Global risk factors and risk indicators for periodontal diseases
About: This article is published in Periodontology 2000.The article was published on 2002-04-01. It has received 580 citations till now. The article focuses on the topics: Risk assessment & Global health.
Citations
More filters
01 Jan 2016
TL;DR: Aspirin has been widely used to prevent myocardial infarction and ischemic stroke, but some studies have suggested it increases risk of hemorrhagic stroke as mentioned in this paper, which is not the case here.
Abstract: Context.— Aspirin has been widely used to prevent myocardial infarction and ischemic stroke but some studies have suggested it increases risk of hemorrhagic stroke. Objective.— To estimate the risk of hemorrhagic stroke associated with aspirin treatment. Data Sources.— Studies were retrieved using MEDLINE (search terms, aspirin, cerebrovascular disorders, and stroke), bibliographies of the articles retrieved, and the authors’ reference files. Study Selection.— All trials published in English-language journals before July 1997 in which participants were randomized to aspirin or a control treatment for at least 1 month and in which the incidence of stroke subtype was reported. Data Extraction.— Information on country of origin, sample size, duration, study design, aspirin dosage, participant characteristics, and outcomes was abstracted independently by 2 authors who used a standardized protocol. Data Synthesis.— Data from 16 trials with 55 462 participants and 108 hemorrhagic stroke cases were analyzed. The mean dosage of aspirin was 273 mg/d and mean duration of treatment was 37 months. Aspirin use was associated with an absolute risk reduction in myocardial infarction of 137 events per 10 000 persons (95% confidence interval [CI], 107-167;P,.001) and in ischemic stroke, a reduction of 39 events per 10 000 persons (95% CI, 17-61; P,.001). However, aspirin treatment was also associated with an absolute risk increase in hemorrhagic stroke of 12 events per 10 000 persons (95% CI, 5-20; P,.001). This risk did not differ by participant or study design characteristics. Conclusions.— These results indicate that aspirin therapy increases the risk of hemorrhagic stroke. However, the overall benefit of aspirin use on myocardial infarction and ischemic stroke may outweigh its adverse effects on risk of hemorrhagic stroke in most populations.
1,450 citations
TL;DR: Many of the systemic risk factors for periodontal disease, such as smoking, diabetes and obesity, and osteoporosis in postmenopausal women, are relatively common and can be expected to affect most patients with periodontals seen in clinics and dental practices.
Abstract: Risk factors play an important role in an individual's response to periodontal infection. Identification of these risk factors helps to target patients for prevention and treatment, with modification of risk factors critical to the control of periodontal disease. Shifts in our understanding of periodontal disease prevalence, and advances in scientific methodology and statistical analysis in the last few decades, have allowed identification of several major systemic risk factors for periodontal disease. The first change in our thinking was the understanding that periodontal disease is not universal, but that severe forms are found only in a portion of the adult population who show abnormal susceptibility. Analysis of risk factors and the ability to statistically adjust and stratify populations to eliminate the effects of confounding factors have allowed identification of independent risk factors. These independent but modifiable, risk factors for periodontal disease include lifestyle factors, such as smoking and alcohol consumption. They also include diseases and unhealthy conditions such as diabetes mellitus, obesity, metabolic syndrome, osteoporosis, and low dietary calcium and vitamin D. These risk factors are modifiable and their management is a major component of the contemporary care of many periodontal patients. Genetic factors also play a role in periodontal disease and allow one to target individuals for prevention and early detection. The role of genetic factors in aggressive periodontitis is clear. However, although genetic factors (i.e., specific genes) are strongly suspected to have an association with chronic adult periodontitis, there is as yet no clear evidence for this in the general population. It is important to pursue efforts to identify genetic factors associated with chronic periodontitis because such factors have potential in identifying patients who have a high susceptibility for development of this disease. Many of the systemic risk factors for periodontal disease, such as smoking, diabetes and obesity, and osteoporosis in postmenopausal women, are relatively common and can be expected to affect most patients with periodontal disease seen in clinics and dental practices. Hence, risk factor identification and management has become a key component of care for periodontal patients.
853 citations
Journal Article•
TL;DR: It is hoped that medical, dental practitioners, and other health-care professionals will get familiar with perio-systemic link and risk factors, and need to refer to the specialized dental or periodontal care.
Abstract: Periodontal diseases are prevalent both in developed and developing countries and affect about 20-50% of global population. High prevalence of periodontal disease in adolescents, adults, and older individuals makes it a public health concern. Several risk factors such as smoking, poor oral hygiene, diabetes, medication, age, hereditary, and stress are related to periodontal diseases. Robust evidence shows the association of periodontal diseases with systemic diseases such as cardiovascular disease, diabetes, and adverse pregnancy outcomes. Periodontal disease is likely to cause 19% increase in the risk of cardiovascular disease, and this increase in relative risk reaches to 44% among individuals aged 65 years and over. Type 2 diabetic individuals with severe form of periodontal disease have 3.2 times greater mortality risk compared with individuals with no or mild periodontitis. Periodontal therapy has been shown to improve glycemic control in type 2 diabetic subjects. Periodontitis is related to maternal infection, preterm birth, low birth weight, and preeclampsia. Oral disease prevention strategies should be incorporated in chronic systemic disease preventive initiatives to curtail the burden of disease in populations. The reduction in the incidence and prevalence of periodontal disease can reduce its associated systemic diseases and can also minimize their financial impact on the health-care systems. It is hoped that medical, dental practitioners, and other health-care professionals will get familiar with perio-systemic link and risk factors, and need to refer to the specialized dental or periodontal care.
580 citations
577 citations
TL;DR: This volume aims to provide a comprehensive evaluation of the distribution of various types of periodontal diseases from each of the world’s five major geographic regions.
Abstract: This volume aims to provide a comprehensive evaluation of the distribution of various types of periodontal diseases from each of the world’s five major geographic regions. Epidemiology is the study of the health and disease in populations, as compared to individuals (20). Study of the distribution of human periodontal diseases and their risk factors on a global scale offers a unique investigational model that can provide power and generalization to observations on the periodontium made initially among more limited populations. In assessing causation between periodontal diseases and their suspected etiologic risk factors, it is useful to demonstrate consistency of the relationships in multiple, representative population samples. When diverse study approaches in various populations by different investigators produce similar conclusions on the distribution of periodontal diseases and/or their associations with putative risk factors, then one can be more confident that real phenomenon and/or causal relationships exist (29). Indeed, population-based studies provide external validity to observations obtained from more discrete subject groups, and enable generalization of the conclusions (14). Alternatively, differences in periodontal disease patterns among various population groups can be exploited to uncover previously unidentified risk factors that may not be expressed in all populations. Available population-based periodontal disease data originate from studies encompassing a wide range of objectives, designs and measurement criteria (18). The lack of standardized study design, definition of periodontal disease status, methods for disease detection and measurement, and criteria for subject selection markedly limit interpretation and
490 citations
Cites background from "Global risk factors and risk indica..."
...In addition, periodontal disease susceptibility is further aggravated by the apparent occurrence in these populations of certain biological and microbiological risk factors that further increase their predisposition to periodontal diseases (3, 5)....
[...]
...While gingivitis parallels the level of oral hygiene in a population, it is by itself a poor predictor of subsequent periodontitis disease activity (5, 16, 19)....
[...]
...Studies show that there is a significant interaction between genetic factors and other environmental and demographic factors, including a possible modifying effect of smoking, and a variability in the occurrence of certain genotypes in different race-ethnicity groups (5)....
[...]
...For example, several gene polymorphisms have been investigated relative to their associations with periodontitis, and some of these have been shown to be related to increased risk for aggressive disease (5)....
[...]
References
More filters
TL;DR: In this paper, the correlation between oral hygiene and periodontal condition was investigated in the context of pregnant women with Periodontal Disease in Pregnancy II (PDI II).
Abstract: (1964). Periodontal Disease in Pregnancy II. Correlation Between Oral Hygiene and Periodontal Condition. Acta Odontologica Scandinavica: Vol. 22, No. 1, pp. 121-135.
7,017 citations
3,304 citations
1,999 citations
1,608 citations
TL;DR: It is demonstrated that specific genetic markers, that have been associated with increased IL-1 production, are a strong indicator of susceptibility to severe periodontitis in adults.
Abstract: Although specific bacteria, dental plaque, and age are associated with periodontal disease, there are currently no reliable predictors of periodontitis severity. Studies in twins have suggested a genetic contribution to the pathogenesis of periodontitis, but previous attempts to identify genetic markers have been unsuccessful. The pro-inflammatory cytokines interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF alpha) are key regulators of the host responses to microbial infection. IL-1 is also a major modulator of extracellular matrix catabolism and bone resorption. We report a specific genotype of the polymorphic IL-1 gene cluster that was associated with severity of periodontitis in non-smokers, and distinguished individuals with severe periodontitis from those with mild disease (odds ratio 18.9 for ages 40-60 years). Functionally, the specific periodontitis-associated IL-1 genotype comprises a variant in the IL-1B gene that is associated with high levels of IL-1 production. In smokers severe disease was not correlated with genotype. In this study, 86.0% of the severe periodontitis patients were accounted for by either smoking or the IL-1 genotype. This study demonstrates that specific genetic markers, that have been associated with increased IL-1 production, are a strong indicator of susceptibility to severe periodontitis in adults.
1,194 citations