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Lin M, Gao XL, Li W. IL-33 in patients with periodontitis and chronic obstructive pulmonary disease. Hum Immunol 2024:110811. [PMID: 38755030 DOI: 10.1016/j.humimm.2024.110811] [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: 11/13/2023] [Revised: 04/22/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE A link between periodontitis and chronic obstructive pulmonary disease (COPD) has been identified, and interleukin-33 (IL-33) may play an important role in the common inflammatory mechanisms of these diseases. This study analyzed the associations of the serum IL-33 level with the occurrence and severity of periodontitis and COPD. METHODS A total of 161 participants were divided into four groups: healthy volunteers, periodontitis patients, COPD patients, and patients with both COPD and periodontitis. Associations between serum IL-33 levels were measured by enzyme-linked immunosorbent assay, and clinical factors as well as the risks and severity of periodontitis and COPD were analyzed. RESULTS Serum IL-33 levels were lower in all patient groups than in healthy controls. A trend toward lower IL-33 levels was observed among patients with both diseases compared with patients with either disease alone. The serum IL-33 level was also inversely associated with the severity of periodontitis and COPD. The serum IL-33 level was negatively associated with risks of periodontitis and COPD, indicating that IL-33 is likely involved in the pathophysiologic mechanism of the relationship between COPD and periodontitis. CONCLUSION This study advances our understanding of the association between COPD and periodontitis and provides new bases for COPD prevention and treatment.
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Affiliation(s)
- Mei Lin
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiao-Li Gao
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Wei Li
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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2
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Weiss S, Tinsky N, Oren L, Chodick G, Spierer S, Yarom N, Ashkenazi M. Effect of prolonged hospitalization on the maintenance of oral health: A self-report survey. Int J Dent Hyg 2024. [PMID: 38575751 DOI: 10.1111/idh.12804] [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: 07/10/2023] [Revised: 03/16/2024] [Accepted: 03/21/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES This study aims to evaluate the effect of prolonged hospitalization on the maintenance of dental health and to assess the nursing staff's approach to addressing these concerns. METHODS A survey questionnaire explored changes in the routine dental care of patients hospitalized for over a month. The involvement of nursing staff in addressing dental care was also evaluated. RESULTS Fifty adult patients aged 18-89 years (mean age 62.4 ± 20.54 years), 27 (54%) males, completed the survey. During hospitalization (mean 58.59 ± 38.63 days) 26% and 18%, increased consumption of sweets and sugary beverages, between meals, respectively; 26% and 20% of the patients reduced the frequency of tooth brushing in the morning and in the evening, respectively, and 42.2% of them, reduced the quality of their toothbrushing during hospitalization. Nevertheless, 95.9% and 93.9% of them were never instructed during hospitalization to limit their consumption of sweets and sugary beverages and 83.3% and 62.5% of them had never been reminded or offered assistance during hospitalization in performing toothbrushing, respectively. The lower frequency of morning toothbrushing was significantly correlated with a lack of nurses' assistance (p = 0.004). In contrast, 62.6% reported they were reminded every day to shower. Patients in the rehabilitation and geriatrics departments reported a greater need for a brush/toothpaste (p < 0.0001) and assistance in toothbrushing (p < 0.0001). CONCLUSIONS Prolonged hospitalization leads to significant deterioration in inpatients' dental health maintenance. Raising awareness among nurses regarding their inpatient's oral health maintenance is warranted. Providing patients with toothbrushes, toothpaste and educational materials upon hospitalization is recommended.
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Affiliation(s)
| | | | - Liat Oren
- Sheba Medical Center, Tel Hashomer, Israel
| | - Gabi Chodick
- School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Noam Yarom
- Sheba Medical Center, Tel Hashomer, Israel
- School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
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3
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Barbosa De Accioly Mattos M, Bernardo Peixoto C, Geraldo de Castro Amino J, Cortes L, Tura B, Nunn M, Giambiagi-deMarval M, Sansone C. Coronary atherosclerosis and periodontitis have similarities in their clinical presentation. FRONTIERS IN ORAL HEALTH 2024; 4:1324528. [PMID: 38292927 PMCID: PMC10825671 DOI: 10.3389/froh.2023.1324528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024] Open
Abstract
Background Periodontitis (PE) and coronary heart disease (CHD) possess multiple mechanisms for a putative association. This case-control study compared the periodontal status among CHD subjects to controls without CHD, while also investigating atheroma invasion by known periodontal pathogens. Methods 161 subjects participated in this study were divided into three CHD groups: No CHD, chronic CHD, acute CHD. Additional analysis involved grouping subjects according to number of atheromas: no atheroma, 1-4 atheromas, 5-18 atheromas. Data were collected from medical records, periodontal examinations, and questionnaires that included demographic, behavioral, and oral health variables. Angiographic catheterizations were analyzed according to the number of atheroma lesions, lesion size, lesion location, and atheroma lesion stability. Lipoprotein profile, inflammatory markers and cells were analyzed. The microbiological branch added 30 individuals who had their atheroma lesion and subgingival plaque analyzed using polymerase chain reaction probes against the 16 s region, red complex and Aggregatibacter actinomycetemcomitans' DNA. Results Subjects with CHD had high levels of systemic inflammatory markers and low levels of high-density lipoproteins compared to subjects without CHD. Subjects without CHD and clear coronaries had a prevalence of mild CAL, while individuals with more atheroma lesions had advanced CAL and more active PE. Subjects with more advanced CAL were 4 times more likely to have CHD compared to subjects with less, which is comparable to smoking. Only 4 subjects had the screened pathogens detected in atheroma, although these subjects also have the screened pathogens in subgingival plaque. However, 80% of atheromas had bacteria. Conclusions CHD and PE showed similarities in progression while active PE led to more atheroma lesions that also tended to be larger in size.
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Affiliation(s)
- Marcelo Barbosa De Accioly Mattos
- School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Division of Periodontics, University of Kentucky College of Dentistry, Lexington, KY, United States
| | | | | | - Leandro Cortes
- Department of Cardiology, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - Bernardo Tura
- Department of Cardiology, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - Martha Nunn
- Department of Biostatistic, Nunn Biostatistical Solutions, Omaha, NE, United States
| | - Marcia Giambiagi-deMarval
- Instituto de Microbiologia Professor Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carmelo Sansone
- Departamento de Periodontia, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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4
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Moghadam MT, Mojtahedi A, Bakhshayesh B, Babakhani S, Ajorloo P, Shariati A, Mirzaei M, Heidarzadeh S, Jazi FM. The Effect of Bacterial Composition Shifts in the Oral Microbiota on Alzheimer's Disease. Curr Mol Med 2024; 24:167-181. [PMID: 35986539 DOI: 10.2174/1566524023666220819140748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/16/2022] [Accepted: 05/30/2022] [Indexed: 11/22/2022]
Abstract
Alzheimer's disease (AD), a neurological disorder, despite significant advances in medical science, has not yet been definitively cured, and the exact causes of the disease remain unclear. Due to the importance of AD in the clinic, large expenses are spent annually to deal with this neurological disorder, and neurologists warn of an increase in this disease in elderly in the near future. It has been believed that microbiota dysbiosis leads to Alzheimer's as a multi-step disease. In this regard, the presence of footprints of perturbations in the oral microbiome and the predominance of pathogenic bacteria and their effect on the nervous system, especially AD, is a very interesting topic that has been considered by researchers in the last decade. Some studies have looked at the mechanisms by which oral microbiota cause AD. However, many aspects of this interaction are still unclear as to how oral microbiota composition can contribute to this disease. Understanding this interaction requires extensive collaboration by interdisciplinary researchers to explore all aspects of the issue. In order to reveal the link between the composition of the oral microbiota and this disease, researchers from various domains have sought to explain the mechanisms of shift in oral microbiota in AD in this review.
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Affiliation(s)
- Majid Taati Moghadam
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Mojtahedi
- Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Babak Bakhshayesh
- Department of Neurology, Neuroscience Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Sajad Babakhani
- Department of Microbiology, Tehran North Branch, Islamic Azad University, Tehran, Iran
| | - Parisa Ajorloo
- Department of Biology, Sciences and Research Branch, Islamic Azad University, Tehran, Iran
| | - Aref Shariati
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran
| | - Mehrnaz Mirzaei
- Department of Microbiology, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Siamak Heidarzadeh
- Department of Microbiology and Virology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Faramarz Masjedian Jazi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Sansores-España LD, Melgar-Rodríguez S, Olivares-Sagredo K, Cafferata EA, Martínez-Aguilar VM, Vernal R, Paula-Lima AC, Díaz-Zúñiga J. Oral-Gut-Brain Axis in Experimental Models of Periodontitis: Associating Gut Dysbiosis With Neurodegenerative Diseases. FRONTIERS IN AGING 2021; 2:781582. [PMID: 35822001 PMCID: PMC9261337 DOI: 10.3389/fragi.2021.781582] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022]
Abstract
Periodontitis is considered a non-communicable chronic disease caused by a dysbiotic microbiota, which generates a low-grade systemic inflammation that chronically damages the organism. Several studies have associated periodontitis with other chronic non-communicable diseases, such as cardiovascular or neurodegenerative diseases. Besides, the oral bacteria considered a keystone pathogen, Porphyromonas gingivalis, has been detected in the hippocampus and brain cortex. Likewise, gut microbiota dysbiosis triggers a low-grade systemic inflammation, which also favors the risk for both cardiovascular and neurodegenerative diseases. Recently, the existence of an axis of Oral-Gut communication has been proposed, whose possible involvement in the development of neurodegenerative diseases has not been uncovered yet. The present review aims to compile evidence that the dysbiosis of the oral microbiota triggers changes in the gut microbiota, which creates a higher predisposition for the development of neuroinflammatory or neurodegenerative diseases.The Oral-Gut-Brain axis could be defined based on anatomical communications, where the mouth and the intestine are in constant communication. The oral-brain axis is mainly established from the trigeminal nerve and the gut-brain axis from the vagus nerve. The oral-gut communication is defined from an anatomical relation and the constant swallowing of oral bacteria. The gut-brain communication is more complex and due to bacteria-cells, immune and nervous system interactions. Thus, the gut-brain and oral-brain axis are in a bi-directional relationship. Through the qualitative analysis of the selected papers, we conclude that experimental periodontitis could produce both neurodegenerative pathologies and intestinal dysbiosis, and that periodontitis is likely to induce both conditions simultaneously. The severity of the neurodegenerative disease could depend, at least in part, on the effects of periodontitis in the gut microbiota, which could strengthen the immune response and create an injurious inflammatory and dysbiotic cycle. Thus, dementias would have their onset in dysbiotic phenomena that affect the oral cavity or the intestine. The selected studies allow us to speculate that oral-gut-brain communication exists, and bacteria probably get to the brain via trigeminal and vagus nerves.
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Affiliation(s)
- Luis Daniel Sansores-España
- Periodontal Biology Laboratory, Faculty of Dentistry, University of Chile, Santiago, Chile
- Faculty of Dentistry, Autonomous University of Yucatán, Mérida, México
| | | | | | - Emilio A. Cafferata
- Department of Periodontology, School of Dentistry, Universidad Científica Del Sur, Lima, Perú
| | | | - Rolando Vernal
- Periodontal Biology Laboratory, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Andrea Cristina Paula-Lima
- Biomedical Neuroscience Institute, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Neuroscience, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Jaime Díaz-Zúñiga
- Periodontal Biology Laboratory, Faculty of Dentistry, University of Chile, Santiago, Chile
- Department of Medicine, Faculty of Medicine, University of Atacama, Copiapó, Chile
- *Correspondence: Jaime Díaz-Zúñiga, ,
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Kim DH, Han GS. The relationship between periodontal disease and cognitive impairment in older adults of Korea. SPECIAL CARE IN DENTISTRY 2021; 42:170-176. [PMID: 34614224 DOI: 10.1111/scd.12657] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 11/28/2022]
Abstract
AIMS A potential association between the periodontal disease and cognitive impairment has been suggested, but the results are not yet conclusive. This study investigated the association between the two diseases. METHODS AND RESULTS This study included 140 individuals (M: 48, F: 92, average age: 77.2). For assessing cognitive ability, MMSE-KC was used. The BGI index categorizes the periodontal disease based on important clinical parameters. In model 1 using the BGI index and the number of residual teeth as independent variables, the cognitive function status was significantly lower in the DL/MB group (β = -0.294), DL/LB group (β = -0.237). In Model 2 including systemic disease was the DL/MB group (β = -0.316) and in Model 3 which also added demographic characteristics, the DL/MB group (β = -0.229) was identified as a related factor (p < .05). CONCLUSION It can be concluded that periodontal disease is strongly associated with cognitive ability.
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Affiliation(s)
- Dong-Hee Kim
- Department of Dental Hygiene, College of Health Science, Gachon University, 191 Hambangmoero, Yeonsu-gu, Incheon, Republic of Korea
| | - Gyeong-Soon Han
- Department of Dental Hygiene, College of Health Science, Gachon University, 191 Hambangmoero, Yeonsu-gu, Incheon, Republic of Korea
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7
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Baniasadi K, Armoon B, Higgs P, Bayat AH, Mohammadi Gharehghani MA, Hemmat M, Fakhri Y, Mohammadi R, Fattah Moghaddam L, Schroth RJ. The Association of Oral Health Status and socio-economic determinants with Oral Health-Related Quality of Life among the elderly: A systematic review and meta-analysis. Int J Dent Hyg 2021; 19:153-165. [PMID: 33523593 DOI: 10.1111/idh.12489] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 12/15/2020] [Accepted: 01/24/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to determine the relationship between poor Oral Health-Related Quality of Life (OHRQoL) and oral health determinants (eg being 75 years of age or greater, marital status, smoking status, denture wearing, depression, low educational level (≤8th grade), poor general health, caries history, tooth-induced pain, decayed, missing filled teeth (DMFT) scores and periodontal diseases) among the elderly. METHODS Formal search strategies in PubMed, Scopus, Cochrane and Web of Science were performed to identify studies in English published before 1 December 2019. We assessed the impacts of the oral health determinants including being 75 years of age or greater, marital status, smoking status, denture wearing, depression, low educational level (≤8th grade), poor general health, caries history, tooth-induced pain, DMFT scores and periodontal diseases) on OHRQoL among elderly individuals. The data were analysed using Stata 12.0 software. RESULTS In total, 19 publications met the inclusion criteria of this meta-analysis. Findings indicate a positive association between low educational level (ie ≤8th grade), marital status, depression, smoking status, denture wearing, poor general health, tooth-induced pain, periodontal diseases and poor OHRQoL among the elderly. We also observed a negative association between DMFT, being older than 75 years of age on poor OHRQoL among the elderly. CONCLUSIONS This review identified that several oral health determinants were associated with poor OHRQoL. The efficacy of preventive measures and the economic aspects of tooth replacement approaches should be explored in the future. Developing oral healthcare plans and policies with the specific aim of improving OHRQoL among this group is essential.
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Affiliation(s)
- Kamal Baniasadi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Pardis, Iran
| | - Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Peter Higgs
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Amir-Hossein Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | | | - Morteza Hemmat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Yadolah Fakhri
- Food Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Rasool Mohammadi
- Department of Epidemiology and Biostatistics, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ladan Fattah Moghaddam
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Robert J Schroth
- Dr. Gerald Niznick College of Dentistry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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8
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Kumari M, Kumar T, Rai S, Rai A, Sultana R, Priya L. Evaluation of Dental Health in Terminally Ill Patients. J Med Life 2020; 13:321-328. [PMID: 33072203 PMCID: PMC7550152 DOI: 10.25122/jml-2020-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Dental health plays an imperative role in the general health and well-being of an individual. Terminally ill patients due to a compromised immune response are susceptible to a wide array of oral complications, which may affect their ability to speak and chew, leading to malnutrition. The present study was conducted to evaluate dental health and various oral manifestations in terminally ill patients. One hundred twenty terminally ill patients hospitalized with diseases of the respiratory tract, gastrointestinal tract, circulatory system, liver, and endocrinal disorders were included in the study. The evaluation of oral manifestations and their prevalence was done by a single examiner. The oral health was evaluated according to symptoms exhibited by the patients and clinical presentation. Of the patients included in the study, 78 were male, and 42 were female. All the individuals were adults between 25 to 55 years of age. Out of 120 admitted terminally ill patients, 27 subjects had respiratory diseases, 17 had gastrointestinal disorders, 5 had disorders of the circulatory system, 39 had liver disorders, and 32 had endocrine disorders. A need for added comprehension is mandatory to link the inter-relationships between dentistry and medicine to further perk up the management of the overall health of patients, which will further reinforce the partnership between dental and medical communities.
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Affiliation(s)
- Minti Kumari
- Department of Public Health Dentistry, Patna Dental College and Hospital, Patna, India
| | - Tanoj Kumar
- Department of Oral Pathology and Microbiology, Patna Dental College and Hospital, Patna, India
| | - Shweta Rai
- Department of Oral and Maxillofacial Surgery, Buddha Institute of Dental Sciences and Hospital, Kankarbagh, Patna, India
| | - Anurag Rai
- Department of Orthodontics, Patna Dental College and Hospital, Bankipore, Patna, India
| | | | - Leena Priya
- Department of Oral Medicine And Radiology, Buddha Institute of Dental Science and Hospital, Patna, India
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9
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Chen X, D'Souza V, Comnick CL, Xie X. How accurate is the assessment of certified nursing assistants on resident's oral self-care function in three North Carolina assisted-living facilities? SPECIAL CARE IN DENTISTRY 2020; 40:580-588. [PMID: 32991747 DOI: 10.1111/scd.12521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/25/2020] [Accepted: 08/24/2020] [Indexed: 11/27/2022]
Abstract
AIMS To examine the association between the assessments of certified nursing assistants (CNAs) on resident's oral self-care function and resident's oral hygiene outcomes in three North Carolina assisted-living (AL) facilities. METHODS AND RESULTS Sixty-five dentate AL residents were included in this secondary analysis. CNAs were asked to rate the AL residents' overall oral self-care function using a 6-point Likert scale. Their assessments were then compared with the objective, performance-based Dental Activities Test and the oral hygiene and gingival health measures. The analysis showed that nearly 90% of the participants presented with at least one untreated decayed or broken tooth. On average, nearly two-thirds of the surfaces were covered by soft deposits (Debris Index = 1.83, SD = 0.60). Generalized mild to moderate inflammation (Gingival Index = 1.51, SD = 0.53) commonly presented on residents' gingiva. CNAs were able to accurately identify the residents with substantial impairment in oral self-care function, yet they tended to overestimate the oral self-care function of residents with mild to moderate impairment. CNAs assessments were also not significantly correlated with residents' oral hygiene measures. CONCLUSION CNAs failed to identify and provide assistance to AL residents with impaired oral self-care function, contributing to poor oral oral hygiene in these vulnerable individuals.
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Affiliation(s)
- Xi Chen
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa, Iowa City
| | - Violet D'Souza
- Faculty of Dentistry, University of Toronto, Toronto, Canada
| | - Carissa L Comnick
- Department of Biostatistics, School of Public Health, University of Iowa, Iowa, Iowa City
| | - Xianjin Xie
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa, Iowa City
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10
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Jia C, Sun M, Wang W, Li C, Li X, Zhang X. Effect of oral plaque control on postoperative pneumonia following lung cancer surgery. Thorac Cancer 2020; 11:1655-1660. [PMID: 32339413 PMCID: PMC7262942 DOI: 10.1111/1759-7714.13448] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/01/2020] [Accepted: 04/04/2020] [Indexed: 12/03/2022] Open
Abstract
Background There have been few studies on the relationship between oral status and postoperative pneumonia (POP) in patients with lung cancer, and whether improving their oral condition assists with a lower incidence of POP before lung cancer surgery remains controversial. This retrospective study was conducted by a stomatologist to assess the effect of controlling oral pathogenic bacteria of patients with lung cancer to prevent POP. Methods A total of 235 patients with lung cancer who underwent lobectomy by open thoracotomy between July 2015 and December 2018 were selected and given the choice of being in the experimental or control group. A total of 122 participants in the experimental group received professional oral plaque control, and 113 participants in the control group did not receive plaque control. All clinical data of participants in both groups were retrospectively studied to determine the incidence of POP at the thirtieth day of discharge from hospital. Results Eight in the experimental group and six in the control group were excluded from the study. It was found that four of 114 patients suffered from POP in the experimental group (incidence = 3.51%). A total of 17 of 107 patients in the control group had pulmonary infection (incidence = 15.89%). Odds ratio was 0.19. The incidence of POP in the experimental group was significantly lower than that of the control group (P < 0.05). Conclusions Professional oral plaque control is associated with a lower incidence of POP following lung cancer surgery and is therefore a favorable factor for preventing POP, and should be carried out before the surgical treatment of lung cancer. Key points Professional oral plaque control was associated with a lower incidence of POP following lung cancer surgery, and it is recommended this should be carried out before the surgical treatment of lung cancer.
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Affiliation(s)
- Chunling Jia
- Department of Oral Medicine, Qilu Hospital of Shandong University, Jinan, China.,Institute of Stomatology, Shandong University, Jinan, China
| | - Mingxia Sun
- Department of Oral Medicine, Qilu Hospital of Shandong University, Jinan, China.,Institute of Stomatology, Shandong University, Jinan, China
| | - Weizhi Wang
- Department of Oral Medicine, Qilu Hospital of Shandong University, Jinan, China.,Institute of Stomatology, Shandong University, Jinan, China
| | - Cuirong Li
- Department of Oral Medicine, Qilu Hospital of Shandong University, Jinan, China
| | - Xibo Li
- Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, China
| | - Xiaoying Zhang
- Department of Geriatrics, Qilu Hospital of Shandong University, Jinan, China
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11
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Zecha JAEM, Raber-Durlacher JE, Laheij AMGA, Westermann AM, Epstein JB, de Lange J, Smeele LE. The impact of the oral cavity in febrile neutropenia and infectious complications in patients treated with myelosuppressive chemotherapy. Support Care Cancer 2019; 27:3667-3679. [PMID: 31222393 PMCID: PMC6726710 DOI: 10.1007/s00520-019-04925-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 06/05/2019] [Indexed: 12/12/2022]
Abstract
Febrile neutropenia (FN) is an inflammatory response causing fever that may develop during cancer therapy-induced neutropenia. FN may herald life-threatening infectious complications and should therefore be considered a medical emergency. Patients presenting with FN are routinely subjected to careful history taking and physical examination including X-rays and microbiological evaluations. Nevertheless, an infection is documented clinically in only 20-30% of cases, whereas a causative microbial pathogen is not identified in over 70% of FN cases. The oral cavity is generally only visually inspected. Although it is recognized that ulcerative oral mucositis may be involved in the development of FN, the contribution of infections of the periodontium, the dentition, and salivary glands may be underestimated. These infections can be easily overlooked, as symptoms and signs of inflammation may be limited or absent during neutropenia. This narrative review is aimed to inform the clinician on the potential role of the oral cavity as a potential source in the development of FN. Areas for future research directed to advancing optimal management strategies are discussed.
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Affiliation(s)
- Judith A E M Zecha
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Judith E Raber-Durlacher
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Department of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Alexa M G A Laheij
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Anneke M Westermann
- Department of Oncology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Joel B Epstein
- Cedars-Sinai Health System, Los Angeles and City of Hope Cancer Center, Duarte, CA, USA
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Academic Centre for Dentistry, (ACTA), University of Amsterdam, Amsterdam, The Netherlands
| | - Ludi E Smeele
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Academic Centre for Dentistry, (ACTA), University of Amsterdam, Amsterdam, The Netherlands.,Department of Head & Neck Oncology & Surgery, Netherlands Cancer Institute- Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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12
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Fox M, Knorr DA, Haptonstall KM. Alzheimer's disease and symbiotic microbiota: an evolutionary medicine perspective. Ann N Y Acad Sci 2019; 1449:3-24. [PMID: 31180143 DOI: 10.1111/nyas.14129] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/19/2019] [Accepted: 05/03/2019] [Indexed: 12/15/2022]
Abstract
Microorganisms resident in our bodies participate in a variety of regulatory and pathogenic processes. Here, we describe how etiological pathways implicated in Alzheimer's disease (AD) may be regulated or disturbed by symbiotic microbial activity. Furthermore, the composition of symbiotic microbes has changed dramatically across human history alongside the rise of agriculturalism, industrialization, and globalization. We postulate that each of these lifestyle transitions engendered progressive depletion of microbial diversity and enhancement of virulence, thereby enhancing AD risk pathways. It is likely that the human life span extended into the eighth decade tens of thousands of years ago, yet little is known about premodern geriatric epidemiology. We propose that microbiota of the gut, oral cavity, nasal cavity, and brain may modulate AD pathogenesis, and that changes in the microbial composition of these body regions across history suggest escalation of AD risk. Dysbiosis may promote immunoregulatory dysfunction due to inadequate education of the immune system, chronic inflammation, and epithelial barrier permeability. Subsequently, proinflammatory agents-and occasionally microbes-may infiltrate the brain and promote AD pathogenic processes. APOE genotypes appear to moderate the effect of dysbiosis on AD risk. Elucidating the effect of symbiotic microbiota on AD pathogenesis could contribute to basic and translational research.
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Affiliation(s)
- Molly Fox
- Department of Anthropology, University of California Los Angeles, Los Angeles, California.,Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California
| | - Delaney A Knorr
- Department of Anthropology, University of California Los Angeles, Los Angeles, California
| | - Kacey M Haptonstall
- Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, California
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13
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Liccardo D, Cannavo A, Spagnuolo G, Ferrara N, Cittadini A, Rengo C, Rengo G. Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease. Int J Mol Sci 2019; 20:ijms20061414. [PMID: 30897827 PMCID: PMC6470716 DOI: 10.3390/ijms20061414] [Citation(s) in RCA: 207] [Impact Index Per Article: 41.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 02/25/2019] [Accepted: 03/18/2019] [Indexed: 12/18/2022] Open
Abstract
Periodontitis is a chronic inflammatory disease, initiated by the presence of a bacterial biofilm, called dental plaque, which affects both the periodontal ligaments and bone surrounding teeth. In the last decades, several lines of evidence have supported the existence of a relationship between periodontitis and systemic health. For instance, as periodontitis acts within the same chronic inflammatory model seen in cardiovascular disease (CVD), or other disorders, such as diabetes, several studies have suggested the existence of a bi-directional link between periodontal health and these pathologies. For instance, people with diabetes are more susceptible to infections and are more likely to suffer from periodontitis than people without this syndrome. Analogously, it is now evident that cardiac disorders are worsened by periodontitis, both experimentally and in humans. For all these reasons, it is very plausible that preventing periodontitis has an impact on the onset or progression of CVD and diabetes. On these grounds, in this review, we have provided an updated account on the current knowledge concerning periodontal disease and the adverse effects exerted on the cardiovascular system health and diabetes, informing readers on the most recent preclinical studies and epidemiological evidence.
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Affiliation(s)
- Daniela Liccardo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
| | - Alessandro Cannavo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Center for Translational Medicine, Temple University, Philadelphia, PA 19140, USA.
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia.
| | - Nicola Ferrara
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Istituti Clinici Scientifici- ICS Maugeri S.p.A. Telese Terme (BN), 82037 Pavia, Italy.
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
| | - Carlo Rengo
- Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, 53100 Siena, Italy.
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy.
- Istituti Clinici Scientifici- ICS Maugeri S.p.A. Telese Terme (BN), 82037 Pavia, Italy.
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14
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Psychometric Properties of the Dental Activities Test: An Exploratory Factor Analysis in Older Adults with Cognitive Impairment. Behav Neurol 2019; 2018:8625916. [PMID: 30651893 PMCID: PMC6311855 DOI: 10.1155/2018/8625916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 11/05/2018] [Indexed: 11/17/2022] Open
Abstract
Objective The Dental Activities Test (DAT) was developed to be used by dental, nursing, and other health professionals to assess the ability of persons with dementia to perform oral health-related activities and aid care planning. The instrument was designed as a unitary scale and has excellent internal consistency, test-retest reliability, interrater reliability, and construct validity. This study examines the underlying factor structure of the DAT among older adults in assisted living settings. Methods In a secondary analysis of the data from the original study, the results of testing of 90 older adults with normal to severely impaired cognition from three assisted living communities in North Carolina from March 2013 to February 2014 were studied. An exploratory factor analysis was used to assess the dimensionality of the presumed unitary assessment scale. Results Two-factor structures were explored. A one-factor model demonstrated acceptably mixed model fit, and a two-factor model had good model fit with moderate correlation between the two factors (r = 0.667, p < 0.05). All the items in the one-factor model demonstrated significant factor loadings (loadings ≥ 0.39, all p < 0.05), while the loadings of some items in the two-factor model (nonsignificant or cross-loadings, loadings < 0.40) did not meet the criteria of factor selection. The one-factor structure was preferred based on the criteria of Scree Plot, eigenvalue, and factor interpretability in relation to clinical relevance. Conclusions The study provided preliminary evidence that the Dental Activities Test has a unidimensional construct among older adults with cognitive impairment. It suggested that this instrument can be used as a unitary scale to assess dental-related function in persons with dementia. Future testing, including using a confirmatory factor analysis, in a new sample is needed to further assess the usefulness and psychometric properties of this instrument.
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15
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Poudel P, Griffiths R, Wong VW, Arora A, Flack JR, Khoo CL, George A. Oral health knowledge, attitudes and care practices of people with diabetes: a systematic review. BMC Public Health 2018; 18:577. [PMID: 29716561 PMCID: PMC5930945 DOI: 10.1186/s12889-018-5485-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 04/19/2018] [Indexed: 01/26/2023] Open
Abstract
Background People with uncontrolled diabetes are at greater risk for several oral health problems, particularly periodontal (gum) disease. Periodontal disease also impacts diabetes control. Good oral hygiene and regular dental visits are recommended to prevent and manage oral health problems. Several studies have been conducted to assess the oral health knowledge, attitudes, and practices of people with diabetes yet a review of these findings has not yet been undertaken. The aim of this systematic review was to synthesize current evidence on the knowledge, attitudes and practices of people with diabetes in relation to their oral health care. Methods A systematic search of all literature was carried out in five databases using key search terms. The inclusion criteria were: 1) published in the English language; 2) from 2000 to November, 2017; 3) conducted on persons with any type of diabetes and of all ages; 4) explored at least one study outcome (knowledge or attitude or practices toward oral health care); and 5) used quantitative methods of data collection. No restrictions were placed on the quality and setting of the study. Results A total of 28 studies met the inclusion criteria. The studies included a total of 27,894 people with diabetes and were conducted in 14 countries. The review found that people with diabetes have inadequate oral health knowledge, poor oral health attitudes, and fewer dental visits. They rarely receive oral health education and dental referrals from their care providers. Provision of oral health education by diabetes care providers and referral to dentists when required, was associated with improved oral health behaviours among patients. Conclusions Overall, people with diabetes have limited oral health knowledge and poor oral health behaviours. It is therefore essential to educate patients about their increased risk for oral health problems, motivate them for good oral health behaviours and facilitate access to dental care. Electronic supplementary material The online version of this article (10.1186/s12889-018-5485-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Prakash Poudel
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia. .,Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia. .,Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia. .,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.
| | - Rhonda Griffiths
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia
| | - Vincent W Wong
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Amit Arora
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia.,Oral Health Services and Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, 2010, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, Westmead, NSW, 2145, Australia
| | - Jeff R Flack
- South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia.,School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 1797, Australia
| | - Chee L Khoo
- Health Focus Family Practice, The Royal Australian College of General Practitioners (RACGP), National Association of Diabetes Centres (NADC), Ingleburn, NSW, 2565, Australia.,Diabetes , Obesity and Metabolism Translational Research Unit (DOMTRU), Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Ajesh George
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia.,Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,Faculty of Dentistry, University of Sydney, Camperdown, 2050, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia
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16
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Sudhakara P, Gupta A, Bhardwaj A, Wilson A. Oral Dysbiotic Communities and Their Implications in Systemic Diseases. Dent J (Basel) 2018; 6:E10. [PMID: 29659479 PMCID: PMC6023521 DOI: 10.3390/dj6020010] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 03/29/2018] [Accepted: 04/06/2018] [Indexed: 12/20/2022] Open
Abstract
The human body supports the growth of a wide array of microbial communities in various niches such as the oral cavity, gastro-intestinal and urogenital tracts, and on the surface of the skin. These host associated microbial communities include yet-un-cultivable bacteria and are influenced by various factors. Together, these communities of bacteria are referred to as the human microbiome. Human oral microbiome consists of both symbionts and pathobionts. Deviation from symbiosis among the bacterial community leads to “dysbiosis”, a state of community disturbance. Dysbiosis occurs due to many confounding factors that predispose a shift in the composition and relative abundance of microbial communities. Dysbiotic communities have been a major cause for many microbiome related systemic infections. Such dysbiosis is directed by certain important pathogens called the “keystone pathogens”, which can modulate community microbiome variations. One such persistent infection is oral infection, mainly periodontitis, where a wide array of causal organisms have been implied to systemic infections such as cardio vascular disease, diabetes mellitus, rheumatoid arthritis, and Alzheimer’s disease. The keystone pathogens co-occur with many yet-cultivable bacteria and their interactions lead to dysbiosis. This has been the focus of recent research. While immune evasion is one of the major modes that leads to dysbiosis, new processes and new virulence factors of bacteria have been shown to be involved in this important process that determines a disease or health state. This review focuses on such dysbiotic communities, their interactions, and their virulence factors that predispose the host to other systemic implications.
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Affiliation(s)
- Preethi Sudhakara
- Department of Genetic Engineering, SRM University, Chennai 603203, India.
| | - Abishek Gupta
- Department of Genetic Engineering, SRM University, Chennai 603203, India.
| | | | - Aruni Wilson
- Division of Microbiology and Molecular Genetics, School of Medicine, Loma Linda University, Loma Linda, CA 92350, USA.
- Musculoskeletal Diseases Center, VA Loma Linda, Department of Veterans Affairs, Loma Linda, CA 92350, USA.
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17
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Scannapieco FA, Cantos A. Oral inflammation and infection, and chronic medical diseases: implications for the elderly. Periodontol 2000 2018; 72:153-75. [PMID: 27501498 DOI: 10.1111/prd.12129] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2015] [Indexed: 12/12/2022]
Abstract
Oral diseases, such as caries and periodontitis, not only have local effects on the dentition and on tooth-supporting tissues but also may impact a number of systemic conditions. Emerging evidence suggests that poor oral health influences the initiation and/or progression of diseases such as atherosclerosis (with sequelae including myocardial infarction and stoke), diabetes mellitus and neurodegenerative diseases (such as Alzheimer's disease, rheumatoid arthritis and others). Aspiration of oropharyngeal (including periodontal) bacteria causes pneumonia, especially in hospitalized patients and the elderly, and may influence the course of chronic obstructive pulmonary disease. This article addresses several pertinent aspects related to the medical implications of periodontal disease in the elderly. There is moderate evidence that improved oral hygiene may help prevent aspiration pneumonia in high-risk patients. For other medical conditions, because of the absence of well-designed randomized clinical trials in elderly patients, no specific guidance can be provided regarding oral hygiene or periodontal interventions that enhance the medical management of older adults.
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18
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Luong E, deClifford J, Coutsouvelis J, Lam SH, Drysdale P, Danckert R, Campbell E. Implementation of standardised oral care treatment and referral guidelines for older sub-acute patients: a multidisciplinary approach. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2017. [DOI: 10.1002/jppr.1311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Eric Luong
- The Mornington Centre; Peninsula Health; Mornington Australia
| | - Jan deClifford
- Frankston Hospital; Peninsula Health; Frankston Australia
| | - John Coutsouvelis
- Pharmacy Department; Alfred Health; Melbourne Australia
- Centre for Medicine Use and Safety; Monash University; Parkville Australia
| | - Sin Hoon Lam
- Frankston Hospital; Peninsula Health; Frankston Australia
| | - Penni Drysdale
- The Mornington Centre; Peninsula Health; Mornington Australia
| | - Rachael Danckert
- Frankston Community Dental; Peninsula Health; Frankston Australia
| | - Evette Campbell
- The Mornington Centre; Peninsula Health; Mornington Australia
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19
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Pritchard AB, Crean S, Olsen I, Singhrao SK. Periodontitis, Microbiomes and their Role in Alzheimer's Disease. Front Aging Neurosci 2017; 9:336. [PMID: 29114218 PMCID: PMC5660720 DOI: 10.3389/fnagi.2017.00336] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 10/02/2017] [Indexed: 12/11/2022] Open
Abstract
As far back as the eighteenth and early nineteenth centuries, microbial infections were responsible for vast numbers of deaths. The trend reversed with the introduction of antibiotics coinciding with longer life. Increased life expectancy however, accompanied the emergence of age related chronic inflammatory states including the sporadic form of Alzheimer's disease (AD). Taken together, the true challenge of retaining health into later years of life now appears to lie in delaying and/or preventing the progression of chronic inflammatory diseases, through identifying and influencing modifiable risk factors. Diverse pathogens, including periodontal bacteria have been associated with AD brains. Amyloid-beta (Aβ) hallmark protein of AD may be a consequence of infection, called upon due to its antimicrobial properties. Up to this moment in time, a lack of understanding and knowledge of a microbiome associated with AD brain has ensured that the role pathogens may play in this neurodegenerative disease remains unresolved. The oral microbiome embraces a range of diverse bacterial phylotypes, which especially in vulnerable individuals, will excite and perpetuate a range of inflammatory conditions, to a wide range of extra-oral body tissues and organs specific to their developing pathophysiology, including the brain. This offers the tantalizing opportunity that by controlling the oral-specific microbiome; clinicians may treat or prevent a range of chronic inflammatory diseases orally. Evolution has equipped the human host to combat infection/disease by providing an immune system, but Porphyromonas gingivalis and selective spirochetes, have developed immune avoidance strategies threatening the host-microbe homeostasis. It is clear from longitudinal monitoring of patients that chronic periodontitis contributes to declining cognition. The aim here is to discuss the contribution from opportunistic pathogens of the periodontal microbiome, and highlight the challenges, the host faces, when dealing with unresolvable oral infections that may lead to clinical manifestations that are characteristic for AD.
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Affiliation(s)
- Anna B. Pritchard
- Dementia & Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, United Kingdom
| | - StJohn Crean
- Dementia & Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, United Kingdom
| | - Ingar Olsen
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Sim K. Singhrao
- Dementia & Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, United Kingdom
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20
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Kanasi E, Ayilavarapu S, Jones J. The aging population: demographics and the biology of aging. Periodontol 2000 2016; 72:13-8. [DOI: 10.1111/prd.12126] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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21
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Latha S, Thirugnanamsambandan S, Arun RT, Masthan KMK, Malathi L, Rajesh E. Serum ferritin level and red blood cell parameters in healthy controls and chronic periodontitis patients. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2015; 7:S184-9. [PMID: 26015705 PMCID: PMC4439665 DOI: 10.4103/0975-7406.155896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 10/31/2014] [Accepted: 11/09/2014] [Indexed: 11/22/2022] Open
Abstract
Periodontitis, which is a chronic inflammatory disease causes reduction in the number of erythrocytes and hemoglobin. It is found to be caused by specific pathogenic subgingival plaque bacteria. Periodontitis is host mediated through release of pro inflammatory cytokines by local tissues and immune cells in response to bacterial flora and its products, especially lipopolysacharides. Periodontitis is found to have systemic effect and the cytokines produced inhibit proliferation and differentiation of erythrocytes leading to anaemia. This study evaluate level of hemoglobin erythrocytes, hematocrit and serum ferritin levels in healthy subjects and periodontitis patient.
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Affiliation(s)
- S Latha
- Department of Periodontics, K. G. F. Dental College and Hospital, Karnataka, India
| | - S Thirugnanamsambandan
- Department of Oral Pathology and Microbiology, K. G. F. Dental College and Hospital, Karnataka, India
| | - R T Arun
- Department of Periodontics, Rajah Muthiah Derntal College and Hospital, Chidambaram, Tamil Nadu, India
| | - K M K Masthan
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - L Malathi
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - E Rajesh
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
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22
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Porphyromonas gingivalis Periodontal Infection and Its Putative Links with Alzheimer's Disease. Mediators Inflamm 2015; 2015:137357. [PMID: 26063967 PMCID: PMC4430664 DOI: 10.1155/2015/137357] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 04/01/2015] [Indexed: 12/18/2022] Open
Abstract
Periodontal disease (PD) and Alzheimer's disease (AD) are inflammatory conditions affecting the global adult population. In the pathogenesis of PD, subgingival complex bacterial biofilm induces inflammation that leads to connective tissue degradation and alveolar bone resorption around the teeth. In health, junctional epithelium seals the gingiva to the tooth enamel, thus preventing bacteria from entering the gingivae. Chronic PD involves major pathogens (Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia) which have an immune armoury that can circumvent host's immune surveillance to create and maintain an inflammatory mediator rich and toxic environment to grow and survive. The neurodegenerative condition, AD, is characterised by poor memory and specific hallmark proteins; periodontal pathogens are increasingly being linked with this dementing condition. It is therefore becoming important to understand associations of periodontitis with relevance to late-onset AD. The aim of this review is to discuss the relevance of finding the keystone periodontal pathogen P. gingivalis in AD brains and its plausible contribution to the aetiological hypothesis of this dementing condition.
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23
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Crocombe LA. Long-term routine dental attendance is important for older adults. J Evid Based Dent Pract 2015; 15:39-40. [PMID: 25666583 DOI: 10.1016/j.jebdp.2015.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Long-term routine dental attendance: influence on tooth loss and oral health-related quality of life in Swedish older adults. Astrøm AN, Ekback G, Ordell S, Nasir E. Community Dent Oral Epidemiol 2014;42(5):460-69. REVIEWER Leonard A. Crocombe, BDSc, MBA, MPA, PhD PURPOSE/QUESTION: To investigate the effect of long-term dental attendance on oral health-n-related quality of life and tooth loss. SOURCE OF FUNDING Government: Department of Dentistry, Orebro County; The Dental Commissioning Unit, Ostergotland County, Sweden; NRC Grant 204887/V50. TYPE OF STUDY/DESIGN Cohort study LEVEL OF EVIDENCE Level 2: Limited-quality, patient-oriented evidence STRENGTH OF RECOMMENDATION GRADE Not applicable.
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Affiliation(s)
- Leonard A Crocombe
- Senior Research Fellow, Australian Research Centre of Population Oral Health, University of Adelaide, Australia; Associate Professor, Oral Health, Centre for Rural Health, University of Tasmania. Private Bag 103, Hobart, Tasmania 7001, Australia.
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24
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Kizildag A, Arabaci T, Dogan GE. Relationship between periodontitis and cardiovascular diseases: A literature review. World J Stomatol 2014; 3:1-9. [DOI: 10.5321/wjs.v3.i1.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 08/14/2013] [Accepted: 11/16/2013] [Indexed: 02/06/2023] Open
Abstract
Periodontitis and cardiovascular disease have a complex etiology and genetics and share some common risk factors (i.e., smoking, age, diabetes, etc.). In recent years, the relationship between periodontal disease and cardiovascular disease has been investigated extensively. This research mostly focused on the fact that periodontitis is an independent risk factor for cardiovascular disease. Our aim in this article is to investigate the etiological relationship between periodontal disease and cardiovascular disease and the mechanisms involved in this association. According to the current literature, it is concluded that there is a strong relationship between these chronic disorders.
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25
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Salamone K, Yacoub E, Mahoney AM, Edward KL. Oral care of hospitalised older patients in the acute medical setting. Nurs Res Pract 2013; 2013:827670. [PMID: 23819046 PMCID: PMC3683489 DOI: 10.1155/2013/827670] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/28/2013] [Accepted: 04/30/2013] [Indexed: 11/18/2022] Open
Abstract
Oral health care is an essential aspect of nursing care. There are many variances in the quality and frequency of the oral care that is delivered to patients by nursing staff, such as oral care being given a low priority when compared to other nursing care elements, oral care being neglected, and oral care delivery being dependent on the nurse's knowledge of oral hygiene. Additionally, there are some particular patient groups known to be at risk of oral health problems or who have existing oral diseases and conditions. As people age their susceptibility increases to chronic and life-threatening diseases, and they can be at increased risk of acute infections increases compromised by ageing immune systems. The aim of this literature review was to ignite the discussion related to the oral care practices of nurses for older acute medical hospitalised patients. The review revealed that nursing staff know that good nursing includes oral health care, but this knowledge does not always mean that oral health care is administered. Oral health care seems to be separated from other nursing activities and is not discussed when nursing care plans are written, only when oral problems are obvious.
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Affiliation(s)
| | - Elaine Yacoub
- Austin Health, P.O. Box 5555, Heidelberg, 3084 VIC, Australia
| | - Anne-Marie Mahoney
- Clinical Education Unit, Austin Health, P.O. Box 5555, Heidelberg, 3084 VIC, Australia
| | - Karen-leigh Edward
- Nursing Research Unit, Faculty of Health Sciences, Street Vincent's Private Hospital, Australian Catholic University, VECCI Building, Locked Bag 4115, Fitzroy MDC, Melbourne, 3065 VIC, Australia
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26
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Strömberg E, Holmèn A, Hagman-Gustafsson ML, Gabre P, Wårdh I. Oral health-related quality-of-life in homebound elderly dependent on moderate and substantial supportive care for daily living. Acta Odontol Scand 2013; 71:771-7. [PMID: 23146109 DOI: 10.3109/00016357.2012.734398] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To describe the oral health-related quality-of-life in homebound elderly dependent on moderate and substantial supportive care for daily living. MATERIALS AND METHODS A total of 302 selected persons in three counties in Sweden over 65 years of age and in need of daily support from society participated in the study. Half of the participants had moderate needs of support, defined as supportive care of 15-50 h per month and half had substantial needs of supportive care, i.e. 3-times a day with a night overview. An oral examination was performed and structured questions were asked about general health and living conditions, medication, oral care routines and quality-of-life, using the instrument GOHAI (Geriatric Oral Health Assessment Instrument). RESULTS Cardiovascular disease was common and an average of seven prescription drugs was used. More than half of the participants had dentures. The strongest correlation with GOHAI was the total number of teeth. There was a significant difference between individuals with moderate and substantial needs according to GOHAI, irrespective of gender. More elderly people with substantial needs of support had low GOHAI values. Decayed teeth, DT/T, root remnants and dry mouth were negatively correlated to GOHAI among individuals with substantial needs. CONCLUSIONS This study found that elderly homebound individuals with substantial needs of supportive care had a lower quality-of-life than elderly homebound individuals with moderate needs of supportive care, although both medical and odontological variables were similar in the groups.
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Affiliation(s)
- Ella Strömberg
- Public Dental Health, Gävleborg County Council, Gävle, Sweden.
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Lantto A, Wårdh I. Dental implants in the functionally impaired: experience from the patients' perspective. Acta Odontol Scand 2013; 71:525-33. [PMID: 22746200 DOI: 10.3109/00016357.2012.696695] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Edentulousness has a great impact on the individual. Extensive tooth loss is more common among functionally impaired individuals. Such groups may have difficulties with removable prostheses. The aim of this qualitative study was to explore functionally impaired patients' experience of receiving and living with dental implants. MATERIALS AND METHODS Seventeen patients with several types of functional impairment who had undergone treatment with dental implants were interviewed. Analysis of the open-ended questions was inspired by grounded theory methodology and began at the first interview, proceeding in parallel until no further relevant information could be obtained. RESULTS 'The implant treatment is a process of normalization' was identified as the core category. It was related to four other categories: 'The functionally impaired are also entitled to dental care', 'Edentulousness is a burden for functionally impaired individuals', 'There is interaction between implant treatment and other aspects of life' and 'It is important to understand the implications of implant treatment'. CONCLUSIONS Normalization was the motivation for implant treatment. Edentulousness had enhanced the feeling of being different and treatment with dental implants was important for well-being. The experience of the treatment process was linked to circumstances of life. Information about procedure, alternative prosthetic constructions and hygiene routines was crucial to the experience and the outcome of the treatment.
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Affiliation(s)
- Angelika Lantto
- The Swedish National Dental Health Service , Norrbotten County Council, Luleå, Sweden.
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Fallon T, Buikstra E, Cameron M, Hegney D, Mackenzie D, March J, Moloney C, Pitt J. Implementation of oral health recommendations into two residential aged care facilities in a regional Australian city. INT J EVID-BASED HEA 2012; 4:162-79. [PMID: 21631764 DOI: 10.1111/j.1479-6988.2006.00040.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Residents of aged care facilities usually have a large number of oral health problems. Residents who suffer from dementia are at particular risk. A systematic review of the best available evidence with regard to maintaining the oral health of older people with dementia in residential aged care facilities provided a number of recommendations. Objectives The aim of the implementation project was to introduce evidence-based oral hygiene practices for patients with dementia in two publicly funded residential aged care facilities and monitor for changes in nursing awareness, knowledge, documentation and practice to improve patient outcomes and ensure appropriate accreditation standards were met. An additional aim was to identify barriers and strategies to overcome barriers to implementation of evidence-based recommendations. Methods Two facilities, a 40-bed facility and a 71-bed facility in the health service district of the regional Australian city of Toowoomba, provided the setting. A quality improvement approach was taken, using a number of strategies from the National Health and Medical Research Council guidelines for implementation studies. The implementation involved a number of stages, including project development, interactive oral health education, oral audits of residents, changes to oral hygiene practice via care plans and critical reflection. Results The multidisciplinary approach to improving oral healthcare appeared to improve knowledge and awareness and move oral health practices in facilities closer to best practice. Specialised training in oral health was provided to a Clinical Nurse Consultant. Regular oral audits were introduced and facility staff were trained in the use of the oral audit tool. Care plans at one facility were of better quality and more comprehensive than before the intervention. Comments made during critical reflection suggested improvements in the oral health of residents, increased use of oral swabs and saliva substitutes, improved care of dentures and mention of the use of mouth props in resident care plans. There was also some evidence that changes brought about by the implementation are sustainable. Conclusion The majority of recommendations provided in the systematic review of oral healthcare for dementia patients were applicable to the applied context. The importance of day-to-day leaders was highlighted by the apparently varied outcomes across target facilities. The quality improvement approach would appear to have considerable advantages when applied to improving practice in residential aged care.
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Affiliation(s)
- Tony Fallon
- Centre for Rural and Remote Area Health, University of Southern Queensland, Australian Centre for Rural and Remote Evidence-Based Practice, Joanna Briggs Institute, Oral Health Unit, Toowoomba Health Service District, Mt Lofty Heights Aged Care Facility, Toowoomba Health Service District, and Nursing Research Centre, Bluecare, University of Queensland
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Abstract
AIMS Periodontitis is an oral infection affecting the tooth- supporting tissues. Although the prime etiology for this condition is bacterial plaque, the host immune response also has substantial contribution to the destruction of the periodontal apparatus. Periodontitis elicits a "low grade systemic inflammation". Diabetes mellitus is intricately related to the development, progression and severity of periodontitis. The literature is abundant with studies depicting this association. Periodontal therapy (PT) involves removal of bacterial component leading to the resolution of clinical signs and symptoms of disease. This review aims to create awareness amongst the medical professionals regarding the two-way relationship between diabetes and periodontitis, emphasizing on the positive effects of PT. MATERIAL AND METHODS Studies addressing the effects of PT on glycemic control in type 2 Diabetes (T2DM) subjects were identified using PubMed search with key search terms such as "Glycemic control", "Periodontitis", "Periodontal therapy", "Type 2 diabetes mellitus". The review has been prepared by screening PUBMED database from January 1990 to March 2012. RESULTS PT bears an unexplored potential and can serve as an adjuvant to the conventional treatment for diabetes. CONCLUSION A major conclusion of this review is that PT instituted in type 2 diabetic human subjects assists in amelioration of the inflammatory biomarker levels and glycemic status. There is a wide scope for further studies to highlight the beneficial effects of PT in diabetic subjects and the dire need for periodontal screening of these individuals for glycemic maintenance.
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Affiliation(s)
- Abhijit N Gurav
- Department of Periodontics, Tatyasaheb Kore Dental College & Research Centre, New Pargaon, Kolhapur 416137, Maharashtra, India.
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Length of tooth survival in older adults with complex medical, functional and dental backgrounds. J Am Dent Assoc 2012; 143:566-78. [DOI: 10.14219/jada.archive.2012.0235] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Olerud E, Hagman-Gustafsson ML, Gabre P. Oral status, oral hygiene, and patient satisfaction in the elderly with dental implants dependent on substantial needs of care for daily living. SPECIAL CARE IN DENTISTRY 2012; 32:49-54. [DOI: 10.1111/j.1754-4505.2012.00236.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Chen X, Clark JJJ, Naorungroj S. Oral health in nursing home residents with different cognitive statuses. Gerodontology 2012; 30:49-60. [PMID: 22364512 DOI: 10.1111/j.1741-2358.2012.00644.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To compare oral health in nursing home (NH) residents with different cognitive statuses. BACKGROUND Oral health is a significant issue for NH residents because of its relationships to quality of life, systemic health and well-being. It is known that oral health is poor in NH residents. However, how oral health differs in NH residents with different cognitive statuses remains unclear. MATERIALS AND METHODS Nine hundred and two NH residents were retrospectively recruited from a community-based geriatric dental clinic in Minnesota, USA. Comprehensive medical, dental, cognitive and functional assessments were completed for the participants. On the basis of medical history and cognitive status, participants were categorized into three groups: without cognitive impairment (non-impaired group), with cognitive impairment but no dementia (impaired group) and with dementia (demented group). ANOVA, Chi-square and Fisher's exact tests were used to compare medical, dental and functional statuses between groups. RESULTS Oral hygiene was poor in NH residents. Forty per cent of participants in the impaired group were edentulous, significantly higher than the edentulism rate in the demented group (29%, p = 0.01). More than 60% of the participants lost 16 or more teeth prior to examination. Depending on their cognitive status, 82-92% of the participants arrived with one or more caries or retained root. Dentate participants in the impaired and demented groups averaged about six caries or retained roots, significantly more than 4.7 caries or retained roots in the non-impaired group (p = 0.01). CONCLUSION Oral health was poor but slightly different in NH residents with different cognitive and functional statuses.
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Affiliation(s)
- Xi Chen
- Department of Dental Ecology, University of North Carolina, Chapel Hill, NC, USA.
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Kitada K, Oho T. Effect of saliva viscosity on the co-aggregation between oral streptococci and Actinomyces naeslundii. Gerodontology 2011; 29:e981-7. [PMID: 22077758 DOI: 10.1111/j.1741-2358.2011.00595.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The co-aggregation of oral bacteria leads to their clearance from the oral cavity. Poor oral hygiene and high saliva viscosity are common amongst the elderly; thus, they frequently suffer from pneumonia caused by the aspiration of oral microorganisms. OBJECTIVES To examine the direct effect of saliva viscosity on the co-aggregation of oral streptococci with actinomyces. MATERIALS AND METHODS Fifteen oral streptococcal and a single actinomyces strain were used. Co-aggregation was assessed by a visual assay in phosphate buffer and a spectrophotometric assay in the same buffer containing 0-60% glycerol or whole saliva. RESULTS Nine oral streptococci co-aggregated with Actinomyces naeslundii ATCC12104 in the visual assay and were subsequently used for the spectrophotometric analysis. All tested strains displayed a decrease in co-aggregation with increasing amounts of glycerol in the buffer. The co-aggregation of Streptococcus oralis with A. naeslundii recovered to baseline level following the removal of glycerol. The per cent co-aggregation of S. oralis with A. naeslundii was significantly correlated with the viscosity in unstimulated and stimulated whole saliva samples (correlation coefficients: -0.52 and -0.48, respectively). CONCLUSION This study suggests that saliva viscosity affects the co-aggregation of oral streptococci with actinomyces and that bacterial co-aggregation decreases with increasing saliva viscosity.
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Affiliation(s)
- Katsuhiro Kitada
- Department of Preventive Dentistry, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Japan
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Strömberg E, Hagman-Gustafsson ML, Holmén A, Wårdh I, Gabre P. Oral status, oral hygiene habits and caries risk factors in home-dwelling elderly dependent on moderate or substantial supportive care for daily living. Community Dent Oral Epidemiol 2011; 40:221-9. [DOI: 10.1111/j.1600-0528.2011.00653.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Holmén A, Strömberg E, Hagman-Gustafsson ML, Wårdh I, Gabre P. Oral status in home-dwelling elderly dependent on moderate or substantial supportive care for daily living: prevalence of edentulous subjects, caries and periodontal disease. Gerodontology 2011; 29:e503-11. [DOI: 10.1111/j.1741-2358.2011.00507.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Agnihotri R, Bhat GS, Bhat KM. Amlodipine-induced gingival overgrowth: considerations in a geriatric patient. Geriatr Gerontol Int 2011; 11:365-8. [PMID: 21696531 DOI: 10.1111/j.1447-0594.2010.00659.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chen X, Clark JJ. Multidimensional Risk Assessment for Tooth Loss in a Geriatric Population with Diverse Medical and Dental Backgrounds. J Am Geriatr Soc 2011; 59:1116-22. [DOI: 10.1111/j.1532-5415.2011.03425.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chen X, Shuman SK, Hodges JS, Gatewood LC, Xu J. Patterns of tooth loss in older adults with and without dementia: a retrospective study based on a Minnesota cohort. J Am Geriatr Soc 2011; 58:2300-7. [PMID: 21143439 DOI: 10.1111/j.1532-5415.2010.03192.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To study tooth loss patterns in older adults with dementia. DESIGN Retrospective longitudinal study. SETTING A community-based geriatric dental clinic in Minnesota. PARTICIPANTS Four hundred ninety-one older adults who presented to the study clinic as new patients during the study period, remained dentate after finishing the initial treatment plan, and returned for care at least once thereafter were retrospectively selected. One hundred nineteen elderly people with International Classification of Diseases, Ninth Revision, codes 290.x, 294.1, or 331.2 or a plain-text diagnosis of dementia, Alzheimer's disease, or chronic brain syndrome in the medical history were considered having dementia. INTERVENTION All existing dental conditions were treated before enrollment. Dental treatment was continually provided for all participants during follow-up. MEASUREMENTS Tooth loss patterns, including time to first tooth loss, number of tooth loss events, and number of teeth lost per patient-year were estimated and compared for participants with and without dementia using Cox, Poisson, and negative-binomial regressions. RESULTS Participants with dementia arrived with an average of 18 and those without dementia with an average of 20 teeth; 27% of remaining teeth in the group with dementia were decayed or retained roots, higher than in the group without dementia (P<.001). Patterns of tooth loss did not significantly differ between the two groups; 11% of participants in both groups had lost teeth by 12 months of follow-up. By 48 months, 31% of participants without dementia and 37% of participants with dementia had lost at least one tooth (P=.50). On average, 15% of participants in both groups lost at least one tooth each year. Mean numbers of teeth lost in 5 years were 1.21 for participants with dementia and 1.01 for participants without dementia (P=.89). CONCLUSION Based on data available in a community-based geriatric dental clinic, dementia was not associated with tooth loss. Although their oral health was poor at arrival, participants with dementia maintained their dentition as well as participants without dementia when dental treatment was provided.
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Affiliation(s)
- Xi Chen
- Department of Dental Ecology, University of North Carolina School of Dentistry, Chapel Hill, North Carolina 27599, USA.
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Sun WL, Chen LL, Zhang SZ, Wu YM, Ren YZ, Qin GM. Inflammatory cytokines, adiponectin, insulin resistance and metabolic control after periodontal intervention in patients with type 2 diabetes and chronic periodontitis. Intern Med 2011; 50:1569-74. [PMID: 21804283 DOI: 10.2169/internalmedicine.50.5166] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To evaluate the effects of periodontal intervention on inflammatory cytokines, adiponectin, insulin resistance (IR), and metabolic control and to investigate the relationship between type 2 diabetes mellitus (T2DM) and moderately poor glycemic control and chronic periodontitis. METHODS AND PATIENTS A total of 190 moderately poorly controlled (HbA1c between 7.5% and 9.5%) T2DM patients with periodontitis were randomly divided into two groups according to whether they underwent periodontal intervention: T2DM-NT and T2DM-T group. The levels of serum adiponectin, C-reactive protein (CRP), tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), lipid profile, glucose, insulin, homeostasis model of assessment-insulin resistance (HOMA-IR) and homeostasis model assessment of β-cell function (HOMA-β) were measured at baseline and after 3 months. RESULTS The levels of clinical periodontal variables, the probing depth, attachment loss, bleeding index, and plaque index were improved significantly in T2DM-T group after 3 months compared to T2DM-NT group (all p<0.01). After 3 months, the serum levels of hsCRP, TNF-α, IL-6, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), fasting insulin (FINS) and HOMA-IR index decreased, and adiponectin was significantly increased in T2DM-T group compared to those in the T2DM-NT group (p<0.05 or p<0.01). CONCLUSION Periodontal intervention can improve glycemic control, lipid profile and IR, reduce serum inflammatory cytokine levels and increase serum adiponectin levels in moderately poorly controlled T2DM patients.
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Affiliation(s)
- Wei-Lian Sun
- Department of Oral Medicine and Periodontology, The Second Affiliated Hospital, College of Medicine, Zhejiang University, China
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Abstract
Cardiovascular disease (CVD) and type 2 diabetes are common systemic illnesses with reliable, predictive risk factors. CVD is the number one killer worldwide accounting for nearly 30% of deaths and type 2 diabetes has reached epidemic proportions in many western industrialized countries. Both of these illnesses can go undiagnosed in an alarming number of people for significant periods of time. The relationship between oral health and systemic health has become the focus of much discussion and research in recent times. It is now widely accepted that periodontal disease is associated with systemic illnesses such as CVD and type 2 diabetes. Cigarette smoking and obesity are major risk factors accounting for a large portion of the global disease burden. Many periodontal patients may be at risk of systemic conditions but be asymptomatic and undiagnosed. With an aging population who are mostly retaining their natural dentition, the need for periodontal management will continue to rise in the future. Dental professionals are well placed to perform general health screening for their patients. Therefore, risk assessment during the periodontal examination may facilitate the early identification of the large proportion of people who are unaware of their risk status. As identification and intervention of patients with increased risk factors is key to lowering the systemic disease burden, general health screening during periodontal examinations may present an important opportunity for many patients.
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Affiliation(s)
- Sarah L. Raphael
- Faculty of Dentistry, The University of Sydney, Westmead, NSW, Australia
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Besdine RW, Wetle TF. Improving health for elderly people: an international health promotion and disease prevention agenda. Aging Clin Exp Res 2010; 22:219-30. [PMID: 20634645 DOI: 10.1007/bf03324800] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Across the world, there are substantial but missed opportunities for promoting health of older persons and extending the healthy life span. Current approaches to health care rely on late detection and treatment of disease, and some of the most expensive systems of care have population health outcomes that are poor to mediocre. A majority of deaths and disability result from progression of preventable chronic diseases for which human behaviors are major contributing factors. An organized and aggressive agenda in health promotion and disease prevention emerges as an important part of the strategy to both promote health and control costs. After reviewing data on determinants of health and contribution of behavioral factors to morbidity and mortality, this paper presents the evidence for efficacy and effectiveness of specific behavioral and clinical interventions to reduce risk for many of the problems accounting for death and disability among elders. We address tobacco use, lack of exercise, inadequate nutrition, hypertension, delirium, obesity, falls, cancer screening, poor oral health, osteoporosis, immunizations and medication safety. Strategies for implementation of effective interventions present an international challenge.
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Cullinan MP, Ford PJ, Seymour GJ. Periodontal disease and systemic health: current status. Aust Dent J 2010; 54 Suppl 1:S62-9. [PMID: 19737269 DOI: 10.1111/j.1834-7819.2009.01144.x] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The relationship between poor oral health and systemic diseases has been increasingly recognized over the past two decades. Indeed, the clichés "You cannot have good general health without good oral health", "The mouth is part of the body" and "Floss or die", are gaining an increasing momentum. A large number of epidemiological studies have now linked poor oral health with cardiovascular diseases, poor glycaemic control in diabetics, low birthweight preterm babies and a variety of other conditions. The majority have shown an association, although not always strong. As a result, a number of meta-analyses have been conducted and have confirmed the associations and at the same time cautioned that further studies are required, particularly with regard to the effect of periodontal treatment in reducing risk. A number of biologically plausible mechanisms have been put forward to explain the association and there is accumulating evidence in support of them, although at this stage, insufficient to establish causality. Nevertheless, the relationship between poor oral health and systemic diseases has become a significant issue, such that adult oral health can no longer be ignored in overall health strategies. This review provides an update on current understanding of the contribution of poor oral health to systemic diseases, the possible mechanisms involved and the relevance of this for general dental practitioners.
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Affiliation(s)
- M P Cullinan
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
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Hunt KJ, Walsh BM, Voegeli D, Roberts HC. Inflammation in aging part 1: physiology and immunological mechanisms. Biol Res Nurs 2009; 11:245-52. [PMID: 19934111 DOI: 10.1177/1099800409352237] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
During the aging process, remodeling of several body systems occurs, and these changes can have a startling effect upon the immune system. The reduction in sex steroids and growth hormones and declines in vitamin D concentration that accompany the aging process are associated with increases in the baseline levels of inflammatory proteins. At the same time, inflammation arising from atherosclerosis and other chronic diseases further contributes to the inflammatory milieu and effects a state of chronic inflammation. This chronic inflammation, or ''inflammaging'' as it has been termed, seems to be associated with a host of adverse effects contributing to many of the health problems that increase morbidity and decrease both quality of life and the ability to maintain independence in old age. For nurses to be truly informed when caring for older people and to ensure that they have a detailed understanding of the complexities of older people's health needs, they must have a knowledge of the physiological and immunological changes with age. This is the first of a two-part article on inflammatory processes in aging. These age-related changes are presented here, including an examination of the impact of genetic and lifestyle factors. The effect of these changes on the health of the individual and implications for practice are described in Part 2.
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Affiliation(s)
- Katherine J Hunt
- School of Health Sciences, University of Southampton, Highfield, Southampton SO17 1BJ, United Kingdom.
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Kandelman D, Petersen PE, Ueda H. Oral health, general health, and quality of life in older people. SPECIAL CARE IN DENTISTRY 2009; 28:224-36. [PMID: 19068063 DOI: 10.1111/j.1754-4505.2008.00045.x] [Citation(s) in RCA: 171] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The purpose of this report is to review the interrelationship between poor oral health conditions of older people and general health. The impact of poor oral health on quality of life (QOL) is analyzed, and the implications for public health intervention and oral health care are discussed. Findings from the current research may lead to the following conclusions: The available scientific evidence is particularly strong for a direct relationship between diabetes and periodontal disease; the direct relationship between periodontal disease and cardiovascular disease is less convincing. General and associated oral health conditions have a direct influence on elder people's QOL and lifestyle. The growing number of elderly people challenges health authorities in most countries. The evidence on oral health-general health relationships is particularly important to WHO in its effort to strengthen integrated oral health promotion and disease prevention around the globe.
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Affiliation(s)
- Daniel Kandelman
- Faculty of Dental Medicine, University of Montreal, Montreal, Canada.
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Cleary JD, Pearson M, Oliver J, Chapman SW. Association between Histoplasma exposure and stroke. J Stroke Cerebrovasc Dis 2009; 17:312-9. [PMID: 18755412 DOI: 10.1016/j.jstrokecerebrovasdis.2008.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Revised: 12/20/2007] [Accepted: 01/08/2008] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND AND PURPOSE The rate of cerebrovascular events within the stroke belt, a geographic area defined in the Southeastern United States, exceeds that of the rest of the nation. Despite evaluation of multiple risk factors for this disparity, specific causes for the stroke belt have not been elucidated. More than 45 years ago, the US Public Health Service and US Navy cooperative skin-testing program (1958-1965) documented adolescent exposure to Histoplasma capsulatum. Our purpose was to evaluate the association between exposure to Histoplasma capsulatum and subsequent development of stroke. METHODS A cross-sectional study of stroke in a cohort of US Navy veterans was designed to assess our hypothesis. Medical records from 23,795 men who participated in the cooperative skin-testing program and who received medical care at Veterans Administration Hospitals and Clinics were reviewed. A logistic regression model was used to estimate the odds ratio of stroke while controlling for multiple covariates. Because of the large number of possible risk factors for stroke, propensity scores were used to reduce bias. RESULTS The adjusted odds ratio for stroke in veterans exposed to Histoplasma capsulatum during adolescence was 1.34 (95% confidence interval: 1.1-1.6; P = .0033). The increased risk was independent of traditional cerebrovascular event risk factors. Less frequent risk factors (atrial fibrillation, coronary heart disease, rheumatic heart disease, and prosthetic cardiac valvular replacement) were not controlled in this model. CONCLUSION Exposure to Histoplasma capsulatum during adolescence was associated with an increased risk of stroke.
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Affiliation(s)
- John D Cleary
- School of Pharmacy, University of Mississippi Medical Center, Jackson, MS 39216, USA.
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Watts A, Crimmins EM, Gatz M. Inflammation as a potential mediator for the association between periodontal disease and Alzheimer's disease. Neuropsychiatr Dis Treat 2008; 4:865-76. [PMID: 19183779 PMCID: PMC2626915 DOI: 10.2147/ndt.s3610] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Periodontal disease (PDD) is associated with increased risk of cardiovascular disease, cerebrovascular disease, and mortality in many studies, while other studies have begun to suggest an association of PDD with Alzheimer's disease (AD). This paper discusses how infectious pathogens and systemic infection may play a role in AD. The roles of infection and inflammation are addressed specifically with regard to known AD pathologic lesions including senile plaques, neuron death, neurofibrillary tangles, and cerebrovascular changes. A testable model of proposed pathways between periodontal infection and AD is presented including three possible mechanisms: a) direct effects of infectious pathogens, b) inflammatory response to pathogens, and c) the effects on vascular integrity. The role of gene polymorphisms is discussed, including apolipoprotein (APOE) varepsilon4 as a pro-inflammatory and pro-infection genotype.
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Affiliation(s)
- Amber Watts
- Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
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Does the periodontal health of thalassemia major patients have an impact on the blood lipid profiles? A preliminary report. J Pediatr Hematol Oncol 2007; 29:694-9. [PMID: 17921850 DOI: 10.1097/mph.0b013e31814d68c3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Cardiac symptoms and premature death from cardiac causes are still suggested to be a major problem in thalassemic patients. One of the main reasons for the cardiovascular events in thalassemia major (TM) patients has suggested having iron overload, in addition to other reasons such as hypoxia, abnormal lipoproteins levels, atherosclerotic conditions, etc. This study aims to investigate whether the periodontal health has an impact on the blood lipid levels. Twenty-four TM patients and sex-matched controls (C) enrolled to this study. The measurements of the periodontal parameters (gingival index, plaque index, bleeding on probing, probing depth, and clinical attachment level) were recorded. Besides, in venous blood samples the lipid profile was investigated. All of the periodontal parameters were significantly higher in TM group than in C group (P<0.05). Triglyceride and cholesterol/high density lipoprotein ratio had significant positive correlations with the periodontal parameters (P<0.05). Multiple regression analyses present significant associations between gingival index, plaque index scores, and the cholesterol/high density lipoprotein ratio (P<0.001). Our study results showed that the lipid profile of TM patients might be affected by their periodontal health. Further studies are needed to determine the lipid profile involvement magnitude and the cardiovascular disease risk caused by the periodontal health of TM patients.
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Yoshihara A, Deguchi T, Hanada N, Miyazaki H. Renal Function and Periodontal Disease in Elderly Japanese. J Periodontol 2007; 78:1241-8. [PMID: 17608579 DOI: 10.1902/jop.2007.070025] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Chronic renal failure involves a slow, progressive loss of renal function over months or years. It is possible that periodontal disease and chronic kidney disease might share common risk factors. This study investigated whether a link exists between periodontal disease and chronic renal function in community-dwelling elderly subjects. METHODS A total of 145 study subjects, all 77 years of age, participated in this study. A periodontal examination was carried out by trained dentists. Urine was collected over 24 hours, and blood was taken on the morning of the dental exam. The volume of creatinine per 24 hours (Cre_U) and volume of urine per 24 hours were used as urinary markers of kidney function; serum creatinine levels (Cre_S) were used as a blood marker of kidney function. Creatinine clearance per 24 hours was calculated as Cre_U/Cre_S. In addition, biochemical parameters of bone turnover were measured: urinary deoxypyridinoline (U-DPD) as a bone resorption marker and serum osteocalcin (S-OC) as a bone formation marker. Multiple regression analysis was used to evaluate the relationship between the percentage of periodontal sites with > or =6-mm clinical attachment level (% > or =6-mm CAL) and renal function, as well as the relationship between % > or =6-mm CAL and bone metabolism. The % > or =6-mm CAL was used as the dependent variable. The number of remaining teeth, smoking habit, gender, use of interdental brushes or dental floss, volume of urine per 24 hours, and creatinine clearance per 24 hours were independent variables in the first test. In addition, the number of remaining teeth, smoking habits, gender, use of interdental brushes or dental floss, U-DPD, and S-OC were independent variables in the second test. RESULTS Multiple regression analysis showed that creatinine clearance per 24 hours and S-OC were significantly associated with % > or =6-mm CAL per person. The standardized coefficients were 0.26 (P = 0.015) and -0.27 (P = 0.006), respectively. CONCLUSIONS The % > or =6-mm CAL was significantly associated with renal function and bone metabolism markers. This study suggests that the increased incidence of chronic renal failure that occurs with age might increase the probability of severe periodontal disease in community-dwelling elderly subjects.
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Affiliation(s)
- Akihiro Yoshihara
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Engebretson S, Chertog R, Nichols A, Hey-Hadavi J, Celenti R, Grbic J. Plasma levels of tumour necrosis factor-alpha in patients with chronic periodontitis and type 2 diabetes. J Clin Periodontol 2006; 34:18-24. [PMID: 17116158 DOI: 10.1111/j.1600-051x.2006.01017.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Studies suggest that elevated circulating tumour necrosis factor-alpha (TNF-alpha) may contribute to insulin resistance in patients with type 2 diabetes. The source of plasma TNF has been thought to be adipocytes associated with obesity, but inflammation and infection result in TNF-alpha production as well. METHODS We studied 46 patients with type 2 diabetes and chronic periodontitis to determine the relationship between plasma TNF-alpha levels and clinical measures of periodontitis, gingival crevicular fluid (GCF) interleukin-1beta (IL-1beta), plasma endotoxin, serum glucose, and glycated haemoglobin (HbA1c). TNF-alpha levels were measured using a high sensitivity enzyme-linked immunosorbent assay. RESULTS TNF-alpha showed a significant positive correlation with attachment loss (r=0.40, p=0.009), plasma endotoxin (r=0.33, p=0.03), and GCF IL-1beta (r=0.33, p=0.035), but not probing depth (r=0.28, p=0.07), bleeding on probing (r=0.30, p=0.053), plaque index (r=0.22, p=0.17), serum glucose, HbA1c (r=0.10, p=0.50), or body mass index (r=0.077, p=0.62). A dose-response relationship was observed between periodontitis severity and TNF-alpha (p=0.012). CONCLUSION The finding that chronic periodontitis is associated with plasma TNF-alpha levels in subjects with type 2 diabetes supports the hypothesis that periodontal infection and inflammation may contribute to insulin resistance.
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Affiliation(s)
- S Engebretson
- Department of Periodontics, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
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Implementation of oral health recommendations into two residential aged care facilities in a regional Australian city. INT J EVID-BASED HEA 2006. [DOI: 10.1097/01258363-200609000-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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