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Liang JH, Liu ML, Pu YQ, Wang C, Huang S, Jiang N, Hu LX, Zhang YS, Gui ZH, Pu XY, Huang SY, Chen YJ. Contribution of individual and cumulative social determinants of health underlying gender disparities in periodontitis in a representative US population: A cross-sectional NHANES study. J Clin Periodontol 2024; 51:558-570. [PMID: 38200631 DOI: 10.1111/jcpe.13941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024]
Abstract
AIM To examine the impact of both individual and cumulative social determinants of health (SDoH) on the likelihood of developing periodontitis, while also exploring any gender disparities in this relationship. MATERIALS AND METHODS Data of self-reported SDoH domains and sub-items based on Healthy People 2030 were obtained from the U.S. National Health and Nutrition Examination Surveys between 1999 and 2014. Logistic regression models, weighted by survey responses, were used to examine the relationship between SDoH (including eight sub-items and the cumulative number of unfavourable SDoH) and periodontitis. The results were further analysed by gender. RESULTS A total of 18,075 participants (8867 males and 9208 females) were included in the main analysis, of which 5814 (32.2%) had periodontitis. The study found that certain unfavourable SDoH were individually associated with higher odds of periodontitis, and the cumulative number of unfavourable SDoH was positively linked to the odds of developing periodontitis. Furthermore, males exposed to more unfavourable SDoH appeared to be more susceptible to developing periodontitis than females. CONCLUSIONS The findings suggest that unfavourable SDoH, especially when they accumulate, are associated with an increased odds of periodontitis and contribute to gender disparities within the U.S. POPULATION
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Affiliation(s)
- Jing-Hong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Mei-Ling Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ying-Qi Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Cong Wang
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China
| | - Shan Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Nan Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Li-Xin Hu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yu-Shan Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Zhao-Huan Gui
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Guangzhou, People's Republic of China
| | - Xue-Ya Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Shao-Yi Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
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Saleh MHA, Dias DR, Kumar P. The economic and societal impact of periodontal and peri-implant diseases. Periodontol 2000 2024. [PMID: 38693603 DOI: 10.1111/prd.12568] [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: 02/01/2024] [Accepted: 03/26/2024] [Indexed: 05/03/2024]
Abstract
Periodontal and peri-implant diseases result from a chronic inflammatory response to dysbiotic microbial communities and are characterized by inflammation in the soft tissue and the ensuing progressive destruction of supporting bone, resulting in tooth or implant loss. These diseases' high prevalence, multifactorial etiology, extensive treatment costs, and significant detriment to patients' quality-of-life underscore their status as a critical public health burden. This review delineates the economic and sociocultural ramifications of periodontal and peri-implant diseases on patient welfare and healthcare economics. We delve into the implications of diagnosis, treatment, supportive care, and managing destructive tissue consequences, contrasting these aspects with healthy patients.
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Affiliation(s)
- Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Debora R Dias
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil
| | - Purnima Kumar
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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3
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Minhas S, Qian Hui Lim R, Raindi D, Gokhale KM, Taylor J, Bradbury-Jones C, Bandyopadhyay S, Nirantharakumar K, Adderley NJ, Chandan JS. Exposure to domestic abuse and the subsequent risk of developing periodontal disease. Heliyon 2022; 8:e12631. [PMID: 36619466 PMCID: PMC9813698 DOI: 10.1016/j.heliyon.2022.e12631] [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: 08/14/2022] [Revised: 10/18/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022] Open
Abstract
Aims Periodontal disease and domestic abuse (DA) are significant public health problems. Previous cross-sectional evidence indicates an association between DA exposure and development of periodontal disease. There have been no large-scale cohort studies exploring this relationship in a UK-setting. Our aim was to conduct a population-based retrospective open cohort study to explore the association between DA exposure and the subsequent development of general practitioner (GP)-coded periodontal disease. Materials and methods We undertook a retrospective open-cohort study using the IQVIA Medical Research Database (IMRD) UK database between the 1st January 1995 to 31st January 2021. Women (aged 18 years and over) exposed to DA were matched by age, deprivation, and smoking status to up to 4 unexposed women, all of whom had no pre-existing record of periodontal disease. Cox regression analysis was used to calculate crude and adjusted hazard ratios (HRs) to describe the risk of developing periodontal disease in the exposed group. Results 23429 exposed patients were matched to 69815 unexposed patients. During the study period, 78 exposed patients had developed GP-recorded periodontal disease compared to 154 in the unexposed group, translating to an IR of 94.18 per 100,000 person years (py) and 54.67 per 100,000 py respectively. Following adjustment for key covariates, this translated to an aHR of 1.74 (95% CI 1.31-2.32), which was robust during our sensitivity analysis. Conclusions Our results provide further evidence that DA exposure is associated with increased risk of developing periodontal disease. There is a need for swift implementation of public health policies to improve surveillance, reporting, and prevention of DA.
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Affiliation(s)
- Sonica Minhas
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Rachel Qian Hui Lim
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, E1 2AD, United Kingdom
| | - Devan Raindi
- Periodontal Research Group, School of Dentistry, Institute of Clinical Sciences, University of Birmingham, B152TT, United Kingdom
| | - Krishna M. Gokhale
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Julie Taylor
- School of Nursing, College of Medical and Dental Sciences, University of Birmingham, Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, B152TT, United Kingdom
| | - Caroline Bradbury-Jones
- School of Nursing, College of Medical and Dental Sciences, University of Birmingham, Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, B152TT, United Kingdom
| | | | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Nicola J. Adderley
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
| | - Joht Singh Chandan
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, B152TT, United Kingdom
- Corresponding author.
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Verma I, Reddy LVK, Verma A, Kashyap P, Sanaullah M, Adwani J. The impact of lifestyles on the periodontal health among 35–44 years old adult population in Lucknow district: A cross-sectional study. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2022. [DOI: 10.4103/jiaphd.jiaphd_13_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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5
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Rahate PS, Kolte RA, Kolte AP, Lathiya VN, Gupta M, Chari S. Evaluation of stress, serum and salivary ghrelin and cortisol levels in smokers and non-smokers with stage iii periodontitis - A cross-sectional study. J Periodontol 2021; 93:1131-1140. [PMID: 34859428 DOI: 10.1002/jper.21-0373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 09/14/2021] [Accepted: 10/21/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND The present study aimed to investigate the serum and salivary ghrelin and cortisol levels in smokers and non-smokers with Stage III Periodontitis. METHODS The present study comprised of a total of 90 systemically healthy patients categorized in three groups: Group I- Periodontally healthy patients; Group II- Non-smokers with Stage III Periodontitis and Group III- Smokers with Stage III periodontitis. Clinical parameters of Probing pocket depth (PPD), Clinical attachment levels (CAL), Plaque Index (PI), Gingival Index (GI) and Papillary Bleeding Index (PBI)were recorded and biochemical parameters of serum and salivary ghrelin and cortisol levels were analyzed via Enzyme Linked Immunosorbent Assay (ELISA). Stress levels were assessed using Zung's self-rating depression scale. RESULTS Serum and salivary ghrelin values were found to be higher in Group II (620.25 ± 260.86 pg/ml, 892.40 ± 271.65 pg/ml respectively) as compared to Group III. Similarly, salivary as well as serum cortisol levels were higher in Group III (20.78 ± 9.23 pg/ml, 399.37 ±189.21 pg/ml respectively) as compared to Group II (16.36 ± 8.88 pg/ml, 320.68 ± 107.01 pg/ml respectively). In Group III, a direct correlation was observed between stress, serum and salivary cortisol levels while an inverse correlation was found between stress, serum and salivary ghrelin levels. Group III showed a greater number of depressed patients followed by Group II and I. CONCLUSION As per the results smokers with Stage III Periodontitis exhibit an elevated stress and cortisol levels, lower serum and salivary ghrelin levels as compared to the non-smokers. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Priyanka S Rahate
- Department of Periodontics & Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, India
| | - Rajashri A Kolte
- Department of Periodontics & Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, India
| | - Abhay P Kolte
- Department of Periodontics & Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, India
| | - Vrushali N Lathiya
- Department of Periodontics & Implant Dentistry, VSPM Dental College and Research Centre, Nagpur, India
| | - Madhur Gupta
- Department of Biochemistry, NKP Salve Institute of Medical Science, Nagpur, India
| | - Suresh Chari
- Department of Biochemistry, NKP Salve Institute of Medical Science, Nagpur, India
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6
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Panhwar M, Rajpar SP, Abrar E, Alqutub M, Abduljabbar T. Effectiveness of Chlorhexidine and Metronidazole Gels in the management of gingivitis. A clinical trial. Pak J Med Sci 2021; 37:1425-1429. [PMID: 34475924 PMCID: PMC8377906 DOI: 10.12669/pjms.37.5.4236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 04/21/2021] [Accepted: 05/04/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: The purpose of the present study was to compare the topical application of chlorohexidine (CHX) and Metronidazole (MTZ) gels, individually and in combination in patients with gingivitis for up to 12 weeks follow-up. Methods: The clinical trial was conducted at Liaquat University of Medical Health Sciences (LUMHS) Jamshoro and Hyderabad, Institute of Dentistry from 1st March 2019 to 1st March 2020. Patients were selected based on inclusion criteria. Out of 125 screened patients, ninety-nine patients agreed to participate in the study. At the beginning of study all patients were assessed for gingival inflammation by using gingival index (GI) (Loe and silness, 1963). Scaling root planning (SRP) was performed in all patients. Subjects were randomly selected in three groups (n=33 each). In Group-A CHX gel was applied, Group-B Metronidazole gel was applied and the combination of two was applied to patients of Group-C. Patient follow up was done and gingival parameters were assessed at baseline, fourth week and twelve weeks. Apart from the clinical evaluation, a subjective evaluation was also undertaken. Significance level of 0.05 and a desired study power of at least 80% was estimated. Analysis of Variance (ANOVA) test for comparison was used within groups. Results: A significant improvement in gingival scores was noted in all groups from baseline. At 4 weeks CHX (1.25±0.21) MTZ (1.81±0.38) CHX+MTZ (1.29±0.34) compared to baseline CHX (2.77±0.24) MTZ (2.84±0.54) CHX+MTZ (2.74±0.31) demonstrated substantial improvement (p<0.001). However, gingival scores showed inclination at 12 weeks CHX (1.18±0.41) MTZ (1.21±0.48) CHX+MTZ (1.11±0.14) with no significant difference to week 4 (p>0.001). Conclusion: Local MTZ gel and MTZ+CHX gel showed effectiveness similar to CHX gel application adjunct to scaling and root planning in the treatment of gingivitis.
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Affiliation(s)
- Maryam Panhwar
- Maryam Panhwar, Department of Community and Preventive Dentistry, Dow International Dental College, Karachi Pakistan
| | - Shazia Parveen Rajpar
- Shazia Parveen Rajpar, Department of Community and Preventive Dentistry, Liaquat University of Medical Health Sciences Jamshoro
| | - Eisha Abrar
- Eisha Abrar, MDS Trainee Department of Operative Dentistry, Dow International Dental College, Karachi Pakistan
| | - Montaser Alqutub
- Montaser Alqutub, Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Tariq Abduljabbar
- Tariq Abduljabbar Department of Prosthetic Dental Science, College of Dentistry, King Saud University; Research Chair for Biological Research in Dental Health , College of Dentistry, Riyadh 11545, Saudi Arabia
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Edman K, Norderyd O, Holmlund A. 'Periodontal health and disease in an older population: A 10-year longitudinal study'. Community Dent Oral Epidemiol 2021; 50:225-232. [PMID: 34056736 DOI: 10.1111/cdoe.12656] [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: 10/12/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate alveolar bone loss (ABL), which is an indicator of periodontitis, and to identify risk factors for ABL in an older population between 2008 and 2018. METHODS This longitudinal study used data from a questionnaire survey and a clinical examination administered on two occasions ten years apart to 273 individuals who were 65 years and 75 years in 2008. RESULTS The mean number of teeth decreased significantly over the ten-year study period, while the proportion of individuals with calculus and moderate ABL visible on radiographs increased. For both ages, the number of teeth decreased by a mean of 2 teeth. The proportions of participants reporting poor general health, daily medication, xerostomia, living singly, visiting dental care irregularly and being in need of extra support in their homes all increased over the observation period. CONCLUSIONS Despite an increased progression of moderate alveolar bone loss, a fairly good dentition and chewing capacity was retained in this older population. However, the individual's age and fragility are important indicators that need to be considered when planning oral health care and the availability of dental care.
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Affiliation(s)
- Kristina Edman
- Public Dental Services, Falun, Sweden.,Center for Clinical Research, Uppsala University/Region Dalarna, Falun, Sweden.,Department of Surgical Sciences, Oral and Maxillofacial Surgery, Medical Faculty, Uppsala University, Uppsala, Sweden
| | - Ola Norderyd
- Department of Periodontology, The Institute for Postgrad Dental Education, Jönköping, Sweden.,Faculty of Odontology, Malmö University, Malmö, Sweden.,Centre for Oral Health, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Anders Holmlund
- Department of Periodontology, Public Dental Service, Gävle, Sweden.,Center for Clinical Research, Uppsala University/Region Gävleborg, Gävle, Sweden
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8
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A. Tanveer S, Afaq A, Alqutub MN, Aldahiyan N, AlMubarak AM, Shaikh AC, Naseem M, Vohra F, Abduljabbar T. Association of Self-Perceived Psychological Stress with the Periodontal Health of Socially Deprived Women in Shelter Homes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5160. [PMID: 34068018 PMCID: PMC8152271 DOI: 10.3390/ijerph18105160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/07/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022]
Abstract
The present study aimed to assess the effect of self-perceived psychological stress on the periodontal health of socially deprived women. The study included three hundred and eighty-five socially deprived women residing in shelter homes. The presence of stress and its severity was assessed by using Sheldon Cohen's 10-item perceived stress scale (PSS), and periodontal health status was assessed utilizing the community periodontal index. Statistical analyses were performed using an independent sample t-test, a one-way ANOVA, the Pearson chi-Square test, and binary logistic regression. Results: A total of 385 samples were included, the majority of whom (n = 297; 72.5%) belonged to the age group of 15-30 years. There were 34 (8.8%) participants who were educated up to graduate level. A total of 47.8% of the women were found with healthy periodontal status, and 52.5% of the samples were diagnosed with major psychological stress. Half of the samples (201-52.2%) had a periodontal problem. The mean PSS was found statistically significant concerning age group, education, and psychological stress level. In the univariate logistic regression analysis, a significant association of periodontal status was observed with the age group 31-45 years [(OR = 1.76; 95% C.I (1.11-2.78)] and with a major psychological stress level [(OR = 2.60; 95% C.I (1.72-3.93)]. Psychosocial stress among socially deprived women was found to be a risk factor for periodontal disease.
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Affiliation(s)
- Syeda A. Tanveer
- Department of Oral Biology, College of Dentistry, Dow International Dental College, Karachi 74200, Pakistan; (S.A.T.); (A.C.S.)
| | - Ashar Afaq
- Department of Community and Preventive Dental Sciences, College of Dentistry, Dow International Dental College, Karachi 74200, Pakistan; (A.A.); (M.N.)
| | - Montaser N. Alqutub
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (M.N.A.); (A.M.A.)
| | - Nada Aldahiyan
- Department of Restorative Dentistry, Division of Operative Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
| | - Abdulrahman M. AlMubarak
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (M.N.A.); (A.M.A.)
| | - Amynah C. Shaikh
- Department of Oral Biology, College of Dentistry, Dow International Dental College, Karachi 74200, Pakistan; (S.A.T.); (A.C.S.)
| | - Mustafa Naseem
- Department of Community and Preventive Dental Sciences, College of Dentistry, Dow International Dental College, Karachi 74200, Pakistan; (A.A.); (M.N.)
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
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ÖZCAN M, ÖZCAN G. Stresin cerrahi olmayan periodontal tedavi üzerine etkisi. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.745326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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10
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Abstract
Patient-based outcomes complement clinical data with patients' self-evaluation of their physical, psychological, and social well-being, and as such facilitate clinical decision-making, assessing the quality of care provided, and evaluating practices and policies. Some validated generic oral health-related quality of life measures used in recent research indicated a high performance. There is a proportional relationship between the quality of life and periodontitis, ie, the higher the level of periodontitis, the poorer the oral health-related quality of life. This relationship is heightened by the presence of symptoms such as bleeding, halitosis, and mobility. On the other hand, periodontal treatment has demonstrated the capability to improve quality of life substantially. Future research should focus on questionnaires that are able to explain the interlinked pathways between periodontal conditions, approaches to treatment approaches, and patients' well-being. The acquisition of new knowledge in the field is essential for the whole community, as we treat people not millimeters.
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Affiliation(s)
- Filippo Graziani
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Georgios Tsakos
- Department of Epidemiology and Public Health, UCL, London, UK
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11
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Barboza-Solís C, Porras-Chaverri M, Fantin R. Is tooth loss important when evaluating perceived general health? Findings from a nationally representative study of Costa Rican adults. Community Dent Oral Epidemiol 2019; 47:358-365. [PMID: 31074536 DOI: 10.1111/cdoe.12466] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/11/2019] [Accepted: 04/19/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Although previous studies have shown that oral diseases can impact certain systemic conditions, dental care has been historically separated from medical healthcare organizations in middle-income countries. There is a lack of research approaches which test the independent relationship between oral health and multidimensional measures of general health. This study analyses the influence of tooth loss on self-rated health (SRH), hypothesizing that, relatively to certain morbidity conditions, tooth loss is a health condition associated with SRH. This study analyses the influence of tooth loss on self-rated health (SRH), hypothesizing that, relative to certain morbidity conditions, tooth loss is a health condition associated with SRH. METHODS Data were obtained from the Costa Rican Longevity and Healthy Aging Study 1945-1955 Retirement Cohort, a national representative longitudinal survey including residents born between 1945 and 1955. The association between severe tooth loss and SRH was analysed cross-sectionally using the first wave of the study conducted in 2010. A multivariable logistic regression, adjusted for potential confounders, was performed on 2797 participants. A counterfactual analysis was additionally performed to illustrate the theoretical change on SRH prevalence-if all the participants were not to have had severe tooth loss. RESULTS Severe tooth loss was associated with poor SRH, after adjustment for smoking, morbidity, biomarkers and performance-based physical measures. The counterfactual analysis showed that severe tooth loss was the fifth most important morbidity condition in determining poor SRH. Declaring a poor SRH would have been decreased by 2.0 percentage points if those participants having severe tooth loss had shared the same risk pattern of those who had not lost the majority of their teeth. CONCLUSION Individuals consider their oral health status to a similar extent as other morbidity conditions when evaluating their general health. A stronger focus on oral health, and its impact on general health, could lead to better planning of national resources, thereby improving accessibility to health care and modifying prevailing conceptions of health care in low- and middle-income countries.
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Affiliation(s)
| | - Mariela Porras-Chaverri
- Centro de Investigación en Ciencias Atómicas, Nucleares y Moleculares, Universidad de Costa Rica, San José, Costa Rica
| | - Romain Fantin
- Facultad de Medicina, Escuela de Salud Pública, Universidad de Costa Rica, San José, Costa Rica.,Facultad de Medicina, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
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12
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Finlayson TL, Lemus H, Becerra K, Kaste LM, Beaver SM, Salazar CR, Singer RH, Youngblood ME. Unfair Treatment and Periodontitis Among Adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Racial Ethn Health Disparities 2018; 5:1093-1106. [PMID: 29327269 PMCID: PMC6760848 DOI: 10.1007/s40615-017-0459-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 12/01/2017] [Accepted: 12/28/2017] [Indexed: 10/18/2022]
Abstract
This study investigates how perceived unfair treatment, towards self and observed towards others due to ethnicity, is associated with periodontitis among diverse Hispanic/Latino adults, accounting for sociodemographic, health behavior, and acculturation factors. Baseline (2008-2011) dental and survey data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multicenter epidemiologic study, were analyzed (N = 12,750). Crude and adjusted prevalence ratios and confidence limits were estimated. Half (49%) reported never being treated unfairly, while 41% reported they were sometimes, and 10% reported it often/always. One third (32%) never saw others treated unfairly, while 42% reported it sometimes, and 26% reported it often/always. In the final fully adjusted model, the prevalence of periodontitis was higher among adults who were as follows: non-Dominican, older, male, had a past year dental visit, current and former smokers, and among those who observed unfair treatment towards others. Lower prevalence was associated with higher income, higher educational attainment, less than full-time employment, reporting experiencing unfair treatment, higher acculturation scores, and having health insurance. Perceived unfair treatment towards self was negatively associated with periodontitis prevalence, while observed unfair treatment towards others was positively associated with the outcome among diverse Hispanics/Latinos. The associations between unfair treatment and periodontitis warrant further exploration.
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Affiliation(s)
| | | | - Karen Becerra
- Gary and Mary West Senior Dental Center, San Diego, CA, USA
| | | | | | | | - Richard H Singer
- Nova Southeastern University, Ft. Lauderdale, FL, USA and Univesity of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL, USA
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13
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Cunha FA, Cota LOM, Cortelli SC, Miranda TB, Neves FS, Cortelli JR, Costa FO. Periodontal condition and levels of bacteria associated with periodontitis in individuals with bipolar affective disorders: A case-control study. J Periodontal Res 2018; 54:63-72. [DOI: 10.1111/jre.12605] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/28/2018] [Accepted: 08/04/2018] [Indexed: 12/12/2022]
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14
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Yu HC, Chen TP, Wei CY, Chang YC. Association between Peptic Ulcer Disease and Periodontitis: A Nationwide Population-Based Case-Control Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050912. [PMID: 29734656 PMCID: PMC5981951 DOI: 10.3390/ijerph15050912] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 04/28/2018] [Accepted: 04/29/2018] [Indexed: 12/25/2022]
Abstract
Previous studies have suggested that peptic ulcer disease (PUD) including stomach and duodenal ulcers might be associated with periodontitis (PD); however, no clear conclusions have been reached thus far. In this retrospective case-control study, we aimed to investigate the association between PUD and PD by using a large population-based dataset in Taiwan. A population-based retrospective case control study was conducted using the Longitudinal Health Insurance Database 2010 (LHID2010) derived from the National Health Insurance Research database (NHIRD) in Taiwan from 2000 to 2013. The case and control group were matched with gender, age, urbanization level, socioeconomic status, and Charlson comorbidity index (CCI) by using the propensity score method at a 1:1 ratio. A total of 177,240 cases and 177,240 control patients were included in this study, with an average age of 46.96 ± 11.76 years. The risk of PUD for patients diagnosed with PD was 1.15-fold when compared with those without PD (OR, 1.15; 95% CI, 1.12–1.18). This population-based case control study demonstrated a significantly positive association between PUD and PD in Taiwan.
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Affiliation(s)
- Hui-Chieh Yu
- School of Dentistry, Chung Shan Medical University, Taichung 40201, Taiwan.
| | - Tsung-Po Chen
- Department of Family Medicine, China Medical University Hospital, Taichung 40402, Taiwan.
| | - Chia-Yi Wei
- School of Dentistry, Chung Shan Medical University, Taichung 40201, Taiwan.
| | - Yu-Chao Chang
- School of Dentistry, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
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15
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Obulareddy VT, Chava VK, Nagarakanti S. Association of Stress, Salivary Cortisol, and Chronic Periodontitis: A Clinico-biochemical Study. Contemp Clin Dent 2018; 9:S299-S304. [PMID: 30294161 PMCID: PMC6169263 DOI: 10.4103/ccd.ccd_289_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Periodontitis and stress are among the areas of increasing interest over the past two decades. Early detection of these diseases plays a crucial role in successful therapy. Cortisol is a protein which was found to be consistently associated with both. Aim The present study was aimed to evaluate saliva cortisol levels (SCLs) in chronic periodontitis (CP) patients with and without stress. Materials and Methods In this cross-sectional study, saliva samples were collected and cortisol levels were determined using ELISA method in 92 participants. The participants were divided into four groups based on periodontal condition (number of teeth present, plaque index (PI), bleeding on probing (BOP), probing pocket depth, and clinical attachment level) and stress levels into Group 1 (no periodontitis and no stress), Group 2 (with periodontitis and no stress), Group 3 (without periodontitis and with stress), and Group 4 (with periodontitis and stress). Results Overall, 92 adult participants (41 males and 51 females) were included in the study. Participants with stress and periodontitis have high mean SCL when compared to other groups (Group 1: 15.01 ± 2.62, Group 2: 31.92 ± 6.80, Group 3: 34.47 ± 13.47, and Group 4: 60.13 ± 6.68). Group I shows a significant negative correlation of cortisol to BOP, stress to PI, and stress to cortisol level, whereas there is a positive correlation of SCL to PD in Group 4 which is not statistically significant. Conclusion SCL showed difference among the groups. SCL were associated with both CP and psychological stress. Increase in inflammation and stress levels enhances the SCL.
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Affiliation(s)
- Vishnu Teja Obulareddy
- Department of Periodontology, Narayana Dental College and Hospital, Andhra Pradesh, India
| | - Vijay Kumar Chava
- Department of Periodontology, Narayana Dental College and Hospital, Andhra Pradesh, India
| | - Sreenivas Nagarakanti
- Department of Periodontology, Narayana Dental College and Hospital, Andhra Pradesh, India
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16
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Yu HC, Su NY, Huang JY, Lee SS, Chang YC. Trends in the prevalence of periodontitis in Taiwan from 1997 to 2013: A nationwide population-based retrospective study. Medicine (Baltimore) 2017; 96:e8585. [PMID: 29137082 PMCID: PMC5690775 DOI: 10.1097/md.0000000000008585] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Periodontitis is one of the most prevalent oral diseases. In this study, we probed the nationwide registered database to assess the time trends of prevalence of periodontitis in Taiwan.A retrospective study was conducted to analyze the registered database compiled by the National Health Insurance provided by the Department of Health, Taiwan, from 1997 to December 2013.We found that the prevalence of periodontitis significantly increased from 11.5% in 1997 to 19.59% in 2013 (P for trend < .0001). The mean age ± standard deviation with periodontitis from 1997 to 2013 was 54.46 ± 14.47 and 45.51 ± 16.58 years old, respectively. The proportion of individuals with periodontitis in age group >65 years old decreased markedly. The proportion of individuals with periodontitis in age groups <25 and 26 to 35 years old demonstrated an increased pattern. Compared to the reference cohort of 1953 to 1957, the recent birth cohort of 1993 to 1997 revealed the highest relative risk (RR) of periodontitis (male: RR, 67.42, 95% confidence interval [CI], 17.04-266.76; female: RR, 65.85, 95% CI, 16.70-259.70). Both male and female groups showed the similar age-effect pattern in the cross-sectional age curve from age-period-cohort model. There was an upturn with advancing age up to 40 to 50 years old and then a downward trend in both genders. Population dwelling in suburban area (RR, 0.95; 95% CI, 0.94-0.97) and rural area (RR, 0.97; 95% CI, 0.95-0.99) had the lower risk of periodontitis than those who lived in urban area. The higher income group revealed the higher risk of periodontitis compared with lower income group (RR, 1.20; 95% CI, 1.18-1.23).The prevalence of periodontitis significantly increased in Taiwan over past 17 years. The mean age with periodontitis was shown in a decreased pattern. The use of a nationwide population-based database could provide sufficient sample size, generalizability, and statistical power to assess the periodontal status in Taiwan.
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Affiliation(s)
- Hui-Chieh Yu
- School of Dentistry, Chung Shan Medical University
| | - Ni-Yu Su
- Department of Dentistry, Chung Shan Medical University Hospital
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital
| | - Shiuan-Shinn Lee
- School of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Chao Chang
- School of Dentistry, Chung Shan Medical University
- Department of Dentistry, Chung Shan Medical University Hospital
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17
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Edman K, Holmlund A, Nordström B, Öhrn K. Attitudes to dental care, Sweden 2003-2013, and clinical correlates of oral health-related quality of life in 2013. Int J Dent Hyg 2017; 16:257-266. [PMID: 28133937 DOI: 10.1111/idh.12269] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 11/27/2022]
Affiliation(s)
- K Edman
- Center for Oral Rehabilitation; Public Dental Services; Falun Sweden
- Department of Surgical Sciences, Oral and Maxillofacial Surgery; Medical Faculty; Uppsala University; Uppsala Sweden
| | - A Holmlund
- Public Dental Services; Gävleborg Sweden
- Center for Clinical Research; Uppsala University/Region Gävleborg; Gävle Sweden
| | - B Nordström
- Center for Public Dental Services; Falun Sweden
| | - K Öhrn
- School of Education, Health and Social Studies; Falun Sweden
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18
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Singla N, Acharya S, Prabhakar RV, Chakravarthy K, Singhal D, Singla R. The impact of lifestyles on the periodontal health of adults in Udupi district: A cross sectional study. J Indian Soc Periodontol 2016; 20:330-5. [PMID: 27563209 PMCID: PMC4976556 DOI: 10.4103/0972-124x.179405] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES (1) To assess the impact of different lifestyle factors on periodontal health of adults. (2) To assess the impact of overall/combined lifestyle variable (calculated by health practice index [HPI]) on periodontal health of adults. MATERIALS AND METHODS A cross-sectional study consisting of a structured questionnaire on HPI, oral health-related behavior, and personal habits as well as sociodemographic variables was conducted on 800 subjects aged 20-50 years attending dental outreach set-ups of Manipal College of Dental Sciences, Manipal. Clinical examination for periodontal status was done by recording loss of attachment scores using community periodontal index (FDI/WHO-1982). Statistical analysis was done by bivariate analysis using Chi-square followed by multivariate analysis to obtain adjusted odds ratio with 95% confidence interval. RESULTS After adjusting for all the confounding variables in multivariate logistic regression analysis, the variables that showed an independent association with periodontitis were age, location, marital status, smoking, hours of sleep per night, physical activity, and overall poor lifestyles. CONCLUSION Our results support studying a combined approach using various lifestyle behaviors for controlling chronic periodontitis. Necessary public health action on conditions which determine unhealthy lifestyle behaviors across population is needed which is possible by patient's involvement in self-care by promoting healthy lifestyles.
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Affiliation(s)
- Nishu Singla
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Shashidhar Acharya
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Ramprasad Vasthare Prabhakar
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Kalyana Chakravarthy
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Deepak Singhal
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
| | - Ritesh Singla
- Department of Orthodontics, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
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19
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López Silva MC, Diz-Iglesias P, Seoane-Romero JM, Quintas V, Méndez-Brea F, Varela-Centelles P. [Update in family medicine: Periodontal disease]. Semergen 2016; 43:141-148. [PMID: 27068254 DOI: 10.1016/j.semerg.2016.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 02/05/2016] [Indexed: 01/18/2023]
Abstract
About 85-94% of the Spanish adults older than 35 experience gum problems, and about 15-30% suffer from periodontitis, being severe in up to 5-11% of them. Unlike other inflammatory conditions, periodontal disease rarely causes discomfort, or limits life or causes functional limitations until its advanced stages, when clinical signs and symptoms arise (gingival recession, pathological teeth migration, or mobility). Lack of knowledge about the disease, together with the idea that tooth loss is linked to ageing, frequently results in a late diagnosis, requiring extensive treatments with a worse prognosis. At Primary Care level, there is series of drugs have been related to periodontal disease (anticonvulsants, immunosuppressive drugs, and calcium channel blockers) as secondary effects, which vary as regards their frequency and severity depending of the amount of accumulated plaque. Stress and depression have also been reported to alter the immune response and to increase the inflammatory response as well as periodontal susceptibility. Certain systemic conditions, such as diabetes mellitus, cardiovascular disorders, respiratory diseases, as well as low-weight pre-term birth, have also been linked to periodontitis.
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Affiliation(s)
- M C López Silva
- Atención Primaria, CS Praza do Ferrol, EOXI Lugo, Cervo, e Monforte de Lemos, Servizo Galego de Saúde, Lugo, España
| | - P Diz-Iglesias
- Departamento de Estomatología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - J M Seoane-Romero
- Departamento de Estomatología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - V Quintas
- Departamento de Estomatología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - F Méndez-Brea
- Pregrado de Odontología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - P Varela-Centelles
- Atención Primaria, CS Praza do Ferrol, EOXI Lugo, Cervo, e Monforte de Lemos, Servizo Galego de Saúde, Lugo, España; Departamento de Estomatología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España.
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20
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Salameh E, Alshaarani F, Hamed HA, Nassar JA. Investigation of the relationship between psychosocial stress and temporomandibular disorder in adults by measuring salivary cortisol concentration: A case-control study. J Indian Prosthodont Soc 2016; 15:148-52. [PMID: 26929502 PMCID: PMC4762310 DOI: 10.4103/0972-4052.158075] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background/Purpose of the Study: Psychological factors, particularly psychosocial stress, have been implicated as risk indicators for temporomandibular disorder (TMD). The aim of this study was to assess any differences in salivary cortisol concentration, scores of perceived stress scale (PSS), and scores of depression and distress between TMD patients and matched controls. Materials and Methods: This case-control study comprised two groups; the patient group consisted of 60 patients attending the Department of Fixed Prosthodontics at the Faculty of Dentistry who met the inclusion criteria (42 females and 18 males aged 19–44), whereas the control group was selected to match the patient group in number, age and sex. Two questionnaires were used for stress assessment: The PSS 10 and the psychosocial measure of Research Diagnostic Criteria (RDC) for TMD axis II. Salivary cortisol levels were measured by a competitive immunoenzymatic colorimetric method. Data were analyzed using SPSS 17. Descriptive statistics, one-way ANOVA test, and independent t-test were used. Results: This study showed statistically significant differences between the patient group and the control group at the three measures of psychosocial stress (P < 0.05). Increased occurrence of this disorder in women has been observed. Conclusion: Psychosocial stress plays an important role in the etiopathogenesis of TMD. Women are at increased risk of TMD when compared to men. Sub-types TMD patients approximately have the same level of stress. Muscle disorders were the most common.
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Affiliation(s)
- Ebtisam Salameh
- Department of Prosthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Fandi Alshaarani
- Department of Prosthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Hussein Abou Hamed
- Department of Face and Oral Biology, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Jihad Abou Nassar
- Department of Prosthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria
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21
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Warren KR, Postolache TT, Groer ME, Pinjari O, Kelly DL, Reynolds MA. Role of chronic stress and depression in periodontal diseases. Periodontol 2000 2015; 64:127-38. [PMID: 24320960 PMCID: PMC7167640 DOI: 10.1111/prd.12036] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2013] [Indexed: 12/15/2022]
Abstract
An extensive body of experimental and clinical evidence documents the negative impact of chronic psychological stress and depression on the immune system and health. Chronic stress and depression can result in general dysregulation of the immune system, of both cellular and humoral pathways, which may contribute to pathogenic infection and concomitant periodontal tissue destruction. In general, the evidence is consistent with the hypothesis that stress can modify the host defense and progression of periodontal infections in patients susceptible to periodontitis. However, substantial evidence also indicates that these conditions can mediate risk for disease, including periodontitis, through changes in health-related behaviors, such as oral hygiene, smoking and diet. The unequivocal interpretation of studies has also been hampered, in part, by issues related to conceptualization of stress and depression, as well as commonly associated comorbidities, such as diabetes, that can modify the onset and progression of periodontal disease. In addition, stress and depression appear to fall into a spectrum, ranging from mild to severe, involving a complex interaction of genetic background, coping strategies and environment. Differences in the conceptualization of stress and depression are probably important in assessing associations with other biologic and clinical measures. Future studies are necessary to clarify the complex interactions of chronic stress and depression in periodontal diseases.
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22
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Edman K, Öhrn K, Nordström B, Holmlund A, Hellberg D. Trends over 30 years in the prevalence and severity of alveolar bone loss and the influence of smoking and socio‐economic factors – based on epidemiological surveys in Sweden 1983–2013. Int J Dent Hyg 2015. [DOI: 10.1111/idh.12164] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- K Edman
- Center for Oral Rehabilitation Falun Sweden
- Oral and Maxillofacial Surgery Department of Surgical Sciences Uppsala University Uppsala Sweden
| | - K Öhrn
- School of Health and Social Studies Dalarna University Falun Sweden
| | - B Nordström
- Administrative Center for Public Dental Services Falun Sweden
| | - A Holmlund
- National Dental Service Gävleborg Center for Clinical Research Uppsala University/Region Gävleborg Gävle Sweden
| | - D Hellberg
- Center for Clinical Research Falun Sweden
- Department of Women's and Children's Health Uppsala University Uppsala Sweden
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23
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Al-Sudani FYH, Vehkalahti MM, Suominen AL. The association between current unemployment and clinically determined poor oral health. Community Dent Oral Epidemiol 2015; 43:325-37. [DOI: 10.1111/cdoe.12157] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 01/18/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Fouad Y. H. Al-Sudani
- Department of Public Health Dentistry; Institute of Dentistry; University of Eastern Finland; Kuopio Finland
| | - Miira M. Vehkalahti
- Department of Oral Public Health; Institute of Dentistry; University of Helsinki; Helsinki Finland
- Oral and Maxillofacial Department; Oulu University Hospital; Oulu Finland
| | - Anna L. Suominen
- Department of Public Health Dentistry; Institute of Dentistry; University of Eastern Finland; Kuopio Finland
- Department of Environmental Health; National Institute for Health and Welfare (THL); Kuopio Finland
- National Institute for Health and Welfare (THL); Helsinki Finland
- Department of Oral and Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
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24
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da Silva AN, da Silva CMFP, Vettore MV. Are resilience and maternal sense of coherence associated with gingival status in adolescents from low-income families? Int J Paediatr Dent 2014; 24:450-9. [PMID: 24444315 DOI: 10.1111/ipd.12093] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The capacity to overcome social disadvantages and maintain oral health through psychosocial processes remains poorly understood in children. AIM This study assessed the relationship of children's resilience and maternal sense of coherence (SOC) with gingival status in children from low-income families. METHODS A cross-sectional study was conducted on 190 schoolchildren aged 11-12 years and their mothers. Family socioeconomic characteristics and housing conditions, maternal and children's oral cleanliness behaviours (tooth brushing and dental floss use), maternal SOC, children's resilience, and demographic data were collected through interviews with children and their mothers. Validated versions of Antonovsky's scale and the resilience scale were used to assess mother's SOC and children's resilience. Gingival status and dental plaque of children were evaluated through clinical examinations using bleeding on probing index and plaque index. Statistical analysis included Pearson's correlation and hierarchical multinomial ordinal logistic regression analyses. RESULTS The mean frequency of gingival bleeding in the sample was 8.4% (SD: 8.5). Children with higher levels of resilience showed 31% lower odds of gingival bleeding (OR: 0.7; 95% CI: 0.4-0.9) after adjustment for socioeconomic characteristics, children's and mothers' use of dental floss. CONCLUSIONS Children's resilience was a psychosocial factor associated with gingival conditions.
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Affiliation(s)
- Andréa Neiva da Silva
- Department of Health and Society, Institute of Community Health, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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25
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Peeran SW, Kumar NP, Azaruk FAA, Alsaid FM, Abdalla KA, Mugrabi MH, Peeran SA. Association between mental well-being, depression, and periodontal attachment level among young adults of the postwar Sebha city, Libya: A pilot study. J Nat Sci Biol Med 2014; 5:308-12. [PMID: 25097404 PMCID: PMC4121904 DOI: 10.4103/0976-9668.136172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The present study was aimed to investigate the association of mental well-being and depression with periodontal clinical attachment loss among young adults in postwar urban population of Sebha city, Libya. MATERIALS AND METHODS Mental well-being and depression were assessed using Arabic versions of World Health Organization (WHO) five well-being index and major depression inventory (ICD-10), respectively. Random sample of 149 subjects were studied. Degree of periodontal attachment was measured at six sites per tooth using a rigid manual periodontal probe. RESULT AND CONCLUSION A total of 59.11% of the studied samples had healthy mental well-being state, whereas 40.81% had poor mental well-being. The severity of depression was stronger in males than in females. In the present study mental well-being, depression, and all its categories did not have any significant effect on periodontal attachment loss. Further studies and health interventions can be planned based on this data.
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Affiliation(s)
- Syed Wali Peeran
- Department of Periodontology and Oral Implantology, Sebha University, Sebha, Libya
| | - Naveen P.G. Kumar
- Department of Community and Preventive Dentistry, College of Dental Sciences, Davengere, India
| | | | | | - Khaled Awidat Abdalla
- Department of Oral Biology and Orthodontics, Faculty of Dentistry, Sebha University, Sebha, Libya
| | - Marei Hamed Mugrabi
- Department of Periodontics, Faculty of Dentistry, Arab Medical University, Benghazi, Libya
| | - Syed Ali Peeran
- Department of Oral and Maxillofacial Prothodontics, Faculty of Dentistry, Jazan University, KSA
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Abstract
UNLABELLED The relationship of a sound mind to the maintenance of a healthy body has been recognized throughout most of recorded history. The term 'stress' is used to describe adverse emotions or reactions to unpleasant experiences. Individuals with high levels of stress and poor coping skills experience twice as much periodontal disease as compared to those with minimal stress and good coping skills. Although stress may predispose an individual to more destruction from periodontitis, the presence of periodontal pathogens remains the essential aetiologic factor. This review presents a summary of stress, discussing how it can predispose an individual to periodontal disease. CLINICAL RELEVANCE Stress, which is a universal phenomenon, is implicated to have various systemic effects besides being a risk factor for periodontal disease. This article elucidates the relationship between psycho-social stress and destructive periodontal disease.
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Darcey J, Devlin H, Lai D, Walsh T, Southern H, Marjanovic E, Horner K. An observational study to assess the association between osteoporosis and periodontal disease. Br Dent J 2013; 215:617-621. [DOI: 10.1038/sj.bdj.2013.1191] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2013] [Indexed: 11/09/2022]
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The effects of stress hormones on growth of selected periodontitis related bacteria. Anaerobe 2013; 24:49-54. [PMID: 24036419 DOI: 10.1016/j.anaerobe.2013.09.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 08/20/2013] [Accepted: 09/02/2013] [Indexed: 11/22/2022]
Abstract
The focus of this study was to examine in vitro the effects of stress hormones (catecholamines: epinephrine, norepinephrine, dopamine and hydrocortisone: cortisol) on the growth of four anaerobic species of periodontitis-related bacteria (Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia and Tannerella forsythia) and one facultative anaerobic species (Eikenella corrodens). Bacterial growth was determined by two different methods: fluorescence in situ hybridization (FISH), and the viable count by culture method. To simulate stress, each single strain was grown in a special growth medium with three different concentrations of each hormone, using an anaerobic chamber at 37 °C. Growth of F. nucleatum increased in the presence of all stress hormones. Growth of P. gingivalis was not significantly influenced by any hormone. Growth of P. intermedia and E. corrodens was inhibited by almost all stress hormones tested. Both methods of analysis revealed that the highest concentrations of norepinephrine and cortisol increased the growth of T. forsythia. Different hormones have a different effect on the growth of periodontitis-related bacteria in vitro. It appears that bacterial viability is more strongly influenced than is bacterial metabolic activity. The growth of F. nucleatum particularly and partially of T. forsythia is increased by several stress hormones and may have an additional negative impact on periodontal disease.
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29
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Bakri I, Douglas CWI, Rawlinson A. The effects of stress on periodontal treatment: a longitudinal investigation using clinical and biological markers. J Clin Periodontol 2013; 40:955-61. [DOI: 10.1111/jcpe.12142] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Issam Bakri
- Oral and Maxillofacial Medicine and Surgery; Charles Clifford Dental Hospital; Sheffield UK
| | - Charles W. Ian Douglas
- Academic Unit of Oral and Maxillofacial Pathology; University of Sheffield; Sheffield UK
| | - Andrew Rawlinson
- Academic Unit of Restorative Dentistry; University of Sheffield; Sheffield UK
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30
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Darby IB, Ngo L. Minimum intervention dentistry: periodontics and implant dentistry. Aust Dent J 2013; 58 Suppl 1:76-84. [DOI: 10.1111/adj.12053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- IB Darby
- Periodontics; Melbourne Dental School; The University of Melbourne; Victoria
| | - L Ngo
- Periodontics; Melbourne Dental School; The University of Melbourne; Victoria
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31
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Petersen PE, Ogawa H. The global burden of periodontal disease: towards integration with chronic disease prevention and control. Periodontol 2000 2013; 60:15-39. [PMID: 22909104 DOI: 10.1111/j.1600-0757.2011.00425.x] [Citation(s) in RCA: 424] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Chronic diseases are accelerating globally, advancing across all regions and pervading all socioeconomic classes. Unhealthy diet and poor nutrition, physical inactivity, tobacco use, excessive use of alcohol and psychosocial stress are the most important risk factors. Periodontal disease is a component of the global burden of chronic disease, and chronic disease and periodontal disease have the same essential risk factors. In addition, severe periodontal disease is related to poor oral hygiene and to poor general health (e.g. the presence of diabetes mellitus and other systemic diseases). The present report highlights the global burden of periodontal disease: the ultimate burden of periodontal disease (tooth loss), as well as signs of periodontal disease, are described from World Health Organization (WHO) epidemiological data. High prevalence rates of complete tooth loss are found in upper middle-income countries, whereas the tooth-loss rates, at the time of writing, are modest for low-income countries. In high-income countries somewhat lower rates for edentulism are found when compared with upper middle-income countries. Around the world, social inequality in tooth loss is profound within countries. The Community Periodontal Index was introduced by the WHO in 1987 for countries to produce periodontal health profiles and to assist countries in the planning and evaluation of intervention programs. Globally, gingival bleeding is the most prevalent sign of disease, whereas the presence of deep periodontal pockets (≥6 mm) varies from 10% to 15% in adult populations. Intercountry and intracountry variations are found in the prevalence of periodontal disease, and these variations relate to socio-environmental conditions, behavioral risk factors, general health status of people (e.g. diabetes and HIV status) and oral health systems. National public health initiatives for the control and prevention of periodontal disease should include oral health promotion and integrated disease-prevention strategies based on common risk-factor approaches. Capacity building of oral health systems must consider the establishment of a financially fair service in periodontal care. Health systems research is needed for the evaluation of population-oriented oral health programs.
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Mannem S, Chava VK. The effect of stress on periodontitis: A clinicobiochemical study. J Indian Soc Periodontol 2013; 16:365-9. [PMID: 23162330 PMCID: PMC3498705 DOI: 10.4103/0972-124x.100912] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Accepted: 04/11/2012] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Clinical and epidemiological data suggest that negative life experience events, like depression, may contribute to an increased susceptibility to periodontal disease. AIM To study the association between psychological stress and chronic periodontitis. MATERIALS AND METHODS One hundred and eleven dentate individuals, of age 40 years and above, were selected. The clinical examination included, the number of teeth present, plaque index, Probing Pocket Depth, and Clinical Attachment Level. Assessment of Psychological stress levels were done by a questionnaire and were correlated with salivary cortisol levels, which were estimated biochemically by using the Enzyme-Linked Immunosorbent Assay (ELISA) method. RESULTS Statistical analysis was done by using the student 't' test and Mann Whitney test. According to our observation, chronic periodontitis showed a significant correlation with hypercortisolemia (P<0.0001), work tension (P=0.04), economic problems (P<0.0001), clinical stress syndrome (P<0.0001), plaque index (P<0.0001), and unsecured job (P=0.003). CONCLUSION Stress may be considered as an important risk factor for periodontal disease. Routine salivary cortisol assessment may be an economical and useful diagnostic marker to rule out stress in periodontitis patients.
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Affiliation(s)
- Satheesh Mannem
- Department of Periodontics, Narayana Dental College, Nellore, Andhra Pradesh, India
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Preeja C, Ambili R, Nisha KJ, Seba A, Archana V. Unveiling the role of stress in periodontal etiopathogenesis: an evidence-based review. ACTA ACUST UNITED AC 2012; 4:78-83. [PMID: 23073923 DOI: 10.1111/jicd.12000] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Accepted: 07/24/2012] [Indexed: 11/30/2022]
Abstract
Periodontal disease is a multifactorial disease affecting the supporting tissues of the teeth, resulting in progressive attachment loss and bone loss. Periodontal disease is influenced by various systemic, environmental, and psychologic factors that have the potential to alter periodontal tissues and host immune response, resulting in more severe periodontal destruction. Several studies have documented the relationship between psychosocial stress and chronic forms of periodontal disease. Stress impairs periodontal health through changes in behavior and complex interactions among the nervous, endocrine, and immune systems. The influence of stress on periodontal disease is affected by the emotional coping skills of the individual. Psychologic stress and depression may also influence the outcome of periodontal therapy. Stressful life events and coping skills are factors to consider in the risk of periodontal disease destruction and the potential for successful periodontal therapy. Therefore psychosocial stress is considered as an important risk factor for periodontal disease, and emotional stress in periodontitis patients should be diagnosed and treatment should be administered for the proper management and successful outcome of periodontal disease.
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Affiliation(s)
- C Preeja
- Department of Periodontics, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India.
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Baehni PC. Translating science into action - prevention of periodontal disease at patient level. Periodontol 2000 2012; 60:162-72. [DOI: 10.1111/j.1600-0757.2011.00428.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Zini A, Sgan-Cohen HD, Marcenes W. Is religiosity related to periodontal health among the adult Jewish population in Jerusalem? J Periodontal Res 2011; 47:418-25. [DOI: 10.1111/j.1600-0765.2011.01447.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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See you in three months! The rationale for the three monthly peridontal recall interval: a risk based approach. Br Dent J 2011; 211:379-85. [DOI: 10.1038/sj.bdj.2011.868] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2011] [Indexed: 11/08/2022]
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O'Dowd LK, Durham J, McCracken GI, Preshaw PM. Patients' experiences of the impact of periodontal disease. J Clin Periodontol 2010; 37:334-9. [PMID: 20447256 DOI: 10.1111/j.1600-051x.2010.01545.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
AIM To examine critically patients' experiences of the impact of periodontal disease on their daily lives. MATERIAL AND METHODS Semi-structured interviews of a purposive sample of patients with periodontal conditions were conducted using a flexible evolving topic guide. Data collection and analysis were an inductive, iterative process that occurred concurrently. The data were organized in a framework and recurrent themes identified. Interviews occurred until it was felt that no new themes or ideas were being expressed by respondents (n=14). RESULTS Effects of periodontal disease on patients' daily lives included impairment, functional limitation, discomfort and disability (including physical, psychosocial and social disability). A large number of the emergent themes from the analysis were relevant to the domains of Locker's conceptual model of oral health. The domain within Locker's model that had no data relevant to it in the context of periodontal disease was death. Two additional themes emerged that appeared unrelated to Locker's model, these were stigma and retrospective regret. CONCLUSION Periodontal disease reportedly affects patients' lives in a negative manner in a variety of ways. This is of relevance in the management of patients with periodontitis.
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Affiliation(s)
- Louise K O'Dowd
- Restorative Department, Newcastle Dental Hospital, Newcastle Upon Tyne, UK.
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Stabholz A, Soskolne WA, Shapira L. Genetic and environmental risk factors for chronic periodontitis and aggressive periodontitis. Periodontol 2000 2010; 53:138-53. [PMID: 20403110 DOI: 10.1111/j.1600-0757.2010.00340.x] [Citation(s) in RCA: 173] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Chiou LJ, Yang YH, Hung HC, Tsai CC, Shieh TY, Wu YM, Wang WC, Hsu TC. The association of psychosocial factors and smoking with periodontal health in a community population. J Periodontal Res 2010; 45:16-22. [PMID: 19602120 DOI: 10.1111/j.1600-0765.2008.01194.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L-J Chiou
- Department of Health Business Administration, Meiho Institute of Technology, Taiwan
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Fardal Ø, Linden GJ. Tooth loss and implant outcomes in patients refractory to treatment in a periodontal practice. J Clin Periodontol 2008; 35:733-8. [DOI: 10.1111/j.1600-051x.2008.01247.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Peruzzo DC, Benatti BB, Ambrosano GMB, Nogueira-Filho GR, Sallum EA, Casati MZ, Nociti FH. A systematic review of stress and psychological factors as possible risk factors for periodontal disease. J Periodontol 2008; 78:1491-504. [PMID: 17668968 DOI: 10.1902/jop.2007.060371] [Citation(s) in RCA: 165] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Clinical observations and epidemiologic studies suggest that some negative life events and psychological factors may contribute to an increased susceptibility to periodontal disease. The aim of the present study was to systematically review the evidence from case-control studies, cross-sectional studies, and prospective clinical trials reporting on the influence of stress and psychological factors on periodontal disease. The focused question addressed in this systematic review was whether the scientific evidence is enough to consider stress and psychological factors as risk factors for periodontal disease. METHODS A literature search was conducted using two databases (MEDLINE and the Cochrane Oral Health Group specialist trials register) in addition to searching reference lists of original and review articles. The search strategy used was the combination of the terms: "stress," "periodontal disease," and "psychosocial disorders." Studies were selected if they were published in dental journals between January 1, 1990 and April 1, 2006; only human studies and studies with adults and middle-aged subjects were included. Suitable variables included control for the potential effect of confounding factors, adequate criteria to define periodontal disease, adequate criteria for establishing stress, and methodologic quality. Only English-language articles were considered, and unpublished data were not sought. Two reviewers independently extracted information regarding quality and study characteristics in duplicate. The studies were assessed regarding their methodologic characteristics, statistical analysis, characteristics of the periodontal outcome measures, and psychological measurements. RESULTS Of the 58 articles identified in the search, 10 were excluded because they were reviews and 34 did not comply with the selection criteria. Fourteen articles (seven case-control studies, six cross-sectional studies, and one prospective clinical trial) were included in the analysis; their quality and main study characteristics were assessed according to the criteria preestablished in the protocol of the study. With regard to the results of the studies, 57.1% found a positive outcome between psychosocial factors/stress and periodontal disease, 28.5% observed a positive outcome for some characteristics and a negative outcome for others, and 14.2% found a negative outcome. CONCLUSIONS Within the limitations of this systematic review, the majority of studies showed a positive relationship between stress/psychological factors and periodontal disease. However, in the future, well-designed and more representative studies should be considered to confirm these factors as a risk for periodontal disease.
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Affiliation(s)
- Daiane C Peruzzo
- Division of Periodontics, School of Dentistry at Piracicaba, State University of Campinas, Piracicaba, SP, Brazil
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Costa JE, Gomes CC, Cota LOM, Pataro AL, Silva JFC, Gomez RS, Costa FO. Polymorphism in the promoter region of the gene for 5-HTT in individuals with aggressive periodontitis. J Oral Sci 2008; 50:193-8. [DOI: 10.2334/josnusd.50.193] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Cury PR, Araújo VC, Canavez F, Furuse C, Araújo NS. Hydrocortisone Affects the Expression of Matrix Metalloproteinases (MMP-1, -2, -3, -7, and -11) and Tissue Inhibitor of Matrix Metalloproteinases (TIMP-1) in Human Gingival Fibroblasts. J Periodontol 2007; 78:1309-15. [PMID: 17608586 DOI: 10.1902/jop.2007.060225] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND There is a positive correlation between the course of periodontal disease and psychosocial stress status. Stress leads to activation of the hypothalamic-pituitary-adrenal axis, resulting in increased cortisol release. The present study evaluates the effect of two different hydrocortisone concentrations on mRNA expression of matrix metalloproteinases (MMPs) and tissue inhibitor of matrix metalloproteinases (TIMPs) in cultured, human gingival fibroblasts. METHODS Gingival fibroblasts were stimulated with 10(-7) or 10(-9) M hydrocortisone for 24 hours; untreated cells served as controls. Alterations in the expression of MMP-1, -2, -3, -7, -11 and TIMP-1 and -2 were evaluated using real-time polymerase chain reaction and Western blotting. beta-actin mRNA expression was used as a reference to normalize gene expression. RESULTS Although the higher hydrocortisone concentration upregulated MMP-1, -2, -7, -11, and TIMP-1 (P <0.05) expression, the lower concentration induced downregulation or diminished upregulation. The lower hydrocortisone concentration induced a 23-fold increase in MMP-3 gene expression, whereas the higher concentration induced less upregulation; however, protein expression was regulated similarly by both hydrocortisone concentrations. The effect of hydrocortisone on TIMP-2 expression was not significant (P >0.05). CONCLUSIONS Hydrocortisone produced a dose-dependent regulation of MMP and TIMP expression. The higher hydrocortisone concentration significantly upregulated expression of MMP-1, -2, -7, and -11 and TIMP-1 in human gingival fibroblasts, which may constitute a mechanism underlying the increased periodontal breakdown associated with psychosocial stress status.
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Affiliation(s)
- Patricia R Cury
- Department of Oral Pathology, University of São Paulo, School of Dentistry, São Paulo, SP, Brazil.
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Abstract
Social inequalities in health and oral health continue to present a major challenge to public health. Progress towards the development of interventions to reduce health inequalities is currently being hampered by an incomplete understanding of the causes of inequalities in health. This paper aims to provide oral health researchers with an overview of four current explanations for inequalities in oral health and to suggest further areas of research needed to advance our understanding of the causes of social inequalities in oral health.
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Affiliation(s)
- Kelly Lorraine Sisson
- Department of Oral Health Services Research & Dental Public Health, King's College London Dental Institute, King's College London, London, UK.
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Affiliation(s)
- Denis F Kinane
- University of Louisville School of Dentistry, Louisville, KY, USA
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Engström S, Gahnberg L, Högberg H, Svärdsudd K. Association between high blood pressure and deep periodontal pockets: a nested case-referent study. Ups J Med Sci 2007; 112:95-103. [PMID: 17578812 DOI: 10.3109/2000-1967-099] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
A hypertension screening project was performed jointly at a dental clinic and a primary health care centre. In this report the hypothesis that there is an association between high diastolic blood pressure and deep periodontal pockets was tested. A total of 1,239 consecutive patients aged 35-65 years had their blood pressure measured before the dental examination or had a known hypertension. Information on medical history and tobacco use was obtained by interview and dental status was recorded. Fifty-four subjects had known hypertension and 141 had previously unknown diastolic blood pressure >90 mmHg (cases). For each case an age, sex and tobacco-use matched referent was chosen from those with diastolic blood pressure < or =90 mmHg. Significantly more cases than referents had periodontal pockets > or = 5 millimeters deep. In multivariate analyses the prevalence of deep periodontal pockets was associated with blood pressure status also after adjustment for the small differences between the groups in age, sex, tobacco use and number of teeth. In conclusion there was an association between diastolic blood pressure and prevalent deep periodontal pockets. Whether the relationship is a causal one remains to be explored. Screening for high blood pressure at regularly visits at the dental clinic may give the dental care a new important role in the public health field.
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Affiliation(s)
- Sevek Engström
- Public Dental Service, Gävleborg County Council, Sweden.
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Abstract
Periodontitis is a multi-factorial disease and in most cases also a disease with a chronic progression. Exposure to factors which contribute to periodontitis occurs over a long period, so that at the time of diagnosis it may be difficult to identify and evaluate what co-factors have contributed to its development. These include exposure to bacteria and viruses, inflammation, genetic factors, health behaviours and a variety of social factors, socio-economic status, behavioural and nutritional habits, the ability to cope with stress and the ability of the immune system to fight infections. Many patients in their 50s also experience other conditions such as heart disease, diabetes mellitus, or rheumatoid arthritis and recent reports on the associations and potential biological mechanisms by which periodontitis can be linked to other systemic diseases suggest that the patient with periodontitis is a challenged individual. Neither individuals nor their oral health care providers are currently prepared for the challenges in oral health care as the expectation of successful ageing with remaining and aesthetically functional teeth is increasing. The scientific evidence is, however, growing, and while the opportunities to prepare for successful ageing exist they must be included in the educational process of both current and future oral health care providers and their patients.
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Affiliation(s)
- G Rutger Persson
- Department of Periodontology and Fixed Prosthodontics, School of Dental Medicine, Berne, Switzerland.
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Hughes FJ, Syed M, Koshy B, Marinho V, Bostanci N, McKay IJ, Curtis MA, Croucher RE, Marcenes W. Prognostic factors in the treatment of generalized aggressive periodontitis: I. Clinical features and initial outcome. J Clin Periodontol 2006; 33:663-70. [PMID: 16856897 DOI: 10.1111/j.1600-051x.2006.00966.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS The aims of this study were to investigate prognostic factors for initial response to non-surgical periodontal treatment for generalized aggressive periodontitis. METHODS Seventy-nine patients with generalized aggressive periodontitis were included in this prospective follow-up intervention study. Patients' clinical and demographic parameters were collected at baseline and 10 weeks following a standard course of treatment (four visits of non-surgical root surface debridement together with OHI as required). The relationship between clinical variables and treatment outcome were analysed at site-specific level by chi(2) analysis and for patient-specific variables by logistic regression. RESULTS In general, there was a good response to the treatment provided. In deep sites the mean pocket depth reduction was 2.11+/-2.01 mm. Site-specific analysis showed that the presence of plaque had a small but significant predictive effect on outcome (odds ratio 1.4). Sites on teeth with grade II/III mobility showed a significantly reduced response to treatment. Twenty-five patients were classified as "non-responders". Current smoking was strongly associated with non-responding patients (odds ratio 3.8) in a logistic regression model; plaque, baseline bleeding and initial pocket depth were not significantly associated with treatment outcomes. CONCLUSIONS Overall, the results emphasize the importance of smoking as a negative prognostic factor, and suggest that treatment outcomes may be determined by a wide range of different determinants requiring further study.
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Affiliation(s)
- Francis J Hughes
- Collaborative Group in Risk Factors for Periodontal Disease, Institute of Dentistry, Queen Mary's School of Medicine, London, UK.
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Ng SKS, Keung Leung W. A community study on the relationship between stress, coping, affective dispositions and periodontal attachment loss. Community Dent Oral Epidemiol 2006; 34:252-66. [PMID: 16856946 DOI: 10.1111/j.1600-0528.2006.00282.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Psychological factors may increase the risk for periodontal diseases. Contemporary conceptualization of the stress process supports the evaluation of stress at three levels: stressors, moderating and mediating factors, and stress reactions. OBJECTIVE This study was undertaken to investigate the relationship of periodontal disease in terms of clinical attachment level (CAL) to psychosocial stress, making reference to the major components of stress process. METHODS A cross-sectional study of 1000 subjects aged 25-64 years in Hong Kong was conducted. Subjects were asked to complete a set of questionnaires measuring stressors including changes, significant life event and daily strains, stress reactions including physiological and affective responses, and coping and affective dispositions. CAL was assessed. RESULTS Individuals with high mean CAL values had higher scores on the job and financial strain scales than periodontally healthy individuals (P < 0.05), after adjusting for age, gender, cigarette smoking and systemic disease. Depression, anxiety trait, depression trait, problem-focused coping, and emotion-focused coping were also related to CAL. Logistic regression analysis indicated that all these factors were significant risk indicators for periodontal attachment loss, except problem-focused coping, which reduced the odds of CAL. Individuals who were high emotion-focused copers, low problem-focused copers, trait anxious, or trait depressive had a higher odds of more severe CAL. CONCLUSION Chronic job and financial strains, depression, inadequate coping, and maladaptive trait dispositions are significant risk indicators for periodontal attachment loss. Adequate coping and adaptive trait dispositions, evidenced as high problem-focused coping and low anxiety/depression trait, may reduce the stress-associated odds.
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Affiliation(s)
- Sam K S Ng
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
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