Associations of periodontal damage and tooth loss with atherogenic factors among patients with type 2 diabetes mellitus.
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OBJECTIVE: To clarify the associations of periodontal damage and tooth loss with atherogenic factors among diabetic patients. METHODS: We examined the correlations of age, sex, smoking, oral hygiene score, blood pressure, body mass index, and blood chemical data with the mean depth of periodontal pockets or the number of remaining teeth. PATIENTS: One hundred outpatients with type 2 diabetes aged 29 to 77 years. RESULTS: The mean depth of periodontal pockets was significantly associated with smoking, oral hygiene score, and HbA1c; the Spearman correlation coefficients (r) were 0.220, 0.417, and 0.260, respectively. Age, oral hygiene score, and HbA1c were inversely correlated with the number of remaining teeth (r=-0.306, -0.287, and -0.275, respectively). Serum total cholesterol was significantly correlated with the mean depth of pockets after adjustment for smoking, oral hygiene score, and HbA1c (r=0.211; P=0.044), while serum HDL cholesterol tended to be negatively associated with depth (r=-0.202; P=0.055). Serum HDL cholesterol was also associated with an increased number of teeth, which remained significant after adjustment for age, oral hygiene score, and HbA1c (r=0.202; P=0.048). The estimated glomerular filtration rate was significantly and positively correlated with the number of teeth in the univariate analysis, although consideration of the potential confounding factors somewhat weakened the association (r=0.186; P=0.069). CONCLUSIONS: We may expect better management of oral health in diabetic patients with control of dyslipidemia in addition to blood glucose. (+info)
Attitudes towards replacement of teeth among patients at the Institute of Dental Sciences, Belgaum, India.
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The purpose of this study was to assess the attitude towards replacement of teeth among patients who reported to the department of prosthodontics in the Institute of Dental Sciences, Belgaum, which is located in the northwestern part of the state of Karnataka in the southern region of India. A fourteen-item, closed-ended questionnaire was completed by 365 volunteer patients who were then examined by a clinician and existing and missing teeth were charted. All the patients who reported to a dental clinic in a period of two months with at least one missing tooth were included in the study. Collected data were statistically analyzed using chi-square test at a significance level of p<0.05. The age of the subjects ranged from sixteen to eighty-four years (mean age 51.06 +/-16.47 years). Among these 365 patients, 228 were in a waiting period for soft tissue healing after extraction of tooth/teeth; 19.7 percent of the patients gave financial constraints as the reason for not replacing teeth; 7.1 percent reported that they lacked the time to have teeth replaced; 6.9 percent had low felt needs; and 3.8 percent indicated they did not know that teeth could be replaced. Subjects with different levels of socioeconomic status reported different reasons for not replacing the teeth and these differences were statistically significant (chi(2)=61.16, P<0.001). Knowledge about the equivalence of artificial teeth with natural teeth (chi(2)=23.01, P<0.05) and problems with artificial teeth (chi(2)=17.25, P<0.05) were also significantly different among subjects from different socioeconomic categories. The findings indicate that awareness needs to be increased regarding the other functions of teeth like esthetics and phonetics because many subjects in this study were only aware of the function of mastication performed by teeth, especially among individuals in the lower socioeconomic group. Attitudes of patients should be taken into consideration to improve patient compliance with and acceptance of prostheses. (+info)
Cigarette smoking and tooth loss experience among young adults: a national record linkage study.
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BACKGROUND: Various factors affect tooth loss in older age including cigarette smoking; however, evidence regarding the association between smoking and tooth loss during young adulthood is limited. The present study examined the association between cigarette smoking and tooth loss experience among adults aged 20-39 years using linked data from two national databases in Japan. METHODS: Two databases of the National Nutrition Survey (NNS) and the Survey of Dental Diseases (SDD), which were conducted in 1999, were obtained from the Ministry of Health, Labor and Welfare with permission for analytical use. In the NNS, participants received physical examinations and were interviewed regarding dietary intake and health practices including cigarette smoking, whereas in the SDD, participants were asked about their frequency of daily brushing, and received oral examinations by certified dentists. Among 6,805 records electronically linked via household identification code, 1314 records of individuals aged 20 to 39 years were analyzed. The prevalence of 1+ tooth loss was compared among non-, former, and current smokers. Multiple logistic regression models were constructed including confounders: frequency of tooth brushing, body mass index, alcohol consumption, and intake of vitamins C and E. RESULTS: Smoking rates differed greatly in men (53.3%) and women (15.5%). The overall prevalence of tooth loss was 31.4% (31.8% men and 31.1% women). Tooth loss occurred more frequently among current smokers (40.6%) than former (23.1%) and non-smokers (27.9%). Current smoking showed a significant association with 1+ tooth loss in men (adjusted OR = 2.21 [1.40-3.50], P = 0.0007) and women (1.70 [1.13-2.55], P = 0.0111). A significant positive exposure-related relationship between cigarette smoking status and tooth loss was observed (P for trend < 0.0001 and 0.0004 in men and women, respectively). Current smoking was also associated with the prevalence of decayed teeth (1.67 [1.28-2.20], P = 0.0002). CONCLUSION: An association between cigarette smoking and tooth loss was evident among young adults throughout Japan. Due to limitations of the available variables in the present databases, further studies including caries experience and its confounders should be conducted to examine whether smoking is a true risk of premature tooth loss in young adults. (+info)
Patients' self-perceived impacts and prosthodontic needs at the time and after tooth loss.
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Studies on self-perception have demonstrated that tooth loss is associated with esthetic, functional, psychological and social impacts for individuals. However, not all subjects seek treatment immediately after tooth loss, even when desire for replacement is strongly expressed. The aim of this study was to evaluate the perception of patients submitted to tooth extraction about factors associated with tooth loss and prosthodontic treatment, at the time and after extraction. A convenience sample of 211 consecutive patients were clinically evaluated and answered to a questionnaire about perceived impacts and prosthodontic treatment needs. Data were collected at the time of extraction and after a 3-month time interval. Perceived impacts were high (21 to 76% at the time and 35 to 87% after extraction). From 72.5% patients who expressed intention of immediate replacement of edentulous spaces, only 8.1% had actually been treated. Financial limitation was considered the most important factor that restricted access to treatment. Bivariate statistical analysis showed association between immediate dental replacement and anterior tooth loss (p=0.00) and extension of edentulous space (p=0.01). Position of lost teeth was associated to perceived functional limitation (p=0.03). Worsened appearance was associated to tooth loss in the maxillary arch (p=0.02), and desire of prosthodontic treatment was associated to the extension of edentulous space (p=0.05). Perceived impacts were more frequent in women than men. It was concluded that although patients usually expressed prosthodontic treatment needs, clinical and financial issues are determinant factors for tooth replacement. (+info)
Trajectory patterns of dental caries experience in the permanent dentition to the fourth decade of life.
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Dental caries is a chronic, cumulative disease, but no studies have investigated longitudinal patterns of caries experience. The objective of this study was to identify and describe developmental trajectories of caries experience in the permanent dentition to age 32. Longitudinal caries data for 955 participants in a longstanding birth cohort study were analyzed by trajectory analysis. Three caries experience trajectories were identified by the SAS macro PROC TRAJ; these were categorized as "high" (approximately 15%), "medium" (approximately 43%), and "low" (approximately 42%) DMFS (Decayed, Missing, and Filled Surfaces). All were relatively linear, although the higher trajectories were more "S-shaped". This effect disappeared following adjustment for the number of unaffected surfaces remaining at each age, suggesting that, among individuals following a similar caries trajectory, caries rate is relatively constant across time. (+info)
Relationship between intake of vegetables, fruit, and grains and the prevalence of tooth loss in Japanese women.
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Epidemiological evidence regarding dental status and its relationship to diet and nutritional status has been limited. The present cross-sectional study examined the relationship between intake of vegetables, fruit, grains, antioxidants, and fiber and the prevalence of tooth loss. Study subjects were 1,002 pregnant Japanese women. Tooth loss was defined as the previous extraction of 1 or more teeth. Adjustment was made for age, gestation, parity, cigarette smoking, passive smoking at home and at work, family income, education, changes in diet in the previous 1 mo, season when data were collected, and body mass index. Of the 1,002 subjects, 256 women had lost 1 or more teeth. Compared with intake of vegetables other than green and yellow vegetables in the lowest quartile, consumption of the other vegetables in the highest quartile was independently associated with a decreased prevalence of tooth loss, showing a clear inverse dose-response relationship. There was a marginally significant inverse dose-response relationship between the intake of insoluble fiber and tooth loss. No association was observed between intake of green and yellow vegetables, soluble fiber, or antioxidant nutrients and tooth loss. These findings suggested that consumption of vegetables other than green and yellow vegetables and insoluble fiber may be related to a decreased prevalence of tooth loss among young Japanese women. (+info)
Age-dependent associations between chronic periodontitis/edentulism and risk of coronary heart disease.
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Dental caries in 6-12-year-old indigenous and non-indigenous schoolchildren in the Amazon basin of Ecuador.
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The purpose of this study was to evaluate the caries experience among 6-12-year-old indigenous (Naporunas) and non-indigenous (recent settlers of mixed ethnic origin) schoolchildren, living in the Amazon basin of Ecuador. Cross-sectional data were obtained from 1,449 clinical exams according to the World Health Organization criteria. Nine (7.6%) indigenous and 3 (4.5%) non-indigenous children had no caries experience in their primary dentition at the age of 6. The mean dmft value (SD) among indigenous and non-indigenous children aged 6 was 6.40 (3.36) and 8.36 (3.93), respectively. Sixty-four (54.2%) indigenous and 29 (43.3%) non-indigenous children had no caries experience in their permanent first molars at the age of 6. Only 7 (6.26%) indigenous and 2 (2.60%) non-indigenous children were caries-free at the age of 12. The mean DMFT values (SD) for 12-year-olds were 4.47 (2.85) among indigenous and 5.25 (2.89) among non-indigenous children. Fillings were almost non existent. Caries rates were high among both groups, with untreated carious lesions predominating in all ages. The data of indigenous children suggest adoption of a non-traditional diet. An appropriate oral health response based primarily on prevention and health promotion is needed. (+info)