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Periodontal disease (PD) has been linked to a range of cardiometabolic disorders. However, the association between PD and composite cardiovascular risk has not been studied. We hypothesized that PD would be associated with an elevated atherosclerotic cardiovascular risk (ASCVD) score.This analysis included 12,402 participants (age 42.7 ± 18.6 years, 46.8% male, 69.6% Caucasian) from the Third National Health and Nutrition Examination Survey. Participants with a history of myocardial infarction or stroke were excluded. PD was defined as moderate (≥4mm attachment loss or ≥5 mm pocket depth in ≥2 mesial sites) or severe (≥6 mm attachment loss in ≥2 mesial sites and ≥5 mm pocket depth in ≥1 mesial site). ASCVD scores were classified categorically: low (5.0%), borderline (5.0-7.4%), intermediate (7.5-19.9%), and high (≥20.0%). Linear and multinomial logistic regression were used to examine the association between PD and ASCVD score.Approximately 12.1% (n = 1499) of participants had PD. Moderate periodontitis was associated with a greater than five-fold increased odds of high-risk ASCVD score [OR (95% CI): 5.40 (4.63-6.31), p-value0.001]. Severe periodontitis was associated with a greater than seven-fold increased odds of high-risk ASCVD score [OR (95% CI): 7.15 (5.14-9.96), p-value0.001]. Composite periodontitis (moderate or severe) was associated with a 7.0% increase in ASCVD score [β (95% CI): 7.01 (6.53-7.50)] when modeled linearly.PD is associated with elevated ASCVD score. Patients with PD should be counseled regarding their elevated cardiovascular risk and risk reduction strategies should be implemented with an emphasis on routine dental care.

AIMS Periodontal diseases and inflammatory bowel diseases (IBD, ulcerative colitis [UC] and Crohn's disease [CD]) have been reported to present with increased salivary and gingival crevicular fluid (GCF) concentrations of cytokines. The aim of this study was to evaluate the salivary and GCF levels of TNF-α, IL-1β, IL-10, and IL-17A and their associations with the periodontal statuses of UC, CD and non-IBD patients, and to analyze the interrelationships among these cytokines, IBD conditions, and periodontal diseases. MATERIALS AND METHODS This cross-sectional study was performed with a total of 131 patients (62 women and 69 men, mean age 42.96±13.02 years). Patients were divided into three groups: UC, CD, and non-IBD. Periodontal status was defined according to the 2017 World Workshop Disease Classification. Salivary and GCF cytokine levels were analyzed using ELISA. RESULTS UC and CD patients diagnosed as having periodontitis and gingivitis presented with significantly higher levels of TNF-α and lower levels of IL-10 as compared with non-IBD patients (p

Background: Although periodontitis is associated with increased risk of hypertension, studies based on new periodontal disease classification is limited. We investigated whether periodontitis severity and progression rate are linked with self-reports on doctor-diagnosed hypertension in a large cohort of patients attending the periodontology clinic at the faculty of dentistry. Methods: Archived patient files, including radiographic image records and results from full-mouth clinical periodontal examination were screened for inclusion. Data on socioeconomic factors, smoking and oral hygiene habits, and medical history were collected with a questionnaire. Results: Diagnosis and background data were available for 7008 patients. The median (IQR) age was 31.0 (21.0) years; 60.1% (n = 4211) were female. Hypertension was diagnosed in 6.2% (n = 435) of patients. Both periodontitis stage and grade differed (p < 0.001) between patients with or without hypertension. Increased periodontal disease severity was associated with a 20% increasing risk for hypertension; the odds ratio (OR) was 2.63 (95% confidence interval [CI] 1.48–4.68, p < 0.001) in stage IV periodontitis. Increasing periodontitis progression rate was associated with a 35% increased risk for hypertension; the OR was 2.22 (95% CI 1.45–3.40, p < 0.001) in grade C periodontitis. Conclusion: Severity and progression rate of periodontitis may be independent risk factors for hypertension in this large cohort of patients attending the university periodontal department. © 2022, The Author(s)., Eskişehir Osmangazi Üniversitesi, ESOGU: 202045A221, This work was supported by Eskisehir Osmangazi University Research Fund, Turkey (no: 202045A221). Open access funded by Helsinki University Library.

The association between periodontitis and diabetes have been assessed by many cross-sectional studies, in which controlling confounding factors is important. Propensity score matching (PSM) may help address this issue. Therefore, we evaluated this relationship in a (PSM) analysis of individuals representing the general Korean population. Periodontitis was significantly associated with diabetes before PSM (odds ratio [OR] = 1.53; 95 % confidence interval (CI) = 1.31-1.80) and after PSM (OR = 1.52; 95 % CI = 1.28-1.80). This study showed the association between periodontitis and diabetes using PSM, suggesting that periodontitis may be positively related with diabetes. We included 9508 adults who were aged ≥ 19 years from the Korea National Health and Nutrition Examination Survey VII (2016-2018) and performed logistic regression analyses before and after PSM. The PSM was based on periodontal disease (yes or no) using a 1:1 match ratio and included 5858 individuals (2929 per group). Confounding variables, such as age, sex, marital status, occupation, education, income, smoking and drinking habits, obesity, hypertension, hypercholesterolemia, and hypertriglyceridemia, were matched and adjusted in the logistic regression analysis.

Periodontal disease is a chronic inflammatory, multifactorial condition, that, in the absence of an early and adequate treatment, may lead to a progressive damaging of the alveolar tissues that support the teeth (periodontal ligament, cement and alveolar bone) followed by teeth mobility and, subsequently, their loss. Periodontal disease is one of the most common inflammatory disease affecting adult individuals all over the world, being considered a real worldwide pandemic. This disease may influence the progression of certain systemic diseases: diabetes mellitus, cardiovascular diseases, ischemic cardiomyopathy, myocardial infarction, stroke, neurodegenerative diseases, chronic kidney diseases, cancer, etc. The association between smoking and periodontal disease was described in numerous clinical and epidemiological studies, suggesting that products derived from tobacco burning may change the clinical aspects and the disease progression. The present study analyzed microscopically and immunohistochemically 58 periodontal fragments, from 50 patients, chronic smokers, clinically diagnosed with severe periodontitis. There were highlighted major changes in the gingival epithelium (epithelium thickening, acanthosis, intraepithelial edema, infiltrates of neutrophils or lymphocytes, epithelial necrosis), in the periodontal conjunctive tissue (more or less intense inflammatory infiltrates, microhemorrhages, vascular congestion, intense immunohistochemical expression for some matrix metalloproteinases). The periodontal changes may be the expression of both toxic factors present in tobacco smoke and due to the changes caused by tobacco in the microbial flora of the oral cavity.

Background This examiner-blind, stratified, parallel study aimed to evaluate the anti-gingivitis efficacy of a non-aqueous (anhydrous) 0.454% w/w stannous fluoride toothpaste (‘Test’) versus a sodium monofluorophosphate toothpaste (‘Control’) in people with clinically-confirmed mild-moderate gingivitis. Plaque-induced gingivitis can progress to irreversible periodontitis if left untreated. This can be controlled by an effective oral hygiene regimen such as one including toothbrushing with a toothpaste containing the chemotherapeutic agent stannous fluoride. Long-term studies over 4–12 weeks have shown the efficacy of stannous fluoride; however, shorter term studies are needed to examine if the effects on measures of gingivitis and plaque control occur sooner. Methods Eligible participants were randomised to 3 weeks’ twice-daily brushing (for 1 min) with Test or Control toothpastes. The primary efficacy variable was between-treatment difference in Bleeding Index (BI) at 3 weeks; secondary variables were between-treatment differences in number of bleeding sites, modified Gingival Index (MGI), and Turesky modification of the Quigley–Hein Plaque Index (TPI) at Weeks 2 and 3. Results A statistically significant (p p Conclusion Three weeks’ twice-daily brushing with the 0.454% w/w stannous fluoride Test toothpaste compared to the Control toothpaste led to statistically significant lower gingival bleeding, gingival inflammation and plaque levels in adults with mild-moderate gingivitis. These results indicate that plaque and gingivitis-reducing benefits of 0.454% w/w stannous fluoride may be seen from 2 weeks’ use. Trial registration ClinicalTrials.gov Identifier: NCT04050722; 08/08/2019.

Objective To investigate the interrelationships among concerns regarding dental visits, the status of regular dental visits, and periodontal health during the coronavirus disease 2019 (COVID‐19) pandemic. Background Continuous oral health care and regular dental visits are important for maintaining periodontal health. Due to the possibility of contracting COVID‐19, individuals have been reluctant to visit medical institutions. It is unclear how the periodontal health of the Japanese population has been affected by the interruption of regular dental visits during the COVID‐19 pandemic and how concerns regarding dental visits have affected attendance at regular dental visits. Methods This study included 199 Japanese office workers in one municipal office at Fukuoka Prefecture, Japan (average age = 42.6 years; age range = 19–77 years; 123 men and 76 women). Periodontitis was defined based on a full‐mouth periodontal examination. The status of regular dental visits during the COVID‐19 pandemic and concerns regarding dental visits were obtained via questionnaire. We tested the hypothesis that concerns regarding dental visits would indirectly affect periodontal health through the interruption of regular dental visits during the COVID‐19 pandemic. We used mediation analysis, in which concerns regarding dental visits (present or absent) were set as the exposure, periodontitis (present or absent) was set as the outcome, and the status of regular dental visits (continued during the COVID‐19 pandemic or not) was set as the mediator. Results Of the 199 study participants, 108 had a habit of attending regular dental visits. Of these, 31 (28.7%) discontinued regular dental visits during the COVID‐19 pandemic. Compared to the individuals who continued regular dental visits, those who discontinued regular dental visits had a higher prevalence of periodontitis (49.4% vs 77.4%, p

The present study aims to assess clinical and inflammatory parameters as indicators for periodontal disease in obese and non-obese adults with and without bronchial asthma (BA).168 patients visiting the outpatient pulmonary clinics were divided into four groups according to BA and obesity. Obesity was defined by body mass index (BMI) and BA was diagnosed by a pulmonary consultant and being on inhaled asthma medication for at least 12 months. Participants were examined for clinical periodontal parameters and samples of gingival crevicular fluid (GCF) were taken and analyzed for the levels of 5 different inflammatory cytokines.Compared with controls, obese asthmatic group had significant higher mean clinical attachment loss (CAL) (2.64 vs. 1.00,ip/ilt; .001). Also, the occurrence of periodontitis was significantly higher among obese patients compared to non-obese patients (ip/i = 0.003). Multivariate logistic regression model showed that age was the strongest predictor of periodontitis (aOR = 1.23). The levels of IL-1β and IL-8 were significantly higher in the non-obese asthmatic group compared to the control group (ip/i lt; 0.05). The level of IL-6 was significantly lower in the control group compared to the other groups (ip/i lt; 0.001). Obese patients had significantly higher concentration of hsCRP compared to non-obese patients (ip/i lt; 0.001). There was no significant difference in the level of TNF- α between groups.BA and obesity combined did not seem to be associated with a significant increased risk of having periodontitis. BA and obesity are associated with increased levels of some local proinflammatory cytokines which adds to the local and systemic inflammatory burden.

Background Ultra-processed foods are associated with both sugar intake and noncommunicable diseases. We aimed to assess whether the intake of ultra-processed food is associated with periodontal disease and whether this association, if present, is dependent on non-communicable diseases. Methods This analysis used data from cycles 2009-2010, 2011-2012 and 2013-2014 of the National Health and Nutrition Examination Survey (NHANES), including participants aged 30 years or older. Dietary recalls were categorized according to the NOVA classification, and total contribution of ultra-processed foods to daily energy intake (%E) was calculated. Cases of periodontitis were defined as moderate or severe according to the CDC working group criteria for use in population surveillance of periodontitis. Adjustment variables to estimate total and direct associations were defined with direct acyclic graphs. Odds ratios were estimated with logistic regression for moderate/severe periodontitis and severe periodontitis, and ordinal logistic regression for the trichotomised outcome. Analyses were done using NHANES fasting subsample weights. Results Sample participants numbered 4809 (52.2% female), with a mean age of 52.1 years (SE, 0.3). The prevalence of periodontal disease was 27.8% for moderate and 6.5% for severe cases. Mean %E from ultra-processed foods was 54.4 (SE, 0.5). No significant crude, direct or total association between ultra-processed %E and periodontal disease was found. Conclusion Intake of ultra-processed foods is not associated with periodontal disease in US non-institutionalized adults over 30 years old, whether directly or by mediation. This article is protected by copyright. All rights reserved.

Periodontal disease affects 42% of adults in the United States. Both the periodontal microbiome and the host immune inflammatory response may be influenced by overweight/obesity status. This retrospective analysis sought to determine the associations of periodontal disease parameters with body mass index (BMI) and obesity status in patients undergoing periodontal maintenance therapy. The records of 418 patients who were undergoing periodontal maintenance after periodontitis treatment were examined, and the patients' demographic characteristics (sex, age, and race/ethnicity), self-reported BMI, periodontal disease condition, number of sites with probing depth ≥ 4 mm, missing teeth, and sites with bleeding on probing (BOP) were recorded. Patients were determined to have active moderate to severe periodontitis if they presented with 2 or more sites in 2 different quadrants with clinical attachment loss ≥ 5 mm and probing depth ≥ 5 mm. Individuals were also categorized into 3 groups: underweight/normoweight, BMI25; overweight, BMI 25 ≤ 30; or obese, BMI ≥ 30. In the study population, BMI ranged from 16.827 to 51.389. The periodontitis status was not significantly associated with a BMI status of overweight (odds ratio [OR] = 1.388 [95% CI, 0.961- 2.006]) or obese (OR = 1.168 [95% CI, 0.77-1.757]). Female sex (OR = 0.561 [95% CI, 0.343-0.918]) and age (OR = 0.983 [95% CI, 0.967-0.999]) were negatively associated with active periodontitis status. Obese patients demonstrated significantly more sites with BOP than either underweight/normoweight or overweight patients, and a BMI indicating obesity was associated with increasing age (P0.001) and higher number of missing teeth (P = 0.0064). In a population of patients undergoing periodontal maintenance therapy, BMI was associated with age and missing teeth, and obese status was associated with a significantly higher number of sites with BOP.

Both periodontal disease and diabetes mellitus (DM) are important public health issues. Compared to the non-diabetic counterparts, diabetic patients more often suffer from dental problems, sometimes requiring fixed-dental prosthesis. Gingival inflammation and other forms of periodontal disease are the common complications of the dental prosthesis. This prospective comparative experimental study was intended to compare the outcome of the periodontal health after placement of full veneer crown in diabetic and non-diabetic patients in the Department of Prosthodontics, Faculty of Dentistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from April 2018 to March 2019. This study involved consecutive 53 diabetic and 53 non-diabetic adult patients of either sex, undergoing treatment with full veneer crown in either maxillary or mandibular posterior teeth with healthy periodontal tissue. The outcome variables were: plaque index, gingival index, periodontal pocket depth, and bleeding on probing, at baseline, 3 months and 6 months post-procedure. Gingival index in the diabetic group reached from 0 at baseline to nearly 0.1 at 3 months which then steeply reached to 0.2 at 6 months interval, whereas the same index in the non-diabetic group reached from 0 at baseline to 0.009 at 3 months and 0.04 at 6 months interval. Plaque index of diabetic patients increased from 0 at baseline to 0.5 at 3- and 6-months interval, whereas the plaque index of non-diabetic patients increased to 0.4 at 3 months and then decreased again 0.3 at 6 months interval (p0.001). Periodontal pocket depth of diabetic group increased from 1.0mm at baseline to 1.2 and 1.5mm at 3 and 6 months respectively, while the same measure in the non-diabetic group increased to 1.1 and 1.3mm at 3 and 6 months respectively (p0.001). Bleeding on probing index in the diabetic group reached sharply to 1.5 at 3 months from 0 at baseline and then it reached 2.3 at 6 months, whereas the same index in non-diabetic group reached 1.1 and 1.6 at 3 and 6 months respectively (p0.001). Periodontal health outcome of full veener crown in diabetic patients is adversely affected compared to that in non-diabetic patients.

Tooth loss is an irreversible condition and it is an indicator of overall dental health. Tooth loss impairs speech, aesthetics, mastication, and deglutition, affecting an individual's oral health related quality of life. This study aimed to review the pattern of tooth loss in Nigerians over a forty-one-year period.A literature search for articles on tooth loss and related subjects was performed on databases (NICB PubMed, Medline and Cochrane). Keywords used for the search included "tooth loss" and "Nigeria' as well as partial edentulousness, partial denture, implant and prosthodontics. The articles included were studies published between 1972 and 2019, written in English language and involving human subjects. A self-developed proforma was used to extract clinical and demographic data from the articles.All the studies assessed were observational. Most studies were conducted in tertiary hospitals. There was a marginal difference in the prevalence of tooth loss between males and females. The mean age of persons presenting in hospitals across Nigeria for extraction of their teeth was identical across several studies. Most of the studies reported the molars as the teeth most frequently lost.In younger adults, tooth loss was more common in 20-29-year-old subjects, while among the elderly it peaked in the 60-70-year-old group. Dental caries was the predominant cause of tooth loss over the years. Community based studies may provide more accurate information on the extent of tooth loss in Nigerians.La perte de dents est un état irréversible et un indicateur de la santé dentaire globale. La perte de dents nuit à l’élocution, à l’esthétique, à la mastication et à la déglutition, affectant ainsi la qualité de vie d’un individu liée à sa santé bucco-dentaire. Cette étude avait pour but d’examiner le profil de la perte de dents chez les Nigérians sur une période de quarante et un ans.Une recherche documentaire d’articles sur la perte de dents et les sujets connexes a été effectuée sur des bases de données (NICB PubMed, Medline et Cochrane). Les motsclés utilisés pour la recherche comprenaient “perte de dents” et “Nigeria” ainsi que édentation partielle, prothèse partielle, implant et prosthodontie. Les articles inclus étaient des études publiées entre 1972 et 2019, rédigées en langue anglaise et impliquant des sujets humains. Un proforma auto-développé a été utilisé pour extraire les données cliniques et démographiques des articles.Toutes les études évaluées étaient observationnelles. La plupart des études ont été menées dans des hôpitaux tertiaires. Il y avait une différence marginale dans la prévalence de la perte de dents entre les hommes et les femmes. L’âge moyen des personnes se présentant dans les hôpitaux du Nigeria pour l’extraction de leurs dents était identique dans plusieurs études. La plupart des études ont indiqué que les molaires étaient les dents les plus fréquemment perdues.Chez les jeunes adultes, la perte de dents était plus fréquente chez les sujets âgés de 20 à 29 ans, tandis que chez les personnes âgées, elle atteignait un pic dans le groupe des 60-70 ans. Les caries dentaires étaient la cause prédominante de la perte de dents au fil des ans. Des études communautaires pourraient fournir des informations plus précises sur l’étendue de la perte de dents chez les Nigérians.Perte de dents, Édentation, Prévalence, Nigeria.

More than 740 million people worldwide are affected by periodontal disease and are at higher risk of secondary damage such as cardiovascular disease and type 2 diabetes, which place a considerable financial burden on healthcare systems. The aim of this study was to use a computer simulation to estimate the direct and indirect costs of prevention and treatment of gingivitis, periodontitis and related secondary damage in the Swiss population, paid both out of pocket (OOP) and from social welfare (SW). For three different scenarios, iterations with 200,000 simulated individuals over their assumed life span of 35 to 100 years corresponded to a period of four months in which an individual could move from one periodontal condition to the next, each associated with presumed direct and indirect treatment costs. Appropriate diagnosis and adherence to professional periodontal care had a strong benefit saving up to CHF 5.94 billion OOP and CHF 1.03 billion SW costs for the current Swiss population. Considering direct and indirect health care costs, the total expected costs for a 35-year-old individual until death were CHF 17'310 with minimal care and CHF 15'606 with optimal care, resulting in savings of CHF 1'704. In conclusion, early detection and appropriate treatment of periodontitis can help to reduce both overall costs of treating periodontitis and associated secondary damage, especially in the second half of life. These cost savings may further pay off on an individual level through regular supportive periodontal care, both for treatments paid out-of-pocket and those covered by social welfare.

This study aimed to investigate the effect of interdental brushes and dental floss on the prevention of periodontitis in participants with ≥ 20 or

There is inconclusive evidence about the link between the severity and prevalence of periodontitis in obese adults. Therefore, this systematic review aims to explore the possibility of significant evidence on the association between obesity and periodontitis and to determine the necessity to consider obesity as a risk factor for periodontitis. We followed the PRISMA protocol, and studies that met the eligibility criteria were included in this review. The risk of bias in individual studies was also evaluated. This review included 15 observational studies (9 cross-sectional studies, 2 case-control, and 4 cohort studies). The total study subjects from these studies were 6603 (males = 3432; females = 3171). Most studies showed a significant association between obesity and periodontitis. Among these studies, a few showed obese females to be at a higher risk, and one study found no association between obesity and periodontal disease at all. Based on the evidence obtained from this review, the body mass index (BMI) should be routinely assessed in patients to assess the risk for periodontal disease and to offer personalized management of periodontitis. Based on the findings of this review, we recommend the need to initiate awareness among clinicians and implement dental hygiene care prevention measures for obese patients.

Background People with poorly managed diabetes are at greater risk of periodontal disease. Periodontal disease that is not effectively managed can affect glycaemic levels. Diabetes care providers, including general practitioners and diabetes educators, are encouraged to promote oral health of their clients. However, valid and reliable oral health screening tools that assess the risk of poor oral health, that are easy to administer among non-dental professionals, currently do not exist. Existing screening tools are difficult to incorporate into routine diabetes consultations due to their length. Thus, this study aimed to develop and pilot a short oral health screening tool that would identify risk of existing oral diseases and encourage appropriate referrals to the dental service. Methods A three-item screening tool was developed after a comprehensive review of the literature and consensus from an expert panel. The tool was then piloted as part of a larger cross-sectional survey of 260 adults with diabetes who were accessing public diabetes clinics at two locations in Sydney, Australia. As part of the survey, participants completed the three-item screening tool and a 14-item validated tool, the Oral Health Impact Profile (OHIP-14), which has been used previously in the preliminary validation of screening tools. Sensitivity and specificity analyses were then undertaken comparing the results of the two tools. Results A statistically significant correlation was found between the shorter screening tool and the OHIP-14 (rho = 0.453, p Conclusions The three-item screening tool developed was found to be valid and sensitive in identifying risk of poor oral health, requiring oral health referrals, among people with diabetes in this pilot. This is a simple, accessible tool that diabetes care providers could incorporate into their routine consultations. Further validation against comprehensive dental assessments is needed to reassess the tool’s specificity and sensitivity in diverse settings.

Oral diseases seriously impair the quality of life (QoL) in a large number of individuals and they may affect various aspects of life.To determine the relationship between tooth loss and oral health-related quality of life (OHRQoL) among adult dental patients.A cross-sectional study was carried out among 296 adult dental patients aged 35-44 years attending Department of Oral Medicine and Radiology of Panineeya Institute of Dental Sciences and Hospital, Hyderabad, India.Oral Health Impact Profile-14 (OHIP-14) was used to assess OHRQoL. Dentition status and periodontal status according to WHO criteria 2013 and position, number of teeth lost by Batista et al. (2014) tooth loss classification were assessed.Mann-Whitney U test and analysis of variance were used to find prevalence and severity of OHIP-14 with tooth loss and logistic regression analysis to evaluate the association between OHIP-14 prevalence and severity based on variables.Except for the subjects with history of previous dental visit, variables such as gender and reason for dental visit showed significant difference (P ≤ 0.05) with tooth loss. Males subjects, who visited dentist with a history of pain, presence of periodontal disease and tooth loss up to 12 teeth (score 3) emerged as significant predictors for OHIP-14 prevalence (OR = 6.7, OR = 1.13, OR = 3.31).The study strongly evidenced that number and position of tooth loss had negative impacts on OHRQoL.

Increasing attention has been paid to the possible link between periodontal disease and atherosclerosis over the past decade. The aim of this study is to investigate the presence of five periopathogens: Porphyromonas gingivalis (P.g.), Aggregatibacter actinomycetemcomitans (A.a.), Tannerella forsythia (T.f.), Treponema denticola (T.d.), and Prevotella intermedia (P.i.) in atheromatous plaques obtained from the carotid and coronary arteries in patients who underwent coronary artery bypass graft surgery and carotid endarterectomy. Group I (carotid arteries) consisted of 30 patients (mean age: 54.5 ± 14.8 ), and group II (coronary arteries) consisted of 28 patients (mean age: 63 ± 12.1 ). Clinical periodontal examinations consisted of plaque index, gingival index, sulcus bleeding index, and periodontal probing depth and were performed on the day of vascular surgery. The presence of periopathogens in periodontal pockets and atherosclerotic vessels was detected using polymerase chain reaction. In both subgingival plaque and atherosclerotic plaque of carotid arteries, P.g., A.a., T.f., T.d., and P.i. were detected in 26.7%, 6.7%, 66.7%, 10.0%, and 20.0%, respectively, while for coronary arteries, P.g. was detected in 39.3%, A.a. in 25%, T.f. in 46.4%, T.d. in 7.1%, and P.i. in 35.7%. The presence of five periopathogens in carotid and coronary atherosclerotic vessels showed correlation in regard to the degree of periodontal inflammation. The present study suggests the relationship between periodontal pathogenic bacteria and atherogenesis. Further studies are necessary in relation to the prevention or treatment of periodontal disease that would result in reduced mortality and morbidity associated with atherosclerosis.

The oral microbiome plays an important role in the human microbial community and in maintaining the health of an individual. Imbalances in the oral microbiome may contribute to oral and systemic diseases. The progression of periodontal disease is closely related to the growth of bacteria, such as Porphyromonas gingivalis, in the oral cavity. However, the pathogen growth mechanism specific to periodontal disease remains unknown. This study aimed to identify bacteria associated with periodontal health by focusing on hemolytic bacteria. Unstimulated saliva samples were collected from ten periodontitis patients and five healthy subjects to detect and identify the presence of hemolytic bacteria. The saliva of healthy subjects contained a higher proportion of G. haemolysans than saliva samples from patients with periodontitis. Growth inhibition assays indicated that the protein components contained in the culture supernatant of G. haemolysans directly suppressed the growth of P. gingivalis. This study shows that the presence of G. haemolysans in saliva is associated with periodontal health and that it inhibits the growth of P. gingivalis in vitro.

Background Oral health is a frequently ignored aspect of global health in sub-Saharan patients. Periodontitis, a very frequent oral disease has been proven to be associated to development of the metabolic syndrome. This study aims to evaluate the relationship between periodontal disease and metabolic syndrome components in a sub-Saharan population. Methods We performed a cross sectional study in 3 Yaounde hospitals. Consenting adults aged 21 years and above were recruited. Participants who presented with a tooth loss of at least 50% or any condition which could alter values of biological and periodontal parameters (tobacco smoking, pregnancy, chronic kidney disease, cancer) were excluded. Metabolic syndrome elements (glycaemia, arterial pressure, HDL cholesterol, abdominal circumference, triglycerides) and periodontal variables were recorded (plaque and gingival index of Silness and Loe, periodontal pocket depth and clinical attachment loss). These variables were compared using Fisher’s exact Test and odds ratio calculated with 95% confidence intervals. Results The prevalence of periodontitis and metabolic syndrome were 43.4% and 10.8% respectively. Age (37.75 ± 13.25, P P P = 0.001) Conclusion Our findings suggest an association between periodontal disease and metabolic syndrome in Sub-Saharan subjects. Increasing age and poor accessory brushing methods are associated risk indicators.

Periodontal disease (PD) can be an important precipitating factor in the production of citrullinated proteins. Its importance is emphasized, but it is not the only way to produce citrullinated proteins. The aim of the current study was to determine the periodontal conditions and the salivary citrullinated protein content in patients with rheumatoid arthritis (RA) compared to healthy controls. We also wished to correlate citrullinated protein levels in the saliva and serum biomarkers with the periodontal status and temporomandibular joint (TMJ) involvement of patients with RA. Twenty-three patients with RA and 17 healthy controls participated the study. Saliva samples were taken: citrulline content of saliva was measured. Blood test results for patients with RA were collected. TMJ disorders were described. Cariological and periodontal indices were registered. Periodontal conditions and periodontal staging were also registered. Comparison of measured values between groups was performed. Intragroup correlation of patients’ values was counted. The prevalence of TMJ complaints was significantly higher in the RA group (8/23) versus controls (1/17). The patients with RA had worse periodontal condition because more patients with RA had gingivitis with a significantly higher bleeding on probing (BOP) (RA: 22.4 ± 25.0%; controls: 6.36 ± 11.6%; p = 0.018). Gingival index (GI) was also significantly higher in the patients than in controls (RA: 0.68 ± 0.58; controls: 0.19 ± 0.38; p = 0.010). The citrullinated protein (relative) content of saliva did not differ significantly (p = 0.147) between patients with RA (1102.2 ± 530.8) and healthy controls (1873.1 ± 1594.9). In RA, the salivary anti-CCP levels positively correlated with PD staging (R = 0.464, p = 0.039) . Control subjects more commonly had healthy gingiva than RA patients. Moreover, in the control group more individuals had intact and reduced height periodontium than periodontitis compared to the RA group. There was no significant difference in the levels of salivary citrulline between patients with RA and controls, despite the significant differences in their periodontal status. Thus, salivary citrulline levels are not associated with RA disease severity.

Introduction We investigated the relationship between periodontal treatment and pre-clinical Alzheimer's disease (AD). Methods In this quasi-experimental design, 177 periodontally treated patients from the "Greifswald Approach to Individualized Medicine" cohort, which used the same protocols as the population-based Study of Health in Pomerania TREND (SHIP-TREND), and 409 untreated subjects from SHIP-TREND were analyzed. Subjects were younger than 60 years at the magnetic resonance imaging examination, with a median observation period of 7.3 years. Imaging markers for brain atrophy in late-onset AD and brain aging were used as the outcomes. Results Robust to sensitivity analyses, periodontal treatment had a favorable effect on AD-related brain atrophy (-0.41; 95% confidence interval: -0.70 to -0.12; P = .0051), which corresponds to a shift from the 50th to the 37th percentile of the outcome distribution. For brain aging, the treatment effect was uncertain. Conclusion Periodontitis is related to pre-clinical AD in our population.

OBJECTIVES: To examine oral cancer screening rates and associated factors among adults with periodontal disease (PD). We hypothesized that adults with severe PD will be less likely to report receipt of any type of oral cancer screening than adults with no PD. MATERIALS AND METHODS: We used 2011-2014 National Health and Nutrition Examination Survey (NHANES) data on adults ≥ 30 years. PD status was classified as no PD, mild/moderate PD, and severe PD. Survey-adjusted logistic regression analysis was used to examine the model adjusted risk ratio (RR) and 95% confidence intervals (CI) for the outcome of not receiving intraoral, extraoral or both types of oral cancer screenings among adults with PD. Control variables included age, sex, race/ethnicity, health insurance, education, income level, smoking status, alcohol use and last dental visit. RESULTS: The analytic sample included 6962 adults weighted to the national population of adults who had a periodontal examination during 2011-2014. Overall 31.5%, 26.8% and 20.9% of adults reported receipt of intraoral, extraoral, and both types of oral cancer screening, respectively. Almost 40% of adults had some form of PD (7.6% severe, and 32.4% mild/moderate PD). A higher proportion of 45-64-year-olds, males, non-Hispanic Blacks, those with less than high school education, with income level less than 200% federal poverty level, or those with no insurance had severe PD than no PD. In adjusted analyses, adults with severe PD were significantly more likely to report no receipt of intraoral (RR= 1.25, 95% CI = 1.12-1.40), extraoral (RR = 1.17, 95% CI = 1.07-1.27) or both types of oral cancer screenings (RR= 1.18, 95% CI = 1.10-1.27) than those with no PD. CONCLUSIONS: Significantly low proportion of adults age ≥ 30 years with severe PD reported receiving any type of oral cancer screening. The association between PD and risk of oral cancers points to the need to improve oral cancer screening rates among adults with PD.

The incidence of periodontal diseases is associated with multiple comorbidities that influence a patient’s treatment planning. This study evaluates the relation between periodontal disease and multiple comorbidities reported in the Saudi population from the Eastern province. This study was conducted on 190 patients, who visited the periodontology clinics at Imam Abdulrahman Bin Faisal University, Saudi Arabia. Demographic data, smoking habits, past medical and dental histories, blood pressure, random blood glucose, and recent haemoglobin A1c were recorded. A comprehensive periodontal examination included the number of missing teeth, pocket depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and mobility of all teeth except third molars. Radiographic bone loss was measured on standardized full-mouth periapical radiographs. Multivariable regression models were calculated aiming to see the association between different comorbidities and alveolar bone loss with confounders controlled. Out of 190 periodontitis patients, 56 (29.5%) were males and 134 (70.5%) were females. More than half of the patients (60%) were between 26 and 50 years, 30% of them had diabetes, and 18% were smokers. The risk of alveolar bone loss was higher in persons who had diabetes and those who had both diabetes and coronary heart disease than those who did not, although the association was not statistically significant ( B = 1.26 , 95 % CI = − 0.30 , 2.82, and B = 2.86 , 95 % CI = − 1.25 , 6.96, respectively). The risk of alveolar bone loss was significantly higher among persons with diabetes and hypertension ( B = 2.82 and 95 % CI = 0.89 , 4.75). Collectively, the risk of alveolar bone loss in periodontitis patients increases with diabetes in the presence of other comorbidities regardless of smoking or gender.

Introduction: Periodontitis is chronic disease leading to tooth loss. Oral hygiene practices combined with regular dental examinations keep oral cavity disease free and maintain periodontal health. The primary objective was to find out the prevalence of periodontal disease of patients measured by the Simplified Oral Hygiene Index and Community Periodontal Index. Methods: This descriptive cross-sectional study was conducted in department of Periodontics of a tertiary care dental hospital from April to June 2019 after obtaining ethical clearance and informed consent. Participants were recruited by convenience sampling and 183 sample size was calculated. Proforma included demographics, Simplified Oral Hygiene Index, Community Periodontal Index, body mass index, and smoking status. Data were entered in Statistical Package for Social Sciences version 23 and descriptive statistics were presented as frequency, percentage, mean, and standard deviation. Results: Prevalence of periodontal disease corresponding to loss of attachment 1, 2, 3, and 4 was found to in 104 (56.83%) participants. Simplified Oral Hygiene Index score was 1.67±0.89 with “fair” status in majority 114 (62.30%). Gingivitis (Community Periodontal Index 1, 2) was seen in 136 (74.32%). The mean age was 36.37±14.43 years of which 92 (50.27%) were female but smoking was more in males. Conclusions: This study suggests deteriorating periodontal health related to age, sex, oral hygiene, smoking, and BMI. As updated information on oral and periodontal health in Nepal is limited, this assessment would help the national policy makers on oral health intervention measures to prevent periodontitis and develop future programs to improve oral health.

The coronavirus disease 2019 (COVID-19) pandemic has led to economic contraction and significant restrictions on society. The shock to the economy could lead to a deterioration of physical health outcomes, including dental health. The present study investigated the association between worsened socioeconomic conditions due to the COVID-19 pandemic and dental pain in Japan. The mediating effects of psychological distress and oral health–related behaviors were also evaluated. Cross-sectional data from the Japan COVID-19 and Society Internet Survey conducted from August to September 2020 ( n = 25,482; age range, 15–79 y) were analyzed. Multivariable logistic regression models were fitted to evaluate the independent associations of household income reduction, work reduction, and job loss due to the COVID-19 pandemic with dental pain within a month. Dental pain was reported by 9.8%. Household income reduction, work reduction, and job loss were independently associated with dental pain after adjusting for confounders (odds ratios: 1.42 [95% confidence interval (CI), 1.28−1.57], 1.58 [95% CI, 1.41−1.76], 2.17 [95% CI, 1.64−2.88], respectively). The association related to household income reduction was mediated by psychological distress, postponing dental visits, toothbrushing behavior, and between-meals eating behavior by 21.3% (95% CI, 14.0−31.6), 12.4% (95% CI, 7.2−19.6), 1.5% (95% CI, −0.01 to 4.5), and 9.3% (95% CI, 5.4−15.2), respectively. Our findings showed that worsened socioeconomic conditions due to the COVID-19 pandemic deteriorated dental health. Policies that protect income and job loss may reduce dental health problems after the pandemic.

Objective To compare the clinical effectiveness and cost benefit of different frequencies of scale and polish (S&P) treatments in combination with different types of oral hygiene advice (OHA). Design Multi-centre, multi-level cluster randomised factorial open trial with blinded outcome evaluation. UK dental practices were cluster randomised to deliver OHA as usual or personalised. In a separate randomisation, patients were allocated to receive S&P 6-monthly, 12-monthly or never. Setting UK primary dental care. Participants Practices providing NHS care and adults who had received regular dental check-ups. Main outcome measures The percent of sites with bleeding on probing, patient confidence in self-care, incremental net benefits (INB) over three years. Results Sixty-three practices and 1,877 adult patients were randomised and 1,327 analysed (clinical outcome). There was no statistically significant or clinically important difference in gingival bleeding between the three S&P groups (for example, six-monthly versus none: difference 0.87% sites, 95% CI: 1.6 to 3.3, p = 0.48) or between personalised or usual OHA groups (difference -2.5% sites, -95%CI: -8.3 to 3.3, p = 0.39), or oral hygiene self-efficacy (cognitive impact) between either group (for example, six-monthly versus none: difference -0.028, 95% CI -0.119 to 0.063, p = 0.543). The general population place a high value on, and are willing to pay for, S&P services. However, from a dental health perspective, none of the interventions were cost-effective. Conclusion Results suggest S&P treatments and delivering brief personalised OHA provide no clinical benefit and are therefore an inefficient approach to improving dental health (38% of sites were bleeding whatever intervention was received). However, the general population value both interventions. Zusatzmaterial online: Zu diesem Beitrag sind unter 10.1038/s41415-021-2662-3 für autorisierte Leser zusätzliche Dateien abrufbar., Key points Describes the process of successfully delivering a multi-centre, cluster randomised factorial open trial in general dental practice in the NHS, for the most frequently provided dental treatment, scale and polish (S&P), and oral hygiene advice.Highlights the clinical, economic and patient-centred outcomes from providing S&P at different time intervals alongside personalised or routine oral hygiene advice to over 2,000 participants for three years.Evidence from IQuaD concludes that there was no difference in gingival bleeding across trial arms at three years; however, the general population are willing to pay for and place a high value on both S&P and personalised oral hygiene advice. Zusatzmaterial online: Zu diesem Beitrag sind unter 10.1038/s41415-021-2662-3 für autorisierte Leser zusätzliche Dateien abrufbar.

To examine the association between the intake of various nutrients (phosphorus, riboflavin, thiamine, niacin, vitamin C, calcium, protein, carbohydrates, and fat) and the prevalence of periodontal disease in Korean adults.The data used for analysis were obtained from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). Data from 12,689 adults aged ≥ 19 years who had a periodontal examination were analysed. Data were analysed using the Chi2 and t-test s. Multiple regression analysis was used to assess the association between the selected nutrients and periodontal diseases.After adjusting for sex, age, income, body mass index, diabetes, smoking, alcohol consumption, and toothbrushing frequency, a statistically significant relationship between phosphorus, carbohydrate, and fat intake and the risk of periodontal disease was identified by multiple logistic regression analysis (odds ratio [OR]: 0.80, 95% confidence interval [CI]: 0.66-0.97; OR: 0.85, 95% CI: 0.70-0.98, OR: 1.41, 95% CI: 1.13-1.75, respectively).Phosphorus, carbohydrates and fat were associated with periodontal disease. Therefore, the improvement of diet should be emphasised to prevent and manage periodontal disease. Further research is needed based on various nutrients related to periodontal disease in the future.

BackgroundPeriodontitis, one of the most common bacterial infections characterized by chronic inflammation, is also known to be a risk factor for chronic conditions, including cardiovascular disease and cancer. This inflammation is driven by an altered microbiota with an increase in pathogenic bacteria. We evaluated the association between oral microbiota and periodontitis severity in high-risk Hispanics.MethodThis cross-sectional study recruited 134 sexually active participants aged 21 to 49 years old from STI Clinics in Puerto Rico. A periodontal examination, saliva collection, and an interviewer-administered questionnaire were performed. Periodontal severity was categorized as: having no disease, mild, and moderate/severe and BOP and tooth loos was noted. Saliva samples were collected for genomic DNA extraction, downstream 16S rDNA amplification sequencing, and bioinformatics analyses.ResultsThe structure, composition, and diversity of bacterial communities differed significantly according to periodontal severity. The richness and overall diversity also differed between participants without periodontitis and participants with some level of periodontal disease. A higher abundance of Prevotella, Veillonella, or Treponema was attributed to periodontal disease and Aggregatibacter to severe bleeding on probing, while Neisseria was found in higher abundance in healthy participants, decreasing its levels with drinking, smoking, and oral sex practices.ConclusionsOur findings indicate that dysbiosis occurs as periodontal disease progresses, and both alcohol consumption and smoking habits pose risk factors for oral dysbiosis. These results are of public health and clinical impact, as several bacteria identified could serve in the future as biomarkers for periodontitis and oral cancer risk.

This study aimed to review the use of interdental care products (ICPs) among adults in Korea, reconfirm their relevance to periodontal health, and identify factors affecting the use of ICPs. Data from 2007 to 2018 from the National Health Nutrition Survey (KNHANES) were used, and 43,069 adults (18,412 men, 24,657 women) aged 30 years or older were included. The frequency and percentage of ICP use according to the characteristics of the subjects are presented. In addition, multivariate logistic regression analysis identified the factors affecting ICP use. The ICP usage rate of participants in the KNHANES phase gradually increased to 22.8% in the 4th, 26.4% in the 5th, and 38.0% in the 6th phase and then decreased to 36.3% in the 7th phase. The adjusted OR values for periodontal health in ICP users were 0.721 for gingivitis and 0.642 for periodontitis, confirming that ICP was associated with a lower prevalence of these conditions. Sex, age, educational level, household income, toothbrushing, and dental check-ups were related to ICP use in all phases. ICP was associated with improved periodontal health, but its use rate was very low. Therefore, oral health professionals should educate adults on the use of ICP, particularly interdental brushing.

Background Studies using salivary inflammatory biomarkers for diagnosing and monitoring the progression of periodontal disease have garnered increased attention in recent years. The present study aimed to identify changes in clinical parameters and concentrations of salivary matrix metalloproteinases (MMPs) following 6 weeks of non-surgical periodontal therapy (NSPT). Methods A 6-week NSPT program was applied to 51 adults aged ≥ 20 years. The program involved scaling, root planing, and professional toothbrushing for healthy participants and those with periodontal disease. Patients with periodontal disease underwent professional toothbrushing during all three visits. Periodontal pocket depth (PD) and gingival bleeding were assessed at week 0, week 3, and week 6, and saliva samples were collected to measure the concentrations of MMP-3, -8, and -9. Results All clinical parameters were improved in the periodontal disease groups following the NSPT course. Compared with healthy participants, the patients with periodontal disease showed increased concentrations of salivary MMP-3, -8, and -9. During the 6-week program, patients with periodontal disease also showed significant reductions in PD and gingival bleeding during the third week; no significant reduction was found during the sixth week. Significant reductions in the concentrations of salivary MMP-3, -8, and -9 were also noted in the periodontal disease group at week 3. The sensitivity and specificity of MMP-3 for predicting periodontitis were 81.8% and 55.5%, respectively. Conclusion The present study found that NSPT resulted in reductions of salivary MMP-3, -8, and -9, and identified the potential of MMP-3 as a biomarker in the diagnosis of periodontal disease. These findings may serve as foundational data for future studies into the development of diagnostic kits for periodontal disease.

Objective To investigate the clinical characteristics and genetic mutations in Kindler syndrome(KS)and provide a theoretical basis for the diagnosis and treatment of KS. Methods The clinical data of one case of KS from Peking Union Medical College Hospital and 185 cases reported in literature were collected. The gene mutation types,patient clinical data,and tumor characteristics were statistically analyzed. Results A total of 186 cases were enrolled,including 110 males and 76 females,with the mean age of(28±16)years. The data of gene mutation and specific clinical manifestations were available in 151 and 94 patients,respectively. The main clinical manifestations of KS included poikiloderma,occurrence of blister in childhood,and photosensitivity,and the secondary clinical manifestations included oral inflammation,palmoplantar keratoderma,webbing/pseudoainhum,dysphagia,urethral stricture and so on.Oral inflammation(