Tooth loss as a potential risk factor for deficient sleep: an analysis of a nationally representative sample of adults in the USA.

PURPOSE: Sleep deficiency is implicated as a risk factor for several systemic conditions. Loss of teeth has a profound effect on the individual's physiologic and psychologic health and quality of life. This study aimed to assess the association between tooth loss and sleep duration and determine if anterior and/or posterior tooth loss is a significant predictor. METHODS: A total of 22,483 individuals ≥ 18 years who participated in the United States National Health and Nutrition Examination Survey (NHANES) 2005-2016 cycles were included. Multinomial logistic regression adjusted for age, gender, race/ethnicity, smoking, diabetes, body mass index, socioeconomic level, education, alcohol, and depression was performed to examine the association between sleep duration and tooth loss. RESULTS: Compared to individuals with > 20 remaining teeth, those who were completely edentulous, had 1-10 or 11-20 teeth remaining were more likely to be in the deficient sleep category (OR [95% CI] = 1.59 [1.35-1.87], 1.29 [1.07-1.54], and 1.26 [1.11-1.43], respectively). When the numbers of both missing anterior and posterior teeth were entered in the model, only posterior teeth were significant. There was a 4% increase in the odds of being in the deficient sleep category for each missing posterior tooth (OR [95% CI] = 1.04 [1.02-1.05]). CONCLUSIONS: Tooth loss was significantly associated with deficient sleep and posterior tooth loss appeared to be the main contributor. Although further research is needed to clarify the nature of this association, our results suggest that improving oral health might have an impact on overall health and quality of life.

Multiple Sclerosis-A Demyelinating Disorder and Its Dental Considerations-A Literature Review with Own Case Report.

Multiple sclerosis (MS) is a chronic, autoimmune condition that primarily affects the myelin sheath covering the neurons of the central nervous system, including those of the brain and spinal cord. Although the etiology is not completely understood, various factors, such as genetic infections and environmental background, play a role in the pathogenesis. Repeated active episodes of MS characterized with marked inflammation results in the scarring of particular nerve segments, and eventually results in functional impairment over a period of time. Based on the clinical course of the disease, four clinical types of MS have been identified, with the relapsing-remitting type being the commonest. MS is known to occur more commonly in females in the age group of 20-40 years. Dysarthria, fatigue, muscle spasm, and numbness are the common presenting symptoms of MS. Diagnosis is generally achieved with MRI brain scans, showing demyelination plaques and lumbar puncture. Treatment of MS's acute phase includes high doses of corticosteroids; whereas preventive treatment of MS includes the prescription of immunosuppressive therapy, including biologics. A large group of MS patients present with oral manifestations, including dysphagia, dysarthria, temporomandibular joint (TMJ) disturbances, facial palsy, and chronic periodontal diseases. Other typical oral manifestations seen in MS patients include trigeminal neuralgia, paresthesia, or orofacial pain. Dental treatment and following drug prescription needs to be tailored to each patient, as there is a possibility of drug interactions. This paper presents a comprehensive, updated review of MS, with emphasis on oral manifestations and dental considerations. Additionally, it presents a case of a 40-year-old female diagnosed with MS that was presented to a dental hospital. The report discusses the oral manifestations and dental management.

MicroRNAs-A Promising Tool for Asthma Diagnosis and Severity Assessment: A Systematic Review.

Micro RNAs (miRNAs) are short, non-coding RNAs (Ribonucleic acids) with regulatory functions that could prove useful as biomarkers for asthma diagnosis and asthma severity-risk stratification. The objective of this systematic review is to identify panels of miRNAs that can be used to support asthma diagnosis and severity-risk assessment. Three databases (Medline, Embase, and SCOPUS) were searched up to 15 September 2020 to identify studies reporting differential expression of specific miRNAs in the tissues of adults and children with asthma. Studies reporting miRNAs associations in animal models that were also studied in humans were included in this review. We identified 75 studies that met our search criteria. Of these, 66 studies reported more than 200 miRNAs that are differentially expressed in asthma patients when compared to non-asthmatic controls. In addition, 16 studies reported 17 miRNAs that are differentially expressed with differences in asthma severity. We were able to construct two panels of miRNAs that are expressed in blood and can serve as core panels to further investigate the practicality and efficiency of using miRNAs as non-invasive biomarkers for asthma diagnosis and severity-risk assessment, respectively.

Clinical manifestations of gastrointestinal diseases in the oral cavity.

AIM: In this review, several gastrointestinal diseases that dentists may encounter in practice are highlighted and discussed. MATERIALS AND METHODS: Using MEDLINE (PubMed), a comprehensive review of gastrointestinal diseases and their oral cavity manifestations was performed. RESULTS: Many gastrointestinal diseases present with oral symptoms that are detectable by dentists and dental hygienists. Often, oral manifestations of the disease may appear before systemic signs and symptoms. Managing patients with these conditions requires dentists to adjust their treatment and/or involve other health professionals. CONCLUSION: Care must be taken when providing periodontal therapy or dental implants to patients suffering gastrointestinal diseases who are at high risk of bleeding, infection, or malnutrition, for example. Also, pharmacological therapy for these patients may need to be customized.

Depression is related to edentulism and lack of functional dentition: An analysis of NHANES data, 2005-2016.

OBJECTIVE: Depression and tooth loss are significant health problems that affect individuals' functionality and quality of life. Comorbidity between depression and oral diseases has been reported. The aim of this study was to investigate the association between depression and tooth loss in a US representative adult sample. METHODS: This study included data from 22,532 adults ≥18 years by combining six 2-year cross-sectional cycles of the National Health and Nutrition Examination Survey (NHANES) administered between 2005 and 2016. Data were analyzed using descriptive statistics and multinomial logistic regression adjusted for gender, age, race/ethnicity, smoking, education, socioeconomic status, body mass index, diabetes, and alcohol intake. RESULTS: Of the total sample, 4.5 percent were edentulous, 10.3 percent were lacking functional dentition (1-19 remaining teeth) and 85.2 percent had functional dentition (≥20 remaining teeth); among whom, the prevalence of depression was 12.4, 11.7, and 5.9 percent, respectively. Compared to individuals without depression, those with depression were more likely to be edentulous or lacking functional dentition versus having functional dentition (adjusted odds ratios (95% CI): 1.48 (1.16-1.89) and 1.43 (1.18-1.75), respectively). CONCLUSIONS: Depression was associated with edentulism and a lack of functional dentition. Further longitudinal and interventional studies are needed to elucidate the nature and direction of the relationship between depression and tooth loss.

Morphological features of Class I, II and III malocclusions of Saudi adolescents.

AIMS: This cross-sectional study compared and contrasted the morphological characteristics of Class I, II and III malocclusions in an adolescent Saudi population. METHODS: Adolescent Saudis with Angle's Class I, II and III malocclusions were selected from orthodontic patients' records. Angular and linear measurements were compared between the three groups. Cephalometric analysis was performed using the VistadentOC® software. Multifactorial ANOVA for angular and linear measurements between and within groups. RESULTS: Orthodontic records of 300 patients were included. There was no significant difference between and within groups in age and distribution of Angle's classification, p > 0.05. Multifactorial ANOVA showed that there were significant interactions between gender and malocclusions in skeletal, dental and soft tissue measurements, p < 0.05. There were significant differences in the sagittal and vertical skeletal measurements between groups, p < 0.05. The dental measurements were also significantly different in most of the measurements (p < 0.05). Moreover, there were significantly different readings among the groups in the soft tissue analysis. CONCLUSION: Morphological characteristics of adolescent Saudis show unique differences between gender and malocclusions, more so in Class III malocclusions. Class II and III malocclusions also show skeletal differences amongst the groups.

Periodontal bone loss and self-reported medical conditions in a dental school patient population.

PURPOSE: This study was undertaken to determine the prevalence of periodontal bone loss and to assess the prevalence of self-reported medical conditions in patients with and without periodontal bone loss in Saudi Arabia. MATERIALS AND METHODS: A total of 2103 dental records with complete data from patients > or = 18 years of age admitted to the King Abdulaziz University Faculty of Dentistry during the year 2005 were included. Age, gender, nationality and self reported medical history were abstracted from the dental records. Periodontal bone loss was determined by a single examiner using panoramic radiographs that were taken prior to any dental treatment. Descriptive statistics, t-test, chi-square and logistic regression models were used for data analyses. RESULTS: About 20% of the study sample reported a positive history for one or more medical conditions. Diabetes was the most frequently reported condition (7.4%), followed by hypertension (5.4%) and anemia (3%). Radiographic alveolar bone loss at one or more sites was found in 71.6% of the sample. The mean number of sites with alveolar bone loss was significantly higher among individuals with diabetes and hypertension than those without these conditions (p < 0.05). CONCLUSION: Prevalence of periodontal bone loss is high in the present sample, especially among those with chronic medical conditions. Collaboration between dental and medical professionals is needed for better oral and general health.

Is inadequate sleep a potential risk factor for periodontitis?

This study was undertaken to investigate the potential association between sleep duration and periodontitis. The study population consisted of 10,291 individuals who participated in the United States National Health and Nutrition Examination Survey (NHANES) from the 2009-2014 cycles. Sleep duration was categorized into sleep deficient (< 7 hours), sleep adequate (7-8 hours), and sleep excessive (> 8 hours). We used the Center for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) periodontitis case definition. Descriptive statistics and logistic regression models were used for data analyses. The prevalence of periodontitis was 36% higher in individuals who reported sleep deficiency when compared to the sleep adequate group (odds Ratio (OR) = 1.36, 95% confidence interval (CI): 1.23-1.50). Those who reported excessive sleep had 41% higher odds of periodontitis (OR: 1.40, 95% CI: 1.16-1.71). After adjusting for confounding factors, sleep deficient individuals were 19% more likely to have periodontitis when compared to sleep adequate individuals (OR: 1.19, 95% CI: 1.06-1.38). Among sleep excessive individuals, the association was non-significant (OR: 1.16, 95% CI: 0.94-1.43). Sleep deficiency was associated with a higher prevalence of periodontitis in this study population. The association however needs to be confirmed in longitudinal studies.

Granulomatous diseases: Oral manifestations and recommendations.

Granulomatous diseases may present with oral manifestations that are detectable by dental care providers. In certain cases, oral manifestations may precede systemic signs and symptoms. Dentists managing patients with these conditions may modify the dental treatment plan and possibly retain the support of other health professionals. This review gives an update on granulomatous diseases that can be faced by the dental practitioner.

Prevalence and morphological variations of maxillary sinus septa in different age groups: a CBCT analysis.

BACKGROUND: There are limited data from Saudi Arabia on the prevalence and characteristics of maxillary sinus septa. OBJECTIVE: Determine the prevalence and morphological characteristics of septa in the maxillary sinus and their relationship to gender and age using cone beam computed tomography (CBCT). DESIGN: Cross-sectional SETTING: CBCT images acquired from the maxillofacial radiology department in a dental school. PATIENT AND METHODS: CBCT scans of 1010 maxillary sinuses from 505 patients were analyzed to determine the prevalence, location, type, and orientation of maxillary sinus septa. Descriptive statistics, chi-square tests and t tests were used to analyze the data. MAIN OUTCOME MEASURES: The prevalence, location, type, and orientation of maxillary sinus septa. SAMPLE SIZE: 1010 sinuses from 505 patients. RESULT: Approximately 46% of the studied patients had maxillary septa, which were present in 370 (37%) sinuses. About 64% of the septa were present on the right side and 85.7% of all septa were mediolater-ally oriented. The mean height of the septa was 6.06 mm (0.84) in the right sinuses and 5.70 mm (0.93) in the left sinuses. Multiple septa were found in 101 patients (20%). Among males, 58.5% had septa compared to 34% of females (P<.001.) A significant positive association was found between age and the presence and number of septa, P<.001. CONCLUSIONS: Maxillary sinus septa were highly prevalent with various heights and directions among the studied sample. Careful assessment of different anatomic variation must be conducted prior to any maxillary sinus augmentation, particularly in older patients. LIMITATIONS: Cross-sectional evaluation of CBCT images from one dental school patient population; thus, the findings cannot be generalized to other populations. CONFLICT OF INTEREST: None.

Gingival health and oral hygiene practices among high school children in Saudi Arabia.

BACKGROUND: Gingivitis is a site-specific inflammatory condition initiated by dental biofilm accumulation. The accumulation of dental plaque on the gingival margin triggers inflammatory effects that can become chronic. In addition to its local effect, gingival inflammation has recently been suggested to have an impact on general health. OBJECTIVE: Determine the prevalence of gingivitis and its relationship to oral hygiene practices in high school children in Saudi Arabia. DESIGN: Cross-sectional. SETTING: High schools from different regions in Saudi Arabia. PATIENTS AND METHODS: Periodontal examinations were conducted on a randomly selected sample of high school children between the ages of 15 and 19 years. Gingival and plaque indices, probing depth, clinical attachment level, oral hygiene practices and sociodemographic characteristics were recorded. Data were analyzed using descriptive statistics, chi-square and the independent t test. MAIN OUTCOME MEASURE: Prevalence of gingivitis as defined by mean gingival index. SAMPLE SIZE: 2435 high school students. RESULTS: Twenty-one percent of the sample had slight gingivitis, 42.3% had moderate, and 1.8% had severe. Gender, toothbrushing, tongue brushing, plaque index, and the percentage of pocket depth (PD) ≥4 mm showed a significant relationship with the severity of gingivitis. Almost 39.3% of females had a healthy periodontal status when compared to males (30.7%). Thirty-five percent (35.5%) of students who brushed their teeth had a healthy periodontium compared to 26.9% who did not brush. The mean plaque index was significantly higher in students with severe gingivitis when compared to students with healthy periodontium (2.4 vs. 0.79, respectively). CONCLUSION: Gingivitis prevalence was high compared with Western countries in a nationally representative sample of high school students in Saudi Arabia and was influenced by oral hygiene practices. LIMITATIONS: The half-mouth study design may underestimate disease prevalence. Data on oral hygiene practices was self-reported and may thus have been affected by social desirability bias. CONFLICT OF INTEREST: None.

Prevalence of periodontitis in high school children in Saudi Arabia: a national study.

BACKGROUND: The occurrence of periodontitis is rather infrequent in children and adolescence and increases with age. We conducted this study because there have been few epidemiological studies on prevalence of periodontitis in children in Saudi Arabia. OBJECTIVE: Determine the prevalence of periodontitis in high school children in Saudi Arabia. DESIGN: Cross-sectional, using cluster and multistage sampling. SETTING: High school children in Saudi Arabia. PARTICIPANTS AND METHODS: Periodontal examinations were conducted on a randomized sample of high school children between the ages 15 to 19 in Saudi Arabia. The study spanned from September 2012 to January 2016. Clinical examinations included measurements of the probing depth (PD) percentage of PD ≥4 mm per patient. MAIN OUTCOME MEASURES: The prevalence of periodontitis (PD ≥4 mm and CAL ≥1 mm), the mean percentage PD ≥4 mm, the mean percentage CAL ≥1 mm, plaque index (PI) and gingival index (GI). SAMPLE SIZE: 2435 high school students. RESULTS: Of 2435 high school children in the sample, 209 students (8.6%) had periodontitis. The mean (standard deviation) for the PD was 0.59 (0.17) mm. Differences in percentage PD ≥4 mm and CAL ≥1 mm were greater in students with periodontitis ( P<.001). The prevalence of periodontitis was higher among non-Saudis, students who did not brush their teeth and did not visit their dentist regularly. In the bivariate analysis, periodontitis was positively associated with GI, PI, number of teeth extracted, mean percentage PD ≥4 mm, and mean PD. However, in the multivariate analysis, tooth brushing was the main factor protective against periodontitis (odds ratio: 0.62, 95% CI 0.42-0.92, P=.017). CONCLUSION: Periodontitis prevalence was high compared with Western countries in a nationally representative sample of high school students in Saudi Arabia. LIMITATIONS: Partial mouth study design, which may underestimate the disease prevalence. CONFLICT OF INTEREST: None.

Anatomical consideration for optimal position of orthodontic miniscrews in the maxilla: a CBCT appraisal.

BACKGROUND: Orthodontic miniscrews are commonly used as temporary anchorage devices. Bone thickness and bone depth are important factors when placing miniscrews. There are no studies to assess the maxillary bone thickness for optimum miniscrew placement in a Saudi population. OBJECTIVE: Assess the proximity of the maxillary sinus and nasal cavity in areas where miniscrews are usually inserted using cone beam computed tomography (CBCT). DESIGN: Retrospective, cross-sectional. SETTING: Department of maxillofacial radiology in a Saudi dental school. PATIENTS AND METHODS: Using CBCT images, we measured the distance between the maxillary sinus and nasal cavity to the palatal bone, buccal intra-radicular and infrazygomatic crest areas. Mean values (SD) were compared at various locations, including by gender, and correlation with age was calculated. MAIN OUTCOME MEASURE: Mean bone thickness at commonly used sites for orthodontic miniscrew placements in the maxilla. Secondary outcome was the insertion angle in the infrazygomatic crest area. SAMPLE SIZE: CBCT images of 100 patients (50 males and 50 females). RESULTS: The mean (standard deviation) age for the sample was 25.4 (6.5) years with no significant difference between males and females. In the palate, the distance to the nasal cavity and maxillary sinus was greater anteriorly and decreased significantly posteriorly (P<.001). Buccally, the interdental bone depth was significantly greater between the second premolar and first molar (11.96 mm) compared to between the central and lateral incisors (7.53 mm, P<.001). The mean bone thickness of the infrazygomatic crest area at a 45° insertion angle was 4.94 mm compared to 3.90 at a 70° insertion angle (P<.001). No correlation was found between age and bone thickness. CONCLUSION: The distance to the nasal cavity and maxillary sinus was greater in the anterior than posterior areas. There is minimal risk of injuring the maxillary sinus or nasal cavity using the buccal approach. Caution is needed when placing miniscrews in the infrazygomatic crest area. LIMITATIONS: Cross-sectional study from one center; hence, findings cannot be generalized to other populations. CONFLICT OF INTEREST: None.

Width of keratinized gingiva and the health status of the supporting tissues around dental implants.

PURPOSE: This cross-sectional study was performed to determine whether an association exists between the width of keratinized mucosa and the health of implant-supporting tissues. MATERIALS AND METHODS: Data on 200 dental implants were collected. Periodontal parameters measured included Plaque Index, Gingival Index, width of keratinized mucosa, thickness of keratinized mucosa, radiographic bone level, and bleeding on probing. Statistical analysis was accomplished with the t test, Wilcoxon rank sum test, and logistic and linear regression models. Significance was established when P was less than .05. RESULTS: The mean Gingival Index score, Plaque Index score, and radiographic bone loss were significantly higher for those implants with a narrow zone (< 2 mm) of keratinized mucosa. Implants with a narrow zone of keratinized mucosa also were more likely to bleed upon probing, even after adjusting for Plaque Index, smoking, thickness of the gingiva, and time since implant placement (adjusted odds ratio, 2.37; 95% confidence interval, 1.04 to 5.83). Significant independent association also was found between the width of keratinized mucosa and radiographic bone loss in favor of wider zone of keratinized mucosa. CONCLUSION: Increased width of keratinized mucosa around implants is associated with lower mean alveolar bone loss and improved indices of soft tissue health.

The relationship between periapical lesions and the serum levels of glycosylated hemoglobin and C-reactive protein in type 2 diabetic patients.

OBJECTIVES: To investigate the relationship between the presence of periapical lesions (PL) and levels of glycosylated hemoglobin (HbA1c), and C-reactive protein (CRP) in patients with type 2 diabetes.  Methods: This cross-sectional study was conducted at Ibn Sina National College for Medical Studies, Jeddah, Kingdom of Saudi Arabia, between September 2013 and February 2015. Medical and dental history and Sociodemographic data were obtained from participants. Dental and periodontal examinations were conducted and blood samples were obtained to determine levels of HbA1c and CRP. The presence of PL was recorded from panoramic and periapical radiographs. Descriptive statistics and multivariable linear and logistic regression models were used for data analyses.  Results: One hundred patients were included; mean age was 48.9 ± 8.5 years. Of these patients, 14% had no PL, whereas 25% had one or 2 lesions, 32% had 3 or 4 lesions, and 29% had ≥5 PL. The mean HbA1c was 9.8% (± 2.5) mg/L and CRP was 6.9 mg/L (± 6.3). The presence of PL was significantly associated with a higher level of HbA1c independent of age, gender, probing depth, and plaque index (p=0.023). Individuals with PL were also more likely to have a high CRP level (greater than 3 mg/L) independent of the previous covariates (odds ratio: 1.19; 95% confidence interval: 1.01-1.41).  Conclusion: Periapical lesions are associated with a poorer glycemic control and a higher CRP level in type 2 diabetic patients.

Comparison of Cone Beam Computed Tomography-Derived Alveolar Bone Density Between Subjects with and without Aggressive Periodontitis.

INTRODUCTION: Understanding the changes in bone density of patients affected by aggressive periodontitis could be useful in early disease detection and proper treatment planning. AIM: The aim of this study was to compare alveolar bone density in patients affected with aggressive periodontitis and periodontally healthy individuals using Cone Beam Computed Tomography (CBCT). MATERIALS AND METHODS: This cross-sectional study was conducted on 20 patients with a confirmed diagnosis of aggressive periodontitis. Twenty periodontally healthy patients attending the dental clinics for implant placement or extraction of impacted third molars served as controls. Alveolar bone density was measured using CBCT scanning. Comparisons between aggressive periodontitis group and controls for age and alveolar bone density of the anterior and posterior regions were performed using an independent sample t-test. Multivariable linear regression models were also performed. RESULTS: The differences between groups in regard to age, anterior and posterior alveolar bone density was not statistically significant (p<0.05). In the posterior region, the multivariable regression model showed that bone density was not associated with age, gender or the study groups. Whereas, in the anterior region, patient's age was found to be significantly associated with bone density, p=0.014. CONCLUSION: Alveolar bone density as measured by CBCT in aggressive periodontitis patients was not different from periodontally healthy individuals. Further studies are needed to confirm these findings.

Increased intake of dairy products is related to lower periodontitis prevalence.

BACKGROUND: An inverse association between calcium intake and periodontitis prevalence was recently reported. Dairy products are rich sources of calcium and other important nutrients. To date, it appears that the relationship between the intake of dairy products and periodontitis has not been investigated. The purpose of the present study was to examine whether or not there is an association between the intake of dairy products and periodontitis prevalence. METHODS: A total of 12,764 individuals who participated in the Third National Health and Nutrition Examination Survey were included in this study. Individuals who had at least one site with an attachment loss>or=3 mm and a probing depth>or=4 mm were considered to have periodontitis. The intake of dairy products was categorized into quintiles. Descriptive statistics and logistic regression models were used for data analyses. RESULTS: Prevalence of periodontitis was 41% lower for individuals in the highest quintile of intake of dairy products than those in the lowest quintile (P<0.001 for trend). After adjusting for known and suspected periodontitis risk factors (age, gender, race\ethnicity, cigarette smoking, education, diabetes, poverty index, vitamin use, body mass index, physical activity, time since the last dental visit, dental calculus, and gingival bleeding), individuals in the highest quintile of intake of dairy products were 20% less likely to have periodontitis than those in the lowest quintile (P=0.024 for trend). CONCLUSIONS: The results of this study showed an inverse association between the intake of dairy products and prevalence of periodontitis. Longitudinal and/or intervention studies are required to confirm these findings and to further examine the impact of a higher intake of dairy products on the prevention and treatment of periodontitis.

Alveolar bone loss and reported medical status among a sample of patients at a Saudi dental school.

PURPOSE: Periodontitis is a common chronic disease globally. It is a major cause of tooth loss among adults, and recently has been suggested as a possible risk factorfor some systemic diseases such as cardiovascular disease. In Saudi Arabia, research on periodontitis prevalence, as well as its relation to systemic diseases, is lacking. The objectives of this study were: (1) to determine the prevalence of periodontitis among a sample of Saudi Dental School patients population; and (2) to examine the association between periodontitis and systemic diseases in the selected sample. MATERIALS AND METHODS: Retrospective evaluations of 282 randomly selected dental records were conducted. Age, gender, nationality and medical history were abstracted from these records. Number of remaining teeth and number of teeth with more than 20% of bone loss were determined from panoramic radiographs. Descriptive statistics, t-test, chi-square and regression models were used for data analyses. RESULTS: About 68% of the sample had radiographic alveolar bone loss; of these, 28% had a localised and 40% had a generalised form. Prevalence of systemic diseases was generally higher among individuals with the generalised form. About 21% and 13% of those with generalised periodontitis reported history of diabetes and hypertension respectively, whereas only about 2% of those with localised periodontitis reported history of these diseases. CONCLUSION: The findings of the present study showed a high prevalence of periodontitis in the selected sample. There is an urgent need for further studies with larger sample size to confirm these findings and to implement an effective measure to reduce periodontitis prevalence in Saudi Arabia.

Periodontitis and cardiovascular disease: a review of shared risk factors and new findings supporting a causality hypothesis.

Periodontitis is a common chronic disease worldwide. It is a major cause of tooth loss among adults and recently has been suggested to increase the risk for developing several systemic diseases, including cardiovascular disease. Populations are not equally affected by periodontal disease because there are several environmental and host factors modulating susceptibility. Cardiovascular disease shares many of the same susceptibility factors. The purpose of this report is to identify risk factors and indicators common to periodontitis and cardiovascular disease, and also to discuss their possible interrelationship in this association. Recent findings to support a causal association between the 2 conditions are also presented.

Periodontitis and three health-enhancing behaviors: maintaining normal weight, engaging in recommended level of exercise, and consuming a high-quality diet.

BACKGROUND: Maintaining normal weight, engaging in the recommended level of exercise, and eating healthy food are known to improve general health. The impact of these behaviors on periodontal health is not well documented. This study is aimed at examining whether the increased number of these behaviors is associated with a decrease in the prevalence of periodontitis in a United States population. METHODS: This study utilized data on 12,110 individuals who participated in the third National Health and Nutrition Examination Survey. Multivariate logistic regression analysis was used to estimate the association between the number of health-enhancing behaviors and periodontitis prevalence. Health enhancing behaviors included maintaining normal weight (body mass index [BMI], 18.5 to 24.9 kg/m(2)), engaging in the recommended level of exercises (>or=episodes of moderate or >or=episodes of vigorous-intensity physical activity per week), and having a high-quality diet (healthy eating index >80). RESULTS: After controlling for age, gender, race\ethnicity, cigarette smoking, other tobacco products, education, diabetes, poverty index, census region, acculturation, vitamin use, time since the last dental visit, dental calculus, and gingival bleeding, a 1-unit increase in the number of the three health-enhancing behaviors was associated with a 16% reduction in the prevalence of periodontitis (odds ratio [OR]=0.84; 95% confidence interval [CI]: 0.77 to 0.93). Individuals who maintained normal weight, engaged in the recommended level of exercise, and had a high-quality diet were 40% less likely to have periodontitis compared to individuals who maintained none of these health-enhancing behaviors. CONCLUSION: An increased number of health-enhancing behaviors is associated with a lower periodontitis prevalence.