Epidemiology Of Periodontal Disease Research Articles

Epidemiology of periodontal disease in dogs in the UK primary-care veterinary setting.

ObjectivesPeriodontal disease is a frequent diagnosis of dogs and can have severe negative impacts on welfare. It was hypothesised that breeds with skull shapes that differ most in conformation from the moderate mesocephalic skull shape have higher odds of periodontal disease.Materials and MethodsThe cohort study included a random sample of dogs under primary veterinary care in 2016 from the VetCompass Programme database. Risk factor analysis used random effects multivariable logistic regression modelling.ResultsThe study included a random sample of 22,333 dogs. The 1‐year period prevalence for diagnosis with periodontal disease was 12.52% (95% CI: 12.09 to 12.97). Eighteen breeds showed increased odds compared with crossbred dogs. Breeds with the highest odds included Toy Poodle (odds ratio 3.97, 95% confidence intervals 2.21 to 7.13), King Charles Spaniel (odds ratio 2.63, 95% confidence interval 1.50 to 4.61), Greyhound (odds ratio 2.58, 95% confidence interval 1.75 to 3.80) and Cavalier King Charles Spaniel (odds ratio 2.39, 95% confidence interval 1.85 to 3.09). Four breeds showed reduced odds compared with crossbreds. Brachycephalic breeds had 1.25 times the odds (95% confidence interval 1.11 to 1.42) of periodontal disease compared with mesocephalic breeds. Spaniel types had 1.63 times the odds (95% confidence interval 1.42 to 1.87) compared with non‐spaniel types. Increasing adult bodyweight was associated with progressively decreasing odds of periodontal disease.Clinical SignificanceThe high prevalence identified in this study highlights periodontal disease as a priority welfare concern for predisposed breeds. Veterinarians can use this information to promote improved dental care in predisposed dogs, especially as these dogs age.

Epidemiology of periodontal diseases among the adult population in the city of Ufa

The article presents the results of an epidemiological study of the prevalence and intensity of inflammatory periodontal diseases (IPD) in the northern and southern parts of Ufa, as well as the need for complex periodontal treatment. The number of visits by primary persons for periodontal care in the NW is 2.1 times less than in the SW. The rank values of common risk factors for the development of IPD have been identified. When assessing the KPI index, the risk to this pathology and its difference in different parts of Ufa, taking into account the nosological form and gender, were identified. With acute gingivitis, men living in NW and SW were statistically equally treated to a periodontist, while women living in NW were 1.8 times more. With acute periodontitis in the NW, men visit a periodontist 1.9 times more than in the SW, and women, on the contrary, in the SW are 1.2 times more likely to visit than in the NW. With chronic forms of IPD, the differences in treatment among men and women were not statistically significant and did not depend on the area of residence.

Epidemiology of periodontal disease in adolescents in mainland China, 1983-2020: a systematic review and meta-analysis.

Periodontal disease is a chronic inflammatory disease that includes primarily gingivitis and periodontitis, caused by bacterial infection of the supporting structures of the teeth. For years, much attention has been diverted to periodontal disease among the elderly, not enough attention is paid to adolescents. The purpose of this meta-analysis is to evaluate the epidemic trend of periodontal disease in adolescents in mainland China. We conducted a comprehensive literature search through PubMed, Embase, CNKI, Chongqing VIP database, Chinese Wan Fang Database, and CBM. A series of subgroup analyses were done to explore the epidemiological characteristics of periodontal disease (gender, location, age, survey year, and geographical distribution) with the help of related software. Thirty studies were included in this study. The data extraction and analysis were from three indexes, including bleeding on probing (BOP), pocket depth (PD), and dental calculus (DC). The detection rates of BOP(+), PD ≥4 mm and DC(+) were 48.8% (95% CI: 36.2-61.4%), 1.0% (0.0-2.0%), and 49.8% (41.0-58.6%), respectively. There were significant differences for the prevalence of gingivitis both in gender and area: the prevalence was higher in males than that in females, and risk ratio was 1.04 (95% CI, 1.01-1.06); a lower prevalence in urban areas compared with rural areas, and the risk ratio was 0.90 (95% CI, 0.85-0.96). This study shows a high prevalence of gingivitis among adolescents in China. Higher-quality epidemiological surveys with standard examination criteria are needed.

Impaired host response and the presence of Acinetobacter baumannii in the serum microbiome of type-II diabetic patients.

SummaryType II diabetes (T2D) affects over 10% of the US population and is a growing disease worldwide that manifests with numerous comorbidities and defects in inflammation. This dysbiotic host response allows for infection of the host by numerous microorganisms. In the course of T2D disease, individuals can develop chronic infections including foot ulcers and periodontitis, which lead to further complications and opportunistic infections in multiple body sites. In this study, we investigated the serum of healthy subjects and patients with T2D with (T2DP) or without periodontitis for both microbiome signatures in addition to cytokine profiles. Surprisingly, we detected the presence of Acinetobacter baumanii in the serum of 23% individuals with T2D/T2DP tested. In T2DP, IL-1β, TNF-α, MCP-1, IL-6, IL-8, and IFN-γ were significantly elevated in ABC-positive subjects. As an emerging pathogen, A. baumanii infection represents a risk for impaired inflammation and the development of comorbidities in subjects with T2D.

Effect of obesity on periodontal attachment loss progression: a 5-year population-based prospective study.

The aim of this study was to assess the effect of overweight and obesity on periodontal attachment loss (PAL) progression in an urban population from south Brazil. In 2001, a population-based oral health survey entitled "Epidemiology of periodontal diseases: the Porto Alegre Study" was conducted by drawing a probabilistic sample of 1586 individuals. After 5years, 755 (participation rate: 47.6%) individuals were re-examined. For this analysis, self-reported diabetics, underweight individuals, and individuals with <6 teeth were excluded. Poisson regressions were used to calculate relative risks (RR) and 95% confidence intervals (CI) adjusted for sex, age, skin colour, education, socio-economic status, smoking and dental care. Five hundred and eighty-two individuals (333 males/249 females, 36.02±14.97years) were included. Overall, obese individuals had significantly higher risk of experiencing PAL progression than individuals with normal weight after adjusting for important co-factors (RR=1.36, 95% CI=1.04-1.78). In a stratified analysis, no statistically significant associations were observed between PAL progression and obesity for males (RR=1.13, 95% CI=0.75-1.69), whereas obese females were at statistically significant higher risk than normal weight females (RR=1.64, 95% CI=1.11-2.43). Obesity appears to be a risk factor for PAL progression for females but not males in this developing country population.

Epidemiology of periodontal diseases in Indian population since last decade.

Objective:India suffers lot of disparities in terms of oral health care and 95% of the Indian population suffers from periodontal disease. The aim of this review is to estimate the risk factors responsible for periodontal diseases as well as prevalence for the same in the last decade to make an attempt to develop a strategy to improve formulation of an effective oral health care policy in India.Materials and Methods:Keywords such as “prevalence of periodontal diseases,” “epidemiology,” “periodontitis in India,” and “oral hygiene status in India” were searched for appropriate studies to obtain a bibliographic database. The references of selected articles and relevant reviews were searched for any missed publications that included studies conducted in India estimating periodontal diseases with adequate sample size. Clinical parameters, sample size, and findings for each study were tabulated from 2006 to 2015 (till September 15, 2015) in chronological order to observe the prevalence as well as epidemiology of periodontal disease in India.Results:The projection of periodontal disease is disturbing. In addition, the majority of studies done have used the Community Periodontal Index of Treatment Needs (CPITN) as its epidemiological tool that can grossly underestimate the presence of deep pockets.Conclusion:Current knowledge has shown that periodontitis does not present a linear progression and is not age-dependent. Moreover, its distribution and severity are strongly influenced by host susceptibility and risk factors. A structured all-inclusive survey of all districts of the states is a prerequisite for the constitution of an apt and cogent health care policy in our country.

Epidemiology of periodontal diseases in adults from Latin America.

A decade has passed since we first reviewed the epidemiology of periodontal diseases in Latin America. At that time, lack of population-based studies was the norm and our conclusions were based on very limited evidence. The aim of the present comprehensive review was to update and expand our previous work by providing a broad overview of Latin America and its current social, economic and demographic status and by focusing on the epidemiology of periodontal diseases in Latin American adults published in the last 15 years. The amount of periodontal epidemiological data available has increased but is still restricted to a few countries only. The scope of the literature available has also broadened to include oral health-related quality of life and systemic interactions; however, most studies had methodological limitations that might have biased their results. In general, periodontitis was very prevalent, but severe periodontal destruction was localized. Besides being associated with well-established risk factors, periodontitis was associated with demographics and socio-economic factors in Latin American populations. To advance epidemiological knowledge, population-based cross-sectional and longitudinal studies, using appropriate methodologies, should be the future focus of the research agenda of researchers and public health planners in Latin American countries.

A Latin American perspective of periodontology.

Periodontal diseases occur worldwide, and Latin American populations are significantly affected by different manifestations of periodontal disease. The interest in periodontics and periodontal therapy first developed in the early 1930s in the southernmost countries of Latin America, and spread, as the years went by, throughout the region. Today, periodontal research is vibrant in Latin America. The aim of this volume of Periodontology 2000 was to present an overview of the periodontal research currently being performed in different countries of Latin America. The epidemiology of periodontal diseases in adults, children and adolescents, and the pathogenesis of such diseases (including microbiological characteristics and risk factors), are discussed. The role of systemic antibiotic therapy and the effect of smoking are discussed in relation to the progression and the treatment of periodontitis. In addition, the benefit of lasers in periodontal therapy is evaluated. Latin American research groups have been active in exploring new venues of regenerative periodontal treatment, addressing the role of cementum proteins, growth factors and oral mesenchymal stem cells in tissue engineering. Finally, basic research to study cancerization is reported.

Common periodontal diseases of children and adolescents.

Background. Since 2000, studies, experiments, and clinical observations revealed high prevalence of periodontal diseases among children and adolescents. Therefore, this paper was designed to provide an update for dental practitioners on epidemiology, microbiology, pathology, prevention, diagnosis, and treatment of periodontal diseases in children and adolescents. Methods. This paper reviews the current literature concerning periodontal diseases in pediatric dentistry. It includes MEDLINE database search using key terms: “periodontal diseases in children,” “Periodontal diseasesin adolescents,” “periodontal diseases risk factors,” “microbiology of periodontal diseases,” “classification of periodontal diseases,” “epidemiology of periodontal diseases,” and “treatment of periodontal diseases.” Articles were evaluated by title and/or abstract and relevance to pediatric dentistry. Sixty-five citations were selected by this method and by the references within the chosen articles. A review of the comprehensive textbooks on pediatric dentistry and periodontology was done. Some recommendations were based on the opinions of experienced researchers and clinicians, when data were inconclusive.

Epidemiology of Periodontal Disease

Epidemiology is the study of health and disease in populations and of how these states are influenced by biology, heredity, and physical and social environment, as well as personal behavior. Advances in research over recent years have led to a fundamental change in our understanding of the periodontal diseases. As recently as the mid-1960s, the prevailing model for the epidemiology of periodontal diseases included the following precepts: (1) all individuals were considered more or less equally susceptible to severe periodontitis; (2) gingivitis usually progressed to periodontitis with consequent loss of bone support and eventually loss of teeth; (3) susceptibility to periodontitis increased with age and was the main cause of tooth loss after age 35–55. Since the development of this paradigm, advances in the understanding of periodontal diseases have led this disease model to be reevaluated. Current knowledge has shown that periodontitis does not present a linear progression and is not age dependent. Moreover, its distribution and severity are strongly influenced by host susceptibility and risk factors. Several epidemiological studies evaluating destructive periodontal diseases have been pursuing associations in the incessant identification of risk factors for these diseases. Analytical epidemiology seeks to identify the risk factors associated with a disease, to quantify the strength of those associations and to estimate whether an association is causal. An understanding of risk factors can lead to theories of causation and then to treatment protocols for clinicians to use in their daily practice. The essential features of epidemiology as a method of research, when compared to clinical research and case studies, are that (1) groups rather than individuals are the focus of study; (2) persons with and without a particular disease (e.g., periodontal diseases) and with and without the exposure of interest are included, rather than just patients. The study of population groups rather than individuals is to allow for valid estimates while accounting for normal biological variation (e.g., some individuals form dental biofilm readily; others do not). Broadening a study to include those with and without a disease can provide a reference point against which a risk is quantified. Under such background, this special issue was designed to summarize the current status of periodontal epidemiology. Thus, we have invited authors to submit original research articles and analysis that seek to clarify aspects of the epidemiology of periodontal diseases and the relevant related factors. As a result, various interesting and scientifically significant papers have been accepted. This special supplement presents manuscripts reporting information about the prevalence and distribution of periodontitis, as well as their associations with risk factors. In addition several studies reported tooth loss, one of the most visible results of the evolution of periodontitis that causes physiological and psychological impacts on patient's life. These papers represent an exciting and insightful observation into the state of art, as well as emerging future topics, in this important interdisciplinary field. We hope that this special issue would attract a major attention of the peers.

Analytic epidemiology and periodontal diseases

AbstractThe validity of epidemiological and clinical observations is paramount, not only for scientific advancement but also in evidence‐based practice. Concern regarding validity with respect to the design and conduct of analytic epidemiological studies is often under‐appreciated, partly as a consequence of our focus on randomized experimental designs as the highest standard of ‘proof’ in clinical science. We review the design, conduct and interpretation of rigorous analytic epidemiological study designs, with specific reference to periodontology. We give special emphasis to intrinsic validity and the use of focused aims to re‐frame the perspective on the strength of evidence in reviews of the literature. Specifically, we draw on the periodontal research literature to provide an overview of the appropriate design and conduct of cohort studies, including randomized designs, case–control and cross‐sectional studies. The concepts of selection bias, information bias and confounding are explored for each study design, both in general terms and with respect to a critical review of the literature on the epidemiology of periodontal diseases.

Comprehensive Periodontal Therapy: A Statement by the American Academy of Periodontology

Comprehensive Periodontal Therapy: A Statement by the American Academy of Periodontology

Methodological issues in epidemiological studies of periodontitis - how can it be improved?

BackgroundThis position paper was commissioned by the European Association of Dental Public Health, which has established six working groups to investigate the current status of six topics related to oral public health. One of these areas is epidemiology of periodontal diseases.MethodsTwo theses "A systematic review of definitions of periodontitis and the methods that have been used to identify periodontitis" [1] and "Factors affecting community oral health care needs and provision" [2] formed the starting point for this position paper. Additional relevant and more recent publications were retrieved through a MEDLINE search.ResultsThe literature reveals a distinct lack of consensus and uniformity in the definition of periodontitis within epidemiological studies. There are also numerous differences in the methods used. The consequence is that data from studies using differing case definitions and differing survey methods are not easily interpretable or comparable. The limitations of the widely used Community Periodontal Index of Treatment Need (CPITN) and its more recent derivatives are widely recognized. Against this background, this position paper reviews the current evidence base, outlines existing problems and suggests how epidemiology of periodontal diseases may be improved.ConclusionsThe remit of this working group was to review and discuss the existing evidence base of epidemiology of periodontal diseases and to identify future areas of work to further enhance it.

First European consensus workshop in periodontal education – objectives and overall recommendation

The first European Workshop in Periodontal Education was held by the European Federation of Periodontology in collaboration with representatives of the Association of Dental Education in Europe (ADEE), in Segovia Spain between the 18th and 21st November 2009. It was generously supported by an educational grant from DENTAID SL (Spain). Over 60 experts broadly representing the European Universities addressed a mission, which focused upon the production of a consensus approach towards the teaching and learning of Periodontology in university undergraduate and post graduate curricula, and within the context of life-long learning. The specific objectives of the workshop were to: review the current trends in the epidemiology of periodontal diseases and periodontal treatment needs in Europe, the current status of the provision of periodontal services and human manpower; make recommendations regarding the scope and limits of periodontal education at the undergraduate, postgraduate and continuing education levels; define the competencies, learning outcomes, teaching and evaluation systems appropriate for undergraduate, postgraduate and continuing education in Periodontology. The following documents, therefore represent the consensus reports of the four working groups. Groups 1 and 4 based their consensus statements and conclusions upon the position paper which follows their report and which was peer reviewed, modified and accepted by the workshop. Groups 2 and 3 produced manuscripts which are the consensus reports of those groups and which were accepted by the workshop. The workshop arrived at an overall recommendation for appropriate interest groups (ADEE, Council of European Chief Dental Officers, Council of European Dental Deans and the Universities they represent), which is recorded below. Given the continued high prevalence of periodontitis within the population and the fact that it remains a major cause of tooth loss in adults, and its association with other chronic inflammatory diseases, core elements of periodontal management should be incorporated into compulsory CPD for dental practitioners. Correspondence Mariano SanzDean Faculty of Odontology University Complutense of MadridPlaza Ramon y Cajal 28040 Madrid (Spain)e-mail: marianosanz@odon.ucm.esTel: +34913941901 Iain ChappleProfessor of PeriodontologyBirmingham Dental SchoolCollege of Medical & Dental SciencesSt Chads QueenswayBirmingham B4 6NN (UK)e-mail: i.l.c.chapple@bham.ac.ukTel: +44 121 2372808Fax: +44 121 2372809

Epidemiology of periodontal diseases in the study of health in Pomerania

The aim of this study was to assess the prevalence and extent of periodontal diseases among adults in a province in Eastern Germany. The Study of Health in Pomerania is a population-based study conducted during 1997-2001. The net random sample comprised 4310 20-81-year-old subjects. Periodontal status was assessed at four surfaces using a half-mouth recording protocol. The prevalence of attachment loss >or=3 mm was 89.7%, with 62.8% of teeth being affected. Probing depths >or=4 mm were prevalent in 69.7% of subjects, and 29.6% of teeth were affected. 25.3% of all subjects had severe pockets (>or=6 mm). Periodontitis was significantly more prevalent in males. For attachment loss, the prevalence and extent increased significantly with increasing age, whereas probing depth values levelled off after the age of 40. In older subjects, increased recession and attachment loss were found, while the probing depth remained constant. According to the recent CDC classification, 17.6% and 33.3% of persons had severe and moderate periodontitis, respectively. The prevalence of periodontitis increased significantly with age and remained constant after the age of 50-59. Periodontitis is more prevalent in Pomerania than in the United States or Western Europe. In older subjects, attachment loss steadily increased, while the probing depth remained constant.

Has the prevalence of periodontitis changed during the last 30 years?

This paper reviews global trends in the change in prevalence of periodontitis over the last 30 years. The epidemiology of periodontal disease is briefly reviewed together with the current classification system and the clinical and radiographic diagnostic methodology in periodontal disease. This review identifies the very limited number of studies that provide prevalence data over time, and this data is discussed in comparison with those stemming from a few corresponding studies from countries outside Europe. The data indicate a possible trend of a lower prevalence of periodontitis in recent years.

Prevalência das Doenças Periodontais no Brasil. Parte II. 1993-2003

In 1993 a review of epidemiological surveys of the prevalence of periodontal diseases in Brazil 10 has shown that 86.7% of the total of examined individuals had evidence of marginal gingivitis or periodontal damage. The aim of this paper was to evaluate the prevalence of periodontal disease through a critical review of the dental literature of several independent epidemiologic studies that have been conducted during the last 10 years in Brazil (1993-2003). Differences in epidemiological methodology and clinical differential diagnosis made comparative evaluation of surveys data difficult and subjective. However, it can be concluded that the general prevalence rate of periodontal diseases was 92.92%. This review also revealed a lack of data on the epidemiology of periodontal disease in all Brazilian geographic regions. All the epidemiological data reviewed pointed to dental plaque as the primary aetiological agent in gingivitis and periodontitis.

Epidemiology of periodontal disease among older adults: a review.

Although many epidemiological studies have been conducted concerning periodontal disease, the majority were not included in this review because of deficiencies in the measures used. Although it is increasingly common for studies in this field to measure periodontal disease using clinical attachment level, attachment loss or bone loss, the evidence pertaining to prevalence, incidence and risk in older adult populations is limited. Although it is the best indicator to date, characterizing periodontal disease by means of attachment loss has some limitations. Prevalence and incidence rates may vary according to the number of teeth and sites probed and bias and case misclassification may occur because of the healthy survivor effect. Moreover, prevalence data that document lifetime disease experience are of little use in planning for periodontal treatment needs. Problems with sampling or subject selection and idiosyncratic ways of reporting data also limit the quality of the evidence currently available. In order to standardize the collection of data on loss of attachment and to measure it as accurately as possible, Papapanou (63) recommends that studies use full-mouth periodontal examinations and the assessment of clinical attachment level at four sites on each remaining tooth. Given the inconsistencies in and problems with the methods used in the studies reviewed above, only broad conclusions can be drawn concerning periodontal disease in older adults. These confirm the conclusions reached in other reviews of the literature. While moderate levels of attachment loss are to be found in a high percentage of middle-aged and elderly subjects, severe loss is confined to a minority, albeit a substantial one. Severe loss is evident in only a few sites and, in general, affects only a small proportion of sites examined. Nevertheless, approximately one-fifth of older individuals have experienced more generalized severe loss; the rate is much higher in the oldest subjects and subjects from minority groups. Although not universal, severe disease is common in some older populations and some population subgroups. Studies using common approaches are needed to fully elucidate the extent to which disease experience varies across different populations. Similar conclusions can be drawn from prevalence studies measuring bone loss. These show that a minority of subjects accounted for most sites with advanced loss. Studies of incidence suggest that 50-75% of older adults experience additional loss of attachment of 2 or 3 mm or more at a minimum of one site over relatively short periods of time. Rates fall dramatically when more stringent case definitions are used. Moreover, relatively few sites examined show evidence of additional loss so that, although rates are high, extent and severity are low. More detailed analyses of incidence data, although few, indicate that new lesions are more common than progressing lesions, and the pattern of loss tends to support an episodic model of periodontal disease progression.

CPITN and the epidemiology of periodontal disease.

This paper discusses the purposes of collecting epidemiological data on periodontal disease, and concludes that the severe shortcomings of the CPITN makes it unsuited as a tool for assessing the prevalence and severity of periodontal disease.

The impact of new technologies to diagnose and treat periodontal disease. A look to the future.

The last 25 years have brought unprecedented advances to our understanding of periodontal disease. Consider that in 1970 periodontitis was believed to effect most individuals over the age of 35 years, to progress steadily in an individual once initiated until teeth were lost, to be the primary cause of tooth loss in adults, to be caused by the bacterial mass accumulating on the tooth surface and subgingivally, and to involve the host in some fashion or another. In the 25 years since then, impressive research advances in the epidemiology of periodontal disease, the specific bacterial etiology of periodontal disease and the immunoinflammatory mediators of periodontal tissue destruction have greatly altered our view of periodontal disease. Thus, given these research advances in the understanding of periodontitis, what may the future hold for improved diagnosis and treatment of periodontal disease? Impressive research into new ways to diagnose the periodontal diseases is well underway. Investigators are seeking new ways to diagnose an individual's degree of risk for periodontal disease initiation, susceptibility to disease progression, level of disease "activity" and the likely response to treatment and recurrence of active disease. New diagnostic tests should greatly advance our ability to more accurately and specifically diagnose periodontal disease. The future also looks promising for new treatment strategies to slow or arrest periodontal disease progression. The bacterial specificity of periodontal disease etiology revealed since 1970 has logically led to the use of antibiotics in periodontitis treatment. In the late 1980s the concept of locally delivering antibiotics to the periodontal pocket was introduced, and subsequent clinical trials have indicated that it is possible to reduce pocket depth and inflammation with tetracycline locally delivered to the periodontal pocket. Likely, we have barely scratched the surface in studying the efficacy of locally delivery antimicrobial agents to alter the progression of periodontal disease. As new agents are developed and better delivery systems to the periodontal pocket are developed, the future should see a variety of antimicrobial agents available which can slow periodontal disease progression. The future also holds promise for slowing periodontal disease progression by blocking inflammatory pathways important in periodontal tissue destruction. Clinical trials of flubiprofen, naproxen and ketoprofen indicate that it is possible to slow periodontal disease progression with non-steroidal anti-inflammatory drugs which inhibit one destructive pathway. In addition, data from animal models indicate that chemically modified tetracycline as an inhibitor of collagenase can slow disease progression in animals. Again, we have likely only just begun to explore the wide range of molecular mediators of tissue destruction which may be targeted for blocking and thereby slow or arrest periodontal disease progression. Last, research into regenerating periodontal structures lost as a result of disease has had a noteworthy record of progress in the past 25 years. Techniques that utilize bone grafts, root treatments, tissue guiding membranes or polypeptide growth factors have ably indicated that it is possible to regenerate new attachment structures in humans. As investigators continue to unravel the mysteries of the embryonic development of the periodontium, the ability to predictably regenerate lost periodontal attachment structures holds great promise for the future.