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Chen HM, Li KY, Li TL, Wong GHY, Kwong YL, Ng RCL, Burrow MF, McGrath C, Chen H. Association of dietary inflammation with tooth loss and cognitive decline in older adults from cross-sectional data: The moderated role of albumin. J Dent 2024; 144:104967. [PMID: 38554801 DOI: 10.1016/j.jdent.2024.104967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE Growing evidence suggests a potential connection between tooth loss and cognitive function in recent years. Increasing studies have focused on their inter-relationship, however, the underlying mechanism has yet to be fully elucidated. Few studies have considered the role of dietary inflammation and serum albumin in the association between tooth loss and cognitive function. Therefore, the aim of this study was to explore the role of dietary inflammation and serum albumin in the association between tooth loss and cognitive impairment. METHODS A sample of 1,009 US adults from the National Health and Nutrition Examination Survey (NHANES) provided data on oral condition, cognitive function, dietary intake, and serum tests. The association between tooth loss (exposure variable) and cognitive function (outcome variable) was assessed by linear regression. Furthermore, a moderated mediation model was established to examine the influence of dietary inflammation on the association between tooth loss and cognitive tests, and the visualization of the moderating effect of serum albumin concentration was displayed through the Johnson-Neyman curve. RESULTS Participants with impaired dentition had worse cognitive function and a higher Dietary Inflammation Index (DII). DII was highly correlated with Immediate Recall Test (IR), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST), which mediated 16.46 %, 14.41 % and 11.28 % of the effect between tooth loss and cognitive functions. Additionally, the relationship between DII and DSST was moderated by serum albumin concentration. CONCLUSION Tooth loss was associated with cognitive function which was affected by pro-inflammatory dietary patterns and serum albumin level. CLINICAL SIGNIFICANCE This study presents evidence for dentists that dietary pattern change due to tooth loss plays a role in cognitive deterioration, which can also be moderated by serum albumin level. Therefore, the preservation of natural teeth is important for cognitive function, especially in an immunocompromised population with decreased serum albumin concentrations.
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Affiliation(s)
- Hui Min Chen
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong Special Administrative Region of China
| | - Kar Yan Li
- Clinical Research Centre, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong Special Administrative Region of China
| | - Tian Le Li
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong Special Administrative Region of China
| | - Gloria Hoi Yan Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam Road, Hong Kong Special Administrative Region of China
| | - Yee Lan Kwong
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Research Institute for Smart Ageing, Hung Hom, Kowloon, Hong Kong Special Administrative Region of China
| | - Roy Chun-Laam Ng
- Division of Neuroscience, Faculty of Biology, Medicine & Health, University of Manchester, AV Hill Building, Oxford Road, Manchester, England, United Kingdom
| | - Michael Francis Burrow
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong Special Administrative Region of China
| | - Colman McGrath
- Division of Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong Special Administrative Region of China
| | - Hui Chen
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong Special Administrative Region of China.
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Syrjäläinen S, Männistö S, Könönen E, Pussinen P, Gürsoy M, Suominen AL, Jousilahti P, Gürsoy UK. Dietary inflammatory index in relation to salivary cytokine concentrations and periodontitis: A cross-sectional analysis. J Clin Periodontol 2024; 51:406-416. [PMID: 38158626 DOI: 10.1111/jcpe.13917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/11/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
AIM To examine the associations of dietary inflammatory index (DII) with salivary cytokine concentrations and periodontitis after controlling for body mass index (BMI), socio-demographic factors and lifestyle. MATERIALS AND METHODS Subgroups from two Finnish surveys, DILGOM 2007 and Health 2000, were included (total n = 727). The DII scores were calculated based on a food frequency questionnaire. Periodontal status was assessed with a cumulative risk score in DILGOM 2007 and by pocket depth measurement in Health 2000. From saliva, interleukin (IL)-1β, IL-1 receptor antagonist, IL-6, IL-8, IL-10 and tumour necrosis factor (TNF)-α concentrations were measured. RESULTS The DII scores did not differ between non-periodontitis and periodontitis participants in pairwise comparison. After adjusting for energy intake, periodontal status, BMI, age, education level, smoking habit and physical activity, DII was not associated with salivary cytokine concentrations. After adjusting for salivary cytokine levels and other confounding factors, DII was associated with periodontitis in the Health 2000 subgroup but not in the DILGOM 2007 subgroup. CONCLUSIONS The current data support the evidence that diet is not associated with salivary cytokine levels but may be associated with periodontitis. The association observed between diet and periodontitis is related to factors other than diet-dependent inflammatory tendency in the oral cavity.
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Affiliation(s)
- Sanna Syrjäläinen
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Satu Männistö
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Eija Könönen
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Pirkko Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Mervi Gürsoy
- Oral Health Care, Welfare Division, City of Turku, Turku, Finland
| | - Anna Liisa Suominen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral and Maxillofacial Teaching Unit, Kuopio University Hospital, Kuopio, Finland
| | - Pekka Jousilahti
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ulvi Kahraman Gürsoy
- Department of Periodontology, Institute of Dentistry, University of Turku, Turku, Finland
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Guo ZL, Zhou J, Lin XJ, Yuan Q, Dong YL, Liu QB, Wang T. Regulation of the AGEs-induced inflammatory response in human periodontal ligament cells via the AMPK/NF-κB/ NLRP3 signaling pathway. Exp Cell Res 2024; 437:113999. [PMID: 38494067 DOI: 10.1016/j.yexcr.2024.113999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/04/2024] [Accepted: 03/10/2024] [Indexed: 03/19/2024]
Abstract
The heightened prevalence and accelerated progression of periodontitis in individuals with diabetes is primarily attributed to inflammatory responses in human periodontal ligament cells (HPDLCs). This study is aimed at delineating the regulatory mechanism of nucleotide-binding oligomerization domain-like receptors (NLRs) in mediating inflammation incited by muramyl dipeptide (MDP) in HPDLCs, under the influence of advanced glycation end products (AGEs), metabolic by-products associated with diabetes. We performed RNA-seq in HPDLCs induced by AGEs treatment and delineated activation markers for the receptor of AGEs (RAGE). It showed that advanced glycation end products modulate inflammatory responses in HPDLCs by activating NLRP1 and NLRP3 inflammasomes, which are further regulated through the NF-κB signaling pathway. Furthermore, AGEs synergize with NOD2, NLRP1, and NLRP3 inflammasomes to augment MDP-induced inflammation significantly.
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Affiliation(s)
- Zhu-Ling Guo
- School of Dentistry, Hainan Medical University, Haikou, China; Department of Health Management Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Jie Zhou
- School of Dentistry, Hainan Medical University, Haikou, China
| | - Xue-Jing Lin
- School of Dentistry, Hainan Medical University, Haikou, China
| | - Qing Yuan
- School of Dentistry, Hainan Medical University, Haikou, China
| | - Yu-Lei Dong
- School of Dentistry, Hainan Medical University, Haikou, China
| | - Qi-Bing Liu
- Engineering Research Center of Tropical Medicine Innovation and Transformation, Ministry of Education, The First Affiliated Hospital, Haikou, 571199, China; Department of Pharmacology, School of Basic Medicine and Life Sciences, Hainan Medical University, Haikou, 571199, China.
| | - Tao Wang
- Dental Medical Center, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital),19 Xiuhua Road, Haikou, 570311, Hainan, China.
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Wang F, Sun M, Wang X, Wu Z, Guo R, Yang Y, Wang Y, Liu Y, Dong Y, Wang S, Li B. The mediating role of dietary inflammatory index on the association between eating breakfast and depression: Based on NHANES 2007-2018. J Affect Disord 2024; 348:1-7. [PMID: 38070746 DOI: 10.1016/j.jad.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/07/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Depression is a significant, pervasive, global public health problem, associated with many factors, such as diet, social factors, and lifestyle habits. We aimed to evaluate the association between eating breakfast, dietary inflammatory index (DII) and depression, and to verify the mediating role of DII on the effect of eating breakfast on depression. METHODS 21,865 participants from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018 were included in this study. Binary logistic regression and mediated effect analysis were conducted to analyze the associations between eating breakfast, DII and depression. Dietary inflammation was divided into pro-inflammatory diet and anti-inflammatory diet according to the DII. RESULTS Both pro-inflammatory diet and skipping breakfast were risk factors for depression. After adjusting for covariables, compared with participants reporting breakfast in both recalls, reporting breakfast in one recall had a higher OR 95%CI (1.54(1.20, 1.98)) of depression. These associations in stratified analysis and sensitivity analysis without cardiovascular diseases (CVD) and diabetes were robust. DII mediated the association between eating breakfast and depression, the proportion of participants who reported breakfast in one recall and no recall was 26.15 % and 26.67 %, respectively. LIMITATIONS This was a cross-sectional study that couldn't argue for the cause-effect relationship. Moreover, the confounding factor regarding medication use was not accounted for due to limited data. CONCLUSIONS Skipping breakfast may increase the risk of depression by raising DII. And our study supported the essential role of regular breakfast and the anti-inflammatory diet in reducing the risk of depression.
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Affiliation(s)
- Fengdan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Xuhan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Zibo Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Ruirui Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Yixue Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Yuxiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Yan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Yibo Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Sizhe Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun 130021, China.
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Petrenya N, Brustad M, Hopstok LA, Holde GE, Jönsson B. Empirically derived dietary patterns in relation to periodontitis and number of teeth among Norwegian adults. Public Health Nutr 2024; 27:e27. [PMID: 38223974 PMCID: PMC10830357 DOI: 10.1017/s1368980023002690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/17/2023] [Accepted: 11/24/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVES To explore dietary patterns in relation to periodontitis and number of teeth. DESIGN A cross-sectional study. SETTING We used data from the seventh survey of the Tromsø Study in Norway, 2015-2016. Three periodontitis groups were compared: (i) no periodontitis/slow bone loss; (ii) moderate bone loss; and (iii) rapid bone loss. Number of teeth was categorised as 25-28, 20-24 and ≤ 19. Dietary patterns were identified by principal component analysis. Multiple logistic regression was applied to examine associations between tertiles of dietary pattern scores and periodontitis, and between these same tertiles and number of teeth. PARTICIPANTS 1487 participants (55·5 % women) aged 40-79 years who were free of major chronic diseases, attended an oral health examination and completed a FFQ. RESULTS Four dietary patterns were identified, which explained 24 % of the total variability in food intake: fruit and vegetables, Westernised, meat/fish and potatoes, and refined grain and dessert. The fruit and vegetables pattern was inversely associated with periodontitis characterised by rapid bone loss when compared with no periodontitis/slow bone loss (OR tertile 3 v. 1 0·49, 95 % CI: 0·25, 0·98). Participants who were in the highest tertile of the refined grain and dessert pattern (tertile 3 v. 1) had 2·38- and 3·52-fold increased odds of having ≤ 19 than 20-24 and 25-28 teeth, respectively. CONCLUSION Out of four identified dietary patterns, only the fruit and vegetables pattern was negatively associated with advanced periodontitis. A more apparent positive association was observed between the refined grain and dessert pattern and having fewer teeth (≤ nineteen teeth).
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Affiliation(s)
- Natalia Petrenya
- The Public Dental Health Service Competence Centre of Northern Norway, P.O Box 2406, N-9271, Tromsø, Norway
| | - Magritt Brustad
- The Public Dental Health Service Competence Centre of Northern Norway, P.O Box 2406, N-9271, Tromsø, Norway
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Laila A Hopstok
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Gro Eirin Holde
- The Public Dental Health Service Competence Centre of Northern Norway, P.O Box 2406, N-9271, Tromsø, Norway
- Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Birgitta Jönsson
- The Public Dental Health Service Competence Centre of Northern Norway, P.O Box 2406, N-9271, Tromsø, Norway
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Basu A, Richardson LA, Carlos A, Abubakr NH, Weltman RL, Ebersole JL. The Associations of Cardiometabolic and Dietary Variables with Clinical Periodontitis in Adults with and without Type 2 Diabetes: A Cross-Sectional Study. Nutrients 2023; 16:81. [PMID: 38201914 PMCID: PMC10780717 DOI: 10.3390/nu16010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Periodontitis is a commonly occurring inflammatory oral disease affecting a large proportion of global and US adults and is characterized by the destruction of the tooth-supporting apparatus. Its etiology is multifactorial, and type 2 diabetes and diet play critical roles in its remission and progression. However, few studies have addressed nutritional and serum vitamin D status in adults with periodontitis in the presence of diabetes. A cross-sectional study (n = 78), and a sub-set of age- and BMI-matched case-control studies (n = 50), were conducted to examine differences in dietary and cardiometabolic variables, and serum vitamin D in adults with periodontitis with or without diabetes. Participants provided fasting blood samples and 24-h diet recalls on at least two different days. Data on health history, body weight, height, nutritional habits, and clinical features of periodontitis were also collected. The Mann-Whitney U Test (with exact p-value estimation by Monte Carlo simulation) was used to examine differences by diabetes status in continuous and ordinal variables. Results revealed significantly lower serum vitamin D, and dietary intake of fruits, vegetables, dairy, vitamins A and C in adults with periodontitis with vs. without diabetes in the sub-study (all p < 0.05). In the overall sample, adults with diabetes presented with higher caries risk measures and lower numbers of teeth than those without diabetes; plaque and bleeding scores did not differ by diabetes status. Finally, a significant associations of food habits was observed, especially consuming protein-rich foods twice a day with a lower bleeding score, and daily consumption of fried or fast foods with a fewer number of teeth present (all p < 0.05). The present findings show significant dietary and serum vitamin D inadequacies among adults with periodontitis, and diabetes further aggravates the observed malnourishment and oral health.
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Affiliation(s)
- Arpita Basu
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Leigh Ann Richardson
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Alicia Carlos
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA; (A.C.); (N.H.A.); (J.L.E.)
| | - Neamat Hassan Abubakr
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA; (A.C.); (N.H.A.); (J.L.E.)
| | - Robin L. Weltman
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA;
| | - Jeffrey L. Ebersole
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada at Las Vegas, Las Vegas, NV 89154, USA; (A.C.); (N.H.A.); (J.L.E.)
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Vu GT, Shakib S, King C, Gurupur V, Little BB. Association between uncontrolled diabetes and periodontal disease in US adults: NHANES 2009-2014. Sci Rep 2023; 13:16694. [PMID: 37794165 PMCID: PMC10550940 DOI: 10.1038/s41598-023-43827-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/28/2023] [Indexed: 10/06/2023] Open
Abstract
This study examined the relationship between uncontrolled diabetes and periodontal disease (PD) among adults in the United States. We used data from the 2009-2014 National Health and Nutrition Examination Survey (NHANES) with a sample of 6108 adults ages 30 and over. To measure PD status, we used the Centers for Disease Control and Prevention/American Academy of Periodontology's standards. To classify DM status (no DM, DM with HbA1c < 9%, diabetes with HbA1c ≥ 9%),we used self-reported Diabetes Mellitus (DM) diagnosis and laboratory report of HbA1c. Approximately 8.5% of the sample had controlled DM, and 1.7% had uncontrolled DM, for a total of 10.2% DM in the analysis. Multivariate logistic regression showed that compared to those without DM, PD was significantly increased with controlled DM (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) 1.01-1.73, p < 0.05) and even more with uncontrolled DM (aOR = 2.48, 95% CI 1.52-4.04, p < 0.001), after adjusting for covariates. Factors that reduced the prevalence of PD included annual dental visits, female gender, and college education. Factors that significantly increased PD prevalence were cigarette smoking, non-white race, income < 200% Federal Poverty Level, and older age (age > 50 years). In conclusion, uncontrolled DM was significantly associated with higher odds of PD among adults in the US.
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Affiliation(s)
- Giang T Vu
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, 32801, USA.
| | - Shaminul Shakib
- Department of Health Management and Systems Sciences, University of Louisville, Louisville, KY, USA
| | - Christian King
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, 32801, USA
| | - Varadraj Gurupur
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, 32801, USA
| | - Bert B Little
- Department of Health Management and Systems Sciences, University of Louisville, Louisville, KY, USA
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Gare J, Kanoute A, Orsini G, Gonçalves LS, Ali Alshehri F, Bourgeois D, Carrouel F. Prevalence, Severity of Extension, and Risk Factors of Gingivitis in a 3-Month Pregnant Population: A Multicenter Cross-Sectional Study. J Clin Med 2023; 12:jcm12093349. [PMID: 37176789 PMCID: PMC10179599 DOI: 10.3390/jcm12093349] [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: 03/28/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
The scope of this study was to assess the prevalence, severity of extension, and risk factors of gingivitis among pregnant women. In this cross-sectional study, 220 nulliparous women at 3 months of pregnancy were recruited in 2022 at the first obstetrical visit in Dakar, Senegal. Demographic characteristics, lifestyle habits, prenatal clinical status, and oral clinical parameters were recorded. Multivariable logistic regression modeling was used to assess relationships between gingivitis and risk factors. Eighty-eight percent of women had gingivitis, 15% were classified as moderate and 73% as severe. A total of 66.7% (95% CI [28.8-92.1]) of the sites had bleeding on interdental brushing. The odds for gingivitis decreased significantly for women consuming more than five portions of fruits and vegetables per day (OR = 0.15; 95% CI [0.03-0.66]) and increased in women who had a professional activity (OR = 6.75; 95% CI [1.27-35.87]) and high education. Concomitantly, the percentage of dental plaque (OR = 131.6; 95% CI [10.80-1619.71] and the severity of clinical attachment loss (OR = 7.70; 95% CI [3.16-18.92]) were important risk factors. Inverse associations were observed with increasing body mass index (OR = 0.76; 95% CI [0.63-0.93]). Our results underline that gingivitis cases and bleeding were particularly high among 3-month pregnant women. Literacy and adequate oral hygiene actions to modify behaviors and to achieve meticulous biofilm disorganization could make a favorable change in the gingival health outcome. Additionally, further research is necessary to precisely determine the role of biofilm-induced gingivitis and systemic-induced gingivitis in improving gingival conditions.
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Affiliation(s)
- Jocelyne Gare
- Health, Systemic, Process (P2S), Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France
- Public Health Laboratory (LASAP), University Joseph Ki Zerbo, Ouagadougou 7021, Burkina Faso
| | - Aida Kanoute
- Public Health Service, Department of Dentistry, Cheikh Anta Diop University, Dakar 10700, Senegal
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology, Università Politecnica delle Marche, 60126 Ancona, Italy
| | - Lucio Souza Gonçalves
- Postgraduate Program in Dentistry, Estácio de Sá University, Rio de Janeiro 22790-710, Brazil
| | - Fahad Ali Alshehri
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia
| | - Denis Bourgeois
- Health, Systemic, Process (P2S), Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France
| | - Florence Carrouel
- Health, Systemic, Process (P2S), Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France
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