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Chaudhary FA, Ahmad B, Arjumand B, Alharkan HM. The Association Between Economic Status and Religious Identity With Oral Health Disparities and Inequalities Around the World. Cureus 2024; 16:e51917. [PMID: 38333499 PMCID: PMC10850934 DOI: 10.7759/cureus.51917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION The inequalities in oral health remain one of the current issues in the global public health agenda. The number of studies investigating health disparity by religious identity is limited and there is currently no such report relating to oral health. Similarly, there is compelling evidence for oral health disparities between socioeconomic statuses, education levels, and ethnic groups. This ecological study aimed to explore the disparity in oral health-related outcomes between Muslim and non-Muslim countries and country income status. METHODS Publicly available data related to oral health measures, country income status, and membership in the Organization of Islamic countries were used. Five oral health-related measures were examined: caries experience (decayed, missing, and filled teeth (DMFT)), percentage of the population with no periodontal disease, and disability-adjusted life years (DALY) attributed to oral conditions, and mouth and oropharynx cancer. One-way analysis of variance (ANOVA) and Kruskal-Wallis tests were used to compare the oral health parameters by country income status and simple linear regression was used to compare the parameters between the non-member countries (n-MC) and member countries (MC). For the significant parameters, adjusted coefficients were obtained using multiple linear regression. RESULTS From 170 countries included, 53 (31%) were MC and 117 (69%) were n-MC. Analysis showed that the mean DMFT in adults aged 35-44 years was significantly higher in the n-MC compared to MC after adjusting for country income status (p<0.05) but the latter was the stronger explanatory predictor of the outcome. The strength of the effect of country membership classification (standardized coefficient β: DMFT35-44-year-old = -0.16) was smaller than country income status (β = -0.60) in the multiple regression. CONCLUSION There is significant but weak evidence from the available data to support the claim that economic status and religion contribute to oral health disparity.
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Affiliation(s)
- Farooq Ahmad Chaudhary
- Department of Community Dentistry, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, PAK
| | - Basaruddin Ahmad
- Department of Dental Public Health, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, MYS
| | - Bilal Arjumand
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraydah, SAU
| | - Hamad Mohammad Alharkan
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraydah, SAU
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Xu J, Jia Y, Mao Z, Wei X, Qiu T, Hu M. Association between serum uric acid, hyperuricemia and periodontitis: a cross-sectional study using NHANES data. BMC Oral Health 2023; 23:610. [PMID: 37644435 PMCID: PMC10466695 DOI: 10.1186/s12903-023-03320-4] [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: 03/23/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Diabetes and other metabolic diseases have been linked to the development of periodontitis, but little research has been done to determine whether serum uric acid (SUA) levels and hyperuricemia play a role. This study aimed to investigate the relationship between SUA, hyperuricemia, and periodontitis. METHODS Using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, we created a nationally representative data set. We used multivariable logistic regression models to assess the relationship between SUA, hyperuricemia, and periodontitis and presented odds ratios (OR) in women and men, respectively. RESULTS In women, adjusted multivariable regression models showed that SUA (4.1-4.3mg/dl) was associated with higher odds of periodontitis (OR = 1.43; 95% confidence interval (CI):1.0 ~ 2.03, p = 0.047) with SUA (≤ 3.3mg/dl) as reference. The risk of periodontitis tended to increase slightly but insignificantly with increasing SUA levels, and the adverse effects occurred only when SUA increased to a certain level, and then reached a plateau. In men, the adjusted OR values for SUA (4.9-5.2mg/dl), SUA (5.3-5.5mg/dl), SUA (5.9-6.2mg/dl), and SUA (6.3-6.5mg/dl) were 0.66 (95% CI: 0.45 ~ 0.96, p = 0.029), 0.58 (95% CI: 0.40 ~ 0.85, p = 0.006), 0.67(95% CI: 0.47 ~ 0.97, p = 0.035), and 0.67 (95% CI: 0.45 ~ 0.99, p = 0.043), respectively, with SUA (≤ 4.3mg/dl) as reference. The elevated SUA levels are protective against periodontitis, but there is a range within which the risk of periodontitis decreases, followed by a non-significant tendency to increase. CONCLUSIONS The levels of SUA that are linked to the risk of periodontitis. Future prospective longitudinal studies and strategies are required to further confirm whether controlled SUA treatment is an effective adjunct to systematic periodontal therapy and whether SUA can be used as a diagnostic biomarker to assess the risk or progression of periodontitis.
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Affiliation(s)
- Jing Xu
- Hospital of Stomatology, Jilin University, Changchun, Jilin Province, 130000, China
| | - Yifan Jia
- Hospital of Stomatology, Jilin University, Changchun, Jilin Province, 130000, China
| | - Zhi Mao
- Hospital of Stomatology, Jilin University, Changchun, Jilin Province, 130000, China
| | - Xiaoxi Wei
- Hospital of Stomatology, Jilin University, Changchun, Jilin Province, 130000, China
| | - Tianyuan Qiu
- Hospital of Stomatology, Jilin University, Changchun, Jilin Province, 130000, China
| | - Min Hu
- Hospital of Stomatology, Jilin University, Changchun, Jilin Province, 130000, China.
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Huang J, Li R, Zhu H, Huang D, Li W, Wang J, Liu Z. Association between serum globulin and cognitive impairment in older American adults. Front Public Health 2023; 11:1193993. [PMID: 37670828 PMCID: PMC10476522 DOI: 10.3389/fpubh.2023.1193993] [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: 03/26/2023] [Accepted: 07/31/2023] [Indexed: 09/07/2023] Open
Abstract
Background and aims Cognitive impairment is on the rise around the world, with profound economic and social consequences. Serum globulin, a marker of liver function, may also play a role in cognitive function. Unfortunately, no consistent conclusion exists regarding the association between serum globulin and cognitive function. Methods Data from the 2011 to 2014 National Health and Nutrition Examination Survey were used to assess the association between serum globulin and cognitive impairment. Cognitive function was assessed by three tests: Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Animal Fluency (AF), and Digit Symbol Substitution Test (DSST). Furthermore, the breakthrough point of cognitive impairment correlated with CERAD < 5, AF < 14, and DSST < 34. A weighted multiple logistics regression model was used to verify the association between serum globulin and cognitive impairment. Generalized additive models (GAMs) and a smooth curve fit (penalty spline method) were used to determine a non-linear relationship between serum globulin and cognitive impairment. Finally, subgroup analysis and interaction tests were conducted to further verify the association between serum globulin and cognitive impairment. Results Data from 2,768 participants aged ≥60 (in accordance with the study design) were collected for the final analysis. Data suggested that serum globulin levels were associated with an elevated cognitive impairment based on the AF [full adjustment, OR = 1.05, 95% CI: 1.01-1.08] and DSST [full adjustment, OR = 1.06, 95% CI: 1.02-1.10] tests. Eventually, the GAM and smooth curve fit model was conducted to confirm that the association between serum globulin and cognitive impairment was non-linear. Moreover, the inflection point was 27 g/L serum globulin based on the CERAD test and 35 g/L serum globulin based on the AF test. Finally, the interaction term between serum globulin and cognitive impairment based on the AF test indicated no significant interactions among all variables (all p for interaction >0.05). Conclusion The association between serum globulin levels and cognitive impairment is non-linear. A threshold effect exists between serum globulin and cognitive impairment. Large-scale prospective clinical trials are needed to validate our findings.
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Affiliation(s)
- Jian Huang
- Department of Neurology, Xijing Hospital, Airforce Military Medical University, Xi'an, Shaanxi, China
| | - Rong Li
- Department of Nephrology, Xijing Hospital, Airforce Military Medical University, Xi'an, Shaanxi, China
| | - Hao Zhu
- Department of Neurology, Xianyang First People's Hospital, Xianyang, Shaanxi, China
| | - Dong Huang
- Department of Neurology, The Second People's Hospital of Shaanxi Province, Xi'an, Shaanxi, China
| | - Weiwang Li
- Department of Neurology, Xi'an Daxing Hospital, Xi'an, Shaanxi, China
| | - Jing Wang
- Department of Neurology, Xi'an First Hospital, Xi'an, Shaanxi, China
| | - Zhirong Liu
- Department of Neurology, Xijing Hospital, Airforce Military Medical University, Xi'an, Shaanxi, China
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Wang BY, Burgardt G, Parthasarathy K, Ho DK, Weltman RL, Tribble GD, Hong J, Cron S, Xie H. Influences of race/ethnicity in periodontal treatment response and bacterial distribution, a cohort pilot study. FRONTIERS IN ORAL HEALTH 2023; 4:1212728. [PMID: 37377523 PMCID: PMC10291508 DOI: 10.3389/froh.2023.1212728] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Objectives Periodontitis disproportionately affects different racial and ethnic populations. We have previously reported the higher levels of Porphyromonas gingivalis and lower ratios of Streptococcus cristatus to P. gingivalis may contribute to periodontal health disparities. This prospective cohort study was designed to investigate if ethnic/racial groups responded differently to non-surgical periodontal treatment and if the treatment outcomes correlated to the bacterial distribution in patients with periodontitis before treatment. Methods This prospective cohort pilot study was carried out in an academic setting, at the School of Dentistry, University of Texas Health Science Center at Houston. Dental plaque was collected from a total of 75 African Americans, Caucasians and Hispanics periodontitis patients in a 3-year period. Quantitation of P. gingivalis and S. cristatus was carried out using qPCR. Clinical parameters including probing depths and clinical attachment levels were determined before and after nonsurgical treatment. Data were analyzed using one-way ANOVA, the Kruskal-Wallis test, the paired samples t-test and the chi-square test. Results The gains in clinical attachment levels after treatment significantly differed amongst the 3 groups-Caucasians responded most favorably, followed by African-Americans, lastly Hispanics, while numbers of P. gingivalis were highest in Hispanics, followed by African-Americans, and lowest in Caucasians (p = 0.015). However, no statistical differences were found in the numbers of S. cristatus amongst the 3 groups. Conclusion Differential response to nonsurgical periodontal treatment and distribution of P. gingivalis are present in different ethnic/racial groups with periodontitis.
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Affiliation(s)
- Bing-Yan Wang
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Grayson Burgardt
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Kavitha Parthasarathy
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
- Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, United States
| | - Daniel K. Ho
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Robin L. Weltman
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
- Department of Clinical Sciences, University of Nevada, Las Vegas, NV, United States
| | - Gena D. Tribble
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jianming Hong
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Stanley Cron
- School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Hua Xie
- School of Dentistry, Meharry Medical College, Nashville, TN, United States
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Wang BY, Cao A, Ho MH, Wilus D, Sheng S, Meng HW, Guerra E, Hong J, Xie H. Identification of microbiological factors associated with periodontal health disparities. Front Cell Infect Microbiol 2023; 13:1137067. [PMID: 36875522 PMCID: PMC9978005 DOI: 10.3389/fcimb.2023.1137067] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/07/2023] [Indexed: 02/18/2023] Open
Abstract
The present study aimed at identifying risk factors associated with periodontitis development and periodontal health disparities with emphasis on differential oral microbiota. The prevalence of periodontitis is recently rising dentate adults in the US, which presents a challenge to oral health and overall health. The risk of developing periodontitis is higher in African Americans (AAs), and Hispanic Americans (HAs) than in Caucasian Americans (CAs). To identify potentially microbiological determinations of periodontal health disparities, we examined the distribution of several potentially beneficial and pathogenic bacteria in the oral cavities of AA, CA, and HA study participants. Dental plaque samples from 340 individuals with intact periodontium were collected prior to any dental treatment, and levels of some key oral bacteria were quantitated using qPCR, and the medical and dental histories of participants were obtained retrospectively from axiUm. Data were analyzed statistically using SAS 9.4, IBM SPSS version 28, and R/RStudio version 4.1.2. Amongst racial/ethnic groups: 1) neighborhood medium incomes were significantly higher in the CA participants than the AA and the HA participants; 2) levels of bleeding on probing (BOP) were higher in the AAs than in the CAs and HAs; 3) Porphyromonas gingivalis levels were higher in the HAs compared to that in the CAs; 4) most P. gingivalis detected in the AAs were the fimA genotype II strain that was significantly associated with higher BOP indexes along with the fimA type IV strain. Our results suggest that socioeconomic disadvantages, higher level of P. gingivalis, and specific types of P. gingivalis fimbriae, particularly type II FimA, contribute to risks for development of periodontitis and periodontal health disparities.
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Affiliation(s)
- Bing-Yan Wang
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
- *Correspondence: Bing-Yan Wang, ; Hua Xie,
| | - Aize Cao
- School of Applied Computational Sciences, Meharry Medical College, Nashville, TN, United States
| | - Meng-Hsuan Ho
- School of Dentistry, Meharry Medical College, Nashville, TN, United States
| | - Derek Wilus
- School of Graduate Studies, Meharry Medical College, Nashville, TN, United States
| | - Sally Sheng
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Hsiu-Wan Meng
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Elissa Guerra
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jianming Hong
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Hua Xie
- School of Dentistry, Meharry Medical College, Nashville, TN, United States
- *Correspondence: Bing-Yan Wang, ; Hua Xie,
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Hajek A, König HH, Kretzler B, Zwar L, Lieske B, Seedorf U, Walther C, Aarabi G. Does Oral Health-Related Quality of Life Differ by Income Group? Findings from a Nationally Representative Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10826. [PMID: 36078541 PMCID: PMC9518370 DOI: 10.3390/ijerph191710826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/24/2022] [Accepted: 08/28/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Clarify the association between income group and oral health-related quality of life. METHODS Data were used from a nationally representative online survey with n = 3075 individuals. It was conducted in late Summer 2021. The established Oral Health Impact Profile (OHIP-G5) was used to measure oral health-related quality of life. The income group (household net income) was used as key independent variable. It was adjusted for several covariates. Full-information maximum likelihood was used to address missing values. RESULTS Individuals in the lowest income decile had a lower oral health-related quality of life (Cohen's d = -0.34) compared to individuals in the second to ninth income deciles. Individuals in the highest income decile had a higher oral health-related quality of life (Cohen's d = 0.20) compared to individuals in the second to ninth income deciles. Consequently, there was a medium difference (Cohen's d = 0.53) between individuals in the lowest income decile and individuals in the highest income decile. Additionally, multiple linear regressions showed significant differences between individuals in the lowest income decile and individuals in the second to ninth income deciles (β = 0.72, p < 0.01). In contrast, only marginal significant differences were identified between individuals in the second to ninth income deciles and individuals in the highest income decile (β = -0.28, p < 0.10). CONCLUSIONS The current study particularly stressed the association between low income and low oral health-related quality of life in the general adult population. Increasing oral health-related quality of life in individuals with low income is a major issue which should be targeted.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany
| | - Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, 20246 Hamburg, Germany
| | - Berit Lieske
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Udo Seedorf
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Carolin Walther
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
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Abrol N, Compton SM, Graf D, Parashar P, Heo G, Gibson MP. Inflammatory bowel disease and periodontitis: A retrospective chart analysis. Clin Exp Dent Res 2022; 8:1028-1034. [PMID: 35707842 PMCID: PMC9562573 DOI: 10.1002/cre2.609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives This study examined the variation in prevalence of periodontitis among different sexes, age groups, smoking status, and oral hygiene adherence in patients affected by either Crohn's disease (CD) or ulcerative colitis (UC). Materials & Methods This study was a retrospective chart analysis that collected data from the School of Dentistry's Oral Health Clinic at the University of Alberta, Edmonton, Canada. Patients' electronic health records between the years of 2013 and 2019 were analyzed. Multiple keywords such as IBD, CD, UC, and periodontal disease with various spelling combinations were used for searching and gathering pertinent data, which was then further assessed. After applying the inclusion and exclusion criteria, a total of 80 patient charts were included. These patient charts were thoroughly screened to gather information such as age, sex, smoking status, and a variety of periodontal parameters. Collected data were analyzed using SPSS software by using Pearson's χ2, Pearson's correlation, and Mann–Whitney U‐test. Results IBD had an impact on the severity of periodontitis in patients between the ages of 50 and 64 years with higher odds ratio (OR). Biological sex or history of smoking in IBD patients did not have higher odds of developing periodontitis. Plaque score derived from this retrospective study was used to estimate the patient's oral hygiene status and showed no impact. Also, prevalence of periodontitis did not differ between UC and CD. We anticipated some of these findings because of the retrospective nature of the study. Conclusions Within the limitation of the retrospective study, IBD patients in the 50–64 age group years showed a higher odds ratio for a greater prevalence of periodontitis. Thus, a closer periodontal recall and evaluation in these patients is recommended for early diagnosis and preventive care. It is advised that periodontists work closely with gastroenterologists to maintain periodontal health in IBD‐affected individuals.
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Affiliation(s)
- Nazia Abrol
- School of Dentistry University of Alberta Faculty of Medicine and Dentistry Edmonton Alberta Canada
| | - Sharon M. Compton
- School of Dentistry University of Alberta Faculty of Medicine and Dentistry Edmonton Alberta Canada
| | - Daniel Graf
- School of Dentistry University of Alberta Faculty of Medicine and Dentistry Edmonton Alberta Canada
| | - Pallavi Parashar
- School of Dentistry University of Alberta Faculty of Medicine and Dentistry Edmonton Alberta Canada
| | - Giseon Heo
- School of Dentistry University of Alberta Faculty of Medicine and Dentistry Edmonton Alberta Canada
| | - Monica P. Gibson
- School of Dentistry University of Alberta Faculty of Medicine and Dentistry Edmonton Alberta Canada
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Almohamad M, Krall Kaye E, Mofleh D, Spartano NL. The association of sedentary behaviour and physical activity with periodontal disease in NHANES 2011-2012. J Clin Periodontol 2022; 49:758-767. [PMID: 35634657 DOI: 10.1111/jcpe.13669] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 04/20/2022] [Accepted: 05/18/2022] [Indexed: 12/30/2022]
Abstract
AIM Periodontal disease is one of the most prevalent oral pathologies and a major chronic disease worldwide. Lifestyle habits such as poor nutrition and smoking have been established to contribute to the development of periodontal disease, but limited research has investigated whether physical activity and sedentary lifestyle play a role. The purpose of this study is to evaluate the association between physical activity, sedentary behaviour, and periodontal disease. MATERIALS AND METHODS We used a nationally representative data set from the National Health and Nutrition Examination Survey (NHANES) 2011-2012. We examined the association between physical activity and sedentary behaviour and periodontal disease using multivariable logistic regression models and reported odds ratios (ORs). RESULTS Individuals with higher total physical activity, higher leisure time physical activity, and lower amount of total sedentary behaviour had lower periodontal disease prevalence. Adjusted multivariable regression models showed that higher sedentary behaviour (more than 7.5 h/day) was associated with higher odds of periodontal disease (OR = 1.17; 95% confidence interval = 1.00-1.36; p = .045). CONCLUSIONS The findings showed that higher sedentary behaviour is associated with higher odds of periodontal disease. Future prospective longitudinal studies and strategies are needed to investigate implications further and define the magnitude of the association between physical activity and periodontal disease.
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Affiliation(s)
- Maha Almohamad
- Division of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center School of Public Health, Houston, Texas, USA
| | - Elizabeth Krall Kaye
- Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
| | - Dania Mofleh
- Division of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center School of Public Health, Houston, Texas, USA
| | - Nicole L Spartano
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University School of Medicine, Boston, Massachusetts, USA
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Castañeda‐Avila MA, Pérez CM, Vivaldi‐Oliver JA, Díaz‐Toro EC, Ortiz AP. Comparison of oral human papilloma virus detection methods among Hispanic adults. Clin Exp Dent Res 2021; 8:169-175. [PMID: 34967144 PMCID: PMC8874069 DOI: 10.1002/cre2.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives Oral human papilloma virus (HPV) infection is associated with nearly three‐quarters of all oropharyngeal cancers in the United States. Research also suggests its association with periodontal disease. There are limited studies evaluating differences in HPV detection methods; however, oral rinse is considered the most sensitive detection method. We compared HPV detection by self‐collected oral rinse versus self‐collected cytobrush and assessed whether the strength of association between periodontitis and HPV is modified by the collection method. Materials and Methods Data from a cross‐sectional study of Hispanic adults in Puerto Rico (n = 346) who provided oral rinse and cytobrush samples for oral HPV detection and were clinically evaluated for periodontitis. The agreement between the oral mouthwash and cytobrush methods was assessed using the Kappa (κ) statistic. Logistic regression models were used to determine if the association between HPV infection and other risk factors varied by oral sample collection method. Results HPV prevalence was slightly higher using cytobrush than oral rinse (5.8% vs. 4.3%). The sensitivity of cytobrush to detect oral HPV was 64.7%, and the specificity was 97.4%. We observed a κ of 0.61 (95% confidence interval [CI]: 0.45–0.78), indicative of fair to good agreement between the two collection methods. The association between oral HPV infection and periodontitis severity was stronger when using the oral rinse collection method (odds ratio [OR] = 3.23, 95% CI: 1.06–9.84); the association was not statistically significant for cytobrush (OR = 1.96, 95% CI: 0.68–5.65). Conclusions These findings support the significance of choosing the most suitable collection method in oral HPV‐related studies. Selecting the most appropriate collection method is an essential criterion in oral HPV‐related studies.
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Affiliation(s)
- Maira A. Castañeda‐Avila
- Department of Population and Quantitative Health SciencesUniversity of Massachusetts Chan Medical SchoolWorcesterMassachusettsUSA
| | - Cynthia M. Pérez
- Department of Biostatistics and EpidemiologyGraduate School of Public Health, Medical Sciences Campus, University of Puerto RicoSan JuanPuerto Rico
| | - José A. Vivaldi‐Oliver
- Department of Restorative SciencesSchool of Dental Medicine, Medical Sciences Campus, University of Puerto RicoSan JuanPuerto Rico
| | - Elba C. Díaz‐Toro
- Department of Restorative SciencesSchool of Dental Medicine, Medical Sciences Campus, University of Puerto RicoSan JuanPuerto Rico
| | - Ana Patricia Ortiz
- Department of Biostatistics and EpidemiologyGraduate School of Public Health, Medical Sciences Campus, University of Puerto RicoSan JuanPuerto Rico
- Division of Cancer Control and Population SciencesUniversity of Puerto Rico Comprehensive Cancer CenterSan JuanPuerto Rico
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10
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Sekino S, Takahashi R, Numabe Y, Okamoto H. Current status of periodontal disease in adults in Takahagi, Japan: a cross-sectional study. BMC Oral Health 2020; 20:60. [PMID: 32075622 PMCID: PMC7031892 DOI: 10.1186/s12903-020-1046-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To date, a few studies have documented the detailed periodontal conditions of a Japanese population. It is important to know if the awareness of Japanese nationals and dentists regarding oral hygiene and prevention of periodontal disease have improved when compared with the past in Japan for the development of future scenarios regarding prevention. The aim of this study was to investigate the severity, prevalence, and extent of periodontal disease in the adult population of the city of Takahagi, Japan. Results were also compared with those of an epidemiological study performed in Japan in the 1980s. METHODS A total of 582 (aged 20 to 89 years) randomly sampled Takahagi residents answered a comprehensive questionnaire and participated in clinical examinations. RESULTS The mean percentages of tooth surfaces harboring plaque and exhibiting BOP were 59.5 ± 20.9% and 31.1 ± 21.1%, respectively. The mean PPD and CAL were 2.5 ± 0.5 mm and 2.9 ± 1.0 mm, respectively. Compared with results of the 1980s survey, the mean percentages of plaque and bleeding on probing were lower in the current population. The mean CAL and prevalence of attachment loss of ≥5 mm in some age groups were higher in the present study than in the 1980s study. There were no statistically significant differences with respect to mean probing depth between the 1980s and current age groups. CONCLUSIONS Periodontal disease was still prevalent in the current Japanese population, even though some improvement occurred. Proper public health programs therefore need to be established.
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Affiliation(s)
- Satoshi Sekino
- Nippon Dental University, School of Life Dentistry, Department of Periodontology, 1-9-20, Fujimi, Chiyodaku, Tokyo, Japan.
| | - Ryoichi Takahashi
- Nippon Dental University, School of Life Dentistry, Department of Periodontology, 1-9-20, Fujimi, Chiyodaku, Tokyo, Japan
| | - Yukihiro Numabe
- Nippon Dental University, School of Life Dentistry, Department of Periodontology, 1-9-20, Fujimi, Chiyodaku, Tokyo, Japan
| | - Hiroshi Okamoto
- Tokyo Periodontal Treatment Center, 16-14, Koamichio, Nihonbashi, Chuo-ku, Tokyo, Japan
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11
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Singh A, Peres MA, Watt RG. The Relationship between Income and Oral Health: A Critical Review. J Dent Res 2019; 98:853-860. [PMID: 31091113 DOI: 10.1177/0022034519849557] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
In this critical review, we summarized the evidence on associations between individual/household income and oral health, between income inequality and oral health, and income-related inequalities in oral health. Meta-analyses of mainly cross-sectional studies confirm that low individual/household income is associated with oral cancer (odds ratio, 2.41; 95% confidence interval [CI], 1.59-3.65), dental caries prevalence (prevalence ratio, 1.29; 95% CI, 1.18-1.41), any caries experience (odds ratio, 1.40; 95% CI, 1.19-1.65), tooth loss (odds ratio, 1.66; 95% CI, 1.48-1.86), and traumatic dental injuries (odds ratio, 0.76; 95% CI, 0.65-0.89). Reviews also confirm qualitatively that low income is associated with periodontal disease and poor oral health-related quality of life. Limited evidence from the United States shows that psychosocial and behavioral explanations only partially explain associations between low individual/household income and oral health. Few country-level studies and a handful of subnational studies from the United States, Japan, and Brazil show associations between area-level income inequality and poor oral health. However, this evidence is conflicting given that the association between area-level income inequality and oral health outcomes varies considerably by contexts and by oral health outcomes. Evidence also shows cross-national variations in income-related inequalities in oral health outcomes of self-rated oral health, dental care, oral health-related quality of life, outcomes of dental caries, and outcomes of tooth loss. There is a lack of discussion in oral health literature about limitations of using income as a measure of social position. Future studies on the relationship between income and oral health can benefit substantially from recent theoretical and methodological advancements in social epidemiology that include application of an intersectionality framework, improvements in reporting of inequality, and causal modeling approaches. Theoretically well-informed studies that apply robust epidemiological methods are required to address knowledge gaps for designing relevant policy interventions to reduce income-related inequalities in oral health.
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Affiliation(s)
- A Singh
- 1 Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - M A Peres
- 2 Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - R G Watt
- 3 Research Department of Epidemiology and Public Health, University College London, London, UK
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12
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Che Y, Sugita N, Yoshihara A, Iwasaki M, Miyazaki H, Nakamura K, Yoshie H. MAEA rs6815464 polymorphism and periodontitis in postmenopausal Japanese females: A cross-sectional study. Arch Oral Biol 2019; 102:128-134. [PMID: 31005685 DOI: 10.1016/j.archoralbio.2019.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Macrophage erythroblast attacher (MAEA) is a membrane protein that regulates the development of mature macrophages by mediating attachment with erythroblasts. A polymorphism rs6815464 (C/G) in MAEA gene was reported to be associated with type II diabetes. Along with diabetes, osteoporosis shows an increased prevalence in postmenopausal females, and both diseases have been reported to be associated with periodontitis. Therefore, we explored the relevance of the MAEA polymorphism to periodontitis, bone mineral density (BMD) and haemoglobin A1c (HbA1c). DESIGN This was a cross-sectional study with the final sample comprised of 344 postmenopausal Japanese females. Probing pocket depth (PPD) and clinical attachment level (CAL) were measured. Genotype was determined by TaqMan assay. Blood biochemical parameters and BMD of the lumbar spine were evaluated. RESULTS No differences were found in age, body mass index, HbA1c, BMD, number of teeth, bone metabolism parameters between the genotypes. Mean CAL and percentage of sites with PPD or CAL ≥ 5 mm were higher in the G-allele carriers than in the non-carriers. Multiple logistic regression analyses revealed that G-allele carriage was associated with severe periodontitis (odds ratio = 3.73, 95% CI = 1.36-10.19). CONCLUSION Our results suggested that the MAEA gene polymorphism was independently associated with severe periodontitis.
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Affiliation(s)
- Yulan Che
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Niigata 951-8514, Japan; Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, China.
| | - Noriko Sugita
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Niigata 951-8514, Japan.
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Niigata 951-8514, Japan.
| | - Masanori Iwasaki
- Division of Community Oral Health Development, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka 803-8580, Japan.
| | - Hideo Miyazaki
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Niigata 951-8514, Japan.
| | - Kazutoshi Nakamura
- Division of Social and Environmental Medicine, Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City 951-8510, Japan.
| | - Hiromasa Yoshie
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Niigata 951-8514, Japan.
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13
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Liu Y, Yu Y, Nickel JC, Iwasaki LR, Duan P, Simmer-Beck M, Brown L. Gender differences in the association of periodontitis and type 2 diabetes. Int Dent J 2018; 68:433-440. [DOI: 10.1111/idj.12399] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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14
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Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global epidemiology of dental caries and severe periodontitis - a comprehensive review. J Clin Periodontol 2018; 44 Suppl 18:S94-S105. [PMID: 28266116 DOI: 10.1111/jcpe.12677] [Citation(s) in RCA: 495] [Impact Index Per Article: 82.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Dental caries and periodontitis are the most common oral diseases and major causes of tooth loss. AIM To perform a review of global prevalence and incidence of dental caries and periodontitis. METHODOLOGY Inclusion and exclusion criteria were developed. MEDLINE database and EMBASE database were used to search for eligible publications using keywords and MeSH terms. Additionally, WHO databank was used for obtaining dental caries information and PUBMED for a search on trends of dental caries prevalence and severity. RESULTS Over the last four decades, the prevalence and severity of dentine carious lesions among 5- and 12-year-olds have declined; the decay-component is very high, with the lowest prevalence among 12-year-olds in high-income countries, which also had the lowest prevalence among 35- to 44-year-olds; and the number of retained teeth has increased around the globe. The prevalence of periodontitis is high, with approximately 10% of the global population affected by severe periodontitis. Study heterogeneity and methodological issues hamper comparisons across studies and over time. CONCLUSION While the prevalence of dental caries has decreased, the disease is prevalent in all age groups. The prevalence of periodontitis is high. There is insufficient evidence to conclude that the prevalence of periodontitis has changed over time.
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Affiliation(s)
- Jo E Frencken
- Department of Oral Function and Prosthetic Dentistry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Praveen Sharma
- Periodontal Research Group, College of Medical and Dental Sciences, Dental School, University of Birmingham, Birmingham, UK
| | - Laura Stenhouse
- Department of Special Care Dentistry, Birmingham Dental Hospital and School of Dentistry, Birmingham, UK
| | - David Green
- Department of Restorative Dentistry, Birmingham Dental Hospital and School of Dentistry, Birmingham, UK
| | - Dominic Laverty
- Department of Restorative Dentistry, Birmingham Dental Hospital and School of Dentistry, Birmingham, UK
| | - Thomas Dietrich
- Periodontal Research Group, College of Medical and Dental Sciences, Dental School, University of Birmingham, Birmingham, UK
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15
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Wahlin Å, Papias A, Jansson H, Norderyd O. Secular trends over 40 years of periodontal health and disease in individuals aged 20-80 years in Jönköping, Sweden: Repeated cross-sectional studies. J Clin Periodontol 2018; 45:1016-1024. [PMID: 29971805 DOI: 10.1111/jcpe.12978] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/13/2018] [Accepted: 07/01/2018] [Indexed: 12/19/2022]
Abstract
AIM To assess trends over 40 years regarding prevalence and severity of periodontitis in a Swedish adult population. MATERIALS AND METHODS Cross-sectional examinations using the same clinical protocol have been repeated every 10 years (1973-2013) in a Swedish city with focus on periodontal disease in adults. Periodontal recordings included all teeth, excluding 3rd molars. Periodontal disease experience was classified (no/minor, moderate and severe). RESULTS The no/minor group increased from 43% in 1983 to 60% in 2013. There was a non-significant trend for a decrease of the severe group. Over the 40-year period, the number of teeth increased significantly and at the examination 2013, the severe group accounted for this increase. More than 60% of the study population in 2013 had no periodontal pockets (PD) ≥6 mm. The number of PD ≥4 mm and ≥6 mm were unaltered between 2003 and 2013 in all age groups, except for the 20-year old individuals. This group showed a statistically significant increase of ≥4 mm PD. CONCLUSIONS The periodontal health has improved in the population over the 40 years. The number of teeth increased significantly in the population, and in 2013, this increase occurred entirely in the severe group. Finally, there was a trend toward diminished prevalence of severe periodontitis.
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Affiliation(s)
- Åsa Wahlin
- The Institute for Postgraduate Dental Education, Jönköping, Sweden.,Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Apostolos Papias
- The Institute for Postgraduate Dental Education, Jönköping, Sweden
| | - Henrik Jansson
- The Institute for Postgraduate Dental Education, Jönköping, Sweden.,Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Biomedicine and Natural Sciences, School of Health Sciences, Centre for Oral Health, Jönköping University, Jönköping, Sweden
| | - Ola Norderyd
- The Institute for Postgraduate Dental Education, Jönköping, Sweden.,Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Biomedicine and Natural Sciences, School of Health Sciences, Centre for Oral Health, Jönköping University, Jönköping, Sweden
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16
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Delange N, Lindsay S, Lemus H, Finlayson TL, Kelley ST, Gottlieb RA. Periodontal disease and its connection to systemic biomarkers of cardiovascular disease in young American Indian/Alaskan natives. J Periodontol 2018; 89:219-227. [PMID: 29520828 PMCID: PMC6242269 DOI: 10.1002/jper.17-0319] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 07/29/2017] [Accepted: 08/20/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Periodontal disease has been shown to be associated with cardiovascular disease (CVD). No known studies evaluate the relationship between periodontal disease status and biomarkers of CVD risk in the American Indian/Alaskan Native (AI/AN) population despite their disproportionately high rates of poor oral health and cardiovascular disease-related outcomes. This study compared levels of interleukin (IL)-6 and C-reactive protein (CRP) across increasing severity of periodontal disease status among younger adults between the ages of 21 and 43 years. METHODS Plasma levels of IL-6 and CRP were measured in adult participants (ages 21 to 43 years) as part of a study of periodontal disease and CVD risk among an AI/AN population in southern California (n = 59). Periodontal evaluations were performed and disease status was classified into three categories based on highest probing depth (none/mild: < 3 mm; moderate: 4 to 5 mm; severe: ≥6 mm). Participants with known systemic disease or active infection were excluded. RESULTS Severe periodontitis was significantly associated with increased levels of IL-6 compared with those with none or mild periodontitis before controlling for other variables (P = 0.02), but lacked significance after controlling for sex, BMI, smoking status, and high-density lipoprotein (P = 0.09). Moderate periodontal disease was positively associated with IL-6 levels after controlling for potential confounders (P = 0.01). Periodontal status was not associated with CRP, before or after adjusting for covariates. CONCLUSIONS In this otherwise healthy AI/AN adult sample, moderate periodontal disease compared with none or mild periodontal disease was associated with increased levels of IL-6. High levels of CRP found in this population warrant further research.
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Affiliation(s)
- Nicole Delange
- San Diego State University, Graduate School of Public Health, Division of Epidemiology and Biostatistics, San Diego, CA
| | - Suzanne Lindsay
- San Diego State University, Graduate School of Public Health, Division of Epidemiology and Biostatistics, San Diego, CA
- Institute for Public Health, San Diego, CA
| | - Hector Lemus
- San Diego State University, Graduate School of Public Health, Division of Epidemiology and Biostatistics, San Diego, CA
| | - Tracy L Finlayson
- San Diego State University, Graduate School of Public Health, Division of Health Management and Policy, San Diego, CA
| | - Scott T Kelley
- San Diego State University, Department of Biology, San Diego, CA
| | - Roberta A Gottlieb
- Cedars-Sinai Heart Institute and Barbra Streisand Women's Heart Center, Los Angeles, CA
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17
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Eke PI, Wei L, Borgnakke WS, Thornton-Evans G, Zhang X, Lu H, McGuire LC, Genco RJ. Periodontitis prevalence in adults ≥ 65 years of age, in the USA. Periodontol 2000 2018; 72:76-95. [PMID: 27501492 DOI: 10.1111/prd.12145] [Citation(s) in RCA: 150] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2016] [Indexed: 12/23/2022]
Abstract
The older adult population is growing rapidly in the USA and it is expected that by 2040 the number of adults ≥ 65 years of age will have increased by about 50%. With the growth of this subpopulation, oral health status, and periodontal status in particular, becomes important in the quest to maintain an adequate quality of life. Poor oral health can have a major impact, leading to tooth loss, pain and discomfort, and may prevent older adults from chewing food properly, often leading to poor nutrition. Periodontitis is monitored in the USA at the national level as part of the Healthy People 2020 initiative. In this report, we provide estimates of the overall burden of periodontitis among adults ≥ 65 years of age and after stratification according to sociodemographic factors, modifiable risk factors (such as smoking status), the presence of other systemic conditions (such as diabetes) and access to dental care. We also estimated the burden of periodontitis within this age group at the state and local levels. Data from the National Health and Nutrition Examination Survey 2009/2010 and 2011/2012 cycles were analyzed. Periodontal measures from both survey cycles were based on a full-mouth periodontal examination. Nineteen per cent of adults in this subpopulation were edentulous. The mean age was 73 years, 7% were current smokers, 8% lived below the 100% Federal Poverty Level and < 40% had seen a dentist in the past year. Almost two-thirds (62.3%) had one or more sites with ≥ 5 mm of clinical attachment loss and almost half had at least one site with probing pocket depth of ≥ 4 mm. We estimated the lowest prevalence of periodontitis in Utah (62.3%) and New Hampshire (62.6%) and the highest in New Mexico, Hawaii, and the District of Columbia each with a prevalence of higher than 70%. Overall, periodontitis is highly prevalent in this subpopulation, with two-thirds of dentate older adults affected at any geographic level. These findings provide an opportunity to determine how the overall health-care management of older adults should consider the improvement of their oral health conditions. Many older adults do not have dental insurance and are also likely to have some chronic conditions, which can adversely affect their oral health.
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18
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Aguirre JI, Akhter MP, Neuville KG, Trcalek CR, Leeper AM, Williams AA, Rivera M, Kesavalu L, Ke HZ, Liu M, Kimmel DB. Age-related periodontitis and alveolar bone loss in rice rats. Arch Oral Biol 2016; 73:193-205. [PMID: 27771588 DOI: 10.1016/j.archoralbio.2016.10.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 08/18/2016] [Accepted: 10/15/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To characterize in rice rats: (a) periodontitis (PD) progress with feeding of standard laboratory rat chow (STD) during ages 4-80 weeks; and (b) PD progress with feeding of a high sucrose-casein (H-SC) diet during young adulthood. METHODS One group (N=12) was euthanized at age 4 weeks (Baseline). Four groups (N=8-16) consumed a STD diet from baseline and were necropsied at ages 22, 30, 52, and 80 weeks. Three groups (N=10-16) consumed an H-SC diet from baseline. Two were necropsied at ages 22 and 30 weeks, respectively. The third switched to the STD diet at age 22 weeks and was necropsied at age 30 weeks. All mandibles/maxillae were assessed by histometry for degree of periodontal inflammation (PD Score), alveolar crest height (ACH, mm), and horizontal alveolar bone height (hABH, mm2). RESULTS In STD diet rats aged ≥30 weeks, all endpoints were worse (P<0.05) than at Baseline. In H-SC diet rats aged ≥22 weeks, all endpoints were worse than at Baseline (P<0.05). At age 22 weeks, all endpoints were worse in the H-SC group than in the STD group (P<0.05). By age 30 weeks, the STD and H-SC groups did not differ. CONCLUSIONS 1) STD diet fed rice rats develop moderate/severe PD by age 30 weeks; 2) an H-SC diet accelerates moderate/severe PD development; and 3) switching to a STD diet does not halt/reverse PD that was accelerated by an H-SC diet. These data further clarify use of the rice rat as a PD model.
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Affiliation(s)
- J I Aguirre
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida (UF), Gainesville, FL 32610, United States.
| | - M P Akhter
- Osteoporosis Research Center, School of Medicine, Creighton University, Omaha, NE 68131, United States.
| | - K G Neuville
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida (UF), Gainesville, FL 32610, United States.
| | - C R Trcalek
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida (UF), Gainesville, FL 32610, United States.
| | - A M Leeper
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida (UF), Gainesville, FL 32610, United States.
| | - A A Williams
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida (UF), Gainesville, FL 32610, United States.
| | - M Rivera
- Department of Periodontology and Oral Biology, College of Dentistry, UF, United States.
| | - L Kesavalu
- Department of Periodontology and Oral Biology, College of Dentistry, UF, United States; Bone Research, Amgen Inc., Thousand Oaks, CA 91320, United States.
| | - H Z Ke
- Bone Research, Amgen Inc., Thousand Oaks, CA 91320, United States.
| | - M Liu
- Bone Research, Amgen Inc., Thousand Oaks, CA 91320, United States.
| | - D B Kimmel
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida (UF), Gainesville, FL 32610, United States.
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Talih M. EXAMINING SOCIOECONOMIC HEALTH DISPARITIES USING A RANK-DEPENDENT RÉNYI INDEX. Ann Appl Stat 2015; 9:992-1023. [PMID: 26566419 DOI: 10.1214/15-aoas822] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The Rényi index (RI) is a one-parameter class of indices that summarize health disparities among population groups by measuring divergence between the distributions of disease burden and population shares of these groups. The rank-dependent RI introduced in this paper is a two-parameter class of health disparity indices that also accounts for the association between socioeconomic rank and health; it may be derived from a rank-dependent social welfare function. Two competing classes are discussed and the rank-dependent RI is shown to be more robust to changes in the distribution of either socioeconomic rank or health. The standard error and sampling distribution of the rank-dependent RI are evaluated using linearization and re-sampling techniques, and the methodology is illustrated using health survey data from the U.S. National Health and Nutrition Examination Survey and registry data from the U.S. Surveillance, Epidemiology and End Results Program. Such data underlie many population-based objectives within the U.S. Healthy People 2020 initiative. The rank-dependent RI provides a unified mathematical framework for eliciting various societal positions with regards to the policies that are tied to such wide-reaching public health initiatives. For example, if population groups with lower socioeconomic position were ascertained to be more likely to utilize costly public programs, then the parameters of the RI could be selected to reflect prioritizing those population groups for intervention or treatment.
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Effects of azithromycin, metronidazole, amoxicillin, and metronidazole plus amoxicillin on an in vitro polymicrobial subgingival biofilm model. Antimicrob Agents Chemother 2015; 59:2791-8. [PMID: 25733510 DOI: 10.1128/aac.04974-14] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 02/24/2015] [Indexed: 01/30/2023] Open
Abstract
Chronic periodontitis is one of the most prevalent human diseases and is caused by dysbiosis of the subgingival microbiota. Treatment involves primarily mechanical disruption of subgingival biofilms and, in certain cases, adjunctive use of systemic antibiotic therapy. In vitro biofilm models have been developed to study antimicrobial agents targeting subgingival species. However, these models accommodate a limited number of taxa, lack reproducibility, and have low throughput. We aimed to develop an in vitro multispecies biofilm model that mimics subgingival plaque, to test antimicrobial agents. Biofilms were cultivated using the Calgary Biofilm Device and were exposed to amoxicillin (AMX), metronidazole (MTZ), azithromycin (AZM), and AMX-MTZ at four different concentrations for 12, 24, or 36 h. Chlorhexidine (CHX) (0.12%) was used as the positive control. The compositions of the biofilms were analyzed by checkerboard DNA-DNA hybridization, and the percent reduction in biofilm metabolic activity was determined using 2,3,5-triphenyltetrazolium chloride and spectrophotometry. Thirty-five of the 40 species used in the inoculum were consistently recovered from the resulting in vitro biofilms. After 36 h of exposure at the 1:27 dilution, AMX-MTZ reduced metabolic activity 11% less than CHX (q = 0.0207) but 54% more than AMX (q = 0.0031), 72% more than MTZ (q = 0.0031), and 67% more than AZM (q = 0.0008). Preliminary evidence of a synergistic interaction between AMX and MTZ was also observed. In summary, we developed reproducible biofilms with 35 subgingival bacterial species, and our results suggested that the combination of AMX and MTZ had greater antimicrobial effects on these in vitro multispecies biofilms than expected on the basis of the independent effects of the drugs.
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Shin BM, Ryu JI, Sheiham A, Do LG, Jung SH. Which life course model better explains the association between socioeconomic position and periodontal health? J Clin Periodontol 2015; 42:213-20. [PMID: 25581381 DOI: 10.1111/jcpe.12360] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2014] [Indexed: 11/28/2022]
Abstract
AIM To assess whether the relationship between socioeconomic position (SEP) and periodontal health fitted the Critical Period or the Social Mobility life course models. METHODS A nationally representative sample of 5570 Korean adults from KNHANES IV study. Log-binomial regression models adjusting for adulthood or childhood socioeconomic (SES) variables was used to assess independent effects of socioeconomic differences for childhood, adulthood and period of transition from child to adult in periodontal health. RESULTS In the Critical Period model, poorer periodontal status was associated with SES disadvantage in adulthood and not predicted by SES disadvantage in childhood. For the intergenerational Social Mobility model, prevalence of current periodontal disease was only different for females aged 30-39 and 40-49 years, after adjustment. Prevalence of periodontal disease in females was highest in the downwardly mobile group. CONCLUSIONS The Critical Period model was better at explaining association between socioeconomic position and periodontal health, such as the adulthood socioeconomic variables (SEP), had a stronger effect than childhood factors on periodontal disease. The Social Mobility model explained more of the variation in the association between SEP and periodontal health among women than among men.
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Affiliation(s)
- Bo-Mi Shin
- Gangneung-Wonju National University, Gangneung, Korea
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Yoshihara A, Sugita N, Iwasaki M, Miyazaki H, Nakamura K. The interaction between beta-3 adrenergic receptor polymorphism and obesity to periodontal disease in community-dwelling elderly Japanese. J Clin Periodontol 2015; 41:460-6. [PMID: 24460850 DOI: 10.1111/jcpe.12235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2014] [Indexed: 01/05/2023]
Abstract
OBJECTIVES The purpose of this study was to elucidate whether the association between beta-3 adrenergic receptor polymorphism and periodontal disease is modified by body weight. MATERIAL AND METHODS We enrolled 332 postmenopausal women and determined their HbA1C levels (%) and beta-3 adrenergic receptor (rs4994) genotypes. Periodontal parameters including clinical attachment level (CAL) were measured. After selecting subjects for each body mass index (BMI) level, the prevalence rate ratio (PRR) by multiple Poisson regression analysis was calculated to evaluate the relationship between periodontal disease and beta-3 adrenergic receptor polymorphism. The number of sites with CAL≥6 mm was used as a dependent variable, and beta-3 adrenergic receptor genotype [categorized as Arg non-carriers (reference) or Arg carriers], age (y) and HbA1C (%) were adopted as independent variables. We converted the number of probing sites (n) to an offset variable. RESULTS The PRR of the beta-3 adrenergic receptor genotype for the number of sites of CAL≥6 mm showed a positive association in subjects with BMI≥25.0 and increased markedly with BMI. The PRR in subjects with BMI≥30 was 3.10 (p < 0.0001). CONCLUSION This study indicates a positive association between periodontal disease and the beta-3 adrenergic receptor genotype in obese individuals.
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Affiliation(s)
- Akihiro Yoshihara
- Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Pei X, Ouyang X, He L, Cao C, Luan Q, Suda R. A 4-year prospective study of the progression of periodontal disease in a rural Chinese population. J Dent 2014; 43:192-200. [PMID: 25527246 DOI: 10.1016/j.jdent.2014.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 12/06/2014] [Accepted: 12/09/2014] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES The natural progression of periodontitis in the Chinese population is not well researched. We investigated the progression of periodontal disease over 4 years in 15-44-year-old Chinese villagers with no access to regular dental care. METHODS In 1992, 486 villagers were enrolled, and in 1996, 413 villagers were re-examined. Probing depth (PD) and clinical attachment level (CAL) were examined at six sites per tooth. Sites with ΔCAL ≥3 mm were defined as active sites. Cross-sectional and longitudinal analyses were performed using means and percentile plots. RESULTS The mean CAL increased by 0.26 mm over 4 years. The incidence of periodontitis (at least one site with CAL ≥3 mm) was 8%. The incidence of periodontitis among those with no periodontal disease at baseline was 44.9%. Seventy-eight percent of the subjects had at least one active site. In the 15-24-year group, 244 of 401 active sites had gingival recession, while only 51 active sites had both gingival recession and deeper pockets. In the 25-34-year and 35-44-year groups, almost one-third of the active sites (329/1087) and more than one-third of the active sites (580/1312) respectively had a combination of gingival recession and deeper pockets. CONCLUSIONS In this study, we demonstrated that in Chinese population without regular dental care, both the initiation of periodontitis and progression of previously existed periodontitis contributed to the natural progression of periodontitis and periodontal pocketing played a greater role with age increasing. CLINICAL SIGNIFICANCE This rare study reports the natural progression of periodontal disease in a group of Chinese villagers (15-44 years) with virtually no access to regular dental care.
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Affiliation(s)
- Xiyan Pei
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China; Outpatient Department, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiangying Ouyang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Lu He
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Caifang Cao
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Qingxian Luan
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Reiko Suda
- Departments of Periodontics, Showa University School of Dentistry, Tokyo, Japan
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Rossen LM, Talih M. Social determinants of disparities in weight among US children and adolescents. Ann Epidemiol 2014; 24:705-713.e2. [PMID: 25174287 PMCID: PMC4669563 DOI: 10.1016/j.annepidem.2014.07.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 07/03/2014] [Accepted: 07/19/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE To explore whether contextual variables attenuate disparities in weight among 18,639 US children and adolescents aged 2 to 18 years participating in the National Health and Nutrition Examination Survey, 2001 to 2010. METHODS Disparities were assessed using the Symmetrized Rényi Index, a new measure that summarizes disparities in the severity of a disease, as well as the prevalence, across multiple population groups. Propensity score subclassification was used to ensure covariate balance between racial and ethnic subgroups and account for individual-level and contextual covariates. RESULTS Before propensity score subclassification, significant disparities were evident in the prevalence of overweight and/or obesity and the degree of excess weight among overweight/obese children and adolescents. After propensity score subclassification, racial/ethnic disparities in the prevalence and severity of excess weight were completely attenuated within matched groups, indicating that racial and ethnic differences were explained by social determinants such as neighborhood socioeconomic and demographic factors. CONCLUSIONS The limited overlap in covariate distributions between various racial/ethnic subgroups warrants further attention in disparities research. The attenuation of disparities within matched groups suggests that social determinants such as neighborhood socioeconomic factors may engender disparities in weight among US children and adolescents.
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Affiliation(s)
- Lauren M Rossen
- Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD.
| | - Makram Talih
- Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
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25
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Abstract
One of four overarching goals of Healthy People 2020 (HP2020) is to achieve health equity, eliminate disparities, and improve the health of all groups. In health disparity indices (HDIs) such as the mean log deviation (MLD) and Theil index (TI), disparities are relative to the population average, whereas in the index of disparity (IDisp) the reference is the group with the least adverse health outcome. Although the latter may be preferable, identification of a reference group can be affected by statistical reliability. To address this issue, we propose a new HDI, the Rényi index (RI), which is reference-invariant. When standardized, the RI extends the Atkinson index, where a disparity aversion parameter can incorporate societal values associated with health equity. In addition, both the MLD and TI are limiting cases of the RI. Also, a symmetrized Rényi index (SRI) can be constructed, resulting in a symmetric measure in the two distributions whose relative entropy is being evaluated. We discuss alternative symmetric and reference-invariant HDIs derived from the generalized entropy (GE) class and the Bregman divergence, and argue that the SRI is more robust than its GE-based counterpart to small changes in the distribution of the adverse health outcome. We evaluate the design-based standard errors and bootstrapped sampling distributions for the SRI, and illustrate the proposed methodology using data from the National Health and Nutrition Examination Survey (NHANES) on the 2001-04 prevalence of moderate or severe periodontitis among adults aged 45-74, which tracks Oral Health objective OH-5 in HP2020. Such data, which uses a binary individual-level outcome variable, are typical of HP2020 data.
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