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Tegelberg P, Tervonen T, Knuuttila M, Saxlin T, Ylöstalo P. Association of obesity and weight gain with alveolar bone loss: Results of the Northern Finland Birth Cohort 1966 study. J Clin Periodontol 2023; 50:1051-1063. [PMID: 37231564 DOI: 10.1111/jcpe.13829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 04/15/2023] [Accepted: 05/06/2023] [Indexed: 05/27/2023]
Abstract
AIM To investigate whether long-term obesity, long-term central obesity and weight gain are associated with alveolar bone loss. MATERIALS AND METHODS A sub-population (n = 1318) of the Northern Finland Birth Cohort 1966 was categorized based on body mass index (BMI: normal weight, overweight and obesity) and waist circumference (WC: no central obesity, central obesity) at ages 31 and 46. These categories were combined to define whether the participants stayed in the same categories or passed on to a higher category (weight gain). Alveolar bone level (BL) data were collected at age 46. RESULTS The associations of long-term obesity and weight gain with BL ≥ 5 mm were stronger in smokers than in the total population and in never smokers. Males who passed on to higher BMI and WC categories showed a higher likelihood for BL ≥ 5 mm (range in relative risks [RRs] 1.3-2.2) than males who stayed in the same categories (range in RRs 0.7-1.1). The associations with BL ≥ 5 mm were weak or non-existent in females. CONCLUSIONS The relation between obesity and periodontal diseases seems more complex than previously presumed. The role of gender and smoking should be taken into account in future studies.
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Affiliation(s)
- P Tegelberg
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - T Tervonen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - M Knuuttila
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - T Saxlin
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - P Ylöstalo
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
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Ollikainen E, Tervonen T, Suominen AL, Knuuttila M, Jula A, Saxlin T, Ylöstalo P. Periodontal condition and ultrasound-based measures of arterial stiffness: results of the Health 2000 Survey. BMC Oral Health 2022; 22:487. [DOI: 10.1186/s12903-022-02502-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/12/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Periodontitis has been associated with inflammatory processes in arterial walls such as impairment in endothelial function and thickening of intima media. As inflammation plays a role also in arterial stiffening, an association between periodontal inflammation and arterial stiffness can be expected. So far, conflicting results of the association between periodontal disease and arterial stiffness have been reported. Many of the earlier studies were conducted in specific populations and heterogeneous measures of both arterial stiffness and periodontal status were used. In this population-based study we aimed to investigate whether periodontal pocketing and gingival bleeding are associated with ultrasound-based measures of arterial stiffness.
Methods
In this cross-sectional study, two sets of data based on the national Health 2000 Survey in Finland were formed. Data set I comprised never-smoking 45–64-year-old dentate (≥ 10 natural teeth), non-diabetic, non-rheumatic, non-obese (BMI ≤ 30 kg/m2), non-hypertensive subjects with no coronary artery disease or ongoing lipid-lowering medications (n = 157). Data set II was formed of an unrestricted 45–74-year-old dentate population (n = 536). Four arterial stiffness measures (carotid artery compliance, Peterson’s elastic modulus, Young’s elastic modulus and beta stiffness index) based on an ultrasound examination of the common carotid artery were used. Periodontal parameters included the number of teeth with ≥ 4 mm deep periodontal pockets and the number of sextants with gingival bleeding. β-estimates, confidence intervals, and p-values were obtained from linear regression models.
Results
In Data set I, the adjusted β-estimates for the association between the number of teeth with ≥ 4 mm deep periodontal pockets and Peterson’s elastic modulus and Young’s elastic modulus were 15.80 (p = 0.12) and 61.02 (p = 0.22), respectively. The respective β-estimates were 31.06 (p = 0.17) and 121.16 (p = 0.28) for the association between the number of bleeding sextants and these two stiffness measures. The results in Data set II were in line with the results in Data set I, with the exception that the adjusted β-estimates for the associations between Peterson’s elastic modulus and Young’s elastic modulus and periodontal parameters were closer to null.
Conclusions
This population-based study did not provide evidence of an association between periodontal condition and arterial stiffness.
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Ollikainen E, Saxlin T, Tervonen T, Suominen AL, Knuuttila M, Jula A, Ylöstalo P. Association between periodontal condition and blood pressure is confounded by smoking. Acta Odontol Scand 2022; 80:457-464. [PMID: 35120431 DOI: 10.1080/00016357.2022.2035430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To investigate the role of smoking as a confounding factor in the association between periodontal pocketing and blood pressure. MATERIAL AND METHODS After restriction to 45-64-year-old subjects without hypertension, diabetes, rheumatic diseases, obesity and with no history of cardiovascular diseases or ongoing lipid-lowering medications, the study population consisted of 307 subjects of the Health 2000 Survey in Finland. Systolic and diastolic blood pressure and pulse pressure (mmHg) were used as outcome variables. Periodontal condition was measured by the number of teeth with ≥4 mm periodontal pockets. β-estimates and 95% confidence intervals (CI) were obtained from linear regression models. Analyses were made in the whole study population and stratified according to smoking habits/history. RESULTS The number of teeth with ≥4 mm periodontal pockets associated statistically significantly with systolic blood pressure and pulse pressure in the whole study population. Among never-smokers or daily smokers, there were no consistent nor statistically significant associations between the number of teeth with ≥4 mm periodontal pockets and systolic/diastolic blood pressure or pulse pressure. CONCLUSIONS Smoking appeared to confound the association between periodontal condition and blood pressure. Thorough control for the effect of smoking was not obtained using multivariate models.
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Affiliation(s)
- Emilia Ollikainen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tuomas Saxlin
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Tellervo Tervonen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland
- Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare (THL), Kuopio, Finland
| | - Matti Knuuttila
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Antti Jula
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Pekka Ylöstalo
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Goswami S, Ylöstalo P, Khan S, Knuuttila M, Bernabe E, Suominen AL. Effect of smoking on periodontal health and validation of self-reported smoking status with serum cotinine levels. Acta Odontol Scand 2021; 79:573-581. [PMID: 33966590 DOI: 10.1080/00016357.2021.1917655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate whether self-reported smoking and serum cotinine levels associate with periodontal pocket development and to determine the accuracy of self-reported smoking using serum cotinine. MATERIALS AND METHODS This 4-year prospective cohort study included data from 294 dentate adults, aged ≥30 years, who participated in both the Health 2000 Survey and the Follow-up Study of Finnish Adults' Oral Health. Subjectively reported smoking status (daily smokers n = 62, occasional smokers n = 12, quitters n = 49, and never-smokers n = 171), serum cotinine levels, demographic factors, education level, dental behaviours and medical history were collected at baseline. The outcome measure was the number of teeth with periodontal pocketing ≥4 mm over 4 years. RESULTS Self-reported daily smokers had 1.82 (95% CI: 1.32-2.50) higher incidence of deepened periodontal pockets than never-smokers. A positive association was observed between serum cotinine (≥42.0 μg/L) and the development of periodontal pockets. The misclassification rate of self-reported smoking was 6%. CONCLUSIONS Both self-reported daily smoking and higher serum cotinine were associated with periodontal pocket development. Self-reported smoking was fairly accurate in this study. However, higher cotinine levels among a few self-reported never-smokers indicated misreporting or passive smoking. Thus, self-reports alone are not enough to assess the smoking-attributable disease burden.
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Affiliation(s)
- Shweta Goswami
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Pekka Ylöstalo
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
- Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Sohaib Khan
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Eduardo Bernabe
- Division of Population and Patient Health, King’s College London Dental Institute, London, United Kingdom
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Public Health Evaluation and Projection Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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Tegelberg P, Saxlin T, Tervonen T, Knuuttila M, Jokelainen J, Auvinen J, Ylöstalo P. Association of long-term obesity and weight gain with periodontal pocketing: Results of the Northern Finland Birth Cohort 1966 study. J Clin Periodontol 2021; 48:1344-1355. [PMID: 34288019 DOI: 10.1111/jcpe.13524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/02/2021] [Accepted: 06/25/2021] [Indexed: 12/01/2022]
Abstract
AIM To investigate whether obesity, central obesity, and weight gain are associated with periodontal pocketing. MATERIALS AND METHODS A never-smoking sub-population (n = 725) of the Northern Finland Birth Cohort 1966 was categorized based on body mass index (BMI; participants with normal weight, overweight, and obesity) and waist circumference (WC; participants without central obesity and with central obesity) at ages 31 and 46. The categories were combined to define whether the participants stayed in the respective BMI and WC categories or moved on to a higher category during follow-up. A periodontal examination was done at age 46. RESULTS WC was more consistently associated with periodontal pocketing than BMI. The relative risks for the number of sites with periodontal pocket depth (PPD) ≥4 mm and bleeding PPD ≥4 mm in participants with central obesity both at age 31 and at age 46 were 1.7 (95% confidence interval [CI] 1.4-2.0) and 2.1 (95% CI 1.6-2.6). The corresponding values for participants who had no central obesity at age 31 but had central obesity at age 46 were 1.6 (95% CI 1.4-1.8) and 1.9 (95% CI 1.6-2.3). CONCLUSION Of all the studied measures, central obesity appeared to be most strongly associated with the inflammatory condition of the periodontium.
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Affiliation(s)
- Paula Tegelberg
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tuomas Saxlin
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Tellervo Tervonen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Jari Jokelainen
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Epidemiology and Systems Medicine, University of Oulu and Unit of Primary Care, Oulu, Finland
| | - Juha Auvinen
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Health Centre of Oulu, Oulu, Finland
| | - Pekka Ylöstalo
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
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6
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Tiisanoja A, Kuukasjärvi M, Syrjälä AM, Komulainen K, Knuuttila M, Hartikainen S, Ylöstalo P. Physical ability and comorbidity and oral health among home-dwelling older people in the Finnish population. Spec Care Dentist 2020; 41:218-227. [PMID: 33280155 DOI: 10.1111/scd.12548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 11/27/2022]
Abstract
AIM To examine how physical ability and comorbidity associate with oral health. METHODS AND RESULTS The study population comprised 161 individuals belonging to the Oral Health GeMS study. Outcome variables were the number of teeth with dental caries and deepened periodontal pockets and self-perceived oral health (pain/discomfort in mouth). Physical ability was determined by measuring limitations in daily activities (activities of daily living [ADL] and instrumental activities of daily life [IADL]) and the number of comorbidities with Functional Comorbidity Index (FCI). Poisson's multivariate regression model was used to estimate prevalence rate ratio (PRR) and their 95% confidence intervals (CI). The physical ability or number of comorbidities did not associate consistently with oral diseases, but ADL, IADL and FCI associated all with self-perceived oral discomfort (PRR: 1.74, CI: 1.01-3.03; PRR: 1.20, CI: 1.06-1.35; PRR: 1.20, CI: 1.05-1.36, respectively). Furthermore, IADL associated also with poor self-perceived oral health (PRR: 1.27, CI: 1.03-1.57). CONCLUSION Older people with impaired physical ability and comorbidities are more likely to have oral discomfort and have poorer self-perceived oral health.
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Affiliation(s)
- Antti Tiisanoja
- Periodontology and Geriatric Dentistry, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Matti Kuukasjärvi
- Periodontology and Geriatric Dentistry, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
| | - Anna-Maija Syrjälä
- Periodontology and Geriatric Dentistry, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Kaija Komulainen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Matti Knuuttila
- Periodontology and Geriatric Dentistry, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
| | - Sirpa Hartikainen
- Kuopio Research Centre for Geriatric Care, University of Eastern Finland, Kuopio, Finland.,School of Pharmacy, Faculty of Health Sciences, Kuopio Campus, University of Eastern Finland, Kuopio, Finland
| | - Pekka Ylöstalo
- Periodontology and Geriatric Dentistry, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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7
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Tegelberg P, Tervonen T, Knuuttila M, Jokelainen J, Keinänen-Kiukaanniemi S, Auvinen J, Ylöstalo P. Association of hyperglycaemia with periodontal status: Results of the Northern Finland Birth Cohort 1966 study. J Clin Periodontol 2020; 48:24-36. [PMID: 33048362 DOI: 10.1111/jcpe.13388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 10/02/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023]
Abstract
AIM To investigate the association of hyperglycaemia and changes in glycaemic control with periodontal status in non-diabetic individuals. MATERIALS AND METHODS A sub-population (n = 647) of the Northern Finland Birth Cohort 1966 was studied. We categorized long-term glucose balance based on fasting plasma glucose (FPG) at ages 31 and 46: FPG <5.0 mmol/l (strict normoglycaemia), FPG 5.0-5.59 mmol/l (slightly elevated FPG) and FPG 5.6-6.9 mmol/l (prediabetes). Probing pocket depth (PPD) and alveolar bone level (BL) data were collected at age 46. Relative risks (RR, 95% CI) were estimated using Poisson regression models. RESULTS Periodontal status was poorer in individuals whose glucose balance worsened from age 31 to 46 years than in those with a stable glucose balance. In the case of strict normoglycaemia at age 31 and slightly elevated FPG or prediabetes at age 46, the RRs for PPD ≥4 mm were 1.8 (95% CI 1.4-2.2) and 2.8 (95% CI 2.0-3.8) and for BL ≥5 mm 1.1 (95% CI 0.8-1.4) and 1.8 (95% CI 1.2-2.8), respectively. CONCLUSION The results of this population-based cohort study suggest that impairment in glucose control in non-diabetic individuals is associated with periodontal pocketing and alveolar bone loss.
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Affiliation(s)
- Paula Tegelberg
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Tellervo Tervonen
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Jari Jokelainen
- Center for Life Course Epidemiology and Systems Medicine, University of Oulu and Unit of Primary Care, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Healthcare and Social Services of Selänne, Pyhäjärvi, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Health Centre of Oulu, Oulu, Finland
| | - Juha Auvinen
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Health Centre of Oulu, Oulu, Finland.,Oulunkaari Health Centre, Ii, Finland
| | - Pekka Ylöstalo
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
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8
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Sankaranarayanan R, Saxlin T, Knuuttila M, Ylöstalo P, Suominen AL. Alcohol use and the development of periodontal pockets: An 11‐year follow‐up study. J Periodontol 2020; 91:1621-1631. [DOI: 10.1002/jper.19-0602] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/05/2020] [Accepted: 03/28/2020] [Indexed: 12/25/2022]
Affiliation(s)
| | - Tuomas Saxlin
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery Oulu University Hospital Oulu Finland
| | - Pekka Ylöstalo
- Department of Oral and Maxillofacial Surgery Oulu University Hospital Oulu Finland
- Research Unit of Oral Health Sciences Medical Research Centre Oulu (MRC Oulu) University of Oulu Oulu Finland
| | - Anna Liisa Suominen
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
- Unit of Public Health Evaluation and Projection National Institute for Health and Welfare (THL ) Helsinki Finland
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Jauhiainen LM, Ylöstalo PV, Knuuttila M, Männistö S, Kanerva N, Suominen AL. Poor diet predicts periodontal disease development in 11‐year follow‐up study. Community Dent Oral Epidemiol 2019; 48:143-151. [DOI: 10.1111/cdoe.12513] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 11/20/2019] [Accepted: 11/29/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Leena Maria Jauhiainen
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- City of Kuopio Health Centre Oral Health Care Services Kuopio Finland
| | - Pekka Viljo Ylöstalo
- Department of Oral and Maxillofacial Surgery Oulu University Hospital Oulu Finland
- Unit of Oral Health Sciences Medical Research Center Oulu (MRC Oulu) Oulu University Hospital and University of Oulu Oulu Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery Oulu University Hospital Oulu Finland
| | - Satu Männistö
- Department of Public Health Promotion Finnish Institute for Health and Welfare Helsinki Finland
| | - Noora Kanerva
- Department of Public Health Promotion Finnish Institute for Health and Welfare Helsinki Finland
- Department of Public Health and Department of Food and Nutrition University of Helsinki Helsinki Finland
| | - Anna Liisa Suominen
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
- Public Health Evaluation and Projection Unit Finnish Institute for Health and Welfare Helsinki Finland
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10
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Abstract
Objective: The objective of this study is to study the association of alcoholic beverages and serum gamma-glutamyltransferase (GGT) level with periodontal condition. Material and methods: The study included 4294 dentate, non-diabetic Finnish adults aged 30-65 years who underwent periodontal examination during the Health 2000 Survey. The number of teeth with deepened (≥4 mm) periodontal pockets was the outcome. The exposures were self-reported beverage-specific alcohol intake (amount and frequency) and serum GGT level. The relative risks (RRs) and 95% confidence intervals (CI) were obtained by fitting zero-inflated negative binomial regression models. Results: We found no consistent association of either the intake of different alcoholic beverages or GGT level with the number of teeth with deepened periodontal pockets in the total study population or among the non-smokers. Among the highly educated non-smokers, spirit intake was associated with a low likelihood of having teeth with deepened periodontal pockets; RRs varied between 0.3 and 0.8. Among the non-smokers who had basic or intermediate education, spirit intake was associated with a higher likelihood of having teeth with deepened periodontal pockets; RRs varied between 1.2 and 1.8. Conclusion: In general, neither the intake of different alcoholic beverages nor the GGT level was consistently associated with the number of teeth with deepened periodontal pockets.
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Affiliation(s)
| | - Tuomas Saxlin
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Pekka Ylöstalo
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
- Research Unit of Oral Health Sciences, Medical Research Centre Oulu (MRC Oulu), University of Oulu, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Unit of Public Health Evaluation and Projection, National Institute for Health and Welfare (THL), Helsinki, Finland
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11
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Sankaranarayanan R, Keränen AL, Saxlin T, Myllykangas R, Knuuttila M, Ylöstalo P, Suominen AL. Association between alcohol use and periodontal pockets in Finnish adult population. Acta Odontol Scand 2019; 77:371-379. [PMID: 30806117 DOI: 10.1080/00016357.2019.1572922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To investigate whether alcohol use is associated with deepened periodontal pockets and whether this association is dependent on age, gender or socioeconomic position (SEP). MATERIAL AND METHODS This cross-sectional study, based on the Health 2000 Survey, consisted of dentate, non-smoking Finnish adults aged 30-65 years (n = 3059). The outcome was the number of teeth with deepened (≥4 mm) periodontal pockets. The exposure was self-reported alcohol use assessed as amount, frequency, and use over the risk limit. Zero-inflated negative binomial regression models were used to estimate relative risks (RRs) and 95% confidence intervals (95% CI). RESULTS In this study, alcohol use did not consistently associate with the number of teeth with deepened periodontal pockets. An association with the number of teeth with deepened periodontal pockets was found among men, older participants, and those participants belonging to basic or intermediate educational groups. An association with poor periodontal health was observed among men or older participants who belonged to the basic or intermediate educational group, whereas such associations were not observed among those participants belonging to the higher educational group. CONCLUSIONS The association between alcohol use and periodontal health appears to be confounded by individual characteristics such as age, gender, and especially one's SEP.
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Affiliation(s)
| | | | - Tuomas Saxlin
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Research Unit of Oral Health Sciences, Medical Research Centre Oulu (MRC Oulu), University of Oulu, Oulu, Finland
| | | | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Pekka Ylöstalo
- Research Unit of Oral Health Sciences, Medical Research Centre Oulu (MRC Oulu), University of Oulu, Oulu, Finland
- Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
- Unit of Public Health Evaluation and Projection, National Institute for Health and Welfare (THL), Helsinki, Finland
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12
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Tegelberg P, Tervonen T, Knuuttila M, Jokelainen J, Keinänen‐Kiukaanniemi S, Auvinen J, Ylöstalo P. Long‐term metabolic syndrome is associated with periodontal pockets and alveolar bone loss. J Clin Periodontol 2019; 46:799-808. [DOI: 10.1111/jcpe.13154] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/09/2019] [Accepted: 05/10/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Paula Tegelberg
- Research Unit of Oral Health Sciences, Faculty of Medicine University of Oulu Oulu Finland
| | - Tellervo Tervonen
- Research Unit of Oral Health Sciences, Faculty of Medicine University of Oulu Oulu Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery Oulu University Hospital Oulu Finland
| | - Jari Jokelainen
- Center for Life Course Epidemiology and Systems Medicine University of Oulu and Unit of Primary Care Oulu Finland
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
| | - Sirkka Keinänen‐Kiukaanniemi
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
- Healthcare and Social Services of Selänne Pyhäjärvi Finland
- Faculty of Medicine, Center for Life Course Health Research, Health Center of Oulu University of Oulu Oulu Finland
| | - Juha Auvinen
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
- Faculty of Medicine, Center for Life Course Health Research, Health Center of Oulu University of Oulu Oulu Finland
- Oulunkaari Health Center Ii Finland
| | - Pekka Ylöstalo
- Research Unit of Oral Health Sciences, Faculty of Medicine University of Oulu Oulu Finland
- Department of Oral and Maxillofacial Surgery Oulu University Hospital Oulu Finland
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13
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Helenius-Hietala J, Suominen AL, Ruokonen H, Knuuttila M, Puukka P, Jula A, Meurman JH, Åberg F. Periodontitis is associated with incident chronic liver disease-A population-based cohort study. Liver Int 2019; 39:583-591. [PMID: 30300961 DOI: 10.1111/liv.13985] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/20/2018] [Accepted: 10/02/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Chronic liver disease is a major health concern worldwide and the identification of novel modifiable risk factors may benefit subjects at risk. Few studies have analyzed periodontitis as a risk factor for liver complications. We studied whether periodontitis is associated with incident severe liver disease. METHODS The study comprised 6165 individuals without baseline liver disease who participated in the Finnish population-based Health 2000 Survey (BRIF8901) during 2000-2001, a nationally representative cohort. Follow-up was until 2013 for liver-related admissions, liver cancer and mortality from National Hospital Discharge, Finnish Cancer Registry and Causes of Death Register, Statistics Finland. Mild to moderate periodontitis was defined as ≥1 tooth with periodontal pocket ≥4 mm deep, and advanced periodontitis as ≥5 teeth with such pockets. Multiple confounders were considered. RESULTS A total of 79 subjects experienced a severe liver event during follow-up. When adjusted for age, sex and number of teeth, hazards ratios by Cox regression regarding incident severe liver disease were, for mild to moderate periodontitis, 2.12 (95% CI 0.98-4.58), and, for advanced periodontitis, 3.69 (95% CI 1.79-7.60). These risk estimates remained stable after additionally adjusting for alcohol use, smoking, metabolic risk, serum gamma-glutamyltransferase, dental-care habits, lifestyle and socioeconomic status. Periodontal disease-associated liver risk was accentuated among subjects with non-alcoholic fatty liver disease or heavy alcohol use at baseline. CONCLUSIONS Periodontitis was associated with incident liver disease in the general population independently of various confounders. As a preventable disease, periodontal disease might present a modifiable risk factor for chronic liver disease.
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Affiliation(s)
- Jaana Helenius-Hietala
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Public Health Evaluation and Projection Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Hellevi Ruokonen
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Matti Knuuttila
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Pauli Puukka
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Antti Jula
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Jukka H Meurman
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Fredrik Åberg
- Transplantation and Liver Surgery Clinic, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,The Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden
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14
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Sankaranarayanan R, Saxlin T, Ylöstalo P, Khan S, Knuuttila M, Suominen AL. Alcohol use and periodontal pocket development: findings from a 4‐yr longitudinal study. Eur J Oral Sci 2019; 127:232-240. [DOI: 10.1111/eos.12610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Tuomas Saxlin
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
- Research Unit of Oral Health Sciences Medical Research Centre Oulu (MRC Oulu) University of Oulu Oulu Finland
| | - Pekka Ylöstalo
- Research Unit of Oral Health Sciences Medical Research Centre Oulu (MRC Oulu) University of Oulu Oulu Finland
- Department of Oral and Maxillofacial Surgery Oulu University Hospital Oulu Finland
| | - Sohaib Khan
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery Oulu University Hospital Oulu Finland
| | - Anna L. Suominen
- Institute of Dentistry University of Eastern Finland Kuopio Finland
- Department of Oral and Maxillofacial Diseases Kuopio University Hospital Kuopio Finland
- Unit of Public Health Evaluation and Projection National Institute for Health and Welfare (THL) Helsinki Finland
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15
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Bernabé E, Knuuttila M, Suominen AL. Interdental cleaning and periodontal pocketing among finnish adults. J Clin Periodontol 2019; 46:310-320. [PMID: 30734957 DOI: 10.1111/jcpe.13081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/29/2019] [Accepted: 02/02/2019] [Indexed: 11/30/2022]
Abstract
AIM To investigate the relationship between frequency of interdental cleaning and 11-year change in teeth with periodontal pocketing in Finnish adults. METHODS Data from 1667 dentate adults, aged 30 to 82 years, who participated in the Health 2000 survey and were re-examined in 2004 and/or 2011 were analysed. Participants reported their frequency of interdental cleaning (either dental floss or interdental brush) at baseline. Teeth with periodontal pocketing (PD) ≥4 mm were counted in every survey and treated as a repeated outcome. The association between the frequency of interdental cleaning and the number of teeth with PD ≥4 mm was evaluated in linear mixed effects models, controlling for demographic factors, socioeconomic position, diabetes, smoking status, toothbrushing frequency, dental attendance and number of teeth. RESULTS Twelve per cent of adults reported daily interdental cleaning. Significant inverse linear trends in the number of teeth with PD ≥4 mm were found in every survey according to the frequency of interdental cleaning. However, this association was completely attenuated after adjustment for the full set of confounders. Contrarily, toothbrushing frequency was negatively associated with the baseline number of teeth with PD ≥4 mm and its rate of change over time. CONCLUSION Interdental cleaning was not associated with 11-year change in periodontal pocketing after accounting for other established risk factors for periodontal disease.
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Affiliation(s)
- Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Matti Knuuttila
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anna L Suominen
- Department of Oral Public Health, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Public Health Evaluation and Projection Unit, National Institute for Health and Welfare (THL), Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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16
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Tiisanoja A, Syrjälä AM, Tertsonen M, Komulainen K, Pesonen P, Knuuttila M, Hartikainen S, Ylöstalo P. Oral diseases and inflammatory burden and Alzheimer's disease among subjects aged 75 years or older. SPECIAL CARE IN DENTISTRY 2019; 39:158-165. [DOI: 10.1111/scd.12357] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/13/2018] [Accepted: 11/23/2018] [Indexed: 01/16/2023]
Affiliation(s)
- Antti Tiisanoja
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
| | - Anna-Maija Syrjälä
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
- Dental Training Clinic; Social and Health Services; Oulu Finland
- Medical Research Center; Oulu University Hospital and University of Oulu; Oulu Finland
| | - Miia Tertsonen
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
| | - Kaija Komulainen
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
| | - Paula Pesonen
- Medical Research Center; Oulu University Hospital and University of Oulu; Oulu Finland
- Faculty of Medicine; University of Oulu; Oulu Finland
| | - Matti Knuuttila
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
- Medical Research Center; Oulu University Hospital and University of Oulu; Oulu Finland
| | - Sirpa Hartikainen
- School of Pharmacy; University of Eastern Finland; Kuopio Finland
- Research Center of Geriatric Care; University of Eastern Finland; Kuopio Finland
| | - Pekka Ylöstalo
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
- Medical Research Center; Oulu University Hospital and University of Oulu; Oulu Finland
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17
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Myllymäki V, Saxlin T, Knuuttila M, Rajala U, Keinänen-Kiukaanniemi S, Anttila S, Ylöstalo P. Association between periodontal condition and the development of type 2 diabetes mellitus-Results from a 15-year follow-up study. J Clin Periodontol 2018; 45:1276-1286. [PMID: 30133880 DOI: 10.1111/jcpe.13005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 08/10/2018] [Accepted: 08/19/2018] [Indexed: 12/14/2022]
Abstract
AIM To study whether periodontal condition is associated with the development of type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS A population-based follow-up study was conducted among persons born in 1935 and living in the city of Oulu, Finland (n = 395). The baseline examinations were done during 1990-1992, and the follow-up examinations were done during 2007-2008. The data were gathered by questionnaires, laboratory tests and clinical measurements. Poisson regression models were used in the data analyses. RESULTS The adjusted rate ratios (RR) with 95% confidence intervals (95% CI) for the incident T2DM among subjects with 4-5 mm deep periodontal pockets (n = 98), among subjects with 6 mm deep or deeper periodontal pockets (n = 91), and among edentulous subjects (n = 118) were 1.32 (95% CI: 0.69-2.53), 1.56 (95% CI: 0.84-2.92) and 1.00 (95% CI: 0.53-1.89), respectively, compared to dentate subjects without deepened (4 mm deep or deeper) periodontal pockets (n = 88). The adjusted RR per site (the number of sites with deepened periodontal pockets as a continuous variable) was 1.02 (95% CI: 1.00-1.04). CONCLUSIONS Poor periodontal condition may be a predictor of the development of T2DM. However, the causality between periodontal condition and the development of T2DM remains uncertain.
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Affiliation(s)
- Ville Myllymäki
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Tuomas Saxlin
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.,Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
| | - Matti Knuuttila
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Ulla Rajala
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Unit of Primary Health Care, Oulu University Hospital, Oulu, Finland
| | | | - Pekka Ylöstalo
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
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18
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Abstract
OBJECTIVE We assessed dental and periodontal health in adults aged ≥30 years living in southern and northern Finland as part of the Health 2000/2011 Surveys (BRIF8901). MATERIAL AND METHODS Clinical findings in 2000 (n = 2967) and 2011 (n = 1496) included the presence of teeth and number of teeth with caries, fillings, fractures or periodontal pockets. RESULTS Edentulousness decreased in all age groups. The prevalence of those with no caries increased from 67% to 69% in men and from 80% to 85% in women, and of those with no periodontal pocketing from 26% to 30% in men and from 39% to 42% in women. In 2011, the mean number of decayed teeth was 0.8 in men and 0.3 in women, and the corresponding mean numbers of teeth with deepened periodontal pockets 5.6 and 3.7. The gender difference had levelled concerning edentulousness, number of teeth and DMF teeth, but still existed in the occurrence of caries and periodontal pocketing. CONCLUSION The findings were in line with other population-based reports in the 2000s. However, periodontal health in Finland seems not to be as good as in many European countries and in the USA.
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Affiliation(s)
- Anna L. Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Public Health Evaluation and Projection Unit, National Institute for Health and Welfare, Helsinki, Finland
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Sinikka Varsio
- Department of Social Services and Health Care, City of Helsinki, Helsinki, Finland
| | - Sari Helminen
- Insurance Medicine Unit, Benefit Services, The Social Insurance Institution, Helsinki, Finland
| | - Anne Nordblad
- Department for Social and Health Services, Ministry of Social Affairs and Health, Helsinki, Finland
| | - Satu Lahti
- Department of Community Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Matti Knuuttila
- Medical Research Center, Oulu University Hospital & Oulu University, Oulu, Finland
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19
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Jauhiainen LM, Suominen AL, Männistö S, Knuuttila M, Ylöstalo PV. Periodontal condition in relation to the adherence to nutrient recommendations in daily smokers. J Clin Periodontol 2018; 45:636-649. [DOI: 10.1111/jcpe.12878] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Leena M. Jauhiainen
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Oral Health Care Services; Health Centre; Kuopio Finland
| | - Anna L. Suominen
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Diseases; Kuopio University Hospital; Kuopio Finland
- Living Environment and Health Unit; National Institute for Health and Welfare; Kuopio Finland
- Public Health Evaluation and Projection Unit; National Institute for Health and Welfare; Helsinki Finland
| | - Satu Männistö
- Department of Public Health Solutions; National Institute for Health and Welfare; Helsinki Finland
| | - Matti Knuuttila
- Department of Oral and Maxillofacial Surgery; Oulu University Hospital; Oulu Finland
- Unit of Oral Health Sciences; Medical Research Center Oulu (MRC Oulu); Oulu University Hospital and University of Oulu; Oulu Finland
| | - Pekka V. Ylöstalo
- Department of Oral and Maxillofacial Surgery; Oulu University Hospital; Oulu Finland
- Unit of Oral Health Sciences; Medical Research Center Oulu (MRC Oulu); Oulu University Hospital and University of Oulu; Oulu Finland
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20
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Joshi S, Suominen AL, Knuuttila M, Bernabé E. Toothbrushing behaviour and periodontal pocketing: An 11-year longitudinal study. J Clin Periodontol 2017; 45:196-203. [PMID: 29178189 DOI: 10.1111/jcpe.12844] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2017] [Indexed: 11/29/2022]
Abstract
AIM To explore the association between toothbrushing behaviour and change in periodontal pocketing among adults. METHODS We pooled data from 1,025 adults, aged 30-89 years, who participated in two national surveys in Finland (Health 2000 and Health 2011, BRIF8901) and reported their toothbrushing frequency. A cumulative measure of regular toothbrushing was created by counting the number of times participants reported brushing twice or more daily across the two surveys (ranging from 0 to 2). The association between toothbrushing behaviour and the number of teeth with periodontal pocket depth (PPD) ≥4 mm over 11 years was assessed in linear regression models adjusting for confounders. RESULTS There was a clear dose-response relationship between toothbrushing frequency (either at baseline or follow-up) and change in number of teeth with PPD ≥ 4 mm. There was also evidence of a cumulative effect of regular toothbrushing on change in number of teeth with PPD ≥ 4 mm. Participants who reported brushing twice or more a day in both surveys developed 1.99 (95% CI: 1.02-2.95) fewer teeth with PPD ≥ 4 mm than those who did not report this behaviour in any survey. CONCLUSION This 11-year prospective study showed that toothbrushing behaviour was associated with smaller increments in the number of teeth with periodontal pocketing.
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Affiliation(s)
- Shriraksha Joshi
- Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, London, UK
| | - Anna L Suominen
- Department of Oral Public Health, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,The Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland.,The Health Monitoring Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Matti Knuuttila
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Eduardo Bernabé
- Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, London, UK
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21
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Tiisanoja A, Syrjälä AM, Komulainen K, Lampela P, Hartikainen S, Taipale H, Knuuttila M, Ylöstalo P. Anticholinergic burden and dry mouth among Finnish, community-dwelling older adults. Gerodontology 2017; 35:3-10. [DOI: 10.1111/ger.12304] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Antti Tiisanoja
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
- Medical Research Center Oulu; Oulu University Hospital; University of Oulu; Oulu Finland
| | - Anna-Maija Syrjälä
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
- Medical Research Center Oulu; Oulu University Hospital; University of Oulu; Oulu Finland
- Dental training clinic; Social and Health services; City of Oulu Finland
| | - Kaija Komulainen
- Social and Health Centre of Kuopio; Kuopio Finland
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
| | - Pasi Lampela
- Kuopio Research Center of Geriatric Care; University of Eastern Finland; Kuopio Finland
- Department of Social Pharmacy; School of Pharmacy; University of Eastern Finland; Kuopio Finland
| | - Sirpa Hartikainen
- Kuopio Research Center of Geriatric Care; University of Eastern Finland; Kuopio Finland
- Department of Social Pharmacy; School of Pharmacy; University of Eastern Finland; Kuopio Finland
| | - Heidi Taipale
- Kuopio Research Center of Geriatric Care; University of Eastern Finland; Kuopio Finland
- Department of Social Pharmacy; School of Pharmacy; University of Eastern Finland; Kuopio Finland
| | - Matti Knuuttila
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
- Medical Research Center Oulu; Oulu University Hospital; University of Oulu; Oulu Finland
| | - Pekka Ylöstalo
- Unit of Oral Health Sciences Research; University of Oulu; Oulu Finland
- Medical Research Center Oulu; Oulu University Hospital; University of Oulu; Oulu Finland
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Diseases; Kuopio University Hospital; Kuopio Finland
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22
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Al-Sudani FYH, Vehkalahti MM, Bernabé E, Knuuttila M, Suominen AL. Role of Employment in 11-Year Changes of Clinical Oral Health: A Multilevel Longitudinal Analysis. JDR Clin Trans Res 2017; 2:376-385. [PMID: 30931752 DOI: 10.1177/2380084417713194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The objective was to investigate the role of employment in the 11-y changes of clinically determined oral health. We used data from the longitudinal Health 2011 Survey, including reinvited subjects from the Health 2000 Survey. Data were gathered by clinical oral examinations, interviews, and questionnaires of those aged 30 to 63 y ( n = 1,031) in 2000. Exposures were change in employment from baseline to follow-up and length of unemployment. Outcomes measures were the numbers of missing teeth, sound teeth, filled teeth, decayed teeth, and teeth with periodontal pockets (≥4 mm and ≥6 mm). Separate mixed-effects and conventional negative binomial regression models were fitted for each oral health outcome. Demographic, socioeconomic, and oral health-related behaviors were added as covariates to the analyses. The findings showed that unemployment was inconsistently associated with poorer clinically determined oral health over 11 y. These effects were attributed to income and education and, to a lesser extent, to oral health-related behaviors. The length of unemployment was also inconsistently associated with oral health. The study concluded that one socioeconomic factor, unemployment, had a partial impact on oral health. Knowledge Transfer Statement: The findings of this study can help clinicians and oral health policy makers to reorient oral health services toward those who are unemployed as a risk group for poor oral health. The research highlights the role of employment in the longitudinal changes of clinically determined oral health, taking into consideration other socioeconomic factors. The study concluded that unemployment seemed to have a role in social inequalities of oral health.
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Affiliation(s)
- F Y H Al-Sudani
- 1 Department of Oral Public Health, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - M M Vehkalahti
- 2 Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - E Bernabé
- 3 King's College London Dental Institute at Guy's, King's College, and St. Thomas's Hospitals, Division of Population and Patient Health, London, UK
| | - M Knuuttila
- 4 Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - A L Suominen
- 1 Department of Oral Public Health, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,5 The Living Environment and Health Unit, National Institute for Health and Welfare (THL), Kuopio, Finland.,6 The Health Monitoring Unit, National Institute for Health and Welfare (THL), Helsinki, Finland.,7 Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland
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23
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Tiisanoja A, Syrjälä AM, Komulainen K, Hartikainen S, Taipale H, Knuuttila M, Ylöstalo P. The association of medications with sedative properties with oral health behaviour in community-dwelling older people. Int J Dent Hyg 2017; 16:e17-e22. [PMID: 28467020 DOI: 10.1111/idh.12285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The objective of this study was to determine whether drugs with sedative properties are related to oral health behaviour-such as frequency of toothbrushing, using toothpaste and dental visits-and oral hygiene, measured by the number of teeth with dental plaque, among community-dwelling older people. METHODS The study population consisted of 159 community-dwelling, dentate, non-smoking, older people from the Oral Health GeMS study (Geriatric Multidisciplinary Strategy for the Good Care of Older People study). The data were collected by interviews and clinical examinations during 2004-2005. Sedative properties of drugs were assessed using the sedative load (SL) model. Logistic and Poisson regression models were used to estimate odds ratios/relative risks (OR/RR) and 95% confidence intervals (CI). RESULTS After adjusting for confounding factors, SL associated with infrequent toothbrushing (OR 1.72, CI: 0.61-4.89), toothpaste use less than twice a day (OR 3.34, CI: 1.39-8.12), non-regular dental visits (OR 2.28 CI: 0.91-5.30) and the number of teeth with dental plaque (RR 1.20 CI: 1.04-1.39) compared to participants without a SL. CONCLUSIONS The results of this study suggest that use of drugs with sedative properties indicates poor oral health behaviour among older people.
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Affiliation(s)
- A Tiisanoja
- Unit of Oral Health Sciences Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - A-M Syrjälä
- Unit of Oral Health Sciences Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Dental Training Clinic, Social and Health services, Oulu, Finland
| | - K Komulainen
- Social and Health Centre of Kuopio, Kuopio, Finland.,Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - S Hartikainen
- Kuopio Research Center of Geriatric Care, University of Eastern Finland, Kuopio, Finland
| | - H Taipale
- Kuopio Research Center of Geriatric Care, University of Eastern Finland, Kuopio, Finland
| | - M Knuuttila
- Unit of Oral Health Sciences Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - P Ylöstalo
- Unit of Oral Health Sciences Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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Suominen AL, Helminen S, Lahti S, Vehkalahti MM, Knuuttila M, Varsio S, Nordblad A. Use of oral health care services in Finnish adults - results from the cross-sectional Health 2000 and 2011 Surveys. BMC Oral Health 2017; 17:78. [PMID: 28438160 PMCID: PMC5402661 DOI: 10.1186/s12903-017-0364-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 03/17/2017] [Indexed: 11/17/2022] Open
Abstract
Background During the 2000s, two major legislative reforms concerning oral health care have been implemented in Finland. One entitled the whole population to subsidized care and the other regulated the timeframes of access to care. Our aim was, in a cross-sectional setting, to assess changes in and determinants of use of oral health care services before the first reform in 2000 and after both reforms in 2011. Methods The data were part of the nationally representative Health 2000 and 2011 Surveys of adults aged ≥ 30 years and were gathered by interviews and questionnaires. The outcome was the use of oral health care services during the previous year. Determinants of use among the dentate were grouped according to Andersen’s model: predisposing (sex, age group), enabling (education, recall, dental fear, habitual use of services, household income, barriers of access to care), and need (perceived need, self-rated oral health, denture status). Chi square tests and logistic regression analyses were used for statistical evaluation. Results No major changes or only a minor increase in overall use of oral health care services was seen between the study years. An exception were those belonging to oldest age group who clearly increased their use of services. Also, a significant increase in visiting a public sector dentist was observed, particularly in the age groups that became entitled to subsidized care in 2000. In the private sector, use of services decreased in younger age groups. Determinants for visiting a dentist, regardless of the service sector, remained relatively stable. Being a regular dental visitor was the most significant determinant for having visited a dentist during the previous year. Enabling factors, both organizational and individual, were emphasized. They seemed to enable service utilization particularly in the private sector. Conclusions Overall changes in the use of oral health care services were relatively small, but in line with the goals set for the reform. Older persons increased use of services in both sectors, implying growing need. Differences between public and private sectors persisted, and recall, costs of care and socioeconomic factors steered choices between the sectors, sustaining inequity in access to care.
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Affiliation(s)
- Anna L Suominen
- Institute of Dentistry, University of Eastern Finland, P.O. BOX 1627, 70211, Kuopio, Finland. .,Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, P.O. BOX 100, Kuopio, 70029, KYS, Finland. .,The Living Environment and Health Unit, National Institute for Health and Welfare (THL), P.O. BOX 95, 70701, Kuopio, Finland. .,The Health Monitoring Unit, National Institute for Health and Welfare (THL), P.O. BOX 30, 00271, Helsinki, Finland.
| | - Sari Helminen
- The Social Insurance Institution (Kela), P.O. BOX 78, 00380, Helsinki, Finland
| | - Satu Lahti
- Department of Community Dentistry, Institute of Dentistry, University of Turku, 20014 Turun yliopisto, Turku, Finland
| | - Miira M Vehkalahti
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, P.O. BOX 41, 00014, Helsinki, Finland
| | - Matti Knuuttila
- Medical Research Center, Oulu University Hospital & Oulu University, 90220, Oulu, Finland
| | - Sinikka Varsio
- Department of Social Services and Health Care, City of Helsinki, P.O. BOX 6452, 00099, Helsinki, Finland
| | - Anne Nordblad
- Department of Social and Health Services, Unit of Health Services, The Ministry of Social Affairs and Health, PO Box 33, FI-00023, Government, Finland
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25
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Kangas S, Timonen P, Knuuttila M, Jula A, Ylöstalo P, Syrjälä AMH. Waist circumference and waist-to-height ratio are associated with periodontal pocketing-results of the Health 2000 Survey. BMC Oral Health 2017; 17:48. [PMID: 28100211 PMCID: PMC5244610 DOI: 10.1186/s12903-017-0336-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 01/06/2017] [Indexed: 12/12/2022] Open
Abstract
Background Body mass index (BMI) has been found to associate with different parameters of chronic periodontal disease in previous studies. It is reasonable to expect that central adiposity measures, such as waist circumference and waist-to-height ratio, which indirectly takes into account visceral fat, are more accurate measures of obesity-related oral health risks than BMI. The aim of this study was to examine whether central obesity is associated with periodontal pocketing, an indication of infectious chronic periodontal disease. Methods The study was based on a subpopulation from the national Health 2000 Survey in Finland. It included dentate, non-diabetic, never-smoking subjects aged 30–49 (n = 1287). The outcome variable was the number of teeth with deepened periodontal pockets (4 mm or more) and the number of teeth with deep periodontal pockets (6 mm or more). Central obesity was measured by means of waist circumference (WC) and waist-to-height ratio (WHtR). Poisson regression models were used to estimate prevalence rate ratios (PRR) and their 95% confidence intervals. Results Our main finding was that both WC and WHtR were associated with the number of teeth with deeper (4 mm or more) periodontal pockets; the PRR for the fifth quintile in WC was 1.5, CI: 1.2–1.9 and in WHtR 1.4, CI: 1.1–1.7, when compared to the lowest quintile. Corresponding figures for deep (6 mm or more) periodontal pockets were 2.3, CI: 0.9–6.1 for WC and 1.9, CI: 0.8–4.4 for WHtR. There were no essential differences in the strengths of the associations between WC and WHtR and the number of teeth with deepened periodontal pockets. Conclusion Both central adipose measures—WC and WHtR—seem to be associated with periodontal pocketing in non-diabetic, never-smoking subjects aged 30–49 years old.
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Affiliation(s)
- Sanna Kangas
- Private Dental Office Viisaudenhammas, Rovaniemi, Finland
| | - Petra Timonen
- Dental Training Clinic, Social and Health Services, Oulu, Finland
| | - Matti Knuuttila
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Antti Jula
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Pekka Ylöstalo
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Periodontology and Geriatric Dentistry, Unit of Oral Health Sciences Research, P.O. Box 5281, FI-90014, Oulu, Finland.,Institute of Dentistry, University of Eastern Finland, Kuopio Campus, Kuopio, Finland.,Oral and Maxillofacial Department, Kuopio University Hospital, Kuopio, Finland
| | - Anna-Maija Hannele Syrjälä
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. .,Periodontology and Geriatric Dentistry, Unit of Oral Health Sciences Research, P.O. Box 5281, FI-90014, Oulu, Finland.
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26
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Haro A, Saxlin T, Suominen AL, Jula A, Knuuttila M, Ylöstalo P. Serum lipids modify periodontal infection - interleukin-6 association. J Clin Periodontol 2016; 44:275-282. [PMID: 28032903 DOI: 10.1111/jcpe.12688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2016] [Indexed: 11/27/2022]
Abstract
AIM The aim of this study was to investigate whether the systemic response against a local inflammatory process in periodontium is dependent on the individual's serum lipid composition. MATERIAL AND METHODS This study was based on a subpopulation of the Health 2000 Survey that included 878 subjects who were aged between 45 and 64 years, dentate, non-diabetic and non-rheumatic. The inflammatory condition of periodontium was measured by means of the number of teeth with deepened (4 mm or deeper) periodontal pockets. Systemic inflammation was assessed by means of the serum levels of interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α). The association between an inflammatory condition in the periodontium and the systemic inflammatory response was analysed using linear regression models. RESULTS The number of teeth with deepened periodontal pockets was associated with elevated serum IL-6 levels among subjects with an unfavourable lipid composition (low-density lipoprotein cholesterol ≥3.7 mmol/l or high-density lipoprotein cholesterol <1.3 mmol/l). There was no association between serum TNF-α levels and the number of teeth with deepened periodontal pockets in these data. CONCLUSION The systemic response against the inflammatory condition of periodontium varied between individuals. The variation appeared to be dependent on the serum lipid composition or related factors.
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Affiliation(s)
- Anniina Haro
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,City of Äänekoski, Public Health Centre, Oral Health Care Services, Äänekoski, Finland
| | - Tuomas Saxlin
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland.,Institute of Dentistry, University of Oulu, Oulu, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland.,The Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland.,The Health Monitoring Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Antti Jula
- National Institute for Health and Welfare (THL), Turku, Finland
| | - Matti Knuuttila
- Institute of Dentistry, University of Oulu, Oulu, Finland.,Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and Oulu University, Oulu, Finland
| | - Pekka Ylöstalo
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland.,Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and Oulu University, Oulu, Finland
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27
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Jauhiainen L, Suominen AL, Kanerva N, Männistö S, Knuuttila M, Ylöstalo P. Periodontal pocketing and gingival bleeding in relation to Nordic diet - results from a population-based survey. J Clin Periodontol 2016; 43:1013-1023. [DOI: 10.1111/jcpe.12631] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2016] [Indexed: 02/01/2023]
Affiliation(s)
- Leena Jauhiainen
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Surgery; North Karelia Central Hospital and Honkalampi Centre; Joensuu Finland
| | - Anna Liisa Suominen
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
- The Living Environment and Health Unit; National Institute for Health and Welfare; Kuopio Finland
- The Health Monitoring Unit; National Institute for Health and Welfare; Helsinki Finland
| | - Noora Kanerva
- Department of Health; National Institute for Health and Welfare; Helsinki Finland
| | - Satu Männistö
- Department of Health; National Institute for Health and Welfare; Helsinki Finland
| | - Matti Knuuttila
- Unit of Oral Health Sciences; Medical Research Center Oulu (MRC Oulu); Oulu University Hospital and Oulu University; Oulu Finland
| | - Pekka Ylöstalo
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
- Unit of Oral Health Sciences; Medical Research Center Oulu (MRC Oulu); Oulu University Hospital and Oulu University; Oulu Finland
- Department of Oral and Maxillofacial Surgery; Oulu University Hospital; Oulu Finland
- Institute of Dentistry; University of Oulu; Oulu Finland
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28
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Jauhiainen L, Ylöstalo P, Männistö S, Kanerva N, Knuuttila M, Suominen AL. Periodontal condition in relation to intake of omega-3 and omega-6 polyunsaturated fatty acids. J Clin Periodontol 2016; 43:901-908. [PMID: 27440456 DOI: 10.1111/jcpe.12599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2016] [Indexed: 01/04/2023]
Abstract
AIM To examine whether the intake of omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) is associated with periodontal condition. MATERIAL AND METHODS The study population consisted of non-smoking, non-diabetic and non-rheumatoid individuals in the Health 2000 Survey in Finland. Analyses were made in two age groups: 30-49 years (n = 1212) and 50-79 years (n = 980). Clinically determined sextants with gingival bleeding and teeth with periodontal pockets were used as outcome variables. Dietary data were collected by a validated food frequency questionnaire. Energy-adjusted intakes of arachidonic acid (AA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), omega-3 and omega-6 PUFAs, as well as ratios of EPA/AA and of DHA/AA, and omega-3/omega-6 PUFAs were used as exposures. Prevalence rate ratios were estimated using Poisson regression models. RESULTS In this population, there were no statistically significant associations between the examined omega-3 or omega-6 fatty acids or their ratios and the periodontal outcome variables. CONCLUSIONS This cross-sectional study provided evidence that individual omega-3 or omega-6 fatty acids, their subclasses or ratios are not associated with periodontal health among a non-diabetic, non-rheumatoid and non-smoking population.
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Affiliation(s)
- Leena Jauhiainen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland. .,Department of Oral and Maxillofacial Surgery, North Karelia Central Hospital and Honkalampi Centre, Joensuu, Finland.
| | - Pekka Ylöstalo
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Institute of Dentistry, University of Oulu, Oulu, Finland.,Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland.,Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and Oulu University, Oulu, Finland.,Department of Oral and Maxillofacial Surgery, Oulu University Hospital, Oulu, Finland
| | - Satu Männistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Noora Kanerva
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Matti Knuuttila
- Unit of Oral Health Sciences, Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and Oulu University, Oulu, Finland
| | - Anna L Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland.,The Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland.,The Health Monitoring Unit, National Institute for Health and Welfare, Helsinki, Finland
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29
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Tiisanoja A, Syrjälä AM, Komulainen K, Hartikainen S, Taipale H, Knuuttila M, Ylöstalo P. Sedative load, carious teeth and infection in the periodontium among community-dwelling older people. Gerodontology 2015; 34:13-23. [PMID: 26612194 DOI: 10.1111/ger.12217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To study the relation of sedative load to carious teeth and periodontal pocketing - indication of infectious periodontal disease - among older people. MATERIALS AND METHODS This cross-sectional study was based on a subpopulation of 158 community-dwelling, dentate, non-smoking, 75-year-old or older people from the Oral Health Geriatric Multidisciplinary Strategy study. The data were collected by interviews and clinical oral examinations during 2004-2005. Sedative load was measured by means of the sedative load model, and Poisson multivariate regression models were used to estimate relative risk (RR) with 95% confidence intervals (CI). RESULTS Participants with a sedative load of either 1-2 (n = 31) or ≥3 (n = 12) had an increased likelihood of having carious teeth (RR: 1.8, CI: 1.2-2.6 and RR: 2.4, CI: 1.4-4.1, respectively) compared to participants without a sedative load. There was an inverse association between sedative load and the number of teeth with periodontal pockets. CONCLUSIONS Presence of dental caries was associated with the use of drugs with sedative properties. The use of drugs with sedative properties was not associated with the presence of periodontal pockets.
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Affiliation(s)
- Antti Tiisanoja
- Periodontology and Geriatric Dentistry, Center of Oral Health Sciences Research, University of Oulu, Oulu, Finland
| | - Anna-Maija Syrjälä
- Periodontology and Geriatric Dentistry, Center of Oral Health Sciences Research, University of Oulu, Oulu, Finland.,Dental Training Clinic, Social and Health services, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Kaija Komulainen
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland.,Social and Health Centre of Kuopio, Kuopio, Finland
| | - Sirpa Hartikainen
- Department of Social Pharmacy, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.,Unit of Clinical Pharmacology and Geriatric Pharmacotherapy, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Heidi Taipale
- Department of Social Pharmacy, School of Pharmacy, University of Eastern Finland, Kuopio, Finland.,Unit of Clinical Pharmacology and Geriatric Pharmacotherapy, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Matti Knuuttila
- Periodontology and Geriatric Dentistry, Center of Oral Health Sciences Research, University of Oulu, Oulu, Finland
| | - Pekka Ylöstalo
- Periodontology and Geriatric Dentistry, Center of Oral Health Sciences Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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30
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Antonoglou GN, Knuuttila M, Niemelä O, Ylöstalo P, Raunio T, Hiltunen L, Karttunen R, Tervonen T. Serum parathyroid hormone and active vitamin D in chronic periodontitis. J Clin Periodontol 2015. [DOI: 10.1111/jcpe.12436] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Georgios N. Antonoglou
- Department of Periodontology and Geriatric Dentistry; Research Group of Oral Health Sciences; University of Oulu; Oulu Finland
| | - Matti Knuuttila
- Department of Periodontology and Geriatric Dentistry; Research Group of Oral Health Sciences; University of Oulu; Oulu Finland
- Medical Research Center; Oulu University Hospital and University of Oulu; Oulu Finland
| | - Onni Niemelä
- Medical Research Unit; Seinäjoki Central Hospital and University of Tampere; Tampere Finland
| | - Pekka Ylöstalo
- Department of Periodontology and Geriatric Dentistry; Research Group of Oral Health Sciences; University of Oulu; Oulu Finland
- Insitute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
| | - Taina Raunio
- Specialist Dental Health Care Unit; City of Oulu; Oulu Finland
| | | | - Riitta Karttunen
- Institute of Diagnostics; Department of Medical Microbiology and Immunology; University of Oulu; Oulu Finland
- Department of Bacteriology and Immunology; Haartman Institute; Laboratory Division (HUSLAB); Helsinki University Central Hospital; University of Helsinki; Helsinki Finland
| | - Tellervo Tervonen
- Department of Periodontology and Geriatric Dentistry; Research Group of Oral Health Sciences; University of Oulu; Oulu Finland
- Medical Research Center; Oulu University Hospital and University of Oulu; Oulu Finland
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31
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Delgado-Angulo EK, Sabbah W, Suominen AL, Vehkalahti MM, Knuuttila M, Partonen T, Nordblad A, Sheiham A, Watt RG, Tsakos G. The association of depression and anxiety with dental caries and periodontal disease among Finnish adults. Community Dent Oral Epidemiol 2015; 43:540-9. [PMID: 26130047 DOI: 10.1111/cdoe.12179] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 05/24/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the association of depression and anxiety with two oral health outcomes, dental caries and periodontal disease and assess possible mediators for any of the associations. METHODS Secondary analysis of the Finnish Health 2000 Survey. Depression was assessed with Beck's Depression Inventory and anxiety with Composite International Diagnostic Interview. Number of decayed teeth included carious lesions reaching dentine; periodontal disease was number of teeth with periodontal pockets of 4 mm or deeper. Third molars were excluded. The association of mental disorders and oral health was tested in regression models adjusted for confounders and potential mediators. RESULTS Depression was associated with number of decayed teeth only among 35- to 54-year-olds. The association between anxiety and the number of decayed teeth was not statistically significant. Depression and periodontal pocketing were not significantly associated. CONCLUSION Depression was significantly associated with number of decayed teeth only among participants aged 35-54 old and not with other age groups. Neither depression nor anxiety was significantly related to periodontal disease.
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Affiliation(s)
- Elsa K Delgado-Angulo
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Wael Sabbah
- Division of Population and Patient Health, King's College London, London, United Kingdom
| | - Anna L Suominen
- Department of Health, Functional Capacity and Welfare, National Institute for Health and Welfare, (THL), Helsinki, Finland.,Department of Environmental Health, National Institute for Health and Welfare (THL), Kuopio, Finland.,Department of Oral Public Health, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Miira M Vehkalahti
- Department of Oral Public Health, Institute of Dentistry, University of Helsinki, Helsinki, Finland.,Oulu University Hospital, Oulu, Finland
| | | | - Timo Partonen
- Department of Health, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Anne Nordblad
- Department for Social and Health Services, Ministry of Social Affairs and Health, Helsinki, Finland
| | - Aubrey Sheiham
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
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32
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Antonoglou GN, Suominen AL, Knuuttila M, Ylöstalo P, Ojala M, Männistö S, Marniemi J, Lundqvist A, Tervonen T. Associations Between Serum 25-Hydroxyvitamin D and Periodontal Pocketing and Gingival Bleeding: Results of a Study in a Non-Smoking Population in Finland. J Periodontol 2015; 86:755-65. [DOI: 10.1902/jop.2015.140262] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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33
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Tseveenjav B, Suominen AL, Varsio S, Knuuttila M, Vehkalahti MM. Do self-assessed oral health and treatment need associate with clinical findings? Results from the Finnish Nationwide Health 2000 Survey. Acta Odontol Scand 2014; 72:926-35. [PMID: 24922090 DOI: 10.3109/00016357.2014.923110] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To associate self-assessed oral health and treatment need with clinically determined findings. MATERIALS AND METHODS As part of the Finnish nationwide comprehensive Health 2000 Survey, the present cross-sectional study included dentate participants aged 30-64 years who self-assessed their oral health and treatment need in an interview and who underwent a clinical oral health examination (n = 4385). Self-assessed oral health and treatment need were used as subjective indicators. Clinically determined dental and periodontal status described objective dental and periodontal health and treatment need. The evaluation of relationships between subjective and objective findings was based on two-by-two tables and multivariate analyses. RESULTS The better the self-assessed oral health, the better the objective dental and periodontal health. Those reporting need for treatment more often had the objective need in terms of dental or periodontal treatment, also when controlling for background factors. Of the subjective indicators, good self-assessed oral health best reflected the absence of clinically determined dental or periodontal treatment need. Those who reported a need for treatment were mainly adults with an objective dental and periodontal treatment need. CONCLUSIONS Self-assessed good oral health is a fairly good estimate for the absence of clinically determined dental and periodontal treatment need. As implication for practice, self-assessed data could be used for screening purposes for oral health service planning and for priority allocation in large adult populations.
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Affiliation(s)
- Battsetseg Tseveenjav
- Department of Oral Public Health, Institute of Dentistry, University of Helsinki , Helsinki , Finland
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34
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Ollikainen E, Saxlin T, Tervonen T, Suominen AL, Knuuttila M, Jula A, Ylöstalo P. Association between periodontal condition and hypertension in a non-smoking population aged 30-49 years: results of the Health 2000 Survey in Finland. J Clin Periodontol 2014; 41:1132-8. [PMID: 25256004 DOI: 10.1111/jcpe.12316] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2014] [Indexed: 11/27/2022]
Abstract
AIM The aim of this cross-sectional study was to investigate whether periodontal condition is associated with hypertension and systolic blood pressure. MATERIALS AND METHODS The study population consisted of dentate, non-diabetic, non-smoking individuals aged 30-49 years (n = 1296) in the national Health 2000 Survey in Finland. The number of teeth with deepened (≥4 mm) and deep (≥6 mm) periodontal pockets and the number of sextants with gingival bleeding were used as explanatory variables. Hypertension and systolic blood pressure were used as outcome variables. RESULTS There was no consistent association between the number of teeth with deepened (≥4 mm) (OR 0.98, 95% CI 0.95-1.01) or deep (≥6 mm) (OR 1.01, 95% CI 0.90-1.12) periodontal pockets and hypertension after adjusting for confounding factors. Nor was there any essential association between the number of bleeding sextants and hypertension. CONCLUSIONS Periodontal pocketing and gingival bleeding did not appear to be related to hypertension in non-diabetic, non-smoking individuals aged 30-49 years. Further studies using experimental study designs would be required to determine the role of infectious periodontal diseases in the development or progression of hypertension.
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35
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Timonen P, Saxlin T, Knuuttila M, Suominen AL, Jula A, Tervonen T, Ylöstalo P. Role of insulin sensitivity and beta cell function in the development of periodontal disease in adults without diabetes. J Clin Periodontol 2014; 40:1079-86. [PMID: 24192072 DOI: 10.1111/jcpe.12162] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2013] [Indexed: 01/22/2023]
Abstract
AIM The goal of this study was to explore whether insulin resistance and beta cell function are related to periodontal pocket formation, indicative of infectious periodontal disease in non-smoking adults without manifest diabetes. MATERIAL AND METHODS We analysed data from a Health 2000 Survey consisting of dentate subjects without any indication of diabetes, aged between 30 and 64, who had never smoked and who had participated in the Follow-up Study on Finnish Adults' Oral Health about 4 years later (n = 157). The Homeostasis Model Assessment Indices were used to measure insulin resistance (HOMA-IR) and β-cell function (HOMA-B). The development of periodontal disease was measured by means of the incidence of deepened periodontal pockets (4 mm deep or deeper) during the follow-up period. Incidence rate ratios (IRR) were estimated using Poisson regression models. RESULTS Both HOMA-IR and HOMA-B indices were associated with periodontal pocket formation during the 4-year follow-up. CONCLUSION The results of this follow-up study suggest that impaired glucose metabolism measured as insulin resistance and altered beta cell function predict the breakdown of periodontal tissues. Further studies about their role in the pathogenesis of periodontal diseases are needed.
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Affiliation(s)
- Petra Timonen
- Department of Periodontology and Geriatric Dentistry, Institute of Dentistry, University of Oulu, Oulu, Finland
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36
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Antonoglou GN, Knuuttila M, Niemelä O, Raunio T, Karttunen R, Vainio O, Hedberg P, Ylöstalo P, Tervonen T. Low serum level of 1,25(OH)2
D is associated with chronic periodontitis. J Periodontal Res 2014; 50:274-80. [DOI: 10.1111/jre.12207] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2014] [Indexed: 12/19/2022]
Affiliation(s)
- G. N. Antonoglou
- Department of Periodontology and Geriatric Dentistry; University of Oulu; Oulu Finland
| | - M. Knuuttila
- Department of Periodontology and Geriatric Dentistry; University of Oulu; Oulu Finland
| | - O. Niemelä
- Medical Research Unit; Seinäjoki Central Hospital and University of Tampere; Tampere Finland
| | - T. Raunio
- Specialist Dental Health Care Unit; Oulu Finland
| | - R. Karttunen
- Department of Medical Microbiology and Immunology; Institute of Diagnostics; University of Oulu; Oulu Finland
- Department of Bacteriology and Immunology; Haartman Institute; Laboratory Division (HUSLAB); Helsinki University Central Hospital; Helsinki Finland
| | - O. Vainio
- Department of Medical Microbiology and Immunology; Institute of Diagnostics; University of Oulu; Oulu Finland
- Clinical Microbiology Laboratory; Oulu University Hospital; Oulu Finland
| | | | - P. Ylöstalo
- Department of Periodontology and Geriatric Dentistry; University of Oulu; Oulu Finland
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
| | - T. Tervonen
- Department of Periodontology and Geriatric Dentistry; University of Oulu; Oulu Finland
- Oral and Maxillofacial Department; Oulu University Hospital; Oulu Finland
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37
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Kanhai J, Harrison VE, Suominen AL, Knuuttila M, Uutela A, Bernabé E. Sense of coherence and incidence of periodontal disease in adults. J Clin Periodontol 2014; 41:760-5. [DOI: 10.1111/jcpe.12272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Jai Kanhai
- Division of Population and Patient Health; King's College London Dental Institute; London UK
| | - Victoria E. Harrison
- Division of Population and Patient Health; King's College London Dental Institute; London UK
| | - Anna L. Suominen
- National Institute for Health and Welfare; Helsinki Finland
- Department of Oral Public Health; Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
| | - Matti Knuuttila
- Oral and Maxillofacial Department; Oulu University Hospital; Oulu Finland
| | - Antti Uutela
- National Institute for Health and Welfare; Helsinki Finland
| | - Eduardo Bernabé
- Division of Population and Patient Health; King's College London Dental Institute; London UK
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38
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Tiisanoja A, Syrjälä AM, Komulainen K, Hartikainen S, Taipale H, Knuuttila M, Ylöstalo P. Sedative load and salivary secretion and xerostomia in community-dwelling older people. Gerodontology 2014; 33:177-84. [DOI: 10.1111/ger.12129] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Antti Tiisanoja
- Department of Periodontology and Geriatric Dentistry; Institute of Dentistry; University of Oulu; Oulu Finland
| | - Anna-Maija Syrjälä
- Department of Periodontology and Geriatric Dentistry; Institute of Dentistry; University of Oulu; Oulu Finland
- Dental Training Clinic; Social and Health services; City of Oulu Finland
| | - Kaija Komulainen
- School of Pharmacy; University of Eastern Finland; Kuopio Finland
- Social and Health Centre of Kuopio; Kuopio Finland
| | - Sirpa Hartikainen
- Department of Social Pharmacy; School of Pharmacy; University of Eastern Finland; Kuopio Finland
- Unit of Clinical Pharmacology and Geriatric Pharmacotherapy; School of Pharmacy; University of Eastern Finland; Kuopio Finland
| | - Heidi Taipale
- Department of Social Pharmacy; School of Pharmacy; University of Eastern Finland; Kuopio Finland
- Unit of Clinical Pharmacology and Geriatric Pharmacotherapy; School of Pharmacy; University of Eastern Finland; Kuopio Finland
| | - Matti Knuuttila
- Department of Periodontology and Geriatric Dentistry; Institute of Dentistry; University of Oulu; Oulu Finland
| | - Pekka Ylöstalo
- Department of Periodontology and Geriatric Dentistry; Institute of Dentistry; University of Oulu; Oulu Finland
- Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Oral and Maxillofacial Department; Oulu University Hospital; Oulu Finland
- Department of Oral and Maxillofacial Diseases; Kuopio University Hospital; Kuopio Finland
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39
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Antonoglou G, Knuuttila M, Niemelä O, Hiltunen L, Raunio T, Karttunen R, Vainio O, Ylöstalo P, Tervonen T. Serum 1,25(OH)D level increases after elimination of periodontal inflammation in T1DM subjects. J Clin Endocrinol Metab 2013; 98:3999-4005. [PMID: 23940127 DOI: 10.1210/jc.2013-1906] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate associations between serum concentrations of vitamin D metabolites, 25-hydroxyvitamin D [25(OH)D], and its active form, 1,25-dihydroxyvitamin D [1,25(OH)D], and the severity of chronic periodontitis. SUBJECTS AND DESIGN Presence of dental plaque, probing pocket depth (PD), and attachment level in 80 type 1 diabetes mellitus subjects were recorded. The serum levels of 25(OH)D, 1,25(OH)D, ultrasensitive C-reactive protein, IL-6, TNF-α, high-density lipoprotein cholesterol, and glycosylated hemoglobin (percentage) were determined. Multivariate regression models were used to explore the associations between serum 25(OH)D (nanomoles per liter) and 1,25(OH)D (picomoles per liter) levels and periodontal health status. INTERVENTION Antiinfective periodontal therapies were delivered and the clinical examination and laboratory analyses were repeated 8 weeks after the therapies. RESULTS A statistically significant association was found between the serum level of 1,25(OH)D (odds ratio 1.06, 95% confidence interval 1.02-1.11) and periodontal health at the baseline; subjects with a high level were more likely to belong to the group of no or mild periodontitis. The serum level of 1,25(OH)D showed a statistically significant increase after antiinfective periodontal therapy in both no or mild (P = .001) and moderate or severe periodontitis (P < .001) subjects. The association between serum 25(OH)D level and periodontal health was negligible. CONCLUSION This study has shown a significant positive association between the serum 1,25(OH)D level and periodontal health status. To what extent this association is causal in nature remains to be confirmed.
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Affiliation(s)
- Georgios Antonoglou
- PhD Cand, DDS, Institute of Dentistry, Box 5281, University of Oulu, 90014 Oulu, Finland.
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40
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Komulainen K, Ylöstalo P, Syrjälä AM, Ruoppi P, Knuuttila M, Sulkava R, Hartikainen S. Oral health intervention among community-dwelling older people: a randomised 2-year intervention study. Gerodontology 2013; 32:62-72. [DOI: 10.1111/ger.12067] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Kaija Komulainen
- Research Centre of Geriatric Care; University of Eastern Finland; Kuopio Finland
- Clinical Pharmacology and Geriatric Pharmacotherapy Unit; School of Pharmacy; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
- Social and Health Centre of Kuopio; Kuopio Finland
| | - Pekka Ylöstalo
- Department of Periodontology; Institute of Dentistry; University of Oulu; Oulu Finland
- Unit of Dentistry; School of Medicine; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
| | - Anna-Maija Syrjälä
- Department of Periodontology; Institute of Dentistry; University of Oulu; Oulu Finland
- Oulu Health Centre; Oulu Finland
| | - Piia Ruoppi
- Social and Health Centre of Kuopio; Kuopio Finland
| | - Matti Knuuttila
- Department of Periodontology; Institute of Dentistry; University of Oulu; Oulu Finland
| | - Raimo Sulkava
- Division of Geriatrics; Institute of Public Health and Clinical Nutrition; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
| | - Sirpa Hartikainen
- Research Centre of Geriatric Care; University of Eastern Finland; Kuopio Finland
- Clinical Pharmacology and Geriatric Pharmacotherapy Unit; School of Pharmacy; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
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41
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Antonoglou G, Knuuttila M, Nieminen P, Vainio O, Hiltunen L, Raunio T, Niemelä O, Hedberg P, Karttunen R, Tervonen T. Serum osteoprotegerin and periodontal destruction in subjects with type 1 diabetes mellitus. J Clin Periodontol 2013; 40:765-70. [DOI: 10.1111/jcpe.12129] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Georgios Antonoglou
- Department of Periodontology and Geriatric Dentistry; University of Oulu; Oulu Finland
| | - Matti Knuuttila
- Department of Periodontology and Geriatric Dentistry; University of Oulu; Oulu Finland
| | - Pentti Nieminen
- Medical Informatics and Statistics Research Group; Oulu University; Oulu Finland
| | - Olli Vainio
- Department of Medical Microbiology and Immunology; Institute of Diagnostics, University of Oulu; Oulu Finland
- Clinical Microbiology Laboratory; Oulu University Hospital; Oulu Finland
| | - Liisa Hiltunen
- Health Centre of Oulu; Oulu Finland
- Department of Primary Health Care; Vaasa Central Hospital; Vaasa Finland
| | - Taina Raunio
- Specialist Dental Health Care Unit; Oulu Finland
| | - Onni Niemelä
- Medical Research Unit; Seinäjoki Central Hospital and University of Tampere; Tampere Finland
| | - Pirjo Hedberg
- Laboratory; Oulu University Hospital; Oulu Finland
- Department of Clinical Chemistry, Institute of Diagnostics; University of Oulu; Oulu Finland
| | - Riitta Karttunen
- Department of Medical Microbiology and Immunology; Institute of Diagnostics, University of Oulu; Oulu Finland
- Department of Bacteriology and Immunology, Laboratory Division (HUSLAB), Haartman Institute; Helsinki University Central Hospital, University of Helsinki; Helsinki Finland
| | - Tellervo Tervonen
- Department of Periodontology and Geriatric Dentistry; University of Oulu; Oulu Finland
- Oral and Maxillofacial Department; Oulu University Hospital; Oulu Finland
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42
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Oikarinen R, Syrjälä AM, Komulainen K, Knuuttila M, Ruoppi P, Hartikainen S, Sulkava R, Ylöstalo P. Body mass index and periodontal infection in a sample of non-smoking older individuals. Oral Dis 2013; 20:e25-30. [PMID: 23577782 DOI: 10.1111/odi.12108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 01/16/2013] [Accepted: 03/11/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association between BMI and periodontal infection in a sample of non-smoking individuals aged 75 years or older. SUBJECTS AND METHODS The study sample included 157 non-smoking dentate persons (110 women, 47 men, mean age 80.6 years) belonging to the Geriatric Multidisciplinary Strategy for the Good Care of Older People study in Kuopio, Finland. The data were gathered by interview together with geriatric and oral clinical examination. The outcome variable was the number of teeth with periodontal pockets measuring 4 mm or more in depth. Poisson regression models were used to estimate relative risk (RR) and 95% confidence intervals (CI). RESULTS After adjustment for confounding factors, the relative risk for the number of teeth with deepened periodontal pockets (≥4 mm) was 0.7 (CI: 0.6-0.9) among those with a BMI 25-29.99 and 1.1 (CI: 0.8-1.4) among those with a BMI ≥30, compared with those having a BMI <25. CONCLUSION Within the limitations of this study, including small sample size, possibility of confounding and other biases, the results do not provide evidence that elevated body weight would be a risk for periodontal infection among older people.
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Affiliation(s)
- R Oikarinen
- Institute of Dentistry, University of Oulu, Oulu, Finland
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43
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Komulainen K, Ylöstalo P, Syrjälä AM, Ruoppi P, Knuuttila M, Sulkava R, Hartikainen S. Determinants for preventive oral health care need among community-dwelling older people: a population-based study. Special Care in Dentistry 2013; 34:19-26. [DOI: 10.1111/scd.12021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Kaija Komulainen
- Research Centre of Geriatric Care; University of Eastern Finland; Kuopio Finland
- Clinical Pharmacology and Geriatric Pharmacotherapy Unit; School of Pharmacy; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
- Social and Health Centre of Kuopio; Finland
| | - Pekka Ylöstalo
- Department of Periodontology; Institute of Dentistry; University of Oulu; Finland
- Institute of Dentistry; School of Medicine; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
| | - Anna-Maija Syrjälä
- Department of Periodontology; Institute of Dentistry; University of Oulu; Finland
- Oulu Health Centre; Oulu Finland
| | | | - Matti Knuuttila
- Department of Periodontology; Institute of Dentistry; University of Oulu; Finland
| | - Raimo Sulkava
- Institute of Public Health and Clinical Nutrition; Division of Geriatrics; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
- Department of Neurology; Kuopio University Hospital; Kuopio Finland
| | - Sirpa Hartikainen
- Research Centre of Geriatric Care; University of Eastern Finland; Kuopio Finland
- Clinical Pharmacology and Geriatric Pharmacotherapy Unit; School of Pharmacy; Faculty of Health Sciences; University of Eastern Finland; Kuopio Finland
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Haro A, Saxlin T, Suominen AL, Ylöstalo P, Leiviskä J, Tervonen T, Knuuttila M. Serum lipids modify periodontal infection - C-reactive protein association. J Clin Periodontol 2012; 39:817-23. [PMID: 22780440 DOI: 10.1111/j.1600-051x.2012.01920.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2012] [Indexed: 11/28/2022]
Abstract
AIM To investigate whether low-grade inflammation-related factors such as serum low-density (LDL-C) and high-density lipoprotein cholesterol (HDL-C) modify the association between periodontal infection and C-reactive protein. MATERIAL AND METHODS This study was based on a subpopulation of the Health 2000 Survey, which consisted of dentate, non-diabetic, non-rheumatic subjects who were 30-49 years old (n = 2710). The extent of periodontal infection was measured by means of the number of teeth with periodontal pocket ≥4 mm and teeth with periodontal pocket ≥6 mm and systemic inflammation using high sensitive C-reactive protein. RESULTS The extent of periodontal infection was associated with elevated levels of C-reactive protein among those subjects whose HDL-C value was below the median value of 1.3 mmol/l or LDL-C above the median value of 3.4 mmol/l. Among those with HDL-C ≥ 1.3 mmol/l or LDL-C ≤ 3.4 mmol/l, the association between periodontal infection and serum concentrations of C-reactive protein was practically non-existent. CONCLUSION This study suggests that the relation of periodontal infection to the systemic inflammatory condition is more complicated than previously presumed. The findings of this study suggest that the possible systemic effect of periodontal infection is dependent on serum lipid composition.
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Affiliation(s)
- Anniina Haro
- Institute of Dentistry, University of Oulu, Finland
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45
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Syrjälä AMH, Pussinen PI, Komulainen K, Nykänen I, Knuuttila M, Ruoppi P, Hartikainen S, Sulkava R, Ylöstalo P. Salivary flow rate and risk of malnutrition - a study among dentate, community-dwelling older people. Gerodontology 2012; 30:270-5. [DOI: 10.1111/j.1741-2358.2012.00679.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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46
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Härmä V, Knuuttila M, Virtanen J, Mirtti T, Kohonen P, Kovanen P, Happonen A, Kaewphan S, Ahonen I, Kallioniemi O, Grafström R, Lötjönen J, Nees M. Lysophosphatidic acid and sphingosine-1-phosphate promote morphogenesis and block invasion of prostate cancer cells in three-dimensional organotypic models. Oncogene 2012; 31:2075-89. [PMID: 21996742 PMCID: PMC3330266 DOI: 10.1038/onc.2011.396] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2011] [Revised: 06/26/2011] [Accepted: 07/28/2011] [Indexed: 12/12/2022]
Abstract
Normal prostate and some malignant prostate cancer (PrCa) cell lines undergo acinar differentiation and form spheroids in three-dimensional (3-D) organotypic culture. Acini formed by PC-3 and PC-3M, less pronounced also in other PrCa cell lines, spontaneously undergo an invasive switch, leading to the disintegration of epithelial structures and the basal lamina, and formation of invadopodia. This demonstrates the highly dynamic nature of epithelial plasticity, balancing epithelial-to-mesenchymal transition against metastable acinar differentiation. This study assessed the role of lipid metabolites on epithelial maturation. PC-3 cells completely failed to form acinar structures in delipidated serum. Adding back lysophosphatidic acid (LPA) and sphingosine-1-phosphate (S1P) rescued acinar morphogenesis and repressed invasion effectively. Blocking LPA receptor 1 (LPAR1) functions by siRNA (small interference RNA) or the specific LPAR1 inhibitor Ki16425 promoted invasion, while silencing of other G-protein-coupled receptors responsive to LPA or S1P mainly caused growth arrest or had no effects. The G-proteins Gα(12/13) and Gα(i) were identified as key mediators of LPA signalling via stimulation of RhoA and Rho kinases ROCK1 and 2, activating Rac1, while inhibition of adenylate cyclase and accumulation of cAMP may be secondary. Interfering with these pathways specifically impeded epithelial polarization in transformed cells. In contrast, blocking the same pathways in non-transformed, normal cells promoted differentiation. We conclude that LPA and LPAR1 effectively promote epithelial maturation and block invasion of PrCa cells in 3-D culture. The analysis of clinical transcriptome data confirmed reduced expression of LPAR1 in a subset of PrCa's. Our study demonstrates a metastasis-suppressor function for LPAR1 and Gα(12/13) signalling, regulating cell motility and invasion versus epithelial maturation.
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Affiliation(s)
- V Härmä
- Medical Biotechnology Knowledge Centre, VTT Technical Research Centre of Finland, Turku, Finland
| | - M Knuuttila
- Biotechnology Centre, University of Turku, Turku, Finland
| | - J Virtanen
- Medical Biotechnology Knowledge Centre, VTT Technical Research Centre of Finland, Turku, Finland
- Biotechnology Centre, University of Turku, Turku, Finland
| | - T Mirtti
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Pathology, Haartman Institute, University of Helsinki and HUSLAB, Helsinki University Central Hospital, Helsinki, Finland
| | - P Kohonen
- Biotechnology Centre, University of Turku, Turku, Finland
| | - P Kovanen
- Department of Pathology, Haartman Institute, University of Helsinki and HUSLAB, Helsinki University Central Hospital, Helsinki, Finland
| | - A Happonen
- Department of Signal Processing, Tampere University of Technology, Tampere, Finland
| | - S Kaewphan
- Department of Information Technology, University of Turku, Turku, Finland
| | - I Ahonen
- Biotechnology Centre, University of Turku, Turku, Finland
| | - O Kallioniemi
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - R Grafström
- Medical Biotechnology Knowledge Centre, VTT Technical Research Centre of Finland, Turku, Finland
- Laboratory for Toxicology, Karolinska Institute, Stockholm, Sweden
| | - J Lötjönen
- Knowledge Intensive Services, VTT Technical Research Centre of Finland, Tampere, Finland
| | - M Nees
- Medical Biotechnology Knowledge Centre, VTT Technical Research Centre of Finland, Turku, Finland
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Komulainen K, Ylöstalo P, Syrjälä AM, Ruoppi P, Knuuttila M, Sulkava R, Hartikainen S. Associations of instrumental activities of daily living and handgrip strength with oral self-care among home-dwelling elderly 75+. Gerodontology 2012; 29:e135-42. [DOI: 10.1111/j.1741-2358.2010.00427.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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48
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Passoja A, Knuuttila M, Hiltunen L, Karttunen R, Niemelä O, Raunio T, Vainio O, Hedberg P, Tervonen T. Serum high-density lipoprotein cholesterol level associated with the extent of periodontal inflammation in type 1 diabetic subjects. J Clin Periodontol 2011; 38:1071-7. [DOI: 10.1111/j.1600-051x.2011.01792.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2011] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | | | - Onni Niemelä
- Medical Research Unit; Seinäjoki Central Hospital and University of Tampere; Tampere
| | - Taina Raunio
- Specialist Dental Health Care Unit; City of Oulu
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49
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Komulainen K, Ylöstalo P, Syrjälä AM, Ruoppi P, Knuuttila M, Sulkava R, Hartikainen S. Preference for dentist's home visits among older people. Community Dent Oral Epidemiol 2011; 40:89-95. [PMID: 21819439 DOI: 10.1111/j.1600-0528.2011.00631.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate factors associated with older people's preference for a dentist's home visit. METHODS This is a report on 321 home-dwelling participants (mean age 81.6) in the population-based Geriatric Multidisciplinary Strategy for Good Care of the Elderly (GeMS) study, conducted in 2004-2005 in the city of Kuopio in eastern Finland. The information about sociodemographic and general health-related factors and the use of social and health services was collected by two study nurses using a structured interview. Each study subject was given a clinical oral examination and an interview about oral health and the use of dental health care services by one of two dentists. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS Of the study subjects, 25.9% preferred a dentist's home visit. The preference for choosing a dentist's home visit was associated with a low score (≤24) in the Mini-Mental State Examination, OR 6.1 (CI: 2.9-13.6), and a low score (<8) on the scale of Instrumental Activities of Daily Living, OR 8.0 (CI: 3.6-18.6). It was also associated with living alone, OR 5.9 (CI: 2.7-13.0), and high use of home care services, OR 9.3 (CI: 4.6-19.0). CONCLUSIONS The findings of this study emphasize the need to organize dentists' home visits in order to increase equality in the use of dental health care services among the older people with disabilities.
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Affiliation(s)
- Kaija Komulainen
- Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland.
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50
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Korhonen S, Saxlin T, Suominen L, Jula A, Knuuttila M, Ylöstalo P. Serum cholesterol ratios and periodontal infection: results of the Health 2000 Survey. J Clin Periodontol 2011; 38:787-94. [DOI: 10.1111/j.1600-051x.2011.01758.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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