Pressure pain sensitivity is associated with dental fear in adults in middle age:findings from the Northern Finland 1966 birth cohort study

Abstract Introduction: Dental fear is a prevalent problem leading to severe deterioration of oral health and health‐related quality of life. Despite the knowledge that dental fear is closely linked to painful experience, the association between pain sensitivity and dental fear remains unclear. This study was designed to evaluate this association with validated measures of dental fear and pressure pain sensitivity in a cohort population. Methods: The study population consisted of a subpopulation of the Northern Finland Birth Cohort 1966. At the age of 46 years, 1736 participants completed the valid and reliable Modified Dental Anxiety Scale (MDAS) and participated in a clinical examination, where their nonorofacial pressure pain sensitivity was evaluated by validated pressure pain threshold (PPT) and tolerance (PPTo) measurements. Gender‐specific Tobit regressions were performed to analyse this association adjusted for smoking and depressive and anxiety symptoms. Results: Women with moderate dental fear had 5% (31.3 kPa; P < 0.05), and women with high dental fear had 7% (42.9 kPa; n.s.) lower pressure pain threshold than women with low dental fear. Women with moderate dental fear had 4% (35.4 kPa; P < 0.05) and women with high dental fear had 9% (82.7 kPa; P < 0.01) lower pressure pain tolerance than women with low dental fear. Men with moderate and high dental fear had 3% lower pressure pain tolerance (35.4 kPa; P < 0.05 and 29.6 kPa; n.s., respectively) than men with low dental fear, whereas the associations with pain threshold were not statistically significant. Among women, both anticipatory and treatment‐related dental fears were associated with pain threshold and pain tolerance. Among men, pain threshold was associated with treatment‐related dental fear only and the associations with pain tolerance were not statistically significant. Conclusions: Nonorofacial pressure pain threshold and tolerance appeared to be lower in participants with dental fear, which emphasizes the role of pain sensitivity in dental fear

Immunization with gingipain A hemagglutinin domain of Porphyromonas gingivalis induces IgM antibodies binding to malondialdehyde-acetaldehyde modified low-density lipoprotein

Abstract Treatment of periodontitis has beneficial effects on systemic inflammation markers that relate to progression of atherosclerosis. We aimed to investigate whether immunization with A hemagglutinin domain (Rgp44) of Porphyromonas gingivalis (Pg), a major etiologic agent of periodontitis, would lead to an antibody response cross-reacting with oxidized low-density lipoprotein (OxLDL) and how it would affect the progression of atherosclerosis in low-density lipoprotein receptor-deficient (LDLR-/-) mice. The data revealed a prominent IgM but not IgG response to malondialdehyde-acetaldehyde modified LDL (MAA-LDL) after Rgp44 and Pg immunizations, implying that Rgp44/Pg and MAA adducts may share cross-reactive epitopes that prompt IgM antibody production and consequently confer atheroprotection. A significant negative association was observed between atherosclerotic lesion and plasma IgA to Rgp44 in Rgp44 immunized mice, supporting further the anti-atherogenic effect of Rgp44 immunization. Plasma IgA levels to Rgp44 and toPg in both Rgp44- and Pg-immunized mice were significantly higher than those in saline control, suggesting that IgA to Rgp44 could be a surrogate marker of immunization in Pg-immunized mice. Distinct antibody responses in plasma IgA levels to MAA-LDL, to Pg lipopolysaccharides (Pg-LPS), and to phosphocholine (PCho) were observed after Rgp44 and Pg immunizations, indicating that different immunogenic components between Rpg44 and Pg may behave differently in regard of their roles in the development of atherosclerosis. Immunization with Rgp44 also displayed atheroprotective features in modulation of plaque size through association with plasma levels of IL-1α whereas whole Pg bacteria achieved through regulation of anti-inflammatory cytokine levels of IL-5 and IL-10. The present study may contribute to refining therapeutic approaches aiming to modulate immune responses and inflammatory/anti-inflammatory processes in atherosclerosis