Associations between atherosclerosis and periodontitis, physical health and dental care: a pilot study

Eun-Sook Cha; Ki-Young Son; Jae-Moon Yun; Won-Joo Chung; Be-Long Cho; Bo-Hyoung Jin

doi:10.11149/jkaoh.2017.41.4.274

Journal List > J Korean Acad Oral Health > v.41(4) > 1057751

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Cha, Son, Yun, Chung, Cho, and Jin: Associations between atherosclerosis and periodontitis, physical health and dental care: a pilot study

Original Article

Journal of Korean Academy of Oral Health 2017; 41(4): 274-281.

Published online: 31 December 2017

DOI: https://doi.org/10.11149/jkaoh.2017.41.4.274

Associations between atherosclerosis and periodontitis, physical health and dental care: a pilot study

Eun-Sook Cha¹, Ki-Young Son^2,³, Jae-Moon Yun^2,³, Won-Joo Chung³, Be-Long Cho^2,³, Bo-Hyoung Jin¹

¹Department of Preventive & Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.

²Health Promotion Center, Seoul National University Hospital, Seoul, Korea.

³Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.

Corresponding Author: Bo-Hyoung Jin. Department of Preventive & Social Dentistry, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongro-gu, Seoul 03080, Korea. Tel: +82-2-740-8783, Fax: +82-2-765-1722, jjbh@snu.ac.kr

Received 28 October 2017 Revised 28 October 2017 Accepted 28 October 2017

Journal of Korean Academy of Oral Health

(open-access):

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This pilot study aimed to obtain preliminary data on the associations between atherosclerosisand periodontitis, physical health status, and general and oral health behaviors.

Methods

Thirty-three subjects were recruited from among those who underwent carotid computed tomography (CT) angiography and general health check-up at the Seoul National University Hospital Health Examination Center (SNUHHEC). Two trained dentists conducted a periodontal examination to evaluate probing pocket depth and clinical attachment loss. A self-administered questionnaire was completed by study subjects, following informed consent. Data on physical health status were collected through review of medical records from the SNUHHEC. Information on general health behavior was obtainedfrom the self-reported questionnaire. Descriptive and comparative analyses were performed using IBM SPSS Statistics 21.0®. Statistical significance was set at P<0.05.

Results

A marginal, but non-significant association was noted between atherosclerosis and periodontitis(P=0.373). Flossing habit showed a significant association with periodontitis (P=0.007) and obesity (P=0.033). A possible association was noted between daily exercise and flossing (P=0.073). The habitual use of interdental brush also showed borderline association with smoking (P=0.098) and a stronger associationwith previous periodontal treatment (P=0.067); however, these associations were not statisticallysignificant.

Conclusions

Our pilot study did not show an association between arteriosclerosis and periodontal disease.However, positive oral health care behavior, especially flossing, seems to alleviate arteriosclerosis. In other words, in this pilot survey, we confirmed the possibility that healthy oral care behavior can help to alleviate arteriosclerosis. Future large-scale studies are needed to confirm whether positive oral health care behaviors improve overall health.

Keywords: Atherosclerosis, Dental care, Exercise, Overweight, Periodontitis

Figures and Tables

Table 1

General characteristics of study participants

Table 2

Characteristics of variables by Atherosclerosis

^†P-value by χ²-test.

^*P-value by Fisher's exact test.

Table 3

Association of general and periodontal health status with sel foral care

^†P-value by χ²-test.

^*P-value by Fisher's exact test.

References

1. Lockhart PB, Bolger AF, Papapanou PN, Osinbowale OE, Trevisan MA, Levison MW, et al. Periodontal disease and atherosclerotic vascular disease: Does the evidence support an independent association? Circulation. 2012; 125:2520–2544.

2. Ebersole JL. Humoral immune responses in gingival crevice fluid: local and systemic implications. Periodontol 2000. 2003; 31:135–166.

3. Noack B, Genco RJ, Trevisan M, Grossi S, Zambon JJ, De Nardin E. Periodontal infections contribute to elevated systemic C-reactive protein level. J Periodontol. 2001; 72:1221–1227.

4. Kwon YE, Ha JE, Paik DI, Jin BH, Bae KH. The relationship between periodontitis and metabolic syndrome among a Korean nationally representative sample of adults. J Clin Periodontol. 2011; 38:781–786.

5. Ferguson JE 2nd, Hansen W, Novak K, Novak J. Should we treat periodontal disease during gestation to improve pregnancy outcomes? Clin Obstet Gynecol. 2007; 50:454–467.

6. Shub A, Swain JR, Newnham JP. Periodontal disease and adverse pregnancy outcomes. J Matern Fetal Neonatal Med. 2006; 19:521–528.

7. Lee WR, Seo JD, Kang DM, Kang YS, Kang JH, Kho EM, et al. Clinical cardiology. 2nd ed. Seoul: Korea Medical Book Publishing Company;2007. p. 621–631.

8. Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, et al. Harrison's principles of internal medicine Korean language edition. 18th ed. Seoul: McGraw-Hill education Korea;2013. p. 1947–1949.

9. Loos BG, Craandijk J, Hoek FJ, Wertheim-van Dillen PM, van der Velden U. Elevation of systemic markers related to cardiovascular diseases in the peripheral blood of periodontitis patients. J Periodontol. 2000; 71:1528–1534.

10. Beck JD, Eke P, Heiss G, Madianos P, Couper D, Lin D, et al. Periodontal disease and coronary heart disease: a reappraisal of the exposure. Circulation. 2005; 112:19–24.

11. Hujoel PP, Drangsholt M, Speirkerman C, DeRouen TA. Periodontal disease and coronary heart disease risk. JAMA. 2000; 284:1406–1410.

12. Tonetti MS, Dyke TE. Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on periodontitis and systemic diseases. J Clin Periodontol. 2013; 40:Suppl. s24–s29.

13. Kim HD, Paik DM, Kho DH, Paik DI. Influence of cardiovascular related disease on periodontitis. J Korean Acad Dent Health. 2006; 30:46–55.

14. Ahn YB. Association of periodontitis with subclinical atherosclerosis and peripheral arterial disease in Korean adults [master's thesis]. Seoul: Seoul National University;2016. [English].

15. Han SH, Kim KH, Yang SM, Chung HJ, Choi YS, Han SB, et al. Mechanism by which periodontitis may contribute to atherosclerosis. J Korean Acad Periodontol. 2002; 32:837–846.

16. Kim JW, Kwon HJ, Lee SG, Choi YH. The relationship between periodontal disease and the prevalence of cardiovascular disease. J Korean Acad Dent Health. 2007; 31:387–395.

17. Yoon SH, Bae JH, Kim KY, Hyun DW, Kim WH, Koo HS. Noninvasive surrogates in assessing the severity of coronary atherosclerosis. Korean J Med. 2005; 69:493–502.

18. Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ, Beck J, et al. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012; 91:914–920.

19. Albandar JM, Brunelle JA, Kingman A. Destructive periodontal disease in adults 30 years of age and older in the United States, 1988-1994. J Periodontol. 1999; 70:13–29.

20. Health Insurance Review & Assessment Service. Healthcare Bigdata Hub, Report DB, Press releases[Internet]. cited 2017 Oct 13. Available from : http://www.hira.or.kr/dummy.do?pgmid=HIRAA020041000000&cmsurl=/cms/inform/02/1349474_27116.htm.

21. World Health Organization (WHO). Prevention of cardiovascular disease: guidelines for assessment and management of cardiovascular risk. Geneva: World Council of Churches Health Organization;2007.

22. Statistics Korea. Korea Statistical Information System (KOSIS), Statistics DB, Mortality rate in Korea[Internet]. cited 2017 Sep 08. Available from : http://kostat.go.kr.

23. Beck J, Elter J, Heiss G, CouperM , Mauriello S, Offenbacher S. Relationship of periodontal disease to carotid artery intima-media wall thickness: the atherosclerosis risk in communities study. Arterioscler Thromb Vasc Biol. 2001; 21:1816–1822.

24. Reichert S, Schlitt A, Beschow V, Lutze A, Lischewski S, Seifert T, et al. Use of floss/interdental brushes is associated with lower risk for new cardiovascular events among patients with coronary heart disease. J Periodontal Res. 2015; 50:180–188.

25. Hujoel PP, Cunha-Cruz J, Kressin NR. Spurious association in oral epidemiological research : the case of dental flossing and obesity. J Clin Periodontol. 2006; 33:520–523.

26. Eberhard J, Stiesch M, Kerling A, Bara C, Eulert C, Hilfiker-Kleiner D, et al. Moderate and severe periodontitis are independent risk factors associated with low cardiorespiratory fitness in sedentary non-smoking men aged between 45 and 65 years. J Clin Periodontol. 2014; 41:31–37.

TOOLS

Similar articles