Preliminary results of screening for pathological lesions in oral mucosa and incidence of oral cancer risk factors in adult population

INTRODUCTION: Oral cancer is a significant problem among global population. In Poland a few thousands of new incidents are reported annually. Prophylaxis and early detection help decreasing the incidence rate. Screening programmes are a tool that enable to achieve that goal. OBJECTIVES: The aim of this study was to evaluate prevalence of selected risk factors and pathological lesions of oral mucosa in adult population. MATERIAL AND METHODS: The study group consisted of 253 patients. After undertaking a medical history in a form of a questionnaire, a conventional intraoral soft tissue examination was performed. This was followed by use of cool white light (Microlux DL Addent). RESULTS: Among patients following risk factors were frequently found: tobacco smoking - 20.9% patients, alcohol consumption - 2/3 of patients drink occasionally, 8.7% drink on regular basis. Over 80% patients were sexually active. 3 patients suffered from oral cancer, 21 patients gave a history of cancer in other locations, 54.2% reported a family history of cancer. Screened patients declare quite healthy diet, although level of grilled and fried meat consumption is fairly high. 37.8% patients were alarmed by the condition of the oral mucosa but only half of them reported it to their dentist. Most of the lesions were found on the buccal mucosa (88 patients, 34.8%), retromandibular triangle and palate and most of lesions were white lesions, categorized as traumatic. CONCLUSIONS: This preliminary study showed, that the incidence of oral cancer risk factors is high in this population. The incidence of pathological lesions of oral mucosa was also high. The study showed low awareness of oral cancer prevention, risk factors and symptoms.

Correlation between the state of periodontal tissues and selected risk factors for periodontitis and myocardial infarction.

BACKGROUND: The current level of knowledge indicates a relationship between periodontitis and diabetes and/or cardiovascular diseases (CVD). Periodontitis can be not only a risk factor for these diseases, but also a condition modifying other primary risk factors associated with the occurrence of cardiovascular complications (lipid disorders, arterial hypertension, etc.) or diabetes. OBJECTIVES: The aim of the study was an analysis of the correlation between the state of periodontal tissues and selected risk factors for myocardial infarction (MI) in patients after recent myocardial infarction. MATERIAL AND METHODS: The study included 417 patients (92 women, 325 men) hospitalized due to recent MI. The inclusion criteria were MI history and age below 70 years. The state of periodontal tissues (plaque index, bleeding on probing, pocket depth and clinical attachment loss, CPI index) and selected risk factors for periodontitis and CVD were recorded. RESULTS: An analysis of the results showed no statistically significant correlation between the depth, the number, percentage of periodontal pockets and the average clinical attachment level on one hand and BMI on the other hand. Whereas a statistically significant correlation was observed between tobacco smoking and the degree of severity of periodontal diseases measured by the average pocket depth, the number and percentage of pockets above 4 mm and the average clinical attachment loss, as well as between hypertension and the state of oral hygiene and between diabetes and the number of preserved teeth and the number of pockets above 4 mm. CONCLUSIONS: The degree of severity of periodontal disease can impact hypertension and diabetes, which could potentially influence the occurrence and course of CVD.

The Association Between Dental Status and Systemic Lipid Profile and Inflammatory Mediators in Patients After Myocardial Infarction.

BACKGROUND: Many epidemiological studies have proven that local infection may influence the levels of systemic lipid profile and inflammatory mediators. OBJECTIVES: The aim of this research was to evaluate the association between the state of the oral cavity, lipids and inflammatory mediator concentrations in Poles after acute myocardial infarction (MI). MATERIAL AND METHODS: A total of 134 subjects with a mean age of 54.3 years (± 8.1) were included in the study. Sociodemographic and cardiologic variables were gathered. Subsequently, serum samples were collected for estimation of total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), high-sensitivity C-reactive protein (hsCRP), fibrinogen and white blood cell counts (WBC). The periodontal parameters measured included bleeding on probing index (BoP), pocket depth (PD), clinical attachment level (CAL), the number of bleeding periodontal pockets (bPP) and the number of lost teeth. RESULTS: Overall, patients shared high levels of periodontal inflammation and tissue breakdown. Multivariate analysis revealed a significant association between the serum concentration of LDL-C and bPP (standardized coefficient b = 0.3179; p = 0.0009) and PD (b = 0.3186; p = 0.0015); the level of fibrinogen and the number of lost teeth (b = 0.3669; p = 0.0013); WBC and bPP (b = 0.2726; p = 0.0035) independent of age, sex, income, education, atherosclerotic disease in the family, tobacco smoking, arterial hypertension, diabetes mellitus and BMI. No correlations were found regarding hsCRP serum concentration. CONCLUSIONS: To our knowledge, this study demonstrated for the first time that local inflammatory processes in the oral cavity are positively associated with the systemic levels of LDL-C, fibrinogen and WBC in adult Poles. This may underscore relationships between periodontitis and MI as well as potentially impinge on atherosclerotic processes and MI prognosis.

Oral health in postmenopausal and premenopausal women after myocardial infarction in Poland: a preliminary study.

INTRODUCTION: Age and hormonal disorders are recognized factors impacting the periodontium and the prevalence of cardiovascular diseases, but as yet the relationship between these two conditions in postmenopausal (post-M) and premenopausal (pre-M) women in Poland has not been assessed. The aim of this study was to compare the periodontal status in women after myocardial infarction (MI) with women without MI history and to determine risk factors for periodontitis. MATERIAL AND METHODS: The study included 35 women hospitalized due to MI, average age 54.7 ± 9.4 years, and 96 women randomly drawn from the general population, average age 56.1 ± 10.0 years. All women were checked for periodontitis risk factors (education, socioeconomic status, tobacco smoking, stress), and underwent dental examination. RESULTS: The lowest number of teeth was found in post-M women after MI (median = 8), whereas pre-M women without MI history had 25 teeth. Edentulousness occurred more frequently in post-M women compared with pre-M women (12.2% vs. 0%), the same was observed for advanced periodontitis (28.4% vs. 21.1%). The severity of periodontitis was highest in the post-M subgroup (more than half demonstrated advanced periodontitis or edentulousness). The most important risk factor for periodontitis, regardless of age, was the level of education. In post-M women the second risk factor was smoking, while in pre-M women negative stress. CONCLUSIONS: The status of oral health in post-M women is unsatisfactory, particularly in those affected by cardiovascular diseases. It is necessary to take preventive and educational measures targeted at these women.

Oral health and prophylactic-therapeutic needs of children aged 6 years in Poland in 2012.

BACKGROUND: Irrespective of the fact that in developed countries, a reduction of dental caries incidence is observed, it still remains the most common chronic disease affecting children in Poland. OBJECTIVES: In the paper, the results of nationwide epidemiological studies conducted in Poland in 2012 within the framework of the Nationwide Dental Health Monitoring Programme were presented. MATERIAL AND METHODS: The children aged 6 years were enrolled into the study. Clinical assessment of oral health status of children was made in accordance with WHO recommendations. RESULTS: The percentage of healthy children aged 6 years, who did not have any signs of dental caries manifested with cavity, tooth filling or tooth loss was only 14.4%. On average, only one tooth per child was filled due to dental caries and four out of five teeth affected by dental caries required invasive treatment. Index of conservative treatment was very low and amounted to 0.23 +/- 0.24. CONCLUSIONS: The results demonstrate high caries prevalence and significant prophylactic-therapeutic needs.

Association of chronic periodontitis with left ventricular mass and central blood pressure in treated patients with essential hypertension.

BACKGROUND: The aim of the study was to answer the question whether chronic periodontitis (CP) in patients with essential hypertension is associated with increased aortic stiffness and increased central blood pressure (CBP), which may in turn increase left ventricular mass (LVM) in those patients. CP influences LVM in hypertensive and renal patients as well as in healthy subjects; however, mechanisms involved are not clear. METHODS: Fifty patients (23 men and 27 women, 51.4 +/- 5.2 years, body mass index (BMI) 29.5 +/- 4.4 kg/m(2)) with severe CP-Community Periodontal Index of Treatment Needs (CPITN) score 3-4, and 49 patients (20 men and 29 women, 49.3 +/- 5.5 years, BMI 29.9 +/- 4.8 kg/m(2)) with no or moderate CP (CPITN 0-2) were included. In all patients LVM, pulse wave velocity (PWV), and CBP were measured, and LVM index (LVMI) calculated. RESULTS: Patients with a CPITN of 3-4 had higher LVM (257.3 +/- 67.9 vs. 220.3 +/- 66.4 g, P < 0.01), LVMI (105.8 +/- 23.6 vs. 92.6 +/- 24.8 g/m(2), P < 0.01) and higher central systolic (124 +/- 17 vs. 116 +/- 15 mm Hg, P < 0.05) and pulse pressure (45 +/- 11 vs. 38.7 +/- 9.8 mm Hg, P < 0.05) as compared with patients with a CPITN of 0-2. In the univariate analysis, for the total group a positive association was observed between CPITN values and LVM, LVMI, age, aortic systolic, and pulse pressure, but not with systemic blood pressure. Linear regression analysis showed an association of borderline significance (P = 0.06) between LVMI and the CPITN value. In other model, a significant positive relationship between CBP and CPITN was observed. CONCLUSIONS: More severe forms of periodontitis are associated with increased CBP and LVM in patients with primary hypertension.

Assessment of the peripheral immunocompetent cells in patients with reticular and atrophic-erosive lichen planus.

OBJECTIVE: To assess the cellular and humoral immunity in patients with reticular and atrophic-erosive oral lichen planus (OLP). STUDY DESIGN: Lymphocyte phenotype analysis of 50 patients with OLP and 16 control subjects was performed by means of flow cytometry. The results were analyzed by the Mann-Whitney U test. RESULTS: In the patient group the percentage of naïve helper T cells was significantly decreased, while that of memory cells was increased, resulting in a significantly higher ratio of memory to naïve cells in the OLP group than in the control group. In the group of patients with atrophic-erosive OLP, the percentages of cytotoxic/suppressor T cells and cytotoxic/suppressor naïve T cells were found to be slightly decreased. CONCLUSIONS: The results indicate that the relative ratio of immunocompetent cells in the peripheral blood is altered in patients with lichen planus and that the exact character of these disturbances depends on OLP form. Some of the alterations observed in these patients are typical to autoimmune diseases, thus promoting the concept of autoimmune etiopathogenesis of lichen planus.