| مستخلص: |
Increasing epidemiological evidence indicates that periodontitis causes an increased risk for future atherosclerotic cardiovascular disease (CVD). The purported mechanism involved in the increased risk for CVD, include bacteremia and the associated inflammatory sequelae resulting in an inflammatory milieu. PURPOSE: To examine the association between periodontal disease (PD) and a marker of systemic inflammation, white blood cell (WBC) count, and the modifying effects of sociobehavorial factors, using the 2013-2014 dataset from The National Health and Nutrition Examination Survey. METHODS: Full mouth periodontal assessment was carried out by trained licensed dentists, on 3624 participants (Age range: 30 to 80 years), using periodontal probes and mirrors. PD was classified according to the CDC-AAP case definitions for surveillance of periodontitis. Of the total pool of participants, 3252 were used for these analyses, of which 1412 (43%) had PD. RESULTS: Univariate logistic regression models revealed those classified as having PD had significant higher WBC counts (OR: 1.12 (95% CI: 1.07-1.16), p<0.001), were male, > 50 years, Hispanic or Blacks, from lower income (ratio of family income to poverty guidelines (FIPR) < 1.3) and education (High School or less) groups, and over 1 year since a last dental visit. Behavioral factors associated with PD included smoking, abnormal glucose levels (Hemoglobin A1c > 6.5%), and increased TV-time (> 2 hours/day). In the adjusted (controlled for gender, age, race, social determinants and A1c, smoking, dental visits, and TV time) model WBC (OR: 1.11 (95% CI: 1.07-1.15, p<0.001) remained a significant contributor to PD. Further analyses revealed contributions of sociobehavioral factors on PD were population specific. Specifically, TV-time was a significant modifier of PD for whites with high incomes (OR: 1.50 (95% CI: 1.02-2.22, p<0.04), but not for other racial or economic distinctions. CONCLUSION: These data support recommendations to advise patients with periodontitis regarding their risk of systemic inflammation, and its consequences. Social determinants of health and behavior contribute significantly to oral health disparities. Recognizing population specific factors associated with PD may assist dental teams in providing appropriate strategies for care. [ABSTRACT FROM AUTHOR] |
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