A Dentist should spot Diabetes !

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'nam vet. - 25 Nov 2008 04:39 GMT

On Mon, 17 Nov 2008 16:58:45 -0000, "Peter"
<peternorthlondon@hotmail.co.uk> wrote:

>I read something recently that looked like sensible research about the

link

>between raised blood glucose and gum disease. I'm looking for any
>respectable research pro or con a link between quiescent dental cysts

and

>raised blood glucose.
>
>Does anyone have information on this?

G'day Peter.

I can only offer some oblique answers.

Thanks Trink and Gys. I've been meaning to up-date that blog
entry since this appeared in Endocrine Today last week:

http://www.endocrinetoday.com/view.aspx?rid=32609
Does periodontal disease cause type 2 diabetes?

"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
³new twist² to the association, suggesting that periodontal
disease may lead to diabetes.

³It 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,² he told Endocrine Today. ³We 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."
<snip>
"³Diabetic patients are more open to the idea of
necessitating a comprehensive periodontal treatment as part
of their control of diabetes, but we need more public
awareness of the need to consult and refer patients to their
dentists to achieve optimal treatment and hopefully early
detection,² said Amar, noting that insurance companies have
already developed plans for patients with diabetes for
coverage of appropriate periodontal therapies."

This appears to be the original study; I haven't had time to
read it in depth yet, but this stands out:
http://www.ncbi.nlm.nih.gov/pubmed/18390797
"We report a positive nonlinear association between baseline
periodontal disease and incident type 2 diabetes in the
NHANES I and NHEFS. This association persisted regardless of
the periodontal disease definition. When compared with
healthy participants, participants with intermediate levels
of periodontal disease had a twofold increased odds of
incident diabetes, and the odds remained elevated among
participants with the highest levels of periodontal
disease."

Cheers, Alan, T2, Australia.
--
d&e, metformin 2000 mg
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (Analysis of a Day's Meals)
http://loraltravel.blogspot.com (Two Indian Hotels: to Sleep,
Perchance...)

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When the Power of Love,replaces the Love of Power.
that's Evolution.

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Mark & Steven Bornfeld - 25 Nov 2008 14:55 GMT

> On Mon, 17 Nov 2008 16:58:45 -0000, "Peter"
> <peternorthlondon@hotmail.co.uk> wrote:
[quoted text clipped - 5 lines]
> and
>> raised blood glucose.

Dental cysts are not a prominent feature in, nor characteristic of
periodontal disease.

>> Does anyone have information on this?
>>
[quoted text clipped - 39 lines]
> read it in depth yet, but this stands out:
> http://www.ncbi.nlm.nih.gov/pubmed/18390797

    The pubmed article is careful to call the association "a predictor"
rather than a cause of diabetes.
    Lately all kinds of medical associations have been proposed for
periodontal disease, broadly implying that periodontal disease has a
role in the progression of (for example) cardiovascular, cerebrovascular
disease, low birth rate, and probably others I'm not aware of. The
working hypothesis is that this is mediated by C-reactive protein. But
periodontal disease and both heart attack and stroke have so many risk
factors in common that I'm suspicious of the studies that claim to have
accounted for so-called "confounding factors". It may eventually prove
to have validity, and I'm not saying it's not a good thing to maintain
the best possible periodontal health. I'm just saying that scaring
patients to "floss or die" is probably not warranted by the information
we have at this point.
    As for diabetes, it is probably true that (at least for type 2
diabetes) there have not been enough well-controlled clinical studies of
the association with periodontal disease. But any dentist will know (if
they have been in practice a while) that the association with type 1
diabetes is very strong. We were told long ago that the well-known
degenerative changes in mid-sized blood vessels seemed to be
contributory. The risk factors for type 2 diabetes are also shared
somewhat with those of periodontal disease. That, coupled with the high
incidence generally of periodontal disease in the adult population, as
well as the really garden-variety of periodontal disease in type 2
diabetes patients (this is not always the case for type 1) raises doubts
in my mind that we have a strong cause-and-effect relationship going on
here.
    I'd love to see the study, though.

Steve

> "We report a positive nonlinear association between baseline
> periodontal disease and incident type 2 diabetes in the
[quoted text clipped - 13 lines]
> http://loraltravel.blogspot.com (Two Indian Hotels: to Sleep,
> Perchance...)

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

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'nam vet. - 30 Nov 2008 17:02 GMT

> Does anyone have information on this?

try the A.D.A.

did you know Periodontal disease is often linked to the control of
diabetes?
patients with inadequate blood sugar control appear to develop P.D. more
often and more severely and they lose more teeth .
read;
"Diabetes & your Oral Health" A.D.A, dec. '07

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When the Power of Love,replaces the Love of Power.
that's Evolution.

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