Dentists Could Play a Future Role in Diagnosing Diabetes

Total Page:16

File Type:pdf, Size:1020Kb

Dentists Could Play a Future Role in Diagnosing Diabetes Dentists Could Play a Future Role in Diagnosing Diabetes By David Stack It is often assumed that a dentist’s influence is limited to the mouth. However, dentists can play an important role in diagnosing systematic disease. New research shows that routine dental exams can find evidence of early diabetes, which allows dentists to help patients avoid serious health problems through early diagnosis. While it is widely known that high body mass index (BMI) is associated with diabetes, it is often less reported that there can be serious periodontal risks as well. A study published in the Journal of the American Dental Association demonstrated that patients who had undiagnosed diabetes mellitus (UDM) were much more likely to also suffer from periodontal diseases. Diabetes impacts nearly 425 million people disease in every APP designated level of severity. globally, and it represents a major cause of damage to These observed outcomes are not isolated, and in the heart, extremities, and oral cavity. As such, the fact, the subJects were drawn from the Atherosclerosis authors of the research reported that since there is a Risk in Communities (ARIC) study, a “large significant association between diabetes, periodontal population-based longitudinal cohort that began in disease, and high BMI, it would be a significant 1987” to observe abnormalities in patients’ arterial contribution to the field of public health if dentists walls. Information was collected from the study would regularly perform screenings for UDM. including patient medical histories, biomarkers, and A common causal factor of insulin resistance oral health screenings. When the populations of the may be the reason for obesity, UDM, and periodontal contributing studies were analyzed for demographic disease working in conjunction to cause illness. data, it became apparent that the large sample sizes’ According to the study, “people who are obese are medical histories, rigorous methodology, and thorough 35% more likely to have periodontal disease and 10 periodontal examinations showed with a high level of times more likely to develop type 2 diabetes than confidence that there was a clear and substantive people of normal weight.” This elevated risk may correlation between UDM, periodontal disease, and cause serious consequences in at risk patients, high BMI. especially in regards to their oral health. Ultimately, the research concludes that in Periodontal disease, or chronic infection of the doing regular diabetes screenings in obese patients oral cavity, leaves patients susceptible to severe and patients with periodontal disease, dental practices infections, discomfort, and in many cases would be able to help identify undiagnosed diabetes. edentulousness (toothlessness). According to the In doing so, dentists would also be able to aid in Centers for Disease Control and American Academy initiating proactive measures to help their patients and of Periodontology (CDC-AAP), both patients with improve both baseline health and quality of life. severe periodontal disease and edentulous patients were highly likely to have UDM. Further, obese David Stack is a Pre-dental student at the Columbia patients had twice the likelihood of having periodontal University. .
Recommended publications
  • Importance of Chlorhexidine in Maintaining Periodontal Health
    International Journal of Dentistry Research 2016; 1(1): 31-33 Review Article Importance of Chlorhexidine in Maintaining Periodontal IJDR 2016; 1(1): 31-33 December Health © 2016, All rights reserved www.dentistryscience.com Dr. Manpreet Kaur*1, Dr. Krishan Kumar1 1 Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak-124001, Haryana, India Abstract Plaque is responsible for periodontal diseases. In order to prevent occurrence and progression of periodontal disease, removal of plaque becomes important. Mechanical tooth cleaning aids such as toothbrushes, dental floss, interdental brushes are used for removal of plaque. However, in some cases, chemical agents are used as an adjunct to mechanical methods to facilitate plaque control and prevent gingivitis. Chlorhexidine (CHX) mouthwash is the most commonly used and is considered as gold standard chemical agent. In this review, mechanism of action and other properties of CHX are discussed. Keywords: Plaque, Chemical agents, Chlorhexidine (CHX). INTRODUCTION Dental plaque is primary etiologic factor responsible for gingivitis and periodontitis [1]. Mechanical plaque control using toothbrushes, interdental brushes, dental floss prevent occurrence of gingivitis. However, in majority of population, mechanical methods of plaque control are ineffective due to less time spent[2] for plaque removal and lack of consistency. These limitations necessitate use of chemical plaque control agents as an adjunct to mechanical plaque control. Among various chemical agents, chlorhexidine (CHX) is considered to be a gold standard chemical agent for plaque control. Its structural formula consists of two symmetric 4-chlorophenyl rings and two biguanide groups connected by a central hexamethylene chain. Mechanism of action for CHX CHX is bactericidal and is effective against gram-positive bacteria, gram-negative bacteria and yeast organisms.
    [Show full text]
  • Probiotic Alternative to Chlorhexidine in Periodontal Therapy: Evaluation of Clinical and Microbiological Parameters
    microorganisms Article Probiotic Alternative to Chlorhexidine in Periodontal Therapy: Evaluation of Clinical and Microbiological Parameters Andrea Butera , Simone Gallo * , Carolina Maiorani, Domenico Molino, Alessandro Chiesa, Camilla Preda, Francesca Esposito and Andrea Scribante * Section of Dentistry–Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy; [email protected] (A.B.); [email protected] (C.M.); [email protected] (D.M.); [email protected] (A.C.); [email protected] (C.P.); [email protected] (F.E.) * Correspondence: [email protected] (S.G.); [email protected] (A.S.) Abstract: Periodontitis consists of a progressive destruction of tooth-supporting tissues. Considering that probiotics are being proposed as a support to the gold standard treatment Scaling-and-Root- Planing (SRP), this study aims to assess two new formulations (toothpaste and chewing-gum). 60 patients were randomly assigned to three domiciliary hygiene treatments: Group 1 (SRP + chlorhexidine-based toothpaste) (control), Group 2 (SRP + probiotics-based toothpaste) and Group 3 (SRP + probiotics-based toothpaste + probiotics-based chewing-gum). At baseline (T0) and after 3 and 6 months (T1–T2), periodontal clinical parameters were recorded, along with microbiological ones by means of a commercial kit. As to the former, no significant differences were shown at T1 or T2, neither in controls for any index, nor in the experimental
    [Show full text]
  • Periodontal Practice Patterns
    PERIODONTAL PRACTICE PATTERNS A Thesis Presented in Partial Fulfillment of the Requirements for the Degree Master of Science in the Graduate School of the Ohio State University By Janel Kimberlay Yu, D.D.S. Graduate Program in Dentistry The Ohio State University 2010 Dissertation Committee: Dr. Angelo Mariotti, Advisor Dr. Jed Jacobson Dr. Eric Seiber Copyright by Janel Kimberlay Yu 2010 Abstract Background: Differences in the rates of dental services between geographic regions are important since major discrepancies in practice patterns may suggest an absence of evidence-based clinical information leading to numerous treatment plans for similar dental problems and the misallocation of limited resources. Variations in dental care to patients may result from characteristics of the periodontist. Insurance claims data in this study were compared to the characteristics of periodontal providers to determine if variations in practice patterns exist. Methods: Claims data, between 2000-2009 from Delta Dental of Ohio, Michigan, Indiana, New Mexico, and Tennessee, were examined to analyze the practice patterns of 351 periodontists. For each provider, the average number of select CDT periodontal codes (4000-4999), implants (6010), and extractions (7140) were calculated over two time periods in relation to provider variable, including state, urban versus rural area, gender, experience, location of training, and membership in organized dentistry. Descriptive statistics were performed to depict the data using measures of central tendency and measures of dispersion. ii Results: Differences in periodontal procedures were present across states. Although the most common surgical procedure in the study period was osseous surgery, greater increases over time were observed in regenerative procedures (bone grafts, biologics, GTR) when compared to osseous surgery.
    [Show full text]
  • Classification and Diagnosis of Aggressive Periodontitis
    Received: 3 November 2016 Revised: 11 October 2017 Accepted: 21 October 2017 DOI: 10.1002/JPER.16-0712 2017 WORLD WORKSHOP Classification and diagnosis of aggressive periodontitis Daniel H. Fine1 Amey G. Patil1 Bruno G. Loos2 1 Department of Oral Biology, Rutgers School Abstract of Dental Medicine, Rutgers University - Newark, NJ, USA Objective: Since the initial description of aggressive periodontitis (AgP) in the early 2Department of Periodontology, Academic 1900s, classification of this disease has been in flux. The goal of this manuscript is to Center of Dentistry Amsterdam (ACTA), review the existing literature and to revisit definitions and diagnostic criteria for AgP. University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands Study analysis: An extensive literature search was performed that included databases Correspondence from PubMed, Medline, Cochrane, Scopus and Web of Science. Of 4930 articles Dr. Daniel H. Fine, Department of Oral reviewed, 4737 were eliminated. Criteria for elimination included; age > 30 years old, Biology, Rutgers School of Dental Medicine, Rutgers University - Newark, NJ. abstracts, review articles, absence of controls, fewer than; a) 200 subjects for genetic Email: fi[email protected] studies, and b) 20 subjects for other studies. Studies satisfying the entrance criteria The proceedings of the workshop were were included in tables developed for AgP (localized and generalized), in areas related jointly and simultaneously published in the Journal of Periodontology and Journal of to epidemiology, microbial, host and genetic analyses. The highest rank was given to Clinical Periodontology. studies that were; a) case controlled or cohort, b) assessed at more than one time-point, c) assessed for more than one factor (microbial or host), and at multiple sites.
    [Show full text]
  • Staging and Grading Periodontitis
    Staging and Grading Periodontitis The 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions resulted in a new classification of periodontitis characterized by a multidimensional staging and grading system. The charts below provide an overview. Please visit perio.org/2017wwdc for the complete suite of reviews, case definition papers, and consensus reports. PERIODONTITIS: STAGING Staging intends to classify the severity and extent of a patient’s disease based on the measurable amount of destroyed and/or damaged tissue as a result of periodontitis and to assess the specific factors that may attribute to the complexity of long-term case management. Initial stage should be determined using clinical attachment loss (CAL). If CAL is not available, radiographic bone loss (RBL) should be used. Tooth loss due to periodontitis may modify stage definition. One or more complexity factors may shift the stage to a higher level. Seeperio.org/2017wwdc for additional information. Periodontitis Stage I Stage II Stage III Stage IV Interdental CAL 1 – 2 mm 3 – 4 mm ≥5 mm ≥5 mm (at site of greatest loss) Severity Coronal third Coronal third Extending to middle Extending to middle RBL (<15%) (15% - 33%) third of root and beyond third of root and beyond Tooth loss No tooth loss ≤4 teeth ≥5 teeth (due to periodontitis) Local • Max. probing depth • Max. probing depth In addition to In addition to ≤4 mm ≤5 mm Stage II complexity: Stage III complexity: • Mostly horizontal • Mostly horizontal • Probing depths • Need for
    [Show full text]
  • The Roots of Periodontology
    THE ROOTS OF PERIODONTOLOGY NMDHA 24th Annual Scientific Session Dennis Miller DMD, MS Diplomate, American Board of Periodontology Oct 19, 2012 A word about the value of history…… Those who don’t know history are destined to repeat it. Edmond Burke (1729-1797) Those of you who don’t remember the past are condemned to repeat it. • George Santayama, 1890 The History of Dentistry • Barbers and blacksmiths were the first dentists in America • 1840 – opening of the first dental school, University of Baltimore • 1859 – ADA was founded, oldest and largest national Dental Society in the world • 1890 – Dr. John Riggs describes periodontal disease • Calls it Riggs disease or pyorrhea • Marketed Anti-Riggs mouthwash (156 proof) • 1896 – Dr. G.V. Black who is known as the father of modern dentistry, describes cavity preparations • 1906 – Dr. C. Edmund Kells exposes first dental radiograph; also the first to use female dental assistants and surgical aspirators • 1929 – Orthodontics recognized as first dental specialty History of Periodontics • 1914 – Dr. Grace Rodgers Spalding and Dr. Gillette Hayden (both physicians) formed the American Academy of Oral Prophylaxis and Periodontology • 1919 – became the American Academy of Periodontology • Circa 1941 - Periodontics recognized as a dental specialty History of Hygiene • 1867 – Lucy Hobbs Taylor graduated from Ohio College of Dental Surgery as a hygienist • 1884 – paper presented at the NY 1st District Dental Society meeting advocating teeth cleaning for prevention, done by “staff” • 1923 – formation of ADHA Historical names of periodontitis • Loculosis • Blennorrhea gingivae • Periostitis • Alveolodental periostitis • Infectious arthrodental gingivitis • Phagedenic pericementitis • Expulsive gingivitis • Symptomatic alveolar arthritis • Smutz pyorrhea • Riggs disease • Periodontoclasia • Pyorrhea alveolaris The roots of Periodontology • The roots of the dental profession including periodontics and dental hygiene were not concocted by some entrepreneur.
    [Show full text]
  • Tobacco and Your Oral Health
    Oral Wellness Series Tobacco and Your Oral Health We all know smoking is bad for us, but did you know that chewing tobacco is just as harmful to your oral health as cigarettes? Tobacco causes bad breath, which nobody likes, but it has far more serious risks to your oral health, including: • Mouth sores • Slow healing after oral surgery • Difficulties correcting cosmetic dental problems • Stained teeth and tongue • Dulled sense of taste and smell The Biggest Risk? Did you know tobacco Cancer. The Centers for Disease Control have linked smoking and use is a huge risk factor tobacco use to oral cancer. Oral cancer is the eighth most common cancer in the U.S., and it’s very difficult to detect. As a result, two- for gum disease? thirds of all cases are diagnosed in late stages, making treatment and survival difficult.1 Tobacco and Gum Disease Tobacco use is also a huge risk factor for gum disease, a leading cause of tooth loss. More than 41% of daily smokers over the age of 65 are toothless because of gum disease, compared to only 20% of non-smokers.2 Maintain good oral health by avoiding tobacco. It keeps your whole body healthier. The Effects of Smoking on Your Gums Smoking reduces blood flow to your gums, cutting Is Smokeless Tobacco Safer? off vital nutrients and preventing bones from healing. Smokeless tobacco—chew, dip and snuff—is not This lets bacteria from tartar infect surrounding tissue, regulated by the FDA so it’s hard to know what’s in it. 3 forming deep pockets between teeth and gums.
    [Show full text]
  • American Academy of Periodontology Task Force Report on the Update to the 1999 Classification of Periodontal Diseases and Conditions*
    J Periodontol • July 2015 American Academy of Periodontology Task Force Report on the Update to the 1999 Classification of Periodontal Diseases and Conditions* The American Academy of Periodontology (AAP) peri- 4 mm CAL, and Severe =‡5 mm CAL.’’ Numerous odically publishes reports, statements, and guidelines important studies since 1999 have used similar pa- on a variety of topics relevant to periodontics. These rameters to define periodontitis. For example, the papers are developed by an appointed committee of recent epidemiologic studies outlining the prevalence experts, and the documents are reviewed and ap- of periodontitis in the United States used attachment proved by the AAP Board of Trustees. loss parameters to define various severities of peri- odontitis.2,3 It is recognized that CAL is of importance for the scientific advancement of the knowledge of n 2014, the American Academy of Periodontology periodontitis. However, in clinical practice, measure- Board of Trustees charged a Task Force to develop ment of CAL has proven to be challenging, and is time Ia clinical interpretation of the 1999 Classification consuming. Measuring the location of the cemento- of Periodontal Diseases and Conditions to address enamel junction (CEJ) when the gingival margin is concerns expressed by the education community, the located coronal to the CEJ is difficult and may involve American Board of Periodontology, and the practic- some guesswork when the CEJ is not readily evident ing community that the current Classification pres- via tactile sensation. These issues can result in ex- ents challenges for the education of dental students aminations being performed in which, rather than and implementation in clinical practice.
    [Show full text]
  • Dentine Hypersensitivity: Analysis of Self-Care Products§
    Periodontics Periodontics Dentine hypersensitivity: analysis of self-care products§ Cassiano Kuchenbecker Rösing(a) Abstract: Dentine hypersensitivity is a condition that is often present in (b) Tiago Fiorini individuals, leading them to seek dental treatment. It has been described Diego Nique Liberman(b) Juliano Cavagni(b) as an acute, provoked pain that is not attributable to other dental prob- lems. Its actual prevalence is unknown, but it is interpreted as very un- pleasant by individuals. Several therapeutic alternatives are available to (a) Professor of Periodontology; (b)Graduate Student, Graduate Program in Dentistry manage dentine hypersensitivity, involving both in-office treatment and – School of Dentistry, Federal University of home-use products. The aim of this literature review was to evaluate self- Rio Grande do Sul, Porto Alegre, RS, Brazil. care products for managing dentine hypersensitivity. Among the prod- ucts available, dentifrices and fluorides are the most studied self-care products, with positive effects. However, a high percentage of individu- als is affected by the placebo effect. Among dentifrices, those containing potassium salts seem to be the most promising. Dental professionals need to understand the advantages and limitations of these therapies and use this knowledge in a positive approach that might help in decreasing den- tine hypersensitivity among patients. Descriptors: Dentin hypersensitivity; Review; Dental devices, home-care. § Paper presented at the “Oral Health Self-Care Products: Realities and
    [Show full text]
  • The Biology of Marine Mammals
    Romero, A. 2009. The Biology of Marine Mammals. The Biology of Marine Mammals Aldemaro Romero, Ph.D. Arkansas State University Jonesboro, AR 2009 2 INTRODUCTION Dear students, 3 Chapter 1 Introduction to Marine Mammals 1.1. Overture Humans have always been fascinated with marine mammals. These creatures have been the basis of mythical tales since Antiquity. For centuries naturalists classified them as fish. Today they are symbols of the environmental movement as well as the source of heated controversies: whether we are dealing with the clubbing pub seals in the Arctic or whaling by industrialized nations, marine mammals continue to be a hot issue in science, politics, economics, and ethics. But if we want to better understand these issues, we need to learn more about marine mammal biology. The problem is that, despite increased research efforts, only in the last two decades we have made significant progress in learning about these creatures. And yet, that knowledge is largely limited to a handful of species because they are either relatively easy to observe in nature or because they can be studied in captivity. Still, because of television documentaries, ‘coffee-table’ books, displays in many aquaria around the world, and a growing whale and dolphin watching industry, people believe that they have a certain familiarity with many species of marine mammals (for more on the relationship between humans and marine mammals such as whales, see Ellis 1991, Forestell 2002). As late as 2002, a new species of beaked whale was being reported (Delbout et al. 2002), in 2003 a new species of baleen whale was described (Wada et al.
    [Show full text]
  • The Dental Office
    GUIDED SURGERY • complete solutions for oral surgery the new generation digital platform iRES® SmartGuide® is the innovative and personalized solution for the entire clinical team-- dentistry that maintains strong ties with the dentistry of the future. iRES® offers dentists a valid system that meets all the patient’s requirements through adequate and personalized solutions planned and achieved using the vast, modern range of Cad Cam technologies with certified materials and executed with absolute excellence. The iRES® system guarantees the right solution for every need, from computer-assisted surgery with all the necessary required computer tools to all components for individual prostheses with 5 axes machine tools that carry out complex, individualized geometries with perfect results- -and all through only one source The dentist uses iRES® SmartGuide® software and with a few simple steps develops his or her own simple treatment plan, if necessary by combining his or her own requisites with our Tutor to achieve personalized assistance SmartGuide®: This is user-friendly software, a cost-contained, state-of- the-art system for quick, smooth ope- rating results—swift and non-traumatic surgery. iRES® offers a new surgery sy- stem using SmartGuide®. iRES® aims at furnishing the professional with an easy and intuitive system that provides both greater accuracy in positioning implan- ts and substantially reduced operating time, thus at once rendering the surgery as un-traumatic as possible. Costs are truly contained. iRES® delivers an overall system that includes: diagno- stic software and surgical/prosthetic planning, creation of the surgical mask, and the surgical kit including all drills ca- librated by diameter for all lengths.
    [Show full text]
  • The Connection Between Socioeconomic Inequalities
    Psychiatria Danubina, 2020; Vol. 32, Suppl. 4, pp S576-582 Medicina Academica Mostariensia, 2020; Vol. 8, No. 1-2, pp 178-184 Original paper © Medicinska naklada - Zagreb, Croatia THE CONNECTION BETWEEN SOCIOECONOMIC INEQUALITIES AND THE APPEARANCE OF THE TOOTHLESSNESS IN MOSTAR Bajro Sariü1, Kristina Galiü2,3, Belma Sariü Zolj3, Zdenko Šarac2, Marina ûurlin2 & Ivan Vasilj2 1Regional Medical Centre Mostar, Mostar, Bosnia and Herzegovina 2Medical School Mostar, Mostar, Bosnia and Herzegovina 3University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina received: 11.12.2019 revised: 7.5.2020 accepted: 7.7.2020 SUMMARY Background: To determine the existence of the toothlessness within the patients in the area of Mostar. The aim is to determine the topography of toothlessness within the population of Mostar, according to Kennedy classification. The aim is to connect measures of socioeconomic status with the appearance of the toothlessness. To develop a model that includes a form of toothlessness and the socioeconomic status of the patients in Mostar. Subjects and methods: The study was conducted at the Health Center in Mostar and the Regional Medical Center in Mostar. The research was cross-sectional study. It included 800 patients who regularlyoccurred to the dental ambulance because of the toothlessness and because of the prosthodontics treatment. The measurement was conducted by the dentist based on the anonymous research cardboard at the first examination of the patient. The dentist will determine the topography of the toothlessness according to Kennedy classification and the etiology of the toothlessness. Results: In the total sample of respondents, the toothlessness was significantly higher represented (P<0.001).
    [Show full text]