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Sangalli L, Souza LC, Letra A, Shaddox L, Ioannidou E. Sex as a Biological Variable in Oral Diseases: Evidence and Future Prospects. J Dent Res 2023; 102:1395-1416. [PMID: 37967405 DOI: 10.1177/00220345231197143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
The interest of the scientific community on sex and gender differences in health and disease has increased substantially over the past 25 to 30 y as a result of a long process of events and policies in the biomedical field. This is crucial as compelling evidence from human and animal model studies has demonstrated that sex and gender influence health, molecular and cellular processes, and response and predisposition to disease. The present scoping review aims to provide a synthesis of sex differences in oral diseases, ranging from periodontal disease to orofacial pain conditions, from risk of caries development to apical periodontitis. Overall, findings from this review further support a role for sexual dimorphism influencing disease predisposition and/or progression in oral diseases. Of note, this review also highlights the lack of consideration of additional factors such as gender and other psychosocial and external factors potentially influencing oral health and disease. New conceptual frameworks capable of capturing multiple fundamental domains and measurements should be developed in clinical and preclinical studies to inform sex-based individualized preventive and treatment strategies.
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Affiliation(s)
- L Sangalli
- College of Dental Medicine-Illinois, Midwestern University, Downers Grove, IL, USA
| | - L C Souza
- Center for Craniofacial Research, Department of Endodontics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - A Letra
- Departments of Oral and Craniofacial Sciences, Endodontics, and Center for Craniofacial and Dental Genetics, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
| | - L Shaddox
- Center for Oral Health Research, Division of Periodontology, University of Kentucky, College of Dentistry, Lexington, KY, USA
| | - E Ioannidou
- UCSF, Department of Orofacial Sciences, San Francisco, CA, USA
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2
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Han P, Liu T, Vaquette C, Frazer D, Anderson G, Ivanovski S. Iron accumulation is associated with periodontal destruction in a mouse model of HFE-related haemochromatosis. J Periodontal Res 2021; 57:294-304. [PMID: 34855211 DOI: 10.1111/jre.12959] [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: 06/17/2021] [Revised: 11/03/2021] [Accepted: 11/17/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To investigate the effect of Hfe gene mutation on the distribution of iron and periodontal bone loss in periodontal tissues. BACKGROUND DATA It remains unclear how tissue iron loading affects the periodontium architectures in a genetic animal model of hereditary haemochromatosis (HH). METHODS Male C57BL/6 Hfe-/- (8 weeks old) and wild-type (WT) mice were utilized to examine the iron distribution in periodontal tissues, as well as periodontal tissues changes using micro-computed tomography and histomorphometric analysis. Furthermore, tissue inflammatory mediators, bone markers and periodontal pathogens were carried out in PFA-fixed paraffin-embedded tissues using ELISA, RT-qPCR and genomic DNA qPCR, respectively. RESULTS Excessive iron deposition was found in the periodontal ligament, gingiva and alveolar bone in Hfe-/- mice relative to their WT counterparts. This, in turn, was associated with significant periodontal bone loss, increased cemento-enamel junction-alveolar bone crest distance and decreased expression of molecules involved in bone development and turnover. Furthermore, the pro-inflammatory cytokine - interleukin 6 and periodontal bacteria - Campylobacter rectus were significantly increased in Hfe-/- mice compared with WT controls. CONCLUSION Our results suggest that the iron loading in a mouse model of HH decreases alveolar bone formation and leads to alterations in the inflammatory state in the periodontium. Periodontal health should be assessed during the clinical assessment of HFE-HH patients.
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Affiliation(s)
- Pingping Han
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Epigenetics Nanodiagnostics and therapeutics Group, The University of Queensland, Herston, QLD, Australia.,School of Dentistry, The University of Queensland, Herston, QLD, Australia
| | - Tianqing Liu
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Cedryck Vaquette
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
| | - David Frazer
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Gregory Anderson
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, Australia
| | - Sašo Ivanovski
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Epigenetics Nanodiagnostics and therapeutics Group, The University of Queensland, Herston, QLD, Australia.,School of Dentistry, The University of Queensland, Herston, QLD, Australia
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3
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Hewlett SA, Anto F, Blankson PK, Tormeti D, Ayettey-Adamafio M, Bayitse P, Danso-Appiah T, Amoah AG. Periodontitis prevalence and severity in an African population: A cross-sectional study in the Greater Accra Region of Ghana. J Periodontol 2021; 93:732-744. [PMID: 34724216 DOI: 10.1002/jper.21-0329] [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: 05/31/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Periodontitis is a major public health problem affecting many adults, with considerable variation in its prevalence and severity worldwide. There is little data on its prevalence or associated risk factors in Ghana making development of evidence based preventive programs challenging. This study assessed the prevalence, severity, extent and associated risk factors of periodontitis in an adult Ghanaian population. METHODS A population based cross-sectional study involving adults aged 25 years and above in the Greater Accra Region (GAR) of Ghana. A random stratified two-stage sampling method was used to select participants from rural and urban communities. Data on socio-demographic and risk factors was collected using a semi-structured questionnaire. A full mouth periodontal examination was carried out to diagnose and describe the severity of periodontitis following the CDC-AAP case definition. RESULTS A total of 729 participants were included in the study, with a mean age of 43.9 ±14.6 years and 61% being female. Majority (84.8%) presented with gingivitis, 46.7% had periodontitis with 41.8% having both, and 13.9% had severe periodontitis. The mean clinical attachment loss (CAL) was 1.36 ±0.67mm and 1.41 ±0.57mm for probing pocket depth (PPD). Factors associated with periodontitis included, increasing age, smoking and alcohol use, being Muslim provided lower odds of disease. Older people, former smoking, being underweight and not having health insurance was associated with severe periodontitis. CONCLUSION This study shows a high burden of periodontitis with comparatively more severe disease. Existing socio-demographic disparities in disease burden highlights the need of developing targeted population based preventive programs. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Sandra Ama Hewlett
- Department of Restorative Dentistry, University of Ghana Dental School, Accra, Ghana
| | - Francis Anto
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health Accra, Ghana
| | - Paa Kwesi Blankson
- Department of Oral and Maxillofacial Surgery, University of Ghana Dental School, Accra, Ghana
| | - Daniel Tormeti
- Department of Community and Preventive Dentistry, University of Ghana Dental School, Accra, Ghana
| | - Mary Ayettey-Adamafio
- Department of Community and Preventive Dentistry, University of Ghana Dental School, Accra, Ghana
| | | | - Tony Danso-Appiah
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health Accra, Ghana
| | - Albert G Amoah
- Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana
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Tobias G, Spanier AB. Using an mHealth App (iGAM) to Reduce Gingivitis Remotely (Part 2): Prospective Observational Study. JMIR Mhealth Uhealth 2021; 9:e24955. [PMID: 34528897 PMCID: PMC8485186 DOI: 10.2196/24955] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/28/2020] [Accepted: 08/02/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Gingivitis is a nonpainful, inflammatory condition that can be managed at home. Left untreated, gingivitis can lead to tooth loss. Periodic dental examinations are important for early diagnosis and treatment of gum diseases. To contain the spread of the coronavirus, governments, including in Israel, have restricted movements of their citizens which might have caused routine dental checkups to be postponed. OBJECTIVE This study aimed to examine the ability of a mobile health app, iGAM, to reduce gingivitis, and to determine the most effective interval between photograph submissions. METHODS A prospective observational cohort study with 160 unpaid participants divided into 2 equal groups using the iGAM app was performed. The intervention group photographed their gums weekly for 8 weeks. The wait-list control group photographed their gums at the time of recruitment and 8 weeks later. After photo submission, the participants received the same message "we recommended that you read the information in the app regarding oral hygiene habits." A single-blinded researcher examined all the images and scored them according to the Modified Gingival Index (MGI). RESULTS The average age of the intervention group was 26.77 (SD 7.43) and 28.53 (SD 10.44) for the wait-list control group. Most participants were male (intervention group: 56/75,74.7%; wait-list control group: 34/51, 66.7%) and described themselves as "secular"; most were "single" non-smokers (intervention group: 56/75, 74.7%; wait-list control group: 40/51, 78.4%), and did not take medications (intervention group: 64/75, 85.3%; wait-list control group: 40/51, 78.4%). A total of 126 subjects completed the study. A statistically significant difference (P<.001) was found in the dependent variable (MGI). Improvements in gingival health were noted over time, and the average gingivitis scores were significantly lower in the intervention group (mean 1.16, SD 1.18) than in the wait-list control group (mean 2.16, SD 1.49) after 8 weeks. Those with more recent dental visits had a lower MGI (P=.04). No association was found between knowledge and behavior. Most participants were familiar with the recommendations for maintaining oral health, yet they only performed some of them. CONCLUSIONS A dental selfie taken once a week using an mobile health app (iGAM) reduced the signs of gingivitis and promoted oral health. Selfies taken less frequently yielded poorer results. During the current pandemic, where social distancing recommendations may be causing people to avoid dental clinics, this app can remotely promote gum health.
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Affiliation(s)
- Guy Tobias
- Department of Community Dentistry, Faculty of Dental Medicine, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Assaf B Spanier
- Department of Software Engineering, Azrieli College of Engineering, Jerusalem, Israel
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A Pilot Study Examining Vitamin C Levels in Periodontal Patients. Nutrients 2020; 12:nu12082255. [PMID: 32731485 PMCID: PMC7469055 DOI: 10.3390/nu12082255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Periodontal disease is the leading cause of tooth loss worldwide. Current periodontal treatment is limited by its dependency on patients learning and maintaining good dental habits, and repeated visits to oral health physicians. Vitamin C's role in collagen synthesis and immune function makes it important in wound healing and possibly periodontal healing. Therefore, if some patients are deficient, this may worsen patient outcomes. METHODS Patients were invited to participate following assessment and treatment at the Westmead Centre of Oral Health Periodontic Clinic, regardless of current disease stage or treatment. Adults were eligible if they gave informed consent and had current periodontal disease. Study involvement consisted of periodontal assessment and care followed by an interview and measurement of serum vitamin C and C-reactive protein (CRP). RESULTS A total of 6 out of 20 patients had vitamin C levels less than the institutional normal range, of whom 2 had levels <11.4 μmol/L and one <28 μmol/L. Low vitamin C was associated with higher periodontal disease stage (p = 0.03). Elevated CRP was found in 2/3 of people with low vitamin C and CRP was negatively correlated with vitamin C (p < 0.01). Vitamin C did not correlate with patient-reported fruit or vegetable consumption, but high processed meat intake was associated with lower vitamin C. CONCLUSION Although a small study, this rate of vitamin C deficiency in the periodontal clinic is clinically important and correlations with disease severity and CRP suggests biological importance. This warrants further studies to assess vitamin C and whether supplementation improves periodontal outcomes, particularly in deficient subjects.
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Trombelli L, Farina R, Silva CO, Tatakis DN. Plaque-induced gingivitis: Case definition and diagnostic considerations. J Periodontol 2019; 89 Suppl 1:S46-S73. [PMID: 29926936 DOI: 10.1002/jper.17-0576] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/15/2017] [Accepted: 10/21/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Clinical gingival inflammation is a well-defined site-specific condition for which several measurement systems have been proposed and validated, and epidemiological studies consistently indicate its high prevalence globally. However, it is clear that defining and grading a gingival inflammatory condition at a site level (i.e. a "gingivitis site") is completely different from defining and grading a "gingivitis case" (GC) (i.e. a patient affected by gingivitis), and that a "gingivitis site" does not necessarily mean a "GC". The purpose of the present review is to summarize the evidence on clinical, biochemical, microbiologic, genetic markers as well as symptoms associated with plaque-induced gingivitis and to propose a set of criteria to define GC. IMPORTANCE A universally accepted case definition for gingivitis would provide the necessary information to enable oral health professionals to assess the effectiveness of their prevention strategies and treatment regimens; help set priorities for therapeutic actions/programs by health care providers; and undertake surveillance. FINDINGS Based on available methods to assess gingival inflammation, GC could be simply, objectively and accurately identified and graded using bleeding on probing score (BOP%) CONCLUSIONS: A patient with intact periodontium would be diagnosed as a GC according to a BOP score ≥ 10%, further classified as localized (BOP score ≥ 10% and ≤30%) or generalized (BOP score > 30%). The proposed classification may also apply to patients with a reduced periodontium, where a GC would characterize a patient with attachment loss and BOP score ≥ 10%, but without BOP in any site probing ≥4 mm in depth.
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Affiliation(s)
- Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases, University of Ferrara, Ferrara, Italy.,Operative Unit of Dentistry, University-Hospital of Ferrara, Ferrara, Italy
| | - Cléverson O Silva
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, Columbus, OH, USA
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7
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Trombelli L, Farina R, Silva CO, Tatakis DN. Plaque-induced gingivitis: Case definition and diagnostic considerations. J Clin Periodontol 2018; 45 Suppl 20:S44-S67. [DOI: 10.1111/jcpe.12939] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/15/2017] [Accepted: 10/21/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Ferrara Italy
- Operative Unit of Dentistry; University-Hospital of Ferrara; Ferrara Italy
| | - Roberto Farina
- Research Centre for the Study of Periodontal and Peri-Implant Diseases; University of Ferrara; Ferrara Italy
- Operative Unit of Dentistry; University-Hospital of Ferrara; Ferrara Italy
| | | | - Dimitris N. Tatakis
- Division of Periodontology; College of Dentistry; The Ohio State University; Columbus OH USA
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8
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Mostafa B, El-Refai I. Prevalence of Plaque-Induced Gingivitis in a Sample of the Adult Egyptian Population. Open Access Maced J Med Sci 2018; 6:554-558. [PMID: 29610619 PMCID: PMC5874384 DOI: 10.3889/oamjms.2018.131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/16/2018] [Accepted: 02/17/2018] [Indexed: 11/05/2022] Open
Abstract
AIM The aim of this cross-sectional study is recording the prevalence and evaluation of the severity of plaque-induced gingival inflammation among a sample of the adult Egyptian population. PATIENTS AND METHODS Four hundred and twenty-five subjects in this contemplate were seen from patients visiting the diagnostic clinic at the Faculty of Dentistry, Cairo University. The gingival and plaque indices for each patient diagnosed as having plaque-induced gingivitis were recorded. The pocket depth was also measured. RESULTS The incidence of gingivitis was 100% amid adult subjects with an age range between 18-45 years. The average plaque index (PI) was 1.05 ± 0.43, which reflects relatively superior plaque control of the participants. The mean gingival index (GI) was 1.66 ± 0.40, which reflects the presence of moderate gingival inflammation. PD mean values confirmed limitation of inflammation to the gingiva. The sex was correlated to the condition of the inflamed gingiva (p = 0.014) and the quantity of biofilm build-up (p = 0.003). Females were less affected than males (p = 0.005). CONCLUSION The outcomes of this contemplate demonstrated that biofilm build-up is stoutly accompanied with elevated incidence of modest to rigorous gingivitis amid adult Egyptian individuals.
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Affiliation(s)
- Basma Mostafa
- Surgery and Oral Medicine Department, Oral and Dental Research Division, National Research Centre, Cairo, Egypt
| | - Ibrahim El-Refai
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
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9
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Elias-Boneta AR, Ramirez K, Rivas-Tumanyan S, Murillo M, Toro MJ. Prevalence of gingivitis and calculus in 12-year-old Puerto Ricans: a cross-sectional study. BMC Oral Health 2018; 18:13. [PMID: 29351752 PMCID: PMC5775617 DOI: 10.1186/s12903-017-0471-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 12/20/2017] [Indexed: 11/24/2022] Open
Abstract
Background Gingivitis is a common oral health problem. Untreated gingivitis may progress to periodontitis, a common cause of tooth loss. The prevalence of gingivitis and calculus among Puerto Rican children is unknown. Understanding this prevalence can support early public health preventative strategies. This study aims to estimate the prevalence of gingivitis and calculus among 12-year-old Puerto Ricans by health region and to explore differences in distribution by school type (proxy for socio-economic status) and gender. Methods A probability-based sample of 113 schools was selected proportional to enrollment size and stratified by health region, school type, and gender. Two trained examiners evaluated the presence of gingivitis and both supragingival and subgingival dental calculus. Gingivitis was defined as the presence of gingival bleeding upon gentle probing (BOP) in at least one site, and the extent of the problem was classified according to the percentage of teeth whose gingiva presented BOP (limited: 25–49% of the teeth tested; extensive: >50% of teeth tested). Logistic and linear regression models, adjusted for health regions, were used to compare gingivitis and calculus prevalence and extent between genders and school types. Results Gingivitis was found in 80.41% of the 1586 children evaluated. Urban-public schoolchildren had a slightly higher prevalence (83.24%) compared to private (79.15%, p = 0.16); those in rural-public (77.59%) and private schools had similar prevalence (p = 0.15). Extensive gingivitis was present in 60.81% of all children. The mean percentage of sites presenting BOP (BOP%) was 17.79%. Rural and urban public schoolchildren presented significantly higher BOP% compared to children from private schools (p = 0.0005, p = 0.002, respectively). Dental calculus was detected in 61.59% of the sample, boys presenting significantly higher (p = 0.005) total and supragingival calculus. Rural-public schoolchildren had a significantly higher prevalence of subgingival calculus compared to private schoolchildren (p = 0.02). Conclusions Gingivitis prevalence is higher among 12-year-old Puerto Ricans compared to data reported for U.S. adolescents. Public schoolchildren presented significantly higher BOP% sites compared to private schoolchildren. Boys presented a significantly higher total and supragingival calculus prevalence than girls. Oral health disparities related to gender and school type were identified by this study. Studies exploring the reasons for these disparities are recommended. Electronic supplementary material The online version of this article (10.1186/s12903-017-0471-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Augusto R Elias-Boneta
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico.
| | - Karol Ramirez
- Faculty of Dentistry, University of Costa Rica, San Pedro Montes de Oca, San José, Costa Rica.,Neuroscience Research Center, University of Costa Rica, San Pedro Montes de Oca, San José, Costa Rica
| | - Sona Rivas-Tumanyan
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico
| | - Margarita Murillo
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico
| | - Milagros J Toro
- School of Dental Medicine, Medical Sciences Campus, University of Puerto Rico, Rio Piedras, Puerto Rico
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Brown LM, Bowman P, O’Rourke VJ, Mercado F, Marshall R, Parsons S. Periodontal Referral Patterns in Australia: 2000 Versus 2015. J Periodontol 2017; 88:869-875. [DOI: 10.1902/jop.2017.160774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Leah M. Brown
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Patrick Bowman
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Vincent J. O’Rourke
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | | | | | - Scott Parsons
- Private practice, Canberra, New South Wales, Australia
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A Pilot Study into the Association between Oral Health Status and Human Papillomavirus-16 Infection. Diagnostics (Basel) 2017; 7:diagnostics7010011. [PMID: 28257064 PMCID: PMC5373020 DOI: 10.3390/diagnostics7010011] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/09/2017] [Accepted: 02/16/2017] [Indexed: 01/10/2023] Open
Abstract
Background: Over the next 20 years, oropharyngeal cancers (OPC) will represent the majority of head and neck cancers (HNCs) in the United States. It is estimated that human papillomavirus (HPV) may account for as much as 70% to 80% of OPCs in North America and in certain parts of Europe. It is hence crucial to understand the disease risk factors and natural history of oral HPV infections. We hypothesized that poor oral health (by measures such as poor oral hygiene and periodontal disease) leads to a higher degree of oral HPV-16 infections within a patient cohort from a dental school clinic. This study aims to test this hypothesis and gauge possible disease associations before larger scale studies. Subjects and Methods: 223 participants were recruited in this study from the University of Queensland Dental School clinic. Clinical oral health parameters (such as oral hygiene measures and periodontal disease measurements) have been examined and determined by dental professionals. We have collected oral rinse samples from these volunteers. Results: 10 (4.5%) out of 223 participants were found to have HPV-16 DNA in their oral rinse samples using NB2 endpoint PCR and Sanger sequencing. Within the HPV-16 DNA positive subjects, 7 (70%) and 3 (30%) were associated with poor oral hygiene and periodontal disease, respectively. Conclusion: Our results show a trend towards a positive correlation between oral HPV-16 infection and poor clinical oral health status.
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12
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de Silva AM, Martin-Kerry JM, McKee K, Cole D. Caries and periodontal disease in Indigenous adults in Australia: a case of limited and non-contemporary data. AUST HEALTH REV 2017; 41:469-478. [DOI: 10.1071/ah15229] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 06/26/2016] [Indexed: 02/05/2023]
Abstract
Objective The aim of the present study was to identify all evidence about the prevalence and severity of clinically measured caries and periodontal disease in Indigenous adults in Australia published in peer-reviewed journals and to summarise trends over time. In addition, we examined whether the studies investigated associations between putative risk factors and levels of caries and periodontal disease. Methods PubMed was searched in September 2014, with no date limitations, for published peer-reviewed articles reporting the prevalence rates and/or severity of caries and periodontal disease in Indigenous adults living in Australia. Articles were excluded if measurement was not based on clinical assessment and if oral disease was reported only in a specific or targeted sample, and not the general population. Results The search identified 18 papers (reporting on 10 primary studies) that met the inclusion criteria. The studies published clinical data about dental caries and/or periodontal disease in Australian Indigenous adults. The studies reported on oral health for Indigenous adults living in rural (40%), urban (10%) and both urban and rural (50%) locations. Included studies showed that virtually all Indigenous adults living in rural locations had periodontal disease. The data also showed caries prevalence ranged from 46% to 93%. Although 10 studies were identified, the peer-reviewed literature was extremely limited and no published studies were identified that provided statistics for a significant proportion of Australia (Victoria, Tasmania, Queensland or the Australian Capital Territory). There were also inconsistencies in how the data were reported between studies, making comparisons difficult. Conclusions This review highlights a lack of robust and contemporary data to inform the development of policies and programs to address the disparities in oral health in Indigenous populations living in many parts of Australia. What is known about the topic? Many studies report that Indigenous people in Australia have poorer general health compared with non-Indigenous people. What does this paper add? This paper documents the available caries and periodontal disease prevalence and experience for Indigenous adults in Australia published in peer-reviewed journals. It demonstrates significant limitations in the data, including no data in several large Australian jurisdictions, inconsistency with reporting methods and most data available being for Indigenous adults living in rural locations. Therefore, the oral health data available in the peer-reviewed literature do not reflect the situation of all Indigenous people living in Australia. What are the implications for practitioners? It is important for oral health practitioners to have access to current and relevant statistics on the oral health of Indigenous Australians. However, we have highlighted significant evidence gaps for this population group within the peer-reviewed literature and identified the limitations of the available data upon which decisions are currently being made. This paper also identifies ways to capture and report oral health data in the future to enable more meaningful comparisons and relevance for use in policy development.
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Carvajal P, Gómez M, Gomes S, Costa R, Toledo A, Solanes F, Romanelli H, Oppermann R, Rösing C, Gamonal J. Prevalence, severity, and risk indicators of gingival inflammation in a multi-center study on South American adults: a cross sectional study. J Appl Oral Sci 2016; 24:524-534. [PMID: 27812624 PMCID: PMC5083031 DOI: 10.1590/1678-775720160178] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 06/27/2016] [Indexed: 01/22/2023] Open
Abstract
Objectives: The aim of this study is to investigate the prevalence and severity of gingival inflammation and associated risk indicators in South American adults. Material and Methods: Multi-stage samples totaling 1,650 adults from Porto Alegre (Brazil), Tucumán (Argentina), and Santiago (Chile) were assessed. The sampling procedure consisted of a 4-stage process. Examinations were performed in mobile dental units by calibrated examiners. A multivariable logistic regression model was utilized for associating variables as indicators of gingival inflammation (GI) (Gingival Index ≥0.5). Statistical significance was set at 0.05. Results: A total of 96.5% of the adults have GI. Regarding the severity of GI, 22.5% of participants examined have mild GI, 74.0% have moderate GI, and 3.6% have severe GI. The multivariate analyses identify the main risk indicators for GI as adults with higher mean of Calculus Index (OR=18.59); with a Visible Plaque Index ≥30% (OR=14.56); living in Santiago (OR=7.17); having ≤12 years of schooling (OR=2.18), and females (OR=1.93). Conclusions: This study shows a high prevalence and severity of gingival inflammation, being the first one performed in adult populations in three cities of South America.
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Affiliation(s)
- Paola Carvajal
- Universidade de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Laboratorio de Biología Periodontal, Santiago, Chile
| | - Mariel Gómez
- Universidad Maimónides, Facultad de Odontología, Buenos Aires, Argentina
| | - Sabrina Gomes
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Brasil
| | - Ricardo Costa
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Brasil
| | - Andres Toledo
- Universidad Maimónides, Facultad de Odontología, Buenos Aires, Argentina
| | - Fernando Solanes
- Universidade de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Laboratorio de Biología Periodontal, Santiago, Chile
| | - Hugo Romanelli
- Universidad Maimónides, Facultad de Odontología, Buenos Aires, Argentina
| | - Rui Oppermann
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Brasil
| | - Cassiano Rösing
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Odontologia Conservadora, Porto Alegre, Brasil
| | - Jorge Gamonal
- Universidade de Chile, Facultad de Odontología, Departamento de Odontología Conservadora, Laboratorio de Biología Periodontal, Santiago, Chile
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14
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Sreenivasan PK, Prasad KVV, Javali SB. Oral health practices and prevalence of dental plaque and gingivitis among Indian adults. Clin Exp Dent Res 2016; 2:6-17. [PMID: 29744145 PMCID: PMC5839247 DOI: 10.1002/cre2.15] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/22/2015] [Accepted: 10/23/2015] [Indexed: 12/11/2022] Open
Abstract
This cross-sectional survey study evaluated oral hygiene habits in conjunction with whole mouth examinations for dental plaque and gingivitis among adults in India. Subjects across several age groups who provided informed consent [220 male and 158 female (mean age 30.9 years)] were enrolled. All enrolled subjects were interviewed for oral hygiene practices and evaluated by the Turesky modification of the Quigley-Hein and the Löe-Silness methods for dental plaque and gingivitis, respectively. Evaluations included oral hygiene parameters, prevalence of dental plaque and gingivitis, and regional differences within the dentition for dental plaque and gingivitis. Results from this study indicate that most subjects (97%) utilized a toothbrush and toothpaste for oral hygiene with a majority (92%) using their right hand to brush their teeth. While 29% reported two or more episodes of daily oral hygiene, a majority (53%) brushed their teeth once daily. Utilization of dental floss and mouthwashes were reported by approximately 1% of this population, and most (73%) reported no dental visits in the preceding 5 years. Whole mouth plaque and gingival scores (average ± standard deviation) for this population were 2.47 ± 0.55 and 1.19 ± 0.31, respectively, with no significant differences between either gender (P > 0.05). Significant correlations (r > 0.44) were observed between plaque and gingival scores for the entire sample, either gender or between age groups (P < 0.001). Analyses indicate that anterior teeth demonstrated lower average scores for dental plaque and gingivitis than posterior and molar regions (P < 0.05). Education was associated with higher plaque and gingival scores: plaque scores [odds ratios; 95% confidence interval; 1.23; 1.01-1.50 and gingival scores odds ratios 1.25; 1.02-1.54]. In summary, results from this study demonstrate the prevalence of dental plaque and gingivitis in the general population and their relationships with demographic characteristics. They reinforce examinations of posterior regions that consistently harbor more plaque and corresponding gingivitis in evaluations of oral health.
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Affiliation(s)
- P K Sreenivasan
- Colgate-Palmolive Technology Center Piscataway New Jersey 08855 USA
| | - K V V Prasad
- Department of Community Dentistry SDM College of Dental Sciences Dharwad India
| | - S B Javali
- Associate Professor in Statistics, Department of Community Medicine USM-KLE International Medical School Belagavi India
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15
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Bailey DL, Barrow SY, Cvetkovic B, Musolino R, Wise SL, Yung C, Darby I. Periodontal diagnosis in private dental practice: a case-based survey. Aust Dent J 2015; 61:244-51. [PMID: 26308865 DOI: 10.1111/adj.12369] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Despite the prevalence of periodontitis in Australia, there are few reports regarding periodontal diagnosis and therapies in the general dental practice setting. This study aimed to assess the degree of diagnostic accuracy in periodontal cases of Victorian general dental practitioners. METHODS Following ethics approval, dentists were invited to complete a scenario-based questionnaire on the Australian Dental Association Victorian Branch (ADAVB) website. Five text-based clinical scenarios (from a total of 10) were randomly presented, representing patients with a range of disease levels from periodontal health/gingivitis to severe periodontitis, and respondents were asked what examinations they would usually perform. Based upon the presented results of periodontal and radiographic examinations, a periodontal diagnosis was requested. RESULTS One hundred and thirty-five dentists attempted the survey. Most were in group practice and based in Melbourne; 22.5% of respondents worked in a practice employing a hygienist. The clinical parameters most commonly measured to diagnose periodontal disease were pocket depth and mobility. The majority of respondents diagnosed health, gingivitis and mild periodontitis correctly compared to American Academy of Periodontology guidelines. However, moderate periodontitis tended to be diagnosed as severe. CONCLUSIONS Dentists in Victoria used appropriate clinical parameters when assessing periodontal disease and were generally accurate in their diagnoses. There is a need for consensus regarding diagnostic definitions.
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Affiliation(s)
- D L Bailey
- Melbourne Dental School, The University of Melbourne, Parkville, Victoria, Australia
| | - S-Y Barrow
- Melbourne Dental School, The University of Melbourne, Parkville, Victoria, Australia
| | - B Cvetkovic
- eviDent Foundation, South Yarra, Victoria, Australia
| | - R Musolino
- eviDent Foundation, South Yarra, Victoria, Australia
| | - S L Wise
- eviDent Foundation, South Yarra, Victoria, Australia
| | - C Yung
- eviDent Foundation, South Yarra, Victoria, Australia
| | - I Darby
- Melbourne Dental School, The University of Melbourne, Parkville, Victoria, Australia
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16
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Stockham S, Stamford JE, Roberts CT, Fitzsimmons TR, Marchant C, Bartold PM, Zilm PS. Abnormal pregnancy outcomes in mice using an induced periodontitis model and the haematogenous migration of Fusobacterium nucleatum sub-species to the murine placenta. PLoS One 2015; 10:e0120050. [PMID: 25806806 PMCID: PMC4373690 DOI: 10.1371/journal.pone.0120050] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 02/03/2015] [Indexed: 12/22/2022] Open
Abstract
Objectives To investigate if there is subspecies specific migration to the placenta by Fusobacterium nucleatum (Fn) and to determine whether experimentally induced periodontitis results in adverse pregnancy outcomes (APO) in mice. Methods Periodontitis was induced in pregnant mice using an inoculum of Fn and Porphyromonas gingivalis. In parallel, four sub-species of Fn were individually injected into the circulatory system. At day 18 of gestation, the placenta, liver, spleen and blood were harvested and litter size, number of viable fetuses and resorptions, maternal, fetal and placenta weights were recorded. For the direct inoculation group, some mice were allowed to deliver for assessment of length of gestation, litter size, maternal, placental and pup weight. The presence of Fn was assessed by PCR and inflammatory mediators were measured by ELISA or multiplex analysis. Results Mice with alveolar bone loss, a marker of periodontitis, demonstrated significantly higher fetal weights (p = 0.015) and fetal/placental weight ratios (p = 0.030). PCR analysis of maternal organs did not identify Fn in any extracted tissues. In mice that received direct injection of Fn subspecies, varying degrees of APO were observed including preterm birth, intrauterine growth restriction, and fetal loss. Haematogenous spread of only Fn subsp. nucleatum to the placenta was confirmed. Litter size was significantly smaller (p = 0.023) and the number of resorptions was higher in inoculated versus control groups. Mice injected with subsp. nucleatum had significantly increased circulating CRP levels (p = 0.020) compared to controls while the mice with induced periodontitis had increased levels of IL-6 (p = 0.047) and IL-8 (p = 0.105). Conclusions Periodontitis in mice elevated fetal weight and the fetal weight/placental weight ratio. This study found that subsp. nucleatum migrated haematogenously to the placenta, leading to APO in mice. The study supports the potential role of Fn in the association between periodontitis and APO.
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Affiliation(s)
- Sara Stockham
- Oral Microbiology, School of Dentistry, The University of Adelaide, Adelaide, Australia
| | - Justine E. Stamford
- Oral Microbiology, School of Dentistry, The University of Adelaide, Adelaide, Australia
| | - Claire T. Roberts
- Robinson Research Institute, The University of Adelaide, Adelaide, South Australia, Australia
| | - Tracy R. Fitzsimmons
- Colgate Australian Clinical Dental Research Centre, School of Dentistry, The University of Adelaide, Adelaide, Australia
| | - Ceilidh Marchant
- Colgate Australian Clinical Dental Research Centre, School of Dentistry, The University of Adelaide, Adelaide, Australia
| | - P. Mark Bartold
- Colgate Australian Clinical Dental Research Centre, School of Dentistry, The University of Adelaide, Adelaide, Australia
| | - Peter S. Zilm
- Oral Microbiology, School of Dentistry, The University of Adelaide, Adelaide, Australia
- * E-mail:
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17
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Darby IB, Ngo L. Minimum intervention dentistry: periodontics and implant dentistry. Aust Dent J 2013; 58 Suppl 1:76-84. [DOI: 10.1111/adj.12053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- IB Darby
- Periodontics; Melbourne Dental School; The University of Melbourne; Victoria
| | - L Ngo
- Periodontics; Melbourne Dental School; The University of Melbourne; Victoria
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18
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19
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Furuta M, Ekuni D, Irie K, Azuma T, Tomofuji T, Ogura T, Morita M. Sex differences in gingivitis relate to interaction of oral health behaviors in young people. J Periodontol 2010; 82:558-65. [PMID: 20936916 DOI: 10.1902/jop.2010.100444] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although many epidemiologic surveys have shown that gingivitis is more prevalent in males than in females, few studies have clearly explained what causes this difference. The objective of the present study is to explain the sex difference in gingivitis based on the interaction between oral health behaviors and related factors, such as knowledge, attitude, and lifestyle, in young people. METHODS The study was comprised of 838 subjects (440 males and 398 females), aged 18 and 19 years. Gingivitis was assessed by the percentage of bleeding on probing (%BOP). Additional information was collected regarding oral hygiene status, oral health behaviors, and related factors. Structural equation modeling was used to test pathways from these factors to %BOP. Multiple-group modeling was also conducted to test for sex differences. RESULTS Females had greater knowledge, a more positive attitude, a healthier lifestyle, and higher level of oral health behaviors than males. There were significant differences in the paths (i.e., from lifestyle, knowledge, and attitude to %BOP) through oral health behaviors and oral health status. CONCLUSIONS Sex-based differences in gingivitis in young people can be explained by oral health behaviors and hygiene status, which are influenced by lifestyle, knowledge, and attitude. To prevent gingivitis, different approaches to males and females may be useful.
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Affiliation(s)
- Michiko Furuta
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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