Impact of smoking on cost-effectiveness of 10-48 years of periodontal care.

The study aims were (1) to explore whether "periodontal treatment" consisting of surgical therapy (flap, resective, or regenerative) or scaling and root planing treatment with long-term periodontal maintenance treatment, is cost-effective in terms of preventing periodontitis-attributable tooth extraction and replacement by implant-supported crowns ("extraction/replacement"); (2) to assess the effect of cigarette smoking on this cost-effectiveness. Data for this observational retrospective study were collected from dental charts of patients who had received periodontal therapy and at least annual follow-up visits for >10 years were analyzed by linear regression generalized estimating equations and generalized linear models. Among 399 adults (199 males, 200 females), those with the least mean annual treatment cost experienced the greatest mean annual costs for extraction/replacement, indicating general cost-effectiveness.

National, State-Level, and County-Level Prevalence Estimates of Adults Aged ≥18 Years Self-Reporting a Lifetime Diagnosis of Depression - United States, 2020.

Depression is a major contributor to mortality, morbidity, disability, and economic costs in the United States (1). Examining the geographic distribution of depression at the state and county levels can help guide state- and local-level efforts to prevent, treat, and manage depression. CDC analyzed 2020 Behavioral Risk Factor Surveillance System (BRFSS) data to estimate the national, state-level, and county-level prevalence of U.

Associations of self-reported chronic obstructive pulmonary disease with indicators of economic instability and stress - 16 states, 2017.

Objectives: To examine the association between chronic obstructive pulmonary disease status and indicators of economic instability and stress to better understand the magnitude of these issues in persons with chronic obstructive pulmonary disease.

Methods: Analyzed 2017 Behavioral Risk Factor Surveillance System data from 16 states that administered the 'Social Determinants of Health' module, which included economic instability and stress measures ( = 101,461). Associations between self-reported doctor-diagnosed chronic obstructive pulmonary disease status and each measure were examined using multinomial logistic models.

Public Health Aspects of Periodontitis: Recent Advances and Contributions by Dr. Robert J. Genco.

Purpose Of Review: This review provides an overview of the objectives, activities and accomplishments of the CDC-AAP collaboration on public health aspects of periodontitis focusing mostly on surveillance. Dr. Robert Genco was co-chair of this effort.

Recent epidemiologic trends in periodontitis in the USA.

The most important development in the epidemiology of periodontitis in the USA during the last decade is the result of improvements in survey methodologies and statistical modeling of periodontitis in adults. Most of these advancements have occurred as the direct outcome of work by the joint initiative known as the Periodontal Disease Surveillance Project by the Centers for Disease Control and Prevention and the American Academy of Periodontology that was established in 2006. This report summarizes some of the key findings of this important initiative and its impact on our knowledge of the epidemiology of periodontitis in US adults.

Geospatial distribution of periodontists and US adults with severe periodontitis.

Background: In this study, the authors report on the geospatial distributions of periodontists and adults with severe periodontitis in the United States.

Methods: The authors used geospatial analysis to describe the distribution of periodontists and adults, periodontists vis-à-vis estimated density of adults with severe periodontitis, and their ratios to adults with severe periodontitis. The authors identified locations of 5,415 practicing periodontists through the 2014 National Provider Identifier Registry, linked them with the weighted census number of adults, and estimated the number of adults within a series of circular distance zones.

Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009-2014.

Background: This report presents weighted average estimates of the prevalence of periodontitis in the adult US population during the 6 years 2009-2014 and highlights key findings of a national periodontitis surveillance project.

Methods: Estimates were derived for dentate adults 30 years or older from the civilian noninstitutionalized population whose periodontitis status was assessed by means of a full-mouth periodontal examination at 6 sites per tooth on all non-third molar teeth. Results are reported according to a standard format by applying the Centers for Disease Control and Prevention/American Academy of Periodontology periodontitis case definitions for surveillance, as well as various thresholds of clinical attachment loss and periodontal probing depth.

Vital Signs: Racial Disparities in Age-Specific Mortality Among Blacks or African Americans - United States, 1999-2015.

Background: Although the overall life expectancy at birth has increased for both blacks and whites and the gap between these populations has narrowed, disparities in life expectancy and the leading causes of death for blacks compared with whites in the United States remain substantial. Understanding how factors that influence these disparities vary across the life span might enhance the targeting of appropriate interventions.

Methods: Trends during 1999-2015 in mortality rates for the leading causes of death were examined by black and white race and age group.

Surveillance for Health Care Access and Health Services Use, Adults Aged 18-64 Years - Behavioral Risk Factor Surveillance System, United States, 2014.

Problem/condition: As a result of the 2010 Patient Protection and Affordable Care Act, millions of U.S. adults attained health insurance coverage.

Health-Related Behaviors by Urban-Rural County Classification - United States, 2013.

Problem/condition: Persons living in rural areas are recognized as a health disparity population because the prevalence of disease and rate of premature death are higher than for the overall population of the United States. Surveillance data about health-related behaviors are rarely reported by urban-rural status, which makes comparisons difficult among persons living in metropolitan and nonmetropolitan counties.

Reporting Period: 2013.

Risk Indicators for Periodontitis in US Adults: NHANES 2009 to 2012.

Background: Through the use of optimal surveillance measures and standard case definitions, it is now possible to more accurately determine population-average risk profiles for severe (SP) and non-severe periodontitis (NSP) in adults (aged 30 years and older) in the United States.

Methods: Data from the 2009 to 2012 National Health and Nutrition Examination Survey were used, which, for the first time, used the "gold standard" full-mouth periodontitis surveillance protocol to classify severity of periodontitis following suggested Centers for Disease Control/American Academy of Periodontology case definitions. Probabilities of periodontitis by: 1) sociodemographics, 2) behavioral factors, and 3) comorbid conditions were assessed using prevalence ratios (PRs) estimated by predicted marginal probability from multivariable generalized logistic regression models.

Cigarette Smoking, Tooth Loss, and Chronic Obstructive Pulmonary Disease: Findings From the Behavioral Risk Factor Surveillance System.

Background: Cigarette smoking and tooth loss are seldom considered concurrently as determinants of chronic obstructive pulmonary disease (COPD). This study examines the multiplicative effect of self-reported tooth loss and cigarette smoking on COPD among United States adults aged ≥18 years.

Methods: Data were taken from the 2012 Behavioral Risk Factor Surveillance System (n = 439,637).

Standards for reporting chronic periodontitis prevalence and severity in epidemiologic studies: Proposed standards from the Joint EU/USA Periodontal Epidemiology Working Group.

Periodontal diseases are common and their prevalence varies in different populations. However, prevalence estimates are influenced by the methodology used, including measurement techniques, case definitions, and periodontal examination protocols, as well as differences in oral health status. As a consequence, comparisons between populations are severely hampered and inferences regarding the global variation in prevalence can hardly be drawn.

Update on Prevalence of Periodontitis in Adults in the United States: NHANES 2009 to 2012.

Background: This report describes prevalence, severity, and extent of periodontitis in the US adult population using combined data from the 2009 to 2010 and 2011 to 2012 cycles of the National Health and Nutrition Examination Survey (NHANES).

Methods: Estimates were derived for dentate adults, aged ≥30 years, from the US civilian non-institutionalized population. Periodontitis was defined by combinations of clinical attachment loss (AL) and periodontal probing depth (PD) from six sites per tooth on all teeth, except third molars, using standard surveillance case definitions.

The multi-center randomized controlled trial (RCT) published by the journal of the American Medical Association (JAMA) on the effect of periodontal therapy on glycated hemoglobin (HbA1c) has fundamental problems.

Subject: Participants had type 2 diabetes, were on stable medication regimens, had HbA levels between 7% and <9%, retained at least 16 natural teeth, and had untreated chronic periodontitis. A total of 514 participants were enrolled between November 2009 and March 2012 from diabetes and dental clinics and communities affiliated with five participating academic medical centers. They were randomized with half ( = 257) allocated to a treatment group and the other half ( = 257) to a control group.

Overview and quality assurance for the oral health component of the National Health and Nutrition Examination Survey (NHANES), 2009-2010.

Objective: In 2009-2010, the oral health component for the National Health and Nutrition Examination Survey (NHANES) focused on adult periodontal health and included a full mouth periodontal examination as well as a series of questions adminis during the home interview. During this period, intraoral assessments were conducted by dental hygienists.

Methods: This report provides oral health content information and results of dental examiner reliability for data collected during NHANES 2009-2010 on 7,189 persons aged 3-19 years and 30 years and older representing the US civilian, noninstitutionalized population in these age groups.

Probing depth is not a reliable predictor for changes in periodontitis.

Article Title And Bibliographic Information: Are changes in probing depth a reliable predictor of change in clinical attachment loss? Michalowicz BS, Hodges JS, Pihlstrom BE. J Am Dent Assoc 2013;144 (2):171-8.

Reviewer: Paul I.

Serologically determined in utero exposure to oral pathogens may be associated with increased risk for neonatal intensive care unit (NICU) admissions and length of stay.

Subjects: The study sample was a subset of 1115 women enrolledinthe Oral Conditions and Pregnancy (OCAP) study, between 1997 and 2002, at Duke University Medical Center. Data from 650 women with umbilical cord blood samples and complete demographic information were analyzed for this study.

Key Exposure/study Factor: Fetal immunoglobulin M (IgM) antibody to periodontal organisms.