Saudi Cultural Missions Theses & Dissertations
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Item Restricted The Association Between Metabolic Syndrome and Oral Diseases Among US Adults(Harvard University School of Dental Medicine, 2025) Alhassan, Hameedaldeen; Natto, ZuhairThe objective was to assess the association between oral diseases and metabolic syndrome (MetS), examining both the individual and combined effects of MetS five components. Also, to validate the NHANES diagnostic criteria and Overjet artificial intelligent (AI) platform with the gold standard for periodontal disease diagnosis. First, a systematic review and meta-analysis were conducted by searching PubMed, Embase, and Web of Science for studies published between 1990 and 2023 that examined the association between Dental caries and MetS in adults. Two independent authors selected and analyzed articles, assessed risk of bias, and evaluated the overall evidence certainty. Meta-analyses were performed to estimate pooled odds ratios (ORs), or mean differences (MDs), and corresponding 95% confidence intervals (CIs) for decayed teeth (DT) and DMFT (Decayed, Missing, and Filled Teeth). Second, data from NHANES 2011-2018 were used to assess the association between MetS and oral diseases (dental caries and periodontal disease). The sample included adults over 29 years who completed laboratory and clinical assessments for MetS and oral diseases. Logistic regression models (OR and 95% CI) were used to assess associations between MetS and both untreated caries and periodontal disease. Negative binomial regression (mean ratio [MR] and 95% CI) was conducted to examine the association between MetS and DMFT score. Third, clinical and radiographic records of patients aged over 29 years were utilized to validate the NHANES diagnostic criteria (based on clinical measures alone) and the Overjet AI software (using full-mouth radiographs) for detecting periodontal disease. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the accuracy of both clinical measures and the Overjet AI software, using a gold standard defined as a combination of clinical and radiographic analysis conducted by a periodontist. The meta-analysis (nine studies with 59,075 participants) revealed that there was a positive statistically insignificant association between DT and MetS (OR: 1.17, 95% CI: 0.87–1.58; MD: 0.22, 95% CI: -0.08–0.52). However, a significant positive association was found between MetS and DMFT (OR: 1.28, 95% CI: 1.08–1.51). Results from NHANES showed that participants with MetS were more likely to have untreated caries and high DMFT mean score by 34% and 10%, respectively. While there was no association between MetS and periodontal disease. Low HDL was the most significant MetS component associated with dental caries, while insulin resistance was the strongest component linked to periodontal disease. Having all five MetS components was associated with a 17% higher likelihood of a high DMFT score. Results from the validity study showed that detecting periodontal disease using clinical measures achieved 96% sensitivity and 99% specificity. While Overjet AI software achieved 100% sensitivity and 89% specificity. In conclusion, the study revealed a positive association between MetS and dental caries, while there was no association between MetS and periodontal disease. Future prospective cohort studies could provide a better understanding of these associations. The validity study demonstrated that both clinical measures and Overjet AI software achieved high accuracy in detecting periodontal disease.6 0Item Restricted Rapid review of longitudinal studies on the association between oral health and frailty(King’s College London , 2024-08) Alhumaidi, Meshari; sabbah, waelAbstract Background Frailty and sarcopenia are prevalent conditions in the elderly, contributing to increased healthcare costs and higher mortality rates. Poor oral health, characterized by issues such as tooth loss and periodontal disease, has been associated with the onset and progression of these conditions. Despite this, there is a lack of comprehensive longitudinal studies examining the relationship between oral health and frailty in older populations. Objective This rapid review aims to consolidate and analyse the existing body of research from longitudinal studies on the association between various oral health conditions and frailty among older adults. The goal is to identify key oral health issues that significantly impact frailty and to provide insights for healthcare providers and policymakers. Methods The review systematically gathered and synthesized data from relevant studies using a standardized methodological approach. It focused on studies involving older adults aged 65 and above, examining conditions such as tooth loss, periodontal diseases, and overall oral hygiene status. The analysis included comparisons between individuals with poor oral health and those with healthier oral conditions, assessing the impact on frailty indicators. From an initial search yielding 1404 records (702 from PubMed, 93 from Ovid, and 609 from Cochrane Library), 609 records remained after removing duplicates. After screening titles and abstracts, 16 articles were assessed for eligibility. Ultimately, 11 studies met the inclusion criteria and were included in the final review. Results The findings highlight significant associations between poor oral health and increased frailty in the elderly. Conditions like tooth loss and periodontal disease were found to be major risk factors for frailty, affecting physical functions such as strength, mobility, and overall vitality. The review also identified gaps in the literature, particularly the need for more longitudinal studies to establish causal relationships. A total of 11 longitudinal studies met the inclusion criteria and were included in this systematic review. These studies provide valuable insights into the association between various oral health conditions and frailty among older adults, highlighting the importance of maintaining good oral health to mitigate the progression of frailty. However, the predominance of cross-sectional designs in some studies limits the ability to establish causal relationships and introduces potential biases, including measurement bias from self-reported data and residual confounding. Conclusion The review underscores the importance of integrating oral health assessments into routine geriatric care. Early interventions targeting oral health could potentially delay the onset of frailty, improving quality of life and reducing healthcare costs. These findings provide a foundation for developing comprehensive geriatric care models that prioritize oral health and for future research to address the identified gaps in the literature.23 0