Impact of periodontal disease on quality of life: a systematic review

Association Between Serum Albumin and Periodontitis Across Disease Subgroups: A Cross-Sectional Study

PURPOSE

This study examines the association between serum albumin (sALB) levels and periodontitis severity, focusing on subgroup differences and nonlinear relationships. It extends previous findings, which were limited to chronic kidney disease (CKD) patients.

MATERIALS AND METHODS

This cross-sectional study utilized data from 8352 participants in the NHANES 2009 to 2014 survey cycles. sALB and periodontitis were the exposure and outcome variables. Logistic regression models and restricted cubic spline curves were used to investigate the relationship between the two. Additionally, subgroup and interaction analyses were conducted to assess the stability of the findings. All statistical analyses considered the complex survey design.

RESULTS

A significant negative association was observed between sALB and periodontitis status (aOR 0.94, 95% confidence intervals: 0.93-0.96, P value <.001). The strength of this association may be influenced by participants' gender, CKD status, and hypertension status. Among participants with sALB levels below 35 g/L (defined as hypoalbuminemia), no significant association with periodontitis was observed, even in those with CKD. Restricted cubic spline analysis demonstrated an inverted U-shaped relationship between sALB levels and periodontitis, with a threshold effect at 38 g/L. Above this inflection point, higher sALB levels were significantly associated with a lower prevalence of periodontitis (P < .001).

CONCLUSIONS

ALB levels were inversely associated with moderate and severe periodontitis, with an inverted U-shaped relationship observed in this study. The differences among subgroups warrant further research.

CLINICAL RELEVANCE

Maintaining appropriate sALB levels may be beneficial for periodontal health. Further research is needed to confirm its role in periodontitis prevention and treatment.

Disparities in periodontitis risk and healthcare use among individuals with disabilities in Korea: a retrospective cohort study

BACKGROUND

We analyzed the relationship between disability status and periodontal disease, focusing on disparities in healthcare utilisation, including outpatient visits and hospitalisation rates, among disability types and severities.

METHODS

This study used data from the National Health Insurance Service(NHIS) of Korea, which includes comprehensive records of the insured population. We examined 966,200 individuals with disabilities, grouped into five categories, and applied propensity score matching to compare with a matched control population. Periodontal disease was defined by the Korean Classification of Diseases criteria, and we used chi-square tests, t-tests, multivariate logistic regression, and negative binomial regression.

RESULTS

Individuals with disabilities had higher odds of hospitalisation for periodontitis (OR: 3.83, 95% CI = 3.59-4.08) but lower odds for outpatient visits (OR: 0.68, 95% CI = 0.68-0.69) and dental treatments (OR: 0.73, 95% CI = 0.72-0.73) compared to those without disabilities. The highest hospitalisation rates were among those with mental health disabilities (OR: 13.70, 95% CI = 12.26-15.30). Severe disabilities were associated with increased hospitalisation rates (OR: 7.14, 95% CI = 6.66-7.66) and fewer outpatient visits and treatments.

CONCLUSION

Individuals with mental health disabilities or severe disabilities experience greater risks of hospitalisation for periodontitis and attend fewer outpatient visits and treatments. Targeted interventions are needed to improve dental care access and reduce disparities.

A systematic review of the patient reported outcome measures used to assess the impact of periodontitis and peri-implantitis on oral health related quality of life

INTRODUCTION

Periodontal disease (PD) and peri-implantitis (PI) can have a significant impact on oral health related quality of life. It is important that any patient reported outcome measures accurately reflect this impact.

AIMS

To identify the measures used to assess the impact of periodontal disease and peri-implantitis on oral health related quality of life. To assess the psychometric properties of the measures identified by applying an adapted version of the Consensus-based standards for the selection of health measurement instruments (COSMIN) checklist.

MATERIALS AND METHODS

A search of the literature incorporated relevant MeSH terms across four separate databases: Scopus, Web of Science, Medline and Embase. Following the removal of duplicates, studies meeting the inclusion criteria were screened. Any condition specific measure or a measure appearing greater than five times was analysed in accordance with the COSMIN criteria.

RESULTS

A total of 2103 articles were identified, of which 140 proceeded to full text review. A total of eight different OHRQoL measures were identified and psychometrically analysed.

DISCUSSION

The majority of measures used to assess the impact of PD and PI were not validated on local populations and were non-specific, generated by clinicians and researchers. The three condition specific measures were adaptations of the Oral Health Impact Profile, a non-specific patient reported outcome measure which may not accurately reflect the specific signs, symptoms and overall impact of PD/PI on an individual's OHRQoL.

CONCLUSION

There is a necessity for a condition-specific instrument to be developed to ensure that the impact of periodontal disease and peri-implantitis on OHRQoL is captured accurately.

HLA Polymorphisms Linked to the Severity and Extent of Periodontitis in Patients with Type 1 Diabetes from a Brazilian Mixed Population

This study aimed to investigate the relationship between Class II human leukocyte antigen (HLA) alleles (DRB1, DQA1, and DQB1) and the severity and extent of periodontitis in patients with Type 1 diabetes (T1D). A cross-sectional study was conducted with 49 patients with T1D. Demographic data and diabetes history were collected. A clinical examination was performed to assess periodontal variables. The patients were categorized by the periodontitis severity and the extent of periodontitis. Peripheral blood samples were analyzed to identify the percentage of autosomal ancestry (Native American, European, and African) and the HLA-DRB1*, HLA-DQA1*, and HLA-DQB1* alleles. The DRB1*03 and DRB1*15 haplogroups were significantly associated with an increased risk of generalized periodontitis (OR = 19.8, 95% CI = 1.14-346, p = 0.003; OR = 41.2, 95% CI = 1.85-917, p < 0.001) and severe periodontitis (OR = 7.7, 95% CI = 1.68-35.5, p = 0.003; OR = 21.2, 95% CI = 0.97-461, p = 0.005). No associations were observed between the HLA-DQA1 and HLA-DQB1 alleles and periodontitis. These findings suggest that patients with T1D from a highly mixed Brazilian population carrying the DRB1*03 and DRB1*15 haplogroups are at higher risk for developing more severe and generalized forms of periodontitis.

Metabolomic Profiles of Oral Rinse Samples to Distinguish Severe Periodontitis Patients From Non-Periodontitis Controls

AIMS

To explore the potential of metabolomic profiles of oral rinse samples to distinguish between patients with severe periodontitis (stage III/IV) and non-periodontitis controls. This is coupled to an analysis of differences in metabolomic profiles between individuals without periodontitis, patients with localized periodontitis, and patients with generalized periodontitis.

METHODS

Periodontitis patients and controls were recruited, all aged ≥ 40 years. Study participants were asked to rinse vigorously for 30 s with 10 mL phosphate buffered saline. Metabolites were identified using a semi-targeted liquid chromatography tandem mass spectrometry (LC-MS/MS) platform.

RESULTS

In total, 38 periodontitis patients (18 localized, 20 generalized stage III/IV periodontitis patients) and 16 controls were included. Metabolomic profiles of oral rinse samples were able to distinguish patients with severe periodontitis (stage III/IV) from non-periodontitis controls. Among various variables for the severity of periodontitis, we found that the number of sites with deep pockets (PPD) ≥ 6 mm explained best the differences in metabolomic profiles between controls and patients with severe periodontitis. Subjects with a high number of sites with PPD ≥ 6 mm were characterized by a higher level of phosphorylated nucleotides, amino acids, peptides, and dicarboxylic acids. Metabolomic profiles were also significantly different between controls vs. generalized periodontitis and between localized periodontitis vs. generalized periodontitis (p < 0.05).

CONCLUSION

Our study demonstrates that simply collected oral rinse samples are suitable for LC-MS/MS based metabolomic analysis. We show that a metabolomic profile with a substantial number of metabolites can distinguish severe periodontitis patients from non-periodontitis controls. These observations can be a basis for further studies into screening to identify subjects with the risk of having severe periodontitis.

Periodontitis and Oral Health-Related Quality of Life: A Systematic Review and Meta-Analysis

AIM

To investigate the association between periodontitis and oral health-related quality of life (OHRQoL) in adults, and to compare OHRQoL across different severities of the disease.

MATERIALS AND METHODS

Searches were conducted in five electronic databases up to December 2023. Observational studies that provided a clear definition of periodontitis and used validated measures of OHRQoL were included. Meta-analyses were performed both overall and based on factors that could explain heterogeneity between studies.

RESULTS

Sixty studies comprising 14,851 individuals were included in the review. Meta-analyses showed that periodontitis was associated with impaired OHRQoL: any OHRQoL instruments (n = 33 studies; SMD: 0.75, 95% CI: 0.53-0.93), solely using the OHIP-14 (n = 26 studies; MD: 5.14, 95% CI: 3.64-6.64), and risk assessment (n = 9 studies; adjusted RR: 1.42, 95% CI: 1.12-1.78). Stages III-IV periodontitis had a greater impact than Stages I-II periodontitis. Subgroup and meta-regression analyses indicated smaller effect size estimates for individuals with comorbidities.

CONCLUSIONS

Periodontitis negatively impacts OHRQoL, with a positive score-response relationship found between periodontitis severity and poorer OHRQoL. However, the magnitude of this association appears to be diminished in individuals with comorbidities.

Translation, cross-cultural adaptation, reliability, and validity assessment of a Turkish version of the oral and systemic health impact profile for periodontal disease (OSHIP-Perio)

The development of the Oral Health Impact Profile-49 (OHIP-49) and its shorter version, OHIP-14, has been criticized for not adequately considering the influence of systemic health on Periodontal health. The lack of a Periodontal status domain in OHIP scales has led to the proposal of the development of a new profile, Oral and Systemic Health Impact Profile (OSHIP-Perio). The newly developed profile has not undergone translation into other languages, cross-cultural adaptation, or validation and reliability testing. The primary objective of this study was to conduct a cross-cultural adaptation, validation, and reliability assessment of the Turkish translation of OSHIP-Perio for the first time. The data set comprises of responses from 354 individuals who participated in a face-to-face survey involving a series of fourteen inquiries related to the influence of Periodontal diseases on their general quality of life. The survey employed the OHIP-14-TR gold standard questionnaire, which has undergone prior validation and reliability testing in cross-cultural adaptation studies. Confirmatory factor analysis was employed to evaluate the construct validity. Test-retest reliability was evaluated using the Spearman-Brown and Gutmann test. Cronbach's alpha was used to assess the internal consistency. The concurrent validity was assessed using Spearman's correlation coefficient. The confirmatory factor analysis revealed that the scale is characterized by a single factor. The Spearman's correlation coefficient results were found to be 0.922 for concurrent validity. The internal consistency analysis yielded a Cronbach's alpha value of 0.944 for the scale. The Spearman-Brown and Guttmann methods yielded coefficients of 0.972 value for test-retest reliability. No floor or ceiling effects were found to be present. The Turkish version of the OSHIP-Perio questionnaire has been found to be valid and reliable. The OSHIP-Perio-TR can be used to assess the relationship between general well-being, its influence on Periodontal health, and the perception of illness in individuals with Periodontal diseases.

Oral health status, behavior and impact profile among naval personnel in the Malaysian naval armed forces

BACKGROUND

The oral health of military personnel is critical in ensuring their operational readiness and overall health. This cross-sectional study aimed to assess the oral health parameters, behaviours and impact profile among naval personnel stationed at a Malaysian naval base.

METHODS

Participants first underwent oral health examinations to evaluate their plaque scores, bleeding scores, Community Periodontal Index of Treatment Needs (CPITN), and Decayed, Missing, and Filled Teeth (DMFT) index. Additionally, the oral health behaviours and oral health impact profiles of the participants were assessed through a structured questionnaire.

RESULTS

A total of 176 naval personnel participated in the study. Overall, the findings indicate high levels of plaque (30.7%) and bleeding scores (39.6%) while the CPITN results showed a significant proportion of participants (52.1%) requiring advanced periodontal treatment (CPITN 3 or 4). The DMFT index highlighted a substantial burden of dental caries with a mean score of 4.59 ± 4.24, including untreated decay (1.15 ± 1.63). The assessment of oral health-related quality of life using the OHIP-14 revealed low scores among some participants, with a mean of 13.47 and a maximum score of 42. Additionally, oral health behaviours were generally inadequate, with 12% of participants reporting infrequent brushing and 68.2% indicating limited use of interdental aids.

CONCLUSIONS

Oral diseases were highly prevalent among the selected population, with notable deficiencies in oral health behaviours such as toothbrushing frequency, the use of interdental cleaning aids, and tongue cleaning. Oral health issues also significantly impacted daily life, as evidenced by the OHIP-14 scores. These findings highlight the need for tailored oral health interventions within the naval setting to enhance deployment readiness, improve oral health outcomes, and elevate the quality of life for naval personnel.

CLINICAL TRIAL NUMBER

Not applicable.

What is the most effective method for reducing pain during debonding procedures? A systematic review

OBJECTIVE

This study aimed to investigate the most effective methods in controlling pain during debonding procedures.

MATERIAL AND METHODS

Electronic searches in published and unpublished studies were performed. Restricted to the English language and publication date up to 23/3/2024, the searches in published literature covered the following databases: MEDLINE, PubMed, EMBASE, Tripe, Web of Science, Scopus and PubMed Central. However, unpublished literature was searched at ClinicalTrials.gov, National Research Register, and ProQuest Dissertations and Theses. Lists of all eligible studies were checked for further scrutiny. Risk of bias for randomized and non-randomized control trials was assessed using ROB2 and ROBINS Cochrane tools.

RESULTS

Thirteen RCTs and two non-RCTs were included. All the reviewed articles studied the pain during debonding events and included 886 patients aged between 12-65. They used different scales such as VAS, NRS, Wong-Baker faces, and others scales. Two studies have shown that the lift-off plier causes less pain than other pliers when comparing different types of dental instruments. However, when comparing different adjunctive techniques, two studies have found that using a wafer causes less pain, while two studies have reported no significant difference between methods and one study has found that using finger pressure causes less pain. In addition, three separate studies have found that utilizing an ultrasonic device, as well as a thermal device and laser radiation, can lead to lower pain scores. Furthermore, two studies have demonstrated that using medication has a positive impact on reducing pain.

CONCLUSIONS

According to reported evidence, applying finger pressure is more effective in relieving pain in the anterior teeth, while wafer biting is more effective in the posterior teeth. Pain-relieving medications like paracetamol or ibuprofen can also effectively reduce debonding pain. Promising procedures, such as using diode or Er-YAG lasers, and thermal devices, may also be effective, but further studies are needed to confirm their efficacy. The protocol of this systematic review was registered with the PROSPERO International Database under ID number CRD42024529190. This review follows the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the instructions provided in the Cochrane Handbook.

Brazilian version of the OHIP 14 Periodontal Disease Questionnaire: cross cultural adaptation and validation

Although it is recognized that periodontal disease negatively impacts quality of life, there is no validated instrument to assess this impact in Brazil. This study aimed to translate, cross-culturally adapt, and validate the OHIP 14 PD (Oral Health Impact Profile Applied to Periodontal Diseases) for application among Brazilian patients. The original instrument was translated and validated into Brazilian Portuguese in a cross-sectional study with 110 participants recruited from a Dental School clinic. The sample was divided into two groups: 55 with periodontal disease and 55 without periodontal disease. The instrument was self-administered twice within an interval of 7 to 10 days for patients with periodontal disease. The psychometric properties of the Brazilian version were verified using internal consistency (Cronbach's α) and the reliability through the test-retest method (ICC, intraclass correlation coefficient), convergent validity (Spearman correlation), and discriminant validity (Mann-Whitney test), with p <0.05. Most of the sample consisted of women (n=69; ±40.65 years). The OHIP 14 DP - Br showed excellent internal consistency (α=0.997) and outstanding reliability using the test-retest method (ICC=0.945, p<0.001). There was a significant correlation between the scores obtained in all seven domains between this questionnaire and self-perceived gingival health (p=0.023). This study provides psychometric evidence supporting the cross-cultural validity of the OHIP 14 DP - Br version for use in Brazil.

Backpack-carrying macrophage immunotherapy for periodontitis

Cell immunotherapy is a promising therapeutic modality to combat unmet medical needs. Macrophages offer a prominent cell therapy modality since their phenotypic plasticity allows them to perform a variety of roles including defending against pathogens, inducing/suppressing adaptive immunity, and aiding in wound healing. At the same time, this plasticity is a major hurdle in implementation of macrophage therapy. This hurdle can be overcome by cellular backpacks (BPs), discoidal particles that adhere on the macrophage surface and regulate M1/M2 phenotypic shift in an environment-independent manner. In this study, we engineered IL-4 BPs for maintaining macrophages in the M2 phenotype to regulate excess inflammation in periodontitis, a major oral infectious disease. IL-4 BPs induced and maintained M2 phenotype in macrophages in vitro for several days. After injection of macrophages carrying IL-4 BPs into the gingiva, the cells stayed in the tissue for over 5 days and maintained the M2 phenotype in the disease sites. Furthermore, treatment with IL-4 BP-macrophages significantly suppressed the disease progression. Altogether, a treatment with BP-carrying macrophages offers a promising local therapy against periodontitis.

[Prevalence of periodontal disease among adolescents in the Nenets autonomous area]

OBJECTIVE

To study the prevalence of periodontal disease (PD) among adolescents in the Nenets autonomous area (NAO).

MATERIALS AND METHODS

A total of 250 adolescents aged 15-17 years participated in a cross-sectional study as a part of State Assignment No. 056-00121-18-00 in the NAO. Periodontal status was assessed using a periodontal button probe. Results were presented as proportions for the prevalence and as arithmetic means for the number of affected sextants with 95% confidence intervals (CI). Categorical data were analyzed using chi-square tests, and discrete data were analyzed using Poisson regression. Risk ratios (RR) with CIs were calculated using robust standard errors to account for overdispersion.

RESULTS

The prevalence of PD was 38.8% (95% CI: 33.0-45.0). The prevalence of bleeding and calculus was 19.2% (95% CI: 14.8-24.5) and 28.4% (95% CI: 23.2-34.3), respectively. The mean number of sextants was 0.91 (95% CI: 0.73-1.10), while the mean number of sextants with bleeding was 0.37 (95% CI: 0.25-0.49), and with calculus was 0.57 (95% CI: 0.42-0.71) Girls had fewer affected sextants (RR=0.61 (95% CI: 0.41-0.91)). The number of affected sextants among the Nenets was twice as high compared to the Russians (RR=2.07 (95% CI: 1.14-3.76)). Urban residents had fewer affected sextants than rural residents (RR=0.38 (95% CI: 0.18-0.80)). Seventeen-year-olds had twice as many affected sextants as the 15-year-olds (RR=1.94 (95% CI: 1.09-3.46)).

CONCLUSION

The results of the study can be used to develop effective dental preventive programs considering the socio-demographic characteristics of adolescents in the NAO.

Patient-related factors that link chronic kidney disease and periodontitis: a scoping review

Several studies have proposed the existence of an association between periodontitis and chronic kidney disease (CKD) based on biological premises. There is growing evidence that chronic inflammation caused by periodontitis may contribute to the progression of CKD. The present study aimed to investigate studies that link CKD and periodontitis, including periodontitis proxies such as oral hygiene and tooth loss, and patient-related factors such as inflammatory response and genetic polymorphisms. An electronic search was conducted on the MEDLINE (Pubmed), Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science databases using an advanced search option up until August 2024. Thirty-two studies were included: 4 interventional, 16 cohort, and 12 case-control. Overall, the prevalence of periodontitis was significantly higher in patients with CKD: the diagnosis of periodontal disease was associated with an increase in the risk of incident CKD, and parameters of periodontal disease were negatively correlated with kidney function. Inside the field of periodontal medicine, the current evidence indicates a possible association between CKD and periodontitis and supports future longitudinal studies to investigate the two-way relationship between the diseases and their pathophysiology, and possibly to establish cause and effect.

Association Between the Two-Year Trajectories of Dental Anxiety and the Changes in the Oral Health-Related Quality of Life in Parents of FinnBrain Birth Cohort Study

Objectives: We evaluated associations between changes in dental anxiety and oral health-related quality of life (OHRQoL) in parents of the FinnBrain Birth Cohort Study. Methods: Two-year dental anxiety trajectories measured with Modified Dental Anxiety Scale from gestational weeks (gw) 14 and 34, and 3 and 24 months after birth were used. OHRQoL was measured with the Oral Health Impact Profile 14-item questionnaire at gw34 and 4 years. Changes in the OHRQoL sum and dimension scores according to dental anxiety trajectories were analyzed with the Jonckheere-Terpstra test separately for mothers (n = 998) and fathers (n = 513). Results: Overall, OHRQoL decreased in all dental anxiety trajectory groups except the High decreasing group in mothers and in fathers. The decline in the overall OHRQoL was greatest in the Stable high trajectory group for both parents. In fathers, OHRQoL increased considerably but not statistically significantly in the High decreasing trajectory group. The changes in OHRQoL dimensions Psychological discomfort and Handicap differed according to dental anxiety trajectories for both of mothers and fathers, and also for the dimension Psychological disability for mothers. Conclusions: These findings highlight the need for targeted interventions in treating high dental anxiety and in preventing the increase in dental anxiety to improve oral health outcomes such as OHRQoL.

The Relationship Between Dental Anxiety and Oral Health-Related Quality of Life in Patients with Periodontitis

OBJECTIVES

This study aimed to (1) investigate whether dental anxiety (DA) and oral health-related quality of life (OHRQoL) differed between patients diagnosed with periodontitis and individuals with periodontal health, (2) examine associations and correlations between these patient-reported measures, and (3) analyze demographic and clinical parameters.

METHODS

Ninety-six patients diagnosed with periodontitis and age- and sex-matched periodontally healthy controls were included. Participants' demographic characteristics, smoking status, current dental pain, dental pain during the last month, the Modified Corah's Scale (MDAS), and the Oral Health Impact Profile (OHIP-14) were determined.

RESULTS

The mean age of participants was 48.51 years ± 11.41. Patients with periodontitis experienced higher pain in the last month compared to controls (p = 0.003). Patients with periodontitis exhibited significantly higher MDAS total and sub-scores (p < 0.001). Compared to controls, the periodontitis group indicated extreme DA (1.04% vs. 7.79%, p = 0.034). Patients with periodontitis feared having a foreign object in the mouth compared to controls (p = 0.004). The periodontitis group exhibited worse OHIP-14 global and sub-scores (all Ps < 0.001). Positive associations and correlations of MDAS total and sub-scores with OHIP-14 global and domain scores were found for the periodontitis group, but not for controls. Patients with periodontitis who reported "moderate and extreme anxiety" had poorer OHRQoL compared to controls (p = 0.001). The minimal importance difference for this finding indicates a large effect size and a moderate standardized response mean between groups.

CONCLUSIONS

Patients with periodontitis had higher levels of DA and worse OHRQoL compared to controls. Our study highlights the importance of providing a comprehensive approach, including psychosocial well-being, when diagnosing and treating periodontal disease.

Thermosensitive hydrogel doped with osteoconductive fillers for the treatment of periodontitis periapicalis chronica: from synthesis to clinical trial

Herein, a chitosan-based thermosensitive hydrogel (CH) containing hydroxyapatite (HAp), poly(lactic acid) (PLDLLA) or their mixture is proposed as an innovative, biomimetic composition with antimicrobial and bone-forming properties for guided bone regeneration. The modified hydrogels were synthesized and characterized to verify their suitability for the treatment of periodontitis periapicalis chronica. Compared to the unmodified hydrogel, both CH_HAp and CH_PLDLLA revealed improved mechanical properties, as evidenced by rotational rheology. FTIR analysis proved that no chemical interplay existed between the components. All the tested samples displayed no cytotoxicity against osteoblast-like cell culture and confirmed antimicrobial features, both crucial from an application perspective. Radiation sterilization dosage was tailored for the tested samples to maintain sterility for a minimum of 8 weeks of storage and limit crosslinking of the samples. Finally, the hydrogel was used in a clinical trial to treat a patient with chronic inflammation of periapical tissues in teeth 26 and 27. The medical procedure proved the safety, nontoxicity, non-allergenicity, and, most importantly, bone-forming properties of the hydrogel formulation. The kinetics of new bone formation was analyzed in-depth using graphical cross-sections of anatomical structures obtained from pre- and post-operative CBCT scans.

Artificial intelligence with counseling on the treatment outcomes and quality of life in periodontitis patients

BACKGROUND

To evaluate the effects of artificial intelligence (AI)-assisted dental monitoring (DM) with and without health counseling on the treatment outcomes and oral health-related quality of life (OHRQoL) of patients with periodontitis.

METHODS

Patients with periodontitis were randomly assigned to either an AI group (AI group, n = 28), an AI and health counseling group (AIHC group, n = 27), or a control group (n = 27). All patients underwent nonsurgical periodontal treatment. Patients in the AI and AIHC groups underwent additional AI-assisted DM and AI-assisted DM with oral health counseling, respectively, for 6 months. Data on OHRQoL and periodontal measures were collected at baseline and follow-ups.

RESULTS

At 3 months of follow-up, the AI and AIHC groups exhibited a significantly greater reduction in probing pocket depth (mean diff: -0.5 and -0.7) and clinical attachment level (mean diff: -0.5 and -0.6) compared with the control group. At 6 months of follow-up, the AI and AIHC groups exhibited a significantly greater improvement in OHRQoL (mean diff: -4.5 and -4.7) compared with the control group. At 3-month follow-up, the AIHC group exhibited a greater improvement in plaque index (mean diff: -0.2) and OHRQoL (mean diff: -4.3) compared with the AI group.

CONCLUSION

AI-assisted DM can be used to remind patients with periodontitis of their oral hygiene at home and effectively improve their periodontal measures and long-term OHRQoL.

PLAIN LANGUAGE SUMMARY

Gum disease is a common problem, but new technology could help. In this study, researchers looked at how AI affects gum health and quality of life (QoL). The researchers divided participants into 3 groups. One group used an AI system to monitor their gums at home. Another used AI plus got health advice. The third did not use any special technology. After 3 and 6 months, the AI groups had healthier gums, with less deep pockets and better gum attachment, compared to the group without AI. The group that also got health advice saw even greater improvements, like cleaner teeth and a bigger boost to their QoL. This is exciting because gum disease is tricky to manage alone. The AI system seems to help by reminding people to care for their teeth and gums. With expert guidance, the AI becomes an even more powerful tool for improving long-term oral health and well-being. This study shows how new technologies like AI could transform how we approach common health problems. By providing personalized support, AI can empower people to better manage their own health, leading to better outcomes.

Multimorbidity Patterns and Periodontal Diseases in a French Hospital-Based Dental School: A Retrospective Cross-Sectional Study

Objectives: To assess the prevalence of systemic pathologies associated with periodontal diseases to determine multimorbidity patterns and risk factors for periodontal care. Methods: A single-center cross-sectional study analyzed patient records from 1 January 2019 to 31 December 2021 at the Department of Periodontology, part of the Dental Service of a hospital-based dental school in Lyon, France. The anonymized data included patient-reported medical history (questionnaire) and billing for periodontal procedures. Data were compared between patients in the Department of Periodontology and from Other Departments of the Dental Service. The association between clinically relevant pathologies, as defined as multimorbidity, and admission in the Department of Periodontology were assessed with logistic regression. Prevalences between the Department of Periodontology and the Other Departments of the Dental Service were compared with chi-squared tests. Relationship among pathologies was described through correlation analysis. Statistical analyses were conducted using R software with a significance level set at p < 0.05. Results: This study included records of 20,945 patients in the Dental Service with 1205 periodontal procedures performed in the Department of Periodontology. Patients admitted for periodontal care were older and mostly female (p-value < 0.001). The most frequent systemic pathologies were hypertension and diabetes in the Department of Periodontology. Hypertension associated with diabetes was the most frequent multimorbidity pattern, while the most frequent triad of multimorbidity was hypertension/diabetes/cardiac rhythm disorders. Patients with diabetes had a 1.49 times higher likelihood of admission to the Department of Periodontology (OR = 1.49 [1.20; 1.86]), with age also being a significant risk factor but with a smaller effect size (OR = 1.02 [1.01; 1.03]). Conclusions: Within the limitations of this study, hypertension, diabetes, cardiac rhythm disorders, and chronic renal insufficiency were identified as prevalent multimorbidity in the Department of Periodontology. Multimorbidity including diabetes seems to constitute a risk factor requiring periodontal care.

Periodontal diseases in Africa

Periodontal diseases, a group of complex conditions marked by an excessive immune response and periodontal tissue destruction, are a global health concern. Since 1990, the incidence of these diseases has doubled, with Western sub-Saharan Africa experiencing the highest burden. Accurate diagnosis and case identification are crucial for understanding the etiology, features of disease, research, treatment and prevention. Modern perspectives on periodontal disease classification are based on commonality among those affected. However, current literature is often plagued by methodological inconsistencies and focused on disease mechanisms in European populations. Health inequalities in low- and middle-income countries (LMICs) are exacerbated by these challenges, with sub-Saharan Africa, and Nigeria specifically, facing unique difficulties such as clinical personnel shortages and limited research infrastructure. This review explored disparities in periodontal disease research, care and outcomes in African populations. We highlighted these disparities and identified the factors contributing to inequities in periodontal health outcomes. We further demonstrated the critical need for inclusive and equitable healthcare and research practices tailored to the unique challenges faced by diverse populations and regions with limited resources. Addressing these disparities is essential for ensuring that advancements in healthcare are accessible to all, thereby improving global oral health and general health.

Radiographic Evaluation of the Prevalence of External Root Resorption in Patients With Periodontitis in Indore: A Cross-Sectional Study

Objective Permanent teeth roots undergo resorption under pathologic conditions such as trauma, orthodontic treatment, pulpal infections, periodontitis, and periodontal therapy. The present study aimed to determine the prevalence of external root resorption (ERR) in patients with periodontitis as seen in orthopantomography (OPGs). Methodology This single-center, retrospective, cross-sectional radiographic study was conducted from January 2021 to December 2022, including 656 orthopantomographs (OPGs) from patients with periodontitis. OPGs were evaluated based on specific inclusion and exclusion criteria. ERR was assessed across mild, moderate, and severe periodontitis cases (Stage I/II/III/IV according to the 2017 American Academy of Periodontology) in both localized and generalized periodontitis and in cases of horizontal and vertical bone loss/defects. Data analysis was performed using IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States). Descriptive statistics were calculated and presented as numbers, percentages, and mean ± standard deviation. Categorical variables were compared using the chi-square test, with a p-value < 0.05 considered statistically significant. Results The study analyzed 656 subjects, with 226 (34.5%) showing external root resorption (ERR). ERR prevalence was higher among males (122, 38.6%) compared to females (104, 30.6%) (p = 0.031). ERR was more common in subjects with vertical bone loss (105, 49.1%) than those without (121, 27.4%) (p < 0.001) and in those with horizontal bone defects (55, 45.8%) compared to those without (171, 31.9%) (p = 0.004). By periodontitis severity, ERR occurred in Stage I (61, 21.2%), Stage II (108, 37.4%), and Stage III/IV (57, 72.2%) (p = 0.001). Localized periodontitis showed higher ERR prevalence (40, 44.0%) than generalized periodontitis (186, 32.9%) (p = 0.040). Age was not significantly associated with ERR (p = 0.423). Conclusion ERR was significantly associated with the severity of periodontitis, localized and generalized periodontitis, and horizontal and vertical bone defects. Prompt diagnosis and treatment planning are essential for preserving teeth affected by ERR, thereby supporting masticatory function, aesthetics, self-esteem, and the overall oral health-related quality of life for patients.

Impact of Periodontal Diseases on Oral Health-Related Quality of Life: A Study with a Condition-Specific Questionnaire in Croatian Population

OBJECTIVES

 The aim of this study was to translate and validate the condition-specific Oral Health Impact Profile (OHIP) in the Croatian cultural context and assess the impact of periodontal diseases and nonsurgical periodontal therapy on quality of life (QoL).

MATERIALS AND METHODS

 A cross-sectional study was carried out on 150 individuals: 50 periodontally healthy, 50 with gingivitis, and 50 with periodontitis who self-administrated the OHIP. The participants' age ranged between 18 and 71 years, with the median age of 45 (34-57) years. Forty-seven percent of the participants were females. The validity and reliability of the Croatian OHIP version were tested. The impact of gingivitis and periodontitis on QoL was assessed. Changes in QoL induced by nonsurgical periodontal therapy in 20 patients with periodontitis were analyzed.

STATISTICAL ANALYSIS

 Categorical data were presented by absolute and relative frequencies. The normality of the distribution of continuous variables was tested by the Shapiro-Wilk test. Continuous data were described by the median and the limits of the interquartile range (IQR). Differences in continuous variables between two independent groups were tested with the Mann-Whitney U test, and between three groups with the Kruskal-Wallis test (post hoc Conover). The Wilcoxon signed-rank test was used to examine the differences in the total score before and after therapy. All p values were two-sided. The level of significance was set at alpha of 0.05.

RESULTS

 The analysis detected a single-factor structure that explained for the 56.9% of the variance. Cronbach's alpha value was 0.937, which indicated an excellent internal consistency. Overall OHIP score reported a strong correlation with the subjective estimate of periodontal problems (Rho = 0.92; p < 0.001). Test-retest reliability was high (r = 0.984; p < 0.001). The periodontitis group had the highest OHIP score (28 [23-34]), followed by the gingivitis group (14 [12-20]) and the periodontally healthy group (9 [5-11]; p < 0.001). Nonsurgical periodontal therapy significantly improved the QoL in those with periodontitis (p < 0.001).

CONCLUSION

 The condition-specific Croatian version of the OHIP instrument can be considered adequate to measure the impact of periodontal diseases on oral health-related QoL. Periodontal diseases, especially periodontitis, have a negative effect on the patient's QoL. Nonsurgical periodontal treatment can improve patients' QoL.

Soluble urokinase plasminogen activator receptor (suPAR) is a potential biomarker of stage III-IV, grade C periodontitis through the impact of post-radiotherapy on head and neck cancer patients

BACKGROUND

The urokinase-type plasminogen activator receptor (uPAR) plays an essential function in leukocytes and endothelial homeostasis and, therefore, in the development of chronic periodontitis.

METHODS

The study enrolled 150 participants, 50 chronic periodontitis with head and neck cancer post radiotherapy (CP + HNC post-RT) patients, 50 chronic periodontitis (CP) without HNC patients, and 50 healthy controls. Clinical Attachment Loss (CAL), Probing Pocket Depth (PPD), Plaque Index (PI), and Gingival Bleeding Index (GBI) were recorded. An enzyme-linked immunosorbent assay (ELISA) was constructed to quantify serum (suPAR) levels.

RESULTS

Stage and grade of periodontitis were stage III-IV, grade C in patients (CP + HNC post-RT), stage I-III, grade A/B in patients (CP without HNC), and absent in (healthy). Chronic periodontitis with HNC post-RT patients presented a significantly higher proportion of suPAR levels (506.7 pg/ml) compared to chronic periodontitis without HNC and healthy controls (423.08 pg/ml and 255.9 pg/ml), respectively. A significant positive correlation was found between serum suPAR levels and CAL, PPD, PI, and GBI in the periodontal disease groups. ROC results of suPAR (AUC = 0.976 for CP + HNC post-RT, AUC = 0.872 for CP without HNC). Hyposalivation appeared in patients (CP + HNC post-RT; 0.15 [0.11-0.23] ml/min, P = 0.001) and (CP without HNC; 0.30 [0.25-0.41] ml/min, P = 0.001), compared to healthy controls; 0.35 [0.28-0.54] ml/min, P = 0.001).

CONCLUSION

The study showed a significant elevation in serum suPAR levels in CP + HNC post-RT patients compared to the CP without HNC and control groups.

CLINICAL TRIAL REGISTRATION

The study was registered retrospectively; clinicaltrials.gov identifier: NCT06529588. Date of registration: July 31, 2024 https://clinicaltrials.gov/study/NCT06529588 .

Changes and Roles of IL-6, hsCRP, and proCT in Patients with Chronic Periodontitis in Head and Neck Cancer Pre/Post Radiotherapy

Background: Head and neck cancer (HNC) patients frequently undergo radiotherapy as a standalone treatment or in combination with chemotherapy. Radiotherapy is associated with adverse effects, including detrimental impacts on periodontal health, which increase the risk of periodontitis. Objective: To investigate the clinical significance of interleukin-6 (IL-6), high-sensitive C-reactive protein (hsCRP), and procalcitonin (proCT) as prognostic indicators. Methods: 150 participants were divided into three groups: (n=50, HNC post-RT) patients with head and neck cancer who had radiation treatment six months ago (n=50, HNC pre-RT), and individuals with periodontal health as the control group (n=50). Probing pocket depth (PPD), clinical attachment loss (CAL), gingival bleeding index (GBI), plaque index (PI), and hyposalivation were meticulously recorded. To quantify serum concentrations of IL-6, hs-CRP, and proCT, an electrochemiluminescence immunoassay (eCLIA) was used. Results: Serum levels of IL-6, hsCRP, and proCT were significantly elevated in two groups of patients with chronic periodontitis with head and neck cancer post-radiotherapy (CP+HNC post-RT) and patients with chronic periodontitis with HNC pre-radiotherapy (CP+HNC pre-RT) compared to a control group. ROC analysis demonstrated the diagnostic accuracy of IL-6, hsCRP, and proCT for both clinical cases. Furthermore, all clinical periodontal index scores (CAL, PPD, PI, and GBI) were significantly elevated compared to a control group. Conclusions: HNC post-RT patients presented significantly higher serum IL-6, hs-CRP, proCT, and periodontal score levels than HNC pre-RT.

Xanthan-based chlorhexidine gel effects in non-surgical periodontal therapy? A meta-analysis

OBJECTIVE

To carry out a systematic review and meta-analysis of randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) comparing scaling and root planing (SRP) or placebo with subgingival application of xanthan-based CHX (chlorhexidine) gel as adjunct to SRP.

MATERIALS AND METHODS

The literature search was carried out in PubMed/MEDLINE, EMBASE, and SCOPUS; primary outcomes were probing pocket depth (PPD) reduction and gain in clinical attachment level (CAL).

RESULTS

Overall, 15 studies were included. Three studies were judged to be at moderate risk of bias while the remaining 12 were rated at high risk of bias. A significant improvement in PPD reduction (standardized mean difference, SMD, 0.87, 95% CI, 0.41-1.34) and CAL gain (SMD = 0.84, 95% CI, 0.36-1.33) emerged for the SRP + CXH gel compared to the SRP alone group, in the presence of significant high heterogeneity among the studies.

CONCLUSIONS

Our systematic review and meta-analysis showed that xanthan-based chlorhexidine gel as adjunct to non-surgical periodontal therapy gives benefit in terms of PPD reduction and CAL gain as compared to non-surgical periodontal therapy only. Since there was high heterogeneity among studies and the quality of the evidence is low, further studies characterized by a better methodology, adequate sample size and longer follow-up are warranted in the next future.

REGISTRATION

The protocol of this scoping review was registered in the International Prospective Register of Systematic Reviews (https://www.crd.york.ac.uk/PROSPERO) with ID: CRD42023391589.

Assessing oral health and the minimally important differences in oral health-related quality of life of non-diabetic and diabetic patients: a cross-sectional study

BACKGROUND

Non-diabetics and diabetics might have different oral health problems and impacts on their oral health-related quality of life (OHRQoL). Comparison of oral health status and coping strategies between these patients, and evaluation of factors associated with OHRQoL might facilitate better treatment planning for improved patient-centred outcome.

METHODS

One hundred and eleven non-diabetics and 107 diabetics attending a public hospital were clinically examined and evaluated for coping strategies (abbreviated coping orientation to problems experienced) and OHRQoL [short-form oral health impact profile (OHIP-14S)]. Factors associated with OHRQoL were analysed through correlation/partial correlation. Minimally important differences (MID) of OHIP-14S were calculated to confirm associations between attachment loss, caries, and tooth loss with OHRQoL.

RESULTS

Non-diabetics had worse periodontal status. Diabetics had more missing teeth. Non-diabetics and diabetics employed maladaptive coping to manage oral health problems. Overall, non-diabetics reported worse OHRQoL. Determination of MID showed that non-diabetics with high-severe attachment loss and <20 teeth experienced poorer OHRQoL. Diabetics with caries, high-severe attachment loss, and <25 teeth experienced poorer OHRQoL.

CONCLUSION

Different factors were associated with OHRQoL of non-diabetics and diabetics. Delivery of treatment aimed at maintaining teeth in a periodontally healthy and caries free state, and provision of more chewing units might help improve OHRQoL of diabetics. © 2024 Australian Dental Association.

Association of anxiety, age and oral health-related quality of life with periodontitis: A case-control study

OBJECTIVE

This case-control study evaluated the association of sociodemographic profile, mental health disorders and oral health-related quality of life (OHRQoL) with periodontitis.

METHODS

Patients with periodontitis (PP, n = 50) and control patients (CP, n = 50) were allocated into 2 groups after a complete periodontal examination. Data collection included age, sex, marital status, education and application of 2 questionnaires: Hospital Anxiety and Depression Scale for the diagnosis of anxiety/depression and Impact Profile on Oral Health (OHIP-14) for classification of well-being. An adjusted multiple binary logistic regression analysis was performed to assess the effect of all studied covariates on periodontitis.

RESULTS

The results show that mean clinical attachment loss and periodontal probing depth were 5.92 (SD = 0.42) and 5.46 (SD = 0.78) in PP and 0.00 (SD = 0.00) and 2.85 (SD = 0.23) in CP, respectively (p < 0.001). The regression analysis demonstrated a significant effect on periodontitis for age (OR = 1.13; p < 0.0001; 95% CI: 1.07-1.20), with the PP having more people aged 50 years or older than CP, anxiety (OR = 1.25; p = 0.020; 95% CI: 1.04-1.50) and OHIP-14 (OR = 1.17; p < 0.0001; 95% CI: 1.08-1.226).

CONCLUSIONS

The findings showed a positive association between anxiety, OHRQoL and age with periodontitis.

Are periodontitis and psoriasis associated? A pre-clinical murine model

AIM

To investigate the bidirectional influence between periodontitis and psoriasis, using the respective experimental models of ligature- and imiquimod-induced diseases on murine models.

MATERIALS AND METHODS

Thirty-two C57/BL6J mice were randomly allocated to four experimental groups: control (P- Pso-), ligature-induced periodontitis (P+ Pso-), imiquimod-induced psoriasis (P- Pso+) and periodontitis and psoriasis (P+ Pso+). Samples (maxilla, dorsal skin and blood) were harvested immediately after death. Measures of periodontitis (distance between the cemento-enamel junction and alveolar bone crest [CEJ-ABC] and the number of osteoclasts) and psoriasis (epidermal thickness and infiltrate cell [/0.03mm2]) severity as well as systemic inflammation (IL-6, IL-17A, TNF-α) were collected.

RESULTS

The P+ Pso+ group exhibited the most severe experimental periodontitis and psoriasis, with the highest values of CEJ-ABC, number of osteoclasts, epidermal thickness and infiltrate cells in the dorsal skin, as well as the highest blood cytokine concentration. The P+ Pso- group presented with higher cell infiltrate (/0.03mm2) compared to the control group (p <.05), while the P- Pso+ group showed substantially higher alveolar bone loss (CEJ-ABC) than the control group (p <.05).

CONCLUSIONS

Experimental periodontitis may initiate and maintain psoriasiform skin inflammation and, vice versa, experimental psoriasis may contribute to the onset of periodontitis. In a combined model of the diseases, we propose a bidirectional association between periodontitis and psoriasis via systemic inflammation.

Exploring the impact of oral health on the quality of life in older patients: a cross-sectional study

OBJECTIVE

To investigate the significant impact of oral health on the quality of life of older individuals in Riyadh, Saudi Arabia, across various socioeconomic and demographic contexts.

METHODS

A cross- sectional study was conducted, involving the distribution of a translated online questionnaire based on the OHQoL-UK® tool to evaluate oral health-related quality of life OHRQoL. This included utilizing the Oral Health Quality of Life Scale to assess overall quality of life.

RESULTS

A total of 586 participants were involved in the study, with the majority being over 60 years old (77.1%). The mean score of OHRQoL was 3.79. The Social Dental Scale SDS had a mean score of 0.71. The General Oral Health Assessment GOHS scored 3.51 on average. The mean score of Dental Impact Profile DIP was 3.12. The Subjective Oral Health Status Indicators SOHSIs had a mean score of 3.82. The mean score of Oral Health Benefit of Life Inventory OHBLI averaged at 4.04, and Dental Impact on Daily Living DIDL scored an average of 4.05. The mean scores of OHRQoL and Oral Impacts on Daily Performance OIDP were 3.90 and 3.89 respectively. Cronbach's Alpha values ranged from 0.854 to 0.939, with an overall questionnaire reliability of 0.977, indicating a good reliability of the study's tool.

CONCLUSION

Older adults exhibited lower OHRQoL compared to younger adults, particularly influenced by factors such as health insurance coverage, monthly income, and educational level. It is essential to develop health programs specifically tailored for senior adults to safeguard their overall health and quality of life. Making health and medical insurance obligatory and accessible to all individuals is crucial for enhancing their QoL and reducing the diseases.

The Role of Different Types of Cannabinoids in Periodontal Disease: An Integrative Review

This integrative review addresses the potential of the Endocannabinoid System (ES) and cannabinoids in the pathogenesis and treatment of periodontal disease (PD). Cannabinoid receptors are expressed in healthy and inflamed periodontal tissues, indicating a potential regulatory role for SEC in oral homeostasis. Healthy periodontal cells express more CB1 receptors, while inflamed sites show increased CB2 receptors. This suggests a dynamic involvement of the SEC in the inflammatory response associated with PD. Cannabinoids such as cannabidiol (CBD) and cannabinoid receptor agonists such as HU-308, anandamide (AEA), and methanamide (Meta-AEA) have demonstrated promising therapeutic potential in studies. CBD has been associated with the control of bone resorption, antibacterial activity, and increased production of gingival fibroblasts, indicating effects in mitigating the progression of PD. HU-308 demonstrated preventive effects against alveolar bone loss, and anti-inflammatory, osteoprotective, and pro-homeostatic properties in animal models of periodontitis. AEA and Meta-AEA have anti-inflammatory effects by reducing pro-inflammatory mediators such as IL-1, IL-6, and TNF-α. The activation of cannabinoid receptors attenuates inflammatory processes, inhibits alveolar bone loss, exerts antibacterial effects, and promotes tissue repair. However, clinical trials are especially needed to validate these results and explore the therapeutic potential of cannabinoids in the treatment of PD in humans.

Human gingival fibroblasts are a source of B cell-activating factor during periodontal inflammation

BACKGROUND

Host-modulating therapy is a possible treatment for individuals that respond poorly to conventional periodontal therapy. B cells, abundant in periodontitis lesions, require the cytokines B cell-activating factor (BAFF) and A proliferation-inducing ligand (APRIL) for survival and maturation. Although mRNA levels of BAFF and APRIL are increased in tissue from periodontitis lesions, it is unknown if periodontal resident cells express BAFF and/or APRIL during periodontal inflammation. In this study, we aim to analyze the expression of BAFF and APRIL in human gingival fibroblasts after stimulation with proinflammatory cytokines. Furthermore, we perform protein analysis in tissues and serum from periodontitis patients and healthy controls.

METHODS

Human gingival fibroblasts were cultured and stimulated with the proinflammatory cytokines' tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β). The mRNA expression of BAFF and APRIL was analyzed by real-time quantitative polymerase chain reaction (qPCR), and the protein was detected in tissue sections using immune staining. Serum levels of BAFF were analyzed with enzyme-linked immunosorbent assay (ELISA).

RESULTS

In gingival fibroblasts, TNF-α upregulated BAFF mRNA, but APRIL was unaffected. IL-1β affected neither BAFF nor APRIL expression. BAFF protein was detected in the oral epithelium and in cells of the underlying connective tissue in periodontitis tissue, and BAFF protein was increased in the serum of periodontitis patients.

CONCLUSION

Periodontal resident cells express BAFF during periodontal inflammation and participate in providing a favorable milieu for the survival and action of B cells.

Impact of Periodontitis on Endothelial Risk Dysfunction and Oxidative Stress Improvement in Patients with Cardiovascular Disease

Periodontitis is a multifactorial chronic inflammatory disease that affects the periodontium and overall oral health and is primarily caused by a dysbiotic gingival biofilm, which includes, among others, Gram-negative bacteria such as Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, and Tannerella forsythensis that colonize gingival tissues and that can lead, if not properly treated, to periodontal tissue destruction and tooth loss. In the last few decades, several large-scale epidemiological studies have evidenced that mild and severe forms of periodontitis are strictly bilaterally associated with several cardiovascular diseases (CVDs), stroke, and endothelial dysfunction. Specifically, it is hypothesized that patients with severe periodontitis would have compromised endothelial function, a crucial step in the pathophysiology of atherosclerosis and several CVD forms. In this regard, it was postulated that periodontal treatment would ameliorate endothelial dysfunction, hence bolstering the notion that therapeutic approaches targeted at diminishing cardiovascular risk factors and different forms of periodontal treatment could improve several CVD biomarker outcomes in the short- and long-term in CVD patients. The aim of this review is to update and analyze the link between periodontitis and CVD, focusing on the inflammatory nature of periodontitis and its correlation with CVD, the effects of periodontal therapy on endothelial dysfunction and oxidative stress, and the impact of such therapy on CVD biomarkers and outcomes. The article also discusses future research directions in this field.

Association between cognitive rumination and periodontal disease, tooth loss and oral health-related quality of life in a rural Southern Brazil population

OBJECTIVES

Rumination is a maladaptive emotion regulation strategy. It has been associated with several psychological disorders and physical problems. This cross-sectional study aimed to evaluate whether cognitive rumination is associated with periodontal disease (PD), tooth loss (TL), and oral health-related quality of life (OHRQoL).

MATERIALS AND METHODS

A population-based sample from a rural area in southern Brazil was evaluated. Calibrated examiners carried out a complete periodontal examination at six sites-per-tooth. Rumination and Reflection (RRQ) and Oral Health Impact Profile (OHIP-14) questionnaires were administered. Regression modeling was used to assess the prevalence ratio (PR) between rumination and PD and to estimate the rate ratio (RR) between rumination and TL and rumination and OHIP.

RESULTS

Severe periodontitis prevalence of 33% was observed in the sample. In the Poisson-adjusted model (n = 587), individuals who ruminate more have 27% more periodontal disease (PR: 1.27, 95%CI:1.02 - 1.60). Regarding TL and OHIP, negative binomial regression (n = 672) showed an association with rumination, but it was not significant (RR 1.14, 95%CI 0.99 - 1.31) and (RR 1.20, 95%CI 0.98 - 1.48), respectively.

CONCLUSIONS

Cognitive rumination was independently associated with periodontal disease in individuals living in a rural area. Borderline non-significant estimates were observed regarding TL and OHRQoL. More research using different populations and focusing on individual's responses to psychological stress may confirm these results.

CLINICAL RELEVANCE

Emotional regulation is crucial to deal with stress, anxiety, and depression. Since psychopathologies are among the most prevalent diseases in the world, it is critical to understand the role of these issues in dental outcomes.

Exploring the links between periodontal diseases and obstructive sleep apnoea: An overview for clinicians

Both periodontal diseases (PDs) and obstructive sleep apnoea (OSA) are highly prevalent disorders with global impact, associated with a large burden at individual patient and health system levels. These disorders often co-exist, but there is growing evidence that the association between the disorders goes beyond an overlap between two highly prevalent diseases that have shared risk factors. Evidence suggests a potential causal relationship, although further research is required to verify this. Regardless of any causal relationship, the co-existence of these disorders is important to recognize since they may act in combination to heighten health risks, particularly cardiovascular risk. Thus, dentists have an important role in screening for OSA in patients presenting with PDs, and similarly, they need to evaluate periodontal health in patients requiring treatment for OSA. Here we provide a narrative review of the association between PDs and OSA to raise awareness among clinicians and promote multidisciplinary collaborations that aim at an evidence-based and effective management of such patients.

The use of patient-related outcomes (PRO) and experience (PRE) in assessing the periodontal and implant patient

The purpose of this review was to summarize the evidence with regard to behavioral and psychosocial assessment of the periodontitis patient, the candidate for implant therapy, and the peri-implantitis patient. Periodontitis has an adverse effect on quality of life and its treatment can lead to significant improvements experienced by the patient. The latter is true for rehabilitation with dental implants, although patients harbor diverse expectations and perceptions of implant therapy, which can often interfere with satisfaction and/or influence long-term success. A thorough behavioral assessment of the candidate for implant therapy is essential, which should include, perceptions, expectations, as well as risk for behavioral disorders. Remedial action is essential to correct misperceptions and any identified risks. Finally, patients have limited awareness of limited ability to identify signs of peri-implantitis. The diagnosis of peri-implantitis can be a cause of significant distress, resentment, and loss of trust to the treatment and the caregivers. Despite documented value in clinical research, currently available instruments assessing patient-reported outcomes have little application in day-to-day clinical practice. Face-to-face patient to doctor open-ended communication remains the most effective way to comprehensively establish the long-term "therapeutic alliance" essential for the long journey for the periodontitis patient.

Engineering Nitric Oxide-Releasing Antimicrobial Dental Coating for Targeted Gingival Therapy

Bacterial biofilms play a central role in the development and progression of periodontitis, a chronic inflammatory condition that affects the oral cavity. One solution to current treatment constraints is using nitric oxide (NO)─with inherent antimicrobial properties. In this study, an antimicrobial coating is developed from the NO donor S-nitroso-N-acetylpenicillamine (SNAP) embedded within polyethylene glycol (PEG) to prevent periodontitis. The SNAP-PEG coating design enabled a controlled NO release, achieving tunable NO levels for more than 24 h. Testing the SNAP-PEG composite on dental floss showed its effectiveness as a uniform and bioactive coating. The coating exhibited antibacterial properties against Streptococcus mutans and Escherichia coli, with inhibition zones measuring up to 7.50 ± 0.28 and 14.80 ± 0.46 mm2, respectively. Furthermore, SNAP-PEG coating materials were found to be stable when stored at room temperature, with 93.65% of SNAP remaining after 28 d. The coatings were biocompatible against HGF and hFOB 1.19 cells through a 24 h controlled release study. This study presents a facile method to utilize controlled NO release with dental antimicrobial coatings comprising SNAP-PEG. This coating can be easily applied to various substrates, providing a user-friendly approach for targeted self-care in managing gingival infections associated with periodontitis.

V, Sinha SP, Singh A, Karmakar S. Development and validation of a structured questionnaire to assess the Knowledge, Attitude and Practice (KAP) regarding the effect of yoga on periodontal health among Indian adults

Background

Periodontal disease is a chronic inflammatory disease of structures surrounding the teeth. Its etiology is multifactorial. The primary etiological factor is the microbial component; the other factors are systemic, behavioral, environmental, and psychological. Conventional management includes routine periodontal therapy involving prophylactic and surgical management. In developing countries like India, complementary medicine and alternative medicines like yoga are gaining popularity for improving systemic health. Hence this pilot study was designed to assess the psychometric properties of a structured questionnaire that can assess knowledge, attitude, and practice (KAP) regarding the impact of yoga on oral and periodontal health in Indian population.

Methods

The KAP questionnaire was developed (Stage One) using a deductive approach, and a psychometric evaluation of the questionnaire was performed to evaluate it's reliability and validity (Stage Two). Initial content validation and test re-test reliability were assessed using kappa statistics with binary responses. An intraclass correlation coefficient (ICC) was used to assess the questions in the practice and attitude category with categorical variables. Further assessment of psychometric properties of the questionnaire was done using item response theory. The developed questionnaire had four principal sections: demography of participants; knowledge regarding yoga and oral health; attitude towards yoga and oral health; and practice towards implementing yoga for oral health.

Results

The ICC for all the assessed questions was greater than 0.60 suggesting satisfactory stability. Internal consistency measured using Cronbach's alpha for knowledge, attitude, and practice items were reported to be 0.632, 0.923, and 0.591 respectively and that of the KAP total was 0.632.

Conclusions

The findings of this study showed that the questionnaire had an acceptable psychometric property for measuring KAP regarding yoga and it's role in oral and periodontal health among Indian adults. The analysis of participant responses revealed that they had a medium level of knowledge regarding yoga and periodontal disease.

The economic and societal impact of periodontal and peri-implant diseases

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.

Impact of periodontitis on oral health-related quality of life of patients with psoriatic arthritis

BACKGROUND

Since oral health issues can have a negative influence on a person's physical functioning, social status, and wellbeing, oral health-related quality of life (OHRQoL) becomes an indispensable part of overall health. Previous published studies report that periodontitis (PD) and psoriatic arthritis (PsA) have a significant negative impact on OHRQoL. Based on these findings, it would be reasonable to assume that patients with coexisting PsA and PD would see a comparable or maybe synergistic effect on their OHRQoL. Hence, the aim of the present study is to evaluate the OHRQoL and its impact among subjects with concurrent PsA and PD.

MATERIAL AND METHODS

The present study was a comparative, cross-sectional investigation. A total of 200 participants were categorized into four groups- PD-PsA (n = 50), PsA (n = 50), PD (n = 50), and healthy controls (n = 50). Demographic data and periodontal parameters-plaque index, sites with gingival bleeding, probing pocket depth, gingival recession, and clinical attachment level were recorded for all the four groups. Number of mobile teeth due to periodontitis was recorded for the PSA-PD and PD groups. OHIP-14 questionnaire was administered to all the four groups. Collected data was then subjected to statistical analysis.

RESULTS

The severity of OHIP-14 summary scores was highest in the PsA-PD group (18.06 ± 11.22) followed by the PD group (17.02 ± 9.99) and lowest in the healthy group (6.32 ± 5.59) (p < .0001). The scores of all the domains- oral pain, oral function, orofacial appearance and psychological impact were highest among the PsA-PD group followed by the PD group (p < .0001). The combined interaction of PsA and PD on the OHRQoL was statistically significant (F = 6.33, p = .012). Results of the multiple linear regression analysis indicated that there was a moderate collective significant effect between age, past dental visit, frequency of daily tooth brushing, use of other oral hygiene aids, and OHIP-14 (F(3,196) = 13.08, p < .001, R2 = 0.17, adjusted R2 = 0.15).

CONCLUSION

The negative impact on OHRQoL was highest in the patients with concurrent presence of PD with PsA followed by those with PD alone. While the summary scores and dimensional scores of OHIP-14 were insignificant when patients with PsA-PD and PD alone were compared, these scores were significantly higher in patients with PsA-PD than patients with PsA alone.

Periodontal Health among Individuals with Intellectual Disabilities Living in a Saudi Institutional Rehabilitation Centre

The aim of this study was to explore periodontal health among intellectually disabled individuals living in an institutional rehabilitation centre in the Al-Baha Region of Saudi Arabia. A cross-sectional study was conducted from November 2023 to January 2024. Clinical oral examinations were carried out using the World Health Organization criteria for bleeding sites and the presence of periodontal pockets. Simplified oral hygiene and community periodontal indices were employed to evaluate participants' oral health. A total of 89 participants, comprising both males and females with intellectual disabilities, were included in this study. Gender, severity of intellectual disability, type of additional physical disability, tooth brushing habits and oral hygiene status were significantly associated with the presence of periodontal disease. Additionally, poor oral hygiene, not brushing teeth and periodontal pockets of 4-5 mm and 6 mm or more were significantly more prevalent among individuals with severe and moderate intellectual disabilities (p = 0.001, p = 0.001, p = 0.001 and p = 0.001, respectively). The prevalence of periodontal disease among the studied population was 54%. The odds of having periodontal disease were significantly higher in the severe intellectual disability group compared to the mild intellectual disability group (OR = 2.328, 95% CI = 1.430-3.631, p = 0.03). It was also found that intellectually disabled participants with additional physical disabilities suffered more from periodontal disease than those without additional physical disabilities (OR = 0.971, 95% CI = 0.235-4.023, p = 0.025). Overall, individuals with intellectual disabilities had a significant demand for periodontal care. This study highlighted the need for more organised preventive programmes for individuals with intellectual disabilities. Dentists should be vigilant about improving periodontal health, focus on preventive programmes and provide comprehensive dental care with an emphasis on periodic recall and monitoring.

Exploring the Potential of Micro-Immunotherapy in the Treatment of Periodontitis

Periodontitis, characterized by the progressive destruction of dental support tissues due to altered immune responses, poses a significant concern for public health. This condition involves intricate interactions between the immune response and oral microbiome, where innate and adaptive immune responses, with their diverse cell populations and inflammatory mediators, play crucial roles in this immunopathology. Indeed, cytokines, chemokines, growth factors, and immune cells perform key functions in tissue remodeling. Focusing on periodontal therapies, our attention turns to micro-immunotherapy (MI), employing low doses (LDs) and ultra-low doses (ULDs) of immunological signaling molecules like cytokines, growth factors, and hormones. Existing studies across various fields lay the groundwork for the application of MI in periodontitis, highlighting its anti-inflammatory and regenerative potential in soft tissue models based on in vitro research. In summary, this review underscores the versatility and potential of MI in managing periodontal health, urging further investigations to solidify its clinical integration. MI supports an innovative approach by modulating immune responses at low doses to address periodontitis.

Supra- and sub-gingival instrumentation of periodontitis with the adjunctive treatment of a chloramine - a one-year randomized clinical trial study

Periodontitis is a bacterial-induced disease and for this reason controlling the microbiota is a necessity. Therapy includes self-performed daily oral hygiene in combination with supra- and sub-gingival instrumentation. An adjunctive antimicrobial agent may improve the outcome.

AIMS

To assess whether a chloramine (Perisolv®) has an adjunctive effect to non-surgical periodontal therapy and whether non-surgical periodontal therapy affects quality of life.

MATERIAL AND METHODS

Thirty-eight patients were randomized to a test or a control group. Clinical indices were performed at baseline and at three and twelve months. In the test group, Perisolv® was applied initially and after the sub-gingival instrumentation in pathological pockets. Oral health-related quality of life was measured with the Oral Health Impact Profile (OHIP) instrument at baseline and twelve months.

RESULTS

In both groups, an initial probing pocket depth (PPD) of > 4 mm and bleeding on probing (BOP) were statistically reduced (p < 0.002 and p < 0.002 respectively) at twelve months and after adjustment for Bonferroni. There were no significant differences between the test and the control group in terms of the number of PPD, BOP or plaque index, or in the mean OHIP score.

CONCLUSIONS

Chloramine did not have an adjunctive effect, but the overall therapy was significantly efficacious both clinically and in terms of quality of life.

TRIAL REGISTRATION

Registered at www.

CLINICALTRIALS

gov:NCT05757921.

Mediterranean diet: a potential player in the link between oral microbiome and oral diseases

Background

The oral microbiome is a complex and dynamic assemblage of microorganisms that colonize different sites of the oral cavity maintaining both oral and systemic health. Therefore, when its composition is altered, oral diseases occur. Among oral inflammatory pathologies, periodontal diseases affect the tissues surrounding the teeth, representing the main cause of tooth loss and one of the most important threats to the oral health. Lifestyle and eating habits influence the composition of the human oral microbiota and the development and progression of oral diseases. In this context, the Mediterranean Diet (MD) model, comprising both healthy dietary choices and lifestyle, is linked to the prevention of several metabolic and chronic-degenerative pathological processes, including oral diseases. Indeed, the MD is a plant-based diet, enriched of anti-inflammatory and antioxidant nutrients, which may induce beneficial effects against dental caries and periodontal diseases.

Aim

This review summarizes the role of the oral microbiome in the development of the oral diseases and the potential of MD in modulating the oral microbiome leading to implications for oral health.

Conclusions

The data collected highlight the need to promote the MD pattern along with the correct hygiene habits to prevent the development of oral diseases.

Preventive dental service use and oral health-related quality of life in Brazilian older adults

BACKGROUND

Information on the use of preventive dental services and associated variables is needed to guide policy for the old adult population and consequently promote better oral health-related quality of life (OHRQoL).

OBJECTIVE

To investigate the association between preventive dental service use and OHRQoL by older Brazilians.

MATERIALS AND METHODS

This cross-sectional study was carried out using the baseline data of participants of the Brazilian Longitudinal Stud of Aging (ELSEI-Brazil) who were aged 60 years or more. Associations with the use of preventive dental services were carried out using Poisson regression models with robust variance, adjusting for confounders.

RESULTS

The final sample consisted of 5432 older adults. Almost all (90.7%) participants reported not having sought preventive dental services in the last year. Individuals who used dental services for prevention had fewer impacts on their OHRQoL (RR: 0.74; [95% CI: 0.57-0.97]).

CONCLUSION

Preventive dental service use is associated with a better OHRQoL in older Brazilians. Policies to improve access to preventive dental services may result in improved OHRQoL in this age group.

Periodontal conditions and association of periodontitis with oral-health-related quality of life in patients experiencing different episodes of bipolar disorder compared with healthy controls

AIM

The aim of the present cross-sectional study was to evaluate periodontal conditions and the association of periodontitis with oral-health-related quality of life (OHRQoL) in patients with a history of bipolar disorder.

MATERIALS AND METHODS

A total of 160 participants were recruited in four groups for the study: 40 patients with euthymic episodes, 40 patients with depression, 40 patients with manic episodes and 40 systemically healthy individuals. Clinical periodontal parameters were recorded. Oral Health Impact Profile (OHIP-14) was used to measure the impact of oral health on the quality of life.

RESULTS

Bipolar disorder groups exhibited generally higher clinical parameters compared with the control group (p < .05). OHIP-14 total score (β = 3.32, 95% confidence interval [CI]: 0.08-6.56, p = .044), functional limitation (β = .89, 95% CI: 0.27-1.49, p = .005) and physical pain (β = .64, 95% CI: 0.01-1.27, p = .046) were associated with bipolar depression episodes. Psychological discomfort was associated with the presence of generalized periodontitis (β = .76, 95% CI: 0.01-1.51, p = .047) and psychological disability was associated with the presence of stage III-IV (β = .83, 95% CI: 0.07-1.59, p = .033) and generalized (β = .75, 95% CI: 0.07-1.42, p = .029) periodontitis.

CONCLUSIONS

According to this study, a history of bipolar disorder episodes (exposure) may be associated with increased prevalence and severity of periodontitis and related reported OHRQoL impacts (outcomes). Bipolar depression episodes had a higher impact on OHRQoL than other bipolar episodes.

Oral microbiota, co-evolution, and implications for health and disease: The case of indigenous peoples

Evidence indicates that oral microbiota plays a crucial role in human health and disease. For instance, diseases with multifactorial etiology, such as periodontitis and caries, which cause a detrimental impact on human well-being and health, can be caused by alterations in the host-microbiota interactions, where non-pathogenic bacteria give way to pathogenic orange/red-complex bacterial species (a change from a eubiotic to dysbiotic state). In this scenario, where thousands of oral microorganisms, including fungi, archaea, and phage species, and their host are co-evolving, a set of phenomena, such as the arms race and Red or Black Queen dynamics, are expected to operate. We review concepts on the subject and revisit the nature of bacterial complexes linked to oral health and diseases, as well as the problem of the bacterial resistome in the face of the use of antibiotics and what is the impact of this on the evolutionary trajectory of the members of this symbiotic ecosystem. We constructed a 16SrRNA tree to show that adaptive consortia of oral bacterial complexes do not necessarily rescue phylogenetic relationships. Finally, we remember that oral health is not exempt from health disparity trends in some populations, such as Native Americans, when compared with non-Indigenous people.

Development and psychometric validation of the gum health experience questionnaire

AIM

To develop and validate a new health-related quality of life measure to capture a wide range of gum-related impacts.

MATERIALS AND METHODS

The measure was developed using a multi-stage approach and a theoretical model. Development involved semi-structured interviews, pilot testing, cross-sectional analysis among a general population (n = 152) to assess psychometric properties and test-retest reliability among a subsample (n = 27).

RESULTS

Psychometric analysis supports the validity and reliability of the measure's impact scale. The measure has excellent internal reliability (nearly all item-total correlations above .4; Cronbach's alpha between .84 and .91 for subscales), with test-retest reliability also performing well (Intra-class correlation coefficient [ICC] of .91-.97 for subscales). Good content validity (indicated by large standard deviations for item and total scores) and construct validity (correlations of .54-.73 with global gum health rating for subscales, all p < .05) were also observed. Qualitative and quantitative data indicate that people with gum health-related symptoms experience different degrees of discomfort and impacts caused by their condition.

CONCLUSIONS

The gum health experience questionnaire holds substantial promise as a measure of gum-related quality of life in people across the gum health-disease continuum. Further face validity, refining and reducing the number of items and longitudinal studies to test evaluative properties are required before the measure can be used with confidence.

Decreased bone mineral density is associated with an increased number of teeth with periodontitis progression: a 5-year retrospective cohort study

OBJECTIVE

Longitudinal studies on the systemic bone loss-periodontitis relationship are limited with disparate results. The aim of this study was to investigate the association between bone mineral density (BMD) and periodontitis progression, controlling for other covariables in a Thai population.

MATERIALS AND METHODS

In 2,418 participants, BMD values of the lumbar spine, femoral neck, and total hip were measured with dual-energy X-ray absorptiometry at baseline. Each participant's BMD status was classified as normal, osteopenia, or osteoporosis. Full mouth periodontal examinations on 6 sites/tooth were performed at baseline and 5-year follow-up visits. Periodontitis progression was defined as a tooth presenting an additional proximal CAL loss of ≥ 3 mm or an additional lost tooth with a baseline CAL ≥ 5 mm. The risk effects of BMD status on the number of teeth with periodontitis progression were analyzed using multivariate Poisson regression.

RESULTS

Baseline BMD status of osteoporosis was associated with an increased number of teeth with periodontitis progression in the subgroups of postmenopausal women, non-smokers, and participants with periodontitis stage III/IV with adjusted risk ratios of 1.31 (95% CI = 1.09-1.58), 1.19 (95% CI = 1.04-1.36), and 1.13 (95% CI = 1.00-1.28), respectively.

CONCLUSION

Baseline BMD in the osteoporosis range increased the risk of having a greater number of teeth with periodontitis progression in specific participant subgroups.

CLINICAL RELEVANCE

Decreased BMD is a potential factor affecting periodontitis progression risk in some individuals. Multidisciplinary approaches in educating and maintaining patients' bone-oral health may help improve their quality of life.

Effect of experimental periodontitis on cardiac functions: a comprehensive study using echocardiography, hemodynamic analysis, and histopathological evaluation in a rat model

Introduction

Periodontitis is a prevalent and severe dental condition characterized by the gradual degradation of the bone surrounding the teeth. Over the past two decades, numerous epidemiological investigations have suggested a potential link between periodontitis and cardiovascular disease. However, the complex mechanistic relationship between oral health issues and cardiovascular disorders remains unclear.

Aim

This study aimed to explore comprehensively the cardiac function through various methods, including conventional echocardiography, intraventricular pressure gradient (IVPG) analysis, speckle tracking echocardiography (STE), and hemodynamics analysis.

Methods

Ligature-induced periodontitis was established in a group of rats while the second group served as sham. The successful establishment of the periodontitis model was confirmed through staining and radiographic examination of the affected mandibles.

Results

X-ray films and methylene blue staining revealed alveolar bone resorption in the affected first molar in the model rats, confirming the successful induction of periodontitis. The rats with periodontitis displayed a decrease in ejection fraction compared to the sham group, accompanied by a decrease in mid-to-apical IVPG and mid IVPG. Lower values of strain rate were recorded in the apical segment of the septum, the middle segment of the septum, and the basal segment of the lateral free wall in the periodontitis group, which was associated with histopathological examination showing some degree of myocardial tissue damage. Conversely, rats with periodontitis showed an increase in heart rate, end-systolic volume, and arterial elastance when compared to the sham rats. However, they also exhibited a decrease in stroke work, stroke volume, cardiac output, and end-systolic pressure.

Conclusion

This study suggests that experimental periodontitis may lead to cardiac dysfunction especially compromised systolic function and myocardial relaxation, potentially indicating an increased risk of cardiovascular events in clinical periodontitis cases. The comprehensive assessment of cardiac function, hemodynamics, and histopathological evaluation underscores the profound impact of periodontitis on heart functions within this specific experimental model.

Enhancing patient-centred care in dentistry: a narrative review

INTRODUCTION

Patient-centred care (PCC) is widely used within the medical setting, but there is a need for more research on PCC implementation in dentistry.

SOURCES OF DATA

A narrative review was conducted with literature identified from the Ovid Interface, including several databases such as Embase and Medline.

AREAS OF AGREEMENT

PCC is associated with better health outcomes for patients, and greater work satisfaction among healthcare professionals.

AREAS OF CONTROVERSY

Efforts to implement PCC in dentistry are lacking due to several issues including non-consensus about PCC definition and lack of explicit guidelines on how to implement PCC in dentistry.

GROWING POINTS AND AREAS TIMELY FOR DEVELOPING RESEARCH

A theory-derived model of PCC explicitly designed for the dental setting was identified. This serves as a starting point to enhance PCC in dentistry, though further research is needed to empirically test the implementation of this model.

Potential Causal Association between Depression and Oral Diseases: A Mendelian Randomization Study

BACKGROUND

Globally, oral diseases are common, pose an economic burden, and significantly decline the quality of life of affected individuals. Recently, researchers have substantially highlighted the effect of depression on oral disease incidence and development. In this study, we elucidated the correlation between depression and oral diseases.

METHODS

Using two-sample Mendelian randomization (MR), the association between depression and the risk of 17 oral diseases was evaluated. Three methods were used to perform MR analysis: the inverse variance-weighted, weighted median, and MR-Egger methods. Furthermore, Cochran's Q test, MR-Egger intercept test, MR Pleiotropy RESidual Sum and Outlier test, and leave-one-out analysis were performed to analyze sensitivity.

RESULTS

After implementing multiple test corrections, we observed that genetic susceptibility to depression was associated with an increased risk of mouth ulcers, toothache, loose teeth, bleeding gums, painful gums, chronic periodontitis, chronic tonsil and adenoid diseases, peritonsillar abscess, and excessive tooth attrition. However, a causal relationship between depression and other oral diseases was not observed. Sensitivity analysis confirmed the robustness of the results.

CONCLUSIONS

We confirmed the causal relationship between depression and several oral diseases, thereby providing a novel viewpoint on the prevention and treatment of oral diseases. Our findings suggest the integration of depression control into routine clinical care to enhance the effectiveness of oral disease treatment.