Higher haemoglobin levels are associated with impaired periodontal status.

AIM: Cellular oxygen sensing mechanisms have been linked to periodontal condition, and levels of haemoglobin (Hb) (the main carrier of oxygen) can be used as a surrogate measure for hypoxia. We aimed to examine relations between Hb levels and key periodontal health parameters in a general population. MATERIALS AND METHODS: The population comprised 1711 (47% male) subjects from the Northern Finland Birth Cohort 1966, for whom an oral health examination was carried out at 46 years of age and whose Hb levels were within the Finnish reference values. Relative risks (RRs) were estimated using Poisson regression models. RESULTS: The low-Hb tertile (mean Hb 133 g/L) had healthier anthropometric, metabolic and periodontal health parameters than the high-Hb tertile (mean Hb 151 g/L). Multivariable regression models adjusted for risk factors showed Hb levels to be positively associated with alveolar bone loss (ABL) and periodontal pocket depth (PPD), although the associations were weaker after adjustment for key metabolic parameters and were strongly influenced by smoking status. CONCLUSIONS: Hb levels within the normal variation are positively associated with PPD and ABL. The association between Hb levels and periodontal condition appeared to be more complex than had previously been anticipated.

Periodontal condition and ultrasound-based measures of arterial stiffness: results of the Health 2000 Survey.

BACKGROUND: Periodontitis has been associated with inflammatory processes in arterial walls such as impairment in endothelial function and thickening of intima media. As inflammation plays a role also in arterial stiffening, an association between periodontal inflammation and arterial stiffness can be expected. So far, conflicting results of the association between periodontal disease and arterial stiffness have been reported. Many of the earlier studies were conducted in specific populations and heterogeneous measures of both arterial stiffness and periodontal status were used. In this population-based study we aimed to investigate whether periodontal pocketing and gingival bleeding are associated with ultrasound-based measures of arterial stiffness. METHODS: In this cross-sectional study, two sets of data based on the national Health 2000 Survey in Finland were formed. Data set I comprised never-smoking 45-64-year-old dentate (≥ 10 natural teeth), non-diabetic, non-rheumatic, non-obese (BMI ≤ 30 kg/m2), non-hypertensive subjects with no coronary artery disease or ongoing lipid-lowering medications (n = 157). Data set II was formed of an unrestricted 45-74-year-old dentate population (n = 536). Four arterial stiffness measures (carotid artery compliance, Peterson's elastic modulus, Young's elastic modulus and beta stiffness index) based on an ultrasound examination of the common carotid artery were used. Periodontal parameters included the number of teeth with ≥ 4 mm deep periodontal pockets and the number of sextants with gingival bleeding. ß-estimates, confidence intervals, and p-values were obtained from linear regression models. RESULTS: In Data set I, the adjusted ß-estimates for the association between the number of teeth with ≥ 4 mm deep periodontal pockets and Peterson's elastic modulus and Young's elastic modulus were 15.80 (p = 0.12) and 61.02 (p = 0.22), respectively. The respective ß-estimates were 31.06 (p = 0.17) and 121.16 (p = 0.28) for the association between the number of bleeding sextants and these two stiffness measures. The results in Data set II were in line with the results in Data set I, with the exception that the adjusted ß-estimates for the associations between Peterson's elastic modulus and Young's elastic modulus and periodontal parameters were closer to null. CONCLUSIONS: This population-based study did not provide evidence of an association between periodontal condition and arterial stiffness.

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.

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.

Effect of smoking on periodontal health and validation of self-reported smoking status with serum cotinine levels.

OBJECTIVE: To investigate whether self-reported smoking and serum cotinine levels associate with periodontal pocket development and to determine the accuracy of self-reported smoking using serum cotinine. MATERIALS AND METHODS: This 4-year prospective cohort study included data from 294 dentate adults, aged ≥30 years, who participated in both the Health 2000 Survey and the Follow-up Study of Finnish Adults' Oral Health. Subjectively reported smoking status (daily smokers n = 62, occasional smokers n = 12, quitters n = 49, and never-smokers n = 171), serum cotinine levels, demographic factors, education level, dental behaviours and medical history were collected at baseline. The outcome measure was the number of teeth with periodontal pocketing ≥4 mm over 4 years. RESULTS: Self-reported daily smokers had 1.82 (95% CI: 1.32-2.50) higher incidence of deepened periodontal pockets than never-smokers. A positive association was observed between serum cotinine (≥42.0 µg/L) and the development of periodontal pockets. The misclassification rate of self-reported smoking was 6%. CONCLUSIONS: Both self-reported daily smoking and higher serum cotinine were associated with periodontal pocket development. Self-reported smoking was fairly accurate in this study. However, higher cotinine levels among a few self-reported never-smokers indicated misreporting or passive smoking. Thus, self-reports alone are not enough to assess the smoking-attributable disease burden.

Periodontitis and gingival bleeding associate with intracranial aneurysms and risk of aneurysmal subarachnoid hemorrhage.

Oral bacteria DNA has been found in intracranial aneurysms (IA) and a high prevalence of periodontitis was reported in IA patients. We investigated whether periodontitis associates with IA formation and aneurysmal subarachnoid hemorrhage (aSAH). First, we compared in a case-control setting the prevalence of periodontal disease in IA patients (42 unruptured IA, 34 ruptured IA) and in age- and gender-matched controls (n = 70) from the same geographical area (Health 2000 Survey, BRIF8901). Next, we investigated whether periodontitis at baseline associated with aSAH in a 13-year follow-up study of 5170 Health 2000 Survey participants. Follow-up data was obtained from national hospital discharge and cause of death registries. Univariate analysis, logistic regression, and Cox-regression were used. Periodontitis (≥ 4mm gingival pocket) and severe periodontitis (≥ 6mm gingival pocket) were found in 92% and 49% of IA patients respectively and associated with IAs (OR 5.3, 95%CI 1.1-25.9, p < 0.000 and OR 6.3, 95%CI 1.3-31.4, p < 0.001, respectively). Gingival bleeding had an even stronger association, especially if detected in 4-6 teeth sextants (OR 34.4, 95%CI 4.2-281.3). Severe periodontitis in ≥ 3 teeth or gingival bleeding in 4-6 teeth sextants at baseline increased the risk of aSAH during follow-up (HR 22.5, 95%CI 3.6-139.5, p = 0.001 and HR 8.3, 95%CI 1.5-46.1, p = 0.015, respectively). Association of periodontitis and gingival bleeding with risk of IA development and aSAH was independent of gender, smoking status, hypertension, or alcohol abuse. Periodontitis and gingival bleeding associate with increased risk for IA formation and eventual aSAH. Further epidemiological and mechanistic studies are indicated.

Alcohol use and periodontal pocket development: findings from a 4-yr longitudinal study.

This study investigated whether alcohol use influences periodontal pocket development during a 4-yr follow-up period. The study included those participants who took part in both the Health 2000 Survey and the Follow-up Study on Finnish Adults' Oral Health. The participants at baseline were aged ≥30 yr, periodontally healthy, and did not have diabetes or rheumatoid arthritis. The development of periodontal pockets at follow-up was measured as the number of teeth with periodontal pockets and the presence of periodontal pockets. Alcohol use at baseline was measured as g/wk, frequency, and use over the risk limit. Incidence rate ratios with 95% CI were estimated using negative binomial regression models and Poisson regression models with a robust variance estimator. No consistent association was found between any of the alcohol variables and periodontal pocket development in the total population or among non-smokers. Among smokers, a positive association was found with the frequency of alcohol use. In general, risk estimates were slightly higher for women than for men. In summary, light-to-moderate alcohol use appears not to be consistently associated with the development of periodontal pockets. The adverse effects on the periodontium seem, to some extent, to be dependent on gender and smoking.

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.

Oral diseases and inflammatory burden and Alzheimer's disease among subjects aged 75 years or older.

AIM: To study whether dental caries, periodontal disease, and stomatitis, and the related inflammatory burden associate with diagnosed Alzheimer's disease (AD) and dementia among older people. METHODS: The study population included 170 individuals aged ≥75 years. The primary outcome was diagnosed AD and the secondary outcome was any types of diagnosed dementia. Information about participants' oral diseases and the related inflammatory burden was based on the clinical oral examination. Relative risks (RRs) and confidence intervals (CIs) were estimated using regression models. RESULTS: Dental caries, the presence of ≥3 carious teeth (RR: 3.47, 95% CI: 1.09-11.1) and the number of carious teeth (RR: 1.24, CI: 1.11-1.39), and inflammatory burden (RR: 1.44, CI: 1.04-2.01) were associated with a higher likelihood of having AD. Also, periodontal disease and stomatitis were associated, although nonstatistically, with AD and dementia. The risk estimates for any type of dementia were in most cases lower than for AD. CONCLUSION: Oral diseases and the related inflammatory burden were in most cases associated more strongly with diagnosed AD than dementia in general. Of the oral diseases studied, the strongest association was between dental caries and AD.

Diagnosis and Treatment of Orofacial Granulomatosis.

Orofacial granulomatosis (OFG) is a chronic inflammatory disorder characterized by lip swelling and gingival alterations. OFG occurs either as a separate clinical entity or associated with a systemic disorder such as Crohn's disease (CD). The purpose of this paper is to report the case of a 13-year old boy who presented with marked granulomatous gingival inflammation and stomach discomfort. Periodontal therapy resulted in only slight reduction in gingival inflammation and enlargement. The diagnosis of OFG, which was evidently associated with inflammation in the bowel, was based on the gingival status and biopsy, self-reported symptoms, and laboratory markers of iron metabolism and fecal calprotectin level. The gingival and bowel inflammation was controlled with, strict adherence to a cinnamon- and benzoate-free diet combined with periodontal prophylaxis. At this point at the age of 17 years, the patient has avoided the use of immune modulatory treatments.

Periodontal condition in relation to the adherence to nutrient recommendations in daily smokers.

AIM: To examine whether a healthy diet based on nutrient recommendations is associated with periodontal condition in smokers. MATERIAL AND METHODS: Daily smokers from the cross-sectional Health 2000 Survey (BRIF 8901) in Finland were analysed in two age groups (30-49 and 50-79 years, n = 704 and 267) and according to the level of oral hygiene. Periodontal condition was measured as the number of sextants with gingival bleeding and teeth with ≥4 mm deepened periodontal pockets. Information on nutrition was collected by a validated food frequency questionnaire and measured using the Baltic Sea Diet Score (BSDS) and the Recommended Finnish Diet Score (RFDS). RESULTS: In the total study population, no association between the scores and periodontal condition was observed. Among 30- to 49-year-old participants with good oral hygiene, diet scores associated inversely with the number of teeth with deepened periodontal pockets (p = .078 (BSDS) and p = .027 (RFDS)). CONCLUSIONS: In a representative sample of Finnish adults who smoke, a healthy diet was not associated with periodontal condition. Among a younger age group with good oral hygiene, a healthy diet associated with better periodontal condition. Age and oral hygiene appeared to modify the association between diet and periodontal condition.

Anticholinergic burden and dry mouth among Finnish, community-dwelling older adults.

OBJECTIVE: The aim was to study whether the anticholinergic burden of drugs is related to xerostomia and salivary secretion among community-dwelling elderly people. BACKGROUND: Anticholinergic drugs have been shown to be a risk factor for dry mouth, but little is known about the effects of cumulative exposure to anticholinergic drugs measured by anticholinergic burden on salivary secretion or xerostomia. METHODS: The study population consisted of 152 community-dwelling, dentate, non-smoking, older people from the Oral Health GeMS study. The data were collected by interviews and clinical examinations. Anticholinergic burden was determined using the Anticholinergic Drug Scale (ADS). A Poisson regression model with robust error variance was used to estimate relative risks (RR) with 95% confidence intervals (CI 95%). RESULTS: Participants with a high-anticholinergic burden (ADS ≥ 3) were more likely to have xerostomia (RR: 3.17; CI: 1.44-6.96), low-unstimulated salivary flow (<0.1 mL/min; RR: 2.31, CI: 1.22-4.43) and low-stimulated salivary flow (<1.0 mL/min; RR: 1.50, CI: 0.80-2.81) compared to reference group (ADS 0). In participants with a moderate anticholinergic burden (ADS 1-2), all the risk estimates for xerostomia, unstimulated and stimulated salivary secretion varied between 0.55 and 3.13. Additional adjustment for the total number of drugs, antihypertensives and sedative load caused only slight attenuation of the risk estimates. CONCLUSION: A high-anticholinergic burden was associated with low-unstimulated salivary secretion and xerostomia.

Waist circumference and waist-to-height ratio are associated with periodontal pocketing-results of the Health 2000 Survey.

BACKGROUND: Body mass index (BMI) has been found to associate with different parameters of chronic periodontal disease in previous studies. It is reasonable to expect that central adiposity measures, such as waist circumference and waist-to-height ratio, which indirectly takes into account visceral fat, are more accurate measures of obesity-related oral health risks than BMI. The aim of this study was to examine whether central obesity is associated with periodontal pocketing, an indication of infectious chronic periodontal disease. METHODS: The study was based on a subpopulation from the national Health 2000 Survey in Finland. It included dentate, non-diabetic, never-smoking subjects aged 30-49 (n = 1287). The outcome variable was the number of teeth with deepened periodontal pockets (4 mm or more) and the number of teeth with deep periodontal pockets (6 mm or more). Central obesity was measured by means of waist circumference (WC) and waist-to-height ratio (WHtR). Poisson regression models were used to estimate prevalence rate ratios (PRR) and their 95% confidence intervals. RESULTS: Our main finding was that both WC and WHtR were associated with the number of teeth with deeper (4 mm or more) periodontal pockets; the PRR for the fifth quintile in WC was 1.5, CI: 1.2-1.9 and in WHtR 1.4, CI: 1.1-1.7, when compared to the lowest quintile. Corresponding figures for deep (6 mm or more) periodontal pockets were 2.3, CI: 0.9-6.1 for WC and 1.9, CI: 0.8-4.4 for WHtR. There were no essential differences in the strengths of the associations between WC and WHtR and the number of teeth with deepened periodontal pockets. CONCLUSION: Both central adipose measures-WC and WHtR-seem to be associated with periodontal pocketing in non-diabetic, never-smoking subjects aged 30-49 years old.

Serum lipids modify periodontal infection - interleukin-6 association.

AIM: The aim of this study was to investigate whether the systemic response against a local inflammatory process in periodontium is dependent on the individual's serum lipid composition. MATERIAL AND METHODS: This study was based on a subpopulation of the Health 2000 Survey that included 878 subjects who were aged between 45 and 64 years, dentate, non-diabetic and non-rheumatic. The inflammatory condition of periodontium was measured by means of the number of teeth with deepened (4 mm or deeper) periodontal pockets. Systemic inflammation was assessed by means of the serum levels of interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α). The association between an inflammatory condition in the periodontium and the systemic inflammatory response was analysed using linear regression models. RESULTS: The number of teeth with deepened periodontal pockets was associated with elevated serum IL-6 levels among subjects with an unfavourable lipid composition (low-density lipoprotein cholesterol ≥3.7 mmol/l or high-density lipoprotein cholesterol <1.3 mmol/l). There was no association between serum TNF-α levels and the number of teeth with deepened periodontal pockets in these data. CONCLUSION: The systemic response against the inflammatory condition of periodontium varied between individuals. The variation appeared to be dependent on the serum lipid composition or related factors.

Sedative load, carious teeth and infection in the periodontium among community-dwelling older people.

OBJECTIVE: To study the relation of sedative load to carious teeth and periodontal pocketing - indication of infectious periodontal disease - among older people. MATERIALS AND METHODS: This cross-sectional study was based on a subpopulation of 158 community-dwelling, dentate, non-smoking, 75-year-old or older people from the Oral Health Geriatric Multidisciplinary Strategy study. The data were collected by interviews and clinical oral examinations during 2004-2005. Sedative load was measured by means of the sedative load model, and Poisson multivariate regression models were used to estimate relative risk (RR) with 95% confidence intervals (CI). RESULTS: Participants with a sedative load of either 1-2 (n = 31) or ≥3 (n = 12) had an increased likelihood of having carious teeth (RR: 1.8, CI: 1.2-2.6 and RR: 2.4, CI: 1.4-4.1, respectively) compared to participants without a sedative load. There was an inverse association between sedative load and the number of teeth with periodontal pockets. CONCLUSIONS: Presence of dental caries was associated with the use of drugs with sedative properties. The use of drugs with sedative properties was not associated with the presence of periodontal pockets.

Periodontal pocketing and gingival bleeding in relation to Nordic diet - results from a population-based survey.

AIM: To examine whether a Nordic diet measured by the Baltic Sea Diet Score (BSDS) and the Recommended Finnish Diet Score (RFDS) is associated with periodontal condition. MATERIAL AND METHODS: The study population consisted of non-smoking, non-diabetic and non-rheumatoid individuals in the Health 2000 Survey in Finland. Analyses were made in two age groups (30-49 years (n = 1210) and 50-79 years (n = 977)) and subsequently in two oral hygiene groups (good oral hygiene and poor oral hygiene). The number of sextants with gingival bleeding and the number of teeth with deepened periodontal pockets were used as outcome variables. Dietary data were collected by a validated food frequency questionnaire. RESULTS: Both the BSDS and the RFDS were weakly, although statistically significantly associated with less gingival bleeding in the younger age group (p = 0.019, p < 0.001). In the older age group, the RFDS or the BSDS associated inversely, although inconsistently, with gingival bleeding. RFDS and BSDS associated with both gingival bleeding and deepened periodontal pockets among those with poor oral hygiene. CONCLUSIONS: The results suggest that the Nordic diet in some cases has a favourable effect on periodontal health. These findings warrant further studies on the role of diet in periodontal diseases.

Periodontal condition in relation to intake of omega-3 and omega-6 polyunsaturated fatty acids.

AIM: To examine whether the intake of omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) is associated with periodontal condition. MATERIAL AND METHODS: The study population consisted of non-smoking, non-diabetic and non-rheumatoid individuals in the Health 2000 Survey in Finland. Analyses were made in two age groups: 30-49 years (n = 1212) and 50-79 years (n = 980). Clinically determined sextants with gingival bleeding and teeth with periodontal pockets were used as outcome variables. Dietary data were collected by a validated food frequency questionnaire. Energy-adjusted intakes of arachidonic acid (AA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), omega-3 and omega-6 PUFAs, as well as ratios of EPA/AA and of DHA/AA, and omega-3/omega-6 PUFAs were used as exposures. Prevalence rate ratios were estimated using Poisson regression models. RESULTS: In this population, there were no statistically significant associations between the examined omega-3 or omega-6 fatty acids or their ratios and the periodontal outcome variables. CONCLUSIONS: This cross-sectional study provided evidence that individual omega-3 or omega-6 fatty acids, their subclasses or ratios are not associated with periodontal health among a non-diabetic, non-rheumatoid and non-smoking population.

Sedative load and salivary secretion and xerostomia in community-dwelling older people.

OBJECTIVE: The aim was to investigate how sedative load and the total number of drugs used are related to hyposalivation and xerostomia among 75-year-old or older dentate, non-smoking, community-dwelling people. MATERIALS AND METHODS: The study population consisted of 152 older people from the Oral Health GeMS study. The data were collected by interviews and clinical examinations during 2004-2005. Sedative load, which measures the cumulative effect of taking multiple drugs with sedative properties, was calculated using the Sedative Load Model. RESULTS: The results showed that participants with a sedative load of either 1-2 or ≥3 had an increased likelihood of having low stimulated salivary flow (<0.7 ml/min; OR: 2.4; CI: 0.6-8.6 and OR: 11; CI: 2.2-59; respectively) and low unstimulated salivary flow (<0.1 ml/min; OR: 2.7, CI: 1.0-7.4 and OR: 4.5, CI: 1.0-20, respectively) compared with participants without a sedative load. Participants with a sedative load ≥3 had an increased likelihood of having xerostomia (OR: 2.5, CI: 0.5-12) compared with participants without a sedative load. The results showed that the association between the total number of drugs and hyposalivation was weaker than the association between sedative load and hyposalivation. CONCLUSION: Sedative load is strongly related to hyposalivation and to a lesser extent with xerostomia. The adverse effects of drugs on saliva secretion are specifically related to drugs with sedative properties.

Associations between serum 25-hydroxyvitamin d and periodontal pocketing and gingival bleeding: results of a study in a non-smoking population in Finland.

BACKGROUND: Apart from the effects of vitamin D on bone metabolism, it is also known for its immunomodulatory properties. However, so far, it is not clear whether serum 25-hydroxyvitamin D [25(OH)D] exerts any beneficial effect on the periodontium. The aim of the present study is to investigate whether the serum level of 25(OH)D is related to periodontal condition, measured by means of pocketing and gingival bleeding. METHODS: This cross-sectional study is based on a non-smoking subpopulation without diabetes of the Finnish Health 2000 Survey (N = 1,262). Periodontal condition was measured as the number of teeth with deep (≥4 mm) periodontal pockets and the number of bleeding sextants per individual. Serum 25(OH)D level was determined by means of a standard laboratory measurement. Prevalence rate ratios and 95% confidence intervals were estimated using Poisson regression models. RESULTS: There were practically no associations between serum 25(OH)D level and teeth with deep (≥4 mm) periodontal pockets or bleeding sextants. A somewhat lower proportion of teeth with deep periodontal pockets was found in higher serum 25(OH)D quintiles among individuals with a good oral hygiene level. CONCLUSION: Serum 25(OH)D did not seem to be related to periodontal condition, measured as periodontal pocketing and gingival bleeding in this low-risk, low-25(OH)D status population.

Association between periodontal condition and hypertension in a non-smoking population aged 30-49 years: results of the Health 2000 Survey in Finland.

AIM: The aim of this cross-sectional study was to investigate whether periodontal condition is associated with hypertension and systolic blood pressure. MATERIALS AND METHODS: The study population consisted of dentate, non-diabetic, non-smoking individuals aged 30-49 years (n = 1296) in the national Health 2000 Survey in Finland. The number of teeth with deepened (≥4 mm) and deep (≥6 mm) periodontal pockets and the number of sextants with gingival bleeding were used as explanatory variables. Hypertension and systolic blood pressure were used as outcome variables. RESULTS: There was no consistent association between the number of teeth with deepened (≥4 mm) (OR 0.98, 95% CI 0.95-1.01) or deep (≥6 mm) (OR 1.01, 95% CI 0.90-1.12) periodontal pockets and hypertension after adjusting for confounding factors. Nor was there any essential association between the number of bleeding sextants and hypertension. CONCLUSIONS: Periodontal pocketing and gingival bleeding did not appear to be related to hypertension in non-diabetic, non-smoking individuals aged 30-49 years. Further studies using experimental study designs would be required to determine the role of infectious periodontal diseases in the development or progression of hypertension.