2026-03-27
Fredy Hugo Cruzado-Oliva, Silvia Elizabet Reyes-Narváez, Edi William Aguilar-Urbina, Edward Demer Infantes-Ruiz, Heber Isac Arbildo-Vega, Rubén Aguirre-Ipenza, Franz Tito Coronel-Zubiate
AimTo evaluate the strength and methodological quality of evidence regarding the association between periodontal disease (PD) and chronic obstructive pulmonary disease (COPD) through an umbrella review.Materials and methodsA comprehensive search was conducted through April 2025 in PubMed, Cochrane Library, Scopus, Embase, Web of Science, Google Scholar, ProQuest Dissertations and Theses, and OpenGrey. Systematic reviews (SRs), with or without meta-analysis, investigating the association between PD and COPD were included without time or language restrictions. Narrative reviews, primary studies, protocols, and non-systematic reports were excluded. Methodological quality was assessed using AMSTAR-2. The degree of primary study overlap was calculated using the Corrected Covered Area (CCA) index. Due to high overlap (CCA = 14.45%) and clinical heterogeneity, no de novo meta-analysis was performed, and a structured qualitative synthesis was conducted.ResultsOf 313 identified records, 12 SRs comprising 145 primary studies were included. Six reviews were rated as high confidence, one as low confidence, and five as critically low confidence according to AMSTAR-2. Most SRs reported a positive association between PD and COPD. However, the magnitude and statistical significance of the association varied according to periodontal parameters, COPD outcomes, and smoking status.ConclusionCurrent evidence suggests a likely association between PD and COPD, although the relationship may be influenced by shared risk factors such as smoking and methodological heterogeneity. Integrating periodontal assessment into COPD management may be clinically relevant, but high-quality prospective studies are needed to clarify causal pathways.Systematic Review RegistrationOpen Science Framework (OSF), https://doi.org/10.17605/OSF.IO/YTXB6.
DOI: 10.3389/froh.2026.17284052026-03-20
Regina Mathai, Morgan Santoro, Lisa J. Heaton, Eric P. Tranby, Tamanna Tiwari
ObjectivesMedical–dental integration promotes early intervention in oral diseases, reduces barriers to care, and optimizes dental home establishment for children. This study aims to explore how child-level [gender, age, number of preventative dental visits (PDVs), and comorbidities] and parent-level [employment, family size, comorbidities, and number of PDVs] characteristics affect dental service claims.MethodsMerative administrative claims data were analyzed for children aged 0–6 years who had a well-child visit, at least one dental visit between 2019 and 2021, and were covered under private insurance plans (N = 198,433). Descriptive statistics and regression analysis were used to predict dental claims, with child- and parent-level factors as predictors.ResultsAt the child level, there were higher odds of claims for male children compared with female children for the treatment of dental pain, anesthesia, and emergencies. With increased age, the odds of having a claim for the treatment of dental pain, dental extractions, anesthesia, and emergencies increased. At the parent level, salaried employment (compared with hourly employment) resulted in lower odds of child claims for the treatment of pain extraction, anesthesia, and emergencies.ConclusionPDV for children and parental employment decreased the odds of dental service claims, indicating that PDV is valuable for reducing oral health burden.
DOI: 10.3389/froh.2026.16882412026-03-18
Congcong Zou, Haibei Liu, Lingli Li, Zhenzhen Lin, Yanhua Qiu
ObjectiveConflicting evidence has shown a connection between tooth loss, periodontitis, and increased risk of mild cognitive impairment (MCI); thus, we conducted a meta-analysis to clarify this association.Materials and methodsPubMed, Embase, Web of Science, the Cochrane Library, and MEDLINE (up to March 2025) were searched. Cross-sectional and longitudinal studies were included. Fully-adjusted odds ratios (aORs) with the most severe form of periodontitis or tooth loss were pooled with a random effects model using STATA 18/MP software. Subgroup and sensitivity analyses were conducted to elucidate possible heterogeneity.ResultsThe meta-analysis of five studies showed that neither periodontitis nor tooth loss substantially increased MCI risk after full adjustment, with pooled aORs of 1.27 (95% CI: 0.87–1.86, I2 = 63.9%) and 1.22 (95% CI: 0.97–1.54, I2 = 53.8%), respectively. A significant association was found between periodontitis and MCI with low heterogeneity in the Centers for Disease Control and Prevention-American Academy of Periodontology diagnostic criteria for periodontitis subgroup (aOR of 2.78, 95%CI 1.54–5.02, I2 = 0.0%) and between MCI and significant tooth loss (aOR of 1.50, 95%CI 1.15–5.95, I2 = 0.0%). The sensitivity result confirmed the robustness of the results.ConclusionOverall, periodontitis and tooth loss were not statistically associated with increased MCI risk. Whereas the association between severe periodontitis and significant tooth loss and MCI was statistically significant. Thus, severe periodontitis and significant tooth loss were linked to decreased cognitive function.Systematic Review RegistrationPROSPERO CRD420251055491.
DOI: 10.3389/froh.2026.1710871