Association of sense of coherence and periodontal disease severity, in two cross-sectional studies.

OBJECTIVES: To investigate the association between the individuals' level of sense of coherence (SOC) and periodontal disease severity. METHODS: The study populations originated from two stratified cross-sectional random samples of residents in a medium-sized Swedish city in 2003 and 2013, respectively. The final samples constituted 491 individuals in 2003 and 538 individuals in 2013. The samples were classified into three groups according to the severity of periodontitis (no/minor, moderate and severe). The 13-item Swedish version of Antonovsky's "Orientation to life" questionnaire, measuring the individual's SOC, was filled out. Descriptive statistics were performed as well as multinomial logistic regression analysis. Dependent variable was the severity of periodontal disease and independent variables, age in years, presently smoking and education at university level. RESULTS: In the multinomial regression analysis, smoking, age, and total SOC score were significantly associated with severe periodontitis at both examinations. The strongest predictor of severe periodontal disease was smoking. The total SOC score did not differ between the examinations, but there was a statistically significant difference in two of the SOC dimensions, manageability (lower), and comprehensibility (higher), over time. CONCLUSIONS: Individuals with severe periodontitis had significantly lower SOC compared to subjects periodontally having no/minor periodontal disease. Smoking was the strongest overall predictor of having severe periodontitis.

Secular trends over 40 years of periodontal health and disease in individuals aged 20-80 years in Jönköping, Sweden: Repeated cross-sectional studies.

AIM: To assess trends over 40 years regarding prevalence and severity of periodontitis in a Swedish adult population. MATERIALS AND METHODS: Cross-sectional examinations using the same clinical protocol have been repeated every 10 years (1973-2013) in a Swedish city with focus on periodontal disease in adults. Periodontal recordings included all teeth, excluding 3rd molars. Periodontal disease experience was classified (no/minor, moderate and severe). RESULTS: The no/minor group increased from 43% in 1983 to 60% in 2013. There was a non-significant trend for a decrease of the severe group. Over the 40-year period, the number of teeth increased significantly and at the examination 2013, the severe group accounted for this increase. More than 60% of the study population in 2013 had no periodontal pockets (PD) ≥6 mm. The number of PD ≥4 mm and ≥6 mm were unaltered between 2003 and 2013 in all age groups, except for the 20-year old individuals. This group showed a statistically significant increase of ≥4 mm PD. CONCLUSIONS: The periodontal health has improved in the population over the 40 years. The number of teeth increased significantly in the population, and in 2013, this increase occurred entirely in the severe group. Finally, there was a trend toward diminished prevalence of severe periodontitis.

Impact of periodontal disease experience on oral health-related quality of life.

BACKGROUND: Periodontal research has traditionally focused on the site level, regarding etiology, pathogenesis, and treatment outcome. Recently, some studies have indicated that the presence of periodontal disease is associated with reduced quality of life. The aim of this study is to investigate the impact of periodontal disease experience on the quality of life. METHODS: This cross-sectional study includes 443 individuals. Clinical and radiographic examinations were performed; in conjunction, the oral health-related quality of life of all participants was assessed using the Swedish short-form version of the Oral Health Impact Profile (OHIP-14). Based on marginal bone loss, measured on radiographs, three different groups were identified: participants with loss of supporting bone tissue of less than one third of the root length (BL-), loss of supporting bone tissue of one third or more of the root length in <30% of teeth (BL), or loss of supporting bone tissue of one third or more of the root length in ≥ 30% of teeth (BL+). RESULTS: The effect of periodontal disease experience on quality of life was considerable. For the BL- group, the mean OHIP-14 score was 3.91 (SD: 5.39). The corresponding mean values were 3.81 (SD: 5.29) for the BL group and 8.47 (SD: 10.38) for the BL+ group. The difference among all groups was statistically significant (P ≤ 0.001). A comparison among the mean OHIP-14 scores in the different groups (BL-, BL, and BL+) revealed significant differences in six of seven conceptual domains. CONCLUSIONS: The BL+ individuals experienced reduced quality of life, expressed as the OHIP-14 score, compared with the BL and BL- participants.

Marginal bone loss in the adult population in the county of Skåne, Sweden.

UNLABELLED: The aim of this study was to investigate the prevalence and extent of periodontal disease registered as marginal bone loss and subject characteristics in the adult population in the county of Skåne in Sweden. One thousand individuals, 20-89 years old, were randomly selected and 451 subjects agreed to participate in the study. They answered a questionnaire and in conjunction with the clinical and radiological examination the subjects answered questions about their medical history. The examiners were co-ordinated regarding the diagnostic criteria through comprehensive written instructions, practice and discussions of clinical cases. One observer estimated marginal bone loss around the teeth on digital panoramic radiographs and bitewings. The individuals were classified regarding periodontal disease experience according to the following criteria: PD- = loss of supporting bone tissue < 1/3 of the root length, PD = loss of supporting bone tissue > or = 1/3 of the root length in < 30% of the teeth and PD+ = loss of supporting bone tissue > or = 1/3 the root length in > or = 30% of the teeth. Subjects with no or minor bone loss, i.e. PD- constituted 69% of the population. Twenty percent of the study population had marginal bone loss corresponding to localised periodontal disease (PD) and 11% exhibited generalised periodontal bone loss (PD+). The periodontal treatment need, defined as probing pocket depth > or = 6 mm and bleeding on probing > or = 20%, was 53% in the PD+ group. An interesting result was that there were no differences in periodontal disease experience between the genders. CONCLUSIONS: The prevalence and extent of periodontal disease in this study correlates well with recent other studies. Eleven percent of the population has experienced generalised periodontal disease, and 53% of them have a periodontal treatment need defined as 1 or more site with PPD > or = 6 mm and BoP > or = 20%.

The effect of Swedish and American smokeless tobacco extract on periodontal ligament fibroblasts in vitro.

Use of moist snuff is widespread in Sweden. In 2004 approximately 8oo,ooo Swedes were daily users which corresponds to 22% of the male population and 3% of the female population. The aim of the present study was to evaluate the effect of Swedish moist snuff extract on PDLfibroblast growth and hard tissue production and compare with moist snuff extract from USA. Periodontal ligament cells (PDL-cells) were obtained from 3 healthy subjects (1 female 14 years, 2 males 14 and 17 years) from the root surface of premolars extracted for orthodontic reasons. The cells were isolated from explants and grown in Dulbecco's Modified Eagle's Medium (DMEM) supplemented with 10% fetal calf serum (FBS) and cultivated in 37 degrees C with 5% CO2 in air. Snuff extract in concentrations 0.3%, 1% and 3% (in DMEM with 1% FBS) was tested. Cells from each individual were tested three times, each time in triplicate. Photographs were taken at o and 24 hours with a digital camera and analysed in terms of growth and morphology. Then the cell suspension was frozen and later thawed for examination of the production of alkaline phosphatase after exposure to different snuff concentrations. This in vitro study has shown that PDL cells from 3 different subjects demonstrated a reduced number of cells at exposure to 3% of both Swedish and American snuff extract. The production of alkaline phosphatase after 2 hours was similarly reduced from cells exposed to 3% snuff extract. Further studies have to be made to understand the effect of smokeless tobacco on periodontal tissues. However, from this study can be concluded that smokeless tobacco has biological effects in terms of reduced PDL cell growth and production of alkaline phosphatase