Waist circumference and waist-to-height ratio are associated with periodontal pocketing-results of the Health 2000 Survey.

BACKGROUND: Body mass index (BMI) has been found to associate with different parameters of chronic periodontal disease in previous studies. It is reasonable to expect that central adiposity measures, such as waist circumference and waist-to-height ratio, which indirectly takes into account visceral fat, are more accurate measures of obesity-related oral health risks than BMI. The aim of this study was to examine whether central obesity is associated with periodontal pocketing, an indication of infectious chronic periodontal disease. METHODS: The study was based on a subpopulation from the national Health 2000 Survey in Finland. It included dentate, non-diabetic, never-smoking subjects aged 30-49 (n = 1287). The outcome variable was the number of teeth with deepened periodontal pockets (4 mm or more) and the number of teeth with deep periodontal pockets (6 mm or more). Central obesity was measured by means of waist circumference (WC) and waist-to-height ratio (WHtR). Poisson regression models were used to estimate prevalence rate ratios (PRR) and their 95% confidence intervals. RESULTS: Our main finding was that both WC and WHtR were associated with the number of teeth with deeper (4 mm or more) periodontal pockets; the PRR for the fifth quintile in WC was 1.5, CI: 1.2-1.9 and in WHtR 1.4, CI: 1.1-1.7, when compared to the lowest quintile. Corresponding figures for deep (6 mm or more) periodontal pockets were 2.3, CI: 0.9-6.1 for WC and 1.9, CI: 0.8-4.4 for WHtR. There were no essential differences in the strengths of the associations between WC and WHtR and the number of teeth with deepened periodontal pockets. CONCLUSION: Both central adipose measures-WC and WHtR-seem to be associated with periodontal pocketing in non-diabetic, never-smoking subjects aged 30-49 years old.

Dementia and oral health among subjects aged 75 years or older.

OBJECTIVE: To study the association between diagnosed dementia and oral health, focusing on the type of dementia, among an elderly population aged 75 years or older. BACKGROUND: Elderly people with dementia are at risk from oral diseases, but to date, only a few studies have analysed the association between type of dementia and oral health, and their results are inconclusive. MATERIALS AND METHODS: This cross-sectional study is based on the Geriatric multi-disciplinary strategy (Gems) study that included 76 demented and 278 non-demented subjects. The data were collected by means of an interview and an oral clinical examination. The type of dementia was diagnosed according to DSM-IV criteria. Poisson's and logistic regression models were used to determine relative risks (RR), odds ratios (OR) and 95% confidence limits (CI). RESULTS: Our results showed that patients with Alzheimer's disease and those with other types of dementia had an increased likelihood of having carious teeth, teeth with deep periodontal pockets, and poor oral and denture hygiene, compared with non-demented persons. The results showed that the type of dementia does not seem to be an essential determinant of oral health. CONCLUSIONS: Among the elderly aged 75 years or older, patients with Alzheimer's disease or other types of dementia are at increased risk of poor oral health and poor oral hygiene.

Periodontal condition of the elderly in Finland.

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.

Number of teeth and selected cardiovascular risk factors among elderly people.

OBJECTIVE: To produce evidence on an association between the number of teeth and selected cardiovascular risk factors among an elderly population. MATERIALS AND METHODS: The study population comprised of 523 community-living elderly people who participated in the population-based Kuopio 75+ study. The data for each subject were collected using a structured clinical health examination, an interview and laboratory tests. Linear regression models were used to estimate adjusted mean values and confidence limits. RESULTS: Edentulous persons and persons with a small number of teeth had lower serum HDL cholesterol and higher triglyceride, leucocyte and blood glucose levels and a higher body mass index (BMI) compared with subjects to a large number of teeth. CONCLUSION: The study showed that, in the Finnish home-dwelling population aged 75 years or older, those with a large number of teeth were less likely to have cardiovascular risk factors such as a low serum HDL cholesterol level, a high triglyceride level and a high BMI than did subjects with a small number of teeth or who were edentulous.

Relationship between cognitive impairment and oral health: results of the Health 2000 Health Examination Survey in Finland.

OBJECTIVE: The aim was to study oral health in relation to cognitive impairment in the general population. MATERIAL AND METHODS: The study population comprised 2320 persons aged 55 years or older who participated in a nationally representative Health 2000 Health Examination Survey in Finland. The data were collected by interviews and clinical oral examinations. Cognition was assessed using a shortened version of the Mini-Mental State Examination (score 0-16). Poisson regression models were used to estimate the relative risk (RR) for continuous variables and logistic regression models to estimate the odds ratio (OR) for dichotomized variables. RESULTS: The results show that individuals with cognitive impairment have more carious teeth (MMSE 11-10: RR: 1.3, CI: 0.9-1.7, MMSE 9-0: RR: 1.5 CI: 1.0-2.4) than healthy persons. Furthermore, compared to cognitively healthy subjects, those with MMSE 9-0 more often have no teeth and no dentures (OR: 5.2, CI: 1.0-26.6) and less often good denture hygiene (OR: 0.4, CI: 0.2-0.7). CONCLUSION: Cognitively impaired subjects among older adults in Finland have more carious teeth, are more often edentulous without using a denture, and have poorer denture hygiene than cognitively healthy persons.