Nutrition, dental caries and periodontal disease: a narrative review

Hujoel, Philippe P.; Lingström, Peter

doi:10.1111/jcpe.12672

Cited by 177 publications

(153 citation statements)

References 45 publications

(58 reference statements)

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“…Although there was not a statistically significant association between lesion depth and patient risk, it is interesting to note that persons at elevated risk had a high percentage of their lesions into dentin (67%; n=204), with small percentages of their SOCLs with no caries (3%; n=8), inactive caries (5%; n=16), or into the enamel only (25%; n=77). These findings are consistent with other studies that have shown that patients in elevated-risk categories are at greater risk for future caries and this is an important factor to consider when developing a treatment plan 32–33 . Our results suggest that patient risk influenced decisions to open lesions, as elevated-risk prevalence was higher among opened lesions (52%; n=305) than in the overall sample (35%; n=554).…”

Section: Discussionsupporting

confidence: 92%

Surface characteristics and lesion depth and activity of suspicious occlusal carious lesions

Makhija¹,

Shugars²,

Gilbert³

et al. 2017

The Journal of the American Dental Association

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Background A lesion on an occlusal tooth surface with no cavitation and no radiographic radiolucency, but where caries is suspected due to surface roughness, opacities, or staining can be defined as a suspicious occlusal carious lesion (SOCL). Our objective was to quantify the characteristics of SOCLs and their relationship to lesion depth/activity after surgically opening these lesions. Methods Ninety-three dentists participated. When consented patients presented with a SOCL, information was recorded about the tooth, lesion, treatment(s) done and, if the SOCL was opened surgically, its lesion depth. The Rao-Scott cluster-adjusted chi-square test was used to evaluate associations between lesion depth and color, roughness, patient risk, and luster. Results 1593 SOCLs were analyzed. Lesion color varied from yellow/light brown (40%) to dark brown/black (47%), with 13% other color. A majority (69%) of SOCLs had a rough surface when examined with an explorer. Over 1/3 of the SOCLs (39%) were treated surgically. Of the surgically treated SOCLs (n=585), 61% had dentinal caries. There were statistically significant associations between lesion depth and color (p=0.03), luster (p=0.04) and roughness (p=0.01). 52% of patients were classified as being at elevated caries risk. There were no significant associations between lesion depth and patient risk (p=0.07). Conclusion Although statistically significant, the clinical characteristics studied do not provide accurate guidance for making definitive treatment decisions, and result in high rates of false positives. Practical implications Given that 39% of opened lesions did not have dentinal caries or were inactive, evidence-based preventive management is an appropriate alternative to surgical intervention.

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Section: Discussionsupporting

confidence: 92%

Surface characteristics and lesion depth and activity of suspicious occlusal carious lesions

Makhija¹,

Shugars²,

Gilbert³

et al. 2017

The Journal of the American Dental Association

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“…Given prior reports of the ineffectiveness of vitamin D in caries prevention, among girls after the age of 13 due to the influence of fat on the effectiveness of a fat‐soluble vitamin like vitamin D, we expected the association between vitamin D and caries experience to differ by gender but this was not the case. Furthermore, our findings suggesting that deficient levels (<30 nmol/L) of vitamin D may pose a greater concern for caries experience than inadequate (30‐<50 nmol/L) levels, should be taken with caution given these associations were modest and imprecisely estimated.…”

Section: Discussionmentioning

confidence: 99%

“…18 Hypoplastic enamel promotes adherence and colonization of the tooth surface by cariogenic bacteria. 19 It has been suggested that caries susceptibility even after tooth eruption may be influenced by micronutrients like vitamin D. 20 Several studies have previously reported inverse associations between serum vitamin D levels and childhood caries, [21][22][23] and systematic reviews of controlled clinical trials found probable evidence for supplemental vitamin D use among children on lower dental caries occurrence. 24,25 However, none have specifically investigated serum vitamin D concentrations and dental caries experience among adolescents.…”

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confidence: 99%

Serum cotinine, vitamin D exposure levels and dental caries experience in U.S. adolescents

Akinkugbe

Moreno

Brickhouse

2018

Comm Dent Oral Epid

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Introduction Epidemiologic studies of risk and protective factors for poor oral health have mostly been among children and adults, seldom focusing on adolescents. The aims of this study were to examine whether serum cotinine, a marker of tobacco exposure, and serum vitamin D are independently associated with dental caries experience among adolescents. Methods Cross‐sectional data from 2579 adolescent participants in the 2005‐2008 National Health and Nutritional Examination Survey were analysed. The exposures, cotinine and vitamin D, were measured in serum while dental caries experience was determined by screening examination, and a case defined as having ≥1 decayed or filled teeth. Survey‐adjusted logistic regression estimated prevalence odds ratios (POR) and 95% confidence intervals (CI) between the respective exposures and outcome. Results The overall median (IQR) serum cotinine level was 0.15 ng/mL (0.04, 1.80) while the mean (SE) serum vitamin D concentration was 68.2 nmol/L (1.36). In contrast to participants with serum cotinine ≤3 ng/L, those with levels >3 ng/L had covariate‐adjusted estimate of 1.69 (1.16, 2.47) for caries experience. Each additional mean (ng/L) serum cotinine level was associated with an 8% (95% CI = 1.01, 1.16) greater adjusted prevalence odds of having caries experience. In contrast to participants with vitamin D ≥ 50 nmol/L, those with levels of30‐ < 50 nmol/L and <30 nmol/L had non‐statistically significant adjusted estimates of 1.02 (0.72, 1.44) and 1.23 (0.70, 2.16) respectively for caries experience. Conclusions Serum cotinine is associated with dental caries experience among adolescents and while deficient (<30 nmol/L) levels of vitamin D appear to be associated with greater prevalence odds of caries experience, this association is inconclusive.

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“…It is substantially, but not entirely, based upon one systematic review of the available and published evidence relating to genetic risk factors for periodontal diseases and caries (Nibali et al 2017), one narrative review on the role of diet and nutrition in development and progression of periodontal diseases and caries (Hujoel & Lingstrom 2017), and reference documentation provided on common modifiable risk factors common to both disease groups. Evidence for the role of genetic factors in periodontal diseases initially emerged from familial aggregation studies (Saxen 1980, van der Velden et al 1993 and from studies of twins reared together and apart (Michalowicz et al 1991).…”

Section: Inherited and Acquired Risk Factors For Dental Caries And Pementioning

confidence: 99%

Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases

Chapple

Bouchard

Cagetti

et al. 2017

J Clinic Periodontology

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388

369

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Periodontal diseases and dental caries are the most common diseases of humans and the main cause of tooth loss. Both diseases can lead to nutritional compromise and negative impacts upon self‐esteem and quality of life. As complex chronic diseases, they share common risk factors, such as a requirement for a pathogenic plaque biofilm, yet they exhibit distinct pathophysiologies. Multiple exposures contribute to their causal pathways, and susceptibility involves risk factors that are inherited (e.g. genetic variants), and those that are acquired (e.g. socio‐economic factors, biofilm load or composition, smoking, carbohydrate intake). Identification of these factors is crucial in the prevention of both diseases as well as in their management. Aim To systematically appraise the scientific literature to identify potential risk factors for caries and periodontal diseases. Methods One systematic review (genetic risk factors), one narrative review (role of diet and nutrition) and reference documentation for modifiable acquired risk factors common to both disease groups, formed the basis of the report. Results & Conclusions There is moderately strong evidence for a genetic contribution to periodontal diseases and caries susceptibility, with an attributable risk estimated to be up to 50%. The genetics literature for periodontal disease is more substantial than for caries and genes associated with chronic periodontitis are the vitamin D receptor (VDR), Fc gamma receptor IIA (Fc‐γRIIA) and Interleukin 10 (IL10) genes. For caries, genes involved in enamel formation (AMELX, AMBN, ENAM, TUFT, MMP20, and KLK4), salivary characteristics (AQP5), immune regulation and dietary preferences had the largest impact. No common genetic variants were found. Fermentable carbohydrates (sugars and starches) were the most relevant common dietary risk factor for both diseases, but associated mechanisms differed. In caries, the fermentation process leads to acid production and the generation of biofilm components such as Glucans. In periodontitis, glycaemia drives oxidative stress and advanced glycation end‐products may also trigger a hyper inflammatory state. Micronutrient deficiencies, such as for vitamin C, vitamin D or vitamin B12, may be related to the onset and progression of both diseases. Functional foods or probiotics could be helpful in caries prevention and periodontal disease management, although evidence is limited and biological mechanisms not fully elucidated. Hyposalivation, rheumatoid arthritis, smoking/tobacco use, undiagnosed or sub‐optimally controlled diabetes and obesity are common acquired risk factors for both caries and periodontal diseases.

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Nutrition, dental caries and periodontal disease: a narrative review

Cited by 177 publications

References 45 publications

Surface characteristics and lesion depth and activity of suspicious occlusal carious lesions

Surface characteristics and lesion depth and activity of suspicious occlusal carious lesions

Serum cotinine, vitamin D exposure levels and dental caries experience in U.S. adolescents

Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases

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