Risk Indicators of Periodontal Disease in Older Thai Adults

Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Journal of Periodontology (Impact Factor: 2.71). 05/2005; 76(4):558-65. DOI: 10.1902/jop.2005.76.4.558
Source: PubMed


The aim of this study was to identify risk indicators for periodontitis using cross-sectional data from a group of older Thai adults.
The study group consisted of 2,005 individuals, aged 50 to 73 years old. They received detailed medical examinations and periodontal examinations including plaque score, probing depth, and clinical attachment level. These individuals were categorized into mild, moderate, or severe periodontitis if mean clinical attachment level was <2.5 mm, 2.5 to 3.9 mm, or > or = 4.0 mm, respectively. The degree of association between the severity of periodontitis and various independent variables was investigated using multinomial logistic regression analysis.
The percentage of subjects classified as mild, moderate, and severe periodontitis was 30.5, 53.6, and 15.9, respectively. The prevalence of severe periodontitis was higher in males and increased with age. In univariate analysis, older subjects, males, less educated persons, persons with lower income, persons with higher plaque score, smokers, drinkers, and diabetics were more likely to have both moderate and severe periodontitis. In multivariate analysis, males, less educated persons, persons with higher plaque score, and current smokers were more likely to have moderate periodontitis. Three additional factors including older age, former smokers, and diabetes significantly increased the odds for having severe periodontitis. Income, alcohol consumption, body mass index, and waist circumference had no significant effects on periodontal disease severity in the multivariate model.
Our data suggest that age, gender, education, oral hygiene status, smoking, and diabetes are significantly associated with periodontal disease severity in this study group. Longitudinal studies will establish whether these variables are true risk factors.

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    • "Al-Zahrani et al., 2003 19 Borges et al., 2007 20 D'Aiuto et al., 2008 21 Dalla Vecchia et al., 2005 22 Dumitrescu; Kawamura, 2010 12 Ekuni et al., 2008 23 Furuta et al., 2010 24 Genco et al., 2005 7 Haffajee; Socransky, 2009 25 Han et al., 2009 13 Khader et al., 2009 14 Kongstad et al., 2009 17 Kumar et al., 2009 26 Kushiyama et al.,2009 18 Li et al., 2009 27 Linden et al., 2007 28 Lundin et al., 2004 29 Machado et al., 2005 30 Morita et al., 2009 31 Pitiphat et al., 2008 32 Saito et al., 2001 33 Saito et al., 2005 34 Saito, 2008 35 Saxlin et al. 2010 36 Saxlin et al., 2008 37 Shimazaki et al., 2007 38 Torrungruang et al., 2005 39 Wang et al., 2009 40 Wood et al., 2003 41 Wood; Johnson, 2008 42 Borges-Yáñez et al., 2006 "
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    ABSTRACT: The scope of this study was to conduct a systematic review of the studies on the association between obesity and periodontitis. The methods applied included a literature search strategy and selection of studies using inclusion and exclusion in accordance with the criteria for characteristics of the studies and meta-analysis. The research was conducted in the PubMed, Embase and Lilacs databases through 2010. Selected papers were on studies on humans investigating whether or not obesity is a risk factor for periodontitis. Of the 822 studies identified, 31 studies met the inclusion criteria and were included in this meta-analysis. The risk of periodontitis was associated with obesity (or had a tendency for this) in 25 studies, though it was not associated in 6 studies. The meta-analysis showed a significant association with obesity and periodontitis (OR = 1.30 [95% Confidence Interval (CI), 1.25 - 1.35]) and with mean Body Mass Index (BMI) and periodontal disease (mean difference = 2.75). Obesity was associated with periodontitis, however the risk factors that aggravate these diseases should be better clarified to elucidate the direction of this association. Working with paired samples and avoiding confusion factors may contribute to homogeneity between the studies.
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    • "Saito et al. first reported that obese Japanese subjects were more likely to have periodontal disease than thin subjects19. Although later studies supported the positive association between obesity and periodontitis202122, there are also studies showing no association between these two conditions23. While there are several epidemiological studies demonstrating this association, there are few reports on the mechanism linking obesity and periodontal diseases. "
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    ABSTRACT: Periodontitis has been implicated as a risk factor for metabolic disorders such as type 2 diabetes, atherosclerotic vascular diseases, and non-alcoholic fatty liver disease. Although bacteremias from dental plaque and/or elevated circulating inflammatory cytokines emanating from the inflamed gingiva are suspected mechanisms linking periodontitis and these diseases, direct evidence is lacking. We hypothesize that disturbances of the gut microbiota by swallowed bacteria induce a metabolic endotoxemia leading metabolic disorders. To investigate this hypothesis, changes in the gut microbiota, insulin and glucose intolerance, and levels of tissue inflammation were analysed in mice after oral administration of Porphyromonas gingivalis, a representative periodontopathogens. Pyrosequencing revealed that the population belonging to Bacteroidales was significantly elevated in P. gingivalis-administered mice which coincided with increases in insulin resistance and systemic inflammation. In P. gingivalis-administered mice blood endotoxin levels tended to be higher, whereas gene expression of tight junction proteins in the ileum was significantly decreased. These results provide a new paradigm for the interrelationship between periodontitis and systemic diseases.
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    • "In our study, low level of education, income and occupation were significantly associated with the prevalence of gingivitis, and the odds of having periodontitis increased in subjects with a low socioeconomic background. A higher prevalence of periodontitis among subjects with low education has been reported in Thailand.[14] In the USA, Borrell et al. (2006)[15] reported that subjects with less than high school education were three-times more likely to have periodontitis than subjects with a higher level of education. "
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    ABSTRACT: Periodontitis is a group of inflammatory diseases affecting the supporting tissues of the tooth. Both aggressive periodontitis (AP) and chronic periodontitis (CP) have a multifactorial etiology, with dental plaque as the initiating factor. However, the initiation and progression of periodontitis are influenced by other factors including microbiologic, social and behavioral and systemic and genetic factors. The prevalence of periodontal diseases varies in different regions of the world according to the definition of periodontitis and the study population, and there are indications that they may be more prevalent in developing than in developed countries. A cross-sectional study was conducted among the adolescents of 15-18 years of age in Mangalore City. One thousand one hundred students aged 15-18 years were selected for the study from the schools and colleges in Mangalore City using a convenient sampling method. The prevalence of AP and CP were assessed in the study using a community periodontal index. Students who were diagnosed clinically and radiographically were subjected to microbiological examination to confirm AP. A high prevalence of gingivitis and periodontitis was found in students belonging to the lower socioeconomic status group compared with the higher socioeconomic groups, which were associated with poor oral hygiene habits. The prevalence of AP was found to be 0.36% and that of CP was found to be 1.5%. Oral diseases have a significant impact on the social and psychological aspects of an individual's life. Exposure to risk factors, such as age, low socio-economic status, poor education, low dental care utilization, poor oral hygiene levels, smoking, psychosocial stress and genetic factors are significantly associated with an increased risk of periodontitis among adolescents. Although genetic factors play a major role in periodontitis, the treatment outcome will still be influenced by environmental and behavioral factors.
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