Immune-mediated inflammatory diseases and periodontal disease: a bidirectional two-sample mendelian randomization study.

BACKGROUND: Previous observational studies have shown a bidirectional association between immune-mediated inflammatory disorders (IMID) and periodontal disease. However, evidence regarding the causal role of IMID and periodontal disease is still lacking. Therefore, we conducted a bidirectional two-sample Mendelian randomization (MR) study to uncover the potential genetic causal effects between IMID and periodontal disease. METHODS: Bidirectional two-sample MR analysis was employed. Data for ten IMIDs were sourced from genome-wide association studies (GWAS) conducted by the FinnGen Consortium (range from 1023 to 36321 cases) and UK Biobank (UKB) (range from 150 to 17574 cases). Furthermore, GWAS data for periodontal disease were obtained from the FinnGen Consortium (87497 cases), UKB (458 cases), and Gene Lifestyle Interactions in Dental Endpoints (GLIDE) consortium (17,353 periodontitis cases). Subsequently, the causal relationships were analyzed by random effects inverse variance weighting, weighted median, and MR-Egger. Sensitivity analyses were performed using the Cochrane Q test, funnel plot, and Mr-Egger intercept test to ensure robustness. Eventually, replication analysis and meta-analysis across different databases were carried out. RESULTS: Systemic lupus erythematosus (SLE) [IVW: OR = 1.079 (95% CI: 1.032-1.128) and P < 0.001], Sjogren syndrome [IVW: OR = 1.082 (95% CI: 1.012-1.157) and P = 0.022] and hypothyroidism [IVW: OR = 1.52 (95% CI: 1.13-2.04) and P = 0.005] may increase the risk of periodontal disease. In addition, periodontal disease may reduce the risk of SLE [IVW: OR = 0.8079 (95% CI: 0.6764-0.9650) and P = 0.019] and hyperthyroidism [IVW: OR = 5.59*10-9 (95% CI: 1.43*10-15-2.18*10-2) and P = 0.014]. Meta-analysis indicated a causal correlation between SLE and an increased risk of periodontal disease: [OR = 1.08 (95% CI: 1.03-1.13), P = 0.0009]. No significant evidence suggests bilateral causal relationships between other IMIDs and periodontal disease. No significant estimation of heterogeneity or pleiotropy is detected. CONCLUSIONS: Our study has confirmed a genetic causal relationship between IMIDs and periodontal disease, thereby unveiling novel potential mechanisms underlying IMIDs and periodontal disease. This discovery is promising in fostering interdisciplinary collaboration between clinicians and stomatologists to facilitate appropriate and precise screening, prevention, and early treatment of IMIDs and periodontal disease.

Association between dental diseases and oral hygiene care and the risk of vertebral fracture: a nationwide cohort study.

Periodontal disease and increased missing teeth were associated with incident vertebral fractures. In contrast, professional dental cleaning and frequent tooth brushing, was associated with a lower risk of vertebral fracture. Better oral hygiene care attenuated the risk associated with dental diseases. PURPOSE: To investigate the association between oral health and the risk of vertebral fractures. METHODS: We included 2,532,253 individuals aged ≥40 years who underwent the Korean National Health Insurance Service health examinations in 2008 and followed up until December 31, 2017. We performed multivariable Cox proportional hazard regression analyses to evaluate the association between dental diseases and oral hygiene care and the risk of vertebral fractures. RESULTS: Over the 9.3-year median follow-up, 1.46% (n = 36,857) experienced vertebral fractures. Individuals with dental diseases had a higher risk of vertebral fracture than those without (hazard ratio [HR] 1.04, 95% confidence interval [CI]: 1.02-1.07 for periodontal diseases; 1.02, 1.00-1.05 for dental caries; 1.12, 1.05-1.20 for ≥15 missing teeth). Good oral hygiene care was associated with a lower vertebral fracture risk (HR 0.89, 95% CI: 0.86-0.91 for ≥1 time/year [vs. <1 time/year] of professional dental cleaning; 0.90, 0.87-0.93 for ≥2 times/day [vs. 0-1 time/day] of toothbrushing). The combined dental diseases was significantly associated with an increased vertebral fracture risk, whereas combined oral hygiene care was associated with further risk reduction. Better oral hygiene care reduced vertebral fracture risk associated with dental diseases (all P <0.001). CONCLUSION: Periodontal disease, dental caries, and an increased number of missing teeth were independently associated with higher risks for vertebral fractures. Conversely, improved oral hygiene care, such as personal dental cleaning and frequent tooth brushing, may modify vertebral fracture risks associated with dental disease.

Ibero-Panamerican Federation of Periodontology Delphi study on the trends of periodontology and periodontics by the year 2030. A Latin American consensus.

BACKGROUND AND OBJECTIVE: As elsewhere in the world, the prevalence of periodontitis in stages I-II is high in the Latin American population, this scenario emphasizes the need for identification of urgent needs for allocating adequate resources to provide diagnosis, prevention, and treatment of these diseases. The aim of this Delphi study was to predict the trends in periodontology/periodontics in the Latin American region by the year 2030. METHODS: A steering committee and an advisory group of experts in periodontology/periodontics were selected from 16 countries. An open questionnaire of 60 questions was validated and used following the Delphi methodology. RESULTS: Two hundred and twenty-five experts from Latin America answered the two rounds of the questionnaire. Moderate to strong consensus was reached on 45 questions (75%). The prediction was that the prevalence of gingivitis and periodontitis in stages I and II will be maintained, the importance of the link with systemic diseases will increase, and the impact of prevention and periodontal treatment will also increase, mainly in the private sector. There was a strong consensus that plastic and regenerative surgical procedures will increase, as well as the demand for training in the specialty of periodontology. CONCLUSIONS: The present study has provided relevant and useful information on predictions in periodontology/periodontics in Latin America, with important level of consensus among experts. It has been predicted that periodontitis will still be a highly prevalent disease, and its links with other medical conditions should demand more attention by health authorities to develop adequate prevention and management policies and strategies.

Periodontal disease prevalence and oral hygiene status of adults with cystic fibrosis: A case-control study.

AIM: To investigate the prevalence of gingivitis and periodontitis, and the oral hygiene status of adults with cystic fibrosis (CF) in the Republic of Ireland. MATERIALS AND METHODS: A case-control study in the form of a clinical examination of 92 adults with a diagnosis of CF was carried out in the adult CF unit in Cork University Hospital. A 40-item questionnaire was used to capture socio-demographic variables and medical and dental information. Two calibrated examiners carried out a periodontal assessment on participants, using the WHO-recommended CPI-modified index, and oral hygiene status was measured using the Greene-Vermillion index. The results were compared with a population-based control group of similar socio-demographic profile. RESULTS: Oral hygiene levels (plaque and calculus) were significantly worse in people with CF, with a median plaque index of 0.83 (interquartile range [IQR] 0.333-1.542) in the CF group compared with 0.5 (IQR 0.167-0.667) in the non-CF group. Calculus index in the CF group was 0.33 (IQR 0.17-0.83) compared with 0.33 (IQR 0.125-0.33) in the non-CF group. However, periodontal disease levels were significantly lower in the CF group. Gingivitis (bleeding on probing ≥ 10% sites) was seen in 67.4% of the CF group, compared with 83.7% of the non-CF group, OR 0.365 (95% confidence interval [CI] 0.181-0.736), relative risk (RR) 0.779 (95% CI 0.655-0.928). Mild periodontitis (periodontal probing depth [PPD] < 5 mm) was seen in 15.2% of the CF group, compared with 31.5% of the non-CF group, OR 0.390 (CI 0.190-0.800), RR 0.483 (95% CI 0.273-0.852). Severe periodontitis (PPD ≥ 6 mm) was seen in 0% of the CF group, compared with 9.8% of the non-CF group. There was a tendency, albeit non-significant, towards reduced periodontitis in PWCF who regularly took antibiotics, particularly azithromycin. CONCLUSIONS: In this study, adults with CF had poor oral hygiene practices, with high levels of plaque and calculus. Despite this finding, adults with CF had lower levels of clinical gingivitis and periodontitis than seen in a non-CF control group. Further study is required to examine the causes of this phenomenon.

Occurrence of periodontal diseases according to the ACES 2018 Classification Framework and the CDC/AAP definition: A cross-sectional study in a major Brazilian city.

AIM: The occurrence of periodontal diseases is still to be determined in large samples of major Brazilian cities. This study aimed to assess the periodontal status of adults from Curitiba, Paraná, Brazil, using periodontitis definitions by the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP) and the recently published ACES 2018 Classification Framework. MATERIALS AND METHODS: A multi-stage probability sampling technique was applied to draw individuals aged 18 or older. A total of 566 individuals underwent a full-mouth periodontal examination. Periodontitis cases were defined according to the CDC/AAP and the ACES 2018 Classification Framework. Non-periodontitis cases were classified as healthy or gingivitis. The agreement between the two definitions was calculated. RESULTS: Periodontal health was present in 33.6% and 13.8% of individuals, and gingivitis was found in 11.7% and 7.5%, according to CDC/AAP and ACES, respectively. Mild, moderate and severe periodontitis (CDC/AAP) were present in 2.1%, 33.4% and 19.1% of individuals, respectively. Using ACES, 34.3% had Stages I/II and 43.3% had Stages III/IV. The occurrence of periodontitis was higher when a subgroup of individuals aged 30+ were analysed, ranging from 69.6% (CDC/AAP) to 90.1% (ACES). CDC/AAP and ACES agreement for health, gingivitis and periodontitis accounted for 68.8% of the observations. CONCLUSIONS: Periodontal diseases affect more than 66% of the population aged 18+ years. Classic definition by the CDC/AAP and the recently published ACES Framework yielded moderate agreement.

Association between periodontal diseases and chronic obstructive pulmonary disease: Evidence from sequential cross-sectional and prospective cohort studies based on UK Biobank.

AIM: To investigate the association between periodontal diseases, airflow limitation and incident chronic obstructive pulmonary disease (COPD) in a large-scale prospective UK Biobank cohort. MATERIALS AND METHODS: Our approach comprised a cross-sectional study and a prospective cohort. Periodontal diseases were determined based on the participants' self-reported dental symptoms, including painful gums, bleeding gums and loose teeth. Logistic regression and Cox proportional hazards models were used to evaluate the association of periodontal diseases with airflow limitation and incident COPD in the cross-sectional study and the prospective cohort, respectively. RESULTS: The cross-sectional study involved 495,610 participants. Multivariable analysis found that periodontal diseases were significantly associated with airflow limitation (odds ratio = 1.036, 95% confidence interval [CI]: 1.015-1.059). The cohort study included 379,266 participants with a median follow-up period of 12.68 years. An elevated risk of incident COPD was associated with the presence of periodontal diseases (hazard ratio: 1.248, 95% CI: 1.174-1.326). The effect was consistent among subgroups, including baseline age (≤65 or >65 years), sex, smoking status and diabetes mellitus. CONCLUSIONS: Periodontal diseases are associated with airflow limitation and elevated COPD incidence. Maintaining good periodontal health in patients with chronic bronchitis and emphysema may help prevent the onset of COPD.

Effect of mandibular advancement appliance use on oral and periodontal health in patients with OSA: a systematic review.

STUDY OBJECTIVES: Use of a mandibular advancement appliance (MAA) is an effective treatment option for mild-to-moderate obstructive sleep apnea (OSA). MAA is well-tolerated but undesirable effects may be observed over time. The present systematic review aimed to assess the effect of MAA use on oral and periodontal health in patients with OSA. METHODS: MEDLINE (PubMed), Cochrane, and Scopus were searched for randomized and non-randomized controlled trials (RCTs, NRCTs), cohorts, and case-control studies reporting on side effects of MAA treatment in OSA patients during a follow-up of at least 6 months. RESULTS: From a total of 169 articles screened, 28 were selected. The most frequently reported MAA-related effects on oral health were: hypersalivation (weighted mean prevalence, 33.3%), occlusal changes (30.2%), muscle pain (22.9%), tooth discomfort or pain (20.2%), and xerostomia (18.3%). No MAA-related periodontal effect was reported. The periodontal status prior to MAA treatment was rarely assessed and described, but 5 studies (17.8%) stated that periodontitis was an exclusion criterion for MAA. Only one retrospective study specifically evaluated periodontal parameters and reported no significant changes in periodontally healthy patients with OSA using MAA for over 7 years. CONCLUSION: MAA use is associated with a number of clinical consequences on oral health, but there is no evidence to conclude whether or not MAA affects periodontal health in patients with OSA. This aspect appears to be under-evaluated and should be further investigated in relation to the type of MAA, the duration of treatment, and prior history of periodontitis.

Oral health inequalities in immigrant populations worldwide: a scoping review of dental caries and periodontal disease prevalence.

BACKGROUND: Inequalities in immigrants' oral health are often masked in population-level data. Therefore, this paper was planned to assess the prevalence data on oral health diseases, namely dental caries, and periodontitis, among immigrants worldwide. METHODS: Following a systematic search in Scopus, Embase, and PubMed for studies published between 2011 and 2023, 1342 records were identified. Following title and abstract screening, 76 studies remained for full-text eligibility-screening based on predefined inclusion criteria. Thirty-two studies were included in the review. RESULTS: Dental caries figures were higher in immigrant populations compared to the local population, regardless of host countries, age, gender, or nationality. In children, the overall mean and standard deviation (SD) for decayed, missing, and filled teeth in the primary dentition (d3mft) was 3.63(2.47), and for D3MFT (permanent dentition), it was 1.7(1.2). Upon comparing overall mean caries counts in children and adults with their control groups in the included studies, untreated dental caries (D3T and d3t) constituted the dominant share of caries experience (D3MFT and d3mft) in immigrant children. For the local population, the highest proportion of caries experience was attributed to filled teeth (FT and ft). Dentin caries prevalence among immigrants ranged from 22% to 88.7% in the primary dentition and 5.6% to 90.9% in the permanent dentition. Gingivitis ranged from 5.1% to 100%. Oral health varied greatly between studies. Regarding oral health accessibility, 52% to 88% of immigrant children had never been to a dentist, suggesting a very limited level of accessibility to dental health services. CONCLUSION: It is imperative to develop interventions and policies that have been customized to address the oral health disparities experienced by immigrant populations. Additionally, host countries should actively implement measures aimed at enhancing the accessibility of oral health care services for these individuals. The utilization of available data is crucial in establishing a hierarchy of objectives aimed at enhancing the oral health of immigrant populations. TRIAL REGISTRATION: The Scoping review protocol was registered at OSF Registries with registration number ( https://doi.org/10.17605/OSF.IO/MYXS4 ).

Periodontal disease increases the severity of chronic obstructive pulmonary disease: a Mendelian randomization study.

BACKGROUND: Recent research suggests that periodontitis can increase the risk of chronic obstructive pulmonary disease (COPD). In this study, we performed two-sample Mendelian randomization (MR) and investigated the causal effect of periodontitis (PD) on the genetic prediction of COPD. The study aimed to estimate how exposures affected outcomes. METHODS: Published data from the Gene-Lifestyle Interaction in the Dental Endpoints (GLIDE) Consortium's genome-wide association studies (GWAS) for periodontitis (17,353 cases and 28,210 controls) and COPD (16,488 cases and 169,688 controls) from European ancestry were utilized. This study employed a two-sample MR analysis approach and applied several complementary methods, including weighted median, inverse variance weighted (IVW), and MR-Egger regression. Multivariable Mendelian randomization (MVMR) analysis was further conducted to mitigate the influence of smoking on COPD. RESULTS: We chose five single-nucleotide polymorphisms (SNPs) as instrumental variables for periodontitis. A strong genetically predicted causal link between periodontitis and COPD, that is, periodontitis as an independent risk factor for COPD was detected. PD (OR = 1.102951, 95% CI: 1.005-1.211, p = 0.039) MR-Egger regression and weighted median analysis results were coincident with those of the IVW method. According to the sensitivity analysis, horizontal pleiotropy's effect on causal estimations seemed unlikely. However, reverse MR analysis revealed no significant genetic causal association between COPD and periodontitis. IVW (OR = 1.048 > 1, 95%CI: 0.973-1.128, p = 0.2082) MR Egger (OR = 0.826, 95%CI:0.658-1.037, p = 0.1104) and weighted median (OR = 1.043, 95%CI: 0.941-1.156, p = 0.4239). The results of multivariable Mendelian randomization (MVMR) analysis, after adjusting for the confounding effect of smoking, suggest a potential causal relationship between periodontitis and COPD (P = 0.035). CONCLUSION: In this study, periodontitis was found to be independent of COPD and a significant risk factor, providing new insights into periodontitis-mediated mechanisms underlying COPD development.

Periodontal disease in down syndrome: Predisposing factors and potential non-surgical therapeutic approaches.

BACKGROUND: Periodontal diseases (PDs) have been documented to be significantly more prevalent and severe in patients with Down syndrome (DS). Different immunological and microbiological factors contributed to predisposing these patients to progressive and recurrent PDs. AIM: The aim of this review was to investigate the altered immunological responses and oral microbiota disorders as well as focus on adjunctive non-surgical methods for the treatment of PDs and its applicability in patients with DS. MATERIAL AND METHODS: A literature review was conducted addressing the following topics: (1) the altered immunological responses, (2) orofacial disorders related to DS patients, (3) oral microbiota changing, and (4) adjunctive non-surgical treatment and its efficacy in patients with DS. RESULTS: Due to the early onset of PDs in children with DS, the need for prompt and effective treatment in these patients is essential. DISCUSSION AND CONCLUSION: So, investigating underlying factors may open a new window to better understand the pathology of PDs in DS people and thus, find better strategies for treatment in such group. Although non-surgical treatments such as photodynamic therapy and probiotic consumption represented acceptable outcomes in different examined patients without DS, data about the application of these convenience and no need for local anesthesia methods in patients with DS is limited.

Associations of remaining teeth number, periodontal disease, and occlusal support status with erectile dysfunction in community-dwelling men.

OBJECTIVES: Several systematic reviews and meta-analyses have reported positive relationships between erectile dysfunction (ED) and periodontal disease. However, no study has evaluated the relationships of occlusal support status and the number of remaining teeth with ED. The aim of the present study was to investigate the relationships between ED and the remaining teeth number, periodontal disease, and occlusal support status. METHODS: This study included 400 community-dwelling men. Periodontal health status and occlusal support condition were evaluated using the Community Periodontal Index (CPI) and Eichner classification. Multivariable analyses were performed to evaluate the relationships between ED and the remaining teeth number, periodontal disease, and occlusal support status. RESULTS: The median age was 53 years. Of the 400 men, 333 (83%) were classified into ED group. In univariable analyses, remaining teeth number, CPI score, and Eichner classification were significantly associated with ED. In multivariable analyses, the remaining teeth number (odds ratio [OR]: 0.907, p = 0.114) and CPI score (OR: 0.978, p = 0.864) were not significantly associated with ED, whereas the Eichner classification was independently and significantly associated with ED (OR: 3.490, p = 0.042). CONCLUSIONS: Poor occlusal support status was significantly associated with ED in community-dwelling men, as opposed to remaining teeth number and periodontal health status.

Association between cognitive rumination and periodontal disease, tooth loss and oral health-related quality of life in a rural Southern Brazil population.

OBJECTIVES: Rumination is a maladaptive emotion regulation strategy. It has been associated with several psychological disorders and physical problems. This cross-sectional study aimed to evaluate whether cognitive rumination is associated with periodontal disease (PD), tooth loss (TL), and oral health-related quality of life (OHRQoL). MATERIALS AND METHODS: A population-based sample from a rural area in southern Brazil was evaluated. Calibrated examiners carried out a complete periodontal examination at six sites-per-tooth. Rumination and Reflection (RRQ) and Oral Health Impact Profile (OHIP-14) questionnaires were administered. Regression modeling was used to assess the prevalence ratio (PR) between rumination and PD and to estimate the rate ratio (RR) between rumination and TL and rumination and OHIP. RESULTS: Severe periodontitis prevalence of 33% was observed in the sample. In the Poisson-adjusted model (n = 587), individuals who ruminate more have 27% more periodontal disease (PR: 1.27, 95%CI:1.02 - 1.60). Regarding TL and OHIP, negative binomial regression (n = 672) showed an association with rumination, but it was not significant (RR 1.14, 95%CI 0.99 - 1.31) and (RR 1.20, 95%CI 0.98 - 1.48), respectively. CONCLUSIONS: Cognitive rumination was independently associated with periodontal disease in individuals living in a rural area. Borderline non-significant estimates were observed regarding TL and OHRQoL. More research using different populations and focusing on individual's responses to psychological stress may confirm these results. CLINICAL RELEVANCE: Emotional regulation is crucial to deal with stress, anxiety, and depression. Since psychopathologies are among the most prevalent diseases in the world, it is critical to understand the role of these issues in dental outcomes.

The associations between dental disease and systemic health.

Understanding the relationship between a patient's systemic and oral health is key for clinicians. The aim of this study was to determine if there is an association between specific findings in a dental exam, such as class V carious lesions, and the American Society of Anesthesiologists (ASA) classification as a proxy for systemic health. A retrospective chart review was performed on all patient charts that met inclusion criteria including detailed, complete, and vetted charts obtained over a three-year period in the predoctoral clinic of a United States dental college. Findings recorded at the initial exam included the decayed, missing or filled teeth (DMFT) score, the location of carious lesions and restorations, the presence of periodontal disease, the number of endodontically treated teeth and the number of fractured teeth or restorations. We found no association found between DMFT score and ASA status but did find that ASA I patients had a higher degree of occlusal carious lesions and that ASA III patients were more likely to have interproximal restorations and fractured teeth. We found associations between a greater number of missing teeth and the presence of periodontal disease with worsening ASA status. Our data suggest that ASA classification cannot be used as a reliable predictor for the health of a patient's dentition or the number of cervical caries. However, the data does demonstrate a positive correlation between the number of missing teeth and ASA status, promoting the idea that the number of missing teeth is a crude prognosticator of systemic health. This information can be used by physicians and dentists to help understand the relationships between a patient's dental and systemic health.

Markers of periodontal disease and risk of stroke: INTERSTROKE case-control study.

BACKGROUND: Periodontal disease may be an important modifiable risk factor for stroke. AIMS: To determine the contribution of markers of periodontal disease to stroke risk globally, within subpopulations, and by stroke subtypes. METHODS: INTERSTROKE is the largest international case-control study of risk factors for first acute stroke. All participants were asked a standardised set of questions about the presence or absence of painful teeth, painful gums or lost teeth, as markers of periodontal disease, within the previous year. The total number of reported variables was calculated per participant. Multivariable conditional logistic regression examined the association of these variables with acute stroke. RESULTS: In 26901 participants, across 32 countries, there was a significant multivariable association between lost teeth and stroke (OR 1.11, 95 % CI 1.01 - 1.22), but not painful teeth (OR 1.00, 95 % CI 0.91-1.10) or painful gums (OR 1.01, 95 % CI 0.89 - 1.14). When these symptoms were considered together there was a graded increased odds of stroke, with the largest magnitude of association seen if a patient reported all three of painful teeth, painful gums and lost teeth (OR 1.34, 95 % CI 1.00 - 1.79). CONCLUSIONS: Our findings suggest that features of severe periodontal disease are a risk factor for acute stroke. Periodontal disease should be considered as a potentially modifiable risk factor for stroke.

[Clinic-X-ray characteristics of periodontal disease in elderly patients.]

The significant prevalence of periodontal diseases in elderly patients makes the research relevant. By now, the issues of complex clinical and radiological semiotics of generalized periodontitis using high-tech research methods is not sufficiently studied. The research addressed the clinical picture and three-dimensional computed tomographic semiotics of severe chronic generalized periodontitis focusing 25 elderly patients with severe chronic generalized periodontitis. It verified the necessity to use an organ-oriented program of multiplanar (volumetric) cone-beam computed tomography coupled with the analysis of the research results, as well as a mandatory analysis of densitometry indicators of the jaw bone tissue in diagnostically significant periodontal zones.

Vitamin intake and periodontal disease: a meta-analysis of observational studies.

OBJECTIVE: A meta-analysis was performed to assess the epidemiological correlation between dietary intake of various types of vitamin intake and the risk of periodontal disease. METHODS: A comprehensive computerized search was conducted in eight databases, namely PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine Disc, CNKI, VIP, and WanFang Database, and a random effect model was applied to combine pooled odds ratio (ORs) with corresponding 95% confidence intervals (CIs) of the included studies, and the sensitivity analysis was performed to explore the impact of a single study on the comprehensive results. RESULTS: We finally included 45 effect groups from 23 observational studies, with a total number of study participants of 74,488. The results showed that higher levels of vitamin A (OR: 0.788, 95% CI: 0.640-0.971), vitamin B complex (OR: 0.884, 95% CI: 0.824-0.948), vitamin C (OR: 0.875, 95% CI: 0.775-0.988), vitamin D (OR: 0.964, 95% CI: 0.948-0.981), and vitamin E (OR: 0.868, 95% CI: 0.776-0.971) intake all were negatively correlated with periodontal disease. After removing each study, leave-one-out sensitivity analysis indicated no significant change in the overall results of any of the five meta-analyses. CONCLUSIONS: The results from this meta-analysis demonstrated a negative association between high-dose vitamin A, vitamin B complex, vitamin C, vitamin D, and vitamin E consumption and the likelihood of developing periodontal disease, revealing the significant role of vitamins in preventing periodontal disease.

Association between dry eye and periodontal disease in community-dwelling Japanese adults: data from the Uonoma cohort study.

BACKGROUND: While research has explored the risk of periodontal disease in various eye conditions, the link between dry eye and periodontal disease remains underexplored, especially in Japanese adults. This study aims to investigate the association between dry eye and periodontal disease in community-dwelling Japanese adults. METHODS: This study is a subset of the Uonuma cohort study, which includes Japanese adults aged 40 years and older residing in the Uonuma area of Niigata Prefecture, Japan. Participants completed a self-administered, paper-based questionnaire. Statistical analyses, including the chi-square test, independent t test, ANOVA test, and logistic regressions, were employed to assess the association of periodontal disease with independent variables. RESULTS: Among 36,488 participants (average age 63.3 years, 47.4% men), 39.3% had a history of periodontal disease, and gender differences were statistically significant (p < 0.001). Significant associations were found between periodontal disease and dry eye diagnosis or symptoms. Univariable logistic regression revealed links between periodontal disease and age, gender, living status, alcohol consumption, remaining teeth, bite molar availability, and history of dry eye disease or symptoms. Multiple-adjusted regression found that doctor-diagnosed dry eye was associated with a higher likelihood of periodontal disease (odds ratio, 1.12; 95% confidence interval, 1.03-1.22). Participants who never experienced dryness or foreign body sensation had lower ORs of periodontal disease than those who always experienced such symptoms across all models. CONCLUSION: A significant correlation was found between dry eye and periodontal disease in Japanese adults. Regular check-ups, early detection, and effective management of both conditions are strongly recommended.

Oral health-related quality of life among people living with HIV and HIV-negative adults in Kigali, Rwanda: a comparative cross-sectional study.

BACKGROUND: Assessing health-related quality of life has become integral to people living with HIV (PLHIV) follow-up. However, there is a lack of data regarding the impact of oral health on quality of life, known as Oral health-related quality of life (OHRQoL) among PLHIV compared to HIV-negative individuals in Rwanda. AIM: The study aimed to assess OHRQoL among PLHIV compared to HIV-negative counterparts in Kigali, Rwanda. METHODS: The Oral Health Impact Profile short version (OHIP-14) questionnaire was interviewer-administered to 200 PLHIV and 200 HIV-negative adults (≥ 18 years old) at an HIV clinic of Kigali Teaching Hospital (CHUK). Socio-demographic characteristics, including age, sex, occupation, and socioeconomic status (SES) of participants, were collected using a survey questionnaire. A 4-point Likert scale was used to assess the frequency of oral impacts for all 14 items within 7 domains of the OHIP tool. The descriptive statistics were used to see frequencies and percentages of OHRQoL among PLHIV and HIV-negative persons, respectively. The Chi-square test was used to determine the association of OHRQoL with caries (DMFT) and periodontal disease (CPITN) among PLHIV compared to HIV-negative individuals. RESULTS: The results revealed a higher prevalence of PLHIV with poor OHRQoL than HIV-negative individuals in 5 domains and almost all items of OHIP-14 except for the OHIP 3 (found it uncomfortable to eat any foods because of problems with teeth or mouth) and OHIP-14 (being totally unable to function because of problems with teeth or mouth). The findings showed statistically significant results (p ≤ 0.05) for the OHIP1 item "trouble pronouncing any word," with a prevalence of 2.5% (n = 11) and 2.25% (n = 9) in PLHIV and HIV-negative, respectively. Also, PLHIV had a significantly higher prevalence, 2.75% (n = 11) for the OHIP 13 item "life not satisfying due to teeth and mouth problems compared to HIV-negative individuals 2% (8) p ≤ 0.05. Moreover, dental caries was significantly associated with poor OHRQoL among PLHIV and HIV-negative adults and for all 14 items of the OHIP tool. Periodontal disease was not significantly associated with OHRQoL among PLHIV and HIV-negative adults. CONCLUSION: This study revealed poor OHRQoL among PLHIV compared to HIV-negative adults. There is a need for further longitudinal studies to investigate the OHRQoL in Rwanda, especially among PLHIV. It is essential to include oral health care as one of the components of the medical health care programs for PLHIV in Rwanda.

Independent and combined effects of smoking, drinking and depression on periodontal disease.

BACKGROUND: Periodontitis is a complex chronic inflammatory disease that is particularly associated with health-related conditions such as smoking, excessive drinking and depression. This research aimed to investigate the interaction between these lifestyles factors on periodontitis risk. METHODS: This study included participants who participated in the National Health and Nutrition Examination Survey in the United States between 2009 and 2014. They had completed oral health-periodontal examination, Smoking-Cigarette Use Questionnaire, Alcohol Use Questionnaire, and Patient Health Questionnaire. Periodontal clinical attachment loss (CAL) of 3 mm or more and Patient Health Questionnaire-9 (PHQ-9) of 10 scores or more were used to identify periodontitis and depression, respectively. Daily alcohol consumption in the past year was classified into three levels: low (1 drink or less), moderate (between 1 and 3 drinks), and heavy drinking (4 drinks or more), while smoking was defined as having smoked at least 100 cigarettes in one's lifetime. Then, the logistic regression combined with interaction models were used to analyze the independent and combined effects of smoking, drinking and depression on periodontitis risk. RESULTS: The results indicated a statistically significant multiplicative interaction between smoking and depression in relation to the development of periodontitis, both in the overall population (P = 0.03) and among male participants (P = 0.03). Furthermore, among individuals experiencing depression, smoking was found to significantly increase the prevalence of periodontitis by 129% in the younger age group compared to non-smokers (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.10 to 4.76). However, the interaction between smoking and alcohol consumption was only significant among females (P < 0.05). There was a dose-dependent relationship between drinking frequency and smoking on periodontitis prevalence. In the smoking population, occasional drinking (OR: 1.70; 95% CI: 1.22 to 2.37) and regular drinking (OR: 2.28; 95% CI: 1.68 to 3.11) significantly increased the prevalence of periodontitis compared to individuals without these two factors. CONCLUSION: These results suggested that there were interactive effects between smoking, drinking and depression on periodontitis risk and policies aimed at healthy behaviours and mental health may be beneficial for our oral health.

Periodontal Diseases in Adult and Elderly Nigerians: A National Survey.

BACKGROUND: Periodontitis has been shown to have links with general health and increase the risk of complications of some systemic diseases now showing a rising prevalence with age. The rising proportion of the elderly globally, and a high prevalence of periodontal disease among older adults may significantly impact the need for oral health care services in the near future. This national survey was carried out to highlight the trend of periodontal diseases among adult and elderly Nigerians and make evidence-based recommendations for good management outcomes. MATERIALS AND METHODS: A national cross-sectional survey of periodontal diseases (using the CPITN Index) among adult (35-44-year-old) and elderly (65-74-year-old) Nigerians selected by multistage sampling method. RESULTS: Periodontal disease is prevalent among adults (96.5%) and elderly (97.6%) Nigerians, with the zonal prevalence approximating the national prevalence. Gingivitis is the prevalent periodontal disease type in these age groups, with a national prevalence of 86.8%, 67.6% respectively, and more in the South than the North for both adults (90.7%, 83%) and elderly (75.7%, 59.7%), respectively (p<0.005). Destructive Periodontitis prevalence in adult and elderly Nigerians is 9.5%, 29.9%, respectively (p<0.05), with the North being more affected than South for both adults (13.4%, 5.6%) and elderly (37%, 22.7%), respectively (p<0.05). There is also a significant rise in the occurrence of destructive periodontitis with age, nationally and in all the zones (p<0.05). CONCLUSION: There is a high prevalence of periodontal diseases in adult and elderly Nigerians. The outcome of the management of periodontal diseases in adults and the elderly is inter-dependent on best practices in both oral and general health care service provision.

CONTEXTE: La parodontite a été liée à la santé générale et à l'augmentation du risque de complications de certaines maladies systémiques, montrant maintenant une prévalence croissante avec l'âge. La proportion croissante de personnes âgées dans le monde et une prévalence élevée des maladies parodontales chez les personnes âgées pourraient avoir un impact significatif sur le besoin de services de santé bucco-dentaire dans un avenir proche. Cette enquête nationale a été réalisée pour mettre en évidence la tendance des maladies parodontales chez les adultes et les personnes âgées nigérianes et formuler des recommandations fondées sur des preuves pour de bons résultats en matière de gestion. MATÉRIEL ET MÉTHODES: Une enquête nationale transversale sur les maladies parodontales (utilisant l'indice CPITN) parmi les adultes (35-44 ans) et les personnes âgées (65-74 ans) nigérianes sélectionnées par méthode d'échantillonnage à plusieurs niveaux. RÉSULTATS: Les maladies parodontales sont prévalentes chez les adultes (96,5 %) et les personnes âgées (97,6 %) nigérianes, la prévalence zonale approchant la prévalence nationale. La gingivite est le type de maladie parodontale prédominant dans ces groupes d'âge, avec une prévalence nationale de 86,8 %, 67,6 % respectivement, et plus dans le Sud que dans le Nord pour les adultes (90,7 %, 83 %) et les personnes âgées (75,7 %, 59,7 %), respectivement (p<0,005). La prévalence de la parodontite destructrice chez les adultes et les personnes âgées nigérianes est de 9,5 %, 29,9 %, respectivement (p<0,05), le Nord étant plus touché que le Sud pour les adultes (13,4 %, 5,6 %) et les personnes âgées (37 %, 22,7 %), respectivement (p<0,05). On observe également une augmentation significative de l'occurrence de la parodontite destructive avec l'âge, nationalement et dans toutes les zones (p<0,05). CONCLUSION: Il existe une prévalence élevée des maladies parodontales chez les adultes et les personnes âgées nigérianes. Les résultats de la gestion des maladies parodontales chez les adultes et les personnes âgées dépendent des meilleures pratiques dans la prestation de services de santé bucco-dentaire et générale. MOTS CLÉS: Prévalence, Gingivite, Parodontite, Nationale, Enquête.