Diabetes And Periodontitis Ppt

Treatment Of Periodontal Disease For Glycaemic Control In People With Diabetes Mellitus

Treatment of periodontal disease for glycaemic control in people with diabetes mellitus Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Cochrane Oral Health, Manchester, UK Jo C Weldon, Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, JR Moore Building, Oxford Road, Manchester, M13 9PL, UK. [email protected] . Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Cochrane Oral Health, Manchester, UK Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Cochrane Oral Health, Manchester, UK Cited by (CrossRef): 10 articles Check for updates Glycaemic control is a key issue in the care of people with diabetes mellitus (DM). Periodontal disease is the inflammation and destruction of the underlying supporting tissues of the teeth. Some studies have suggested a bidirectional relationship between glycaemic control and periodontal disease. This review updates the previous version published in 2010. The objective is to investigate the effect of periodontal therapy on glycaemic control in people with diabetes mellitus. We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 31 December 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Library 2014, Issue 11), MEDLINE via OVID (1946 to 31 December 2014), EMBASE via OVID (1980 to 31 December 2014), LILACS via BIREME (1982 to 31 December 2014), and CINAHL via EBSCO (1937 to 31 December 2014). ZETOC (1993 to 31 December 2014) and Web of Knowledge (1990 to Continue reading >>

The Prevalence And Associated Factors Of Periodontitis According To Fasting Plasma Glucose In The Korean Adults: The 20122013 Korea National Health And Nutrition Examination Survey

Periodontitis is a chronic inflammatory condition characterized by destruction of the periodontal tissues and resulting in loss of connective tissue attachment, loss of alveolar bone, and the formation of pathological pockets around the affected teeth. 1,2 Recent epidemiologic studies showed that >50% of the adult population is affected by periodontitis. 35 Severe periodontitis, which may result in tooth loss, is found in 5% to 20% of the adult population worldwide. 6 Periodontitis is associated with age, inadequate oral hygiene, smoking, obesity, socioeconomic status, and chronic diseases, such as cardiovascular disease, osteoporosis, and diabetes. 613 Among the above-mentioned risk factors, diabetes, especially, is regarded as a major risk factor for periodontitis. 14,15 Epidemiological studies and meta-analyses of studies in various diabetic populations have shown that diabetes increases the risk of developing periodontitis approximately 3-fold when compared with nondiabetic individuals. 16 Furthermore, subjects with poorly controlled diabetes had a greater risk of severe periodontal disease compared with subjects with better-controlled diabetes. 17 Although the relationship between diabetes and periodontitis is well established, the association between periodontitis and pre-diabetes has been relatively understudied. A few studies suggested that periodontal disease was positively associated with impaired glucose tolerance or impaired fasting glucose (IFG), 1820 but other studies found no association between periodontal disease and impaired glucose tolerance. 21,22 Furthermore, there has been little research on the prevalence of periodontitis between individuals with prediabetes and diabetes, as well as in the overall population, using nationally representative data. Continue reading >>

Systemic Antibiotics In Periodontal Treatment Of Diabetic Patients: A Systematic Review

Abstract To evaluate the effects of systemic antibiotics in combination with scaling and root planing (SRP) on periodontal parameters, tooth loss and oral health-related quality of life in diabetes patients. Materials and Methods Two independent reviewers screened for controlled clinical trials with at least 6-month follow-up in six electronic databases, registers of clinical trials, meeting abstracts and four major dental journals. After duplicates removal, electronic and hand searches yielded 1,878 records; 18 full-text articles were independently read by two reviewers. To evaluate the additional effect of antibiotic usage, pooled weighted mean differences and 95% confidence intervals were calculated using a fixed effects model. Five studies met the inclusion criteria, four of which were included in meta-analyses. The meta-analyses showed a significant effect favouring SRP plus antibiotic for reductions in mean probing depth (PD) (-0.22 mm [-0.34, -0.11]) and mean percentage of bleeding on probing (BoP) (4% [-7, -1]). There was no significant effect for clinical attachment level gain and plaque index reduction. No study reported on tooth loss and oral health-related quality of life. Adjunctive systemic antibiotic use in diabetic patients provides a small additional benefit in terms of reductions in mean PD and mean percentage of BoP. Continue reading >>

Diabetes And Periodontal Disease

If you have diabetes, you know the disease can harm your eyes, nerves, kidneys, heart and other important systems in the body. Did you know it can also cause problems in your mouth? People with diabetes have a higher than normal risk of periodontal diseases. Periodontal diseases are infections of the gum and bone that hold the teeth in place. In advanced stages, they lead to painful chewing problems and even tooth loss. Like any infection, gum disease can make it hard to keep your blood sugar under control. Diabetic Control. Like other complications of diabetes, gum disease is linked to diabetic control. People with poor blood sugar control get gum disease more often and more severely, and they lose more teeth than do persons with good control. In fact, people whose diabetes is well controlled have no more periodontal disease than persons without diabetes. Children with IDDM (insulin-dependent diabetes mellitus) are also at risk for gum problems. Good diabetic control is the best protection against periodontal disease. Studies show that controlling blood sugar levels lowers the risk of some complications of diabetes, such as eye and heart disease and nerve damage. Scientists believe many complications, including gum disease, can be prevented with good diabetic control. Blood Vessel Changes. Thickening of blood vessels is a complication of diabetes that may increase risk for gum disease. Blood vessels deliver oxygen and nourishment to body tissues, including the mouth, and carry away the tissues' waste products. Diabetes causes blood vessels to thicken, which slows the flow of nutrients and the removal of harmful wastes. This can weaken the resistance of gum and bone tissue to infection. Bacteria. Many kinds of bacteria (germs) thrive on sugars, including glucose -- the Continue reading >>

Diabetes And Periodontal Disease

Diabetic patients are more likely to develop periodontal disease, which in turn can increase blood sugar and diabetic complications. People with diabetes are more likely to have periodontal disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered a complication of diabetes. Those people who don't have their diabetes under control are especially at risk. Research has suggested that the relationship between diabetes and periodontal disease goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar. Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts people with diabetes at increased risk for diabetic complications. Continue reading >>

Diabetes And Periodontitis – Two Way Relationship

Presentation on theme: "Diabetes and Periodontitis – two way relationship"— Presentation transcript: 1 Diabetes and Periodontitis – two way relationship 2 Overview Bi-directional relationship 3 Introduction Pd and db are both highly prevalent conditions. Epidemiological studies have clearly identified that diabetes is a major risk factor for periodontitis, increasing the risk approximately three-fold compared to non-diabetic individuals, particularly if glycaemic control is poor. 4 Periodontal Disease 5 Periodontal Disease Signs and Symptoms Painless Tooth mobility 6 Diabetes Metabolic disorder 7 Type 1 db Auto immune disorder 8 Type 2 db Insulin resistance. Reduced responsiveness of the cells in the body to insulin, leading to a reduced capacity to transfer glucose out of the circulation and into cells. 9 Gestational db 10 Blood glucose measurement The complications are closely linked to the level of glycemic control, and it has been shown that each 1% reduction in HbA1c has been associated with measurable reductions in risk of db complications, a 21% reduction in deaths related to db, a 14% reduction for MI, and a 37% reduction for microvascular complications of db. 11 Effect of db on pd Increased risk of periodontitis in pts with db is estimated to be between 2-3 fold – that is, it increases the risk for periodontitis by 2-3 times. 12 Oral conditions associated with db 13 Mechanism Not completely understood. Accumulation of ROS, oxidative stress, and interactions between advanced glycation end products (AGEs) in the periodontal tissues and their receptor (RAGE, the receptor for advanced glycation end products) all contribute to increased inflammation in the periodontal tissues in people with db. 14 Implications for the dental professional Pd and db are direct Continue reading >>

Periodontitis And Diabetes: A Two-way Relationship

Go to: Abstract Periodontitis is a common chronic inflammatory disease characterised by destruction of the supporting structures of the teeth (the periodontal ligament and alveolar bone). It is highly prevalent (severe periodontitis affects 10–15% of adults) and has multiple negative impacts on quality of life. Epidemiological data confirm that diabetes is a major risk factor for periodontitis; susceptibility to periodontitis is increased by approximately threefold in people with diabetes. There is a clear relationship between degree of hyperglycaemia and severity of periodontitis. The mechanisms that underpin the links between these two conditions are not completely understood, but involve aspects of immune functioning, neutrophil activity, and cytokine biology. There is emerging evidence to support the existence of a two-way relationship between diabetes and periodontitis, with diabetes increasing the risk for periodontitis, and periodontal inflammation negatively affecting glycaemic control. Incidences of macroalbuminuria and end-stage renal disease are increased twofold and threefold, respectively, in diabetic individuals who also have severe periodontitis compared to diabetic individuals without severe periodontitis. Furthermore, the risk of cardiorenal mortality (ischaemic heart disease and diabetic nephropathy combined) is three times higher in diabetic people with severe periodontitis than in diabetic people without severe periodontitis. Treatment of periodontitis is associated with HbA1c reductions of approximately 0.4%. Oral and periodontal health should be promoted as integral components of diabetes management. Keywords: Diabetes, Diabetes complications, Periodontal diseases, Periodontitis, Type 1 diabetes mellitus, Type 2 diabetes mellitus Periodontitis (r Continue reading >>

Diabetes And Periodontal Disease ,at Two Way Relationship

1. Diabetes and Periodontal disease A two way relationship 2. Contents • Diabetes overview • Periodontal disease overview • Relation between Diabetes and Periodontal disease • effect of diabetes on periodontal disease and its mechanism • Effect of periodontal disease on diabetes and its mechanism • references 3. Introduction • Its widely thought that any diseases associated with each other , then one caused the other . • But many of these diseases interrelationship mechanisms is obscure ! • A better understanding of this relationship provides more appropriate treatment for these patients. • So in this seminar we will figure out the relation between diabetes and periodontal disease and its bidirectional mechanisms. 4. Diabetes Among many systemic diseases , diabetes ,have been a nightmare to researches ,doctors and patients , due to its difficult control and diverse complications 5. Classification according to its patho- physiology DM Type I IDDM due to destruction of beta cells of pancreas Type II NIDDM due to insulin resistance Gestational temporary condition occurs during pregnancy others Drug- or chemical- induced Diseases of the exocrine pancreas Genetic defects in *β-cell function, *insulin action 6. • Actually to understand diabetes its as simple as just increase in glucose in blood , whether its due to insulin deficiency or resistance. • But what will result from this increase ? Why is it dangerous then ? 7. • Deficiency of insulin secretion or insulin resistance , results in : Inability to transport glucose into cells Glucose retained in the blood stream Hyperglycemia Complications 8. • microangiopathy • nephropathy • neuropathy, • macro vascular disease • delayed wound healing. - All the forms of DM are associated with hyper Continue reading >>

Diabetes And Periodontal Disease The Relation

1. Periodontal Inflammation and Diabetes: a two way relationshipKaumudi Joshipura BDS, MS, ScD Center for Clinical Research and Health PromotionSchool of Dental MedicineUniversity of Puerto RicoHarvard University 2. Biological Pathways: Periodontal Disease, Systemic Inflammation and Cardiometabolic ConditionsCommon Risk FactorsAgeSmokingObesity, DiabetesPhysical ActivityGeneticsRaceAlcoholComorbidityMedicationsFluorideMicrobesAccess to CarePeriodontitisCariesToothlossSystemic Inflammation Nutrition (Body Composition,(Biomarkers) Dietary intake; Nutritional Status) Dyslipidemia Arterial StiffnessObesityAdverse Pregnancy OutcomesHypertensionPre-diabetesAtherosclerosis DiabetesCHDPADStrokeGestationalDiabetesPre-eclampsia2Kidney DiseaseCancer 3. Dental CariesCavities are holes or structural damage to the teeth.There may be no symptoms, but if present, may include:Toothache or painful sensation in the teeth, especially after consuming sweet drinks or hot or cold foodRisk factors include: Poor oral hygiene Fermentable carbohydrates 4. It is an infection and inflammation affecting the soft tissues and bone that support the teeth.Periodontitis occurs when infection and inflammation of the gums (gingivitis) progresses to involve other surrounding tissues. Periodontitis 5. Healthy GingivaPeriodontal Disease 6. Pocket DepthHealthy gingivaPeriodontal Pocket 7. Attachment Level6mm6mm 8. Bone Loss 9. Gingival RecessionCauses:

• Periodontal Disease 10. Traumatic tooth cleaning technique 11. Local irritants (plaque or calculus) 12. Orthodontic tipping 13. Provisional crowns 14. Extraction of adjacent teeth 15. Occlusal forces

9 16. U.S. Adults PeriodontalDiseasePrevalence (≥1 site Pocket Depth ≥4mm)NHANES III, 1988-94Adapted: Burt and Eklund, 2005 17. U.S. Adults Cum Continue reading >>

Diabetes Mellitus & Periodontium

1. Presented by: Dr. Yogender Singh Under the guidance of: Dr. H S Grover & Faculty 2. CONTENTS • INTRODUCTION • DEFINITIONS • HISTORY • EPIDEMIOLOGY • CLASSIFICATION • DIAGNOSIS • INSULIN & DIABETES • CLASSICAL SIGNS, SYMPTOMS & COMPLICATIONS OF DM • DIABETES AND PERIODONTAL DISEASE • DENTAL THERAPY CONSIDERATIONS • CONCENSUS REPORT- EFP/AAP JOINT WORKSHOP • CONCLUSION • REFRENCES 3. INTRODUCTION • Diabetes mellitus represents a spectrum of metabolic disorders and has emerged as a major health issue worldwide. • It is a complex metabolic disease characterized by:  Chronic hyperglycemia,  Diminished insulin production,  Impaired insulin action, or a combination of both • Result in the inability of glucose to be transported from the bloodstream into the tissues, which in turn, results in high blood glucose levels and excretion of sugar in the urine.  Alteration in lipid and protein metabolism. 4. DEFINITIONS • International Diabetes Federation (IDF) describes Diabetes as a chronic disease that arises when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. • According to Carranza, DM is defined as a complex metabolic disorder characterized by chronic hyperglycaemia, diminished insulin production, impaired insulin action or a combination of both result in the inability of glucose to be transported from the blood stream into the tissues, which in turn results in high blood glucose levels and excretion of sugar in the urine. 5. HISTORY • Diabetes is one of the first diseases described with an Egyptian manuscript from 1500 BC mentioning “too great emptying of the urine.” • The term diabetes was probably coined by Apollonius of Memphis around 250 BC, which litera Continue reading >>

The Relationship Between Oral Health And Diabetes Mellitus

ABSTRACT Background The term “diabetes mellitus” describes a group of disorders characterized by elevated levels of glucose in the blood and abnormalities of carbohydrate, fat and protein metabolism. A number of oral diseases and disorders have been associated with diabetes mellitus, and periodontitis has been identified as a possible risk factor for poor metabolic control in subjects with diabetes. Methods The authors reviewed the literature to identify oral conditions that are affected by diabetes mellitus. They also examined the literature concerning periodontitis as a modifier of glycemic control. Results Although a number of oral disorders have been associated with diabetes mellitus, the data support the fact that periodontitis is a complication of diabetes. Patients with long-standing, poorly controlled diabetes are at risk of developing oral candidiasis, and the evidence indicates that periodontitis is a risk factor for poor glycemic control and the development of other clinical complications of diabetes. Evidence suggests that periodontal changes are the first clinical manifestation of diabetes. Conclusions Diabetes is an important health care problem. The evidence suggests that oral health care providers can have a significant, positive effect on the oral and general health of patients with diabetes mellitus. Continue reading >>

Hiv Oral Health And Systemic Health

Over the last several years, some intriguing associations between oral and systemic disease have been reported. If oral conditions really impact the risk for systemic disease, such findings have important implications for the prevention of these systemic diseases. Furthermore, the existence of such associations supports biomedical research on the microinfection theory of cardiovascular disease (CVD) and raises other pathophysiologic questions. Additionally, a causal link between oral conditions and morbidity and mortality would establish the medical model for management of dental caries and periodontal disease. Recent reports have also shown associations between poor oral health, mainly periodontal disease and tooth loss, and increased risk of CVD, pulmonary disease, diabetes, pregnancy outcomes and osteoporosis. A recent review2 lists about 200 possible associations between systemic conditions and oral symptoms or oral manifestations, although for most of these associations, the oral conditions are a consequence rather than a risk factor for the systemic condition. The original focal infection theory, suggested during the 19th century, postulated a causal relationship between infectious diseases and inflammatory changes at distant body sites. Associations between dental diseases and systemic outcomes are potentially important because of the high occurrence of dental diseases. Among the elderly in the United States, about 33% have experienced severe periodontal disease, nearly 40% have lost all of their teeth,6,7 and the prevalence of gingivitis is 48%.8 If this extremely common source of chronic infection (dental disease) leads to an increased mortality rate, the public health impact of oral disease on the health of millions of Americans would be subs Continue reading >>

Diabetes And Oral Health—current Concepts Regarding Periodontal Disease And Dental Caries

Abstract: There are a number of important oral manifestations of diabetes. Periodontal disease and dental caries are the most common oral diseases, and both are modified when diabetes is present. There is an increased prevalence of periodontal disease in patients with diabetes, and periodontal disease can adversely affect glycemic control. Root caries also is more prevalent in patients with diabetes. The sequelae of both periodontal disease and dental caries are infection, pain, tooth loss, and reduced masticatory function. Non-oral health care providers who treat patients with diabetes must be aware of the oral manifestations of the disease and inform patients that ideal oral health is part of comprehensive management of diabetes. Correspondence: Ira B Lamster, DDS, MMSc, Professor, Department of Health Policy and Management, Mailman School of Public Health, Dean Emeritus, College of Dental Medicine, Columbia University, 722 West 168th Street, Room 938, New York, NY 10032, US. E: [email protected] Support: The publication of this article was funded by Colgate-Palmolive Company. The views and opinions expressed are those of the author and not necessarily those of Colgate-Palmolive Company. The increased morbidity and mortality associated with diabetes are well known to health care providers. Retinopathy, nephropathy, macrovascular disease, neuropathy, and poor wound healing can have a major impact on the lives of patients with diabetes. These complications take an enormous personal and financial toll. In addition to these recognized complications, the oral cavity and contiguous structures can be dramatically affected by diabetes. These oral complications are not widely recognized by non-dental health care providers, but can have important effects on quality of life of p Continue reading >>

Periodontal Disease, Insulin Resistance, And Diabetes Mellitus: A Review And Clinical Implications

PERIODONTAL DISEASE, INSULIN RESISTANCE, AND DIABETES MELLITUS: A REVIEW AND CLINICAL IMPLICATIONS This review examines the unique relationships between periodontal diseases and diabetes mellitus (DM). Scientific literature related to possible mechanisms of interaction, with a focus on potential common pathophysiologic pathways, including those associated with inflammation, altered host responses, and insulin resistance, is reviewed. Current evidence suggests that insulin resistance may be a major shared metabolic abnormality linking the interaction of periodontal disease and type 2 DM. As insulin resistance in type 1 patients is less prominent, this relationship may be most significant for type 2 patients. A model is proposed by which chronic inflammation resulting from periodontal disease may contribute to increased insulin resistance in type 2 DM, thus worsening glycemic control. Subsequently, a reduction in periodontal inflammation through treatment may possibly result in enhanced insulin sensitivity and better glycemic control. Understanding these processes will allow health care providers to gain further insight into additional features these diseases share: both conditions are ultimately treatable and in many ways preventable. Citation: Moritz A, Mealey B. Periodontal disease, insulin resistance, and diabetes mellitus: a review and clinical implications. Grand Rounds Oral-Sys Med. 2006;2:13-20. (Digital version Grand Rounds Oral-Sys Med. 2006;2:13-20c.) (A complimentary copy of this article may be downloaded at www.thesystemiclink.com.) Key Words: Periodontal disease, diabetes mellitus, inflammation, insulin resistance, obesity Periodontal disease and diabetes mellitus (DM) are chronic disorders that rely on a major inflammatory component to affect host tissue d Continue reading >>

Periodontal Disease And Control Of Diabetes Mellitus

Data from the Centers for Disease Control and Prevention indicate that more than 20 million people (approximately 7% of the population) in the United States have diabetes mellitus. Physicians often fail to examine the mouths and teeth of their patients, even though the condition of the mouth and teeth have clinical relevance for the treatment of patients with diabetes mellitus. The authors examine the current state of knowledge regarding periodontal disease and the effect of periodontal disease on worsening of glycemic control. They review several studies investigating how the management of periodontal disease affects the ability of patients to control symptoms of diabetes mellitus. The authors conclude with several recommendations for the treatment of patients with periodontal disease to improve glycemic control. A physician's examination of the mouth usually involves a “Say `Ahh...'” and a quick look at the pharynx. Unfortunately, this brief examination is likely to miss important, clinically relevant information.1,2 For example, periodontal disease has the potential to have an adverse impact on glycemic control in patients with diabetes mellitus. Data from the Centers for Disease Control and Prevention (CDC) indicate that more than 20 million people (approximately 7% of the population) in the United States have diabetes mellitus.3 Diabetes mellitus remains undiagnosed in more than 6 million of these individuals, according to CDC estimates.3 Figure 1 lists a number of medical conditions, including periodontitis, gingivitis, lesions, and pigmentation changes, that can be revealed with a thorough examination of the mouth. Family physicians need to recognize how such conditions can affect various disease processes, including that of diabetes mellitus, and refer their Continue reading >>