Overview and quality assurance for the National Health and Nutrition Examination Survey (NHANES) oral health component, 1999–2002

Dye, Bruce A.; Barker, Laurie; Selwitz, Robert H.; Lewis, Brenda; Wu, Tao; Fryar, Cheryl D.; Ostchega, Yechiam; Beltrán, Eugenio D.; Ley, Eric J.

doi:10.1111/j.1600-0528.2007.00310.x

Cited by 56 publications

(64 citation statements)

References 10 publications

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“…Participants are initially interviewed at home and subsequently invited to attend an in-person examination [27]. 31,126 participants were enrolled in NHANES 1999–2004.…”

Section: Methodsmentioning

confidence: 99%

Periodontal Infection and Cardiorespiratory Fitness in Younger Adults: Results from Continuous National Health and Nutrition Examination Survey 1999–2004

et al. 2014

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ObjectivePrevious studies report associations between periodontal infection and cardiorespiratory fitness but no study has examined the association among younger adults. Our objective was to study the association between clinical measures of periodontal infection and cardiorespiratory fitness levels among a population-based sample of younger adults.MethodsThe Continuous National Health and Nutrition Examination Survey 1999–2004 enrolled 2,863 participants (46% women) who received a partial-mouth periodontal examination and completed a submaximal treadmill test for the assessment of estimated VO2 max(eVO2 max ). Participants were mean±SD age 33±9 years (range = 20–49 years), 30% Hispanic, 48% White, 19% Black, and 3% other. Mean eVO2 max (mL/kg/minute) as well as eVO2 max≤32 mL/kg/minute (20th percentile) were regressed across quartiles of mean probing depth and mean attachment loss in multivariable linear and logistic regression models.ResultsAfter multivariable adjustment, mean eVO2 max levels±SE across quartiles of attachment loss were 39.72±0.37, 39.64±0.34, 39.59±0.36, and 39.85±0.39 (P = 0.99). Mean eVO2 max±SE across quartiles of probing depth were 39.57±0.32, 39.78±0.38, 39.19±0.25, and 40.37±0.53 (P = 0.28). Similarly, multivariable adjusted mean eVO2 max values were similar between healthy participants vs. those with moderate/severe periodontitis: 39.70±0.21 vs. 39.70±0.90 (P = 1.00). The odds ratio (OR) for low eVO2 max comparing highest vs. lowest quartile of attachment loss = 0.89[95% CI 0.64–1.24]. The OR for comparing highest vs. lowest probing depth quartile = 0.77[95% CI 0.51–1.15].ConclusionClinical measures of periodontal infection were not related to cardiorespiratory fitness in a sample of generally healthy younger adults.

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“…Participants are initially interviewed at home and subsequently invited to attend an in-person examination [27]. 31,126 participants were enrolled in NHANES 1999–2004.…”

Section: Methodsmentioning

confidence: 99%

Periodontal Infection and Cardiorespiratory Fitness in Younger Adults: Results from Continuous National Health and Nutrition Examination Survey 1999–2004

et al. 2014

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“…Prior to the study, all dental examiners were trained in accordance with the NHANES standards 14 and calibrated by NHANES reference examiner (Dr. Bruce Dye). Periodontal measurements taken by trained examiners were in absolute agreement with the reference examiner 87%–94% of the times, with weighted kappa coefficients ranging between 0.75 and 0.87.…”

Section: Methodsmentioning

confidence: 99%

Periodontal Disease, Hypertension, and Blood Pressure Among Older Adults in Puerto Rico

Rivas‐Tumanyan¹,

Campos²,

Zevallos

et al. 2013

Journal of Periodontology

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Background Current scientific evidence addressing the relation between periodontitis and hypertension is limited to a few studies producing inconsistent results. Methods All participants of an on-going representative cohort of Puerto Rican elderly who were 70 years and older and residing in San Juan metropolitan area were invited to this cross-sectional study. Periodontal probing depth (PD) and attachment loss (AL) were summarized using CDC-AAP definition for severe periodontitis (≥2 teeth with AL ≥6mm and ≥1 tooth with PD ≥5mm). We averaged three repeated blood pressure (BP) measurements taken using a standardized auscultatory method. Information on hypertension history, use of anti-hypertensive medications and potential confounders (age, gender, smoking, heavy and binge drinking, diabetes, utilization of preventive dental services, flossing, body mass index, fruit and vegetable, whole wheat bread and high-fiber cereal consumption) was collected during in-person interviews. High BP was defined as average systolic BP ≥140 mmHg or diastolic ≥90 mmHg. Multivariate logistic regression models were used to study the relation between severe periodontitis, hypertension history and high BP. Results The study population comprised 182 adults. In multivariate analysis, there was no association between severe periodontitis and hypertension history (OR=0.99, 95% CI: 0.40–2.48). Severe periodontitis was associated with high BP, with OR of 2.93 (95% CI: 1.25–6.84), after adjusting for age, gender, smoking, and binge drinking. This association was stronger when restricted to those with hypertension or taking anti-hypertensive medications: OR=4.20 (95% CI: 1.28–13.80). Conclusion Our results suggest that periodontitis may contribute to poor blood pressure control among older adults.

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“…The NHANES oral health examination (OHE) has been previously described (11,12). Trained dentists performed a full-mouth tooth count as well as a periodontal examination according to a random half-mouth method (excluding third molars).…”

Section: Methodsmentioning

confidence: 99%

“…When the examiner was equivocal as to the best value to assign, measurements were rounded to the next lowest band. Interexaminer reproducibility ranged from good to very good with κ scores ranging from 0.64 to 0.82 (11,12). …”

Section: Methodsmentioning

confidence: 99%

Periodontal Infection, Systemic Inflammation, and Insulin Resistance

et al. 2012

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OBJECTIVEAdverse microbial exposures might contribute to diabetogenesis. We hypothesized that clinical periodontal disease (a manifestation of microbial exposures in dysbiotic biofilms) would be related to insulin resistance among diabetes-free participants. The roles of inflammatory mediation and effect modification were also studied.RESEARCH DESIGN AND METHODSThe continuous National Health and Nutrition Examination Survey 1999–2004 enrolled 3,616 participants (51% women) who received a periodontal examination and fasting blood draw. Participants were mean age (± SD) 43 ± 17 years and 28% Hispanic, 52% Caucasian, 17% African American, and 3% other. Log-transformed values of the homeostasis model assessment of insulin resistance (HOMA-IR) or HOMA-IR ≥3.30 (75th percentile) were regressed across full-mouth periodontal probing depth (PD) levels using linear and logistic models. White blood cell (WBC) count and C-reactive protein (CRP) were considered as either mediators or effect modifiers in separate analyses. Risk ratios (RRs) stem from marginal predictions derived from the logistic model. Results were adjusted for multiple periodontal disease and insulin resistance risk factors.RESULTSIn linear regression, geometric mean HOMA-IR levels increased by 1.04 for every 1-mm PD increase (P = 0.007). WBC mediated 6% of the association (P < 0.05). Among participants with WBC ≤6.4 × 109, PD was unrelated to HOMA-IR ≥3.30. Fourth-quartile PD was associated with HOMA-IR ≥3.30 among participants with WBC >7.9 × 109; RR 2.60 (1.36–4.97) (P for interaction = 0.05). Findings were similar among participants with CRP >3.0 mg/L (P for interaction = 0.04).CONCLUSIONSPeriodontal infection was associated with insulin resistance in a nationally representative U.S. sample of diabetes-free adults. These data support the role of inflammation as both mediator and effect modifier of the association.

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Overview and quality assurance for the National Health and Nutrition Examination Survey (NHANES) oral health component, 1999–2002

Cited by 56 publications

References 10 publications

Periodontal Infection and Cardiorespiratory Fitness in Younger Adults: Results from Continuous National Health and Nutrition Examination Survey 1999–2004

Periodontal Infection and Cardiorespiratory Fitness in Younger Adults: Results from Continuous National Health and Nutrition Examination Survey 1999–2004

Periodontal Disease, Hypertension, and Blood Pressure Among Older Adults in Puerto Rico

Periodontal Infection, Systemic Inflammation, and Insulin Resistance

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