Public Awareness of the Association between Periodontal Disease and Systemic Disease

Bibliometric analysis in Scopus of scientific production on the relationship between periodontitis and gastrointestinal cancer (2014 - 2023)

BACKGROUND

Recent studies have suggested that some opportunistic periodontal pathobionts have oncogenic properties. However, few bibliometric studies investigate the relationship between periodontitis and gastrointestinal cancer. This bibliometric study aimed to analyze these epidemiological studies conducted between 2014 and 2023 to guide future research.

MATERIAL AND METHODS

In March 2024, the Scopus database was explored. The articles selected were subjected to a bibliometric analysis of study designs, trends in annual scientific production, and networks of collaboration among countries. Furthermore, the most outstanding countries, academic institutions, authors and journals with the most significant number of publications and the top most cited articles were analyzed. For this purpose, Microsoft Excel, SPSS and VOSviewer 1.6.20 were used.

RESULTS

A total of 123 documents were included for analysis. China contributed the most significant number of publications (33 articles) and the United States had the most significant number of citations (2709). Weimin Ye (h-index:81) and Dominique Michaud (h-index:73) were the most prolific authors (5 articles); Dominique Michaud also had the most citations (470). International Journal of Cancer was the journal with the highest number of articles published (6), in addition to being the publication that had the most citations of these articles (409). Tufts University in the United States had the highest number of citations.

CONCLUSIONS

Between 2014 and 2023, 123 articles on the relationship between periodontitis and gastrointestinal cancer were published. The largest scientific production was found in China, and the most cited articles were those from the United States. Likewise, the research design most commonly used was the cross-sectional type.

Patient awareness of the association between periodontal and systemic diseases in an academic setting

BACKGROUND

Periodontal diseases (PD) have been increasingly associated with several systemic conditions such as cardiovascular disease (CVD), diabetes mellitus (DM), rheumatoid arthritis (RA), and Alzheimer's disease (AD). This study aimed to gain insight into patients' awareness of the association between PD and systemic diseases.

METHODS

A survey was developed to analyze patient awareness of the association between PD and systemic diseases. Descriptive and categorical variables were summarized with counts and percentages. Chi-squared tests were used to evaluate differences between variables. A linear logistical regression model was used to assess the simultaneous, independent association between each variable.

RESULTS

Data from 161 completed surveys were analyzed. The majority of the participants (61.49%) reported awareness of symptoms of PD, but only 36.36% identified all its major symptoms. Individuals reporting awareness of the association between PD and systemic diseases was 48.4%, 31.7%, 14.9%, and 9.9% for CVD, DM, RA, and AD, respectively. Patients aged ≥51 years and males were more aware of the association between PD and CVD. Increased awareness of an association between PD and DM was observed among patients who had a higher frequency of dental visits and those with a self-reported history of DM.

CONCLUSIONS

This study provides insight that, even with the vast amount of scientific knowledge on the inter-relationships that exist between PD and systemic diseases, most patients are still unaware of these associations. This research identified that improvement of health literacy surrounding PD, their symptoms, and their association with systemic diseases may be warranted.

The impact of prebiotics and probiotics on the oral microbiome of individuals with periodontal disease: a scoping review

Background

The influence of prebiotics and probiotics on oral microbiome composition, addressing dysbiosis, and aiding in the regulation of the immune-inflammatory response has recently been discussed. The objective of this scoping review is to explore current literature that examines the use of prebiotics and probiotics as adjunctive therapy for the treatment of periodontal disease with the intent to identify gaps in the literature to inform future research and dental hygiene practice.

Methods

This review was conducted from December 2022 to August 2023 using the Arksey and O'Malley approach and PRISMA-ScR guidelines. Three databases were searched using combinations of keywords. Only peer-reviewed human/in vitro studies published in the last 10 years were included.

Results

The search retrieved 204 articles. Duplicates were removed, titles and abstracts screened, and the full text of 80 articles examined, resulting in the inclusion of 19 articles.

Discussion and Conclusion

Most of the included literature indicated that probiotics have a positive impact on periodontal health as evidenced by changes in periodontal disease parameters. Future research should further examine various modes of administration and dosages. The effects of specific prebiotic and probiotic strains on specific pathogenic bacteria in conjunction with non-surgical periodontal therapy should also be further explored.

Periodontal and Systemic Diseases: A Descriptive Analysis of Awareness Among the General Saudi Population

Background Taking into account the limited availability of research data, this study aimed to determine the general Saudi population's awareness of the link between periodontal diseases and systemic diseases. Methodology A structured online questionnaire with eight awareness items, apart from demographic variables, was distributed through email, WhatsApp, and Telegram to a sample of 500 individuals. The data were analyzed using a simple descriptive statistical approach and interpreted as ratios for comparison. The awareness regarding systemic diseases associated with periodontal diseases was classified into the following four categories based on the Bloom cutoff points: high (>80%), average (60-79%), low (40-59%), and extremely low (<40%). Results A response rate of 68% was reached with the participation of 340 Saudi citizens residing in the Al Qassim region. Overall, 61.22% of research participants had an average awareness of the link between periodontal and systemic diseases. Almost two-thirds (>60%) of participants were aware that periodontal diseases and systemic diseases have an association and that individuals with systemic diseases need a periodontal checkup. A majority (85%) of participants opined that periodontal treatment has the potential to enhance overall health. Nonetheless, only a few participants (60%) were aware of the association between diabetes mellitus and periodontal diseases, and they had a limited awareness of the association with other systemic diseases. Conclusions Although the Saudi general population possesses average awareness about the relationship between periodontal diseases and systemic diseases, their awareness about different systemic diseases and conditions is extremely low, particularly regarding infertility, stroke, and metabolic diseases. The present research indicates a deficiency in the efforts by healthcare professionals, community service providers, and community administrators to educate the general public regarding the association between periodontal diseases and systemic diseases. This awareness is crucial for individuals to control these intricate, interconnected diseases.

Awareness of physicians and dentists in Serbia about the association between periodontitis and systemic diseases: a cross-sectional study

BACKGROUND

Strong evidence supports the association between periodontitis and certain systemic diseases. The aim of the present study was to evaluate the knowledge of a group of physicians and dentists in Serbia regarding this topic and assess their professional actions to prevent and control both periodontal and systemic diseases.

METHODS

An anonymous self-administered structured questionnaire was sent to the available e-mail addresses of randomly selected healthcare providers working in Serbia. According to the inclusion criteria, general practitioners, specialists, general dentists, and specialists working in government hospitals and private practices in various cities in Serbia were recruited in the study. The questionnaire consisted of 17 questions divided into three parts. The first part recorded the sociodemographic characteristics of participants, the second part included questions about the clinical manifestation and etiology of periodontitis, as well as knowledge of the association between periodontitis and systemic diseases, and the third part included questions about professional procedures for the prevention and control of periodontitis and systemic diseases.

RESULTS

A total of 1301 health participants, 739 (57.8%) physicians and 562 (43.2%) dentists, were included in this cross-sectional study. Most respondents (94.7%) were aware of the association between periodontitis and general health. The highest percentage of respondents associated diabetes mellitus and periodontitis. Factors significantly associated with higher knowledge were female sex (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.37-2.52; p < 0.001) and dental profession (OR, 5.86; 95% CI], 4.03-8.53; p < 0.001). Participants who had higher knowledge score were more likely to ask their patients about gum/systematic health (p < 0.001) and refer them to dentists/physicians (p < 0.001).

CONCLUSIONS

It was concluded that compared to the group of dentists, the group of physicians had less knowledge of the relationship between periodontitis and systemic diseases. The female gender was significantly associated with better knowledge. A better understanding of this topic is associated with better clinical practice.

Association between Chronic Gingivitis and Cancer: A Retrospective Cohort Study of 19,782 Outpatients from the United Kingdom

Purpose: Recent data argue for the involvement of inflammatory and infectious diseases in cancer development. However, clinical data on the association between chronic gingivitis and cancer have been less conclusive. Here, we systematically evaluated the cancer incidence in a population-based cohort of outpatients with chronic gingivitis from the United Kingdom. Methods: 9891 patients with chronic gingivitis and an identical number of people without gingivitis matched by age, gender, index year, and the Charlson Comorbidity Index were identified from the Disease Analyzer database (IQVIA) between January 2000 and December 2016. Cox regression models were used to study the association between gingivitis and cancer. Results: The probability of cancer was significantly higher among patients with diagnosed chronic gingivitis compared to non-gingivitis individuals (HR = 1.36, 95% CI = 1.15–1.62). In cancer site-stratified analyses, we observed a trend towards higher rates of cancer in almost all cancers (breast cancer, lymphoid system cancer, digestive tract cancers, skin cancer); however, a significant association was only observed for prostate cancer (HR: 3.38; 95% CI: 1.57–7.27). Notably, the largest increase in cancer rates was observed in male patients (HR: 1.46, 95% CI: 1.13–1.89) between 41 and 60 years old (HR: 1.74, 95% CI: 1.30–2.32). Conclusions: Our data suggest that chronic gingivitis represents an important risk factor for the development of cancer. Therefore, in the context of patient dental care, awareness should be raised to refer gingivitis patients to existing screening programs, especially for prostate cancer. Moreover, the consistent treatment of gingivitis could potentially have a positive impact on the morbidity of certain cancers.

Periodontal Disease in Young Adults as a Risk Factor for Subclinical Atherosclerosis: A Clinical, Biochemical and Immunological Study

Although a strong relationship between periodontal disease (PD) and atherosclerosis was shown in adults, little data are published in younger PD patients. Therefore, this study aimed to investigate and correlate clinical parameters of PD, pro- and immunoregulatory cytokines in gingival crevicular fluid (GCF) and serum, biochemical and hematological parameters associated with atherosclerosis risk, and carotid intima-media thickness (IMT) in our younger study participants (n = 78) (mean age 35.92 ± 3.36 years) who were divided into two equal groups: subjects with and without PD. PD patients had higher values of IMT, hs-CRP, triglycerides, total cholesterol, and LDL; most proinflammatory and Th1/Th17-associated cytokines in GCF; and IL-8, IL-12, IL-18, and IL-17A in serum compared to subjects without PD. These cytokines in GCF positively correlated with most clinical periodontal parameters. Clinical periodontal parameters, TNF-α and IL-8 in GCF and IL-17A, hs-CRP, and LDL in serum, had more significant predictive roles in developing subclinical atherosclerosis (IMT ≥ 0.75 mm) in comparison with other cytokines, fibrinogen, and other lipid status parameters. Hs-CRP correlated better with the proinflammatory cytokines than the parameters of lipid status. Except for serum IL-17A, there was no significant association of clinical and immunological PD parameters with lipid status. Overall, these results suggest that dyslipidemia and PD status seem to be independent risk factors for subclinical atherosclerosis in our younger PD population.