INTRODUCTION: Chronic periodontal disease is a highly prevalent dental condition affecting tooth-supporting tissues. Scientific evidence is accumulating on links between periodontal disease and various systemic conditions. This narrative review provides a holistic yet succinct overview that would assist medical practitioners to deliver integrated care for better clinical outcomes. METHOD: Scientific evidence on associations between periodontal disease and systemic conditions was synthesised and critically appraised. Key findings of latest prospective cohort studies, randomised clinical trials, and meta-analysis were closely assessed and compiled. RESULTS: A bidirectional relationship has been established, indicating that diabetes and periodontal disease are closely linked and amplify one another, if not successfully controlled. Existing evidence also supports the associations of periodontal disease with cardiovascular diseases and adverse pregnancy outcomes. Successful treatment of periodontal disease and dental prophylaxis has been shown to improve clinical outcomes in these systemic conditions. Other systemic conditions associated with periodontal disease include respiratory diseases, Alzheimer's disease, rheumatoid arthritis and chronic kidney disease. Although the underlying mechanisms remain to be fully elucidated, it is generally accepted that the inflammatory burden of chronic periodontal disease has an important systemic impact. CONCLUSION Oral-systemic links are multifaceted and complex. While evidence linking periodontal disease with a variety of systemic conditions is still emerging, the nature of the relationship is becoming clearer. The updated understanding of these associations warrants the attention of medical experts and policymakers for a concerted effort to develop a patient-centric, integrated model for the treatment of comorbid dental and medical conditions.
Cardiovascular Diseases/epidemiology* ; Diabetes Mellitus/epidemiology* ; Female ; Humans ; Meta-Analysis as Topic ; Periodontal Diseases/epidemiology* ; Pregnancy ; Pregnancy Outcome ; Prospective Studies ; Randomized Controlled Trials as Topic

To analyze the global burden of periodontal disease and its relation with socioeconomic development. Data of global disability-adjusted life year (DALY) due to periodontal disease and human development index (HDI) from 1990 to 2019 were obtained from Global Health Data Exchange (GHDx) and human development reports. The trend of the global burden of periodontal disease from 1990 to 2019 was described. The correlation between age-standardized DALY rates and HDI were examined in 2019, and between-country periodontal disease burden inequality from 1990 to 2019 was measured using health-related Gini coefficients and concentration indexes. From 1990 to 2019, the global DALY rate due to periodontal disease increased from 78.63 to 85.48, and the epidemiological burden did not increase significantly. Statistical differences were found across different HDI categories for age-standardized DALY rates of periodontal disease ( 44.315, <0.01) in 2019. Linear regression analysis also revealed a negative correlation between age-standardized DALY rate of periodontal disease and HDI ( = -0.417, <0.01) . Gini coefficients decreased from 0.361 to 0.281 and concentration indexes fell from 0.0339 to -0.0538 between 1990 and 2019. The global burden of periodontal disease did not increase between 1990 and 2019, though the socioeconomic-associated inequality still existed. The burden of periodontal disease was more concentrated in less developed countries, and the socioeconomic-associated inequality has increased since 2000.
Disability-Adjusted Life Years ; Global Health ; Humans ; Periodontal Diseases/epidemiology* ; Quality-Adjusted Life Years ; Socioeconomic Factors

ABSTRACT This hospital-based cross-sectional study aimed at determining frequency and risk indicators/predictors of periodontitis in a sample of Egyptian adult population and to develop a prediction equation for classifying periodontal diseases. Seven hundred and fifty subjects were consecutively recruited from outpatient Diagnostic Center, Faculty of Dentistry, Cairo University. Validated oral health questionnaire for adults and oral health impact profile-14 (OHIP-14) questionnaire were filled by all patients. Diagnosis was made based on measurements of clinical periodontal parameters including plaque index, bleeding on probing, pocket depth, clinical attachment level and gingival recession. Radiographic examination was performed using digital periapical radiographs. Ordinal logistic regression analysis was used to determine significant predictors of periodontal diseases and discriminant analysis was performed to predict periodontal disease classification. Gingivitis was the most frequent periodontal disease (39.6%) followed by periodontitis stage I (38%), stage II (20.4%), stage III (1.6%) and stage IV (0.4%). The lowest OHIP-14 scores were in patients with periodontitis stages III and IV. Multivariate analysis showed that education (p < 0.001), OHIP-14 score (p = 0.003), non-smoking (p = 0.001) and non-alcohol drinking (p = 0.021) were significant negative predictors, while never to clean the teeth (p <0.001) and cleaning the teeth once a month (p < 0.001) were significant positive predictors of periodontal disease. Periodontitis stages III and IV were the least frequent on a sample of Egyptian adult patients. Education, frequency of teeth cleaning, smoking, alcohol drinking and OHIP-14 scores were significant predictors of periodontal disease. Through discriminant analysis this study could classify patients into different periodontal diseases with an overall correct prediction of 99.2%.
Periodontal Diseases--epidemiology

PURPOSE: The aim of this study is to analyze and visualize the distribution of patients visiting the periodontology department at a dental college hospital, using a geographic information system (GIS) to utilize these data in patient care and treatment planning, which may help to assess the risk and prevent periodontal diseases. METHODS: Basic patient information data were obtained from Dankook University Dental Hospital, including the unit number, gender, date of birth, and address, down to the dong (neighborhood) administrative district unit, of 306,656 patients who visited the hospital between 2007 and 2014. The data of only 26,457 patients who visited the periodontology department were included in this analysis. The patient distribution was visualized using GIS. Statistical analyses including multiple regression, logistic regression, and geographically weighted regression were performed using SAS 9.3 and ArcGIS 10.1. Five factors, namely proximity, accessibility, age, gender, and socioeconomic status, were investigated as the explanatory variables of the patient distribution. RESULTS: The visualized patient data showed a nationwide scale of the patient distribution. The mean distance from each patient's regional center to the hospital was 30.94±29.62 km and was inversely proportional to the number of patients from the respective regions. The distance from a regional center to the adjacent toll gate had various effects depending on the local distance from the hospital. The average age of the patients was 52.41±12.97 years. Further, a majority of regions showed a male dominance. Personal income had inconsistent results between analyses. CONCLUSIONS: The distribution of patients is significantly affected by the proximity, accessibility, age, gender and socioeconomic status of patients, and the patients visiting the periodontology department travelled farther distances than those visiting the other departments. The underlying reason for this needs to be analyzed further.
Epidemiology ; Geographic Information Systems* ; Humans ; Logistic Models ; Male ; Parturition ; Patient Care ; Periodontal Diseases ; Social Class ; Spatial Regression

Aged ; China ; epidemiology ; Dental Caries ; epidemiology ; Dental Health Surveys ; Epidemiologic Studies ; Health Promotion ; Humans ; Middle Aged ; Oral Health ; education ; Periodontal Diseases ; therapy ; Prevalence

Age Factors ; China ; epidemiology ; Dental Caries ; epidemiology ; Dental Health Surveys ; Epidemiologic Studies ; Humans ; Oral Health ; Periodontal Diseases ; epidemiology ; Prevalence

For a long time, oral disease is one of the major problems of the public health for its high prevalence and incidence throughout the world, which is especially true for low-income populations. Since China's economic reform in 1978, great changes have taken place in China. These changes have significant impact on and have been reflected in oral disease trends in China. This paper provides an overview and assessment of the oral health status in China. It focuses on changes in the nation's demographic profile, in the marketplace, the oral disease status and trends. The paper also suggests some possible measures and strategies for bettering oral health in future China.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Dental Caries ; epidemiology ; Dental Health Services ; Health Expenditures ; statistics & numerical data ; Health Status Disparities ; Humans ; Middle Aged ; Mouth, Edentulous ; epidemiology ; Oral Health ; Periodontal Diseases ; epidemiology ; Population Dynamics ; Urbanization ; Young Adult

AIMThe objective of this discussion paper is to investigate whether the experience gained through the German paradigm shift in dental care can be of benefit in China's deliberations on the introduction of universal dental care for its people. METHODOLOGY A comparison of representative oral health outcome data from China and Germany, two countries at different stages in their development, is presented here in order to analyse whether the findings meet expected outcome and confirm the presumption that more developed countries perform better.

RESULTSThe epidemiological comparison reveals surprising findings concerning the severity of dental diseases and, in particular, missing teeth per person in adults and rates of total edentulousness in seniors. In all of these areas German adults and seniors show significantly inferior outcomes compared with the Chinese population. The main reason for these striking discrepancies, as it turned out, is the decisive role played by the treatment philosophies and strategies of German dentists.

CONCLUSION AND RECOMMENDATIONSIf dentists take a less interventionist approach, checking as well as treating dental diseases with preventive and strictly tooth-preserving methods, dental treatment results in oral health. Under these conditions it can be assumed that modern dentistry is generally good for the teeth. These findings are important for developing countries that are seeking to integrate dental care into their health care system. On the basis of long-term experience from highly industrialized Western countries and especially from Germany we will attempt to put forward proposals for creating an effective and efficient dental care system in China.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Community Dentistry ; Delivery of Health Care ; organization & administration ; Dental Caries ; epidemiology ; Dental Health Services ; organization & administration ; Dentists ; supply & distribution ; Germany ; epidemiology ; Health Care Reform ; Health Policy ; Health Priorities ; Health Transition ; Humans ; Insurance, Health ; Middle Aged ; Mouth, Edentulous ; epidemiology ; Oral Health ; Outcome Assessment (Health Care) ; Periodontal Diseases ; epidemiology ; Philosophy, Dental ; Preventive Dentistry ; Reimbursement Mechanisms ; Tooth Loss ; epidemiology ; Universal Coverage ; organization & administration ; Young Adult

China ; epidemiology ; Dental Caries ; epidemiology ; Evidence-Based Medicine ; Humans ; Oral Health ; Oral Hygiene ; Periodontal Diseases ; epidemiology ; Practice Guidelines as Topic ; Prevalence

AIMTo find the relationship of periodontal status and dental caries status with oral health knowledge, attitude, behavior, among professional students in India.

METHODOLOGYIn a cross sectional study, a total of 825 students (males: 577, females: 248) from six professions were surveyed using a self administered structured questionnaire including 41 multiple choice questions and the WHO Oral Health Assessment Form (1997). The data was analyzed using the SPSS version 13.0 to perform the Student's t-test, ANOVA test, Scheffe's test and Chi-square test, linear regression analysis.

RESULTSThe mean percentage scores of the students for knowledge were 53.25 +/- 15.05; for attitude 74.97 +/- 20.48; and for behavior 59.09 +/- 18.77. The percentage of students with calculus score was found to be significantly high (43.8%). The percentage of professional students with DMFT >4 was 14.1% and the percentage of students with decayed teeth was 46.2%. The regression analysis showed that the oral health behavior of the students was dependent on the attitude (P < 0.001), but showed no significant linear relation with the knowledge. Also, that the mean DMFT score was dependent on the oral health behavior (P < 0.05), but showed no significant relationship with the knowledge and attitude of the students. The periodontal status was independent on the knowledge, but showed a significant relationship with attitude and behavior of the students.

CONCLUSIONA positive attitude and adherence to good oral hygiene behaviors is associated with better oral health.

Attitude to Health ; Cross-Sectional Studies ; DMF Index ; Dental Calculus ; epidemiology ; Dental Caries ; epidemiology ; Education, Professional ; statistics & numerical data ; Epidemiologic Studies ; Female ; Health Behavior ; Health Education, Dental ; Health Knowledge, Attitudes, Practice ; Humans ; India ; epidemiology ; Male ; Oral Health ; Oral Hygiene ; statistics & numerical data ; Periodontal Diseases ; epidemiology ; Periodontal Index ; Students ; statistics & numerical data ; Students, Health Occupations ; statistics & numerical data ; Surveys and Questionnaires ; Young Adult