Periodontitis–systemic disease associations in the presence of smoking – causal or coincidental?

Hujoel, Philippe P.; Drangsholt, Mark; Spiekerman, Charles; DeRouen, Timothy A.

doi:10.1034/j.1600-0757.2002.03005.x

Cited by 160 publications

(153 citation statements)

References 29 publications

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“…33 Most studies have adjusted for smoking by means of multivariable analyses, an approach open to bias due to residual confounding. As for other morbidities, it has been suggested that statistical adjustment is insufficient to control for smoking and that stratification is needed.…”

mentioning

confidence: 99%

Periodontal Disease and Coronary Heart Disease

et al. 2005

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Background-Results from studies relating periodontal disease to cardiovascular disease have been mixed. Residual confounding by smoking and use of clinical measures of periodontal disease rather than measures of infection have been 2 major criticisms. The aims of this study were to investigate relationships between prevalent coronary heart disease (CHD) and 2 exposures, (1) clinical periodontal disease and (2) IgG antibodies to 17 oral organisms, and to evaluate the role of smoking in these relationships. Methods and Results-Our study is based on a subset of participants in the Atherosclerosis Risk in Communities (ARIC)Study, who received a complete periodontal examination during visit 4 (1996 -1998). The exposures were periodontal status and serum IgG antibody levels against 17 periodontal organisms, and the outcome was prevalent CHD at visit 4. Multivariable analyses indicate that periodontal status is not significantly associated with CHD in either ever smokers or never smokers. Similar analyses evaluating antibodies indicate that high antibodies (above the median) to Treponema denticola (odds ratio [OR]ϭ1.7; 95% CI, 1.2 to 2.3), Prevotella intermedia (ORϭ1.5; 95% CI, 1.1 to 2.0), Capnocytophaga ochracea (ORϭ1.5; 95% CI, 1.1 to 2.1), and Veillonella parvula (ORϭ1.7; 95% CI, 1.2 to 2.3) are significantly associated with CHD among ever smokers, whereas Prevotella nigrescens (ORϭ1.7; 95% CI, 1.1 to 2.6), Actinobacillus actinomycetemcomitans (ORϭ1.7; 95% CI, 1.2 to 2.7), and Capnocytophaga ochracea (ORϭ2.0; 95% CI, 1.3 to 3.0) were associated with CHD among never smokers. Conclusions-Clinical signs of periodontal disease were not associated with CHD, whereas systemic antibody response was associated with CHD in ever smokers and never smokers. These findings indicate that the quality and quantity of the host response to oral bacteria may be an exposure more relevant to systemic atherothrombotic coronary events than clinical measures.

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confidence: 99%

Periodontal Disease and Coronary Heart Disease

et al. 2005

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“…This association was also seen in large cohort studies 22,23 , although some of them have been criticised for not correcting for confounding variables such as smoking, which would prevent the associations from becoming statistically significant 17,24,25 . However, a potential pathologic pathway exists as the inflammatory burden contributes to atherosclerosis, and periodontal pathogens are found in atherosclerotic vessel walls 1,26,27 .…”

Section: Cardiovascular Diseasementioning

confidence: 93%

The relationship of oral health with general health and NCDs: a brief review

Dörfer

Benz

Aida

et al. 2017

International Dental Journal

150

108

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Oral health is closely related to systemic health. Periodontitis, a chronic inflammatory disease which is highly prevalent worldwide, interacts with a variety of noncommunicable diseases (NCDs). It is a risk factor in the complex pathogenesis of diabetes mellitus and cardiovascular disease and plays a role in the development of endocarditis and recurrent pneumonia in elderly people. However, the available data may be interpreted in different ways, and more and better-designed studies are still needed to answer relevant questions about the causal role of periodontitis in NCDs. What is clear is that periodontitis contributes to the systemic inflammatory burden. As periodontitis shares many common risk factors with NCDs, close collaboration between physicians and dentists is needed to increase the chance of early detection and improve the prevention and control of these conditions.

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“…As smoking is a risk factor common to many diseases, it may be a confounding factor that is complicating apparent associations between periodontal disease and poor pregnancy outcome [46].…”

Section: Discussionmentioning

confidence: 99%