewing “moderately difficult”, “easy”, and “very easy” were combined to form the normal chewing group. RESULTS Of the 999 subjects, 47.7% had chewing difficulties and the prevalence of chewing difficulty was higher in females than in males (P = 0.03) and higher in those 75 years of age and over than in younger individuals (P < 0.001). The chewing difficulty group had a significantly lower intake of fruits and vegetables (P < 0.05) and lower vitamin C and potassium intake than those in the normal group. Comparison of the percentages of Dietary Reference Intakes for Koreans (KDRIs) in the two groups indicated that the intake of most nutrients (energy, vitamin C, thiamin, riboflavin, niacin, calcium, phosphorus, sodium, potassium, and iron) were significantly lower in the chewing difficulty group than in the normal group. In particular, calcium intake was inadequate (51% of KDRIs) in the chewing difficulty group. CONCLUSIONS The results indicate that chewing difficulty is closely related to food and nutrient intake in the elderly and can result in vitamin and mineral intake deficiencies. It is evident that the care of elderly subjects with chewing difficulty is essential for maintaining a healthy lifestyle.
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Affiliation(s)
- Song Hee Kwon
- Department of Food and Nutrition, Myongji University, 116, Myongji-ro, Cheoin-gu, Yongin-si, Gyeonggi 17058, Korea
| | - Hae Ryun Park
- Department of Food and Nutrition, Myongji University, 116, Myongji-ro, Cheoin-gu, Yongin-si, Gyeonggi 17058, Korea
| | - Young Mi Lee
- Department of Food and Nutrition, Myongji University, 116, Myongji-ro, Cheoin-gu, Yongin-si, Gyeonggi 17058, Korea
| | - Soo Youn Kwon
- Department of Food and Nutrition, Honam University, Gwangju 62399, Korea
| | - Ok Sun Kim
- Department of Food and Nutrition, Jangan University, Gyeonggi 18331, Korea
| | - Hee Young Kim
- Department of Occupational Therapy, Honam University, Gwangju 62399, Korea
| | - Young Suk Lim
- Department of Food and Nutrition, Myongji University, 116, Myongji-ro, Cheoin-gu, Yongin-si, Gyeonggi 17058, Korea
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21
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Khocht A, Rogers T, Janal MN, Brown M. Gingival Fluid Inflammatory Biomarkers and Hypertension in African Americans. JDR Clin Trans Res 2017; 2:269-277. [PMID: 28879249 DOI: 10.1177/2380084417694335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Hypertension and periodontitis are highly prevalent among African Americans. This cross-sectional study investigated the relationships among inflammatory biomarkers in the gingival fluid, periodontitis, and blood pressure in these individuals. Twenty-one subjects who reported a diagnosis of hypertension and a comparison group of 26 nonhypertensive participants were enrolled. All were African Americans, non-cigarette smoking, and free from other systemic illness. Blood pressure and body mass index were assessed. A comprehensive periodontal examination was performed. Gingival fluid was collected from 3 healthy sites and 3 diseased sites when available. Samples were assessed for 8-isoprostane, interleukin 1β, monocyte chemoattractant protein 1, tumor necrosis factor-alpha (TNFα), C-reactive protein (CRP), and matrix metalloproteinase 8. Regardless of hypertension status, diseased sites were associated with increased levels of these biomarkers. CRP and TNFα levels were also significantly higher in hypertensive than nonhypertensive individuals without diseased sites. After adjusting for demographics and body mass index, periodontal attachment loss was higher among hypertensive than nonhypertensive subjects. TNFα and CRP levels and hypertension were in the same association pathway with attachment loss. Elevated blood pressure may increase the risk of periodontitis through a localized inflammatory mechanism. Knowledge Transfer Statement: The results of this study can be used by clinicians to better understand the etiology and pathogenesis of periodontitis in hypertensive individuals in general and African Americans in particular. The information could lead to better management of periodontal disease.
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Affiliation(s)
- A Khocht
- Department of Periodontics, Loma Linda University, Loma Linda, CA, USA
| | - T Rogers
- Center for Inflammation, Temple University, Philadelphia, PA, USA
| | - M N Janal
- College of Dentistry, New York University, NY, USA
| | - M Brown
- Kinesiology and Nutrition, University of Illinois, Chicago, IL, USA
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22
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Abstract
Assessment of the periodontium has relied exclusively on a variety of physical measurements (e.g., attachment level, probing depth, bone loss, mobility, recession, degree of inflammation, etc.) in relation to various case definitions of periodontal disease. Periodontal health was often an afterthought and was simply defined as the absence of the signs and symptoms of a periodontal disease. Accordingly, these strict and sometimes disparate definitions of periodontal disease have resulted in an idealistic requirement of a pristine periodontium for periodontal health, which makes us all diseased in one way or another. Furthermore, the consequence of not having a realistic definition of health has resulted in potentially questionable recommendations. The aim of this manuscript was to assess the biological, environmental, sociological, economic, educational and psychological relationships that are germane to constructing a paradigm that defines periodontal health using a modified wellness model. The paradigm includes four cardinal characteristics, i.e., 1) a functional dentition, 2) the painless function of a dentition, 3) the stability of the periodontal attachment apparatus, and 4) the psychological and social well-being of the individual. Finally, strategies and policies that advocate periodontal health were appraised. I'm not sick but I'm not well, and it's a sin to live so well. Flagpole Sitta, Harvey Danger
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Grubbs V, Vittinghoff E, Taylor G, Kritz-Silverstein D, Powe N, Bibbins-Domingo K, Ishani A, Cummings SR. The association of periodontal disease with kidney function decline: a longitudinal retrospective analysis of the MrOS dental study. Nephrol Dial Transplant 2015; 31:466-72. [PMID: 26320037 DOI: 10.1093/ndt/gfv312] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 07/06/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Identifying modifiable risk factors for chronic kidney disease (CKD) is essential for reducing its burden. Periodontal disease is common, modifiable and has been implicated as a novel potential CKD risk factor, but evidence of its association with kidney function decline over time is limited. METHODS In a longitudinal retrospective cohort of 761 elderly men with preserved kidney function [estimated glomerular filtration rate > 60 mL/min/1.73 m(2) using a calibrated creatinine and cystatin C (eGFRcr-cys) equation] at baseline, we performed multivariable Poisson's regression to examine the association of severe periodontal disease with incident CKD, defined as incident eGFRcr-cys <60 mL/min/1.73 m(2) and rapid (>5% annualized) eGFRcr-cys decline. Severe periodontal disease was defined in two ways: (i) ≥5 mm proximal attachment loss in 30% of teeth examined (European Workshop in Periodontology Group C, European Workshop); and (ii) 2+ interproximal sites with attachment loss ≥6 mm and 1+ interproximal sites with probing depth ≥5 mm (Centers for Disease Control/American Academy of Periodontology, CDC/AAP). RESULTS At baseline, the mean age was 73.4 (SD 4.8) years, the median eGFRcr-cys was 82.4 mL/min/1.73 m(2), and 35.5 and 25.4% of participants had severe periodontal disease by European Workshop and CDC/AAP criteria, respectively. After a mean follow-up of 4.9 years (SD 0.3), 56 (7.4%) participants had incident CKD. Severe periodontal disease was associated with a 2-fold greater rate of incident CKD [incidence rate ratio (IRR) 2.01 (1.21-3.44), P = 0.007] after adjusting for confounders compared with not severe periodontal disease by European Workshop criteria but did not reach statistical significance by CDC/AAP criteria [IRR 1.10 (0.63-1.91), P = 0.9]. CONCLUSIONS Severe periodontal disease may be associated with incident clinically significant kidney function decline among a cohort of elderly men.
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Affiliation(s)
- Vanessa Grubbs
- Division of Nephrology, University of California, San Francisco/San Francisco General Hospital, San Francisco, CA, USA
| | - Eric Vittinghoff
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - George Taylor
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco,San Francisco, CA, USA
| | - Donna Kritz-Silverstein
- Department of Family Medicine & Public Health, University of California, San Diego, San Diego, CA, USA
| | - Neil Powe
- Department of Medicine, University of California, San Francisco/San Francisco General Hospital, San Francisco, CA, USA
| | | | - Areef Ishani
- Division of Nephrology, University of Minnesota, Minneapolis, MN, USA
| | - Steven R Cummings
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA
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Sanchez-Torres D, Gutierrez-Bejarano D, Hurtado-Roca Y, Guallar-Castillon P, Muntner P, Laclaustra M. Non-linear association of periodontal pathogen antibodies with mortality. Int J Cardiol 2015; 187:628-36. [DOI: 10.1016/j.ijcard.2015.03.315] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/18/2015] [Accepted: 03/20/2015] [Indexed: 12/01/2022]
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de Araujo Neris M, Cortelli SC, Aquino DR, de Miranda TB, Costa FDO, Cortelli JR. A. actinomycetemcomitans profile and red complex bacterial species of an Afro-Brazilian community: A comparative study. Arch Oral Biol 2015; 60:753-9. [DOI: 10.1016/j.archoralbio.2015.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Revised: 11/18/2014] [Accepted: 01/31/2015] [Indexed: 11/29/2022]
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Influence of Demographics on Patients' Receipt of Endodontic Therapy or Implant Placement. J Endod 2015; 41:470-2. [DOI: 10.1016/j.joen.2014.12.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/17/2014] [Accepted: 12/28/2014] [Indexed: 12/27/2022]
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Lee MY, Chang SJ, Kim CB, Chung WG, Choi EM, Kim NH. Community periodontal treatment needs in South Korea. Int J Dent Hyg 2014; 13:254-60. [DOI: 10.1111/idh.12102] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2014] [Indexed: 01/22/2023]
Affiliation(s)
- M-Y Lee
- Department of Dental Hygiene; The Graduate School; Yonsei University; Seoul Korea
- Department of Preventive Medicine; Institute of Occupational & Environmental Medicine; Wonju College of Medicine; Yonsei University; Wonju Korea
| | - S-J Chang
- Department of Preventive Medicine; Institute of Occupational & Environmental Medicine; Wonju College of Medicine; Yonsei University; Wonju Korea
| | - C-B Kim
- Department of Preventive Medicine; Institute for Poverty Alleviation and International Development (IPAID); Wonju College of Medicine; Yonsei University; Wonju Korea
| | - W-G Chung
- Department of Dental Hygiene; Wonju College of Medicine; Yonsei University; Wonju Korea
| | - E-M Choi
- Department of Dental Hygiene; Kyungdong University; Wonju Korea
| | - N-H Kim
- Department of Dental Hygiene; Wonju College of Medicine; Yonsei University; Wonju Korea
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Mejia G, Jamieson LM, Ha D, Spencer AJ. Greater inequalities in dental treatment than in disease experience. J Dent Res 2014; 93:966-71. [PMID: 25081039 DOI: 10.1177/0022034514545516] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study aimed to (1) describe social gradients in dental caries in a population-level survey and (2) examine whether inequalities are greater in disease experience or in its treatment. Using data from Australia's National Survey of Adult Oral Health 2004-2006, we examined absolute and relative income inequalities for DMFT and its separate components (DT, MT, FT) using adjusted proportions, means, and health disparity indices [Slope Index of Inequality (SII) and Relative Index of Inequality (RII)]. Approximately 90% of Australian adults had experienced caries, with prevalence ranging from 89.7% in the highest to 96.6% in the lowest income group. Social gradients in caries were evident across all components of DMFT, but particularly notable in Missing (SII = -15.5, RII = -0.3) and untreated Decay (SII = -23.7, RII = -0.9). Analysis of age- and gender-adjusted data indicated less variation in levels of disease experienced (DMFT) than in the health outcomes of its management (missing teeth). The findings indicate that social gradients for dental caries have a greater effect on how the disease was treated than on lifetime disease experience.
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Affiliation(s)
- G Mejia
- Australian Research Centre for Population Oral Health, University of Adelaide School of Dentistry, South Australia, Australia
| | - L M Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide School of Dentistry, South Australia, Australia
| | - D Ha
- Australian Research Centre for Population Oral Health, University of Adelaide School of Dentistry, South Australia, Australia
| | - A J Spencer
- Australian Research Centre for Population Oral Health, University of Adelaide School of Dentistry, South Australia, Australia
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Christian LM, Iams J, Porter K, Leblebicioglu B. Self-rated health among pregnant women: associations with objective health indicators, psychological functioning, and serum inflammatory markers. Ann Behav Med 2014; 46:295-309. [PMID: 23765366 DOI: 10.1007/s12160-013-9521-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Biobehavioral correlates of self-rated health in pregnancy are largely unknown. PURPOSE The goals of this study were to examine, in pregnant women, associations of self-rated health with (1) demographics, objective health status, health behaviors, and psychological factors, and (2) serum inflammatory markers. METHODS In the second trimester of pregnancy, 101 women provided a blood sample, completed measures of psychosocial stress, health status, and health behaviors, and received a comprehensive periodontal examination. RESULTS The following independently predicted poorer self-rated health: (1) greater psychological stress, (2) greater objective health diagnoses, (3) higher body mass index, and (4) past smoking (versus never smoking). Poorer self-rated health was associated with higher serum interleukin-1β (p = 0.02) and marginally higher macrophage migration inhibitory factor (p = 0.06). These relationships were not fully accounted for by behavioral/psychological factors. CONCLUSIONS This study provides novel data regarding factors influencing subjective ratings of health and the association of self-rated health with serum inflammatory markers in pregnant women.
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Affiliation(s)
- Lisa M Christian
- Department of Psychiatry, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA,
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Liu Y. The relationship between lifestyle and self-reported oral health among American adults. Int Dent J 2014; 64:46-51. [DOI: 10.1111/idj.12061] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Brennan D, Spencer A. Childhood Oral Health and SES Predictors of Caries in 30-Year-Olds. Caries Res 2014; 48:237-43. [DOI: 10.1159/000354044] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 06/14/2013] [Indexed: 11/19/2022] Open
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McKee MD, Hoac B, Addison WN, Barros NM, Millán JL, Chaussain C. Extracellular matrix mineralization in periodontal tissues: Noncollagenous matrix proteins, enzymes, and relationship to hypophosphatasia and X-linked hypophosphatemia. Periodontol 2000 2013; 63:102-22. [PMID: 23931057 PMCID: PMC3766584 DOI: 10.1111/prd.12029] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2012] [Indexed: 12/26/2022]
Abstract
As broadly demonstrated for the formation of a functional skeleton, proper mineralization of periodontal alveolar bone and teeth - where calcium phosphate crystals are deposited and grow within an extracellular matrix - is essential for dental function. Mineralization defects in tooth dentin and cementum of the periodontium invariably lead to a weak (soft or brittle) dentition in which teeth become loose and prone to infection and are lost prematurely. Mineralization of the extremities of periodontal ligament fibers (Sharpey's fibers) where they insert into tooth cementum and alveolar bone is also essential for the function of the tooth-suspensory apparatus in occlusion and mastication. Molecular determinants of mineralization in these tissues include mineral ion concentrations (phosphate and calcium), pyrophosphate, small integrin-binding ligand N-linked glycoproteins and matrix vesicles. Amongst the enzymes important in regulating these mineralization determinants, two are discussed at length here, with clinical examples given, namely tissue-nonspecific alkaline phosphatase and phosphate-regulating gene with homologies to endopeptidases on the X chromosome. Inactivating mutations in these enzymes in humans and in mouse models lead to the soft bones and teeth characteristic of hypophosphatasia and X-linked hypophosphatemia, respectively, where the levels of local and systemic circulating mineralization determinants are perturbed. In X-linked hypophosphatemia, in addition to renal phosphate wasting causing low circulating phosphate levels, phosphorylated mineralization-regulating small integrin-binding ligand N-linked glycoproteins, such as matrix extracellular phosphoglycoprotein and osteopontin, and the phosphorylated peptides proteolytically released from them, such as the acidic serine- and aspartate-rich-motif peptide, may accumulate locally to impair mineralization in this disease.
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Affiliation(s)
- Marc D. McKee
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
- Department of Anatomy and Cell Biology, Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Betty Hoac
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - William N. Addison
- Department of Oral Medicine, Infection and Immunity, Harvard University School of Dental Medicine, Boston, MA, USA
| | - Nilana M.T. Barros
- Departamento de Biofísica, Universidade Federal de São Paulo, São Paulo, SP, Brasil, and Departamento de Ciências Exatas e da Terra, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - José Luis Millán
- Sanford Children's Health Research Center, Sanford-Burnham Medical Research Institute, La Jolla, CA, USA
| | - Catherine Chaussain
- EA 2496, UFR Odontologie, University Paris Descartes PRES Sorbonne Paris Cité; AP-HP: Odontology Department Bretonneau, Paris and Centre de Référence des Maladies Rares du Métabolisme du Phosphore et du Calcium, Kremlin Bicêtre, France
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Fonesca FA, Jones KM, Mendes DC, dos Santos Neto PE, Ferreira RC, Pordeus IA, de Barros Lima Martins AM. The oral health of seniors in Brazil: addressing the consequences of a historic lack of public health dentistry in an unequal society. Gerodontology 2013; 32:18-27. [DOI: 10.1111/ger.12046] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | - Kimberly M. Jones
- Department of Medical Anthropology; Health Science Studies Graduate Program; Universidade Estadual de Montes Claros (UNIMONTES); Montes Claros Brazil
- Faculdades Integradas do Norte de Minas (FUNORTE); Montes Claros Brazil
| | - Danilo C. Mendes
- Health Science Studies Graduate Program; Universidade Estadual de Montes Claros (UNIMONTES); Montes Claros Brazil
| | - Pedro E. dos Santos Neto
- Department of Dentistry; Universidade Estadual de Montes Claros (UNIMONTES); Montes Claros Brazil
- Department of Medicine; Faculdades Integradas do Norte de Minas (FUNORTE); Montes Claros Brazil
| | - Raquel C. Ferreira
- Department of Community and Preventive Dentistry; Universidade Federal de Minas Gerais (UFMG); Montes Claros Brazil
| | - Isabela A. Pordeus
- Department of Public Health and Epidemiology; Universidade Federal de Minas Gerais (UFMG); Montes Claros Brazil
| | - Andréa M.E. de Barros Lima Martins
- Department of Public Health and Epidemiology; Universidade Estadual de Montes Claros (UNIMONTES); Montes Claros Brazil
- Faculdades Integradas do Norte de Minas (FUNORTE); Montes Claros Brazil
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Holtfreter B, Demmer RT, Bernhardt O, Papapanou PN, Schwahn C, Kocher T, Desvarieux M. A comparison of periodontal status in the two regional, population-based studies of SHIP and INVEST. J Clin Periodontol 2012; 39:1115-24. [PMID: 23061920 PMCID: PMC3499632 DOI: 10.1111/jcpe.12018] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 07/13/2012] [Accepted: 08/17/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare the prevalence of periodontal disease between two randomly selected population-based studies (the Oral Infections and Vascular Disease Epidemiology Study (INVEST) and the Study of Health in Pomerania (SHIP)) and address relevant methodological issues. METHODS Comparison was restricted to 55- to 81-year olds. Attachment loss (AL), probing depth (PD) and tooth count were assessed in INVEST (full-mouth, six sites) and SHIP (half-mouth, four sites). Subjects were classified according to the CDC/AAP case definition. Recording protocols were standardized. Mixed linear or logistic models were used to compare INVEST with SHIP. RESULTS Mean half-mouth AL was lower in INVEST versus SHIP (INVEST: 2.9 mm versus SHIP: 4.0 mm, p < 0.05). Findings were similar across multiple periodontal disease definitions. After equalization of recording protocols and adjustment for periodontal risk factors, mean AL and PD were 1.2 and 0.3 mm lower in INVEST versus SHIP (p < 0.001). The odds for severe periodontitis (CDC/AAP) was 0.2-fold in INVEST versus SHIP (p < 0.001). Confounding effects of age, gender, race/ethnicity, education and use of interdental care devices were highest as indicated by change-in-estimate for study. CONCLUSION Implementation of the proposed method for comparison of epidemiological studies revealed that periodontitis was less prevalent in INVEST compared with SHIP, even after extensive risk-factor adjustment.
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Affiliation(s)
- Birte Holtfreter
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - Ryan T. Demmer
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Olaf Bernhardt
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - Panos N. Papapanou
- Section of Oral and Diagnostic Sciences, Division of Periodontics, Columbia University College of Dental Medicine, New York, NY, USA
| | - Christian Schwahn
- Department of Prosthodontics, Gerodontology, and Biomaterials, University Medicine, Ernst-Moritz-Arndt-University Greifswald, Germany
| | - Thomas Kocher
- Unit of Periodontology, Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Institut National de la Santé et de la Recherche Médicale, Unité 738, Paris, France
- École des Hautes Études en Santé Publique, Paris et Rennes, France
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Lundegren N, Axtelius B, Akerman S. Oral health in the adult population of Skåne, Sweden: a clinical study. Acta Odontol Scand 2012; 70:511-9. [PMID: 22181829 DOI: 10.3109/00016357.2011.640279] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to describe the oral health in the adult population of Skåne by clinical factors with special reference to age, gender, ethnicity and education. MATERIALS AND METHODS Clinical examinations were performed on 451 randomly selected individuals, 20-89 years old, living in Skåne, Sweden. The clinical examination included a radiographic examination and a questionnaire. Clinical variables were put into cross-tabulations along with age, gender, educational level and ethnicity. RESULTS For all of the described clinical variables, except caries, the frequency increased with age. There were no differences in the clinical variables due to gender. The frequencies of missing teeth, caries, periodontal conditions and DMFT were higher among those with a lower educational level. More missing teeth, worse periodontal conditions, more apical destructions and less dental fillings were found in individuals who were not born in Sweden. CONCLUSIONS The oral health in the adult population of Skåne was overall good, with low frequencies of oral disease and a large number of remaining teeth up to a high age. The patients' oral health status, as determined by a dentist's clinical examination, differed due to age, educational level and ethnicity, but not due to gender.
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Affiliation(s)
- Nina Lundegren
- Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Sweden.
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Kim JK, Baker LA, Seirawan H, Crimmins EM. Prevalence of oral health problems in U.S. adults, NHANES 1999-2004: exploring differences by age, education, and race/ethnicity. SPECIAL CARE IN DENTISTRY 2012; 32:234-41. [PMID: 23095066 PMCID: PMC3552432 DOI: 10.1111/j.1754-4505.2012.00280.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Using the National Health and Nutrition Examination Surveys (NHANES) 1999-2004, the authors examined age patterns in oral health indicators by race/ethnicity and socioeconomic status related to edentulism, presence of root caries, and periodontal disease. Our analysis included subjects who were non-Hispanic White, Mexican American, and African American over the age of 20, and who participated in the NHANES oral health examination. African Americans experienced more oral health problems at younger ages; as age increased, so did racial disparities in oral health problems. Lower educational attainment was strongly associated with more oral health problems at all ages. These results may indicate a faster progression of oral health problems with age among African Americans, thus suggesting that the "earlier aging" of members of racial/ethnic minorities which has been reported in prior research may also be found in oral health.
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Affiliation(s)
- Jung Ki Kim
- Andrus Gerontology Center, University of Southern California, Los Angeles, California
| | | | - Hazem Seirawan
- Herman Ostrow School of Dentistry, University of Southern California
| | - Eileen M. Crimmins
- Andrus Gerontology Center, University of Southern California, Los Angeles, California
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Borrell LN, Talih M. Examining periodontal disease disparities among U.S. adults 20 years of age and older: NHANES III (1988-1994) and NHANES 1999-2004. Public Health Rep 2012; 127:497-506. [PMID: 22942467 PMCID: PMC3407849 DOI: 10.1177/003335491212700505] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We examined disparities in periodontal disease in U.S. adults according to age, sex, race/ethnicity, country of birth, education, income, and poverty-income ratio within and between the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) and NHANES 1999-2004. METHODS We assessed disparities and changes therein using prevalence differences and ratios, as well as the Symmetrized Theil Index (STI). While these measures document disparities between pairs of population subgroups, and changes in relative disparities between surveys, the STI is a summary measure of health disparities that also tracks between-group disparities relative to the total population. RESULTS Prevalence differences and ratios for the prevalence of periodontitis, the mean pocket depth (PD), and the mean clinical attachment loss (CAL) suggest that periodontal disease significantly decreased between NHANES III and NHANES 1999-2004 (p<0.01). However, the STI for the prevalence of periodontitis suggests that disparities significantly increased within categories of race/ethnicity, country of birth, and education in NHANES 1999-2004 compared with NHANES III. These findings were corroborated for mean PD and mean CAL (p<0.001): the overall STI significantly increased for mean PD from 4.53% in NHANES III to 11.02% in NHANES 1999-2004 and for mean CAL for teeth with CAL >0 from 31.73% in NHANES III to 43.36% in NHANES 1999-2004. CONCLUSIONS Our findings suggest that inequalities in periodontal disease significantly decreased between NHANES III and NHANES 1999-2004 in the total population and across selected characteristics of the population. However, these inequalities increased within groups of the population in NHANES 1999-2004 compared with NHANES III. These findings call attention to the absolute and relative differences not only between population groups across surveys, but also within population groups within and between surveys.
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Affiliation(s)
- Luisa N Borrell
- The City University of New York, Lehman College, Department of Health Sciences, New York, NY 10468, USA.
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Elani HW, Harper S, Allison PJ, Bedos C, Kaufman JS. Socio-economic inequalities and oral health in Canada and the United States. J Dent Res 2012; 91:865-70. [PMID: 22837551 DOI: 10.1177/0022034512455062] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This paper describes and compares the magnitude of socio-economic inequalities in oral health among adults in Canada and the US over the past 35 years. We analyzed data from nationally representative examination surveys in Canada and the US: Nutrition Canada National Survey (1970-1972, N = 11,546), Canadian Health Measures Survey (2007-2009, N = 3,508), The First National Health and Nutrition Examination Survey (1971-1974, N = 13,131), and National Health and Nutrition Examination Survey (2007-2008, N = 5,707). Oral health outcomes examined were prevalence of edentulism, proportion of individuals having at least 1 untreated decayed tooth, and proportion of individuals having at least 1 filled tooth. Sociodemographic indicators included in our analysis were place of birth, education, and income. Data were age-adjusted, and survey weights were used to account for the complex survey design in making population inferences. Our findings demonstrate that oral health outcomes have improved for adults in both countries. In the 1970s, Canada had a higher prevalence of edentulism and dental decay and lower prevalence of filled teeth. This was also combined with a more pronounced social inequality gradient among place of birth, education, and income groups. Over time, both countries demonstrated a decline in absolute socio-economic inequalities in oral health.
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Affiliation(s)
- H W Elani
- McGill University, 1020 Pine Avenue West, Montreal, QC H3A 1A2, Canada.
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Ioannidou E, Hall Y, Swede H, Himmelfarb J. Periodontitis associated with chronic kidney disease among Mexican Americans. J Public Health Dent 2012; 73:112-9. [PMID: 22775287 PMCID: PMC3470761 DOI: 10.1111/j.1752-7325.2012.00350.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE In comparison to non-Hispanic whites, a number of health-care disparities, including poor oral health, have been identified among Hispanics in general and Mexican Americans in particular. We hypothesized that Mexican Americans with chronic kidney disease (CKD) would have higher prevalence of chronic periodontitis compared with Mexican Americans with normal kidney function, and that the level of kidney function would be inversely related to the prevalence of periodontal disease. METHODS We examined this hypothesis using the National Health and Nutrition Examination Survey 1988-1994 (NHANES III) data set. We followed the American Academy of Periodontology/Center for Disease Control and Prevention case definition for periodontitis. Glomerular filtration rate was estimated using the CKD-Epidemiology equation for Hispanic populations. The classification to CKD stages was based on the National Kidney Foundation Kidney Disease Outcomes Quality Initiative. RESULTS Periodontitis prevalence increased across the kidney function groups showing a statistically significant dose-response association (P<0.001). Mexican Americans with reduced kidney function were twofold more likely to have periodontitis compared with Mexican Americans with normal kidney function after adjusting for potential confounders such as smoking, diabetes, and socioeconomic status. Multivariate adjusted odds ratio for periodontitis significantly increased with 1, 5, and 10 mL/minute estimated glomerular filtration rate reduction from the mean. CONCLUSION This is the first report, to the best our knowledge, that showed an increase of periodontitis prevalence with decreased kidney function in this population.
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Affiliation(s)
- Effie Ioannidou
- Division of Periodontology, Department of Oral Health and Diagnostic Sciences, University of Connecticut Health Center, Farmington, CT 06030-1710, USA.
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Borrell LN, Crawford ND. Socioeconomic position indicators and periodontitis: examining the evidence. Periodontol 2000 2012; 58:69-83. [PMID: 22133367 DOI: 10.1111/j.1600-0757.2011.00416.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Blanchard AK, Wang X, El-Gabalawy H, Tan Q, Orr P, Elias B, Rawsthorne P, Hart D, Chubey S, Bernstein CN. Oral health in a First Nations and a non-Aboriginal population in Manitoba. Int J Circumpolar Health 2012; 71:17394. [PMID: 22456040 PMCID: PMC3417699 DOI: 10.3402/ijch.v71i0.17394] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objectives To analyze the prevalence of poor oral health and selected determinants in First Nations (FN) and Caucasian samples in Manitoba, Canada. Study design Cross-sectional survey, nested in a cohort study. Methods FN and Caucasian participants completed a questionnaire on socio-demographic variables, oral health symptoms, and oral health-related behaviours as part of a broader cohort study comparing these ethnic groups for different chronic immune mediated diseases. Results Caucasians reported higher levels of employment, education, and urban dwelling than FNs (p<0.001). FNs reported smoking more, and having poorer oral health-related behaviours than Caucasians (p<0.001). After adjustment for age and sex, FN reported having more oral health symptoms than Caucasians (odds ratio (OR): 2.71; 95% confidence interval (CI): 1.73, 4.52), but the association was reduced and not statistically significant after adjustment for other socio-demographic variables (OR=1.34; 95% CI: 0.58, 3.10). Oral health symptoms were associated with current smoking among FN (adjusted OR=2.67, 95% CI: 1.05, 6.78). Oral hygiene behaviours were significantly related to smoking status, rural living and education for both groups. Conclusions Oral health-related behaviours and smoking were found to be significant factors explaining poor oral health, which were lower for the FNs cohort than the Caucasian sample. However oral health and related behaviours were less related to their ethnicity than to socio-demographic factors, suggesting that policies to change behaviour will not result in lasting reductions in oral health differences between these groups in Manitoba.
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Valerio MA, Kanjirath PP, Klausner CP, Peters MC. A qualitative examination of patient awareness and understanding of type 2 diabetes and oral health care needs. Diabetes Res Clin Pract 2011; 93:159-165. [PMID: 21514966 DOI: 10.1016/j.diabres.2011.03.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 03/21/2011] [Accepted: 03/28/2011] [Indexed: 11/25/2022]
Abstract
AIMS The study examined awareness and understanding of the bidirectional relationship between type 2 diabetes and oral health care in adult patients with type 2 diabetes. METHODS Focus groups were held with 30 participants with type 2 diabetes. Groups were comprised of African Americans (n=16), Hispanics (n=6), and Caucasians (n=8). A grounded theory approach was used to analyse and interpret findings. RESULTS Participants were unaware of the relationship between type 2 diabetes and oral health but were concerned about the influence of poor oral health on quality of life. Having diabetes was reported as a potential challenge for the coordination and receipt of dental care. Patient-provider communication of diabetes and oral health needs were perceived to be inadequate. CONCLUSIONS Patients with type 2 diabetes are at-risk for poor oral health, yet have limited awareness and understanding of the specific oral health care needs and risks associated with type 2 diabetes. This lack of awareness and understanding of the relationship between diabetes and oral health may be an indicator of inadequate oral health literacy. Addressing the relationship between diabetes and oral health with patients may improve dental outcomes, increase quality of life, and promote oral health literacy in at-risk populations.
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Affiliation(s)
- Melissa A Valerio
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1450 Washington Hts., Ann Arbor, MI, United States.
| | - Preetha P Kanjirath
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Christine P Klausner
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Mathilde C Peters
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI, United States
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Elangovan S, Nalliah R, Allareddy V, Karimbux NY, Allareddy V. Outcomes in Patients Visiting Hospital Emergency Departments in the United States Because of Periodontal Conditions. J Periodontol 2011; 82:809-19. [DOI: 10.1902/jop.2010.100228] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sanders AE, Slade GD, Beck JD, Agústsdóttir H. Secondhand smoke and periodontal disease: atherosclerosis risk in communities study. Am J Public Health 2011; 101 Suppl 1:S339-46. [PMID: 21551377 DOI: 10.2105/ajph.2010.300069] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We investigated the relationship between secondhand smoke and periodontal disease in nonsmokers. METHODS We undertook a cross-sectional analysis of the Atherosclerosis Risk in Communities study with 2739 lifetime nonsmokers aged 53-74 years, unexposed to other sources of tobacco, who received a complete periodontal examination at visit 4. Exposure was reported as average hours per week in close contact with a smoker in the preceding year. We defined severe periodontitis as 5 or more periodontal sites with probing pocket depth of 5 millimeters or more and clinical attachment levels of 3 millimeters or more in those sites. Other outcomes were extent of periodontal probing depths of 4 millimeters or more and extent of clinical attachment levels of 3 millimeters or more. RESULTS In a binary logistic regression model, adjusted odds of severe periodontitis for those exposed to secondhand smoke 1 to 25 hours per week increased 29% (95% confidence interval = 1.0, 1.7); for those exposed to secondhand smoke 26 hours per week, the odds were twice as high (95% confidence interval = 1.2, 3.4) as for those who were unexposed. CONCLUSIONS Exposure to secondhand smoke and severe periodontitis among nonsmokers had a dose-dependent relationship.
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Affiliation(s)
- Anne E Sanders
- Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, NC 27599, USA.
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Lo JC, O'Ryan F, Yang J, Hararah MK, Gonzalez JR, Gordon N, Silver P, Ansfield A, Wang B, Go AS. Oral Health Considerations in Older Women Receiving Oral Bisphosphonate Therapy. J Am Geriatr Soc 2011; 59:916-22. [DOI: 10.1111/j.1532-5415.2011.03371.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ye L, Liu R, White N, Alon US, Cobb CM. Periodontal status of patients with hypophosphatemic rickets: a case series. J Periodontol 2011; 82:1530-5. [PMID: 21417586 DOI: 10.1902/jop.2011.100736] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND It was previously reported that dentin matrix protein 1-null mice, which are the hypophosphatemic rickets animal model, postnatally developed severe periodontal defects. However, to the best of our knowledge, it was not documented whether similar periodontal defects were present in human patients with hypophosphatemic rickets. The aim of this study is to evaluate the periodontal status of adult patients with hypophosphatemic rickets. METHODS This case-series study evaluates the periodontal condition of adults with genetic hypophosphatemic rickets and compared their periodontal status with similar data from several cycles of the National Health and Nutrition Examination Survey (NHANES). Information regarding medical histories, dental histories, intraoral photos, probing depths (PD), calculated clinical attachment loss (AL), the presence of gingival recession, bleeding on probing, and full-mouth radiographic surveys were acquired. Descriptive statistics were used for comparison to NHANES data. RESULTS A total of 10 adult patients with hypophosphatemic rickets (two males and eight females) were evaluated. The definition of periodontitis used in this study is as follows: "A periodontitis case was defined as a person who had ≥ 3 sites with clinical AL ≥ 4 mm and ≥ 2 sites with PD ≥ 3 mm." According to this definition, the patients exhibited periodontal bone loss at a much higher prevalence (60%) compared to the reported national periodontitis prevalence (3.6% to 7.3%). CONCLUSION The preliminary data from our study suggests that patients with hypophosphatemic rickets are more prone to periodontal bone loss than the general population and may require a more careful examination by dental care providers.
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Affiliation(s)
- Ling Ye
- Department of Oral Biology, School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, 64108, USA.
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Abstract
Oral health is essential to overall health in the prenatal period. Pregnancy is not a time to delay dental care. Several studies have shown an association between periodontal disease and poor pregnancy outcomes including preterm birth. Interventions to provide periodontal treatment to pregnant women yield inconsistent results regarding preterm birth but have established the safety of periodontal therapy during pregnancy. Postpartum women in poor dental health readily transmit the tooth decay pathogen Streptococcus mutans from their saliva to their infants, resulting in increased risk of early childhood caries. Preventive services and treatment for acute problems should be recommended, fears allayed, and women referred. Dental radiographs may be performed safely with the use of appropriate shielding. Nonemergent interventions are best provided between 14 and 20 weeks' gestation for comfort and optimal fetal safety. Most gravid women do not seek dental care. Increased interprofessional communication to encourage dentists to treat pregnant women will reduce the number of women without care. In states where it is available, Medicaid coverage of dental services for pregnant women is typically allowed during pregnancy and for 2 months postpartum. Women's health providers should understand the importance of protecting oral health during pregnancy and educate their patients accordingly.
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Affiliation(s)
- Megan K Kloetzel
- Madigan Army Medical Center: Joint Base Lewis-McChord, WA 98431, USA.
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Grubbs V, Plantinga LC, Crews DC, Bibbins-Domingo K, Saran R, Heung M, Patel PR, Burrows NR, Ernst KL, Powe NR. Vulnerable populations and the association between periodontal and chronic kidney disease. Clin J Am Soc Nephrol 2011; 6:711-7. [PMID: 21350109 DOI: 10.2215/cjn.08270910] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Recent studies suggest an overall association between chronic kidney disease (CKD) and periodontal disease, but it is unknown whether this association is similar across various subpopulations. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS This study was a cross-sectional analysis of 2001 to 2004 National Health and Nutrition Examination Survey data. CKD was defined as a urinary albumin-to-creatinine ratio ≥30 mg/g or estimated GFR of 15 to 59 ml/min per 1.73 m(2). Adjusted odds ratios were calculated using multivariable logistic regression with U.S. population-based weighting. RESULTS These analyses included 6199 dentate adult participants (aged 21 to 75 years) with periodontal exams. The estimated prevalences of moderate/severe periodontal disease and CKD were 5.3% and 10.6%, respectively. Periodontal disease was associated with >2-fold higher risk of CKD that was moderately attenuated after adjustment for age, gender, race/ethnicity, tobacco use, hypertension, diabetes, educational attainment, poverty index ratio, and dental care use. There were no statistically significant interactions between periodontal disease and race/ethnicity, educational attainment, or poverty status. Less-than-recommended dental care use was associated with periodontal disease and CKD and was increasingly prevalent among nonwhites, lower educational attainment, and lower poverty status. CONCLUSIONS The association between periodontal disease and CKD is not significantly different among subgroups. However, because nonwhites, those with a lower educational level, and the poor less frequently report use of recommended dental care, the association between periodontal disease and kidney function over time may become stronger among these groups and warrants further investigation.
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Affiliation(s)
- Vanessa Grubbs
- Division of Nephrology, University of California-San Francisco/San Francisco General Hospital Renal Center, Box 1341, 1001 Potrero Avenue, Building 100, Room 342, San Francisco, CA 94110, USA.
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Trevilatto PC, de Souza Pardo AP, Scarel-Caminaga RM, de Brito RB, Alvim-Pereira F, Alvim-Pereira CC, Probst CM, Garlet GP, Sallum AW, Line SR. Association of IL1 gene polymorphisms with chronic periodontitis in Brazilians. Arch Oral Biol 2011; 56:54-62. [DOI: 10.1016/j.archoralbio.2010.09.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 08/21/2010] [Accepted: 09/07/2010] [Indexed: 02/02/2023]
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Bastos JL, Boing AF, Peres KG, Antunes JLF, Peres MA. Periodontal outcomes and social, racial and gender inequalities in Brazil: a systematic review of the literature between 1999 and 2008. CAD SAUDE PUBLICA 2011; 27 Suppl 2:S141-53. [DOI: 10.1590/s0102-311x2011001400003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Accepted: 12/20/2010] [Indexed: 11/21/2022] Open
Abstract
The objective of this study was to review the Brazilian epidemiologic literature on periodontal outcomes and socio-demographic factors, assessing bibliographic and methodological characteristics of this scientific production, as well as the consistency and statistical significance of the examined associations. A systematic review was carried out in six bibliographic sources. The review was limited to the period between 1999 and 2008, without any other type of restriction. Among the 410 papers identified, 29 were included in the review. An increasing number of articles, specifically in the last four years of study, was observed. However, there is a concentration of studies in the South and Southeast regions of Brazil, and many of them are not closely connected to theoretical formulations in the field. In spite of these shortcomings, the review findings corroborate the idea that poor socioeconomic conditions are associated with periodontal outcomes, as demonstrated primarily by income and schooling indicators.
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