Abstract
Background: Certain risk factors such as tobacco use, diabetes, genetic variations on the IL1 gene, and other inflammatory conditions are hypothesized to predict tooth loss in patients treated in a large medical center. Tooth loss trends are hypothesized to be greater in patients with more risk factors. Methods: DNA samples for 881 individuals were taken from the Dental Registry and DNA Repository at University of Pittsburgh School of Dental Medicine. Clinical data for all 4137 subjects in the registry were also available. SNP genotyping was performed on the samples for IL1α (rs1800587) and IL1β (rs1143634). IL1 positive status was determined as having one or more of the recessive alleles for either SNP. Tooth loss status was determined based on dental records and data gathered for age, sex, ethnicity, and self-reported medical history. Various statistical analyses were performed on the data including genetic association analysis by the PLINK software, chi-square, Mann-Whitney U, and ANOVA tests to determine significance. Results: Tooth loss averages increased with age by all risk factors (smoking, diabetes, hypertension, and interleukin genotypes; p = 4.07E-13) and by number of risk factors (p = 0.006). Increased tooth loss is associated with age and number of risk factors including diabetes, tobacco use, IL1+, and cardiovascular disease. Conclusion: These trends suggest that older patients and those with more risk factors should seek further preventive care to reduce future tooth loss.
Highlights
In dentistry, the traditional claims of “everyone should go to the dentist twice a year” and/or “everyone should brush their teeth three times a day” are not based on evidence
An analysis of the self-reported medical history adjusted by sex, age, and ethnic background indicated that individuals who smoked, had diabetes, or cardiovascular diseases had statistically more tooth loss (Table 1)
We initially selected 881 adult subjects out of the 4137 with complete periodontal examinations and evaluated tooth loss based on smoking, diabetes, having interleukin 1 risk alleles, and hypertension
Summary
The traditional claims of “everyone should go to the dentist twice a year” and/or “everyone should brush their teeth three times a day” are not based on evidence. More problematic stereotypes and/or cultural norms are associated with the region, such as fatalistic outlook, distrust of outsiders, and distrust of formalized medical systems Independent from these data, quantitative data clearly show socio-economic indicators are much worse for the communities in the Appalachian region compared to those in the rest of the United States (reviewed in [4]). We keep a registry of patients in our School of Dental Medicine, where clinical information is linked to a biological sample of consented individuals This resource (The Dental Registry and DNA Repository project) is available for supporting hypothesis driven work that requires careful dental clinical information. We report the analyses of the population participating in the registry and measured tooth loss as the outcome of interest aiming the identification of risk factors that may guide a preventive strategy that will reduce tooth loss and increase tooth longevity
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