Gum Disease Increases Risk for Diabetes

Study finds over 90 percent of people with gum disease are at risk for diabetes
December 14, 2009

The study, led by Dr. Shiela Strauss, Associate Professor of Nursing and
Co-Director of the Statistics and Data Management Core for NYU's Colleges of
Dentistry and Nursing, examined data from 2,923 adult participants in the
2003-2004 National Health and Nutrition Examination Survey who had not been
diagnosed with diabetes. The survey, conducted by the National Center for
Health Statistics of the Centers for Disease Control and Prevention, was
designed to assess the health and nutritional status of adults and children in
the United States.

Using guidelines established by the American Diabetes Association, Dr. Strauss
determined that 93 percent of subjects who had periodontal disease, compared to
63 percent of those without the disease, were considered to be at high risk for
diabetes and should be screened for diabetes. The guidelines recommend diabetes
screening for people at least 45 years of age with a body mass index (a
comparative measure of weight and height) of 25 or more, as well as for those
under 45 years of age with a BMI of 25 or more who also have at least one
additional diabetes risk factor. In Dr. Strauss's study, two of those
additional risk factors - high blood pressure
and a first-degree relative (a parent or sibling) with diabetes - were reported
in a significantly greater number of subjects with periodontal disease than in
subjects without the disease.

Dr. Strauss's findings, published today in the
online edition of the Journal of Public Health Dentistry, add to a growing body
of evidence linking periodontal infections to an increased risk for diabetes.
Dr. Strauss also examined how often those with gum disease and a risk for
diabetes visit a dentist, finding that three in five reported a dental visit in
the past two years; half in the past year; and a third in the past six months.
"In light of these findings, the dental visit could be a useful opportunity to
conduct an initial diabetes screening -- an important first step in identifying
those patients who need follow-up testing to diagnose the disease."
"It's been estimated that 5.7 million Americans with diabetes were undiagnosed
in 2007," Dr. Strauss added, "with the number expected to increase dramatically
in coming years. The issue of undiagnosed diabetes is especially critical
because early treatment and secondary prevention efforts may help to prevent or
delay the long-term complications of diabetes that are responsible for reduced
quality of life and increased levels of mortality among these patients. Thus,
there is a critical need to increase opportunities for diabetes screening and
early diabetes detection."

>From PhysOrg.com
http://www.physorg.com/news180015527.html

Tongue Piercing Cause of Death

Man, 22, Dies After Tongue-Piercing Causes Brain Abscesses
Wednesday, October 14, 2009

They may seem cool to teenagers and young adults, but having your
tongue pierced can be deadly, BBC News reported.

A 22-year-old man died of multiple brain abscesses just weeks after
piercing his tongue, according to a report in the Archives of
Neurology.

According to doctors, an infection can spread from the site of the
piercing and go up to the brain.

"Dentists are all too aware of the health problems that can be caused
by oral piercings," said Professor Damien Walmsley, a scientific
adviser to the British Dental Association. "There are many potential
complications, ranging from pain and swelling to chipped or cracked
teeth. Patients who have oral piercings can also suffer with recession
of the gums and prolonged bleeding.

"Piercing of oral sites also carries with it a risk of infection. The
clear message is that oral piercing is ill-advised and should be
avoided."

Prevent Periodontitis To Reduce The Risk Of Head And Neck Cancer

ScienceDaily (2009-09-08) -- Chronic periodontitis, a form of gum disease, is an independent risk factor for head and neck squamous cell carcinoma. This suggests the need for increased efforts to prevent and treat periodontitis as a possible means to reduce the risk of this form of cancer.

http://www.sciencedaily.com/releases/2009/09/090908023642.htm

Treating Periodontal Disease May Help Rheumatoid Arthritis

According to a recent article appearing on WebMD, “It was exciting to find that if we eliminated the infection and inflammation in the gums, then patients with a severe kind of active rheumatoid arthritis reported improvement on the signs and symptoms of that disease,” says Nabil Bissada, DDS, chairman of the department of periodontics at the Case Western Reserve University School of Dental Medicine. “It gives us new intervention.”

The study by Bissada and colleagues is published in the Journal of Periodontology.

The study was done with 40 subjects who had rheumatoid arthritis (moderate to severe) and periodontal disease that was classified as severe.

While one study is not a reason to make wholesale changes in the way we think, it is one more piece of the puzzle between the potential links between periodontal disease and other systemic health problems that have been and continue to be explored by researchers.

To read the complete article at WebMD, click here.

Top 5 Most Annoying Dental Patient Behaviors

Dentists Dish On What Drives Them Crazy While They Work...

30,000+ Dentists Converge in Chicago February 27-March 1

CHICAGO, Feb. 24 /PRNewswire-USNewswire/ -- The following is being issued by the Chicago Dental Society:

Who: The Chicago Dental Society (CDS) recently polled more than 300 members to find out some wacky, unusual, and just plain distracting behaviors they've encountered while patients are in their chair.

As we countdown to CDS's annual Midwinter Meeting, one of the largest displays of dental products in North America, here are the most annoying patient behaviors, according to those surveyed. Give your dentist a break and avoid these activities if possible.

5) Public displays of affection. Your breath may be minty fresh after a cleaning, but don't test it on your significant other until after you leave the dental office.

4) Playing games on your handheld. A few dentists reported getting knocked upside the head during an exam while their patients tried to continue playing their games at arms-length. Really, Tetris can wait.

3) Reading a book or magazine while the dentist is trying to perform an exam. You'll have to relinquish that People magazine or John Grisham novel so your dentist can get a look at your teeth.

2) Grooming. The light in the dental chair might be just right for touching up makeup or - heaven help us - plucking your eyebrows, but dentists really would prefer you save those activities for the bathroom.

And the most annoying thing patients do while in the dentists' chair?

Answering cell phone!

Why: Data was collected for the Chicago Dental Society's 144th annual Midwinter Meeting, which begins at McCormick Place in Chicago on February 26, 2009. The exhibit floor opens on February 27.

The Truth About Whitening

I get many inquiries from patients regarding in office whitening techniques such as so called laser whitening and Zoom. Studies show that the light or laser has absolutely no beneficial effect upon the results of teeth whitening. In other words the chemical applied to the teeth does the work, not the light.

The active ingredient in virtually all teeth whitening products is either hydrogen peroxide or carbamide peroxide, which releases hydrogen peroxide in the mouth. There is no science behind the light.

I have tried several in office whitening systems, and the results have been inferior to the take home systems.

Dentists who offer in office whitening often charge hundreds of dollars more than we charge for the take home whitening because the patient is taking up valuable chair and staff time. The teeth look whiter when the patient leaves the office because the treatment dehydrates the teeth, but they revert back to the original shade after a few hours. Many offices still give the patient a take home bleaching tray to "touch up" or finish the job.

So, if you are willing to pay more in the pursuit of instant gratification for a result that at best is equivalent to or at worst is inferior to take home whitening, then go for it.

Periodontitis And Myocardial Infarction: A Shared Genetic Predisposition

http://www.sciencedaily.com/releases/2009/02/090213115011.htm

ScienceDaily (Feb. 24, 2009) — A mutual epidemiological relationship between aggressive periodontitis and myocardial infarction has already been shown in the past. Scientists at the universities of Kiel, Dresden, Amsterdam and Bonn have now presented the first evidence of a shared genetic variant on chromosome 9, which maps to a genetic region that codes for the "antisense RNA" Anril, as reported in the latest edition of the specialist journal PLoS Genetics.

The first author, Dr Arne Schaefer from the Institute for Clinical Molecular Biology at Kiel University, sees clear similarities in the genetic predisposition: "We have examined the aggressive form of periodontitis, the most extreme form of periodontitis which is characterized by a very early age of onset. The genetic variation associated with this clinical picture is identical to that of patients who suffer from cardiovascular disease and have already had a myocardial infarction."

Because it has to be assumed that there is a causal connection between periodontitis and myocardial infarction, periodontitis should be taken seriously by dentists and diagnosed and treated at an early stage. "Aggressive periodontitis has shown itself to be associated not only with the same risk factors such as smoking, but it shares, at least in parts, the same genetic predisposition with an illness that is the leading cause of death worldwide.," warned Schaefer. Knowledge of the risk of heart attacks could also induce patients with periodontitis to keep the risk factors in check and take preventive measures.

Besides Arne Schaefer, Gesa Richter, who is doing a doctorate on the subject, is also part of Professor Stefan Schreiber's working group from the Institute for Clinical Molecular Biology at Schleswig Holstein University Hospital (UK S-H), Kiel Campus. As cardiologist, Dr Nour Eddine El Mokhtari from the Kiel Heart Centre is an important partner in the group. Dental expertise came from Dr Birte Größner-Schreiber from the Hospital for Conservative Dentistry and Periodontology at the UK S-H, Dr Barbara Noack, Technische Universität Dresden, as well as Professor Søren Jepsen from Bonn University and Professor Bruno Loos, Free University Amsterdam.

Mountain Dew Mouth

Dentists have known for a long time how chronic consumption of soft drinks, Mountain Dew in particular, can ravage tooth enamel. I have seen the devastating effects in my own practice. Now PepsiCo, the manufacturer of Mountain Dew, has agreed to support a dentist’s efforts in rehabilitating kids suffering from “Mountain Dew Mouth” in rural Appalachia. The story was featured on the ABC TV series 20/20. Click the link below or copy and paste it to your browser to watch a video of the 20/20 report.

http://www.abcnews.go.com/Health/story?id=6899312&page=1

Your Mouth and Heart Disease

ScienceDaily (Dec. 7, 2008) — Individuals 

reporting a history of periodontal disease 

were more likely to have increased levels of 

inflammation, a risk factor for heart 

disease, compared to those who reported no 

history of periodontal disease, according to 

an American Journal of Cardiology report 

available online. 

Led by investigators from Columbia University 

Medical Center and NewYork-Presbyterian 

Hospital, the findings suggest persons with 

increased levels of inflammatory markers 

associated with a higher risk of 

cardiovascular disease might be identified by 

asking about oral health history. This group 

might not be detected by traditional 

cardiovascular risk screening. 

Inflammation has been associated with 

cardiovascular disease and has been suggested 

to be a potential link between periodontal 

disease and cardiovascular disease. To 

examine whether oral health history and 

inflammatory markers associated with 

cardiovascular disease were linked, the 

investigators followed participants in the 

National Heart, Lung and Blood Institute 

(NHLBI) Family Intervention Trial for Heart 

Health (F.I.T. Heart), an ongoing national 

trial led by principal investigator Lori 

Mosca, M.D., M.P.H., Ph.D., professor of 

medicine at Columbia University College of 

Physicians and Surgeons and director of 

preventive cardiology at NewYork-Presbyterian 

Hospital/Columbia University Medical Center. 

The NHLBI Family Intervention Trial for Heart 

Health aims to study family members of 

patients hospitalized with heart disease 

because they may be at increased risk 

themselves due to shared genetic and/or 

lifestyle factors. Dr. Mosca and her research 

team recruited family members or co-habitants 

of patients hospitalized for such cardiac 

events as a heart attack or narrowed arteries 

that required bypass surgery or an 

angioplasty procedure. Previous research has 

shown that family members of cardiovascular 

disease patients may be at increased risk for 

the disease due to the genes and lifestyle 

habits they share. 

In this study, 421 individuals who were blood 

related to and/or living with a person 

recently hospitalized due to cardiovascular 

disease were screened for traditional 

cardiovascular risk factors (such as elevated 

blood pressure and abnormal cholesterol 

levels), inflammatory markers associated with 

disease risk (high-sensitivity c-reactive 

protein (hsCRP) and lipoprotein-associated 

phospholipase A2 (Lp-PLA2)). They were also 

asked standardized questions about their oral 

health status, including whether they had 

ever been diagnosed with periodontal (gum) 

disease, whether they had ever been treated 

for periodontal disease, whether they used 

partial or complete removable dentures, and 

the date of their last teeth cleaning. The 

oral health history was then correlated with 

standard markers of inflammation. 

Results found that among participants who did 

not have traditional cardiovascular disease 

risk factors (such as high blood pressure, 

high cholesterol, and overweight/obese 

status), almost one in four were found to 

have a personal history of periodontal 

disease and higher levels of Lp-PLA2, an 

inflammatory marker which has been found 

present in inflamed rupture prone plaque in 

heart arteries/valves. 

It is important to note that it is not 

possible to determine from this study that 

poor oral health causes cardiovascular 

disease risk or that any therapy based on 

oral health status would be effective in 

preventing cardiovascular disease. However, 

Dr. Mosca says, "Our finding is novel because 

it suggests the dentist and oral health exam 

may be the latest weapon in identifying 

persons at risk of cardiovascular disease, 

our nation's number one killer." 

"Many people don't realize how oral health is 

often a predictor of one's overall health," 

says co-author John T. Grbic, DMD, MS, MMSc, 

professor of clinical dental medicine at the 

Columbia University College of Dental 

Medicine. "Symptoms for many life-threatening 

illnesses, such as diabetes and heart 

disease, first appear in the mouth. For this 

reason, it's vitally important for people to 

have routine dental check-ups and have an 

ongoing dialogue with their dentist about 

their oral health. Patients may also benefit 

from seeing dentists affiliated with an 

academic medical center, where they are 

tapped into deep referral networks to 

appropriate clinicians." 

The Mouth - Body Connection

ScienceDaily (Sep. 11, 2008) — Heart disease is the leading cause of death worldwide. However, many people with cardiovascular disease have none of the common risk factors such as smoking, obesity and high cholesterol. Now, researchers have discovered a new link between gum disease and heart disease that may help find ways to save lives, scientists heard September 9, 2008 at the Society for General Microbiology's Autumn meeting being held at Trinity College, Dublin.

In recent years chronic infections have been associated with a disease that causes "furring" of the arteries, called atherosclerosis, which is the main cause of heart attacks. Gum disease is one of the most common infections of humans and there are now over 50 studies linking gum disease with heart disease and stroke.

"A number of theories have been put forward to explain the link between oral infection and heart disease," said Professor Greg Seymour from the University of Otago Dunedin, New Zealand. "One of these is that certain proteins from bacteria initiate atherosclerosis and help it progress. We wanted to see if this is the case, so we looked at the role of heat shock proteins."

Heat shock proteins are produced by bacteria as well as animals and plants. They are produced after cells are exposed to different kinds of stress conditions, such as inflammation, toxins, starvation and oxygen and water deprivation. Because of this, heat shock proteins are also referred to as stress proteins. They can work as chaperone molecules, stabilising other proteins, helping to fold them and transport them across cell membranes. Some also bind to foreign antigens and present them to immune cells.

Because heat shock proteins are produced by humans as well as bacteria, the immune system may not be able to differentiate between those from the body and those from invading pathogens. This can lead the immune system to launch an attack on its own proteins. "When this happens, white blood cells can build up in the tissues of the arteries, causing atherosclerosis," said Professor Seymour.

"We found white blood cells called T cells in the lesions of arteries in patients affected by atherosclerosis. These T cells were able to bind to host heat shock proteins as well as those from bacteria that cause gum disease. This suggests that the similarity between the proteins could be the link between oral infection and atherosclerosis," said Professor Seymour.

This molecular mimicry means that when the immune system reacts to oral infection, it also attacks host proteins, causing arterial disease. These findings could fundamentally change health policy, highlighting the importance of adult oral health to overall health and wellbeing: control of gum disease should be essential in reducing the risk of heart disease.

"This is a significant step towards a more complete understanding of heart disease and improving treatment and preventive therapies," said Professor Seymour. "An understanding of all the possible risk factors could help lower the risk of developing heart disease and lead to a significant change in disease burden."