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Ghanbari Z, Moradi Y, Samiee N, Moradpour F. Dental caries prevalence in relation to the cardiovascular diseases: cross-sectional findings from the Iranian kurdish population. BMC Oral Health 2024; 24:509. [PMID: 38685018 PMCID: PMC11059578 DOI: 10.1186/s12903-024-04280-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/19/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE Oral and dental health (ODH) is a significant public health concern globally, affecting billions of people. This cross-sectional study aimed to examine the prevalence of dental caries using the DMFT index and investigate its relationship with cardiovascular diseases in the Iranian Kurdish population. METHODS A total of 3,996 individuals aged 35-70 years were included from the Dehgolan prospective cohort study (DehPCS). Clinical examinations were performed to assess decayed (DT), missing (MT) and filled (FT) teeth (DMFT index). Data on demographics, socioeconomic status, medical history, oral hygiene practices were also collected. Cardiovascular disease (CVD) history was self-reported via questionnaires assessing heart disease, heart attack and stroke. Logistic regression was used to assess associations between oral health indicators and self-reported CVD, adjusting for potential confounders. RESULTS The mean DMFT score was 18.18 ± 19, indicating a high oral disease burden. Specifically, 60.04% had DT, 37.82% had more than 16 MT, and 38.83% had FT. Only 13.21% reported flossing regularly and 43.17% brushed less than daily, showing suboptimal oral hygiene. The overall CVD prevalence was 9.21%. Individuals with high DMFT (≥ 14) scores had approximately two times higher CVD prevalence than those with low DMFT. DMFT decreased by 10.23% with increase in education level, and by 5.87% as economic status increased In adjusted analyses, high DMFT scores (OR = 1.5, 95%CI: 1.2-1.9) and MT (OR = 1.5, 95%CI: 1.1-2.1) were associated with 50-150% increased odds of CVD, though associations weakened after adjusting for age. Among men, DMFT remained a significant predictor for CVD after age adjustment, with an odds ratio of 2.37 (95% CI: 1.22-4.60). CONCLUSION This population had substantial oral disease and poor oral hygiene. Higher DMFT scores and MT positively correlated with increased CVD prevalence. Promoting preventive oral care and health education could help reduce dental issues and potentially lower CVD risk. Further research is needed to clarify biological mechanisms linking oral and systemic health.
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Affiliation(s)
- Zahra Ghanbari
- Department of oral and maxillofacial medicine, School of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Negin Samiee
- Department of oral and maxillofacial medicine, School of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health Development, University of Medical Sciences, Kurdistan, Sanandaj, Iran.
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2
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Shen M, Li Z, Li H, Yan X, Feng B, Xu L. Association of periodontitis and tooth loss with extent of coronary atherosclerosis in patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2023; 14:1243992. [PMID: 38075042 PMCID: PMC10702216 DOI: 10.3389/fendo.2023.1243992] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
Aim The objective was to investigate the association of periodontitis and tooth loss with extent of diabetic coronary atherosclerosis. Materials and methods 272 patients who were hospitalized at Shanghai East hospital and underwent a coronary artery calcium (CAC) CT scan were enrolled in this study. Individuals were grouped based on their CAC scores into a normal-to-mild coronary atherosclerosis (AS) group (0 ≤ score ≤ 100, n=184) and a moderate-to-severe group (score≥101, n=88). Periodontitis parameters and number of missing teeth were evaluated for every patient. The severity of periodontitis was categorized as mild, moderate, or severe. The taxonomic composition of the microbiota was determined using full-length 16S ribosomal RNA gene sequencing. Salivary inflammatory factors were tested by ELISA. Results Clinical attachment loss (CAL) (P =0.05) and the number of teeth lost (P = 0.016) were significantly higher in the moderate-to-severe coronary AS group, with these differences being more obvious in younger patients and patients with short-duration diabetes. Multivariate logistic regression analysis revealed that CAL (OR = 1.231, 95% CI = 1.066-1.214, P = 0.047) and having 10-19 missing teeth (OR = 1.604, 95% CI = 1.393-6.555, P = 0.05) were strongly associated with the presence of moderate-to-severe coronary AS. Salivary IL-6 and TNF-α levels, as well as levels of Porphyromonas gingivalis and Neisseria mucosa, were significantly elevated in the moderate-to-severe coronary AS group. Conclusion It was found that both tooth loss and CAL were related to the extent of diabetic coronary AS. Saliva inflammatory factors and oral bacteremia may be new biomarkers for moderate-to-severe coronary AS.
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Affiliation(s)
- Minhua Shen
- Department of Stomatology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhen Li
- Department of Stomatology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Huizhi Li
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xinfeng Yan
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bo Feng
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lei Xu
- Department of Endocrinology, East Hospital, Tongji University School of Medicine, Shanghai, China
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Shoaee S, Heydari M, Hessari H, Mehrdad N, Khalilazar L, Hatami B, Sharifi F. Development and initial validation of the Comprehensive Geriatric Oral Health Assessment Tool. Clin Exp Dent Res 2023; 9:879-886. [PMID: 37767734 PMCID: PMC10582220 DOI: 10.1002/cre2.791] [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: 11/11/2022] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVES Improving the oral health of the elderly is crucial to improving their general health and quality of life. To reach this goal, it is necessary to start with a comprehensive oral health assessment and a detailed treatment plan. The aim of this study was, therefore, to develop a comprehensive Oral Health Assessment Tool for the geriatric population. MATERIAL AND METHODS Following a panel of experts' consultation, a clinical form and a self-assessment questionnaire were developed, encompassing eight domains: dental caries, periodontal diseases, partial and complete edentulism, oral soft tissue lesions, occlusion, xerostomia, temporomandibular joints, and oral or oral prostheses hygiene. Subsequently, a pilot study was conducted to appraise the clinical form and questionnaire involving 84 residents of an Iranian nursing home. After securing ethics approval, both the qualitative and quantitative aspects of the self-assessment questions' validity and reliability were assessed, and specificity and sensitivity were calculated. RESULTS The mean age of the participants was 69.8 (±4.1) years, and 86% had less than 12 years of education. The questions regarding the number of remaining teeth and the number of decayed teeth had the highest sensitivity (97% and 88%), respectively. Questions regarding the presence of periodontitis and gingivitis had the highest specificity (both 100%). CONCLUSIONS A Comprehensive Geriatric Oral Health Assessment Tool has been developed and its validity and reliability evaluated in a pilot study. It should now be further evaluated in larger studies.
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Affiliation(s)
- Shervan Shoaee
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Research InstituteTehran University of Medical SciencesTehranIran
- Research Center for Caries Prevention, Dentistry Research InstituteTehran University of Medical SciencesTehranIran
| | - Mohammad‐Hossein Heydari
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Research InstituteTehran University of Medical SciencesTehranIran
- School of DentistryShahid Beheshti University of Medical SciencesTehranIran
| | - Hossein Hessari
- Research Center for Caries Prevention, Dentistry Research InstituteTehran University of Medical SciencesTehranIran
| | - Neda Mehrdad
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Laleh Khalilazar
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Bahareh Hatami
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
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De Rubeis V, Jiang Y, de Groh M, Dufour L, Bronsard A, Morrison H, Bassim CW. Barriers to oral care: a cross-sectional analysis of the Canadian longitudinal study on aging (CLSA). BMC Oral Health 2023; 23:294. [PMID: 37189101 PMCID: PMC10184348 DOI: 10.1186/s12903-023-02967-3] [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: 11/18/2022] [Accepted: 04/15/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Oral health plays a role in overall health, indicating the need to identify barriers to accessing oral care. The objective of this study was to identify barriers to accessing oral health care and examine the association between socioeconomic, psychosocial, and physical measures with access to oral health care among older Canadians. METHODS A cross-sectional study was conducted using data from the Canadian Longitudinal Study on Aging (CLSA) follow-up 1 survey to analyze dental insurance and last oral health care visit. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between socioeconomic, psychosocial, and physical measures with access to oral care, measured by dental insurance and last oral health visit. RESULTS Among the 44,011 adults included in the study, 40% reported not having dental insurance while 15% had not visited an oral health professional in the previous 12 months. Several factors were identified as barriers to accessing oral health care including, no dental insurance, low household income, rural residence, and having no natural teeth. People with an annual income of <$50,000 were four times more likely to not have dental insurance (adjusted OR: 4.09; 95% CI: 3.80-4.39) and three times more likely to report not visiting an oral health professional in the previous 12 months (adjusted OR: 3.07; 95% CI: 2.74-3.44) compared to those with annual income greater than $100,000. CONCLUSIONS Identifying barriers to oral health care is important when developing public health strategies to improve access, however, further research is needed to identify the mechanisms as to why these barriers exist.
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Affiliation(s)
- Vanessa De Rubeis
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, L8S 4L8, Canada
- Applied Research Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, K0A 0K9, Canada
| | - Ying Jiang
- Applied Research Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, K0A 0K9, Canada
| | - Margaret de Groh
- Applied Research Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, K0A 0K9, Canada
| | - Lisette Dufour
- Office of the Chief Dental Officer, Public Health Agency of Canada, Ottawa, ON, K0A 0K9, Canada
| | - Annie Bronsard
- Office of the Chief Dental Officer, Public Health Agency of Canada, Ottawa, ON, K0A 0K9, Canada
| | - Howard Morrison
- Applied Research Division, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, K0A 0K9, Canada
| | - Carol W Bassim
- Department of Medicine, McMaster University, Hamilton, ON, L8S 4L8, Canada.
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Larvin H, Kang J, Aggarwal VR, Pavitt S, Wu J. The additive effect of periodontitis with hypertension on risk of systemic disease and mortality. J Periodontol 2022; 93:1024-1035. [PMID: 35460076 PMCID: PMC9544472 DOI: 10.1002/jper.21-0621] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/24/2022] [Accepted: 04/10/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Recent evidence suggests that periodontitis (PD) causes hypertension, which is a precursor to development of other systemic diseases. The aim of this study was to examine the effect of hypertension and PD on the risk of subsequent systemic disease. METHODS This longitudinal cohort study included 244,393 UK Biobank participants who were free of systemic disease other than hypertension at baseline. Self-reported responses of painful gums or loose teeth were surrogates for PD. Hypertensives were identified by clinical diagnosis, or elevated blood pressure (≥140/90 mmHg). Systemic diseases including cancer, cardiovascular disease (CVD), and diabetes were identified from linked diagnostic codes. Multivariable Cox proportional hazard models were used to quantify the risk of systemic diseases and all-cause mortality, stratified by hypertensive and PD status. RESULTS The average age of the study population was 55.4 years (standard deviation [SD:] 8.1 years), and 130,220 (53.3%) participants were female. At baseline, 131,566 (53.8%) participants were hypertensive and 4.5% reported PD. The incidence rates of all systemic diseases were higher in hypertensive than non-hypertensive participants of the same PD status. In hypertensives, an additive effect was observed for PD on the risks of CVD (adjusted hazard ratio [HR]: 1.35, 95% confidence interval [CI]: 1.21-1.53) and respiratory disease (HR: 1.11, 95% CI: 0.95-1.30) compared to hypertensive healthy controls. CONCLUSIONS Hypertensives with PD have exacerbated risks of several systemic diseases. Future interventional studies should consider the effect of periodontal treatment on systemic outcomes in targeted hypertensive populations.
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Affiliation(s)
| | - Jing Kang
- Oral Biology, School of DentistryUniversity of LeedsLeedsUK
| | | | - Sue Pavitt
- School of DentistryUniversity of LeedsLeedsUK
| | - Jianhua Wu
- School of DentistryUniversity of LeedsLeedsUK
- Leeds Institute for Data AnalyticsUniversity of LeedsLeedsUK
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Atanda AJ, Livinski AA, London SD, Boroumand S, Weatherspoon D, Iafolla TJ, Dye BA. Tooth retention, health, and quality of life in older adults: a scoping review. BMC Oral Health 2022; 22:185. [PMID: 35585618 PMCID: PMC9118621 DOI: 10.1186/s12903-022-02210-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This scoping review describes the relationship between tooth retention, health, and quality of life in older adults. METHODS Seven databases were searched for English language articles for subjects ≥ 65 y from 1981 to 2021. Exposure was tooth retention (≥ 20), and outcomes were general/systemic health and quality of life. Methodological quality was assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias 2.0 tool. RESULTS 140 articles were included, only four were randomized trials. Inter-rater agreement (κ) regarding study inclusion was 0.924. Most were assessed with low risk of bias (n = 103) and of good quality (n = 96). Most studies were conducted in Japan (n = 60) and Europe (n = 51) and only nine in the US. Tooth retention was referred to as "functional dentition" in 132 studies and "shortened dental arch" in 19 studies. Study outcomes were broadly synthesized as (1) cognitive decline/functional dependence, (2) health status/chronic diseases, (3) nutrition, and (4) quality of life. DISCUSSION There is a positive relationship between tooth retention, overall health, and quality of life. Older adults retaining ≥ 20 teeth are less likely to experience poorer health. Having < 20 teeth increases the likelihood for functional dependence and onset of disability, and may affect successful ageing. This review supports the general finding that the more teeth older adults retain as they age, the less likely they are to have adverse health outcomes. However, significant knowledge gaps remain which can limit decision-making affecting successful ageing for many older adults. This review highlights the need to consider, as an important marker of oral health and function, the retention of a functional minimum of a natural dentition, rather than a simple numeric score of missing teeth.
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Affiliation(s)
- Adejare Jay Atanda
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA.
- National Library of Medicine, National Institutes of Health, Bethesda, MD, USA.
| | - Alicia A Livinski
- National Institutes of Health Library, Office of Research Services, OD, National Institutes of Health, Bethesda, MD, USA
| | - Steven D London
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA
- National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
- School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Shahdokht Boroumand
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA
| | | | - Timothy J Iafolla
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA
| | - Bruce A Dye
- National Institute of Dental and Craniofacial Research, National Institutes of Health, 31 Center Dr., Suite 5B55, Bethesda, MD, USA.
- School of Dental Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
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Kim HJ, Cho Y, Noh Y, Joo JY, Park HR. A decision tree to identify the combinations of non-communicable diseases that constitute the highest risk for dental caries experience: A hospital records-based study. PLoS One 2021; 16:e0257079. [PMID: 34614007 PMCID: PMC8494304 DOI: 10.1371/journal.pone.0257079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 08/23/2021] [Indexed: 11/18/2022] Open
Abstract
To investigate whether dental status, represented by the DMFT score, was affected by the presence of NCDs and determined the NCDs that had a greater impact on the DMFT score. This retrospective cross-sectional study included a total of 10,017 individuals. The presence of NCDs was investigated based on self-reported medical history recorded on each patient's dental hospital record. Individual DMFT score was evaluated on the basis of the dental records and panoramic radiographs. The data were further analyzed using multiple regression analysis and chi-squared automatic interaction detection (CHAID) analysis. A total of 5,388 individuals had more than one NCD among hypertension (HT), diabetes mellitus (DM), hyperlipidemia, cardiovascular disease (CVD), and osteoporosis. The average DMFT score was 8.62 ± 7.10 in the NCD group, significantly higher than that in those without NCD (5.53 ± 5.48) (P < 0.001). In the regression analysis, age, NCDs, and psychiatric problems were selected as risk factors of DMFT score. In the CHAID decision tree analysis, age was the risk factor that most influenced the DMFT score. HT was the most influential factor in a newly generated decision tree excluding age, and osteoporosis, DM, and CVD were important risk factors acting in the subgroups. Patients with NCD had worse dental conditions than those who did not, and some combinations of NCDs related highest risk for a dental caries-related index. In clinical practice, dentists should provide meticulous care for dental caries in elderly patients with NCDs, especially when certain diseases, such as HT, osteoporosis, DM, and CVD, are present together.
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Affiliation(s)
- Hyun-Joo Kim
- Department of Periodontology, Dental and Life Science Institute, Pusan National University, School of Dentistry, Yangsan, Republic of Korea
- Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea
- Periodontal Disease Signaling Network Research Center, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Youngseuk Cho
- Department of Statistics, Pusan National University, Busan, Republic of Korea
| | - Yunhwan Noh
- Department of Statistics, Pusan National University, Busan, Republic of Korea
| | - Ji-Young Joo
- Department of Periodontology, Dental and Life Science Institute, Pusan National University, School of Dentistry, Yangsan, Republic of Korea
- Department of Periodontology and Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Republic of Korea
- Periodontal Disease Signaling Network Research Center, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Hae Ryoun Park
- Periodontal Disease Signaling Network Research Center, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
- Department of Oral Pathology, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
- * E-mail:
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Larvin H, Kang J, Aggarwal VR, Pavitt S, Wu J. Multimorbid disease trajectories for people with periodontitis. J Clin Periodontol 2021; 48:1587-1596. [PMID: 34409647 DOI: 10.1111/jcpe.13536] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/28/2021] [Accepted: 08/10/2021] [Indexed: 11/29/2022]
Abstract
AIM Periodontitis is a multifactorial condition linked to increased risk of systemic diseases. This study aimed to identify disease trajectories of people with periodontitis using the process mining technique as a heuristic approach. MATERIALS AND METHODS A total of 188,863 participants from the UK Biobank cohort were included. Self-reported oral health indicators (bleeding gums, painful gums, loose teeth) were surrogates for periodontitis at baseline. Systemic disease diagnoses and dates formed the process mining event log. Relative risk (RR) of systemic diseases, disease trajectories, and Cox proportional hazard ratio models for mortality were compared to age- and sex-matched controls who did not report a history of periodontitis. RESULTS Participants with loose teeth had shorter median time to most systemic diseases, and crude RR was increased for several diseases including cardiovascular disease (crude RR: 1.15, 95% CI: 1.03-1.28), hypertension (crude RR: 1.14, 95% CI: 1.05-1.24), and depression (crude RR: 1.33, 95% CI: 1.09-1.61). Participants with loose teeth had increased RR for 20 disease trajectories, though these were not significant after adjustments. Participants with bleeding/painful gums had similar disease trajectories as those of matched controls. CONCLUSIONS Self-reported periodontitis may be associated with early and frequent multimorbidity development, though further evidence is required to confirm this hypothesis. People with periodontitis should be informed of the risks of disease progression and be targeted in prevention initiatives.
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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
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Poli O, Manzon L, Niglio T, Ettorre E, Vozza I. Masticatory Force in Relation with Age in Subjects with Full Permanent Dentition: A Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9060700. [PMID: 34207805 PMCID: PMC8228061 DOI: 10.3390/healthcare9060700] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 01/16/2023] Open
Abstract
Masticatory performance is directly correlated with masticatory muscle work to grind and cut the food. Chewing efficacy is decisive to eating a variety of foods needed maintain general health status at all ages. Older people have oral problems that get worse with age. Elders have more pathologies such as periodontal diseases, caries, tooth loss and inadequate dental prostheses than younger subjects. Objectives: to investigate the correlation between masticatory bite force (MBF) and body mass index (BMI) vs. aging and sex. Methods: This study was performed on 426 subjects (213 females plus 213 male) assigned into five different groups by age. Group “A” aged from 20 to 35 years; group “B” aged 45–59 years; group “C” aged 60–69 years; group “D” aged 70–79 years; and group “E” aged more than 79 years. Results: There were not statistically significant differences in right-side MBF versus left-side MBF. The differences between sex were statistically significant with a stronger bite in males than females (p < 0.05). At the same time, younger subjects had a stronger bite than elders (p < 0.05). In group “E”, more corpulent subjects (BMI > 25) had an MBF higher than less corpulent subjects (BMI < 25, p < 0.05). The analysis of mean MBF showed a statistically significant difference within all groups stratified by BMI with mean values inversely proportional with age (p < 0.001). Conclusion: The results in our study confirm data from many scientific papers. The importance of the present paper was to correlate data between and within a large sample with a wide range of ages. Our sample subjects had a 31%–33% decrease in MBF from group “A” to group “E” group, but they all had full permanent dentation and they preserved a valid MBF.
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Affiliation(s)
- Ottavia Poli
- Dental School, “Sapienza” University, 00185 Rome, Italy; (O.P.); (L.M.)
| | - Licia Manzon
- Dental School, “Sapienza” University, 00185 Rome, Italy; (O.P.); (L.M.)
| | | | - Evaristo Ettorre
- Department of Cardiovascular, Respiratory, Nephrological, Anesthetic and Geriatric Sciences, “Sapienza” University, 00185 Rome, Italy;
| | - Iole Vozza
- Dental School, “Sapienza” University, 00185 Rome, Italy; (O.P.); (L.M.)
- Correspondence:
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Bianco A, Mazzea S, Fortunato L, Giudice A, Papadopoli R, Nobile CGA, Pavia M. Oral Health Status and the Impact on Oral Health-Related Quality of Life among the Institutionalized Elderly Population: A Cross-Sectional Study in an Area of Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042175. [PMID: 33672197 PMCID: PMC7926719 DOI: 10.3390/ijerph18042175] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 12/20/2022]
Abstract
Background: The objectives of this study were to describe the oral health status in the institutionalized geriatric population in an area of southern Italy and to identify the impact of oral health on the Oral Health Related Quality of Life (OHRQoL). Methods: Data were collected from individuals aged ≥60 years in randomly selected Calabrian long-term care facilities. The dental health status was assessed recording the decayed, missing, or filled dental elements due to the carious lesions (DMFT) index, the presence of visible dental plaque, and the gingival condition. The influence of the dental health status on the self-perceived value of life was assessed using the Geriatric Oral Health Assessment Index (GOHAI). Results: Among the 344 elderly individuals included, 18.4% reported frequent tooth-brushing, and only 39.9% reported the need of dental care. The DMFT index was 26.4. Less than a third of the participants had a GOHAI score of ≤50 which is suggestive of highly compromised OHRQoL. The GOHAI score was significantly better for elderly individuals with no self-perceived need of dental care and with a lower DMFT index. Conclusions: The burden of oral conditions among residents in long-term care facilities was considerable, with a high prevalence of missing teeth and dentures. Strategies targeting care providers are needed.
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Affiliation(s)
- Aida Bianco
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (A.B.); (S.M.); (R.P.)
| | - Silvia Mazzea
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (A.B.); (S.M.); (R.P.)
| | - Leonzio Fortunato
- Department of Health Sciences, School of Dentistry, University of Catanzaro “Magna Græcia”, Via T. Campanella, 88100 Catanzaro, Italy; (L.F.); (A.G.)
| | - Amerigo Giudice
- Department of Health Sciences, School of Dentistry, University of Catanzaro “Magna Græcia”, Via T. Campanella, 88100 Catanzaro, Italy; (L.F.); (A.G.)
| | - Rosa Papadopoli
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (A.B.); (S.M.); (R.P.)
| | | | - Maria Pavia
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Viale Europa, 88100 Catanzaro, Italy; (A.B.); (S.M.); (R.P.)
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Via L. Armanni, 5, 80138 Naples, Italy
- Correspondence: ; Tel./Fax: +39-81-5667716
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11
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Manzon L, Vozza I, Poli O. Bite Force in Elderly with Full Natural Dentition and Different Rehabilitation Prosthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041424. [PMID: 33546493 PMCID: PMC7913710 DOI: 10.3390/ijerph18041424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 01/05/2023]
Abstract
(1) Background: This study aimed to investigate maximum bite force (MBF) in elderly patients with natural full dentition (FD), patients rehabilitated with Traditional Complete Dentures (CD), with overdentures (IRO) and edentulous patients (ED). We also tested whether MBF changes are associated with gender, age of the patients and body mass index (BMI) as result of altered food; (2) Methods: Three hundred and sixty-eight geriatric patients were included. We studied two types of prostheses: (a) IRO with telescopic attachments. (b) CD (heat polymerized polymethyl methacrylate resin). The MBF was measured using a digital dynamometer with a bite fork; (3) Results: We found that MBF is higher in males than females, regardless of teeth presence or absence (p < 0.01). In patients with CD or IRO, there are no differences between males and females; prostheses improve MBF compared to edentulous patients (p < 0.0001) and this effect is greater with IRO prostheses (p < 0.0001); the chewing force of FD subjects remains greater (p < 0.0001); there are no differences among chewing strength based on different BMI categories, although FD subjects have a reduced incidence of obesity; there is a significant negative correlation between MBF and age (p = 0.038; R = 0.145), and no correlation between MBF and BMI; (4) Conclusions: This study showed that MBF improves more in patients using IRO prostheses, although not reaching the MBF of FD subjects. MBF does not correlate with BMI, although we found increased percentages of obesity in edentulous subjects or those with prostheses. Thus, old people wearing prostheses require special attention by a nutritionist to avoid risk of malnutrition.
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Affiliation(s)
- Licia Manzon
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, 00161 Rome, Italy; (L.M.); (O.P.)
| | - Iole Vozza
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
- Correspondence: ; Tel.: +39-0649976612 or +39-0649976649
| | - Ottavia Poli
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza University of Rome, 00161 Rome, Italy; (L.M.); (O.P.)
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12
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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 2021; 7:109-122. [PMID: 33124761 PMCID: PMC7853902 DOI: 10.1002/cre2.336] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [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.
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Affiliation(s)
| | - Jing Kang
- Oral Biology, School of DentistryUniversity of LeedsLeedsUK
| | | | - Sue Pavitt
- School of DentistryUniversity of LeedsLeedsUK
| | - Jianhua Wu
- School of DentistryUniversity of LeedsLeedsUK
- Leeds Institute for Data AnalyticsUniversity of LeedsLeedsUK
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13
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Poor oral hygiene and dental caries predict high mortality rate in hemodialysis: a 3-year cohort study. Sci Rep 2020; 10:21872. [PMID: 33318507 PMCID: PMC7736314 DOI: 10.1038/s41598-020-78724-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/30/2020] [Indexed: 12/20/2022] Open
Abstract
The aim of this study was to investigate the impact of oral hygiene, periodontal diseases, and dental caries on all-cause mortality in hemodialysis. This prospective cohort study included 266 patients with end-stage renal disease who were undergoing hemodialysis. Medical interviews, blood biochemical tests, and comprehensive dental examinations including periodontal pocket examination on all teeth and dental plaque accumulation by debris index-simplified (DI-S), were performed. Survival rates were assessed at a 3-year follow-up. Overall, 207 patients were included in the longitudinal analysis, and 38 subjects died during the follow-up period. Cox proportional hazards analysis of the multivariate model demonstrated that the highest tertile of DI-S had a significantly higher risk of all-cause mortality than the lowest two tertiles after adjustment for age, sex, smoking habit, body mass index, diabetes, prior cardiovascular disease, hemodialysis vintage, high sensitivity C-reactive protein, albumin, and number of remaining teeth (hazard ratio, 3.04; 95% confidence interval, 1.50–6.17; p = 0.002). Moreover, the number of decayed teeth significantly increased the hazard ratio to 1.21 (95% confidence interval, 1.06.1.37; p = 0.003). This study suggests that accumulated dental plaque and untreated decay, but not periodontal disease, may be independently associated with all-cause mortality in patients undergoing hemodialysis.
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14
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Noetzel N, Meyer AM, Siri G, Pickert L, Heeß A, Verleysdonk J, Benzing T, Pilotto A, Barbe AG, Polidori MC. The impact of oral health on prognosis of older multimorbid inpatients: the 6-month follow up MPI oral health study (MPIOH). Eur Geriatr Med 2020; 12:263-273. [PMID: 33206351 DOI: 10.1007/s41999-020-00427-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/30/2020] [Indexed: 01/11/2023]
Abstract
PURPOSE There is clear evidence for an association between oral health and systemic illnesses, geriatric syndromes, and mortality. Frail and multimorbid older people often suffer from insufficient oral health care, but standardized dental examinations are not routinely performed in clinical settings. The aim of this study was to verify the practicability of in-hospital oral health examinations and to identify their association with patients' prognosis as assessed by means of the Comprehensive Geriatric Assessment (CGA)-based Multidimensional Prognostic Index (MPI). METHODS One hundred hospitalized patients aged 65 years and older (mean age 76.9 years (SD 6.4); 58.2% male, 41.8% female) underwent a CGA-based MPI calculation at discharge with subdivision into three mortality risk groups (MPI-1, low risk, score 0-0.33; MPI-2, moderate risk, score 0.34-0.66; MPI-3, high risk, score 0.67-1). To identify the current oral health status and the Oral Health-related Quality of Life (OHRQoL), three oral health examinations were performed. Information on survival, the incidence of oral diseases, dental appointments, and treatments up to 6 months after discharge were collected. RESULTS All oral health examinations were feasible during hospitalization and were associated with MPI prognosis, even though they were not associated with 6-month mortality. The MPI could not predict the use of dental health care or treatment, as, irrespective of MPI and oral health examinations, dental services were underutilized during follow up. CONCLUSION Besides MPI evaluation, oral health examinations should be implemented into an inhospital course to improve clinical decision-making as well as secondary and tertiary prevention of oral health- and related systemic diseases. TRIAL REGISTRATION NUMBER German Clinical Trials Register: DRKS00013607 (07.02.2019, retrospectively registered).
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Affiliation(s)
- Nicolas Noetzel
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
| | - Anna Maria Meyer
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Giacomo Siri
- Scientific Directorate-Biostatistics, E.O. Galliera Hospital, Genova, Italy
| | - Lena Pickert
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Annika Heeß
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Joshua Verleysdonk
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Thomas Benzing
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Cologne Excellence Cluster On Cellular Stress-Responses in Aging-Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Frailty Area, E.O. Galliera Hospital, Genova, Italy.,Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Anna Greta Barbe
- Department of Operative Dentistry and Periodontology, Centre of Dental Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Maria Cristina Polidori
- Ageing Clinical Research, Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.,Cologne Excellence Cluster On Cellular Stress-Responses in Aging-Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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15
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Oral health status as predictor of 1-year mortality after discharge from an acute geriatric unit. Eur Geriatr Med 2019; 10:889-897. [DOI: 10.1007/s41999-019-00248-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 09/26/2019] [Indexed: 10/25/2022]
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