Biological and Psychosocial Mechanisms Underlying Oral Inflammation and Disease - PROJECT SUMMARY/ABSTRACT Periodontal diseases affect nearly half of all adults in the US, and the physical, psychological, and financial burdens of these conditions fall disproportionally on non-white and lower-income Americans. Oral health disparities persist in parallel with disparities in several systemic health conditions, including type 2 diabetes (T2D) - one of the leading causes of death in the US. T2D and periodontal disease (PD) have well-characterized reciprocal relations with shared risk factors and inflammatory mechanisms driving increased risk for both conditions. Recent evidence suggests that unresolved oral inflammation pays a key role in the onset and progression of both PD and T2D. However, what causes exacerbated oral inflammation in some individuals and not others remains elusive. This study focuses on the psychosocial and environmental sensitivity of oral inflammatory processes as a key driver of disparities in PD and T2D risk. This project’s overall objective is to determine the role of various sources of oral inflammation and psychosocial risk factors in mediating relations linking race, ethnicity, and SES with PD and T2D risk. The central hypothesis is that exposure to individual (e.g., chronic stress) and structural (e.g., pollution) psychosocial stressors and adversities can increase oral inflammation via several mechanisms, which can, in turn, increase PD and T2D risk. This project further examines whether the downstream consequences of these psychosocial factors on oral inflammation partially explain disparities in PD and T2D risk associated with race, ethnicity, and SES. To address these hypotheses, a longitudinal study of the biologic and psychosocial factors underlying oral inflammation and disease risk will be conducted with our clinical partners in a diverse, community-based sample of 350 adults. Biologic, psychosocial, and clinical assessments will be conducted at baseline and two years later to allow for the examination of three specific aims:1) examine various biologic processes contributing to oral inflammation and their associations with current and future PD risk/severity; 2) examine associations between psychosocial stress and structural adversities and current and future oral inflammation; and 3) examine relations between oral inflammation and current and future T2D risk. Through completion of this project, common, modifiable biologic and psychosocial mechanisms contributing to oral inflammation and disparities in PD and T2D risk will be elucidated. Findings from this study could help identity new, innovative prevention, screening, and intervention strategies for PD and T2D, both of which are reversable conditions if intervention is initiated early in the disease course (e.g., at the onset of gingivitis and prediabetes). These findings will also inform an integrated understanding of health disparities in the US and help advance public health and clinical interventions that maximize efficiency and impact by targeting factors underpinning health across multiple domains.
