Refining definitions of periodontal disease and caries for prediction models of incident tooth loss

Houshmand, Mohammad; Holtfreter, Birte; Berg, Marie; Schwahn, Christian; Meisel, Peter; Biffar, Reiner; Kindler, Stefan; Kocher, Thomas

doi:10.1111/j.1600-051x.2012.01892.x

Cited by 19 publications

(21 citation statements)

References 42 publications

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“…Our analysis revealed that the severity of atherosclerosis is linearly related to tooth loss, which often results from the breakdown of periodontal tissue caused by periodontal disease. As tooth loss is a marker of current and long-term cumulative effects of periodontal disease (Desvarieux et al 2003;Houshmand et al 2012), our findings suggest that periodontal disease may play a role in the pathogenesis of atherosclerosis progression. In this study, we excluded noninflammatory reasons for tooth loss such as traumatic or orthodontic procedures, because we considered that noninflammatory tooth loss may bias the association between tooth loss and CAVI.…”

Section: Discussionmentioning

confidence: 95%

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Tooth Loss and Atherosclerosis

et al. 2014

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Several epidemiologic studies have suggested that oral disease is a risk factor for cardiovascular disease (CVD). However, whether a clinically significant association exists between the 2 disorders remains controversial. Here, we investigated the association between tooth loss, as an indicator of oral disease, and arterial stiffness, as a marker of atherosclerosis, in Japanese adults. Cross-sectional data were collected for 8,124 persons aged 30 to 75 y with no history of tooth loss for noninflammatory reasons, such as orthodontic treatment, malposition, and trauma. Participants received a comprehensive dental examination and extensive in-person measurements of CVD risk factors, and arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI). We examined the association between CAVI and tooth loss using general linear models with adjustment for age, sex, body mass index, smoking status, hemoglobin A1c, and a history of insulin or hypoglycemic medication depending on the model. In addition, we performed an analysis that included interaction terms of the centered variables tooth loss, sex, and age. The results of the multiple regression analysis that included the interaction terms detected that the relationship between CAVI and tooth loss was dependent on sex, with only men showing a positive correlation (β for interaction = 0.04; 95% confidence interval, 0.02–0.06). The findings from this study suggest that a linear relationship exists between tooth loss and degree of arterial stiffness and that the association differed depending on sex.

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Section: Discussionmentioning

confidence: 95%

“…Oral disease, such as periodontal disease, is characterized by chronic systemic inflammation and often results in tooth loss due to the breakdown of periodontal tissue. Therefore, tooth loss is a useful proxy for the accumulated burden of inflammatory disease (Desvarieux et al 2003;Houshmand et al 2012).…”

Section: Introductionmentioning

confidence: 99%

Tooth Loss and Atherosclerosis

et al. 2014

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“…It is interesting to note that while there was no correlation between CCAP and periodontal bone loss, the number of teeth present was significantly higher in patients without CCAP (p-value<0.001). Periodontal disease as an etiology for tooth loss has been documented in the literature 51. The lack of correlation between periodontal bone loss and CCAP in our study could possibly be related to how periodontitis was defined, as other studies have primarily used clinical attachment loss and increased probing depth, while we used radiographic assessment only.…”

Section: Discussionmentioning

confidence: 79%

Coincidence of calcified carotid atheromatous plaque, osteoporosis, and periodontal bone loss in dental panoramic radiographs

2013

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PurposeThis study was performed to assess the correlation of calcified carotid atheromatous plaque (CCAP), the mandibular cortical index, and periodontal bone loss in panoramic radiographs.Materials and MethodsOne hundred eighty-five panoramic radiographs with CCAP and 234 without this finding were evaluated by 3 observers for the presence of osseous changes related to osteoporosis and periodontal bone loss. Chi-squared and Mann-Whitney U tests were used to compare the two groups for an association of CCAP with the mandibular cortical index and periodontal bone loss, respectively.ResultsThere was a statistically significant coincidence of CCAP and osseous changes related to osteopenia/osteoporosis, with a p-value <0.001. There was no statistically significant coincidence of CCAP and periodontal bone loss. When comparing the 2 groups, "With CCAP" and "Without CCAP", there was a statistically significant association with the mean body mass index (BMI), number of remaining teeth, positive history of diabetes mellitus, and vascular accidents. There was no statistically significant association with gender or a history of smoking.ConclusionThis study identified a possible concurrence of CCAP and mandibular cortical changes secondary to osteopenia/osteoporosis in panoramic radiographs. This could demonstrate the important role of dental professionals in screening for these systemic conditions, leading to timely and appropriate referrals resulting in early interventions and thus improving overall health.

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“…A study that compared several definitions of periodontal disease for predicting 5‐year tooth loss events suggested that prediction models need to be gender‐ and age‐specific, while mean CAL was the best definition to assess incident tooth loss. However, tooth loss and periodontal assessment in that study were restricted to half‐mouth examinations .…”

Section: Discussionmentioning

confidence: 99%

“…Healthy People 2020 includes a goal to reduce complete tooth loss by 10 percent (to 21.6 percent) among this age group . However, there are few models available to target interventions among individuals at high‐risk for tooth loss .…”

Section: Introductionmentioning

confidence: 99%

Racial differences in periodontal disease and 10‐year self‐reported tooth loss among late middle‐aged and older adults: the dental ARIC study

Naorungroj

Slade

Divaris

et al. 2017

J Public Health Dent

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Objective To investigate racial differences in the associations between periodontitis and 10-year self-reported incident tooth loss in a biracial, community-based cohort of U.S. late middle-aged and older adults. Methods Subjects were 3,466 dentate men and women aged 53–74 who underwent dental examinations from 1996 to 1998. In 2012–2013, telephone interviewers asked participants about tooth loss in the preceding 10 years. Separate multivariable ordinal logistic regression models were used to calculate proportional odds ratios (OR) and 95% confidence intervals (CI) as estimates of association between periodontitis and tooth loss for Whites and African-Americans (AAs). Results The majority of participants were White (85%) and female (57%) with 23 teeth on average at enrollment. Approximately half the Whites (56%) and AAs (49%) had periodontitis. At follow-up, approximately 44% of AAs and 38% of Whites reported having lost ≥ 1 tooth. In multivariable models, severe periodontitis (OR = 3.03; 95% CI= 2.42–3.80) and moderate periodontitis (OR = 1.64; 95% CI= 1.39–1.94) were significant risk factors of incident tooth loss among Whites. For AAs, severe but not moderate periodontitis increased the odds of incident tooth loss (OR = 2.22; 95% CI = 1.37–3.59). In the final model, education was inversely associated with incident tooth loss among AAs, while lower income was associated with greater odds of tooth loss among Whites. Conclusions In this population-based cohort, there is racial heterogeneity in the association between periodontitis and tooth loss. Interventions to reduce the impact of periodontitis on tooth loss need to consider these differences.

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Refining definitions of periodontal disease and caries for prediction models of incident tooth loss

Abstract: Caries parameters best predicted incident tooth loss in men aged 20-39 years; in the intermediate and oldest age group and in young women, mean AL was most informative. Therefore, prediction models need to be developed for different age and gender groups.

Cited by 19 publications

References 42 publications

Tooth Loss and Atherosclerosis

Tooth Loss and Atherosclerosis

Coincidence of calcified carotid atheromatous plaque, osteoporosis, and periodontal bone loss in dental panoramic radiographs

Racial differences in periodontal disease and 10‐year self‐reported tooth loss among late middle‐aged and older adults: the dental ARIC study

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