Factors associated with periodontal diseases in Jordan: principal component and factor analysis approach

Association of urinary albumin excretion with periodontal parameters in patients with type 2 diabetes mellitus: a cross-sectional study

Background

Our previous pilot study using patients with type 2 diabetes mellitus in one medical clinic showed an association of urinary albumin excretion, a marker of generalized vascular dysfunction and kidney damage, with periodontitis. The purpose of this study was to confirm the association by increasing the number of patients and medical clinics.

Methods

Participants were 2302 patients (59.9% males, aged 29-93 years) with type 2 diabetes mellitus from 25 medical clinics. Their medical records and information about socioeconomic status and health behavior were collected. Periodontal status was assessed in a nearby dental office. Multiple linear regression analyses were conducted to examine the association of log-transformed urinary albumin-to-creatinine ratio with periodontal parameters after adjusting for sociodemographic status, general health conditions, and health behaviors. The analyses were performed in all subjects and subjects with normoalbuminuria only.

Results

Multiple linear regression analysis showed that mean probing pocket depth (beta: 0.062), percentage of sites with probing pocket depth of 4 mm or deeper (beta: 0.068), percentage of mobile teeth (beta: 0.055), and severity of periodontitis (beta: 0.049) were significantly (p < 0.05) correlated with log-transformed urinary albumin-to-creatinine ratio after adjusting for possible confounders in all subjects. However, no significant associations between urinary albumin-to-creatinine ratio and periodontal parameters were observed in subjects with normoalbuminuria only.

Conclusions

These results suggest that periodontitis is associated with urinary albumin excretion in patients with type 2 diabetes mellitus. Collaboration between medical and dental healthcare providers is needed for treatment of diabetes and periodontitis.

Body mass index and periodontal health status among young Saudi adults: a cross-sectional study

BACKGROUND

Obesity has been suggested as a risk factor for periodontal disease. Despite the high prevalence of obesity and over-weight among Saudi population, no study has assessed whether there is an association between periodontal health status and body mass index (BMI).

OBJECTIVES

Assess the association between BMI and other variables with periodontal health status among young Saudi adults.

DESIGN

Analytical, hospital-based cross-sectional study.

SETTING

University dental hospital, Riyadh.

PATIENTS AND METHODS

All dental students aged 21-35 years who met inclusion criteria were invited to participate in the study. Periodontal health status was assessed by the plaque index (PI), gingival index (GI) and community periodontal index (CPI) scores. Biometric measurements included weight, height and BMI. Multiple logistic regression was used to assess the association of independent variables with periodontal disease (CPI>2 vs CPI ≤2) and multiple linear regression models to assess associations with PI and GI.

MAIN OUTCOME MEASURES

Periodontal health by BMI and other variables.

SAMPLE SIZE

308.

RESULTS

Of 700 participants invited, 380 participated for a response rate of 54.2%. Slightly more than half of the obese subjects 54 (52%) did not brush their teeth regularly. The mean (standard deviation) PI and GI scores were significantly higher among the obese (PI score: 1.54 [0.45]); GI score: 1.52 [0.51]) and overweight (PI score: 1.36 [0.47]) and (GI score: 1.42 [0.57]) subjects when compared with subjects with normal weight (PI score: 1.27 [0.51]); (GI score: 1.31 [0.48]); ( P<.05). No significant differences were seen between BMI groups in CPI scores. There were also no significant differences in the mean number and percentage of sextants between different BMI groups. The only signficant factor for periodontal disease in the multivariable analysis was toothbrushing.

CONCLUSION

The present study shows a significant positive correlation between BMI and PI and GI scores. However, no statistically significant association was found between BMI and periodontal health status.

LIMITATION

Cross-sectional, so not possible to assess the association of oral health and BMI over time.

CONFLICT OF INTEREST

None.

The association between oral hygiene and periodontitis: a systematic review and meta-analysis

Objective: Dental plaque accumulation and inadequate personal oral hygiene (OH) are known major risk factors of periodontitis. Nevertheless, the magnitude of their effects has not yet been the subject of a meta-analysis. Material and methods: The Medline and Scopus databases were searched up to May 2016. Observational studies were eligible if they assessed associations between OH and periodontitis in adult subjects. A multivariate random-effects meta-analysis was used to pool the effects of fair/poor OH versus good OH on periodontitis across studies. The associations between oral care habits and periodontitis were also assessed. Results: A total of 50 studies were eligible; 15 were used for pooling the effect of fair OH versus good OH and poor OH versus good OH on periodontitis, with pooled odds ratios (ORs) of 2.04 [95% confidence interval (CI): 1.65–2.53] and 5.01 (95% CI: 3.40–7.39), respectively. Eleven studies examined oral care habits measured according to toothbrushing regularity and dental visit frequency; pooled ORs of 0.66 (95% CI: 0.47–0.94) and 0.68 (95% CI: 0.47–0.98) were obtained, respectively. Conclusions: Fair to poor OH increases the risk of periodontitis by two- to five-fold. This risk can be reduced by regular toothbrushing and dental visits.

Oral hygiene and periodontal status of 12 and 15-year-old Greek adolescents. A national pathfinder survey

AIM

To investigate oral hygiene and periodontal status of 12- and 15-year old Greek adolescents, in relation to sociodemographic and behavioural parameters.

METHODS

A stratified cluster sample of 1,224 12-year old and 1,257 15-year old adolescents of Greek nationality were selected and examined by calibrated examiners. Periodontal and oral hygiene status were assessed using the Community Periodontal Index (CPI) and the simplified Debris Index (DIs) respectively. The socio-demographic and behavioural data collected included region, location, gender, parental educational level, tooth brushing frequency and reason for dental attendance.

RESULTS

The majority of adolescents aged 12 (75.0%) and 15-years (61.4%) had fair oral hygiene levels. The most frequently observed condition in both ages was calculus with or without bleeding (42.8% in the younger and 53.3% in the older age group). Bleeding on probing was found in 41.5% of the 12-year-olds and in 30.0% of the 15-year-olds. The occurrence of shallow and/ or deep periodontal pockets was very low (0.2%). Multivariable modelling revealed that gender, location and tooth brushing frequency were strongly associated with oral hygiene status in both ages; girls, those living in urban areas and brushing teeth more frequently had significantly lower DI-s. Tooth brushing frequency was also associated with periodontal status in both ages, while living in urban areas was associated with better periodontal health only in the 15-year-olds.

CONCLUSIONS

The study demonstrated that oral hygiene conditions among Greek children and adolescents are not satisfactory and that the occurrence of gingivitis is high. More efforts on oral health education and oral hygiene instruction are needed to improve their periodontal and oral hygiene status.

Periodontal disease status in gullah african americans with type 2 diabetes living in South Carolina

BACKGROUND

African Americans have a disproportionate burden of diabetes. Gullah African Americans are the most genetically homogeneous population of African descent in the United States, with an estimated European admixture of only 3.5%. This study assessed the previously unknown prevalence of periodontal disease among a sample of Gullah African Americans with diabetes and investigated the association between diabetes control and the presence of periodontal disease.

METHODS

Two hundred thirty-five Gullah African Americans with type 2 diabetes were included. Diabetes control was assessed by percentage of glycosylated hemoglobin (HbA1c) and divided into three categories: well controlled, <7%; moderately controlled, 7% to 8.5%; and poorly controlled, >8.5%. Participants were categorized as healthy (no clinical attachment loss [AL] or bleeding on probing) or as having early periodontitis (clinical AL > or =1 mm in at least two teeth), moderate periodontitis (three sites with clinical AL > or =4 mm and at least two sites with probing depth [PD] > or =3 mm), or severe periodontitis (clinical AL > or =6 mm in at least two teeth and PD > or =5 mm in at least one site). Observed prevalences of periodontitis were compared to rates reported for the National Health and Nutrition Examination Survey (NHANES) studies.

RESULTS

All subjects had evidence of periodontal disease: 70.6% had moderate periodontitis and 28.5% had severe disease. Diabetes control was not associated with periodontal disease. The periodontal disease proportions were significantly higher than the reported national prevalence of 10.6% among African Americans without diabetes.

CONCLUSION

Our sample of Gullah African Americans with type 2 diabetes exhibited a higher prevalence of periodontal disease compared to African Americans, with and without diabetes, as reported in NHANES III and NHANES 1999-2000.