Association between serum calcium and periodontal disease progression in non-institutionalized elderly

The association of healthy eating index with periodontitis in NHANES 2013-2014

Background

Periodontal disease is very common worldwide and is one of the main causes of tooth loss in adults. Periodontal disease is characterized by chronic inflammation that can destroy adjacent alveolar bone and lead to a loss of periodontal ligaments. Although previous studies have found that a daily diet can influence the development of periodontal disease (e.g., a diet low in carbohydrates and rich in vitamins C and D and fiber can have a protective effect). Periodontal disease may present as gingivitis or periodontitis. However, studies on the role of healthy eating index in periodontitis are lacking. The purpose of this study was to assess the association between healthy eating index and periodontitis.

Methods

We analyzed data collected from participants in the National Health and Nutrition Examination Survey (NHANES), a nationally representative survey conducted in 2-year cycles from 2013 to 2014. As part of our analysis, we developed multivariate logistic regression models to examine the independent association between the healthy eating index and periodontitis. We evaluated the significance of association using odds ratios (OR) with 95% confidence intervals (95%CI).

Results

Individuals with a lower total healthy eating index had a higher prevalence of periodontitis. Adjusted multivariate regression models showed that a higher healthy diet index was associated with a lower prevalence of periodontitis (OR = 0.69, 95% CI: 0.55-0.86, P < 0.05).

Conclusion

The results of the study showed that dietary structure was associated with the prevalence of periodontitis. Patients with a higher healthy eating index had a lower prevalence of periodontitis. These findings will need to be confirmed by longitudinal, prospective studies in the future.

Calcium and Vitamin D Supplementation as Non-Surgical Treatment for Periodontal Disease with a Focus on Female Patients: Literature Review

Periodontal disease is a complex disease that involves an imbalance between the oral microbiota and an individual's inflammatory response. Moreover, the inflammatory response contributes to further imbalance; if left untreated, periodontal disease may result in tooth loss. Vitamin D is intricately involved in the regulation of calcium-phosphate homeostasis and bone mineral metabolism; considering that periodontal surgery usually includes regenerative therapy, adequate vitamin D and calcium levels are essential. The benefits of vitamin D and calcium supplementation have been demonstrated in situations where deficiency is associated with adverse outcomes, such as periodontal disease and maternal health. However, knowledge and attitudes about supplementation, as well as the actual levels of supplementation, vary greatly in the general population; they also differ between men and women. The aim of this review is to discuss how vitamin D and calcium supplementation affect oral and periodontal health, especially in women. Additionally, this review provides suggestions for public health strategies regarding vitamin D and calcium supplementation, as well as the effects of both types of supplementation on maternal oral health.

Serum Alkaline Phosphatase and Calcium in Relation to Periodontal Status among Perimenopausal and Postmenopausal Women

Background:

Menopause is a physiological phenomenon that occurs in aging women. Periodontal disease is associated with menopausal status. Alkaline phosphatase (ALP) plays a role in general and periodontal bone turnover. Calcium is essential for the maintenance of bone and teeth, and serum ALP and calcium are specific bone markers related to the acceleration of bone mass loss in elderly women and periodontitis.

Objectives:

The aim of this study was to correlate the levels of serum ALP and calcium with periodontal status in perimenopausal and postmenopausal women with periodontitis.

Methods:

A total of 22 perimenopausal and 49 postmenopausal women underwent a full periodontal examination assessing the pocket depth, number of teeth lost, clinical attachment loss, plaque index, calculus index, and papillary bleeding index. Using these measurements, the subjects were divided according to periodontal severity. Serum ALP and calcium were measured using the Enzyme-Linked Immunosorbent Assay (ELISA) method. A correlation between serum ALP and calcium to periodontal status was investigated.

Results:

Serum ALP was significantly correlated with the severity of periodontitis, clinical attachment loss, and the number of teeth lost among perimenopausal and postmenopausal women (p < 0.05). Serum calcium levels were not correlated with periodontal status.

Conclusion:

Postmenopausal women tended to have more periodontal breakdown, and the level of serum ALP was increased in severe periodontitis.

The evaluation of the effect of hypercalcemia in oral pathologies

OBJECTIVE

Hypercalcemia is determined as an increase in the serum calcium level (above 10.5 mg/dL or ionized calcium is above 1.5 mmol/L). It was aimed to evaluate the effect of the increased serum calcium levels in dental panoramic radiographs with oral pathologies.

MATERIALS & METHODS

The final sample number of the present study was determined as 143. 61 patients with hypercalcemic calcium levels were grouped in Hypercalcemia Group (HPEG) whereas 82 patients were grouped in Normal Group. (NG) Measurements were performed only on the panoramic radiographs. The evaluated parameters were cyst-tumor or granuloma existence, sinus pneumatization, stylohyoid ligament calcifications, lamina dura loss, bone loss existence, etc. Statistical tests were carried out at p < 0.05 significance level.

RESULTS

The cyst-tumor formation (p = 0.03) and stylohyoid ligament calcification (p = 0.009) and increased radiopacity (p = 0.03) were significantly more common in NG than the HPEG group. Alveolar bone loss (p = 0.001) and periodontal defects (p = 0.01) were significantly more common in HPEG than the NG group. There was no significant relationship between other examined parameters. (p > 0.05) CONCLUSION: The serum calcium level revealed statistically significant outcomes and a close relationship with the pathologies occurring in the alveolar bone in the oral and maxillofacial region. However, it is highly recommended to include more patients in the newly planned studies and another bone-related biomarker should be evaluated simultaneously.

Effect of micronutrient malnutrition on periodontal disease and periodontal therapy

Periodontitis is a complex chronic inflammatory noncommunicable disease, initiated by the development of a dysbiotic microbial plaque biofilm below the gingival margin. Whilst the pathogenic biofilm is a "necessary cause" of periodontitis, it is insufficient on its own to cause the disease, and a destructive immune-inflammatory response is a key to the translation of risk to destructive events. Other exposures or "component causes" include individual genetic predisposition, lifestyle (including smoking and nutrition), and environmental factors. Dietary nutrients are essential for life as they provide crucial energy sources in the form of macronutrients, as well as important cofactors in the form of micronutrients, which regulate the functionality of enzymes during the regulation of anabolic and catabolic processes in human cells. Moreover, micronutrients can regulate gene transcription factors, such as the proinflammatory nuclear factor kappa B and the anti-inflammatory nuclear factor (erythroid-derived 2)-like 2. This review focuses on the role of vitamins (vitamin A, carotenoids, the vitamin B complex, vitamins C, D, and E, and coenzyme Q10) and minerals (calcium, magnesium, iron, zinc, potassium, copper, manganese, and selenium) in human physiology and the impact of their deficiencies upon periodontal health and disease.

Patients with chronic periodontitis are more likely to develop upper urinary tract stone: a nation-wide population-based eight-year follow up study

Background

The purpose of this study was to investigate the relationship between chronic periodontitis (CP) and upper urinary tract stone (UUTS) in Taiwan by using a population-based data set.

Methods

A total of 16,292 CP patients and 48,876 randomly-selected controls without chronic periodontitis were selected from the National research database and studied retrospectively. Subjects selected have not been diagnosed with UUTS previously. These subjects were prospectively followed for at least eight years. Cox regression models were used to explore the connection between risk factors and the development of UUTS.

Results

The CP patients have a greater chance of developing UUTS compared to controls (1761/16292, 10.8% vs. 4775/48876, 9.8%, p-values < 0.001). Conditioned logistic regression suggested CP increases the risk of UUTS development (HR 1.14, 95% CI [1.08–1.20], p < 0.001). After respective adjustment for age, gender, hypertension and diabetes, results showed that CP still increases the risk of developing UUTS (HR 1.14, 95% CI [1.08–1.20], p < 0.001).

Conclusion

By using a population-based database with a minimum eight 8 follow-up of CP in Taiwan, we discovered patients with CP are more likely to develop UUTS.

A Systematic Review on the Implication of Minerals in the Onset, Severity and Treatment of Periodontal Disease

Periodontal disease is an inflammatory disease with high prevalence in adults that leads to destruction of the teeth-supporting tissues. Periodontal therapy has been traditionally directed at reduction of the bacterial load to a level that encourages health-promoting bacteria and maintenance of oral-hygiene. The role of nutrition in different chronic inflammatory diseases has been the subject of an increasing body of research in the last decades. In this sense, there has been an important increase in the volume of research on role of nutrition in periodontitis since the diet has known effects on the immune system and inflammatory cascades. Minerals play a key role in all these processes due to the multiple pathways where they participate. To clarify the role of the different minerals in the establishment, progression and/or treatment of this pathology, a systemically review of published literature cited in PubMed until May 2016 was conducted, which included research on the relationship of these elements with the onset and progression of periodontal disease. Among all the minerals, calcium dietary intake seems important to maintain alveolar bone. Likewise, dietary proportions of minerals that may influence its metabolism also can be relevant. Lastly, some observations suggest that all those minerals with roles in immune and/or antioxidant systems should be considered in future research.

Magnesium/Calcium Ratio in Serum Predicts Periodontitis and Tooth Loss in a 5-Year Follow-up

In the cross-sectional Study of Health in Pomerania (SHIP-0), subjects with an adequate magnesium supply had a lower risk of periodontal disease and more teeth than those with low magnesium levels. The authors analyzed 5-y follow-up data (SHIP-1) to determine whether the baseline magnesium levels had a long-term effect on attachment level and number of teeth lost. Of the participants examined dentally in the baseline study, 3,300 (75%) were examined for progression or recession of periodontal attachment level after 5 y. For 2,432 subjects, the authors related the outcome variables of periodontal attachment level and tooth loss to baseline characteristics, especially serum magnesium and calcium concentrations, as well as systemic markers of inflammation. The progression of periodontitis was associated with the magnesium/calcium (Mg/Ca) ratio at baseline in a dose-dependent manner. Progression of mean attachment loss was prevented in the upper quartile of the Mg/Ca ratio ( P < 0.001) with antagonistic effects of magnesium and calcium irrespective of inflammatory state. With respect to tooth loss, Mg/Ca exerted dimorphic effects. In inflammatory states as indicated by high C-reactive protein (>3 mg/L), tooth loss was prevented in subjects with high Mg/Ca ratio (incidence rate ratio = 0.60, 95% confidence interval: 0.45 to 0.80, P = 0.001), but the contrary was observed in subjects with low C-reactive protein levels (incidence rate ratio = 1.14, 95% confidence interval: 0.97 to 1.34, NS). Similar results were observed with stratifying the regression on tooth loss by interleukin 6 or fibrinogen threshold. An adequate magnesium serum level and Mg/Ca balance may prevent progression of attachment level and tooth loss, especially in inflammatory states. Knowledge Transfer Statement: The results of this study present evidence that an adequate magnesium supply may be important in the prevention of periodontal diseases and future tooth loss. A diet high in magnesium could improve periodontal health, notwithstanding its beneficial effects on systemic disease. In populations with a high prevalence of hypomagnesemia, additional intake of supplements is advisable.

The patients knowledge about the role of calcium in the primary prevention of colorectal cancer

AIM OF THE STUDY

The objective of this research was to become aquainted with patients' knowledge of the calcium role in the primary prevention of colorectal cancer.

MATERIAL AND METHODS

A group of 400 patients treated in Nikolay Pirogov Provincial Specialist Hospital in Łódź was interviewed by means of the author's own survey in which specific tools were used to become aquainted with patients' knowledge of the calcium role in the primary prevention of colorectal cancer. The necessary statistics were conducted by means of STATISTICA 7.1 and EXCEL 2008 programmes.

RESULTS

The analysis of the results shows that 363 (90.7%) of respondents did not know about the protective role of calcium in the digestive tract and reduce the risk of colorectal cancer. The study shows that 396 (99.0%) of respondents were not informed by doctors about the protective effect of calcium in the digestive tract. In this survey 357 (89.25%) of respondents did not know what is the recommended daily intake of calcium in the diet.

CONCLUSIONS

The results of the study shows that patients do not know about the role of calcium in primary prevention of colorectal cancer and were not informed by their doctors about such action of calcium. Patients were not aware of the need to consume the Recommended Dietary Allowance of calcium in the diet, which shows little knowledge of the subjects on the diet. It seems necessary to change the eating habits of patients, while the introduction of nutrition education from an early age in the society. Such actions may prevent in the future many civilization diseases.

Host-derived diagnostic markers related to soft tissue destruction and bone degradation in periodontitis

BACKGROUND

A major challenge in clinical periodontics is to find a reliable molecular marker of periodontal tissue destruction with high sensitivity, specificity and utility.

OBJECTIVES

The aim of this systematic review is to evaluate available literature on 'the utility of molecular markers of soft and hard periodontal tissue destruction'.

MATERIALS AND METHODS

Based on the focused question, 'What is the utility of molecular markers of soft and hard periodontal tissue destruction', an electronic and manual search was conducted for human studies presenting clinical data for the potential of molecular markers of tissue destruction in biofluids; gingival crevicular fluid (GCF), saliva, and serum.

RESULTS

Papers fulfilling the inclusion criteria were selected. All relevant data from the selected papers were extracted and recorded in separate tables for molecules in GCF, saliva, and serum.

CONCLUSION

Within the defined limits of the Problem/Population, Intervention, Comparison, Outcome, the present analysis reveals that (a) no single or combination of markers exists that can disclose periodontal tissue destruction adequately; (b) while the most fruitful source of biomarkers for periodontal destruction appears to be in molecules tightly related to bone and soft tissue destruction, this remains to be objectively demonstrated. Currently, clinical measurements are still the most reliable.

Low calcium intake is related to increased risk of tooth loss in men

Our aim was to investigate the association between calcium (Ca) intake and number of teeth and tooth loss. The Danish Monica (Monitoring Trends and Determinants in Cardiovascular Disease) study is a prospective observational study from 1982-83 to 1993-94. The study population included 1602 adults (30-60 y) with information on dietary Ca intake and number of teeth and a subset of 511 participants with information on tooth loss from 1987-88 to 1993-94. Ca intake less than the recommendations, estimated by a 7-d food record or a diet history interview in 1982-83, was more frequent among females (55%) than males (45%; P < 0.001). Low Ca intake was associated with low number of teeth (1-25 vs. 26-32 teeth) in males [odds ratio (OR) = 1.57 (95% CI = 1.10-2.29)] and females [OR = 1.44 (95% CI = 1.10-2.05)] after adjustment for age, education, smoking, alcohol and sucrose consumption, subjective oral dryness, and time since last dental care visit. The reference group (26-32 teeth) and edentulous participants did not significantly differ. A Ca intake below recommendations was significantly associated with increased risk of subsequent tooth loss in males [incidence-rate ratio = 1.70 (95% CI = 1.15-2.48)]. There was no association in women. Ca intake below recommendations was significantly associated with fewer teeth in both sexes. However, there was a significant, negative association between Ca intake below recommendations and tooth loss in males only. Given the high percentage of individuals with Ca intake below recommendations, consumption of foods rich in Ca should be promoted to preserve oral health.

Predictors and correlates of edentulism in healthy older people

PURPOSE OF REVIEW

To review peer-reviewed, original research studies published in 2008-2009 that present data relating to the predictors and correlates of edentulism and tooth loss in older adults.

RECENT FINDINGS

Edentulism rates vary markedly between countries and between urban and rural settings within countries. Rates are generally falling over time, but this reduction largely reflects a cohort effect on tooth loss in childhood and young adulthood. Socioeconomic factors, along with accompanying lifestyles and health behaviours remain strong predictors of edentulism, many of these factors relate to peak prior intelligence. Immunological mechanisms of tooth loss are becoming elucidated. Edentulism, itself, predicts mortality and correlates with a wide range of health outcomes, but these, in turn, also correlate with predictors of tooth loss such as peak prior intelligence. Edentulism correlates separately from these lifelong traits with measures of self-esteem and quality of life.

SUMMARY

Edentulism is important as a correlate of self-esteem and quality of life in older adults. It is also a useful marker of socioeconomic status earlier in life.