The association between periodontal disease,physical activity and healthy diet among adults in Jordan

Bawadi HA, Khader YS, Haroun TF, Al‐Omari M, Tayyem RF. The association between periodontal disease, physical activity and healthy diet among adults in Jordan. J Periodont Res 2011; 46: 74–81. © 2010 John Wiley & Sons A/S Background and Objective: Physical inactivity and an unhealthy diet have been implicated as risk factors for several chronic diseases that are known to be associated with periodontitis, such as cardiovascular diseases, obesity and diabetes. Studies investigating the relationship between periodontitis and physical activity and diet are limited. Therefore, this study was conducted to determine the relationship between physical activity, healthy eating habits and periodontal health status. Material and Methods: A systematic random sample of 340 persons, 18–70 years of age, was selected from persons accompanying their relative patients who attended the outpatient clinics in the medical center of Jordan University of Science and Technology in north of Jordan. Data collected included socio‐demographic and clinical characteristics, anthropometric measurements, physical activity level and dietary assessment. Results: Individuals who were highly physically active had a significantly lower average plaque index, average gingival index, average clinical attachment loss (CAL) and percentage of sites with CAL ≥ 3 mm compared to individuals with a low level of physical activity and individuals with a moderate level of physical activity. Those who had a poor diet had a significantly higher average number of missing teeth and an average CAL compared with those who had a good diet. In the multivariate analysis, a low level of physical activity and a poor diet (diets with a healthy eating index score of < 50 points) were significantly associated with increased odds of periodontitis. Conclusions: A low physical activity level and a poor diet were significantly associated with increased odds of periodontal disease. Further studies are needed to understand this relationship in greater detail.     

Fluoridation effects on periodontal disease among adults

Numerous studies report that water fluoridation reduces caries in children, but little current evidence exists about fluoridation's effects on the periodontal health of adults. To address this issue, we estimated fluoridation effects on periodontal disease among 1066 Washington state employees and their spouses, aged 20 to 34, with current residences divided evenly between fluoridated and nonfluoridated communities. Subjects were interviewed by telephone to collect residence histories, personal characteristics and other data. Each subject's lifetime years of fluoridation exposure (YFE) was calculated from the person's residence history and the U.S. Centers for Disease Control's Fluoridation Census . Oral assessments were conducted to measure the extent of periodontal disease. Relative to adults with no exposure, continuous lifetime exposure reduced the probability of attachment loss from 0.87 to 0.72. Similar benefits were obtained for bleeding gingiva and calculus. The estimates of fluoridation's benefits were not influenced by selection bias due to subjects' nonparticipation in the oral assessments.     

On the association between hypercholesterolemia, cardiovascular disease and severe periodontal disease

BACKGROUND: Premature death in men is known to be significantly associated with coronary heart disease (CHD). More and more studies are pointing toward a possible association between periodontal disease and increased risk of cardiovascular disease. The association of poor oral hygiene and atherosclerosis can be explained by the effect of chronic inflammatory disease on blood rheology. The purpose of the present study was to assess the relationship between CHD and periodontal disease. PATIENTS AND METHODS: The study population included 1094 Israeli army service men aged 26-53 years (mean: 39+/-5 years). The study group comprised 151 subjects classified as having coronary heart disease CHD, i.e., myocardial infarction, and or anginal syndrome with angiographic evidence of significant coronary disease, or suffer from atherosclerotic risk factors, i.e., diabetes (fasting glucose) and HTN according to strict, well-established criteria. Blood levels of cholesterol and triglycerides were also determined. The severity of periodontal disease was assessed by the aid of CPITN. The control group comprised 943 healthy subjects. Statistical analysis was performed with chi2 test. RESULTS: Statistical analysis showed a significant association of CPITN score 4 with hypercholesterolemia and a possible association with CHD. CONCLUSIONS: The generation of higher cholesterol blood levels is proposed as a possible link between chronic periodontal inflammation and atherosclerosis.     

Relationship between obesity, glucose tolerance, and periodontal disease in Japanese women: the Hisayama study

BACKGROUND: Recent studies have reported a relationship between obesity and periodontal disease. Obesity is the strongest risk factor for type 2 diabetes, which is, in turn, a risk factor for periodontal disease. An oral glucose tolerance test is necessary to diagnose diabetes; however, no study has examined the relationship between obesity and periodontal disease by taking oral glucose tolerance test results into consideration. METHODs: In all, 584 Japanese women aged between 40 and 79 years old, with at least 10 teeth, underwent health examinations. Body mass index, waist-hip ratio, body fat, and oral glucose tolerance test results were used as independent variables with known risk factors for periodontal disease. Mean probing pocket depth and mean attachment loss were used as the dependent variables. RESULTS: In all of the analyses, body mass index, body fat, and waist--hip ratio were significantly associated with the highest quintile of mean probing pocket depth, even when adjusted for oral glucose tolerance test results. In the multivariate analysis, the subjects with the highest quartile of body mass index had a significantly higher odds ratio (OR) for the highest quintile of mean probing pocket depth [OR, 4.3; 95% confidence interval (CI), 2.1--8.9; p<0.001], whereas neither impaired glucose tolerance nor diabetes were significantly associated with deep pockets. The relationships between the obesity indexes and mean attachment loss did not reach statistical significance. CONCLUSION: Obesity was associated with deep pockets in Japanese women, even after adjusting for oral glucose tolerance test.     

Pre-diabetes and diabetes: Medical risk factors and periodontal conditions

Abstract

Objective. The aim of this study was to evaluate the difference between subjects with pre-diabetes, well or poorly controlled diabetes mellitus type 2 (T2D) and non-diabetes concerning such medical risk factors as hemoglobin A1c, body mass index (BMI) and waist circumference (WC) with periodontal conditions. Materials and methods. BMI, WC, PI, BOP, PD and marginal bone level (MBL) were recorded. Hemoglobin A1c (HbA1c) level and random blood glucose level (RBGL) were analyzed. Results. Forty-five subjects were pre-diabetics, 64 subjects had poorly controlled T2D, 28 subjects had well controlled T2D and 76 subjects were non-diabetics. Non-diabetics, pre-diabetics as well as subjects with T2D were overweight. Females in all groups had increased mean levels of WC. Number of PD ≥ 6 mm were increased in subjects with poorly controlled T2D compared to non-diabetics and pre-diabetics (p < 0.05). Conclusions. Pre-diabetic subjects showed the same periodontal conditions as non-diabetic subjects. Forty-five of the subjects reporting to have no diabetes were pre-diabetics. Non-diabetic, pre-diabetic and diabetic subjects were overweight. Subjects with poorly controlled T2D had severe periodontal conditions.