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Chaffee BW. Self-perceived quality of social roles, activities and relationships predicts incident gingivitis. Community Dent Oral Epidemiol 2024; 52:716-722. [PMID: 38654403 DOI: 10.1111/cdoe.12966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/21/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES While physical health status is known to impact social functioning, a growing literature suggests that social well-being may affect oral health. This investigation evaluated whether self-perceived quality of social roles, activities and relationships (social well-being) influences gingival inflammation. METHODS Data were from the Population Assessment of Tobacco and Health Study, a nationally representative cohort of US adults, biennial waves 4 (2017) to 6 (2021). Social well-being was derived from the validated PROMIS Global-10 survey instrument, categorized for this longitudinal analysis as high, moderate or low. The main outcome was incident self-reported gum bleeding (dichotomous, proxy for gingivitis). Survey-weighted logistic regression modelling adjusted for overall health status, sociodemographic (e.g. age, sex, race/ethnicity), socioeconomic (e.g. income, education) and behavioural (e.g. tobacco, alcohol) confounders and was used to predict marginal mean gum bleeding incidence. RESULTS Cross-sectionally at wave 4 (N = 23 679), gum bleeding prevalence was higher along a stepwise gradient of decreasing satisfaction with social activities and relationships (extremely satisfied: 20.4%; not at all: 40.1%). Longitudinally, among participants who had never reported gum bleeding through wave 4 (N = 9695), marginal predicted new gum bleeding at wave 6 was greater with each category of lower wave 4-5 social well-being (high: 7.6%; moderate: 8.6%; low: 12.4%). Findings were robust to alternative model specifications. Results should be interpreted considering study limitations (e.g. potential unmeasured confounding; outcome by self-report). CONCLUSIONS Social functioning may affect physical health. Specifically, social roles, activities and relationships may influence inflammatory oral conditions, like gingivitis. Confirmatory research is warranted, along with policies and interventions that promote social well-being.
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Affiliation(s)
- Benjamin W Chaffee
- University of California San Francisco School of Dentistry, San Francisco, California, USA
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Kocher T, Meisel P, Baumeister S, Holtfreter B. Impact of public health and patient-centered prevention strategies on periodontitis and caries as causes of tooth loss in high-income countries. Periodontol 2000 2024. [PMID: 39323071 DOI: 10.1111/prd.12592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 04/29/2024] [Accepted: 06/17/2024] [Indexed: 09/27/2024]
Abstract
In high-income countries, the oral health of the population is influenced by public health interventions, widespread use of oral care products, dental practice measures, and the cost of dental treatment. We compiled information on changes of the prevalence of proximal and upstream determinants of periodontitis, caries, and tooth loss over the last three decades to outline their potential effects on changes of oral health during this period. Information was retrieved from repeated cross-sectional studies and from published literature. While both the prevalence of edentulism and the number of missing teeth (from the DMF-T index) decreased, the number of sound teeth as well as the total number of teeth increased. The prevalence of severe periodontitis was unchanged, whereas the prevalence of periodontal health and moderate periodontitis may have increased to a minor extent. Concerning oral health risk factors, the proportion of individuals with tertiary education increased, while smoking prevalence declined. More and more people used oral care products. Whether one reimbursement system worked better than another one in terms of tooth retention could not be elucidated. In tooth retention, population-wide use of fluoridated toothpastes had the greatest impact. To some extent, the higher number of teeth present may be related to the more frequent use of interdental cleaning aids and powered toothbrushes. Since there was no decrease in severe periodontitis in most cohorts, periodontal interventions probably contributed little to improved tooth retention.
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Affiliation(s)
- Thomas Kocher
- Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Greifswald, Germany
| | - Peter Meisel
- Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Greifswald, Germany
| | - Sebastian Baumeister
- Institute of Health Services Research in Dentistry, University of Münster, Münster, Germany
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Greifswald, Germany
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Holtfreter B, Conrad E, Kocher T, Baumeister SE, Völzke H, Welk A. Interdental cleaning aids are beneficial for oral health at 7-year follow-up: Results from the Study of Health in Pomerania (SHIP-TREND). J Clin Periodontol 2024; 51:252-264. [PMID: 38116705 DOI: 10.1111/jcpe.13936] [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: 06/29/2023] [Revised: 11/14/2023] [Accepted: 12/02/2023] [Indexed: 12/21/2023]
Abstract
AIM To estimate association between the use of interdental cleaning aids (IDAs) and type on 7-year follow-up levels of interdental plaque, interdental gingival inflammation, interdental periodontitis severity, the number of interdental sound surfaces and the number of missing teeth in a population-based cohort study. MATERIALS AND METHODS We used 7-year follow-up data of 2224 participants from the Study of Health in Pomerania (SHIP-TREND). We applied generalized linear and ordinal logistic models, adjusting for confounding and selection bias using inverse probability treatment weighting and multiple imputation. RESULTS Flossers were 32% less likely to have higher interdental plaque (iPlaque) levels than non-users of IDAs (odds ratio [OR] = 0.68; 95% confidence interval [CI]: 0.50-0.94); flossing resulted in 5% lower means of iPlaque. Effects on interdental bleeding on probing (iBOP), mean interdental probing depths and mean interdental clinical attachment levels were direction-consistent but statistically non-significant. Interdental brushing was associated with lower follow-up levels for interdental plaque (OR = 0.73; 95% CI: 0.57-0.93) and iBOP (OR = 0.69; 95% CI: 0.53-0.89). IDAs were more effective in reducing iPlaque in participants with periodontitis, whereas iBOP reduction was more pronounced in participants with no or mild periodontitis. The analyses did not suggest that the use of IDAs affected caries. Finally, applying change score analyses, flossing reduced tooth loss incidence (incidence rate ratio [IRR] = 0.71) compared with non-users of IDAs. CONCLUSIONS Recommending flossing and interdental brushing in dental practices represents an approach to the prevention of gingivitis and consequently periodontitis.
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Affiliation(s)
- Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Elena Conrad
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | | | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Alexander Welk
- Department of Restorative Dentistry, Periodontology, Endodontology and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
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Shi L, Zhu Z, Tian Q, He L. Association of Interdental Cleaning and Untreated Root Caries in Adults in the United States of America. Int Dent J 2023; 73:819-827. [PMID: 37316412 PMCID: PMC10658437 DOI: 10.1016/j.identj.2023.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 04/14/2023] [Accepted: 04/17/2023] [Indexed: 06/16/2023] Open
Abstract
PURPOSE This study aimed to evaluate the association between interdental cleaning and untreated root caries amongst middle-aged and older adults in the US. MATERIALS AND METHODS Data were obtained from the National Health and Nutrition Examination Survey (NHANES) (2015-2016 and 2017-2018). Adults aged ≥40 years who underwent full mouth examination and root caries assessment were included. Participants were classified based on their interdental cleaning frequency as none, 1-3 d/wk, and 4-7 d/wk. Associations between interdental cleaning and untreated root caries were assessed using a weighted multivariable logistic regression model adjusted for sociodemographics, general behaviour, general health condition, oral conditions, oral health behavior, and dietary factors. Subgroup analyses stratified by age and sex were performed after adjusting for covariates in the logistic regression models. RESULTS The prevalence of untreated root caries was 15.3% amongst 6217 participants. Interdental cleaning for 4-7 d/wk was a significant risk factor (odds ratio, 0.67; 95% confidence interval, 0.52-0.85). It was associated with a 40% reduction in the risk of untreated root caries in participants aged 40 to 64 years and a 37% reduction in women. Untreated root caries was also significantly associated with age, family income, smoking status, root restoration, number of teeth, untreated coronal caries, and recent dental visit. CONCLUSIONS Interdental cleaning for 4-7 d/wk was associated with fewer untreated root caries amongst middle-aged adults and women in the US. The risk of root caries increases with age. Low family income was a risk indicator for root caries amongst middle-aged adults. Additionally, smoking, root restoration, number of teeth, untreated coronal caries, and recent dental visits were common risk factors for root caries in middle-aged and older people in the US.
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Affiliation(s)
- Lingfang Shi
- Department of Stomatology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Zhongxin Zhu
- Clinical Research Center, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Qiqi Tian
- Department of Stomatology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Libo He
- Department of Stomatology, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China.
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Lipman RD, O’Brien KK, Bardsley JK, Magee MF. A Scoping Review of the Relation Between Toothbrushing and Diabetes Knowledge, Glycemic Control, and Oral Health Outcomes in People With Type 2 Diabetes. Diabetes Spectr 2023; 36:364-372. [PMID: 38024218 PMCID: PMC10654122 DOI: 10.2337/ds22-0089] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Objective Given the bidirectional relationship between type 2 diabetes and periodontal disease, this study sought to compile the available data regarding the relationship between home oral hygiene, specifically toothbrushing, and glycemic control and oral health in people with type 2 diabetes. Methods A systematic scoping review was conducted using a combination of controlled vocabulary and keyword terms for type 2 diabetes and home oral care in PubMed and CINHAL. Publications from the past 20 years were considered for inclusion. Study data were summarized. Results A total of 11 studies met our inclusion criteria. In all survey research identified, self-report of more frequent toothbrushing in people with type 2 diabetes was always found to be associated with self-report of better glycemic control and was often associated with better clinician-conducted measures oral health. In the interventional studies identified, health coaching about oral health was associated with improvements in glycemic control, and health coaching compared with health education was found to be associated with enhanced improvement in glycemic control and self-reported toothbrushing behavior. Conclusion The available data suggest that improved engagement in toothbrushing behavior may be associated with improved oral health and better glycemic control in people with type 2 diabetes. Whether improvement in glycemic control is a direct result of change to the oral environment, succeeding with one behavior change stimulating engagement in other health behavior changes, a combination of the two, or something else cannot be determined from this review. Additional studies are needed to further explore the potential for oral health coaching to improve the well-being of people with type 2 diabetes.
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Affiliation(s)
- Ruth D. Lipman
- American Dental Association Science and Research Institute, Chicago, IL
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Silveira ML, Everard CD, Sharma E, Lauten K, Alexandridis AA, Duffy K, Taylor EV, Tolliver EA, Blanco C, Compton WM, Kimmel HL, Iafolla T, Hyland A, Chaffee BW. Tobacco Use and Incidence of Adverse Oral Health Outcomes Among US Adults in the Population Assessment of Tobacco and Health Study. JAMA Netw Open 2022; 5:e2245909. [PMID: 36484986 PMCID: PMC9856400 DOI: 10.1001/jamanetworkopen.2022.45909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/24/2022] [Indexed: 12/13/2022] Open
Abstract
Importance Evolving tobacco use patterns, including increasing electronic nicotine delivery systems (ENDS) use, warrant re-examination of the associations between tobacco use and oral health. Objective To examine associations between tobacco product use and incidence of adverse oral health outcomes. Design, Setting, and Participants This cohort study used nationally representative data from wave (W) 1 to W5 (2013-2019) of the Population Assessment of Tobacco and Health Study. Recruitment used a stratified address-based, area-probability household sample of the noninstitutionalized US civilian population. The W1 cohort included respondents aged 18 years and older without lifetime history of oral health outcomes at W1 or W3, depending on when the outcome was first assessed. Data analysis was performed from October 2021 to September 2022. Exposures Current (every day or someday use) established (lifetime use of at least 100 cigarettes or "fairly regular" use of other products) use of cigarettes, ENDS, cigars, pipes, hookah, snus, and smokeless tobacco, excluding snus at W1 to W4. Main Outcomes and Measures The primary outcomes were past 12-month self-reported diagnosis of gum disease and precancerous oral lesions (W2-W5) and bone loss around teeth, bleeding after brushing or flossing, loose teeth, and 1 or more teeth removed (W4-W5). Results Sample sizes varied across the 6 oral health outcomes (13 149 respondents for the gum disease sample, 14 993 respondents for the precancerous oral lesions sample, 16 312 respondents for the bone loss around teeth sample, 10 286 respondents for the bleeding after brushing or flossing sample, 15 686 respondents for the loose teeth sample, and 12 061 respondents for the 1 or more teeth removed sample). Slightly more than half of adults (52%-54% across the 6 samples) were women, and the majority were of non-Hispanic White race and ethnicity. Cox proportional hazards models were developed with covariates that included time-dependent tobacco use variables mutually adjusted for each other. Cigarette smoking was positively associated with incidence of gum disease diagnosis (adjusted hazard ratio [AHR], 1.33; 95% CI, 1.11-1.60), loose teeth (AHR, 1.35; 95% CI, 1.05-1.75), and 1 or more teeth removed (AHR, 1.43; 95% CI, 1.18-1.74). Cigar smoking was positively associated with incidence of precancerous oral lesions (AHR, 2.18; 95% CI, 1.38-3.43). In addition, hookah smoking was positively associated with incidence of gum disease diagnosis (AHR, 1.78; 95% CI, 1.20-2.63), and ENDS use was positively associated with incidence of bleeding after brushing or flossing (AHR, 1.27; 95% CI, 1.04-1.54). No associations were observed between snus and smokeless tobacco excluding snus and incidence of oral health outcomes. Conclusions and Relevance The observed associations of combustible tobacco use with incidence of several adverse oral health outcomes and ENDS use with incidence of bleeding after brushing or flossing highlight the importance of longitudinal studies and emphasize the continued importance of tobacco cessation counseling and resources in clinical practice.
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Affiliation(s)
- Marushka L. Silveira
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland
- Kelly Government Solutions, Rockville, Maryland
| | - Colm D. Everard
- Kelly Government Solutions, Rockville, Maryland
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | | | | | | | - Kara Duffy
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | - Ethel V. Taylor
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | - Eric A. Tolliver
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland
| | - Carlos Blanco
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Heather L. Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland
| | - Timothy Iafolla
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Benjamin W. Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California, San Francisco
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The use of interdental cleaning devices and periodontal disease contingent on the number of remaining teeth in Korean adults. Sci Rep 2022; 12:13853. [PMID: 35974036 PMCID: PMC9381548 DOI: 10.1038/s41598-022-17885-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/02/2022] [Indexed: 11/08/2022] Open
Abstract
This study aimed to investigate the effect of interdental brushes and dental floss on the prevention of periodontitis in participants with ≥ 20 or < 20 remaining teeth by using the Korea National Health and Nutrition Examination Survey 2016-2018. Data from 11,614 participants were analysed using multivariate logistic regression after adjusting for sociodemographic factors (age and sex), socioeconomic factors (level of education and individual income), oral health-related variables (daily toothbrushing), and systemic health-related variables (smoking, diabetes, and obesity). The adjusted odds ratio (AOR) showed statistically significant results for both floss (AOR, 1.41; 95% confidence interval (CI) 1.22-1.64) and interdental brushes (AOR, 1.16; 95% CI 1.01-1.34). However, no significant difference was found in the subjects with fewer than 20 teeth. The subgroup analysis showed that interdental brushes had a significant preventive effect on women who had more than 20 teeth. Among participants with fewer than 20 teeth, interdental brush users had more periodontitis in men. Regarding those with more than 20 teeth, health inequality was alleviated when floss and interdental brushes were used. The bottom line is that the effect of preventing periodontitis in interdental brushes and dental floss was more evident in participants with ≥ 20 remaining teeth rather than in participants with < 20 remaining teeth.
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Han SJ. The Use of Interdental Care Products in Korean Adults Aged 30 Years and Older and Factors Affecting Their Use: 4th to 7th Korean National Health and Nutrition Examination Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148639. [PMID: 35886497 PMCID: PMC9323650 DOI: 10.3390/ijerph19148639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 01/27/2023]
Abstract
This study aimed to review the use of interdental care products (ICPs) among adults in Korea, reconfirm their relevance to periodontal health, and identify factors affecting the use of ICPs. Data from 2007 to 2018 from the National Health Nutrition Survey (KNHANES) were used, and 43,069 adults (18,412 men, 24,657 women) aged 30 years or older were included. The frequency and percentage of ICP use according to the characteristics of the subjects are presented. In addition, multivariate logistic regression analysis identified the factors affecting ICP use. The ICP usage rate of participants in the KNHANES phase gradually increased to 22.8% in the 4th, 26.4% in the 5th, and 38.0% in the 6th phase and then decreased to 36.3% in the 7th phase. The adjusted OR values for periodontal health in ICP users were 0.721 for gingivitis and 0.642 for periodontitis, confirming that ICP was associated with a lower prevalence of these conditions. Sex, age, educational level, household income, toothbrushing, and dental check-ups were related to ICP use in all phases. ICP was associated with improved periodontal health, but its use rate was very low. Therefore, oral health professionals should educate adults on the use of ICP, particularly interdental brushing.
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Affiliation(s)
- Su-Jin Han
- Department of Dental Hygiene, College of Health Science, Gachon University, 191 Hambakmoero, Yeonsu-gu, Incheon 21936, Korea
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Chaffee BW. Cannabis Use and Oral Health in a National Cohort of Adults. JOURNAL OF THE CALIFORNIA DENTAL ASSOCIATION 2021; 49:493-501. [PMID: 34483631 PMCID: PMC8415705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Cannabis use is common and increasing among adults. Evidence connects cannabis use to poor periodontal health, but few prospective studies exist of adults in the United States. METHODS This investigation examined associations between cannabis use and self-reported adverse oral health conditions among participants (N = 18,872) in the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative cohort. Survey-weighted regression modeling estimated associations between cannabis use and seven self-reported measures of oral health status, adjusted for tobacco use and other disease risk factors. RESULTS Reporting past-30-days cannabis use in any of PATH Waves 1-3 was positively and statistically significantly associated at Wave 4 with multiple periodontal disease sequalae and with self-rated fair or poor overall oral health (adjusted odds ratio versus never-users: 1.75; 95% confidence interval: 1.52, 2.01). CONCLUSIONS These findings provide further evidence that cannabis use is an independent risk factor for poor oral health, although study limitations (self-reported outcomes, limited information on cannabis use frequency and modality) must be considered. PRACTICAL IMPLICATIONS Dental professionals should engage patients in clear, nonjudgmental dialogue about cannabis use to address oral health risks and avoid potential patient safety issues in care delivery. General recommendations for addressing cannabis use in dental practice are presented.
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Affiliation(s)
- Benjamin W Chaffee
- Associate professor of oral epidemiology and dental public health at the University of California, San Francisco, School of Dentistry
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Wu P, Zhang X, Zhou P, Zhang W, Li D, Lv M, Liao X. Assessment of Bidirectional Relationships Between Polycystic Ovary Syndrome and Periodontitis: Insights From a Mendelian Randomization Analysis. Front Genet 2021; 12:644101. [PMID: 33868379 PMCID: PMC8044848 DOI: 10.3389/fgene.2021.644101] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/10/2021] [Indexed: 02/01/2023] Open
Abstract
Background Observational studies have indicated an association between polycystic ovary syndrome (PCOS) and periodontitis, but it is unclear whether the association is cofounded or causal. We conducted a two-sample Mendelian randomization (MR) study to investigate the bidirectional relationship between genetically predicted PCOS and periodontitis. Methods From two genome-wide association studies we selected 13 and 7 single nucleotide polymorphisms associated with PCOS and periodontitis, respectively, as instrumental variables. We utilized publicly shared summary-level statistics from European-ancestry cohorts. To explore the causal effect of PCOS on periodontitis, 12,289 cases of periodontitis and 22,326 controls were incorporated, while 4,890 cases of PCOS and 20,405 controls in the reverse MR. Inverse-variance weighted method was employed in the primary MR analysis and multiple sensitivity analyses were implemented. Results Genetically determined PCOS was not causally associated with risk of periodontitis (odds ratio 0.97; 95% confidence interval 0.88-1.06; P = 0.50) per one-unit increase in the log-odds ratio of periodontitis. Similarly, no causal effect of periodontitis on PCOS was shown with the odds ratio for PCOS was 1.17 (95% confidence interval 0.91-1.49; P = 0.21) per one-unit increase in the log-odds ratio of periodontitis. Consistent results were yielded via additional MR methods. Sensitivity analyses demonstrated no presence of horizontal pleiotropy or heterogeneity. Conclusion The bidirectional MR study couldn't provide convincing evidence for the causal relationship between genetic liability to PCOS and periodontitis in the Europeans. Triangulating evidence across further observational and genetic-epidemiological studies is necessary.
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Affiliation(s)
- Pengfei Wu
- Hunan Key Laboratory of Animal Models for Human Diseases, Department of Laboratory Animals, Third Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Center for Medical Genetics, Central South University, Changsha, China
| | - Xinghao Zhang
- Department of Ultrasound, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ping Zhou
- Department of Ultrasound, Third Xiangya Hospital, Central South University, Changsha, China
| | - Wan Zhang
- Department of Biology, College of Arts and Sciences, Boston University, Boston, MA, United States
| | - Danyang Li
- Department of Biology, College of Arts and Sciences, Boston University, Boston, MA, United States
| | - Mingming Lv
- Department of Oral Maxillofacial-Head Neck Oncology, College of Stomatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xiaoyao Liao
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
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