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Hu Z, Tang L, Zhan Y. Depression, stress-related disorders and risk for dental caries and periodontitis: A bidirectional and multivariable Mendelian randomization study. J Affect Disord 2024; 361:285-290. [PMID: 38876316 DOI: 10.1016/j.jad.2024.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/14/2024] [Accepted: 06/11/2024] [Indexed: 06/16/2024]
Abstract
AIMS Our Mendelian randomization (MR) analysis focused on investigating the bidirectional relationships between major depressive disorder (MDD), anxiety and stress-related disorder (ASRD), and dental caries as well as periodontitis. MATERIALS AND METHODS We used summary statistics from two studies: an MDD genome-wide association study (GWAS) including 135,458 cases with 344,901 controls and a Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) GWAS based on 12,655 ASRD individuals and 19,225 controls from Denmark. GWASs on dental caries and periodontitis were based on the Gene-Lifestyle Interactions in Dental Endpoints (GLIDE) consortium. We employed different MR approaches, such as inverse-variance weighted (IVW), MR-Egger, weighted median, and MR-PRESSO, to calculate causal effects. RESULTS Single-variable MR analysis revealed that ASRD was potentially significantly associated with decayed, missing, and filled tooth surfaces (DMFS) (β = 0.056; 95 % CI: 0.009, 0.103; p = 0.018). Periodontitis was suggested to be causally related to increased ASRD risk (OR = 1.143, 95 % CI: 1.008, 1.298; p = 0.038). According to the multivariable MR analysis, no significant associations were detected between MDD and ASRD with dental caries and periodontitis, and vice versa. CONCLUSIONS ASRD demonstrated a potential association with DMFS, and periodontitis was found to potentially impact ASRD according to single-variable MR analysis. Nevertheless, no significant associations were identified between MDD, ASRD, dental caries, or periodontitis after adjusting for smoking status and education level. Hence, more robust genetic instruments are required to validate and reinforce our findings.
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Affiliation(s)
- Zhao Hu
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China.
| | - Lu Tang
- The Seventh Affiliated Hospital, Sun Yat-Sen University, China
| | - Yiqiang Zhan
- Department of Epidemiology, School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China.
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Biomarkers common for inflammatory periodontal disease and depression: A systematic review. Brain Behav Immun Health 2022; 21:100450. [PMID: 35330865 PMCID: PMC8938251 DOI: 10.1016/j.bbih.2022.100450] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 12/12/2022] Open
Abstract
Background Dysregulated immune response arising in the periphery can induce depressive symptoms through neuroimmune interactions. Inflammatory oral pathology can be a potent inducer of chronic neuroimmune response relevant to depression. We aimed to synthesize available evidence for the association between inflammatory periodontal diseases (IPD) and major depression (MD) in relation to a broad range of biomarkers. Methods Medline, Embase, PsycInfo, Cochrane Library, Web of Science and Scopus databases were searched from inception until January 27, 2022. Search terms included subject headings and synonyms for inflammatory periodontal disease and depression. Studies that reported data on both depression and inflammatory periodontal disease as categories along with measurement of a biomarker were considered. Two reviewers independently selected the articles for inclusion, extracted data and assessed the quality of each study. The protocol for this study was registered with PROSPERO, CRD42021215524. Results Twenty-eight studies were included in the final review-eleven cross-sectional studies, seven case-control studies, and six prospective cohort studies conducted in humans; the remaining four were experimental animal studies. Eighteen studies including all animal studies reported a positive association between depression and periodontal disease; one study reported a negative association and another nine studies found no such associations. Twenty studies reported mixed associations between IPD and biomarkers (i.e, salivary, serum, urine or gingival crevicular fluid cortisol, C reactive protein, cytokines, etc.). Biomarkers related to depression were gingival crevicular fluid cortisol, interleukin 6 (IL-6), Il-1β, immunoglobulin G against Bacterioides forsythus; root canal lipopolysaccharides; blood IL-6, IL-1β, cortisol, advanced oxidation protein products, nitric oxide metabolites, lipid hydroperoxides and trapping antioxidant parameter; whereas five studies found no associations between depression and a biomarker. Although animal studies showed interaction of immune, inflammatory and neurotrophic biomarkers in the relationship between depression and periodontal disease, human studies showed mixed findings. In most studies, there were risks of bias due to the sample selection and assessment protocol. Study heterogeneity and limited number of comparable studies reporting on shared biomarkers precluded a meta-analysis. Conclusion Immune-inflammatory contribution to depression was evident in the context of inflammatory periodontal diseases, but whether biomarkers mediate the associations between IPD and MD needs to be tested through methodologically rigorous studies aiming specifically at this hypothesis.
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Influence of Depression and Anxiety on Non-Surgical Periodontal Treatment Outcomes: A 6-Month Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179394. [PMID: 34501984 PMCID: PMC8431014 DOI: 10.3390/ijerph18179394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 01/10/2023]
Abstract
Periodontal treatment could be worsened by risk factors. Depression and anxiety have been suggested as potentially influencing periodontal treatment outcomes. The aim of this study was to determine their association with non-surgical periodontal treatment outcomes in patients with generalized severe periodontitis (stage III/IV generalized periodontitis) at 6 months. A total of 68 patients diagnosed with generalized severe periodontitis were treated with scaling and root planing (SRP) and were followed at 3 and 6 months. The data of the 54 patients that followed the entire protocol were considered for analysis. Depression and anxiety levels were determined at baseline by the Beck Depression Inventory (BDI) and State-Trait Inventory (STAI) questionnaires. The association between psychological scores and periodontal parameters was evaluated by multivariate analysis. At 3 and 6 months, SRP induced an improvement for all periodontal parameters (plaque index (PI), bleeding on probing (BOP), periodontal probing depth (PPD) and clinical attachment loss (CAL)). BDI and STAI scores were associated with the evolution of PI, BOP, mean PPD and number of sites with PPD > 3 mm and with CAL > 3 mm. Depression and anxiety should be considered as risk factors for SRP and the identification of at-risk patients should be performed using well-established tools.
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Baniasadi K, Armoon B, Higgs P, Bayat AH, Mohammadi Gharehghani MA, Hemmat M, Fakhri Y, Mohammadi R, Fattah Moghaddam L, Schroth RJ. The Association of Oral Health Status and socio-economic determinants with Oral Health-Related Quality of Life among the elderly: A systematic review and meta-analysis. Int J Dent Hyg 2021; 19:153-165. [PMID: 33523593 DOI: 10.1111/idh.12489] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 12/15/2020] [Accepted: 01/24/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to determine the relationship between poor Oral Health-Related Quality of Life (OHRQoL) and oral health determinants (eg being 75 years of age or greater, marital status, smoking status, denture wearing, depression, low educational level (≤8th grade), poor general health, caries history, tooth-induced pain, decayed, missing filled teeth (DMFT) scores and periodontal diseases) among the elderly. METHODS Formal search strategies in PubMed, Scopus, Cochrane and Web of Science were performed to identify studies in English published before 1 December 2019. We assessed the impacts of the oral health determinants including being 75 years of age or greater, marital status, smoking status, denture wearing, depression, low educational level (≤8th grade), poor general health, caries history, tooth-induced pain, DMFT scores and periodontal diseases) on OHRQoL among elderly individuals. The data were analysed using Stata 12.0 software. RESULTS In total, 19 publications met the inclusion criteria of this meta-analysis. Findings indicate a positive association between low educational level (ie ≤8th grade), marital status, depression, smoking status, denture wearing, poor general health, tooth-induced pain, periodontal diseases and poor OHRQoL among the elderly. We also observed a negative association between DMFT, being older than 75 years of age on poor OHRQoL among the elderly. CONCLUSIONS This review identified that several oral health determinants were associated with poor OHRQoL. The efficacy of preventive measures and the economic aspects of tooth replacement approaches should be explored in the future. Developing oral healthcare plans and policies with the specific aim of improving OHRQoL among this group is essential.
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Affiliation(s)
- Kamal Baniasadi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Pardis, Iran
| | - Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Peter Higgs
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Amir-Hossein Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | | | - Morteza Hemmat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Yadolah Fakhri
- Food Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Rasool Mohammadi
- Department of Epidemiology and Biostatistics, School of Public Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ladan Fattah Moghaddam
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Robert J Schroth
- Dr. Gerald Niznick College of Dentistry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Zheng DX, Kang XN, Wang YX, Huang YN, Pang CF, Chen YX, Kuang ZL, Peng Y. Periodontal disease and emotional disorders: A meta-analysis. J Clin Periodontol 2020; 48:180-204. [PMID: 33103263 DOI: 10.1111/jcpe.13395] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 09/08/2020] [Accepted: 10/21/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the relationship of periodontal disease with depression and anxiety via a systematic review and meta-analysis. METHOD We systematically searched the EMBASE, PubMed, Web of Science, PsycINFO, and SinoMed databases (until August 4, 2019) with language restricted to English and Chinese. Case-control, cross-sectional, and cohort studies that calculated the risk ratio (RR), odds ratio (OR)/prevalence OR (POR), and hazard ratio (HR) of depression/anxiety with periodontal disease or the OR/POR/RR/HR of periodontal disease caused by depression/anxiety were included. Observational studies that reported the depression/anxiety scale score of patients with periodontal disease and healthy periodontal subjects aged ≥14 years were also included. We used the standard format to extract the following information from each included study: author/s, survey year, study design, age of participants, periodontal disease definition, depression/anxiety measurement, and summary of results. The Newcastle-Ottawa scale was used to ascertain the quality of the included citations. RESULTS After screening, 40 studies were included. A meta-analysis of the case-control studies showed that periodontal disease was positively associated with depression (OR = 1.70, 95% confidence interval [CI] = 1.01-2.83). A meta-analysis of 12 studies showed that periodontal disease was significantly correlated with anxiety (OR = 1.36, 95% CI = 1.11-1.66). A meta-analysis of 18 studies showed that subjects with periodontal disease had higher depression scale score (standardized mean difference [SMD] = 1.05, 95% CI = 0.68-1.41) and anxiety scale score (SMD = 0.70, 95% CI = 0.44-0.96). CONCLUSION Periodontal disease is associated with emotional disorders. However, the high degree of heterogeneity among studies should be considered. More high-quality prospective studies are required to confirm the relationship.
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Affiliation(s)
- De-Xiu Zheng
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Xiao-Ning Kang
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Yi-Xi Wang
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Yi-Na Huang
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Chun-Feng Pang
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Yu-Xuan Chen
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Zhi-Li Kuang
- The Department of Stomatology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yun Peng
- Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China
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Chang KH, Hsu YC, Chiu IM, Chen LC, Hsu CC, Lee CY, Fan HC, Chen HJ, Chou RH. Association between periodontitis and bipolar disorder: A nationwide cohort study. Medicine (Baltimore) 2020; 99:e21423. [PMID: 32756145 PMCID: PMC7402799 DOI: 10.1097/md.0000000000021423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Whether periodontitis is a risk factor for developing bipolar disorders (BD) has not been investigated. We aimed to determine whether periodontitis is associated with the subsequent development of BD and examine the risk factors for BD among patients with periodontitis.Using ambulatory and inpatient claims data from the National Health Insurance Research Database (NHIRD), we identified 12,337 patients who were aged at least 20 years and newly diagnosed with periodontitis between 2000 and 2004. The date of the first claim with a periodontitis diagnosis was set as the index date. For each patient with periodontitis, 4 subjects without a history of periodontitis were randomly selected from the NHIRD and frequency-matched with the patients with periodontitis according to sex, age (in 5-year bands), and index year.The periodontitis group had a mean age of 44.0 ± 13.7 years and slight predominance of men (51.3%). Compared with the subjects without periodontitis, the patients with periodontitis had higher prevalence of diabetes mellitus, hyperlipidemia, hypertension, ischemic heart disease, stroke, head injury, major depressive disorder, chronic obstructive pulmonary disease (COPD), and asthma (P < .001). The incidence rate of BD was higher in the periodontitis group than in the non-periodontitis group (2.74 vs 1.46 per 1000 person-year), with an adjusted hazard ratio of 1.82 (95% confidence interval = 1.59-2.08) after adjustment for sex, age, and comorbidities.The patients with periodontitis exhibited a significantly higher risk of developing BD. Keep the better oral hygiene to reduce periodontitis might be a preventive strategy for BD.
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Affiliation(s)
- Kuang-Hsi Chang
- Department of Medical Research
- Graduate Institute of Biomedical Sciences, China Medical University
- General Education Center
| | | | - Ing-Ming Chiu
- Institute of Cellular and System Medicine, National Health Research Institutes
| | - Lih-Chyang Chen
- Department of Medicine, Mackay Medical College, New Taipei City
| | - Chih-Chao Hsu
- Division of Psychiatry, Taitung Branch, Taipei Veterans General Hospital, Taitung
| | - Chang-Yin Lee
- College of Medicine, The School of Chinese Medicine for Post Baccalaureate, I-Shou University (Yancho Campus)
- Department of Chinese Medicine, E-DA Hospital
- Department of Chinese Medicine, E-DA Cancer Hospital, Kaohsiung
| | - Hueng-Chuen Fan
- Department of Medical Research
- Department of Pediatrics, Tungs’ Taichung Metroharbor Hospital
- Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli
| | | | - Ruey-Hwang Chou
- Graduate Institute of Biomedical Sciences, China Medical University
- Center for Molecular Medicine, China Medical University Hospital
- Department of Biotechnology, Asia University, Taichung, Taiwan
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Plaque Index, Oral Hygiene Habits, and Depressive Symptomatology as Predictors of Clinical Attachment Loss: A Pilot Study. Int J Dent 2020. [DOI: 10.1155/2020/3257937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background. The effect of depressive symptomatology on periodontitis is not clear in its path of action. Objective. To test a model to predict clinical attachment loss by direct effect of the dental plaque accumulation, which is a direct effect of worse oral hygiene habits and an indirect effect of greater depressive symptomatology. Methods. Three incidental samples were collected: 35 dental patients with periodontitis, 26 mental health patients with depressive symptomatology, and 29 people from the general population. The Beck Depression Inventory-II and the Oral Hygiene Habits Scale were applied. Plaque index and clinical attachment loss were assessed. Path analysis was used to test the model. The parameters were estimated by the maximum-likelihood method. Results. Depressive symptomatology had no direct effect on oral hygiene habits nor an indirect effect (mediated by oral hygiene habits) on the plaque index in any of the 3 samples. Oral hygiene habits had a large-size direct effect on plaque index and a medium-size indirect effect on clinical attachment loss in the general population sample. The plaque index had a direct effect on clinical attachment loss with a large effect size in general population sample and with a medium effect size in dental patients and depressive symptomatology patients. Conclusion. The model shows that dental plaque accumulation has a direct effect on clinical attachment loss in the 3 samples, and oral hygiene habits have an indirect effect on attachment loss mediated by dental plaque accumulation only in the general population sample. However, depressive symptomatology is not a relevant variable.
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Yazdanian M, Armoon B, Noroozi A, Mohammadi R, Bayat AH, Ahounbar E, Higgs P, Nasab HS, Bayani A, Hemmat M. Dental caries and periodontal disease among people who use drugs: a systematic review and meta-analysis. BMC Oral Health 2020; 20:44. [PMID: 32041585 PMCID: PMC7011515 DOI: 10.1186/s12903-020-1010-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 01/15/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The aim of our study was to perform a systematic review of the literature and meta-analysis in order to investigate relationship between drug use and oral health. METHODS We searched for studies in English published before July 1, 2019 on PsycINFO, PubMed, SciELO, Scopus, and Web of Science. We assessed the relationship between drug use (methamphetamines, heroin; opiates; crack, cocaine and cannabis as dependent variables) and reported tooth loss, periodontal disease, or decayed, missing, and filled teeth index as an independent variable. The data were analyzed using Stata 12.0 software. RESULTS We initially identified 1836 potential articles (with 1100 duplicates) and screened the remaining 736 titles and abstracts, comprising 54 studies. In the next step, we evaluated the full-texts; 44 studies were excluded, accordingly. In total, we included 10 publications in the meta-analysis. Drug type was associated with periodontal disease (OR 1.44; 95% CI 0.8-2.6) and pooled estimates showed that type of drug used increased the odds of the number of decayed, missed and filled teeth (DMFT) (OR 4.11; 95% CI 2.07-8.15) respectively. CONCLUSIONS The analytical challenges of segregating the impact of individual drug types on oral health diseases mean that investigations on the direct relationship between oral health status and drug use are limited. Developing programs to improve potential confounding with various substances and addressing the dental health needs of people who use drugs is vital if we are to improve their overall quality of life.
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Affiliation(s)
- Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Bahram Armoon
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Alireza Noroozi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasool Mohammadi
- Department of Public Health,, Loresatn University of Medical Sciences, Khoram Abad, Iran
| | - Amir-Hosein Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Elahe Ahounbar
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Peter Higgs
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Hormoz Sanaei Nasab
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Hemmat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
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Cunha FA, Cota LOM, Cortelli SC, Miranda TB, Neves FS, Cortelli JR, Costa FO. Periodontal condition and levels of bacteria associated with periodontitis in individuals with bipolar affective disorders: A case-control study. J Periodontal Res 2018; 54:63-72. [DOI: 10.1111/jre.12605] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/28/2018] [Accepted: 08/04/2018] [Indexed: 12/12/2022]
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Baghaie H, Kisely S, Forbes M, Sawyer E, Siskind DJ. A systematic review and meta-analysis of the association between poor oral health and substance abuse. Addiction 2017; 112:765-779. [PMID: 28299855 DOI: 10.1111/add.13754] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 11/08/2016] [Accepted: 01/02/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Substance use disorders are associated commonly with comorbid physical illness. There are fewer data on dental disease in these conditions, in spite of high rates of dry mouth (xerostomia), as well as the associated indirect or life-style effects such as poverty and lack of access to care. We compared the oral health of people with substance use disorders (SUDs) with non-using controls. METHOD This was a systematic search for studies from the last 35 years of the oral health of people reporting SUDs. We used MEDLINE, PsycInfo, OVID, Google Scholar, EMBASE and article bibliographies. Results were compared with the general population. Oral health was assessed in terms of dental caries and periodontal disease using the following standardized measures: the mean number of decayed, missing and filled teeth (DMFT) or surfaces (DMFS) and probing pocket depth. Non-carious tooth loss was assessed clinically. RESULTS We identified 28 studies that had sufficient data for a meta-analysis, comprising 4086 SU patients and 28 031 controls. People with SUD had significantly higher mean scores for DMFT [mean difference = 5.15, 95% confidence interval (CI) = 2.61-7.69 and DMFS (mean difference = 17.83, 95% CI = 6.85-28.8]. They had more decayed teeth but fewer restorations, indicating reduced access to dental care. Patients with SUD also exhibited greater tooth loss, non-carious tooth loss and destructive periodontal disease compared to controls. CONCLUSION Patients with substance use disorders have greater and more severe dental caries and periodontal disease than the general population, but are less likely to have received dental care.
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Affiliation(s)
- Hooman Baghaie
- School of Dentistry, The University of Queensland, Herston, QLD, Australia
| | - Steve Kisely
- School of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - Malcolm Forbes
- School of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,School of Medicine, The University of Melbourne, Melbourne, VIC, Australia
| | - Emily Sawyer
- James Cook University, Townsville, QLD, Australia
| | - Dan J Siskind
- School of Medicine, The University of Queensland, Woolloongabba, QLD, Australia.,Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
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Kisely S, Sawyer E, Siskind D, Lalloo R. The oral health of people with anxiety and depressive disorders - a systematic review and meta-analysis. J Affect Disord 2016; 200:119-32. [PMID: 27130961 DOI: 10.1016/j.jad.2016.04.040] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 04/06/2016] [Accepted: 04/16/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Many psychological disorders are associated with comorbid physical illness. There are less data on dental disease in common psychological disorders such as depression and anxiety in spite of risk factors in this population of diet, lifestyle or antidepressant-induced dry mouth. METHODS We undertook a systematic search for studies of the oral health of people with common psychological disorders including depression, anxiety and dental phobia. We searched MEDLINE, PsycInfo, EMBASE and article bibliographies. Results were compared with the general population. Outcomes included partial or total tooth-loss, periodontal disease, and dental decay measured through standardized measures such as the mean number of decayed, missing and filled teeth (DMFT) or surfaces (DMFS). RESULTS There were 19 papers on depression and/or anxiety, and seven on dental phobia/anxiety (total n=26). These covered 334,503 subjects. All the psychiatric diagnoses were associated with increased dental decay on both DMFT and DMFS scores, as well as greater tooth loss (OR=1.22; 95%CI=1.14-1.30). There was no association with periodontal disease, except for panic disorder. LIMITATIONS Cross-sectional design of included studies, heterogeneity in some results, insufficient studies to test for publication bias. CONCLUSION The increased focus on the physical health of psychiatric patients should encompass oral health including closer collaboration between dental and medical practitioners. Possible interventions include oral health assessment using standard checklists that can be completed by non-dental personnel, help with oral hygiene, management of iatrogenic dry mouth, and early dental referral. Mental health clinicians should also be aware of the oral consequences of inappropriate diet and psychotropic medication.
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Affiliation(s)
- Steve Kisely
- School of Medicine, The University of Queensland, Woolloongabba, Qld, Australia; Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia; Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada.
| | - Emily Sawyer
- School of Medicine, James Cook University, Qld, Australia
| | - Dan Siskind
- School of Medicine, The University of Queensland, Woolloongabba, Qld, Australia
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, Herston, Qld, Australia
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Dumitrescu AL. Depression and Inflammatory Periodontal Disease Considerations-An Interdisciplinary Approach. Front Psychol 2016; 7:347. [PMID: 27047405 PMCID: PMC4804721 DOI: 10.3389/fpsyg.2016.00347] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 02/25/2016] [Indexed: 12/18/2022] Open
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Araújo MM, Martins CC, Costa LCM, Cota LOM, Faria RLAM, Cunha FA, Costa FO. Association between depression and periodontitis: a systematic review and meta-analysis. J Clin Periodontol 2016; 43:216-28. [DOI: 10.1111/jcpe.12510] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Milena Moreira Araújo
- Department of Dental Clinics, Oral Pathology, and Oral Surgery; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Carolina Castro Martins
- Department of Pediatric Dentistry and Orthodontics; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Lidiane Cristina Machado Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery; Federal University of Minas Gerais; Belo Horizonte Brazil
| | | | - Fabiano Araújo Cunha
- Department of Dental Clinics, Oral Pathology, and Oral Surgery; Federal University of Minas Gerais; Belo Horizonte Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery; Federal University of Minas Gerais; Belo Horizonte Brazil
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Solis ACDO, Marques AH, Dominguez WV, Prado EBDA, Pannuti CM, Lotufo RFM, Lotufo-Neto F. Evaluation of periodontitis in hospital outpatients with major depressive disorder. A focus on gingival and circulating cytokines. Brain Behav Immun 2016; 53:49-53. [PMID: 26616397 DOI: 10.1016/j.bbi.2015.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 11/20/2015] [Accepted: 11/21/2015] [Indexed: 02/07/2023] Open
Abstract
An imbalance in stimulated cytokine production is associated with the etiopathogenesis of numerous diseases such as major depressive disorder (MDD) and periodontal disease. Increased cytokine levels have been reported in the gingival crevicular fluid (GCF) of patients with MDD. Thirty-six outpatients with MDD participated in this study. Each outpatient was age-matched (± 3 years) with a healthy control (n=36). The patients were controlled for race and smoking habits. Unstimulated and stimulated interleukin 6 (IL-6), interleukin 1β (IL-1β), and interferon-γ (INF-γ) production in whole blood culture (WBC) and IL-6 and IL-1β levels in the GCF were evaluated. Circulating levels of IL-6 and IL-1β (unstimulated) as well as GCF IL-1β were modestly lower in MDD patients, compared to the levels in age-matched controls (Mann-Whitney, p=0.002, 0.0075, ANCOVA, p=0.025, respectively). In the unstimulated group, there was no correlation between the levels of circulating IL-6 and GCF IL-6 (r=0.07, p=0.67), and between the levels of circulating IL-1β and the IL-1β level in the CGF (r=-0.08, p=0.63). In the LPS stimulation group, there was no correlation between the levels of circulating levels of IL-6 and GCF IL-6 (r=0. 02, p=0.91) or between the circulating IL-1β and GCF IL-1β (r=0.13, p=0.42). We observed modest immunosuppression in MDD patients (evaluated by no stimulation whole blood culture [WBC]), especially in patients with melancholic depression, chronic depression, and severe depression.
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Affiliation(s)
- Ana Cristina de Oliveira Solis
- Department of Stomatology, Division of Periodontics, University of São Paulo, São Paulo, Brazil; Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.
| | | | | | | | - Cláudio Mendes Pannuti
- Department of Stomatology, Division of Periodontics, University of São Paulo, São Paulo, Brazil.
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Wiener RC, Wiener MA, McNeil DW. Comorbid depression/anxiety and teeth removed: Behavioral Risk Factor Surveillance System 2010. Community Dent Oral Epidemiol 2015; 43:433-43. [PMID: 25970143 PMCID: PMC4568997 DOI: 10.1111/cdoe.12168] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/15/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the association between participants (i) who reported having had clinical diagnoses of depression and anxiety with 6+ teeth removed and (ii) who reported having had clinical diagnoses of depression and anxiety with edentulism. METHODS The Behavioral Risk Factor Surveillance System (BRFSS) Survey 2010 was used for the study. Analyses involved using SAS 9.3® to determine variable frequencies, Rao-Scott chi-square bivariate analyses, and Proc Surveylogistic for the logistic regressions on complex survey designs. Participants eligibility included being 18 years or older and having complete data on depression, anxiety, and number of teeth removed. RESULTS There were 76 292 eligible participants; 13.4% reported an anxiety diagnosis, 16.7% reported a depression diagnosis, and 8.6% reported comorbid depression and anxiety. The adjusted logistic regression models were significant for anxiety and depression alone and in combination for 6+ teeth removed (AOR: anxiety 1.23; 95% CI: 1.10, 1.38; P = 0.0773; AOR: depression 1.23; 95% CI: 1.10, 1.37; P = 0.0275; P < 0.0001; and AOR: comorbid depression and anxiety 1.30; 95% CI: 1.14, 1.49; P = 0.0001). However, the adjusted models with edentulism as the outcome failed to reach significance. CONCLUSIONS Comorbid depression and anxiety are associated independently with 6+ teeth removed compared with 0-5 teeth removed in a national study conducted in United States. Comorbid depression and anxiety were not shown to be associated with edentulism as compared with any teeth present.
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Affiliation(s)
- R Constance Wiener
- Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Michael A Wiener
- Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA
| | - Daniel W McNeil
- Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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