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Chaffee BW. Self-perceived quality of social roles, activities and relationships predicts incident gingivitis. Community Dent Oral Epidemiol 2024; 52:716-722. [PMID: 38654403 DOI: 10.1111/cdoe.12966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/21/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES While physical health status is known to impact social functioning, a growing literature suggests that social well-being may affect oral health. This investigation evaluated whether self-perceived quality of social roles, activities and relationships (social well-being) influences gingival inflammation. METHODS Data were from the Population Assessment of Tobacco and Health Study, a nationally representative cohort of US adults, biennial waves 4 (2017) to 6 (2021). Social well-being was derived from the validated PROMIS Global-10 survey instrument, categorized for this longitudinal analysis as high, moderate or low. The main outcome was incident self-reported gum bleeding (dichotomous, proxy for gingivitis). Survey-weighted logistic regression modelling adjusted for overall health status, sociodemographic (e.g. age, sex, race/ethnicity), socioeconomic (e.g. income, education) and behavioural (e.g. tobacco, alcohol) confounders and was used to predict marginal mean gum bleeding incidence. RESULTS Cross-sectionally at wave 4 (N = 23 679), gum bleeding prevalence was higher along a stepwise gradient of decreasing satisfaction with social activities and relationships (extremely satisfied: 20.4%; not at all: 40.1%). Longitudinally, among participants who had never reported gum bleeding through wave 4 (N = 9695), marginal predicted new gum bleeding at wave 6 was greater with each category of lower wave 4-5 social well-being (high: 7.6%; moderate: 8.6%; low: 12.4%). Findings were robust to alternative model specifications. Results should be interpreted considering study limitations (e.g. potential unmeasured confounding; outcome by self-report). CONCLUSIONS Social functioning may affect physical health. Specifically, social roles, activities and relationships may influence inflammatory oral conditions, like gingivitis. Confirmatory research is warranted, along with policies and interventions that promote social well-being.
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Affiliation(s)
- Benjamin W Chaffee
- University of California San Francisco School of Dentistry, San Francisco, California, USA
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Nascimento GG, Machado FW, Cascaes AM, Silva AE, Boscato N, Demarco FF. Validity of self-reported oral conditions among Brazilian older women: Do socio-economic factors matter? Int J Dent Hyg 2024; 22:521-529. [PMID: 37183553 DOI: 10.1111/idh.12680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/06/2023] [Accepted: 04/02/2023] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To validate the level of agreement between self-report and clinical examination for oral conditions and evaluate the effect of sociodemographic conditions on the validity of self-report among women aged 60 and older. METHODS A cross-sectional study was conducted in a social community center for seniors in Southern Brazil. Sociodemographic data (age, level of education, and income) were measured. Participants were interviewed and clinically examined for the number of teeth (DMF-T index) and the use of dental prostheses. The self-reported number of teeth in each arch and the use of dental prostheses were gathered through interviews. The level of agreement was estimated using the observed agreement, Kappa statistics, sensitivity/specificity (edentulism/prostheses) and Lin's concordance correlation coefficient, and related tests (number of teeth). The validity of the oral conditions was estimated according to sociodemographic information. RESULTS Ninety-nine women participated in the study. High levels of agreement were observed for edentulism (97.8%; 95%CI 92.8;99.7; Kappa 0.947) and the use of dental prostheses (97.0%; 95%CI 91.3;99.4; Kappa 0.922). In both conditions, despite achieving similar concordance correlation coefficients (ranging from weak to moderate), the mean number of upper teeth was lower in clinical examination (7.1 ± 5.2) compared with self-reported (8.6 ± 3.6), while the opposite was observed for lower teeth (clinical examination: 9.1 ± 3.4; self-reported: 6.6 ± 5.3). Larger differences were found among women of low income and educational levels. CONCLUSIONS Our findings suggest that the participants' socio-economic position might influence their self-reported number of teeth.
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Affiliation(s)
- Gustavo G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore City, Singapore
- Oral Health ACP, Duke-NUS Medical School, Singapore City, Singapore
| | - Fernanda W Machado
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Andréia M Cascaes
- Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Alexandre E Silva
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Noéli Boscato
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Flávio F Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
- Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Qi X, Zhu Z, Wang K, Zheng Y, Li A, Wu B. Association of Gum Treatment with Cognitive Decline and Dementia Risk among Older Adults with Periodontal Symptoms: A 12-Year Prospective Cohort Study. Neuroepidemiology 2024:1-10. [PMID: 39053434 DOI: 10.1159/000540086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/24/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION This study examines the associations of gum treatment with cognitive decline and dementia risk among older adults with periodontal symptoms in the USA. METHODS A cohort of 866 adults aged ≥50 with periodontal symptoms was recruited for the 2008 Health and Retirement Study "Dental Health Experimental Module" and followed until 2020. Cognitive function was assessed with the Telephone Interview for Cognitive Status (TICS). Dementia status was ascertained with the Langa-Weir algorithm based on TICS scores and proxy assessments. Linear mixed-effects model and multivariable Cox regression models were utilized to analyze the associations of gum treatment with cognitive decline and the risk of dementia, respectively. RESULTS Of 866 participants (mean age 67.7, 61.4% women), 105 (12.1%) developed dementia with a median follow-up of 9 (IQR, 6-10) years. The dementia incidence rates were lower in the group with gum treatment (7.4 vs. 12.9 per 1,000 person-years). Compared with participants who did not have gum treatment, those with gum treatment experienced a decline in TICS score that was on average 0.025 (95% CI, 0.005-0.044) points less per year and a 38% lower incidence of dementia (hazard ratio, 0.62; 95% CI, 0.41-0.93). These associations were consistent across participants with a different severity of periodontal symptoms and sociodemographic characteristics (age, sex, race, ethnicity, and education) except for income levels. CONCLUSION Prompt gum treatment for older adults with periodontal symptoms may be beneficial for their cognitive health.
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Affiliation(s)
- Xiang Qi
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Zheng Zhu
- Rory Meyers College of Nursing, New York University, New York, New York, USA
- School of Nursing, Fudan University, Shanghai, China
| | - Katherine Wang
- Trinity College of Arts and Sciences, Duke University, Durham, North Carolina, USA
| | - Yaguang Zheng
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - An Li
- Department of Periodontology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, New York, USA
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Buck D, Seong J, Daud A, Davies M, Newcombe R, West NX. A randomised controlled trial to evaluate the effectiveness of personalised oral hygiene advice delivered via video technology. J Dent 2024; 149:105243. [PMID: 39019247 DOI: 10.1016/j.jdent.2024.105243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024] Open
Abstract
OBJECTIVES To determine whether video-technology oral hygiene advice (OHA) improved clinical plaque and bleeding on probing (BOP) scores in individuals diagnosed with gingivitis, compared to conventional OHA after 3-months. METHODS This parallel, randomised 2-arm treatment, single-centre study, assessed Turesky Plaque Index (TPI) and BOP at baseline and 3-months in adult participants with mild-moderate gingivitis. Eligible participants with smartphones were randomised at baseline to intervention (tailored video OHA), or control (conventional OHA). Oral hygiene (OH) habits/attitudes were recorded with a questionnaire. All participants used a manual toothbrush with anti-gingivitis toothpaste twice daily. RESULTS 57 participants completed the study. Both groups had improved gingival health (BOP) after 3-months, change from baseline being significantly greater in the intervention group (12.21% vs 6.80 %, p < 0.05). TPI scores decreased more in the intervention than control group, but the difference did not reach significance (1.15 vs 0.92, p = 0.079). OH habits and attitudes were similar at baseline and few differences between the groups were observed after 3-months, however frequency of interdental brush use was significantly increased, while self-rated oral health was significantly decreased in the intervention as compared to control group at this timepoint (p < 0.05). CONCLUSIONS The combination of an individually tailored instructional video with appropriate toothbrushing using anti-gingivitis toothpaste and interdental brush, significantly improved participants' gingival health over 3-months compared to brushing with an anti-gingivitis toothpaste with conventional OHA as delivered in the general dental services. This study demonstrates the benefit of changing OH behaviour and delivering OHA using an individually tailored approach with contemporary methodology. CLINICAL SIGNIFICANCE OHA is usually verbally delivered over short time periods. This study demonstrates video technology with individualised OHA improves OH adherence and empowers individuals, the recipient receiving personal visual cues with ability to replay advice and technique reiteration. This real-world technology could be better utilised in general dental practice.
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Affiliation(s)
- Derele Buck
- Clinical Trials Group, Periodontology, Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol BS1 2LY, United Kingdom.
| | - Joon Seong
- Clinical Trials Group, Periodontology, Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol BS1 2LY, United Kingdom.
| | - Alaa Daud
- Clinical Trials Group, Periodontology, Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol BS1 2LY, United Kingdom.
| | - Maria Davies
- Clinical Trials Group, Periodontology, Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol BS1 2LY, United Kingdom.
| | | | - Nicola X West
- Clinical Trials Group, Periodontology, Bristol Dental School, University of Bristol, Lower Maudlin Street, Bristol BS1 2LY, United Kingdom.
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He T, Grender J, Farrell S, Biesbrock AR. Relationship between 1-, 3-, and 6-Month Gingival Bleeding Outcomes. JDR Clin Trans Res 2024; 9:286-293. [PMID: 37919970 DOI: 10.1177/23800844231206387] [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] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION Results from systematic reviews and meta-analyses show generally consistent antigingivitis effects between 3- and 6-mo observation time points with twice-daily use of stannous fluoride (SnF2) dentifrice. However, the relationship between 1-, 3-, and 6-mo gingivitis responses has not been investigated. METHODS This pooled analysis was conducted to understand the relationship of 1-, 3-, and 6-mo gingival bleeding outcomes. Number of bleeding sites, derived from Löe-Silness Gingival Index (LSGI) or Gingival Bleeding Index, was identified as the primary end point of the analysis for the biological and clinical relevance. Randomized, double-blinded, controlled clinical studies meeting the following predefined selection criteria were identified: 1) published and unpublished gingivitis clinical trials conducted from 1995 to 2022 comparing efficacy of 0.454% SnF2 dentifrices to negative controls (sodium fluoride or sodium monofluorophosphate dentifrice) and 2) studies with a 3-mo assessment and at least a 1- or 6-mo assessment. RESULTS The search resulted in ten 6-mo and fourteen 3-mo studies meeting selection criteria. A mixed-effects model was performed on the pooled data to assess gingival bleeding outcomes across time. The bleeding efficacy significantly increased between months 1 and 3 (P < 0.0001) and plateaued between months 3 and 6 (P = 0.007), supporting the fact that bleeding reduction relative to control established by 1 mo will increase and be maintained through 3 and 6 mo (R2 = 0.857). In addition, gingival bleeding and gingivitis efficacy, as measured by LSGI, were found to be highly correlated (R2 = 0.874). CONCLUSION A clear relationship has been demonstrated between 1-, 3-, and 6-mo gingival bleeding outcomes in gingivitis clinical studies comparing SnF2 dentifrice to negative control dentifrice. These findings have important implications to the dental practice and scientific research as antigingivitis efficacy evaluations can be observed as early as 1 mo and are consistent with those seen at 3 or 6 mo. KNOWLEDGE TRANSFER STATEMENT Outcomes from this investigation indicate that the clinical evaluation of antigingivitis efficacy at 1 mo is predictive of that at 3 and 6 mo, supporting studies of 1-mo duration as a viable method of knowledge acquisition. This more efficient, expedited research design has positive implications for patient care, clinical practice guidelines, protocols, and policies.
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Affiliation(s)
- T He
- The Procter & Gamble Company, Mason, OH, USA
| | - J Grender
- The Procter & Gamble Company, Mason, OH, USA
| | - S Farrell
- The Procter & Gamble Company, Mason, OH, USA
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Doughan M, Chehab O, Doughan B, Lima JAC, Michos ED. Association of endogenous sex hormone levels with tooth loss due to periodontitis in men and post-menopausal women: The multi-ethnic study of atherosclerosis. J Periodontal Res 2024. [PMID: 38895935 DOI: 10.1111/jre.13312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 05/25/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024]
Abstract
AIM To investigate the association between endogenous sex hormone levels and history of tooth loss related to periodontitis in healthy middle-aged to older men and post-menopausal women. METHODS This cross-sectional study included 5649 participants aged 45-84 (mean age, 63 ± 10 years) from the Multi-Ethnic Study of Atherosclerosis cohort who had sex hormone levels measured and answered a questionnaire regarding perceived periodontal status at exam 1. Multivariable logistic regression was used to examine the association of sex hormones (exposure) with history of tooth loss (outcome), stratified by sex. RESULTS Among post-menopausal women, higher free testosterone (per 1SD) was associated with a greater prevalence of tooth loss [OR 1.49 (95% CI, 1.08-2.05)], whereas higher sex hormone binding globulin (SHBG) was associated with a lower prevalence of tooth loss [OR 0.74 (0.58-0.94)], after adjustment for cardiometabolic risk factors and reproductive factors. In men, higher free testosterone and lower SHBG were associated with a lower prevalent probability of tooth loss in unadjusted analysis, but these associations lost significance after covariate adjustment. CONCLUSION A higher androgenic sex hormone profile in post-menopausal women (i.e., increased free testosterone, lower SHBG) was associated with an increased prevalence of tooth loss, after adjusting cardiometabolic risk factors. No such association was found in men. These findings suggest that sex hormones may influence or serve as a marker for periodontal health.
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Grants
- R01 HL074406 NHLBI NIH HHS
- R01 HL074338 NHLBI NIH HHS
- 946222 American Heart Association
- HHSN268201500003I NHLBI NIH HHS
- N01-HC-95159 National Heart, Lung and Blood Institute
- N01-HC-95160 National Heart, Lung and Blood Institute
- N01-HC-95161 National Heart, Lung and Blood Institute
- N01-HC-95162 National Heart, Lung and Blood Institute
- N01-HC-95163 National Heart, Lung and Blood Institute
- N01-HC-95164 National Heart, Lung and Blood Institute
- N01-HC-95165 National Heart, Lung and Blood Institute
- N01-HC-95166 National Heart, Lung and Blood Institute
- N01-HC-95167 National Heart, Lung and Blood Institute
- N01-HC-95168 National Heart, Lung and Blood Institute
- N01-HC-95169 National Heart, Lung and Blood Institute
- Johns Hopkins University: Amato Fund in Women's Cardiovascular Health Research
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Affiliation(s)
- Maria Doughan
- School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Omar Chehab
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bassel Doughan
- Faculty of Dental Surgery, Côte d'Azur University, Nice, France
| | - Joao A C Lima
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Wen X, Li H, Li S, Chang B, Chen S, Li H, Liu C, Li G. Associated factors of periodontitis and predicted study among young man in China: a population-based cross-sectional study. BMC Public Health 2024; 24:1235. [PMID: 38704531 PMCID: PMC11070096 DOI: 10.1186/s12889-024-18732-2] [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: 01/09/2024] [Accepted: 04/29/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Periodontitis represents the foremost oral condition in young men, strongly correlated with socioeconomic elements and oral health behaviors. This research aimed to assess the prevalence of periodontitis and associated associations with socio-demographics and oral health practices for subsequent Hazard Ratio (HR) estimation. METHODS A total of 46,476 young men were recruited to the study between August 2022 and October 2023. A questionnaire on socio-demographic factors and oral health-related behaviors related to periodontitis was completed. The standard procedure was used for oral examination. Logistic regression and hazard ratios were used to estimate the influencing factors, whereas the nomogram was used to predict the risk of periodontitis in young men. RESULTS A total of 46,476 young men were surveyed and completed the questionnaire. The overall prevalence of periodontitis among young men was 1.74%. Out of these, 1.7% had mild periodontitis and 0.6% had moderate periodontitis. Age and dental calculus were important factors in the periodontal health of young men. This nomogram, which includes 7 easily obtainable clinical characteristics routinely collected during periodontitis risk assessment, provides clinicians with a user-friendly tool to assess the risk of periodontal disease in young men. CONCLUSIONS Regular dental prophylaxis is crucial for young men to maintain their gingival health and prevent the onset of periodontitis. Dental calculus plays a prominent role in this matter, as it serves as a significant contributing factor.
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Affiliation(s)
- Xiaohui Wen
- Department of Epidemiology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Hui Li
- School of Public Health, Southwest Medical University, Luzhou, 646000, China
| | - Shiting Li
- Department of Oral Implantology, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, 646000, China
- Institute of Stomatology, Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Southwest Medical University, Luzhou, 646000, China
| | - Bei Chang
- Department of Stomatology, The PLA Rocket Force Characteristic Medical Center, Beijing, 100000, China
| | - Shichao Chen
- Department of Oral Implantology, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, 646000, China
- Institute of Stomatology, Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Southwest Medical University, Luzhou, 646000, China
| | - Hongcai Li
- Department of Stomatology, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Caixia Liu
- Xichang People's Hospital, Xichang, 615000, China
| | - Guangwen Li
- Department of Oral Implantology, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, 646000, China.
- Institute of Stomatology, Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Southwest Medical University, Luzhou, 646000, China.
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China.
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Tankova HI, Lazarova ZB, Mitova NG. Dynamics of Gingival Indices and Microbiological Findings During Treatment of Plaque-Induced Gingivitis in Children Aged 10-14 Years. Niger J Clin Pract 2024; 27:361-367. [PMID: 38528357 DOI: 10.4103/njcp.njcp_757_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/07/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND The study analyzed the dynamics of the clinical periodontal status during the treatment of adolescents with generalized plaque-induced gingivitis. AIM Assessment of the predominant subgingival microflora in the case of a diagnosed inflammatory process in the gingiva in childhood. METHODS Full-mouth periodontal assessment of plaque accumulation and bleeding on probing with an electronic periodontal probe was performed during the treatment of 34 adolescents with generalized plaque-induced gingivitis. The treatment protocol includes five visits (1, 3, 7, 14, and 30 days). Subgingival biofilm sampling was performed by real-time PCR testing to identify, follow-up in dynamics, and determine the quantities of main subgingival periodontopathogens during treatment. Three samples per child were taken from five teeth with the most severe inflammation. RESULTS For children aged 10-14 years with generalized plaque-induced gingivitis, two weeks after the start of treatment, the index values for bleeding on probing decreased twice from 53 to 27%. C. gingivalis was isolated before the start of treatment in all children, followed by P. intermedia, P. micros (70,4%) and T. denticola, T. forsythia (52,9%). Representatives of the red complex according to Socransky showing greater resistance to the therapy performed in terms of frequency and amount. CONCLUSION The predominant subgingival microflora in adolescents with generalized plaque-induced gingivitis is representative of the orange and red Socransky complex, with index values decreasing smoothly at each subsequent visit during treatment.
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Affiliation(s)
- H I Tankova
- Department of Pediatric Dental Medicine, Faculty of Dental Medicine, Medical University, Sofia, Bulgaria
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Aguiar FJN, Menezes FDS, Fagundes MDA, Fernandes GA, Alves FDA, Filho JG, Curado MP. Gastric adenocarcinoma and periodontal disease: A systematic review and meta-analysis. Clinics (Sao Paulo) 2024; 79:100321. [PMID: 38301538 PMCID: PMC10847461 DOI: 10.1016/j.clinsp.2023.100321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/15/2023] [Accepted: 12/11/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND The oral cavity is a link between of external environment with gastrointestinal tract. Studies are controversial on the presence of Periodontal Disease (PD) and its association with Gastric Adenocarcinoma (GAC). METHODS The authors performed a systematic review and meta-analysis to verify the association between PD and GAC. Six electronic databases were evaluated between 1961 and 2022. Titles and abstracts were reviewed independently according to the eligibility criteria, assessing full texts of selected studies. The quality of the included research was verified using the Newcastle-Ottawa Scale for case-control and cohort studies. Statistical analyses were performed based on fixed and/or random effects models to calculate the summarized Relative Risk (RR) and its 95 % Confidence Interval (95 % CI). RESULTS There were 639 studies, of which nine articles were included (3 case-controls and 6 cohorts). Overall, the authors identified 1,253 cases of GAC 2,501 controls in case-control studies, and 1,631 patients with GAC enrolled in cohort studies. Patients presenting PD increased the risk of developing GAC by 17 % (RR=1.17; 95 % CI 1.03‒1.32), which remained regardless of the diagnostic method for PD, i.e., clinical examination (RR = 1.19; 95 % CI 1.14‒1.24) and self-report (RR = 1.34; 95 % CI 1.06‒1.69). Moreover, Asian patients (RR=1.17; 95 % CI 1.00‒1.36) with PD had a higher risk of having GAC than American and European patients (RR = 1.18; 95 % CI 0.84‒1.66). CONCLUSIONS The presence of PD the risk of GAC suggesting that its infectious-inflammatory process of PD may be related to GAC development. Further investigations on the oral-gastric microbiota and its role in the carcinogenesis of gastric cancer should be carried out, and the screening of patients with potential risk for GAC should be considered in the clinical practice of dentists.
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Affiliation(s)
| | | | | | | | - Fabio de Abreu Alves
- Head of Service, Oral Medicine Department, A. C. Camargo Cancer Center, São Paulo, Brazil; Stomatology Department, Faculdade de Odontologia, Universidade São Paulo, São Paulo, SP, Brazil
| | - João Goncalves Filho
- Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Maria Paula Curado
- Nucleus of Epidemiology and Statistics in Cancer, A. C. Camargo Cancer Center, São Paulo, Brazil.
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Barbosa De Accioly Mattos M, Bernardo Peixoto C, Geraldo de Castro Amino J, Cortes L, Tura B, Nunn M, Giambiagi-deMarval M, Sansone C. Coronary atherosclerosis and periodontitis have similarities in their clinical presentation. FRONTIERS IN ORAL HEALTH 2024; 4:1324528. [PMID: 38292927 PMCID: PMC10825671 DOI: 10.3389/froh.2023.1324528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024] Open
Abstract
Background Periodontitis (PE) and coronary heart disease (CHD) possess multiple mechanisms for a putative association. This case-control study compared the periodontal status among CHD subjects to controls without CHD, while also investigating atheroma invasion by known periodontal pathogens. Methods 161 subjects participated in this study were divided into three CHD groups: No CHD, chronic CHD, acute CHD. Additional analysis involved grouping subjects according to number of atheromas: no atheroma, 1-4 atheromas, 5-18 atheromas. Data were collected from medical records, periodontal examinations, and questionnaires that included demographic, behavioral, and oral health variables. Angiographic catheterizations were analyzed according to the number of atheroma lesions, lesion size, lesion location, and atheroma lesion stability. Lipoprotein profile, inflammatory markers and cells were analyzed. The microbiological branch added 30 individuals who had their atheroma lesion and subgingival plaque analyzed using polymerase chain reaction probes against the 16 s region, red complex and Aggregatibacter actinomycetemcomitans' DNA. Results Subjects with CHD had high levels of systemic inflammatory markers and low levels of high-density lipoproteins compared to subjects without CHD. Subjects without CHD and clear coronaries had a prevalence of mild CAL, while individuals with more atheroma lesions had advanced CAL and more active PE. Subjects with more advanced CAL were 4 times more likely to have CHD compared to subjects with less, which is comparable to smoking. Only 4 subjects had the screened pathogens detected in atheroma, although these subjects also have the screened pathogens in subgingival plaque. However, 80% of atheromas had bacteria. Conclusions CHD and PE showed similarities in progression while active PE led to more atheroma lesions that also tended to be larger in size.
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Affiliation(s)
- Marcelo Barbosa De Accioly Mattos
- School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Division of Periodontics, University of Kentucky College of Dentistry, Lexington, KY, United States
| | | | | | - Leandro Cortes
- Department of Cardiology, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - Bernardo Tura
- Department of Cardiology, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - Martha Nunn
- Department of Biostatistic, Nunn Biostatistical Solutions, Omaha, NE, United States
| | - Marcia Giambiagi-deMarval
- Instituto de Microbiologia Professor Paulo de Góes, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carmelo Sansone
- Departamento de Periodontia, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Medina-Vega M, Ibarra MCB, Quezada-Conde MDC, Reis INRD, Frias AC, Raggio DP, Michel-Crosato E, Mendes FM, Pannuti CM, Romito GA. Periodontal status among 12-year-old schoolchildren: a population-based cross-sectional study in Quito, Ecuador. Braz Oral Res 2024; 38:e002. [PMID: 38198302 DOI: 10.1590/1807-3107bor-2024.vol38.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/15/2023] [Indexed: 01/12/2024] Open
Abstract
This study aimed to estimate the prevalence and extent of bleeding on probing and calculus in 12-year-old schoolchildren of Quito, Ecuador, and evaluate the associated factors. We conducted an epidemiological survey with a representative sample of 1,100 12-year-old schoolchildren from public schools in the urban area of Quito, Ecuador. We assessed the periodontal health using the Community Periodontal Index (CPI). The prevalence and extent of the periodontal condition was based on the presence of at least one site with bleeding on probing (BOP), and the presence of dental calculus was also evaluated. We used univariate and multiple multilevel Poisson regression analyses to verify the association between the independent variables and the number of sextants with BOP and calculus. The prevalence of BOP and calculus was 92% and 69.9%, respectively. The adjusted mean of the affected sextants was 4.3 and 2.2 for BOP and calculus, respectively. The mother's schooling and malocclusion were associated with the number of sextants with bleeding. The mother's schooling and dental caries experience were associated with calculus. Gingival bleeding and the presence of dental calculus are highly prevalent in 12-year-old schoolchildren from Quito. Gingival bleeding is associated with maternal education and malocclusion, and dental calculus is associated with maternal education and dental caries.
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Affiliation(s)
| | | | | | | | - Antonio Carlos Frias
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | - Daniela Prócida Raggio
- Universidade de São Paulo - USP, School of Dentistry, Department of Pediatric Dentistry, São Paulo, SP, Brazil
| | - Edgard Michel-Crosato
- Universidade de São Paulo - USP, School of Dentistry, Department of Community Dentistry, São Paulo, SP, Brazil
| | - Fausto Medeiros Mendes
- Universidade de São Paulo - USP, School of Dentistry, Department of Pediatric Dentistry, São Paulo, SP, Brazil
| | - Claudio Mendes Pannuti
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
| | - Giuseppe Alexandre Romito
- Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, São Paulo, SP, Brazil
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12
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Wright CD, Heaton B, Garcia RI, Leonard MM, Fasano A, McNeil DW. Gastrointestinal distress as a potential mediator between stress and periodontal inflammation. Community Dent Oral Epidemiol 2023; 51:1250-1257. [PMID: 37430381 PMCID: PMC10776810 DOI: 10.1111/cdoe.12889] [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: 02/17/2023] [Revised: 05/18/2023] [Accepted: 06/11/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVES Periodontal disease is multifactorial in its aetiology, which encompasses biopsychosocial contributors, including psychological stress. Gastrointestinal distress and dysbiosis have been associated with several chronic inflammatory diseases yet have rarely been investigated with respect to oral inflammation. Given the implications of gastrointestinal distress on extraintestinal inflammation, this study aimed to evaluate the potential role of such distress as a mediator between psychological stress and periodontal disease. METHODS Utilizing a cross-sectional, nationwide sample of 828 adults in the USA generated via Amazon Mechanical Turk, we evaluated data collected from a series of validated self-report psychosocial questionnaires on stress, gut-specific anxiety around current gastrointestinal distress and periodontal disease, including periodontal disease subscales targeted at physiological and functional factors. Structural equation modelling was used to determine total, direct and indirect effects, while controlling for covariates. RESULTS Psychological stress was associated with gastrointestinal distress (ß = .34) and self-reported periodontal disease (ß = .43). Gastrointestinal distress also was associated with self-reported periodontal disease (ß = .10). Gastrointestinal distress likewise mediated the relation between psychological stress and periodontal disease (ß = .03, p = .015). Given the multifactorial nature of periodontal disease(s), similar results were demonstrated using the subscales of the periodontal self-report measure. CONCLUSIONS Associations exist between psychological stress and overall reports of periodontal disease as well as more specific physiological and functional components. Additionally, this study provided preliminary data supporting the potential mechanistic role that gastrointestinal distress plays in connecting the gut-brain and the gut-gum pathways.
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Affiliation(s)
- Casey D. Wright
- Department of Developmental Sciences, School of Dentistry, Marquette University, Milwaukee, WI 53201, USA*
| | - Brenda Heaton
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA 02118, USA
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA 02118, USA
| | - Raul I. Garcia
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA 02118, USA
| | - Maureen M. Leonard
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Alessio Fasano
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Daniel W. McNeil
- Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, FL 32610, USA*
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13
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Alhassani AA. The influence of periodontitis case definition on the association between periodontal disease and glycaemic status. Community Dent Oral Epidemiol 2023; 51:1100-1108. [PMID: 36601914 DOI: 10.1111/cdoe.12839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 12/06/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The association between periodontitis and glycaemic control is complex, and often described as 'bidirectional'. Although epidemiological studies have examined this relationship extensively, a disagreement on periodontitis case definition still exists. This study aimed to assess the influence of case definition on the association between periodontal disease and glycaemic status. METHODS The study is a secondary analysis of data from the United States National Health and Nutrition Examination Survey (NHANES), 2009-2014 cycles. The association between periodontitis and glycated haemoglobin (HbA1c) was assessed using different periodontitis case definitions: the definition by the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP), Community Periodontal Index (CPI), ≥1 site with ≥3 mm clinical attachment loss (CAL) and ≥4 mm probing depth (PD), ≥1 site with ≥4 mm CAL and ≥4 mm PD, the 5th European Workshop definitions, Machtei et al. 'established periodontitis', the 2017 World Workshop classification, and self-reported periodontitis. The associations between periodontitis and HbA1c were compared across the case definitions. RESULTS There was substantial variability in prevalence estimates of periodontitis, and in the strength of association between periodontitis and HbA1c when different case definitions were applied. The CDC/AAP and stage III/IV periodontitis were consistently significantly associated with elevated HbA1c. For stage III/IV, the adjusted odds ratios of prediabetes and diabetes HbA1c were 1.19 and 1.76, respectively. CONCLUSION Comprehensive periodontitis case definitions that account for CAL and PD, such as the CDC/AAP and the 2017 classification, seem to better detect the association between periodontal disease and HbA1c.
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Affiliation(s)
- Ahmed A Alhassani
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
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14
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Sindi AM, Hosny KM, Rizg WY, Sabei FY, Madkhali OA, Bakkari MA, Alfayez E, Alkharobi H, Alghamdi SA, Banjar AA, Majrashi M, Alissa M. Utilization of experimental design in the formulation and optimization of hyaluronic acid-based nanoemulgel loaded with a turmeric-curry leaf oil nanoemulsion for gingivitis. Drug Deliv 2023; 30:2184311. [PMID: 36846914 PMCID: PMC9980406 DOI: 10.1080/10717544.2023.2184311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Numerous problems affect oral health, and intensive research is focused on essential oil-based nanoemulsions that might treat prevent or these problems. Nanoemulsions are delivery systems that enhance the distribution and solubility of lipid medications to targeted locations. Turmeric (Tur)- and curry leaf oil (CrO)-based nanoemulsions (CrO-Tur-self-nanoemulsifying drug delivery systems [SNEDDS]) were developed with the goal of improving oral health and preventing or treating gingivitis. They could be valuable because of their antibacterial and anti-inflammatory capabilities. CrO-Tur-SNEDDS formulations were produced using the response surface Box-Behnken design with different concentrations of CrO (120, 180, and 250 mg), Tur (20, 35, and 50 mg), and Smix 2:1 (400, 500, and 600 mg). The optimized formulation had a bacterial growth inhibition zone of up to 20 mm, droplet size of less than 140 nm, drug-loading efficiency of 93%, and IL-6 serum levels of between 950 ± 10 and 3000 ± 25 U/ml. The optimal formulation, which contained 240 mg of CrO, 42.5 mg of Tur, and 600 mg of Smix 2:1, was created using the acceptable design. Additionally, the best CrO-Tur-SNEDDS formulation was incorporated into a hyaluronic acid gel, and thereafter it had improved ex-vivo transbuccal permeability, sustained in-vitro release of Tur, and large bacterial growth suppression zones. The optimal formulation loaded into an emulgel had lower levels of IL-6 in the serum than the other formulations evaluated in rats. Therefore, this investigation showed that a CrO-Tur-SNEDDS could provide strong protection against gingivitis caused by microbial infections.
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Affiliation(s)
- Amal M. Sindi
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khaled M. Hosny
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia,CONTACT Khaled M. Hosny , Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Waleed Y. Rizg
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fahad Y. Sabei
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Osama A. Madkhali
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Mohammed Ali Bakkari
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Eman Alfayez
- Department of Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hanaa Alkharobi
- Department of Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Samar A Alghamdi
- Department of Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Arwa A. Banjar
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Majrashi
- Department of Pharmacology, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Mohammed Alissa
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
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15
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Larvin H, Kang J, Aggarwal VR, Pavitt S, Wu J. Periodontitis and risk of immune-mediated systemic conditions: A systematic review and meta-analysis. Community Dent Oral Epidemiol 2023; 51:705-717. [PMID: 36377800 DOI: 10.1111/cdoe.12812] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/22/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim of this review is to examine and quantify the long-term risk of immune-mediated systemic conditions in people with periodontitis compared to people without periodontitis. METHODS Medline, EMBASE and Cochrane databases were searched up to June 2022 using keywords and MeSH headings. The 'Risk of Bias in Non-Randomised Studies of Interventions' tool was used to assess bias. Cohort studies comparing incident metabolic/autoimmune/inflammatory diseases in periodontitis to healthy controls were included. Meta-analysis and meta-regression quantified risks and showed impact of periodontitis diagnosis type and severity. RESULTS The search retrieved 3354 studies; 166 studies were eligible for full-text screening, and 30 studies were included for review. Twenty-seven studies were eligible for meta-analysis. The risks of diabetes, rheumatoid arthritis (RA) and osteoporosis were increased in people with periodontitis compared to without periodontitis (diabetes-relative risk [RR]: 1.22, 95% CI: 1.13-1.33; RA-RR: 1.27, 95% CI: 1.07-1.52; osteoporosis-RR: 1.40, 95% CI: 1.12-1.75). Risk of diabetes showed gradient increase by periodontitis severity (moderate-RR = 1.20, 95% CI = 1.11-1.31; severe-RR = 1.34, 95% CI = 1.10-1.63). CONCLUSION People with moderate-to-severe cases of periodontitis have the highest risk of developing diabetes, while the effect of periodontal severity on risk of other immune-mediated systemic conditions requires further investigation. More homologous evidence is required to form robust conclusions regarding periodontitis-multimorbidity associations.
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Affiliation(s)
| | - Jing Kang
- Oral Biology, School of Dentistry, University of Leeds, Leeds, UK
| | | | - Susan 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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16
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Enevold C, Nielsen CH, Christensen LB, Kongstad J, Fiehn NE, Hansen PR, Holmstrup P, Havemose-Poulsen A, Damgaard C. Suitability of machine learning models for prediction of clinically defined Stage III/IV periodontitis from questionnaires and demographic data in Danish cohorts. J Clin Periodontol 2023. [PMID: 37691160 DOI: 10.1111/jcpe.13874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 07/14/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023]
Abstract
AIM To evaluate if, and to what extent, machine learning models can capture clinically defined Stage III/IV periodontitis from self-report questionnaires and demographic data. MATERIALS AND METHODS Self-reported measures of periodontitis, demographic data and clinically established Stage III/IV periodontitis status were extracted from two Danish population-based cohorts (The Copenhagen Aging and Midlife Biobank [CAMB] and The Danish Health Examination Survey [DANHES]) and used to develop cross-validated machine learning models for the prediction of clinically established Stage III/IV periodontitis. Models were trained using 10-fold cross-validations repeated three times on the CAMB dataset (n = 1476), and the resulting models were validated in the DANHES dataset (n = 3585). RESULTS The prevalence of Stage III/IV periodontitis was 23.2% (n = 342) in the CAMB dataset and 9.3% (n = 335) in the DANHES dataset. For the prediction of clinically established Stage III/IV periodontitis in the CAMB cohort, models reached area under the receiver operating characteristics (AUROCs) of 0.67-0.69, sensitivities of 0.58-0.64 and specificities of 0.71-0.80. In the DANHES cohort, models derived from the CAMB cohort achieved AUROCs of 0.64-0.70, sensitivities of 0.44-0.63 and specificities of 0.75-0.84. CONCLUSIONS Applying cross-validated machine learning algorithms to demographic data and self-reported measures of periodontitis resulted in models with modest capabilities for the prediction of Stage III/IV periodontitis in two Danish cohorts.
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Affiliation(s)
- C Enevold
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - C H Nielsen
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Copenhagen, Denmark
- Research Area Periodontology, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L B Christensen
- Research Area Periodontology, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Kongstad
- Research Area Periodontology, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - N E Fiehn
- Costerton Biofilm Centre, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - P R Hansen
- Department of Cardiology, Herlev-Gentofte Hospital, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - P Holmstrup
- Research Area Periodontology, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - A Havemose-Poulsen
- Research Area Periodontology, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - C Damgaard
- Research Area Periodontology, Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Martínez-García M, Rodríguez-Hernández AP, Gutiérrez-Esparza GO, Castrejón-Pérez RC, Hernández-Lemus E, Borges-Yáñez SA. Relationship between the Social Development Index and Self-Reported Periodontal Conditions. Healthcare (Basel) 2023; 11:healthcare11111548. [PMID: 37297688 DOI: 10.3390/healthcare11111548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/12/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Inequalities in oral health are influenced by the social strata of the population. Few studies have focused on the multitude of factors related to social development as indicators of living conditions and periodontal health status. The aim of this study is to evaluate the association between self-reported periodontal conditions and the Social Development Index (SDI). A cross-sectional validated questionnaire was carried out among 1294 Mexican adults. Descriptive statistics and multivariate logistic regression models were used to identify the best predictors of self-reported periodontal conditions. Bone loss reporting was used as a proxy for the presence of periodontal disease. We found that higher global scores on the SDI and quality and available space in the home (QASH) increase the probability of having bone loss. Global SDI (OR = 7.27) and higher QASH (OR = 3.66) were indeed the leading societal factors related to periodontal disease. These results have pointed out how SDI and its indicators, in particular QASH, can be used to further explore inequities related to privileged access to dental care in the context of periodontal diseases.
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Affiliation(s)
- Mireya Martínez-García
- Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
| | - Adriana-Patricia Rodríguez-Hernández
- Laboratory of Molecular Genetics, Graduate Studies and Research Division, School of Dentistry, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Guadalupe O Gutiérrez-Esparza
- Cátedras CONACYT Consejo Nacional de Ciencia y Tecnología, Mexico City 08400, Mexico
- Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
| | - Roberto Carlos Castrejón-Pérez
- Department of Clinical and Epidemiological Geriatric Research, Instituto Nacional de Geriatría, Mexico City 10200, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Division, Instituto Nacional de Medicina Genómica, Mexico City 14610, Mexico
- Center for Complexity Sciences, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Socorro Aída Borges-Yáñez
- Dental Public Health Department, Graduate Studies and Research Division, School of Dentistry, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
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De Rubeis V, Jiang Y, de Groh M, Dufour L, Bronsard A, Morrison H, Butt F, Walker Bassim C. Oral Health Problems among Canadians Aged 45 to 85: Data from the Canadian Longitudinal Study on Aging Baseline Survey (2011-2015). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085533. [PMID: 37107815 PMCID: PMC10138597 DOI: 10.3390/ijerph20085533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/24/2023] [Accepted: 04/13/2023] [Indexed: 05/07/2023]
Abstract
Oral health is a critical component of overall health. The objective of this study was to describe oral health problems among 47,581 adults aged 45 to 85 in the Canadian Longitudinal Study on Aging (CLSA) among those who have at least one natural tooth (92%) and those without natural teeth across various demographic categories. Among the 47,581 participants in the study, 92% reported having at least one natural tooth (dentate). Among those without teeth, 63% reported an income less than CAD 50,000 versus 39% among those with teeth. Whether they had teeth or not, over 30% of people reported two or more oral health problems. Older adults appear to be retaining their natural teeth (28.9%), but still report experiencing oral health problems. As the population ages, loss of all teeth may not be the most useful proxy for poor oral health, and a population-level understanding of oral health problems may help to better define poor oral health.
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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
| | - Fahad Butt
- Health Sciences, Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Carol Walker Bassim
- Health Sciences, Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
- Correspondence:
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Jaumet L, Hamdi Z, Julia C, Hercberg S, Touvier M, Bouchard P, Carra MC, Andreeva VA. Periodontitis assessed with a new screening tool and oral health-related quality of life: cross-sectional findings among general-population adults. Qual Life Res 2023; 32:259-272. [PMID: 35948787 PMCID: PMC9365217 DOI: 10.1007/s11136-022-03215-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Periodontitis, as a chronic, multifactorial inflammatory disease, has complex relationships with other diseases and ultimately with well-being. The aim of this cross-sectional study was to investigate the association between self-report periodontitis, as measured with the recently developed and validated modified Periodontal Screening Score (mPESS), and oral health-related quality of life (OHRQol) in a large population-based sample derived from the French NutriNet-Santé e-cohort. METHODS The sample was composed of 32,714 adults (75.5% women) with a mean age of 48.8 ± 13.9 years. Periodontitis was assessed based on age, smoking, and oral health status data obtained in 2011-2012, which allowed calculating the mPESS. An mPESS ≥ 5 was used to identify individuals at risk of severe periodontitis (main exposure). OHRQoL was measured with the Oral Health Impact Profile (OHIP-14) (main outcome) and the total score was dichotomized for analysis. Multivariable logistic regression analyses, considering physical health status, dietary and lifestyle confounding variables, were performed. RESULTS Overall, 6407 participants (19.6%) were at a high risk of severe periodontitis. A total of 7383 participants (22.6%) presented a relatively poor OHRQoL (OHIP-14 > 8, highest quartile). In the multivariable model, each of the following variables was independently and significantly associated with lower OHRQoL: older age (50-64 years), female sex, obesity, snacking between meals, frequent consumption of soft drinks and sweets/chocolate, risk of severe periodontitis, and having < 20 natural teeth were significantly. An mPESS ≥ 5 showed the highest odds for relatively poor OHRQoL (OR = 3.45; 95% CI 3.21-3.72). CONCLUSION The results support the association between periodontitis and OHRQoL in non-clinical samples. The use of mPESS could be tested in future prevention programs aiming at improving OHRQoL.
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Affiliation(s)
- Lauranne Jaumet
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France
| | - Zeineb Hamdi
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France
| | - Chantal Julia
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France ,Department of Public Health, Paris-Seine-Saint-Denis University Hospitals (AP-HP), Bobigny, France
| | - Serge Hercberg
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France ,Department of Public Health, Paris-Seine-Saint-Denis University Hospitals (AP-HP), Bobigny, France
| | - Mathilde Touvier
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France
| | - Philippe Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France ,Laboratory URP 2496 Orofacial Pathologies, Imaging and Biotherapies, University of Paris Cité, Paris, France
| | - Maria Clotilde Carra
- Department of Periodontology, Service of Odontology, Rothschild Hospital, AP-HP, U.F.R. of Odontology-Garancière, University of Paris Cité, Paris, France ,Population-Based Epidemiologic Cohorts Unit, INSERM UMS 011, Villejuif, France
| | - Valentina A. Andreeva
- INSERM U1153/INRAE U1125/CNAM, Nutritional Epidemiology Research Unit (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, 93017 Bobigny, France
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Liu X, Xu J, Li S, Wang X, Liu J, Li X. The prevalence of gingivitis and related risk factors in schoolchildren aged 6-12 years old. BMC Oral Health 2022; 22:623. [PMID: 36544102 PMCID: PMC9768968 DOI: 10.1186/s12903-022-02670-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND According to epidemiological studies, gingivitis is a common disease. However, its morbidity, considerably varies among individual. This study aimed to investigate the epidemiological characteristics of gingivitis, including prevalence, severity, intraoral distribution, and associated risk factors, in children aged 6-12 years in Jinzhou, China. METHODS A multistage, whole-group, randomized sample of 2880 children aged 6-12 years in Jinzhou City, China, was selected and clinically examined. Each selected child completed a questionnaire on sociodemographic factors and oral health behaviors in cooperation with the investigator and teacher. Gingival bleeding refers to the bleeding of 10% or more teeth under the condition of ingivitis. Gingivitis was further categorized into localized gingivitis (30% ≥ number of teeth positive for gingival bleeding ≥ 10%) and generalized gingivitis (number of positive for gingival bleeding > 30%). The score of gingival bleeding was recorded using the Gingival Index. RESULTS The prevalence of gingivitis in children aged 6-12 years in Jinzhou was 28.58%, including 701 cases of localized gingivitis (24.3%) and 122 cases of generalized gingivitis (4.2%). There were 429 cases (28.3%) of gingivitis in males and 394 cases (28.9%) in females, with no statistically significant difference in prevalence between males and females (P > 0.05). Chi-square tests and binary logistic regression analysis showed that aging, dental calculus, plaque, and dental crowding were significantly associated with a high prevalence of gingivitis. CONCLUSIONS Our study showed that dental calculus, large amount dental plaque, poor oral health behavior, and oral health awareness are associated with the prevalence of gingivitis and maintaining children's oral health requires professional guidance and regular preventive care.
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Affiliation(s)
- Xiaoyu Liu
- grid.454145.50000 0000 9860 0426The Second Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Jianhui Xu
- grid.454145.50000 0000 9860 0426The Second Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Siwei Li
- grid.454145.50000 0000 9860 0426The Second Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Xueqin Wang
- grid.454145.50000 0000 9860 0426The Second Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Jin Liu
- grid.454145.50000 0000 9860 0426The Second Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Xin Li
- grid.454145.50000 0000 9860 0426The Second Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
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21
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Lertpimonchai A, Tuntrakul S, Rattanasiri S, Sutthiboonyapan P, Vathesatogkit P, Udomsak A, Tavedhikul K. Validity of Simple Self-Reported Periodontal Status Questions. Int Dent J 2022; 73:121-127. [PMID: 36460520 PMCID: PMC9875259 DOI: 10.1016/j.identj.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/03/2022] [Accepted: 10/30/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The aim of this research was to evaluate the validity of the questions developed by Thai periodontists on self-reported periodontal status and symptoms in identifying severe periodontitis amongst adults in Thailand. METHODS Registered Electricity Generating Authority of Thailand (EGAT) employees completed medical examinations and full-mouth periodontal examinations. They also were interviewed using a self-reported questionnaire that was developed by Thai periodontists. The questions pertained to their periodontal status and symptoms comprising swollen gums, bad breath, loose teeth, bleeding on brushing, painful gums, and pus or abscesses. The participants were categorised as having nonsevere and severe periodontitis according to the Centers for Disease Control and Prevention in partnership with the American Academy of Periodontology (CDC/AAP) case definitions. Self-reported periodontal status and symptom results were compared with actual periodontal status. The area under the receiver operating characteristic curve (AUROCC), sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. RESULTS A total of 1393 EGAT employees participated in this study. The questions on self-reported periodontal status and all symptoms poorly identified patients with severe periodontitis, with an AUROCC of 0.52 to 0.60. The sensitivity was 5.0% to 40.2%; however, the specificity was good, at 73.2% to 99.1%. The validity of the self-reported questions was comparable amongst the sex, education, and income subgroups. CONCLUSIONS This study demonstrated that self-reported periodontal status and symptoms were inadequate in identifying patients with severe periodontal disease.
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Affiliation(s)
- Attawood Lertpimonchai
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Supang Tuntrakul
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Sasivimol Rattanasiri
- Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pimchanok Sutthiboonyapan
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand
| | - Prin Vathesatogkit
- Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Artit Udomsak
- Medical and Health Division, Electric Generation Authority of Thailand, Nonthaburi, Thailand
| | - Kanoknadda Tavedhikul
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand,Center of Excellence in Periodontal Disease and Dental Implant, Chulalongkorn University, Bangkok, Thailand,Corresponding author. Kanoknadda Tavedhikul, Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, 34 Henri-Dunant Road, Pathumwan, Bangkok 10330, Thailand.
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22
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Nakahara M, Toyama N, Ekuni D, Takeuchi N, Maruyama T, Yokoi A, Fukuhara D, Sawada N, Nakashima Y, Morita M. Trends in Self-Rated Oral Health and Its Associations with Oral Health Status and Oral Health Behaviors in Japanese University Students: A Cross-Sectional Study from 2011 to 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013580. [PMID: 36294160 PMCID: PMC9602464 DOI: 10.3390/ijerph192013580] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 05/27/2023]
Abstract
Self-rated oral health (SROH) is a valid, comprehensive indicator of oral health status. The purpose of this cross-sectional study was to analyze how oral health behaviors and clinical oral status were associated with SROH and how they had changed over the course of nine years in Japanese university students. Data were obtained from 17,996 students who underwent oral examinations and completed self-questionnaires from 2011 to 2019. Oral status was assessed using the decayed and filled teeth scores, bleeding on probing (BOP), probing pocket depth, the Oral Hygiene Index-Simplified (OHI-S), oral health behaviors, and related factors. SROH improved from 2011 to 2019. The logistic regression model showed that university students who were female and had a high daily frequency of tooth brushing, no BOP, no decayed teeth, no filled teeth, and a low OHI-S score and were significantly more likely to report very good, good, or fair SROH. An interaction effect was observed between survey year and regular dental check-ups (year × regular dental check-ups). The improvement trend in SROH might be associated with changes in oral health behaviors and oral health status.
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Affiliation(s)
- Momoko Nakahara
- Department of Preventive Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Naoki Toyama
- Department of Preventive Dentistry, Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Noriko Takeuchi
- Department of Preventive Dentistry, Okayama University Hospital, Okayama 700-8558, Japan
| | - Takayuki Maruyama
- Department of Preventive Dentistry, Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Aya Yokoi
- Department of Preventive Dentistry, Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
| | - Daiki Fukuhara
- Department of Preventive Dentistry, Okayama University Hospital, Okayama 700-8558, Japan
| | - Nanami Sawada
- Department of Preventive Dentistry, Okayama University Hospital, Okayama 700-8558, Japan
| | - Yukiho Nakashima
- Department of Preventive Dentistry, Okayama University Hospital, Okayama 700-8558, Japan
| | - Manabu Morita
- Department of Preventive Dentistry, Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan
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23
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Machado V, Lyra P, Santos C, Proença L, Mendes JJ, Botelho J. Self-Reported Measures of Periodontitis in a Portuguese Population: A Validation Study. J Pers Med 2022; 12:1315. [PMID: 36013264 PMCID: PMC9410440 DOI: 10.3390/jpm12081315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/25/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Self-reported questionnaires have been developed and validated in multiple populations as useful tools to estimate the prevalence of periodontitis in epidemiological settings. This study aimed to explore the accuracy of self-reporting for predicting the prevalence of periodontitis in a Portuguese population. The questionnaires were given to patients at a university clinic. Thirteen self-reported questions on periodontal health were gathered in a patient-reported questionnaire. Then, self-reporting responses were validated using full-mouth periodontal examination as a comparison. Multivariable logistic regression was used to analyze sensitivity, specificity, accuracy, precision, and area under the curve-receiver operator characteristic (AUC-ROC). Self-reported answers from 103 participants (58 females and 45 males) were included. Self-reported gum health, loose teeth, tooth appearance, and use of dental floss were associated with different definitions of severe periodontitis. The self-reported questions on "having gum disease," combined with "having gum treatment" and "having lost bone" were the items with higher performance for the 2018 case definition and the 2012 case definition, as well as for each respective severity staging. Categorization of tooth loss was only valuable for the prediction of periodontitis cases according to the 2012 case definition and its severe stage. Multiple self-reporting set-ups showed elevated performance levels for predicting periodontitis in Portuguese patients. These results may pave the way for future epidemiological surveillance programs using self-reporting approaches.
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Affiliation(s)
- Vanessa Machado
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
| | - Patrícia Lyra
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
| | - Catarina Santos
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
| | - Luís Proença
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
- Quantitative Methods for Health Research, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
| | - José João Mendes
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
| | - João Botelho
- Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
- Evidence-Based Hub, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Almada, Portugal
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24
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Chaffee B, Lauten K, Sharma E, Everard C, Duffy K, Park-Lee E, Taylor E, Tolliver E, Watkins-Bryant T, Iafolla T, Compton W, Kimmel H, Hyland A, Silveira M. Oral Health in the Population Assessment of Tobacco and Health Study. J Dent Res 2022; 101:1046-1054. [PMID: 35403466 PMCID: PMC9305842 DOI: 10.1177/00220345221086272] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
Tobacco use is a well-established risk factor for multiple adverse oral conditions. Few nationally representative oral health data sets encompass the current diversity of tobacco and nicotine products. This investigation examines the validity of oral health measures in the Population Assessment of Tobacco and Health (PATH) Study to assess relationships between tobacco use and oral health. Cross-sectional data from PATH Study wave 4 (N = 33,643 US adults, collected 2016-2018) were used to obtain estimates for 6 self-reported oral conditions (e.g., bone loss around teeth, tooth extractions) and compared with analogous estimates from the National Health and Nutrition Examination Survey (NHANES) cycle 2017-2018 (N = 5,856). Within the PATH Study, associations were calculated between tobacco use status and lifetime and past 12-mo experience of adverse oral conditions using survey-weighted multivariable logistic regression. Nationally representative estimates of oral conditions between the PATH Study and NHANES were similar (e.g., ever-experience of bone loss around teeth: PATH Study 15.2%, 95% CI, 14.4%-15.9%; NHANES 16.6%, 95% CI, 14.9%-18.4%). In the PATH Study, combustible tobacco smoking was consistently associated with lifetime and past 12-mo experience of adverse oral health (e.g., exclusive cigarette smoking vs. never tobacco use, adjusted odds ratio [AOR] for loose teeth in past 12 mo: 2.02; 95% CI, 1.52-2.69). Exclusive smokeless tobacco use was associated with greater odds of loose teeth (AOR, 1.93; 95% CI, 1.15-3.26) and lifetime precancerous lesions (AOR, 3.85; 95% CI, 1.73-8.57). Use of other noncigarette products (e.g., pipes) was inconsistently associated with oral health outcomes. PATH Study oral health measures closely align with self-reported measures from NHANES and are internally concurrent. Observed associations with tobacco use and the ability to examine emerging tobacco products support application of PATH Study data in dental research, particularly to examine potential oral health effects of novel tobacco products and longitudinal changes in tobacco use behaviors.
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Affiliation(s)
- B.W. Chaffee
- University of California San Francisco, San Francisco, CA, USA
| | | | | | - C.D. Everard
- National Institute on Drug Abuse, Kelly Government Solutions, Bethesda, MD, USA
| | - K. Duffy
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - E. Park-Lee
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - E. Taylor
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - E. Tolliver
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - T. Watkins-Bryant
- Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - T. Iafolla
- National Institute on Dental and Craniofacial Research, Bethesda, MD, USA
| | - W.M. Compton
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - H.L. Kimmel
- National Institute on Drug Abuse, Bethesda, MD, USA
| | - A. Hyland
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - M.L. Silveira
- National Institute on Drug Abuse, Kelly Government Solutions, Bethesda, MD, USA
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25
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Arsiwala LT, Mok Y, Yang C, Ishigami J, Selvin E, Beck JD, Allison MA, Heiss G, Demmer RT, Matsushita K. Periodontal disease measures and risk of incident peripheral artery disease: The Atherosclerosis Risk in Communities (ARIC) Study. J Periodontol 2022; 93:943-953. [PMID: 34590322 PMCID: PMC8960475 DOI: 10.1002/jper.21-0342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/19/2021] [Accepted: 09/20/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The association of periodontal disease with atherosclerotic cardiovascular diseases is well known, but not specifically with incident peripheral artery disease (PAD). Therefore, we studied the associations of periodontal disease with incident PAD in a population-based setting. METHODS Among 9,793 participants (aged 53-75 years) without prevalent PAD, self-reported history of periodontal disease was ascertained. Of these, 5,872 participants underwent full-mouth examinations from which periodontal status was defined using the US Centers for Disease Control and Prevention-American Academy of Periodontology (CDC-AAP) definition. We quantified the association of periodontal disease with incident PAD (defined by hospital admission diagnosis or procedures) using multivariable Cox regression models. RESULTS During a median follow-up of 20.1 years, 360 participants (3.6%) developed PAD. In models accounting for potential confounders including diabetes and smoking pack-years, there was higher hazard of PAD in participants with self-reported tooth loss because of periodontal disease (hazard ratio:1.54 [95% CI:1.20-1.98]), history of periodontal disease treatment (1.37 [1.05-1.80]), and periodontal disease diagnosis (1.38 [1.09-1.74]), compared to their respective counterparts. The clinical measure of periodontal disease (n = 5,872) was not significantly associated with incident PAD in the fully adjusted model (e.g., 1.53 [0.94-2.50] in CDC-AAP-defined severe periodontal disease versus no disease). CONCLUSION We observed a modest association of self-reported periodontal disease, especially when resulting in tooth loss, with incident PAD in the general population. Nonetheless, a larger study with the clinical measure of periodontal disease is warranted.
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Affiliation(s)
| | - Yejin Mok
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Chao Yang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Junichi Ishigami
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - James D. Beck
- Department of Dental Ecology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | | | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, USA
| | - Ryan T. Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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26
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Sumayin Ngamdu K, Mallawaarachchi I, Dunipace EA, Chuang LH, Jafri SH, Shah NR, Jeong YN, Morrison AR, Bhatt DL. Association Between Periodontal Disease and Cardiovascular Disease (from the NHANES). Am J Cardiol 2022; 178:163-168. [PMID: 35773046 DOI: 10.1016/j.amjcard.2022.05.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 11/01/2022]
Abstract
As observational studies support the association between periodontal disease (PD) and cardiovascular diseases (CVDs), we examined this relationship using the National Health and Nutrition Examination Survey 2013 to 2014 data. This cross-sectional study involved 2,830 adult participants, aged ≥30 years who underwent a home interview, followed by a standardized assessment at a mobile examination center from 2013 to 2014. PD was defined using the new classification scheme issued by American Academy of Periodontology Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions in 2017, and CVD was defined as the composite of coronary artery disease and stroke. The gathered data were subjected to weighted statistical analysis to examine the relation between CVD prevalence and PD. The sample (mean age 51.5 ± 13.6 years) comprised 50.1% men and 69.5% White participants. Stage I (mild/subclinical), II (moderate), and III to IV (severe) PD was noted in 16.7% (95% confidence interval [CI] 12.7 to 21.7), 57.4% (95% CI 53.9 to 60.9), and 25.9% (95% CI 21.4 to 30.8) of the participants, respectively. Patients with stage III and IV PD were more likely to have CVD than those with stage I (adjusted odds ratio 3.59, 95% CI 1.12 to 11.54, p = 0.03). Similarly, participants who reported fair/poor gum health were more likely to have CVD than those who reported excellent/very good gum health (adjusted odds ratio 2.17, 95% CI 0.98 to 4.79, p = 0.055). In conclusion, the data from the National Health and Nutrition Examination Survey 2013 to 2014 demonstrated that PD severity is associated with CVD risk. However, the information gathered by trained professionals during periodontal examinations is a more reliable predictor of PD-CVD associations compared with self-reported measures of oral health.
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Affiliation(s)
- Kyari Sumayin Ngamdu
- Division of Cardiovascular Medicine, Department of Internal Medicine, Providence VA Medical Center, Providence, Rhode Island; Division of Cardiovascular Medicine, Department of Internal Medicine, Alpert Medical School at Brown University, Providence, Rhode Island
| | - Indika Mallawaarachchi
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Eric A Dunipace
- David Geffen School of Medicine, University of California, Los Angeles, California
| | - Lin-Hsin Chuang
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, Massachusetts
| | - S Hammad Jafri
- Division of Cardiovascular Medicine, Department of Internal Medicine, Providence VA Medical Center, Providence, Rhode Island; Division of Cardiovascular Medicine, Department of Internal Medicine, Alpert Medical School at Brown University, Providence, Rhode Island
| | - Nishant R Shah
- Division of Cardiovascular Medicine, Department of Internal Medicine, Providence VA Medical Center, Providence, Rhode Island; Division of Cardiovascular Medicine, Department of Internal Medicine, Alpert Medical School at Brown University, Providence, Rhode Island
| | - Youjin N Jeong
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Alan R Morrison
- Division of Cardiovascular Medicine, Department of Internal Medicine, Providence VA Medical Center, Providence, Rhode Island; Division of Cardiovascular Medicine, Department of Internal Medicine, Alpert Medical School at Brown University, Providence, Rhode Island
| | - Deepak L Bhatt
- Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts.
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27
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Radiographically screened periodontitis is associated with deteriorated oral-health quality of life: A cross-sectional study. PLoS One 2022; 17:e0269934. [PMID: 35687588 PMCID: PMC9187079 DOI: 10.1371/journal.pone.0269934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 05/31/2022] [Indexed: 12/22/2022] Open
Abstract
Periodontitis is greatly related to worse perceived oral health-related quality of life (OHRQoL), yet this association has never been explored using radiographically screened periodontal bone loss. Here we have radiographically screened patients for periodontitis via a validated method and assessed its association with measures of OHRQoL. From a total of 10,267 participants (6,112 females and 4,155 males), self-reported general health questionnaire, body mass index, self-reported oral health behaviours, panoramic x-rays and the oral health impact profile (OHIP-14) were gathered. Radiographically screened periodontitis was measured through a radiographic-based periodontal bone loss (R-PBL) approach. We compared the respective variables according to the R-PBL status and explored using multiple logistic regression adjusted for the significant variables. Overall, patients with periodontitis shown significantly different sociodemographic, health measures and oral hygiene characteristics. All domains of the OHIP-14 were significantly worsened in the periodontitis group, and further confirmed through adjusted logistic regression (p<0.001). Active smoking, number of missing teeth, sex and age were the most impactful variables in this relationship. Our results demonstrate the existence of a link between radiographically screened periodontitis and OHRQoL, mostly upheld by active smoking, number of missing teeth, sex and age.
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28
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Birkeholm Jensen A, Haubek D. Self-perception of periodontal health and pain experience during periodontal examination in 14- to 15-year-old Danish adolescents. Acta Odontol Scand 2022; 80:554-560. [PMID: 35694740 DOI: 10.1080/00016357.2022.2052958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To evaluate different aspects of periodontal examination among Danish adolescents. MATERIALS AND METHODS In all, 521 Danish adolescents underwent a periodontal examination and answered a questionnaire concerning their self-perception of periodontal health (PH). Furthermore, 107 participants reported their pain experience during periodontal examination using a visual analog scale. The self-perception of PH and the pain experience were correlated with plaque score (PS), bleeding on probing (BOP), probing pocket depth (PPD), and interdental clinical attachment loss (CAL). RESULTS Good PH was reported by 424 (81%) of the participants. However, the association between PH and PS, BOP, PPD, and CAL was small (sensitivity: 7.7, 7.8, 12.0, and 0.0%, respectively). Only 57 (11%) of the participants reported bleeding gums (BG) during tooth brushing, but the correlation with BOP showed a sensitivity of 11.7%. The specificity of both self-perception of PH and BG was high. Sixty-seven (66.6%) of the participants experienced 'mild pain' during periodontal examination. There were no differences in periodontal outcomes between the pain groups (p > .05). CONCLUSIONS The adolescents showed a poor ability to identify themselves as having poor PH and BG, and 67 (66.6%) of the adolescents experienced mild pain during periodontal examination. The findings emphasize the need for dental staff to monitor the PH of Danish adolescents and advise them as necessary.
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Affiliation(s)
| | - Dorte Haubek
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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29
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Sim CPC, Li H, Peres MA. Who to Be Treated: Nomogram Using Self-Reported Periodontal Screening Instrument among English-Speaking Adults in Multi-Ethnic Singapore. J Pers Med 2022; 12:jpm12060931. [PMID: 35743716 PMCID: PMC9225178 DOI: 10.3390/jpm12060931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023] Open
Abstract
Periodontal disease is a major public health problem. This study aimed to develop a nomogram using a self-reported periodontitis screening instrument in predicting severe periodontitis (SP), defined by the World Workshop on Classification of Periodontal and Peri-Implant Diseases and Conditions, and evaluate its utility in clinical setting. An Akaike information criterion selected multivariable model was developed to predict SP using a self-reported questionnaire, with a nomogram developed based on its regression coefficients. Discriminatory capability was evaluated by Receiver-operating characteristic curve. Ability to predict SP of individual patients was evaluated with bootstrapping. Decision curve analysis (DCA) was performed to evaluate its potential clinical utility by evaluating clinical net benefit at different thresholds. 58.1% of 155 participants were classified with SP. Older males without tertiary education, with ‘loose teeth’, ‘bone loss’ and ‘mouth rinse use’ had higher SP risk. The nomogram showed excellent discriminatory capability with Area under Curve of 0.83 (95% CI = (0.76, 0.89)), good calibration (intercept = 0.026) and slight overestimation of high risk and underestimation of low risk (slope = 0.834). DCA showed consistent clinical net benefit across the range of thresholds relative to assumption of ‘no patient’ or ‘all patient’ with SP. Our nomogram using a self-reported periodontitis instrument is useful in SP screening in English-speaking Singaporean adults.
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Affiliation(s)
- Christina P. C. Sim
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore 169857, Singapore
- Correspondence: ; Tel.: +65-6324-8928; Fax: +65-6324-8900
| | - Huihua Li
- ACP Research Office, National Dental Centre Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore;
- Centre for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore 169857, Singapore
| | - Marco A. Peres
- National Dental Centre Singapore, National Dental Research Institute Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore;
- Oral Health Academic Clinical Programme, Health Services and Systems Research Institute Singapore, Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore 169857, Singapore
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Salivary Assessments in Post-Liver Transplantation Patients. J Clin Med 2022; 11:jcm11113152. [PMID: 35683539 PMCID: PMC9181838 DOI: 10.3390/jcm11113152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 02/04/2023] Open
Abstract
Saliva is in the first line of the body's defense mechanism. In order to better understand how liver transplantation impacts salivary biochemistry, the aim of this cross-sectional study was to explore variations of salivary markers for oral health in post-liver transplantation patients, as compared with systemically healthy dental outpatients (controls). In this case, 26 patients were enrolled in each group, with similar socio-demographic characteristics. Unstimulated whole saliva was collected; total protease activity and total protein content were measured. The oral health in both groups was assessed using a self-report oral health questionnaire. Data were analyzed using parametric and nonparametric tests. Comparable results were recorded in terms of salivary protein and protease activity assessments. In post-liver transplantation group, positive correlation was found between the salivary pH level and the salivary secretion rate (r = 0.39; p = 0.04). With respect to self-reported oral health, there were no significant differences between the two groups, except for dental and oral care habits, the controls reporting more frequently use of dental floss and mouthwash (p = 0.02, and p = 0.003, respectively). Considering the high risk for developing systemic complications after liver transplantation, oral health care is an important issue to be addressed, salivary investigations representing powerful tool for disease changes monitoring.
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Self-Reported Gum Bleeding, Perception, Knowledge, and Behavior in Working-Age Hong Kong Chinese-A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095749. [PMID: 35565144 PMCID: PMC9103544 DOI: 10.3390/ijerph19095749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 12/10/2022]
Abstract
Gingivitis and periodontitis are highly prevalent in Hong Kong, where the provision of oral health services is predominantly private. This cross-sectional study aimed to investigate the association between the oral symptoms of gum bleeding and self-reported behavioral factors, beliefs, and knowledge among Hong Kong Chinese. The research team commissioned the Public Opinion Programme of The University of Hong Kong to conduct a structured, population-based, computer-assisted telephone interview (CATI), which covered questions related to the demography, perception, and knowledge (including traditional Cantonese beliefs) of gum health, dental attendance, oral health behavior, and dental anxiety. A total of 1,265 individuals aged 25−60 years old were successfully contacted, and 704 (55.7%) reported prior gum bleeding experience. A total of 516 individuals (64.9% females, median 55−60 years) completed the CATI satisfactorily, and 321 (62.2%) experienced gum bleeding in the past 12 months. The factors that were significantly associated with reports of gum bleeding in the past 12 months include having periodontitis, sensitive teeth, having tertiary or higher education, flossing/interdental cleaning, not cleaning teeth well enough, lack of sleep, consuming too much ‘heaty’ food, avoiding going to the dentist when gums are bleeding, and waiting for gum bleeding to subside (p < 0.05, r2 =0.198; forward stepwise logistic regression). Within the limitations of this study, approximately half of the Hong Kong working-age adults surveyed reported experiencing gum bleeding, and 62.2% of the participants experienced it within the past 12 months. Members of Hong Kong’s working-age population who reported having higher levels of education appeared more readily aware of their gum problems. Those with bleeding gums, especially those who have discernable periodontitis, poor dental awareness/behaviors, and/or a poor lifestyle should be targeted to receive education and encouragement, which will allow them to take action and improve their own gum health.
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Pimentel RP, Bittencourt LF, Miller LM, Borges RB, Oppermann RV, Gomes SC. Self-reported questionnaire on periodontal condition validated for use in Brazil. Braz Oral Res 2022; 36:e060. [PMID: 36507747 DOI: 10.1590/1807-3107bor-2022.vol36.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 01/12/2022] [Indexed: 12/15/2022] Open
Abstract
There is a current expectation of instruments for periodontal condition surveillance worldwide. The present study aimed to validate the Oral Health Questions Set B (OHQB) for the Brazilian Portuguese and evaluate its temporal stability. This is a sequential mixed-method investigation. After the forward-backward translation process to the Brazilian Portuguese, the OHQB Brazil (OHQB-Br) was applied to 156 participants (39.5 ± 14.14 years; 51.9% males). In sequence, through a full-mouth six-sites/teeth examination and in accordance with the original instrument, the periodontal diagnosis was obtained (March 2020). In January 2021, the OHB-BR was reapplied (n = 71). Ordinal alpha and McDonald's omega tested the internal consistency of the OHQB-Br. Temporal stability was investigated [Spearman correlation, intraclass correlation coefficient (ICC), and the Bland-Altman]. The concurrent validity was also verified, considering the periodontal clinical diagnosis (Kruskal Wallis). The ordinal alpha (0.69) and McDonald's omega (0.73) coefficients showed an adequate internal consistency of the OHQB-Br. The OHQB-Br temporal stability was high, as demonstrated by the Spearman coefficient (0.80) and ICC (0.79) and by the Bland-Altman plot. A concurrent validity showed a direct relationship between the OHQB-Br and the clinical condition of no periodontitis, mild, moderate, and severe periodontitis (p < 0.05). Because the OHQB-Br shows internal validity, temporal stability, and adequately identifies periodontal health and moderate/severe periodontitis, the instrument might represent an important tool, at the public level or other settings, for periodontal surveillance in Brazil.
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Affiliation(s)
- Roberto Pereira Pimentel
- Universidade Federal do Rio Grande do Sul - UFRGS, School, of Dentistry, Porto Alegre, RS, Brasil
| | - Liana Flores Bittencourt
- Universidade Federal do Rio Grande do Sul - UFRGS, School, of Dentistry, Porto Alegre, RS, Brasil
| | - Luisa Martins Miller
- Universidade Federal do Rio Grande do Sul - UFRGS, School, of Dentistry, Porto Alegre, RS, Brasil
| | - Rogério Boff Borges
- Hospital de Clínicas de Porto Alegre - HCPA, Biostatistics Unit, Porto Alegre, RS, Brasil
| | - Rui Vicente Oppermann
- Universidade Federal do Rio Grande do Sul - UFRGS, School, of Dentistry, Department of Periodontics, Porto Alegre, RS, Brasil
| | - Sabrina Carvalho Gomes
- Universidade Federal do Rio Grande do Sul - UFRGS, School, of Dentistry, Department of Periodontics, Porto Alegre, RS, Brasil
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Self-reported periodontitis and C-reactive protein in Parkinson's disease: a cross-sectional study of two American cohorts. NPJ Parkinsons Dis 2022; 8:40. [PMID: 35418117 PMCID: PMC9008053 DOI: 10.1038/s41531-022-00302-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 03/10/2022] [Indexed: 12/20/2022] Open
Abstract
Periodontitis triggers systemic repercussions, such as elevated levels of high-sensitive C-reactive protein (hs-CRP). This has never been studied within Parkinson's Disease (PD). The aim of this study is to compare hs-CRP levels of self-reported periodontitis cases versus cases without periodontitis in PD patients. Data from the National Health and Nutrition Examination Survey (2015-2016 and 2017-2018 waves) were analyzed. PD cases were identified through medication regimens and periodontitis cases through a validated self-report questionnaire. 51 participants were included (24 females, 27 males, with mean age of 62.96 (14.71)). While the self-reported periodontitis group presented elevated levels of circulating hs-CRP (5.36 vs. 1.99 mg/L, p = 0.031), the self-reported without periodontitis group presented higher lymphocyte levels (29.35 vs. 28.03%, p = 0.007). Blood levels of hs-CRP were significantly higher in PD cases with self-reported periodontitis. Apart from the lymphocyte levels, there were no other significant differences according to the self-reported periodontal status. Future studies shall explore this association using clinical measures.
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Kocher T, Holtfreter B, Nauck MA. Comment: Type 1 diabetes and oral health: Findings from the Epidemiology of Diabetes Interventions and Complications (EDIC) study. J Diabetes Complications 2022; 36:108146. [PMID: 35256267 DOI: 10.1016/j.jdiacomp.2022.108146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany.
| | - Birte Holtfreter
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, University Medicine Greifswald, Greifswald, Germany
| | - Michael A Nauck
- Diabetes, Endocrinology and Metabolism Section, Medical Department I, Katholisches Klinikum Bochum gGmbH, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany
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Idrissi Janati A, Karp I, Latulippe JF, Charlebois P, Emami E. Periodontal disease as a risk factor for sporadic colorectal cancer: results from COLDENT study. Cancer Causes Control 2022; 33:463-472. [PMID: 35079924 PMCID: PMC8821510 DOI: 10.1007/s10552-021-01541-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 12/14/2021] [Indexed: 02/06/2023]
Abstract
Colorectal cancer remains the top leading cancer worldwide. Accumulating evidence suggests periodontal pathogens are involved in colorectal carcinogenesis, indicating the need for high-quality epidemiological evidence linking periodontal disease (PD) and colorectal cancer (CRC). Thus, we conducted the first population-based case–control study that was specifically designed to investigate the association between compromised oral health and sporadic CRC. A total of 348 incident cases of colon or rectal cancer, and 310 age and sex frequency-matched controls, from the Montreal island and Laval population participated in the study. Data were collected on PD and on several CRC risk factors using validated questionnaires. A life-course approach was used to document long-term history regarding lifestyle factors. Multivariable unconditional logistic regression analysis was used to estimate the rate ratio (RR) quantifying the association between CRC and PD. Results showed that the rate of new diagnosis of CRC in persons with a positive history of PD was 1.45 times higher than in those with a negative history of PD adjusting for age, sex, BMI, education, income, diabetes, family history of CRC, regular use of non-steroidal anti-inflammatory drugs, lifetime cumulative smoking, lifetime consumption of red meats, processed meats, and alcoholic drinks, and lifetime total physical activity score (adjusted RR = 1.45; 95% CI 1.04–2.01; p = 0.026). Our results support the hypothesis of an association between PD and sporadic CRC risk.
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Affiliation(s)
| | - Igor Karp
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Jean-François Latulippe
- Department of Surgery, Hospital Maisonneuve-Rosemont, Université de Montréal, Montreal, QC, Canada
| | - Patrick Charlebois
- Department of Surgery, McGill University Health Centre, Montreal, QC, Canada
| | - Elham Emami
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, QC, H3A 1G1, Canada.
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Santos SA, Ortiz FR, Agostini BA, Ardenghi TM. Self-reported oral health and normative indices of dental caries among adolescents: a cohort study. Braz Oral Res 2022; 36:e021. [DOI: 10.1590/1807-3107bor-2022.vol36.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/10/2021] [Indexed: 11/21/2022] Open
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Shaheen RS, Alsaffan AD, Al-Dusari RS, Helmi RN, Baseer MA. Self-Perceived Oral Hygiene And Periodontal Health Among Dental and Medical Students, Dentists and Physicians in KSA. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/nvczej0ybv] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Influence of symptomatic periodontal disease on changes in skeletal bone density during medication therapy for osteoporosis in postmenopausal women: the Japanese Osteoporosis Intervention Trial (JOINT)-04 and JOINT-05. Arch Osteoporos 2021; 17:7. [PMID: 34958402 DOI: 10.1007/s11657-021-01054-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/20/2021] [Indexed: 02/03/2023]
Abstract
Japanese postmenopausal women with symptomatic periodontal disease had a significantly smaller increase in the T-score for total hip bone density than those without periodontal disease during medication therapy for osteoporosis. Intervention to treat symptomatic periodontal disease before and/or during osteoporosis therapy could maintain the effect of osteoporosis medications. PURPOSE Women with periodontal disease may be more likely to develop osteoporosis. We evaluated whether the presence of symptomatic periodontal disease can influence changes in skeletal bone mineral density (BMD) during medication therapy for osteoporosis in Japanese postmenopausal women. METHODS A total of 4,258 postmenopausal women participated in the Japanese Osteoporosis Intervention Trial protocol number 4 (JOINT-04 trial) and number 5 (JOINT-05 trial), which were multi-center, open-label, randomized controlled trials in Japan. Of these, 3,670 non-edentulous subjects participated in the study. Subjects who had self-reported symptoms of periodontal disease at baseline were defined as having periodontal disease. The study outcome was the difference in BMD changes during the study between subjects with and without periodontal disease. Mixed models for repeated measures after adjusting for covariates were used to investigate the difference in the BMD changes during the study between subjects with and without periodontal disease. RESULTS Subjects with periodontal disease had significantly lower T-scores for total hip (p = 0.035) and metacarpal (p = 0.048) BMD than those without periodontal disease at baseline. During medication therapy for osteoporosis, subjects with periodontal disease had a significantly smaller increase in T-score for total hip BMD than those without periodontal disease (p = 0.021), although no significant differences were observed in the changes in T-scores for other skeletal BMD measurements between subjects with and without periodontal disease. CONCLUSIONS The presence of self-reported symptoms of periodontal disease may be associated with a decrease in the effect of osteoporosis medications in Japanese postmenopausal women.
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Nijland N, Overtoom F, Gerdes VEA, Verhulst MJL, Su N, Loos BG. External validation of a rapid, non-invasive tool for periodontitis screening in a medical care setting. Clin Oral Investig 2021; 25:6661-6669. [PMID: 33978832 PMCID: PMC8602137 DOI: 10.1007/s00784-021-03952-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/16/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Medical professionals should advise their patients to visit a dentist if necessary. Due to the lack of time and knowledge, screening for periodontitis is often not done. To alleviate this problem, a screening model for total (own teeth/gum health, gum treatment, loose teeth, mouthwash use, and age)/severe periodontitis (gum treatment, loose teeth, tooth appearance, mouthwash use, age, and sex) in a medical care setting was developed in the Academic Center of Dentistry Amsterdam (ACTA) [1]. The purpose of the present study was to externally validate this tool in an outpatient medical setting. MATERIALS AND METHODS Patients were requited in an outpatient medical setting as the validation cohort. The self-reported oral health questionnaire was conducted, demographic data were collected, and periodontal examination was performed. Algorithm discrimination was expressed as the area under the receiver operating characteristic curve (AUROCC). Sensitivity, specificity, and positive and negative predictive values were calculated. Calibration plots were made. RESULTS For predicting total periodontitis, the AUROCC was 0.59 with a sensitivity of 49% and specificity of 68%. The PPV was 57% and the NPV scored 55%. For predicting severe periodontitis, the AUROCC was 0.73 with a sensitivity of 71% and specificity of 63%. The PPV was 39% and the NPV 87%. CONCLUSIONS The performance of the algorithm for severe periodontitis is found to be sufficient in the current medical study population. Further external validation of periodontitis algorithms in non-dental school populations is recommended. CLINICAL RELEVANCE Because general physicians are obligated to screen patients for periodontitis, it is our general goal that they can use a prediction model in medical settings without an oral examination.
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Affiliation(s)
- N Nijland
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands.
| | - F Overtoom
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands
| | - V E A Gerdes
- Department of Vascular Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - M J L Verhulst
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands
- Sunstar Suisse, Etoy, Switzerland
| | - N Su
- Department of Oral Public Health, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - B G Loos
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081, LA, Amsterdam, The Netherlands
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Kothari SF, Nascimento GG, De Caxias FP, Jakobsen MB, Nielsen JF, Kothari M. Internal structure and validity of the bedside oral examination tool in patients with brain injury at neurorehabilitation setting. J Oral Rehabil 2021; 49:344-352. [PMID: 34817886 DOI: 10.1111/joor.13285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To assess the internal structure and validity of the 'bedside oral examination' (BOE) instrument in individuals with acquired brain injury (ABI). METHODS Ninety ABI individuals were examined using BOE in their first week of neurorehabilitation. BOE measures oral health within eight categories including: swallow, tongue, odour, teeth, lips, saliva, mucosa and gingiva. To assess the validity of BOE, full-mouth clinical examination (gold standard) was performed. The internal structure of BOE was assessed using exploratory and confirmatory factor analyses. To measure the validity, the BOE scores were dichotomised into excellent oral health and altered oral health. Sensitivity, specificity and area under the receiver operating characteristic (ROC) curve of the six/eight BOE items were compared with their related clinical oral examination tool. RESULTS Overall, the patients had poor oral health irrespective of the oral examination tool used. Factor analyses indicated two factors within BOE: 'oral hygiene' (teeth, gingiva and mucosa) and 'orofacial health' (lips, swallow and saliva). BOE tongue and odour items loaded in neither factor. BOE items showed low validity since the highest area under the ROC curve was 0.60. Findings on the sensitivity value ranged from 35.0 to 74.2, while specificity from 44.4 to 83.3, depending on the item evaluated. CONCLUSION Bedside oral examination does not seem to be an ideal 'single' outcome tool in a neurorehabilitation setting as it lacks validity. BOE evaluates oral health as two independent but correlated components and treat them separately indicating precision treatment depending on their oral health dysfunction. It is advisable to use BOE as a screening tool. However, it should be complimented by proper clinical examination before establishing a treatment plan for oral health in patients with ABI.
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Affiliation(s)
- Simple F Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Hammel, Denmark.,Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Fernanda P De Caxias
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - Mille B Jakobsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Hammel, Denmark
| | - Jørgen F Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Hammel, Denmark
| | - Mohit Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Hammel, Denmark.,JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, India
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Perdoncini NN, Furquim CP, Bonfim CMS, Soares GMS, Torres-Pereira CC. Self-perception of periodontal health status among individuals with Fanconi anemia. Hematol Transfus Cell Ther 2021; 43:453-458. [PMID: 33023865 PMCID: PMC8573027 DOI: 10.1016/j.htct.2020.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/05/2020] [Accepted: 07/20/2020] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Fanconi anemia (FA) is a rare genetic disease characterized by congenital malformations and bone marrow failure. One of the most common oral diseases in individuals with FA is periodontitis and adequate self-perception of periodontal status could contribute to its prevention and early detection. AIM To compare oral health self-perception, measured by a questionnaire, with the clinical oral condition of patients with FA. METHODS AND RESULTS Fifty-six patients with FA, over 11 years of age, answered a questionnaire about dental history and self-reported oral health. Decayed, missing, and filled teeth (DMFT), Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) were measured. The median age of participants was 21 years (min 11, max 44), 31 (55%) were females and 25 (45%) males. Thirty-five (62.5%) participants rated their oral condition as satisfactory and 7 (12.5%) participants reported tooth mobility, 10 (17.9%) exposed roots and 21 (37.5%) gingival bleeding. Clinical examination detected average DMFT = 5.23, VPI = 31.36% and GBI = 33.77%. The gingival bleeding report was more frequent among individuals with higher GBI (p = 0.014). The DMFT was higher in those who had already undergone dental treatments (p = 0.031). There was an association between participants who presented dental caries and who rated their oral health as poor (p = 0.03). The question "Do your gums bleed easily?" had good accuracy in the evaluation of periodontal disease (p = 0.68). CONCLUSION Oral health self-perception of individuals with FA about gingival inflammation was associated with their gingival bleeding index.
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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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Chaffee BW. Cannabis Use and Oral Health in a National Cohort of Adults. JOURNAL OF THE CALIFORNIA DENTAL ASSOCIATION 2021; 49:493-501. [PMID: 34483631 PMCID: PMC8415705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Cannabis use is common and increasing among adults. Evidence connects cannabis use to poor periodontal health, but few prospective studies exist of adults in the United States. METHODS This investigation examined associations between cannabis use and self-reported adverse oral health conditions among participants (N = 18,872) in the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative cohort. Survey-weighted regression modeling estimated associations between cannabis use and seven self-reported measures of oral health status, adjusted for tobacco use and other disease risk factors. RESULTS Reporting past-30-days cannabis use in any of PATH Waves 1-3 was positively and statistically significantly associated at Wave 4 with multiple periodontal disease sequalae and with self-rated fair or poor overall oral health (adjusted odds ratio versus never-users: 1.75; 95% confidence interval: 1.52, 2.01). CONCLUSIONS These findings provide further evidence that cannabis use is an independent risk factor for poor oral health, although study limitations (self-reported outcomes, limited information on cannabis use frequency and modality) must be considered. PRACTICAL IMPLICATIONS Dental professionals should engage patients in clear, nonjudgmental dialogue about cannabis use to address oral health risks and avoid potential patient safety issues in care delivery. General recommendations for addressing cannabis use in dental practice are presented.
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Affiliation(s)
- Benjamin W Chaffee
- Associate professor of oral epidemiology and dental public health at the University of California, San Francisco, School of Dentistry
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Validation of a self-report questionnaire for periodontitis in a Japanese population. Sci Rep 2021; 11:15078. [PMID: 34301979 PMCID: PMC8302714 DOI: 10.1038/s41598-021-93965-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/30/2021] [Indexed: 12/25/2022] Open
Abstract
We aimed to assess the validity of the self-report questionnaire for periodontitis in a Japanese population. A Japanese 9-item self-report questionnaire, developed by translating English-version questions that were used to detect periodontitis, was validated against full-mouth clinically-assessed periodontitis in 949 Japanese adults (average age = 43.2 years). Multivariable logistic regression modeling was used to calculate the area under the receiver operating characteristic curve (AUC), wherein the periodontitis case definition of the Centers for Disease Control and Prevention/American Academy of Periodontology was considered the gold standard. Severe, moderate, and mild periodontitis were identified in 6.2%, 30.0%, and 6.7% of the study population, respectively. Self-reported oral health questions combined with socio-demographic and health-related variables had an AUC > 0.70 (range, 0.71-0.87) for any periodontitis category. Four oral health questions ("have gum disease," "loose tooth," "lost bone," and "bleeding gums") were selected in the parsimonious model for severe periodontitis. The periodontitis screening score generated by the responses to these four questions had an AUC, sensitivity, and specificity of 0.82, 73.1%, and 74.3%, respectively, where the cut-off was set at 2 points. In conclusion, a locally adapted version of the self-report questionnaire had an acceptable diagnostic capacity for the detection of periodontitis in this study population.
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Larvin H, Wilmott S, Kang J, Aggarwal V, Pavitt S, Wu J. Additive Effect of Periodontal Disease and Obesity on COVID-19 Outcomes. J Dent Res 2021; 100:1228-1235. [PMID: 34271846 PMCID: PMC8461046 DOI: 10.1177/00220345211029638] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
This study aims to examine the impact of periodontal disease in obesity on COVID-19 infection and associated outcomes. This retrospective longitudinal study included 58,897 UK Biobank participants tested for COVID-19 between March 2020 and February 2021. Self-reported oral health indicators (bleeding gums, painful gums, and loose teeth) were used as surrogates for periodontal disease. Body fat levels were quantified by body mass index (BMI) and categorized as normal weight (18.5 to 24.9 kg/m2), overweight (25 to 29.9 kg/m2), and obese (≥30 kg/m2). Multivariable logistic regression and Cox proportional hazard models were used to quantify risk of COVID-19 infection, hospital admission, and mortality, adjusted for participants’ demographics and covariates. Of 58,897 participants, 14,466 (24.6%) tested positive for COVID-19 infection. COVID-19 infection was higher for participants who were overweight (odds ratio, 1.18; 95% CI, 1.12 to 1.24) and obese (odds ratio, 1.33; 95% CI, 1.26 to 1.41) as compared with those of normal weight, but infection was not affected by periodontal disease. The hospital admission rate was 57% higher (hazard ratio, 1.57; 95% CI, 1.25 to 1.97) in the obese group with periodontal disease than without periodontal disease, and admission rates increased with BMI category (normal weight, 4.4%; overweight, 6.8%; obese, 10.1%). Mortality rates also increased with BMI category (normal weight, 1.9%; overweight, 3.17%; obese, 4.5%). In addition, for participants with obesity, the mortality rate was much higher (hazard ratio, 3.11; 95% CI, 1.91 to 5.06) in participants with periodontal disease than those without. Obesity is associated with higher hospitalization and mortality rates, and periodontal disease may exacerbate this impact. The results could inform health providers, policy makers, and the general public of the importance to maintain good oral health through seamless provision of dental services and public oral health prevention initiatives.
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Affiliation(s)
- H. Larvin
- School of Dentistry, University of Leeds, Leeds, UK
| | - S. Wilmott
- Leeds Dental Institute, Leeds Teaching Hospitals Trust, Leeds, UK
| | - J. Kang
- Oral Biology, School of Dentistry, University of Leeds, Leeds, UK
| | | | - S. Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
| | - J. Wu
- School of Dentistry, University of Leeds, Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
- J. Wu, University of Leeds, Worsley Building, Level 6, Clarendon Way, Leeds, LS2 9LU, UK.
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Epidemiology and associated factors of gingivitis in adolescents in Guangdong Province, Southern China: a cross-sectional study. BMC Oral Health 2021; 21:311. [PMID: 34134691 PMCID: PMC8207589 DOI: 10.1186/s12903-021-01666-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/04/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Gingivitis is the most prevalent form of periodontal disease in children and adolescents, being strongly associated to some socioeconomic factors and oral health behaviours. This study aimed to assess the prevalence of gingivitis and its association with socio-demographic factors and oral health-related behaviours in children aged 12-15 years in Guangdong, Southern China. METHODS A total of 7680 children were sampled using an equal-sized, stratified, multistage, random sampling method and clinically examined between December 2015 and April 2016. A questionnaire on socio-demographic factors and oral health-related behaviours related to gingivitis was completed by each of the selected children. Gingival bleeding was recorded using the Community Periodontal Index probe, and children with a gingival bleeding positive score ≥ 10% were defined as having gingivitis. A multivariate logistic regression analysis was performed to assess the association between socio-demographic factors and gingivitis. All statistical tests were performed at a two-sided significance level of 0.05. RESULTS The weighted prevalence of gingivitis among 12-15-year-old children was 29.6%, with 22.6% having localised gingivitis and 7.0% having generalised gingivitis. Age differences were observed in the prevalence of gingivitis, whereas urban-rural differences were not. According to the multivariate logistic regression analysis results, factors such as increasing age, being the only child, lack of regular annual dental check-up, and heavy dental calculus were significantly associated with higher prevalence of gingivitis. In addition, the association of gingivitis with these factors was inconsistent among the urban and rural areas. CONCLUSIONS Dental calculus and oral health behaviour were found to be important factors for maintaining the gingival health of children aged 12-15 years in Guangdong. Maintaining gingival health in children requires promoting positive oral health behaviours and regular dental prophylaxis.
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Ramírez GM, Villar CC, Saraiva L, Benítez CG, Rubio CM, Malheiros ZM, Stewart B, Kilpatrick L, Romito GA. The effect of a toothpaste containing oleanolic acid in reducing plaque and gingivitis: a proof-of-concept randomized trial. Int J Dent Hyg 2021; 19:450-463. [PMID: 34046989 DOI: 10.1111/idh.12526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/17/2021] [Accepted: 05/22/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess the safety and efficacy of an oleanolic acid (OA)-containing toothpaste in reducing gingival inflammation and plaque in patients with gingivitis. METHODS This proof-of-concept parallel, double-blind, randomized controlled clinical trial included 99 patients. Following a 1-week washout, patients were randomized into three groups: OA group (fluoride toothpaste containing 0.1% OA and placebo mouthwash); negative control (fluoride toothpaste and placebo mouthwash); and CHX group (fluoride toothpaste and 0.12% chlorhexidine mouthwash). Patients were clinically assessed at inclusion, pre-washout visit, baseline and after 4 days, 1 week and 2 weeks of twice-daily use of the products. Patients received a diary for documentation of bleeding on brushing and provided unstimulated saliva samples. RESULTS After two weeks, all groups showed significant reductions in all clinical parameters. The CHX group exhibited significantly greater reductions in gingival index and interproximal gingival index scores at week 2, as compared to patients in the negative control (p = 0.04). In contrast, reductions in gingival index scores did not differ between CHX and OA groups and between OA and negative control groups at week 2. The CHX group had significantly greater reductions in plaque index scores at day-4, 1-week and 2-week evaluations, as compared to the negative control and OA groups. The frequency of adverse events was similar among the groups. None of the groups reduced salivary transferrin levels. Finally, the OA group had the lowest percentage of self-reported bleeding events. CONCLUSION OA toothpaste failed to provide antiplaque and antigingivitis effects superior to those of a fluoride toothpaste after 2 weeks of use.
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Affiliation(s)
- Gloria M Ramírez
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Cristina Cunha Villar
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Luciana Saraiva
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Carlos G Benítez
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Colgate-Palmolive, Piscataway, NJ, USA
| | - Carlos M Rubio
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Giuseppe A Romito
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Goulão B, MacLennan GS, Ramsay CR. Have you had bleeding from your gums? Self-report to identify giNGival inflammation (The SING diagnostic accuracy and diagnostic model development study). J Clin Periodontol 2021; 48:919-928. [PMID: 33751629 DOI: 10.1111/jcpe.13455] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 02/26/2021] [Accepted: 02/28/2021] [Indexed: 12/22/2022]
Abstract
AIM To assess the diagnostic performance of self-reported oral health questions and develop a diagnostic model with additional risk factors to predict clinical gingival inflammation in systemically healthy adults in the United Kingdom. METHODS Gingival inflammation was measured by trained staff and defined as bleeding on probing (present if bleeding sites ≥ 30%). Sensitivity and specificity of self-reported questions were calculated; a diagnostic model to predict gingival inflammation was developed and its performance (calibration and discrimination) assessed. RESULTS We included 2853 participants. Self-reported questions about bleeding gums had the best performance: the highest sensitivity was 0.73 (95% CI 0.70, 0.75) for a Likert item and the highest specificity 0.89 (95% CI 0.87, 0.90) for a binary question. The final diagnostic model included self-reported bleeding, oral health behaviour, smoking status, previous scale and polish received. Its area under the curve was 0.65 (95% CI 0.63-0.67). CONCLUSION This is the largest assessment of diagnostic performance of self-reported oral health questions and the first diagnostic model developed to diagnose gingival inflammation. A self-reported bleeding question or our model could be used to rule in gingival inflammation since they showed good sensitivity, but are limited in identifying healthy individuals and should be externally validated.
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Affiliation(s)
- Beatriz Goulão
- Health Services Research Unit, Centre for Healthcare Randomized Trials, University of Aberdeen, Aberdeen, UK
| | - Graeme S MacLennan
- Health Services Research Unit, Centre for Healthcare Randomized Trials, University of Aberdeen, Aberdeen, UK
| | - Craig R Ramsay
- Health Services Research Unit, Centre for Healthcare Randomized Trials, University of Aberdeen, Aberdeen, UK
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Periodontal Disease and Tooth Loss Are Associated with Lung Cancer Risk. BIOMED RESEARCH INTERNATIONAL 2021; 2020:5107696. [PMID: 32802852 PMCID: PMC7403933 DOI: 10.1155/2020/5107696] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/22/2020] [Accepted: 07/13/2020] [Indexed: 01/11/2023]
Abstract
Background The associations between periodontal disease, tooth loss, and lung cancer risk remain debatable. Therefore, the purpose of the present study is to evaluate whether periodontal disease and tooth loss are associated with lung cancer risk. Methods A literature search was performed for relevant studies using PubMed and Embase databases. Risk ratio (RR) with 95% confidence interval (CI) was applied as effect size to summarize the associations between periodontal disease, tooth loss, and lung cancer risk. A further dose-response analysis was also performed. Results A total of twelve studies comprising 263,238 participants were included. The results indicated that periodontal disease was positively associated with lung cancer risk (RR = 1.37, 95%CI = 1.16‐1.63). There was a positive association between tooth loss and lung cancer risk (RR = 1.69, 95%CI = 1.46‐1.96). Moreover, there was a significantly linear dose-response relationship between tooth loss and lung cancer risk, and every 5 increment in tooth loss was associated with 10% increased lung cancer risk. Similar results were obtained in subgroup analysis. Conclusions Periodontal disease and tooth loss are increased risk factors for lung cancer. Prevention and treatment of periodontal disease may be effective potential prevention strategies for lung cancer.
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Akinkugbe A, Raskin S, Donahue E, Youngblood M, Laniado N, Perreira K. Prevalence and Patterns of Dental Care Utilization among US-Born and Non-US Born Hispanics in the Hispanic Community Health Study/Study of Latinos. JDR Clin Trans Res 2021; 6:222-233. [PMID: 32437635 PMCID: PMC7970345 DOI: 10.1177/2380084420923338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Access to routine dental services is important to maintaining good oral health. The aims of this study were to describe the dental care utilization patterns of a diverse group of Hispanic/Latino men and women and assess differences in dental care utilization by perceived need for dental care and proxy measures of acculturation. METHODS Data from 13,792 participants of the Hispanic Community Health Study were analyzed with SAS 9.4. Time since last dental visit was dichotomized into <1 and ≥1 y. Acculturation measures included the language and social subscales of the Short Acculturation Scale for Hispanics, the Multiethnic Study of Atherosclerosis nativity subscore, and immigrant generation. Survey logistic regression adjusted for demographic (age and sex) and health-related variables, estimated associations among perceived need for dental care, acculturation measures, and dental care utilization. RESULTS About a quarter (23%) of the participants were born in the 50 US states, excluding territories, while 77% were non-US born. Overall, 74% perceived a need for dental care. Upon covariate adjustment, perceiving a need for dental care was associated with reduced odds of reporting a past-year dental visit (odds ratio, 0.32; 95% CI, 0.28 to 0.37), while there appeared to be no meaningful association between proxy measures of acculturation and past-year dental visit. Having health insurance was significantly associated with a past-year dental visit (odds ratio, 2.23; 95% CI, 1.99 to 2.49) for all groups combined and among the different Hispanic/Latino background groups. CONCLUSIONS Acculturation affects general health and contributes to general health disparities; however, its role in dental care utilization remains questionable. Given that acculturation is a process that occurs over several years, longitudinal studies that evaluate oral health trajectories along the acculturation continuum are needed. KNOWLEDGE TRANSFER STATEMENT The results of this study are valuable for dental public health program planning and implementation for minority groups, as it describes the varying patterns of dental care utilization among US-born and non-US born Hispanics/Latinos and identifies factors that may partly explain dental care utilization patterns, such as acculturation.
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Affiliation(s)
- A.A. Akinkugbe
- Department of Dental Public Health and
Policy, School of Dentistry, and Division of Epidemiology, School of Medicine,
Virginia Commonwealth University, Richmond, VA, USA
- Institute for Inclusion, Inquiry and
Innovation, Virginia Commonwealth University, Richmond, VA, USA
| | - S.E. Raskin
- Institute for Inclusion, Inquiry and
Innovation, Virginia Commonwealth University, Richmond, VA, USA
- L. Douglas Wilder School of Government
and Public Affairs, Virginia Commonwealth University, Richmond, VA, USA
| | - E.E. Donahue
- Department of Biostatistics, Virginia
Commonwealth University, Richmond, VA, USA
| | - M.E. Youngblood
- Data Coordinating Center, University of
North Carolina at Chapel Hill, NC, USA
| | - N.N. Laniado
- Department of Dentistry and Department
of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx,
NY, USA
| | - K.M. Perreira
- Department of Social Medicine, School of
Medicine, University of North Carolina, Chapel Hill, NC, USA
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