Oral Health in Adults: Predictors, Social Gradients and Correlation With Cardiovascular Health in Women and Men
Conditions: Oral Disease, Cardiovascular Diseases, Diabetes
Sponsor: Oral Health Centre of Expertise in Western Norway

Outcome measure  
Oral health will be described as the outcome measures: caries, periodontal health and tooth loss. 
Caries will be measured as number of teeth or surfaces with caries. We will also use DMFT 
measure defined as the sum of decayed, missed, filled teeth for each participant. The number of 
participants is 1325. The measure will be given as a continuous variable 
Periodontal health (See: (Papapanou et al. 2018) 
Case definition of periodontal health in an intact periodontium 
PD ≤ 3 mm  
No interdental REC ≥1 mm  
BoP < 10% (mean at patient level) 
 
Mild periodontitis 
≥ 2 interdental sites with CAL ≥ 3 mm and ≥ 2 interdental sites with PD ≥ 4 mm (not on the same 
tooth) 
or 
≥ 1 interdental site with PD ≥ 5 mm  
 
Moderate periodontitis 
≥2 interdental sites with CAL ≥4 mm (not on the same tooth) 
 or  
≥2 interdental sites with PD ≥5 mm (not on the same tooth) 
 
Severe periodontitis 
≥2 interdental sites with CAL ≥6 mm (not on the same tooth) and ≥1 interdental site with PD 
≥5mm 
The measure will be given a categorical variable  
 
Tooth loss will be given as number of lost teeth in each participant.  
The measure will be given as a continous variable.(Saleem et al. 2021) 
 
Oral health related quality of life 
For measurement of OHRQoL, the instrument to be used is the eight item Oral Impacts on Daily 
Performances (abbreviated OIDP) which has proven appropriate as a discriminative and 
descriptive measure in cross-sectional studies (Adulyanon et al. 1996). This scale has also shown 
to have longitudinal validity. We previously (Astrom et al. 2005) used the OIDP scale in a national 
sample of adults and found it to be reliable and valid in the Norwegian context. All eight 
frequency OIDP items are included in our questionnaire and OIDP frequency SC score will be 
performed. 
 

The eight item OIDP index refers to difficulty carrying out eight daily activities during the past 6 
months – ‘How often have you experienced difficulties with--- 1) eating and enjoying food, 2) 
speaking an pronouncing clearly, 3) cleaning teeth, 4) sleeping and relaxing, 5) smiling, laughing 
and showing teeth without embarrassment, 6) maintaining usual emotional state without being 
irritable, 7) carrying out wok and major social role, 8) Enjoying social contact without being 
irritable’. Each frequency OIDP item is assessed on a Likert scale; 0- never, 1- less than once a 
month, 2- once or twice a month, 3- once or twice a month, 4- once or twice a week, 5- every day 
or almost every day. 
An overall OIDP impact score is constructed by adding the eight originally scored (0-5) and 
reported in terms of means and SD. The extent of oral impacts is also be calculated as a simple 
count score (range 0-8) by summing eight dichotomized frequency items in terms of (1) affected- 
including original categories 1,2,3,4 and 0 not affected – including the original category 0. The 
simple count score with a range 0-8 is most often dichotomized into 0= no impact and 1= at least 
one impact and reported as percentage of participants without oral impacts and percentages of 
participants with at least one oral impact. 
Variables preclinical hearth disease 
Preclinical heart disease: aterial stifness and left ventricular hypertrophy:  
arterial stiffness will be measured as carotid-femoral pulse wave velocity, and >10 m/s will be set 
as arterial stiffness. Left ventricular hypertrophy is detected by echocardiography. Left 
ventricular mass >47 g/height 2,7 for woman and  >50 g/height 2,7 for menn will be 
registrated aa left ventricular hypertrophy. 
 
References 
Adulyanon S, Vourapukjaru J, Sheiham A. 1996. Oral impacts affecting daily performance in a low 
dental disease thai population. Community Dent Oral Epidemiol. 24(6):385-389. 
Astrom AN, Haugejorden O, Skaret E, Trovik TA, Klock KS. 2005. Oral impacts on daily 
performance in norwegian adults: Validity, reliability and prevalence estimates. Eur J Oral 
Sci. 113(4):289-296. 
Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, Flemmig TF, Garcia R, Giannobile 
WV, Graziani F et al. 2018. Periodontitis: Consensus report of workgroup 2 of the 2017 
world workshop on the classification of periodontal and peri-implant diseases and 
conditions. J Clin Periodontol. 45 Suppl 20:S162-S170. 
Saleem R, Mohamed-Ahmed S, Elnour R, Berggreen E, Mustafa K, Al-Sharabi N. 2021. Conditioned 
medium from bone marrow mesenchymal stem cells restored oxidative stress-related 
impaired osteogenic differentiation. Int J Mol Sci. 22(24).