Association between birth-related factors and periodontitis in women: Korea National Health and Nutrition Examination Survey 2013-2018.

AIM: Adult women experience several changes in physiological status, such as pregnancy and childbirth, during their life cycle. This study analyses the association between birth-related factors (the number of childbirths, abortions and miscarriages) and periodontitis using data from the Korea National Health and Nutrition Examination Survey, which represents Korean adults. MATERIALS AND METHODS: The study used data from Korea National Health and Nutrition Examination Survey VI and VII (2013-2018) and included 10,072 women 19 years or older, with no missing data on the variables assessed. Periodontitis was defined according to the Community Periodontal Index (CPI) criteria. Multiple logistic regression analysis, adjusting for age, household income, education, alcohol consumption, smoking, stress, body mass index, waist circumference, hypertension, diabetes mellitus, an oral examination within 1 year, daily tooth brushing frequency, hygiene products and self-perceived oral health as identified via logistic regression analyses, was performed to determine the association between birth-related variables and periodontitis. RESULTS: In the crude model, the odds ratio (OR) showed a significantly increased risk of periodontitis (CPI ≥ 3) and severe periodontitis (CPI = 4) based on the number of childbirths, abortions and miscarriages (p < .05). After covariate adjustment, periodontitis (CPI ≥ 3) was associated with the number of childbirths (1: OR = 1.92; 95% confidence interval [CI]: 1.47-2.50; 2: OR = 2.03; 95% CI: 1.57-2.61; ≥3: OR = 2.11; 95% CI: 1.60-2.78). Furthermore, severe periodontitis (CPI = 4) was also associated with the number of childbirths (1: OR = 2.33; 95% CI: 1.24-4.38; 2: OR = 2.99; 95% CI: 1.62-5.52; ≥3: OR = 3.34; 95% CI: 1.79-6.21). CONCLUSIONS: The findings of this large-scale, nationally representative study suggest that the number of childbirths is associated with the severity of periodontitis. However, the relationship between the number of abortions and miscarriages and periodontitis (CPI ≥ 3) or severe periodontitis (CPI = 4) is not significant.

Chronic kidney disease in postmenopausal women is associated with tooth loss.

OBJECTIVE: Menopause is characterized by changes in reproductive hormone levels that can negatively affect bone. Chronic kidney disease (CKD) and tooth loss are also important and common health issues after menopause. This study aimed to evaluate the association between CKD and tooth loss in postmenopausal women. METHODS: The study evaluated 64,971 participants who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) from 2010-2018, including postmenopausal women, aged 40 to 79 years. Participants were divided into two groups based on the number of teeth in their dentition (≥20 and <20). MAIN OUTCOME MEASURES: The association between CKD and tooth loss was analyzed using multivariate logistic regression. Age, income, education, smoking, alcohol intake, body mass index, hypertension, diabetes, annual oral examination, toothbrushing, and the use of oral care products were considered. Subgroup analyses were further conducted according to age (40-65 yr and 66-79 yr). RESULTS: After adjusting for covariates, CKD and estimated glomerular filtration rate were significantly associated with having ≥20 teeth (PT20; CKD: odds ratio [OR] 1.41, 95% confidence interval [CI] 1.04-1.90; estimated glomerular filtration rate (10 mL/min/1.73 m 2 ): OR 0.90, 95% CI 0.86-0.94). Importantly, the association between CKD and PT20 was significant in postmenopausal women, aged 66 to 79 years (OR 1.45, 95% CI 1.05-2.01). CONCLUSIONS: In postmenopausal women, CKD and tooth loss may be associated. The association is significant in postmenopausal women, aged 66 to 79 years.

Disruption of cholesterol homeostasis triggers periodontal inflammation and alveolar bone loss.

Oral diseases exhibit a significant association with metabolic syndrome, including dyslipidemia. However, direct evidence supporting this relationship is lacking, and the involvement of cholesterol metabolism in the pathogenesis of periodontitis (PD) has yet to be determined. In this study, we showed that high cholesterol caused periodontal inflammation in mice. Cholesterol homeostasis in human gingival fibroblasts was disrupted by enhanced uptake through C-X-C motif chemokine ligand 16 (CXCL16), upregulation of cholesterol hydroxylase (CH25H), and the production of 25-hydroxycholesterol (an oxysterol metabolite of CH25H). Retinoid-related orphan receptor α (RORα) mediated the transcriptional upregulation of inflammatory mediators; consequently, PD pathogenesis mechanisms, including alveolar bone loss, were stimulated. Our collective data provided direct evidence that hyperlipidemia is a risk factor for PD and supported that inhibition of the CXCL16-CH25H-RORα axis is a potential treatment mechanism for PD as a systemic disorder manifestation.

Prevention of Dental Erosion Caused by Fermented Milk: An In-vitro Study.

PURPOSE: This study aimed to assess the efficacy of three techniques for preventing dental erosion and thereby identify effective methods. The three techniques were: 1) adding calcium to fermented milk (2% Ca and 0.5% Ca); 2) topical application of fluoride to the teeth before exposure to fermented milk (acidulated phosphate fluoride [APF] gel and 0.05% NaF); and 3) a combination of the two techniques (APF gel + 0.5% Ca, 0.05% NaF + 0.5% Ca). MATERIALS AND METHODS: pH cycling was performed on bovine-tooth specimens alternately immersed in experimental solutions and artificial saliva. After treatment, the microhardness and roughness of the enamel surfaces were measured, and changes in the surface morphology were observed using atomic force microscope images. RESULTS: Microhardness did not differ statistically significantly between the 2% Ca and mineral water (negative control) groups (2% Ca: 295.34 ± 11.50; mineral water group: 294.76 ± 10.67; p > 0.05). Surface roughness did not differ statistically significantly between the 2% Ca, 0.05% NaF + 0.5% Ca, and mineral water groups (2% Ca: 16.81 ± 7.23; 0.05% NaF + 0.5% Ca: 15.77 ± 2.86; mineral water group: 13.35 ± 5.53; p > 0.05). The surface morphology did not change in the mineral water and 2% Ca groups. CONCLUSION: Considering that 2% calcium is a high concentration, adding a low concentration of calcium to fermented milk and applying a low concentration of fluoride daily decreased the reduction of surface microhardness and reduced the increase in surface roughness without causing marked changes in surface morphology. This confirms that combining the two techniques is an effective strategy to prevent dental erosion in-vitro.

Association between Present Teeth and Muscle Strength in Older People in Korea.

BACKGROUND: As the world population continues to age, interest in muscle strength loss in older people is increasing. This study aimed to confirm the association between present teeth and muscle strength in older people in Korea. METHODS: Using data extracted from the 2014-2019 Korea National Health and Nutrition Examination Survey, we analyzed 5136 older people aged 65-79 years. The present teeth were based on 20 teeth, which is the criteria for comfortable mastication. The association of the risk of low muscle strength according to the present teeth was assessed using multiple logistic regression analysis, and the association was confirmed by dividing into subgroups according to sex. RESULTS: The prevalence of low muscle strength was 17.87% among all participants. Multiple logistic regression analysis confirmed the association between low muscle strength and present teeth; a significant association was found even in the model in which all covariates were adjusted (odds ratios (OR) = 1.35; 95% confidence interval (CI): 1.13-1.61). Subgroup analysis revealed a significant association between present teeth and low muscle strength even in the model in which both covariates were adjusted for sex (Men, OR = 1.41; 95% CI: 1.02-1.95; Women, OR = 1.31; 95% CI: 1.06-1.6). CONCLUSION: An association between present teeth and low muscle strength was confirmed in older people in Korea. These results indicate that the importance of oral hygiene management should be emphasized to prevent muscle strength loss in older people.

Association between Metabolic Syndrome and the Number of Remaining Teeth in Postmenopausal Women: A Cross-Sectional Analysis Using the Korean National Health and Nutritional Examination Survey.

There are very few studies on metabolic syndrome (MetS) and oral health in postmenopausal women. The purpose of this cross-sectional study was to determine the association between MetS and its components and the number of remaining teeth in postmenopausal women in Korea. The study selected 3320 menopausal women (40-79 years old) from those who participated in the seventh Korea National Health and Nutrition Survey (2016-2018). Multiple regression and multiple logistic regression analyses were performed to determine the association between MetS and its components and the number of remaining teeth. According to the multiple regression analysis, the regression coefficient (B) values were -1.62 (p < 0.05), -1.31 (p < 0.05), -1.60 (p < 0.05), and -2.28 (p < 0.05) in the hypertension group, hyperglycemia group, low high-density lipoprotein (HDL) cholesterol group, and MetS prevalence group, respectively. This indicates that the number of remaining teeth was lower in the MetS prevalence group as compared to the non-prevalence groups. As observed in the multiple logistic regression analysis, the odds ratio of the number of remaining teeth (less than 20) was higher in the MetS prevalence group (1.82 (p < 0.05)) as compared to the non-prevalence groups (1.25 (p < 0.05) in the abdominal obesity group, 1.50 (p < 0.05) in the hypertension group, 1.36 (p <0.05) in the hyperglycemia group, and 1.72 (p < 0.05) in the low HDL cholesterol group). Therefore, our results indicate that abdominal obesity, hypertension, diabetes, dyslipidemia, and prevalence of MetS are associated with tooth loss in postmenopausal women.

No Association between Metabolic Syndrome and Periodontitis in Korean Postmenopausal Women.

This study aimed to determine the association between metabolic syndrome (MetS) and periodontitis in Korean postmenopausal women. The study selected 3320 menopause women (40-79-year-old) from those who participated in the seventh Korea National Health and Nutrition Survey (2016-2018). This association was determined using frequency and multiple logistic regression analyses. The prevalence of MetS in postmenopausal women was 33.2%, and among the MetS components, abdominal obesity showed a higher odds ratio of periodontitis by 1.36 (95% confidence interval (CI): 1.12-1.65; p < 0.05). The odds ratio for periodontitis was 1.34 times higher (95% CI: 1.12-1.60) in the MetS prevalence group with three or more MetS components (p < 0.05); however, after adjusting for demographic characteristics and health behavior variables, it was not statistically significant. Therefore, our results indicated that MetS has no association with periodontitis in postmenopausal women after adjusting for confounding variables.

Association between Oral Health Status and Relative Handgrip Strength in 11,337 Korean.

Grip strength is a simple indicator of physical strength and is closely associated with systemic health. Conversely, oral health has also been reported to have an important association with systemic health. The present study aimed to assess the effect of oral health status on relative handgrip strength. The data pertaining to 11,337 participants were obtained by means of the seventh Korea National Health and Nutrition Survey (2016 to 2018). Oral health status was evaluated on the basis of the presence of periodontitis and number of remaining teeth (PT, present teeth). Relative handgrip strength was evaluated by means of a digital dynamometer and the value pertaining to the lower 25% of measurements was used as the quartile by gender. The association between oral health status and relative handgrip strength was evaluated by means of multiple regression analysis and multiple logistic regression analysis with covariate correction. Analysis of the crude model revealed a significant association in the group of patients with periodontal disease (odds ratio = 1.69, 95% confidence interval: 1.51-1.89). However, analysis with adjusted covariates revealed that the association was not statistically significant. Moreover, statistical analysis after adjustment for covariates revealed a consistent correlation between PT and relative handgrip strength as categorical and continuous variables. Hence, the present study observed a significant association between oral health status and relative handgrip strength among the Korean adult population.

Effect of antimicrobial photodynamic therapy with Chlorella and Curcuma extract on Streptococcus mutans biofilms.

BACKGROUND: Antimicrobial photodynamic therapy (aPDT) using natural photosensitive agents is an effective method for preventing oral diseases of bacterial origin. The purpose of this study was to evaluate the antimicrobial effect of aPDT, using powdered extracts of Chlorella and Curcuma, on the biofilms of Streptococcus mutans (S. mutans), a bacterium that is known to cause dental caries. METHODS: Commercially available powdered Chlorella and Curcuma extracts were used as photosensitizers. S. mutans, cultured for 2 days, was inoculated (0.1 ml; 1 × 109 CFU/ml) on the surface of a hydroxyapatite (HA) disc and incubated for 24 h to allow the formation of a biofilm. The HA disc with the S. mutans biofilm was immersed in either Curcuma extract (0.5 mg/ml), Chlorella extract, distilled water (negative control), or Listerine (positive control) for 1 min and then irradiated with an LED (Qraycam; wavelength, 405 nm; energy, 59 mW) for 5 min. RESULTS: The application of aPDT with Curcuma or Chlorella extract to S. mutans 24-hour biofilms significantly decreased the number of viable cells and the live/dead cell ratio when compared with those in the negative control (distilled water; p < 0.05). CONCLUSIONS: aPDT using 405 nm light and Chlorella or Curcuma as a photosensitizer has significant antimicrobial effects against S. mutans biofilms. Thus, employing aPDT with natural plant extracts as photosensitizers could be an effective strategy for preventing dental caries but needs to be evaluated in properly controlled clinical trials..

Antibacterial photodynamic therapy with curcumin and Curcuma xanthorrhiza extract against Streptococcus mutans.

BACKGROUND: Bacteria are becoming increasingly resistant to conventional antibacterial chemotherapy. This has prompted the application of antibacterial photodynamic therapy (aPDT) in bacteria-related diseases due to its excellent biocide effects. However, few studies have attempted to develop a novel photosensitizer based on natural components. The aim of the present study was to compare the aPDT effects of curcumin and Curcuma xanthorrhiza extract (CXE) against Streptococcus mutans. METHODS: A planktonic suspension containing an S. mutans strain was treated in three separate groups: aPDT with curcumin, CXE, and a mixture of curcumin and CXE (ratio= 1:1) at concentrations of 0, 10, 102, 103, and 104ng/ml. Light irradiation with a center wavelength of 405nm was applied using an LED (power density of 84.5mW for 300s at an energy density of 25.3J/cm2). The phototoxicity of photosensitizers against S. mutans was investigated using a colony-forming-unit assay. Percentage logarithmic reductions [log10(CFU/ml) values] were analyzed using one-way ANOVA followed by the Tukey test (p<0.05) and Student's independent t-test. RESULTS: The viability of S. mutans in the presence of curcumin, CXE, and a mixture of these two components was substantially reduced during irradiation with 405nm light. The phototoxicity of the photosensitizer varied with its solubility and concentration. CONCLUSION: These preliminary in vitro findings imply that combining curcumin and CXE with a 405nm LED may be a novel method of applying aPDT. This could be advantageous in preventing and treating dental caries using devices that are readily available in clinics.