1
|
Pecher AC, Günaydin B, Finke H, Henes J. Evaluation of oral health in 148 patients with systemic sclerosis-data from a prospective interdisciplinary monocentric cohort. Rheumatol Int 2024; 44:1567-1573. [PMID: 38874787 PMCID: PMC11222211 DOI: 10.1007/s00296-024-05635-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 05/29/2024] [Indexed: 06/15/2024]
Abstract
In daily rheumatology practice, systemic sclerosis is primarily regarded as a potentially life-threatening disease characterized by fibrosis of various organs. Therefore, other manifestations, such as orofacial involvement, are often not of primary concern. Furthermore, due to its rarity, the disease might not be well known by dentists, which contrasts with the increased risk of various problems in the oral cavity. Periodontitis in particular is a known risk factor for morbidity and mortality and is associated with various systemic diseases. The risk of periodontitis appears to be increased in patients with systemic sclerosis, but little is known about the gender-specific differences. This study aims to elucidate the health-conscious behaviour of patients, their dental care and the risk of periodontitis with regard to gender-specific differences. This descriptive study of the Interdisciplinary Centre of Rheumatic Diseases (INDIRA) in collaboration with the Department of Orthodontics at the University Hospital of Tuebingen, Germany, examined the data of 148 patients with systemic sclerosis with regard to their oral health using a questionnaire and evaluating the risk of periodontitis with the DG Paro self-assessment score in this cohort. Among the participating patients, 90% reported regular visits to the dentist and good dental care. Nevertheless, more than half of the patients had missing teeth and problems opening their mouths. Sicca symptoms in the oral cavity were also common (40%). The risk of periodontitis among female participants was high (around 60%), and even higher among male study participants (around 80%). Gingival bleeding as a surrogate parameter for periodontitis was associated with salivary flow and the modified Rodnan skin score (mRSS). Despite a high awareness of dental health, we observed a high risk of periodontitis, especially in male patients with systemic sclerosis. In addition, the association between xerostomia and missing teeth as well as gingival bleeding and mRSS may indicate an increased risk in patients with a more progressive disease. We would therefore recommend regular dental consultations and careful oral hygiene for patients with systemic sclerosis in addition to the-more organ-focused-regular examinations of patients.
Collapse
Affiliation(s)
- Ann-Christin Pecher
- Interdisciplinary Center of Rheumatic Diseases (INDIRA), University Hospital Tuebingen, Tuebingen, Germany
| | - Bahar Günaydin
- Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Hannah Finke
- Department of Orthodontics, University Hospital Tuebingen, Osianderstr. 2-8, 72076, Tuebingen, Germany.
| | - Jörg Henes
- Interdisciplinary Center of Rheumatic Diseases (INDIRA), University Hospital Tuebingen, Tuebingen, Germany
| |
Collapse
|
2
|
Teza H, Pattanateepapon A, Lertpimonchai A, Vathesatogkit P, J McKay G, Attia J, Thakkinstian A. Development of Risk Prediction Models for Severe Periodontitis in a Thai Population: Statistical and Machine Learning Approaches. JMIR Form Res 2023; 7:e48351. [PMID: 38096008 PMCID: PMC10755655 DOI: 10.2196/48351] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 12/31/2023] Open
Abstract
BACKGROUND Severe periodontitis affects 26% of Thai adults and 11.2% of adults globally and is characterized by the loss of alveolar bone height. Full-mouth examination by periodontal probing is the gold standard for diagnosis but is time- and resource-intensive. A screening model to identify those at high risk of severe periodontitis would offer a targeted approach and aid in reducing the workload for dentists. While statistical modelling by a logistic regression is commonly applied, optimal performance depends on feature selections and engineering. Machine learning has been recently gaining favor given its potential discriminatory power and ability to deal with multiway interactions without the requirements of linear assumptions. OBJECTIVE We aim to compare the performance of screening models developed using statistical and machine learning approaches for the risk prediction of severe periodontitis. METHODS This study used data from the prospective Electricity Generating Authority of Thailand cohort. Dental examinations were performed for the 2008 and 2013 surveys. Oral examinations (ie, number of teeth and oral hygiene index and plaque scores), periodontal pocket depth, and gingival recession were performed by dentists. The outcome of interest was severe periodontitis diagnosed by the Centre for Disease Control-American Academy of Periodontology, defined as 2 or more interproximal sites with a clinical attachment level ≥6 mm (on different teeth) and 1 or more interproximal sites with a periodontal pocket depth ≥5 mm. Risk prediction models were developed using mixed-effects logistic regression (MELR), recurrent neural network, mixed-effects support vector machine, and mixed-effects decision tree models. A total of 21 features were considered as predictive features, including 4 demographic characteristics, 2 physical examinations, 4 underlying diseases, 1 medication, 2 risk behaviors, 2 oral features, and 6 laboratory features. RESULTS A total of 3883 observations from 2086 participants were split into development (n=3112, 80.1%) and validation (n=771, 19.9%) sets with prevalences of periodontitis of 34.4% (n=1070) and 34.1% (n=263), respectively. The final MELR model contained 6 features (gender, education, smoking, diabetes mellitus, number of teeth, and plaque score) with an area under the curve (AUC) of 0.983 (95% CI 0.977-0.989) and positive likelihood ratio (LR+) of 11.9 (95% CI 8.8-16.3). Machine learning yielded lower performance than the MELR model, with AUC (95% CI) and LR+ (95% CI) values of 0.712 (0.669-0.754) and 2.1 (1.8-2.6), respectively, for the recurrent neural network model; 0.698 (0.681-0.734) and 2.1 (1.7-2.6), respectively, for the mixed-effects support vector machine model; and 0.662 (0.621-0.702) and 2.4 (1.9-3.0), respectively, for the mixed-effects decision tree model. CONCLUSIONS The MELR model might be more useful than machine learning for large-scale screening to identify those at high risk of severe periodontitis for periodontal evaluation. External validation using data from other centers is required to evaluate the generalizability of the model.
Collapse
Affiliation(s)
- Htun Teza
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Anuchate Pattanateepapon
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Attawood Lertpimonchai
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Prin Vathesatogkit
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Gareth J McKay
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - John Attia
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, New Lambton, NSW, Australia
| | - Ammarin Thakkinstian
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| |
Collapse
|
3
|
Filgueiras LV, Konflanz W, Haas AN, Celeste RK. Assessment of the contextual effects on the prevalence of periodontitis: a systematic review. Braz Oral Res 2023; 36:e0125. [PMID: 36651384 DOI: 10.1590/1807-3107bor-2022.vol36.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/02/2021] [Indexed: 01/17/2023] Open
Abstract
This study reviews the influence of contextual factors on periodontitis based on a systematic search of studies recorded in the PubMed, Scopus, Web of Science, and EMBASE databases. Periodontitis was assessed by clinical attachment loss and probing depth for studies with data on the socioeconomic status (SES) of a specific area (area-level SES) or dental care service (service-level) in a catchment area among individuals aged 18 and over. Two independent reviewers performed study selection, data extraction, and assessment of methodological quality. Of the 646 articles identified, 13 were included in the systematic review, representing 101,362 individuals from five countries (USA, UK, Brazil, China, and Uruguay). A higher prevalence of periodontitis was described in lower SES neighborhoods, more deprived postcodes, and poorer provinces. Gini Index results were mixed and inconclusive. Three studies showed that higher coverage of primary dental care at the municipal level was associated with a lower prevalence of periodontitis. Contextual factors at the area-level SES and dental care service might influence periodontitis, but the existing evidence is unclear. The contextual effect is important for periodontal health and may contribute to the prevalence of periodontitis, independent of well-known risk factors and individual levels.
Collapse
Affiliation(s)
- Leonardo Vilar Filgueiras
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Preventive and Social Dentistry, Porto Alegre, RS, Brazil
| | - Willian Konflanz
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Alex Nogueira Haas
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Roger Keller Celeste
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Preventive and Social Dentistry, Porto Alegre, RS, Brazil
| |
Collapse
|
4
|
Oral and Dental Considerations of Combat-Induced Post Traumatic Stress Disorder (PTSD)-A Cross-Sectional Study. J Clin Med 2022; 11:jcm11113249. [PMID: 35683634 PMCID: PMC9181801 DOI: 10.3390/jcm11113249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 02/04/2023] Open
Abstract
Objective: This study compared dental, periodontal, oral, and joint/muscle tenderness among Israeli combat-induced post-traumatic stress disorder (Ci-PTSD) war veterans to non-PTSD patients. Study design: This retrospective three-arm study compared oral and facial manifestations between 100 Israeli veterans with Ci- PTSD (study group) and 103 non-PTSD periodontal patients (Control group). The study group was further divided into two subgroups of individuals who received psychiatric medications (40 patients) or did not (60 patients). All patients underwent complete dental, oral, and periodontal examinations, including assessing signs of parafunction. Results: All PTSD patients had poor oral hygiene. The plaque index (PI) was higher in the PTSD group compared to the control group (0.72 ± 0.28 vs. 0.45 ± 0.29, respectively, p < 0.001). The decayed, missing, and filled teeth score (DMFt) was higher in the PTSD population than in the controls (19.97 ± 8.07 vs. 13.05 ± 6.23 p < 0.05). Severe periodontal disease was more common among the PTSD subgroup taking medications (med -group) (62.5%) compared to the nonmedicated group (non-med group) (30.0%) and the controls (27.2%) (p = 0.001). Heavy smoking was more prevalent in the medicated PTSD patients than in other groups. Conclusions: The present study shows higher morbidities in combat-induced PTSD patients, including oral, dental, and periodontal manifestations, especially in medicated patients.
Collapse
|
5
|
Self-Reported Gum Bleeding, Perception, Knowledge, and Behavior in Working-Age Hong Kong Chinese-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095749. [PMID: 35565144 PMCID: PMC9103544 DOI: 10.3390/ijerph19095749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 12/10/2022]
Abstract
Gingivitis and periodontitis are highly prevalent in Hong Kong, where the provision of oral health services is predominantly private. This cross-sectional study aimed to investigate the association between the oral symptoms of gum bleeding and self-reported behavioral factors, beliefs, and knowledge among Hong Kong Chinese. The research team commissioned the Public Opinion Programme of The University of Hong Kong to conduct a structured, population-based, computer-assisted telephone interview (CATI), which covered questions related to the demography, perception, and knowledge (including traditional Cantonese beliefs) of gum health, dental attendance, oral health behavior, and dental anxiety. A total of 1,265 individuals aged 25−60 years old were successfully contacted, and 704 (55.7%) reported prior gum bleeding experience. A total of 516 individuals (64.9% females, median 55−60 years) completed the CATI satisfactorily, and 321 (62.2%) experienced gum bleeding in the past 12 months. The factors that were significantly associated with reports of gum bleeding in the past 12 months include having periodontitis, sensitive teeth, having tertiary or higher education, flossing/interdental cleaning, not cleaning teeth well enough, lack of sleep, consuming too much ‘heaty’ food, avoiding going to the dentist when gums are bleeding, and waiting for gum bleeding to subside (p < 0.05, r2 =0.198; forward stepwise logistic regression). Within the limitations of this study, approximately half of the Hong Kong working-age adults surveyed reported experiencing gum bleeding, and 62.2% of the participants experienced it within the past 12 months. Members of Hong Kong’s working-age population who reported having higher levels of education appeared more readily aware of their gum problems. Those with bleeding gums, especially those who have discernable periodontitis, poor dental awareness/behaviors, and/or a poor lifestyle should be targeted to receive education and encouragement, which will allow them to take action and improve their own gum health.
Collapse
|
6
|
Nijland N, Overtoom F, Gerdes VEA, Verhulst MJL, Su N, Loos BG. External validation of a rapid, non-invasive tool for periodontitis screening in a medical care setting. Clin Oral Investig 2021; 25:6661-6669. [PMID: 33978832 PMCID: PMC8602137 DOI: 10.1007/s00784-021-03952-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/16/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Medical professionals should advise their patients to visit a dentist if necessary. Due to the lack of time and knowledge, screening for periodontitis is often not done. To alleviate this problem, a screening model for total (own teeth/gum health, gum treatment, loose teeth, mouthwash use, and age)/severe periodontitis (gum treatment, loose teeth, tooth appearance, mouthwash use, age, and sex) in a medical care setting was developed in the Academic Center of Dentistry Amsterdam (ACTA) [1]. The purpose of the present study was to externally validate this tool in an outpatient medical setting. MATERIALS AND METHODS Patients were requited in an outpatient medical setting as the validation cohort. The self-reported oral health questionnaire was conducted, demographic data were collected, and periodontal examination was performed. Algorithm discrimination was expressed as the area under the receiver operating characteristic curve (AUROCC). Sensitivity, specificity, and positive and negative predictive values were calculated. Calibration plots were made. RESULTS For predicting total periodontitis, the AUROCC was 0.59 with a sensitivity of 49% and specificity of 68%. The PPV was 57% and the NPV scored 55%. For predicting severe periodontitis, the AUROCC was 0.73 with a sensitivity of 71% and specificity of 63%. The PPV was 39% and the NPV 87%. CONCLUSIONS The performance of the algorithm for severe periodontitis is found to be sufficient in the current medical study population. Further external validation of periodontitis algorithms in non-dental school populations is recommended. CLINICAL RELEVANCE Because general physicians are obligated to screen patients for periodontitis, it is our general goal that they can use a prediction model in medical settings without an oral examination.
Collapse
Affiliation(s)
- N Nijland
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands.
| | - F Overtoom
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands
| | - V E A Gerdes
- Department of Vascular Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - M J L Verhulst
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands
- Sunstar Suisse, Etoy, Switzerland
| | - N Su
- Department of Oral Public Health, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - B G Loos
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands
| |
Collapse
|
7
|
|
8
|
Association, prediction, generalizability: Cross-center validity of predicting tooth loss in periodontitis patients. J Dent 2021; 109:103662. [PMID: 33857544 DOI: 10.1016/j.jdent.2021.103662] [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: 02/04/2021] [Revised: 03/24/2021] [Accepted: 04/09/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To predict patients' tooth loss during supportive periodontal therapy across four German university centers. METHODS Tooth loss in 897 patients in four centers (Kiel (KI) n = 391; Greifswald (GW) n = 282; Heidelberg (HD) n = 175; Frankfurt/Main (F) n = 49) during supportive periodontal therapy (SPT) was assessed. Our outcome was annualized tooth loss per patient. Multivariable linear regression models were built on data of 75 % of patients from one center and used for predictions on the remaining 25 % of this center and 100 % of data from the other three centers. The prediction error was assessed as root-mean-squared-error (RMSE), i.e., the deviation of predicted from actually lost teeth per patient and year. RESULTS Annualized tooth loss/patient differed significantly between centers (between median 0.00 (interquartile interval: 0.00, 0.17) in GW and 0.09 (0.00, 0.19) in F, p = 0.001). Age, smoking status and number of teeth before SPT were significantly associated with tooth loss (p < 0.03). Prediction within centers showed RMSE of 0.14-0.30, and cross-center RMSE was 0.15-0.31. Predictions were more accurate in F and KI than in HD and GW, while the center on which the model was trained had a less consistent impact. No model showed useful predictive values. CONCLUSION While covariates were significantly associated with tooth loss in linear regression models, a clinically useful prediction was not possible with any of the models and generalizability was not given. Predictions were more accurate for certain centers. CLINICAL RELEVANCE Association should not be confused with predictive value: Despite significant associations of covariates with tooth loss, none of our models was useful for prediction. Usually, model accuracy was even lower when tested across centers, indicating low generalizability.
Collapse
|
9
|
Wright CD, Heaton B, McNeil DW. Development and validation of a latent, multidimensional, self-report periodontal disease measure. J Periodontol 2021; 92:1554-1563. [PMID: 33651894 DOI: 10.1002/jper.20-0066] [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: 01/31/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Self-report measures of periodontal disease have utility for screening, but have not capitalized on a latent variable approach based on psychometric theory to validate such measures. This study aimed to develop a psychometrically valid self-report measure of periodontal disease using latent variable factor analysis and other evidence-based psychometric analyses. METHODS Likert-type items reflecting periodontal disease were administered to a sample of adults (n = 828) in the United States via an online survey. Items were adapted from prior self-report measures or were newly developed based on psychometric item development theory and theoretical knowledge of periodontal disease. Psychometric analyses included exploratory and confirmatory factor analysis, parallel analysis, and a calculation of internal consistency. RESULTS Exploratory factor analysis (EFA) was indicative of the goodness-of-fit with two factors (root mean square error of approximation (RMSEA) = 0.08; comparative fit index (CFI) = 0.97; Tucker Lewis index (TLI) = 0.96; standardized root mean squared residual = 0.06); five of the 22 original survey questions were eliminated based on the results of this EFA. Parallel analysis supported a two-factor model to represent the similarities across items-one factor reflecting physiologic components and another reflecting functional components of periodontal disease. Confirmatory Factor Analysis also indicated adequate model fit (RMSEA = 0.07; CFI = 0.98; TLI = 0.98; and weighted root mean square residual = 1.20). CONCLUSIONS Psychometric analyses of a new 17-item periodontal disease self-report measure provided initial evidence of construct/factor validity. This approach to developing self-report periodontal disease measures may facilitate useful and cost-effective estimates of periodontal disease and provide a testable scale. Future work should include clinical validation.
Collapse
Affiliation(s)
- Casey D Wright
- Department of Psychology, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WV
| | - Brenda Heaton
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA
| | - Daniel W McNeil
- Department of Psychology, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WV.,Department of Dental and Rural Practice, School of Dentistry, West Virginia University, Morgantown, WV
| |
Collapse
|
10
|
Sekundo C, Bölk T, Kalmus O, Listl S. Accuracy of a 7-Item Patient-Reported Stand-Alone Tool for Periodontitis Screening. J Clin Med 2021; 10:E287. [PMID: 33466797 PMCID: PMC7830157 DOI: 10.3390/jcm10020287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 02/06/2023] Open
Abstract
Periodontitis is interrelated with various other chronic diseases. Recent evidence suggests that treatment of periodontitis improves glycemic control in diabetes patients and reduces the costs of diabetes treatment. So far, however, screening for periodontitis in non-dental settings has been complicated by a lack of easily applicable and reliable screening tools which can be applied by non-dental professionals. The purpose of this study was to assess the diagnostic accuracy of a short seven-item tool developed by the German Society for Periodontology (DG PARO) to screen for periodontitis by means of patient-reported information. A total of 88 adult patients filled in the patient-reported Periodontitis Risk Score (pPRS; range: 0 points = lowest periodontitis risk; 20 points = very high periodontitis risk) questionnaire before dental check-up at Heidelberg University Hospital. Subsequent clinical assessments according to Periodontal Screening and Recording (PSR®) were compared with pPRS scores. The diagnostic accuracy of pPRS at different cutoff values was assessed according to sensitivity, specificity, positive, and negative predictive values, as well as Receiver-Operator-Characteristic curves, Area Under the Curve (AUC), and logistic regression analysis. According to combined specificity and sensitivity (AUC = 0.86; 95%-CI: 0.76-0.95), the diagnostic accuracy of the pPRS for detecting periodontal inflammation (PSR® ≥ 3) was highest for a pPRS cutoff distinguishing between pPRS scores < 7 vs. ≥ 7. Patients with pPRS scores ≥ 7 had a 36.09 (95%-CI: 9.82-132.61) times higher chance of having a PSR® ≥ 3 than patients with scores < 7. In conclusion, the pPRS may be considered an appropriately accurate stand-alone tool for the screening for periodontitis.
Collapse
Affiliation(s)
- Caroline Sekundo
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Tobias Bölk
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Olivier Kalmus
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
| | - Stefan Listl
- Translational Health Economics Group (THE Group), Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University, 69120 Heidelberg, Germany; (T.B.); (O.K.); (S.L.)
- Department of Dentistry—Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, 6525 Nijmegen, The Netherlands
| |
Collapse
|
11
|
Iao S, Pei X, Ouyang X, Liu J, Liu W, Cao C. Natural progression of periodontal diseases in Chinese villagers based on the 2018 classification. J Periodontol 2020; 92:1232-1242. [PMID: 33277921 DOI: 10.1002/jper.20-0199] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 11/09/2020] [Accepted: 11/30/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Based on the 2018 classification, we aimed to determine the prevalence, distribution, and progression of periodontitis in the rural Chinese population without access to dental care. METHODS In all, 404 subjects (28.7 ± 8.9 years, M:F = 182:222) were randomly enrolled in 1992 and re-called in 1996. With the new classification, the prevalence and distribution of stage, grade, and extent were characterized. Stage progression was compared with the progression of clinical attachment loss (CAL) and radiographic bone loss (RBL). RESULTS At baseline, 94.1% villagers suffered from periodontitis, of whom 53.7% were in stage III/IV. The prevalence of stage III/IV increased from 18.2% in the age group of 15 to 24 years to 60.9% in 25 to 34-year-old group and 88.7% in the 35 to 44-year-old group. Significantly more stage III/IV, generalized, and grade C periodontitis were found in male villagers than female villagers. In 1996, the prevalence rate of periodontitis increased to 98.5%, with 80.0% in stage III/IV. Further, 84.2% villagers presented with grade C periodontitis based on longitudinal ΔCAL. The rate of progression (≥1 site with ΔCAL ≥3 mm) was 63.7%. Stage progression correlated significantly with CAL and RBL progression in stage I/II, but this association was not found in stage III/IV. Among subjects with disease progression in stage III/IV, 90.4% shifted from localized to generalized cases. Furthermore, ceiling effects were observed in stage III/IV. CONCLUSIONS In villagers without access to dental care, 94.1% suffered from periodontitis, with more than half having stage III/IV disease based on the 2018 classification. The majority cases presented with rapid periodontal progression. Although stage progression correlated significantly with CAL and RBL progression in stage I/II, ceiling effects existed in stage III/IV.
Collapse
Affiliation(s)
- Siniong Iao
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiyan Pei
- First Clinic Division, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiangying Ouyang
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jianru Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wenyi Liu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Caifang Cao
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| |
Collapse
|
12
|
Hamdi Z, Detzen L, Fessi S, Julia C, Hercberg S, Czernichow S, Boillot A, Touvier M, Bouchard P, Andreeva VA, Carra MC. Alcoholic beverage consumption, smoking habits, and periodontitis: A cross-sectional investigation of the NutriNet-Santé study. J Periodontol 2020; 92:727-737. [PMID: 32895953 DOI: 10.1002/jper.20-0192] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/15/2020] [Accepted: 07/15/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Recent evidence suggests that dietary habits influence the development and severity of periodontitis. The present cross-sectional study evaluated the association between different types and quantity of alcoholic beverage consumption (alone and interacting with smoking) and the probability to suffer from severe periodontitis in the French e-cohort NutriNet-Santé. METHODS The study population consisted of 35,390 adults (mean age: 49.04 ± 13.94 years), who filled oral health questionnaires and completed at least three non-consecutive 24-hour dietary records. Data on type and frequency of alcoholic beverage consumption were obtained from a semi-quantitative self-reported alcohol frequency questionnaire; the daily quantity (g/day) was estimated from the 24-hour dietary records. The probability of severe periodontitis (main dependent variable) was assessed by calculating the modified periodontal screening score (mPESS) from selected questions. RESULTS A total of 7263 individuals (20.5%) presented a high probability of suffering from severe periodontitis (high-mPESS). After adjusting for confounding factors, the frequency of alcoholic beverage consumption was significantly higher among high-mPESS group than their low-mPESS counterparts, especially for hard liquor/spirits (1.9 ± 1.4 days/week for high-PESS versus 1.6 ± 1.1 days/week the low-PESS [P < 0.0001]). The mean daily quantity of ethanol was also higher in high-mPESS versus low-mPESS individuals (11.2 ± 15.6 versus 7.9 ± 12.3 g/day; P = 0.011). A stronger association with self-report severe periodontitis was noted when alcohol consumption exceeding > 20 g/day for women and > 30 g/day for men was combined with smoking habit (OR = 7.30 [95% CI: 6.1-8.73]). CONCLUSION The present results support an association between alcoholic beverage consumption and self-report severe periodontitis, particularly when it is associated with current smoking.
Collapse
Affiliation(s)
- Zeineb Hamdi
- Department of Periodontology, U.F.R. of Odontology, Garanciere, Université de Paris, Paris, France.,Department of Periodontology, Odontology Unit, Rothschild Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Paris, France
| | - Laurent Detzen
- Department of Periodontology, U.F.R. of Odontology, Garanciere, Université de Paris, Paris, France.,Department of Periodontology, Odontology Unit, Rothschild Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Paris, France
| | - Sabrine Fessi
- Department of Periodontology, U.F.R. of Odontology, Garanciere, Université de Paris, Paris, France.,Department of Periodontology, Odontology Unit, Rothschild Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Paris, France
| | - Chantal Julia
- Sorbonne Paris Nord University, Inserm U1153, Inra U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France.,Public Health Department, Avicenne Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Nord University, Inserm U1153, Inra U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Sébastien Czernichow
- Department of Nutrition, Georges-Pompidou European Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Université de Paris, Paris, France
| | - Adrien Boillot
- Department of Periodontology, U.F.R. of Odontology, Garanciere, Université de Paris, Paris, France.,Department of Periodontology, Odontology Unit, Rothschild Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Paris, France
| | - Mathilde Touvier
- Sorbonne Paris Nord University, Inserm U1153, Inra U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Philippe Bouchard
- Department of Periodontology, U.F.R. of Odontology, Garanciere, Université de Paris, Paris, France.,Department of Periodontology, Odontology Unit, Rothschild Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Paris, France.,EA 2496 Dental School, Université de Paris, U.F.R. of Odontology, Paris, France
| | - Valentina A Andreeva
- Sorbonne Paris Nord University, Inserm U1153, Inra U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France
| | - Maria Clotilde Carra
- Department of Periodontology, U.F.R. of Odontology, Garanciere, Université de Paris, Paris, France.,Department of Periodontology, Odontology Unit, Rothschild Hospital (Assistance Publique des Hopitaux de Paris, AP-HP), Paris, France.,Inserm, Population-based Epidemiologic Cohorts Unit, UMS 011, Villejuif, France
| |
Collapse
|
13
|
Micu IC, Bolboacă SD, Caracostea GV, Gligor D, Ciurea A, Iozon S, Soancă A, Mureșan D, Roman A. Self-reported and clinical periodontal conditions in a group of Eastern European postpartum women. PLoS One 2020; 15:e0237510. [PMID: 32810155 PMCID: PMC7433868 DOI: 10.1371/journal.pone.0237510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 07/28/2020] [Indexed: 12/02/2022] Open
Abstract
Periodontitis is a highly prevalent condition leading to a continuous destruction of tooth-supporting tissues. It increases the risk for various systemic diseases and adverse pregnancy outcomes. Therefore, screening for periodontitis is important. Screening measures can range from self-reported symptoms to clinical full-mouth periodontal examination. The hypothesis of our study was that self-reported parameters and clinical definition perform equally well in identifying periodontitis patients. The aim of this study was to develop, validate its internal consistency, and evaluate a self-reported instrument against periodontal clinical evaluation for diagnosis of periodontitis in a group of postpartum women, as well as to describe their periodontal status and the risk factors associated with periodontal disease. A cross-sectional study on postpartum women was conducted in a tertiary university hospital, from April 2018 to March 2019. Sociodemographic and behavioral data, periodontal clinical parameters, and self-reported periodontal perception were collected. A 16-item questionnaire was developed to obtain information about perceived periodontal alterations and oral hygiene habits. The utility of the questionnaire was tested against a periodontal diagnosis based on a full-mouth periodontal examination. The questionnaire was applied in 215 postpartum women aged 29.16±5.54 years (mean age (y) ± standard deviation) having the following periodontal status: 16 individuals without periodontal disease (7.44%), 32 individuals with gingivitis (14.88%), 19 individuals with mild periodontitis (8.84%), 132 individuals with moderate periodontitis (61.39%), and 16 individuals with severe periodontitis (7.44%). A significant association was observed between oral hygiene score, smoking status, and periodontal conditions (p<0.05). A significant association between the self-reported items related to “gum swelling”, “halitosis”, “previous periodontal diagnosis” and “previous periodontal treatment” with clinical periodontitis have been identified (p<0.05). Using self-reported questionnaires for detection of periodontal disease was ineffective in our studied population, since self-reported parameters and clinical definition do not appear to perform equally in identifying periodontitis cases. Clinical periodontal examination remains the gold standard for screening. Periodontitis was frequent in our group and the severity was significantly associated with the oral hygiene score and smoking. These results underline the necessity for periodontal clinical examination during pregnancy.
Collapse
Affiliation(s)
- Iulia C. Micu
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
- * E-mail: (SDB); (GVC)
| | - Gabriela V. Caracostea
- Department of Obstetrics and Gynecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
- * E-mail: (SDB); (GVC)
| | - Diana Gligor
- Department of Obstetrics and Gynecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Andreea Ciurea
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sofia Iozon
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Andrada Soancă
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Daniel Mureșan
- Department of Obstetrics and Gynecology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| | - Alexandra Roman
- Department of Periodontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Emergency County Clinical Hospital, Cluj-Napoca, Romania
| |
Collapse
|
14
|
Saka-Herrán C, Jané-Salas E, González-Navarro B, Estrugo-Devesa A, López-López J. Validity of a self-reported questionnaire for periodontitis in a Spanish population. J Periodontol 2020; 91:1027-1038. [PMID: 31984491 DOI: 10.1002/jper.19-0604] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/28/2019] [Accepted: 12/29/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Clinical examination is the gold-standard approach for surveillance of periodontitis; however, it requires large resources. Several self-reported measures have been developed and tested in diverse scenarios with results suggesting that it may be a useful tool for screening periodontal disease in different populations; yet they have not being tested in Spanish population. We aimed to assess the validity of a self-reported questionnaire for periodontitis in a Spanish population from Barcelona during 2018. METHODS One hundred and twelve participants were enrolled in the study and, in one appointment; a dentist performed the self-reported questionnaire and a full-mouth periodontal examination. Periodontitis was defined as at least mild periodontitis according to three criterion of classification. Receiver-operating characteristics curve analyses were used to test the discriminatory capability, sensitivity and specificity of the self-reported questionnaire and logistic regression models were adjusted to estimate the minimal-set of questions associated with periodontitis. RESULTS The self-reported questionnaire had a useful discriminative capability for detecting individuals with periodontitis (area under the curve [AUC] = 0.85 95% CI 0.78-0.92) and its moderate/severe form (AUC = 0.86 95% CI 0.79-0.04) with sensitivity and specificity of 77% and 74% and 73% and 87%, respectively; representing moderate validity. The combination of four-specific questions had high accuracy (AUC = 0.88 95% CI 0.81-0.94) and validity (sensitivity = 92.2%) and was strongly associated with moderate/severe periodontitis after adjusting by socio-demographic factors. CONCLUSIONS The use of several self-reported questions proved to have a good performance for screening periodontitis in the population under study; specifically, those related with tooth mobility and gum migration. Large community-based studies are needed to test its validity and predictive capability.
Collapse
Affiliation(s)
- Constanza Saka-Herrán
- Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Barcelona, Spain
| | - Enric Jané-Salas
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona-Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain
| | - Beatriz González-Navarro
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona-Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain
| | - Albert Estrugo-Devesa
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona-Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), Odontological Hospital University of Barcelona, University of Barcelona Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain
| |
Collapse
|
15
|
Chen H, Zhang R, Cheng R, Xu T, Zhang T, Hong X, Zhao X, Wu Y, Cheng L, Hu T. Gingival bleeding and calculus among 12-year-old Chinese adolescents: a multilevel analysis. BMC Oral Health 2020; 20:147. [PMID: 32429918 PMCID: PMC7238592 DOI: 10.1186/s12903-020-01125-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 04/28/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Gingivitis is a common oral health problem, and untreated gingivitis can progress to periodontitis. The objectives of this study were to (1) explore associated factors of gingival bleeding and calculus among 12-year-old adolescents; (2) find predictive models for gingivitis management. METHODS Four thousand five hundred twenty-five subjects aged 12 in Sichuan Province were investigated. The questionnaire and clinical examination were applied in schools, and two-level logistic regression models were constructed to interpret the effect of individual and contextual factors on Chinese adolescents' gingival bleeding and calculus. RESULTS 46.63% (95%CI: 40.71, 51.60) and 66.94% (95%CI: 56.85, 67.45) of the subjects presented gingival bleeding and calculus, respectively. For the gingival bleeding cases, the model showed the significant associated indicators were hukou (OR = 0.61, 95% CI: 0.52-0.72), family size (OR = 1.41, 95% CI: 1.19-1.68), parental educational level (father: OR = 0.53, 95% CI: 0.45-0.63; mother: OR = 0.71, 95% CI: 0.59-0.86), tooth-brushing frequency (OR = 0.35, 95% CI: 0.26-0.48), dental floss use (OR = 0.58, 95% CI: 0.41-0.83), sugar-containing drink consumption (OR = 2.11, 95% CI: 1.80-2.49), and dental visit (OR = 1.44, 95% CI: 1.19-1.74). It also confirmed that gender (OR = 1.32, 95% CI: 1.13-1.54), hukou (OR = 0.69, 95% CI: 0.59-0.82), family size (OR = 1.34, 95% CI: 1.12-1.59), parental educational level (father: OR = 0.46, 95% CI: 0.39-0.54; mother: OR = 0.65, 95% CI: 0.59-0.82), tooth-brushing frequency (OR = 0.57, 95% CI: 0.42-0.78), dental floss use (OR = 0.66, 95% CI: 0.48-0.90) and sugar-containing drink consumption (OR = 1.30, 95% CI: 1.11-1.53) were associated factors for dental calculus. CONCLUSIONS Gingival bleeding and calculus were common in western Chinese adolescents. Socio-demographic factors including gender, hukou and family factors are strong determinants of gingival health in Chinese adolescents. In addition, health-related lifestyle behaviors such as healthy diet, good hygiene care and more dental visits are good predictors of better gingival status.
Collapse
Affiliation(s)
- Hong Chen
- Graduate Student in Department of Preventive Dentistry, West China School & Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
| | - Rui Zhang
- Graduate Student in Department of Preventive Dentistry, West China School & Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
| | - Ran Cheng
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
- Associate Professor in Department of Preventive Dentistry, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Ting Xu
- Graduate Student in Department of Preventive Dentistry, West China School & Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
| | - Tao Zhang
- Graduate Student in Department of Preventive Dentistry, West China School & Hospital of Stomatology, Sichuan University, Chengdu, China
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
| | - Xiao Hong
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
- Associate Professor in Department of Preventive Dentistry, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Xing Zhao
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Yunyun Wu
- West China School of Public Health, Sichuan University, Chengdu, China
| | - Li Cheng
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China
- Associate Professor in Department of Preventive Dentistry, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Tao Hu
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, PR China.
- Professor in Department of Preventive Dentistry, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, PR China.
| |
Collapse
|
16
|
Krois J, Graetz C, Holtfreter B, Brinkmann P, Kocher T, Schwendicke F. Evaluating Modeling and Validation Strategies for Tooth Loss. J Dent Res 2019; 98:1088-1095. [PMID: 31361174 PMCID: PMC6710618 DOI: 10.1177/0022034519864889] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Prediction models learn patterns from available data (training) and are then validated on new data (testing). Prediction modeling is increasingly common in dental research. We aimed to evaluate how different model development and validation steps affect the predictive performance of tooth loss prediction models of patients with periodontitis. Two independent cohorts (627 patients, 11,651 teeth) were followed over a mean ± SD 18.2 ± 5.6 y (Kiel cohort) and 6.6 ± 2.9 y (Greifswald cohort). Tooth loss and 10 patient- and tooth-level predictors were recorded. The impact of different model development and validation steps was evaluated: 1) model complexity (logistic regression, recursive partitioning, random forest, extreme gradient boosting), 2) sample size (full data set or 10%, 25%, or 75% of cases dropped at random), 3) prediction periods (maximum 10, 15, or 20 y or uncensored), and 4) validation schemes (internal or external by centers/time). Tooth loss was generally a rare event (880 teeth were lost). All models showed limited sensitivity but high specificity. Patients' age and tooth loss at baseline as well as probing pocket depths showed high variable importance. More complex models (random forest, extreme gradient boosting) had no consistent advantages over simpler ones (logistic regression, recursive partitioning). Internal validation (in sample) overestimated the predictive power (area under the curve up to 0.90), while external validation (out of sample) found lower areas under the curve (range 0.62 to 0.82). Reducing the sample size decreased the predictive power, particularly for more complex models. Censoring the prediction period had only limited impact. When the model was trained in one period and tested in another, model outcomes were similar to the base case, indicating temporal validation as a valid option. No model showed higher accuracy than the no-information rate. In conclusion, none of the developed models would be useful in a clinical setting, despite high accuracy. During modeling, rigorous development and external validation should be applied and reported accordingly.
Collapse
Affiliation(s)
- J Krois
- 1 Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - C Graetz
- 2 Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - B Holtfreter
- 3 Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - P Brinkmann
- 2 Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany
| | - T Kocher
- 3 Department of Restorative Dentistry, Periodontology, Endodontology, Preventive Dentistry and Pedodontics, Dental School, University Medicine Greifswald, Greifswald, Germany
| | - F Schwendicke
- 1 Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
17
|
Abstract
Although periodontal disease and gastrointestinal tract health are closely associated, few studies have investigated whether periodontitis is a risk factor for colorectal adenoma. The aim of this study was to investigate whether there is an association between periodontitis and the risk of colorectal adenoma in asymptomatic healthy people.From January 2013 to October 2015, we retrospectively enrolled 42,871 patients who underwent health screening at Kangbuk Samsung Hospital in South Korea. Demographic and clinical data were collected before colonoscopy. We calculated the odds ratio (OR) for adenoma in these patients.The median age was 39.3 ± 8.7 years and 70.4% of the patients were men; 32.5% had a body mass index (BMI) 25.0 kg/m. The frequency of adenoma was 12% (n = 5136). A higher risk of adenoma was associated with the following factors: BMI 25.0 kg/m (OR 1.51, 95% confidence interval [CI]: 1.42-1.61), current smoker (OR 1.51, 95% CI: 1.42-1.61), former smoker (OR 1.28, 95% CI: 1.19-1.37), periodontitis (OR 1.95, 95% CI: 1.82-2.0), moderate alcohol intake (OR 1.8, 95% CI: 1.69-1.93), and heavy alcohol intake (OR 2.67, 95% CI: 2.24-3.18).Being male or a former or current smoker, alcohol intake above the moderate level, and periodontitis increase the risk of colorectal adenoma. These findings suggest that controlling oral disease is important to the prevention and management of colorectal adenoma. The findings of this study could be applied to risk stratification and colorectal cancer prevention programs, including screening guidelines.
Collapse
Affiliation(s)
- Donghyoun Lee
- Department of Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju Self-governing Province
| | - Kyung Uk Jung
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyung Ook Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hungdai Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ho-Kyung Chun
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| |
Collapse
|
18
|
Abstract
This volume of Periodontology 2000 represents the 25th anniversary of the Journal, and uses the occasion to assess important advancements in periodontology over the past quarter-century as well as the hurdles that remain. Periodontitis is defined by pathologic loss of the periodontal ligament and alveolar bone. The disease involves complex dynamic interactions among active herpesviruses, specific bacterial pathogens and destructive immune responses. Periodontal diagnostics is currently based on clinical rather than etiologic criteria, and provides limited therapeutic guidance. Periodontal causative treatment consists of scaling, antiseptic rinses and occasionally systemic antibiotics, and surgical intervention has been de-emphasized, except perhaps for the most advanced types of periodontitis. Plastic surgical therapy includes soft-tissue grafting to cover exposed root surfaces and bone grafting to provide support for implants. Dental implants are used to replace severely diseased or missing teeth, but implant overuse is of concern. The utility of laser treatment for periodontitis remains unresolved. Host modulation and risk-factor modification therapies may benefit select patient groups. Patient self-care is a critical part of periodontal health care, and twice-weekly oral rinsing with 0.10-0.25% sodium hypochlorite constitutes a valuable adjunct to conventional anti-plaque and anti-gingivitis treatments. A link between periodontal herpesviruses and systemic diseases is a strong biological plausibility. In summary, research during the past 25 years has significantly changed our concepts of periodontitis pathobiology and has produced more-effective and less-costly therapeutic options.
Collapse
|
19
|
Carra MC, Gueguen A, Thomas F, Pannier B, Caligiuri G, Steg PG, Zins M, Bouchard P. Self-report assessment of severe periodontitis: Periodontal screening score development. J Clin Periodontol 2018; 45:818-831. [DOI: 10.1111/jcpe.12899] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Maria Clotilde Carra
- Department of Periodontology; Service of Odontology; Rothschild Hospital, AP-HP; Paris France
- U.F.R. of Odontology; Paris 7-Denis Diderot University; Paris France
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Alice Gueguen
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Frédérique Thomas
- Centre d'Investigations Préventives et Cliniques (IPC); Paris France
| | - Bruno Pannier
- Centre d'Investigations Préventives et Cliniques (IPC); Paris France
- Department of Cardiology; Georges Pompidou European Hospital, AP-HP; Paris France
- Medicine Faculty; Paris 5-Descartes University; Paris France
| | | | - Philippe Gabriel Steg
- INSERM-Unité 1148; Paris France
- French Alliance for Cardiovascular Trials (FACT); Département Hospitalo-Universitaire FIRE; Hôpital Bichat; Assistance Publique-Hôpitaux de Paris; Paris France
- Université Paris-Diderot; Sorbonne-Paris Cité; Paris France
- Royal Brompton Hospital; Imperial College; London UK
| | - Marie Zins
- Population-based Epidemiologic Cohorts Unit; Inserm, UMS 011; Villejuif France
| | - Philippe Bouchard
- Department of Periodontology; Service of Odontology; Rothschild Hospital, AP-HP; Paris France
- U.F.R. of Odontology; Paris 7-Denis Diderot University; Paris France
- EA 2496, Paris 5-Descartes University; Paris France
| |
Collapse
|
20
|
Kalala EK, Nyimi FB, Ngamala BK, Sekele JPI, Nyengele AK, Muyembi PM, Bolenge JI, Ntumba HM. Frequency and Profile of Severe Periodontitis in Kinshasa Dental Hospitals, DR Congo. Health (London) 2018. [DOI: 10.4236/health.2018.104032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
21
|
Cobb CM, Kelly PJ, Williams KB, Babbar S, Angolkar M, Derman RJ. The oral microbiome and adverse pregnancy outcomes. Int J Womens Health 2017; 9:551-559. [PMID: 28848365 PMCID: PMC5557618 DOI: 10.2147/ijwh.s142730] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Significant evidence supports an association between periodontal pathogenic bacteria and preterm birth and preeclampsia. The virulence properties assigned to specific oral pathogenic bacteria, for example, Fusobacterium nucleatum, Porphyromonas gingivalis, Filifactor alocis, Campylobacter rectus, and others, render them as potential collaborators in adverse outcomes of pregnancy. Several pathways have been suggested for this association: 1) hematogenous spread (bacteremia) of periodontal pathogens; 2) hematogenous spread of multiple mediators of inflammation that are generated by the host and/or fetal immune response to pathogenic bacteria; and 3) the possibility of oral microbial pathogen transmission, with subsequent colonization, in the vaginal microbiome resulting from sexual practices. As periodontal disease is, for the most part, preventable, the medical and dental public health communities can address intervention strategies to control oral inflammatory disease, lessen the systemic inflammatory burden, and ultimately reduce the potential for adverse pregnancy outcomes. This article reviews the oral, vaginal, and placental microbiomes, considers their potential impact on preterm labor, and the future research needed to confirm or refute this relationship.
Collapse
Affiliation(s)
| | - Patricia J Kelly
- Department of Public Health Nursing, School of Nursing and Health Studies
| | - Karen B Williams
- Department of Biomedical & Health Informatics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO
| | - Shilpa Babbar
- Department of Obstetrics, Gynecology & Women's Health, Division of Maternal & Fetal Medicine, School of Medicine, Saint Louis University, St Louis, MO, USA
| | - Mubashir Angolkar
- Department of Public Health, Jawaharlal Nehru Medical College (JNMC), KLE University, Karnataka, India
| | - Richard J Derman
- Department of Obstetrics & Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| |
Collapse
|
22
|
Leite FR, Peres KG, Do LG, Demarco FF, Peres MA. Prediction of Periodontitis Occurrence: Influence of Classification and Sociodemographic and General Health Information. J Periodontol 2017; 88:731-743. [DOI: 10.1902/jop.2017.160607] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Fábio R.M. Leite
- Currently, Department of Dentistry and Oral Health, Section of Periodontology, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark; previously, Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Karen G. Peres
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Loc G. Do
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| | - Flávio F. Demarco
- Postgraduate Program in Epidemiology, Federal University of Pelotas
- Postgraduate Program in Dentistry, Federal University of Pelotas
| | - Marco A.A. Peres
- Australian Research Center for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
| |
Collapse
|
23
|
Han K, Park JB. Association between oral health behavior and periodontal disease among Korean adults: The Korea national health and nutrition examination survey. Medicine (Baltimore) 2017; 96:e6176. [PMID: 28207558 PMCID: PMC5319547 DOI: 10.1097/md.0000000000006176] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
This study was performed to assess the association between oral health behavior and periodontal disease using nationally representative data.This study involved a cross-sectional analysis and multivariable logistic regression analysis models using the data from the Korean National Health and Nutrition Examination Survey. A community periodontal index greater than or equal to code 3 was used to define periodontal disease.Adjusted odds ratios and their 95% confidence intervals of periodontitis for the toothbrushing after lunch group and the toothbrushing before bedtime group were 0.842 (0.758, 0.936) and 0.814 (0.728, 0.911), respectively, after adjustments for age, sex, body mass index, drinking, exercise, education, income, white blood cell count, and metabolic syndrome. Adjusted odds ratios and their 95% confidence intervals of periodontitis for the floss group and the powered toothbrush group after adjustment were 0.678 (0.588, 0.781) and 0.771 (0.610, 0.974), respectively.The association between oral health behavior and periodontitis was proven by multiple logistic regression analyses after adjusting for confounding factors among Korean adults. Brushing after lunch and before bedtime as well as the use of floss and a powered toothbrush may be considered independent risk indicators of periodontal disease among Korean adults.
Collapse
Affiliation(s)
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
24
|
Chang Y, Guo X, Guo L, Li Z, Li Y, Sun Y. The feasibility of two new anthropometric indices to identify hypertension in rural China: A cross-sectional study. Medicine (Baltimore) 2016; 95:e5301. [PMID: 27858905 PMCID: PMC5591153 DOI: 10.1097/md.0000000000005301] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Recently, 2 new anthropometric indices, the A Body Shape Index (ABSI) and Body Roundness Index (BRI), have been developed. Our study was to compare the associations between different anthropometric indices, including ABSI, BRI, body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR), and hypertension in a rural population of northeast China.This cross-sectional study was conducted in the rural areas of northeast China from January 2012 to August 2013 using a multistage, stratified random cluster-sampling scheme. All eligible permanent residents aged ≥35 years (a total of 14,016 individuals) in each village were invited to participate in the study. A final sample size of 11,345 (5253 males and 6092 females) were included in this study.All the 5 anthropometric measures were positively correlated with hypertension. The prevalence of hypertension increased across quartiles for ABSI, BMI, BRI, WC, and WHR. Multivariable logistic regression analysis of the presence of hypertension for the highest quartile versus the lowest quartile of each anthropometric measure, showed that BRI had the largest values of ORs (OR: 3.49, 95% CI: 2.86-4.21 in men; OR: 3.06, 95% CI: 2.56-3.67 in women) and ABSI had the smallest ORs (OR: 1.30, 95% CI: 1.06-1.58 in men; OR: 1.19, 95% CI: 1.04-1.34 in women). BRI had the highest AROCs for hypertension (AROC: 0.65, 95% CI: 0.64-0.67 for men and AROC: 0.68, 95% CI: 0.67-0.70 for women), while ABSI had the lowest AROCs for hypertension (AROC: 0.60, 95% CI: 0.58-0.61 for men and AROC: 0.59, 95% CI: 0.58-0.61 for women).Our results showed that ABSI, BMI, BRI, WC, and WHR were all associated with hypertension. ABSI showed the weakest association with hypertension, while BRI showed potential for use as an alternative obesity measure in assessment of hypertension.
Collapse
Affiliation(s)
| | | | | | | | | | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, People's Republic of China
- Correspondence: Yingxian Sun, Department of Cardiology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang 110001, People's Republic of China (e-mail: )
| |
Collapse
|
25
|
|
26
|
Eke PI, Zhang X, Lu H, Wei L, Thornton-Evans G, Greenlund KJ, Holt JB, Croft JB. Predicting Periodontitis at State and Local Levels in the United States. J Dent Res 2016; 95:515-22. [PMID: 26848071 PMCID: PMC6092742 DOI: 10.1177/0022034516629112] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The objective of the study was to estimate the prevalence of periodontitis at state and local levels across the United States by using a novel, small area estimation (SAE) method. Extended multilevel regression and poststratification analyses were used to estimate the prevalence of periodontitis among adults aged 30 to 79 y at state, county, congressional district, and census tract levels by using periodontal data from the National Health and Nutrition Examination Survey (NHANES) 2009-2012, population counts from the 2010 US census, and smoking status estimates from the Behavioral Risk Factor Surveillance System in 2012. The SAE method used age, race, gender, smoking, and poverty variables to estimate the prevalence of periodontitis as defined by the Centers for Disease Control and Prevention/American Academy of Periodontology case definitions at the census block levels and aggregated to larger administrative and geographic areas of interest. Model-based SAEs were validated against national estimates directly from NHANES 2009-2012. Estimated prevalence of periodontitis ranged from 37.7% in Utah to 52.8% in New Mexico among the states (mean, 45.1%; median, 44.9%) and from 33.7% to 68% among counties (mean, 46.6%; median, 45.9%). Severe periodontitis ranged from 7.27% in New Hampshire to 10.26% in Louisiana among the states (mean, 8.9%; median, 8.8%) and from 5.2% to 17.9% among counties (mean, 9.2%; median, 8.8%). Overall, the predicted prevalence of periodontitis was highest for southeastern and southwestern states and for geographic areas in the Southeast along the Mississippi Delta, as well as along the US and Mexico border. Aggregated model-based SAEs were consistent with national prevalence estimates from NHANES 2009-2012. This study is the first-ever estimation of periodontitis prevalence at state and local levels in the United States, and this modeling approach complements public health surveillance efforts to identify areas with a high burden of periodontitis.
Collapse
Affiliation(s)
- P I Eke
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - X Zhang
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - H Lu
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - L Wei
- DB Consulting Group, Inc., Atlanta, GA, USA
| | - G Thornton-Evans
- Division of Oral Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - K J Greenlund
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - J B Holt
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - J B Croft
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| |
Collapse
|
27
|
Abstract
We aim to build models for peripheral arterial disease (PAD) risk prediction and seek to validate these models in 2 different surveys in the US general population. Model building survey was based on the National Health and Nutrition Examination Surveys (NHANES, 1999-2002). Potential predicting variables included race, gender, age, smoking status, total cholesterol (TC), body mass index, high-density lipoprotein (HDL), ratio of TC to HDL, diabetes status, HbA1c, hypertension status, and pulse pressure. The PAD was diagnosed as ankle brachial index <0.9. We used multiple logistic regression method for the prediction model construction. The final predictive variables were chosen based on the likelihood ratio test. Model internal validation was done by the bootstrap method. The NHANES 2003-2004 survey was used for model external validation. Age, race, sex, pulse pressure, the ratio of TC to HDL, and smoking status were selected in the final prediction model. The odds ratio (OR) and 95% confidence interval (CI) for age with 10 years increase was 2.00 (1.72, 2.33), whereas that of pulse pressure for 10 mm Hg increase was 1.19 (1.10, 1.28). The OR of PAD was 1.11 (95% CI: 1.02, 1.21) for 1 unit increase in the TC to HDL ratio and was 1.61 (95% CI: 1.40, 1.85) for people who were currently smoking compared with those who were not. The respective area under receiver operating characteristics (AUC) of the final model from the training survey and validation survey were 0.82 (0.82, 0.83) and 0.76 (0.72, 0.79) indicating good model calibrations. Our model, to some extent, has a moderate usefulness for PAD risk prediction in the general US population.
Collapse
Affiliation(s)
- Yang Zhang
- From the Department of Anesthesiology (YZ), Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang; Department of Cardiology (JH), The National Hospital of Enshi Autonomous Prefecture, Enshi, P. R. China; and Department of Cardiology (PW), Wendeng Central Hospital of Weihai, Wendeng, P. R. China
| | | | | |
Collapse
|
28
|
Eke PI, Dye BA, Wei L, Slade GD, Thornton-Evans GO, Borgnakke WS, Taylor GW, Page RC, Beck JD, Genco RJ. Update on Prevalence of Periodontitis in Adults in the United States: NHANES 2009 to 2012. J Periodontol 2015; 86:611-22. [PMID: 25688694 PMCID: PMC4460825 DOI: 10.1902/jop.2015.140520] [Citation(s) in RCA: 956] [Impact Index Per Article: 106.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND This report describes prevalence, severity, and extent of periodontitis in the US adult population using combined data from the 2009 to 2010 and 2011 to 2012 cycles of the National Health and Nutrition Examination Survey (NHANES). METHODS Estimates were derived for dentate adults, aged ≥30 years, from the US civilian non-institutionalized population. Periodontitis was defined by combinations of clinical attachment loss (AL) and periodontal probing depth (PD) from six sites per tooth on all teeth, except third molars, using standard surveillance case definitions. For the first time in NHANES history, sufficient numbers of non-Hispanic Asians were sampled in 2011 to 2012 to provide reliable estimates of their periodontitis prevalence. RESULTS In 2009 to 2012, 46% of US adults, representing 64.7 million people, had periodontitis, with 8.9% having severe periodontitis. Overall, 3.8% of all periodontal sites (10.6% of all teeth) had PD ≥4 mm, and 19.3% of sites (37.4% teeth) had AL ≥3 mm. Periodontitis prevalence was positively associated with increasing age and was higher among males. Periodontitis prevalence was highest in Hispanics (63.5%) and non-Hispanic blacks (59.1%), followed by non-Hispanic Asian Americans (50.0%), and lowest in non-Hispanic whites (40.8%). Prevalence varied two-fold between the lowest and highest levels of socioeconomic status, whether defined by poverty or education. CONCLUSIONS This study confirms a high prevalence of periodontitis in US adults aged ≥30 years, with almost fifty-percent affected. The prevalence was greater in non-Hispanic Asians than non-Hispanic whites, although lower than other minorities. The distribution provides valuable information for population-based action to prevent or manage periodontitis in US adults.
Collapse
Affiliation(s)
- Paul I. Eke
- Division of Population Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Bruce A. Dye
- Division of Health and Nutrition Examination Surveys, CDC, Hyattsville, MD
| | | | - Gary D. Slade
- Department of Dental Ecology, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Wenche S. Borgnakke
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - George W. Taylor
- Department of Preventive and Restorative Dental Sciences, University of California School of Dentistry, San Francisco, CA
| | - Roy C. Page
- Department of Periodontics, University of Washington School of Dentistry, Seattle, WA
| | - James D. Beck
- Department of Dental Ecology, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - Robert J. Genco
- Department of Oral Biology, State University of New York School of Dental Medicine, Buffalo, NY
| |
Collapse
|
29
|
Lai H, Su CW, Yen AMF, Chiu SYH, Fann JCY, Wu WYY, Chuang SL, Liu HC, Chen HH, Chen LS. A prediction model for periodontal disease: modelling and validation from a National Survey of 4061 Taiwanese adults. J Clin Periodontol 2015; 42:413-21. [DOI: 10.1111/jcpe.12389] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Hongmin Lai
- QC Dental Clinic; Taipei Taiwan
- Department of Dentistry; National Yang-Ming University; Taipei Taiwan
- School of Dentistry; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
| | - Chiu-Wen Su
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
- Oral Health Care Research Center; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
| | - Sherry Yueh-Hsia Chiu
- Department and Graduate Institute of Health Care Management; College of Management; Chang Gung University; Tao-Yuan Taiwan
| | | | - Wendy Yi-Ying Wu
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Shu-Lin Chuang
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Hsing-Chih Liu
- School of Oral Hygiene; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
| | - Hsiu-Hsi Chen
- Graduate Institute of Epidemiology and Preventive Medicine; College of Public Health; National Taiwan University; Taipei Taiwan
| | - Li-Sheng Chen
- School of Oral Hygiene; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
- Oral Health Care Research Center; College of Oral Medicine; Taipei Medical University; Taipei Taiwan
| |
Collapse
|
30
|
Jordan RA, Bodechtel C, Hertrampf K, Hoffmann T, Kocher T, Nitschke I, Schiffner U, Stark H, Zimmer S, Micheelis W. The Fifth German Oral Health Study (Fünfte Deutsche Mundgesundheitsstudie, DMS V) - rationale, design, and methods. BMC Oral Health 2014; 14:161. [PMID: 25547464 PMCID: PMC4417261 DOI: 10.1186/1472-6831-14-161] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 12/18/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral diseases rank among the most prevalent non-communicable diseases in modern societies. In Germany, oral epidemiological data show that both dental caries and periodontal diseases are highly prevalent, though significant improvements in oral health has been taking in the population within the last decades, particularly in children. It is, therefore, the aim of the Fifth German Oral Health Study (DMS V) to actualize the data on current oral health status and to gather information on oral health behavior and risk factors. In addition to current oral health monitoring, the study will also permit conclusions about trends in the development of oral health in Germany between 1989 and 2014. METHODS/DESIGN DMS V is a cross-sectional, multi-center, nationwide representative, socio-epidemiological study to investigate the oral health status und behavior of the German resident population in four age cohorts. Study participants are children (12-year-olds), adults (35- to 44-year-olds), young olds (65- to 74-year-olds), and old olds (75- to 100-year-olds) who are drawn from local residents' registration offices. Social-science investigation parameters concern subjective perceptions and attitudes regarding oral health and nutrition, sense of coherence, and socio-demographic data. Clinical oral parameters are tooth loss, caries and periodontitis, prosthodontic status, further developmental and acquired dental hard tissue and mucosal lesions. To ensure reproducibility, the dental investigators are trained and calibrated by experts and multiple reliability checks are performed throughout the field phase. Statistical analyses are calculated according to a detailed statistical analysis plan. DISCUSSION The DMS studies first performed in 1989, 1992 and repeated in 1997 and 2005 are the only cross-sectional oral health studies conducted in Germany on a population-based national representative level. Updated prevalence and trend analyses of key oral diseases are, therefore, of major epidemiological and health services research interest. TRIAL REGISTRATION German Health Services Research Data Bank VfD_DMSV_13_002152.
Collapse
Affiliation(s)
- Rainer A Jordan
- Institute of German Dentists (IDZ), Universitaetsstrasse 73, 50931, Cologne, Germany.
| | | | - Katrin Hertrampf
- Clinic of Oral and Maxillofacial Surgery, Faculty of Medicine, Christian Albrechts University, Kiel, Germany.
| | - Thomas Hoffmann
- Department of Periodontology, Faculty of Medicine, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| | - Thomas Kocher
- Unit of Periodontology, School of Dentistry, Ernst Moritz Arndt University Medicine, Greifswald, Germany.
| | - Ina Nitschke
- Clinic for Geriatric and Special Care Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
| | - Ulrich Schiffner
- Department of Restorative and Preventive Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education, and Dental Materials Science, Rhenish Friedrich Wilhemls University of Bonn, Bonn, Germany.
| | - Stefan Zimmer
- Department of Operative and Preventive Dentistry, School of Dental Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany.
| | - Wolfgang Micheelis
- Institute of German Dentists (IDZ), Universitaetsstrasse 73, 50931, Cologne, Germany.
| | | |
Collapse
|