Exploring the genetic basis of chronic periodontitis: a genome-wide approach

Chronic periodontitis (CP) is a common-complex oral disease that affects the majority of the adult population and is a major cause of tooth loss. The disease is characterized by an oral biofilm pathological shift that contributes to cascade of events leading to periodontal destruction. Factors modulating the establishment of a dysbiotic oral microbiome or affecting the host immunity and inflammatory response are promising preventive and therapeutic targets. Although a substantial genetic component of CP is theorized and numerous candidate-gene studies have been completed, to-date no wholegenome association (GWA) studies have been performed. We performed a GWA analysis of CP in well-defined cohort of 4500 white subjects who were participants of the Atherosclerosis Risk In Communities study. Traits of interest were the three-level disease CDC/AAP classification (healthy/mild, moderate, severe CP) and a continuous extent of disease [proportion of sites exhibiting ≥3 mm attachment loss (EAL)] measure. Additionally, we examined three traits of high bacterial colonization defined as the highest quintile of the distribution of “red” and “orange” complex bacteria, and Aggregatibacter actinomycetemcomitans that were quantified using DNA-DNA checkerboard hybridization in a subset of 1020 white study subjects. Genotyping was performed using the Affymetrix 6.0 platform. Imputation to 2.5million markers was based on HapMap II-CEU and a multiple-test corrected significance threshold was applied (P<5x10-8). We detected no genome-wide significant signals. However, we found suggestive evidence of association (P<5x10-6) for CP with ten loci including NPY, NIN, WNT5A for severe, NCR2, EMR1 for moderate CP, and TBX18, ETS1, DYNC2H1, TTC26 and ZC3HAV1 for EAL. Additionally, thirteen loci including KCNK1, FBXO38, IL33, RUNX2, CAMTA1 and VAMP3 provided suggestive signals of association (P<5x10-6) with the examined “high” bacterial colonization traits. The NPY (7p15) locus was replicated in an independent cohort of whites of European descent. These genome-wide scan results from a large well-defined cohort provide information on multiple candidate regions for interrogation in genetic studies of CP. Future investigations providing further replication of these findings may lead to an improved understanding of the complex nature of host-biofilm and -bacteria interactions that characterizes states of health and disease

Pediatric obesity‐related curricular content and training in dental schools and dental hygiene programs: systematic review and recommendations

ObjectivesThe authors conducted a systematic review to determine: a) What dental schools and dental hygiene programs are doing to promote knowledge and skills related to addressing childhood obesity and to reduce consumption of sugar‐sweetened beverages (SSBs) and b) What else these schools and programs could do to better equip future oral health professionals to address childhood obesity and reduce consumption of SSBs.MethodsThe authors searched PubMed, Scopus, Education Full Text (EBSCOHost), and ERIC (EBSCOHost) to identify peer‐reviewed publications reporting on obesity or dietetic‐related curricula in dental and dental hygiene education within the last 20 years. Three studies met inclusion and exclusion criteria. Outcomes of the identified studies were abstracted and summarized independently by two investigators.ResultsThe first study describes a 2009 survey of pediatric dentistry residents. Approximately, half had received formal training yet they lacked essential knowledge or skills for managing children who were obese. The second study describes nutrition‐related coursework offered in the second year of a predoctoral dental school curriculum in Saudi Arabia, and the third study reports on the development of an “oral health rotation” dietetic internship in a pediatric dentistry clinic, in the context of interprofessional education (IPE).ConclusionsEvidence of dental schools’ and dental hygiene programs’ efforts to address obesity and SSB consumption in children in their curricula is scant, while Commission on Dental Accreditation standards make sporadic mentions of diet and nutrition. Opportunities exist to leverage existing resources and innovative, experiential approaches, including IPE, to formally, and effectively address this important issue in predoctoral oral health education.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138365/1/jphd12236.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138365/2/jphd12236_am.pd

Benefits of Case-Based versus Traditional Lecture-Based Instruction in a Preclinical Removable Prosthodontics Course

This study compared the acceptability and relative effectiveness of case-based learning (CBL) versus traditional lecture-based (LB) instruction in a preclinical removable prosthodontics course in the University of North Carolina at Chapel Hill School of Dentistry DDS curriculum. The entire second-year class (N=82) comprised this crossover study's sample. Assessments of baseline comprehension and confidence in removable partial denture (RPD) treatment planning were conducted at the beginning of the course. Near the end of the course, half of the class received CBL and LB instruction in an RPD module in alternating sequence, with students serving as their own control group. Assessments of perceived RPD treatment planning efficacy, comprehension, and instruction method preference were administered directly after students completed the RPD module and six months later. Analyses of variance accounting for period, carryover, and sequence effects were used to determine the relative effects of each approach using a p<0.05 statistical significance threshold. The results showed that the students preferred CBL (81%) over LB instruction (9%), a pattern that remained unchanged after a six-month period. Despite notable period and carryover effects, CBL was also associated with higher gains in RPD treatment planning comprehension (p=0.04) and perceived efficacy (p=0.01) compared to LB instruction. These gains diminished six months after the course-a finding based on a 49% follow-up response rate. Overall, the students overwhelmingly preferred CBL to LB instruction, and the findings suggest small albeit measurable educational benefits associated with CBL. This study's findings support the introduction and further testing of CBL in the preclinical dental curriculum, in anticipation of possible future benefits evident during clinical training

Systematic Review and Meta-analysis of the Association Between Exposure to Environmental Tobacco Smoke and Periodontitis Endpoints Among Nonsmokers

A systematic review was conducted to summarize the epidemiological evidence on environmental tobacco smoke (ETS) exposure and prevalent periodontitis endpoints among nonsmokers

The relationship of oral health literacy with oral health-related quality of life in a multi-racial sample of low-income female caregivers

<p>Abstract</p> <p>Background</p> <p>To investigate the association between oral health literacy (OHL) and oral health-related quality of life (OHRQoL) and explore the racial differences therein among a low-income community-based group of female WIC participants.</p> <p>Methods</p> <p>Participants (N = 1,405) enrolled in the Carolina Oral Health Literacy (COHL) study completed the short form of the Oral Health Impact Profile Index (OHIP-14, a measure of OHRQoL) and REALD-30 (a word recognition literacy test). Socio-demographic and self-reported dental attendance data were collected via structured interviews. Severity (cumulative OHIP-14 score) and extent of impact (number of items reported fairly/very often) scores were calculated as measures of OHRQoL. OHL was assessed by the cumulative REALD-30 score. The association of OHL with OHRQoL was examined using descriptive and visual methods, and was quantified using Spearman's <it>rho </it>and zero-inflated negative binomial modeling.</p> <p>Results</p> <p>The study group included a substantial number of African Americans (AA = 41%) and American Indians (AI = 20%). The sample majority had a high school education or less and a mean age of 26.6 years. One-third of the participants reported at least one oral health impact. The OHIP-14 mean severity and extent scores were 10.6 [95% confidence limits (CL) = 10.0, 11.2] and 1.35 (95% CL = 1.21, 1.50), respectively. OHL scores were distributed normally with mean (standard deviation, SD) REALD-30 of 15.8 (5.3). OHL was weakly associated with OHRQoL: prevalence <it>rho </it>= -0.14 (95% CL = -0.20, -0.08); extent <it>rho </it>= -0.14 (95% CL = -0.19, -0.09); severity <it>rho </it>= -0.10 (95% CL = -0.16, -0.05). "Low" OHL (defined as < 13 REALD-30 score) was associated with worse OHRQoL, with increases in the prevalence of OHIP-14 impacts ranging from 11% for severity to 34% for extent. The inverse association of OHL with OHIP-14 impacts persisted in multivariate analysis: Problem Rate Ratio (PRR) = 0.91 (95% CL = 0.86, 0.98) for one SD change in OHL. Stratification by race revealed effect-measure modification: Whites--PRR = 1.01 (95% CL = 0.91, 1.11); AA--PRR = 0.86 (95% CL = 0.77, 0.96).</p> <p>Conclusions</p> <p>Although the inverse association between OHL and OHRQoL across the entire sample was weak, subjects in the "low" OHL group reported significantly more OHRQoL impacts versus those with higher literacy. Our findings indicate that the association between OHL and OHRQoL may be modified by race.</p

Methodological Considerations in Longitudinal Analyses of Microbiome Data: A Comprehensive Review

Biological processes underlying health and disease are inherently dynamic and are best understood when characterized in a time-informed manner. In this comprehensive review, we discuss challenges inherent in time-series microbiome data analyses and compare available approaches and methods to overcome them. Appropriate handling of longitudinal microbiome data can shed light on important roles, functions, patterns, and potential interactions between large numbers of microbial taxa or genes in the context of health, disease, or interventions. We present a comprehensive review and comparison of existing microbiome time-series analysis methods, for both preprocessing and downstream analyses, including differential analysis, clustering, network inference, and trait classification. We posit that the careful selection and appropriate utilization of computational tools for longitudinal microbiome analyses can help advance our understanding of the dynamic host–microbiome relationships that underlie health-maintaining homeostases, progressions to disease-promoting dysbioses, as well as phases of physiologic development like those encountered in childhood

Framing Young Childrens Oral Health: A Participatory Action Research Project

Despite the widespread acknowledgement of the importance of childhood oral health, little progress has been made in preventing early childhood caries. Limited information exists regarding specific daily-life and community-related factors that impede optimal oral hygiene, diet, care, and ultimately oral health for children. We sought to understand what parents of young children consider important and potentially modifiable factors and resources influencing their children’s oral health, within the contexts of the family and the community

Derivation and Validation of the Periodontal and Tooth Profile Classification System for Patient Stratification

BACKGROUND: The goal of this study is to use bioinformatics tools to explore identification and definition of distinct periodontal and tooth profile classes (PPCs/TPCs) among a cohort of individuals by using detailed clinical measures at the tooth level, including both periodontal measurements and tooth loss. METHODS: Full-mouth clinical periodontal measurements (seven clinical parameters) from 6,793 individuals from the Dental Atherosclerosis Risk in Communities Study (DARIC) were used to identify PPC. A custom latent class analysis (LCA) procedure was developed to identify clinically distinct PPCs and TPCs. Three validation cohorts were used: NHANES (2009 to 2010 and 2011 to 2012) and the Piedmont Study population (7,785 individuals). RESULTS: The LCA method identified seven distinct periodontal profile classes (PPCs A to G) and seven distinct tooth profile classes (TPCs A to G) ranging from health to severe periodontal disease status. The method enabled identification of classes with common clinical manifestations that are hidden under the current periodontal classification schemas. Class assignment was robust with small misclassification error in the presence of missing data. The PPC algorithm was applied and confirmed in three distinct cohorts. CONCLUSIONS: The findings suggest PPC and TPC using LCA can provide robust periodontal clinical definitions that reflect disease patterns in the population at an individual and tooth level. These classifications can potentially be used for patient stratification and thus provide tools for integrating multiple datasets to assess risk for periodontitis progression and tooth loss in dental patients

Examining the accuracy of caregivers' assessments of young children's oral health status

Caregivers' perceptions of their young children's oral health status (OHS) are a strong determinant of whether the children visit a dentist. Our aims were to quantify the correlation between caregivers' assessments and their children's clinically determined restorative treatment needs, while investigating factors related to this association

Caregivers' oral health literacy and their young children's oral health-related quality-of-life

To investigate the association of caregivers’ oral health literacy (OHL) with their children's oral health related-quality of life (C-OHRQoL) and explore literacy as a modifier in the association between children's oral health status (COHS) and C-OHRQoL