Enzymatic Analysis of the Gingival Crevicular Fluid in Hypoxia of High Altitude (Everest)

The correlation of altitude with gingival status among adolescents in western China: a cross-sectional study

Periodontal disease is common in Chinese adolescents. There is little information about the effect of different altitudes on gingival health. This study aimed to investigate the gingival status at different altitudes and to identify relative factors that affect adolescents' gingival status. A total of 1033 adolescents aged 12-14 years were included in this cross-sectional study in Ganzi (plateau, 1400 m, 2560 m, 3300 m) and Suining (plain, 300 m). Gingival status was assessed by the presence of gingival bleeding on probing (BOP) and dental calculus (DC). Demographic variables, socioeconomic status, dairy habits and oral health-related knowledge, attitudes and behaviors were obtained via questionnaire. Univariate and multivariate binary logistic regression analyses were performed to identify potential relative factors. A total of 64.09% and 77.15% of adolescents had BOP and DC, respectively. The prevalence rates of BOP and DC were higher in the plateau than the plain (P < 0.05). After adjusting for all other factors and interaction terms, residence altitudes of 2560 m [300 m as reference: P < 0.001, odds ratio (OR) = 4.072] and 3300 m (300 m as reference: P = 0.002, OR = 4.053) were significant relative factors of BOP, and an altitude of 2560 m (300 m as reference: P = 0.001, OR = 3.866, 1400 m as reference: P = 0.001, OR = 3.944) was an important relative factor of DC. Gingival bleeding and calculus deposits were common at different altitudes. High altitude was a significant relative factor of gingival bleeding and calculus deposits.

High Altitude and Its Effects on Oral Health: A Review of Literature

Health deterioration at high altitudes is related to many pathophysiological processes. The literature contains much evidence describing the multiple factors responsible for this deterioration, including hypoxia, decreased oxygen saturation, and decreased barometric pressure. An increase in the levels of oxidative stress at high altitudes can lead to many serious health events, although the human body may be able to adapt to such changes in the case of people who are accustomed to living at a high altitude. The pathophysiological processes at high altitudes also have adverse effects on oral tissue health. The aim of this review is to summarize the major published findings about oral health deterioration of living in and travelling to high-altitude areas.

Most studies have noted the adverse effects of prolonged exposure to hypoxia at high altitudes on oral tissues, including the salivary gland, periodontal tissue, gingival crevicular fluids, and jawbone. These changes include increases in the levels of inflammatory mediators and periodontal inflammation parameters. In addition, the incidence and severity of dental fluorosis is higher in residents of high-altitude areas. Abrupt changes in barometric pressure in people who travel to high altitudes may cause dental barotrauma and appear to increase sensitivity to pain (barodontalgia). In conclusion, it is important to consider that travelling to and living in high-altitude areas is a possible risk factor for multiple oral diseases.