Periodontal Disease In Older Adults Research Articles

IMPACT OF AGING AND STRESS ON THE PERIODONTAL HEALTH OF THE GERIATRIC POPULATION BEFORE AND AFTER PERIODONTAL TREATMENT IN OLD HOMES OF KARACHI, PAKISTAN

Age and stress-related periodontal diseases are prevalent in the geriatric population and continue to provide a significant epidemiological concern. Objective: To assess the impact of ageing and stress on the periodontal health of the senior population before and after periodontal treatment Method: A cross-sectional study was conducted between February and October 2023. Twenty-two senior patients aged 55 to 77 were selected through purposeful random sampling, excluding those unwilling or unable to participate. A semi-structured questionnaire, translated into the native language, assessed periodontal health using the Basic Periodontal Examination (BPE). Informed consent was obtained from participants, who were assured confidentiality and the right to withdraw. Data analysis was performed using SPSS version 23, employing mean and standard deviation for continuous data and frequency tables for categorized data. Cross-tabulation and significance testing were utilized to demonstrate associations. Results: The results of the prevailing cross-sectional study reveal that there exists an association between moderate to elevated levels of perceived stress and the manifestation of severe instances of periodontal disease. As per the study findings, periodontitis tends to afflict individuals across older adult age demographics. Conclusion: The study emphasised that stress and ageing are key risk factors for periodontal diseases, underlining the importance of addressing them during therapy. Consistent oral hygiene can prevent periodontitis in older adults.

Association between depressive mood and chronic periodontitis among senior residents using the National Health Insurance Service-Senior Cohort Database.

Bacteria involved in chronic periodontal disease induce inflammatory cytokines. These cytokines can enter the brain through systemic circulation and cause depression. In this study, we investigated the association between depressed mood and chronic periodontitis in older adults in Korea. This study used data from the Life-changing Period Health Checkup (2007-2008), performed only at 66 years of age, which is available from the National Health Insurance Service-Senior Cohort Database. The depressed mood status was evaluated by three questions in the mental health examination. The definition of chronic periodontitis was determined based on the diagnosis and treatment codes for chronic periodontitis. Based on the three questions, we investigated the association between depressive mood and chronic periodontal disease by dividing the study population into 9622 depressed mood subjects (DMS) and 9091 non-depressed mood subjects (NDMS). Multivariable-adjusted logistic regression analysis was performed, and odds ratios (ORs) with 95% confidence intervals (95% CIs) were presented. Among the NDMS, 5390 patients with chronic periodontitis were identified, and among the DMS, 5964 patients with chronic periodontitis were identified. The crude OR (95% CI) for chronic periodontitis in DMS compared to NDMS was 1.12 (1.06-1.19). The adjusted OR (95% CI) for chronic periodontitis was 1.12 (1.06-1.19). As a result of confirming the effect of sex and comorbidity on the association between depressed mood and chronic periodontitis, a significant association was observed for women at 1.15 (1.07-1.25). In addition, the adjusted OR (95% CI) for depressive mood and chronic periodontitis was 1.15 (1.07-1.25) for patients with hypertension, 1.13 (1.03-1.25) for patients with diabetes, 1.12 (1.02-1.22) for patients with dyslipidemia, and 1.18 (1.04-1.34) for patients with heart disease. This study confirmed the relationship between depressed mood and chronic periodontitis in older adults. Therefore, education to strengthen the emotional management of older adults, especially with respect to depression, would play an auxiliary role in preventing and treating periodontitis.

Validity of a combination of periodontal pathogens and salivary biomarkers as predictors of periodontitis.

Chronic periodontitis is caused by multiple risk factors. To predict chronic periodontitis in older people, we evaluated the association between a combination of major periodontal pathogens and salivary biomarkers and the presence of periodontitis. Stimulated saliva samples were collected to analyze the prevalence of Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Prevotella intermedia, as well as four biomarkers: interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α), and prostaglandin E2 (PGE2). A total of 201 Japanese patients were recruited. Oral examinations ware performed to determine chronic periodontitis as measured by Community Periodontal Index. The sociodemographic and behavioral characteristics were also obtained, and the parameters were adjusted as potential confounders to employ statistical models. The odds ratio (OR) for the presence of P.gingivalis and the third tertile level of IL-1β as compared with the absence of P.gingivalis and the lowest tertile of IL-1β was highest in individuals with periodontitis (OR=13.98; 95% confidence interval [CI] 3.87-50.52) with the best level (0.79) of area under the curve (AUC) based on the receiver operating characteristic curve. The OR for the presence of P.gingivalis and the third tertile of PGE2 was 7.76 (CI 1.89-31.91) with an AUC of 0.78. The coexistence of more than two periodontal bacteria and the third tertile of PGE2 was also strongly associated with chronic periodontitis (OR=9.23, 95% CI 2.38-35.79) with an AUC of 0.76. The combined information of the presence of P.gingivalis in stimulated saliva, and higher levels of salivary IL-1β may play a vital role in the detection and prediction of chronic periodontitis in older adults.

Association Serum Lipid Levels with Periodontal Disease in Korean Adults Over the Age of 50: The Korea National Health and Nutrition Examination Survey, 2016-2018

PURPOSE: Although the prevalence of periodontal disease in adults over the age of 50 is rapidly increasing, the association between serum lipid levels and periodontal disease in Korean adults over the age of 50 still remains to investigate. Thus, the aim was to determine the effect of serum lipid levels on periodontal disease in older adults over the age of 50 using data from the seventh Korea National Health and Nutrition Examination Survey.METHODS: The study used the data of 809 adults aged ≥50 years targeted in the 7th Korea National Health and Nutrition Examination Survey, 2016-2018. Levels of total cholesterol, triglyceride, high density- lipoprotein (HDL-cholesterol), and low density-lipoprotein (LDL-cholesterol) and periodontal conditions were measured. Complex-sample chi square test and linear regression were used to analyze the relationship serum lipid levels with periodontal disease.RESULTS: The results of chi square tests showed that the prevalence of periodontal disease among the elderly ≥50 years were statistically significant differences according to gender, age, education level, marital status, and smoking status. After adjusting for all confounding factors, HDL-cholesterol alleviated periodontal disease, while LDL-cholesterol exacerbates periodontal disease. However, total cholesterol and triglycerides were not connected with periodontal disease.CONCLUSIONS: Therefore, controlling HDL and LDL cholesterol levels through physical exercise could be a preventative measure for periodontal disease.

PERIODONTAL STATUS OF INSTITUTIONALIZED ELDERLY

Impaired general health in institutionalized elderly has an impact on oral health and dental status, especially on periodontal health and oral hygiene. The periodontal health of institutionalized elderly people is influenced by a number of other factors such as: multimorbidity, dependence in maintaining oral hygiene, limited abilities and mobility and the use of numerous medications. Progression of periodontal disease is characterized by the presence of increased destruction of periodontal tissues. The destruction of periodontal tissues is seen through the presence and increased clinical loss of the attachment, but also through the presence of gingival recession and resorption of the alveolar bone. The most common form of periodontal disease in older adults is chronic periodontitis. Due to the chronicity of this disease, most of the detected periodontal disorders are due to the accumulation of the disease over time. The interaction of the highly prevalent xerostomia and the inability to maintain oral hygiene at a satisfactory level in institutionalized elderly leads to an increased incidence of dental plaque. Due to that, the elderly have an increased risk of manifesting dental caries and periodontal diseases. Taking into account the aforementioned facts about oral health, the presence of numerous dental and oral problems, as well as the increased health needs and impaired health in institutionalized elderly people, the aim of this paper was to assess periodontal health among institutionalized elderly people over 65 years of age. Assessment of periodontal status among institutionalized elderly was done by using the Ramfjord Periodontal Disease Index. The research was conducted in the period from April to July 2018 in the Department “Mother Teresa”, part from the Gerontological Institute “Thirteenth November” - Skopje. It included a total number of 75 people over the age of 65 who were accommodated in the department and gave their consent to participate in the research. The dental clinical examination was performed in the long-term care institution, in the office or in the rooms of the institutionalized elderly or in a room determined for that purpose. The examination of the subjects was performed on a patient sitting on a chair, lying in bed or placed in a wheelchair. For the examination a dental probe, a dental mirror and disposable gloves and a portable lamp for artificial illumination were used. The average number of present (remaining) teeth in the respondents was 5.81± 7.34 (range 0-24, with Confidence interval from 4.09 to 5.52).The mean value of the simplified OHI Green Vermilion index obtained for the presence of dental plaque was 2.33 ± 0.51 (range from 1.33 to 3.00, with Confidence interval from 2.15 to 2.51). The average value for the Ramfjord index (for assessment of periodontal health) was 4.57 ± 0.74 (range 2.5 to 6.00, with Confidence interval 4.33 to 4.82). Most of the subjects after the appropriate analysis had moderately advanced periodontitis (68.42% of the subjects). Based on the obtained data and subsequent analysis of the results we had found high percentage of people with unsatisfactory oral hygiene and high prevalence of periodontal disease.

Metabolomic Evaluation of Chronic Periodontal Disease in Older Adults.

Periodontal disease is an infectious inflammatory disease related to the destruction of supporting tissues of the teeth, leading to a functional loss of the teeth. Inflammatory molecules present in the exudate are catalyzed and form different metabolites that can be identified and quantified. Thus, we evaluated the inflammatory exudate present in crevicular fluid to identify metabolic biological markers for diagnosing chronic periodontal disease in older adults. Research participants were selected from long-term institutions in Brazil. Participants were individuals aged 65 years or older, healthy, or with chronic periodontal disease. Gas chromatography/mass spectrometry was used to evaluate potential biomarkers in 120 crevicular fluid samples. We identified 969 metabolites in the individuals. Of these, 15 metabolites showed a variable importance with projection score > 1 and were associated with periodontal disease. Further analysis showed that among the 15 metabolites, two (5-aminovaleric acid and serine, 3TMS derivative) were found at higher concentrations in the crevicular fluid, indicating their potential diagnostic power for periodontal disease in older adults. Our findings indicated that some metabolites are present at high concentrations in the crevicular fluid in older adults with periodontal disease and can be used as biomarkers of periodontal disease.

Mouthwash with Tagetes lucida Cav. for Control of Chronic Periodontitis in Older Adults

Background: Tagetes lucida Cav (T. lucida) is an herbaceous plant from the family Asteraceae, native to Mexico, Guatemala, and other Mesoamerican countries. Their common names are: (i) Spanish names: “hierbanís”, “jericón”, “pericón vomol”, “Santa María”, “cuchrucumín”, “falso hipericón”, “hierba añil”, “pericón”, “periquillo”; (ii) indigenous names: “ichka”, “cuahuyauhtli”, “yahuhtli”, “naná uarhi”, and (iii) English names: “sweet-scented marigold”, “sweet mace”, and “sweet marigold”., Its chemical composition of coumarins, estragole, quercetin, and flavonoids has antioxidant, anti-inflammatory, and antimicrobial effects. This study aimed to evaluate the effect of a mouthwash made with T. lucida for control of chronic periodontitis (CP) in older adults. Methods: We carried out a quasi-experimental study with a convenience sample of 60 older adults with CP. The sample was divided into a placebo group (PG) n = 30, administered with a mouthwash made with alcohol diluted with purified water (10%), and the experimental group (EG) n = 30 treated with a mouthwash made with T. lucida extract in 10% alcohol; both groups were administered three times a day for three months. Results: We found a significant improvement in the EG group compared with the PG group in: probing pocket depth (baseline, 5.2 ± 0.81 vs. post-treatment, 3.1 ± 0.43, p < 0.05), the clinical attachment loss (baseline, 6.6 ± 1.9 vs. post-treatment, 2.1 ± 1.5, p < 0.05), lipoperoxides (baseline, 0.056 ± 0.03 vs. post-treatment, 0.034 ± 0.02 µmol/L, p < 0.05), and chronic inflammation markers (IL-1, IL-8, and TNF-α) (p < 0.05). Conclusions: Our findings suggest that mouthwash made with T. lucida extract, administered three times a day, clinically improved chronic periodontitis in older adults, associated to a significant decrease in lipoperoxides and proinflammatory markers.

Dental Pulp Mesenchymal Stem Cells as a Treatment for Periodontal Disease in Older Adults.

Periodontal disease (PD) is one of the main causes of tooth loss and is related to oxidative stress and chronic inflammation. Although different treatments have been proposed in the past, the vast majority do not regenerate lost tissues. In this sense, the use of dental pulp mesenchymal stem cells (DPMSCs) seems to be an alternative for the regeneration of periodontal bone tissue. A quasi-experimental study was conducted in a sample of 22 adults between 55 and 64 years of age with PD, without uncontrolled systemic chronic diseases. Two groups were formed randomly: (i) experimental group (EG) n = 11, with a treatment based on DPMSCs; and a (ii) control group (CG) n = 11, without a treatment of DPMSCs. Every participant underwent clinical and radiological evaluations and measurement of bone mineral density (BMD) by tomography. Saliva samples were taken as well, to determine the total concentration of antioxidants, superoxide dismutase (SOD), lipoperoxides, and interleukins (IL), before and 6 months after treatment. All subjects underwent curettage and periodontal surgery, the EG had a collagen scaffold treated with DPMSCs, while the CG only had the collagen scaffold placed. The EG with DPMSCs showed an increase in the BMD of the alveolar bone with a borderline statistical significance (baseline 638.82 ± 181.7 vs. posttreatment 781.26 ± 162.2 HU, p = 0.09). Regarding oxidative stress and inflammation markers, salivary SOD levels were significantly higher in EG (baseline 1.49 ± 0.96 vs. 2.14 ± 1.12 U/L posttreatment, p < 0.05) meanwhile IL1β levels had a decrease (baseline 1001.91 ± 675.5vs. posttreatment 722.3 ± 349.4 pg/ml, p < 0.05). Our findings suggest that a DPMSCs treatment based on DPMSCs has both an effect on bone regeneration linked to an increased SOD and decreased levels of IL1β in aging subjects with PD.

The Subgingival Microbiome Relationship to Periodontal Disease in Older Women

Understanding of the oral microbiome in relation to periodontal disease in older adults is limited. The composition and diversity of the subgingival microflora and their oligotypes in health and levels of periodontal disease were investigated in this study on older postmenopausal women. The 16S rRNA gene was sequenced using the Illumina MiSeq platform in 1,206 women aged 53 to 81 y. Presence and severity of periodontal disease were defined by Centers for Disease Control and Prevention/American Academy of Periodontology criteria. Composition of the microbiome was determined by 16S rRNA amplicon sequencing and the abundance of taxa described by the centered log2-ratio (CLR) transformed operational taxonomic unit (OTU) values. Differences according to periodontal disease status were determined by analysis of variance with Bonferroni correction. Bacteria oligotypes associated with periodontal disease and health were determined by minimum entropy decomposition and their functions estimated in silico using PICRUSt. Prevalence of none/mild, moderate, and severe periodontal disease was 25.1%, 58.3%, and 16.6%, respectively. Alpha diversity of the microbiome differed significantly across the 3 periodontal disease categories. β-Diversity differed between no/mild and severe periodontal disease, although considerable overlap was noted. Of the 267 bacterial species identified at ≥0.02% abundance, 56 (20.9%) differed significantly in abundance according to periodontal disease status. Significant linear correlations for pocket depth and clinical attachment level with bacterial amounts were observed for several taxa. Of the taxa differing in abundance according to periodontal disease status, 53% had multiple oligotypes appearing to differ between none/mild and severe periodontal disease. Among older women, taxonomic differences in subgingival microbiome composition and diversity were observed in relation to clinical periodontal disease measures. Potential differences in bacterial subspecies (oligotypes) and their function were also identified in periodontal disease compared with health.

Substantial Differences in the Subgingival Microbiome Measured by 16S Metagenomics According to Periodontitis Status in Older Women.

Aging invokes physiological changes, such as immunosenescence and inflammation, that could increase host susceptibility to oral microbiome shifts that enable periodontitis progression in later life. At present, there is a dearth of studies specifically evaluating the oral microbiome and periodontitis in older adults. We used high-throughput untargeted sequencing methods and functional metagenomic analyses to assess and compare the subgingival biofilm of postmenopausal women (mean age 71 years) according to periodontitis status. Subgingival plaque samples were obtained from 15 postmenopausal women with no periodontitis, and from 15 women with severe periodontitis, determined by probing measures. The 16S rRNA gene (V1–V3 region) was sequenced on the 454 FLX platform. The PICRUSt technique was used to provide information on what the potential functional characteristics of microbiota might be in healthy, compared with diseased, periodontium. The subgingival microbiome associated with periodontitis showed clear differences to that associated with health. Of the 464 species identified, 22.8% had elevated abundance in disease, while only 6.3% had elevated abundance in health. Among the 12 most prevalent organisms in periodontitis, one-half have previously been recognized as periodontal pathogens by other investigators. The subgingival microbiome in periodontitis contained genes that could code for specific activities, including microbial mobility, synthesis of endotoxin, and proteolytic degradation. The healthy microbiome included genes that could code for sustaining microbial life, including encoding for transporters, glycolysis, gluconeogenesis, the Krebs cycle, and protein kinases. In the present study on postmenopausal women, aged 60 and older, the subgingival microbiome differed in composition and potential function between those with and without periodontitis. Studies of functional gene expression, such as transcriptomics, are needed to definitively identify the molecules carrying out functions associated with pathogenic subgingival complexes. This, in turn, could lead to identification of targets for enhanced management of periodontitis and, possibly, other diseases, in later life.

Treatment of periodontal disease in older adults.

Within the next 40years the number of older adults worldwide will more than double. This will impact periodontal treatment needs and presents a challenge to health-care providers and governments worldwide, as severe periodontitis has been reported to be the sixth most prevalent medical condition in the world. Older adults (≥80 years of age) who receive regular dental care retain more teeth than those who do not receive such care, but routine general dental care for these individuals is not sufficient to prevent the progression of periodontitis with the same degree of success as in younger individuals. There is a paucity of data on the efficacy of different periodontal therapies for older individuals. However, considering the higher prevalence of chronic medical conditions seen in older adults, it cannot be assumed that periodontal therapy will yield the same degree of success seen in younger individuals. Furthermore, medications can influence the status of the periodontium and the delivery of periodontal care. As an example, anticoagulant drugs are common among older patients and may be a contraindication to certain treatments. Newer anticoagulants will, however, facilitate surgical intervention in older patients. Furthermore, prescription medications taken for chronic conditions, such as osteoporosis and cardiovascular diseases, can affect the periodontium in a variety of ways. In summary, consideration of socio-economic factors, general health status and multiple-drug therapies will, in the future, be an important part of the management of periodontitis in older adults.

Geriatric periodontology: how the need to care for the aging population can influence the future of the dental profession.

The world's population is aging, and it has been estimated that by 2050, the number of people 65years of age and older will reach 1.5 billion. The aging population will be affected by noncommunicable chronic diseases, including diabetes mellitus, cardiovascular disease and cognitive impairment. This important demographic shift includes a reduction in tooth loss/edentulism, particularly in older adults of the developed countries in North America, western Europe and north-east Asia. Therefore, in the future, dental providers will be required to care for an expanded number of older adults who have retained teeth and are medically complex. As the linkage of oral disease and systemic disease has focused on the relationship of periodontitis and noncommunicable chronic diseases, a broad review of 'geriatric periodontology' is both timely and important. This volume of Periodontology 2000 covers a range of subjects under this heading. Included are the demographics of an aging world; the effect of aging on stem cell function in the periodontium; the periodontal microbiota associated with aging; the host response in the periodontium of aging individuals; an analysis of the prevalence of periodontitis in the USA on a national, state-wide and community basis; differentiation of physiologic oral aging from disease; treatment of periodontal disease in older adults; implant therapy for older patients; oral disease and the frailty syndrome; the relationship of tooth loss to longevity and life expectancy; and the relationship of periodontal disease to noncommunicable chronic diseases. Although 'geriatric dentistry' is not a recognized specialty in dentistry, and 'geriatric periodontology' is a descriptive title, the subject of this volume of Periodontology 2000 is critical to the future of clinical dentistry, dental public health and dental research. Any comprehensive focus on older patients can only be accomplished with an emphasis on interprofessional education and practice. If embraced, this shift will allow the dental profession to be more closely aligned with the larger health-care environment, and can improve both oral health and health outcomes for patients seen in the dental office.

The subgingival periodontal microbiota of the aging mouth

Different mechanisms have been hypothesized to explain the increase in prevalence and severity of periodontitis in older adults, including shifts in the periodontal microbiota. However, the actual impact of aging on the composition of subgingival biofilms remains unclear. In the present article, we provide an overview of the composition of the subgingival biofilm in older adults and the potential effects of age on the oral microbiome. In particular, this review covers the following topics: (i) the oral microbiota of an aging mouth; (ii) the effects of age and time on the human oral microbiome; (iii) the potential impact of inflammaging and immunosenescence in the host-oral microbiota interactions; and (iv) the relationship of the aging oral microbiota and Alzheimer's disease. Finally, we present analyses of data compiled from large clinical studies that evaluated the subgingival microbiota of periodontally healthy subjects and patients with periodontitis from a wide age spectrum (20-83years of age).

Ascorbic acid: new role of an age-old micronutrient in the management of periodontal disease in older adults.

To review the new role of an age-old micronutrient - ascorbic acid - in the management of periodontal disease. Articles pertaining to the topic were searched in PubMed and other search engines from year 1974 to April 2014 with the following key words: "ascorbic acid," "ascorbate," "vitamin C," "periodontal disease," "gingivitis," "periodontitis," "anti-oxidants" and "elderly." Balanced nutrition is an essential factor in the elderly. Modification of nutritional requirement is important to overcome the effect of an unbalanced diet in older individuals as a result of several external and internal host-associated factors. Micronutrient requirements as aging advances could change, and require due attention. Ascorbic acid and its relationship with periodontal disease are very well known. However, recent changes in the concept of understanding the pathogenicity has led to a new path of therapeutic intervention with ascorbic acid in many chronic diseases. Oxidative stress with its associated burden might alter the disease process. In the era of "periodontal medicine," the impact of remote tissue changes on systemic disease has to be taken into serious consideration. Deficiency of nutritional impact on the host, with micronutrient vitamin C detailed in this review with sources, absorption, interaction and its relationship with systemic disease, and thereby the impact on periodontal disease. Ascorbic acid plays an important role in the aging process, and in the maintenance of periodontal health in the elderly.

Impaired neutrophil extracellular trap formation: a novel defect in the innate immune system of aged individuals.

Neutrophil extracellular traps (NETs) are a recently discovered addition to the defensive armamentarium of neutrophils, assisting in the immune response against rapidly dividing bacteria. Although older adults are more susceptible to such infections, no study has examined whether aging in humans influences NET formation. We report that TNF-α-primed neutrophils generate significantly more NETs than unprimed neutrophils and that lipopolysaccharide (LPS)- and interleukin-8 (IL-8)-induced NET formation exhibits a significant age-related decline. NET formation requires generation of reactive oxygen species (ROS), and this was also reduced in neutrophils from older donors identifying a mechanism for reduced NET formation. Expression of IL-8 receptors (CXCR1 and CXCR2) and the LPS receptor TLR4 was similar on neutrophils from young and old subjects, and neutrophils challenged with phorbol-12-myristate-13-acetate (PMA) showed no age-associated differences in ROS or NET production. Taken together, these data suggest a defect in proximal signalling underlies the age-related decline in NET and ROS generation. TNF-α priming involves signalling through p38 MAP kinase, but activation kinetics were comparable in neutrophils from young and old donors. In a clinical setting, we assessed the capacity of neutrophils from young and older patients with chronic periodontitis to generate NETs in response to PMA and hypochlorous acid (HOCL). Neutrophil extracellular trap generation to HOCL, but not PMA, was lower in older periodontitis patients but not in comparison with age-matched controls. Impaired NET formation is thus a novel defect of innate immunity in older adults but does not appear to contribute to the increased incidence of periodontitis in older adults.

Tai Chi exercise increases SOD activity and total antioxidant status in saliva and is linked to an improvement of periodontal disease in the elderly.

The aim of this study was to determine the effect of Tai Chi on biological markers of oxidative stress in saliva and its relationship with periodontal disease (PD) in older adults. We carried out a quasi-experimental study with a sample of 71 sedentary volunteers with PD who were divided into a control group of 34 subjects and an experimental group of 37 subjects who performed Tai Chi 5 days a week for a period of 6 months. PD status was characterized using the Periodontal Disease Index (PDI). Superoxide dismutase (SOD), total antioxidant status (TAS), and TBARS levels of both groups were measured by spectrophotometric methods. In addition, inflammation markers (TNF-α, IL-1β, IL-6, IL-8, and IL-10) were measured by flow cytometry. We found a statistically significant increase in SOD activity (P < 0.001) and TAS concentration (P < 0.05), whereas levels of IL-1β were significantly lower (P < 0.01). Likewise, a statistically significant decrease in the PDI (P < 0.05) was observed in subjects who performed Tai Chi during a period of 6 months. Our findings suggest that the practice of Tai Chi has both antioxidant and anti-inflammatory effects that are linked to the improvement of PD in older adults.

PSS256 - Effect of Tai Chi on Oxidative Stress and Periodontal Disease in Older Adults

PSS256 - Effect of Tai Chi on Oxidative Stress and Periodontal Disease in Older Adults

A Cross-Sectional Study on the Relationship between Behavioral Variables and Economic Status in Periodontal Disease among Elderly Individuals

The objectives of this study were to examine the relationship between behavioral variables, such as smoking and level of income on the periodontal disease among older South Indian adults. Data pertaining to participants aged 55 years and above from the Outpatient Department of MR Ambedkar Dental College and Hospital were used. A total of 209 elderly subjects were selected by convenient sampling and a complete evaluation of their periodontal status was carried out. Our study showed that patients belonging to the lower income group and smokers had more severe disease compared to other groups. They were found to have higher plaque scores, higher calculus scores, deeper pockets and attachment loss compared to the subjects of the other groups. Variables, such as smoking, gender and low income are associated with the severity of periodontal disease in older adults.

Effects of human aging on periodontal tissues

Loss of teeth is frequently associated with periodontal disease in older adults. The aim of this review was to present the effects of aging on the periodontal tissues. Aging alone does not lead to critical loss of periodontal attachment in healthy elderly persons. The effects of aging on periodontal tissues are based on molecular changes in the periodontal cells, which intensify bone loss in elderly patients with periodontitis. These effects may be associated with (1) alterations in differentiation and proliferation of osteoblasts and osteoclasts; (2) an increase in periodontal cell response to the oral microbiota and mechanical stress leading to the secretion of cytokines involved in osseous resorption; and (3) systemic endocrine alterations in the elderly people.

The Association Between Serum Folate Levels and Periodontal Disease is not Clearly Established

Article Title and Bibliographic Information The association between serum folate levels and periodontal disease in older adults: data from the National Health and Nutrition Examination Survey (NHANES) 2001/02. Yu YH, Kuo HK, Lai YL. J Am Geriatr Soc 2007;55:108-113. Level of Evidence Level 3 (Other evidence) Strength of Recommendation Grade Not applicable Purpose/Question Is low folate levels associated with periodontal disease in older adults? Source of Funding NHANES was funded by the US government. No Information was provided by the authors regarding the funding of this specific analysis. Type of Study/Design Cross sectional