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Interaction of lifestyle, behaviour or systemic diseases with dental caries and periodontal diseases: consensus report of group 2 of the joint EFP / ORCA workshop on the boundaries between caries and periodontal diseases
Author(s) -
Chapple Iain L.C.,
Bouchard Philippe,
Cagetti Maria Grazia,
Campus Guglielmo,
Carra MariaClotilde,
Cocco Fabio,
Nibali Luigi,
Hujoel Philippe,
Laine Marja L.,
Lingström Peter,
Manton David J.,
Montero Eduardo,
Pitts Nigel,
Rangé Hélène,
Schlueter Nadine,
Teughels Wim,
Twetman Svante,
Van Loveren Cor,
Van der Weijden Fridus,
Vieira Alexandre R.,
Schulte Andreas G.
Publication year - 2017
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.12685
Subject(s) - periodontitis , medicine , chronic periodontitis , disease , tooth loss , genetic predisposition , risk factor , immunology , bioinformatics , biology , dentistry , oral health
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‐γ RIIA ) and Interleukin 10 ( IL 10 ) genes. For caries, genes involved in enamel formation ( AMELX , AMBN , ENAM , TUFT , MMP 20 , and KLK 4) , salivary characteristics ( AQP 5 ), 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.