Periodontitis may predict the use of prescription medicines later in life, a database study (original) (raw)
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Association between periodontitis and systemic medications intake: A case-control study
Journal of Periodontology, 2020
Background: To investigate the frequency of systemic drugs taken by elderly patients with or without periodontitis and the possible association between medication consumption and the severity of periodontitis. Methods: A total of 1221 patients, including 608 with generalized moderate to severe periodontitis (periodontitis group) and 613 age-and gender-matched individuals with healthy periodontium (healthy group) were selected. Systemic conditions, medications and periodontal status were recorded. Medication intake frequency (%) was compared using unconditional logistic regression. Results: The top three most common medications were angiotensin-converting enzyme (ACE) inhibitors (17.9%), antidepressants (17.8%), and lipid-lowering medications (16.5%). Both ACE inhibitors and antidepressants showed statistically higher intake frequency in the periodontitis group relative to healthy controls (21.5% versus 14.4%; odds ratio [OR] = 1.64), (21.1% versus 14.5%, OR = 1.57) (P < 0.01). Additionally , intake of oral hypoglycemic agents, calcium channel blockers (CCB), insulin, and diuretics were significantly higher in the periodontitis group with OR = 2.49, 2.32, 2.08 and 1.79, respectively (P < 0.05). Several medications demonstrated a disease severity-dependent association comparing generalized severe periodontitis with moderate periodontitis and healthy group: oral hypoglycemic agents (17.4% versus 16.8% versus 8.0%), CCB (14.8% versus 14.4% versus 8.0%) and anticonvulsants (13.4% versus 7.7% versus 6.4%) with OR of 2.43, 1.99, and 2.28 (severe periodontitis versus healthy group), respectively. Conclusion: There was a significantly higher frequency of medication intake related to cardiovascular disease and diabetes in patients with periodontitis. A disease severity-dependence with medication intake frequency was also noted. This study provides indirect evidence for the possible relationship between systemic diseases and periodontitis. K E Y W O R D S cardiovascular diseases, diabetes mellitus, drug therapy, periodontitis J Periodontol. 2020;00:1-11.
2021
OBJECTIVE: This case-control study was conducted to analyze the association of periodontitis with risk indicators i.e. age, gender, education status, brushing habits and past dental visits in systemically healthy patients. METHODS: The study included total of 1097 systemically healthy, non-tobacco using patients with age ≥ 18 years that reported to periodontology department from year 2018. The demographic details and dental care pattern of the patients were extracted from the records of periodontology department, and their frequencies were formulated. The association of five study variables i.e. age, gender, education status, brushing habits and past dental visits was assessed using forward step-wise logistic regression analysis. RESULTS: Total of 471(42.9%) patients were diagnosed with periodontitis. Higher frequency of periodontitis was observed in patients who were male and ≥ 50 years of age. Regression analysis showed that the subjects with < 50 years of age, ≥ 12 years of ed...
Impact of Periodontitis Case Criteria: A Cross-Sectional Study of Lifestyle
Journal of Periodontology, 2017
N.B. Johanne Kongstad and Christian Enevold contributed equally to the study Background: Associations of risk factors/indicators with periodontitis may depend on the included case criterion. The objective was to evaluate differences in outcome by applying five periodontitis case definitions for crosssectional associations with lifestyle factors among participants of The Danish Health Examination Survey (DANHES). Methods: A total of 4,402 adults aged 18-96 years from the general health examination of DANHES had a periodontal examination consisting of half-mouth registration at 6 sites per tooth including probing pocket depth (PPD) and clinical attachment level (CAL). Periodontitis was defined according to severe periodontitis, EWP-specific, meanCAL≥2.55mm, CAL-tertile, and PPD-CAL definition. Multivariable logistic regression models fitted the association of age, gender, smoking status, diabetes, educational level, alcohol consumption, body mass index, physical activity, body fat percentage, waist circumference, triglycerides, total cholesterol, and C-reactive protein with periodontitis. Results: Number of cases captured by the five periodontitis case definitions ranged from 337 (9.2%) to 1,136 (31.0%). A total of, 224 participants were defined as periodontitis cases by all five criteria. Analyses on 3,665 participants with complete data revealed statistically significant associations of age and smoking with all periodontitis case definitions and of male gender with Severe periodontitis and EWP specific definitions. Educational level (two lowest groups) was related to three periodontitis criteria. Among obesity and hyperlipidemia measures no factors were related to periodontitis. Conclusion: Regression analyses showed little difference in OR across the five periodontitis case definitions, however, the level of significance did show some variation.
Is there a relationship between periodontal conditions and number of medications among the elderly?
Ghana Medical Journal, 2016
Objective: To investigate possible correlations of clinical attachment level and pocket depth with number of medications in elderly individuals. Methods: Intra-oral examinations for 139 patients visiting Tufts dental clinic were done. Periodontal assessments were performed with a manual UNC-15 periodontal probe to measure probing depth (PD) and clinical attachment level (CAL) at 6 sites. Complete lists of patients' medications were obtained during the examinations. Statistical analysis involved Kruskal-Wallis, chi square and multivariate logistic regression analyses. Results: Age and health status attained statistical significance (p< 0.05), in contingency table analysis with number of medications. Number of medications had an effect on CAL: increased attachment loss was observed when 4 or more medications were being taken by the patient. Number of medications did not have any effect on periodontal PD. In multivariate logistic regression analysis, 6 or more medications had a higher risk of attachment loss (>3mm) when compared to the no-medication group, in crude OR (1.20, 95% CI:0.22-6.64), and age adjusted (OR=1.16, 95% CI:0.21-6.45), but not with the multivariate model (OR=0.71, 95% CI:0.11-4.39). Conclusion: CAL seems to be more sensitive to the number of medications taken, when compared to PD. However, it is not possible to discriminate at exactly what number of drug combinations the breakdown in CAL will happen. We need to do further analysis, including more subjects, to understand the possible synergistic mechanisms for different drug and periodontal responses.
2021
AIMS: This case-control study was conducted to analyze the association of periodontitis with risk predictors i.e. education status, brushing habits and past dental visits in systemically healthy patients. MATERIALS AND METHODS: A total of 1097 systemically healthy, non-tobacco using patients with age ≥18 years who reported to periodontology department were included. The demographic details and dental care pattern of the patients were extracted from the records of periodontology department and their frequencies were formulated. The association of three predicting factors i.e. education status, brushing habits and past dental visits was assessed on SPSS using binary logistic regression analysis. RESULTS: A total of 471(42.9%) patients were diagnosed with periodontitis. Higher frequency of periodontitis was observed in patients who were male and >50 years of age. Subjects with ≥ 12 years of education, regular brushing habits and regular past dental visits showed greater odds of bein...
2021
Background: In Norway, dental care services are mostly paid for privately by the individuals themselves. Periodontitis is a gum disease requiring ongoing treatment creating a potential economic burden for the patient. Periodontitis is irreversible, but preventable, and the prevalence is unknown. The disease is the primary cause of tooth loss in the adult population. Regarding screening for periodontitis, there are disagreements on the appropriate starting age and economic evaluations appear to be lacking. Objective: To assess the cost-effectiveness of screening for periodontitis compared with today’s practice in 60 year old individuals, over a lifetime horizon. Methods: A state transition Markov model was developed to assess changes in costs and quality-adjusted tooth years (QATYs) by a hypothetical screening intervention for periodontitis. There is limited available literature on the progression of periodontal disease, and no available data on the utility associated with the diseas...
Brazilian Oral Research, 2020
In view of the epidemiological relevance of periodontal disease and chronic noncommunicable diseases, the study aimed to evaluate the relationship between them through subclinical indicators of systemic risk in a population group with healthy habits, including alcohol and tobacco abstinence. A complete periodontal examination of six sites per tooth was performed in a sample of 420 participants from the Advento study (Sao Paulo), submitted to anthropometric and laboratory evaluation. Periodontitis was defined and classified based on the Community Periodontal Index score 3 (periodontal pocket = 4-5 mm) and score 4 (periodontal pocket ≥ 6 mm). The prevalence of mild/ moderate and severe periodontitis was 20% and 8.2%, respectively. Both categories of periodontal disease had significantly higher levels of triglycerides, C-reactive protein, calcium score, and calcium percentile, whereas blood glucose after tolerance test was significantly higher among people with severe periodontitis and HDL-c levels were lower (p < 0.05). Young adults with severe periodontitis had significantly higher prevalence of obesity, pre-diabetes, hypertension, and metabolic syndrome. Besides these conditions, the older adults with severe periodontitis had significantly higher prevalence of dyslipidemia and subclinical atherosclerosis. The group with periodontitis had also a higher coronary heart disease risk based on the PROCAM score (p < 0.05). The results indicated associations of periodontitis with several systemic indicators for chronic noncommunicable diseases, and highlighted the need for multiprofessional measures in the whole care of patients.
BMJ Open
ObjectivesTo identify the association between periodontal diseases (gingivitis and periodontitis) and chronic diseases including cardiovascular disease, cardiometabolic disease, autoimmune disease and mental ill health.DesignRetrospective cohort.SettingIQVIA Medical Research Data-UK between 1 January 1995 and 1 January 2019.Participants64 379 adult patients with a general practitioner recorded diagnosis of periodontal disease (exposed patients) were matched to 251 161 unexposed patients by age, sex, deprivation and registration date.Main outcome measuresLogistic regression models accounting for covariates of clinical importance were undertaken to estimate the adjusted OR (aOR) of having chronic diseases at baseline in the exposed compared with the unexposed group. Incidence rates for each outcome of interest were then provided followed by the calculation of adjusted HRs using cox regression modelling to describe the risk of outcome development in each group.ResultsThe average age at...
Comorbidity of periodontal disease: two sides of the same coin? An introduction for the clinician
Journal of oral microbiology, 2017
Increasing evidence has suggested an independent association between periodontitis and a range of comorbidities, for example cardiovascular disease, type 2 diabetes, rheumatoid arthritis, osteoporosis, Parkinson's disease, Alzheimer's disease, psoriasis, and respiratory infections. Shared inflammatory pathways are likely to contribute to this association, but distinct causal mechanisms remain to be defined. Some of these comorbid conditions may improve by periodontal treatment, and a bidirectional relationship may exist, where, for example, treatment of diabetes can improve periodontal status. The present article presents an overview of the evidence linking periodontitis with selected systemic diseases and calls for increased cooperation between dentists and medical doctors to provide optimal screening, treatment, and prevention of both periodontitis and its comorbidities.