Longterm abrasive and erosive effect of whitening toothpaste on dentin surface.

PURPOSE: To evaluate the amount of dentin loss following immersion in or toothbrushing with whitening toothpaste (WT) containing hydrogen peroxide (HP) and citric acid (CA). Additionally, the amount of dentin loss after brushing with a WT alone or in combination with a conventional toothpaste was assessed, and the effects of HP and CA solutions on the dentin surface were investigated. METHODS: Bovine dentin specimens (n= 350) were randomly assigned to seven solutions of various compositions as toothpaste: The specimens assigned to each solution were then further divided into five treatment groups (n=10 each) : Group A = 1-hour immersion in each solution (ES); Group B = 10,000 brushing in ES; Group C = 1-hour immersion in ES + 10,000 brushing in ES; Group D = 1-hour immersion in ES + 10,000 brushing in reference slurry (RS); Group E = 10,000 brushing in ES + 10,000 brushing in RS. The amount and pattern of dentin loss were determined, and the surfaces were observed using noncontact profilometry. RESULTS: The WT (pH 5.0) caused lower dentin loss than RS after a single brushing cycle; however, the extent of dentin loss after 1 hour of immersion in the WT was significantly greater than that in the RS. Among the specimens treated with WT, a significant difference in dentin loss was observed between Group C and Groups D and E (P< 0.05) but not between Groups D and E. The surfaces exposed to CAS1, CAPB, and WT exhibited U-shaped patterns of dentin loss after brushing or immersion, whereas a wedge-shaped pattern was observed in those that underwent brushing with the RS. CLINICAL SIGNIFICANCE: The effects (dentin abrasion) of a whitening toothpaste containing hydrogen peroxide and citric acid when used in combination with a conventional toothpaste were similar to those seen with the continuous use of a conventional toothpaste alone.

Oral Probiotics, Streptococcus salivarius K12 and M18, Suppress the Release of Volatile Sulfur Compounds and a Virulent Protease from Oral Bacteria: An In-Vitro Study.

PURPOSE: To evaluate the inhibitory effects of Streptococcus salivarius K12 and M18 strains on the growth of six oral pathogens as well as their release of volatile sulfur compounds (VSCs), and whether these probiotics can inhibit the expression of arginine-specific gingipain A (RgpA), a protease secreted by Porphyromonas gingivalis. MATERIALS AND METHODS: After six halitogenic oral pathogens (P. gingivalis, Treponema denticola, Tannerella forsythia, Fusobacterium nucleatum, Parvimonas micra, and Eikenella corrodens) were cultured with or without S. salivarius K12 and M18, the concentration of two VSCs was measured. Moreover, the antimicrobial activity of S. salivarius K12 and M18 against these pathogens and the suppressive effect on RgpA release by P. gingivalis were assessed. RESULTS: In the co-culture of S. salivarius K12 or M18 with oral pathogenic bacteria, the growth of all six oral pathogens was significantly inhibited (p < 0.01). Additionally, S. salivarius K12 and M18 had an inhibitory effect on the production of the halitogenic substances H2S and CH3SH (p < 0.01) as well as the expression of P. gingivalis RgpA. Finally, we demonstrated that the addition of only culture supernatants of the two strains K12/M18 to oral pathogen cultures was sufficient to mimic the effects of K12/M18 co-cultures upon VSCs production and protease expression. CONCLUSIONS: S. salivarius K12 and M18 inhibited VSC release by all six of the major oral pathogens that were assayed and reduced the expression of RgpA.

Effects of Lingual and Palatal Site Toothbrushing on Periodontal Disease in the Elderly: A Cross-Sectional Study.

(1) Background: To analyze the association between periodontal health status and daily oral health activities including lingual and palatal site toothbrushing. (2) Methods: One hundred and fifty Korean elderly people aged >65 years participated in the study. Clinical examination regarding oral health status, including periodontal health status, was evaluated, and data on the oral health activities, socio-demographic factors, and systemic health-related factors were obtained using a questionnaire. Statistical analyses assessed the differences of periodontal health status according to daily oral health activities, including lingual and palatal site toothbrushing. (3) Results: Oral health activities including lingual and palatal site toothbrushing, frequency of toothbrushing, use of an interdental toothbrush, dietary patterns, and activity dependence correlated with bleeding on probing (BOP) and periodontitis. After adjusting for covariates, the prevalence of periodontitis was lower in the group where the inner surfaces of the teeth were partially or wholly cleaned than in the group without such cleaning. High BOP was significantly associated with the brushing of the inner surfaces of teeth. (4) Conclusions: Lingual and palatal site toothbrushing was associated with good periodontal health status in the elderly; the importance of brushing the inner surfaces of teeth should be emphasized for them and their caregivers.

Influence of a new polishing system on changes in gloss and surface roughness of resin composites after polishing and brushing.

This study aimed to compare the change of surface roughness (Ra) and gloss units (GU) of five dental composites (Filtek Z250, Filtek Z350XT, Metafil CX, Ceram X one, and Venus Diamond) polished with three systems (Sof-Lex XT, Enhance/Pogo, and Sof-Lex Diamond) before/after simulated brushings and to determine the amount of time required to achieve maximum gloss. Ninety rectangular specimens (n=18 per composite) were prepared. Six specimens of each composite were assigned to one of the polishing systems. The Ra and GU of each specimen were measured after each polishing step. Five polished specimens per composite were brushed with a toothbrush machine, and the Ra and GU values were determined. Filtek Z350XT exhibited the most stable and lowest Ra during the brushing cycles regardless of polishing system. When using the Sof-Lex Diamond and Enhance/Pogo systems, the highest gloss and the smoothest surfaces were achieved after polishing and brushing.

Efficacy of non-surgical treatment accompanied by professional toothbrushing in the treatment of chronic periodontitis in patients with type 2 diabetes mellitus: a randomized controlled clinical trial.

PURPOSE: The present study aimed to evaluate the clinical benefit of additional toothbrushing accompanying non-surgical periodontal treatment on oral and general health in patients with type 2 diabetes mellitus (T2DM). METHODS: We conducted a doubled-blind randomized controlled trial in 60 T2DM patients between June 2013 and June 2014. The patients were randomly assigned to the scaling and root planing (SRP) group; the scaling and root planing with additional toothbrushing (SRPAT) group, in which additional toothbrushing was performed by toothpick methods; or the control group. Microbiological and oral examinations were performed for up to 12 weeks following treatment. Non-surgical treatment was conducted in the experimental groups. The SRP group received scaling and root planing and the SRPAT group received additional toothbrushing with the Watanabe method once a week from the first visit through the fifth visit. The primary outcomes were changes in haemoglobin A1c (or glycated haemoglobin; HbA1c) levels, serum endotoxin levels, and interleukin-1 beta levels. Periodontal health status was measured by periodontal pocket depth, the calculus index, and bleeding on probing (BOP). RESULTS: Both the SRP and SRPAT groups showed improvements in periodontal health and HbA1c, but the SRPAT group showed significantly less BOP than the SRP group. Furthermore, only the SRPAT group showed a statistically significant decrease in serum endotoxin levels. CONCLUSIONS: Non-surgical periodontal treatment was effective in improving HbA1c and serum endotoxin levels in T2DM patients. Furthermore, non-surgical treatment with additional tooth brushing had a more favourable effect on gingival bleeding management.Trial RegistrationClinical Research Information Service Identifier: KCT000416.

Oral health status of the disabled compared with that of the non-disabled in Korea: A propensity score matching analysis.

BACKGROUND: There are many types of disabilities, and each type has a variety related to socioeconomic factors. Such factors affect to many health problems of the disabled. However, surveys of the oral health status of the disabled in Korea are rare. OBJECTIVE: The purpose of this study was to estimate oral health disparity through comparing oral health status of the disabled to the non-disabled, adjusted for the net effect of the disability on oral health status. METHODS: A cross-sectional study was conducted among the disabled in urban and suburban areas in Korea from June to September 2016. People with physical, mental, and multiple disabilities took part in this survey. The clinical examinations were carried out by trained dentists. Statistical analysis was performed to quantify the association between oral health and socioeconomic status after restricting the analysis using a propensity score matching method. RESULTS: The disabled had more DMFT, DT, and MT, fewer FT, and fewer teeth than the non-disabled based on entire groups (P<0.01). No difference in the ratio of periodontitis was observed. The subjects with mental disabilities (MD) scored 3.09 (95% CI, 1.07-8.97), and those with multiple disabilities scored 4.37 (95% CI, 1.16-16.37) for edentulous status. The MD had an odds ratio of 1.34 (95% CI, 1.03-1.74), and those with multiple disabilities had an odds ratio of 1.75 (95% CI, 1.11-2.76) for the DMFT index. CONCLUSIONS: These results represent poor oral health status of the disabled compared to the non-disabled. Consequentially, we can verify that not only the existence of disability but also the type of disability has a decisive effect on oral health condition. This comparison is necessary to widen our approach to evaluate the actual status condition of the disabled.

Comparison of oral health status and daily nutrient intake between elders who live alone and elders who live with family: Based on the Korean National Health and Nutrition Examination Survey (KNHANES VI) (2013-2015).

OBJECTIVE: To compare the nutritional factors and oral status of elders living alone and elders living with their families in Korea. BACKGROUND: Numerous studies have found that the presence of fewer remaining teeth is associated with decreased nutrient intake; however, there is no study comparing the nutritional status and oral status of elders living alone with that of elders living with family based on a nationally representative sample. METHODS: A sample of 2904 individuals who participated in the sixth Korean National Health and Nutrition Examination Survey was reviewed (65-84 years of age). Living status was defined according to the participants' self-reported questionnaire, and a nutrient intake questionnaire was designed as an open questionnaire and used during the face-to-face interviews. The number of existing teeth was used to determine oral status. A complex-sample general linear analysis and multivariate logistic regression analysis were used to evaluate the association between the number of teeth and nutrient intake among elders living with family and elders living alone after adjusting for confounders. RESULTS: Elders living alone were significantly older and tended to have the following characteristics: women, lower household income, lower educational level, poor perceived health status, non-smokers, non-drinkers and lack of physical activity. Elders living alone had a poorer perceived oral health status, had not received an oral examination in the past year, had chewing problems and had fewer existing teeth (P < .05). Elders living with family showed better oral health and nutrient intake status. Participants who had many existing teeth had higher nutrient intake than the participants who had fewer existing teeth. CONCLUSIONS: For healthy lives at old age, family support or additional social support for elders living alone should be considered.

Association of Some Vitamins and Minerals with Periodontitis in a Nationally Representative Sample of Korean Young Adults.

The purpose of this study was to investigate whether the intakes of some kinds of vitamins and minerals are associated with periodontitis in a nationally representative sample of young adults. This study comprised 2049 young adults aged 19-39 years who took both periodontal examination and nutrition survey. The vitamin and mineral intakes were calculated from dietary intake data gained by complete one-day 24-h recall interviews, and the intake levels for each nutrient were classified by the Recommended Nutrient Intake (RNI) in Dietary Reference Intakes for Koreans and median values. Periodontitis was assessed using Community Periodontal Index (CPI). Multivariate logistic regression analyses were performed in a whole sample and subgroups with the strata of gender or smoking, following a complex sampling design. In analyses according to RNI, a lower intake of niacin was significantly associated with periodontitis in young adults (odd ratio [OR] 1.47, 95% confidential interval [CI] 1.09-2.00) and in its subgroup of women (OR 1.70; 95% CI 1.10-2.64) and current non-smokers (OR 1.75; 95% CI 1.22-2.51). Whereas, in analyses according to median intake values, there were significant associations of periodontitis with a lower intake of niacin in women (OR 1.58; 95% CI 1.02-2.46) and current non-smokers (OR 1.50; 95% CI 1.01-2.22), with lower intake of vitamin C in women (OR 1.66; 95% CI 1.04-2.64) and in current non-smokers (OR 1.49; 95% CI 1.04-2.14), with lower intake of iron in women (OR 1.85; 95% CI 1.11-3.07), and with lower intake of vitamin A marginally in women (OR 1.56; 95% CI 1.00-2.44). In young adults, periodonitis is significantly associated with the lower intakes of niacin, vitamin C, and iron, especially in women and current non-smokers.

The cariogenicity of hydrolyzed starch foods by measuring the polyacrylamide hydroxyapatite (PAHA) disc.

OBJECTIVES: This study measured the degree of demineralization of starch foods affected by hydrolyzed starch in total starch using the polyacrylamide hydroxyapatite (PAHA) disc. DESIGN: A total of 10 ml of test food was added to a PAHA disc and 5 ml artificial saliva, followed by inoculation with 1 µl of S. mutans and incubation at 37 °C for 180 min. The demineralization effects were then determined using CLSM. RESULTS: The proportion of hydrolyzed starch in total starch in potato increased over time, while hydrolyzed starch in other test food decreased. When the amount of hydrolyzed starch in total starch increased after 180 min (p=0.000), the surface roughness of the PAHA disc in potato was significantly decreased. Wheat-based sugary snacks, such as chips and cookie, had relatively high cariogenic potentials, whereas baked potato had a relatively low cariogenic potential. CONCLUSIONS: Hydrolyzed starch in total starch increased over time, and cariogenic potential was notably decreased. Measurement of PAHA disc may be a valid method for assessing the cariogenic potential of hydrolyzed starch foods.

Risk factors for dental caries in childhood: a five-year survival analysis.

OBJECTIVES: The purpose of this study was to examine the risk factors of dental caries at the level of an individual person with survival analysis of the prospective data for 5 years. METHODS: A total of 249 first-grade students participated in a follow-up study for 5 years. All participants responded to a questionnaire inquiring about socio-demographic variables and oral health behaviors. They also received an oral examination and were tested for Dentocult SM and LB. Over 5 years, the participants received yearly oral follow-up examinations to determine the incidence of dental caries. The incidence of one or more dental caries (DC1) and four or more dental caries (DC4) were defined as one or more and four or more decayed, missing, and filled permanent teeth increments, respectively. Socio-demographic variables, oral health behaviors, and status and caries activity tests were assessed as risk factors for DC1 and DC4. The adjusted hazard ratios (HRs) of risk factors for DC1 and DC4 were calculated using Cox proportional hazard regression models. RESULTS: During the 5-year follow-up period, DC1 and DC4 occurred in 87 and 25 participants, respectively. In multivariate hazard models, five or more decayed, missing, and filled primary molar teeth [HR 1.93, 95% confidence interval (CI) 1.19-3.13], and Dentocult LB of two or three (HR 2.21, 95% CI 1.37-3.56) were independent risk factors of DC1. For DC4, only Dentocult LB of two or three was an independent risk factor (HR 2.95, 95% CI 1.11-7.79). CONCLUSIONS: Our results suggest that dental caries incidence at an individual level can be associated with the experience of dental caries in primary teeth and Dentocult LB based on the survival models for the 5-year prospective data.

Systemic effect of water fluoridation on dental caries prevalence.

OBJECTIVES: The aim of this study was to evaluate the systemic effect of water fluoridation on dental caries prevalence and experience in Cheongju, South Korea, where water fluoridation ceased 7 years previously. METHODS: A cross-sectional survey was employed at two schools where water fluoridation had ceased (WF-ceased area) and at two schools where the water had never been fluoridated (non-WF area). The schools in the non-WF area were of a similar population size to the schools in the WF-ceased area. Children of three age groups were examined in both areas: aged 6 (n = 505), 8 (n = 513), and 11 years (n = 467). The differences in the mean number of decayed or filled primary teeth (dft) and the mean number of decayed, missing, or filled permanent teeth (DMFT) scores between areas after adjusting for oral health behaviors and socio-demographic factors were analyzed by a Poisson regression model. RESULTS: The regression model showed that the DMFT ratio for children aged 11 years in the WF-ceased area was 0.581 (95% CI 0.450-0.751). In contrast, the dft ratio for age 6 in the WF-ceased area was 1.158 (95% CI 1.004-1.335). Only the DMFT ratio for age 8 (0.924, 95% CI 0.625-1.368) was not significant. CONCLUSIONS: While 6-year-old children who had not ingested fluoridated water showed higher dft in the WF-ceased area than in the non-WF area, 11-year-old children in the WF-ceased area who had ingested fluoridated water for approximately 4 years after birth showed significantly lower DMFT than those in the non-WF area. This suggests that the systemic effect of fluoride intake through water fluoridation could be important for the prevention of dental caries.

Who succeeds at dental school? Factors predicting students' academic performance in a dental school in republic of Korea.

The purpose of this study was to examine what cognitive and non-cognitive factors were responsible for predicting the academic performance of dental students in a dental school in the Republic of Korea. This school is one of those in Korea that now require applicants to have a bachelor's degree. In terms of cognitive factors, students' undergraduate grade point average (GPA) and Dental Education Eligibility Test (DEET) scores were used, while surveys were conducted to evaluate four non-cognitive measures: locus of control, self-esteem, self-directed learning, and interpersonal skills. A total of 353 students matriculating at Seoul National University School of Dentistry in 2005, 2006, 2007, and 2008 consented to the collection of records and completed the surveys. The main finding was that applicants who scored higher on internal locus of control and self-efficacy were more likely to be academically successful dental students. Self-directed learning was significantly associated with students ranked in the top 50 percent in cumulative GPA. However, students' interpersonal skills were negatively related to their academic performance. In particular, students' lack of achievement could be predicted by monitoring their first-year GPA. Therefore, the identification of those factors to predict dental school performance has implications for the dental curriculum and effective pedagogy in dental education.

A retrospective cohort study on the association between periapical abscess, advanced periodontal disease, and the national oral health screening program among Korean adults.

The National Oral Health Screening Program (NOHSP) is a general population-based program in Korea. The objective of this study was to assess the association between participation in the NOHSP and dental visit for periapical abscess (PA) and advanced periodontal disease (APD) among Korean adults. Data were obtained for subjects from the National Health Insurance database. The authors conducted a retrospective cohort study of 9358 randomly selected subjects who were between 40 and 64 years old in 2002. The outcomes of dental visit for PA or APD from the years 2003 to 2007 were compared between the screening and nonscreening groups. The nonscreening group had 19% higher risk of PA and 15% higher risk of APD. This study suggests that the NOHSP may decrease the risk of dental visit because of PA and APD by preventing the progress of lesion to the advanced stage among Korean adults.

Measurement of the cariogenicity of snacks using a radioisotope PAHA disc.

OBJECTIVES: This study aimed to establish a method for measuring the cariogenic potential of foods with high reproducibility in vitro. METHODS: Streptococcus mutans (S. mutans) was incubated in test foods with radioisotope polyacrylamide hydroxyapatite (PAHA) for 150 min at 37 °C. Then, the amount of radioisotope (32)P released from PAHA was measured using a liquid scintillation counter and scanning electron microscopy (SEM). RESULTS: The radioisotope PAHA discs that were soaked in 10% sucrose solutions had a high cariogenic potential and showed a remarkably demineralized surface (p < 0.05). The radioisotope PAHA disc that was incubated with snacks that had a high cariogenic potential showed a remarkably demineralized surface via SEM. Candy had a relatively high cariogenic potential, whereas xylitol gum had a relatively low potential. CONCLUSIONS: The cariogenicity of snacks can easily be evaluated by measuring the amount of (32)P released from radioisotope PAHA discs.

Transfer students' personality types and their academic performance in a graduate-entry dental school.

PURPOSE: The study was designed to identify how different types of transfer student personality would be constituted in Seoul National University School of Dentistry (SNU SD) and delve into what personal types were often observed more competent in academic performance. METHODS: Among 40 students who transferred to SNU SD in 2004, 15 students voluntarily participated in completing the Myers-Briggs type indicator (MBTI; GS form); then, it was tested whether or not their MBTI types would be dependent upon their final grades. In addition, another 32 out of the 50 students who were enrolled through a traditional pre-den system served as a control group. RESULTS: It was mainly found that ISTJ type was the most typical one for those transfer dental students as well as for other native dental students who excelled in their academic performance. The noticeable majority of transfer students were Introverted (67%), Sensing (80%), Thinking (86%), and Judging (80%), with S-J pattern being statistically significant. CONCLUSION: SNU SD has been in a rebuilding process in terms of student/outcome centered dental education to have it up to the global standards. For this reason, it is ultimately a crucial part of that process to understand what personality types of the dental students with different backgrounds in major are observed and thus recognize how to support their learning according to different patterns of individual personality.

The relationship between periodontitis and metabolic syndrome among a Korean nationally representative sample of adults.

AIMS: The aim of this study was to examine whether metabolic syndrome (MS) is associated with periodontitis in a representative sample of Korean adults, who were involved in the Fourth Korea National Health and Nutrition Examination Survey (KNHANES). MATERIALS AND METHODS: A total of 7178 subjects over the age of 19 years who participated in KNHANES were examined. MS was defined as the definition proposed by the National Cholesterol Education Program Adult Treatment Panel III and the abdominal obesity cut-off line based on Korean Society for the Study of Obesity. The periodontal status was assessed by the Community Periodontal Index. Multivariate logistic regression analysis was carried out adjusting for the sociodemographics, oral health behaviours and status, and health behaviour. All analyses considered a complex sampling design, and multivariate analysis was also performed in the subgroups (age, gender, current smoking status). RESULTS: Multivariate logistic regression analysis revealed significant associations between MS and periodontitis. After adjusting for all covariates, the adjusted odds ratio (OR) of periodontitis (community periodontal index ≥ 3) was 1.55 (1.32-1.83) for MS. In subgroup analysis, periodontitis is associated with MS in subjects over age 40 and the adjusted ORs were higher in females and in the smoker group than in males and in non-smokers. CONCLUSIONS: MS is associated with periodontitis.

Oral health behaviors, periodontal disease, and pathogens in preeclampsia: a case-control study in Korea.

BACKGROUND: The aim of this study is to confirm the association among oral health behaviors, periodontitis, and preeclampsia in Korean women. METHODS: This study is designed as a case-control study. Sixteen women with preeclampsia and 48 without preeclampsia post-delivery were included in this study from November 2007 to January 2010. Information was collected on demographics, health behaviors, and obstetric and systemic diseases that may influence the periodontal condition and preeclampsia. Full-mouth periodontal probing was conducted by one trained examiner (KHB). Localized periodontitis was defined as periodontal clinical attachment loss (AL) ≥ 3.5 mm on two or three sites not on the same tooth. In addition, generalized periodontitis was defined as clinical AL ≥ 3.5 mm on ≥ 4 sites not on the same tooth. Gingival crevicular fluid was collected using a sterilized paper point for quantitative analysis of Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia (Pi), and Tannerella forsythia (previously T. forsythensis). RESULTS: After adjusting for confounders, the adjusted odds ratio (OR) was 4.79 (95% confidence interval [CI]: 1.02 to 29.72) for localized periodontitis and 6.60 (95% CI: 1.25 to 41.61) for generalized periodontitis. In addition, the proportion of floss or interdental brush users in women with preeclampsia was lower than that in women without (adjusted OR: 0.21; 95% CI: 0.02 to 0.93). Pi was significantly more prevalent in women with preeclampsia (P = 0.028). CONCLUSION: These results indicate that preeclampsia could be associated with the maternal periodontal condition and interdental cleaning.

Periodontitis and obesity: a study of the Fourth Korean National Health and Nutrition Examination Survey.

BACKGROUND: The present study aims to determine whether there is an association between periodontitis and obesity among Korean adults who participated in the Fourth Korean National Health and Nutrition Examination Survey (KNHANES). METHODS: In 2007, 4,246 subjects, >19 years of age, who participated in the KNHANES (a cross-sectional survey conducted by the Korea Centers for Disease Control and Prevention) were selected for analysis. Participants underwent a periodontal examination and anthropometric measurements, and were asked to complete a questionnaire about their socioeconomic status and overall health status. Body mass index (BMI) and waist circumference (WC) were used as measures of overall body fat and upper body fat. Standard BMI and WC cutoff points were used, as established by the World Health Organization and the Korean Society for the Study of Obesity. Periodontal status was assessed by Community Periodontal Index and periodontitis was defined as ≥ "code 3." Multivariate logistic regression analyses were carried out, adjusting for the following variables: sex; age; household income; bedtime toothbrushing habits; use of dental floss; use of an interproximal toothbrush; presence of active tooth decay; the number of decayed, missing, or filled permanent teeth; diabetes mellitus; and present smoking status. RESULTS: In multivariate logistic regression analysis, there was no association between BMI and periodontitis. Obese people with BMI ≥25 had an adjusted odds ratio of 0.991 (0.806 to 1.220) for having periodontitis. But we found a significant association between abdominal obesity and periodontitis. After adjusting for all covariates, the adjusted odds ratio for periodontitis was 1.358 (confidence interval 1.003 to 1.839) for obese subjects. CONCLUSIONS: A high WC seems to be associated with periodontitis, whereas BMI does not. This finding shows that abdominal obesity is significantly correlated with periodontitis.

Health behaviors, periodontal conditions, and periodontal pathogens in spontaneous preterm birth: a case-control study in Korea.

BACKGROUND: This study aims to determine whether periodontal conditions or dental health behaviors are risk factors for preterm birth (PTB), and whether periodontal pathogens are risk indicators for PTB among Korean mothers. METHODS: This study was designed as a hospital-based case-control study. Examiner masking was ensured for the validity of the examinations. The mothers included those who gave birth between November 2007 and July 2009 at the obstetrics clinic of a general hospital in Seoul, Korea. Information on demographic and health conditions, periodontal conditions, and microbacterial data was collected. RESULTS: A total of 172 women met the inclusion criteria, 59 mothers who delivered a preterm neonate were assigned to the case group while the other 113 were assigned to the control group. There were no significant differences in demographic information, oral health conditions, and obstetric characteristics. Among health-related behaviors, only scaling within 12 months before pregnancy showed a significant difference (P = 0.031). Even in the adjusted logistic model, only the difference in the experience of scaling before pregnancy was significant between the PTB cases and the controls (P = 0.039). Periodontal disease did not exhibit a significant relationship with PTB even after adjustment for potential confounding factors. Among the microbacterial factors, only Porphyromonas gingivalis showed a slight difference (P = 0.060). CONCLUSION: There was a significant difference in scaling experience within 12 months before pregnancy and P. gingivalis showed a marginal difference between the PTB and the control groups but clinical periodontal conditions showed no association with PTB.

Periodontitis and the risk for non-fatal stroke in Korean adults.

BACKGROUND: The association between periodontal inflammation and non-fatal stroke is still controversial and limited to evidence in Western countries. The aim of this study was to investigate whether periodontitis is independently associated with non-fatal stroke in Korean adults. METHODS: A case-control study was conducted on 265 non-fatal chronic stroke cases at the National Rehabilitation Center, Seoul, Korea, and 214 non-stroke population controls. Medical specialists diagnosed stroke by using brain imaging from magnetic resonance imaging and/or computerized tomography. A dentist recorded the clinical attachment level (CAL), the distance between the cemento-enamel junction and the probed base of the periodontal pocket, using a University of North Carolina-15 manual probe. An interview assessed 17 sociodemographic, behavioral, systemic/oral health-related possible confounders. Multiple logistic regression analysis was used to evaluate the association between periodontitis and stroke while controlling for age, gender, income, education, smoking, drinking, history of systemic disease, body mass index, familial cardiovascular risk factors, and oral health behaviors. Subgroup analyses were also performed. RESULTS: Stroke was strongly associated with periodontitis (presence of CAL > or =6 mm): the odds ratio was 4.0 (95% confidence interval: 2.3 to 7.0) after controlling for all possible confounders. The association with periodontitis (tertiary percentage of CAL > or =5 mm) had a dose-response effect. The association between periodontitis and stroke was higher among adults younger than age 60 (6.0 versus 2.6) and normotensives (4.8 versus 3.2). CONCLUSION: Our data suggested that periodontitis is independently associated with non-fatal stroke, and its impact seems to be greater among younger or normotensive Korean adults.