Tooth loss in relation to serum cotinine levels - A cross-sectional study from the Belville South area in South Africa
Tooth loss constitutes a major public health challenge, sharing common risk factors with non-communicable diseases. To report the relationship between tooth loss and serum cotinine levels in a population sample of mixed ethnic heritage from the Belville South area in South Africa. Cross-sectional epidemiological study.
Subjects were invited from 2014 to 2016 according to a consecutive sampling technique and all those who met the inclusion criteria were included. In all, 1876 individuals were included, being 1416 females (75.5%), with a combined average age of 49.5 ± 15.3 years. In total 46.7% of the sample was edentulous, with females presenting a higher proportion than males (50.7% vs. 34.1%, p < 0.001). The relative risk (RR) of being edentulous was higher for females (RR=1.8, 95% CI=1.35-2.41, p<0.001) and for participants with cotinine levels 15-299 ng/ml (RR = 1.37, 95% CI=1.02=1.83, p=0.04) and ≥300 ng/ml (RR=1.51, 95% CI=1.09-2.08, p=0.01). Maxillary incisors and mandibular molars were the most prevalent missing teeth. The burden of tooth loss is high in the studied population sample, as well their unmet needs for dental care. Female gender, tobacco exposure, and aging were associated with partial and total edentulism.
2. Kassebaum NJ, Bernabé E, Dahiya M, et al. Global Burden of Severe Tooth Loss. J Dent Res. 2014; 93: 20S-28S. Doi: 10.1177/0022034514537828.
3. Ortíz-Barrios LB, Granados-García V, Cruz-Hervert P, et al. The impact of poor oral health on the oral health-related quality of life (OHRQoL) in older adults: the oral health status through a latent class analysis. BMC Oral Health. 2019; 19: 141. Doi: 10.1186/s12903-019-0840-3.
4. Carlsson GE, Jansson J-O, Österberg T, et al. Edentulism associated with obesity: a study of four national surveys of 16 416 Swedes aged 55-84 years. Acta Odontol Scand. 2010; 68: 360-7. Doi: 10.3109/00016357.2010.514721.
5. Abnet CC, Qiao YL, Dawsey SM, et al. Tooth loss is associated with increased risk of total death and death from upper gastrointestinal cancer, heart disease, and stroke in a Chinese population-based cohort. Int J Epidemiol. 2005; 34: 467-74. Doi: 10.1093/ije/dyh375.
6. Fisher MA, Taylor GW, Shelton BJ, et al. Periodontal Disease and Other Nontraditional Risk Factors for CKD. Am J Kidney Dis. 2008; 51: 45-52. Doi: 10.1053/j.ajkd.2007.09.018.
7. Holmlund A, Holm G, Lind L. Number of teeth as a predictor of cardiovascular mortality in a cohort of 7,674 subjects followed for 12 years. J Periodontol. 2010; 81: 870-6. Doi: 10.1902/jop.2010.090680.
8. Holm-Pedersen P, Schultz-Larsen K, Christiansen N, et al. Tooth loss and subsequent disability and mortality in old age.J Am Geriatr Soc. 2008; 56: 429-35. Doi: 10.1111/j.1532- 5415.2007.01602.x.
9. Petersen PE, Ogawa H. The global burden of periodontal disease: towards integration with chronic disease prevention and control. Periodontol 2000. 2012; 60: 15-39. Doi: 10.11 11/j.1600-0757.2011.00425.x.
10. Watt RG, Daly B, Allison P, et al. Ending the neglect of global oral health: time for radical action. Lancet. 2019: 261-72. Doi: 10.1016/S0140-6736(19)31133-X.
11. Kailembo A, Preet R, Stewart Williams J. Common risk factors and edentulism in adults, aged 50 years and over, in China, Ghana, India and South Africa: Results from the WHO Study on global AGEing and adult health (SAGE). BMC Oral Health. 2016; 17. Doi: 10.1186/s12903-016-0256-2.
12. van Wyk PJ, van Wyk C. Oral health in South Africa. Int Dent J. 2004; 54: 373-7. Doi: 10.1111/j.1875-595X.2004.tb00014.x.
13. Peltzer K, Hewlett S, Yawson AE, et al. Prevalence of loss of all teeth (Edentulism) and associated factors in older adults in China, Ghana, India, Mexico, Russia and South Africa. Int J Environ Res Public Health. 2014; 11: 11308-24. Doi: 10.3390/ ijerph111111308.
14. Benowitz NL, III PJ, Ahijevych K, et al. Biochemical verification of tobacco use and cessation. Nicotine Tob Res. 2002; 4:149-59. Doi: 10.1080/14622200210123581.
15. Al-Bayaty F, Baharuddin N, Abdulla M. The relationship between serum cotinine levels and periodontal status. Online Journal of Biological Sciences. 2010; 10(2): 54-9.
16. Matsha TE, Hassan MS, Kidd M, et al. The 30-year cardiovascular risk profile of South Africans with diagnosed diabetes, undiagnosed diabetes, pre-diabetes or normoglycaemia: the Bellville, South Africa pilot study. Cardiovasc J Afr. 2012; 23: 5-11. Doi: 10.5830/CVJA-2010-087.
17. Chikte U, Pontes CC, Karangwa I, et al. Dental caries in a South African adult population: findings from the Cape Town Vascular and Metabolic Health Study. Int Dent J. 2020; 70(3): 176-82.
18. Matsha TE, Soita DJ, Hassan MS, et al. Three-year’s changes in glucose tolerance status in the Bellville South cohort: Rates and phenotypes associated with progression. Diabetes Res Clin Pract. 2013; 99: 223-30. Doi: 10.1016/j.diabres. 2012. 10.018.
19. Bunaes DF, Mustafa M, Mohamed HG, et al. The effect of smoking on inflammatory and bone remodeling markers in gingival crevicular fluid and subgingival microbiota following periodontal therapy. J Periodontal Res. 2017; 52: 713-24. Doi: 10.1111/jre.12438.
20. Jarvis MJ, Tunstall-Pedoe H, Feyerabend C, et al. Comparison of tests used to distinguish smokers from nonsmokers. AmJ Public Health. 1987; 77: 1435-8. Doi: 10.2105/AJPH.77.11. 1435.
21. Lee E. Ordinal Logistic Regression and its Assumptions - Full Analysis. Available at: https://medium.com/evangelinelee/ ordinal-logistic-regression-on-world-happiness-report-22137 2709095.
22. van Wyk PJ, van Wyk C. Oral health in South Africa. Int Dent J. 2004; 54: 373-7.
23. Ribeiro CG, Cascaes AM, Silva AER, et al. Edentulism, severe tooth loss and lack of functional dentition in elders: A study in Southern Brazil. Braz Dent J. 2016; 27: 345-52. Doi: 10.1590/0103-6440201600670.
24. Pengpid S, Peltzer K. The prevalence of edentulism and their related factors in Indonesia, 2014/15. BMC Oral Health. 2018; 18. Doi: 10.1186/s12903-018-0582-7.
25. Russell SL, Gordon S, Lukacs JR, et al. Sex/gender differences in tooth loss and edentulism. Historical perspectives, biological factors, and sociologic reasons. Dent Clin North Am. 2013: 317-37. Doi: 10.1016/j.cden.2013.02.006.
26. Government of South Africa. The dental caries status of the coloured population in the major metropolitan areas of the republic of South Africa. National Oral Health Survey, South Africa 1988/89. Department of Health. 2004.
27. WHO: Oral health surveys: basic methods - 5th edition. WHO. 2016.
28. Koltermann AP, Giordani JM do A, Pattussi MP. A associação entre aspectos individuais e contextuais na dentição funcional de adultos do Rio Grande do sul, Brasil: Um estudo multinível. Cad Saude Publica. 2011; 27: 173-82. Doi: 10.1590/S0102-311X2011000100018.
29. Ferreira RC, Kawachi I, Souza JGS, et al. Is reduced dentition with and without dental prosthesis associated with oral health-related quality of life? A cross-sectional study. Health Qual Life Outcomes. 2019; 17: 79. Doi: 10.1186/s12955- 019-1149-2.
30. Kim S. Overview of cotinine cutoff values for smoking status classification. Int J Environ Res Public Health. 2016; 13(12): 1236. Doi: 10.3390/ijerph13121236.
31. Seerig LM, Nascimento GG, Peres MA, et al. Tooth loss in adults and income: Systematic review and meta-analysis. J Dent. 2015; 1051-9. Doi: 10.1016/j.jdent.2015.07.004.
32. Glantz S, Gonzalez M. Effective tobacco control is key to rapid progress in reduction of non-communicable diseases. Thw Lancet. 2012; 1269-71. Doi: 10.1016/S0140-6736(11) 60615-6.
33. Friedling LJ, Morris AG. Pulling teeth for fashion: dental modification in modern day Cape Town, South Africa. SADJ. 2007; 62: 106, 108-113.
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