Tooth loss is a complex measure of oral disease: Determinants and methodological considerations

Haworth, Simon; Shungin, Dmitry; Kwak, So Young; Kim, Hae Young; West, Nicola; Thomas, Steven J.; Franks, Paul W.; Timpson, Nicholas J.; Shin, Min Jeong; Johansson, Ingegerd

doi:10.1111/cdoe.12391

Cited by 68 publications

(64 citation statements)

References 36 publications

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“…Here, DMFS/dentures is described as a measure of dental caries. This measure might capture some variation in periodontal status, as periodontitis is a major cause of tooth loss 49 . Conversely, we note that the SIGLEC5 periodontitis risk locus is not a main finding for DMFS/dentures and that there is little evidence for heterogeneity in DMFS effect sizes between periodontal cases and controls, supporting the idea that the two primary meta-analyses capture distinct dental diseases.…”

Section: Discussionmentioning

confidence: 99%

Genome-wide analysis of dental caries and periodontitis combining clinical and self-reported data

et al. 2019

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Dental caries and periodontitis account for a vast burden of morbidity and healthcare spending, yet their genetic basis remains largely uncharacterized. Here, we identify self-reported dental disease proxies which have similar underlying genetic contributions to clinical disease measures and then combine these in a genome-wide association study meta-analysis, identifying 47 novel and conditionally-independent risk loci for dental caries. We show that the heritability of dental caries is enriched for conserved genomic regions and partially overlapping with a range of complex traits including smoking, education, personality traits and metabolic measures. Using cardio-metabolic traits as an example in Mendelian randomization analysis, we estimate causal relationships and provide evidence suggesting that the processes contributing to dental caries may have undesirable downstream effects on health.

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Section: Discussionmentioning

confidence: 99%

Genome-wide analysis of dental caries and periodontitis combining clinical and self-reported data

et al. 2019

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“…Additionally, dental restorative work (eg, fillings, crowns, dentures, and extractions) is known to inflate measures of dental caries burden compared with what would be measured among “untreated” individuals . Finally, and similar to studies of periodontitis, tooth loss and its cause (ie, dental caries, periodontitis, orthodontic reasons, trauma, or congenitally missing) may not always be discernable and will probably vary between populations and study samples Key points: Genome‐wide association evidence of dental caries is still limited, but a few promising and plausible candidates with corroborating evidence have been reported.…”

Section: Genomics Of Traditional Clinical Definitions Of Oral and Denmentioning

confidence: 99%

“…74 Finally, and similar to studies of periodontitis, tooth loss and its cause (ie, dental caries, periodontitis, orthodontic reasons, trauma, or congenitally missing) may not always be discernable and will probably vary between populations and study samples. 58 Key points: Genome-wide association evidence of dental caries is still limited, but a few promising and plausible candidates with corroborating evidence have been reported. A recent, large-scale, consortium meta-analysis identified many loci associated with dental caries, providing a rich resource of candidates to be followed-up in subsequent investigations.…”

Section: Dental Cariesmentioning

confidence: 99%

Genomics of periodontal disease and tooth morbidity

Morelli

Agler

Divaris

2019

Periodontology 2000

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In this review we critically summarize the evidence base and the progress to date regarding the genomic basis of periodontal disease and tooth morbidity (ie, dental caries and tooth loss), and discuss future applications and research directions in the context of precision oral health and care. Evidence for these oral/dental traits from genome‐wide association studies first emerged less than a decade ago. Basic and translational research activities in this domain are now under way by multiple groups around the world. Key departure points in the oral health genomics discourse are: (a) some heritable variation exists for periodontal and dental diseases; (b) the environmental component (eg, social determinants of health and behavioral risk factors) has a major influence on the population distribution but probably interacts with factors of innate susceptibility at the person‐level; (c) sizeable, multi‐ethnic, well‐characterized samples or cohorts with high‐quality measures on oral health outcomes and genomics information are required to make decisive discoveries; (d) challenges remain in the measurement of oral health and disease, with current periodontitis and dental caries traits capturing only a part of the health‐disease continuum, and are little or not informed by the underlying biology; (e) the substantial individual heterogeneity that exists in the clinical presentation and lifetime trajectory of oral disease can be identified and leveraged in a precision medicine framework or, if unappreciated, can hamper translational efforts. In this review we discuss how composite or biologically informed traits may offer improvements over clinically defined ones for the genomic interrogation of oral diseases. We demonstrate the utility of the results of genome‐wide association studies for the development and testing of a genetic risk score for severe periodontitis. We conclude that exciting opportunities lie ahead for improvements in the oral health of individual patients and populations via advances in our understanding of the genomic basis of oral health and disease. The pace of new discoveries and their equitable translation to practice will largely depend on investments in the education and training of the oral health care workforce, basic and population research, and sustained collaborative efforts..

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“…Inquéritos epidemiológicos. socioeconomic groups 10 . Marked social inequalities are commonly found in oral conditions 11,12 in different age groups 9 .…”

Section: Introductionmentioning

confidence: 99%

Income inequalities in oral health and access to dental services in the Brazilian population: National Health Survey, 2013

Bastos

Medina

Sousa

et al. 2019

Rev. bras. epidemiol.

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Introduction: Despite the improvement in oral health conditions observed in the Brazilian population, there are still high social inequalities that must be monitored. Objective: To evaluate income inequality in oral hygiene practices, oral health status and the use of dental services in the adult and senior Brazilian population. Methods: Data from the National Health Survey conducted in 2013 (Pesquisa Nacional de Saúde - PNS 2013) were used for the population aged 18 years old or older. Results: Inequalities were found among the income strata in most of the oral health indicators evaluated. The greatest inequalities were observed in the use of dental floss, in hygiene practices (PR = 2.85 in adults and PR = 2.45 in seniors), and in total tooth loss (PR = 6.74 in adults and PR = 2.24 in seniors) and difficulty in chewing (PR = 4.49 in adults and PR = 2.67 in seniors) among oral condition indicators. The magnitude of inequalities was high in both groups in most oral condition indicators. Income was a factor that persisted in limiting access to dental services, and even the lower income segments had high percentages that paid for dental consultations. Conclusion: Based on data from the first PNS, the findings of this study enabled the identification of oral health and dental care aspects more compromised by income differentials, thus, contributing to the planning of dental care in Brazil and to stimulate the monitoring of these disparities with data from future surveys.

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Tooth loss is a complex measure of oral disease: Determinants and methodological considerations

Cited by 68 publications

References 36 publications

Genome-wide analysis of dental caries and periodontitis combining clinical and self-reported data

Genome-wide analysis of dental caries and periodontitis combining clinical and self-reported data

Genomics of periodontal disease and tooth morbidity

Income inequalities in oral health and access to dental services in the Brazilian population: National Health Survey, 2013

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