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Diabetes Type 2 And Periodontitis

Periodontitis May Be An Early Sign Of Type 2 Diabetes

Periodontitis May Be An Early Sign Of Type 2 Diabetes

Periodontitis may be an early sign of type 2 diabetes A new study suggests severe gum disease - also known as periodontitis - may be an early marker of type 2 diabetes. New research suggests there may be a link between gum disease and diabetes. According to the latest data, diabetes affects approximately 422 million people worldwide, and this number is expected to increase. In the United States, 29 million people live with the disease. Of these, over 8 million people have it but have not been diagnosed, according to the Centers for Disease Control and Prevention (CDC). The CDC also estimate that 37 percent of American adults over the age of 20 have prediabetes. New research - published in the journal BMJ Open Diabetes Research & Care - suggests severe gum disease , or periodontitis , might be an early sign of diabetes. The authors also suggest a simple finger stick diabetes screening procedure could be carried out in the dental office to avoid the adverse effects of leaving diabetes untreated. Studying the link between severe gum disease and diabetes Researchers from the University of Amsterdam in The Netherlands assessed a total of 313 participants from a dental clinic at the university. Of these, 126 patients had mild-to-moderate gum disease, 78 patients had severe periodontitis, and 198 individuals did not have signs of gum disease. Participants with periodontitis had a higher body mass index ( BMI ) than the rest, with an average BMI of 27. However, other diabetes risk factors - such as high blood pressure or high cholesterol - were similar across all three groups. The researchers analyzed higher glycated hemoglobin (HbA1c) values in dry blood spots, and evaluated the differences in mean HbA1c values, as well as the prevalence of diabetes and prediabetes between th Continue reading >>

Periodontitis And Type 2 Diabetes

Periodontitis And Type 2 Diabetes

Periodontitis and diabetes are closely linked, and people who have poorly controlled diabetes are more likely to be affected by periodontitis. This increased risk is primarily linked to the blood glucose levels. When individuals have a high level of glucose in the blood, an infection of the gums is more likely and the symptoms of the condition are often more severe. Additionally, pathological changes to the blood vessels that can occur in diabetic people can also increase their risk of being affected. There are several reasons that people with diabetes are more likely to suffer from periodontitis, such as changes to the blood vessels. Uncontrolled diabetes can cause thickening of blood vessels in the body, which may contribute to the increased risk of periodontitis. Blood vessels are responsible for the removal of waste products and delivery of nutrients all around the body, including dental structures. Thickening of the blood vessel walls can slow down the delivery of nutrients and removal of waste products, thus causing the bodys defenses against infection to become weaker. Many types of bacteria thrive in the presence of sugars such as glucose. People with poorly controlled diabetes have higher levels of glucose in their blood than usual, which can provide the perfect environment for bacteria to proliferate in the mouth and eventually lead to periodontitis. It is for this reason that high blood glucose levels in diabetic can be problematic for dental health. Fortunately, with adequate treatment and preventative techniques it is possible for people with diabetes to reduce the risk of being affected by periodontitis. The first step is to ensure that the blood sugar levels are well controlled with adequate medications. Patients should be encouraged to speak to their do Continue reading >>

Periodontal Disease And Incident Type 2 Diabetes

Periodontal Disease And Incident Type 2 Diabetes

Results from the First National Health and Nutrition Examination Survey and its Epidemiologic Follow-Up Study Abstract OBJECTIVE—Type 2 diabetes and periodontal disease are known to be associated, but the temporality of this relationship has not been firmly established. We investigated whether baseline periodontal disease independently predicts incident diabetes over two decades of follow-up. RESEARCH DESIGN AND METHODS—A total of 9,296 nondiabetic male and female National Health and Nutrition Examination Survey (NHANES I) participants aged 25–74 years who completed a baseline dental examination (1971–1976) and had at least one follow-up evaluation (1982–1992) were studied. We defined six categories of baseline periodontal disease using the periodontal index. Of 7,168 dentate participants, 47% had periodontal index = 0 (periodontally healthy); the remaining were classified into periodontal index quintiles. Incident diabetes was defined by 1) death certificate (ICD-9 code 250), 2) self-report of diabetes requiring pharmacological treatment, or 3) health care facility stay with diabetes discharge code. Multivariable logistic regression models assessed incident diabetes odds across increasing levels of periodontal index in comparison with periodontally healthy participants. RESULTS—The adjusted odds ratios (ORs) for incident diabetes in periodontal index categories 1 and 2 were not elevated, whereas the ORs in periodontal index categories 3 through 5 were 2.26 (95% CI 1.56–3.27), 1.71 (1.0–2.69), and 1.50 (0.99–2.27), respectively. The OR in edentulous participants was 1.30 (1.00–1.70). Dentate participants with advanced tooth loss had an OR of 1.70 (P < 0.05) relative to those with minimal tooth loss. CONCLUSIONS—Baseline periodontal disease is an in Continue reading >>

Does Periodontal Disease Cause Type 2 Diabetes?

Does Periodontal Disease Cause Type 2 Diabetes?

Diabetes has long been a risk factor for periodontal disease; new research may point to reverse causation. Diabetes has long been believed to be a risk factor for periodontal disease. Results of a new study show that the reverse might also be true, according to researchers at Columbia University Mailman School of Public Health. Ryan T. Demmer, PhD, MPH, associate research scientist in the department of epidemiology, said that these findings add a “new twist” to the association, suggesting that periodontal disease may lead to diabetes. “It has been generally accepted that periodontal disease is a consequence of diabetes despite the fact that this association has not been studied with the same methodological rigor applied to coronary and stroke outcomes,” he told Endocrine Today. “We found that over two decades of follow-up, individuals who had periodontal disease were more likely to develop type 2 diabetes later in life when compared to individuals without periodontal disease.” The researchers studied over 9,000 participants without diabetes from a nationally representative sample of the U.S. population, with more than 800 eventually developing diabetes. They then compared the risk of developing diabetes over the next 20 years between people with varying degrees of periodontal disease and found that individuals with elevated levels of periodontal disease were nearly twice as likely to become diabetic in that 20-year timeframe. Demmer said to keep an open mind about the results, however. “They certainly are thought-provoking, biologically plausible and supported by longstanding research regarding periodontal disease and atherosclerotic cardiovascular disease. While there are no immediate clinical implications that stem from these findings, they do suggest a Continue reading >>

Periodontitis Associated With Developments Of Type 2 Diabetes And Its Complications - Oral Disease Treatment Can Help Control High Glycemic Levels

Periodontitis Associated With Developments Of Type 2 Diabetes And Its Complications - Oral Disease Treatment Can Help Control High Glycemic Levels

Periodontitis Associated with Developments of Type 2 Diabetes and its Complications - Oral Disease Treatment can Help Control High Glycemic Levels Critical links between periodontal (gum) disease and the development of type 2 diabetes, as well as the development and progression of its complications, were reported here today in the first ever symposium presented by dentists to diabetes experts at the American Diabetes Association's Annual Scientific Sessions at its 68th such event. "One of the many complications of diabetes is a greater risk for periodontal disease,"said Maria E. Ryan, DDS, PhD, Professor of Oral Biology and Pathology, and Director of Clinical Research, School of Dental Medicine, Stony Brook University, New York, in a recent interview. "If you have this oral infection and inflammation, as with any infection, it's much more difficult to control blood glucose levels." Intensive periodontitis treatment significantly reduces levels of A1C, a measure of glucose control over the prior two to three months. These links between oral and systemic health may start even before clinical diabetes begins. "We have found evidence that the severity of periodontal disease is associated with higher levels of insulin resistance, often a precursor of type 2 diabetes, as well as with higher levels of A1C, a measure of poor glycemic control of diabetes," she said. The importance of these findings were emphasized by her colleague, George W. Taylor, DrPH, DMD, Associate Professor of Dentistry, Schools of Dentistry and Public Health, University of Michigan. "Several recent studies have shown that having periodontal disease makes those with type 2 diabetes more likely to develop worsened glycemic control and puts them at much greater risk of end-stage kidney disease and death," h Continue reading >>

The Influence Of Type 1 And Type 2 Diabetes On Periodontal Disease Progression

The Influence Of Type 1 And Type 2 Diabetes On Periodontal Disease Progression

OBJECTIVE To explore associations between diabetes etiology (type 1 diabetes mellitus [T1DM] vs. T2DM) and glycemic control in the prediction of 5-year periodontal status change. RESEARCH DESIGN AND METHODS The Study of Health in Pomerania (SHIP) is a population-based stratified sample of German men and women. Healthy participants and those determined to have T2DM arose from the SHIP cohort, and T1DM participants were recruited from diabetes clinics in the catchment area that gave rise to SHIP. Dentate participants (n = 2,626; 53% women; 20–81 years of age) were included. Diabetes was determined via physician diagnosis and/or HbA1c ≥6.5% (uncontrolled diabetes >7.0%). Examiners blinded to diabetes status performed random half-mouth periodontal examinations, assessing probing depth (PD) and attachment loss (AL) (four sites/tooth) at baseline and follow-up. Participants were categorized into six groups as follows: 1) diabetes free (n = 2,280), 2) incident T2DM (n = 79), 3) controlled T2DM (n = 80), 4) uncontrolled T2DM (n = 72), 5) controlled T1DM (n = 43), and 6) uncontrolled T1DM (n = 72). In multivariable regressions, mean PD change (ΔMPD), mean AL change (ΔMAL), or incident tooth-loss values were regressed across the aforementioned diabetes categories. RESULTS Mean (SD) ΔMPD and ΔMAL values among all participants were −0.08 ± 0.5 mm and 0.08 ± 1.03 mm, respectively, and 34% lost one or more teeth. Relative to diabetes-free participants, those with uncontrolled T2DM experienced greater ΔMPD ± SE (P < 0.05), whereas participants with either uncontrolled T1DM or uncontrolled T2DM realized greater ΔMAL (P < 0.05). Uncontrolled T1DM and T2DM were both associated with an increased risk of future tooth loss (P < 0.05). CONCLUSIONS Diabetes control, but not eti Continue reading >>

Is Periodontal Disease Influenced By Diabetes Type?

Is Periodontal Disease Influenced By Diabetes Type?

Severity of periodontal disease between type 1 and type 2 diabetes patients…. Periodontal disease, and specifically periodontitis, is an inflammatory disease caused by a chronic bacterial presence that adhere and grow on the tooth surface. This can cause gingival (gum) bleeding, gingival recession, clinical attachment loss (teeth do not attach to gums as well), and the formation of periodontal pockets (spaces between the gum and tooth). A large number of studies have shown that periodontitis is more prevalent and severe in patients with diabetes than those without diabetes, and because of this diabetes has been cited as a significant risk factor for periodontal disease. The majority of research on this subject has been done between periodontal disease and either type 1 or type 2 diabetes, but there have not been any studies that evaluated the association between the severity of periodontal disease with respect to the type of diabetes. A study was done in which patients aged 18-70 were evaluated. Two groups of patients were formed depending on their type of diabetes. A total of 179 randomly selected patients were in the group with type 1 diabetes and 87 randomly selected patients were in the type 2 diabetes group. Periodontal examinations were performed on all patients and were evaluated on 5 parameters: presence of dental plaque, pocket depth, gingival recession, clinical attachment level, and amount of bleeding on probing. The results of the examination showed that the relative values of the periodontal parameters were significantly higher in the type 2 diabetes group, which suggests that the type 2 diabetic group had more severe periodontal pathology than the type 1 group. In conclusion, the risk of having severe periodontitis was twice as high for type 2 diabetics Continue reading >>

Periodontal Disease In Children With Type 2 Diabetes Mellitus

Periodontal Disease In Children With Type 2 Diabetes Mellitus

The incidence of diabetes mellitus in children began increasing 20 years ago. 1 Approximately 8.3% of the U.S. population has diabetes, with nearly 19,000 cases of type 2 diabetes mellitus (T2DM) in children and adolescents. 1,2 The World Health Organization estimates 90% of individuals with diabetes have T2DM. 1 Between 2001 and 2009, researchers from the SEARCH for Diabetes in Youth study found that T2DM in children and adolescents ages 10 to 19 years had increased 21%. 2,3 The prevalence of type 1 and T2DM (predominantly T2DM) is predicted to increase by 54% to over 54 million individuals by 2030. 1,2,4 Reducing the incidence of T2DM may improve the health of children and adolescents, and delayed screening can result in a missed opportunity to impact their health. 2 This article highlights the importance of collaborative care between NPs and dental hygienists in the detection, prevention, and treatment of periodontal disease in children with T2DM. It focuses on the reciprocal relationship between T2DM and periodontitis and the importance of early intervention and interprofessional teams achieving the goals established for Healthy People 2020. The relationship between T2DM and periodontitis in children has not been extensively discussed in the literature. Multiple published studies describe the reciprocal relationship between diabetes mellitus and periodontal disease. 5-7 It is well established that poor oral health can lead to adverse health outcomes. 8 Current data suggest periodontal disease may occur in the tissues from inflammation as a result of elevated blood glucose levels. 6 A higher incidence of periodontal disease in children with poorly controlled blood glucose levels can also result in a negative health outcomes. 7-9 In a hallmark study by Le in 1993, pe Continue reading >>

Original Article Interrelationships Of Periodontitis And Diabetes: A Review Of The Current Literature

Original Article Interrelationships Of Periodontitis And Diabetes: A Review Of The Current Literature

Introduction Diabetesis a disease of metabolic dysfunction characterized by hyperglycemia, giving rise to the risk of several complications including retinopathies, neuropathies, nephropathies, cardiovascular complications,1 and delayed wound-healing.2 It is associated with a reduced life expectancy, significant morbidity due to specific diabetes-related microvascular complications, increased risk of macrovascular complications, such as ischemicheart disease, stroke, and peripheral vascular disease, and a diminished quality of life. Currently, there are three types of diabetes recognized by the World Health Organization (WHO)3: (1) type I diabetes, previously known as insulin-dependent or childhood-onset diabetes (IDDM), is characterized by a lack of insulin production due to destruction of β-cells; (2) type II diabetes, formerly termed non-insulin-dependent diabetes (NIDDM), or adult-onset diabetes, is caused by increasing insulin resistance. It is the major type of diabetes in the adult population and is closely related to obesity4; (3) a third category, hyperglycemia secondary to systemic diseases or conditions,5 includes gestational diabetes3 and diabetes associated with diseases involving the pancreas and destruction of β-cells,6 endocrine diseases,7 tumors,8 a pancreatectomy,9 and drug- or chemical-induced insulin insensitivity or resistance.10 Periodontitis is the consequence of local infections in the oral cavity resulting in irreversible destruction of the tooth attachment apparatus (i.e., alveolar bone, root cementum, and the periodontal ligament).11 One clinical manifestation of periodontitis is the appearance of periodontal pockets, enabling further microbial colonization and challenge. Other manifestations include redness and gingival swelling, pain, and Continue reading >>

Gum Disease

Gum Disease

Tweet Gum disease, also known as periodontal disease, is the sixth most common disease in the world. People with diabetes are more likely to experience gum disease if they’ve had poor blood sugar levels for a long period of time. What is gum disease? Gum disease affects the gums and bone supporting the teeth and eventually leads to tooth loss. The good news, though, is that gum disease is preventable and can be easily treated in the early stages of the disease. What does gum disease have to do with diabetes? People with diabetes have an increased risk of developing gum disease. Poorly managed blood sugar levels can cause damage to nerves, blood vessels, the heart, the kidneys, the eyes and the feet. In the same way, the gums can too be affected. Because high blood sugar levels lead to damage to blood vessels, this reduces the supply of oxygen and nourishment to the gums, making infections of the gums and bones more likely. Uncontrolled blood sugar levels can cause levels of glucose to rise in the saliva and this creates a breeding ground for bacteria, increasing the risk of gum disease and dental decay. Severe gum disease can negatively affect your blood sugar control and increase your chances of suffering from other common long-term complications of diabetes. The inflammation, which occurs in the gums, escapes into the bloodstream and upsets the body’s defence system which in turn affects blood sugar control. In other words, gum disease and diabetes are linked in both directions. The European Federation of Periodontology recommends that following a diagnosis of diabetes you should inform your dentist and undergo a comprehensive dental check up. People with diabetes should have regular dental check-ups, including a review of gum health. If your dentist or hygienist Continue reading >>

Diabetes And Gum Disease: Understanding The Link To Protect Your Health

Diabetes And Gum Disease: Understanding The Link To Protect Your Health

Do you know that there is a link between diabetes and gum disease? Diabetics have a higher risk of developing gum disease than people who have healthy blood sugar levels. The relationship appears to go both ways; research indicates that having a serious gum infection can make it more difficult to control blood sugar levels. Taking care of your mouth, whether you have diabetes or not, is more important than you may be aware of. What Causes the Increased Gum Disease Risk? What do high blood glucose levels have to do with your oral health? For a person with diabetes it is more difficult to defend the body from a bacterial infection; high glucose levels make it easier for bacteria to flourish in the mouth. Gum disease is an inflammation of the gums caused by a bacterial infection. The germs in plaque infect the teeth and gums, leading to gingivitis, the first stage of this disease. If left untreated, this oral health condition can result in tissue damage and eventual tooth loss. The more serious stages of gum disease are known as periodontitis and advanced periodontitis. How Does Periodontitis Affect Diabetes? The relationship between diabetes and gum disease becomes even more powerful when you look at the potential effect of an infection on blood glucose levels. Having a serious infection may contribute to rising blood sugar levels. This means that not only does having diabetes make an infection harder to fight, but also having serious gum disease may make diabetes harder to control. What can be done to prevent your health from spiraling out of control? Even if you don't have blood glucose problems or periodontitis, you should still make your oral health and overall priority. Brush twice a day and floss once a day before bedtime. Use a toothpaste like Colgate Total which w Continue reading >>

Periodontitis And Diabetes: A Two-way Relationship

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 >>

Periodontitis And Its Association With Type 2 Diabetes

Periodontitis And Its Association With Type 2 Diabetes

Cellular inflammation from immune cells appears to be the common biological denominator that is the link between type 2 diabetes and periodontal complications. Abstract Type 2 diabetes and periodontal disease are separate inflammatory diseases that augment each other. A complication such as type 2 diabetes makes people more likely to have problems with oral health and has been shown to promote periodontal disease. In turn, periodontal disease appears to exacerbate type 2 diabetes. Cellular inflammation from immune cells appears to be the common biological denominator that is the link between type 2 diabetes and periodontal complications. Introduction Inflammatory diseases share a common biological denominator which is the ability to produce pro-inflammatory cytokines that play an important role in physiologic regulation of many biological activities. However, inflammatory diseases sometimes produce cytokines at levels that have pathological consequences. The role of cellular inflammation Diabetes affects an increase in periodontal disease through impaired defense mechanisms involving micro- and macrovasculature changes that lead to an increased susceptibility to infection and reduced healing capacity. (1) Insulin resistance is the primary driving force in type 2 diabetes. Adipocytes and macrophages by synthesizing excessive cytokines directly and indirectly affect glucose metabolism (2) and hyperglycemia. This results in an increase in the levels of advanced glycation end products (AGE), which make endothelial cells and monocytes more susceptible to inflammation and lead to an increase in vascular permeability. (3) Inflammation is further exacerbated when a shift toward an increased incidence of periodontal pathogens in diabetic patients (4) causes an alteration from a Continue reading >>

Diabetes And Gum Disease: Understanding The Link To Protect Your Health

Diabetes And Gum Disease: Understanding The Link To Protect Your Health

Do you know that there is a link between diabetes and gum disease? Diabetics have a higher risk of developing gum disease than people who have healthy blood sugar levels. The relationship appears to go both ways; research indicates that having a serious gum infection can make it more difficult to control blood sugar levels. Taking care of your mouth, whether you have diabetes or not, is more important than you may be aware of. What Causes the Increased Gum Disease Risk? What do high blood glucose levels have to do with your oral health? For a person with diabetes it is more difficult to defend the body from a bacterial infection; high glucose levels make it easier for bacteria to flourish in the mouth. Gum disease is an inflammation of the gums caused by a bacterial infection. The germs in plaque infect the teeth and gums, leading to gingivitis, the first stage of this disease. If left untreated, this oral health condition can result in tissue damage and eventual tooth loss. The more serious stages of gum disease are known as periodontitis and advanced periodontitis. How Does Periodontitis Affect Diabetes? The relationship between diabetes and gum disease becomes even more powerful when you look at the potential effect of an infection on blood glucose levels. Having a serious infection may contribute to rising blood sugar levels. This means that not only does having diabetes make an infection harder to fight, but also having serious gum disease may make diabetes harder to control. What can be done to prevent your health from spiraling out of control? Even if you don't have blood glucose problems or periodontitis, you should still make your oral health and overall priority. Brush twice a day and floss once a day before bedtime. Use a toothpaste like Colgate Total which w Continue reading >>

Diabetes And Periodontal Disease

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 >>

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