1
|
Ravidà A, Saleh MHA, Ghassib IH, Qazi M, Kumar PS, Wang HL, Eke PI, Borgnakke WS. Impact of smoking on cost-effectiveness of 10-48 years of periodontal care. Periodontol 2000 2024. [PMID: 39054672 DOI: 10.1111/prd.12585] [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: 02/23/2024] [Revised: 06/02/2024] [Accepted: 06/03/2024] [Indexed: 07/27/2024]
Abstract
The study aims were (1) to explore whether "periodontal treatment" consisting of surgical therapy (flap, resective, or regenerative) or scaling and root planing treatment with long-term periodontal maintenance treatment, is cost-effective in terms of preventing periodontitis-attributable tooth extraction and replacement by implant-supported crowns ("extraction/replacement"); (2) to assess the effect of cigarette smoking on this cost-effectiveness. Data for this observational retrospective study were collected from dental charts of patients who had received periodontal therapy and at least annual follow-up visits for >10 years were analyzed by linear regression generalized estimating equations and generalized linear models. Among 399 adults (199 males, 200 females), those with the least mean annual treatment cost experienced the greatest mean annual costs for extraction/replacement, indicating general cost-effectiveness. Cigarette smoking adversely impacted this cost-effectiveness, with current heavy smokers experiencing no cost-effectiveness. Former smokers with Grade C periodontitis benefitted most, whereas smoking did not influence cost-effectiveness for Grade B periodontitis. Assessed by mean annual costs of "extraction/replacement," periodontal treatment was cost-effective, which decreased in a dose-response manner by former and current smoking intensity. Cigarette smoking should be factored into treatment planning and cost-effective analyses of periodontal treatment. Smoking cessation should be encouraged.
Collapse
Affiliation(s)
- Andrea Ravidà
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Iya H Ghassib
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Periodontics, The Virginia Commonwealth University, Richmond, Virginia, USA
| | - Musa Qazi
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Purnima S Kumar
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Paul I Eke
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, The University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| |
Collapse
|
2
|
Hensel ALJ, Nicholson K, Anderson KK, Gomaa NA. Biopsychosocial factors in oral and systemic diseases: a scoping review. FRONTIERS IN ORAL HEALTH 2024; 5:1378467. [PMID: 38872985 PMCID: PMC11169703 DOI: 10.3389/froh.2024.1378467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/15/2024] [Indexed: 06/15/2024] Open
Abstract
Background The association between chronic oral diseases and other major systemic health conditions, commonly referred to as the oral-systemic health connection, has been previously studied with several underlying common risk factors and pathways linking both groups of diseases. Psychosocial factors contribute to an increased susceptibility to chronic oral and non-oral diseases. The aim of this review is to summarize the current state of knowledge on the role of psychosocial stress in chronic oral and systemic diseases. Methods A search strategy was built and a literature search was conducted using four databases (CINAHL, Embase, Medline, PsycINFO). A combination of search terms related to psychosocial stress, systemic disease, and oral conditions were used. Studies were eligible for inclusion if they included human adults (aged 18 years and older), included psychosocial factors as an exposure measure, and outcome measures of both an oral and systemic condition. Only English-language articles were considered. Pilot testing of the data extraction form and calibration were conducted and data were extracted independently by one researcher. Results A total of fifteen articles out of eighty full-text articles screened were determined to be eligible for inclusion in this review. Periodontal disease was the most commonly studied oral disease, measured in 53% of included articles, with the most commonly studied systemic diseases being of mental health conditions (40%) and diabetes (47%). Psychosocial stress was measured using a range of psychometric indicators and/or biomarkers, including perceived stress, individual behaviours, childhood adversity, and cortisol. In total, fourteen studies found a positive association between measures of psychosocial stress and oral-systemic health. Conclusion Psychosocial stress may be a common contributor to both chronic oral and non-oral diseases.
Collapse
Affiliation(s)
- Abby L. J. Hensel
- Dentistry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Kathryn Nicholson
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Kelly K. Anderson
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Children's Health, Lawson Health Research Institute, London, ON, Canada
| | - Noha A. Gomaa
- Dentistry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Children's Health, Lawson Health Research Institute, London, ON, Canada
| |
Collapse
|
3
|
Borgnakke WS. Current scientific evidence for why periodontitis should be included in diabetes management. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 4:1257087. [PMID: 38274772 PMCID: PMC10809181 DOI: 10.3389/fcdhc.2023.1257087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024]
Abstract
This Perspective provides a brief summary of the scientific evidence for the two-way links between periodontal diseases and hyperglycemia (diabetes mellitus [DM] and pre-DM). It delivers in a nutshell current scientific evidence for manifestations of hyperglycemia on periodontal health status and effects of periodontal diseases on blood glucose levels and in turn incidence, progression, and complications of diabetes. Of outmost importance is presentation of scientific evidence for the potential of routine periodontal treatment to lower blood glucose levels, providing a novel, economical tool in DM management. Non-surgical periodontal treatment ("deep cleaning") can be provided by dental hygienists or dentists in general dental offices, although severe cases should be referred to specialists. Such therapy can decrease the costs of DM care and other health care costs for people with DM. The great importance of a healthy oral cavity free of infection and subsequent inflammation - especially periodontitis that if untreated will cause loosening and eventually loss of affected teeth - has largely gone unnoticed by the medical community as the health care curricula are largely void of content regarding the bi-directional links between oral health and systemic health, despite elevation of blood glucose levels being an integral part of the general systemic inflammation response. The importance of keeping disease-free, natural teeth for proper biting and chewing, smiling, self-esteem, and pain avoidance cannot be overestimated. Medical and dental professionals are strongly encouraged to collaborate in patient-centered care for their mutual patients with - or at risk for - hyperglycemia.
Collapse
Affiliation(s)
- Wenche Sylling Borgnakke
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| |
Collapse
|
4
|
Iwasaki M, Motokawa K, Shirobe M, Hayakawa M, Ohara Y, Motohashi Y, Edahiro A, Kawai H, Fujiwara Y, Sakata Y, Ihara K, Watanabe Y, Obuchi S, Hirano H. Serum levels of vitamin D and periodontal inflammation in community-dwelling older Japanese adults: The Otassha Study. J Clin Periodontol 2023; 50:1167-1175. [PMID: 37317881 DOI: 10.1111/jcpe.13834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/20/2023] [Accepted: 05/18/2023] [Indexed: 06/16/2023]
Abstract
AIM To evaluate the association between vitamin D status and periodontal inflammation as determined by the periodontal inflamed surface area (PISA) in community-dwelling older adults. MATERIALS AND METHODS This cross-sectional study included 467 Japanese adults (mean age = 73.1 years) who underwent full-mouth periodontal examinations and measurements of serum levels of 25-hydroxyvitamin D (25(OH)D). We used linear regression and restricted cubic spline models to analyse the association between exposure (serum 25(OH)D) and outcome (PISA). RESULTS The linear regression model showed that, after adjusting for potential confounders, participants in the lowest quartile of serum 25(OH)D had 41.0 mm2 more PISA (95% confidence interval [CI]: 4.6-77.5) than the reference group (the highest quartile of serum 25(OH)D). The spline model showed that the association between serum 25(OH)D and PISA was non-linear and restricted to the low 25(OH)D range. PISA initially sharply decreased as serum 25(OH)D increased, and then the decreasing trend slowed and plateaued. The inflection point with the minimum PISA value was a serum 25(OH)D level of 27.1 ng/mL, above which there was no decreasing trend in PISA with increasing serum 25(OH)D levels. CONCLUSIONS Low vitamin D status had an L-shaped association with periodontal inflammation in this cohort of Japanese adults.
Collapse
Affiliation(s)
- Masanori Iwasaki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Keiko Motokawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Misato Hayakawa
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yuki Ohara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshiko Motohashi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yasuyuki Sakata
- Health Care and Nutritional Science Institute, Morinaga Milk Industry Co., Ltd., Kanagawa, Japan
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Yutaka Watanabe
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| |
Collapse
|
5
|
Iwasaki M, Yoshihara A, Suwama K, Zaitsu T, Suzuki S, Ihira H, Sawada N, Aida J. A cross-sectional study of the association between periodontitis and physical activity in the Japanese population. J Periodontal Res 2023; 58:350-359. [PMID: 36642784 DOI: 10.1111/jre.13095] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/13/2022] [Accepted: 12/27/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The aim of this study was to determine whether physical activity (PA) is associated with periodontitis in the Japanese population. BACKGROUND The potential association between PA and periodontitis has not been thoroughly investigated in the Japanese population. METHODS We used cross-sectional data from the Japan Public Health Center-based Prospective Study for the Next-Generation Oral Health Study. Periodontitis was determined by a full-mouth periodontal examination. PA was assessed using a validated questionnaire. We performed multivariable ordinal logistic regression analyses to assess the association of total PA (the first quintile was set as the reference category) with periodontitis (three categories: no/mild, moderate, and severe), stratified by sex. The associations of periodontitis with domain- and intensity-specific PA were also studied in separate logistic regression models. RESULTS This study included 2160 Japanese adults [1414 women and 746 men; mean (standard deviation) age 58.1 (9.6) years]. After adjusting for potential confounders, total PA was inversely associated with the presence and severity of periodontitis in women. The multivariable-adjusted odds ratios (95% confidence intervals) for periodontitis in the second to fifth quintiles (compared with the first quintile) of total PA were 0.81 (0.59-1.12), 0.74 (0.53-1.02), 0.77 (0.55-1.06), and 0.64 (0.46-0.89), respectively (p for trend = .01). We did not find different results when we further investigated the associations of periodontitis with domain- and intensity-specific PA. By contrast, PA was not associated with periodontitis in men. CONCLUSION Total PA had an inverse, linear association with the presence and severity of periodontitis in Japanese women but not in Japanese men. Further prospective studies are required to determine the association between PA and periodontitis.
Collapse
Affiliation(s)
- Masanori Iwasaki
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kana Suwama
- Division of Oral Science for Health Promotion, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Takashi Zaitsu
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Seitaro Suzuki
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Hikaru Ihira
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Hokkaido, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
6
|
Maia MB, Souza JGS, Bertolini M, Costa RC, Costa GS, Torres SDAS, Ferreira EF, Martins AMEBL. Knowledge of bidirectional relationship between diabetes and periodontal disease among diabetes patients: A systematic review. Int J Dent Hyg 2023; 21:28-40. [PMID: 35080344 DOI: 10.1111/idh.12586] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 01/12/2022] [Accepted: 01/21/2022] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The bidirectional relationship between diabetes mellitus and periodontal disease has been reported in the literature, suggesting that poor glycemic control is strongly associated with increased risk of developing periodontal disease. Therefore, this systematic review evaluated the level of knowledge of this bidirectional relationship among patients with diabetes. METHODS This systematic review (protocol CRD42018117902) was conducted according to PRISMA guidelines. The following databases were considered: Medline/PubMed, Scopus, and Web of Science. Search strategy (April 05th , 2021) considered proper combination of keywords and eligibility criteria. The quality of studies was evaluated using the Appraisal tool for Cross-Sectional Studies (AXIS). RESULTS Among the 328 records identified in the initial search, 24 studies were selected, considering a total of 8,693 patients. All studies used a cross-sectional design. Among the included studies, only five showed prevalence of knowledge higher than 50%, ranging from 5.8% to 75.9%. Interestingly, 58.0% of patients reported that they brush their teeth at least 1x/day, but only four studies reported that the dentist was the main source of information. In terms of methodology and result quality, just one study clearly showed all information evaluated by the AXIS tool. Most of studies did not report sample size calculations and did not used validated questionnaires to assess patient knowledge. CONCLUSION The results show that less than half of people with diabetes have knowledge about their increased risk for periodontal disease, and often the dentist is not the main source of information to motivate them.
Collapse
Affiliation(s)
| | - João G S Souza
- Dental Research Division, Guarulhos University, Guarulhos, São Paulo, Brazil.,Dental Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Brazil.,School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Martinna Bertolini
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Raphael C Costa
- Piracicaba Dental School - University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Silvério de A S Torres
- State University of Montes Claros, Montes Claros, Brazil.,Dental Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Brazil
| | - Efigênia F Ferreira
- School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | |
Collapse
|
7
|
Walther C, Spinler K, Borof K, Kofahl C, Heydecke G, Seedorf U, Beikler T, Terschüren C, Hajek A, Aarabi G. Evidence from the Hamburg City Health Study - association between education and periodontitis. BMC Public Health 2022; 22:1662. [PMID: 36056348 PMCID: PMC9438138 DOI: 10.1186/s12889-022-14096-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Large-scale population-based studies regarding the role of education in periodontitis are lacking. Thus, the aim of the current study was to analyze the potential association between education and periodontitis with state of the art measured clinical phenotypes within a large population-based sample from northern Germany. MATERIAL & METHODS The Hamburg City Health Study (HCHS) is a population-based cohort study registered at ClinicalTrial.gov (NCT03934957). Oral health was assessed via plaque-index, probing depth, gingival recession and gingival bleeding. Periodontitis was classified according to Eke & Page. Education level was determined using the International Standard Classification of Education (ISCED-97) further categorized in "low, medium or high" education. Analyses for descriptive models were stratified by periodontitis severity. Ordinal logistic regression models were stepwise constructed to test for hypotheses. RESULTS Within the first cohort of 10,000 participants, we identified 1,453 with none/mild, 3,580 with moderate, and 1,176 with severe periodontitis. Ordinal regression analyses adjusted for co-variables (age, sex, smoking, diabetes, hypertension and migration) showed that the education level (low vs. high) was significantly associated with periodontitis (OR: 1.33, 95% CI: 1.18;1.47). CONCLUSION In conclusion, the current study revealed a significant association between the education level and periodontitis after adjustments for a set of confounders. Further research is needed to develop strategies to overcome education related deficits in oral and periodontal health.
Collapse
Affiliation(s)
- Carolin Walther
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Kristin Spinler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katrin Borof
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christopher Kofahl
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Udo Seedorf
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Terschüren
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Andre Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
8
|
Hajek A, Kretzler B, König HH. Oral Health, Loneliness and Social Isolation. A Systematic Review and Meta-Analysis. J Nutr Health Aging 2022; 26:675-680. [PMID: 35842757 PMCID: PMC9166168 DOI: 10.1007/s12603-022-1806-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/12/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Thus far, some empirical studies have investigated the association between oral health and loneliness as well as social isolation. However, a systematic review and meta-analysis is lacking synthesizing this evidence. Hence, our purpose was to close this knowledge gap. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Observational studies examining the association between oral health and loneliness or social isolation were included. Disease-specific samples were excluded. METHODS We searched three electronic databases (PubMed, PsycINFO, CINAHL), and did an additional hand search. Data extraction covered methods, sample characteristics and main findings. To evaluate study quality/risk of bias, the NIH tool was used. Study selection, data extraction and assessment of study quality were each conducted by two reviewers. RESULTS Seven studies were included in our current work. Several cross-sectional studies and one longitudinal study reported an association between poorer oral health and higher loneliness as well as higher social isolation. The quality of the studies was mostly fair, with two studies of high quality. The pooled OR was 1.47 (95% CI: 1.24-1.75) among the studies with adult samples. CONCLUSION Most of the included studies demonstrated an association between oral health and loneliness or social isolation. There is a lack of high quality studies on these associations; in particular, future studies should use longitudinal data to clarify the directionality between oral health and loneliness or social isolation. Prospero registration number: CRD42021268116.
Collapse
Affiliation(s)
- A Hajek
- André Hajek, Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany, E-Mail:
| | | | | |
Collapse
|
9
|
Shah PD, Badner VM, Moss KL. Association between asthma and periodontitis in the US adult population: A population-based observational epidemiological study. J Clin Periodontol 2021; 49:230-239. [PMID: 34866232 DOI: 10.1111/jcpe.13579] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022]
Abstract
AIM To examine the association between asthma and periodontitis in a nationally representative sample of adults in the United States. MATERIALS AND METHODS Data obtained from 10,710 adult men and women who participated in National Health and Nutritional Examination Survey from 2009 to 2014 were analysed. Asthma was measured based on self-reported physician diagnosis. Periodontitis was the outcome of interest. It was classified into mild, moderate, and severe periodontitis according to the updated CDC/AAP case definitions. Multivariable models were developed to examine the association of asthma with periodontitis while controlling for age, race/ethnicity, gender, education, income, body mass index, diabetes, and smoking. Odds ratio (OR) and respective 95% confidence interval (CI) were calculated. Replication was performed by differently classifying the outcome using another system called periodontal profile class (PPC). RESULTS Current asthmatics, in reference to never asthmatics, had lower odds of severe periodontitis [(adjusted OR = 0.51, 95% CI = 0.30-0.87) and (adjusted OR = 0.58, 95% CI = 0.35-0.97) as classified using CDC/AAP case definitions and PPC system, respectively]. However, there was no statistically significant association between asthma and any other forms of periodontitis (p value >.05). CONCLUSIONS In the United States, current-asthmatic adults were less likely to have severe periodontitis as compared with never-asthmatic adults. Further research is required to fully understand this association.
Collapse
Affiliation(s)
- Parth D Shah
- Division of Population Health & Community Dentistry, Department of Dentistry and Oral & Maxillofacial Surgery, Jacobi Medical Center in affiliation with the Albert Einstein College of Medicine, Bronx, New York, USA
| | - Victor M Badner
- Department of Dentistry and Oral & Maxillofacial Surgery, Jacobi Medical Center in affiliation with the Albert Einstein College of Medicine, Bronx, New York, USA
| | - Kevin L Moss
- Department of Dental Ecology, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Borgnakke WS, Poudel P. Diabetes and Oral Health: Summary of Current Scientific Evidence for Why Transdisciplinary Collaboration Is Needed. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.709831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This Perspective provides a brief summary of the scientific evidence for the often two-way links between hyperglycemia, including manifest diabetes mellitus (DM), and oral health. It delivers in a nutshell examples of current scientific evidence for the following oral manifestations of hyperglycemia, along with any available evidence for effect in the opposite direction: periodontal diseases, caries/periapical periodontitis, tooth loss, peri-implantitis, dry mouth (xerostomia/hyposalivation), dysbiosis in the oral microbiome, candidiasis, taste disturbances, burning mouth syndrome, cancer, traumatic ulcers, infections of oral wounds, delayed wound healing, melanin pigmentation, fissured tongue, benign migratory glossitis (geographic tongue), temporomandibular disorders, and osteonecrosis of the jaw. Evidence for effects on quality of life will also be reported. This condensed overview delivers the rationale and sets the stage for the urgent need for delivery of oral and general health care in patient-centered transdisciplinary collaboration for early detection and management of both hyperglycemia and oral diseases to improve quality of life.
Collapse
|
12
|
Ghassib IH, Batarseh FA, Wang HL, Borgnakke WS. Clustering by periodontitis-associated factors: A novel application to NHANES data. J Periodontol 2021; 92:1136-1150. [PMID: 33315260 DOI: 10.1002/jper.20-0489] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 11/28/2020] [Accepted: 12/03/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Unsupervised clustering is a method used to identify heterogeneity among groups and homogeneity within a group of patients. Without a prespecified outcome entry, the resulting model deciphers patterns that may not be disclosed using traditional methods. This is the first time such clustering analysis is applied in identifying unique subgroups at high risk for periodontitis in National Health and Nutrition Examination Surveys (NHANES 2009 to 2014 data sets using >500 variables. METHODS Questionnaire, examination, and laboratory data (33 tables) for >1,000 variables were merged from 14,072 respondents who underwent clinical periodontal examination. Participants with ≥6 teeth and available data for all selected categories were included (N = 1,222). Data wrangling produced 519 variables. k-means/modes clustering (k = 2:14) was deployed. The optimal k-value was determined through the elbow method, formula = ∑ (xi 2 ) - ((∑ xi )2 /n). The 5-cluster model showing the highest variability (63.08%) was selected. The 2012 Centers for Disease Control and Prevention/American Academy of Periodontology (AAP) and 2018 European Federation of Periodontology/AAP periodontitis case definitions were applied. RESULTS Cluster 1 (n = 249) showed the highest prevalence of severe periodontitis (43%); 39% self-reported "fair" general health; 55% had household income <$35,000/year; and 48% were current smokers. Cluster 2 (n = 154) had one participant with periodontitis. Cluster 3 (n = 242) represented the greatest prevalence of moderate periodontitis (53%). In Cluster 4 (n = 35) only one participant had no periodontitis. Cluster 5 (n = 542) was the systemically healthiest with 77% having no/mild periodontitis. CONCLUSION Clustering of NHANES demographic, systemic health, and socioeconomic data effectively identifies characteristics that are statistically significantly related to periodontitis status and hence detects subpopulations at high risk for periodontitis without costly clinical examinations.
Collapse
Affiliation(s)
- Iya H Ghassib
- School of Dentistry, Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI
| | | | - Hom-Lay Wang
- School of Dentistry, Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI
| | - Wenche S Borgnakke
- School of Dentistry, Department of Periodontics and Oral Medicine, University of Michigan, Ann Arbor, MI
| |
Collapse
|
13
|
Smith SL, Gorantla R. Analysing the global health agenda: A comparison of priority for diabetes and oral diseases. Glob Public Health 2020; 16:517-531. [PMID: 32903145 DOI: 10.1080/17441692.2020.1814834] [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: 12/31/2022]
Abstract
Many claims are made concerning which issues are on the global health agenda and which are neglected. Scholarship is inconsistent and generally vague about how an issue's status is (or should be) measured, however, leaving such claims open to questions about their validity. This inquiry explores a novel way of addressing the largely overlooked matter of how to comparatively assess the agenda status of health issues systematically, over time and in consideration of a global health context that lacks centralised authority. We draw upon a model from sociology which proposes that collective definitions of social problems and public attention evolve in multiple, interacting institutional arenas, each of which has the capacity to give robust attention to a limited number of issues. We systematically track status indicators for two significant global health issues, diabetes and oral diseases, in three arenas since 2000. Oral health's status declined while diabetes rose in international representation, international organisation and scientific research arenas during the past decade. This article sets out some preliminary contours of an analytical approach that holds promise for enhancing understanding of causal mechanisms and outcomes across a wider set of global health issues and agenda setting arenas.
Collapse
Affiliation(s)
- Stephanie L Smith
- School of Public and International Affairs, Virginia Tech, Arlington, VA, USA
| | - Ramya Gorantla
- School of Public Administration, University of New Mexico, Albuquerque, NM, USA
| |
Collapse
|
14
|
Nyvad B, Takahashi N. Integrated hypothesis of dental caries and periodontal diseases. J Oral Microbiol 2020; 12:1710953. [PMID: 32002131 PMCID: PMC6968559 DOI: 10.1080/20002297.2019.1710953] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 12/14/2022] Open
Abstract
This review considers an integrated hypothesis of dental caries and periodontal diseases that builds on theoretical ecological principles. The backbone of the hypothesis is based on the dynamic stability stage of the oral microbiota, at which intrinsic (mainly saliva and gingival crevicular fluid) and bacterial (mainly metabolic) resilience factors maintain ecological dynamic stability, compatible with clinical health. However, loss of intrinsic resilience factors and/or prolonged changes in the availability of microbial metabolic substrates may shift the ecological balance of the microbiota into either saccharolytic (acidogenic) or amino acid-degrading/proteolytic (alkalinogenic) stages, depending on the nature of the predominant substrates, leading to clinical diseases. Therefore, to maintain and restore the dynamic stability of the oral microbiota, it is necessary to control the drivers of disease, such as salivary flow and influx of bacterial nutrients into the oral cavity. Contrary to conventional wisdom, excessive intake of fermentable carbohydrates may contribute to inflammation in periodontal tissues resulting from hyperglycaemia. An integrated hypothesis emphasizes that both dental caries and periodontal diseases originate in the dynamic stability stage and emerge in response to nutritional imbalances in the microbiota. Periodontal diseases may belong to the sugar driven inflammatory diseases, similar to diabetes, obesity, and cardiovascular diseases.
Collapse
Affiliation(s)
- Bente Nyvad
- Section of Dental Pathology, Operative Dentistry and Endodontics, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Nobuhiro Takahashi
- Division of Oral Ecology and Biochemistry, Department of Oral Biology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| |
Collapse
|
15
|
Borgnakke WS. IDF Diabetes Atlas: Diabetes and oral health - A two-way relationship of clinical importance. Diabetes Res Clin Pract 2019; 157:107839. [PMID: 31520714 DOI: 10.1016/j.diabres.2019.107839] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 09/06/2019] [Indexed: 12/22/2022]
Abstract
The current scientific evidence for the bi-directional associations between oral health and diabetes is summarized. The universal biologic mechanisms and demographic and behavioral risk drivers underlying these associations in both directions are also described. Dysglycemia, even slightly elevated blood sugar levels, adversely affects oral health, manifesting itself in several oral diseases and conditions. In the opposite direction, any oral infection with its subsequent local and systemic inflammatory responses adversely affects blood glucose levels. Moreover, painful, mobile, or missing teeth may lead to intake of soft food items representing a sub-optimal diet and hence poor nutrition, and thereby contribute to incident type 2 diabetes or to poorer glucose control in existing diabetes. Treatment of inflammation related oral conditions, such as non-surgical periodontal treatment and extraction of infected teeth, can lead to a clinically significant decrease in blood glucose levels. Attention to infectious oral diseases and referral to dental care professionals for treatment can therefore be an important novel tool for medical care professionals in preventing and managing diabetes mellitus. Dental professionals can detect unrecognized potential dysglycemia and refer for medical examination. Such interprofessional, patient centered care may contribute to improved health, wellbeing, and quality of life in people with diabetes.
Collapse
Affiliation(s)
- Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1011 North University Avenue Rm# 3060, Ann Arbor, MI 48109-1078, USA.
| |
Collapse
|
16
|
Eke PI, Thornton-Evans GO, Wei L, Borgnakke WS, Dye BA, Genco RJ. Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009-2014. J Am Dent Assoc 2019; 149:576-588.e6. [PMID: 29957185 DOI: 10.1016/j.adaj.2018.04.023] [Citation(s) in RCA: 331] [Impact Index Per Article: 66.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 04/12/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND This report presents weighted average estimates of the prevalence of periodontitis in the adult US population during the 6 years 2009-2014 and highlights key findings of a national periodontitis surveillance project. METHODS Estimates were derived for dentate adults 30 years or older from the civilian noninstitutionalized population whose periodontitis status was assessed by means of a full-mouth periodontal examination at 6 sites per tooth on all non-third molar teeth. Results are reported according to a standard format by applying the Centers for Disease Control and Prevention/American Academy of Periodontology periodontitis case definitions for surveillance, as well as various thresholds of clinical attachment loss and periodontal probing depth. RESULTS An estimated 42% of dentate US adults 30 years or older had periodontitis, with 7.8% having severe periodontitis. Overall, 3.3% of all periodontally probed sites (9.1% of all teeth) had periodontal probing depth of 4 millimeters or greater, and 19.0% of sites (37.1% of teeth) had clinical attachment loss of 3 mm or greater. Severe periodontitis was most prevalent among adults 65 years or older, Mexican Americans, non-Hispanic blacks, and smokers. CONCLUSIONS This nationally representative study shows that periodontitis is a highly prevalent oral disease among US adults. PRACTICAL IMPLICATIONS Dental practitioners should be aware of the high prevalence of periodontitis in US adults and may provide preventive care and counselling for periodontitis. General dentists who encounter patients with periodontitis may refer these patients to see a periodontist for specialty care.
Collapse
|
17
|
Bartold PM. Lifestyle and periodontitis: The emergence of personalized periodontics. Periodontol 2000 2019; 78:7-11. [PMID: 30198129 DOI: 10.1111/prd.12237] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Personalized medicine is a medical model that involves the tailoring of healthcare - with medical decisions, practices, and/or products being customized to an individual patient. In this model, diagnostic testing is often employed for selecting appropriate and optimal therapies based on the context of a patient's genetic content or other epidemiologic, sociologic, molecular, physiologic, or cellular analyses. With the advent of major advances in periodontal medicine, including genomic discoveries and greater understanding of the multifactorial nature of periodontitis, it seems that the time is ripe to use personalized medicine as a model for personalized periodontics. This volume of Periodontology 2000 explores how new advances in our understanding of periodontitis within a medical model can evolve into new treatment strategies tailor-made for individual patients and not merely based on wholesale treatment paradigms.
Collapse
Affiliation(s)
- P Mark Bartold
- Faculty of Health Sciences, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
18
|
Eke PI, Lu H, Zhang X, Thornton-Evans G, Borgnakke WS, Holt JB, Croft JB. Geospatial distribution of periodontists and US adults with severe periodontitis. J Am Dent Assoc 2018; 150:103-110. [PMID: 30470389 DOI: 10.1016/j.adaj.2018.09.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/13/2018] [Accepted: 09/25/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND In this study, the authors report on the geospatial distributions of periodontists and adults with severe periodontitis in the United States. METHODS The authors used geospatial analysis to describe the distribution of periodontists and adults, periodontists vis-à-vis estimated density of adults with severe periodontitis, and their ratios to adults with severe periodontitis. The authors identified locations of 5,415 practicing periodontists through the 2014 National Provider Identifier Registry, linked them with the weighted census number of adults, and estimated the number of adults within a series of circular distance zones. RESULTS Approximately 60% of adults 30 through 79 years lived within 5 miles of a periodontist, 73% within 10 miles, 85% within 20 miles, and 97% within 50 miles. Proximity to a periodontist varied widely. In urban areas, 95% of adults resided within 10 miles of a periodontist and 100% within 20 miles. Only 24% of adults in rural areas lived within 10 miles of a periodontist. Most periodontists (96.1%) practiced in urban areas, clustering along the eastern and western coasts and in the Midwest, 3.1% in urban clusters elsewhere, and 0.8% in rural areas. Ratios of fewer than 8,000 adults with periodontitis to 1 or more periodontists within 10 miles were clustered mostly in the Northeast, central East Coast, Florida, West Coast, Arizona, and Midwest. CONCLUSIONS In this study, the authors identified wide variations in geographic proximity to a practicing periodontist for adults with severe periodontitis. PRACTICAL IMPLICATIONS Dental practitioners may provide preventive care and counseling for periodontitis and referrals for specialty care. Geographic proximity to specialized periodontal care may vary widely by locality.
Collapse
|
19
|
Kocher T, König J, Borgnakke WS, Pink C, Meisel P. Periodontal complications of hyperglycemia/diabetes mellitus: Epidemiologic complexity and clinical challenge. Periodontol 2000 2018; 78:59-97. [DOI: 10.1111/prd.12235] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Thomas Kocher
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
| | - Jörgen König
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
| | - Wenche Sylling Borgnakke
- Department of Periodontics and Oral Medicine; University of Michigan School of Dentistry; Ann Arbor Michigan
| | - Christiane Pink
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
| | - Peter Meisel
- Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry; University Medicine Greifswald; Greifswald Germany
| |
Collapse
|
20
|
Al-Alimi A, Halboub E, Al-Sharabi AK, Taiyeb-Ali T, Jaafar N, Al-Hebshi NN. Independent determinants of periodontitis in Yemeni adults: A case-control study. Int J Dent Hyg 2018; 16:503-511. [DOI: 10.1111/idh.12352] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2018] [Indexed: 12/26/2022]
Affiliation(s)
- A Al-Alimi
- Faculty of Dentistry; Department of Oral Biology & Biomedical Sciences (Periodontology); University Malaya; Kuala Lumpur Malaysia
- Faculty of Dentistry; Department of Periodontology, Oral Pathology, Oral Medicine and Radiology; University of Sana'a; Sana'a Yemen
| | - E Halboub
- Faculty of Dentistry; Department of Maxillofacial Surgery and Diagnostic Sciences; Jazan University; Jazan Saudi Arabia
| | - AK Al-Sharabi
- Faculty of Dentistry; Department of Periodontology, Oral Pathology, Oral Medicine and Radiology; University of Sana'a; Sana'a Yemen
| | - T Taiyeb-Ali
- Faculty of Dentistry; Department of Oral Biology & Biomedical Sciences (Periodontology); University Malaya; Kuala Lumpur Malaysia
| | - N Jaafar
- Faculty of Dentistry; Department of Community Oral Health & Clinical Prevention; University Malaya; Kuala Lumpur Malaysia
| | - NN Al-Hebshi
- Maurice H. Kornberg School of Dentistry; Temple University; Philadelphia PA USA
| |
Collapse
|
21
|
Iwasaki M, Borgnakke WS, Ogawa H, Yamaga T, Sato M, Minagawa K, Ansai T, Yoshihara A, Miyazaki H. Effect of lifestyle on 6‐year periodontitis incidence or progression and tooth loss in older adults. J Clin Periodontol 2018; 45:896-908. [DOI: 10.1111/jcpe.12920] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 04/23/2018] [Accepted: 05/08/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Masanori Iwasaki
- Department of Oral Health ScienceDivision of Preventive DentistryNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
- Division of Community Oral Health DevelopmentKyushu Dental University Kitakyushu Japan
| | - Wenche S. Borgnakke
- Department of Periodontics and Oral MedicineUniversity of Michigan School of Dentistry Ann Arbor Michigan
| | - Hiroshi Ogawa
- Department of Oral Health ScienceDivision of Preventive DentistryNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Takayuki Yamaga
- Department of Oral Health ScienceDivision of Preventive DentistryNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Misuzu Sato
- Department of Oral Health ScienceDivision of Preventive DentistryNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Kumiko Minagawa
- Department of Oral Health ScienceDivision of Preventive DentistryNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Toshihiro Ansai
- Division of Community Oral Health DevelopmentKyushu Dental University Kitakyushu Japan
| | - Akihiro Yoshihara
- Department of Oral Health and WelfareDivision of Oral Science for Health PromotionNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| | - Hideo Miyazaki
- Department of Oral Health ScienceDivision of Preventive DentistryNiigata University Graduate School of Medical and Dental Sciences Niigata Japan
| |
Collapse
|
22
|
Ziukaite L, Slot DE, Van der Weijden FA. Prevalence of diabetes mellitus in people clinically diagnosed with periodontitis: A systematic review and meta-analysis of epidemiologic studies. J Clin Periodontol 2018; 45:650-662. [DOI: 10.1111/jcpe.12839] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Laura Ziukaite
- Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | - Dagmar E. Slot
- Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | - Fridus A. Van der Weijden
- Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| |
Collapse
|
23
|
Krieger N, Davey Smith G. Response: FACEing reality: productive tensions between our epidemiological questions, methods and mission. Int J Epidemiol 2018; 45:1852-1865. [PMID: 28130315 DOI: 10.1093/ije/dyw330] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2017] [Indexed: 12/20/2022] Open
Affiliation(s)
- Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | |
Collapse
|
24
|
Acharya A, Cheng B, Koralkar R, Olson B, Lamster IB, Kunzel C, Lalla E. Screening for Diabetes Risk Using Integrated Dental and Medical Electronic Health Record Data. JDR Clin Trans Res 2018; 3:188-194. [PMID: 29568804 DOI: 10.1177/2380084418759496] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Undiagnosed diabetes and prediabetes present a serious public health challenge. We previously reported that data available in the dental setting can serve as a tool for early dysglycemia identification in a primarily Hispanic, urban population. In the present study, we sought to determine how the identification approach can be recalibrated to detect diabetes or prediabetes in a White, rural cohort and whether an integrated dental-medical electronic health record (iEHR) offers further value to the process. We analyzed iEHR data from the Marshfield Clinic, a health system providing care in rural Wisconsin, for dental patients who were ≥21 y of age, reported that they had never been told they had diabetes, had an initial periodontal examination of at least 2 quadrants, and had a glycemic assessment within 3 mo of that examination. We then assessed the performance of multiple predictive models for prediabetes/diabetes. The study outcome, glycemic status, was gleaned from the medical module of the iEHR based on American Diabetes Association blood test cutoffs. The sample size was 4,560 individuals. Multivariate logistic regression revealed that the best performance was achieved by a model that took advantage of the iEHR. Predictors included age, sex, race, ethnicity, number of missing teeth, percentage of teeth with at least 1 pocket ≥5 mm from the dental EHR, and overweight/obesity, hypertension, hyperlipidemia, and smoking status from the medical EHR. The model achieved an area under the receiver operating characteristic curve of 0.71 (95% confidence interval, 0.69-0.72), yielding a sensitivity of 0.70 and a specificity of 0.62. Across a range of populations, informed by certain patient characteristics, dental care team members can play a role in helping to identify dental patients with undiagnosed diabetes or prediabetes. The accuracy of the prediction increases when dental findings are combined with information from the medical EHR. Knowledge Transfer Statement: Prediabetes and diabetes often go undiagnosed for many years. Early identification and care can lead to improved glycemic outcomes and prevent wide-ranging morbidity, including adverse oral health consequences, in affected individuals. Information available in the dental office can be used by clinicians to identify those who remain undiagnosed or are at risk; the accuracy of this prediction increases when combined with information from the medical electronic health record.
Collapse
Affiliation(s)
- A Acharya
- Marshfiled Clinic Research Institute, Marshfield, WI, USA
| | - B Cheng
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - R Koralkar
- Marshfiled Clinic Research Institute, Marshfield, WI, USA
| | - B Olson
- Marshfiled Clinic Research Institute, Marshfield, WI, USA
| | - I B Lamster
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - C Kunzel
- College of Dental Medicine, Columbia University, New York, NY, USA
| | - E Lalla
- College of Dental Medicine, Columbia University, New York, NY, USA
| |
Collapse
|
25
|
Al-Sowygh ZH, Ghani SMA, Sergis K, Vohra F, Akram Z. Peri-implant conditions and levels of advanced glycation end products among patients with different glycemic control. Clin Implant Dent Relat Res 2018; 20:345-351. [PMID: 29350883 DOI: 10.1111/cid.12584] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 12/31/2017] [Accepted: 01/02/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND A close relationship between poor glycemic control and peri-implant break down has been demonstrated. It is hypothesized that levels of advanced glycation end products (AGEs) in peri-implant sulcular fluid (PISF) are higher with increased glycemic levels in type 2 diabetes mellitus patients. PURPOSE In the present study, we examined the clinical and radiographic peri-implant parameters and levels of AGEs among different glycemic levels in diabetic patients and assessed whether the levels of AGEs correlate with clinical peri-implant parameters. MATERIALS AND METHODS Ninety-three patients who participated in this study were divided into four groups; Group-1: HbA1c 6.1%-8%; Group-2: HbA1c 8.1%-10%; Group-3: HbA1c > 10%; Group-4: non-diabetic individuals with HbA1c < 6%. Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD) and crestal bone loss (CBL) were recorded. Levels of AGEs in PISF were quantified using enzyme-linked immunosorbent assay. Between-group comparison of means was verified with Kruskal-Wallis test and Pearson correlation coefficient for correlations of AGE levels with peri-implant parameters. RESULTS Peri-implant PI, BOP, PD, and CBL were significantly higher in group-1, -2, and -3 as compared to non-diabetic patients (P < .05). These parameters were significantly higher in group-2 and group-3 versus group-1 (P < .01). Mean PI, BOP, PD, and CBL were comparable between group-2 and group-3 patients (P > .05). Mean levels of AGEs in PISF were significantly higher in relation to higher levels of HbA1c levels. Significant positive correlations were found between AGEs and PD (P = .0221) and CBL (P = .0425); and significant negative correlation was found for PI (P = .0376) in patients with HbA1c levels >10%, respectively. CONCLUSIONS Clinical and radiographic peri-implant parameters were poor and levels of AGEs were significantly high in patients with high glycemic levels. These findings suggest that AGEs may be considered as potential marker of inflammation in diabetic individuals with peri-implantitis.
Collapse
Affiliation(s)
- Zeyad H Al-Sowygh
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Siti Mariam Ab Ghani
- Department of Restorative Dentistry, Universiti Teknologi MARA, Shah Alam, Malaysia
| | - Konstantinos Sergis
- SergisDentist, Scientific Associate of Athens University, 13 Xenofontos Street, Athens, Greece
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Zohaib Akram
- Faculty of Dentistry, Department of Periodontology, Ziauddin University, Karachi, Pakistan
| |
Collapse
|
26
|
Monje A, Catena A, Borgnakke WS. Association between diabetes mellitus/hyperglycaemia and peri-implant diseases: Systematic review and meta-analysis. J Clin Periodontol 2017; 44:636-648. [PMID: 28346753 DOI: 10.1111/jcpe.12724] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 12/11/2022]
Abstract
AIM This systematic review investigates whether hyperglycaemia/diabetes mellitus is associated with peri-implant diseases (peri-implant mucositis and peri-implantitis). MATERIALS AND METHODS Electronic and manual literature searching was conducted. An a priori case definition for peri-implantitis was used as an inclusion criterion to minimize risk of bias. The Newcastle-Ottawa Scale was used for quality assessment; random effect models were applied; and results were reported according to the PRISMA Statement. RESULTS Twelve studies were eligible for qualitative and seven of them for quantitative analyses. Meta-analyses detected the risk of peri-implantitis was about 50% higher in diabetes than in non-diabetes (RR = 1.46; 95% CI: 1.21-1.77 and OR = 1.89; 95% CI: 1.31-2.46; z = 5.98; p < .001). Importantly, among non-smokers, those with hyperglycaemia had 3.39-fold higher risk for peri-implantitis compared with normoglycaemia (95% CI: 1.06-10.81). Conversely, the association between diabetes and peri-implant mucositis was not statistically significant (RR = 0.92; 95% CI: 0.72-1.16 and OR = 1.06; 95% CI: 0.84-1.27; z = 1.06, p = .29). CONCLUSIONS Within its limits that demand great caution when interpreting its findings, this systematic review suggests that diabetes mellitus/hyperglycaemia is associated with greater risk of peri-implantitis, independently of smoking, but not with peri-implant mucositis.
Collapse
Affiliation(s)
- Alberto Monje
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.,Department of Oral Surgery and Stomatology, ZMK School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andres Catena
- Department of Experimental Psychology, University of Granada, Granada, Spain
| | - Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
27
|
Winning L, Patterson CC, Neville CE, Kee F, Linden GJ. Periodontitis and incident type 2 diabetes: a prospective cohort study. J Clin Periodontol 2017; 44:266-274. [DOI: 10.1111/jcpe.12691] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2016] [Indexed: 01/27/2023]
Affiliation(s)
- Lewis Winning
- Centre for Public Health; School of Medicine Dentistry and Biomedical Sciences; Queen's University Belfast; Belfast UK
| | - Christopher C. Patterson
- Centre for Public Health; School of Medicine Dentistry and Biomedical Sciences; Queen's University Belfast; Belfast UK
| | - Charlotte E. Neville
- Centre for Public Health; School of Medicine Dentistry and Biomedical Sciences; Queen's University Belfast; Belfast UK
| | - Frank Kee
- Centre for Public Health; School of Medicine Dentistry and Biomedical Sciences; Queen's University Belfast; Belfast UK
| | - Gerard J. Linden
- Centre for Public Health; School of Medicine Dentistry and Biomedical Sciences; Queen's University Belfast; Belfast UK
| |
Collapse
|
28
|
|