Higher Plaque Scores Research Articles

Gingivitis and plaque scores among residents of low-income senior housing.

The purpose of this paper is to present Gingival Index (GI) and Plaque Scores (PS) of older and disabled adults living in low-income senior housing and their association with sociodemographic, health status and oral health behaviours. Participants were recruited from six low-income senior housing residences in Connecticut. Primary outcome measures were Gingival Index (GI) and Plaque Scores (PS). Surveys assessed sociodemographic characteristic, beliefs and behaviours. Logistic regression analysis was used to model the binary outcomes of probability of unfavourable GI status (>=0.34) and unfavourable PS (>=74%) against variables including demographic characteristics, oral hygiene behaviours and health status. 331 participants volunteered for the study. Mean baseline GI was 0.38 (SD: 0.3), and mean PS was 71.7% (SD: 18%). Logistic regression showed that males were more likely to have higher GI and plaque scores than females. Those with less formal education were more likely to have worse GI scores and high PS compared to those with college educations. Those with lower incomes and those who rated their oral health poor/fair were more likely to have higher PS. Participants had remarkably good gingival health regardless of relatively high PS. Males and less educated individuals should receive special attention when implementing oral hygiene interventions because of their relatively poor oral hygiene status.

Early childhood caries among 3- to 5-year-old children in Hong Kong

The aim of this study was to describe the prevalence of dental caries among 3- to 5-year-old children in Hong Kong and to investigate the factors associated with their dental caries status. Seven kindergartens in Hong Kong were selected using stratified random sampling. The 3- to 5-year-old kindergarten children were invited to join the study. The participants' parents were asked to complete a questionnaire regarding their children's demographic and socio-economic backgrounds, their dental habits and their own dental knowledge. Dental caries experience was measured using the decayed, missing and filled primary teeth (dmft) index. The visible plaque index was adopted for recording oral hygiene. The relationships between caries experience and children's demographic backgrounds, dental habits, oral hygiene and parental dental knowledge were studied using a zero-inflated negative binomial (ZINB) regression analysis. Among the 1,204 participating preschool children, the overall prevalence of dental caries (dmft > 0) was 46%. The mean dmft score was 2.1 ± 3.4. The prevalences of dental caries among the 3-, 4- and 5-year-old children were 38%, 43% and 55%, respectively. ZINB regression analysis revealed that the study children who were boys, came from families with lower incomes, had dental visit experiences, had higher plaque scores and had parents with lower levels of dental knowledge, had higher dmft scores (P < 0.05). Dental caries is prevalent among preschool children in Hong Kong. The caries experiences of the study children are associated with gender, family income, parental dental knowledge, dental visit experience and oral hygiene.

Erosive tooth wear among preschool children in Hong Kong.

This study aimed to assess the prevalence of erosive tooth wear among 3- to 5-year-old children in Hong Kong and to determine the effect of socio-economic factors, dental habits, and oral hygiene on their dental erosive wear status. Stratified random sampling was adopted. Their parents were asked to complete a questionnaire regarding their children's backgrounds. A single examiner evaluated the children for erosive tooth wear using Basic Erosive Wear Examination (BEWE) criteria. Multiple logistic regression was used to determine the relationship between erosive wear and the children's socio-economic factors, dental habits, and oral hygiene. 1204 children participated in this study. Prevalence of erosive tooth wear (BEWE score>0) was 14.9%. Among these, 153 children (12.8%) had initial wear, 21 children (1.8%) had distinct tooth loss, and five (0.4%) had severe erosive wear. Prevalence of erosive wear among the 3-, 4-, and 5-year-old children was 10.7%, 15.0%, and 17.7%, respectively. Increasing age, the low education of mother and high plaque scores were risk factors of erosive wear (P<0.05). Prevalence of erosive tooth wear is low among preschool children in Hong Kong. The erosive tooth wear prevalence increased with increasing age, lower education of mother, and poorer oral hygiene.

Oral Health Status of Kuwaiti Children with a History of Chronic Liver Disease

Objective: To investigate the oral health status and dental manifestations of children with a history of chronic liver disease (CLD) compared to healthy children.Subjects and Methods: Twenty children (15 boys and 5 girls) with a history of CLD were compared to 20 healthy controls matched for age and gender. The clinical examination was carried out by the same dentist. Caries prevalence, using the decayed, missing, and filled primary and permanent teeth indices (dmft/DMFT), was recorded. Developmental enamel defects, plaque scores, and gingival overgrowth were also investigated. Results: No statistically significant differences were found in mean dmft scores for children with a history of CLD (4.9 ± 5.4) and for healthy individuals (3.9 ± 4.5). However, the mean DMFT score was significantly higher (p =0.025) in children with CLD (4.2 ± 4.6) compared to controls (1.7 ± 1.6). The mean decayed teeth parameter (DT) was also significantly higher in children with CLD (p =0.004). All patients with CLD exhibited enamel defects compared to only 33% in the control group (p< 0.05). A higher mean plaque index was observed in children with a history of CLD (p< 0.001). Also, a positive correlation for gingival overgrowth was noted in patients with a history of CLD (p< 0.05). Green staining was evident only in the permanent dentition of 1 child with CLD. Conclusion: Children with a history of CLD exhibited a high caries prevalence, high plaque scores, and more enamel defects compared to healthy subjects. Gingival overgrowth is less prevalent among pediatric liver transplant patients on tacrolimus therapy.

Diet intake and caries status among final year students in IIUM Kuantan campus

Abstract One of the most significant factors for caries is diet intake.100 final year students IIUM Kuantan Campus was undergone clinical examination and completed self-administered questionnaire. Statistical analysis was done using SPSS version 22. Chi-square test was used. Majority of respondents took 3 to 4 times food intake per day. Almost half of respondents did snacking between meals. Among the respondent, 41% has low, 35% has moderate and 24% has high DMFT score respectively. Majority of the final year students has low DMFT, mild inflammation gingiva, and high plaque score. Lastly, sugary food did have significant effect to the DMFT.

Effectiveness of "Audio-tactile Performance Technique" to improve the oral hygiene status of visually impaired schoolchildren.

Maintaining oral hygiene is a challenging task for the visually impaired population. Oral health is often overlooked because of lack of knowledge about oral health practices. Therefore, there was a need to train visually impaired individuals with the aid of customized techniques so that the understanding of brushing technique could be perceived at its best. Comparative evaluation to check the effectiveness of "Audio-tactile Performance Technique (ATP)" to improve oral hygiene status of visually impaired schoolchildren. The present study was an interventional study of 92 visually impaired children in Wardha district. Their knowledge regarding oral hygiene practices was tested with a verbal questionnaire in a pre- and post-test to check the improvement in their knowledge after imparting health education. Fones method of toothbrushing was taught by "ATP," and a health talk was delivered. The plaque scores were recorded using the Quigley-Hein Plaque Index (modified by Turesky et al.) at baseline and at the end of 3 months. Periodic reinforcement was provided twice at an interval of 20 days in between the visits. The collected data were tabulated and analyzed using Student's paired t-test in Stata version 15.1, and kappa statistics were done to test inter-rater reliability and agreement was found to be 90%. There was a statistically significant decrease in the postinterventional plaque scores from 2.78 to 1.63 (P < 0.05) and an increase in the posthealth education test scores from 1.98 to 8.21 (P < 0.05). A substantial decrease in the percentage of children, who had high plaque scores initially, was seen postintervention. The "ATP" along with oral health education served as a very effective customized method of teaching oral hygiene practices and its maintenance to the visually impaired children.

Tooth Loss And Mobility In Aggressive Periodontitis Patients: A Retrospective Study

Introduction: Tooth loss has much negative implication in aesthetics and oral function of an individual. Aggressive periodontitis has been known to result in rapid tissue and bone destruction and if left untreated eventually tooth loss. Hence, this study was conducted to assess the prevalence of tooth loss and tooth mobility in a group of aggressive periodontitis patients. Materials and Methods: This was a retrospective data of aggressive periodontitis patients attending IIUM Dental Clinic that has been diagnosed in year 2014 up to June 2017. The data was extracted from patients’ case records systematically using data extraction forms representing all specific objectives. IBM SPSS-24 was used for data analysis. Results: The prevalence of aggressive periodontitis patients attending IIUM dental clinic within 4 years was 4.2%. Out of this 45.5% presented with tooth loss. Most of them had being diagnosed as generalized aggressive periodontitis and showed to have high mean plaque and bleeding score compared to aggressive periodontitis with no tooth loss. However it was statistically insignificant difference (p&lt;0.05). The tooth loss group also presented with more remaining teeth with mobility. Conclusion: Tooth loss was prevalence in aggressive periodontitis patients. Moreover, remaining teeth were also affected by some degree of mobility, which may affect the normal oral cavity functions and aesthetic. Further study with bigger sample size should be conducted to analyze the impact of the high tooth loss to the patients’ oral and general well-being.

Association of early childhood caries experience with oral hygiene status and oral health practices of preschool children in Tandale, Tanzania

Background: Early Childhood Caries (ECC) has short and long-term effects on children and parents. The short-term effects include higher risk of new lesions, emergency room visits and hospitalization, increased treatment costs and days with restricted activity. The long-term effects are diminished learning ability and delayed physical growth and development.Objectives: To determine the association of ECC with oral hygiene status and oral health practices among children attending informal preschools in Dar es Salaam, Tanzania.Materials and methods: A descriptive cross-sectional study among 297 preschool children and their caregivers. Schools were selected using a stratified random sampling technique while children were conveniently selected. A questionnaire to interview parents inquired on socio-demographic characteristics, oral hygiene practices and dietary habits. Clinical examination for children’s plaque and dental caries scores was conducted. Data was analyzed using SPSS Version 20. Chi square and logistic regression statistical tests were done to determine the association between variables. The level of significance was set at p ≤ 0.05Results: Small proportion of the children brushed their teeth twice per day (24.6%), consumed sugar containing snacks (23.9%) or sugary drinks (20.9%) more than twice per day. Seventy percent had caries with a decayed missing and filled teeth index (dmft) of 4.19(±4.52 SD). Children brushing less than twice a day (p=0.021) and having high plaque scores (p=0.000) were more likely to develop dental caries than their counterparts.Conclusion: Caries experience among preschool children was positively associated with poor oral hygiene status and brushing teeth less than twice per day.

Clinical significance of the coexistence of carotid artery plaque and white matter disease in patients with symptomatic cerebral infarction

ObjectivesSymptomatic cerebral infarction (CI) can occur in patients without main cerebral artery stenosis or occlusion. This study investigated the unique features of carotid artery plaque and white matter disease (WMD) in patients with symptomatic CI and transient ischemic attack (TIA) but without stenosis or occlusion of a main cerebral artery. Patients and methodsWe studied 647 patients who underwent both carotid ultrasound examination and brain magnetic resonance images. Plaque score (PS), plaque number, maximal plaque intima-media thickness and grades of WMD were examined. Subjects were divided into four groups, the CI group, TIA group, myocardial infarction (MI) group and risk factor (RF) group. Plaque and WMD were analyzed in cerebral ischemia group (CI and TIA), compared to non-cerebral ischemia groups and to a high PS group and a high WMD grade group from the RF group. ResultsBoth of each value of plaque and grades of WMD in the cerebral ischemia group were significantly higher than those in other groups. Grades of WMD in the cerebral ischemia group were significantly higher than those in the high PS group, although there was no significant difference of the each value of plaque between the two groups. The each value of plaque in the cerebral ischemia group was also significantly higher than those in the high WMD grade group, although there was no significant difference of grade of WMD between the two groups. ConclusionSimultaneous increases in carotid artery plaque and WMD are associated with symptomatic CI, which is not caused by stenosis or occlusion of a main cerebral artery.

Differences in optic nerve head microcirculation between evening and morning in patients with coronary artery disease.

To determine whether differences or variation of blood flow in the ONH are independent risk factors for CAD. We studied 144 consecutive patients whose ocular blood flow in the ONH was measured in the evening and morning by LSFG. We analyzed the MBR throughout the ONH (MBR-A) and in the tissue (MBR-T) and vessels (MBR-V) in the ONH. We also evaluated the MBR-T, MBR-V, and MBR-A values obtained in the evening and morning and the variation (Δ) between evening and morning values in each group. Twenty-three patients (16%) were diagnosed with CAD. The morning MBR-T and MBR-A values were significantly lower in these patients with CAD compared to the patients without CAD. ΔMBR-T in the CAD patients was significantly lower compared to that of the no-CAD patients. The logistic regression analysis was revealed that a high carotid artery plaque score, lower ΔDBP, and ΔMBR-T were identified as risk factors for CAD. Ocular microcirculation obtained from LSFG may provide a window for detecting changes in microvasculature related to CAD.

Association between carotid plaque score and microvascular complications of type 2 diabetes.

According to the "common soil" hypothesis, diabetic microangiopathy and macroangiopathy have a similar pathophysiological background. It has been well documented that carotid artery atherosclerosis in patients with type 2 diabetes is associated with cardiovascular complications; however, it remains unclear whether there is a similar association for microvascular complications. We investigated whether the carotid plaque score and the carotid intima-media thickness (IMT) are associated with macroangiopathic and microangiopathic complications of type 2 diabetes. We enrolled patients with type 2 diabetes and microvascular complications or overt macroangiopathy. A B‑mode carotid ultrasound was performed in all participants, and anthropometric parameters, hemoglobin A1c (HbA1c) levels, lipid profile, and smoking status were assessed. The study included 73 patients (mean [SD] age, 63.6 [7.5] years; 36 men [49%]). The mean (SD) diabetes duration was 11.7 (8.1) years. Microvascular complications were observed in 32 patients (43.8%), and overt macroangiopathy, in 42 (57.5%). Hypertension was reported for 60 patients (82%); dyslipidemia, for 56 (77%); obesity, for 37 (51%); and smoking, for 10 (14%). A multivariate regression analysis showed that the carotid plaque score, but not carotid IMT, was significantly associated with dyslipidemia (P = 0.03) and microangiopathy (P = 0.01). Our results indicate that, unlike carotid IMT, the carotid plaque score is independently associated with microangiopathic complications in type 2 diabetes. Patients with a high plaque score should receive special care and the most intensive treatment to stop progression of these complications.

Applying Bayesian Model to Predict Socio-demographic and Occlusal Determinants of Early Childhood Caries (ECC)

Objective: To use the Bayesian statistical Model approach to predict the most important socio-demographic and occlusal factors pertinent to high prevalence of ECC. Material and Methods: A questionnaire and an oral examination was conducted on children who attended a pediatric dental clinic in Nairobi during the period of study. The parents provided information on socio-demographic and oral habits of the children. The oral examination for presence of dental caries was recorded for each child. Descriptive statistics were obtained for dental caries, oral hygiene, using plaque score, and malocclusion. The results of the questionnaire and presence of dental caries were analyzed and the results subjected to Bayesian statistical analysis to determine any predictive factors for ECC. Results: 55% of the children had plaque accumulating on more than one third but less than two thirds of tooth surfaces. The highest plaque scores were reported among children whose fathers (48.2%) and mothers (42.0%) had completed secondary, and whose fathers were in non-formal employment 73.2%. The overall prevalence of dental caries in the study group was 95.5% with a mean dmft of 8.53 (+ 5.52 SD), with the male children having higher dmft 8.65 (SD+5.54) than the female children 8.37 (SD+ 5.50). The prevalence of malocclusion among children in the study was 55%. The majority had mesial step, 51.5% (n=140) and flush terminal plane 28.3% (n=77). Conclusion: The Bayesian Model, with a correct assumption, can be used to determine the important factors involved in high prevalence of ECC.

Carotid atherosclerosis, cytomegalovirus infection, and cognitive decline in the very old: a community-based prospective cohort study.

To investigate various risk factors of cognitive decline in the very old, we studied 494 subjects over 85years old without diagnosis of dementia at baseline from the Tokyo Oldest Old Survey on Total Health, an ongoing, community-based cohort in Japan. Cognitive function was assessed at baseline and at 3-year follow-up using Mini-Mental State Examination (MMSE). Plasma samples were assayed for levels of cytomegalovirus (CMV) immunoglobulin G (IgG) antibodies, tumor necrosis factor-alpha, interleukin-6, and blood chemistry. Carotid artery plaques were measured using an ultrasonography. In the cross-sectional analyses using Tobit regression, individuals with high carotid artery plaque score (≥5.0) had MMSE scores that were 1.08 points lower compared to those with no plaque (95% confidence interval (CI) -1.95 to -0.20; p = 0.016), adjusted for age, sex, and education. Individuals with CMV IgG titers in the highest quartile had MMSE scores that were 1.47 points lower compared to individuals in the lowest quartile (95% CI -2.44 to -0.50; p = 0.003). CMV and carotid atherosclerosis showed evidence of an interaction, where the association between CMV and MMSE was present only in subjects with carotid artery plaque. In the longitudinal analyses using linear regression, carotid atherosclerosis, smoking, low grip strength, and poor activities of daily living (ADL) status were associated with faster cognitive decline, adjusted for age, sex, education, and baseline cognitive function. Our findings suggest that carotid atherosclerosis is consistently associated with low cognitive function in the very old and modifies the association between latent CMV infection and cognition.

Hospitalisation impacts on oral hygiene: an audit of oral hygiene in a metropolitan health service.

Poor oral health has been associated with systemic diseases, morbidity and mortality. Many patients in hospital environments are physically compromised and rely upon awareness and assistance from health professionals for the maintenance or improvement of their oral health. This study aimed to identify whether common individual and environment factors associated with hospitalisation impacted on oral hygiene. Data were collected during point prevalence audits of patients in the acute and rehabilitation environments on three separate occasions. Data included demographic information, plaque score, presence of dental hygiene products, independence level and whether nurse assistance was documented in the health record. Data were collected for 199 patients. A higher plaque score was associated with not having a toothbrush (p = 0.002), being male (p = 0.007), being acutely unwell (p = 0.025) and requiring nursing assistance for oral hygiene (p = 0.002). There was fair agreement between the documentation of requiring assistance for oral care and the patient independently able to perform oral hygiene (ICC = 0.22). Oral hygiene was impacted by factors arising from hospitalisation, for those without a toothbrush and male patients of acute wards. Establishment of practices that increase awareness and promote good oral health should be prioritised.

Abstract P388: Novel Metabolic Markers for the Risk of Carotid Plaque Progression in American Indians

Background: Carotid atherosclerotic plaque and its progression significantly predict cardiovascular events. Traditional clinical factors have limited value in early risk prediction. Metabolomics is an emerging technology that can accurately quantify hundreds to thousands of small metabolites in biofluids, thus providing a powerful tool for early biomarker discovery. Previous studies were largely cross-sectional with a focus on the European population, results of which may not be generalized to other ethnic groups. In addition, causality cannot be resolved in cross-sectional analysis. Objective: To prospectively identify novel metabolic markers predictive of carotid plaque onset and progression in American Indians in the Strong Heart Study (SHS). Methods: This study includes 396 apparently healthy American Indians attending both clinical exams in 2001-2003 and 2006-2009 (average 5.5 years of follow-up). All participants had normal fasting glucose and were free of overt CVD at baseline. Plaque progression was defined as having a higher plaque score at the end of follow-up compared to baseline. Fasting plasma metabolites were detected using untargeted LC-MS. A total of 1,364 matching metabolites that passed stringent QC were included in the current analysis. The prospective association of plaque progression with each metabolite was examined using Cox proportional hazards model, adjusting for sex, site, age, BMI, eGFR, lipids, blood pressure, smoking and alcohol drinking at baseline. The combined metabolic effect was examined using a weighted multi-marker metabolites score comprising of all significant metabolites. Incremental value of novel metabolites over traditional risk factors for risk prediction was tested using the net reclassification improvement index (NRI). Multiple testing was corrected using the q-value method (q&lt; 0.05 was considered statistical significance). Results: Of all 396 participants, 100 developed new plaque or progressed to a high order of atherosclerosis during follow-up. Five metabolites including PC (6:2/14:2) (HR 1.56[1.23-1.96]), proscillaridin A (HR 1.68 [1.27-2.21]), 8e-heptadecenedioic acid (HR 1.56 [1.22-1.98]), flavone (HR 1.69 [1.27-2.26]), and n-palmitoyl methionine (HR 1.72 [1.28-2.32]), significantly increase, whereas one metabolite, PC (18:0/18:1) (HR 0.62 [0.52-0.73]), significantly decreases the risk of plaque progression. A multi-marker score comprising of all six metabolites significantly improves risk prediction beyond traditional risk factors (NRI=0.22, P=1.23x10-5). Conclusions: Altered levels of fasting plasma metabolites significantly predict the risk of plaque onset and progression over and above conventional risk factors. The newly detected metabolites may unravel novel metabolic pathways underlying CVD pathogenesis and could be used as new markers for risk prediction and stratification.

Abstract 13452: Serum Apolipoprotein B-48 levels Are Significantly Correlated with Plaque Score of Carotid Arteries

Introduction: Fasting hypertriglyceridemia is a “residual risk” factor for atherosclerotic cardiovascular diseases and related to postprandial hypertriglyceridemia (PHTG). Intestine-derived lipoproteins such as chylomicrons and chylomicron remnants (CM-Rs), which contain one apolipoprotein(apo) B-48 molecule per one particle, are accumulated in patients with PHTG. Basic studies showed that CM-R had an atherogenic nature and apoB-48 molecule was observed in atherosclerotic plaque twice as many as apoB-100 molecule histologically. We established a CLEIA for measuring serum apoB-48 concentrations and reported that high apoB-48 concentrations correlated with the prevalence of dyslipidemia, diabetes mellitus, metabolic syndrome, chronic kidney disease and coronary heart disease. Hypothesis: We investigated whether serum apoB-48 concentration correlated with subclinical carotid atherosclerosis. Methods: A total of 163 subjects who received ultrasonography of carotid arteries in Osaka University were enrolled. Blood pressure (BP) at the supine position and serum concentrations of apoB-48, plasma glucose, HbA1c, TC, TG HDL-C and LDL-C were measured. Intima-media thickness (IMT) of carotid arteries was measured and plaque score (PS) were calculated in all subjects. Results: All subjects were classified into 4 groups by apoB-48 concentration quartiles: 1st (0-2.2 μg/mL, n=41), 2nd (2.3-3.5 μg/mL, n=39), 3rd (3.6-6.7 μg/mL, n=42) and 4th quartile (≧6.8 μg/mL, n=41), respectively. TG concentrations, prevalence of high BMI (≧25), max-IMT and PS were increased as apoB-48 concentrations were increased. Max-IMT and PS had significant correlations with age, eGFR, systolic BP, log-TG and log-apoB-48 levels and a multiple regression analysis indicated that the age, eGFR, and log-apoB-48 concentrations (p&lt;0.05) were a significant determinant of an increased max-IMT and PS. In subjects whose TG concentrations were &lt;150 mg/dL, max-IMT and PS were significantly higher in subjects of the 4th quartile than those of other quartiles. Conclusions: High serum apoB-48 concentrations strongly correlated with increased max-IMT and PS, indicating that the accumulated CM-Rs might be one of the increased risk for subclinical carotid atherosclerosis.

Reexamining the Association Between Smoking and Periodontitis in the Dunedin Study With an Enhanced Analytical Approach

Smoking is a major risk factor for periodontal disease. Conventional oral epidemiology approaches have found strong, consistent associations between chronic smoking and periodontal attachment loss (AL) through ages 26, 32, and 38 years, but those statistical methods disregarded the data's hierarchical structure. This study reexamines the association using hierarchical modeling to: 1) overcome the limitations of an earlier approach (trajectory analysis) to the data and 2) determine the robustness of the earlier inferences. Periodontal examinations were conducted at ages 26, 32, and 38 years in the Dunedin Multidisciplinary Health and Development Study. The number of participants examined at those three ages were 913, 918, and 913, respectively. A generalized linear mixed model with a quasi-binomial approach was used to examine associations between chronic smoking and periodontal AL. At ages 26, 32, and 38, smokers had 3.5%, 12.8%, and 23.2% greater AL than non-smokers. Regular cannabis use was associated with greater AL after age 32, but not at age 26. Males had more AL than females. Participants with high plaque scores had consistently greater AL; those who were of persistently low socioeconomic status had higher AL at ages 32 and 38, but not at age 26. The amount of AL in anterior teeth was less than in premolars and molars. Gingival bleeding was associated with higher AL at ages 26, 32, and 38. The smoking-periodontitis association is observable with hierarchical modeling, providing strong evidence that chronic smoking is a risk factor for periodontitis.

Occupational characteristics and the progression of carotid artery intima-media thickness and plaque over 9 years: the Multi-Ethnic Study of Atherosclerosis (MESA)

ObjectivesThe role of occupation in the development of cardiovascular disease (CVD) remains a topic of research because few studies have examined longitudinal associations, and because occupation can be an indicator...

Further evidence that periodontal bone loss increases with smoking and age.

Cohort study. COHORT SELECTION: A birth cohort born at the Queen Mary Hospital, Dunedin, New Zealand between 1 April 1972 and 31 March 1973 that are being followed as part of the Dunedin Multidisciplinary Health and Development Study (DMHDS). EXPOSURE MEASUREMENT: Periodontal examinations were conducted at ages 26, 32 and 38, with only half-mouth examinations possible at age 26, but full-mouth examinations undertaken at 32 and 38. Third molars and implants were not included in the periodontal examinations. Tobacco smoking was determined at ages 15, 18, 21, 26, 32 and 38. Attachment loss (AL). Generalised linear mixed modelling with a quasi-binomial approach was used to examine associations between chronic smoking and periodontal attachment loss. Of the 1037 participants initially enrolled in the study, 913 were periodontally examined at age 26, and periodontal data were available for 863 (94.5%) individuals at ages 26, 32, and 38 using listwise deletion. At age 32 and 38 respectively, 918 and 905 (98.6%), and 913 and 869 (95.1%) participants were examined and included in the analysis. Approximately equal numbers of females and males were included. Attachment loss increased in smokers with age. At ages 26, 32 and 38, smokers had 3.5%, 12.8% and 23.2% (respectively) greater AL than non-smokers. Regular cannabis use was associated with greater AL after age 32, but not at age 26. Males had more AL than females. Participants with high plaque scores had consistently greater AL; those who were of persistently low SES (socio-economic status) had higher AL at age 32 and 38, but not at age 26. The amount of AL in anteriors was less than in premolars and molars. Gingival bleeding was associated with higher AL at ages 26, 32 and 38. This research confirmed the strong association between chronic smoking and periodontal disease.

Short leukocyte telomere length predicts incidence and progression of carotid atherosclerosis in American Indians: the Strong Heart Family Study.

Short leukocyte telomere length (LTL) has been associated with atherosclerosis in cross-sectional studies, but the prospective relationship between telomere shortening and risk of developing carotid atherosclerosis has not been well-established. This study examines whether LTL at baseline predicts incidence and progression of carotid atherosclerosis in American Indians in the Strong Heart Study. The analysis included 2,819 participants who were free of overt cardiovascular disease at baseline (2001-2003) and were followed through the end of 2006-2009 (average 5.5-yr follow-up). Discrete atherosclerotic plaque was defined as focal protrusion with an arterial wall thickness ≥50% the surrounding wall. Carotid progression was defined as having a higher plaque score at the end of study follow-up compared to baseline. Associations of LTL with incidence and progression of carotid plaque were examined using Cox proportional hazard regression, adjusting for standard coronary risk factors. Compared to participants in the highest LTL tertile, those in the lowest tertile had significantly elevated risk for both incident plaque (HR, 1.49; 95% CI, 1.09-2.03) and plaque progression (HR, 1.61; 95% CI, 1.26-2.07). Our results provide initial evidence for a potential prognostic utility of LTL in risk prediction for atherosclerosis.