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Objective: To investigate the role of smoking as a confounding factor in the association between periodontal pocketing and blood pressure., Material and Methods: After restriction to 45-64-year-old subjects without hypertension, diabetes, rheumatic diseases, obesity and with no history of cardiovascular diseases or ongoing lipid-lowering medications, the study population consisted of 307 subjects of the Health 2000 Survey in Finland. Systolic and diastolic blood pressure and pulse pressure (mmHg) were used as outcome variables. Periodontal condition was measured by the number of teeth with ≥4 mm periodontal pockets. β -estimates and 95% confidence intervals (CI) were obtained from linear regression models. Analyses were made in the whole study population and stratified according to smoking habits/history., Results: The number of teeth with ≥4 mm periodontal pockets associated statistically significantly with systolic blood pressure and pulse pressure in the whole study population. Among never-smokers or daily smokers, there were no consistent nor statistically significant associations between the number of teeth with ≥4 mm periodontal pockets and systolic/diastolic blood pressure or pulse pressure., Conclusions: Smoking appeared to confound the association between periodontal condition and blood pressure. Thorough control for the effect of smoking was not obtained using multivariate models.

Aim: To investigate whether the periodontal condition as measured by bleeding periodontal pockets is associated with atopic dermatitis, seborrheic dermatitis, and eczema nummulare., Materials and Methods: The study population (n = 1871) was obtained from the 46-year follow-up study of the Northern Finland Birth Cohort 1966 study (NFBC1966). The periodontal condition was measured by the number of sites with bleeding periodontal pockets that were ≥4 mm deep. The whole skin of the participants was clinically examined, and diagnoses of skin diseases were made according to the International Classification of Diseases. Prevalence rate ratios (PRR) and 95% confidence intervals (95% CIs) were estimated using Poisson regression models with robust error variance., Results: In this cohort, comprising 46-year-old participants of NFBC1966, the presence of 1-3 and ≥4 bleeding-deepened periodontal pockets (≥4 mm deep) were associated with seborrheic dermatitis (PRR 1.9, 95% CI: 1.3-2.8 and PRR 2.2, 95% CI: 1.4-3.3, respectively) and with eczema nummulare (PRR 1.7, 95% CI: 0.9-3.1 and PRR 1.7, 95% CI: 0.9-3.3, respectively). For non-smokers, the corresponding estimates were 1.7 for seborrheic dermatitis (95% CI: 1.1-2.6) and 1.8 (95% CI: 1.1-3.1) and 1.4 for eczema nummulare (95% CI: 0.7-2.9) and 1.2 (95% CI: 0.5-2.9), respectively. No association was found between bleeding-deepened periodontal pockets and atopic dermatitis. Further adjustments for C-reactive protein, diabetes, and inflammatory diseases did not essentially change the risk estimates among either the total population or the non-smokers., Conclusion: Bleeding periodontal pockets appeared to be associated with the presence of seborrheic dermatitis and eczema nummulare., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: A genome-wide association study is an analytical approach that investigates whether genetic variants across the whole genome contribute to disease progression. The aim of this study was to investigate genome-wide associations of periodontal condition measured as deepened periodontal pockets (≥ 4 mm) in Finnish adults., Methods: This study was based on the data of the national Health 2000 Survey (BRIF8901) in Finland and the Northern Finland Birth Cohort 1966 Study totalling 3,245 individuals. The genotype data were analyzed using the SNPTEST v.2.4.1. The number of teeth with deepened periodontal pockets (≥ 4 mm deep) was employed as a continuous response variable in additive regression analyses performed separately for the two studies and the results were combined in a meta-analysis applying a fixed effects model., Results: Genome-wide significant associations with the number of teeth with ≥ 4 mm deep pockets were not found at the p-level of < 5 × 10 -8 , while in total 17 loci reached the p-level of 5 × 10 -6 . Of the top hits, SNP rs4444613 in chromosome 20 showed the strongest association (p = 1.35 × 10 -7 )., Conclusion: No statistically significant genome-wide associations with deepened periodontal pockets were found in this study., (© 2021. The Author(s).)

Degeneration of intracranial aneurysm wall is under active research and recent studies indicate an increased risk of rupture of intracranial aneurysm among patients with periodontal diseases. In addition, oral bacterial DNA has been identified from wall samples of ruptured and unruptured aneurysms. These novel findings led us to evaluate if oral diseases could predispose to pathological changes seen on intracranial aneurysm walls eventually leading to subarachnoid hemorrhage. The aim of this review is to consider mechanisms on the relationship between periodontitis and aneurysm rupture, focusing on recent evidence.

Background: This study investigates whether alcohol use predicts the periodontal pocket development over an 11-year follow-up period., Methods: The study participants' periodontal condition was examined both in the Health 2000 and 2011 Surveys (BRIF8901). Participants were aged 30 to 65 years, dentate, periodontally healthy, and did not have diabetes or rheumatoid arthritis in 2000. Periodontal outcome measures in 2011 were the number of teeth with deepened (≥4 mm) periodontal pockets and the presence of deepened periodontal pockets. The exposure in 2000 was alcohol use (amount [g/week], frequency [any alcohol or different beverages]). Incidence rate ratios (IRRs) with 95% confidence intervals (CI) were estimated using negative binomial regression model and Poisson regression model with a robust variance estimator., Results: Overall, the amount of alcohol use or use over the risk limit in 2000 was inconsistently associated with the development of periodontal pockets (IRRs varied from 0.6 to 1.0). The frequency of alcohol use (any alcohol or different beverages) had an inconsistent association with the presence of periodontal pockets (IRRs varied from 0.5 to 1.2) while there was an inverse association with the number of teeth with periodontal pockets. Among smokers, there were no clear associations between any of the exposures and either of the outcomes. The same was found among non-smokers except an inverse association was found between frequency of alcohol use and the number of teeth with periodontal pockets., Conclusion: Alcohol use was not consistently associated with the periodontal pocket development over a period of 11 years., (© 2020 American Academy of Periodontology.)

Objective: The objective of this study is to study the association of alcoholic beverages and serum gamma-glutamyltransferase (GGT) level with periodontal condition. Material and methods: The study included 4294 dentate, non-diabetic Finnish adults aged 30-65 years who underwent periodontal examination during the Health 2000 Survey. The number of teeth with deepened (≥4 mm) periodontal pockets was the outcome. The exposures were self-reported beverage-specific alcohol intake (amount and frequency) and serum GGT level. The relative risks (RRs) and 95% confidence intervals (CI) were obtained by fitting zero-inflated negative binomial regression models. Results: We found no consistent association of either the intake of different alcoholic beverages or GGT level with the number of teeth with deepened periodontal pockets in the total study population or among the non-smokers. Among the highly educated non-smokers, spirit intake was associated with a low likelihood of having teeth with deepened periodontal pockets; RRs varied between 0.3 and 0.8. Among the non-smokers who had basic or intermediate education, spirit intake was associated with a higher likelihood of having teeth with deepened periodontal pockets; RRs varied between 1.2 and 1.8. Conclusion: In general, neither the intake of different alcoholic beverages nor the GGT level was consistently associated with the number of teeth with deepened periodontal pockets.

Aim: To study whether dental caries, periodontal disease, and stomatitis, and the related inflammatory burden associate with diagnosed Alzheimer's disease (AD) and dementia among older people., Methods: The study population included 170 individuals aged ≥75 years. The primary outcome was diagnosed AD and the secondary outcome was any types of diagnosed dementia. Information about participants' oral diseases and the related inflammatory burden was based on the clinical oral examination. Relative risks (RRs) and confidence intervals (CIs) were estimated using regression models., Results: Dental caries, the presence of ≥3 carious teeth (RR: 3.47, 95% CI: 1.09-11.1) and the number of carious teeth (RR: 1.24, CI: 1.11-1.39), and inflammatory burden (RR: 1.44, CI: 1.04-2.01) were associated with a higher likelihood of having AD. Also, periodontal disease and stomatitis were associated, although nonstatistically, with AD and dementia. The risk estimates for any type of dementia were in most cases lower than for AD., Conclusion: Oral diseases and the related inflammatory burden were in most cases associated more strongly with diagnosed AD than dementia in general. Of the oral diseases studied, the strongest association was between dental caries and AD., (© 2019 Special Care Dentistry Association and Wiley Periodicals, Inc.)

Aim: To study whether periodontal condition is associated with the development of type 2 diabetes mellitus (T2DM)., Materials and Methods: A population-based follow-up study was conducted among persons born in 1935 and living in the city of Oulu, Finland (n = 395). The baseline examinations were done during 1990-1992, and the follow-up examinations were done during 2007-2008. The data were gathered by questionnaires, laboratory tests and clinical measurements. Poisson regression models were used in the data analyses., Results: The adjusted rate ratios (RR) with 95% confidence intervals (95% CI) for the incident T2DM among subjects with 4-5 mm deep periodontal pockets (n = 98), among subjects with 6 mm deep or deeper periodontal pockets (n = 91), and among edentulous subjects (n = 118) were 1.32 (95% CI: 0.69-2.53), 1.56 (95% CI: 0.84-2.92) and 1.00 (95% CI: 0.53-1.89), respectively, compared to dentate subjects without deepened (4 mm deep or deeper) periodontal pockets (n = 88). The adjusted RR per site (the number of sites with deepened periodontal pockets as a continuous variable) was 1.02 (95% CI: 1.00-1.04)., Conclusions: Poor periodontal condition may be a predictor of the development of T2DM. However, the causality between periodontal condition and the development of T2DM remains uncertain., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: To investigate whether low-grade inflammation-related factors such as serum low-density (LDL-C) and high-density lipoprotein cholesterol (HDL-C) modify the association between periodontal infection and C-reactive protein., Material and Methods: This study was based on a subpopulation of the Health 2000 Survey, which consisted of dentate, non-diabetic, non-rheumatic subjects who were 30-49 years old (n = 2710). The extent of periodontal infection was measured by means of the number of teeth with periodontal pocket ≥4 mm and teeth with periodontal pocket ≥6 mm and systemic inflammation using high sensitive C-reactive protein., Results: The extent of periodontal infection was associated with elevated levels of C-reactive protein among those subjects whose HDL-C value was below the median value of 1.3 mmol/l or LDL-C above the median value of 3.4 mmol/l. Among those with HDL-C ≥ 1.3 mmol/l or LDL-C ≤ 3.4 mmol/l, the association between periodontal infection and serum concentrations of C-reactive protein was practically non-existent., Conclusion: This study suggests that the relation of periodontal infection to the systemic inflammatory condition is more complicated than previously presumed. The findings of this study suggest that the possible systemic effect of periodontal infection is dependent on serum lipid composition., (© 2012 John Wiley & Sons A/S.)

Aim: To investigate the role of periodontal infection in obesity in an adult population., Material and Methods: This study was based on a subpopulation of the Health 2000 Survey that included dentate, non-diabetic subjects, aged 30-49 years (n=2784). Obesity was measured using the body mass index (BMI), body fat percentage (BF%) and waist circumference (WC). The extent of periodontal infection was measured using the number of teeth with deepened (4 mm deep or deeper) periodontal pockets and was categorized into four categories (0, 1-3, 4-6, 7 or more)., Results: The number of teeth with deepened periodontal pockets was found to be associated with BMI in an exposure-response manner among the total study population. The association was found among men and women, and also among never-smokers. The number of teeth with deepened periodontal pockets was also associated with BF% and WC among never-smokers., Conclusion: Periodontal infection measured by means of the number of teeth with deepened periodontal pockets appears to be associated with obesity. However, no inferences about causality can be made and further studies are needed to clarify the possible role of periodontal infection in obesity., (© 2010 John Wiley & Sons A/S.)

Aim: The aim of this study was to investigate the association between body weight and periodontal infection in a longitudinal setting., Material and Methods: This study was based on a subpopulation of the Health 2000 Survey that included dentate, non-diabetic subjects aged 30-59 years, who had never smoked and who had participated in the Follow-Up Study on Finnish Adults' Oral Health approximately 4 years later (n=396). The number of new teeth with deepened (4 mm deep or deeper) periodontal pockets in the follow-up examination was used as the outcome variable. Body weight was measured using body mass index, categorized into three categories: <25.0 (normal weight), 25.0-29.9 (overweight) and 30.0 or more (obesity). Incidence rate ratios were estimated using Poisson's regression models., Results: Body weight was weakly, but not statistically significantly, associated with the number of new teeth with deepened periodontal pockets among subjects who were periodontally healthy in the baseline examinations, whereas only a minuscule association was found among subjects who had periodontal infection at baseline., Conclusions: The results of this follow-up study do not provide evidence that overweight and obesity can be considered significant risk factors in the pathogenesis of periodontal infection., (© 2010 John Wiley & Sons A/S.)

Only a few studies have examined the association of metabolic syndrome with periodontal infection and dental caries. The aim in this study was to examine the association of metabolic syndrome with periodontal infection and dental caries using the European Group for the Study of Insulin Resistance (EGIR) definition and its separate components. This study population consisted of dentate, non-diabetic individuals aged 30 to 64 years (N = 2050) who had never smoked. Relative risks (RR) were estimated with Poisson regression models. Metabolic syndrome was associated with teeth with deepened periodontal pockets 4 mm deep or deeper [adjusted RR 1.19 (95% CI 1.01-1.42)], with pockets 6 mm deep or deeper [adjusted RR 1.50 (95% CI 0.96-2.36)], and carious teeth [adjusted RR 1.25 (95% CI 0.93-1.70)]. The results suggest that metabolic syndrome or some of its components are associated weakly with periodontal infection.

Objective: To describe the periodontal condition of the elderly in Finland and its association with sociodemographic factors., Material and Methods: The study was based on a subpopulation of 1460 persons (748 dentate persons) aged > or =65 years who participated in a nationally representative Health 2000 Survey in Finland. The data for this study were collected by means of an interview and a clinical oral examination., Results: Seventy-three percent of the participants in this study had gingival bleeding in at least one sextant. The proportion of participants with no teeth with deepened periodontal pockets > or =4 mm deep was 31%. Twenty-eight percent of the participants had one to three teeth with deepened periodontal pockets > or =4 mm deep, 15% had four to six and 26% had > or =7. At the individual level, a high number of teeth with deepened periodontal pockets was associated with sociodemographic factors such as high age, intermediate or higher education, and living in a rural area., Conclusion: At a national level, the greatest need for periodontal treatment presently derives from persons aged 65-74 years and/or those with low education, due to their high representation in the elderly population.

Objectives: There is large variation in the results of studies on the association between periodontitis and systemic diseases. The variation might be explained by the fact that the association between periodontitis and systemic diseases is confounded, or the association might be modified by extraneous factors. In this article, we show, using simple examples, how confounding and effect modification may cause variation in results. In addition, these examples show that uncontrolled or partially controlled confounders can induce spurious associations., Conclusion: Confounding and effect modification may explain the variation in the results of studies on the association between periodontitis and systemic diseases.