Relationship Between Low Education and Poor Periodontal Status among Mexican Adults Aged ≥50 Years.

PURPOSE: To examine the association between educational level and the presence of periodontal disease in adults ages ≥ 50 years in Mexico. MATERIALS AND METHODS: A cross-sectional study was conducted on 2098 Mexican adults, using data from the annual reports of the Epidemiological Monitoring System for Oral Pathologies from 2019-2022. Data were collected on sociodemographic characteristics such as gender, age, educational level, oral hygiene, and diabetes. Periodontal status was evaluated using the Community Periodontal Index (CPI) and was classified into: CPI = 0 (healthy); CPI = 1 (bleeding on probing); CPI = 2 (calculus); and CPI = 3 or 4 (pocket depth ≥ 4 mm). A multinomial regression model was used to estimate the odds ratio (OR) and the 95% confidence intervals (CI), using periodontal status as the result. RESULTS: 39.9% of subjects presented periodontal pockets of ≥ 4 mm, 20.8% presented calculus, and 12.8% presented bleeding, while only 26.4% were classified as healthy. A low level of education (≤ 9 years) (OR = 4.84; p 0.001), age ≥ 65 years (OR = 1.33; p = 0.025), poor oral hygiene (OR = 6.86; p 0.001), smoking (OR = 1.51; p = 0.025), and diabetes (OR = 1.73; p 0.001) were statistically significantly associated with the presence of periodontal pockets ≥ 4 mm. CONCLUSIONS: A low level of education is associated with worse periodontal status in adults aged 50 years or more. These findings reiterate the importance of implementing effective strategies and the incorporation of interventions for improving the access to and quality of services targeted at aging communities.

Association of Periodontal Condition With Impaired Glucose Tolerance: Results of a 15-Year Follow-Up Study.

OBJECTIVES: The aim of this study was to investigate whether periodontal condition is associated with the development of impaired glucose tolerance (IGT). MATERIAL AND METHODS: This study was based on a subpopulation of a cohort of persons born in 1935 and living in Oulu, Finland, on October 1, 1990. The participants were normoglycemic (no previously diagnosed diabetes mellitus and a 2-h oral glucose tolerance test [OGTT] blood glucose < 7.8 mmol/L) in the baseline examinations (1990-1992) and had fasting blood glucose < 7.0 mmol/L in the follow-up examinations (2007-2008) (n = 225). The outcome was IGT on follow-up, measured by a blood glucose level of ≥ 7.8 mmol/L after OGTT. The exposure was the periodontal condition at baseline categorized into four groups: 0, 1-6, ≥ 7 sites with deepened (≥ 4 mm) periodontal pockets, and edentulousness. RESULTS: A total of 23% of the participants developed IGT. The adjusted incidence rate ratios with 95% confidence intervals (CI) for dentate participants with 1-6 sites and ≥ 7 sites with deepened periodontal pockets, and edentate participants (reference category dentate participants without deepened periodontal pockets) were 1.5 (95% CI, 0.6-4.0), 1.8 (95% CI, 0.7-4.4), and 1.6 (95% CI, 0.6-4.0), respectively. CONCLUSIONS: Poor periodontal condition may predispose individuals to IGT; however, further studies on this matter are warranted.

Prevalence of species of yellow, purple and green microbial complexes in endo-perio lesions: a systematic review.

This review aimed to determine the prevalence of species of yellow, purple and green microbial complexes in root canals (RC) and periodontal pockets (PP) of teeth with endodontic-periodontal lesions. For this purpose, two reviewers searched the literature up to January 2022. Studies reporting the prevalence of species of the yellow, purple and green microbial complexes in teeth diagnosed with endodontic-periodontal lesions were included. The risk of bias of the included studies was assessed using the 14 criteria from the NIH Quality Assessment Tool. Of 1,611 references identified in the initial search, only four studies were eligible and included in the qualitative analysis. The profile and prevalence rates of bacterial species in RC and PP varied among the included studies: levels of Agregatibacter actinomycetemcomitans (12% RC, 58% PP), Capnocytophaga granulosa (10% RC, 35% PP), Capnocytophaga sputigena (15-70% RC, 0-30% PP), Streptococcus mitis (30% RC, 35% PP), Streptococcus sanguinis (30% RC, 35% PP), and Veillonella parvula (70% RC, 50% PP) were identified. The high methodological heterogeneity prevented grouping and quantitative analysis of data. The risk of bias was considered 'moderate' for all studies. The included studies identified the presence of seven bacterial species belonging to the yellow, purple, and green microbial complexes in RC and PP, but with different prevalence rates. Future clinical studies are encouraged to investigate the presence and role of these species in the occurrence and development of endodontic-periodontal lesions.

Periodontitis and the incidence of metabolic syndrome: An 8-year longitudinal study of an adult Japanese cohort.

AIM: To examine the effect of periodontitis on the development of metabolic syndrome (MetS) and MetS components. MATERIALS AND METHODS: This study included 4761 participants aged 30-74 years who underwent health examinations at both baseline and 8-year follow-up. The Japanese MetS criteria were used for diagnosis. The Community Periodontal Index was used to assess periodontal status. The association between periodontal status and MetS incidence was examined by Poisson regression analysis. RESULTS: Multivariate analysis revealed that individuals with a ≥6 mm periodontal pocket had a significantly higher relative risk (RR) for MetS onset, as compared to individuals without deep periodontal pockets (adjusted RR 1.30, 95% confidence interval [CI]: 1.01-1.67). Compared to individuals without a deep periodontal pocket, individuals with a ≥6 mm periodontal pocket had significantly higher RRs for developing two components of MetS; the RRs were 1.25 (95% CI: 1.01-1.56) for abdominal obesity and 1.39 (95% CI: 1.03-1.86) for hyperglycaemia. CONCLUSIONS: Individuals with periodontitis had a significantly higher risk of MetS onset, possibly due to the influence of periodontitis on abdominal obesity and hyperglycaemia.

Analysis of epidemiological trends of and associated factors for tooth loss among 35- to 44-year-old adults in Guangdong, Southern China, 1995-2015: a population-based cross-sectional survey.

BACKGROUND: Tooth loss is a known marker of oral and systemic health, but large-scale population-based and cross-sectional multi-year comparative studies on tooth loss have yet to be much studied in China. This study explores the changing trends in tooth loss status and the associated factors influencing the prevalence of tooth loss over the past two decades in Guangdong, Southern China. METHODS: Data from three cross-sectional, representative oral epidemiological surveys in Guangdong Province were analyzed, including 400 in 1995, 720 in 2005, and 288 in 2015, for a total of 1408 participants. Sample selection is based on the National Census of China published by the National Bureau of Statistics. In this study, each year, the number of missing teeth (MT) and the prevalence of tooth loss (MT > 0) were calculated. Basic demographic information, socioeconomic status, caries and periodontal status, personal lifestyle factors, and dental health care behaviors were analyzed by multivariate logistic regression to estimate their associations with tooth loss. Statistical significance was evaluated with 2-sided tests with a significance level of P < 0.05. RESULTS: This study found that the mean number of missing teeth and the prevalence of tooth loss among adults aged 35-44 years in Guangdong Province did not change significantly in the first decade (1995-2005) but decreased significantly in the second decade (2005-2015) (0.94 and 40.8% in 1995, 0.99 and 42.9% in 2005, and 0.63 and 33.3% in 2015, respectively). The mean number of MT by tooth position was highest for the first and second molars, and both were larger in the mandible than in the maxilla. In 1995, populations with low educational attainment and the presence of caries or periodontal pocket (periodontal probing depth ≥ 4 mm) were associated with a higher chance of MT > 0. In 2005, those with low educational attainment, the presence of caries, and 40-44 years old were associated with a higher chance of MT > 0. Moreover, in 2015, females, rural residents, and those with caries or periodontal pocket were associated with a higher chance of MT > 0. CONCLUSIONS: Although tooth retention has improved recently (2005-2015) and the preventive effect of education level on tooth loss has increased over time, efforts to prevent tooth loss in adults need to be strengthened. Particular attention should be given to preventive interventions for women, rural residents, and those suffering from caries or periodontal pocket.

[Association between periodontal pocket depth determined during dental check-ups and new onset of diabetes in community residents: the LIFE study].

Objectives　Recent studies have shown a bidirectional association between diabetes and periodontal disease. However, the longitudinal association between periodontal pocket depth and new onset of diabetes remains controversial. Therefore, this study aimed to examine the association between periodontal pocket depth and new onset of diabetes using dental check-up data in a community-based population.Methods　The study comprised 5,163 participants aged≥20 years (mean age±standard deviation, 57.4±13.9 years; women, 66.3%) who underwent dental check-ups between April 2016 and March 2019 in a Tokyo ward. We classified the participants into three groups using community periodontal index codes from dental check-ups: healthy periodontal pocket group, periodontal pocket 4-5 mm group, and periodontal pocket ≥6 mm group. The participants were followed until the end of March 2020. Additionally, data on individuals who developed diabetes in the same ward were acquired from the National Health Insurance and Latter-Stage Older Persons Health Care System using ICD-10 codes. As the study outcome, we identified individuals who developed diabetes after the dental check-up date. Diabetes incidence rates were compared using the log-rank test and Cox regression analysis. Additionally, we performed a sensitivity analysis using a similar framework.Results　The log-rank test showed that the cumulative incidence of diabetes between the three groups was significantly different (P<0.01). A Cox regression analysis model adjusted for sex, age, smoking habits, number of teeth present, and oral hygiene status showed that the diabetes development hazard ratio (HR) for the periodontal pocket ≥6 mm group was 1.44 (95% confidence interval [CI]; 1.04-2.00) when compared with that of the healthy periodontal pocket group. In the sensitivity analysis of individuals aged ≥40 years, the HR for the periodontal pocket ≥6 mm group was 1.55 (95% CI; 1.11-2.16) when compared with that of the healthy periodontal pocket group. Similarly, among men aged ≥40 years, the HR for the periodontal pocket ≥6 mm group was 1.72 (95% CI; 1.04-2.85) when compared with that of the healthy periodontal pocket group. However, no significant association between new onset of diabetes and periodontal pocket depth was found for women aged ≥40 years (HR=1.39, 95% CI; 0.89-2.18).Conclusion　This The study suggests a longitudinal association between periodontal pocket depth and new onset of diabetes. The association was particularly pronounced in men aged ≥40 years. Therefore, men aged <40 years should maintain good oral health through appropriate dental health guidance to prevent the future development of diabetes.

[Periodontal status of temporarily institutionalized homeless adults and associated factors]. / Condição periodontal de adultos em situação de rua temporariamente institucionalizados e fatores associados.

The scope of this cross-sectional study was to describe the periodontal status and its association with sociodemographic, oral-health related behaviors and use of drugs among temporarily institutionalized homeless adults. The data were collected through oral clinical examination and a questionnaire with 102 adults attending the only public institution for this group in Goiânia, Goiás, Brazil. The periodontal condition was measured by the presence of bleeding on probing, dental calculus and pockets, according to the Community Periodontal Index (CPI). Chi-square test and Poisson regressions with robust variance were performed. The prevalence of CPI>1 was 83.3%. Approximately 68% of the sample had bleeding, 82.4% had calculus and 9.8% had periodontal pockets. In the bivariate analyses, those who reported having used illicit drugs had a higher prevalence of calculus; males and unmarried adults had a higher prevalence of pockets. In the adjusted analysis, individuals who used dental floss had a lower prevalence of bleeding (PR=0.58; 95%CI=0.35-0.96). The remaining covariates were not associated with the outcomes. It was concluded that the prevalence of periodontal alteration was high, the most frequent condition was calculus and the only independent association was between bleeding and the use of dental floss.

O objetivo deste estudo transversal foi descrever a condição periodontal e sua associação com fatores sociodemográficos, comportamentos em saúde bucal e uso de drogas entre indivíduos em situação de rua temporariamente institucionalizados. Os dados foram coletados por meio de exame clínico e questionário com 102 adultos atendidos na única instituição pública para este grupo em Goiânia, Goiás. A condição periodontal foi avaliada pela presença de sangramento à sondagem, cálculo dentário e bolsas, de acordo com o Índice Periodontal Comunitário (CPI). Foram realizados o teste Qui-quadrado e regressões de Poisson com variância robusta. A prevalência de CPI>1 foi de 83,3%. Cerca de 68,0% da amostra apresentou sangramento, 82,4% cálculo e 9,8% bolsa periodontal. Nas análises bivariadas, os que tinham usado drogas ilícitas alguma vez tinham maior prevalência de cálculo; os homens e os indivíduos sem união estável tinham maior prevalência de bolsa. Na análise ajustada, indivíduos que usavam fio dental tiveram menor prevalência de sangramento (RP=0,58; IC95%=0,35-0,96). As demais covariáveis não foram associadas aos desfechos. Concluiu-se que a prevalência de alteração periodontal foi alta, houve predomínio de cálculo e a única associação independente foi entre sangramento e uso de fio dental.

Association between bleeding periodontal pockets and eczemas: Results of the Northern Finland Birth Cohort 1966.

AIM: To investigate whether the periodontal condition as measured by bleeding periodontal pockets is associated with atopic dermatitis, seborrheic dermatitis, and eczema nummulare. MATERIALS AND METHODS: The study population (n = 1871) was obtained from the 46-year follow-up study of the Northern Finland Birth Cohort 1966 study (NFBC1966). The periodontal condition was measured by the number of sites with bleeding periodontal pockets that were ≥4 mm deep. The whole skin of the participants was clinically examined, and diagnoses of skin diseases were made according to the International Classification of Diseases. Prevalence rate ratios (PRR) and 95% confidence intervals (95% CIs) were estimated using Poisson regression models with robust error variance. RESULTS: In this cohort, comprising 46-year-old participants of NFBC1966, the presence of 1-3 and ≥4 bleeding-deepened periodontal pockets (≥4 mm deep) were associated with seborrheic dermatitis (PRR 1.9, 95% CI: 1.3-2.8 and PRR 2.2, 95% CI: 1.4-3.3, respectively) and with eczema nummulare (PRR 1.7, 95% CI: 0.9-3.1 and PRR 1.7, 95% CI: 0.9-3.3, respectively). For non-smokers, the corresponding estimates were 1.7 for seborrheic dermatitis (95% CI: 1.1-2.6) and 1.8 (95% CI: 1.1-3.1) and 1.4 for eczema nummulare (95% CI: 0.7-2.9) and 1.2 (95% CI: 0.5-2.9), respectively. No association was found between bleeding-deepened periodontal pockets and atopic dermatitis. Further adjustments for C-reactive protein, diabetes, and inflammatory diseases did not essentially change the risk estimates among either the total population or the non-smokers. CONCLUSION: Bleeding periodontal pockets appeared to be associated with the presence of seborrheic dermatitis and eczema nummulare.

Association between periodontal condition and blood pressure is confounded by smoking.

OBJECTIVE: To investigate the role of smoking as a confounding factor in the association between periodontal pocketing and blood pressure. MATERIAL AND METHODS: After restriction to 45-64-year-old subjects without hypertension, diabetes, rheumatic diseases, obesity and with no history of cardiovascular diseases or ongoing lipid-lowering medications, the study population consisted of 307 subjects of the Health 2000 Survey in Finland. Systolic and diastolic blood pressure and pulse pressure (mmHg) were used as outcome variables. Periodontal condition was measured by the number of teeth with ≥4 mm periodontal pockets. ß-estimates and 95% confidence intervals (CI) were obtained from linear regression models. Analyses were made in the whole study population and stratified according to smoking habits/history. RESULTS: The number of teeth with ≥4 mm periodontal pockets associated statistically significantly with systolic blood pressure and pulse pressure in the whole study population. Among never-smokers or daily smokers, there were no consistent nor statistically significant associations between the number of teeth with ≥4 mm periodontal pockets and systolic/diastolic blood pressure or pulse pressure. CONCLUSIONS: Smoking appeared to confound the association between periodontal condition and blood pressure. Thorough control for the effect of smoking was not obtained using multivariate models.

The frequency of periodontitis in end-stage renal disease on hemodialysis in a sample of Egyptian population: multi-center clinical cross-sectional study.

BACKGROUND: There is a general assumption that periodontal disease is highly prevalent among patients with chronic renal failure undergoing hemodialysis. The aim of the study to estimate the frequency of periodontitis in patients on hemodialysis among a sample of the Egyptian population, as well as the correlation between different clinical parameters of periodontal status with serum creatinine and blood urea. This may rule out the bidirectional relationship between periodontitis and renal failure in patients on hemodialysis. METHODS: The study was conducted on 263 hemodialysis patients (165 males and 98 females) at three dialysis centers in Benha Governorate, Egypt (Benha Hospital, Tukh hospital, Qalyub hospital). Periodontal parameters including plaque index (PI), gingival index (GI), clinical attachment level (CAL), and probing pocket depth (PPD) had been recorded in these patients. Serum urea and creatinine levels had been measured, the data had been collected and undergone statistical analysis. RESULTS: Frequency of periodontitis was 85.6% with stage III is the most prevalent stage. There was a significant positive strong correlation between age and periodontitis stage (rs = 0.707, p < 0.001). There was a positive correlation between clinical parameters and serum creatinine level. CONCLUSION: In the present study, a high frequency of periodontitis had been found among ESRD patients on hemodialysis in the severe form (stage III) periodontitis. There was a significant direct correlation between the severity of periodontitis and CAL with a duration of hemodialysis. There was a weak insignificant association between periodontal indices (PD, BOP, and plaque score) and duration of hemodialysis.

Association of long-term obesity and weight gain with periodontal pocketing: Results of the Northern Finland Birth Cohort 1966 study.

AIM: To investigate whether obesity, central obesity, and weight gain are associated with periodontal pocketing. MATERIALS AND METHODS: A never-smoking sub-population (n = 725) of the Northern Finland Birth Cohort 1966 was categorized based on body mass index (BMI; participants with normal weight, overweight, and obesity) and waist circumference (WC; participants without central obesity and with central obesity) at ages 31 and 46. The categories were combined to define whether the participants stayed in the respective BMI and WC categories or moved on to a higher category during follow-up. A periodontal examination was done at age 46. RESULTS: WC was more consistently associated with periodontal pocketing than BMI. The relative risks for the number of sites with periodontal pocket depth (PPD) ≥4 mm and bleeding PPD ≥4 mm in participants with central obesity both at age 31 and at age 46 were 1.7 (95% confidence interval [CI] 1.4-2.0) and 2.1 (95% CI 1.6-2.6). The corresponding values for participants who had no central obesity at age 31 but had central obesity at age 46 were 1.6 (95% CI 1.4-1.8) and 1.9 (95% CI 1.6-2.3). CONCLUSION: Of all the studied measures, central obesity appeared to be most strongly associated with the inflammatory condition of the periodontium.

Periodontal Health, Nutrition and Anthropometry in Professional Footballers: A Preliminary Study.

Poor oral health in elite sport is a pressing issue, however little is known about the periodontal status of professional footballers. The aim of this study was to examine the prevalence of periodontitis in a group of professional footballers and its association with nutritional parameters and self-report non-traumatic injuries. Additionally, we assessed its association with anthropometric, dietary inflammatory load and self-reported muscular and/or articular injuries. Twenty-two professional footballers were evaluated at the beginning of the 2020-2021 season via full-mouth periodontal inspection, anthropometric measurements and the application of the dietary inflammatory index through a food intake measurement of 24 h dietary recall on two different days. Self-reporting non-traumatic muscular and articular injuries for the past 6 months were recorded from each athlete. Then we compared clinical measurements according to the periodontal status and we correlated age, periodontal and nutritional parameters. Overall, the prevalence of periodontitis was 40.9% and peri-implantitis was also observed. No significant differences were found regarding age or nutritional parameters according to the periodontal status. More non-traumatic muscular events in the past 6 months were found in the periodontitis group (55.6% vs. 38.4%), although the difference was non-significant. Both clinical attachment loss, periodontal pocket depth and the periodontal epithelial surface area revealed a significant moderate correlation with the percentage of fat mass, muscle mass, muscle mass index and total adipose folds. This group of professional footballers showed an alarming prevalence of periodontitis. Further studies shall examine whether periodontitis and periodontal treatment impact the performance of this group of athletes.

Influence of Micronutrient Intake, Sociodemographic, and Behavioral Factors on Periodontal Status of Adults Assisted by a Public Health Care System in Brazil: A Cross-Sectional Multivariate Analysis.

The lack of access to a balanced diet, rich in vitamins and minerals, can predispose people to inflammatory diseases such as obesity, diabetes mellitus, and periodontitis. We aimed to evaluate the relationship between micronutrient intake, sociodemographic behavioral characteristics, and periodontal health in adults assisted by a public health care system. Participants (n = 450) answered a food frequency questionnaire and were submitted to anthropometric and oral clinical examinations. Principal component analysis was used to summarize the number of components emerging from 17-micronutrient intake. Subsequently, cluster analysis was employed. The prevalence of at least one periodontal pocket ≥ 4 mm was 67.4%. Three clusters were identified according to periodontal status. Cluster 1 "poor periodontal status" was characterized by older individuals (n = 202; 85% females) with poor periodontal status, lower education level, mainly smokers with non-transmissible chronic diseases (NTCD), with lower energy, omega-3, fiber, Zn, K, Cu, and vitamin C intake. Cluster 3 "healthy periodontal status" included younger individuals (n = 54) with the healthiest periodontal status, a higher education level, without NTCD, and with higher energy, omega-3, fiber, Zn, calcium, retinol, and riboflavin intake. Cluster 2 was labeled as "intermediate periodontal status". Micronutrient ingestion was associated with periodontal status and may be considered in health promotion actions for low-income populations.

Determinants of periodontitis according to the immunological and virological profiles of HIV-infected patients in Yaoundé, Cameroon.

BACKGROUND: HIV infection is associated to different oral manifestations (including periodontal diseases), which have decreased with the advent of antiretroviral therapy (ART). Yet, the occurrence of periodontitis is still consistent among patients with HIV living in sub Saharan-Africa, with limited evidence on the driven factors and mitigating measures in these settings. We aimed at evaluating the occurrence of periodontitis and its associated immunological and virological factors in patients with HIV living in Yaoundé, Cameroon. METHODS: We included 165 (44 ART-naïve and 121 ART-experienced) patients > 18 years old attending the Yaoundé Central Hospital and the Chantal BIYA International Reference Centre, from January-April 2018. The periodontal status was assessed by measuring the clinical attachment loss, periodontal pocket depth, plaques index and gingival bleeding index. CD4+/CD8+ cells and viremia were measured using the fluorescence-activated cell sorting method (FACS Calibur) and the Abbott m2000 RT HIV-1 RNA kit respectively. A standard-questionnaire concerning participants' medical records and oral hygiene methods was filled. Data was analyzed and p < 0.05 considered statistically significant. RESULTS: There was a significantly high prevalence of periodontitis in the ART-naïve (53.2%) compared to the ART-experienced group (37.3%), with a twofold increased risk of the ART-naïve population presenting with periodontitis than the ART-experienced population (OR 2.06, p = 0.03). More importantly, ART-naïve, patients with CD4 < 200 cells presented with higher risk of having periodontitis compared to those with higher CD4-values, with a threefold difference (OR 3.21). Worth noting, males presented with a higher risk of having clinical attachment loss (OR 6.07). There was no significant association between the occurrence of periodontitis and the CD8 (p = 0.45) or viremia (p = 0.10). CONCLUSION: In the Cameroonian context, a considerable number of adults infected with HIV suffer from periodontitis regardless of their treatment profile. Nonetheless, ART-naïve patients have a higher risk, indicating the protective role of ART. Interestingly, severely immune-compromised patients and men are vulnerable to periodontitis, thereby highlighting the need for clinicians to refer patients for regular periodontal screening especially male patients and those with low CD4. Such measures could greatly improve the quality of life of the population living with HIV in Cameroon.

Alcohol use and the development of periodontal pockets: An 11-year follow-up study.

BACKGROUND: This study investigates whether alcohol use predicts the periodontal pocket development over an 11-year follow-up period. METHODS: The study participants' periodontal condition was examined both in the Health 2000 and 2011 Surveys (BRIF8901). Participants were aged 30 to 65 years, dentate, periodontally healthy, and did not have diabetes or rheumatoid arthritis in 2000. Periodontal outcome measures in 2011 were the number of teeth with deepened (≥4 mm) periodontal pockets and the presence of deepened periodontal pockets. The exposure in 2000 was alcohol use (amount [g/week], frequency [any alcohol or different beverages]). Incidence rate ratios (IRRs) with 95% confidence intervals (CI) were estimated using negative binomial regression model and Poisson regression model with a robust variance estimator. RESULTS: Overall, the amount of alcohol use or use over the risk limit in 2000 was inconsistently associated with the development of periodontal pockets (IRRs varied from 0.6 to 1.0). The frequency of alcohol use (any alcohol or different beverages) had an inconsistent association with the presence of periodontal pockets (IRRs varied from 0.5 to 1.2) while there was an inverse association with the number of teeth with periodontal pockets. Among smokers, there were no clear associations between any of the exposures and either of the outcomes. The same was found among non-smokers except an inverse association was found between frequency of alcohol use and the number of teeth with periodontal pockets. CONCLUSION: Alcohol use was not consistently associated with the periodontal pocket development over a period of 11 years.

Tooth loss in adults: factors associated with the position and number of lost teeth.

OBJECTIVE: To evaluate the factors associated with tooth loss in adults from the position and number of teeth lost in the dental arches. METHODS: This is a cross-sectional, population-based study with adults participating in the epidemiological survey of oral health of São Paulo in 2015. The outcome of the study was tooth loss, assessed by the proposed classification, namely: I) lost up to 12 back teeth; II) lost up to 12 teeth (including front teeth); and III) lost more than 12 teeth. A four-block analysis was conducted, supported by a conceptual theoretical model adapted for tooth loss. For the multinomial logistic regression, "individuals who did not lose teeth due to caries or periodontal disease" was used as reference (p < 0.05). RESULTS: Of 6,051 adults evaluated, 25.3% (n = 1,530) were classified in category I, 32.7% (n = 1,977) in II, 9.4% (n = 568) in III, and 1.9% (n = 117) were edentulous. Lower income and schooling, the perception of need for treatment and the last appointment motivated by routine, pain or extraction were associated with tooth loss, regardless of the classification. The negative evaluation of the dental service was associated with individuals who lost up to 12 teeth, both front and back. The presence of women and periodontal pocket were associated with tooth loss of up to 12 teeth, including front, and more than 12 teeth. Caries were associated with adults who lost up to 12 teeth, including front teeth. CONCLUSION: The proposed classification allowed the identification of differences between the associated factors. Thus, the need to consider such classification in future studies is evident.

Effect of Periodontitis and Toothbrushing Frequency on Obesity Onset: A Cohort Study.

BACKGROUND The interplay between obesity and periodontitis has been widely examined. While obesity was reported as a risk factor for periodontitis, the inverse relationship is still little explored. Therefore, we aimed to determine whether periodontitis and toothbrushing frequency affect the onset of obesity. MATERIAL AND METHODS This cohort study included 1619 employees of a business enterprise headquartered in Tokyo, who in 2002 and 2006 underwent in prescribed annual health checks, both general and dental-specific, and who were not obese in 2002 (body mass index <25). The response variable was obesity (or absence) at 4 years, while the explanatory variables were presence/absence of periodontal pockets and toothbrushing frequency in 2002; their relationships were examined by multiple logistic regression analysis. RESULTS Subjects with periodontal pockets ≥4 mm showed a significantly higher odds ratio (OR) for onset of obesity at 4 years than those without periodontal pockets [OR: 1.59, 95% CI (confidence interval): 1.08-2.35, p<0.05]. Similarly, subjects who brushed their teeth ≥3 times/day had a significantly lower obesity OR than those who brushed ≤1 time/day (OR: 0.49, 95% CI: 0.28-0.85, p<0.01). CONCLUSIONS The presence of periodontal pockets and toothbrushing frequency are significantly associated with the onset of obesity. Periodontal pockets ≥4 mm are associated with increased risk of obesity, while frequent toothbrushing (≥3 times/day) appears to reduce the risk of obesity.

Oral Health, Disability and Physical Function: Results From Studies of Older People in the United Kingdom and United States of America.

OBJECTIVES: Studies examining the associations between oral health and disability have limited oral health measures. We investigated the association of a range of objectively and subjectively assessed oral health markers with disability and physical function in older age. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analyses were based on the British Regional Heart Study (BRHS) comprising men aged 71 to 92 years (n = 2147) from 24 British towns, and the Health, Aging, and Body Composition (HABC) Study comprising men and women aged 71 to 80 years (n = 3075) from the United States. Assessments included oral health (periodontal disease, tooth count, dry mouth, and self-rated oral health), disability, and physical function (grip strength, gait speed, and chair stand test). RESULTS: In the BRHS, dry mouth, tooth loss, and cumulative oral health problems (≥3 problems) were associated with mobility limitations and problems with activities of daily living and instrumental activities of daily living; these remained significant after adjustment for confounding variables (for ≥3 dry mouth symptoms, odds ratio (OR) 2.68, 95% confidence interval (CI) 1.94-3.69; OR 1.76, 95% CI 1.15-2.69; OR 2.90, 95% CI 2.01, 4.18, respectively). Similar results were observed in the HABC Study. Dry mouth was associated with the slowest gait speed in the BRHS, and the weakest grip strength in the HABC Study (OR 1.75, 95% CI 1.22, 2.50; OR 2.43, 95% CI 1.47-4.01, respectively). CONCLUSIONS AND IMPLICATIONS: Markers of poor oral health, particularly dry mouth, poor self-rated oral health, and the presence of more than 1 oral health problem, were associated with disability and poor physical function in older populations. Prospective investigations of these associations and underlying pathways are needed.

Impact of oral conditions on the quality of life of incarcerated women in Brazil.

Imprisoned women represent a growing population worldwide with important health needs. In this study, we aimed to analyze the impact of oral health conditions on the quality of life of female inmates in a maximum security correctional facility. Participants were examined and answered the OHIP-14 questionnaire. A total of 305 inmates were included in the study. Prevalence of untreated caries was 84%. Worse quality of life was associated with dental caries, dental pain, deep periodontal pocket, prosthetic use, and age. Sociodental indicators should be incorporated into healthcare and health policies in order to promote wellbeing among this vulnerable population.

Association between alcohol use and periodontal pockets in Finnish adult population.

OBJECTIVE: To investigate whether alcohol use is associated with deepened periodontal pockets and whether this association is dependent on age, gender or socioeconomic position (SEP). MATERIAL AND METHODS: This cross-sectional study, based on the Health 2000 Survey, consisted of dentate, non-smoking Finnish adults aged 30-65 years (n = 3059). The outcome was the number of teeth with deepened (≥4 mm) periodontal pockets. The exposure was self-reported alcohol use assessed as amount, frequency, and use over the risk limit. Zero-inflated negative binomial regression models were used to estimate relative risks (RRs) and 95% confidence intervals (95% CI). RESULTS: In this study, alcohol use did not consistently associate with the number of teeth with deepened periodontal pockets. An association with the number of teeth with deepened periodontal pockets was found among men, older participants, and those participants belonging to basic or intermediate educational groups. An association with poor periodontal health was observed among men or older participants who belonged to the basic or intermediate educational group, whereas such associations were not observed among those participants belonging to the higher educational group. CONCLUSIONS: The association between alcohol use and periodontal health appears to be confounded by individual characteristics such as age, gender, and especially one's SEP.