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Maia MB, Souza JGS, Bertolini M, Costa RC, Costa GS, Torres SDAS, Ferreira EF, Martins AMEBL. Knowledge of bidirectional relationship between diabetes and periodontal disease among diabetes patients: A systematic review. Int J Dent Hyg 2023; 21:28-40. [PMID: 35080344 DOI: 10.1111/idh.12586] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 01/12/2022] [Accepted: 01/21/2022] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The bidirectional relationship between diabetes mellitus and periodontal disease has been reported in the literature, suggesting that poor glycemic control is strongly associated with increased risk of developing periodontal disease. Therefore, this systematic review evaluated the level of knowledge of this bidirectional relationship among patients with diabetes. METHODS This systematic review (protocol CRD42018117902) was conducted according to PRISMA guidelines. The following databases were considered: Medline/PubMed, Scopus, and Web of Science. Search strategy (April 05th , 2021) considered proper combination of keywords and eligibility criteria. The quality of studies was evaluated using the Appraisal tool for Cross-Sectional Studies (AXIS). RESULTS Among the 328 records identified in the initial search, 24 studies were selected, considering a total of 8,693 patients. All studies used a cross-sectional design. Among the included studies, only five showed prevalence of knowledge higher than 50%, ranging from 5.8% to 75.9%. Interestingly, 58.0% of patients reported that they brush their teeth at least 1x/day, but only four studies reported that the dentist was the main source of information. In terms of methodology and result quality, just one study clearly showed all information evaluated by the AXIS tool. Most of studies did not report sample size calculations and did not used validated questionnaires to assess patient knowledge. CONCLUSION The results show that less than half of people with diabetes have knowledge about their increased risk for periodontal disease, and often the dentist is not the main source of information to motivate them.
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Affiliation(s)
| | - João G S Souza
- Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.,Dental Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Brazil.,School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Martinna Bertolini
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Raphael C Costa
- Piracicaba Dental School - University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Silvério de A S Torres
- State University of Montes Claros, Montes Claros, Brazil.,Dental Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Brazil
| | - Efigênia F Ferreira
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Poudel P, Rawal LB, Kong A, Yadav UN, Sousa MS, Karmacharya B, Pradhan S, George A. Oral Health Knowledge, Attitudes and Practices of People Living with Diabetes in South Asia: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13851. [PMID: 36360731 PMCID: PMC9654734 DOI: 10.3390/ijerph192113851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
Diabetes increases the risk of oral health complications. This review aimed to synthesise the current evidence on the oral health knowledge, attitudes and practices of people living with diabetes in South Asian countries and provide recommendations on possible strategies for addressing the gaps in oral health care in this population, including the role of non-dental professionals. Using a scoping review framework, six electronic databases (Ovid Medline, CINAHL, ProQuest Central, Scopus, Web of Science and Embase) were searched to identify the relevant literature published between January 2000 and December 2021. The data were extracted into three main categories based on the review's aims, and further refined into sub-categories. A total of 23 studies were included. The review identified that while people with diabetes living in South Asian countries had some level of awareness about oral health and limited care practices to maintain good oral health, there were gaps in knowledge, and there were areas where their oral health practices and attitudes could be improved. The findings suggest a need for developing targeted oral health policies as well as implementing integrated oral health care interventions involving non-dental professionals to improve the oral health outcomes of people with diabetes.
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Affiliation(s)
- Prakash Poudel
- eHealth, NSW Government, St Leonards, NSW 2065, Australia
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Lal B. Rawal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney Campus, Sydney, NSW 2000, Australia
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Norman Gardens, QLD 4710, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Ariana Kong
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Uday N. Yadav
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT 2601, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia
| | - Mariana S. Sousa
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Broadway, NSW 2007, Australia
| | - Biraj Karmacharya
- Department of Community and Public Health Dentistry, Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Panauti 45209, Nepal
| | - Shaili Pradhan
- Department of Dental Surgery, National Academy of Medical Sciences, Bir Hospital, Mahabouddha, Kathmandu 44600, Nepal
| | - Ajesh George
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Campbelltown, NSW 2560, Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, NSW 2010, Australia
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3552, Australia
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Saddki N, Hashim MIBM, Mohamad N. Factors Associated with Oral Health Literacy among Patients with Type 2 Diabetes Mellitus Attending Hospital Universiti Sains Malaysia. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/10/2022] Open
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Akl S, Ranatunga M, Long S, Jennings E, Nimmo A. A systematic review investigating patient knowledge and awareness on the association between oral health and their systemic condition. BMC Public Health 2021; 21:2077. [PMID: 34772370 PMCID: PMC8590282 DOI: 10.1186/s12889-021-12016-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 10/13/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The prevalence of the oral-systemic relationship has accounted for potentially preventable chronic conditions and morbidity worldwide. Health literacy is a large contributing factor. This systematic review investigates the knowledge and awareness of patients with major systemic conditions, regarding the oral associations to their condition. METHODS Electronic databases including Medline (Ovid), CINAHL, The Cochrane Library, Web of Science, Informit Health Databases and Scopus were searched. All articles from 2011 to 2020, investigating knowledge of the oral-systemic link, of adult patients with the following major system conditions were searched: diabetes mellitus (DM), respiratory disease, cardiovascular disease (CVD), pregnancy and bone disease. Two independent reviewers completed screening, data extraction and quality assessment. A synthesis without meta-analysis was conducted. Twenty-four studies, from 14 different countries, were included in the systematic review. RESULTS Analysis showed that globally, patients with major systemic conditions have poor knowledge and awareness (< 50%) of the oral health associations to their condition. Improvements in health education are particularly necessary for patients with heart disease, bone disease and diabetes. Dentists and the media were the most common source of information. There were no relevant studies investigating the knowledge of patients with respiratory disease. CONCLUSION To improve the global burden of preventable chronic conditions, it is essential to address inequalities in the dissemination of health education to at-risk populations. Improvements in patient education rely on an increase in patient-practitioner communication on the oral-systemic link, implementation of oral health educational programs and greater interdisciplinary collaboration.
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Affiliation(s)
- Sabrina Akl
- College of Medicine and Dentistry, Cairns Campus, James Cook University, Cairns, QLD, 4878, Australia.
| | - Madusha Ranatunga
- College of Medicine and Dentistry, Cairns Campus, James Cook University, Cairns, QLD, 4878, Australia
| | - Sharron Long
- College of Medicine and Dentistry, Cairns Campus, James Cook University, Cairns, QLD, 4878, Australia
| | - Ernest Jennings
- College of Medicine and Dentistry, Cairns Campus, James Cook University, Cairns, QLD, 4878, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, 4878, Australia
- Centre for Molecular Therapeutics, James Cook University, Cairns, QLD, 4878, Australia
| | - Alan Nimmo
- College of Medicine and Dentistry, Cairns Campus, James Cook University, Cairns, QLD, 4878, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD, 4878, Australia
- Centre for Molecular Therapeutics, James Cook University, Cairns, QLD, 4878, Australia
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Zhang Y, Leveille SG, Shi L, Camhi SM. Disparities in Preventive Oral Health Care and Periodontal Health Among Adults With Diabetes. Prev Chronic Dis 2021; 18:E47. [PMID: 33988497 PMCID: PMC8139443 DOI: 10.5888/pcd18.200594] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION People with diabetes are more vulnerable to periodontal disease than those without; thus, practicing preventive oral health care is an important part of diabetes self-care. Our objective was to examine disparities in preventive oral health care among US adults with diabetes. METHODS We performed a secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Periodontal examinations were conducted in adults aged 30 and older. We compared the weighted prevalence of periodontal disease and the practice of preventive oral health care, including practicing dental interproximal cleaning (flossing or using other interproximal cleaning devices) and use of preventive dental services, among people with and without diabetes. Multivariable logistic regressions were performed to examine the relationship between the presence of diabetes, periodontal disease, and preventive oral health care practices. RESULTS Weighted prevalence of periodontal disease in the US population was higher among adults with diabetes than those without (58.0% vs 37.6%). This difference persisted after controlling for sociodemographic characteristics and smoking status. People with diabetes were more likely to have periodontal disease (adjusted odds ratio [aOR] 1.39; 95% CI, 1.17-1.65), less likely to practice daily interproximal cleaning (aOR 0.85; 95% CI, 0.75-0.95), and less likely to visit a dentist for preventive care in the past year (aOR 0.86; 95% CI, 0.76-0.96) than people without diabetes. CONCLUSION Adults with diabetes reported suboptimal preventive oral health care behaviors in use of preventive dental services and interproximal dental cleaning than people without diabetes, despite their health disparity related to periodontal disease. Educating people to improve their preventive oral health care is essential for good oral health and diabetes self-management.
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Affiliation(s)
- Yuqing Zhang
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
- 100 William T. Morrissey Blvd, Boston, MA 02125-3393.
| | - Suzanne G Leveille
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Ling Shi
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
| | - Sarah M Camhi
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts
- College of Arts and Sciences, Kinesiology Department, University of San Francisco, San Francisco, California
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Ahmad R, Haque M. Oral Health Messiers: Diabetes Mellitus Relevance. Diabetes Metab Syndr Obes 2021; 14:3001-3015. [PMID: 34234496 PMCID: PMC8257029 DOI: 10.2147/dmso.s318972] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/19/2021] [Indexed: 12/13/2022] Open
Abstract
This article aims to narrate the various oral complications in individuals suffering from diabetes mellitus. Google search for "diabetes mellitus and oral complications" was done. The search was also carried out for "diabetes mellitus" and its oral complications individually. Diabetes mellitus is a chronic metabolic disorder that is a global epidemic and a common cause of morbidity and mortality in the world today. Currently, there are about 422 million cases of diabetes mellitus worldwide. Diabetic patients can develop different complications in the body such as retinopathy, neuropathy, nephropathy, cardiovascular disease. Complications in the oral cavity have been observed in individuals suffering from diabetes mellitus. A study noted that more than 90% of diabetic patients suffered from oral complications. Another research has shown a greater prevalence of oral mucosal disorders in patients with diabetes mellitus than non-diabetic population: 45-88% in patients with type 2 diabetes compared to 38.3-45% in non-diabetic subjects and 44.7% in type 1 diabetic individuals compared to 25% in the non-diabetic population. Oral complications in people with diabetes are periodontal disease, dental caries, oral infections, salivary dysfunction, taste dysfunction, delayed wound healing, tongue abnormalities, halitosis, and lichen planus. The high glucose level in saliva, poor neutrophil function, neuropathy, and small vessel damage contribute to oral complications in individuals with uncontrolled diabetes. Good oral health is imperative for healthy living. Oral complications cause deterioration to the quality of life in diabetic patients. Complications like periodontal disease having a bidirectional relationship with diabetes mellitus even contribute to increased blood glucose levels in people with diabetes. This article intends to promote awareness regarding the oral health of diabetics and to stress the importance of maintaining proper oral hygiene, taking preventive measures, early detection, and appropriate management of oral complications of these patients through a multidisciplinary approach.
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Affiliation(s)
- Rahnuma Ahmad
- Department of Physiology, Medical College for Women and Hospital, Dhaka, Bangladesh
| | - Mainul Haque
- The Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
- Correspondence: Mainul Haque The Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, 57000, Malaysia Email
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Santhiya B, Puranik M, Sowmya KR. Association between health locus of control and oralhealth status in type 2 diabetics - A cross sectional comparative study. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2020. [DOI: 10.4103/jiaphd.jiaphd_48_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Siddiqi A, Zafar S, Sharma A, Quaranta A. Diabetic patients' knowledge of the bidirectional link: are dental health care professionals effectively conveying the message? Aust Dent J 2019; 64:312-326. [PMID: 31509258 DOI: 10.1111/adj.12721] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2019] [Indexed: 11/28/2022]
Abstract
Diabetes mellitus (DM) has emerged as a global public health concern with significant upshots due to its high prevalence, severity and associated complications. The present review aims to evaluate the literature that has investigated the awareness and attitude of diabetic patients about their oral/periodontal health to identify gaps in the dissemination of this critical information. Literature addressing diabetic patient's awareness/knowledge, response to their periodontal health needs, and the source of oral health education was investigated using a computer search of electronic databases. Twenty-six papers were included in the systematic review for analysis. The studies reported data from 13 different countries involving 10 550 participants, 9843 patients with DM and 974 healthy controls. The overall analysis of the studies showed that approximately 73% of the diabetic patients were unaware of the link between their systemic condition (DM) and periodontal health. The results of the study show that a large number of diabetic patients are unaware of the link between oral/periodontal health and DM. There is a strong need to implement the recent guidelines established by the IDF/EFP concerning mutual care of diabetic patients by the medical and dental health care professionals. This will result in improved general and oral health of our diabetic patients.
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Affiliation(s)
- A Siddiqi
- Department of Periodontics and Implantology, School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - S Zafar
- Paediatric Dentistry, School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - A Sharma
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
| | - A Quaranta
- Department of Periodontics and Implantology, School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia
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Choubaya C, Chahine R, Zalloua P, Salameh Z. Periodontitis and diabetes interrelationships in rats: biochemical and histopathological variables. J Diabetes Metab Disord 2019; 18:163-172. [PMID: 31275887 PMCID: PMC6581989 DOI: 10.1007/s40200-019-00403-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 04/12/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND A two-way relationship between diabetes and periodontitis is now clinically established. Both conditions share common mechanisms of pathogenesis that are related to altered immune-inflammatory responses at local and/or systemic levels. The aim of this study is to investigate whether periodontitis is associated with the development and progression of diabetes and to evaluate the health impact of coexistence of both diseases. MATERIAL AND METHODS Male Sprague Dawley rats (10 weeks old) were randomized into seven groups (n = 12): Group 1) Control; Groups 2 and 6) Periodontitis induced at two or six weeks; Groups 3 and 5) Diabetes induced at two or six weeks; Groups 4 and 7) Periodontitis followed by diabetes, and diabetes followed by periodontitis at two or six weeks. For diabetes induction, animals received a one-time intravenous injection of streptozotocin (50 mg/kg). Periodontitis was induced by Lipoppolysaccharide injection (20 μg/rat) through the palatal gingival and by placing a ligature of 0/0 braided silk around the cervix of the upper right second molar. Body weight, glycaemia as well as urine were collected weekly. Rats were sacrificed at the end of week 10, gingival tissue was removed, fixed in formaldehyde and processed for histopathological study. RESULTS Body weight was significantly decreased (25%) following diabetes induction (p < 0.01). 40% weight loss was observed when diabetes was induced first compared to 30% when periodontitis was first induced in the animals (p < 0.01). Rats treated with streptozotocin showed a three-fold increase in diabetes compared to the control group (p < 0.01). In rats where periodontitis was induced after diabetes, glucose levels increased significantly (450 mg/dL) compared to glucose levels (410 mg/dL) where periodontitis was induced first (p < 0.01). Histopathological studies showed greater alveolar bone loss when both diabetes and periodontitis were present. CONCLUSION When periodontitis occurs after diabetes it aggravates the symptoms of the two pathologies. When diabetes is induced after periodontitis, no symptoms aggravation is observed for diabetes, although periodontitis gets worse.
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Affiliation(s)
- Charbel Choubaya
- Department of Surgery, Faculty of Dentistry, Lebanese University, Hadat, Lebanon
| | - Ramez Chahine
- Oxidative Stress and Antioxidant Research Team, Lebanese University and Faculty of Public Health La Sagesse University, Beirut, Lebanon
| | - Pierre Zalloua
- Faculty of Medicine, Lebanese American University, Byblos, Lebanon
| | - Ziad Salameh
- Department of Prosthodontics and Department of Research, Faculty of Dentistry, Lebanese University, Hadat, Lebanon
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Poudel P, Griffiths R, Wong VW, Arora A, Flack JR, Khoo CL, George A. Oral health knowledge, attitudes and care practices of people with diabetes: a systematic review. BMC Public Health 2018; 18:577. [PMID: 29716561 PMCID: PMC5930945 DOI: 10.1186/s12889-018-5485-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 04/19/2018] [Indexed: 01/26/2023] Open
Abstract
Background People with uncontrolled diabetes are at greater risk for several oral health problems, particularly periodontal (gum) disease. Periodontal disease also impacts diabetes control. Good oral hygiene and regular dental visits are recommended to prevent and manage oral health problems. Several studies have been conducted to assess the oral health knowledge, attitudes, and practices of people with diabetes yet a review of these findings has not yet been undertaken. The aim of this systematic review was to synthesize current evidence on the knowledge, attitudes and practices of people with diabetes in relation to their oral health care. Methods A systematic search of all literature was carried out in five databases using key search terms. The inclusion criteria were: 1) published in the English language; 2) from 2000 to November, 2017; 3) conducted on persons with any type of diabetes and of all ages; 4) explored at least one study outcome (knowledge or attitude or practices toward oral health care); and 5) used quantitative methods of data collection. No restrictions were placed on the quality and setting of the study. Results A total of 28 studies met the inclusion criteria. The studies included a total of 27,894 people with diabetes and were conducted in 14 countries. The review found that people with diabetes have inadequate oral health knowledge, poor oral health attitudes, and fewer dental visits. They rarely receive oral health education and dental referrals from their care providers. Provision of oral health education by diabetes care providers and referral to dentists when required, was associated with improved oral health behaviours among patients. Conclusions Overall, people with diabetes have limited oral health knowledge and poor oral health behaviours. It is therefore essential to educate patients about their increased risk for oral health problems, motivate them for good oral health behaviours and facilitate access to dental care. Electronic supplementary material The online version of this article (10.1186/s12889-018-5485-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Prakash Poudel
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia. .,Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia. .,Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia. .,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.
| | - Rhonda Griffiths
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia
| | - Vincent W Wong
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Amit Arora
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia.,Oral Health Services and Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, 2010, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, Westmead, NSW, 2145, Australia
| | - Jeff R Flack
- South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia.,School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 1797, Australia
| | - Chee L Khoo
- Health Focus Family Practice, The Royal Australian College of General Practitioners (RACGP), National Association of Diabetes Centres (NADC), Ingleburn, NSW, 2565, Australia.,Diabetes , Obesity and Metabolism Translational Research Unit (DOMTRU), Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Ajesh George
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia.,Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,Faculty of Dentistry, University of Sydney, Camperdown, 2050, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia
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Predictors for Gingival Index in Middle-Aged Asian Indians with Type 2 Diabetes from South India: A Cross-Sectional Observational Study. ScientificWorldJournal 2018; 2018:9081572. [PMID: 29479293 PMCID: PMC5816844 DOI: 10.1155/2018/9081572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 11/02/2017] [Accepted: 11/19/2017] [Indexed: 12/25/2022] Open
Abstract
Asian Indians develop type 2 diabetes mellitus (T2DM) much earlier as compared to White Caucasians, due to unique phenotypic and genetic architecture. Periodontitis in T2DM patients is often a neglected clinical feature. This study was conducted to derive predictor variables for gingival index in middle-aged Asian Indians with T2DM in a semiurban population of Dravidian ethnicity from Tamil Nadu, India. T2DM patients (n = 232, mean age: 50.6 ± 10.4 years) with periodontitis (n = 123, mean age: 54.3 ± 2.4 years) and without periodontitis (n = 109, mean age: 55.2 ± 3.1 years) were recruited between 2014 and 2016 by purposive sampling method. Dental examinations for pocket depth (PD) and clinical attachment level (CAL) were performed and gingival index was calculated. Fasting venous blood samples were analysed for measures of glycaemia and cholesterol. Significant positive correlation (p < 0.01) was observed for gingival index with glycosylated haemoglobin (HbA1c), pocket depth, presence of T2DM, and clinical attachment level. Stepwise multiple linear regression analysis derived increased pocket depth (p < 0.01), elevated HbA1c (p < 0.01), clinical attachment level (p < 0.01), and presence of diabetes (p < 0.01) as significant predictors (r2 value = 0.67) for increased gingival index in middle aged patients with T2DM. These variables significantly (p < 0.01) predispose middle-aged T2DM patients to increased gingival index, thus warranting appropriate intervention.
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Obulareddy VT, Nagarakanti S, Chava VK. Knowledge, attitudes, and practice behaviors of medical specialists for the relationship between diabetes and periodontal disease: A questionnaire survey. J Family Med Prim Care 2018; 7:175-178. [PMID: 29915755 PMCID: PMC5958564 DOI: 10.4103/jfmpc.jfmpc_425_16] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction: Increased risk of periodontal disease has been associated with diabetes mellitus (DM) and also periodontitis is considered as the sixth complication of DM. Medical physicians may have an advantageous position compared to the dentists to provide early patient counseling about oral health because patients attend medical offices more often than to dental offices and are more likely to be affiliated to medical than to dental insurance. Hence, the medical practitioners should have sufficient knowledge in this regard. The study aimed to assess the knowledge, attitudes, and practice behaviors of endocrinologists, general medicine practitioners, and diabetologists on the relationship between periodontal disease and DM. Materials and Methods: Data were collected from sixty participants practicing in Nellore, using a structured questionnaire survey. The obtained data were analyzed through percentages. Results: All the participants (100%) were aware that there existed a relation between oral health and general health. However, only 17.8% (10) of the participants refer their patients to dentists without patients asking for referral. Conclusion: The endocrinologists were aware of the didactic relationship, whereas general medicine practitioners and diabetologists are not much well-equipped with the knowledge on relationship between DM and periodontitis. There exists a wide gap between their practice behaviors and current scientific evidence. Therefore, more emphasis must be made by medical practitioners for the diabetic patient toward periodontal health which is most important yet neglected aspect of comprehensive health care.
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Affiliation(s)
- Vishnu Teja Obulareddy
- Department of Periodontology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Sreenivas Nagarakanti
- Department of Periodontology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Vijay Kumar Chava
- Department of Periodontology, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
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Suzuki S, Yoshino K, Takayanagi A, Ishizuka Y, Satou R, Nara N, Kamijo H, Sugihara N. Relationship between Blood HbA1c Level and Decayed Teeth in Patients with Type 2 Diabetes: A Cross-sectional Study. THE BULLETIN OF TOKYO DENTAL COLLEGE 2018; 60:89-96. [DOI: 10.2209/tdcpublication.2018-0039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Seitaro Suzuki
- Department of Epidemiology and Public Health, Tokyo Dental College
| | - Koichi Yoshino
- Department of Epidemiology and Public Health, Tokyo Dental College
| | | | - Yoichi Ishizuka
- Department of Epidemiology and Public Health, Tokyo Dental College
| | - Ryouichi Satou
- Department of Epidemiology and Public Health, Tokyo Dental College
| | | | - Hideyuki Kamijo
- Department of Social Security for Dentistry, Tokyo Dental College
| | - Naoki Sugihara
- Department of Epidemiology and Public Health, Tokyo Dental College
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Han MA. Oral Health Status and Behavior among Cancer Survivors in Korea Using Nationwide Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 15:ijerph15010014. [PMID: 29295470 PMCID: PMC5800114 DOI: 10.3390/ijerph15010014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 12/14/2017] [Accepted: 12/20/2017] [Indexed: 02/07/2023]
Abstract
Cancer survivors remain at life-long risk of developing oral complications. This study investigated the oral health status and behavior among cancer survivors in comparison to subjects without a history of cancer using a nationwide survey. Cancer survivors and control subjects were selected from the sixth Korean National Health and Nutrition Examination Survey (2013-2015). Survivors reported chewing (34.8%) and speaking difficulties (15.3%) resulting from oral health problems. More than 36% of survivors had periodontal disease and 15.9% needed dentures. In multiple logistic regression analysis, age, household income, education level, smoking status, cancer site, and current cancer status were associated with oral health status. Approximately 43.3% of cancer survivors brushed their teeth more than three times a day. In addition, 44.9% of survivors used secondary oral products, and 30.8% had been screened for oral health problems over the past year. Age, household income and education level were associated with oral health behavior. The oral health status and behavior excepting periodontal disease and the use of secondary oral products were not significantly different between cancer survivors and controls. Although oral health status of cancer survivors was not worse than that of controls, more than half of the survivors maintained unhealthy oral practices.
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Affiliation(s)
- Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju 61452, Korea.
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Jeong MJ, Shin HS, Jeong SJ, Lim DS. Comparing Chewable and Manual Toothbrushes for Reducing Dental Plaque: A Pilot Study. ACTA ACUST UNITED AC 2017. [DOI: 10.17135/jdhs.2017.17.3.267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Moon-Jin Jeong
- Department of Oral Histology and Biology, School of Dentistry, Chosun University, Gwangju 61452, Korea
| | - Hye-Sun Shin
- Department of Dental Hygiene, College of Health Science, Eulji University, Seongnam 13135, Korea
| | - Soon-Jeong Jeong
- Department of Dental Hygiene, College of Health Science, Youngsan University, Yangsan 50510, Korea
| | - Do-Seon Lim
- Department of Dental Hygiene, College of Health Science, Eulji University, Seongnam 13135, Korea
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16
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Toothbrushing, Blood Glucose and HbA1c: Findings from a Random Survey in Chinese Population. Sci Rep 2016; 6:28824. [PMID: 27385509 PMCID: PMC4935949 DOI: 10.1038/srep28824] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 06/06/2016] [Indexed: 01/19/2023] Open
Abstract
Both diabetes and periodontal disease are prevalent in China. Poor oral hygiene practice is the major cause of periodontal disease. An association between oral hygiene practice and blood glucose level was reported in individuals with diabetes, but not in the general population. We examined the association in a population-based random survey recruiting 2,105 adults without previously diagnosed diabetes in Chongqing city, China. Plasma glucose and hemoglobin A1c (HbA1c) were measured, and a 2-hour oral glucose tolerance test was conducted for each respondent. Self-reported toothbrushing frequency was used as a proxy for oral hygiene practice. In a linear model controlling for potential confounders (demographic characteristics, socio-economic status, lifestyle risk factors, BMI, dental visit frequency, etc.), urban residents who barely brushed their teeth had an increase of 0.50 (95% CI: 0.10-0.90) mmol/L in fasting plasma glucose, and an increase of 0.26% (0.04-0.47%) in HbA1c, relative to those brushing ≥twice daily; for rural residents, the effects were 0.26 (0.05-0.48) mmol/L in fasting plasma glucose and 0.20% (0.09-0.31%) in HbA1c. Individuals with better oral practice tended to have lower level of blood glucose and HbA1c. Establishing good oral health behavioral habits may be conducive to diabetes prevention and control in the general population.
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Kuwabara M, Motoki Y, Ichiura K, Fujii M, Inomata C, Sato H, Morisawa T, Morita Y, Kuwabara K, Nakamura Y. Association between toothbrushing and risk factors for cardiovascular disease: a large-scale, cross-sectional Japanese study. BMJ Open 2016; 6:e009870. [PMID: 26769787 PMCID: PMC4735199 DOI: 10.1136/bmjopen-2015-009870] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To clarify the association between toothbrushing and risk factors for cardiovascular disease--namely, hypertension (HT), diabetes mellitus (DM), dyslipidaemia (DL), hyperuricaemia (HUA) and chronic kidney disease (CKD). DESIGN A large-scale, single-centre, cross-sectional study. SETTING St Luke's International Hospital, Center for Preventive Medicine, Tokyo, Japan, between January 2004 and June 2010. PARTICIPANTS This study examined the toothbrushing practices of 85,866 individuals according to the 3-category frequency criterion: 'after every meal', 'at least once a day' and 'less than once a day'. The ORs by frequency were calculated for the prevalences of HT, DM, DL, HUA and CKD according to binominal logistic regression analyses adjusted for age, gender, body mass index and lifestyle habits--smoking, drinking, walk time and sleep time. RESULTS The prevalences of the risk factors were as follows: HT ('after every meal': 13.3%, 'at least once a day': 17.9% and 'less than once a day': 31.0%), DM (3.1%, 5.3% and 17.4%, respectively), DL (29.0%, 42.1% and 60.3%, respectively), HUA (8.6%, 17.5% and 27.2%, respectively) and CKD (3.8%, 3.1% and 8.3%, respectively). The prevalences were significantly higher in the 'less than once a day' group than in the 'after every meal' group for DM (OR=2.03; 95% CI 1.29 to 3.21) and DL (OR=1.50; 95% CI 1.06 to 2.14), but not for HT, HUA and CKD. CONCLUSIONS Even taking into account lifestyle habits, a lower frequency of toothbrushing was associated with high prevalences of DM and DL. Toothbrushing practices may be beneficial for oral health improvement and also for prevention of certain systemic diseases.
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Affiliation(s)
- Masanari Kuwabara
- Department of Cardiology, Toranomon Hospital, Tokyo, Japan
- Department of Cardiology, St Luke's International Hospital, Tokyo, Japan
- Department of Public Health, Jichi Medical University, Shimotsuke, Japan
| | - Yoko Motoki
- Department of Obstetrics, Gynecology and Molecular Reproductive Science, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kayoko Ichiura
- Department of Clinical Nursing, Shiga University of Medical Science, Otsu, Japan
| | - Mizue Fujii
- School of Nursing, Sapporo City University, Sapporo, Japan
| | - Chisato Inomata
- Graduate School of Dentistry, Osaka University, Osaka, Japan
| | - Hiroki Sato
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan
| | - Taichiro Morisawa
- Department of Internal Medicine and Cardiology, Tama-Nagayama Hospital, Nippon Medical School, Tokyo, Japan
| | - Yoshinori Morita
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan
| | | | - Yosikazu Nakamura
- Department of Public Health, Jichi Medical University, Shimotsuke, Japan
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Sasaki H, Hirai K, Martins CM, Furusho H, Battaglino R, Hashimoto K. Interrelationship Between Periapical Lesion and Systemic Metabolic Disorders. Curr Pharm Des 2016; 22:2204-15. [PMID: 26881444 PMCID: PMC4856634 DOI: 10.2174/1381612822666160216145107] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/15/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Periapical periodontitis, also known as periapical lesion, is a common dental disease, along with periodontitis (gum disease). Periapical periodontitis is a chronic inflammatory disease, caused by endodontic infection, and its development is regulated by the host immune/inflammatory response. Metabolic disorders, which are largely dependent on life style such as eating habits, have been interpreted as a "metabolically-triggered" low-grade systemic inflammation and may interact with periapical periodontitis by triggering immune modulation. The host immune system is therefore considered the common fundamental mechanism of both disease conditions. METHOD We have reviewed >200 articles to discuss the interrelationship between periapical lesions and metabolic disorders including type 2 diabetes mellitus, hypertension, and non-alcoholic fatty liver diseases (NAFLD), and their common pathological background in immunology/osteoimmunology and cytokine biology. RESULTS An elevated inflammatory state caused by metabolic disorders can impact the clinical outcome of periapical lesions and interfere with wound healing after endodontic treatment. Although additional well-designed clinical studies are needed, periapical lesions appear to affect insulin sensitivity and exacerbate non-alcoholic steatohepatitis. CONCLUSION Immune regulatory cytokines produced by various cell types, including immune cells and adipose tissue, play an important role in this interrelationship.
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Affiliation(s)
- Hajime Sasaki
- Department of Immunology & Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, MA 02494, U.S.A.
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Ummadisetty T, Chava VK, Bhumanapalli VRR. Diabetes and periodontitis: How well are the patients aware about an established relation? J Indian Soc Periodontol 2016; 20:472-475. [PMID: 28298834 PMCID: PMC5341327 DOI: 10.4103/0972-124x.184035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM The study aimed to assess the levels of awareness about the mutual relationship between diabetes and periodontitis among high-risk age group of the general population and to assess the attitude of general physicians in suggesting diabetic patients to visit a dentist. MATERIALS AND METHODS A structured, closed-ended questionnaire either in English or in local language (Telugu) was distributed and collected from 203 patients who were willing to participate in the study attending the Department of Periodontics, Narayana Dental College & Hospital, Nellore, AP. Data were statistically analyzed and represented in percentages and number. RESULTS Only 49.8% of the sample population knew about the mutual relationship between diabetes and periodontitis and only 46% of the diabetic study population was suggested to visit a dentist by the physician. CONCLUSION There is an insufficient knowledge among the diabetic population regarding the mutual relationship. Only few physicians have suggested their diabetic patients to visit a dentist. As diabetic patients tend to visit a physician earlier than a dentist, it is their responsibility to educate and motivate their patients to seek dental treatment.
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Affiliation(s)
- Teja Ummadisetty
- Department of Periodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Vijay Kumar Chava
- Department of Periodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
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Lin H, Zhang H, Yan Y, Liu D, Zhang R, Liu Y, Chen P, Zhang J, Xuan D. Knowledge, awareness, and behaviors of endocrinologists and dentists for the relationship between diabetes and periodontitis. Diabetes Res Clin Pract 2014; 106:428-34. [PMID: 25444355 DOI: 10.1016/j.diabres.2014.09.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 09/14/2014] [Accepted: 09/16/2014] [Indexed: 01/14/2023]
Abstract
AIMS This study aimed to compare the opinions of dentists and endocrinologists regarding diabetes mellitus (DM) and periodontitis, and to investigate the possible effects on their practice. METHODS Cross-sectional data were collected from 297 endocrinologists and 134 dentists practicing in southern China using two separated questionnaires. Questions were close-ended or Likert-scaled. Statistical analyses were done by descriptive statistics, bivariate and binary logistic regression analysis. RESULTS Compared with endocrinologists, dentists presented more favorable attitudes for the relationship of DM and periodontitis (P<0.001). 61.2% of dentists reported they would frequently refer patients with severe periodontitis for DM evaluation, while only 26.6% of endocrinologists reported they would frequently advise patients with DM to visit a dentist. Nearly all of the respondents (94.4%) agreed that the interdisciplinary collaboration should be strengthened. The logistic regression analysis exhibited that respondents with more favorable attitudes were more likely to advise a dental visit (P=0.003) or to screen for DM (P=0.006). CONCLUSIONS Endocrinologists and dentists are not equally equipped with the knowledge about the relationship between DM and periodontitis, and there is a wide gap between their practice and the current evidence, especially for endocrinologists. It's urgent to take measures to develop the interdisciplinary education and collaboration among the health care providers.
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Affiliation(s)
- Hanxiao Lin
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, S253 Industry Boulevard, Guangzhou 510282, China
| | - Hua Zhang
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, S253 Industry Boulevard, Guangzhou 510282, China
| | - Yuxia Yan
- Department of Biostatistics, Southern Medical University, S1023 Shatai Boulevard, Guangzhou 510515, China
| | - Duan Liu
- Department of Endocrinology, Zhujiang Hospital, Southern Medical University, S253 Industry Boulevard, Guangzhou 510282, China
| | - Ruyi Zhang
- Department of Endocrinology, Guangzhou Red Cross Hospital, Medical College of Jinan University, No. 396 Tong Fu Zhong Road, Guangzhou 510220, China
| | - Yeungyeung Liu
- Department of Periodontology, Guangdong Provincial Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulevard, Guangzhou 510280, China
| | - Pei Chen
- Department of Periodontology, Guangdong Provincial Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulevard, Guangzhou 510280, China
| | - Jincai Zhang
- Department of Periodontology, Guangdong Provincial Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulevard, Guangzhou 510280, China
| | - Dongying Xuan
- Department of Periodontology, Guangdong Provincial Stomatological Hospital, Southern Medical University, S366 Jiangnan Boulevard, Guangzhou 510280, China.
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Zhu P, Lin H, Han Y, Lin Y, Xu Y, Zhang Z. A computational fluid dynamic analysis of peri-bracket salivary flow influencing the microbial and periodontal parameters. PLoS One 2013; 8:e62242. [PMID: 23620815 PMCID: PMC3631146 DOI: 10.1371/journal.pone.0062242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 03/19/2013] [Indexed: 11/24/2022] Open
Abstract
Fixed vestibular appliances decrease the “self-cleansing” action of saliva and promote aggregation of dental plaque by disturbing the salivary flow field on tooth surfaces, leading to a higher prevalence of enamel demineralization and periodontal diseases. In the current study, we investigated the salivary dynamic characteristics of plaque retention and periodontal status around appliances during orthodontic treatment. By reconstructing lower central incisors and orthodontic appliances, we simulated saliva flow on the tooth surface and then characterized and quantified the salivary flow pattern surrounding the bracket and archwire. In parallel, we tested the total peri-bracket bacterial counts and periodontal status to assess interrelations. Our results demonstrate that orthodontic appliances disturb the salivary flow field on tooth surfaces and can lead to a decrease in salivary velocity and an increase in bacterial numbers. Local vortexes forming in the areas gingival to the bracket, together with the narrow space limitation, contributed to the periodontal inflammatory response. This study confirms that changes in salivary flow are an obvious predisposing factor for bacterial accumulation, and advances the ability to replicate, invitro, the salivary characteristics of plaque retention and periodontal status around appliances during orthodontic treatment.
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Affiliation(s)
- Ping Zhu
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, People’s Republic of China
| | - Han Lin
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, People’s Republic of China
| | - Yi Han
- Department of Applied Mechanics and Engineering, Sun Yat-Sen University, Guangzhou, Guangdong, People’s Republic of China
| | - Yi Lin
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, People’s Republic of China
| | - Yue Xu
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, People’s Republic of China
- * E-mail:
| | - Zhaoqiang Zhang
- Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guangzhou Medical College, Guangzhou, Guangdong, People’s Republic of China
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