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Shah J, Poirier BF, Hedges J, Jamieson L, Sethi S. Effect of sleep on oral health: A scoping review. Sleep Med Rev 2024; 76:101939. [PMID: 38781809 DOI: 10.1016/j.smrv.2024.101939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 05/25/2024]
Abstract
Sleep is a vital biological process that facilitates numerous vital functions integral to mental and physical restoration of the body. Sleep deprivation or poor sleep quality not only affects physical health but may also affect oral health. This scoping review aims to collate existing evidence related to the impact of sleep duration and/or quality on oral health. A systematic search strategy using PubMed, Embase, Scopus and CINAHL databases was performed to identify studies that assessed the association between sleep quality or duration and oral health or hygiene. Two researchers independently screened and extracted the data. Eligible studies were critically appraised using the NIH quality assessment tool for observational cohort and cross-sectional studies checklist. The search identified 18,398 studies, from which 14 fulfilled the inclusion criteria. Of the 14 papers, four papers were associated with effect of sleep on caries, 8 papers described the effect of sleep on gingival and periodontal health, and two papers described the effect of sleep on general oral health and oral disease symptoms. This review found a direct link between sleep and dental decay in children, and short sleep duration was associated with an increased risk of periodontitis adults.
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Affiliation(s)
- Jainy Shah
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Brianna F Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Sneha Sethi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia.
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Ju X, Hedges J, Sethi S, Jamieson LM. Poor Self-Rated Sleep Quality and Quantity Associated with Poor Oral Health-Related Quality of Life among Indigenous Australian Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:453. [PMID: 38673364 PMCID: PMC11050505 DOI: 10.3390/ijerph21040453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/31/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Indigenous Australians score worse on both sleep and oral health. This study aimed to evaluate sleep quality and quantity associated with oral health-related quality of life (OHRQoL) among Indigenous Australian adults. METHODS A cross-sectional study involving 728 Indigenous Australian adults aged 18+ years was conducted. Exposure variables were sleep quality and quantity. The primary outcome variable was Oral Health Impact Profile-14 (OHIP14), which has been used to assess OHRQoL. Multivariable log-Poisson regression models were applied to estimate the mean ratios (MRs) for mean OHIP14 scores. RESULTS The average OHIP14 score was 14.9, and the average amount of sleep was 6.8 h/night. After adjusting for all covariates, self-rated very bad sleep quality was associated with 2.2 times (MR = 2.17, 95% CI: 1.97-2.37) higher OHIP14 scores than those who rated their sleep quality as very good. Participants who self-reported sleeping 7-8 h/night had 0.9 times (MR = 0.89, 95%CI: 0.83-0.95) lower OHIP14 scores than those sleeping more than 8 h. CONCLUSIONS The average number of sleep hours for Indigenous participants were lower than recommended (7-8 h/night). Our findings indicate that poor sleep quality and quantity, and oral health-related behaviours associated with sleep deprivation were positively associated with poor oral health related quality of life among Indigenous Australian adults.
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Affiliation(s)
- Xiangqun Ju
- Australian Research Centre of Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (S.S.); (L.M.J.)
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Wu C, Li W, Cen D, Zhou Q. Is insufficient sleep duration a risk indicator for periodontal disease? A systematic review. Int J Dent Hyg 2023; 21:18-27. [PMID: 36385732 DOI: 10.1111/idh.12633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/15/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES In this study, we conducted a systematic review and meta-analysis to assess whether people who achieved <7 h of sleep were more likely to develop periodontal disease (PD). SOURCES We executed electronic searches in the PubMed, EMBASE and Cochrane Library, as well as a manual search of articles published by leading journals in related fields, for observational studies, published in English from 1 January 1966 to 31 March 2021.which evaluated the relationship between sleep duration and PD. The Agency for Healthcare Research and Quality (AHRQ) quality evaluation scale was used for the cross-sectional studies, and the random effects model was used to summarize the effect sizes in the included studies with a 95% confidence interval (CI). RESULTS A total of six cross-sectional studies met the inclusion criteria, totaling 107,777 participants, of which 69,773 had PD. The results of the present indicated that shorter sleep duration (<7 h) is significantly associated with PD (Odd ratio [OR], 1.19; 95% CI, 1.16-1.23; p < 0.001; I2 , 0.0%, I2 interval, 0%-75%). The strength of the sensitivity analysis and cumulative meta-analysis confirmed the reliability of the results. CONCLUSION Although the inclusion of only six studies makes it difficult to explore whether there is a publication bias, we found that insufficient sleep duration was closely related to PD, and we therefore speculated that getting enough sleep may help prevent PD.
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Affiliation(s)
- Chuanbin Wu
- School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Weiqi Li
- School and Hospital of Stomatology, China Medical University, Shenyang, China.,Liaoning Province Key Laboratory of Oral Diseases, Shenyang, China
| | - Dongdong Cen
- School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Qing Zhou
- School and Hospital of Stomatology, China Medical University, Shenyang, China
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Jin F, Song J, Luo Y, Wang B, Ding M, Hu J, Chen Z. Association between skull bone mineral density and periodontitis: Using the National Health and Nutrition Examination Survey (2011-2014). PLoS One 2022; 17:e0271475. [PMID: 36584175 PMCID: PMC9803209 DOI: 10.1371/journal.pone.0271475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/03/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Bone mineral density (BMD) and periodontitis have been the subject of many studies. However, the relationship between skull (including mandible) BMD and periodontitis has not been extensively studied. An objective of this cross-sectional study was to examine the relationship between skull BMD and periodontitis using data from the National Health and Nutrition Examination Surveys (NHANES) for 2011-2012 and 2013-2014. MATERIALS AND METHODS From NHANES 2011-2014, 3802 participants aged 30-59 were selected. We divided the skull BMD level into quartiles to check the distribution of variables. Periodontitis was defined by the Centers for Disease Control and Prevention (CDC) and the American Association of Periodontology (AAP) in 2012. Multivariate logical regression analysis was used to explore the independent relationship between skull BMD and periodontitis. The generalized additive model (GAM), smooth curve fitting (penalty spline) and threshold effect analysis was used to evaluate dose-response relationship between skull BMD and periodontitis and the potential nonlinear relationship between skull BMD and periodontitis. Finally, subgroup analysis and interaction test were conducted to determine the role of covariates between skull BMD and periodontitis. RESULTS The overall average skull BMD of 3802 participants was 2.24g/cm2, the average age was 43.94 years, and the prevalence of periodontitis was 41.03%. In the fully adjusted logistic regression model, skull BMD and periodontitis showed an independent negative correlation (OR 0.73, 95% CI 0.59-0.90, P = 0.0032) and a linear relationship. Compared with the lowest quartile array (Q1:1.22-1.98) of skull BMD, the highest quartile array(Q4: 2.47-3.79) had a significantly lower risk of periodontitis (OR 0.70,95% CI 0.56-0.87, P = 0.0014). Subgroup analysis showed a highly consistent negative correlation between skull BMD and periodontitis. In the interaction test, people with moderate poverty income ratio (1.57-3.62) and those who had more than 12 alcohol drinks in the past year had a lower risk of periodontitis. CONCLUSIONS This result suggested that periodontal disease can be related to low skull BMD, for those people, oral hygiene and health care should be more closely monitored. Validation of our findings will require further research.
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Affiliation(s)
- Fuqian Jin
- School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
- Department of Oral Medicine, Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Jukun Song
- The Affiliated Stomatological Hospital & Stomatology of Guizhou Medical University, Guizhou Medical University, Guiyang, China
| | - Yi Luo
- Department of Oral Medicine, Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Beichuan Wang
- School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
- Department of Oral Medicine, Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Ming Ding
- School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
- Department of Oral Medicine, Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Jiaxin Hu
- School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
- Department of Oral Medicine, Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
| | - Zhu Chen
- School of Stomatology, Zunyi Medical University, Zunyi, Guizhou, China
- Department of Oral Medicine, Guiyang Hospital of Stomatology, Guiyang, Guizhou, China
- * E-mail:
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The Dental-BIOfilm Detection TECHnique (D-BioTECH): A Proof of Concept of a Patient-Based Oral Hygiene. Medicina (B Aires) 2022; 58:medicina58040537. [PMID: 35454375 PMCID: PMC9030559 DOI: 10.3390/medicina58040537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 12/13/2022] Open
Abstract
To date, no strong long-term data have been reported about new innovative clinical protocols to manage oral hygiene. An improper management of oral hygiene may lead to an increase in dental implant failure, and to an increase in infective complications in prosthetic rehabilitation. Personalized techniques are strongly required in dentistry and dental hygiene. A customized and personalized approach to oral hygiene is crucial in ensuring not only effective treatment, but also a careful analysis of the general health status of the patient involved in the therapeutic process. D-BioTECH is an acronym for Dental BIOfilm Detection Technique: it is based on a tailored approach to patients, ensuring that the operator actively interacts with the patient and their specific needs, especially during the domiciliary therapy. D-BioTECH is an approach to preventive care: in D-BioTECH, both dental hygienists and dentists play a central role. The use of a personalized approach to oral hygiene is the first step towards increasing implant and prosthesis survival rate; moreover, personalized medicine is strategic for managing and preventing the biological complications associated with several dental risk factors.
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Iwasaki M, Usui M, Ariyoshi W, Nakashima K, Nagai-Yoshioka Y, Inoue M, Kobayashi K, Nishihara T. Sleep duration and severe periodontitis in middle-aged Japanese workers. J Clin Periodontol 2021; 49:59-66. [PMID: 34605052 DOI: 10.1111/jcpe.13561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/30/2021] [Accepted: 09/25/2021] [Indexed: 12/01/2022]
Abstract
AIM To evaluate the association between sleep duration and severe periodontitis in Japanese workers. MATERIALS AND METHODS This cross-sectional study included 1130 workers (mean age 43.0 years) who underwent full-mouth periodontal examinations and health check-ups and completed a self-administered questionnaire that included questions on sleep duration. Logistic regression and a restricted cubic spline model were used to analyse the data. RESULTS Severe periodontitis was identified in 6.3% of the study population. Those with <5, 5-5.9, 6-6.9, 7-7.9, and ≥8 hr of sleep were 6.7%, 17.4%, 40.3%, 26.3%, and 8.9%, respectively. After adjusting for potential confounders, study participants who slept <5 hr were more likely to have severe periodontitis (adjusted odds ratio = 2.64; 95% confidence interval = 1.06-6.60) than those who slept 7-7.9 hr. The spline model, with a reference value of 399 min (the median sleep duration), showed a non-linear association between sleep duration and severe periodontitis, where an increased prevalence of severe periodontitis was observed only among those with a shorter sleep duration. The prevalence of severe periodontitis did not increase with longer sleep duration. CONCLUSIONS Short sleep duration was associated with severe periodontitis in this cohort of Japanese adults.
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Affiliation(s)
| | - Michihiko Usui
- Division of Periodontology, Kyushu Dental University, Kitakyushu, Japan
| | - Wataru Ariyoshi
- Division of Infections and Molecular Biology, Kyushu Dental University, Kitakyushu, Japan
| | - Keisuke Nakashima
- Division of Periodontology, Kyushu Dental University, Kitakyushu, Japan
| | - Yoshie Nagai-Yoshioka
- Division of Infections and Molecular Biology, Kyushu Dental University, Kitakyushu, Japan
| | - Maki Inoue
- Dental Center for Regional Medical Survey, Kyushu Dental University, Kitakyushu, Japan
| | - Kaoru Kobayashi
- Graduate School of Dentistry, MSc Program, Kyushu Dental University, Kitakyushu, Japan
| | - Tatsuji Nishihara
- Dental Center for Regional Medical Survey, Kyushu Dental University, Kitakyushu, Japan
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Are periodontal diseases associated with sleep duration or sleep quality? A systematic review. Arch Oral Biol 2021; 129:105184. [PMID: 34118748 DOI: 10.1016/j.archoralbio.2021.105184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVES This study aimed to systematically review the associations between periodontal diseases/tooth loss and sleep duration/quality. MATERIAL AND METHODS PubMed, Scopus, and Embase databases were searched (up to May 2021) to identify studies that assessed the association between periodontal diseases or number of teeth with sleep quality and sleep duration. Two researchers independently selected the studies and extracted the data. Considering the high heterogeneity among the included studies, meta-analysis was deemed unviable. Results are presented descriptively for sleep quality (studies that have used PSQI), self-reported sleep hours, and other tools that assessed sleep patterns. RESULTS Twenty studies (16 cross-sectional, two case-control, and two cohort) were included. Eight studies used the Pittsburgh Sleep Quality Index (PSQI) to assess quality of sleep. Six of these studies demonstrated that individuals with worse periodontal conditions demonstrated poorer sleep quality. However, most of the included studies that performed adjusted analysis showed no statistically significant association between self-reported hours of sleep and periodontitis. The mean number of present teeth was assessed in four studies; three of them demonstrated lower numbers of present teeth in individuals with inadequate sleep. CONCLUSION The literature shows conflicting results for the association between sleep hours and periodontitis. However, inadequate sleep may be associated with lower number of present teeth and periodontal diseases. Further studies are necessary in order to confirm these results.
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Han DH, Kim MS, Kim S, Yoo JW, Shen JJ. Sleep time and duration is associated with periodontitis in a representative sample of Koreans. J Periodontol 2021; 93:208-217. [PMID: 34041756 DOI: 10.1002/jper.20-0252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 10/25/2020] [Accepted: 10/27/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND So far, studies on the association between sleep and periodontitis have shown conflicting results. This study assessed the association among sleep duration, sleep time, and periodontitis among a nationally representative Korean population and the mediation effect of WBC. METHODS We analyzed data from the Seventh Korean National Health and Nutrition Examination Survey (KNHANES VII) collected from 2016 to 2018. With the screenings by age (45 to 64), edentate, and the adequacy of information provided, the analysis was confined to a selected group of respondents of 4407 with measurements for the sleep survey and periodontal health status out of total 24,269. Periodontitis was defined according to the World Health Organization's community periodontal index (CPI) code greater than or equal to three, and severe periodontitis was defined as CPI code 4. Multivariable logistic regression analysis was used to test the association between sleep and periodontitis controlling the confounding factors. RESULTS Those who went to bed during the daytime were associated with periodontitis (OR = 1.49, 95% confidence interval [CI]: 1.07 to 2.07). In a combined sleep time and duration model, those who went to bed at night with a sleep duration of 9 hours or more were associated with periodontitis (OR = 1.69, 95% CI: 1.04 to 2.77) and severe periodontitis (OR = 1.88, 95% CI: 1.02-3.45). WBC count had the highest impact on the association between sleep time and periodontitis. CONCLUSIONS Our findings suggest that an extra-long sleep duration and going to bed during the daytime are associated with periodontitis.
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Affiliation(s)
- Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, South Korea
- Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Mi-Sun Kim
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, South Korea
- Department of Dental Hygiene, Kyungdong University, Seoul, South Korea
| | - Seohee Kim
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry, Seoul, South Korea
| | - Ji-Won Yoo
- Department of Internal Medicine, University of Nevada Las Vegas School of Medicine, Las Vegas, NV
| | - Jay J Shen
- Department of Health Care Administration and Policy, School of Public Health, University of Nevada, Las Vegas, NV
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Hu Z, Zhang H, Hu K, Song X. Associations between sleep duration, lung function, FeNO and blood eosinophils among current asthmatics (NHANES 2007-12). J Breath Res 2021; 15:026008. [PMID: 33491662 DOI: 10.1088/1752-7163/abd192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Short sleep duration potentially affects the risk of developing asthma and asthmatic exacerbation. Our aim is to determine the associations between sleep duration with asthmatic phenotypes, fraction of exhaled NO (FeNO), blood eosinophils, and lung function among current asthmatics. A total of 558 individuals from the National Health and Nutrition Examination Survey during 2007-2012 were included in this study. Self-reported sleep duration was divided into three groups: short (⩽6 h), healthy (7-8 h) and long (⩾9 h). By using a multivariate generalized additive model with binomial or Poisson regression, the abovementioned associations were evaluated after adjustment for potential confounders. Our study population included 284 short sleepers, 240 healthy sleepers and 34 long sleepers. In multivariate binomial regression analysis, we found that short sleep duration was associated with increased risk of asthma with central obesity (adjusted OR = 0.58, 95%CI: 0.33-0.99, P = 0.047) compared with healthy sleep duration. Multivariate Poisson regression analyses revealed a significant increase in FeNO (adjusted OR = 1.19, 95%CI: 1.14-1.26, P < 0.01) and reduction of blood eosinophil percentage (adjusted OR = 0.86, 95%CI: 0.77-0.96, P < 0.01) in the healthy sleep duration group compared with the short sleep duration group. The individuals with healthy and long sleep duration harbored better lung function than those with short sleep duration, with the exception of FEV1/FVC. Our study suggested that short sleepers potentially increase the risk of asthma with central obesity and lung function impairment than healthy sleepers among current asthmatics. We also observed that short sleep duration is associated with a significant reduction of FeNO and increase of blood eosinophil percentage.
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Affiliation(s)
- Zhigang Hu
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang 443003, People's Republic of China. Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, People's Republic of China. Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Zhangzhidong Road No. 99, Wuhan 430060, People's Republic of China
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Bof de Andrade F, Watt RG, Lima-Costa MF, de Oliveira C. Poor sleep quality and oral health among older Brazilian adults. Oral Dis 2020; 28:227-232. [PMID: 33244826 DOI: 10.1111/odi.13734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study evaluates the association between normative and subjective oral health measures and poor self-reported sleep quality among community-dwelling older adults in Brazil. METHODS This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging. The dependent variable was the poor sleep quality. Independent variables of interest included number of teeth and self-reported impact of oral health on eating/chewing and on maintaining emotional stability. RESULTS Poor sleep quality was reported by 17.8 (95% CI 16.6; 19.2) of the participants, 29% of the participants were edentulous, and 30% had 20 or more teeth. Impacts of oral health on eating and maintaining emotional stability was found among 33.3% and 20% of the older adults, respectively. After adjusting for all oral health measures and covariates, the magnitude of the associations between the number of teeth and sleep quality was attenuated. Sleep quality was related to oral health impacts on eating (OR 1.19 [95% CI 1.00; 1.41]) and on emotional stability (OR 1.51 [95% CI 1.21; 1.87]). CONCLUSIONS This study found an association between oral health and sleep quality emphasizing the importance of oral health to general health.
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Affiliation(s)
| | - Richard G Watt
- Department of Epidemiology & Public Health, University College London, London, UK
| | | | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London, UK
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Lu R, Li W, Wang X, Shi D, Meng H. Elevated neutrophil-to-lymphocyte ratio but not platelet-to-lymphocyte ratio is associated with generalized aggressive periodontitis in a Chinese population. J Periodontol 2020; 92:507-513. [PMID: 32909291 DOI: 10.1002/jper.20-0282] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/29/2020] [Accepted: 09/02/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Host inflammatory mediators are associated with tissue destruction in patients suffering from generalized aggressive periodontitis (GAgP). However, the correlations between neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with GAgP remain unknown. METHODS Periodontal clinical parameters, including probing depth (PD), bleeding index (BI) and attachment loss (AL) were collected from patients with GAgP and healthy controls. Complete blood cells analyses were obtained; further, NLR and PLR were calculated using neutrophil, platelet, and lymphocyte counts. Smooth curve fitting and segmented regression models were used to analyze the roles and predictive value of NLR with GAgP. RESULTS In total, 505 participants from a Chinese population were recruited, including 133 healthy controls and 372 patients with GAgP. Periodontal clinical parameters, NLR, and neutrophil counts were significantly higher in patients with GAgP than the control group. Moreover, NLR was positively correlated with the risk and clinical parameters of GAgP. When NLR < 3, the risk of GAgP increased by 20.6% for each 0.1 increase in NLR, reaching saturation when NLR > 3. An increase in NLR equivalent to 1 was associated with an increase in PD, BI, and AL by 0.41 mm, 0.26, and 0.57 mm, respectively. Notably, PLR did not show obvious correlations with GAgP. CONCLUSIONS NLR but not PLR may be a potential marker to identify GAgP in healthy individuals, particularly in a Chinese population.
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Affiliation(s)
- Ruifang Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wenjing Li
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiane Wang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Dong Shi
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Li A, Chen Y, van der Sluis LWM, Schuller AA, Tjakkes GH. White Blood Cell Count Mediates the Association Between Periodontal Inflammation and Cognitive Performance Measured by Digit Symbol Substitution Test Among Older U.S. Adults. J Gerontol A Biol Sci Med Sci 2020; 76:1309-1315. [DOI: 10.1093/gerona/glaa223] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Indexed: 02/07/2023] Open
Abstract
Abstract
Background
Systemic effects of periodontal infection may increase the risk of central neuroinflammation, aggravating impaired cognition. This study aims to examine whether systemic inflammatory factors mediate the possible association between periodontal inflammation and cognitive function.
Methods
We conducted a cross-sectional analysis of 766 participants aged ≥ 60 years and who had completed periodontal and cognitive examinations in the National Health and Nutrition Examination Survey (NHANES) 2001–2002. We used multivariable linear regression to investigate the overall association between periodontal health and cognitive function as measured by the digit symbol substitution test (DSST). Bleeding on probing (BOP) and periodontal inflamed surface area (PISA) were used to assess the periodontal inflammatory activity and burden, respectively. Mediation analyses were used to test the indirect effects of the BOP/PISA on DSST via C-reactive protein, white blood cell (WBC) count, and fibrinogen.
Results
Participants with superior periodontal health obtained higher DSST scores than those with poorer periodontal health, adjusting for demographic factors and chronic conditions. Concerning the inflammatory activity, WBC count acted as a full mediator in the association between BOP and DSST (β = −0.091; 95% confidence interval [CI] = −0.174 to −0.008) and mediated 27.5% of the total association. Regarding the inflammatory burden, WBC count acted as a partial mediator in the association between PISA and DSST (β = −0.059; 95% CI = −0.087 to −0.031) and mediated 20.3% of the total association.
Conclusion
Our study indicated the potential role of systemic inflammatory factors as a mediator of associations between periodontal inflammation and cognitive function in the U.S. geriatric population.
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Affiliation(s)
- An Li
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
| | - Yuntao Chen
- Medical Statistics and Decision Making, Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
| | - Luc W M van der Sluis
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
| | - Annemarie A Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
- Department of Child Health, the Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands
| | - Geerten-Has Tjakkes
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen (UMCG), University of Groningen, the Netherlands
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Schmidlin PR, Khademi A, Fakheran O. Association between periodontal disease and non-apnea sleep disorder: a systematic review. Clin Oral Investig 2020; 24:3335-3345. [DOI: 10.1007/s00784-020-03475-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/24/2020] [Indexed: 12/22/2022]
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Botelho J, Machado V, Proença L, Mendes JJ. The 2018 periodontitis case definition improves accuracy performance of full-mouth partial diagnostic protocols. Sci Rep 2020; 10:7093. [PMID: 32341429 PMCID: PMC7184582 DOI: 10.1038/s41598-020-63700-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 04/01/2020] [Indexed: 12/19/2022] Open
Abstract
We aimed to compare the accuracy performance of the new 2018 periodontitis case definition by the European Federation of Periodontology (EFP)/ American Association of Periodontology (AAP) with Centers for Disease Control (CDC)/AAP 2012 in full-mouth partial recording protocols (PRP). Retrospective data from NHANES 2011-2012 and 2013-2014 were analyzed. For each case definition, full-mouth diagnostic was defined as the reference standard. Patients were diagnosed for the presence of periodontitis and staging for each PRP. Sensitivity, specificity, accuracy and precision, through several indicators, were determined. Performance measurement was assessed through binary and multiclass ROC/AUC analyses. Our performance analysis shows that the new 2018 classification outperforms the 2012 classification regarding the diagnosis and staging of periodontitis on full-mouth PRPs. This recent case definition has strengthened the utility of PRPs and its improvements certainly explain the observed findings. Also, our findings contribute to the reliability of PRPs and its use in future worldwide epidemiological surveys.
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Affiliation(s)
- João Botelho
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal.
- Clinical Research Unit (CRU), CiiEM, IUEM, Almada, Portugal.
| | - Vanessa Machado
- Periodontology Department, Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz (IUEM), Almada, Portugal
- Clinical Research Unit (CRU), CiiEM, IUEM, Almada, Portugal
| | - Luís Proença
- Quantitative Methods for Health Research (MQIS), CiiEM, IUEM, Almada, Portugal
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Grender J, Ram Goyal C, Qaqish J, Adam R. An 8-week randomized controlled trial comparing the effect of a novel oscillating-rotating toothbrush versus a manual toothbrush on plaque and gingivitis. Int Dent J 2020; 70 Suppl 1:S7-S15. [PMID: 32243573 DOI: 10.1111/idj.12571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To compare a novel oscillating-rotating (O-R) electric rechargeable toothbrush with micro-vibrations (Oral-B iO) to a manual brush for gingivitis and plaque reduction. METHODS Adult subjects with gingivitis and plaque were randomized to use either the O-R or the manual toothbrush with standard fluoride dentifrice twice daily. Efficacy was assessed at baseline, week 1, and week 8 using the Rustogi Modification of the Navy Plaque Index (RMNPI), Modified Gingival Index (MGI), and Gingival Bleeding Index (GBI). Gingivitis status ('healthy'/'not healthy') was also assessed, per the American Academy of Periodontology/European Federation of Periodontology criteria. RESULTS One hundred and ten subjects were enrolled and completed the randomized controlled trial. The baseline mean number (SD) of bleeding sites for all subjects was 32.11 (16.703). At week 8, 82% of subjects using the O-R toothbrush were categorized as 'healthy' (<10% bleeding sites), versus 24% of subjects using the manual brush (P < 0.001). Subjects using the O-R toothbrush showed statistically significantly greater reductions (P < 0.001) in the number of bleeding sites, GBI scores and MGI scores versus those using a manual toothbrush as early as 1 week and throughout the 8-week study. The O-R toothbrush also provided statistically significantly greater reductions (P < 0.001) in all plaque measures, including sub-regions, versus the manual toothbrush after a single brushing and at weeks 1 and 8. CONCLUSIONS The novel O-R electric toothbrush with micro-vibrations provided statistically significantly greater plaque and gingivitis reductions versus a manual toothbrush, with performance benefits demonstrated after a single brushing and continuing throughout the 8-week study.
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Affiliation(s)
| | - C Ram Goyal
- All Sum Research Center Ltd, Mississauga, ON, Canada
| | - Jimmy Qaqish
- All Sum Research Center Ltd, Mississauga, ON, Canada
| | - Ralf Adam
- Procter & Gamble Service GmbH, Kronberg, Germany
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