Risk Factor For Oral Diseases Research Articles

Oral health and multimorbidity: is diet the chicken or the egg?

Oral health is a critical component of overall health and well-being, not just the absence of disease. The objective of this review paper is to describe relationships among diet, nutrition and oral and systemic diseases that contribute to multimorbidity. Diet- and nutrient-related risk factors for oral diseases include high intakes of free sugars, low intakes of fruits and vegetables and nutrient-poor diets which are similar to diet- and nutrient-related risk factors for systemic diseases. Oral diseases are chronic diseases. Once the disease process is initiated, it persists throughout the lifespan. Pain and tissue loss from oral disease leads to oral dysfunction which contributes to impaired biting, chewing, oral motility and swallowing. Oral dysfunction makes it difficult to eat nutrient-dense whole grains, fruits and vegetables associated with a healthy diet. Early childhood caries (ECC) associated with frequent intake of free sugars is one of the first manifestations of oral disease. The presence of ECC is our 'canary in the coal mine' for diet-related chronic diseases. The dietary sugars causing ECC are not complementary to an Eatwell Guide compliant diet, but rather consistent with a diet high in energy-dense, nutrient-poor foods - typically ultra-processed in nature. This diet generally deteriorates throughout childhood, adolescence and adulthood increasing the risk of diet-related chronic diseases. Recognition of ECC is an opportunity to intervene and disrupt the pathway to multimorbidities. Disruption of this pathway will reduce the risk of multimorbidities and enable individuals to fully engage in society throughout the lifespan.

Salivary Metabolites Produced by Oral Microbes in Oral Diseases and Oral Squamous Cell Carcinoma: A Review.

In recent years, salivary metabolome studies have provided new biological information and salivary biomarkers to diagnose different diseases at early stages. The saliva in the oral cavity is influenced by many factors that are reflected in the salivary metabolite profile. Oral microbes can alter the salivary metabolite profile and may express oral inflammation or oral diseases. The released microbial metabolites in the saliva represent the altered biochemical pathways in the oral cavity. This review highlights the oral microbial profile and microbial metabolites released in saliva and its use as a diagnostic biofluid for different oral diseases. The importance of salivary metabolites produced by oral microbes as risk factors for oral diseases and their possible relationship in oral carcinogenesis is discussed.

Impact of tobacco habits on poor oral health status among bone-factory workers in a low literacy city in India: A cross-sectional study.

Oral health is a vital indicator of well-being that is influenced by various habits and lifestyles of individuals. Oral diseases are the bottleneck in the effective control of non-communicable diseases (NCDs) due to chronic in nature and reciprocal relationship as sharing the common risk factors and habits such as sugar, tobacco, and alcohol consumption that increase the risk of developing various inevitable diseases. However, there is a lack of literature highlighting the relationship between risk factors for oral diseases and general health among individuals. This cross-sectional study was carried out among 500 study participants aged 20 to 64 years who gave written informed consent and were recruited by Multistage Stratified Cluster Sampling technique among workers in five bone factories, working for at least one year since January 2001 to March 2022 in Sambhal city, Uttar Pradesh. WHO-Basic Oral Health Survey-1997 was used to record the data regarding sociodemographic and oral health status variables. We used the modified WHO-STEPWISE pre-structured questionnaire to record tobacco consumption habits and oral health-seeking behavior. We scheduled a clinical intra-oral examination to record the Decayed Missing Filled Teeth (DMFT) index and the interview on the premises of five bone factories. Among the 500 bone-factory workers, the total number of males was 342 (68.40%) and 158 (31.60%) were females. The mean age (Standard Deviation) was 33.18 (10), and the mean DMFT score of factory workers was 2.84 (3.12). Production workers had the highest mean DMFT score of 4.60 (3.25). More than half of the factory workers (53.2%) were tobacco users. Tobacco users were 3.52 times more likely to have a severe DMFT index. Most common pre-cancerous lesions were oral submucous fibrosis and leukoplakia. Compared to non-tobacco users, mild tobacco users have 6.80 folds higher odds of oral lesions. Tobacco consumption is not only harmful for oral health but also leads to several non-communicable and systemic diseases. NCDs and dental caries are chronic and preventable conditions with a bidirectional relationship implicated by modifiable major risk factors such as tobacco consumption. Decreasing the consumption of tobacco use may improve oral health and reduce the risk of the development of NCDs. Also, regular dental visits should be scheduled to monitor the oral health status of factory workers. Additionally, tailored intervention for tobacco cessation should be implicated to maintain the general and oral health of industrial workers.

Evidence pertaining to modifiable risk factors for oral diseases: an umbrella review to Inform oral health messages for Australia.

The aim of this umbrella review was to collate and appraise the evidence base regarding modifiable risk factors for the prevention of oral diseases to inform the update of the Oral Health Messages for Australia. Eleven questions related to modifiable risk factors and dental disease were investigated. Electronic databases (Medline, Embase and PubMed) were searched from January 2010 to October 2022. Systematic reviews evaluating interventions/exposures in healthy subjects from high-income countries, where Westernized practices, oral health promotion and healthcare systems are similar to Australia, were included. Quality appraisal of included systematic reviews was guided by the AMSTAR tool. Of the 3637 articles identified, 29 articles met eligibility criteria. High-quality systematic reviews were identified for questions relating to diet, infant feeding, dental check-ups and oral hygiene. Free sugars consumption above 5% of energy intake, infrequent toothbrushing, smoking/vaping and alcohol intake were consistently associated with poorer oral health outcomes. Breastfeeding up to the age of 24 months was not associated with an increased risk of early childhood caries. The use of interdental cleaning devices and mouthguards during contact sports are likely to be effective in preventing dental disease.

Effect of e-cigarettes on oral health and the development of periodontitis

Tobacco cigarette smoking is a well-established risk factor for oral diseases, especially periodontal diseases. Over the past few years, electronic cigarettes (or "E-cigarettes") have gained popularity. There is some evidence that e-cigarettes may play a role in helping people quit smoking, and they are occasionally seen as a less dangerous alternative to tobacco use. However, there are worries about their effects on health, notably in terms of oral health and the emergence of periodontal disease. Limited information is available regarding the effect on oral disease. E-cigarettes come in a variety of nicotine strengths and flavoring combinations, all of which have been associated with detrimental oral health issues. A growing body of research supports the idea that vaping or using electronic cigarettes may increase the chance of developing oral health problems such as tooth decay, gum disease, periodontal disease, cracked or broken teeth, and pain in the tongue or inside of the cheek. Even if e-cigarettes were less harmful, they still could lead to the development of periodontal diseases through the decreased antioxidant capacity of saliva, the inflammatory effect, cell injury, and impaired reparability. High levels of nicotine content and menthol-favoring additives increase risk of periodontal damage in e-cigarette users. However, conflicting study results are also published for smokers who transitioned to e-cigarettes. Even though benefits or value of e-cigarettes as a substitute for tobacco cigarettes are still unknown, their impact on periodontal and general health status is still prominent.

An umbrella review of the evidence linking oral health and systemic noncommunicable diseases.

Oral diseases are highly prevalent worldwide. Recent studies have been supporting a potential bidirectional association of oral diseases with systemic noncommunicable diseases (NCDs). Available evidence supports that people with NCDs have a greater prevalence of oral diseases particularly those with limited ability of oral self-care. Regarding the reverse relationship, the lines of evidence pointing out NCDs as putative risk factors for oral diseases have increased significantly but not with a consistent agreement. This umbrella review of meta-analyses appraises the strength and validity of the evidence for the association between oral health and systemic health (registered at PROSPERO, ID: CRD42022300740). An extensive search included systematic reviews that have provided meta-analytic estimates on the association of oral diseases with NCDs. The overall strength of evidence was found to be unfavorable and with methodological inconsistencies. Twenty-eight NCDs were strongly associated with oral diseases. Among those NCDs are five types of cancer, diabetes mellitus, cardiovascular diseases, depression, neurodegenerative conditions, rheumatic diseases, inflammatory bowel disease, gastric helicobacter pylori, obesity, and asthma. According to fail-safe number statistics, the evidence levels are unlikely to change in the future, indicating a fairly robust consistency.

Cross-sectional associations between effort-reward imbalance at work and oral diseases in Japan.

BackgroundPsychological stress is a potential risk factor for oral diseases. However, evidence for the association between work stress and oral diseases is scarce. We aimed to examine the associations of work stress, according to the effort-reward imbalance model, with dental caries, periodontal status, and tooth loss.MethodsThis cross-sectional study included 184 regular employees at a medical university and 435 registrants of a web research company. Work stress was assessed using the effort-reward imbalance (ERI) ratio. Dental caries and tooth loss were assessed according to the number of decayed, filled, and missing teeth (DMFT) among the set of 28 teeth. Periodontal status was assessed using a self-administered questionnaire. For the DMFT, a linear regression model was used to estimate the unstandardised coefficients. A Poisson regression model was used to estimate the prevalence ratios (PRs) of poor periodontal status.ResultsAmong medical university employees and employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was associated with −2.81 (95% CI [−4.70 to −0.92]; p-value = 0.004) and −0.84 (95% CI [−1.80 to 0.12]; p-value = 0.085) changes in the DMFT from adjusted linear regression models, respectively. In employees enrolled from among the registrants of an online research company, a one-unit increase in the ERI ratio was also associated with 1.55 (95% CI [1.04–2.32]; p-value = 0.032) of the PR for poor periodontal status based on Poisson regression models.ConclusionERI at work was associated with an increased risk of poor periodontal status.

Is gender a risk factor for oral diseases in India? A metadata exploration

1. Alam N, Mishra P, Chandrasekaran SC. Gender Basis of Periodontal Diseases. Indian Journal of Basic & Applied Medical Research. 2012;1(2):128-135. Accessed December 19, 2021. https://www.ijbamr.com/assets/... WWW Google Scholar

Assessment of oral health status in a Ghanaian\xa0population: rationale, methods, and population characteristics

BackgroundOral health surveys aid in estimating the oral health of a population and provide a projection for future oral health care needs. We report the procedures and rationale of a survey carried out to assess the oral health status and risk factors for oral disease among adults in the Greater Accra Region (GAR) of Ghana. The objective was to provide prevalence estimates on dental diseases, oral health behaviour and risk factors, and to establish baseline epidemiological data on the population’s oral health for further research.MethodsThis was a population-based cross-sectional study of adults aged 25 years and above. A random, stratified two-stage sampling method was used to select participants from rural and urban communities in three types of districts (Metropolitan, Municipal, Ordinary). A semi- structured questionnaire was used to collect data on socio-demographic characteristics, oral health behaviours and risk factors for oral disease. Anthropometric data and a full-mouth clinical examination was carried out including: soft tissue assessment, tooth count, prosthodontic status, dental caries assessment and periodontal assessment.ResultsA total of 729 participants were included in the study with a mean age of 43.9 years (SD 14.6). Majority 425 (61.0%) were females. Though the metropolitan districts had more dental clinics and personnel, along with better health insurance coverage, they had a higher prevalence of missing teeth, retained roots, severe periodontitis and poorer oral health coverage. The findings also show some significant differences in disease prevalence, within the different localities and districts.ConclusionsAvailability and access to oral health services is not the most important determinant of good oral health outcomes in this region. We recommend exploring socio-behavioral and cultural factors as well. This study provides district level data to inform policy and guide further research.

Association between exposure to secondhand smoking at home and tooth loss in Japan: A cross-sectional analysis of data from the 2016 National Health and Nutrition Survey.

INTRODUCTIONTooth loss affects oral health and physical and social functions. With widespread population aging, its prevalence is increasing. Secondhand smoking is a risk factor for oral diseases; however, in Japan, there are currently no regulations restricting exposure to secondhand smoke at home. This cross-sectional study examined the association between secondhand smoking at home and tooth loss among Japanese adults.METHODSThe study examined secondary data from the 2016 National Health and Nutrition Survey, Japan. The self-reported responses of 18812 non-smokers aged ≥20 years were analyzed. The association between exposure to secondhand smoke at home and number of teeth was examined through multiple linear regression with multiple imputation. To obtain a more normal distribution, logarithmic transformation was applied to the number of teeth that deviated substantially from a normal distribution. Adjustments were made for sex, age, occupation, household size, dental check-up within the past year, and exposure to secondhand smoke outside the home.RESULTSOverall, 8.4% of the respondents were exposed to secondhand smoking at home almost every day; this percentage was larger among younger respondents, who also had more teeth than the older respondents. Although the univariate linear regression did not show a positive association between exposure to secondhand smoke and tooth loss, the multivariate-adjusted analysis revealed that respondents who were exposed to secondhand smoke at home almost every day had fewer teeth (β= -0.04; 95% CI: -0.07 – -0.01).CONCLUSIONSThe present results suggest that exposure to secondhand smoke at home increases the risk of tooth loss.

Smoking a Dangerous Addiction: A Systematic Review on an Underrated Risk Factor for Oral Diseases.

Despite growing knowledge of the adverse effects of cigarette smoking on general health, smoking is one of the most widely prevalent addictions around the world. Globally, about 1.1 billion smokers and over 8 million people die each year because of cigarette smoking. Smoking acts as a source for a variety of oral and systemic diseases. Various periodontal issues such as increased pocket depth, loss of alveolar bone, tooth mobility, oral lesions, ulcerations, halitosis, and stained teeth are more common among smokers. This systematic review was conducted according to the guidelines from PRISMA, and research articles were retrieved from the Web database sources on 31 May 2021. The quality of research articles was ensured by the type of evidence from combined schema incorporating as schema-13 evidence type description, Cochrane health promotion and public health field (CHPPHF), and the health gains notation framework-14 screening question for quality assessment of qualitative and quantitative studies. Smokers have been found to have bleeding on probing, periodontal pockets, and clinical attachment loss compared to nonsmokers. Oral and respiratory cancers are among the most lethal known diseases caused by cigarette smoking and other commonly occurring sequelae such as stained teeth, periodontal diseases, etc.

Oral health seeking behaviors of adults in Nebbi District, Uganda: a community-based survey

BackgroundDental health is often neglected by the majority of the population and has contributed to the global burden of oral diseases. We assessed awareness, utilization and barriers to seeking oral health care among adults in Nebbi District, Uganda.MethodsA community-based, cross sectional study was conducted in the central division, Nebbi District in Uganda among adults between the age of 18 years or older. An interviewer-administered, semi-structured questionnaire was used for data collection on socio-demographic characteristics, oral health awareness, oral health utilization, associated factors and barriers.ResultsA total of 400 adults with a median age of 32 years (interquartile range 24–43) years were enrolled. More than half (57.5%, n = 230) of the participants were female. Participants identified smoking (42.8%, n = 171) and consumption of sugary foodstuffs (29.0%, n = 116) as risk factors for oral disease. Not brushing was also identified by 260 participants (65.0%) as the cause of tooth decay and 95.8% (n = 383) believed brushing one’s teeth could prevent tooth decay. Of the 51.5% (n = 206) who had experienced a toothache or discomfort 12 months prior to the study but only about half (52%, n = 106) had sought healthcare from a dental clinic or facility. About 89.5% (n = 94) of the participants were able to see a dentist during their last visits. Dental carries (76.6%, n = 70) and gum bleeding (14.9%, n = 14) were the most frequent reasons for visiting a dental clinic, and 73.7% (n = 70) had their tooth extracted. Barriers to seeking oral healthcare were cost of treatment (47.5%, n = 190), and long waiting time (18.5%, n = 74). The odds of seeking oral healthcare was 2.8-fold higher in participants who were being married (Odds ratio (OR): 2.8, 95% CI 1.3–6.3, p = 0.011) and 3.5-fold higher among housewives (COR: 3.5, 95% CI 1.1–11.4, p = 0.040).ConclusionAbout half of the participants had sought healthcare following a dental condition. Cost of treatment seems to be an important factor affecting utilization of oral health services. Optimization of costs, and creating awareness regarding benefits of utilizing preventive dental services are recommended.

Work stress and oral conditions: a systematic review of observational studies

ObjectivesAlthough psychological stress is a risk factor for oral diseases, there seems to be no review on work stress. This study aimed to review the evidence on the association between...

Knowledge and Practice of Rural Mothers on Oral Hygiene for Children

Oral health is a condition in which the mouth and the teeth are healthy and free from any diseases. Improper maintenance of hygiene of the mouth is one of the risk factors for oral diseases. Researches showed that parents are responsible for inculcating good oral hygiene habits in children and mothers are considered to be the most accountable in educating the children about proper oral hygiene. This study was undertaken to explore the knowledge and practice of mothers regarding the importance of oral hygiene for children. A non-experimental descriptive research design was used, and 100 mothers of under-five children were randomly selected from the rural areas of Rajpura in Patiala District, Punjab. A self-structured knowledge questionnaire and practice checklist was used to collect the data. Analysis and interpretation of the data was done according to the objectives of the study using descriptive and inferential statistics. The present study revealed that 58 (58%) respondents had good knowledge and 57 (57%) mothers had average practices regarding the importance of oral hygiene for children. No significant relationship was observed between knowledge and practice scores. There was no significant association between the level of knowledge and the level of practice and socio-demographic variables. The study concluded that there is a lack of knowledge and practice regarding the importance of oral hygiene for children amongst the mothers residing in rural areas.

Провідні фактори ризику порушень здоров’я порожнини рота населення Івано-Франківської області

In Ukraine, as well as throughout the world, oral diseases remain an urgent medical and social problem. In the Ivano-Frankivsk region, the incidence of dental caries, periodontal disease, and oral cancer exceeds the same in the country, which made this study relevant. The purpose of the study was to identify risk factors for oral diseases in the population of Ivano-Frankivsk region and to supplement the information support of local authorities of territorial communities with the results of the study. Material and methods. We analyzed scientific sources (16 units), data from state, industry and regional statistics (13 units) in our study. The following methods were used: system approach and system analysis; generalizations; medical and statistical; graphics. Results and discussion. The obtained results showed that the living conditions of the population of the Ivano-Frankivsk region in 2018 were better than the average for Ukraine: household incomes for a month were by UAH 469.45 (4.96%) higher, non-monetary incomes in cash equivalent were by UAH 850.24 (98.2%) higher, which was favorable for maintaining oral health. However, in terms of education, the population of the region was generally inferior to the population of Ukraine (17.8% of people with higher education, 1.7% with basic higher education, 15.2% with incomplete higher education with corresponding indicators for the country 27%, 1.4% and 21%); the proportion of households that had access to Internet services at home was 53.0% in the region, 61.5% in Ukraine, which created risks to support the sanitary and hygienic literacy of the region's residents. The population of the region actively practiced behavioral risks in relation to oral diseases: the incidence rate of mental disorders and behavior due to alcohol consumption (83.87 per 100 thousand of population) exceeded the corresponding indicators in the industry (64.81 per 100 thousand of population), as well as the prevalence of these disorders (1574.88 and 1080.51 per 100 thousand of population, respectively); the intensity of smoking (51.9% of smokers smoked 11-20 cigarettes per day) exceeded the corresponding data for Ukraine (46%); household expenses for sweets were higher by 26.0% of similar expenses in Ukraine. Drinking water in the region has a fluoride deficiency (0-0.3 mg / l), which is one of the leading causes of tooth decay. In 17.9% of cases, household members of the region with dental care needs could not meet them due to the high cost of services. Conclusion. The risk factors for oral diseases of the population of the Ivano-Frankivsk region were identified: fluoride deficiency in drinking water, behavioral risks, and low level of affordability of dental care for the population. The obtained data can be taken into account when developing a regional program for the prevention of oral diseases and improving the organization of dental care for the population

Assessment of the Knowledge and Attitude of Mothers Regarding Oral Hygiene of Under Five Children in Selected Rural Areas of Ambala, Haryana

Oral Health is an important component of general health and to maintain oral health oral hygiene plays amajor role. It has also become clear that causative and risk factors in oral diseases are often the same asthose implicated in the major general diseases. The objectives of the study were to assess the knowledgeand attitude of mothers regarding oral hygiene of under five children, to find out their relationship betweenknowledge and attitude and to determine the association of knowledge and attitude score of mothers ofregarding oral hygiene of under five children with selected variables. The research approach adopted forthe study was quantitative research approach and design was descriptive research design. The study wasconducted at selected rural areas of Ambala, Haryana. A total of 200 mothers having under five children wereselected by using purposive sampling technique. The tool used for the data collection consisted of SelectedVariables and knowledge questionnaire to measure knowledge of under-five mothers. The Reliability of thetool was calculated by Cronbach’s alpha and it was 0.81 for rating scale. Themajor findings revealed thatmean of knowledge score was 19.1 and mean of attitude score was 60.9 in the study. There was a significantassociation found between the level of knowledge and demographic variables i.e. type of family (p=0.00),Have dental problem before (p=0.03), Method used for oral hygiene (p=0.00) and concerned about oralhealth (p=0.00) in the present study. Hence,It was concluded from the study that the mothers have goodknowledge and positive attitude regarding oral hygiene of under five children

Examining relationship between occupational acid exposure and oral health in workplace

BackgroundAcid mist can suspend in the air and enter the body via skin contact, the respiratory tract, or even oral intake, which pose various health hazards. Previous studies have shown that occupational exposure to acid mist or acidic solutions is a major risk factor for oral diseases. However, the findings are inconsistent and do not consider individual factors and lifestyles that may cause the same oral diseases. Therefore, we conducted a comprehensive oral health survey and collected detail information to confirm the effect of acidic solution exposure on worker’s oral health.MethodsFrom 4 acidic solution factories, a total of 309 subjects (157 in control and 152 in exposed group) was enrolled. All participants competed oral examinations and self-report questionnaire, including the decayed, missing, and filled teeth (DMFT) index, community periodontal index (CPI), loss of attachment (LA) index, and tooth erosion. Multivariate logistic regression analysis was used to determine the association between the acidic solution exposure and oral health.ResultsThe results showed that acid exposure was correlated with soft oral tissue injury rather than hard oral tissue in our survey. In the multivariate model (adjusted for sex, age, worked years, education level, mouthwash use, dental floss use, tooth brushing, mask use, smoking, drinking, chewing areca and dietary habits with acidic foods), significant relationships of acid exposure with LA score were observed (OR = 2.32, 95% CI 1.03–5.26). However, the presence of acid exposure was not significantly associated with tooth erosion, DMFT, and CPITN.ConclusionOur study highlighted that occupational acid exposure was an independent risk factor for periodontal health, especially LA. It is important to strengthen occupational hazard control, educate workers on oral disease and related factors, and raise the awareness of oral hygiene.

Dental Medicine and Psychiatry: The Need for Collaboration and Bridging the Professional Gap.

Dental health and mental health are strongly associated. Neglecting either of them can negatively influence on the other and induce many health and communication problems. Association between oral/dental health, self-esteem, quality of life and holistic health has been recognized for a long time. There has been increasing interest in dental health among patients with major mental disorders as well as in mental states and problems among patients with orodental disorders. Despite of huge progress in the field of dentistry psychiatric patients have had poor oral/dental health. Patients with major mental disorders have quite number of the risk factors for oral disease and consequently poorer dental health, but oral/dental problems and diseases are commonly overlooked or neglected. Bad or inappropriate dental care is related to the patients' amotivation, ignorance, fears, low economic status, stigmas and negative attitudes by the medical professionals. It is important to stress that dental diseases in psychiatric patients deserve the same attention as other comorbid somatic diseases. In this review we accentuate the need for more collaboration in order to bridge the professional gap between dentistry and psychiatry.

Infectious Triggers in Periodontitis and the Gut in Rheumatoid Arthritis (RA): A Complex Story About Association and Causality.

Rheumatoid arthritis (RA) is a systemic immune mediated inflammatory disease of unknown origin, which is predominantly affecting the joints. Antibodies against citrullinated peptides are a rather specific immunological hallmark of this heterogeneous entity. Furthermore, certain sequences of the third hypervariable region of human leukocyte antigen (HLA)-DR class II major histocompatibility (MHC) molecules, the so called “shared epitope” sequences, appear to promote autoantibody positive types of RA. However, MHC-II molecule and other genetic associations with RA could not be linked to immune responses against specific citrullinated peptides, nor do genetic factors fully explain the origin of RA. Consequently, non-genetic factors must play an important role in the complex interaction of endogenous and exogenous disease factors. Tobacco smoking was the first environmental factor that was associated with onset and severity of RA. Notably, smoking is also an established risk factor for oral diseases. Furthermore, smoking is associated with extra-articular RA manifestations such as interstitial lung disease in anatomical proximity to the airway mucosa, but also with subcutaneous rheumatoid nodules. In the mouth, Porphyromonas gingivalis is a periodontal pathogen with unique citrullinating capacity of foreign microbial antigens as well as candidate RA autoantigens. Although the original hypothesis that this single pathogen is causative for RA remained unproven, epidemiological as well as experimental evidence linking periodontitis (PD) with RA is rapidly accumulating. Other periopathogens such as Aggregatibacter actinomycetemcomitans and Prevotella intermedia were also proposed to play a specific immunodominant role in context of RA. However, demonstration of T cell reactivity against citrullinated, MHC-II presented autoantigens from RA synovium coinciding with immunity against Prevotella copri (Pc.), a gut microbe attracted attention to another mucosal site, the intestine. Pc. was accumulated in the feces of clinically healthy subjects with citrulline directed immune responses and was correlated with RA onset. In conclusion, we retrieved more than one line of evidence for mucosal sites and different microbial taxa to be potentially involved in the development of RA. This review gives an overview of infectious agents and mucosal pathologies, and discusses the current evidence for causality between different exogenous or mucosal factors and systemic inflammation in RA.

Oral Health and Risk Factors for Oral Disease

Oral Health and Risk Factors for Oral Disease