Assessing the association between tea intake and risk of dental caries and periodontitis: a two-sample Mendelian randomization study.

Tea is an indispensable beverage in people's daily life. However, the relationship between tea intake and dental caries and periodontitis is controversial. We extracted datasets for tea intake and oral diseases from genome-wide association studies (GWASs) conducted by the UK Biobank and the Gene Lifestyle Interactions in Dental Endpoints consortium. We selected 38 single-nucleotide polymorphisms (SNPs) significantly associated with tea intake as instrumental variables (IVs) (P < 5.0 × 10-8). Mendelian randomization (MR) was performed to investigate the potential causality between tea intake and caries and periodontitis. Multivariable Mendelian randomization (MVMR) analyses were utilized to estimate causal effects of tea intake on risk of caries and periodontitis after adjusting for smoking, body mass index (BMI), and socioeconomic factors. The results showed that higher tea intake was suggestively associated with fewer natural teeth (ß = - 0.203; 95% CI = 0.680 to 0.980; P = 0.029) and higher risk of periodontitis (OR = 1.622; 95% CI = 1.194 to 2.205; P = 0.002). After Bonferroni correction, the causality of tea intake on periodontitis remained significant. The significance of periodontitis disappeared after adjusting for the socioeconomic factors in MVMR (OR = 1.603; 95% CI = 0.964 to 2.666; P = 0.069). Tea intake had no association with risk of caries. Statistical insignificance of the heterogeneity test and pleiotropy test supported the validity of the MR study. Our results provide insight into the potential relationship between tea intake and oral diseases from a dietary lifestyle perspective, which may help prevent oral diseases.

Association of periodontitis with handgrip strength and skeletal muscle mass in middle-aged US adults from NHANES 2013-2014.

OBJECTIVES: The relationship between periodontitis and sarcopenia parameters in middle-aged adults is largely unexplored. This study investigated the association between periodontitis and combined handgrip strength and skeletal muscle mass in middle-aged adults. MATERIALS AND METHODS: A sub-cohort of 1912 individuals with complete periodontal and whole-body dual X-ray absorptiometry examinations from the 2013-2014 wave of the National Health and Nutrition Examination Survey (n = 10,175) were analyzed using fully adjusted multiple linear regression models for associations between periodontitis and skeletal muscle mass index (kg/m2) and combined handgrip strength (kg). RESULTS: The mean age of the study cohort was 43 (± 8.4) years and 49.4% of the participants were male. In total, 612 participants (32%) were determined to have periodontitis, of which 513 (26.8%) had non-severe (mild or moderate) periodontitis, and 99 (5.2%) had severe periodontitis. In unadjusted regression models, both non-severe and severe periodontitis were associated with SMMI (ßnon-severe = 1.01, 95% CI 0.50; 1.52 and ßsevere = 1.42, 95% CI 0.59; 2.25) but not with cHGS. After adjusting for age, sex, education, body mass index, bone mineral density, diabetic status, education, total energy intake, total protein intake, and serum vitamin D2 + D3, periodontitis was associated with cHGS (ßnon-severe = -2.81, 95% CI - 4.7; - 1.15 and ßsevere = - 2.73, 95% CI - 6.31; 0.83). The association between periodontitis and SMMI remained for non-severe periodontitis (ßnon-severe = 0.07, 95% CI - 0.26; 0.40 and ßsevere = 0.22, 95% CI - 0.34; 0.78). CONCLUSION: The present study highlights the need of further prospective research to investigate the nature and direction of the relationship between periodontitis and sarcopenia indicators. Future studies can support the screening, prevention and clinical management of sarcopenia and periodontitis, and emphasize the interdisciplinary and complementary approach between the disciplines of geriatric medicine and periodontology.

Relationship of obstructive sleep apnea with periodontal condition and its local and systemic risk factors.

OBJECTIVE: Obstructive sleep apnea (OSA) and periodontitis share risk factors, such as age, obesity, stress, and cardiovascular events, which have a bidirectional cause-effect relationship through systemic inflammation. Our objective was to determine the relationship between OSA and the periodontal condition and its associated local and systemic risk factors. MATERIAL AND METHODS: This was an observational case-control study involving 60 patients. Local oral risk factors and the systemic condition of each patient were evaluated. All patients underwent polysomnography for the diagnosis of OSA. Chi-squared, one-way ANOVA, and Bonferroni's tests were performed. RESULTS: A higher percentage of patients with periodontitis had severe OSA (66.66%); however, no statistically significant association was found between the two pathologies (p = 0.290). In terms of systemic risk factors, an association was found between arterial hypertension and severe OSA (p = 0.038), and in terms of local factors, an association was found between the use of removable prostheses and severe OSA (p = 0.0273). CONCLUSION: In the general population, patients with periodontitis showed a higher prevalence of severe OSA. Obesity and hypothyroidism were the most prevalent systemic findings in patients with OSA and periodontitis. Arterial hypertension and osteoarthritis were found to be associated with severe OSA. The local risk factors associated with periodontitis and severe OSA were removable partial dentures and misfit resins. CLINICAL RELEVANCE: To study the factors that can facilitate the progression of OSA and periodontitis, physicians and dentists should be advised to provide comprehensive care for patients with both pathologies.

Prevalence of cancer in relation to signs of periodontal inflammation.

We investigated the associations between periodontal inflammation (gingivitis and periodontitis) and all-kind malignancies, specifically breast and prostate cancer, in a cohort followed-up for 30 years. The study hypothesis was based on the oral inflammation vs. systemic health paradigm. A sample of 2,168 subjects from an original cohort of 105,718 individuals from the greater Stockholm area in Sweden that had been followed since 1985 was investigated. Swedish national health registers were used in the study. Chi-square tests and logistic multiple regression analyses were conducted. The results showed that periodontitis was significantly associated with any cancer after adjusting for gender, age, income, and education (p = 0.015). The probability of getting cancer increased on average by 38% if the patient had periodontitis vs. had not; the odds ratio was 1.380 (95% confidence interval l.066-1.786). No significant association was observed between periodontitis and breast cancer (p = 0.608), while the association between periodontitis and prostate cancer tended towards significance (p = 0.082). However, no statistically significant difference was found between the observed and the calculated distribution of any cancer in gingivitis groups (p = 0.079). Thus, the study hypothesis was partly confirmed by showing a statistically significant association between periodontitis and any cancer.

Abnormal Micronutrient Intake Is Associated with the Risk of Periodontitis: A Dose-response Association Study Based on NHANES 2009-2014.

The association between micronutrient intake and the risk of periodontitis has received much attention in recent years. However, most studies focused on the linear relationship between them. This study aimed to explore the dose-response association between micronutrient intake and periodontitis. A total of 8959 participants who underwent a periodontal examination, and reported their micronutrient intake levels were derived from the US National Health and Nutrition Examination Survey (NHANES, 2009-2014) database. Logistic regression was performed to evaluate associations between micronutrient intake and periodontitis after propensity score matching (PSM), and restricted cubic splines (RCS) analysis was conducted to explore the dose-response associations. Following PSM, 5530 participants were included in the RCS analysis. The risk of periodontitis was reduced with sufficient intake of the following micronutrients: vitamin A, vitamin B1, vitamin B2, and vitamin E. In addition, the risk of periodontitis was increased with excessive intake of the following micronutrients: vitamin B1 (1.8 mg/day, males; 1.3 mg/day, females), vitamin C (90 mg/day, males), and copper (1.1 mg/day, combined). In conclusion, a linear association was found between vitamin A, vitamin B2, vitamin C, and copper and periodontitis-namely, a sufficient intake of vitamin A and vitamin B2 might help reduce the prevalence of periodontitis; by contrast, a high intake of vitamin C and copper increased the risk. In addition, a nonlinear dose-response association was found for the incidence of periodontitis with vitamin B1 and vitamin E. When within reasonable limits, supplemental intake helped reduce the prevalence of periodontitis, while excessive intake did not help significantly and might even increase the risk. However, confounding factors, such as health awareness, should still be considered.

The association between coffee consumption and periodontitis: a cross-sectional study of a northern German population.

BACKGROUND: Positive and negative influences on oral health are attributed to coffee consumption. The aim of the current study is to evaluate the association between coffee consumption and periodontitis in the general population of Hamburg. METHODS: A total of 6,209 participants from the Hamburg City Health Study were included in this cross-sectional study. Information on coffee consumption was collected using a food frequency questionnaire. Periodontal examination included assessment of dental care ability via Plaque Index, measurement of pocket depth, gingival recession, and bleeding on probing. Classification was based on the criteria of Eke and Page. Ordinal logistic regression models were performed unadjusted and adjusted for confounding variables. RESULTS: Periodontal cohort consists of 6,209 participants, presenting either none/mild (n = 1,453, 39.6% men, 2.4% strong coffee drinkers), moderate (n = 3,580, 49.3% men, 3.3% strong coffee drinkers), or severe (n = 1,176, 60.9% men, 5.0% strong coffee drinkers) periodontitis. There was a significant association between strong coffee consumption (≥ 7or more cups/day) and periodontitis (OR: 1.51; CI: 1.07, 2.12; p > 0.001), compared with low coffee consumption. Conversely, moderate coffee consumption was not associated with periodontitis, compared with low coffee consumption. CONCLUSION: and clinical relevance. In this cross-sectional study of a northern German population, strong coffee consumption was significantly associated with periodontitis. Influence of changes in coffee consumption on periodontal disease etiology/progression should be investigated in future prospective study designs, in order to identify strong coffee consumption as a potential risk factor of periodontitis.

[Lifestyle and periodontology]. / Leefstijl en parodontologie.

The use of stimulants, an improperly composed diet, lack of exercise, metabolic and mental stress, as well as overweight increase the risk of periodontitis. These lifestyle choices have an (in)direct influence on the immune system and can initiate inflammatory reactions at the level of the periodontium. Ultimately, this increases the susceptibility to gingivitis and periodontitis. A complete diet in terms of macro- (proteins, omega-3 fatty acids) and micro-nutrients (vitamins), as well as physical activity and sufficient relaxation appear to be essential for a healthy periodontium. A healthy weight, but especially a waist circumference within the normal range, also contribute to a reduction in the risk of periodontitis: directly, through the release of pro-inflammatory cytokines via the adipocytes, and indirectly, through obesity-related disorders. An unhealthy lifestyle thus increases the susceptibility to periodontal disease. Lifestyle advice should therefore be part of periodontal care.

Evaluation of the Relationship between Drink Intake and Periodontitis Using KoGES Data.

It was hypothesized that periodontal diseases could be influenced by nutrition and food types. However, the role of nutritional factors in the risk of periodontal disease has not been clearly elucidated. This study was aimed at investigating the relationship between coffee, green tea, or soft drink intake and periodontitis. This prospective cohort study used epidemiological data from 2004 to 2016 from the Korean Genome and Epidemiology Study. Among 173,209 participants, 9,933 with periodontitis and 124,922 controls were selected. The frequency histories of coffee/green tea/soft drink intake among the participants were analyzed, and intake was categorized as no drink, mild drink (one time a month through six times a week), and heavy drink (one or more times a day). Variable factors were adjusted using logistic regression analysis (adjusted model). The chi-square test and independent t-test were used for statistical analysis. Adjusted odds ratio (aOR) for coffee or green tea intake and periodontitis were not statistically significant. The aOR was 1.16 (95% confidence interval (CI) = 1.11-1.21, P < 0.001) for mild soft drink intake and 1.02 (95%CI = 0.96-1.09, P = 0.518) for heavy soft drink intake. Subgroup analysis showed that mild soft drink intake was significant across all groups (P < 0.05), whereas coffee and green tea intakes were not significant in any subgroup. Overall, the study elucidated an association between mild soft drink intake and periodontitis.

The Importance of Integrated Healthcare in the Association Between Oral Health and Awareness of Periodontitis and Diabetes in Type 2 Diabetics.

PURPOSE: Purpose: To assess the association of various factors including education level and oral health with type 2 diabetics' awareness of periodontitis and periodontitis/diabetes relationship, and to evaluate the importance of integrated healthcare in this association. Materials and Methods: 288 type 2 diabetics were evaluated through a validated structured questionnaire about oral hygiene habits, access and attendance to dental treatment, the presence of periodontitis and previously received information of periodontitis and periodontitis/diabetes relationship. Descriptive data were explored and both simple and multiple logistic regressions were performed. Results: The average age of participants was 62.24 (±10.93) years, 81.6% were previously treated for periodontitis and approximately 70% have never received information on periodontitis and its relationship with diabetes. A higher chance of participants having previously received information regarding periodontitis was associated with more than 8 years of schooling, daily flossing habit, presence of periodontitis and prior treatment for periodontitis (p < 0.005). Regarding previously received information about periodontitis/diabetes relationship, statistically significant associations were observed for more than 12 years of schooling and diabetes diagnosed more than 8 years ago (p < 0.05). Conclusion: The vast majority of participants were previously treated for periodontitis without receiving proper oral health education, which means that access to costly dental treatment is provided while patient education is neglected. It was shown the influence of habits and living conditions on the previously received information about diseases, and therefore, particular attention to the population characteristics is important to make the information accessible to everyone.

Impact of periodontitis on the Oral Health Impact Profile: A systematic review and meta-analysis.

BACKGROUND: Periodontitis, being a chronic and multifactorial disease, affects oral health, and consequently, the patient's quality of life (QoL). The assessment of the oral health-related quality of life (OHRQoL) is possible with the Oral Health Impact Profile-14 (OHIP-14) questionnaire comprising 7 subdomains: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. OBJECTIVES: The aim of this study was to conduct a systematic review of cross-sectional or case-control studies concerning the impact of periodontitis on QoL measured with OHIP-14. The outcomes of the studies were subjected to a meta-analysis. MATERIAL AND METHODS: On the basis of a survey of databases (MEDLINE, Scopus, Google Scholar, and Polish Medical Bibliography - PBL), 1,346 titles related thematically to the impact of periodontitis on QoL were obtained and analyzed. Ten studies were considered eligible for evaluation (8 cross-sectional ones and 2 case-control ones). RESULTS: All studies indicated a significant influence of periodontitis on the deterioration of the OHIP-14 values. This relationship was shown to be directly modified in proportion to the degree of the advancement of the periodontal disease and to the extent of periodontal tissue damage. Our own meta-analysis confirmed the correlation between the prevalence of periodontitis and increased OHIP-14 scores with a cumulative odds ratio (OR) of 1.33, demonstrated a moderately significant deterioration of the OHIP-14 scores by 4.2 points in the group with periodontitis as compared to the control group, and assessed the probability of OHIP-14 deterioration to be 3.5 times greater in severe periodontitis. CONCLUSIONS: The impact of periodontitis on the deterioration of OHRQoL is quite clearly explained by the clinical symptoms of periodontitis. According to patients, the most important problems that periodontitis may cause include psychological discomfort, stress, problems in interpersonal relations, or even difficulties in daily activities. This indicates the need for more of a holistic approach in planning the goals of the periodontal therapy, taking into account the psychological and social aspects of the patient's perception of the disease.

Rheumatoid arthritis and periodontitis in adults: Using the Korean National Health Insurance Service-National Sample Cohort.

BACKGROUND: Using the database of the National Health Insurance Service-National Sample Cohort (NHIS-NSC), we aimed to assess the relationship between the prevalence of rheumatoid arthritis (RA) and periodontitis. METHODS: Participants aged ≥19 years with a previous health check-up at the NHIS between 2009 and 2015 were selected. In total, 559,280 participants were included after implementing appropriate exclusion criteria. The Chi-squared test was used to compare the general and health-related characteristics of participants with and without RA or periodontitis. Univariate and multivariate logistic regression analyses with consecutive adjustment for confounders, were used to assess the association between the prevalence of rheumatoid arthritis and periodontitis. RESULTS: The prevalence of rheumatoid arthritis in patients with and without periodontitis was 6.2% and 5.2%, respectively. The prevalence of periodontitis in patients with and without rheumatoid arthritis was 19.6% and 16.6%, respectively. The possibility of having rheumatoid arthritis was greater in patients with periodontitis than in individuals without periodontitis (odds ratio [OR]; 1.22, P <0.001), and remained high (OR; 1.07, P <0.001) after adjusting for confounders. CONCLUSION: Our results revealed a significant association between the prevalence of rheumatoid arthritis and periodontitis.

Marine ω-3, vitamin D levels, disease outcome and periodontal status in rheumatoid arthritis outpatients.

OBJECTIVES: Marine ω-3 fatty acids (FAs) and Vitamin D (VitD) are reportedly capable of down-regulating inflammation in rheumatoid arthritis (RA) and periodontal disease. This study was undertaken to relate marine FA and VitD status to RA disease status and periodontal conditions. METHODS: RA outpatients (age ≥35 y) were consecutively recruited. Rheumatologic clinical data were collected and periodontal status obtained. A food frequency questionnaire was used to estimate fish and supplement intake. FA profiles in whole-blood and serum VitD levels were determined. RESULTS: A total of 78 RA patients (age 57 ± 12 y, disease duration 15 ± 11 y) were included, 58% had active RA. Periodontitis was diagnosed in 82% of the patients, 18% had severe periodontitis. Seropositivity for rheumatoid factor and/or anticitrullinated protein antibodies was related to higher prevalence of periodontitis (P= 0.008). Seafood intake in accordance with nutritional recommendations was associated with better RA disease outcome (largest P= 0.008). An ω-3 index >8, present in 14% of the patients, correlated with a more desirable patient global health assessment scored on a visual analog scale (VAS; P= 0.004), lower periodontal probing depth (PD; P= 0.021), and ω-3 supplementation (P= 0.001). Serum VitD levels >50 nmol/L were found in 89%, of these 48% had VitD levels ≥75 nmol/L, no differences were found for RA disease activity and periodontal measurements. CONCLUSIONS: Seropositive RA patients had a higher prevalence of periodontitis than seronegative patients. An ω-3 index >8 was related to ω-3 supplementation and more desirable VAS and lower PD. VitD status was satisfactory for most patients and was not associated with differences in RA severity or periodontal diagnosis.

Dietary Polyphenols and Periodontitis-A Mini-Review of Literature.

Periodontitis, which is a chronic infection and disease of the periodontium, is a significant global health burden and is linked to other chronic health conditions such as diabetes and cardiovascular diseases. Dietary polyphenols present in a wide variety of plant-based foods, herbs, and botanicals have been shown to exert antimicrobial, anti-inflammatory, and reduced osteoclast and alveolar bone loss activities in animal models of periodontitis. Polyphenol-containing beverages and foods especially green tea and its active catechin epigallocatechin-3-gallate, cranberries, pomegranates, and fruit and vegetable extracts have reported bacteriostatic/bactericidal activity against microbial species such as P. gingivalis and shown total bacterial burden in clinical studies. These polyphenols also exhibit anti-inflammatory and antioxidant effects, which have the potential to impact various biological mechanisms for reducing the initiation and progression of periodontitis. The main objective of this mini-review is to focus on the mechanisms of action of dietary polyphenols in improving the pathophysiology underlying chronic inflammatory diseases like periodontitis based on pre-clinical and clinical models.

Association between osteoporosis treatment and severe periodontitis in postmenopausal women.

OBJECTIVE: To estimate the association between osteoporosis treatment and severe periodontitis in postmenopausal women. METHODS: This cross-sectional study comprised of 492 postmenopausal women, 113 women in osteoporosis treatment, and 379 not treated. Osteoporosis treatment consisted of systemic estrogen alone, or estrogen plus progestin, and calcium and vitamin D supplements, for at least 6 months. Severe periodontitis was defined as at least two interproximal tooth sites with clinical attachment loss of at least 6 mm, and at least one interproximal site with probing depth of at least 5 mm; and dental caries experience was measured using the decayed, missing, and filled teeth (DMFT) index. Analysis included descriptive statistics and Poisson multivariate analysis with robust variance. RESULTS: Women receiving osteoporosis treatment had less periodontal probing depth, less clinical attachment loss, and less gingival bleeding than women not receiving treatment for osteoporosis (P ≤ 0.05). In the osteoporosis treatment group, the estimated mean DMFT index score was approximately 20, the most frequent component being the number of missing teeth, and in the nontreated group, the DMFT index was approximately 19. The prevalence of severe periodontitis was 44% lower in the osteoporosis treatment group than in the nontreatment group. The prevalence ratioadjusted was 0.56, 95% confidence interval was 0.31 to 0.99 (P = 0.05), after adjustments for smoking, age, family income, and visit to the dentist. CONCLUSIONS: The results suggest that women treated with estrogen for postmenopausal osteoporosis have a lower prevalence of severe periodontitis than women not receiving treatment.

Excessive Consumption of Green Tea as a Risk Factor for Periodontal Disease among Korean Adults.

This study was performed to assess the relationship between the amount of green tea that is consumed and periodontitis. It is based on data obtained from the Korea National Health and Nutrition Examination Survey, conducted between 2008 and 2010. A community periodontal index equal to code 3 was defined as moderate periodontitis, and code 4 was defined as severe periodontitis (n = 16,726). Consumption of green tea less than one cup per day was associated with a decreased prevalence of periodontal disease among Korean adults. The association between the consumption of green tea and periodontal disease was independent of various potential confounding factors, such as age, sex, body mass index, smoking, drinking, exercise, metabolic syndrome, frequency of tooth brushing per day, use of secondary oral products, the number of dental examination per year, diabetes, hypertension, and white blood cell count. Adjusted odds ratio and 95% confidence interval of no consumption was 1.360 (1.156, 1.601) when participants with consumption of two times per week ≤ x < 7 times per week was considered as a reference. However, consumption of one or more cups per day increased the prevalence of moderate and severe periodontitis. In conclusion, excessive consumption of green tea may be considered as a risk factor for periodontal disease among Korean adults.

Association between Consumption of Coffee and the Prevalence of Periodontitis: The 2008-2010 Korea National Health and Nutrition Examination Survey.

BACKGROUND: This study was performed to assess the relationship between the consumption of coffee and periodontitis using nationally representative data. METHODS: The data from the Korea National Health and Nutrition Examination Survey were used; the analysis in this study was confined to a total of 16,730 respondents over 19 years old who had no missing values for the consumption of coffee or outcome variables. A community periodontal index greater than or equal to code 3 was defined as periodontal disease. RESULTS: Consumption of coffee was significantly higher in the individuals with periodontitis in males. The odds ratios of the percentage of individuals with periodontitis tended to increase with the consumption of coffee. Adjusted odds ratios and their 95% confidence intervals of the male participants were 1, 1.131(0.792-1.617), 1.161(0.857-1.573), 1.053(0.805-1.379), 1.299(1.007-1.676), and 1.458(1.141-1.862) for once per month or less, once per month

Nutrient supplementation may adversely affect maternal oral health--a randomised controlled trial in rural Malawi.

Nutritional supplementation during pregnancy is increasingly recommended especially in low-resource settings, but its oral health impacts have not been studied. Our aim was to examine whether supplementation with multiple micronutrients (MMN) or small-quantity lipid-based nutrient supplements affects dental caries development or periodontal health in a rural Malawian population. The study was embedded in a controlled iLiNS-DYAD trial that enrolled 1391 pregnant women <20 gestation weeks. Women were provided with one daily iron-folic acid capsule (IFA), one capsule with 18 micronutrients (MMN) or one sachet of lipid-based nutrient supplements (LNS) containing protein, carbohydrates, essential fatty acids and 21 micronutrients. Oral examination of 1024 participants was conducted and panoramic X-ray taken within 6 weeks after delivery. The supplement groups were similar at baseline in average socio-economic, nutritional and health status. At the end of the intervention, the prevalence of caries was 56.7%, 69.1% and 63.3% (P = 0.004), and periodontitis 34.9%, 29.8% and 31.2% (P = 0.338) in the IFA, MMN and LNS groups, respectively. Compared with the IFA group, women in the MMN group had 0.60 (0.18-1.02) and in the LNS group 0.59 (0.17-1.01) higher mean number of caries lesions. In the absence of baseline oral health data, firm conclusions on causality cannot be drawn. However, although not confirmatory, the findings are consistent with a possibility that provision of MMN or LNS may have increased the caries incidence in this target population. Because of the potential public health impacts, further research on the association between gestational nutrient interventions and oral health in low-income settings is needed.

Actions of Adjunctive Nutritional Antioxidants in Periodontitis and Prevalent Systemic Inflammatory Diseases.

Common risk markers for periodontitis and prevalent systemic comorbidities indicate similarities in their progression and molecular mechanisms involved. Resultant pro-oxidant disease profiles provide scope for attenuating their pathogeneses with appropriate adjunctive antioxidants. Levels of oxidative stress markers 8-hydroxy-deoxguanosine (8-HOdG) and malondialdehyde (MDA) are significantly higher in periodontitis and other chronic inflammatory conditions. There is a clear link between periodontitis and diseases associated with significant systemic inflammatory loading, such as metabolic syndrome. Micro- and macro-nutrients have proven to be effective in curbing molecular mechanisms that generate reactive oxygen and nitrogen species. A Mediterranean diet rich in fruits, vegetables, legumes, whole grain, nuts, fish, olive oil and red wine in moderation, could be attributed to the lower occurrence of cardiovascular disease, insulin resistance and other inflammatory diseases in this region. A significant number of naturally occurring flavonoids have been identified in these products. Flavonoids comprising flavonols, flavones and isoflavones are potent free radical scavengers, effective in inhibiting lipid peroxidation, with anti-atherosclerotic and antihypertensive effects.The phenolic compound oleocanthal isolated in virgin olive oil has similar anti-inflammatory actions to that of ibuprofen. The anti-atherogenic effects of MUFA and PUFA in nuts, enhance endothelial function by reducing total cholesterol, oxidized LDL, hs-CRP, sVCAM-1 levels, lipids, lipoproteins and inflammatory markers. Epigenetics influenced by environmental factors and interactions between genes and nutrients, are important considerations in influencing these effects. Using antioxidants as therapeutic adjuncts could enhance the antioxidant capacity of an inherent glutathione system and overcome oxidative effects, thereby mitigating therapeutic side-effects.

Severe periodontitis is inversely associated with coffee consumption in the maintenance phase of periodontal treatment.

This cross-sectional study addressed the relationship between coffee consumption and periodontitis in patients during the maintenance phase of periodontal treatment. A total of 414 periodontitis patients in the maintenance phase of periodontal treatment completed a questionnaire including items related to coffee intake and underwent periodontal examination. Logistic regression analysis showed that presence of moderate/severe periodontitis was correlated with presence of hypertension (Odds Ratio (OR) = 1.99, p < 0.05), smoking (former, OR = 5.63, p < 0.01; current, OR = 6.81, p = 0.076), number of teeth present (OR = 0.89, p < 0.001), plaque control record ≥20% (OR = 1.88, p < 0.05), and duration of maintenance phase (OR = 1.07, p < 0.01). On the other hand, presence of severe periodontitis was correlated with smoking (former, OR = 1.35, p = 0.501; current, OR = 3.98, p < 0.05), coffee consumption (≥1 cup/day, OR = 0.55, p < 0.05), number of teeth present (OR = 0.95, p < 0.05), and bleeding on probing ≥ 20% (OR = 3.67, p < 0.001). There appears to be an inverse association between coffee consumption (≥1 cup/day) and prevalence of severe periodontitis in the maintenance phase of periodontal treatment.

Prospective Study of Serum 25-hydroxy Vitamin D and Tooth Loss.

Vitamin D deficiency and oral diseases (periodontitis, caries, and tooth loss) are highly prevalent in Germany. Previous studies suggested that vitamin D might be a modifiable and protective factor for periodontitis, caries, and tooth loss. However, prospective studies investigating such associations are limited. We explored the association between the concentration of serum 25-hydroxy vitamin D (25OHD) and incidence of tooth loss, progression of clinical attachment loss (CAL) ≥ 3 mm, and progression of restorative and caries status in a population-based longitudinal study. We analyzed data from 1,904 participants from the Study of Health in Pomerania with a five-year follow-up. Generalized estimating equation models were applied to evaluate tooth-specific associations between serum 25OHD and incidence of tooth loss, progression of CAL ≥ 3 mm, and progression of restorative and caries status. Age, sex, education, smoking status, alcohol drinking, waist circumference, dental visit frequency, reasons of dental visit, vitamin D or calcium supplements, and season of blood draw were considered as confounders. Serum 25OHD was inversely associated with incidence of tooth loss. A significant dose-response relationship (p = .0022) was observed across the quintiles of serum 25OHD. After adjusting for multiple confounders, each 10-µg/L increase of serum 25OHD was associated with a 13% decreased risk of tooth loss (risk ratio: 0.87; 95% confidence interval: 0.79, 0.96). The association was attenuated for changes of CAL ≥ 3 mm when adjusting for multiple confounders. No significant association was found between serum 25OHD and caries progression. Vitamin D might be a protective factor for tooth loss. The effect might partially be mediated by its effect on periodontitis.