The role of physiological markers of health in the association between demographic factors and periodontal disease

Abstract

Objectives This study examines whether the association between periodontal disease and demographic factors is mediated by physiological measures of health. Background Age is highly related to oral health status. The higher prevalence of oral disease within sub-groups of the population may reflect a tendency towards “early aging” and dysregulation of multiple physiological systems. Methods Logistic regression was used to examine whether biomarkers and demographic factors, such as SES and race/ethnicity, were associated with periodontal disease, and then whether the strength of these relationships could be attributed to associations between demographic variables and physiological measures of systemic health. Results Periodontal disease was associated with measures of SES and race/ethnicity. Furthermore, one unit increases in CMV optical density, CRP, and HbA1c were associated with a 25% (OR=1.25; 95% CI: 1.14–1.36), 13% (OR: 1.13; 95% CI: 1.03–1.24), and 19% (OR: 1.19; 95% CI: 1.12–1.27) increased likelihood of periodontal disease, respectively. However, when biomarkers and sociodemographic variables were both included in the model, their associations with periodontal disease were significantly reduced or eliminated. Conclusions The risk of periodontal disease is higher among blacks and/or low income individuals; however, these associations appear to be partly due to the greater probability of elevated levels of CRP, CMV, or HbA1c among these groups.

Expression of Concern: Role of cytokines in development of pre‐eclampsia associated with periodontal disease – Cohort Study

“…In contrast, a study by Levine et al. () reported that the risk of periodontal disease is higher among black and/or low‐income individuals (Levine et al. ).…”

“…() reported that the risk of periodontal disease is higher among black and/or low‐income individuals (Levine et al. ). A study from France reported that tooth decay was statistically associated with lower age (OR = 1.58, 95% CI [1.03, 2.45]) and lower educational level (OR = 1.53, 95% CI [1.06, 2.23]) (Vergnes et al.…”

Socioeconomic Inequalities in Oral Health among Middle-Aged and Elderly Japanese: NIPPON DATA2010

“…Furthermore, the remaining associations indicate that these factors are insufficient to explain these inequalities, which is consistent with the findings of previous studies using health behaviors 6 – 8 , 10 and physiological markers. 9 These results suggest the presence of more complex determinants of oral health inequalities and imply that the elimination of oral health inequalities necessitates the development of strategies that look beyond proximal causes, such as early-life unequal exposure to risk factors. 31 …”

Periodontal herpesviruses: prevalence, pathogenicity, systemic risk

“…Levine et al. found that the cytomegalovirus serum antibody level in the USA was highest in low‐income individuals and higher in non‐Hispanic black subjects than in white subjects, and was predictive of periodontal disease.…”