The relationship between blood lead levels and periodontal bone loss in the United States, 1988-1994.

Abstract

An association between bone disease and bone lead has been reported. Studies have suggested that lead stored in bone may adversely affect bone mineral metabolism and blood lead (PbB) levels. However, the relationship between PbB levels and bone loss attributed to periodontal disease has never been reported. In this study we examined the relationship between clinical parameters that characterize bone loss due to periodontal disease and PbB levels in the U.S. population. We used data from the Third National Health and Nutritional Examination Survey (NHANES III), 1988-1994, for the analyses. A total of 10,033 participants 20-69 years of age who completed a periodontal examination and had whole blood tested for lead were examined. Four types of periodontal disease measures were used to indicate oral bone loss: periodontal pocket depth, attachment loss extent, attachment loss severity, and the presence of dental furcations. We found that dental furcations were the best periodontal bone loss indicator for PbB levels (p = 0.005) in a multivariate linear regression model adjusting for sex, age, race/ethnicity, educational attainment, poverty status, smoking, and age of home. Furthermore, after additional modeling, we found a smoking and dental furcation interaction (p = 0.034). Subsequent stratified analyses indicated that current and past smoking is an effect modifier for dental furcations on PbB levels. These findings indicate that increased PbB levels may be associated with advanced periodontal bone loss, particularly among people with a history of smoking.

The periodontal health of lead-exposed children living in a shipyard industrial area

“…More prevalent deep pockets in the high PbB group than in the low PbB group in the current study indicated that lead exposure could affect periodontal health in the level of periodontitis. This observation was consistent with other adult studies (Dye et al, 2002;El-Said et al, 2008;Saraiva et al, 2007). The study by El-Said et al (2008) showed a significant excess of periodontal pockets among exposed workers compared with non-exposed individuals (OR ¼ 4.99).…”

“…In addition, the PbB levels were demonstrated to be positively associated with periodontitis for both men and women (Saraiva et al, 2007). The data analysis of the Third National Health and Nutrition Examination Survey (NHANES III) revealed the relationship between PbB levels and alveolar bone loss attributed to advanced periodontal disease (Dye et al, 2002). This study detected a remarkable occurrence of pocket formation in children living in a lead-contamination area.…”

“…Another study by Saraiva et al (2007) showed that prevalence ratios comparing 20-56-year-old individuals with a blood lead (PbB) level of >7 mg/dl with those with a PbB level of <3 mg/dl were 1.7 (95% CI: 1.0-2.8) for men and 3.8 (95% CI: 1.7-8.7) for women. In addition, it was also indicated that increased PbB levels may be associated to bone loss due to periodontal disease (Dye et al, 2002). However, the study by Yetkin-Ay et al (2007) did not observe significant differences of clinical periodontal parameters (expressed as gingival index, gingival bleeding time index, probing depth, and clinical attachment loss) between lead-exposed apprentices and a control group.…”

Elevated Cadmium Exposure may be Associated with Periodontal Bone Loss.

“…For instance, smoking has been shown to be an effect modifier in the relationship between elevated blood lead levels and periodontal bone loss. 3 The authors in that study presented the odds of having elevated blood lead levels in the presence of a dental furcation stratified by smoking status (nonsmoker, former smoker, and current smoker). In the current cadmium study, the authors did present a separated analysis restricted to limited tobacco exposure, but their findings were inconclusive.…”

Gene–environment interactions between JAZF1 and occupational and household lead exposure in prostate cancer among African American men

“…A less frequently considered exposure source for adults is older housing which contains Pb-based paint. Although household Pb exposure is generally associated with children, adult blood Pb levels have been correlated with household dust Pb levels [23], peeling paint [24] and the year housing was built [25,26]. Krieger with others [27,28] used the proportion of housing built before 1940 and Sargent et al [29] used housing built before 1950 to demarcate housing with high likelihood for Pb exposure.…”