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de Mendonça GV, Junior CC, Feitosa ACR, de Mendonça BFS, Pimassoni LHS. Periodontitis and non-communicable diseases in a Brazilian population, a cross-sectional study, Vila Velha-ES, Brazil. Osong Public Health Res Perspect 2024; 15:212-220. [PMID: 38988024 PMCID: PMC11237320 DOI: 10.24171/j.phrp.2024.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND The objective of this study was to examine the hypothesis that periodontal disease is associated with chronic non-communicable diseases. METHODS In this cross-sectional study, we evaluated the periodontal health condition of the population, based on the community periodontal index, as well as the number of missing teeth and the presence of systemic health conditions. We quantified the association between oral health and the presence of chronic diseases using simple logistic regression, adjusting for confounding factors including age, smoking, and overweight. RESULTS The study population consisted of 334 volunteers, aged between 19 and 81 years. In patients over 45 years old, periodontal disease was found to be significantly associated with hypertension and diabetes. Furthermore, in female patients, periodontal disease was significantly associated with hypertension, diabetes, and cancer. CONCLUSION Our findings indicate that periodontal disease is positively and significantly associated with both arterial hypertension and diabetes, independent of potential confounding factors.
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Garrido L, Lyra P, Rodrigues J, Viana J, Mendes JJ, Barroso H. Revisiting Oral Antiseptics, Microorganism Targets and Effectiveness. J Pers Med 2023; 13:1332. [PMID: 37763100 PMCID: PMC10532628 DOI: 10.3390/jpm13091332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/24/2023] [Accepted: 08/27/2023] [Indexed: 09/29/2023] Open
Abstract
A good oral health status is mostly dependent on good oral hygiene habits, which knowingly impacts systemic health. Although controversial, chemical oral antiseptics can be useful in adjunct use to mechanical dental plaque control techniques in the prevention and management of local and overall health and well-being. This review aims to revisit, gather and update evidence-based clinical indications for the use of the most popular oral antiseptics, considering different types, microorganism targets and effectiveness in order to establish updated clinical recommendations.
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Affiliation(s)
| | | | | | | | | | - Helena Barroso
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, 2829-511 Almada, Portugal (P.L.); (J.V.); (J.J.M.)
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Beltrán V, Flores M, Sanzana C, Muñoz-Sepúlveda F, Alvarado E, Venegas B, Molina JC, Rueda-Velásquez S, von Marttens A. Tooth Loss and Caries Experience of Elderly Chileans in the Context of the COVID-19 Pandemic in Five Regions of Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3001. [PMID: 36833696 PMCID: PMC9967189 DOI: 10.3390/ijerph20043001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 06/18/2023]
Abstract
Risk factors associated with tooth loss have been studied; however, the current status of the epidemiological profiles and the impact of the pandemic on the oral health of the elderly is still unknown. This study aims to determine the experience of caries and tooth loss among elderly Chilean citizens in five regions and to identify the risk factors associated with tooth loss. The sample includes 135 participants over 60 years old assessed during COVID-19 lockdown. Sociodemographic variables such as education and RSH (Social Registry of Households) were obtained through a teledentistry platform called TEGO. The history of chronic diseases such as diabetes, obesity, depression and dental caries reported by DMFT index scores were incorporated. The statistical analysis included Adjusted Odds Ratios (ORs) to assess risk factors associated with the lack of functional dentition. Multivariate hypothesis testing was used to compare the mean equality of DMFT and its components between regions (p-value < 0.05). Individuals with RSH ≤ 40% were at higher risk of having no functional dentition with OR 4.56 (95% CI: 1.71, 12.17). The only mean difference between regions was the filled tooth component. Tooth loss was associated with multidimensional lower income, where the elderly belonging to the 40% most vulnerable population had a higher prevalence of non-functional dentition. This study highlights the importance of implementing a National Oral Health Policy that focuses on oral health promotion and minimally invasive dentistry for the most vulnerable population.
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Affiliation(s)
- Víctor Beltrán
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco 4811230, Chile
- Postgraduate Program in Oral Rehabilitation, Interuniversity Center for Healthy Aging, Universidad de La Frontera, Temuco 4811230, Chile
| | - Marco Flores
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco 4811230, Chile
- Postgraduate Program in Oral Rehabilitation, Interuniversity Center for Healthy Aging, Universidad de La Frontera, Temuco 4811230, Chile
| | - Cristina Sanzana
- Postgraduate Program in Oral Rehabilitation, Interuniversity Center for Healthy Aging, Universidad de La Frontera, Temuco 4811230, Chile
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago 8380544, Chile
| | - Fernanda Muñoz-Sepúlveda
- Clinical Investigation and Dental Innovation Center (CIDIC), Dental School and Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco 4811230, Chile
- Program of Master in Dental Sciences, Dental School, Universidad de La Frontera, Temuco 4811230, Chile
| | - Eloy Alvarado
- Department of Industrial Engineering, Universidad Técnica Federico Santa María, Santiago 7630000, Chile
| | - Bernardo Venegas
- Carlos Van Buren Hospital of Valparaíso, Valparaíso 2340000, Chile
| | | | - Sandra Rueda-Velásquez
- Department of Oral Pathology, Faculty of Dentistry, Universidad Santo Tomás, Bucaramanga 680001, Colombia
| | - Alfredo von Marttens
- Department of Prosthesis, Faculty of Dentistry, Interuniversity Center for Healthy Aging, University of Chile, Santiago 8380000, Chile
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Costa FO, Costa AM, Cortelli JR, Cortelli SC, Costa AA, Lima RPE, Pereira GHM, Oliveira AMSD, Oliveira PAD, Cota LOM. Effect of supragingival plaque control on recurrent periodontitis and clinical stability among individuals under periodontal maintenance therapy: 10-year follow-up. J Periodontol 2023; 94:55-65. [PMID: 35904985 DOI: 10.1002/jper.22-0301] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of supragingival plaque control on the recurrence of periodontitis (RP) and the achievement of a stable periodontal clinical endpoint after 10 years of periodontal maintenance therapy (PMT). METHODS The present retrospective cohort study included 225 individuals in continuous PMT. The plaque index (PI) determining the oral hygiene (OH) status, periodontal clinical parameters, and other variables of interest were collected at three time points: T1 (prior to active periodontal therapy [APT]), T2 (after APT), and T3 (10 years after T2). According to PI records at T3, participants were categorized into: (1) good OH (GOH; PI ≤ 30%, n = 63); (2) fair OH (FOH; PI > 30% and ≤40%, n = 73); and (3) poor OH (POH; PI > 40%, n = 88). Data were analyzed using the chi-square and Student t tests, analysis of variance (ANOVA), and mediation and regression analyses. RESULTS Significant differences in all periodontal clinical parameters between the GOH, FOH, and POH groups were observed at T3. The POH group exhibited higher mean bleeding on probing (BOP), periodontal probing depth (PD), and clinical attachment level (CAL), as well as higher tooth loss (POH > FOH > GOH; P < .001). There was an increased risk for RP in the FOH (odds ratio [OR] 2.02; CI, 1.10-4.38) and POH (OR 4.33; CI, 2.17-8.65) groups. Moreover, the FOH and POH groups had an approximately 2.5 and 6.0 times greater chance of not achieving a stable periodontal clinical endpoint, respectively. CONCLUSIONS After 10 years of monitoring in PMT, individuals with higher PI scores (>30%) presented an unhealthier periodontal status, a higher risk for RP, and a lower chance of achieving ≤4 sites with PD ≥ 5 mm.
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Affiliation(s)
- Fernando Oliveira Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - José Roberto Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Sheila Cavalca Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Amanda Almeida Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Association of hypertension with infection and inflammation in a setting of disadvantage in rural India. J Hum Hypertens 2022; 36:1011-1020. [PMID: 34535756 DOI: 10.1038/s41371-021-00609-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/28/2021] [Accepted: 09/08/2021] [Indexed: 01/09/2023]
Abstract
We assessed the association of hypertension with markers of inflammation and infection in a rural and disadvantaged Indian population. In a case-control study, we age- and gender-matched 300 cases with hypertension to 300 controls without hypertension. Blood pressure was measured according to a strict protocol. We measured markers of inflammation and infection including serum high-sensitivity C-reactive protein (hs-CRP), blood lymphocyte count, serum homocysteine, tooth loss, overcrowding and exposure to fecal contamination. Multivariable conditional logistic regression was used to determine their association with hypertension. Median serum hs-CRP was 42% greater in cases than controls, while median serum homocysteine was 10% greater. In multivariable conditional logistic regression, elevated homocysteine (OR 1.75, 95% CI 1.09-2.82), greater lymphocyte count (OR 1.49, 95% CI 1.01-2.01) and exposure to fecal contamination, defined as a distance from the field used for toilet purposes to the household of ≤50 m (OR 2.38, 95% CI 1.07-5.29), were independently associated with hypertension in this rural population. In separate analyses for each gender, elevated hs-CRP (OR 2.62, 95% CI 1.04-6.58) was associated with hypertension in men, whereas edentulism (OR 4.75, 95% CI 1.62-13.96) was associated with greater odds of hypertension in women. Our findings demonstrate specific associations between hypertension and markers of inflammation and infection including hs-CRP, homocysteine, lymphocyte count, edentulism and exposure to fecal contamination. Thus, strategies aimed at reducing inflammation and infection may reduce the burden of hypertension in such settings of disadvantage in rural India.
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Ribeiro AB, Ribeiro AB, de Araújo CB, Fortes CV, Clemente LM, Paranhos HDFO, Watanabe E, Salgado HC, Silva-Lovato CH. Effect of a Hygiene Protocol on Denture-Related Stomatitis Remission, Local Inflammatory Factors, and Hemodynamic Responses by Arterial Pressure. Antibiotics (Basel) 2022; 11:antibiotics11101320. [PMID: 36289978 PMCID: PMC9598829 DOI: 10.3390/antibiotics11101320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/16/2022] [Accepted: 09/24/2022] [Indexed: 11/17/2022] Open
Abstract
Denture-related stomatitis (DRS) is frequent oral inflammation in complete denture wearers. This study evaluated the effect of a hygiene protocol on DRS remission, local inflammatory factors, and hemodynamic responses. Thirty-three individuals were enrolled in the study. The outcomes were measured before and after 10 days of a hygiene protocol treatment consisting of brushing the palate with a soft brush and water and denture brushing with a denture-specific brush and mild soap, as well as immersion of the denture for 20 min in a 0.25% sodium hypochlorite solution. Data were analyzed by paired Wilcoxon for biofilm removal and CFU count of microorganisms. The paired T test was used to assess salivary MUC 1, cytokines, and arterial pressure (p < 0.05). A significant difference was found in the DRS degree (p < 0.001), biofilm (p < 0.001), microbial load of Candida spp. (p < 0.001), Gram-negative (p < 0.004), Staphylococcus spp. (p < 0.001), and S. mutans (p < 0.001) of the denture, and S. mutans (p < 0.001) of the palate after use of the protocol. The salivary flow (p = 0.2) and pH (p = 0.97) did not change; there was an increase of MUC 1 (p = 0.049) and a decrease in IL-6 (p = 0.038), IL-2 (p = 0.04), IL-10 (p = 0.041), and IFNγ (p = 0.04). There was also a decrease in systolic (p = 0.012) and mean arterial pressure (p = 0.02). The current hygiene protocol reduced the inflammation degree of DRS and promoted an improvement of local inflammatory factors and a reduction in the systolic arterial pressure of the patients.
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Affiliation(s)
- Adriana Barbosa Ribeiro
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Aline Barbosa Ribeiro
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Camila Borba de Araújo
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Caroline Vieira Fortes
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Lorena Mosconi Clemente
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Helena de Freitas Oliveira Paranhos
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Evandro Watanabe
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Helio Cesar Salgado
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Cláudia Helena Silva-Lovato
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
- Correspondence: ; Tel.: +55-16-3315-4006
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The relationship between tooth loss and hypertension: a systematic review and meta-analysis. Sci Rep 2022; 12:13311. [PMID: 35922537 PMCID: PMC9349209 DOI: 10.1038/s41598-022-17363-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
As tooth loss is the high end of periodontal problems and edentulous individuals are at higher risk of nutritional problems like obesity, understanding the association between tooth loss and hypertension is important for improving cardiovascular health. We searched for publications from the last two decades using three electronic databases (PubMed, Web of Science and Scopus) and conducted a systematic review and meta-analysis on the association between tooth loss and hypertension according to PRISMA-P guidelines. Quality assessments were performed using the Newcastle–Ottawa Scale and the GRADE approach. Twenty-four studies (20 cross-sectional, and 4 cohort) met the inclusion criteria for this review. Most cross-sectional studies showed that subjects with more tooth loss exhibited a greater proportion of hypertension and higher systolic blood pressure than those with less tooth loss. Meta-analyses revealed a statistically significant association between tooth loss and hypertension. The pooled odds ratios of hypertension for having tooth loss with no tooth loss and for edentulous with dentate were 2.22 (95% CI 2.00–2.45) and 4.94 (95% CI 4.04–6.05), respectively. In cohort studies, subjects with more tooth loss had a greater incidence of hypertension than those with less tooth loss during the follow-up period. The present systematic review and meta-analysis suggests that tooth loss is associated with an increased risk of hypertension and higher systolic blood pressure.
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Larvin H, Kang J, Aggarwal VR, Pavitt S, Wu J. The additive effect of periodontitis with hypertension on risk of systemic disease and mortality. J Periodontol 2022; 93:1024-1035. [PMID: 35460076 PMCID: PMC9544472 DOI: 10.1002/jper.21-0621] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/24/2022] [Accepted: 04/10/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Recent evidence suggests that periodontitis (PD) causes hypertension, which is a precursor to development of other systemic diseases. The aim of this study was to examine the effect of hypertension and PD on the risk of subsequent systemic disease. METHODS This longitudinal cohort study included 244,393 UK Biobank participants who were free of systemic disease other than hypertension at baseline. Self-reported responses of painful gums or loose teeth were surrogates for PD. Hypertensives were identified by clinical diagnosis, or elevated blood pressure (≥140/90 mmHg). Systemic diseases including cancer, cardiovascular disease (CVD), and diabetes were identified from linked diagnostic codes. Multivariable Cox proportional hazard models were used to quantify the risk of systemic diseases and all-cause mortality, stratified by hypertensive and PD status. RESULTS The average age of the study population was 55.4 years (standard deviation [SD:] 8.1 years), and 130,220 (53.3%) participants were female. At baseline, 131,566 (53.8%) participants were hypertensive and 4.5% reported PD. The incidence rates of all systemic diseases were higher in hypertensive than non-hypertensive participants of the same PD status. In hypertensives, an additive effect was observed for PD on the risks of CVD (adjusted hazard ratio [HR]: 1.35, 95% confidence interval [CI]: 1.21-1.53) and respiratory disease (HR: 1.11, 95% CI: 0.95-1.30) compared to hypertensive healthy controls. CONCLUSIONS Hypertensives with PD have exacerbated risks of several systemic diseases. Future interventional studies should consider the effect of periodontal treatment on systemic outcomes in targeted hypertensive populations.
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Affiliation(s)
| | - Jing Kang
- Oral Biology, School of DentistryUniversity of LeedsLeedsUK
| | | | - Sue Pavitt
- School of DentistryUniversity of LeedsLeedsUK
| | - Jianhua Wu
- School of DentistryUniversity of LeedsLeedsUK
- Leeds Institute for Data AnalyticsUniversity of LeedsLeedsUK
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Bajgai GP, Okuma N, Khovidhunkit SOP, Thanakun S. Comparison of measured blood pressure levels, hypertension history, oral diseases, and associated factors among Thai dental patients. J Oral Sci 2022; 64:236-241. [PMID: 35691889 DOI: 10.2334/josnusd.22-0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE To compare blood pressure (BP), hypertension (HT) history, oral diseases, and potentially associated factors among dental patients in Thailand and explore the associations among them. METHODS This study included 709 patients. Demographic data, BP levels, oral diseases, xerostomia, anxiety, depression, and associated factors were evaluated. RESULTS One-third of the patients were male; patients with a history of HT were older than those without (P < 0.001). In total, 53 (7.5%) had such a history, and HT was controlled in 29 (54.7%) of them. Patients with possible HT (BP ≥140/90 mmHg; 94 in total, 13.3%) were five times more likely to have a definitive diagnosis of HT than those without possible HT (odd ratio [OR] = 4.95; 95% confidence interval [CI]: 2.76-8.87; P < 0.001). They also had an increased tendency to be taking antidyslipidemic (OR = 5.54; 95% CI: 2.90-10.60; P = 0.001) or antidiabetic (OR = 4.80; 95% CI: 1.91-12.08; P = 0.001) drugs. Male sex (ß = 0.156, P < 0.001), higher age (ß = 0.299, P < 0.001), higher body mass index (ß = 0.410, P < 0.001), and periapical tissue diseases (ß = 0.073, P = 0.019) were significantly associated with elevated systolic BP. Severe periodontitis (ß = 0.081, P = 0.023) and a comparable association pattern with systolic BP were related to diastolic BP. Multivariate analysis revealed no significant association between BP and tooth loss, xerostomia, smoking, education level, anxiety, or depression. CONCLUSION Dentists play an essential role in screening for undiagnosed and uncontrolled HT. Significant associations were noted between oral inflammatory diseases and high BP.
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Affiliation(s)
- Gyan P Bajgai
- Department of Dentistry, Jigme Dorji Wangchuck National Referral Hospital
| | - Nis Okuma
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University
| | | | - Supanee Thanakun
- Oral Diagnostic Science Division, College of Dental Medicine, Rangsit University
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Association between tooth loss and hypertension: A systematic review and meta-analysis. J Dent 2022; 123:104178. [PMID: 35661800 DOI: 10.1016/j.jdent.2022.104178] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Poor oral health status may increase the risk of cardiovascular disease. However, whether a specific association exists between tooth loss and hypertension is inconclusive. Accordingly, a quantitative systematic review was conducted to investigate the relationship between tooth loss and hypertension. METHODS Systematic search, data analysis and quality assessment were conducted on relevant literature published in PubMed, Embase, Web of Science and Cochrane Libraries until October 2021. Odds ratio (OR) with 95% confidence interval (CI) was used as effect size to evaluate the association between tooth loss and hypertension. Meta-regression and subgroup analyses were performed to identify whether difference was associated with study-level factors. RESULTS Of the 56 studies selected, 28 studies in 16 different countries involving 1,224,821 individuals were eligible for the systematic review. After adjustment for confounding factors, individuals with tooth loss had a higher risk for hypertension (OR 1.20; 95%CI 1.10-1.30, I2 = 40.02%). With respect to the risk of hypertension on tooth loss, individuals with hypertension still had a higher risk for tooth loss (OR 1.35; 95%CI 1.07-1.62, I2 = 51.10%). Age limitation of the included population is the major source of heterogeneity. However, studies in which the population was limited to the elderly did not report an increase in association between tooth loss and hypertension compared with studies without age limitation. CONCLUSIONS The results suggest a bidirectional association between tooth loss and hypertension. Future longitudinal prospective studies are required to establish causality between tooth loss and hypertension. CLINICAL SIGNIFICANCE Subjects with severe tooth loss should be carefully monitored for the manifestation of hypertension. The oral health status of hypertensive patients should also be meticulous maintained to prevent unwarranted tooth loss.
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Wang Y, Jiang Y, Chen Y, Yu L, Zhou J, Wang N, Liu T, Fu C. Associations of oral hygiene with incident hypertension and type 2 diabetes mellitus: A population based cohort study in Southwest China. J Clin Hypertens (Greenwich) 2022; 24:483-492. [PMID: 35255181 PMCID: PMC8989750 DOI: 10.1111/jch.14451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/01/2022]
Abstract
Oral health has been previously reported to be related with cardiovascular diseases (CVD). This study aimed to evaluate whether oral hygiene could reduce the risk of incident hypertension and type 2 diabetes mellitus (T2DM) in a population-based cohort. A total of 9280 people aged 18 years or above in Guizhou province were recruited from November 20th, 2010 to December 19th, 2012. Sociodemographic characteristics, lifestyles, anthropometric measurements, oral health status and care were collected by trained interviewers. The occurrences of hypertension and T2DM were ascertained until 2020. Cox proportional hazard models were used to evaluate the associations between oral hygiene and the occurrence of hypertension and T2DM, respectively. Compared with almost no tooth brushing, tooth brushing at least twice a day was associated with a 45% reduction (HR: .55; 95% CI: .42-.73) in hypertension events and reduced diabetes risk by 35% (HR: .65; 95% CI: .45-.94). For hypertension, those associations tended to be more pronounced in participants with Han ethic, or living in urban area, while those aged less than 60 or without baseline hypertension were more likely to have T2DM when they brush teeth less than twice a day. Frequent tooth brushing was associated with reduced risks of incident hypertension and T2DM. Tooth brushing at least twice a day may prevent future hypertension and T2DM events.
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Affiliation(s)
- Yiying Wang
- Guizhou Province Centre for Disease Control and Prevention, Guizhou ProvinceGuiyangChina
| | - Yizhou Jiang
- School of Public HealthKey Laboratory of Public Health SafetyFudan UniversityShanghaiChina
- NHC Key Laboratory of Health Technology AssessmentFudan UniversityShanghaiChina
| | - Yun Chen
- School of Public HealthKey Laboratory of Public Health SafetyFudan UniversityShanghaiChina
- NHC Key Laboratory of Health Technology AssessmentFudan UniversityShanghaiChina
| | - Lisha Yu
- Guizhou Province Centre for Disease Control and Prevention, Guizhou ProvinceGuiyangChina
| | - Jie Zhou
- Guizhou Province Centre for Disease Control and Prevention, Guizhou ProvinceGuiyangChina
| | - Na Wang
- School of Public HealthKey Laboratory of Public Health SafetyFudan UniversityShanghaiChina
- NHC Key Laboratory of Health Technology AssessmentFudan UniversityShanghaiChina
| | - Tao Liu
- Guizhou Province Centre for Disease Control and Prevention, Guizhou ProvinceGuiyangChina
| | - Chaowei Fu
- School of Public HealthKey Laboratory of Public Health SafetyFudan UniversityShanghaiChina
- NHC Key Laboratory of Health Technology AssessmentFudan UniversityShanghaiChina
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12
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Tani N, Ohta M, Higuchi Y, Yamamoto R, Akatsu J. Does difficulty in chewing induce subjective musculoskeletal symptoms? A case-control study. BMJ Open 2022; 12:e053360. [PMID: 35318231 PMCID: PMC8943742 DOI: 10.1136/bmjopen-2021-053360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Risk factors associated with the development of musculoskeletal disorders and symptoms remain an important issue worldwide. This study aimed to investigate the relationship between oral health problems such as difficulty chewing and the occurrence of stiff neck/shoulders (SN/S) and low back pain (LBP). DESIGN Case-control study. SETTING AND PARTICIPANTS This study was conducted from 1 April 2018 to 31 March 2020. The subjects were 77 341 workers among 646 281 workers from several employers in Japan. OUTCOME MEASURES Participants were asked to evaluate their subjective SN/S and LBP symptoms using a self-administered questionnaire. METHODS We defined the chewing condition using a questionnaire, and workers who responded with 'I can chew anything' were classified as the good condition group (GCG), and those who responded with 'Sometimes I have difficulty chewing due to problems with the teeth, gums, or bite' or 'I can hardly chew' were classified as the poor condition group (PCG). Setting the year 2018 as the baseline, we performed a logistic regression model using propensity score and inverse probability weighting (IPW) methods and chewing condition groups as explanatory variables and SN/S and LBP as objective variables. RESULTS The IPW-adjusted logistic regression model showed that the OR of SN/S was approximately 1.25 (95% CI 1.17 to 1.33) times higher in the PCG than that in the GCG (p<0.001). Similarly, the OR of LBP was about 1.37 (95% CI 1.27 to 1.48) times higher in the PCG than that in the GCG in the IPW-adjusted logistic regression model (p<0.001). CONCLUSIONS Our study suggests that the occurrence of SN/S and LBP symptoms in workers could be predicted depending on the presence of difficulty in chewing. Therefore, oral health and health guidance are gaining importance for the prevention of subjective musculoskeletal symptoms.
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Affiliation(s)
- Naomichi Tani
- Department of Health Information Analysis and Research, The Association for Preventive Medicine of Japan, Fukuoka, Japan
| | - Masanori Ohta
- Graduate School of Health and Environmental Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Yoshiyuki Higuchi
- Department of Health and Physical Education, University of Teacher Education Fukuoka, Fukuoka, Japan
| | - Ryoko Yamamoto
- Department of Occupational health, The Association for Preventive Medicine of Japan, Fukuoka, Japan
| | - Junichi Akatsu
- Wellbeing Mori Clinic, The Association for Preventive Medicine of Japan, Tokyo, Japan
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13
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Costa FO, Cortelli JR, Cortelli SC, Costa AA, Esteves Lima RP, Costa AM, Pereira GHM, Cota LOM. The loss of molars in supportive periodontal care: a 10-year follow-up for tooth- and patient-related factors. J Clin Periodontol 2021; 49:292-300. [PMID: 34905803 DOI: 10.1111/jcpe.13585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022]
Abstract
AIM Determining the impact of the degree of furcation involvement (FI) on the longevity of molar teeth and assessing risk variables (tooth- and patients-related factors) associated with loss of molars (LM) in individuals treated for periodontitis and monitored in a private program of supportive periodontal care (SPC). MATERIALS AND METHODS The present retrospective cohort study included 222 individuals with 1,329 molars under a 10-year monitoring period in SPC. Periodontal clinical parameters, FI, type of molar, pulp vitality and other variables of interest were colleted at approximately 50 days after active periodontal therapy and after 10 years. The association of tooth- and patients-related factors with LM was assessed using a multilevel Cox regression analysis. RESULTS 235 molars were extracted during the SPC period of 12.4(±1.9) years. Age >50 years old, male gender, diabetes, smoking and no compliance were identified as relevant patient-related factors for LM during SPC (p<0.05). Significant tooth-related factors for LM were bleeding on probing (BOP) and probing depth (PD) ≥5mm, tooth non-vitality and class II and III FI (p<0.05). CONCLUSIONS Class III FI, tooth non-vitality, higher mean PD and BOP, age, male gender, diabetes and smoking all strongly influenced the prognosis of molars during SPC. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Fernando Oliveira Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Roberto Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Sheila Cavalca Cortelli
- Departament of Dentistry, Periodontics Research Division, University of Taubaté, São Paulo, Brazil
| | - Amanda Almeida Costa
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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14
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Association between liver cirrhosis and peri-implant diseases: a case-control study on implant- and patient-related risk factors. Clin Oral Investig 2021; 26:3563-3572. [PMID: 34859326 DOI: 10.1007/s00784-021-04324-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/27/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the potential association between liver cirrhosis and peri-implant diseases, as well as the influence of different risk indicators on this association. METHODS This case-control study included 64 cases with liver cirrhosis and 128 controls without liver diseases that presented the same socio-demographic and economic profile. The specific inclusion criteria were the following: aged group of 35-55 years and presenting at least one osseointegrated implant functioning for >5 years. A full-mouth peri-implant and periodontal examination was performed and risk variables were recorded. The association between risk variables and the occurrence of peri-implant diseases was tested through univariate analysis and multivariate logistic regression, stratified by alcohol status. Additionally, a mediation analysis was performed to examine the mediating effect of age with peri-implantitis. RESULTS A high prevalence of peri-implantitis (29.7%) was observed among cases when compared to controls (18.0%). Individuals with cirrhosis presented ~2.5 higher chance of having peri-implantitis than controls (p<0.001). Significant variables associated with the occurrence of peri-implantitis in the final logistic model were the following: cirrhosis, alcohol use, age (>55 years), male sex, smoking, periodontitis, and number of ≤14. CONCLUSIONS An important risk association between liver cirrhosis and peri-implantitis was reported. Future studies with a larger sample size controlling for the patient- and implant-related confounders are needed to better understand the link between peri-implantitis and liver cirrhosis. CLINICAL RELEVANCE Cirrhosis individuals, age, and periodontitis, as well as alcohol use and smoking interaction, should be considered as potential risk indicators for peri-implantitis.
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Lyra P, Machado V, Proença L, Mendes JJ, Botelho J. Tooth Loss and Blood Pressure in Parkinson's Disease Patients: An Exploratory Study on NHANES Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095032. [PMID: 34068631 PMCID: PMC8126086 DOI: 10.3390/ijerph18095032] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 04/26/2021] [Accepted: 05/04/2021] [Indexed: 12/15/2022]
Abstract
Objectives: To evaluate tooth loss severity in PD patients and the impact of missing teeth on blood pressure (BP) and glycated hemoglobin (Hba1c) levels. Methods: All adults reporting specific PD medication regimens with complete dental examinations were included from the NHANES 2001 to 2018 databases. Sociodemographic, systolic BP (SBP), diastolic BP (DBP) and Hba1c data were compared according to tooth loss severity, and linear regression analyses on the impact of tooth loss on SBP, DBP and Hba1c levels were conducted. Results: The 214 included participants presented 9.7 missing teeth, 23.8% severe tooth loss and 18.2% total edentulousness. Severe tooth loss cases were significantly older (p < 0.001), had higher smoking prevalence (p = 0.008), chronic medical conditions (p = 0.012) and higher Hba1c (p = 0.001), SBP (p = 0.015) and DBP (p < 0.001) levels. Crude and adjusted linear models revealed a relationship between SBP, DBP and missing teeth; however, age confounded these links (SBP: B = 0.10, SE = 0.16, p < 0.05; DBP: B = 0.16, SE = 0.10, p < 0.05). Tooth loss presented no significant relationship with Hba1c levels. Conclusions: Severe tooth loss is prevalent among PD patients. Blood pressure levels showed a positive linear relationship with the number of missing teeth, although age was a confounding factor. Furthermore, tooth loss and Hba1c levels revealed no significant linear relationship.
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Affiliation(s)
- Patrícia Lyra
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Clinical Research Unit (CRU), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal; (P.L.); (V.M.); (J.J.M.)
| | - Vanessa Machado
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Clinical Research Unit (CRU), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal; (P.L.); (V.M.); (J.J.M.)
- Evidence-Based Hub, CRU, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal;
| | - Luís Proença
- Evidence-Based Hub, CRU, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal;
- Quantitative Methods for Health Research (MQIS), CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal
| | - José João Mendes
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Clinical Research Unit (CRU), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal; (P.L.); (V.M.); (J.J.M.)
- Evidence-Based Hub, CRU, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal;
| | - João Botelho
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Clinical Research Unit (CRU), Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal; (P.L.); (V.M.); (J.J.M.)
- Evidence-Based Hub, CRU, CiiEM, Egas Moniz—Cooperativa de Ensino Superior, 2829-511 Caparica, Portugal;
- Correspondence: ; Tel.: +351-969-848-394
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