TY - JOUR
T1 - Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases
T2 - consensus report of group 2 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases
AU - Chapple, Iain L.C.
AU - Bouchard, Philippe
AU - Cagetti, Maria Grazia
AU - Campus, Guglielmo
AU - Carra, Maria Clotilde
AU - Cocco, Fabio
AU - Nibali, Luigi
AU - Hujoel, Philippe
AU - Laine, Marja L.
AU - Lingstrom, Peter
AU - Manton, David J.
AU - Montero, Eduardo
AU - Pitts, Nigel
AU - Rangé, Hélène
AU - Schlueter, Nadine
AU - Teughels, Wim
AU - Twetman, Svante
AU - Van Loveren, Cor
AU - Van der Weijden, Fridus
AU - Vieira, Alexandre R.
AU - Schulte, Andreas G.
PY - 2017/3/6
Y1 - 2017/3/6
N2 - Periodontal diseases and dental caries are the most common diseases of humans and the main cause of tooth loss. Both diseases can lead to nutritional compromise and negative impacts upon self-esteem and quality of life. As complex chronic diseases, they share common risk factors, such as a requirement for a pathogenic plaque biofilm, yet they exhibit distinct pathophysiologies. Multiple exposures contribute to their causal pathways, and susceptibility involves risk factors that are inherited (e.g. genetic variants), and those that are acquired (e.g. socio-economic factors, biofilm load or composition, smoking, carbohydrate intake). Identification of these factors is crucial in the prevention of both diseases as well as in their management. Aim: To systematically appraise the scientific literature to identify potential risk factors for caries and periodontal diseases. Methods: One systematic review (genetic risk factors), one narrative review (role of diet and nutrition) and reference documentation for modifiable acquired risk factors common to both disease groups, formed the basis of the report. Results & Conclusions: There is moderately strong evidence for a genetic contribution to periodontal diseases and caries susceptibility, with an attributable risk estimated to be up to 50%. The genetics literature for periodontal disease is more substantial than for caries and genes associated with chronic periodontitis are the vitamin D receptor (VDR), Fc gamma receptor IIA (Fc-γRIIA) and Interleukin 10 (IL10) genes. For caries, genes involved in enamel formation (AMELX, AMBN, ENAM, TUFT, MMP20, and KLK4), salivary characteristics (AQP5), immune regulation and dietary preferences had the largest impact. No common genetic variants were found. Fermentable carbohydrates (sugars and starches) were the most relevant common dietary risk factor for both diseases, but associated mechanisms differed. In caries, the fermentation process leads to acid production and the generation of biofilm components such as Glucans. In periodontitis, glycaemia drives oxidative stress and advanced glycation end-products may also trigger a hyper inflammatory state. Micronutrient deficiencies, such as for vitamin C, vitamin D or vitamin B12, may be related to the onset and progression of both diseases. Functional foods or probiotics could be helpful in caries prevention and periodontal disease management, although evidence is limited and biological mechanisms not fully elucidated. Hyposalivation, rheumatoid arthritis, smoking/tobacco use, undiagnosed or sub-optimally controlled diabetes and obesity are common acquired risk factors for both caries and periodontal diseases.
AB - Periodontal diseases and dental caries are the most common diseases of humans and the main cause of tooth loss. Both diseases can lead to nutritional compromise and negative impacts upon self-esteem and quality of life. As complex chronic diseases, they share common risk factors, such as a requirement for a pathogenic plaque biofilm, yet they exhibit distinct pathophysiologies. Multiple exposures contribute to their causal pathways, and susceptibility involves risk factors that are inherited (e.g. genetic variants), and those that are acquired (e.g. socio-economic factors, biofilm load or composition, smoking, carbohydrate intake). Identification of these factors is crucial in the prevention of both diseases as well as in their management. Aim: To systematically appraise the scientific literature to identify potential risk factors for caries and periodontal diseases. Methods: One systematic review (genetic risk factors), one narrative review (role of diet and nutrition) and reference documentation for modifiable acquired risk factors common to both disease groups, formed the basis of the report. Results & Conclusions: There is moderately strong evidence for a genetic contribution to periodontal diseases and caries susceptibility, with an attributable risk estimated to be up to 50%. The genetics literature for periodontal disease is more substantial than for caries and genes associated with chronic periodontitis are the vitamin D receptor (VDR), Fc gamma receptor IIA (Fc-γRIIA) and Interleukin 10 (IL10) genes. For caries, genes involved in enamel formation (AMELX, AMBN, ENAM, TUFT, MMP20, and KLK4), salivary characteristics (AQP5), immune regulation and dietary preferences had the largest impact. No common genetic variants were found. Fermentable carbohydrates (sugars and starches) were the most relevant common dietary risk factor for both diseases, but associated mechanisms differed. In caries, the fermentation process leads to acid production and the generation of biofilm components such as Glucans. In periodontitis, glycaemia drives oxidative stress and advanced glycation end-products may also trigger a hyper inflammatory state. Micronutrient deficiencies, such as for vitamin C, vitamin D or vitamin B12, may be related to the onset and progression of both diseases. Functional foods or probiotics could be helpful in caries prevention and periodontal disease management, although evidence is limited and biological mechanisms not fully elucidated. Hyposalivation, rheumatoid arthritis, smoking/tobacco use, undiagnosed or sub-optimally controlled diabetes and obesity are common acquired risk factors for both caries and periodontal diseases.
KW - acquired risk factors
KW - amelogenin (AMELX) gene
KW - aquaporin (AQP5) gene
KW - candidate gene study (CGS)
KW - carbohydrate
KW - caries
KW - diabetes
KW - diet
KW - Fc gamma receptor IIA (FcγRIIA) gene
KW - fluoride
KW - genetics
KW - genome wide association study (GWAS)
KW - gingival bleeding
KW - gingivitis
KW - hyposalivation
KW - Interleukin 10 (IL10) gene
KW - macronutrient
KW - malnutrition
KW - micronutrient
KW - nutrition
KW - oral hygiene frequency
KW - periodontal diseases
KW - periodontitis
KW - polyunsaturated fatty acid (PUFA)
KW - prediction factor
KW - prognostic factor
KW - protein
KW - risk factor
KW - saliva
KW - single nucleotide polymorphism (SNP)
KW - smoking
KW - starch
KW - sugars
KW - vitamin B12
KW - vitamin C
KW - vitamin D
KW - vitamin D receptor (VDR) gene
UR - http://www.scopus.com/inward/record.url?scp=85014713121&partnerID=8YFLogxK
U2 - 10.1111/jcpe.12685
DO - 10.1111/jcpe.12685
M3 - Article
AN - SCOPUS:85014713121
SN - 0303-6979
VL - 44
SP - S39-S51
JO - Journal of Clinical Periodontology
JF - Journal of Clinical Periodontology
ER -