Exposure to occupational noise and periodontitis in Korean workers

1 Background

Chronic exposure to occupational noise is reported to cause a wide range of health problems. But, there are no reports on studies investigating the association between noise exposure and periodontitis. The purpose of this study was to examine the relationship between occupational noise exposure and periodontitis in a nationally representative sample of Korean workers.

2 Methods

This cross‐sectional study used data from the 4^th Korean National Health and Nutrition Examination Survey. The study sample included 8,927 workers aged 19 to 54 years. Noise exposure assessment was performed by using self‐report questionnaires. The dependent variable was periodontitis. Age, sex, perceived stress level, place of residence, income, education, health behaviors (frequency of daily toothbrushing, binge drinking, smoking status, regular dental checkup), diabetes, obesity, and white blood cell count were included as covariates. Logistic regression analyses estimated the association between noise exposure and periodontitis after sequential adjustment.

3 Results

Compared with never‐exposed individuals, participants exposed to occupational noise had an increased prevalence of periodontitis. The association remained significant after full adjustment of covariates (odds ratio [OR] 1.34; 95% confidence interval [CI] 1.06 to 1.70). Association of noise exposure with periodontitis was particularly strong for individuals aged < 45 years (OR 1.65; 95% CI 1.22 to 2.23).

4 Conclusions

Our study shows that there is an association between occupational noise exposure and periodontitis in a representative sample of Korean workers. Policy efforts to improve workplace noise environments might have an effect on improving periodontal health status among Korean workers.     

Amount and type of alcohol and periodontitis in the Copenhagen City Heart Study

Aim: The aim of this study was to study the association between alcohol consumption and periodontitis assessed as clinical attachment loss (CAL) and bleeding on probing (BOP) in a cross‐sectional design. Material and Methods: The study included 1,521 adults aged 20–95 years, who underwent an oral examination including full‐mouth registration of CAL and BOP. Alcohol was ascertained using a food‐frequency questionnaire. The association between total and type‐specific alcohol and periodontitis was assessed by means of multivariate logistic regression. Results: A lower odds ratio (OR) for CAL (defined as mean 3 mm) was observed in men consuming 21–34 [OR=0.51, 95% confidence interval (CI), 0.27–0.95] and 35+ drinks/week (OR=0.34, 95% CI, 0.15–0.79) compared with men drinking 1–13 drinks/week. Also, men with a weekly wine consumption of more than 14 drinks compared with men who reported no wine intake had lower OR for CAL (OR=0.24; 95% CI, 0.09–0.62). A higher OR for BOP (defined as 25%) among male abstainers was observed (OR=1.79, 95% CI, 1.03–3.12) compared with men in the light‐drinking group (1–13 drinks/week). No significant association was observed for either CAL or BOP in women. Conclusions: The results indicate that higher alcohol consumption, particularly intake of wine, is inversely associated with CAL in men. Such an association is not found in women.     

Impact of periodontitis definition in epidemiological research. Results from the EPIPAP study in postpartum women

The purpose of this investigation was to study the impact of using various definitions of periodontitis on the frequency of periodontitis and on the associations with some known risk factors for periodontitis in a population of postpartum women in France. A clinical examination was performed within 2-4 d postpartum in 932 at-term women at five maternity units. We studied six definitions of periodontitis; five were applicable if at least two teeth were found to have the following: (i) a proximal clinical attachment level (CAL) of ≥ 3 mm; (ii) a probing depth (PD) of ≥ 4 mm; (iii) a PD of ≥ 4 mm and a CAL of ≥ 3 mm at the same site; (iv) a proximal PD of ≥ 5 mm or a proximal CAL of ≥ 4 mm; or (v) a PD of ≥ 4 mm and a CAL ≥ 3 mm and bleeding on probing at the same site. The sixth definition required the involvement of four teeth with a PD of ≥ 4 mm and a CAL of ≥ 3 mm at the same site. Associations between case status according to each definition and maternal characteristics (age, educational level, smoking before pregnancy, and time since last dental visit) were analyzed using generalized estimating equation models. The definition of periodontitis had an impact on the frequency of periodontitis, which ranged from 12.1% to 37.7%, and produced different ORs for the associations with risk factors for periodontitis.     

Association between psychosocial factors and periodontitis: a case-control study

OBJECTIVE: This case-control study investigated the association between life events, anxiety, and depression with periodontitis. METHODOLOGY: The study counted with 165 individuals, both sexes, 35-60 years of age. Case group included 96 individuals suffering from periodontal disease; and in control group 69 subjects with no history of periodontitis. Clinical examinations were performed by a single examiner. Psychological assessment included four inventories: Life Events Scale, Beck Anxiety Inventory, State-Trait Anxiety Inventory and Beck Depression Inventory. Bivariate and multivariate logistic regression analyses were performed to compare cases and controls. RESULTS: Mean probing depth and clinical attachment level were 3.44+/-0.80 and 4.01+/-1.61 in the case group and 1.96+/-0.19 and 0.95+/-0.50 in the control group, respectively (p<0.05). Positive association of periodontitis with age (odds ratio (OR)=1.15 95% confidence interval (CI): 1.06-1.24), male gender (OR=2.71, CI: 1.13-6.49), smoking (OR=6.05, CI: 1.67-21.94) and educational level (OR=6.49, CI: 1.14-36.95) was confirmed. Bivariate analysis did not demonstrate significant mean differences in life events, anxiety symptoms, trait or state of anxiety, or depression symptoms between cases and controls. Multivariate logistic regression, controlling for confounding factors, demonstrated no significant association between psychosocial factors and periodontal disease. CONCLUSIONS: Within the limits of this study it is possible to conclude that there was no significant association between periodontitis and the psychosocial factors analysed.     

Coronary heart disease and periodontitis -- a case control study in Chilean adults

OBJECTIVES: To investigate the association between periodontal disease parameters and coronary ischemic disease among 30-50-year-old Chileans. MATERIAL AND METHODS: Cases were 30-50-year-olds who were hospitalized in one of four Cardiologic Units in Santiago, Chile, for acute myocardial infarction, unstable angina or angina pectoris. Controls had undergone surgery due to gall bladder stones or abdominal hernia. Information on blood pressure, serum cholesterol, body weight and height, age, occupation, smoking, diabetes and use of antidepressants was obtained. A total of 86 persons participated based on informed consent, but the analysis is based on 61 persons, for whom a complete set of data was obtained. Cases and controls were given a clinical periodontal examination comprising assessment of number of teeth present, periodontal pocket depth and clinical attachment level at six sites per tooth. The association between mean attachment level; mean pocket probing depth; number of teeth present and case status was analyzed by conditional logistic regression controlling for known risk factors for CHD. RESULTS: The mean attachment level was positively associated with case status (OR = 3.17; 95% CI = [1.31; 7.65]), as was the mean pocket depth (OR = 8.64; 95% CI = [1.22; 61.20]). The number of teeth present was not statistically significantly associated with case status (OR = 0.93; 95% CI = [0.83; 1.04]). CONCLUSION: The results are in accordance with those of several previous reports. If the results reflect a causal link between periodontal diseases and CHD they emphasize the need for better control of periodontal diseases. If the associations are-non-causal, they still demonstrate that CHD and periodontal diseases cluster in the same sections of the population, which is important from a public health point of view.     

Association between periodontal pathogens and risk of nonfatal myocardial infarction

Andriankaja O, Trevisan M, Falkner K, Dorn J, Hovey K, Sarikonda S, Mendoza T, Genco R. Association between periodontal pathogens and risk of nonfatal myocardial infarction. Community Dent Oral Epidemiol 2011; 39: 177–185. © 2011 John Wiley & Sons A/S Abstract – Background: The direct effect of periodontal pathogens on atherosclerotic plaque development has been suggested as a potential mechanism for the observed association between periodontal disease and coronary heart disease, but few studies have tested this theory. Objectives: (i) To assess the association of periodontal pathogens in periodontal pockets with the risk of myocardial infarction (MI) and (ii) to assess whether an increase in the number of periodontal bacterial species increases the risk of MI. Methods: A total of 313 cases and 747 controls, consisting of Caucasian men and women from Western New York, aged 35 to 69 years, were recruited for this study. The presence of microorganisms was assessed by indirect immunofluorescence microscopy, using species‐specific polyclonal and monoclonal serodiagnostic reagents. The presence of six periodontal pathogens, Porphyromonas gingivalis (Pg), Tannerella forsythensis (Tf), Prevotella intermedia (Pi), Campylobacter recta (Cr), Fusobacterium nucleatum (Fn), and Eubacterium saburreum (Es), and their co‐occurrence (0–6) was compared with the odds of having myocardial infarction. Results: Univariate analyses revealed a higher percentage of the presence of each bacterium in cases compared to controls. In multivariate analyses, only Tf and Pi were statistically associated with an increase in the odds of having MI [Odds ratio OR = 1.62; 95% CI (1.18–2.22); and 1.40; 95% (1.02–1.92), respectively] after adjusting for age, gender, education, cholesterol, high blood pressure, diabetes, and total pack‐years of cigarette smoking. An increase in the number of different periodontal bacteria in pockets was also found to increase the odds of MI [adjusted OR = 1.14; 95% CI (1.03–1.26)]. Participants who had three species or more of periodontal pathogens had about 2‐fold increase in odds of having nonfatal MI than those who did not have any type of bacterial species [OR = 2.01 (1.31–3.08)]. Conclusion: The presence of periodontal pathogens, specifically Tf or Pi, and an increase in total burden of periodontal pathogenic species were both associated with increased odds of having MI. However, further studies are needed to better assess any causal relationship, as well as the biological mechanisms underlying this association.     

Association between periodontitis and low birth weight: a case-control study

OBJECTIVE: To verify a possible association between periodontitis and low-birth-weight babies. MATERIAL AND METHODS: One hundred and fifty-one mothers were examined. The case group included 76 mothers (mean age 25.6 years), whose babies at birth weighed <2500 g and had a gestational age (GA) <37 weeks, while 75 mothers (mean age 24.4 years), whose babies were born with a weight of >2500 g and with a GA>37 weeks, were the control group. Data from the mothers and the babies were collected from the Hospital registration records and during an interview with the mother. The periodontal examination included measurements of probing pocket depth (PPD) and clinical attachment loss (CAL) in six sites from all existing teeth, except for third molars. Mothers with periodontitis had at least four sites with PPD> or =4 and CAL> or =3 mm, while healthy mothers had PPD< or =3 mm and CAL< or =1 mm. RESULTS: The median number of sites with PPD> or =4 and CAL> or =3 mm was eight in the case group, and four in the control group. The significant associations with low birth weight (LBW) babies were periodontitis (odds ratio (OR)=3.48, 95% confidence interval (CI): 1.17; 10.36), arterial hypertension (OR=9.65, 95% CI: 2.22; 41.91), haemorrhage during pregnancy (OR=10.88, 95% CI: 1.95; 60.53), number of pre-natal examinations (OR=0.10, 95% CI: 0.02; 0.43) and genitourinary infection (OR=3.21, 95% CI: 1.25; 8.20). CONCLUSION: Periodontitis was considered a risk indicator for LBW in this sample, similar to other risk factors already recognized by obstetricians.     

Association between oral health status and chronic obstructive pulmonary disease in Korean adults

Objectives: This study aimed to elucidate the association between oral health status and chronic obstructive pulmonary disease (COPD) in Korean adults (≥ 40 years old) using a representative national dataset from the 6th Korea National Health and Nutrition Examination Survey (6th KNHANES, 2013–2015). Methods: Participants aged ≥ 40 years from the 6th KNHANES who had received an oral and pulmonary function tests (N = 7719) were included in this study. The participant characteristics according to COPD were compared using t-test and chi-squared test. Logistic regression analysis was used to estimate the association between oral health status and COPD. Results: Participants with poor periodontal status exhibited a higher prevalence of COPD. Moreover, patients with COPD had a greater number of missing teeth than those without COPD. The logistic regression model adjusted for demographic, socioeconomic, health- and oral health-related factors showed that the periodontal status was not significantly associated with COPD, while participants with more missing teeth had a significantly increased possibility of having COPD. Conclusions: This study revealed that loss of teeth in adults aged ≥ 40 years was associated with COPD.Key words: Chronic obstructive pulmonary disease, Korea National Health and Nutrition Examination Survey (KNHANES), tooth loss, oral health, periodontal disease     

Systemic medications: clinical significance in periodontics

Systemic medications are of value as adjuncts to periodontal therapy. These medications can be divided into two major categories: antibiotics and agents for host modulation. Antibiotics have been shown to be valuable adjuncts in specialized types of periodontal disease, such as localized and generalized aggressive periodontitis, and of possible value in severe chronic periodontitis. Antibiotics have been studied individually, in combination and in sequential therapy. Host modulators include Periostat, non-steroidal anti-inflammatory agents, alendronate (Fosamax), hormone replacement therapy and anti-arthritic medications. These agents produce their beneficial effects by a variety of mechanisms of action, including inhibition of matrix metalloproteinases, inhibition of prostaglandin production, stimulation of osteoblasts, inhibition of osteoclasts, and other anti-inflammatory mechanisms of action.