Trends in socioeconomic inequality of periodontal health status among Dutch adults: a repeated cross-sectional analysis over two decades

Association Between Gastroesophageal Reflux Disease and Periodontitis: A Longitudinal Follow-Up Study from the Korean National Health Screening Cohort

BACKGROUND

Gastroesophageal reflux disease (GERD) and periodontitis are common conditions in older adults that can lead to serious complications, gaining public health attention. Although GERD and periodontitis share common risk factors, such as age, lifestyle habits, and socioeconomic status, large-scale studies examining their specific relationship are limited.

METHODS

This study aimed to assess the association between GERD and the likelihood of developing periodontitis using a national validated cohort data from Korea. Data were drawn from the Korean National Health Insurance Service Health Screening Cohort (2004-2019) using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnostic codes. The study included 16,744 GERD patients and 66,976 matched controls (matched 1:4 by age, sex, income, and residence). Cox proportional hazard models estimated hazard ratios (HRs) for periodontitis, adjusting for various factors, with subgroup analyses based on age, income, and other covariates.

RESULTS

The overall incidence of periodontitis was similar between the GERD and control groups, with no significant difference in the adjusted hazard ratios (aHR = 1.00, 95% CI 0.99-1.02, p = 0.625). However, subgroup analyses in the GERD group showed a slightly increased likelihood of periodontitis in individuals over 60 years old (aHR = 1.03, 95% CI 1.00-1.06, p = 0.050) and those in lower-income brackets (aHR = 1.03, 95% CI 1.01-1.06, p = 0.023).

CONCLUSIONS

In summary, while GERD was not associated with an increased overall probability of periodontitis, age and socioeconomic factors may influence the likelihood of periodontitis development in certain GERD patients. These findings may highlight the need for targeted preventive strategies and closer oral health monitoring in older and lower-income populations with GERD.

Predictors of oral healthcare utilization and satisfaction among Indian migrants and the host population in the Netherlands

BACKGROUND

The aim of this study was to explore predictors associated with reasons for visiting an oral healthcare professional (OHP) and satisfaction with OHPs in the Netherlands among the Indian migrants and the host population.

METHODS

A random sample was obtained for this cross-sectional questionnaire study. Variables were classified according to the Andersen Behavioural Model of Health Services Utilization. Multivariable binary logistic regression analysis was conducted to identify significant predictors for reasons for visiting an oral healthcare professional (OHP) (routine checkups and preventive care or visiting only for pain and/or treatment) and satisfaction with OHPs (satisfied or dissatisfied).

RESULTS

The sample consisted of 391 participants (Indian migrants = 147 and host population = 244). Indian migrants with higher internal locus of control (LoC) [OR = 7.73 (95% CI: 2.13;27.99)], more trust in OHPs [OR = 4.12 (95% CI:1.68;10.14)] and higher integration level [OR = 1.09 (95% CI:1.03;1.17)] had higher odds of visiting an OHP for routine checkups and preventive care. In the host population, having dental insurance [OR = 2.64 (95% CI:1.00;6.95)] was significantly associated with increased odds of visiting an OHP for routine checkups and preventive care. For satisfaction, Indians with low paid jobs [OR = 16.26 (95% CI:2.83;93.36)] and those with higher integration levels [OR = 1.29 (95% CI:1.16;1.42)] had higher odds of being satisfied with the Dutch OHPs. Among the host population, those with more trust in OHPs [OR = 2.86 (95% CI:1.19;6.88)] had higher odds of being satisfied.

CONCLUSION

Our study emphasize that integration levels and trust emerged as two crucial factors, policy makers can leverage upon to improve access to care for Indian migrants.

CLINICAL TRIAL

N.A as this is a survey based cross sectional study.

Oral health inequalities among geriatric population: A systematic review

As per the World Health Organization, governments should aim to accomplish two significant global milestones by 2030: reducing health disparities and granting universal accessibility to healthcare. The aim of this article was to systematically review the inequalities and understand the multifactorial causation of oral health inequalities among the older adults.

Methods

Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) standards were used to carry out the review and is documented in PROSPERO CRD42026695761. Two authors did the search and screening in accordance with the protocol. Electronic databases such as PubMed, Google Scholar, and EBSCOhost articles of the last 10 years were searched for research presenting data on oral health status and oral health related quality of life in the elderly population. Quality assessment was performed using the Newcastle Ottawa Scale (NOS) for retrospective and prospective research.

Results

Only 24 studies fulfilled the eligibility criteria and were incorporated into the qualitative synthesis. Multiple aspects of oral health and the related variables influencing disparities in oral health in the elderly population living in institutions have a positive link.

Conclusion

The findings support the notion that this demographic consists of weak, dependent individuals who have poor oral health. The vulnerable elderly institutionalized population was recognized and validated, thus helps in providing measures that will eventually focus the risk factors to improve their OHRQoL.

Oral health status of Dutch Armed Forces recruits in the years 2000, 2010 and 2020, a retrospective repeated cross-sectional study

BACKGROUND

Studies on oral health status of adults are sparse and rarely include data on endodontic treatment and trauma. In the military, those data are available because recruits are routinely assessed with a clinical and radiological examination at the start of their career. This study aimed to identify differences in oral health status of Dutch Armed Forces recruits between cohorts, departments, sex, age and rank, with DMF-T, endodontic treatment and dental trauma as outcome measures.

METHODS

Data from Electronic Patient Files from all recruits enlisted in 2000, 2010 and 2020 were used for analysis in a hurdle model resulting in the estimated cohort effect, controlled for the demographic variables. The total number of recruits was 5,764. Due to the retrospective character of the study a proxy was used to compose D-T and dental trauma.

RESULTS

The mean DMF-T number in recruits decreases from 5.3 in cohort 2000 to 4.13 in cohort 2010 and 3.41 in cohort 2020. The percentage of endodontically treated teeth increases from 6% in cohort 2000 to respectively 9% in 2010 and 8% in 2020. The percentage of recruits showing signs of dental trauma did not change significantly between cohort 2000 (3.1%) and cohort 2010 and 2020 (both 2.7%).

CONCLUSIONS

Oral health in Armed Forces recruits is improving over the years, following a similar trend as the general population in the Netherlands. Lower SES represented by enlisted rank showed substantial lower oral health status.

Policy interventions to improve the accessibility and affordability of Dutch dental care. A scoping review of effective interventions

Caries and periodontitis remain prevalent in the Netherlands. Given the assumption that increasing the accessibility and affordability of dental care can improve oral health outcomes, policy interventions aimed at improving these aspects may contribute to better oral health. To identify possible solutions, this scoping review firstly identifies policy interventions from around the world that have effectively improved the accessibility or affordability of dental care. Secondly, this review discusses the potential of the policy interventions identified that are applicable to the Dutch healthcare sector specifically. A literature search was performed in four databases. Two reviewers independently screened all potentially relevant titles and abstracts before doing the same for the full texts. Only studies that had quantitatively evaluated the effectiveness of policy interventions aimed at improving the accessibility or affordability of dental care were included. 61 of the 1288 retrieved studies were included. Interventions were grouped into four categories. Capacity interventions (n = 5) mainly focused on task delegation. Coverage interventions (n = 25) involved the expansion of covered dental treatments or the group eligible for coverage. Managed care interventions (n = 20) were frequently implemented in school or community settings. Payment model interventions (n = 11) focused on dental reimbursement rates or capitation. 199 indicators were identified throughout the 61 included studies. Indicators were grouped into three categories: accessibility (n = 137), affordability (n = 21), and oral health status (n = 41). Based on the included studies, increasing managed care interventions for children and adding dental coverage to the basic health insurance plan for adults could improve access to dental care in the Netherlands. Due to possible spillover effects, it is advisable to investigate a combination of these policy interventions. Further research will be necessary for the development of effective policy interventions in practice.

Disparities and social determinants of periodontal diseases

Periodontal diseases are highly prevalent in populations worldwide and are a major global public health problem, with major negative impacts on individuals and communities. This study investigates evidence of disparities in periodontal diseases by age groups, gender, and socioeconomic factors. There is ample evidence that these diseases disproportionally affect poorer and marginalized groups and are closely associated with certain demographics and socioeconomic status. Disparities in periodontal health are associated with social inequalities, which in turn are caused by old age, gender inequality, income and education gaps, access to health care, social class, and other factors. In health care, these factors may result in some individuals receiving better and more professional care compared to others. This study also reviews the potential causes of these disparities and the means to bridge the gap in disease prevalence. Identifying and implementing effective strategies to eliminate inequities among minorities and marginalized groups in oral health status and dental care should be prioritized in populations globally.

Predictive factors for the treatment success of peri-implantitis: a protocol for a prospective cohort study

INTRODUCTION

Peri-implantitis, a common biological complication of dental implant, has attracted considerable attention due to its increasing prevalence and limited treatment efficacy. Previous studies have reported several risk factors associated with the onset of peri-implantitis (eg, history of periodontitis, poor plaque control and smoking). However, inadequate data are available on the association between these risk factors and successful outcome after peri-implantitis therapy. This prospective cohort study aims to identify the local and systemic predictive factors for the treatment success of peri-implantitis.

METHODS AND ANALYSIS

A single-centre cohort study will be conducted by recruiting 275 patients diagnosed with peri-implantitis. Sociodemographic variables, healthy lifestyles and systemic disorders will be obtained using questionnaires. In addition, clinical and radiographic examinations will be conducted at baseline and follow-up visits. Treatment success is defined as no bleeding on probing on more than one point, no suppuration, no further marginal bone loss (≥0.5 mm) and probing pocket depth ≤5 mm at the 12-month follow-up interval. After adjustment for age, sex and socioeconomic status, potential prognostic factors related to treatment success will be identified using multivariable logistic regression models.

ETHICS AND DISSEMINATION

This cohort study in its current version (2.0, 15 July 2022) is in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Stomatological Hospital, Southern Medical University (EC-CT-(2022)34). The publication will be on behalf of the study site.

TRIAL REGISTRATION NUMBER

ChiCTR2200066262.

Co-Payments and Inequality in Gingival Bleeding and Dental Visits

OBJECTIVES

Japan's universal health insurance covers a wide range of dental treatments, and the co-payment rates differ by age. We investigated whether the inequality in gingival bleeding and dental visits was smaller amongst those with lower co-payment rates.

METHODS

This cross-sectional study used data from the 2019 Japan Gerontological Evaluation Study. The participants were functionally independent adults aged 65 years or older. The dependent variables were current gingival bleeding as a symptom of periodontal diseases and dental nonattendance for treatment in the past year. The independent variables were ridit scores of equivalent income and educational status. For covariates, we used age, sex, and the number of remaining teeth. To evaluate the inequalities, we used the slope index of inequality (SII) and the relative index of inequality (RII). We also conducted stratified analyses by co-payment rates (30%, 20%, and 10%) to clarify the difference in inequalities by co-payment rate.

RESULTS

A total of 15,389 participants were included in the analysis; their mean age was 71.8 (SD = 4.1) and 51.8% were women. There were significant absolute and relative inequalities in gingival bleeding and dental visits by equivalent income and education. With regards to educational status, inequalities were lower with a decrease in the co-payment rate. In particular, relative inequality by education in gingival bleeding was the largest amongst the 30% co-payment group (RII, 1.918; 95% confidence interval [CI], 1.386 to 2.656). For gingival bleeding, the absolute and relative inequality by equivalent income were not significant amongst the 10% co-payment group (SII, -0.003; 95% CI, -0.003 to 0.028; RII, 1.006; 95% CI = 0.676 to 1.498).

CONCLUSIONS

A low co-payment rate was associated with smaller inequalities in gingival bleeding and dental visits by equivalent income and educational status.

Heavy metals in drinking water and periodontitis: evidence from the national oral health survey from China

BACKGROUND

Periodontitis has become an increasingly important public health issue, coupled with a high economic burden for prevention and treatment. Exposure to essential trace heavy metals has been associated with various diseases; however, the relationships between essential trace heavy metals and periodontitis remain inconclusive.

OBJECTIVES

To investigate the association between essential trace heavy metals in tap water and periodontitis in a nationally representative sample in China.

METHODS

We conducted a nationwide study including 1348 participants from the Fourth National Oral Health Survey in the 2015-2016 period. The trace heavy metals concentration was measured in the local pipeline terminal tap water. Periodontitis was diagnosed according to the classification scheme proposed at the 2018 world workshop on the classification of periodontal and peri-implant diseases and conditions. We used weighted multivariable logistic regression to estimate the association between essential trace heavy metals and the risk of periodontitis. We additionally used spline analysis to explore the possible nonlinear dose-response associations.

RESULTS

Periodontitis patients were exposed to higher concentrations of essential trace heavy metals. In adjusted models, for 1 SD increase in the concentration of iron, manganese, and copper in tap water, the risk of periodontitis increased by 30% (OR: 1.30, 95%CI: 1.12-1.50), 20% (OR: 1.20, 95%CI: 1.03-1.41), and 20% (OR: 1.20, 95%CI: 1.04-1.39), respectively. Stratified analyses demonstrated that the associations between essential trace heavy metals and periodontitis were higher in females, elders, and rural residents. Spline analysis revealed nonlinear exposure-response relationships between periodontitis and exposure to iron, manganese, and copper in tap water.

CONCLUSIONS

Exposures to essential trace heavy metals in drinking water were associated with greater odds of periodontitis. Given the growing burden of periodontitis, our study sheds light on tailored public health policies for improving drinking water standards to alleviate periodontitis impairment.

Chronic Periodontitis and the Potential Likelihood of Gastric Cancer: A Nested Case-Control Study in the Korean Population Utilizing a National Health Sample Cohort

There is limited information regarding the potential association between chronic periodontitis (CP) and gastric cancer, especially in the Korean population. This study aimed to explore this relationship. This nested case-control study analyzed data from 10,174 patients with gastric cancer and 40,696 controls from the Korean National Health Insurance Service-National Sample Cohort using propensity score matching. Standardized differences were used to compare baseline characteristics between study groups. Logistic regression analyses adjusted for confounders were conducted to assess the association between history of CP and gastric cancer occurrence. CP histories and comprehensive subgroup analyses in the 1- and 2-year periods preceding the index date were evaluated. Individuals with a history of CP within the 1-year and 2-year periods showed an increased likelihood of developing gastric cancer. Subgroup analyses consistently supported these findings in male participants aged <65 years and individuals with various income levels or living in residential areas. However, no significant associations were observed among participants aged ≥65 years. In conclusion, CP may be a potential risk factor for gastric cancer development in the Korean population. Regular screening for gastric cancer may be necessary for high-risk individuals, specifically men aged <65 years with a history of CP.