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Li X, Li Q, Wang L, Ding H, Wang Y, Liu Y, Gong T. The interaction between oral microbiota and gut microbiota in atherosclerosis. Front Cardiovasc Med 2024; 11:1406220. [PMID: 38932989 PMCID: PMC11199871 DOI: 10.3389/fcvm.2024.1406220] [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: 03/24/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024] Open
Abstract
Atherosclerosis (AS) is a complex disease caused by multiple pathological factors threatening human health-the pathogenesis is yet to be fully elucidated. In recent years, studies have exhibited that the onset of AS is closely involved with oral and gut microbiota, which may initiate or worsen atherosclerotic processes through several mechanisms. As for how the two microbiomes affect AS, existing mechanisms include invading plaque, producing active metabolites, releasing lipopolysaccharide (LPS), and inducing elevated levels of inflammatory mediators. Considering the possible profound connection between oral and gut microbiota, the effect of the interaction between the two microbiomes on the initiation and progression of AS has been investigated. Findings are oral microbiota can lead to gut dysbiosis, and exacerbate intestinal inflammation. Nevertheless, relevant research is not commendably refined and a concrete review is needed. Hence, in this review, we summarize the most recent mechanisms of the oral microbiota and gut microbiota on AS, illustrate an overview of the current clinical and epidemiological evidence to support the bidirectional connection between the two microbiomes and AS.
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Affiliation(s)
- Xinsi Li
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Chongqing Municipal KeyLaboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
| | - Qian Li
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Chongqing Municipal KeyLaboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
| | - Li Wang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Chongqing Municipal KeyLaboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Department of Implantology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Huifen Ding
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Chongqing Municipal KeyLaboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Department of Prosthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Yizhong Wang
- Department of Research & Development, Zhejiang Charioteer Pharmaceutical Co., Ltd, Taizhou, China
| | - Yunfei Liu
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Chongqing Municipal KeyLaboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Department of Implantology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Ting Gong
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Medical University, Chongqing, China
- Chongqing Municipal KeyLaboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, China
- Department of Implantology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
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Ghanbari Z, Moradi Y, Samiee N, Moradpour F. Dental caries prevalence in relation to the cardiovascular diseases: cross-sectional findings from the Iranian kurdish population. BMC Oral Health 2024; 24:509. [PMID: 38685018 PMCID: PMC11059578 DOI: 10.1186/s12903-024-04280-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/19/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE Oral and dental health (ODH) is a significant public health concern globally, affecting billions of people. This cross-sectional study aimed to examine the prevalence of dental caries using the DMFT index and investigate its relationship with cardiovascular diseases in the Iranian Kurdish population. METHODS A total of 3,996 individuals aged 35-70 years were included from the Dehgolan prospective cohort study (DehPCS). Clinical examinations were performed to assess decayed (DT), missing (MT) and filled (FT) teeth (DMFT index). Data on demographics, socioeconomic status, medical history, oral hygiene practices were also collected. Cardiovascular disease (CVD) history was self-reported via questionnaires assessing heart disease, heart attack and stroke. Logistic regression was used to assess associations between oral health indicators and self-reported CVD, adjusting for potential confounders. RESULTS The mean DMFT score was 18.18 ± 19, indicating a high oral disease burden. Specifically, 60.04% had DT, 37.82% had more than 16 MT, and 38.83% had FT. Only 13.21% reported flossing regularly and 43.17% brushed less than daily, showing suboptimal oral hygiene. The overall CVD prevalence was 9.21%. Individuals with high DMFT (≥ 14) scores had approximately two times higher CVD prevalence than those with low DMFT. DMFT decreased by 10.23% with increase in education level, and by 5.87% as economic status increased In adjusted analyses, high DMFT scores (OR = 1.5, 95%CI: 1.2-1.9) and MT (OR = 1.5, 95%CI: 1.1-2.1) were associated with 50-150% increased odds of CVD, though associations weakened after adjusting for age. Among men, DMFT remained a significant predictor for CVD after age adjustment, with an odds ratio of 2.37 (95% CI: 1.22-4.60). CONCLUSION This population had substantial oral disease and poor oral hygiene. Higher DMFT scores and MT positively correlated with increased CVD prevalence. Promoting preventive oral care and health education could help reduce dental issues and potentially lower CVD risk. Further research is needed to clarify biological mechanisms linking oral and systemic health.
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Affiliation(s)
- Zahra Ghanbari
- Department of oral and maxillofacial medicine, School of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Negin Samiee
- Department of oral and maxillofacial medicine, School of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health Development, University of Medical Sciences, Kurdistan, Sanandaj, Iran.
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Gomes-Filho IS, Freitas TOB, Cruz SSD, Trindade SC, Figueiredo ACMG, Couto Souza PH, Cerqueira EDMM, Hintz AM, Carneiro DO, Lacerda JAD, Seymour GJ, Scannapieco FA, Loomer PM, Passos-Soares JDS. Periodontitis in individuals with few remaining teeth and a high gingival bleeding index increases the probability of dyslipidemia. J Periodontol 2023; 94:1243-1253. [PMID: 37310101 DOI: 10.1002/jper.23-0091] [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: 02/11/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Dyslipidemia, a silent multifactorial condition, is characterized by changes in blood lipid levels, affecting all socioeconomic strata, increasing the risk for atherosclerotic diseases. This study investigated whether there is an association between dyslipidemia and the combined exposure of periodontitis plus the number of remaining teeth, gingival bleeding, or caries. METHODS A two-center cross-sectional study was conducted involving 1270 individuals, with a minimum age of 18 years. Socioeconomic and demographic data, health conditions, lifestyle parameters, and anthropometric, biochemical, and oral clinical examinations were performed. The exposures considered were the presence of periodontitis, dental caries, number of remaining teeth, and gingival bleeding. The outcome was dyslipidemia as defined by the Brazilian Guidelines on Dyslipidemia and Prevention of Atherosclerosis. The combined associations between periodontitis plus other oral health conditions and dyslipidemia were estimated using confounder-adjusted prevalence ratios (PRsingle , PRmultiple , for single and multiple covariable adjustments) with 95% confidence intervals (95% CIs), in a Poisson regression model with robust variance. RESULTS The occurrence of dyslipidemia was 70.1% and periodontitis was 84.1%. A positive association between periodontitis and dyslipidemia existed: PRsingle = 1.13; 95% CI: 1.01-1.26. Combined exposure of periodontitis plus <11 remaining teeth (PRmultiple = 1.23; 95% CI: 1.05-1.43), as well as combined exposure of periodontitis plus ≥10% gingival bleeding and <11 remaining teeth (PRmultiple = 1.22; 95% CI: 1.03-1.44), represented greater probabilities of 23% and 22% of individuals having a diagnosis of dyslipidemia. CONCLUSION Periodontitis combined with fewer than 11 teeth doubled the likelihood of being diagnosed with dyslipidemia.
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Affiliation(s)
| | | | - Simone Seixas da Cruz
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
- Health Sciences Center, Federal University of Recôncavo of Bahia, Bahia, Brazil
| | - Soraya Castro Trindade
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
| | | | | | | | | | - Daline Oliveira Carneiro
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
- Department of Preventive Dentistry, Faculty of Dentistry, Federal University of Bahia, Salvador, Brazil
| | | | | | | | - Peter Michael Loomer
- School of Dentistry, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Johelle de Santana Passos-Soares
- Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil
- Department of Preventive Dentistry, Faculty of Dentistry, Federal University of Bahia, Salvador, Brazil
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Byon MJ, Kim SY, Kim JS, Kim HN, Kim JB. Association of Periodontitis with Atherosclerotic Cardiovascular Diseases: A Nationwide Population-based Retrospective Matched Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7261. [PMID: 33020434 PMCID: PMC7578974 DOI: 10.3390/ijerph17197261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/28/2020] [Accepted: 10/02/2020] [Indexed: 11/16/2022]
Abstract
We investigated the association between periodontitis and atherosclerotic cardiovascular disease (ACVD) development using the National Health Insurance Service-National Sample Cohort 2.0 (NHIS-NSC2) database, which contains data for approximately 1 million nationally representative random participants. We selected 52,425 participants aged 20+ years and diagnosed with periodontitis from January to December 2003 and used propensity score matching to select an equivalent number of participants who were never diagnosed with periodontitis in the period covered by the NHIS-NSC2 database (2002-2015). The propensity scores were based on sex, age group, type of national health insurance, household income, diabetes status, and hypertension status and were used for 1:1 matching of individuals with similar propensities. A total of 104,850 participants were selected for the study. A multivariable Cox proportional hazard regression model was used to investigate the risk of ACVD development due to periodontitis from 2003 to 2015 after adjusting for sex, age, type of national health insurance, household income, hypertension status, and diabetes status. Participants with periodontitis had a higher risk of ACVD (adjusted hazard ratio: 1.09, 95% confidence interval: 1.05-1.13) than those without periodontitis. Thus, periodontitis can increase the risk of ACVD, and prevention of periodontitis may help reduce the risk of cardiovascular disease.
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Affiliation(s)
- Min-Ji Byon
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea; (M.-J.B.); (S.-Y.K.); (J.-S.K.)
- BK21 FOUR project, School of Dentistry, Pusan National University, Yangsan 50612, Korea
| | - Se-Yeon Kim
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea; (M.-J.B.); (S.-Y.K.); (J.-S.K.)
| | - Ji-Soo Kim
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea; (M.-J.B.); (S.-Y.K.); (J.-S.K.)
| | - Han-Na Kim
- Department of Dental Hygiene, College of Health and Medical Sciences, Cheongju University, Cheongju 28503, Korea;
| | - Jin-Bom Kim
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea; (M.-J.B.); (S.-Y.K.); (J.-S.K.)
- BK21 FOUR project, School of Dentistry, Pusan National University, Yangsan 50612, Korea
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Tobacco Products, Periodontal Health and Education Level: Cohort Study from Sweden. Dent J (Basel) 2020; 8:dj8030090. [PMID: 32785107 PMCID: PMC7559463 DOI: 10.3390/dj8030090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/04/2020] [Accepted: 08/07/2020] [Indexed: 12/14/2022] Open
Abstract
Background: The aim of this study is to investigate if using tobacco products (including snuff, smoking tobacco and dual-using) associates with periodontal health, education level and mortality in a Swedish cohort, hypothesizing that tobacco products affect periodontal health, associate with lower education and increase the risk of death. Method: Study cohort of 1080 subjects aged 31–40 years (528 men, 552 women) was clinically examined and interviewed in 1985 and followed for mortality until 2015. Subjects were classified into two groups: “tobacco users” and “non-users”. Associations between periodontal health parameters, tobacco products, education level and age of death were analysed. SPSS was used for analyses. Results: Tobacco products, as well as education level associated, with poor periodontal health. Tobacco users and lower education was linked to higher plaque-, calculus- and gingival-index scores than non-users (p < 0.001). They also had significantly higher prevalence of deep periodontal pockets (≥5 mm) (p < 0.001 and 0.010, respectively), missing teeth (p = 0.010 and 0.003, respectively) and lower education level (p < 0.001) compared with non-users. However, tobacco product users did not die significantly earlier than non-users. Conclusion: Tobacco products had a negative impact on periodontal health. Tobacco product users were less educated. However, using tobacco products may not cause premature death.
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Chagas P, Mazocco L, Piccoli JDCE, Ardenghi TM, Badimon L, Caramori PRA, Pellanda L, Gomes I, Schwanke CHA. Association of alcohol consumption with coronary artery disease severity. Clin Nutr 2017; 36:1036-1039. [DOI: 10.1016/j.clnu.2016.06.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 06/07/2016] [Accepted: 06/22/2016] [Indexed: 11/15/2022]
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Wiener RC, Shen C, Findley PA, Sambamoorthi U, Tan X. The association between diabetes mellitus, sugar-sweetened beverages, and tooth loss in adults: Evidence from 18 states. J Am Dent Assoc 2017; 148:500-509.e4. [PMID: 28483048 DOI: 10.1016/j.adaj.2017.03.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Sugar-sweetened beverages (SSBs) are dietary sources of sugar that are factors in caries development and tooth loss. Dietary sugar also is linked to diabetes mellitus (DM). There is limited research related to SSBs and tooth loss in people with DM. The authors investigated the association between SSBs and tooth loss as it related to the presence or absence of DM. METHODS The authors used a cross-sectional design with data reported by adults (18 years and older) who responded to the 2012 Behavior Risk Factor Surveillance System questionnaire, which was used in 18 states (N = 95,897; 14,043 who had DM and 81,854 who did not have DM). The authors conducted χ2 and logistic regression analyses to determine associations related to DM status. RESULTS Overall, 12.3% of the survey respondents had DM, 15.5% had 6 or more teeth extracted, and 22.6% reported that they consumed 1 or more SSB daily. In the adjusted analyses, among adults who had DM, those who consumed at least 2 SSBs daily were more likely to have had 6 or more teeth extracted than those who reported that they did not consume SSBs (adjusted odds ratio, 2.35; 95% confidence interval, 1.37 to 4.01; P = .0018). Among adults who did not have DM, those who consumed more than 1 but fewer than 2 SSBs per day were more likely to have had at least 6 teeth extracted (adjusted odds ratio, 1.46; 95% confidence interval, 1.21 to 1.77; P < .0001). CONCLUSIONS The authors found that, among adults with DM, consuming 2 or more SSBs per day was associated with having had 6 or more teeth extracted. PRACTICAL IMPLICATIONS Dietary sugar is a concern for oral and systemic health; however, a strong, independent relationship between the number of teeth extracted and a single source of dietary sugar is not adequate to explain the complexity of tooth loss. Clinicians should use broadly worded dietary messages when discussing caries assessment with patients.
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Grudyanov AI, Tkacheva ON, Avraamova TV. [Correlation of chronic periodontal disease and cardiovascular disease]. STOMATOLOGII︠A︡ 2017; 96:4-7. [PMID: 28317819 DOI: 10.17116/stomat20179614-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of the study was to assess correlative risk of progression of inflammatory periodontal lesions, the development of a systemic inflammatory reaction and cardiovascular diseases. The study involved 89 patients with chronic periodontal disease (CPD) of varying degrees. High cardiovascular disease risk was revealed in 8.8% of patients with moderate and 13.3% of patients with severe periodontal disease. It is proved that an additional factor contributing to the pathogenic relationship between periodontal inflammatory changes and the development of cardiovascular disease is systemic inflammatory response with increased hrC-reactive protein >3.4 mg/l and interleukin-6 to11.0±3.4 mg/l. Changes of blood lipid spectrum with a reduction in apolipoprotein A1 were associated with progression and development of the CPD. Correlations of somatic and dental pathology requires dentists and cardiologists joint efforts to modify common risk factors.
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Affiliation(s)
- A I Grudyanov
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia, National Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
| | - O N Tkacheva
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia, National Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
| | - T V Avraamova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia, National Research Center for Preventive Medicine, Ministry of Health of Russia, Moscow, Russia
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de Silva AM, Martin-Kerry JM, McKee K, Cole D. Caries and periodontal disease in Indigenous adults in Australia: a case of limited and non-contemporary data. AUST HEALTH REV 2017; 41:469-478. [DOI: 10.1071/ah15229] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 06/26/2016] [Indexed: 02/05/2023]
Abstract
Objective The aim of the present study was to identify all evidence about the prevalence and severity of clinically measured caries and periodontal disease in Indigenous adults in Australia published in peer-reviewed journals and to summarise trends over time. In addition, we examined whether the studies investigated associations between putative risk factors and levels of caries and periodontal disease. Methods PubMed was searched in September 2014, with no date limitations, for published peer-reviewed articles reporting the prevalence rates and/or severity of caries and periodontal disease in Indigenous adults living in Australia. Articles were excluded if measurement was not based on clinical assessment and if oral disease was reported only in a specific or targeted sample, and not the general population. Results The search identified 18 papers (reporting on 10 primary studies) that met the inclusion criteria. The studies published clinical data about dental caries and/or periodontal disease in Australian Indigenous adults. The studies reported on oral health for Indigenous adults living in rural (40%), urban (10%) and both urban and rural (50%) locations. Included studies showed that virtually all Indigenous adults living in rural locations had periodontal disease. The data also showed caries prevalence ranged from 46% to 93%. Although 10 studies were identified, the peer-reviewed literature was extremely limited and no published studies were identified that provided statistics for a significant proportion of Australia (Victoria, Tasmania, Queensland or the Australian Capital Territory). There were also inconsistencies in how the data were reported between studies, making comparisons difficult. Conclusions This review highlights a lack of robust and contemporary data to inform the development of policies and programs to address the disparities in oral health in Indigenous populations living in many parts of Australia. What is known about the topic? Many studies report that Indigenous people in Australia have poorer general health compared with non-Indigenous people. What does this paper add? This paper documents the available caries and periodontal disease prevalence and experience for Indigenous adults in Australia published in peer-reviewed journals. It demonstrates significant limitations in the data, including no data in several large Australian jurisdictions, inconsistency with reporting methods and most data available being for Indigenous adults living in rural locations. Therefore, the oral health data available in the peer-reviewed literature do not reflect the situation of all Indigenous people living in Australia. What are the implications for practitioners? It is important for oral health practitioners to have access to current and relevant statistics on the oral health of Indigenous Australians. However, we have highlighted significant evidence gaps for this population group within the peer-reviewed literature and identified the limitations of the available data upon which decisions are currently being made. This paper also identifies ways to capture and report oral health data in the future to enable more meaningful comparisons and relevance for use in policy development.
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Ruokonen H, Nylund K, Furuholm J, Meurman JH, Sorsa T, Kotaniemi K, Ortiz F, Heikkinen AM. Oral Health and Mortality in Patients With Chronic Kidney Disease. J Periodontol 2017; 88:26-33. [DOI: 10.1902/jop.2016.160215] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Corrêa MG, Pires PR, Ribeiro FV, Pimentel SZ, Casarin RCV, Cirano FR, Tenenbaum HT, Casati MZ. Systemic treatment with resveratrol and/or curcumin reduces the progression of experimental periodontitis in rats. J Periodontal Res 2016; 52:201-209. [DOI: 10.1111/jre.12382] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2016] [Indexed: 12/20/2022]
Affiliation(s)
- M. G. Corrêa
- Dental Research Division; School of Dentistry; Paulista University; São Paulo São Paulo Brazil
| | - P. R. Pires
- Dental Research Division; School of Dentistry; Paulista University; São Paulo São Paulo Brazil
| | - F. V. Ribeiro
- Dental Research Division; School of Dentistry; Paulista University; São Paulo São Paulo Brazil
| | - S. Z. Pimentel
- Dental Research Division; School of Dentistry; Paulista University; São Paulo São Paulo Brazil
| | - R. C. V. Casarin
- Dental Research Division; School of Dentistry; Paulista University; São Paulo São Paulo Brazil
| | - F. R. Cirano
- Dental Research Division; School of Dentistry; Paulista University; São Paulo São Paulo Brazil
| | - H. T. Tenenbaum
- Department of Periodontology; Faculty of Dentistry; University of Toronto; Toronto ON Canada
- Laboratory Medicine and Pathobiology; Faculty of Medicine; University of Toronto; Toronto ON Canada
- Department of Periodontics; School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| | - M. Z. Casati
- Dental Research Division; School of Dentistry; Paulista University; São Paulo São Paulo Brazil
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Wiener RC, Wiener MA, McNeil DW. Comorbid depression/anxiety and teeth removed: Behavioral Risk Factor Surveillance System 2010. Community Dent Oral Epidemiol 2015; 43:433-43. [PMID: 25970143 PMCID: PMC4568997 DOI: 10.1111/cdoe.12168] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/15/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the association between participants (i) who reported having had clinical diagnoses of depression and anxiety with 6+ teeth removed and (ii) who reported having had clinical diagnoses of depression and anxiety with edentulism. METHODS The Behavioral Risk Factor Surveillance System (BRFSS) Survey 2010 was used for the study. Analyses involved using SAS 9.3® to determine variable frequencies, Rao-Scott chi-square bivariate analyses, and Proc Surveylogistic for the logistic regressions on complex survey designs. Participants eligibility included being 18 years or older and having complete data on depression, anxiety, and number of teeth removed. RESULTS There were 76 292 eligible participants; 13.4% reported an anxiety diagnosis, 16.7% reported a depression diagnosis, and 8.6% reported comorbid depression and anxiety. The adjusted logistic regression models were significant for anxiety and depression alone and in combination for 6+ teeth removed (AOR: anxiety 1.23; 95% CI: 1.10, 1.38; P = 0.0773; AOR: depression 1.23; 95% CI: 1.10, 1.37; P = 0.0275; P < 0.0001; and AOR: comorbid depression and anxiety 1.30; 95% CI: 1.14, 1.49; P = 0.0001). However, the adjusted models with edentulism as the outcome failed to reach significance. CONCLUSIONS Comorbid depression and anxiety are associated independently with 6+ teeth removed compared with 0-5 teeth removed in a national study conducted in United States. Comorbid depression and anxiety were not shown to be associated with edentulism as compared with any teeth present.
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Affiliation(s)
- R Constance Wiener
- Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Michael A Wiener
- Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA
| | - Daniel W McNeil
- Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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Cotti E, Mercuro G. Apical periodontitis and cardiovascular diseases: previous findings and ongoing research. Int Endod J 2015; 48:926-32. [DOI: 10.1111/iej.12506] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 07/05/2015] [Indexed: 11/28/2022]
Affiliation(s)
- E. Cotti
- Department of Conservative Dentistry and Endodontics; University of Cagliari; Sardinia Italy
| | - G. Mercuro
- Department of Medical Sciences; University of Cagliari; Sardinia Italy
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Gomes MS, Hugo FN, Hilgert JB, Sant'Ana Filho M, Padilha DMP, Simonsick EM, Ferrucci L, Reynolds MA. Apical periodontitis and incident cardiovascular events in the Baltimore Longitudinal Study of Ageing. Int Endod J 2015; 49:334-42. [PMID: 26011008 DOI: 10.1111/iej.12468] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 05/18/2015] [Indexed: 12/19/2022]
Abstract
AIM To evaluate whether the presence of apical periodontitis (AP), root canal treatment (RCT) and endodontic burden (EB) - as the sum of AP and RCT sites - were associated with long-term risk of incident cardiovascular events (CVE), including cardiovascular-related mortality, using data on participants in the Baltimore Longitudinal Study of Ageing (BLSA). METHODOLOGY This retrospective cohort included 278 dentate participants in the BLSA with complete medical and dental examinations. Periodontal disease (PD) and missing teeth were recorded. The total number of AP and RCT sites was determined from panoramic radiographs. EB was calculated as the sum of AP and RCT sites. Oral inflammatory burden (OIB) was calculated combining PD and EB. The main outcome was incident CVE including angina, myocardial infarction and cardiovascular-related death. Participants were monitored for up to 44 years (mean = 17.4± 11.1 years) following dental examination. Relative risks (RRs) were calculated through Poisson regression models, estimating the relationship between AP, RCT, EB, PD, OIB and incident CVE. RESULTS Mean age at baseline was 55.0 ±16.8 years and 51.4% were men. Sixty-two participants (22.3%) developed CVE. Bivariate analysis showed that PD, EB, number of teeth and OIB were associated with incident CVE. Multivariate models, adjusted for socio-demographic and medical variables, showed that age ≥60 years (RR = 3.07, 95% CI =1.68-5.62), hypertension (RR = 2.0, 95% CI = 1.16-3.46) and EB ≥3 (RR = 1.77, 95% CI = 1.04-3.02) were independently associated with incident CVE. The association between OIB and incident CVE was reduced to nonsignificance after adjustments (RR = 1.97, 95% CI = 0.83-4.70). CONCLUSIONS EB in midlife was an independent predictor of CVE amongst community-dwelling participants in the BLSA. Prospective studies are required to evaluate cardiovascular risk reduction with the treatment of AP.
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Affiliation(s)
- M S Gomes
- Medical and Dental Center of the Military Police of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - F N Hugo
- Department of Community Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - J B Hilgert
- Department of Community Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - M Sant'Ana Filho
- Postgraduate Program, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - D M P Padilha
- Department of Community Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - E M Simonsick
- National Institute on Aging, Translational Gerontology Branch, Intramural Research Program, Baltimore, MD, USA
| | - L Ferrucci
- National Institute on Aging, Translational Gerontology Branch, Intramural Research Program, Baltimore, MD, USA
| | - M A Reynolds
- Department of Periodontics, School of Dentistry, University of Maryland, Baltimore, MD, USA
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15
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Liljestrand J, Havulinna A, Paju S, Männistö S, Salomaa V, Pussinen P. Missing Teeth Predict Incident Cardiovascular Events, Diabetes, and Death. J Dent Res 2015; 94:1055-62. [DOI: 10.1177/0022034515586352] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Periodontitis, the main cause of tooth loss in the middle-aged and elderly, associates with the risk of atherosclerotic vascular disease. The objective was to study the capability of the number of missing teeth in predicting incident cardiovascular diseases (CVDs), diabetes, and all-cause death. The National FINRISK 1997 Study is a Finnish population–based survey of 8,446 subjects with 13 y of follow-up. Dental status was recorded at baseline in a clinical examination by a trained nurse, and information on incident CVD events, diabetes, and death was obtained via national registers. The registered CVD events included coronary heart disease events, acute myocardial infarction, and stroke. In Cox regression analyses, having ≥5 teeth missing was associated with 60% to 140% increased hazard for incident coronary heart disease events ( P < 0.020) and acute myocardial infarction ( P < 0.010). Incident CVD ( P < 0.043), diabetes ( P < 0.040), and death of any cause ( P < 0.019) were associated with ≥9 missing teeth. No association with stroke was observed. Adding information on missing teeth to established risk factors improved risk discrimination of death ( P = 0.0128) and provided a statistically significant net reclassification improvement for all studied end points. Even a few missing teeth may indicate an increased risk of CVD, diabetes, or all-cause mortality. When individual risk factors for chronic diseases are assessed, the number of missing teeth could be a useful additional indicator for general medical practitioners.
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Affiliation(s)
- J.M. Liljestrand
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - A.S. Havulinna
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - S. Paju
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - S. Männistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - V. Salomaa
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - P.J. Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
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16
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Bartova J, Sommerova P, Lyuya-Mi Y, Mysak J, Prochazkova J, Duskova J, Janatova T, Podzimek S. Periodontitis as a risk factor of atherosclerosis. J Immunol Res 2014; 2014:636893. [PMID: 24741613 PMCID: PMC3987959 DOI: 10.1155/2014/636893] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 01/29/2014] [Accepted: 02/17/2014] [Indexed: 11/24/2022] Open
Abstract
Over the last two decades, the amount of evidence corroborating an association between dental plaque bacteria and coronary diseases that develop as a result of atherosclerosis has increased. These findings have brought a new aspect to the etiology of the disease. There are several mechanisms by which dental plaque bacteria may initiate or worsen atherosclerotic processes: activation of innate immunity, bacteremia related to dental treatment, and direct involvement of mediators activated by dental plaque and involvement of cytokines and heat shock proteins from dental plaque bacteria. There are common predisposing factors which influence both periodontitis and atherosclerosis. Both diseases can be initiated in early childhood, although the first symptoms may not appear until adulthood. The formation of lipid stripes has been reported in 10-year-old children and the increased prevalence of obesity in children and adolescents is a risk factor contributing to lipid stripes development. Endothelium damage caused by the formation of lipid stripes in early childhood may lead to bacteria penetrating into blood circulation after oral cavity procedures for children as well as for patients with aggressive and chronic periodontitis.
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Affiliation(s)
- Jirina Bartova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Pavla Sommerova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Yelena Lyuya-Mi
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Jaroslav Mysak
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Jarmila Prochazkova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Jana Duskova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Tatjana Janatova
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
| | - Stepan Podzimek
- Institute of Clinical and Experimental Dental Medicine, First Faculty of Medicine and General University Hospital, Charles University, Karlovo Namesti 32, 12000 Prague, Czech Republic
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17
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Cross-Sectional Association between the Number of Missing Teeth and Cardiovascular Disease among Adults Aged 50 or Older: BRFSS 2010. Int J Vasc Med 2014; 2014:421567. [PMID: 24624297 PMCID: PMC3928861 DOI: 10.1155/2014/421567] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 10/31/2013] [Accepted: 11/24/2013] [Indexed: 11/17/2022] Open
Abstract
Objective. The relationship between oral health and cardiovascular disease is an emerging area of research. The objective of the current study is to evaluate the association of cardiovascular disease and the number of missing teeth as a risk indicator. Methods. Cross-sectional study design with data on 275,424 respondents aged 50 or older from the 2010 Behavioral Risk Factor Surveillance System survey was used. The dependent variable was self-reported cardiovascular disease. The association between the number of missing teeth and cardiovascular disease was analyzed with multivariable logistic regression. The regression was adjusted for sex, race/ethnicity, age, education, income, dental visits, smoking status, physical activity, and body mass index. Results. In our study sample, 9.9% reported edentulism. Cardiovascular prevalence rates for those with edentulism were 25.4% and for those without any missing teeth were 7.5%. Respondents who reported edentulism teeth were more likely to report cardiovascular disease (AOR = 1.85, 95% CI = 1.71, 2.01). Conclusion. There was an independent association between the number of missing teeth and cardiovascular disease even after controlling for a comprehensive set of risk factors. These findings highlight the need to explore the potential role the number of missing teeth have in the risk of cardiovascular disease among older adults.
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Can Apical Periodontitis Modify Systemic Levels of Inflammatory Markers? A Systematic Review and Meta-analysis. J Endod 2013; 39:1205-17. [DOI: 10.1016/j.joen.2013.06.014] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 04/29/2013] [Accepted: 06/29/2013] [Indexed: 01/01/2023]
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19
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Glodny B, Nasseri P, Crismani A, Schoenherr E, Luger AK, Bertl K, Petersen J. The occurrence of dental caries is associated with atherosclerosis. Clinics (Sao Paulo) 2013; 68:946-53. [PMID: 23917658 PMCID: PMC3714742 DOI: 10.6061/clinics/2013(07)10] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 03/13/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Previous studies have suggested that marginal periodontitis is a risk factor for developing atherosclerosis. The objective of this study was to determine whether caries may also be associated with atherosclerosis. METHODS The computed tomography data sets of 292 consecutive patients, 137 women and 155 men with a mean age of 54.1±17.3 years, were analyzed. Caries were quantified based on the number of decayed surfaces of all the teeth, and periodontitis was quantified on the basis of the horizontal bone loss in the jaw. The presence of chronic apical periodontitis (CAP) was assessed, and the aortic atherosclerotic burden was quantified using a calcium scoring method. RESULTS The patients with <1 caries surfaces/tooth had a lower atherosclerotic burden (0.13±0.61 mL) than patients with ≥1 caries surfaces/tooth. The atherosclerotic burden was greater in patients with a higher number of lesions with pulpal involvement and more teeth with chronic apical periodontitis. In the logistical regression models, age (Wald 49.3), number of caries per tooth (Wald 26.4), periodontitis (Wald 8.6), and male gender (Wald 11) were found to be independent risk factors for atherosclerosis. In the linear regression analyses, age and the number of decayed surfaces per tooth were identified as influencing factors associated with a higher atherosclerotic burden, and the number of restorations per tooth was associated with a lower atherosclerotic burden. CONCLUSION Dental caries, pulpal caries, and chronic apical periodontitis are associated positively, while restorations are associated inversely, with aortic atherosclerotic burden. Prospective studies are required to confirm these observations and answer the question of possible causality.
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Affiliation(s)
- Bernhard Glodny
- Department of Radiology, Innsbruck Medical University, Innsbruck, Austria
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