Association of endogenous sex hormone levels with tooth loss due to periodontitis in men and post-menopausal women: The multi-ethnic study of atherosclerosis.

AIM: To investigate the association between endogenous sex hormone levels and history of tooth loss related to periodontitis in healthy middle-aged to older men and post-menopausal women. METHODS: This cross-sectional study included 5649 participants aged 45-84 (mean age, 63 ± 10 years) from the Multi-Ethnic Study of Atherosclerosis cohort who had sex hormone levels measured and answered a questionnaire regarding perceived periodontal status at exam 1. Multivariable logistic regression was used to examine the association of sex hormones (exposure) with history of tooth loss (outcome), stratified by sex. RESULTS: Among post-menopausal women, higher free testosterone (per 1SD) was associated with a greater prevalence of tooth loss [OR 1.49 (95% CI, 1.08-2.05)], whereas higher sex hormone binding globulin (SHBG) was associated with a lower prevalence of tooth loss [OR 0.74 (0.58-0.94)], after adjustment for cardiometabolic risk factors and reproductive factors. In men, higher free testosterone and lower SHBG were associated with a lower prevalent probability of tooth loss in unadjusted analysis, but these associations lost significance after covariate adjustment. CONCLUSION: A higher androgenic sex hormone profile in post-menopausal women (i.e., increased free testosterone, lower SHBG) was associated with an increased prevalence of tooth loss, after adjusting cardiometabolic risk factors. No such association was found in men. These findings suggest that sex hormones may influence or serve as a marker for periodontal health.

Impact of Protracted War Crisis on Dental Students: A Comparative Multicountry Cross-sectional Study.

BACKGROUND: The impact of conflict and war crisis on dental students is poorly understood. Given the prolonged conflicts and political instability in the Arabic-speaking countries, it is crucial to investigate the effect of these conditions on dental students. This study aimed to assess the impact of protracted war on dental students by comparing the personal, university, and wider context challenges they face across war-affected and unaffected countries. METHODS: A cross-sectional study was conducted including a convenience sample of dental students from 13 universities in 12 Arabic-speaking countries. Respondents were those at entry and exit points of their undergraduate dental training. A self-administered paper questionnaire collected anonymized data on sociodemographics, and personal, university, and wider context challenges that students were facing. Multivariable Poisson regression analyses were carried out. RESULTS: The overall response rate was 64.8%. The mean age was 21.2 (standard deviation = 2.1) years, with 68% of participants being female. After adjusting for age and sex, dental students in Arabic-speaking countries affected by protracted war crisis were significantly more likely to report wider context challenges compared to their counterparts in unaffected countries (n = 2448; beta = 1.12; 95% confidence interval: 1.10-1.13; P < 0.001). DISCUSSION: Dental students in Arabic-speaking countries affected by protracted war crisis were more likely to suffer from wider context challenges such as difficulties in attendance due to the deterioration of security and lack of flexibility of teaching time to accommodate the different circumstances induced by the war crisis. Supporting dental students in areas affected by protracted war crises is needed and may include developing online dental education programs.

Periodontal Disease Associated With Interstitial Myocardial Fibrosis: The Multiethnic Study of Atherosclerosis.

Background Periodontitis is a chronic inflammatory disease common among adults. It has been suggested that periodontal disease (PD) may be a contributing risk factor for cardiovascular disease; however, pathways underlying such a relationship require further investigation. Methods and Results A total of 665 men (mean age 68±9 years) and 611 women (mean age 67±9 years) enrolled in the MESA (Multiethnic Study of Atherosclerosis) underwent PD assessment using a 2-item questionnaire at baseline (2000-2002) and had cardiovascular magnetic resonance 10 years later. PD was defined when participants reported either a history of periodontitis or gum disease or lost teeth caused by periodontitis or gum disease. Multivariable linear regression models were constructed to assess the associations of baseline self-reported PD with cardiovascular magnetic resonance-obtained measures of interstitial myocardial fibrosis (IMF), including extracellular volume and native T1 time. Men with a self-reported history of PD had greater extracellular volume percent (ß=0.6%±0.2, P=0.01). This association was independent of age, left ventricular mass, traditional cardiovascular risk factors, and history of myocardial infarction. In a subsequent model, substituting myocardial infarction for coronary artery calcium score, the association of PD with IMF remained significant (ß=0.6%±0.3, P=0.03). In women, a self-reported history of PD was not linked to higher IMF. Importantly, a self-reported history of PD was not found to be associated with myocardial scar independent of sex (odds ratio, 1.01 [95% CI, 0.62-1.65]; P=0.9). Conclusions In a community-based setting, men but not women with a self-reported PD history at baseline were found to be associated with increased measures of IMF. These findings support a plausible link between PD, a proinflammatory condition, and subclinical IMF.

Dental caries and fluorosis among children in Lebanon.

PURPOSE: The purpose of this study is to assess caries and enamel fluorosis in a sample of 1433 children aged 6-8, 12, and 15 years from 48 schools in 6 regions of Lebanon, selected by probability proportional to size. METHODS: Children were examined according to the World Health Organization criteria. RESULTS: Our results showed a mean of decayed, missing, and filled teeth (DMFT) of 0.6 (dft of 5.15), 3.42, and 5.44 corresponding respectively to the groups of 6-8-, 12-, and 15-year-old children. In the same groups, the percentage of DMFT = 0 for the 6-8-year-old category was 74%, the 12-year-old category was 20.9%, and for the 15-year-old category was 9.7%; Ten (2.1%) 12 year olds had moderate and one (0.2%) severe scores; these children had been born in other countries. CONCLUSIONS: Survey results confirm the need to implement nationwide dental caries prevention measures. Since water fluoridation is not feasible, salt fluoridation would be the alternative.

Development of an Arabic Version of the Hiroshima University-Dental Behavioral Inventory: Cross-cultural Adaptation, Reliability, and Validity.

The Hiroshima University-Dental Behavioral Inventory (HU-DBI) has not been adequately translated to the Arabic language. The aim of this study is the translation and cultural adaption of the English HU-DBI into standard Arabic. The English HU-DBI was translated into Arabic by three bilingual dental academics. A nonmedical professional performed backward translation into English. The three bilinguals compared both English versions and accordingly modified the Arabic version. English and Arabic versions were answered by 58 bilingual participants. Focus groups and cognitive interviews were conducted to pretest the working version, after which the final Arabic version was tested for test-retest validity on 58 dental students. Bilingual validity and test-retest validity were assessed using the kappa statistic. Responses were similar in the English and Arabic versions for bilingual individuals and on both tests in the test-retest sample. Kappa values ranged from 0.85 to 1.00 for bilingual validity and between 0.82 and 1.00 for test-retest reliability. In conclusion, the Arabic HU-DBI will enable the assessment of knowledge and attitudes toward oral diseases and their prevention in Arab countries and will allow meaningful comparisons between different countries in the region.

Factors influencing total mercury levels among Lebanese dentists.

The aim of the current study is to examine the various factors, which contribute to high levels of mercury (Hg) in the hair of Lebanese dentists. The survey, which was carried out on ninety-nine dentists in the greater Beirut area, included a structured questionnaire designed to provide information about the parameters that influenced their occupational exposure to Hg. These included: precautionary measures, dental fillings, work habits and lifestyle of the tested dentists. The study showed that two of the four investigated precautionary measures had a significant effect on Hg level. The results revealed that, at the 95% confidence levels, Hg concentration in hair was significantly lower among the dentists who always used gloves and masks. Multiple regression analysis showed that the use of masks (P = 0.055) had significant effects on mercury accumulation in hair. In addition, dentists who saw more than eight patients per day had marginally higher mercury levels in their hair than those who did not. Since it was shown that precautionary measures could limit exposure to Hg concentration, then the use of protective measures needs to be emphasized.

[Oral health in school children in Lebanon]. / La santé bucco-dentaire des écoliers au Liban.

This survey is the first epidemiological investigation to be carried out at the national level in Lebanon. It provides a first series of basic data indicative of the present oral health situation in the country. The results of this survey should contribute to the elaboration of a National Oral Health Plan and to the development of a broad strategy for the implementation of preventive measures [8]. Indeed, experience clearly indicates that dental caries cannot be successfully eradicated nation-wide through curative measures only and that preventive measures must also be implemented. The main effort in the field of oral health care should mainly focus on health promotion and education, leading in turn to improved oral hygiene.