title: Bacterial species in subgingival plaque and oral bone loss in postmenopausal women.
abstract: BACKGROUND
  Oral bacteria are widely recognized in the etiology of periodontal disease. We investigated the prevalence of subgingival bacterial infection with eight species, tested associations between infection and oral bone loss, and assessed potential confounding factors and effect modifiers of those associations in a large community-based cohort of postmenopausal women.
  
  
  METHODS
  A cross-sectional study of oral health and osteoporosis in 1,256 postmenopausal women recruited from the Buffalo, New York Women's Health Initiative Observational Study was conducted. Standardized dental radiographs were used to measure alveolar crestal height (ACH). Subgingival plaque samples were taken, and the presence of eight bacterial species was assessed by indirect immunofluorescent microscopy in each participant.
  
  
  RESULTS
  The most prevalent infection was Streptococcus sanguis (59.5%), followed by Prevotella intermedia (43.4%), Tannerella forsythensis (37.9%), Capnocytophaga sp. (36.9%), Eubacterium saburreum (32.7%), Campylobacter rectus (17.4%), Porphyromonas gingivalis (15.1%), and Fusobacterium nucleatum (14.2%). Infections with P. gingivalis, T. forsythensis, P. intermedia, and C. rectus were associated with an increased likelihood of having oral bone loss as measured by ACH, even after adjustment for age, smoking, and income. The body mass index (BMI) was a modifier of this association. Overweight women with T. forsythensis infection were more likely to have oral bone loss (OR = 3.37; 95% confidence interval [CI]: 2.08 to 5.46) than normal weight (OR = 1.27; 95% CI: 0.82 to 1.98) or obese (OR = 1.26, 95% CI: 0.72 to 2.20) women with T. forsythensis infection.
  
  
  CONCLUSIONS
  The prevalence of specific bacterial infections was determined for a large group of postmenopausal women. Those with infection were more likely to have oral bone loss. Further studies should investigate potential modifying effects of BMI and/or inflammatory factors.
authors.affiliation: Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY 14212, USA. brennan3@buffalo.edu
authors.forename: Renee M
authors.initials: RM
authors.lastname: Brennan
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Genco
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Wilding
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Hovey
authors.forename: Maurizio
authors.initials: M
authors.lastname: Trevisan
authors.forename: Jean
authors.initials: J
authors.lastname: Wactawski-Wende
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology*; D015992:Body Mass Index; D003773:Dental Plaque / Q000382:microbiology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008336:Mandibular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology; D008439:Maxillary Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology; D008875:Middle Aged; D010518:Periodontitis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology*; D017698:Postmenopause; D011859:Radiography; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors