Bo-Hyoung Jin

The relationship between periodontitis and metabolic syndrome among a Korean nationally representative sample of adults

AIMS The aim of this study was to examine whether metabolic syndrome (MS) is associated with periodontitis in a representative sample of Korean adults, who were involved in the Fourth Korea National Health and Nutrition Examination Survey (KNHANES). MATERIALS AND METHODS A total of 7178 subjects over the age of 19 years who participated in KNHANES were examined. MS was defined as the definition proposed by the National Cholesterol Education Program Adult Treatment Panel III and the abdominal obesity cut-off line based on Korean Society for the Study of Obesity. The periodontal status was assessed by the Community Periodontal Index. Multivariate logistic regression analysis was carried out adjusting for the sociodemographics, oral health behaviours and status, and health behaviour. All analyses considered a complex sampling design, and multivariate analysis was also performed in the subgroups (age, gender, current smoking status). RESULTS Multivariate logistic regression analysis revealed significant associations between MS and periodontitis. After adjusting for all covariates, the adjusted odds ratio (OR) of periodontitis (community periodontal index ≥ 3) was 1.55 (1.32-1.83) for MS. In subgroup analysis, periodontitis is associated with MS in subjects over age 40 and the adjusted ORs were higher in females and in the smoker group than in males and in non-smokers. CONCLUSIONS MS is associated with periodontitis.

Oral health behaviors, periodontal disease, and pathogens in preeclampsia: a case-control study in Korea.

BACKGROUND The aim of this study is to confirm the association among oral health behaviors, periodontitis, and preeclampsia in Korean women. METHODS This study is designed as a case-control study. Sixteen women with preeclampsia and 48 without preeclampsia post-delivery were included in this study from November 2007 to January 2010. Information was collected on demographics, health behaviors, and obstetric and systemic diseases that may influence the periodontal condition and preeclampsia. Full-mouth periodontal probing was conducted by one trained examiner (KHB). Localized periodontitis was defined as periodontal clinical attachment loss (AL) ≥ 3.5 mm on two or three sites not on the same tooth. In addition, generalized periodontitis was defined as clinical AL ≥ 3.5 mm on ≥ 4 sites not on the same tooth. Gingival crevicular fluid was collected using a sterilized paper point for quantitative analysis of Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia (Pi), and Tannerella forsythia (previously T. forsythensis). RESULTS After adjusting for confounders, the adjusted odds ratio (OR) was 4.79 (95% confidence interval [CI]: 1.02 to 29.72) for localized periodontitis and 6.60 (95% CI: 1.25 to 41.61) for generalized periodontitis. In addition, the proportion of floss or interdental brush users in women with preeclampsia was lower than that in women without (adjusted OR: 0.21; 95% CI: 0.02 to 0.93). Pi was significantly more prevalent in women with preeclampsia (P = 0.028). CONCLUSION These results indicate that preeclampsia could be associated with the maternal periodontal condition and interdental cleaning.

Health behaviors, periodontal conditions, and periodontal pathogens in spontaneous preterm birth: a case-control study in Korea.

BACKGROUND This study aims to determine whether periodontal conditions or dental health behaviors are risk factors for preterm birth (PTB), and whether periodontal pathogens are risk indicators for PTB among Korean mothers. METHODS This study was designed as a hospital-based case-control study. Examiner masking was ensured for the validity of the examinations. The mothers included those who gave birth between November 2007 and July 2009 at the obstetrics clinic of a general hospital in Seoul, Korea. Information on demographic and health conditions, periodontal conditions, and microbacterial data was collected. RESULTS A total of 172 women met the inclusion criteria, 59 mothers who delivered a preterm neonate were assigned to the case group while the other 113 were assigned to the control group. There were no significant differences in demographic information, oral health conditions, and obstetric characteristics. Among health-related behaviors, only scaling within 12 months before pregnancy showed a significant difference (P = 0.031). Even in the adjusted logistic model, only the difference in the experience of scaling before pregnancy was significant between the PTB cases and the controls (P = 0.039). Periodontal disease did not exhibit a significant relationship with PTB even after adjustment for potential confounding factors. Among the microbacterial factors, only Porphyromonas gingivalis showed a slight difference (P = 0.060). CONCLUSION There was a significant difference in scaling experience within 12 months before pregnancy and P. gingivalis showed a marginal difference between the PTB and the control groups but clinical periodontal conditions showed no association with PTB.

Risk factors for dental caries in childhood: a five‐year survival analysis

OBJECTIVES The purpose of this study was to examine the risk factors of dental caries at the level of an individual person with survival analysis of the prospective data for 5 years. METHODS A total of 249 first-grade students participated in a follow-up study for 5 years. All participants responded to a questionnaire inquiring about socio-demographic variables and oral health behaviors. They also received an oral examination and were tested for Dentocult SM and LB. Over 5 years, the participants received yearly oral follow-up examinations to determine the incidence of dental caries. The incidence of one or more dental caries (DC1) and four or more dental caries (DC4) were defined as one or more and four or more decayed, missing, and filled permanent teeth increments, respectively. Socio-demographic variables, oral health behaviors, and status and caries activity tests were assessed as risk factors for DC1 and DC4. The adjusted hazard ratios (HRs) of risk factors for DC1 and DC4 were calculated using Cox proportional hazard regression models. RESULTS During the 5-year follow-up period, DC1 and DC4 occurred in 87 and 25 participants, respectively. In multivariate hazard models, five or more decayed, missing, and filled primary molar teeth [HR 1.93, 95% confidence interval (CI) 1.19-3.13], and Dentocult LB of two or three (HR 2.21, 95% CI 1.37-3.56) were independent risk factors of DC1. For DC4, only Dentocult LB of two or three was an independent risk factor (HR 2.95, 95% CI 1.11-7.79). CONCLUSIONS Our results suggest that dental caries incidence at an individual level can be associated with the experience of dental caries in primary teeth and Dentocult LB based on the survival models for the 5-year prospective data.

Systemic effect of water fluoridation on dental caries prevalence.

OBJECTIVES The aim of this study was to evaluate the systemic effect of water fluoridation on dental caries prevalence and experience in Cheongju, South Korea, where water fluoridation ceased 7 years previously. METHODS A cross-sectional survey was employed at two schools where water fluoridation had ceased (WF-ceased area) and at two schools where the water had never been fluoridated (non-WF area). The schools in the non-WF area were of a similar population size to the schools in the WF-ceased area. Children of three age groups were examined in both areas: aged 6 (n = 505), 8 (n = 513), and 11 years (n = 467). The differences in the mean number of decayed or filled primary teeth (dft) and the mean number of decayed, missing, or filled permanent teeth (DMFT) scores between areas after adjusting for oral health behaviors and socio-demographic factors were analyzed by a Poisson regression model. RESULTS The regression model showed that the DMFT ratio for children aged 11 years in the WF-ceased area was 0.581 (95% CI 0.450-0.751). In contrast, the dft ratio for age 6 in the WF-ceased area was 1.158 (95% CI 1.004-1.335). Only the DMFT ratio for age 8 (0.924, 95% CI 0.625-1.368) was not significant. CONCLUSIONS While 6-year-old children who had not ingested fluoridated water showed higher dft in the WF-ceased area than in the non-WF area, 11-year-old children in the WF-ceased area who had ingested fluoridated water for approximately 4 years after birth showed significantly lower DMFT than those in the non-WF area. This suggests that the systemic effect of fluoride intake through water fluoridation could be important for the prevention of dental caries.

The impact of the National Denture Service on oral health-related quality of life among poor elders

The objective of this study was to assess the effects of the Korean National Denture Service (NDS) for poor elderly people requiring dentures on oral health-related quality of life (OHRQOL). Data from follow-up studies were collected from 439 subjects at eight public health centres who answered every question of a questionnaire, and the OHRQOL was measured at the baseline and at 3-month follow-up after receiving the NDS according to the type of denture provision. The multivariate linear mixed model with a public health centre as a random effect for the score change of Oral Health Impact Profile (OHIP)-14K was carried out to confirm the factors related to the improvement in OHRQOL. The mean OHIP-14K was 28.60 at the baseline time points, and there was a decrease in the OHIP-14 scores to 21.14 ± 12.52 at the 3-month follow-up of the removable partial denture beneficiaries. The changes in OHIP-14K among complete denture beneficiaries were 21.53 ± 12.01 for previously dentate subjects and 22.54 ± 11.12 for edentate subjects. The multivariate linear mixed model of dentate subjects demonstrated that the improvement in the OHRQOL was associated with the number of remaining teeth, satisfaction with denture and self-reported oral health status after 3 months. In the case of the edentate model, satisfaction with denture was the only factor related to the improvement in OHRQOL. This study revealed considerable improvement in OHRQOL among poor elderly people after NDS. Satisfaction with provision of dentures was associated with improvement in the OHRQOL.

The cariogenicity of hydrolyzed starch foods by measuring the polyacrylamide hydroxyapatite (PAHA) disc

OBJECTIVES This study measured the degree of demineralization of starch foods affected by hydrolyzed starch in total starch using the polyacrylamide hydroxyapatite (PAHA) disc. DESIGN A total of 10 ml of test food was added to a PAHA disc and 5 ml artificial saliva, followed by inoculation with 1 μl of S. mutans and incubation at 37 °C for 180 min. The demineralization effects were then determined using CLSM. RESULTS The proportion of hydrolyzed starch in total starch in potato increased over time, while hydrolyzed starch in other test food decreased. When the amount of hydrolyzed starch in total starch increased after 180 min (p=0.000), the surface roughness of the PAHA disc in potato was significantly decreased. Wheat-based sugary snacks, such as chips and cookie, had relatively high cariogenic potentials, whereas baked potato had a relatively low cariogenic potential. CONCLUSIONS Hydrolyzed starch in total starch increased over time, and cariogenic potential was notably decreased. Measurement of PAHA disc may be a valid method for assessing the cariogenic potential of hydrolyzed starch foods.

Effect of School-Based Fluoride Mouth Rinsing Program in a Socially Deprived Community

Purpose: The objective of this study was to evaluate the caries prevention effect of school-based fluoride mouth rinsing (FMR) program implemented in the Hanuul district of Mongolia, which has a very low socioeconomic status and extremely poor infrastructure for oral health. Materials and Methods: One hundred and seventy children aged from 6 to 8 years of the FMR school and 187 children aged from 6 to 8 years of the control school completed the baseline survey. Children from the FMR school rinsed with 0.05% sodium fluoride everyday under supervision, while those from the control school did not. Adjusted caries preventive fraction (CPF) for 2 years were calculated to evaluate the effect of the FMR program. Result: After 2 years, 288 schoolchildren remained in the study. Decayed, missing or filled permanent teeth (DMFT) and index of the FMR and the control schools at baseline were 0.11 and 0.12, respectively, and the average DMFT increment of the FMR and the control schools after 2 years were 0.35 and 0.65, respectively. The adjusted CPF of DMFT was 48.5%. Conclusion: These findings show that a school-based FMR is an effective caries preventive program in a socially deprived community with poor infrastructure for oral health.

A Retrospective Cohort Study on the Association Between Periapical Abscess, Advanced Periodontal Disease, and the National Oral Health Screening Program Among Korean Adults

The National Oral Health Screening Program (NOHSP) is a general population-based program in Korea. The objective of this study was to assess the association between participation in the NOHSP and dental visit for periapical abscess (PA) and advanced periodontal disease (APD) among Korean adults. Data were obtained for subjects from the National Health Insurance database. The authors conducted a retrospective cohort study of 9358 randomly selected subjects who were between 40 and 64 years old in 2002. The outcomes of dental visit for PA or APD from the years 2003 to 2007 were compared between the screening and nonscreening groups. The nonscreening group had 19% higher risk of PA and 15% higher risk of APD. This study suggests that the NOHSP may decrease the risk of dental visit because of PA and APD by preventing the progress of lesion to the advanced stage among Korean adults.

Measurement of the cariogenicity of snacks using a radioisotope PAHA disc

OBJECTIVES This study aimed to establish a method for measuring the cariogenic potential of foods with high reproducibility in vitro. METHODS Streptococcus mutans (S. mutans) was incubated in test foods with radioisotope polyacrylamide hydroxyapatite (PAHA) for 150 min at 37 °C. Then, the amount of radioisotope (32)P released from PAHA was measured using a liquid scintillation counter and scanning electron microscopy (SEM). RESULTS The radioisotope PAHA discs that were soaked in 10% sucrose solutions had a high cariogenic potential and showed a remarkably demineralized surface (p < 0.05). The radioisotope PAHA disc that was incubated with snacks that had a high cariogenic potential showed a remarkably demineralized surface via SEM. Candy had a relatively high cariogenic potential, whereas xylitol gum had a relatively low potential. CONCLUSIONS The cariogenicity of snacks can easily be evaluated by measuring the amount of (32)P released from radioisotope PAHA discs.