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Background: Air pollutants can influence local and systemic inflammation, oxidative stress and microbiome composition. Therefore, air pollution may potentially represent an unexplored modifiable risk indicator for periodontitis. The aim of the current cross-sectional study was to investigate the epidemiological association between outdoor air pollution and periodontitis in a representative sample of the South Korean population. Methods: A total of 42,020 individuals, which were representative of 35.2 million South Koreans, were examined. The mean annual levels of particulate matter of 10 μm (PM10), ozone, sulfur dioxide (SO2), nitrogen dioxide (NO2) and humidity, were studied. Periodontitis was defined according to the Community Periodontal Index (CPI ≥ 3). Simple and multiple regression analyses using four different models were applied. Results: Every 5-μg/m3 increase in PM10 (OR = 1.17; 95% confidence interval—CI: 1.11–1.24) and of 0.005 ppm in ozone levels (OR = 1.4; 95% CI: 1.00–1.30) were positively associated with periodontitis prevalence. Conversely, every 5% increase in humidity (OR = 0.94; 95% CI: 0.90–0.99) and 0.003 ppm increase in NO2 levels (OR = 0.93; 95% CI: 0.89–0.96) were inversely associated with periodontitis occurrence. Conclusions: In this nationally representative population several air pollutants were found to be associated with periodontitis occurrence. Hence, the present results suggest that air pollution may be a new modifiable risk indicator for periodontitis. [ABSTRACT FROM AUTHOR]

Background: Handgrip strength is easily assessed by muscle strength and is an important factor for health and physical performance. Empirical evidence for the association between the number of teeth and handgrip strength remains controversial. The objective of this study was to investigate the association between the number of teeth and handgrip strength.Methods: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2014 to 2015 were used (N = 7,741). The number of teeth was categorized into three groups: 0 to 9 teeth, 10 to 19 teeth, and 20 to 28 teeth. Handgrip strength of the participants was measured using a digital hand dynamometer. Multivariate linear regression and logistic regression models were fitted to assess the association between the number of teeth and hand grip strength after adjusting for sociodemographic factors, general health behaviors, and oral and general health factors.Results: Reduced handgrip strength was much more frequent in male and female participants with a lower number of teeth. Each tooth increased handgrip strength by 0.12 kg and 0.07 kg in males and females, respectively (P < 0.001 for both males and females). The association between the number of teeth and handgrip strength disappeared in females in the fully adjusted models, but the odds ratio of participants with 0 to 9 teeth was 1.73 (95% confidence interval: 1.02 to 2.95), which was higher than the reference group in males.Conclusion: Our results showed a significant association between the number of teeth and handgrip strength in Korean adults. [ABSTRACT FROM AUTHOR]

Background: No studies have reported the association between the number of teeth and hypertension in the Korean national data. The purpose of this study was to investigate whether the number of teeth is associated with blood pressure and hypertension in a representative sample of the Korean population.Methods: A cross-sectional study was conducted on 13,561 participants aged ≥19 years using the 2012 to 2014 Korea National Health and Nutrition Examination Survey data. The number of teeth was divided into four groups: 0, 1 to 19, 20 to -27, and 28. The definition of hypertension was systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or being medicated for hypertension. Multivariate logistic regression analyses were performed after controlling for age, sex, income, education, smoking, drinking, diabetes mellitus, obesity, and hypercholesterolemia. Age- and sex-stratified analyses were performed.Results: The fully adjusted odds ratios (AOR) of the number of teeth group for hypertension were as follows: AOR: 1.25, 95% CI: 1.11 to 1.43 for 20 to 27 teeth; AOR: 1.46, 95% CI: 1.22 to 1.76; 1 to 19 teeth; and AOR: 1.63, 95% CI: 1.22 to 2.18 for edentulism. The strength of the association was highest in women aged ≥60 years across all age and sex groups (OR = 1.81, 95% CI = 1.15 to 2.86).Conclusion: Findings suggest that a decrease in the number of teeth may be independently associated with hypertension in the Korean population. [ABSTRACT FROM AUTHOR]

Background: Objectives of this research are to determine the relationship between number of natural teeth and metabolic syndrome (MetS) in a representative sample of the Korean population.Methods: From the Korean National Health and Nutrition Examination Survey, a cross-sectional study was conducted on 13,066 participants aged >19 years. The number of teeth was assessed by clinical oral examination. MetS was defined based on the joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. Multivariable logistic regression analyses were used to evaluate the association between number of teeth and MetS adjusted for the following criteria: 1) age; 2) sex; 3) income; 4) education; 5) toothbrushing frequency; 6) periodontitis; 7) smoking; 8) drinking; 9) physical activity; and 10) diabetes mellitus.Results: The number of existing permanent teeth was inversely associated with MetS after controlling for all confounders (adjusted odds ratio [AOR] = 1.19, 95% confidence interval [CI] = 1.04 to 1.36 for 20 to 27 teeth; AOR = 1.37, 95% CI = 1.12 to 1.67 for 0 to 19 teeth). Association between fewer teeth and MetS increased for individuals aged ≥40 years and for women.Conclusion: The number of teeth found is inversely proportional to occurrence of MetS. [ABSTRACT FROM AUTHOR]

Objectives To assess the association between chewing difficulty and symptoms of depression in a representative sample of the Korean population. Design Cross-sectional. Setting Korea National Health and Nutrition Examination Survey ( KNHANES). Participants KNHANES participants (N = 5,158). Measurements Chewing difficulty was assessed according to the self-reported presence of chewing problems using a structured questionnaire. Symptoms of depression were defined as having feelings of sadness or depression consecutively over 2 weeks during the last 12 months. Multivariable logistic regression analysis was used to determine the adjusted odds ratios ( AORs) and 95% confidence intervals ( CIs) of the associations between chewing difficulty and symptoms of depression, adjusted for age; sex; monthly household income; education; number of teeth; number of decayed, missing, or filled permanent teeth; periodontitis; state of dentition; tooth brushing frequency; regular dental visits; smoking status; alcohol consumption; hypertension; diabetes mellitus; and obesity. The interaction effects between chewing difficulty and confounders were evaluated, and age- and sex-stratified analyses were performed. Results There was a significant positive association between chewing difficulty and symptoms of depression in the fully adjusted model ( AOR = 1.86, 95% CI = 1.48-2.33). The strength of the association was highest in men aged 60 and older ( AOR = 3.28, 95% CI = 1.54-7.00). Conclusion Chewing difficulty was independently associated with symptoms of depression in a representative sample of Korean adults. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to evaluate the association between salivary 8-hydroxydeoxyguanosine (8- OHdG) and periodontitis among community-dwelling Korean adults. Methods A total of 211 adults (80 men and 131 women) were cross-sectionally surveyed from the Sunchang Longevity Cohort. Periodontitis was defined as having at least 30% of teeth with proximal attachment loss ≥5 mm. The salivary 8- OHdG level was categorized into tertiles: low (<0.916 ng/ml), medium (0.916 to <2.675 ng/ml) and high (≥2.675 ng/ml). Sociodemographic, habitual and systemic health-related factors were controlled for. Logistic regression analysis was performed for the outcome of severe periodontitis. Analysis of covariance in general linear model was performed for the outcome of 8- OHdG. Results The high 8- OHdG level showed a significant association with periodontitis. The odds ratio (95% confidence interval) was 2.40 (1.05-5.51), and it was highlighted by adding the interaction term with drinking and smoking. The adjusted mean log-transformed value of 8- OHdG was significantly higher in the severe periodontitis group (1.40 ng/ml) than in the control group (1.02 ng/ml) ( ancova, P = 0.028). Conclusions 8- OHdG was associated with periodontitis. Thus, salivary 8- OHdG could be a useful marker for periodontitis. [ABSTRACT FROM AUTHOR]

Objectives To investigate the association between periodontitis and cognitive impairment in elderly Koreans. Design Cross-sectional study with age- and sex-matched case-control selection. Setting The Yangpyeong cardiovascular cohort ( YCC), a part of the Korean Genome Epidemiologic Study (Ko GES), Yangpyeong, South Korea. Participants Individuals with cognitive impairment (n = 65) and cognitively normal controls (n = 124) aged 60 and older from the YCC. Measurements Alveolar bone loss was assessed on dental panoramic radiographs to categorize the cumulative history of periodontitis ( HOP) into three groups: normal, moderate periodontitis, severe periodontitis. The Mini-Mental State Examination ( MMSE) was used to categorize participants as cognitively normal or cognitively impaired. Age- and sex-matched conditional logistic regression models were used for analysis. Confounders considered in the analysis were age, sex, drinking, smoking, exercise, total cholesterol, total protein, body mass index, fasting plasma glucose, intima-media thickness, hypertension medication, and depression. Results Participants with HOP were more likely to have cognitive impairment than those without (odds ratio = 2.14, 95% confidence interval = 1.04-4.41). The interaction effect of smoking and exercise on periodontitis highlighted the link. Conclusion Periodontitis was independently associated with cognitive impairment after controlling for various confounders. Further longitudinal research is needed to determine whether periodontitis plays a role in cognitive decline in older adults. [ABSTRACT FROM AUTHOR]

Background: Nitric oxide (NO) is known to play an important role in many biologic systems, although the relationship between NO metabolites and periodontitis remains controversial. Moreover, little evidence of an association between salivary NO (S-NO) and periodontitis in the general population has been reported. This study aims to investigate the relationship between S-NO and periodontitis in an elderly Korean population. Methods: A cross-sectional study was conducted using participants and salivary samples from Sunchang Elderly Cohort Study. The total number of final participants was 242 (91 males and 151 females; 48 to 93 years old). Periodontitis was determined by a clinical attachment loss of >6 mm at six probe points on 12 index teeth. NO was measured in unstimulated saliva via the Griess reaction. Sociodemographic status, general/oral health, and health-related behaviors were investigated as confounders. Bivariate analysis and multivariable linear regression analyses including confounders were applied. Results: After controlling for age, sex, education, salivary flow rate, number of teeth, smoking status, physical activity, hypertension, and diabetes, three metabolites of S-NO (total NO, nitrite, and nitrate) were independently associated with the percentage of probe points exhibiting periodontitis. Of these linear associations, total NO was found to have the strongest correlation with periodontitis (partial r = 0.181, P = 0.009). These associations were most pronounced in females (except for nitrate), non-smokers, those without hypertension, and those without diabetes. Conclusions: Our data suggest that high concentrations of S-NO are associated with severe periodontitis. Thus, S-NO may serve as a potential biologic marker for detecting and monitoring periodontitis. [ABSTRACT FROM AUTHOR]

Background and aims We aimed to evaluate the association of periodontitis with the development of early atherosclerotic vascular disease in Korean adults. Methods In this cross-sectional study, a total of 1343 adults aged over 40 years were recruited from a community-based cohort of Yangpyeong county, Korea, during the period 2010–2014. Only dentate individuals were included in the study. Subclinical atherosclerosis (SA) was defined as carotid intima-media thickness (cIMT)≥0.754 mm, as assessed bilaterally by B-mode ultrasound. Peripheral arterial disease (PAD) was defined as ankle-brachial index (ABI)≤1.0, as measured by Doppler. History of periodontitis was assessed by measuring the radiographic alveolar bone loss (RABL) on a digital dental panorama and was classified into three groups: normal, moderate and severe periodontitis (≥2 non-adjacent interproximal sites with RABL ≥ 4 mm and 6 mm, respectively). The associations of periodontitis with SA and PAD were evaluated by multivariable logistic regression analysis and analysis of covariance, adjusted for age, sex, education level, tooth loss, smoking, drinking, exercise, obesity, triglycerides, HDL, LDL, hs-CRP, diabetes and hypertension. Stratified analyses were performed to identify specific risk groups. Results After controlling for confounders, severe periodontitis was associated with SA [adjusted odds ratio (aOR) = 1.55; 95% confidence interval (CI): 1.07–2.24] and PAD (aOR = 2.03; 95% CI: 1.05–3.93). These associations were highlighted in never-smokers. For increasing severity of periodontitis, the adjusted mean cIMT increased ( p = 0.011) while that of ABI decreased ( p = 0.033). Conclusions Our data showed that periodontitis is a substantially important risk factor for atherosclerotic vascular disease among Korean adults. [ABSTRACT FROM AUTHOR]