Risk of pneumonia in the elderly doubled by sleeping in dentures

Poor oral health and hygiene are increasingly recognized as major risk factors for pneumonia among the elderly. To identify modifiable oral health-related risk factors, lead researcher Toshimitsu Iinuma, Nihon University School of Dentistry, Japan, and a team of researchers prospectively investigated associations between a constellation of oral health behaviors and incidences of pneumonia in the community-living of elders 85 years of age or older. This study, titled “Denture Wearing During Sleep Doubles the Risk of Pneumonia in Very Elderly,” has been published by the International and American Associations for Dental Research (IADR/AADR in the OnlineFirst portion of the Journal of Dental Research (JDR).

At baseline, 524 randomly selected seniors (228 males, 296 females, average age was 87.8 years old) were examined for oral health status and oral hygiene behaviors as well as medical assessment, including blood chemistry analysis, and followed up annually until first hospitalization for or death from pneumonia. Over a three-year follow-up period, 48 events associated with pneumonia were identified (20 deaths and 28 acute hospitalizations). Among 453 denture wearers, 186 (40.8%) who wore their dentures during sleep, were at higher risk for pneumonia than those who removed their dentures at night.

In a multivariate Cox model, both perceived swallowing difficulties and overnight denture wearing were independently associated with approximately 2.3-fold higher risk of the incidence of pneumonia, which was comparable with the high risk attributable to cognitive impairment, history of stroke and respiratory disease. In addition, those who wore dentures while sleeping were more likely to have tongue and denture plaque, gum inflammation, positive culture for Candida albicans, and higher levels of circulating interleukin-6 as compared to their counterparts.

This study provides empirical evidence that denture wearing during sleep is associated not only with oral inflammatory and microbial burden but also with incident pneumonia, suggesting potential implications of oral hygiene programs for pneumonia prevention in the community. Frauke Mueller, University of Geneva, Switzerland, wrote a perspective titled “Oral Hygiene Reduces the Mortality From Aspiration Pneumonia in Frail Elders,” commenting that these findings lead to a simple and straight forward clinical recommendation – denture wearing during the night should be discouraged in geriatric patients.

 

http://www.medicalnewstoday.com/releases/283627.php

 

 

 

The sixth most prevalent health condition in the world – severe periodontitis

The International and American Associations for Dental Research (IADR/AADR) have published a paper titled “Global Burden of Periodontitis: A Systematic Review and Meta-Regression.” The manuscript, by lead researcher Wagner Marcenes (Queen Mary University of London, Institute of Dentistry, Barts and The London School) is published in the Online First portion of the IADR/AADR Journal of Dental Research (JDR).

The purpose of this study was to consolidate all epidemiological data about severe periodontitis and subsequently to generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 and 2010. From the systematic search, a total of 72 qualifying studies involving 291,170 individuals aged 15 years or older from 37 countries were included in the meta-regression using modeling resources of the Global Burden of Disease (GBD) 2010 Study.

In 2010, severe periodontitis was the sixth most prevalent condition in the world affecting 743 million people worldwide. Between 1990 and 2010, the global age-standardized prevalence of severe periodontitis was static at 11.2%. The age-standardized incidence of severe periodontitis in 2010 was 701 cases per 100,000 person-years, a non-significant increase from the 1990 incidence of severe periodontitis. Prevalence increased gradually with age showing a steep increase between the third and fourth decades of life that was driven by a peak in incidence at around 38 years of age. There were considerable variations in prevalence and incidence between regions and countries.

These findings underscore the enormous public health challenge posed by severe periodontitis and are a microcosm of the epidemiologic transition to non-communicable diseases occurring in many countries. “The results of this first global assessment of periodontal diseases underscore the healthcare burden of this prevalent oral disease on a major portion of the world’s population,” said Editor-in-Chief of the journal William Giannobile.

http://www.medicalnewstoday.com/releases/283149.php

 

 

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Researchers note need to improve dental service use among US women of childbearing age

Oral diseases can be prevented or improved with regular dental visits. The objective of this study was to assess and compare national estimates on self-reported oral health conditions and dental visits among pregnant women and non-pregnant women of childbearing age by using data from the National Health and Nutrition Examination Survey (NHANES).

Researchers analyzed self-reported oral health information on 897 pregnant women and 3,971 non-pregnant women of childbearing age (15-44 years) from NHANES 1999-2004. They found disparities in self-reported oral health conditions and use of dental services among women regardless of pregnancy status. The percentage of women who reported having very good or good mouth and teeth condition was significantly higher among older pregnant women (aged 35-44 years) than among younger pregnant women (15-24 years). In contrast, the percentage of women who reported having very good or good mouth and teeth condition was significantly higher among younger non-pregnant women aged 15 to 24 than among older pregnant women aged 35 to 44.

Researchers note that the results highlight the need to improve dental service use among US women of childbearing age, especially young pregnant women, those who are non-Hispanic black or Mexican American, and those with low family income or low education level. Prenatal visits could be used as an opportunity to encourage pregnant women to seek preventive dental care during pregnancy.

Study: Oral Health Conditions and Dental Visits Among Pregnant and Nonpregnant Women of Childbearing Age in the United States, National Health and Nutrition Examination Survey, 1999-2004, Alejandro Azofeifa, DDS, MSc, MPH,Preventing Chronic Disease, published 18 September 2014.

http://www.medicalnewstoday.com/releases/282732.php

 

 

Association between widely used depression drug and dental implant failure

The International and American Associations for Dental Research (IADR/AADR) have published a paper titled “SSRIs and the Risk of Osseointegrated Implant Failure – A Cohort Study.” Selective Serotonin Reuptake Inhibitors (SSRIs), the most widely used drugs for the treatment of depression, have been reported to reduce bone formation and increase the risk of bone fracture. Since osseointegration is influenced by bone metabolism, this study investigates the association between SSRIs and the risk of failures in osseointegrated implants. The manuscript, by researchers Khadijeh Al-Abedalla, Samer Abi Nader, Belinda Nicolau, Emad Rastikerdar, Faleh Tamimi and Xixi Wu, from McGill University, Montreal, Quebec, Canada; and Nach Daniel, from East Coast Oral Surgery, Moncton, New Brunswick, Canada, is published in the OnlineFirst portion of the IADR/AADR Journal of Dental Research (JDR).

This retrospective cohort study was conducted on patients treated with dental implants from January 2007 to January 2013. A total of 916 dental implants in 490 patients (94 implants on 51 patients using SSRIs) were used to estimate the risk of failure associated with the use of SSRIs. Data analysis involved cox proportional hazards, generalized estimating equations models and Kaplan-Meier analysis. After three to 67 months of follow-up, 38 dental implants failed and 784 succeeded in nonusers group while 10 failed and 84 succeeded in SSRIs-users group.

The primary outcome was that compared with non-users of SSRIs, SSRIs usage was associated with an increased risk of dental implants failure (HR= 2∙31; P< 0∙01). The failure rates were 4.6% for SSRI non-users and 10.6% SSRI users, respectively. The secondary outcomes were that small implant diameters (≤4mm) (P=0∙01), bone augmentation (P=0∙04) and smoking habits (P<0∙01) also seemed to be associated with higher risk of implant failure. The main limitation of this retrospective study was that drug compliance dose and treatment period could not be acquired from the files of the patients.

Within the limits of this study, these findings indicate that treatment with SSRIs is associated with an increased failure risk of osseointegrated implants.

 

http://www.medicalnewstoday.com/releases/282056.php