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      The association between oral hygiene and periodontitis: a systematic review and meta‐analysis

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          Abstract

          Objective

          Dental plaque accumulation and inadequate personal oral hygiene ( OH) are known major risk factors of periodontitis. Nevertheless, the magnitude of their effects has not yet been the subject of a meta‐analysis.

          Material and methods

          The Medline and Scopus databases were searched up to May 2016. Observational studies were eligible if they assessed associations between OH and periodontitis in adult subjects. A multivariate random‐effects meta‐analysis was used to pool the effects of fair/poor OH versus good OH on periodontitis across studies. The associations between oral care habits and periodontitis were also assessed.

          Results

          A total of 50 studies were eligible; 15 were used for pooling the effect of fair OH versus good OH and poor OH versus good OH on periodontitis, with pooled odds ratios ( ORs) of 2.04 [95% confidence interval ( CI): 1.65–2.53] and 5.01 (95% CI: 3.40–7.39), respectively. Eleven studies examined oral care habits measured according to toothbrushing regularity and dental visit frequency; pooled ORs of 0.66 (95% CI: 0.47–0.94) and 0.68 (95% CI: 0.47–0.98) were obtained, respectively.

          Conclusions

          Fair to poor OH increases the risk of periodontitis by two‐ to five‐fold. This risk can be reduced by regular toothbrushing and dental visits.

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          Most cited references67

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          PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION.

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            Periodontal diseases: epidemiology.

            1. The interpretation of epidemiological data of periodontal disease is difficult, due to inconsistencies in the methodology used. It is not possible, therefore, to accurately assess if the prevalence of the periodontal diseases shows a world-wide decline. As long as the disease is assessed through accumulated clinical attachment loss, retention of the natural dentition in older ages entails increased prevalence in these cohorts. Contemporary epidemiological studies should ideally employ full-mouth examination of the periodontal tissues. Partial recording estimates are generally biased, especially when the prevalence of the disease is low. 2. Early-onset periodontitis is infrequent in all populations. Adult periodontitis is rather prevalent; however, advanced disease affects limited subfractions of the population (probably less than 10 to 15%). Although prevalence figures vary with race and geographic region, in most cases, the progression pattern of the disease seems compatible with the retention of a functional dentition throughout life. 3. Of a plethora of behavioral and environmental risk markers identified by multi-variate analysis, smoking and presence of certain subgingival microorganisms have been proven to be true risk factors. The same holds true for diabetes mellitus, a systemic condition that confers a risk for periodontal disease which is independent of the effect of other significant factors. 4. In certain cases, periodontal infections appear to have a systemic impact on the host. Most recent data indicate that periodontal disease may confer risk for coronary heart disease and pre-term low birth weight.
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              Association between overweight/obesity and periodontitis in adults. A systematic review : Hypothalamic obesity

              Overweight and obesity have been suggested to be associated with periodontitis as published in studies and narrative summaries. This project presents results of a systematic review investigating the association between overweight or obesity (as defined by the World Health Organization) and periodontitis. Search strategy included electronic and hand searching to December 2009. Ovid MEDLINE, EMBASE, LILACS, and SIGLE were searched. RCTs, cohort, case-control and cross-sectional study designs that included measures of periodontitis and body composition were eligible. Duplicate, independent screening and data abstraction were performed. Meta-analyses were performed when appropriate. A total of 526 titles and abstracts were screened, resulting in 61 full text articles and abstracts assessed for eligibility with 33 being included. Nineteen studies provided sufficient information for inclusion in meta-analyses. Meta-analyses indicated statistically significant associations between periodontitis and body mass index (BMI) category obese OR 1.81(1.42, 2.30), overweight OR 1.27(1.06, 1.51) and obese and overweight combined OR 2.13(1.40, 3.26). In conclusion, these results support an association between BMI overweight and obesity and periodontitis although the magnitude is unclear. Additional prospective studies to further quantify, or understand the mechanisms, of this association are merited. There is insufficient evidence to provide guidelines to clinicians on the clinical management of periodontitis in overweight and obese individuals. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.
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                Author and article information

                Contributors
                sasivimol.rat@mahidol.ac.th
                Journal
                Int Dent J
                Int Dent J
                10.1002/(ISSN)1875-595X
                IDJ
                International Dental Journal
                John Wiley and Sons Inc. (Hoboken )
                0020-6539
                1875-595X
                23 June 2017
                December 2017
                : 67
                : 6 ( doiID: 10.1111/idj.2017.67.issue-6 )
                : 332-343
                Affiliations
                [ 1 ] Section for Clinical Epidemiology and Biostatistics Faculty of Medicine Ramathibodi Hospital Mahidol University Bangkok Thailand
                [ 2 ] Department of Periodontology Faculty of Dentistry Chulalongkorn University Bangkok Thailand
                [ 3 ] School of Medicine and Public Health Centre for Clinical Epidemiology and Biostatistics University of Newcastle Newcastle NSW Australia
                [ 4 ] Hunter Medical Research Institute Newcastle NSW Australia
                Author notes
                [*] [* ] Correspondence to:

                Sasivimol Rattanasiri,

                Section for Clinical Epidemiology and Biostatistics,

                Faculty of Medicine,

                Ramathibodi Hospital,

                Mahidol University,

                270 RAMA VI Road, Rachathevi,

                Bangkok 10400, Thailand.

                Email: sasivimol.rat@ 123456mahidol.ac.th

                Article
                IDJ12317
                10.1111/idj.12317
                5724709
                28646499
                eb360ea4-2112-4e1a-a70f-06c69469ebb8
                © 2017 The Authors. International Dental Journal published by John Wiley & Sons Ltd on behalf of World Dental Federation.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 5, Tables: 2, Pages: 12, Words: 7694
                Categories
                Concise Review
                Concise Review
                Custom metadata
                2.0
                idj12317
                December 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.2.8 mode:remove_FC converted:11.12.2017

                meta‐analysis,oral hygiene,periodontitis,risk factor,systematic review

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