Triclosan (TCS) is an antimicrobial used so ubiquitously that 75% of the US population is likely exposed to this compound via consumer goods and personal care products. In September 2016, TCS was banned from soap products following the risk assessment by the US Food and Drug Administration (FDA). However, TCS still remains, at high concentrations, in other personal care products such as toothpaste, mouthwash, hand sanitizer, and surgical soaps. TCS is readily absorbed into human skin and oral mucosa and found in various human tissues and fluids. The aim of this review was to describe TCS exposure routes and levels as well as metabolism and transformation processes. The burgeoning literature on human health effects associated with TCS exposure, such as reproductive problems, was also summarized.

Triclosan exposure, transformation, and human health effects.

Objectives. This paper aims to review the evidence on the potential roles of modifiable and nonmodifiable risk factors associated with periodontal disease. Data. Original articles that reported on the risk factors for periodontal disease were included. Sources. MEDLINE (1980 to Jan 2014), PubMed (using medical subject headings), and Google Scholar were searched using the following terms in different combinations: “periodontal disease,” “periodontitis,” “risk factors,” and “causal.” This was supplemented by hand-searching in peer-reviewed journals and cross-referenced with the articles accessed. Conclusions. It is important to understand the etiological factors and the pathogenesis of periodontal disease to recognize and appreciate the associated risk factors. As periodontal disease is multifactorial, effective disease management requires a clear understanding of all the associated risk factors.

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Risk Factors of Periodontal Disease: Review of the Literature

Background: and objectives: There is still debate regarding potential relationships between maternal periodontitis during pregnancy and adverse pregnancy outcomes. The aim of this systematic review was to synthesize the available epidemiological evidence on this association.Data sources: Combined electronic and hand search of MEDLINE, EMBASE, WEB OF SCIENCE and Cochrane Central Register databases.Study eligibility criteria: Original publications reporting data from cross-sectional, case-control or prospective cohort epidemiological studies on the association between periodontal status and preterm birth, low birthweight (LBW) or preeclampsia. The search was not limited to publications in English. All selected studies provided data based on professional assessments of periodontal status, and outcome variables, including preterm birth (<37 weeks gestation), LBW (<2500 g), gestational age, small for gestational age, birthweight, pregnancy loss or miscarriage, or pre-eclampsia.Participants: Pregnant women with...

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jcpe.12063

Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes – systematic review

Background: Few studies have examined the potential effects of periodontal treatment during pregnancy on pregnancy outcomes, periodontal status, and inflammatory biomarkers.Methods: A randomized, delayed-treatment, controlled pilot trial was conducted to evaluate the effects of second-trimester scaling and root planing and the use of a sonic toothbrush on the rate of preterm delivery (<37 weeks gestation). Secondary outcome measures included changes in periodontal status, levels of eight oral pathogens, levels of gingival crevicular fluid (GCF) interleukin-1β (IL-1β), prostaglandin E2 (PGE2), 8-isoprostane (8-iso), and IL-6, and serum levels of IL-6, soluble intercellular adhesion molecule 1 (sICAM1), 8-isoprostane, soluble glycoprotein 130 (sGP130), IL-6 soluble receptor (IL-6sr), and C-reactive protein (CRP). Logistic regression models were used to test for effects of treatment on preterm delivery. Secondary outcomes were analyzed by analysis of covariance adjusting for subject baseline values.Results: ...

Effects of Periodontal Therapy During Pregnancy on Periodontal Status, Biologic Parameters, and Pregnancy Outcomes: A Pilot Study

Aim
Periodontal diseases (PDs) may play an important role in the effect oral health status has on a person's quality of life (QoL). The objective was to investigate the influence of PDs (gingivitis and periodontitis) on oral health-related QoL (OHRQoL) by systematically reviewing the literature.

Materials and Methods
Studies using clinical periodontal examinations and validated survey instruments were included. Among 1134 citations initially identified through electronic and hand searching, 37 were eligible and data were extracted from full texts. A vote counting method was used for synthesis of the results.

Results
Included studies were published between 2001 and 2014 and revealed considerable heterogeneity in participant selection, clinical assessments, and OHRQoL measures. A significant association between PDs and OHRQoL was reported in 28 studies, of which eight reported increasing impact with greater disease severity or extent.

Conclusions
Within the limits of the available literature, OHRQoL was affected by clinically assessed PDs. There was evidence for increased impairment with greater severity and extent of PDs, and the recognition of the association was increased when full mouth recording protocols were applied.

Are periodontal diseases really silent? A systematic review of their effect on quality of life

summary The aims of this study were to assess the periodontal health and oral hygiene status of pregnant women and non-pregnant controls and to evaluate the effect of socio-demographic and other variables on such periodontal status. A total of 400 women, of whom 200 were pregnant (mean age=30 years, s.e.m.=0ḃ05) and 200 non-pregnant controls (mean age=32 years, s.e.m.=0ḃ05) were chosen at random from four health centres. The clinical parameters used were the Silness and Loe plaque index (Pl.I), Loe and Silness gingival index (GI), probing pocket depth (PPD), probing attachment level (PAL), any relationship to socio-demographic (age, level of education and professional level) and clinical variables (gestation period, previous pregnancy and vomiting during pregnancy) was evaluated. The results showed that pregnant women had significantly higher GI and PPD scores (P   0ḃ01) compared with non-pregnant controls. Increased age, lower level of education and non-employment were associated with significantly higher GI and PPD scores (P   0ḃ05). Also, women who vomited during pregnancy had significantly higher GI and PPD scores compared with those who did not vomit (P < 0ḃ05). It is concluded that gingival inflammatory symptoms are aggravated during pregnancy and are related to increased age, lower level of education and non-employment. Therefore periodontal preventive programmes are very important for pregnant women.

The periodontal status of pregnant women and its relationship with socio-demographic and clinical variables.

Habashneh RA, Khader YS, Alhumouz MK, Jadallah K, Ajlouni Y. The association between inflammatory bowel disease and periodontitis among Jordanians: a case–control study. J Periodont Res 2012; 47: 293–298. © 2011 John Wiley & Sons A/S

Background and Objective:  Inflammatory bowel disease (IBD) is hypothesized to involve immuno-inflammatory alterations, and the condition has been related to increased susceptibility to oral challenges. The objective of the study was to determine the association between the prevalence, severity and extent of periodontitis and both ulcerative colitis (UC) and Crohn’s disease (CD).

Material and Methods:  A case–control study was conducted among patients who attended outpatient clinics at King Hussein Medical City in Jordan during the study period. All participants completed the questionnaire and underwent thorough oral and periodontal examinations. Periodontitis was defined as presence of four or more teeth with one or more sites with probing pocket depth ≥ 4mm and clinical attachment level ≥ 3mm. The general linear model multivariate procedure and multivariate binary logistic regression were used to analyse the data.

Results:  This case–control study included 260 Jordanian adults (101 with UC, 59 with CD and 100 with no IBD) with a mean (SD) age of 39.4 (0.7) years. The prevalence of periodontitis was much higher among patients with CD and those with UC compared with subjects having no IBD in the age groups < 36 and 36–45 years old only. After adjusting for age and number of missing teeth, patients with CD (odds ratio 4.9, 95% confidence interval 1.8–13.2) and patients with UC (odds ratio 7.00, 95% confidence interval 2.8–17.5) had significantly higher odds of periodontitis than subjects with no IBD. In multivariate analysis, the severity of periodontitis was significantly higher among patients with CD and patients with UC when compared with subjects having no IBD. Ulcerative colitis patients but not CD patients had significantly higher prevalence of deep ulcers in oral soft tissues than the non-IBD group (p = 0.004).

Conclusion:  Patients with IBD have higher prevalence, severity and extent of periodontitis compared with those having no IBD.

The association between inflammatory bowel disease and periodontitis among Jordanians: a case-control study.

We used the short-form of the Oral Health Impact Profile (OHIP-14) to assess the impact of periodontal diseases on the quality of life of Jordanian adults. A systematic random sample of 400 individuals was selected from patients referred to the periodontics clinic at the Dental Teaching Center in Irbid, Jordan. Those willing to participate were examined by specifically trained dentists and requested to complete the Arabic short-form version of the OHIP-14 questionnaire. Multivariate analysis of differences in OHIP-14 subscales among the periodontal disease groups was conducted using the general linear model multivariate procedure. This study included 400 adults (164 men and 236 women) aged between 18 and 60 years, with a mean (SD) of 36.7 (11.9) years. Of the 400 participants, 41.8% had chronic gingivitis, 19.8% had mild periodontitis, 23.3% had moderate periodontitis, and 15.3% had severe periodontitis. "Fairly often" or "very often" was reported for one or more items of the OHIP-14 by fewer than one-third of patients with gingivitis (32.9%) or mild periodontitis (31.6%), by about one-half of patients with moderate periodontitis (53.8%), and by about two-thirds of those with severe periodontitis (63.9%). There was a statistically significant association between the severity of periodontal disease and OHIP-14 scores (P < 0.05). Severe chronic periodontitis had a significantly greater impact on quality of life, specifically with regard to physical pain and physical disability (P < 0.05). Physical pain and physical disability were the dimensions most affected, and all OHIP-14 scores were significantly associated with severity of periodontal disease after adjusting for common confounders.

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Use of the Arabic version of Oral Health Impact Profile-14 to evaluate the impact of periodontal disease on oral health-related quality of life among Jordanian adults

Background: Some studies suggest that females with osteoporosis are at an increased risk of periodontal attachment loss and tooth loss; however, results have varied. The aim of this study is to determine the relationship between periodontitis and osteoporosis among postmenopausal Jordanian women.

Association between periodontal disease and osteoporosis in postmenopausal women in jordan.

The aim of this study is to evaluate the awareness, perception, sources of information, and knowledge of diabetes mellitus and periodontal health among Jordanians, to examine the factors related to their knowledge, and organize effective education programs. A random sample of 500 diabetic patients was recruited from three hospitals and three comprehensive health centers that represent both urban and rural populations in Jordan between September 25, 2006, and February 20, 2007. Completed questionnaires with the answers were returned by 405 participants (response rate was 81%). Only 28% indicated that they followed up gum diseases with the dentist; 48% were aware that diabetic patients are more prone to gum diseases and oral health complications. About a third (38%) recognized that their periodontal health might affect their glycaemic level. Television and Internet were the main source of knowledge for dentists with the rate of 50%. Knowledge about diabetes and periodontal health among diabetic patients is low, and majority of patients were unaware of the oral health complications of their disease and the need for proper preventive care. Issues on education need to be addressed. Therefore, appropriate educational programs should be planned according to community needs, and the target of these programs should be patients with irregular visits to the dentist and physicians. The clinical implication of our findings is that dentists, physicians, and other health providers should inspect diabetic patients for gum diseases each time they come for care and recommend that diabetic patient see a dentist regularly.

Rola Al Habashneh

Papers

The periodontal status of pregnant women and its relationship with socio-demographic and clinical variables.

The association between inflammatory bowel disease and periodontitis among Jordanians: a case-control study.

Use of the Arabic version of Oral Health Impact Profile-14 to evaluate the impact of periodontal disease on oral health-related quality of life among Jordanian adults

Association between periodontal disease and osteoporosis in postmenopausal women in jordan.

Knowledge and awareness about diabetes and periodontal health among Jordanians.