1
|
Yu YH, Steffensen B, Chasman DI, Buring JE. Self-reported oral health is associated with systemic health outcomes and all-cause mortality. J Am Dent Assoc 2024; 155:233-243.e8. [PMID: 38276920 PMCID: PMC10932849 DOI: 10.1016/j.adaj.2023.11.006] [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: 08/29/2023] [Revised: 11/06/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND Self-reported oral health questions (OHQs) are used commonly for epidemiologic surveillance of periodontal disease (PD). The authors' objective was to investigate how OHQs are associated with well-established systemic comorbidities of PD and their impact on all-cause mortality. The authors hypothesized that OHQs exhibit associations with systemic comorbidities similar to PD. METHODS Two independent data sets were used to achieve these objectives: the Women's Health Study, a prospective cohort of women 45 years or older with self-reported information on PD, OHQs, cardiovascular disease, diabetes, and osteoporosis in various timeframes (continuous from 1992) and the National Health and Nutrition Examination Survey (NHANES), with data on OHQs and linked mortality (1999-2018). The authors applied multivariate logistic regression models and Cox proportional hazard regression survival analyses to test their hypotheses. RESULTS The Women's Health Study participants who reported having PD until 2006 were more likely to later report deteriorating oral health, bone loss around their teeth, or periodontal treatment in 2018. Self-rated fair or poor oral health was independently associated with increased risk of cardiovascular disease (odds ratio, 1.39; 95% CI, 1.14 to 1.69; P < .001), diabetes (odds ratio, 1.21; 95% CI, 1.02 to 1.43; P = .028), and osteoporosis (odds ratio, 1.60; 95% CI, 1.38 to 1.84; P < .001). National Health and Nutrition Examination Survey participants who self-rated fair or poor oral health had higher risks of all-cause mortality (hazard ratio, 1.18; 95% CI, 1.02 to 1.37; P = .027). CONCLUSIONS Self-reported oral health had a similar magnitude of associations with systemic comorbidities as established with PD previously. Moreover, self-rated fair or poor oral health, suboptimal dental visits, or infrequent flossing were associated with increased all-cause mortality. PRACTICAL IMPLICATIONS These results support the use of OHQs in assessing systemic connections, especially when clinical dental access is limited. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT00000479.
Collapse
Affiliation(s)
- Yau-Hua Yu
- Dept. of Periodontology, Tufts University School of Dental Medicine, Boston MA, USA
| | - Bjorn Steffensen
- Dept. of Periodontology, Tufts University School of Dental Medicine, Boston MA, USA
| | - Daniel I. Chasman
- Division of Preventive Medicine, Brigham and Women’s Hospital, Boston MA, USA
- Harvard Medical School, Boston MA, USA
| | - Julie E. Buring
- Division of Preventive Medicine, Brigham and Women’s Hospital, Boston MA, USA
- Harvard Medical School, Boston MA, USA
| |
Collapse
|
2
|
van Noort HHJ, Harderwijk A, Everaars B, Akkermans R, van der Putten GJ, Waal GHD. The Dutch version of the Oral Health Assessment Tool: Translation and inter-rater reliability among community nurses. Int J Dent Hyg 2024; 22:140-147. [PMID: 37093920 DOI: 10.1111/idh.12678] [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: 04/07/2022] [Revised: 02/02/2023] [Accepted: 04/02/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVES Translating the Oral Health Assessment Tool (OHAT) into Dutch and assessing the inter-rater reliability among community nurses. METHODS The original version of the OHAT was translated following the five stages of the 'Guidelines for the Process of Cross-Cultural Adaptation'. After a forward and backward translation, consensus on the pre-final version was obtained in an expert panel discussion. This version was pre-tested on its comprehensibility among 31 nurses and hereafter finalized. Then, inter-rater reliability of the OHAT-NL was determined by two trained nurses during oral assessments of 37 care-dependent community-dwelling older people. Intraclass correlation coefficient (ICC) and the Cohen's kappa statistic for individual items were estimated. RESULTS Feedback from nurses in the pre-test did lead to minor changes of the OHAT-NL. Inter-rater reliability was good (ICC 0.79; 95% CI 0.63-0.89) on the total score. Agreement on item level ranged from fair to very good, the kappa ranged from 0.36-0.89. CONCLUSIONS OHAT is now available in Dutch having good inter-rater reliability among trained community nurses. Future research can further validate the OHAT-NL and develop intervention according to total OHAT-NL scores.
Collapse
Affiliation(s)
- Harm H J van Noort
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Nutrition, Physical Activity and Sports, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Anne Harderwijk
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nursing Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Babette Everaars
- Research Group Innovations in Preventive Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Reinier Akkermans
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Gert-Jan van der Putten
- Medical Department, Orpea Dagelijks Leven, Apeldoorn, The Netherlands
- Department of Oral Function and Rehabilitation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| |
Collapse
|
3
|
Delbari A, Ghavidel F, Rashedi V, Bidkhori M, Saatchi M, Hooshmand E. Evaluation of oral health status in the population above 50: evidence from the ardakan cohort study on aging (ACSA). BMC Oral Health 2024; 24:154. [PMID: 38297233 PMCID: PMC10832343 DOI: 10.1186/s12903-024-03916-4] [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: 08/23/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND The global population is undergoing rapid aging, and older individuals are more susceptible to various health issues, including oral health problems. Despite the increasing attention given to healthy aging, oral health has often been overlooked in discussions related to health problems. This study aims to assess the oral health status of middle-aged and older adults in Iran. METHODS This cross-sectional study analyzed data from 4970 men and women aged 50 years and above, who participated in the Ardakan Cohort Study on Aging (ACSA) between 2020 and 2022. Trained personnel administered a questionnaire and conducted oral health examinations to determine the oral health status and oral hygiene behaviors of the participants. RESULTS The mean value (SD) of the total Decayed, Missing, and Filled Teeth (DMFT) index was 21.3 (10.7). Approximately 46% of all participants were completely edentulous (without natural teeth). Moreover, 58.5% of the total sample wore dentures, and the mean age (SD) when they started using dentures was 48.5 (20.7) years. About 71% of participants with natural teeth reported brushing their teeth at least once a day, while about 63% of denture wearers cleaned their dentures daily. In the sample, 28% of individuals had visited a dentist in the last year. The prevalence of difficulty in biting and chewing food among the participants was 48.2% and 44.6%, respectively. Additionally, nearly 68% of all samples reported experiencing at least one difficulty in daily functioning due to oral/dental conditions. The study identified cutoff points of seven (sensitivity = 56.8 and specificity = 77.5) and 10 (sensitivity = 72.1 and specificity = 71.1) missing teeth, indicating the presence of at least one problem in daily functioning due to oral/dental conditions in middle-aged and older adults, respectively. CONCLUSION The study reveals a high prevalence of edentulism and denture use among participants aged 50 years and above. The majority of samples reported difficulties in daily functioning due to oral and dental conditions, especially in biting and chewing food. These findings highlight the importance of proactive measures to address oral health issues in middle-aged and older adults, thereby enhancing their overall health and well-being.
Collapse
Affiliation(s)
- Ahmad Delbari
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Evin, Daneshjoo Boulevard, Koodakyar Street, Tehran, Iran
| | - Fatemeh Ghavidel
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Evin, Daneshjoo Boulevard, Koodakyar Street, Tehran, Iran
| | - Vahid Rashedi
- Iranian Research Center on Aging, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Bidkhori
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Evin, Daneshjoo Boulevard, Koodakyar Street, Tehran, Iran
| | - Mohammad Saatchi
- Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Science, Tehran, Iran
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Elham Hooshmand
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Evin, Daneshjoo Boulevard, Koodakyar Street, Tehran, Iran.
| |
Collapse
|
4
|
Guo X, Li X, Liao C, Feng X, He T. Periodontal disease and subsequent risk of cardiovascular outcome and all-cause mortality: A meta-analysis of prospective studies. PLoS One 2023; 18:e0290545. [PMID: 37682950 PMCID: PMC10490928 DOI: 10.1371/journal.pone.0290545] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/10/2023] [Indexed: 09/10/2023] Open
Abstract
Studies reported periodontal disease (PD) periodontal disease is associated with many systemic diseases, including cardiovascular outcomes and all-cause mortality. However, the precise mechanistic link for these relationship remained unclear. We therefore performed a meta-analysis of cohort studies to investigate the association of PD with the risk of cardiovascular outcomes and all-cause mortality. We systematically searched the databases of PubMed, EmBase, and the Cochrane library to identify eligible studies until April 2023. The investigated outcomes included major adverse cardiovascular events (MACEs), coronary heart disease (CHD), myocardial infarction (MI), stroke, cardiac death, and all-cause mortality. The summary relative risk (RR) with 95% confidence interval (CI) were calculated using the random-effects model. Thirty-nine cohort studies with 4,389,263 individuals were selected for final meta-analysis. We noted PD were associated with elevated risk of MACEs (RR: 1.24; 95%CI: 1.15-1.34; P<0.001), CHD (RR: 1.20; 95%CI: 1.12-1.29; P<0.001), MI (RR: 1.14; 95%CI: 1.06-1.22; P = 0.001), stroke (RR: 1.26; 95%CI: 1.15-1.37; P<0.001), cardiac death (RR: 1.42; 95%CI: 1.10-1.84; P = 0.007), and all-cause mortality (RR: 1.31; 95%CI: 1.07-1.61; P = 0.010). Sensitivity analyses indicated the pooled conclusions for cardiovascular outcomes and all-cause mortality are robustness. The associations of PD with the risk of ardiovascular outcomes and all-cause mortality could affected by region, study design, PD definition, follow-up duration, and study quality. This study found the risk of cardiovascular outcomes and all-cause mortality were elevated in PD patients, and the intervention for PD should be applied to prevent the risk of cardiovascular outcomes.
Collapse
Affiliation(s)
- Xiangyu Guo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral DiseasesWest China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xue Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral DiseasesWest China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Chunjuan Liao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral DiseasesWest China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xingyu Feng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral DiseasesWest China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Tao He
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral DiseasesWest China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
5
|
Farva K, Sattar H, Ullah H, Raziq A, Mehmood MD, Tareen AK, Sultan IN, Zohra Q, Khan MW. Phenotypic Analysis, Molecular Characterization, and Antibiogram of Caries-Causing Bacteria Isolated from Dental Patients. Microorganisms 2023; 11:1952. [PMID: 37630520 PMCID: PMC10457851 DOI: 10.3390/microorganisms11081952] [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: 06/27/2023] [Revised: 07/23/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
Dental caries is a biofilm-mediated, sugar-driven, multifactorial, dynamic disease that results in the phasic demineralization and remineralization of dental hard tissues. Despite scientific advances in cariology, dental caries remains a severe global concern. The aim of this study was to determine the optimization of microbial and molecular techniques for the detection of cariogenic pathogens in dental caries patients, the prevalence of cariogenic bacteria on the basis of socioeconomic, climatological, and hygienic factors, and in vitro evaluation of the antimicrobial activity of selected synthetic antibiotics and herbal extracts. In this study, oral samples were collected from 900 patients for bacterial strain screening on a biochemical and molecular basis. Plant extracts, such as ginger, garlic, neem, tulsi, amla, and aloe vera, were used to check the antimicrobial activity against the isolated strains. Synthetic antimicrobial agents, such as penicillin, amoxicillin, erythromycin, clindamycin, metronidazole, doxycycline, ceftazidime, levofloxacin, and ciprofloxacin, were also used to access the antimicrobial activity. Among 900 patients, 63% were males and 37% were females, patients aged between 36 and 58 (45.7%) years were prone to disease, and the most common symptom was toothache (61%). For oral diseases, 21% used herbs, 36% used antibiotics, and 48% were self-medicated, owing to sweets consumption (60.66%) and fizzy drinks and fast food (51.56%). Staphylococcus mutans (29.11%) and Streptococcus sobrinus (28.11%) were found as the most abundant strains. Seven bacterial strains were successfully screened and predicted to be closely related to genera S. sobrinus, S. mutans, Actinomyces naeslundii, Lactobacillus acidophilus, Eubacterium nodatum, Propionibacterium acidifaciens, and Treponema Pallidum. Among plant extracts, the maximum zone of inhibition was recorded by ginger (22.36 mm) and amla (20.01 mm), while among synthetic antibiotics, ciprofloxacin and levofloxacin were most effective against all microbes. This study concluded that phyto extracts of ginger and amla were considered suitable alternatives to synthetic antibiotics to treat dental diseases.
Collapse
Affiliation(s)
- Khushbu Farva
- Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore 54000, Pakistan
| | - Huma Sattar
- Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore 54000, Pakistan
| | - Hayat Ullah
- Metabolic Engineering Lab, Department of Biological Engineering, Utah State University, Logan, UT 84322, USA
| | - Abdur Raziq
- State Key Laboratory for Biology of Plant Diseases and Insect Pests, School of Bioengineering, Dalian University of Technology, Dalian 116024, China
| | - Muhammad Danish Mehmood
- Institute of Molecular Biology and Biotechnology, The University of Lahore, Lahore 54000, Pakistan
| | - Afrasiab Khan Tareen
- Department of Biotechnology, Balochistan University of Information Technology Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Imrana Niaz Sultan
- Department of Biotechnology, Balochistan University of Information Technology Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Quratulaain Zohra
- Department of Biotechnology, Project of Sahara for Life Trust, The Sahara College Narowal, Punjab 51601, Pakistan
| | - Muhammad Waseem Khan
- Department of Biotechnology, Balochistan University of Information Technology Engineering and Management Sciences, Quetta 87300, Pakistan
| |
Collapse
|
6
|
Vetter CAM, Lourenço BN, Meindl AG, Mees A, Stone A, Farnsworth R, Everett SE, Gonzalez SE, Roth IG, Schmiedt C. Cross-sectional characterization of renal function in cats with caudal stomatitis. J Feline Med Surg 2023; 25:1098612X231179883. [PMID: 37350300 PMCID: PMC10811980 DOI: 10.1177/1098612x231179883] [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] [Indexed: 06/24/2023]
Abstract
OBJECTIVES The objective of the study was to compare renal functional biomarkers in cats and in caudal stomatitis (CS) and in age-matched control cats. METHODS A cross-sectional, case-control study was conducted on 44 client-owned cats with CS that were prospectively enrolled and evaluated for a Comprehensive Oral Health Assessment and Treatment at one of four institutions. Renal function was assessed with measurement of serum creatinine, urea nitrogen, serum symmetric dimethylarginine, urinalysis, urine protein:creatinine ratio and urine protein electrophoresis. Affected gingiva was biopsied to confirm the diagnosis of stomatitis. Renal biochemical analyses from the experimental group were compared with those of 44 age-matched controls without CS enrolled prospectively or retrospectively after presenting to the primary institution for routine healthcare. Control cats were included if they were clinically stable, their chronic illnesses were well managed and minimal dental disease was present on examination. Renal biomarkers were compared between groups using a t-test or the Mann-Whitney U-test. Frequency of azotemia, proteinuria and the clinical diagnosis of renal disease were compared using Fisher's exact test. RESULTS Relative to the control group, cats in the CS group had significantly lower serum creatinine (P <0.001) and albumin concentrations (P <0.001), urine specific gravity (P = 0.024) and hematocrit (P = 0.003), and higher serum phosphorus (P <0.001), potassium (P <0.001) and globulin concentrations (P <0.001), white blood cell count (P <0.001) and urine protein:creatinine ratio (P = 0.009). There were no significant differences in serum symmetric dimethylarginine or urea nitrogen concentrations. No clinically significant findings were noted on urine protein electrophoresis. There were no significant differences in the frequency of azotemia, proteinuria or renal disease categories between the two groups. CONCLUSIONS AND RELEVANCE The present study does not demonstrate a significant difference in the frequency of kidney disease between cats with and without CS. Longitudinal evaluation is warranted to investigate the relationship between renal disease and CS.
Collapse
Affiliation(s)
- C Autumn M Vetter
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Bianca N Lourenço
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Alison G Meindl
- Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, CO, USA
| | - Angela Mees
- Atlanta Veterinary Dental Services, Roswell, GA, USA
| | - Amy Stone
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Raelynn Farnsworth
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - S Ellen Everett
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Sara E Gonzalez
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Ira G Roth
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Chad Schmiedt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| |
Collapse
|
7
|
Munteanu R, Feder RI, Onaciu A, Munteanu VC, Iuga CA, Gulei D. Insights into the Human Microbiome and Its Connections with Prostate Cancer. Cancers (Basel) 2023; 15:cancers15092539. [PMID: 37174009 PMCID: PMC10177521 DOI: 10.3390/cancers15092539] [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: 02/21/2023] [Revised: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
The human microbiome represents the diversity of microorganisms that live together at different organ sites, influencing various physiological processes and leading to pathological conditions, even carcinogenesis, in case of a chronic imbalance. Additionally, the link between organ-specific microbiota and cancer has attracted the interest of numerous studies and projects. In this review article, we address the important aspects regarding the role of gut, prostate, urinary and reproductive system, skin, and oral cavity colonizing microorganisms in prostate cancer development. Various bacteria, fungi, virus species, and other relevant agents with major implications in cancer occurrence and progression are also described. Some of them are assessed based on their values of prognostic or diagnostic biomarkers, while others are presented for their anti-cancer properties.
Collapse
Affiliation(s)
- Raluca Munteanu
- Department of In Vivo Studies, Research Center for Advanced Medicine-MEDFUTURE, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
- Department of Hematology, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Victor Babes Street 8, 400012 Cluj-Napoca, Romania
| | - Richard-Ionut Feder
- Department of In Vivo Studies, Research Center for Advanced Medicine-MEDFUTURE, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
| | - Anca Onaciu
- Department of NanoBioPhysics, Research Center for Advanced Medicine-MEDFUTURE, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
- Department of Pharmaceutical Physics and Biophysics, "Iuliu Hațieganu" University of Medicine and Pharmacy, Louis Pasteur Street 6, 400349 Cluj-Napoca, Romania
| | - Vlad Cristian Munteanu
- Department of Urology, The Oncology Institute "Prof Dr. Ion Chiricuta", 400015 Cluj-Napoca, Romania
- Department of Urology, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Cristina-Adela Iuga
- Department of Proteomics and Metabolomics, Research Center for Advanced Medicine-MEDFUTURE, "Iuliu Hațieganu" University of Medicine and Pharmacy Cluj-Napoca, Louis Pasteur Street 6, 400349 Cluj-Napoca, Romania
- Department of Pharmaceutical Analysis, Faculty of Pharmacy, "Iuliu Hațieganu" University of Medicine and Pharmacy, Louis Pasteur Street 6, 400349 Cluj-Napoca, Romania
| | - Diana Gulei
- Department of In Vivo Studies, Research Center for Advanced Medicine-MEDFUTURE, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
| |
Collapse
|
8
|
Association between cardiovascular diseases and periodontal disease: more than what meets the eye. Drug Target Insights 2023; 17:31-38. [PMID: 36761891 PMCID: PMC9906023 DOI: 10.33393/dti.2023.2510] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/10/2022] [Indexed: 02/05/2023] Open
Abstract
Cardiovascular diseases (CVDs) are inflammatory diseases of coronary arteries accompanying atheroma formation that can spawn impairment and, in severe cases, death. CVDs are the leading cause of death in the world. In recent decades, investigators have focused their impact on CVD by periodontal disease (PD). PD is a risk factor that can trigger the formation, maturation, and instability of atheroma in the arteries. Two mechanisms have been proposed to explain this relationship: periodontopathic pathogens explicitly invade the circulation or indirectly increase systemic levels of inflammatory mediators. It has been suggested that improvement in disease state has a positive effect on others. This review summarizes evidence from epidemiological studies as well as researches focusing on potential causation channels to deliver a comprehensive representation of the relationship between PD and CVD.
Collapse
|
9
|
Leng Y, Hu Q, Ling Q, Yao X, Liu M, Chen J, Yan Z, Dai Q. Periodontal disease is associated with the risk of cardiovascular disease independent of sex: A meta-analysis. Front Cardiovasc Med 2023; 10:1114927. [PMID: 36923959 PMCID: PMC10010192 DOI: 10.3389/fcvm.2023.1114927] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023] Open
Abstract
Objectives Studies have established a link between periodontal disease and cardiovascular disease (CVD), but it is unclear whether there is a sex difference in their association. Methods The PubMed, Embase, and Cochrane databases were searched until June, 21 2022. Cardiovascular outcomes included any CVD, myocardial infarction (MI), coronary heart disease (CHD), or stroke. Studies reported the prevalence of CVD in patients with periodontal disease and the relationship between periodontal disease and CVD. The study is registered with PROSPERO (CRD42022333663). The level of evidence and recommendations is assessed by the Grading of Recommendations for Assessment, Development and Evaluation (GRADE). Results Twenty-six studies were included. In patients with periodontal disease, the prevalence of CVD was 7.2% [9 studies; 95% confidence interval (CI): 2.7-13.6%], and prevalence for CHD, hypertension, stroke, and heart failure was 6.6, 25.3, 1, and 1.1%, respectively. There was a significant association between periodontal disease and CVD in men [odds ratio (OR) = 1.22; 95% CI: 1.12-1.34] and women (OR = 1.11; 95% CI: 1.05-1.17), with no significant sex difference (P > 0.05). Conclusion Cardiovascular disease is relatively common in patients with periodontal disease, and an increased risk of CVD is associated with periodontal disease independent of sex. Interventions targeting periodontal disease may be beneficial for CVD. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022333663.
Collapse
Affiliation(s)
- Yurong Leng
- The Affiliated Stomatological Hospital of Nanchang University, Nanchang, Jiangxi, China.,The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi, China.,Jiangxi Province Clinical Research Center for Oral Disease, Nanchang, Jiangxi, China
| | - Qinwen Hu
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Qin Ling
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Xiongda Yao
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Menglu Liu
- Department of Cardiology, Seventh People's Hospital of Zhengzhou, Zhengzhou, China
| | - Jiawei Chen
- The Second Clinical Medical College of Nanchang University, Nanchang, Jiangxi, China
| | - Zhiwei Yan
- Department of Sports Rehabilitation, College of Human Kinesiology, Shenyang Sport University, Shenyang, China
| | - Qun Dai
- The Affiliated Stomatological Hospital of Nanchang University, Nanchang, Jiangxi, China.,The Key Laboratory of Oral Biomedicine, Nanchang, Jiangxi, China.,Jiangxi Province Clinical Research Center for Oral Disease, Nanchang, Jiangxi, China
| |
Collapse
|
10
|
Meregildo-Rodriguez ED, Robles-Arce LG, Chunga-Chévez EV, Asmat-Rubio MG, Zavaleta-Alaya P, Vásquez-Tirado GA. Periodontal disease as a non-traditional risk factor for acute coronary syndrome: a systematic review and meta-analysis. LE INFEZIONI IN MEDICINA 2022; 30:501-515. [PMID: 36482952 PMCID: PMC9715009 DOI: 10.53854/liim-3004-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/21/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Previous observational studies have suggested an association between periodontal disease (PD) and cardiovascular and cerebrovascular diseases. Nonetheless, evidence linking PD with coronary heart disease (CHD) and acute coronary syndrome (ACS) is still contradictory. We aim to systematically review the role of PD as a risk factor for ACS (myocardial infarction and unstable angina). METHODS The protocol was registered in PROSPERO (CRD42021286278) and we followed the recommendations of the PRISMA and AMSTAR 2 guidelines. We systematically searched for 7 databases and electronic thesis repositories from inception to February 2022. We included articles without language restriction following the PECO strategy (population: "adult participants"; exposure: "periodontal disease"; comparator: "no periodontal disease"; outcome: "acute coronary syndrome" OR "acute myocardial infarction" OR "unstable angina"). Odds ratios (OR) with 95% confidence intervals (95% CI) were pooled using random effects and heterogeneity was quantified by Cochran's Q and Higgins' I2 statistics. Subgroup analyses were carried out according to the participants' sex, type of diagnosis of PD, type of study, and continent of origin of studies. RESULTS We included 46 papers (17 cohort, 25 case-control, and 4 cross-sectional studies) that met the inclusion criteria. This meta-analysis includes a total of 6,806,286 participants and at least 68,932 ACS events, mainly myocardial infarction (MI). In accordance with our results, PD is associated with a higher risk of ACS (OR 1.35; 95% CI 1.25-1.45). However, clinical and methodological heterogeneity was significant (I2=86%, p<0.05). In the sensitivity analysis, the exclusion of some studies with "extreme" results (outliers) did not significantly affect the overall estimate or heterogeneity. In subgroup analysis, we found no statistically significant differences between men and women according to subgroup difference tests (I2=0%, p=0.67). Conversely, there were differences according to the type of diagnosis of PD (clinical or self-reported diagnosis), type of study (cohort, case-control, or cross-sectional study), and the continent of origin (North America, South America, Asia, or Europe) of the studies (I2=79%-96%, p<0.10). Of the 46 studies, only 4 had a high risk of bias. Additionally, the funnel plot suggested publication bias. CONCLUSION PD may be an important non-traditional risk factor for ACS. Although, this meta-analysis brings together more studies, and therefore more evidence, than any other previous similar study, its results should be interpreted with caution due to the great heterogeneity and the potential presence of bias.
Collapse
|
11
|
Ghasemi S, Oveisi-Oskouei L, Torab A, Salehi-Pourmehr H, Babaloo A, Vahed N, Abolhasanpour N, Taghilou S, Ghasemi A. Prevalence of proximal contact loss between implant-supported fixed prosthesis and adjacent teeth and associated factors: A systematic review and meta-analysis. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2022; 14:119-133. [PMID: 36714081 PMCID: PMC9871184 DOI: 10.34172/japid.2022.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/14/2022] [Indexed: 01/09/2023]
Abstract
Background. This systematic review and meta-analysis investigated the prevalence of proximal contact loss and its associated factors. Methods. A bibliographic search was conducted in June 2021 with no limitation in the article date or language and updated in January 2022 by hand searching. There was no time limit on the search to retrieve all studies. The search included randomized controlled trials or quasi-experiments, and cross-sectional or cohort studies were included in the absence of these studies. Two authors screened the title and abstract. After evaluating the full texts of selected articles, irrelevant studies and or non-English papers that were impossible to translate were excluded. Disagreements between the re-viewers' selection process were resolved by debate on the eligibility of studies. Standardized critical appraisal instruments from the Joanna Briggs Institute for different types of studies were used to assess the studies' quality. Comprehensive Meta-Analysis (CMA) software (Version 2.2; Biostat, Englewood, NJ) was used for data analysis. Results. The proximal contact loss (PCL) frequency was %29. According to the results, the frequencies of PCL for the distal and mesial aspects were %7 and %21, respectively. The meta-analysis results showed that the contact loss events on the mesial aspect were statistically higher than on the distal aspect (P<0.0001). There were no significant differences between other associated factors such as the mandibular or maxillary arch, retention type, opposing dentition, implant type, molar or non-molar, parafunction behaviors, and vitality of adjacent teeth. There was a significant association between bone loss and PCL, and in individuals with bone loss >%50, the proximal contact loss was higher (OR: %95[ 2.43 CI: 4.03‒1.47], P=0.0006). The PCL in the anterior area was lower than in the posterior area (P=0.004). Although the frequency of contact loss in females was higher than in males, this rate was not statistically significant. Conclusion. The PCL on the mesial aspect and the posterior area was high. In individuals with bone loss >%50, the proximal contact loss was higher than in others.
Collapse
Affiliation(s)
- Shima Ghasemi
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Ali Torab
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hanieh Salehi-Pourmehr
- Research Center for Evidence-based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding author: Hanieh Salehi-Pourmehr, E-mail:
| | - Amirreza Babaloo
- Department of Periodontology and Implant Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nafiseh Vahed
- Research Center for Evidence-based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasrin Abolhasanpour
- Research Center for Evidence-based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sina Taghilou
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Atieh Ghasemi
- Department of Pediatrics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
12
|
Morel MM, Chuang E, Laniado N. Bridging gaps in oral health education in a medical school in the United States: a pilot study. BMC MEDICAL EDUCATION 2022; 22:578. [PMID: 35902912 PMCID: PMC9330983 DOI: 10.1186/s12909-022-03648-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 07/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Oral health is an important component of medical education given its connection to overall health and quality of life; however, oral health is infrequently incorporated into medical school curricula in the United States. The aim of this study was to pilot a novel oral health care clerkship for United States medical students that implemented the Smiles for Life (SFL) curriculum, in-person clinical activities, and pre and post curricula assessments to assess knowledge acquisition, attitude change, and clinical skill development. METHODS Third year medical students at Albert Einstein College of Medicine, Bronx, New York, volunteered (n = 37) for a clerkship in oral health. Students completed the Smiles For Life National Oral Health Curriculum and participated in three half-day clinical sessions in a hospital-based dental clinic. The participants were evaluated on knowledge acquisition, attitude change, and clinical skill development through a pre and post clerkship assessment in order to assess the efficacy of the intervention. RESULTS There was a 23.4% increase in oral health knowledge (p < 0.001) following participation in the online modules and clerkship. Additionally, attitudes in the following domains showed improved familiarity and proficiency: causes and prevention of dental caries (78.4%, p < 0.001) and periodontal disease (83.8%, p < 0.001), provision of oral health information to patients (67.6%, p < 0.001), and ability to conduct an oral examination (62.2%, p < 0.001). CONCLUSIONS Third year medical students who participated in a novel oral health clerkship demonstrated significant increases in basic oral health knowledge and reported increased comfort in providing oral examinations and anticipatory guidance to patients. The results support the feasibility of this approach to incorporating oral health education into a medical school curriculum in the United States.
Collapse
Affiliation(s)
- Mallory Morse Morel
- Division of Oral and Maxillofacial Surgery, Jacobi Medical Center/Mt Sinai Beth Israel, 1400 Pelham Parkway South, Building 1, Suite 3NE1, Bronx, NY, 10461, USA.
| | - Elizabeth Chuang
- Family and Social Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Nadia Laniado
- Dentistry, Epidemiology & Population Health, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| |
Collapse
|
13
|
Caldara M, Belgiovine C, Secchi E, Rusconi R. Environmental, Microbiological, and Immunological Features of Bacterial Biofilms Associated with Implanted Medical Devices. Clin Microbiol Rev 2022; 35:e0022120. [PMID: 35044203 PMCID: PMC8768833 DOI: 10.1128/cmr.00221-20] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The spread of biofilms on medical implants represents one of the principal triggers of persistent and chronic infections in clinical settings, and it has been the subject of many studies in the past few years, with most of them focused on prosthetic joint infections. We review here recent works on biofilm formation and microbial colonization on a large variety of indwelling devices, ranging from heart valves and pacemakers to urological and breast implants and from biliary stents and endoscopic tubes to contact lenses and neurosurgical implants. We focus on bacterial abundance and distribution across different devices and body sites and on the role of environmental features, such as the presence of fluid flow and properties of the implant surface, as well as on the interplay between bacterial colonization and the response of the human immune system.
Collapse
Affiliation(s)
- Marina Caldara
- Interdepartmental Center on Safety, Technologies, and Agri-food Innovation (SITEIA.PARMA), University of Parma, Parma, Italy
| | - Cristina Belgiovine
- IRCCS Humanitas Research Hospital, Rozzano–Milan, Italy
- Scuola di Specializzazione in Microbiologia e Virologia, Università degli Studi di Pavia, Pavia, Italy
| | - Eleonora Secchi
- Institute of Environmental Engineering, ETH Zürich, Zürich, Switzerland
| | - Roberto Rusconi
- IRCCS Humanitas Research Hospital, Rozzano–Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele–Milan, Italy
| |
Collapse
|
14
|
Dain CP, Ganapathi S, Geevar Z, Harikrishnan S, Ammu JV, Chacko M. The traditional and modifiable risk factors of coronary artery disease - a community-based cross-sectional study among 2 populations. Medicine (Baltimore) 2021; 100:e27350. [PMID: 34596141 PMCID: PMC8483818 DOI: 10.1097/md.0000000000027350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/10/2021] [Indexed: 01/05/2023] Open
Abstract
A community-based cross-sectional study was undertaken by the Cardiology Society of India (Kerala Chapter) to determine the prevalence of coronary artery disease (CAD) and its risk factors. The periodontal health status of the rural and urban participants in the Thiruvananthapuram district of Kerala was evaluated to document any association between periodontal disease (PD) and CAD and to describe any shared risk factors.The participants were selected using a multistage cluster random sampling method. Socio-demographic data and personal histories were collected using a structured interview schedule and validated tools. Body mass index, blood pressure, electrocardiogram, and biochemical investigations were recorded and analyzed using standard protocols. A modification of the Ramfjord periodontal disease index was used to assess periodontal health.PD was more frequent among rural (61.4%) than in the urban population (35.5%). The frequencies of CAD associated with PD in the rural and urban populations were 82.6% and 40.5%, respectively. PD was not found to be a significant risk factor for CAD in the univariate regression analysis of urban populations. In the rural population, the odds of PD as a risk factor for CAD were found to be 3.08 (95% CI [1.38-8.38]) and significant (P = .043) in univariate regression analysis and 1.54 (95% CI: 0.44-5.4) and non-significant (P = .503) in the multivariate regression analysis.In rural areas, male sex and dyslipidemia demonstrated borderline significance as risk factors for CAD. PD was not found to be an independent risk factor after adjusting for age, sex, tobacco use, hypertension, sedentary lifestyle, and dyslipidemia. Male sex and dyslipidemia were identified as shared risk factors between PD and CAD, which could have confounded the significant association between the latter. In urban areas, age, male sex, and dyslipidemia demonstrated an independent association with CAD. This study could not establish an independent association between PD and CAD in either community. Future epidemiological studies should identify and recruit novel environmental factors to understand the interrelationships between PD and CAD and focus on the role of effect modifiers that may have a protective role against PD colluding with CAD.
Collapse
Affiliation(s)
- Chacko Pearl Dain
- Department of Oral and Maxillofacial Surgery, Government Dental College, Medical College, Thiruvananthapuram, Kerala, India
| | - Sanjay Ganapathi
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, (Institute of National Importance under the Government of India) www.sctimst.ac.in, Thiruvananthapuram, Kerala, India
| | | | - Sivadasanpillai Harikrishnan
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, (Institute of National Importance under the Government of India) www.sctimst.ac.in, Thiruvananthapuram, Kerala, India
| | - Jayanthi Viswanathan Ammu
- Division of Biostatistics and Cancer Epidemiology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Manas Chacko
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, (Institute of National Importance under the Government of India) www.sctimst.ac.in, Thiruvananthapuram, Kerala, India
| |
Collapse
|
15
|
Febbraio M, Roy CB, Levin L. Is There a Causal Link Between Periodontitis and Cardiovascular Disease? A Concise Review of Recent Findings. Int Dent J 2021; 72:37-51. [PMID: 34565546 PMCID: PMC9275186 DOI: 10.1016/j.identj.2021.07.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/19/2021] [Accepted: 07/23/2021] [Indexed: 01/08/2023] Open
Abstract
There is substantial evidence in support of an association between periodontitis and cardiovascular disease. The most important open question related to this association is causality. This article revisits the question of causality by reviewing intervention studies and systematic reviews and meta analyses published in the last 3 years. Where are we now in answering this question? Whilst systematic reviews and epidemiological studies continue to support an association between the diseases, intervention studies fall short in determining causality. There is a dearth of good-quality, blinded randomised control trials with cardiovascular disease outcomes. Most studies use surrogate markers/biomarkers for endpoints, and this is problematic as they may not be reflective of cardiovascular disease status. This review further highlights another issue with surrogate markers/biomarkers: the potential for collider bias. Ethical considerations surrounding nontreatment have led to calls for a well-annotated database containing in-depth dental health data. Finally, a relatively new and important risk factor for cardiovascular disease, clonal haematopoiesis of indeterminate potential, is discussed. Clonal haematopoiesis of indeterminate potential increases cardiovascular risk by more than 40%, and inflammation is a contributing factor. The impact of periodontal disease on this emerging risk factor has yet to be explored. Although the question of causality in the association between periodontal disease and cardiovascular disease remains unanswered, the importance of good oral health in maintaining good heart health is reiterated.
Collapse
Affiliation(s)
- Maria Febbraio
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| | | | - Liran Levin
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
16
|
Gao S, Tian J, Li Y, Liu T, Li R, Yang L, Xing Z. Periodontitis and Number of Teeth in the Risk of Coronary Heart Disease: An Updated Meta-Analysis. Med Sci Monit 2021; 27:e930112. [PMID: 34421117 PMCID: PMC8394608 DOI: 10.12659/msm.930112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background A positive link between periodontitis and chronic systemic disease has been indicated. However, few studies focused on the loss of teeth. Our analysis aims to analyze the relationship of periodontitis and number of teeth with the risk of coronary heart disease (CHD). Material/Methods A meta-analysis was conducted on qualified data extracted from the PubMed, Embase, and Cochrane Library databases. Only cohort studies were included in this study. We screened articles that assessed the periodontal condition and teeth number as well as the incidence or mortality of CHD. Hazard ratio (HR) and relative risk (RR) were calculated by Stata SE software. Results A total of 11 prospective studies with over 200 000 total participants were analyzed. Ten studies reported on periodontitis and CHD, and 4 studies included data on number of teeth. After adjusting for multivariate factors, there was a significant association between periodontitis and the risk of CHD (RR, 1.18; 95% confidence interval [CI], 1.10–1.26); the RR of CHD in the edentulous population was 1.20 (95% CI, 1.08–1.34). Moreover, results on the RR values for number of teeth were as follows: 24–17 teeth (RR, 1.12; 95% CI, 1.05–1.19); 16–11 (RR, 1.28; 95% CI, 1.15–1.42); and ≤10 (RR, 1.55; 95% CI, 1.43–1.69). Conclusions Our study showed that periodontitis is a risk factor for CHD and that the number of removed teeth is positively correlated with the risk of CHD. During clinical assessment, both factors need to be considered as factors associated with cardiovascular risks.
Collapse
Affiliation(s)
- Shuting Gao
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Jinhui Tian
- Center of Evidence-Based Medicine, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Yiting Li
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Tingjie Liu
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Ruiping Li
- School of Stomatology, Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Lan Yang
- Department of Oral and Maxillofacial, Secondary Hospital of Lanzhou University, Lanzhou, Gansu, China (mainland)
| | - Zhankui Xing
- Department of Oral and Maxillofacial, Secondary Hospital of Lanzhou University, Lanzhou, Gansu, China (mainland)
| |
Collapse
|
17
|
Caplan DJ, Ghazal TS, Cowen HJ. Effect of Receiving Dental Treatment on mortality among nursing facility residents. SPECIAL CARE IN DENTISTRY 2021; 42:3-8. [PMID: 34403522 DOI: 10.1111/scd.12641] [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: 06/24/2021] [Revised: 07/08/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022]
Abstract
AIM To assess the association between receipt of different types of dental procedures and mortality among nursing home residents. METHODS AND RESULTS Between June 2006 and March 2008, 535 nursing home residents received a health screening assessment and were offered comprehensive dental care. Death certificate data were obtained in September 2013 and multivariable regression models were generated to assess the effect of dental procedures delivered after the screening assessment on mortality, adjusting for demographic and health-related covariates. Residents had a mean age of 85.2 years at baseline and approximately 30% were edentulous. About two-thirds received at least one dental procedure, and about 88% had died, between the screening date and the end of follow-up. Among dentate residents, after adjustment for relevant covariates, for each one-unit increase in the number of intervals during which they received at least one preventive dental procedure there was a 13% decrease in mortality (HR = 0.87, 95% CI = 0.78-0.98) at any given time, while for prosthetic dental procedures there was a 16% decrease in mortality (HR = 0.84, 95% CI = 0.72-0.97). Among edentulous residents, only prosthetic procedures were analyzed, and they were not significantly associated with mortality. CONCLUSION Among dentate institutionalized elderly, receipt of preventive or prosthetic dental procedures was associated with decreased mortality.
Collapse
Affiliation(s)
- Daniel J Caplan
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Tariq S Ghazal
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Howard J Cowen
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| |
Collapse
|
18
|
Leao TSDS, Zanoni AV, Franzon R, Tomasi GH, Conzatti LP, Marrone LCP, Reynolds MA, Gomes MS. Number of teeth is independently associated with ischemic stroke: A case-control study. J Clin Neurosci 2021; 90:233-237. [PMID: 34275555 DOI: 10.1016/j.jocn.2021.05.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/15/2021] [Accepted: 05/27/2021] [Indexed: 12/17/2022]
Abstract
Poor oral health has been suggested as a potential risk factor for the occurrence of cardiovascular events. The present study aimed to test the hypothesis that the number of permanent natural teeth (NT) is independently associated with the occurrence of ischemic stroke (IS) or transient ischemic attack (TIA) in a southern Brazilian population. This case-control study enrolled 458 subjects, 229 hospital patients diagnosed with IS or TIA (cases) and 229 patients with no history of cardiovascular disease (controls). NT was assessed through a head and neck multidetector computed tomography angiography (MDCTA) and panoramic radiographs. The participants were matched by age and sex. Sociodemographic and medical confounding variables were obtained from the hospital charts and through a structured questionnaire. Multivariate logistic regression analysis were carried out to estimate the association between NT and the occurrence of IS or TIA. The mean age was 58.37 ± 10.75 years, with 46.7% males. Adjusted analyses showed an independent association between IS or TIA and hypertension (OR = 6.34, 95%CI = 3.93-10.24), smoking (OR = 4.70, 95%CI = 2.76-7.99) and NT (lower quartile: ≤7 teeth) (OR = 5.59, 95%CI = 2.88-10.86). The number of permanent natural teeth was inversely and independently associated with the occurrence of IS or TIA in this population. Present findings suggest a gradient effect on the association between oral health and IS.
Collapse
Affiliation(s)
- Thayana Salgado de Souza Leao
- Graduate Program in Dentistry, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, United States.
| | - Aline Veloso Zanoni
- Graduate Program in Dentistry, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Raiane Franzon
- Graduate Program in Dentistry, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Gustavo Henrique Tomasi
- Department of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lucas Piccoli Conzatti
- Department of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luiz Carlos Porcelo Marrone
- Department of Neurology, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Mark Allan Reynolds
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, United States.
| | - Maximiliano Schünke Gomes
- Graduate Program in Dentistry, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil; Medical and Dental Center of the Military Police of Rio Grande do Sul, Brazil.
| |
Collapse
|
19
|
Beukers NGFM, Su N, Loos BG, van der Heijden GJMG. Lower Number of Teeth Is Related to Higher Risks for ACVD and Death-Systematic Review and Meta-Analyses of Survival Data. Front Cardiovasc Med 2021; 8:621626. [PMID: 34026863 PMCID: PMC8138430 DOI: 10.3389/fcvm.2021.621626] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/22/2021] [Indexed: 12/17/2022] Open
Abstract
Tooth loss reflects the endpoint of two major dental diseases: dental caries and periodontitis. These comprise 2% of the global burden of human diseases. A lower number of teeth has been associated with various systemic diseases, in particular, atherosclerotic cardiovascular diseases (ACVD). The aim was to summarize the evidence of tooth loss related to the risk for ACVD or death. Cohort studies with prospective follow-up data were retrieved from Medline-PubMed and EMBASE. Following the PRISMA guidelines, two reviewers independently selected articles, assessed the risk of bias, and extracted data on the number of teeth (tooth loss; exposure) and ACVD-related events and all-cause mortality (ACM) (outcome). A total of 75 articles were included of which 44 were qualified for meta-analysis. A lower number of teeth was related to a higher outcome risk; the pooled risk ratio (RR) for the cumulative incidence of ACVD ranged from 1.69 to 2.93, and for the cumulative incidence of ACM, the RR ranged from 1.76 to 2.27. The pooled multiple adjusted hazard ratio (HR) for the incidence density of ACVD ranged from 1.02 to 1.21, and for the incidence density of ACM, the HR ranged from 1.02 to 1.30. This systematic review and meta-analyses of survival data show that a lower number of teeth is a risk factor for both ACVD and death. Health care professionals should use this information to inform their patients and increase awareness on the importance of good dental health and increase efforts to prevent tooth loss.
Collapse
Affiliation(s)
- Nicky G F M Beukers
- Academic Centre for Dentistry Amsterdam, Department of Periodontology, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Naichuan Su
- Academic Centre for Dentistry Amsterdam, Department of Social Dentistry, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Bruno G Loos
- Academic Centre for Dentistry Amsterdam, Department of Periodontology, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Geert J M G van der Heijden
- Academic Centre for Dentistry Amsterdam, Department of Social Dentistry, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
20
|
Qin X, Zhao Y, Guo Y. Periodontal disease and myocardial infarction risk: A meta-analysis of cohort studies. Am J Emerg Med 2021; 48:103-109. [PMID: 33866268 DOI: 10.1016/j.ajem.2021.03.071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/20/2021] [Accepted: 03/24/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The objective of this meta-analysis was to systematically assess the association between periodontal disease (PD) and myocardial infarction (MI). METHODS We searched the EMBASE, PubMed, and Cochrane Library databases for eligible cohort studies from inception to August 31st, 2020 that reported the association between PD and MI. Data extraction was conducted after screening the literature. The risk of bias of the included studies was evaluated by using the Newcastle-Ottawa Scale (NOS). The combined OR value and 95% confidence interval (CI) were calculated by using STATA 11.0 software, and the source of any heterogeneity was determined by performing subgroup analysis and sensitivity analysis. RESULTS A total of 10 cohort studies involving 5,369,235 participants fulfilled the inclusion criteria. The meta-analysis showed an increased risk for MI in patients with PD [RR = 1.13, 95% CI (1.04, 1.21), P = 0.004], and this result was robust according to sensitivity analysis. Subgroup analyses indicated that the results were affected by sex, effect value, study quality, survey form and investigation type. DISCUSSION This meta-analysis suggests that PD is modestly associated with MI, especially in women, which is similar to the conclusions of earlier meta-analyses of case-control or observational studies. PD may be an untraditional risk factor for cardiovascular diseases, including MI; thus, maintaining periodontal health may be an effective measure to prevent MI. More cohort studies are still needed to further explore the relationship between the incidence of MI and PD.
Collapse
Affiliation(s)
- Xiaoru Qin
- Fenyang College, Shanxi Medical University, Fenyang, China.
| | - Yifeng Zhao
- First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Yuxuan Guo
- Department of Management, Shanxi Medical University, Taiyuan, China
| |
Collapse
|
21
|
Wadhawan A, Reynolds MA, Makkar H, Scott AJ, Potocki E, Hoisington AJ, Brenner LA, Dagdag A, Lowry CA, Dwivedi Y, Postolache TT. Periodontal Pathogens and Neuropsychiatric Health. Curr Top Med Chem 2021; 20:1353-1397. [PMID: 31924157 DOI: 10.2174/1568026620666200110161105] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 12/04/2019] [Accepted: 12/04/2019] [Indexed: 02/08/2023]
Abstract
Increasing evidence incriminates low-grade inflammation in cardiovascular, metabolic diseases, and neuropsychiatric clinical conditions, all important causes of morbidity and mortality. One of the upstream and modifiable precipitants and perpetrators of inflammation is chronic periodontitis, a polymicrobial infection with Porphyromonas gingivalis (P. gingivalis) playing a central role in the disease pathogenesis. We review the association between P. gingivalis and cardiovascular, metabolic, and neuropsychiatric illness, and the molecular mechanisms potentially implicated in immune upregulation as well as downregulation induced by the pathogen. In addition to inflammation, translocation of the pathogens to the coronary and peripheral arteries, including brain vasculature, and gut and liver vasculature has important pathophysiological consequences. Distant effects via translocation rely on virulence factors of P. gingivalis such as gingipains, on its synergistic interactions with other pathogens, and on its capability to manipulate the immune system via several mechanisms, including its capacity to induce production of immune-downregulating micro-RNAs. Possible targets for intervention and drug development to manage distal consequences of infection with P. gingivalis are also reviewed.
Collapse
Affiliation(s)
- Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States.,Department of Psychiatry, Saint Elizabeths Hospital, Washington, D.C. 20032, United States
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore 21201, United States
| | - Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States
| | - Alison J Scott
- Department of Microbial Pathogenesis, University of Maryland School of Dentistry, Baltimore, United States
| | - Eileen Potocki
- VA Maryland Healthcare System, Baltimore VA Medical Center, Baltimore, United States
| | - Andrew J Hoisington
- Air Force Institute of Technology, Wright-Patterson Air Force Base, United States
| | - Lisa A Brenner
- Departments of Psychiatry, Neurology, and Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States
| | - Christopher A Lowry
- Departments of Psychiatry, Neurology, and Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States.,Department of Integrative Physiology, Center for Neuroscience and Center for Microbial Exploration, University of Colorado Boulder, Boulder, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, United States
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Alabama, United States
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, United States.,Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Aurora, United States.,Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, United States.,Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, United States
| |
Collapse
|
22
|
Tiensripojamarn N, Lertpimonchai A, Tavedhikul K, Udomsak A, Vathesatogkit P, Sritara P, Charatkulangkun O. Periodontitis is associated with cardiovascular diseases: A 13-year study. J Clin Periodontol 2021; 48:348-356. [PMID: 33386631 DOI: 10.1111/jcpe.13418] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 09/25/2020] [Accepted: 12/01/2020] [Indexed: 12/12/2022]
Abstract
AIM To prospectively evaluate the association between periodontitis and the incidence of cardiovascular diseases (CVDs) in Thai adults. MATERIALS AND METHODS Medical data from the questionnaires and physical examinations of 1850 participants aged 47-73 years from EGAT study were gathered. Random half-mouth periodontal examination of each participant was performed by calibrated periodontists, and periodontal status was defined. The incidence of new CVD events, including coronary heart disease (CHD) and stroke, was verified by cardiologists. The Cox proportional hazard regression model was used to estimate hazard ratios (HRs). RESULTS The prevalence of no/mild, moderate and severe periodontitis in the study participants was 11.7%, 52.7% and 35.6%, respectively. During the 13-year follow-up, CVD events occurred in 110 (5.9%) participants, with 82 (4.4%) from CHD and 28 (1.5%) from stroke. After adjusting for cardiovascular risk factors, a significant association between severe periodontitis and the incidence of CHD was found compared with the no/mild periodontitis group with an HR of 4.53 (95% confidence intervals: 1.08-19.02). However, no significant association was seen when considering total CVD events and stroke outcome. CONCLUSIONS This study demonstrates that severe periodontitis is associated with an increased incidence of CHD, independent of established cardiovascular risk factors.
Collapse
Affiliation(s)
| | - Attawood Lertpimonchai
- Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Kanoknadda Tavedhikul
- Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Artit Udomsak
- Electricity Generating Authority of Thailand, Nonthaburi, Thailand
| | | | | | - Orawan Charatkulangkun
- Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
23
|
Larvin H, Kang J, Aggarwal VR, Pavitt S, Wu J. Risk of incident cardiovascular disease in people with periodontal disease: A systematic review and meta-analysis. Clin Exp Dent Res 2020; 7:109-122. [PMID: 33124761 PMCID: PMC7853902 DOI: 10.1002/cre2.336] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/02/2020] [Accepted: 09/27/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Cardiovascular disease (CVD) is a major cause of mortality; periodontal disease (PD) affects up to 50% of the world's population. Observational evidence has demonstrated association between CVD and PD. Absent from the literature is a systematic review and meta-analysis of longitudinal cohort studies quantifying CVD risk in PD populations compared to non-PD populations. To examine the risk of incident CVD in people with PD in randomised controlled trials and longitudinal cohort studies. MATERIAL AND METHODS We searched Medline, EMBASE and Cochrane databases up to 9th Oct 2019 using keywords and MeSH headings using the following concepts: PD, CVD, longitudinal and RCT study design. CVD outcomes included but were not restricted to any CVD, myocardial infarction, coronary heart disease (CHD) and stroke. Diagnosis method and severity of PD were measured either clinically or by self-report. Studies comparing incident CVD in PD and non-PD populations were included. Meta-analysis and meta-regression was performed to determine risk of CVD in PD populations and examine the effects of PD diagnosis method, PD severity, gender and study region. RESULTS Thirty-two longitudinal cohort studies were included after full text screening; 30 were eligible for meta-analysis. The risk of CVD was significantly higher in PD compared to non-PD (relative risk [RR]: 1.20, 95% CI: 1.14-1.26). CVD risk did not differ between clinical or self-reported PD diagnosis (RR = 0.97, 95% CI: 0.87-1.07,). CVD risk was higher in men (RR: 1.16, 95% CI: 1.08-1.25) and severe PD (RR: 1.25, 95% CI: 1.15-1.35). Among all types of CVD, the risk of stroke was highest (RR = 1.24; 95% CI:1.12-1.38), the risk of CHD was also increased (RR = 1.14; 95% CI:1.08-1.21). CONCLUSION This study demonstrated modest but consistently increased risk of CVD in PD populations. Higher CVD risk in men and people with severe PD suggests population-targeted interventions could be beneficial.
Collapse
Affiliation(s)
| | - Jing Kang
- Oral Biology, School of Dentistry, University of Leeds, Leeds, UK
| | | | - Sue Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
| | - Jianhua Wu
- School of Dentistry, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| |
Collapse
|
24
|
Dental caries status is associated with arteriosclerosis in patients on hemodialysis. Clin Exp Nephrol 2020; 25:87-93. [PMID: 32918134 DOI: 10.1007/s10157-020-01966-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/27/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND We previously found that worse dental caries status was associated with high pulse pressure among patients on hemodialysis, indicating that such patients might have arteriosclerosis. In this study, we used abdominal computed tomography to evaluate arteriosclerosis in patients on hemodialysis and investigated the association between arteriosclerosis and dental caries status. We also prospectively examined risk factors associated with 2-year prognosis. METHODS The dental caries and periodontal disease statuses of 80 patients on hemodialysis were evaluated using the decayed, missing, or filled teeth (DMFT) index, and periodontal pocket depth, respectively. The aortic calcification index was semiquantitatively measured using computed tomography images of the abdominal aorta. Clinical data were also analyzed after all patients on hemodialysis provided written, informed consent to participate in the study. RESULTS Regression analysis demonstrated a significant correlation between the DMFT and aortic calcification indexes. Multiple regression analysis showed that the DMFT index was significantly correlated with the aortic calcification index, following adjustment for age, sex, and dialysis period. Thirteen of the 80 patients died during the 2-year follow-up period; logistic regression analysis showed that mortality rate was significantly associated with the aortic calcification index, but not the DMFT index. However, periodontal pocket depth was not correlated with the aortic calcification index. CONCLUSION These findings suggest that worse dental caries status could be associated with arteriosclerosis among patients on hemodialysis, which may indirectly affect the prognosis of arteriosclerosis in these patients.
Collapse
|
25
|
Effects of occlusal disharmony on susceptibility to atrial fibrillation in mice. Sci Rep 2020; 10:13765. [PMID: 32792672 PMCID: PMC7426945 DOI: 10.1038/s41598-020-70791-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 07/20/2020] [Indexed: 12/12/2022] Open
Abstract
Tooth loss or incorrect positioning causes occlusal disharmony. Furthermore, tooth loss and atrial fibrillation (AF) are both risk factors for ischemic stroke and coronary heart disease. Therefore, we hypothesized that occlusal disharmony-induced stress increases susceptibility to AF, and we designed the present study to test this idea in mice. Bite-opening (BO) was done by cementing a suitable appliance onto the mandibular incisor to cause occlusal disharmony by increasing the vertical height of occlusion by 0.7 mm for a period of 2 weeks. AF susceptibility, evaluated in terms of the duration of AF induced by transesophageal burst pacing, was significantly increased concomitantly with atrial remodeling, including fibrosis, myocyte apoptosis and oxidative DNA damage, in BO mice. The BO-induced atrial remodeling was associated with increased calmodulin kinase II-mediated ryanodine receptor 2 phosphorylation on serine 2814, as well as inhibition of Akt phosphorylation. However, co-treatment with propranolol, a non-selective β-blocker, ameliorated these changes in BO mice. These data suggest that improvement of occlusal disharmony by means of orthodontic treatment might be helpful in the treatment or prevention of AF.
Collapse
|
26
|
Chiu JJN, Zheng Y, Lai SML, Chan WS, Yeung SKW, Bow HYC, Samartzis D, Corbet EF, Leung WK. Periodontal conditions of essential hypertension attendees to a general hospital in Hong Kong. Aust Dent J 2020; 65:259-268. [DOI: 10.1111/adj.12784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2020] [Indexed: 12/11/2022]
Affiliation(s)
- JJN Chiu
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR China
| | - Y Zheng
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR China
| | - SML Lai
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR China
| | - WS Chan
- Department of Medicine Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong SAR China
| | - SKW Yeung
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR China
| | - HYC Bow
- Department of Orthopedics and Traumatology Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong SAR China
| | - D Samartzis
- Department of Orthopedics and Traumatology Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong SAR China
| | - EF Corbet
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR China
| | - WK Leung
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR China
| |
Collapse
|
27
|
Ohadian Moghadam S, Momeni SA. Human microbiome and prostate cancer development: current insights into the prevention and treatment. Front Med 2020; 15:11-32. [PMID: 32607819 DOI: 10.1007/s11684-019-0731-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 10/31/2019] [Indexed: 12/14/2022]
Abstract
The huge communities of microorganisms that symbiotically colonize humans are recognized as significant players in health and disease. The human microbiome may influence prostate cancer development. To date, several studies have focused on the effect of prostate infections as well as the composition of the human microbiome in relation to prostate cancer risk. Current studies suggest that the microbiota of men with prostate cancer significantly differs from that of healthy men, demonstrating that certain bacteria could be associated with cancer development as well as altered responses to treatment. In healthy individuals, the microbiome plays a crucial role in the maintenance of homeostasis of body metabolism. Dysbiosis may contribute to the emergence of health problems, including malignancy through affecting systemic immune responses and creating systemic inflammation, and changing serum hormone levels. In this review, we discuss recent data about how the microbes colonizing different parts of the human body including urinary tract, gastrointestinal tract, oral cavity, and skin might affect the risk of developing prostate cancer. Furthermore, we discuss strategies to target the microbiome for risk assessment, prevention, and treatment of prostate cancer.
Collapse
Affiliation(s)
| | - Seyed Ali Momeni
- Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
28
|
Smith LA, Smith M, Thomson WM. Barriers and enablers for dental care among dentate home‐based older New Zealanders who receive living support. Gerodontology 2020; 37:244-252. [DOI: 10.1111/ger.12464] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/16/2019] [Accepted: 01/01/2020] [Indexed: 01/24/2023]
Affiliation(s)
- Lee A. Smith
- Sir John Walsh Research Institute School of Dentistry University of Otago Dunedin New Zealand
| | - Moira Smith
- Department of Public Health University of Otago Wellington New Zealand
| | - William Murray Thomson
- Department of Oral Sciences Sir John Walsh Research Institute School of Dentistry University of Otago Wellington New Zealand
| |
Collapse
|
29
|
Lee HJ, Choi EK, Park JB, Han KD, Oh S. Tooth Loss Predicts Myocardial Infarction, Heart Failure, Stroke, and Death. J Dent Res 2020; 98:164-170. [PMID: 30782090 DOI: 10.1177/0022034518814829] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
We investigated whether oral health, represented by missing teeth, was associated with an increased risk of cardiovascular disease, including myocardial infarction (MI), heart failure (HF), stroke, and all-cause mortality. Subjects who underwent routine dental examinations and health checkups provided by the Korean National Health Insurance from 2007 to 2008 ( n = 4,440,970) were followed up for incident MI, HF, stroke, and death until 2016. During follow-up of 7.56 y, 68,063 (1.5%) subjects died, and 31,868 (0.7%) were admitted for MI, 22,637 (0.5%) for HF, and 30,941 (0.7%) for stroke. Cardiovascular events and mortality increased in proportion to tooth loss. Tooth loss was an independent risk factor for cardiovascular events after multivariable analysis adjusted for cardiovascular risk, behavioral, and income factors. Each missing tooth was associated with an approximately 1% increase in MI (HR, 1.010; 95% CI, 1.007 to 1.014), 1.5% increase in HF (HR, 1.016; 95% CI, 1.013 to 1.019) and stroke (HR, 1.015; 95% CI, 1.012 to 1.018), and 2% increase in mortality (HR, 1.022; 95% CI, 1.020 to 1.023). Having ≥5 missing teeth substantially increased risk for cardiovascular outcomes, and even a small number of missing teeth (1 to 4) was associated with an increased risk for MI, stroke, and death. This association was consistent in subgroup analyses and especially strong among the younger subjects (age <65 y) and those with periodontitis. In this large Korean nationwide cohort study, we found that tooth loss showed a dose-dependent association with incident MI, HF, ischemic stroke, and all-cause death and was a good predictor of cardiovascular outcome. In clinical practice, the number of missing teeth can aid physicians in discriminating patients with a higher cardiovascular risk.
Collapse
Affiliation(s)
- H J Lee
- 1 Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - E K Choi
- 1 Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - J B Park
- 2 Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K D Han
- 3 Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - S Oh
- 1 Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| |
Collapse
|
30
|
Cho MJ, Choi YH, Kim HC, Shim JS, Amano A, Kim JY, Song KB. Presence of Metabolic Syndrome Components Is Associated with Tooth Loss in Middle-Aged Adults. Yonsei Med J 2019; 60:554-560. [PMID: 31124339 PMCID: PMC6536391 DOI: 10.3349/ymj.2019.60.6.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 02/26/2019] [Accepted: 03/20/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE In general, the prevalence of metabolic syndrome (MS) and tooth loss increases with age. We investigated the relationship between the presence of MS, its elements, and tooth loss in middle-aged Korean adults. MATERIALS AND METHODS This study included Korean adults between 30 and 64 years of age who resided in the capital area of Seoul. From January to June 2014, individuals interested in participating in the oral health survey among those who visited the university hospital's cardiovascular center and provided informed consent were selected. Among 748 subjects who responded to the oral health questionnaires, 30 were excluded due to unclear responses; therefore, a total of 718 were included in the final analysis. RESULTS The crude odds ratio (OR) of ≥one MS component affecting tooth loss was 1.45 [95% confidence interval (CI), 1.06-2.00]. After adjusting for sex, age, education, income level, occupation, smoking status, kidney disease, chronic obstructive pulmonary disease, and rheumatic disease, the adjusted OR was 1.47 (95% CI, 1.06-2.05), which was statistically significant (p<0.05). The OR for tooth loss was higher in the presence of ≥one component of MS (50-64 years of age) in females. CONCLUSION This study suggests that female aged 50-64 years may have higher likelihood of tooth loss upon the presence of at least one MS component. Prevention against MS among female of older age could contribute to maintenance of remaining teeth. Further well-designed studies are needed.
Collapse
Affiliation(s)
- Min Jeong Cho
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| | - Youn Hee Choi
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
- Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Korea.
| | - Hyeon Chang Kim
- Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Seon Shim
- Cardiovascular and Metabolic Disease Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Atsuo Amano
- Department of Preventive Dentistry, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Ji Young Kim
- Department of Dental Hygiene, Ulsan College, Ulsan, Korea
| | - Keun Bae Song
- Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea
| |
Collapse
|
31
|
Lee H, Kim HL, Jin KN, Oh S, Han YS, Jung DU, Sim HY, Kim HS, Lim WH, Seo JB, Kim SH, Zo JH, Kim MA. Association between dental health and obstructive coronary artery disease: an observational study. BMC Cardiovasc Disord 2019; 19:98. [PMID: 31029089 PMCID: PMC6487007 DOI: 10.1186/s12872-019-1080-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 04/15/2019] [Indexed: 11/10/2022] Open
Abstract
Background The association between dental health and coronary artery disease (CAD) remains a topic of debate. This study aimed to investigate the association between dental health and obstructive CAD using multiple dental indices. Methods Eighty-eight patients (mean age: 65 years, 86% male) were prospectively enrolled before undergoing coronary CT angiography (n = 52) or invasive coronary angiography (n = 36). Obstructive CAD was defined as luminal stenosis of ≥50% for the left main coronary artery or ≥ 70% for the other epicardial coronary arteries. All patients underwent thorough dental examinations to evaluate 7 dental health indices, including the sum of decayed and filled teeth, the ratio of no restoration, the community periodontal index of treatment needs, clinical attachment loss, the total dental index, the panoramic topography index, and number of lost teeth. Results Forty patients (45.4%) had obstructive CAD. Among the 7 dental health indices, only the number of lost teeth was significantly associated with obstructive CAD, with patients who had obstructive CAD having significantly more lost teeth than patients without obstructive CAD (13.08 ± 10.4 vs. 5.44 ± 5.74, p < 0.001). The number of lost teeth was correlated with the number of obstructed coronary arteries (p < 0.001). Multiple binary logistic regression analysis revealed that having ≥10 lost teeth was independently associated with the presence of obstructive CAD (odds ratio: 8.02, 95% confidence interval: 1.80–35.64; p = 0.006). Conclusions Tooth loss was associated with the presence of obstructive CAD in patients undergoing coronary evaluation. Larger longitudinal studies are needed to determine whether there is a causal relationship between tooth loss and CAD.
Collapse
Affiliation(s)
- Ho Lee
- Section of Dentistry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea.
| | - Kwang Nam Jin
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Yoon-Sic Han
- Section of Dentistry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Da-Un Jung
- Section of Dentistry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hye-Young Sim
- Section of Dentistry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hee-Sun Kim
- Section of Dentistry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Woo-Hyun Lim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea
| | - Jae-Bin Seo
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea
| | - Joo-Hee Zo
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea
| | - Myung-A Kim
- Division of Cardiology, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea
| |
Collapse
|
32
|
Kitagawa M, Kurahashi T, Matsukubo T. Relationship between General Health, Lifestyle, Oral Health, and Periodontal Disease in Adults: A Large Cross-sectional Study in Japan. THE BULLETIN OF TOKYO DENTAL COLLEGE 2019; 58:1-8. [PMID: 28381729 DOI: 10.2209/tdcpublication.2016-2100] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of this study was to investigate how general health, oral conditions, and lifestyle were associated with periodontal disease in adults, as clarifying this relationship may be useful in preventing periodontal disease. Medical checkups were conducted on individuals aged 40, 50, or 60 years. Data were obtained for analysis on a total of 36,110 patients (men, 12,784; women, 22,896). A stepwise logistic regression model was used to calculate the odds ratio (OR) for patients who were ≥code 3 according to the Community Periodontal Index (CPI). Approximately 40, 60, and 70% of men aged 40, 50, and 60 years, respectively, had a CPI score of ≥3. There were 10% fewer women than men at each age. Stepwise logistic regression revealed a BMI score of ≥30 kg/m2(OR, 1.44; 95% confidence interval [95%CI], 1.20-1.73); systolic blood pressure of ≥140 mmHg (OR, 1.09; 95%CI, 1.02-1.18); a fasting blood sugar level of ≥110 mg/dl (OR, 1.17; 95%CI, 1.04-1.30); high-density lipoprotein cholesterol level of <40 mg/dl (OR, 1.21; 95%CI, 1.06-1.37); smoker (OR, 1.59; 95%CI, 1.48-1.71); drinking ≥3 cups of Japanese sake per day (OR, 1.09; 95%CI, 1.05-1.14); use of salts for seasoning (OR, 1.17; 95%CI, 1.07-1.28); and fair and poor oral hygiene (OR, 2.27; 95%CI, 2.08-2.47) as significant risk factors for a CPI score of ≥3. These results suggest that smoking, oral hygiene status, and factors associated with metabolic syndrome are associated with periodontitis. This indicates that health guidance on tooth brushing, the importance of quitting smoking, and control of obesity may be effective in preventing the development of periodontal disease in adults.
Collapse
Affiliation(s)
- Miki Kitagawa
- Department of Epidemiology and Public Health, Tokyo Dental College
| | | | | |
Collapse
|
33
|
Rai NK, Carey C, Brunson D, Tiwari T. Increasing Dental Students' Understanding of Population Surveillance Through Data Mining. J Dent Educ 2019; 83:281-286. [PMID: 30692190 DOI: 10.21815/jde.019.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/30/2018] [Indexed: 01/08/2023]
Abstract
An understanding of population surveillance is important for predoctoral dental students, so they will comprehend the health needs of the population in order to provide needed care and promote overall health. The aim of this study was to teach data mining and surveillance methodologies to dental students and to assess the association between systemic health factors and tooth loss in patients visiting the University of Colorado School of Dental Medicine clinics. The students were calibrated to using the data mining methodologies from the Electronic Health Record (EHR) using a rubric and presentation by a faculty member. The EHR was reviewed for age, gender, race/ethnicity, number of natural teeth present, systemic diseases reported including cardiovascular disease and diabetes, and history of any form of tobacco use. A total of 1,338 patients who visited the clinics in spring 2017 were included in the study; of those, 354 (27%) had <20 teeth. The results showed greater odds of having <20 teeth for those who reported cardiovascular disease (OR=2.1, 95% CI 1.6, 2.7), diabetes (OR=1.7, 95% CI 1.2, 2.3), tobacco use (OR=1.4, 95% CI 1.0, 1.9), and being Hispanic (OR=1.4, 95% CI 1.0, 1.9). After adjusting for age, gender, and ethnicity, the odds of having <20 teeth for patients with tobacco use were found to be twice that of patients with no tobacco use (OR=2.1, 95% CI 1.5, 3.0). Understanding population surveillance could be beneficial in designing evidence-based interventions at the dental school and community levels.
Collapse
Affiliation(s)
- Nayanjot K Rai
- Nayanjot K. Rai, MPH, BDS, is Research Associate, Department of Community Dentistry and Population Health, School of Dental Medicine, University of Colorado; Clifton Carey, PhD, is Professor, Department of Craniofacial Biology and Director of Translational Research, School of Dental Medicine, University of Colorado; Diane Brunson, RDH, MPH, works at the School of Dental Medicine, University of Colorado; and Tamanna Tiwari, MPH, MS, BDS, is Assistant Professor, Department of Community Dentistry and Population Health and Associate Director, Center for Oral Disease Prevention and Population Health Research, School of Dental Medicine, University of Colorado.
| | - Clifton Carey
- Nayanjot K. Rai, MPH, BDS, is Research Associate, Department of Community Dentistry and Population Health, School of Dental Medicine, University of Colorado; Clifton Carey, PhD, is Professor, Department of Craniofacial Biology and Director of Translational Research, School of Dental Medicine, University of Colorado; Diane Brunson, RDH, MPH, works at the School of Dental Medicine, University of Colorado; and Tamanna Tiwari, MPH, MS, BDS, is Assistant Professor, Department of Community Dentistry and Population Health and Associate Director, Center for Oral Disease Prevention and Population Health Research, School of Dental Medicine, University of Colorado
| | - Diane Brunson
- Nayanjot K. Rai, MPH, BDS, is Research Associate, Department of Community Dentistry and Population Health, School of Dental Medicine, University of Colorado; Clifton Carey, PhD, is Professor, Department of Craniofacial Biology and Director of Translational Research, School of Dental Medicine, University of Colorado; Diane Brunson, RDH, MPH, works at the School of Dental Medicine, University of Colorado; and Tamanna Tiwari, MPH, MS, BDS, is Assistant Professor, Department of Community Dentistry and Population Health and Associate Director, Center for Oral Disease Prevention and Population Health Research, School of Dental Medicine, University of Colorado
| | - Tamanna Tiwari
- Nayanjot K. Rai, MPH, BDS, is Research Associate, Department of Community Dentistry and Population Health, School of Dental Medicine, University of Colorado; Clifton Carey, PhD, is Professor, Department of Craniofacial Biology and Director of Translational Research, School of Dental Medicine, University of Colorado; Diane Brunson, RDH, MPH, works at the School of Dental Medicine, University of Colorado; and Tamanna Tiwari, MPH, MS, BDS, is Assistant Professor, Department of Community Dentistry and Population Health and Associate Director, Center for Oral Disease Prevention and Population Health Research, School of Dental Medicine, University of Colorado
| |
Collapse
|
34
|
The relationship between tooth loss and mortality from all causes, cardiovascular diseases, and coronary heart disease in the general population: systematic review and dose-response meta-analysis of prospective cohort studies. Biosci Rep 2019; 39:BSR20181773. [PMID: 30530864 PMCID: PMC6328868 DOI: 10.1042/bsr20181773] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/12/2018] [Accepted: 11/26/2018] [Indexed: 12/20/2022] Open
Abstract
Background: The association of tooth loss with mortality from all causes, cardiovascular diseases (CVD), and coronary heart disease (CHD) has been studied for many years; however, the results are inconsistent. Method: PubMed, Embase, Web of Knowledge, and Cochrane Oral Health Group’s Trials Register databases were searched for papers published from 1966 to August 2018. We conducted dose–response meta-analysis to quantitatively evaluate the relation between tooth loss and risk of mortality from all causes, CVD, and CHD. Results: In the present study, 18 prospective studies conducted until August 2018 were considered eligible for analysis. In the analysis of linear association, the summarized relative risk (RR) values for each 10-, 20-, and 32-tooth loss for all-cause mortality were 1.15 (1.11–1.19), 1.33 (1.23–1.29), and 1.57 (1.39–1.51), respectively. Subgroup and sensitivity analyses showed consistent results. A linear relationship was found among all-cause mortality, with Pnonlinearity = 0.306. The susceptibility to all-cause mortality increased by almost 1.48 times at very high tooth loss (28–32), and slight flattening of the curve was noted. However, the summarized RR values for increment for 10-, 20-, and 32-tooth loss were not or were marginally related to increased risk of mortality from CVD/CHD. Subgroup and sensitivity analyses revealed inconsistent results. Tooth loss showed linear association with CHD mortality but not with CVD mortality. The susceptibility to all-cause mortality increased by almost 1.48 and 1.70 times for CVD and CHD, respectively, at very high tooth loss (28–32). The curve exhibited slight flattening; however, no statistical significance was detected. Conclusion: In the meta-analysis, our findings confirmed the positive relationship between tooth loss and susceptibility to all-cause mortality, but not for circulatory mortality. However, the finding that tooth loss might play a harmful role in the development of all-cause mortality remains inconclusive. Tooth loss may be a potential risk marker for all-cause mortality: however, their association must be further validated through large prospective studies.
Collapse
|
35
|
Kumari M, Patthi B, Jankiram C, Singla A, Malhi R, Rajeev A. Risk of having myocardial infarction in periodontal disease patients: A systematic review. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2019. [DOI: 10.4103/jiaphd.jiaphd_15_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
36
|
Makkar H, Reynolds MA, Wadhawan A, Dagdag A, Merchant AT, Postolache TT. Periodontal, metabolic, and cardiovascular disease: Exploring the role of inflammation and mental health. Pteridines 2018; 29:124-163. [PMID: 30705520 PMCID: PMC6350811 DOI: 10.1515/pteridines-2018-0013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Previous evidence connects periodontal disease, a modifiable condition affecting a majority of Americans, with metabolic and cardiovascular morbidity and mortality. This review focuses on the likely mediation of these associations by immune activation and their potential interactions with mental illness. Future longitudinal, and ideally interventional studies, should focus on reciprocal interactions and cascading effects, as well as points for effective preventative and therapeutic interventions across diagnostic domains to reduce morbidity, mortality and improve quality of life.
Collapse
Affiliation(s)
- Hina Makkar
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Mark A Reynolds
- Department of Advanced Oral Sciences & Therapeutics, University of Maryland School of Dentistry, Baltimore, MD 21201, USA
| | - Abhishek Wadhawan
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Teodor T Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA; Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome Consortium for Research and Education (MVM-CoRE), Denver, CO 80220, USA; Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21201, USA,
| |
Collapse
|
37
|
Gonzalez-Navarro B, Pintó-Sala X, Corbella E, Jané-Salas E, Miedema MD, Yeboah J, Shea S, Nasir K, Comin-Colet J, Corbella X, Lopez-López J, Blumenthal RS, Blaha MJ, Cainzos-Achirica M. Associations between self-reported periodontal disease, assessed using a very short questionnaire, cardiovascular disease events and all-cause mortality in a contemporary multi-ethnic population: The Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2018; 278:110-116. [PMID: 30265891 DOI: 10.1016/j.atherosclerosis.2018.09.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS Periodontal disease (PD) is believed to be associated with cardiovascular disease (CVD) events. Nevertheless, the additive prognostic value of PD for the prediction of CVD events beyond traditional risk factors is unclear, particularly when self-reported using a short questionnaire. METHODS In the community-based, multicenter, prospective, Multi-Ethnic Study of Atherosclerosis (MESA), PD was assessed at baseline using a two-item questionnaire. We used Cox proportional hazards regression models to evaluate the independent associations between self-reported PD and coronary heart disease (CHD), CVD events, and all-cause death. In addition, the area under the receiver-operator characteristic curve (AUC) was calculated for each of the study endpoints, for models including traditional CVD risk factors alone and models including traditional CVD risk factors plus information on PD. Subgroup analyses were performed stratifying by age and tobacco use. RESULTS Among the 6640 MESA participants, high education level, high income, and access to healthcare were more frequent among individuals who self-reported PD. In multivariable analyses, null associations were observed between self-reported PD and incident CVD events, CHD events, and all-cause mortality; and self-reported PD did not improve risk prediction beyond traditional CVD risk factors in terms of AUC, for any of the three study endpoints. Subgroup analyses were consistent with the overall results. CONCLUSIONS Our findings suggest that the prevalence of self-reported PD may be strongly influenced by educational status and other socioeconomic features. In this context, self-reported PD does not improve CVD risk assessment when evaluated using a brief questionnaire. Future studies should prioritize objective, dental health-expert assessments of PD.
Collapse
Affiliation(s)
- Beatriz Gonzalez-Navarro
- Oral Health and Masticatory System Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Odonto-Stomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Xavier Pintó-Sala
- Cardiovascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Emili Corbella
- Cardiovascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Enric Jané-Salas
- Oral Health and Masticatory System Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Odonto-Stomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Steve Shea
- Departments of Medicine and Epidemiology, Columbia University, New York, NY, USA
| | | | - Josep Comin-Colet
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Xavier Corbella
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jose Lopez-López
- Oral Health and Masticatory System Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Odonto-Stomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain; Dental Hospital Barcelona University (HOUB), University of Barcelona, Barcelona, Spain
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Miguel Cainzos-Achirica
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain; RTI Health Solutions, Pharmacoepidemiology and Risk Management, Barcelona, Spain.
| |
Collapse
|
38
|
Poor oral health and risk of incident myocardial infarction: A prospective cohort study of Swedish adults, 1973-2012. Sci Rep 2018; 8:11479. [PMID: 30065312 PMCID: PMC6068156 DOI: 10.1038/s41598-018-29697-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 07/11/2018] [Indexed: 12/31/2022] Open
Abstract
Previous studies provide conflicting evidence as to whether there is an association between poor oral health and an increased risk of myocardial infarction. The aim of the study was to deepen knowledge of the association between oral health and myocardial infarction risk using a large (n = 20,133), prospective, and population-based cohort in Uppsala, Sweden. Oral health was determined during a clinical dental examination at entry into the cohort in 1973/74. Individuals were followed through linkage with the Swedish National Patient Register, Cause of Death Register and Emigration Register. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) for total, non-fatal and fatal myocardial infarction events. Increased risks of total, non-fatal and fatal myocardial infarction events among individuals with fewer reference teeth at examination, more dental plaque and a borderline significant increased risk among individuals with oral lesions were observed. Adjustment for multiple potential confounding factors did not change the results appreciably. However, the observed HRs generally decreased towards one when the analysis was confined to non-tobacco users only. The results from this study indicate that poor oral health is associated with a slightly increased risk of myocardial infarction; however, these results may be partly explained by residual confounding.
Collapse
|
39
|
Cheng F, Zhang M, Wang Q, Xu H, Dong X, Gao Z, Chen J, Wei Y, Qin F. Tooth loss and risk of cardiovascular disease and stroke: A dose-response meta analysis of prospective cohort studies. PLoS One 2018; 13:e0194563. [PMID: 29590166 PMCID: PMC5874035 DOI: 10.1371/journal.pone.0194563] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 03/06/2018] [Indexed: 12/16/2022] Open
Abstract
Conflicting results identifying the association between tooth loss and cardiovascular disease and stroke have been reported. Therefore, a dose-response meta-analysis was performed to clarify and quantitatively assess the correlation between tooth loss and cardiovascular disease and stroke risk. Up to March 2017, seventeen cohort studies were included in current meta-analysis, involving a total of 879084 participants with 43750 incident cases. Our results showed statistically significant increment association between tooth loss and cardiovascular disease and stroke risk. Subgroups analysis indicated that tooth loss was associated with a significant risk of cardiovascular disease and stroke in Asia and Caucasian. Furthermore, tooth loss was associated with a significant risk of cardiovascular disease and stroke in fatal cases and nonfatal cases. Additionally, a significant dose-response relationship was observed between tooth loss and cardiovascular disease and stroke risk. Increasing per 2 of tooth loss was associated with a 3% increment of coronary heart disease risk; increasing per 2 of tooth loss was associated with a 3% increment of stroke risk. Subgroup meta-analyses in study design, study quality, number of participants and number of cases showed consistent findings. No publication bias was observed in this meta-analysis. Considering these promising results, tooth loss might provide harmful health benefits.
Collapse
Affiliation(s)
- Fei Cheng
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Mi Zhang
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Quan Wang
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Haijun Xu
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Xiao Dong
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Zhen Gao
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jiajuan Chen
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yunjie Wei
- Department of Cardiology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Fen Qin
- Department of Obstetrics and Gynecology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| |
Collapse
|
40
|
Impact of prosthodontic rehabilitation on the masticatory performance of partially dentate older patients: Can it predict nutritional state? Results from a RCT. J Dent 2018; 68:66-71. [DOI: 10.1016/j.jdent.2017.11.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/06/2017] [Accepted: 11/08/2017] [Indexed: 01/14/2023] Open
|
41
|
Vieira AT, Castelo PM, Ribeiro DA, Ferreira CM. Influence of Oral and Gut Microbiota in the Health of Menopausal Women. Front Microbiol 2017; 8:1884. [PMID: 29033921 PMCID: PMC5625026 DOI: 10.3389/fmicb.2017.01884] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 09/14/2017] [Indexed: 01/08/2023] Open
Abstract
Sex differences in gut microbiota are acknowledged, and evidence suggests that gut microbiota may have a role in higher incidence and/or severity of autoimmune diseases in females. Additionally, it has been suggested that oral, vaginal, and gut microbiota composition can be regulated by estrogen levels. The association of vaginal microbiota with vulvovaginal atrophy at menopause is well described in the literature. However, the relevance of oral and gut microbiota modulation in the immune system during estrogen deficiency and its effect on inflammatory diseases is not well explored. Estrogen deficiency is a condition that occurs in menopausal women, and it can last approximately 30 years of a woman’s life. The purpose of this mini- review is to highlight the importance of alterations in the oral and gut microbiota during estrogen deficiency and their effect on oral and inflammatory diseases that are associated with menopause. Considering that hormone replacement therapy is not always recommended or sufficient to prevent or treat menopause-related disease, we will also discuss the use of probiotics and prebiotics as an option for the prevention or treatment of these diseases.
Collapse
Affiliation(s)
- Angélica T Vieira
- Department of Biochemistry and Immunology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Paula M Castelo
- Department of Pharmaceutics Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, Brazil.,Pathology Graduate Program, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Daniel A Ribeiro
- Pathology Graduate Program, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Biosciences, Universidade Federal de São Paulo, Santos, Brazil
| | - Caroline M Ferreira
- Department of Pharmaceutics Sciences, Institute of Environmental, Chemical and Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, Brazil.,Pathology Graduate Program, Universidade Federal de São Paulo, São Paulo, Brazil
| |
Collapse
|
42
|
LaMonte MJ, Genco RJ, Hovey KM, Wallace RB, Freudenheim JL, Michaud DS, Mai X, Tinker LF, Salazar CR, Andrews CA, Li W, Eaton CB, Martin LW, Wactawski-Wende J. History of Periodontitis Diagnosis and Edentulism as Predictors of Cardiovascular Disease, Stroke, and Mortality in Postmenopausal Women. J Am Heart Assoc 2017; 6:e004518. [PMID: 28356279 PMCID: PMC5532989 DOI: 10.1161/jaha.116.004518] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 01/25/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few studies have reported associations between periodontitis and cardiovascular disease (CVD) risk in older women, which is the objective of the present investigation. METHODS AND RESULTS Participants were 57 001 postmenopausal women ages 55 to 89 years (mean 68 years; >85% 60 and older) who were enrolled (1993-1998) in the Women's Health Initiative Observational Study, and were without known CVD when history of periodontitis and edentulism was assessed by questionnaire at study Year-5 (1998-2003). There were 3589 incident CVD events and 3816 total deaths during a mean follow-up of 6.7 years. In multivariable analysis, periodontitis was not associated with CVD events, but was associated with higher total mortality (hazard ratio (HR)=1.12, 95% CI: 1.05-1.21). Edentulism was associated with higher age- and smoking-adjusted risks of CVD (HR=1.42, 95% CI: 1.27-1.59) and mortality (HR=1.47, 95% CI: 1.32-1.63). Further adjustment eliminated the association with CVD, but mortality remained significantly increased (HR=1.17, 95% CI: 1.02-1.33). Stratification on age, race-ethnicity, smoking, and diabetes mellitus yielded comparable results; however, edentulism was more strongly associated with CVD in women reporting ≥1 dental visit (HR=1.57) compared with <1 visit (HR 1.03, interaction P=0.004) annually. CONCLUSIONS In community-dwelling older women, edentulism was associated with increased risks of CVD and total mortality, and presence of periodontitis, which is more prevalent than edentulism, was associated with 17% higher mortality rate. These findings suggest that improving periodontal condition of the general population could reduce overall mortality.
Collapse
Affiliation(s)
- Michael J LaMonte
- Department of Epidemiology and Environmental Health, University at Buffalo, NY
| | | | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, University at Buffalo, NY
| | | | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, University at Buffalo, NY
| | - Dominique S Michaud
- Department of Public Health and Community Medicine, Tufts University, Boston, MA
| | - Xiaodan Mai
- Department of Epidemiology and Environmental Health, University at Buffalo, NY
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Christian R Salazar
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | | | - Wenjun Li
- Department of Preventive and Behavioral Medicine, University of Massachusetts, Worcester, MA
| | - Charles B Eaton
- Departments of Family and Preventive Medicine and Epidemiology, Brown University, Providence, RI
| | - Lisa W Martin
- Department of Cardiology, The George Washington University, Washington, DC
| | | |
Collapse
|
43
|
Adolph M, Darnaud C, Thomas F, Pannier B, Danchin N, Batty GD, Bouchard P. Oral health in relation to all-cause mortality: the IPC cohort study. Sci Rep 2017; 7:44604. [PMID: 28294149 PMCID: PMC5353629 DOI: 10.1038/srep44604] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 02/09/2017] [Indexed: 11/21/2022] Open
Abstract
We evaluated the association between oral health and mortality. The study population comprised 76,188 subjects aged 16–89 years at recruitment. The mean follow-up time was 3.4 ± 2.4 years. Subjects with a personal medical history of cancer or cardiovascular disease and death by casualty were excluded from the analysis. A full-mouth clinical examination was performed in order to assess dental plaque, dental calculus and gingival inflammation. The number of teeth and functional masticatory units <5 were recorded. Causes of death were ascertained from death certificates. Mortality risk was evaluated using Cox regression model with propensity score calibrated for each oral exposure. All-cause mortality risk were raised with dental plaque, gingival inflammation, >10 missing teeth and functional masticatory units <5. All-cancer mortality was positively associated with dental plaque and gingival inflammation. Non-cardiovascular and non-cancer mortality were also positively associated with high dental plaque (HR = 3.30, [95% CI: 1.76–6.17]), high gingival inflammation (HR = 2.86, [95% CI: 1.71–4.79]), >10 missing teeth (HR = 2.31, [95% CI: 1.40–3.82]) and functional masticatory units <5 (HR = 2.40 [95% CI 1.55–3.73]). Moreover, when ≥3 oral diseases were cumulated in the model, the risk increased for all-cause mortality (HR = 3.39, [95% CI: 2.51–5.42]), all-cancer mortality (HR = 3.59, [95% CI: 1.23–10.05]) and non-cardiovascular and non-cancer mortality (HR = 4.71, [95% CI: 1.74–12.7]). The present study indicates a postive linear association between oral health and mortality.
Collapse
Affiliation(s)
- Margaux Adolph
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7-Denis Diderot University, U.F.R. of Odontology, Paris, France
| | - Christelle Darnaud
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7-Denis Diderot University, U.F.R. of Odontology, Paris, France
| | | | - Bruno Pannier
- Centre d'Investigation Préventive et Clinique (IPC), Paris, France.,Manhès Hospital, Fleury-Mérogis, France
| | - Nicolas Danchin
- Centre d'Investigation Préventive et Clinique (IPC), Paris, France.,Department of Cardiology, Georges Pompidou European Hospital, AP-HP, Paris 5 - Descartes University, Medicine Faculty, Paris, France
| | - G David Batty
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Philippe Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, Paris 7-Denis Diderot University, U.F.R. of Odontology, Paris, France.,EA 2496, Paris 5 - Descartes University, U.F.R. of Odontology, Paris, France
| |
Collapse
|
44
|
Acharya A, Shimpi N, Mahnke A, Mathias R, Ye Z. Medical care providers' perspectives on dental information needs in electronic health records. J Am Dent Assoc 2017; 148:328-337. [PMID: 28284418 DOI: 10.1016/j.adaj.2017.01.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/26/2017] [Accepted: 01/26/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND The authors conducted this study to identify the most relevant patient dental information in a medical-dental integrated electronic health record (iEHR) necessary for medical care providers to inform holistic treatment. METHODS The authors collected input from a diverse sample of 65 participants from a large, regional health system representing 13 medical specialties and administrative units. The authors collected feedback from participants through 11 focus group sessions. Two independent reviewers analyzed focus group transcripts to identify major and minor themes. RESULTS The authors identified 336 of 385 annotations that most medical care providers coded as relevant. Annotations strongly supporting relevancy to clinical practice aligned with 18 major thematic categories, with the top 6 categories being communication, appointments, system design, medications, treatment plan, and dental alerts. CONCLUSIONS Study participants identified dental data of highest relevance to medical care providers and recommended implementation of user-friendly access to dental data in iEHRs as crucial to holistic care delivery. PRACTICAL IMPLICATIONS Identification of the patients' dental information most relevant to medical care providers will inform strategies for improving the integration of that information into the medical-dental iEHR.
Collapse
|
45
|
Xu S, Song M, Xiong Y, Liu X, He Y, Qin Z. The association between periodontal disease and the risk of myocardial infarction: a pooled analysis of observational studies. BMC Cardiovasc Disord 2017; 17:50. [PMID: 28143450 PMCID: PMC5286862 DOI: 10.1186/s12872-017-0480-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 01/20/2017] [Indexed: 02/07/2023] Open
Abstract
Background Several meta-analyses have indicated that periodontal disease (PD) are related to cardiovascular diseases (CVDs). However, the association between PD and myocardial infarction (MI) remains controversial. Here we aimed to assess the association between PD and MI by meta-analysis of observational studies. Methods PubMed, EMBASE and the Cochrane Library were searched through July, 2016. Observational studies including cohort, cross-sectional and case–control studies reporting odds ratio (OR) or relative risk (RR) with 95% confidence intervals (CIs) were included in the analysis. Either fixed or random-effects model were applied to evaluate the pooled risk estimates. Sensitivity and subgroup analyses were also carried out to identify the sources of heterogeneity. Publication bias was assessed by the Begg’s, Egger’s test and funnel plot. Results We included 22 observational studies with 4 cohort, 6 cross-sectional and 12 case–control studies, including 129,630 participants. Patients with PD have increased risk of MI (OR 2.02; 95% CI 1.59-2.57). Substantial heterogeneity in risk estimates was revealed. Subgroup analyses showed that the higher risk of MI in PD patients exists in both cross-sectional studies (OR 1.71; 95% CI 1.07-2.73) and case–control studies (OR 2.93; 95% CI 1.95-4.39), and marginally in cohort studies (OR 1.18; 95% CI 0.98-1.42). Further, subgroup meta-analyses by location, PD exposure, participant number, and study quality showed that PD was significantly associated with elevated risk of MI. Conclusion Our meta-analysis suggested that PD is associated with increased risk of future MI. However, the causative relation between PD and MI remains not established based on the pooled estimates from observational studies and more studies are warranted. Electronic supplementary material The online version of this article (doi:10.1186/s12872-017-0480-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Shuai Xu
- Department of Stomatology, Xinqiao Hospital, Third Military Medical University, 400037, Chongqing, China
| | - Mingbao Song
- Department of Cardiology, Xinqiao Hospital, Third Military Medical University, 183 Xinqiaozhengjie St., Shapingba District, 400037, Chongqing, China
| | - Yu Xiong
- Department of Stomatology, Southwest Hospital, Third Military Medical University, 400038, Chongqing, China
| | - Xi Liu
- Department of Cardiology, Xinqiao Hospital, Third Military Medical University, 183 Xinqiaozhengjie St., Shapingba District, 400037, Chongqing, China
| | - Yongming He
- Department of Cardiology, Xinqiao Hospital, Third Military Medical University, 183 Xinqiaozhengjie St., Shapingba District, 400037, Chongqing, China
| | - Zhexue Qin
- Department of Cardiology, Xinqiao Hospital, Third Military Medical University, 183 Xinqiaozhengjie St., Shapingba District, 400037, Chongqing, China.
| |
Collapse
|
46
|
Impact of prosthodontic rehabilitation on the masticatory performance of partially dentate older patients: Can it predict nutritional state? Results from a RCT. Proc Nutr Soc 2017. [DOI: 10.1017/s0029665117001823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
47
|
Karhunen V, Forss H, Goebeler S, Huhtala H, Ilveskoski E, Kajander O, Mikkelsson J, Penttilä A, Perola M, Ranta H, Meurman JH, Karhunen PJ. Radiographic Assessment of Dental Health in Middle-aged Men Following Sudden Cardiac Death. J Dent Res 2016; 85:89-93. [PMID: 16373688 DOI: 10.1177/154405910608500116] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Poor oral health has been suggested to be a risk factor for myocardial infarction. To study if dental pathology might predispose to pre-hospital sudden cardiac death, and using a sum index of panoramic tomography findings, we compared the oral health of middle-aged (33–69 yrs) male victims (Helsinki Sudden Death Study) of sudden cardiac death (n = 117) with that of controls, who died of non-cardiac diseases (n = 63) or suffered unnatural sudden death (n = 120). The mean number of teeth was 15.2, and 17.4% of the men were edentulous. Frequent age-associated findings in dentate victims were fillings (79.9%), horizontal bone loss (72.1%), periapical lesions (45.6%), residual roots (38.2%), and vertical pockets (30.9%). In multivariate analysis with coronary heart disease risk factors and number of teeth as covariates, poor oral health was associated (p = 0.053) with the risk of sudden cardiac death along with age, smoking, and body mass index. This association was especially strong (p = 0.009) among victims < 50 yrs.
Collapse
Affiliation(s)
- V Karhunen
- Medical School, University of Tampere and Research Unit of Clinical Chemistry, Tampere University Hospital, Finland.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Joshy G, Arora M, Korda RJ, Chalmers J, Banks E. Is poor oral health a risk marker for incident cardiovascular disease hospitalisation and all-cause mortality? Findings from 172 630 participants from the prospective 45 and Up Study. BMJ Open 2016; 6:e012386. [PMID: 27577588 PMCID: PMC5013478 DOI: 10.1136/bmjopen-2016-012386] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/23/2016] [Accepted: 08/05/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate the relationship between oral health and incident hospitalisation for ischaemic heart disease (IHD), heart failure (HF), ischaemic stroke and peripheral vascular disease (PVD) and all-cause mortality. DESIGN Prospective population-based study of Australian men and women aged 45 years or older, who were recruited to the 45 and Up Study between January 2006 and April 2009; baseline questionnaire data were linked to hospitalisations and deaths up to December 2011. Study exposures include tooth loss and self-rated health of teeth and gums at baseline. SETTING New South Wales, Australia. PARTICIPANTS Individuals aged 45-75 years, excluding those with a history of cancer/cardiovascular disease (CVD) at baseline; n=172 630. PRIMARY OUTCOMES Incident hospitalisation for IHD, HF, ischaemic stroke and PVD and all-cause mortality. RESULTS During a median follow-up of 3.9 years, 3239 incident hospitalisations for IHD, 212 for HF, 283 for ischaemic stroke and 359 for PVD, and 1908 deaths, were observed. Cox proportional hazards models examined the relationship between oral health indicators and incident hospitalisation for CVD and all-cause mortality, adjusting for potential confounding factors. All-cause mortality and incident CVD hospitalisation risk increased significantly with increasing tooth loss for all outcomes except ischaemic stroke (ptrend<0.05). In those reporting no teeth versus ≥20 teeth left, risks were increased for HF (HR, 95% CI 1.97, 1.27 to 3.07), PVD (2.53, 1.81 to 3.52) and all-cause mortality (1.60, 1.37 to 1.87). The risk of IHD, PVD and all-cause mortality (but not HF or ischaemic stroke) increased significantly with worsening self-rated health of teeth and gums (ptrend<0.05). In those reporting poor versus very good health of teeth and gums, risks were increased for IHD (1.19, 1.03 to 1.38), PVD (1.66, 1.13 to 2.43) and all-cause mortality (1.76, 1.50 to 2.08). CONCLUSIONS Tooth loss and, to a lesser extent, self-rated health of teeth and gums, are markers for increased risk of IHD, PVD and all-cause mortality. Tooth loss is also a marker for increased risk of HF.
Collapse
Affiliation(s)
- Grace Joshy
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Manish Arora
- Faculty of Dentistry, University of Sydney, Sydney, New South Wales, Australia
- Department of Preventive Medicine and the Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rosemary J Korda
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - John Chalmers
- The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
- The Sax Institute, Sydney, New South Wales, Australia
| |
Collapse
|
49
|
Abstract
The connection between oral and systemic health is becoming more obvious. Oral infections, specifically periodontitis, have been associated with diseases such as diabetes, cardiovascular disease, respiratory infection, erectile dysfunction, metabolic syndrome, and rheumatoid arthritis, to name a few. As people age, they become more susceptible for developing both oral and systemic diseases. This article discusses the oral-systemic relationship as well as sheds light on preventive measures that can be taken.
Collapse
|
50
|
Hsieh E. Voices of the Homeless: An Emic Approach to the Experiences of Health Disparities Faced by People Who Are Homeless. SOCIAL WORK IN PUBLIC HEALTH 2016; 31:328-340. [PMID: 27093127 DOI: 10.1080/19371918.2015.1137512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
People who are homeless are particularly vulnerable to health disparities. Rather than using population statistics to highlight the prevalence or severity of the suffering of people who are homeless, 28 undergraduate students each conducted an in-depth interview with an individual who relied on a local homeless shelter to cope with everyday life. The interview explored the participants' health concerns and strategies for health management. Due to equipment failure and incomplete recording, only 16 interviews are included in this study. The author adopted thematic analysis while focused on preserving the richness of the interactions between the participants who are homeless and the undergraduate students. The author's goal is to provide emic, intimate insights about the struggles and challenges faced by the people who are homeless. The author concluded the study by situating the findings in the larger literature of health disparities experienced by people who are homeless.
Collapse
Affiliation(s)
- Elaine Hsieh
- a Department of Communication , University of Oklahoma , Norman , Oklahoma, USA
| |
Collapse
|