| 1. |
- Gonda, Tomoya, et al.
(author)
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Predictors of multiple tooth loss among socioculturally diverse elderly subjects
- 2013
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In: International Journal of Prosthodontics. - 0893-2174 .- 1139-9791. ; 26:2, s. 127-134
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Journal article (peer-reviewed)abstract
- Purpose: This study identifies clinical factors that predict multiple tooth loss in a socioculturally diverse population of older adults.Materials and Methods: A total of 193 participants from English-, Chinese-, or Punjabi-speaking communities in Vancouver, British Columbia, with low incomes and irregular use of dental services were followed for 5 years as part of a clinical trial of a 0.12% chlorhexidine mouthrinse. The participants were interviewed and examined clinically, including panoramic radiographs, at baseline and annually for 5 years. Binary logistic regression was used to test the hypothesis that there was no difference between incidence of multiple (≥ 3) tooth loss in older people with various biologic, behavioral, prosthodontic, and cultural variables over 5 years.Results: Multiple tooth loss, which was distributed similarly among the groups in the trial, occurred in 39 (20%) participants over 5 years. The use of removable prostheses was the best predictor of loss, followed by the number of carious surfaces and number of sites with gingival attachment loss > 6 mm. The pattern of prediction was consistent across the three linguocultural groups.Conclusion: The use of removable dentures was the dominant predictor of multiple tooth loss in the three communities, but that tooth loss was not significantly associated with the cultural heritage of the participants.
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| 2. |
- Gonda, Tomoya, et al.
(author)
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Predictors of multiple tooth loss among socioculturally diverse elderly subjects
- 2013
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In: International Journal of Prosthodontics. - : Quintessence Publishing Company. - 0893-2174 .- 1139-9791. ; 26:2, s. 127-134
-
Journal article (peer-reviewed)abstract
- Purpose: This study identifies clinical factors that predict multiple tooth loss in a socioculturally diverse population of older adults. Materials and Methods: A total of 193 participants from English-, Chinese-, or Punjabi-speaking communities in Vancouver, British Columbia, with low incomes and irregular use of dental services were followed for 5 years as part of a clinical trial of a 0.12% chlorhexidine mouthrinse. The participants were interviewed and examined clinically, including panoramic radiographs, at baseline and annually for 5 years. Binary logistic regression was used to test the hypothesis that there was no difference between incidence of multiple (≥ 3) tooth loss in older people with various biologic, behavioral, prosthodontic, and cultural variables over 5 years. Results: Multiple tooth loss, which was distributed similarly among the groups in the trial, occurred in 39 (20%) participants over 5 years. The use of removable prostheses was the best predictor of loss, followed by the number of carious surfaces and number of sites with gingival attachment loss > 6 mm. The pattern of prediction was consistent across the three linguocultural groups. Conclusion: The use of removable dentures was the dominant predictor of multiple tooth loss in the three communities, but that tooth loss was not significantly associated with the cultural heritage of the participants.
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| 3. |
- Kiyak, H Asuman, et al.
(author)
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Ethnicity and oral health in community-dwelling older adults.
- 2002
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In: General dentistry. - 0363-6771. ; 50:6, s. 513-518
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Journal article (peer-reviewed)abstract
- Epidemiological studies consistently have found differences in oral health status between white and non-white elders. This has been attributed primarily to lack of access to dental care, especially preventive services. The study reported here examined psychosocial factors in an attempt to explain these differences.
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| 4. |
- Persson, G. Rutger, et al.
(author)
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The impact of a low-frequency chlorhexidine rinsing schedule on the subgingival microbiota (the TEETH clinical trial).
- 2007
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In: Journal of Periodontology. - 0022-3492 .- 1943-3670. ; 78:9, s. 1751-1758
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Journal article (peer-reviewed)abstract
- BACKGROUND: Information on the efficacy of chlorhexidine (CHX) rinsing on the subgingival microbiota is limited. This study tested if intermittent CHX rinsing over 5 years had an impact on the subgingival microbiota.METHODS: Subgingival plaque samples were analyzed by the checkerboard DNA-DNA hybridization method in a double-blind randomized CHX rinse study.RESULTS: A total of 210 subjects were included. The mean age of the subjects was 71.7 (+/- 4.1) years, and 56.2% were women. Evidence of alveolar bone loss was found in 39% of subjects. Bacterial loads were not correlated significantly with probing depth. At year 5, subjects in the CHX rinse group with no evidence of bone loss presented with lower total bacterial counts than control subjects with no bone loss. The levels of the following bacteria were significantly lower in the CHX group: Lactobacillus acidophilus (P <0.05), Eikenella corrodens (P <0.05), Fusobacterium nucleatum sp. nucleatum (P <0.01), Treponema denticola (P <0.05), Leptotrichia buccalis (P <0.05), and Eubacterium saburreum (P <0.05). No differences in bacterial loads were found between CHX and control rinse subjects with alveolar bone loss.CONCLUSIONS: Older subjects with or without periodontitis carry a large variety of bacteria associated with periodontitis. Intermittent rinsing with CHX may provide a preventive benefit in reducing levels of bacteria but only in subjects without alveolar bone loss.
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| 5. |
- Persson, G. Rutger, et al.
(author)
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The impact of ethnicity, gender, and marital status on periodontal and systemic health of older subjects in the Trials to Enhance Elders' Teeth and Oral Health (TEETH).
- 2004
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In: Journal of Periodontology. - 0022-3492 .- 1943-3670. ; 75:6, s. 817-23
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Journal article (peer-reviewed)abstract
- BACKGROUND: Few studies have examined the association between periodontitis risk, gender, and marital status in older adults. The purpose of this study was to assess if the oral health status of older subjects could be explained by differences in: 1) marital status; 2) gender; and 3) ethnicity.METHODS: Clinical and radiographic periodontal oral conditions were studied in 701 older subjects from the TEETH clinical trial. Medical conditions as well as ethnic and marital status and smoking habits were considered.RESULTS: A total of 89 married couples were identified; 40.7% of these were of European descent and 48.1% of Chinese descent. The mean age was 67.7 years (SD +/- 4.7). The men were older than the women (mean difference: 1.5 years, SD +/- 4.6, 95% confidence interval [CI]: 0.5 to 2.5, P<0.01). No significant differences in periodontal conditions were found between spouses or by marital status. Chinese descent was associated with a higher risk for periodontitis, regardless of marital status (odds ratio: 1.5, 95% CI: 1.05 to 2.04, P<0.03).CONCLUSIONS: 1) Married couples have similar social habits, similar oral health perceptions, and similar patterns of periodontal disease. 2) Dental studies including married couples do not bias data for married subjects as such. 3) Marital status has a limited impact on periodontal health but may have a greater impact on several systemic conditions, especially in widowed, divorced, or never married women. 4) Older Chinese subjects perceive themselves as being at lower risk for periodontitis but have more objective signs of periodontitis than older subjects of European descent.
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| 6. |
- Persson, Rigmor E, et al.
(author)
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Smoking, a weak predictor of periodontitis in older adults.
- 2005
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 32:5, s. 512-517
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Journal article (peer-reviewed)abstract
- BACKGROUND: The impact of smoking habits on periodontal conditions in older subjects is poorly studied.AIMS: To assess if a history of smoking is associated with chronic periodontitis and medical history in older subjects.MATERIAL AND METHODS: The medical and dental history was collected from 1084 subjects 60-75 years of age. Smoking history information was obtained from self-reports. Periodontal variables [clinical probing depth (PD)>/=5.0 mm, clinical attachment levels (CALs) >/=4.0 mm], and radiographic evidence of alveolar bone loss were assessed.RESULTS: 60.5% had never smoked (NS), 32.0% were former smokers (FS) (mean smoke years: 26.1 years, SD+/-13.1), and 7.5% were current smokers (CS) (mean smoke years 38.0 years, (SD+/-12.1). The proportional distribution of CAL >/=4.0 mm differed significantly by smoking status (NS and CS groups) (mean difference: 12.1%, 95% confidence interval (CI): 1.5-22.6, p<0.02). The Mantel-Haenszel common odds ratio between smoking status (CS+FS) and periodontitis (>20% bone loss) was 1.3 (p<0.09, 95% CI: 0.9-2.0) and changed to 1.8 (p<0.02, 95% CI: 1.3-2.7) with 30 years of smoking as cutoff. A weak correlation between number of years of smoking and CAL>/=4.0 mm was demonstrated (r(2) values 0.05 and 0.07) for FS and CS, respectively. Binary logistic forward (Wald) regression analysis demonstrated that the evidence of carotid calcification, current smoking status, gender (male), and the number of remaining teeth were explanatory to alveolar bone loss.CONCLUSIONS: A clinically significant impact on periodontal conditions may require 30 years of smoking or more. Tooth loss, radiographic evidence of carotid calcification, current smoking status, and male gender can predictably be associated with alveolar bone loss in older subjects.
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| 7. |
- Swoboda, Jessica, et al.
(author)
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Predictors of oral health quality of life in older adults.
- 2006
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In: Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry. - 0275-1879. ; 26:4, s. 137-144
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Journal article (peer-reviewed)abstract
- There is limited information regarding oral health status and other predictors of oral health-related quality of life. An association between oral health status and perceived oral health-related quality of life (OHQOL) might help clinicians motivate patients to prevent oral diseases and improve the outcome of some dental public health programs. This study evaluated the relationship between older persons' OHQOL and their functional dentition, caries, periodontal status, chronic diseases, and some demographic characteristics. A group of 733 low-income elders (mean age 72.7 [SD = 4.71, 55.6% women, 55.1% members of ethnic minority groups in the U.S. and Canada) enrolled in the TEETH clinical trial were interviewed and examined as part of their fifth annual visit for the trial. OHQOL was measured by the Geriatric Oral Health Assessment Index (GOHAI); oral health and occlusal status by clinical exams and the Eichner Index; and demographics via interviews. Elders who completed the four-year assessment had an average of 21.5 teeth (SD = 6.9), with 8.5 occluding pairs (SD = 4.6), and 32% with occlusal contacts in all four occluding zones. Stepwise multiple regressions were conducted to predict total GOHAI and its subscores (Physical, Social, and Worry). Functional dentition was a less significant predictor than ethnicity and being foreign-born. These variables, together with gender, years since immigrating, number of carious roots, and periodontal status, could predict 32% of the variance in total GOHAI, 24% in Physical, 27% in Social, and 21% in the Worry subscales. These findings suggest that functional dentition and caries influence older adults' OHQOL, but that ethnicity and immigrant status play a larger role.
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| 8. |
- Swoboda, Jessica R, et al.
(author)
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Correlates of periodontal decline and biologic markers in older adults.
- 2008
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In: Journal of Periodontology. - 0022-3492 .- 1943-3670. ; 79:10, s. 1920-1926
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Journal article (peer-reviewed)abstract
- BACKGROUND: There is limited information on infectious and host responses distinguishing older people with or without active periodontitis. This study measured bacterial and serum cytokine and high-sensitivity C-reactive protein (hsCRP) levels in older persons.METHODS: Elders (mean age: 67 years), whose periodontal status had declined most or least (20% worst or 20% best) over 5 years, were enrolled. Two years later, they were classified as periodontally declining (active periodontitis [AP]), if they had at least five teeth with probing depth (PD) > or =5 mm, or stable (stable periodontally [SP]), if they did not. Groups were compared with respect to demographics, PD, clinical loss of attachment, subgingival bacteria, serum hsCRP, interleukin (IL)-1beta and -6, and chronic diseases.RESULTS: Ten AP and 24 SP subjects were identified; 13% of women and 44% of men from the original sample were in the AP group (P <0.05). Most Asians were SP; most whites and all African Americans were classified as having AP (P <0.01). More AP elders had osteoporosis (P <0.01), but the AP and SP groups did not differ with respect to IL-1beta and -6 or hsCRP. Bacterial counts were higher in the AP group for Parvimonas micra (previously Peptostreptococcus micros or Micromonas micros) (7.7 x 10(5) cells versus 3.8 x 10(5) cells; P <0.05), Prevotella intermedia (25.7 x 10(5) cells versus 9.8 x 10(5) cells; P <0.01), Tannerella forsythia (previously T. forsythensis) (16.2 x 10(5) cells versus 8.0 x 10(5) cells; P <0.05), and Streptococcus mutans (6.2 x 10(5) cells versus 2.0 x 10(5) cells; P <0.01). Three risk factors were most predictive of periodontal decline: PD, osteoporosis, and being white or African American.CONCLUSION: Periodontal decline was associated with osteoporosis, ethnicity, PD, gender, serum hsCRP, and levels of four bacterial species.
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| 9. |
- Vitaliano, Peter P, et al.
(author)
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Caregiving and gingival symptom reports : psychophysiologic mediators.
- 2005
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In: Psychosomatic Medicine. - 0033-3174 .- 1534-7796. ; 67:6, s. 930-938
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Journal article (peer-reviewed)abstract
- OBJECTIVE: We first assessed the association of caregiving with gingival symptom reports. We then assessed whether the observed relationship was mediated by psychophysiologic host factors.METHODS: Caregivers of spouses with Alzheimer's disease (n = 123) were compared with demographically similar noncaregiver spouses (n = 117).RESULTS: The percentage of caregivers (17%) who reported gingival symptoms was twice that of noncaregivers (8.5%) (p < .05), despite the fact that caregivers and noncaregivers did not differ in oral health care. The relationship between caregiving and gingival symptom reports was mediated by psychophysiologic variables. Caregivers were higher on hassles (p < .05), depressed mood (p < .05), and metabolic risk (insulin, glucose, obesity; p < .05) than were noncaregivers. Greater gingival symptom reports were also associated with greater hassles (p < .01), depressed mood (p < .001), and metabolic risk (p < .001). Measures of subcutaneous fat, inflammation, and frank diabetes were related to gingival symptom reports but not to caregiver status.CONCLUSIONS: A higher percentage of caregivers reported gingival symptoms than noncaregivers. These results have implications for research on aging, psychophysiology, and chronic stress.
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