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dc.contributor.authorGomez, Franciscoen_US
dc.contributor.authorBarrionuevo, Laura Perezen_US
dc.contributor.authorFranklin, K.en_US
dc.contributor.authorLindberg, E.en_US
dc.contributor.authorBertelsen, Randi Jacobsenen_US
dc.contributor.authorBenediktsdottir, Bryndisen_US
dc.contributor.authorForsberg, Ben_US
dc.contributor.authorGislason, Ten_US
dc.contributor.authorJøgi, Rainen_US
dc.contributor.authorJohannessen, Aneen_US
dc.contributor.authorOmenaas, Ernsten_US
dc.contributor.authorSaure, Eirunn Waateviken_US
dc.contributor.authorSchlunssen, V.en_US
dc.contributor.authorSkorge, Trude Duelienen_US
dc.contributor.authorToren, Kjellen_US
dc.contributor.authorSaavedra, Aen_US
dc.contributor.authorSvanes, Øisteinen_US
dc.contributor.authorÅstrøm, Anne Nordrehaugen_US
dc.contributor.authorJanson, Christeren_US
dc.contributor.authorSvanes, Cecilieen_US
dc.PublishedPLoS ONE 2016, 11(1): e0147518eng
dc.description.abstractBackground: There is little knowledge about how oral and respiratory health is interrelated even though the mucosa of the oral cavity and airways constitutes a continuum and the exposures to these are partly similar. Aims: To investigate whether gum bleeding is related to asthma, respiratory symptoms and self-reported COPD. Methods: A postal questionnaire including questions about respiratory and oral health was sent to general population samples in seven Northern European centres. In 13,409 responders, gum bleeding when brushing teeth was reported always/often by 4% and sometimes by 20%. Logistic regressions accounted for age, smoking, educational level, centre and gender. Effects of BMI, cardio-metabolic diseases, early life factors, gastro-oesophageal reflux, dental hygiene, nasal congestion, and asthma medication were addressed. Results: Gum bleeding always/often was significantly associated with ≥3 asthma symptoms (OR 2.58, 95% CI 2.10–3.18), asthma (1.62 [1.23–2.14]) and self-reported COPD (2.02 [1.28–3.18]). There was a dose-response relationship between respiratory outcomes and gum bleeding frequency (≥3 symptoms: gum bleeding sometimes 1.42 [1.25–1.60], often/always 2.58 [2.10–3.18]), and there was no heterogeneity between centres (pheterogeneity = 0.49). None of the investigated risk factors explained the associations. The observed associations were significantly stronger among current smokers (pinteraction = 0.004). Conclusions: A consistent link between gum bleeding and obstructive airways disease was observed, not explained by common risk factors or metabolic factors. We speculate that oral pathogens might have unfavourable impact on the airways, and that the direct continuity of the mucosa of the oral cavity and the airways reflects a pathway that might provide novel opportunities for interventions.en_US
dc.rightsAttribution CC BYeng
dc.titleThe Association of Gum Bleeding with Respiratory Health in a Population Based Study from Northern Europeen_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright 2016 The Author(s)

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