Medical Forum / General / Dentistry / December 2005
Any connection between periodontitis and chronic pancreatitis?
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ckouza@eudoramail.com - 15 Dec 2005 04:25 GMT I have both ...
My hypothesis:
Chronic pancreatitis -----> Malabsorption -----> Periodontitis
Plausible?
Amatus Cremona - 15 Dec 2005 12:33 GMT Forget it. Get your teeth scaled and root planed, charted and brush and floss all of them twice a day.
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>I have both ... > [quoted text clipped - 3 lines] > > Plausible? Sdores - 15 Dec 2005 12:38 GMT What is scaled and root planed? I don't have many teeth but I would like to see if I can save the ones I do have. I have one tooth in particle that I think is going to be lost, my crohn's disease is killing my teeth due to absorption issues and bleeding in the past plus my restricted diet can't be helping though I do take a RX supplement to try to help. Thanks in advance. UM MOM Susan
> Forget it. Get your teeth scaled and root planed, charted and brush and > floss all of them twice a day. [quoted text clipped - 6 lines] >> >> Plausible? Amatus Cremona - 15 Dec 2005 12:45 GMT Then, go see a dentist.
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> What is scaled and root planed? I don't have many teeth but I would like > to see if I can save the ones I do have. I have one tooth in particle [quoted text clipped - 12 lines] >>> >>> Plausible? Dartos - 15 Dec 2005 14:00 GMT > Forget it. Get your teeth scaled and root planed, charted and brush and > floss all of them twice a day. Or visit Doctores Dewey Yankem and Howie Slickem.
Dartos
Whamatus - 15 Dec 2005 18:32 GMT >> Forget it. Get your teeth scaled and root planed, charted and brush and >> floss all of them twice a day. > >Or visit Doctores Dewey Yankem and Howie Slickem. > >Dartos New one to me ! --
Whamatus Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com
Whamatus - 15 Dec 2005 18:30 GMT What about pancreas hygiene ?
Less sugar ?
>Forget it. Get your teeth scaled and root planed, charted and brush and >floss all of them twice a day. [quoted text clipped - 6 lines] >> >> Plausible? --
Whamatus Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com
Sdores - 15 Dec 2005 12:41 GMT I am not a dentist but I do have crohn's. If you are having absorption issues, a blood test can help you know for sure. I have heard from others that pancreatic disease can cause problems with the teeth due to absorption problems and bleeding and probably other things too. UM MOM Susan
>I have both ... > [quoted text clipped - 3 lines] > > Plausible? Mark & Steven Bornfeld - 15 Dec 2005 14:32 GMT > I have both ... > [quoted text clipped - 3 lines] > > Plausible? Speculative. What do you think isn't being absorbed that would contribute to periodontitis?
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
Sue - 15 Dec 2005 21:13 GMT > > I have both ... > > [quoted text clipped - 14 lines] > Brooklyn, NY > 718-258-5001 Speculative as well:
Chronic pancreatitis can cause type II diabetes; diabetics are more prone to periodontitis
Chronic pancreatitis is often caused by heavy alcohol and tobacco use. We know these habits are associated with poor gum health
Chronic pancreatitis results in poor lipid metabolism and poor glycemic control. Perhaps the latter may adversely affect gum health
-Sue
Mark & Steven Bornfeld - 15 Dec 2005 21:26 GMT >>>I have both ... >>> [quoted text clipped - 27 lines] > > -Sue I do not know what the nature of the link is between diabetes and damage to medium-sized blood vessels, as seen in diabetic nephropathy, neuropathy, retinopathy, etc. It seems logical that a similar mechanism may be responsible between the association between diabetes and periodontitis. I can tell you that chronic alcohol and tobacco use are associated with periodontitis, but have no reason to believe this is due to abnormal pancreatic function.
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
Sue - 15 Dec 2005 21:41 GMT > >>>I have both ... > >>> [quoted text clipped - 38 lines] > > Steve
> Mark & Steven Bornfeld DDS > http://www.dentaltwins.com > Brooklyn, NY > 718-258-5001 "I can tell you that chronic alcohol and tobacco use are associated with periodontitis, but have no reason to believe this is due to abnormal pancreatic function."
Reply. Exactly my point. The cause-effect relationship has not been established, at least as far as I know (but I have not studied this)
Point. If there is a correlation with periodontitis, this may not be due to poor pancreatic function, but rather, the bad habits that cause poor pancreatic fucntion.
Re: Diabetes. I do not know the etiological relationship of diabetes and periodontitis. I just know there is an association.
Hypotheses only:
We know that circulation is impaired and diabetics have a higher propensity for infection... so maybe this also affects healthy circulation to the gums? (More prone to bacteria infection)
We know that diabetics have poorer glycemic control and perhaps this affects the gums? (more prone to tooth decay and this leads to gum disease)
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These are wild guesses. I am only curious.
Sound plausible at all?
Thanks, Sue
Mark & Steven Bornfeld - 15 Dec 2005 22:56 GMT >>>>>I have both ... >>>>> [quoted text clipped - 77 lines] > Thanks, > Sue Could be almost anything. I have not heard that (for example) the carbohydrate content of crevicular fluid may be higher, and this could affect the bacterial flora. I am not aware of any correlation between diabetes and caries, which one might expect if this were the case.
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
Dartos - 16 Dec 2005 13:27 GMT Adult onset diabetics are usually on 'several' medications. These have symptoms and problems themselves which may be part of any other health condition with these people.
Pretty hard to make any direct correlations from the disease itself.
Dartos
> Could be almost anything. I have not heard that (for example) the > carbohydrate content of crevicular fluid may be higher, and this could > affect the bacterial flora. I am not aware of any correlation between > diabetes and caries, which one might expect if this were the case. > > Steve Sue - 15 Dec 2005 21:54 GMT > >>>I have both ... > >>> [quoted text clipped - 40 lines] > > --
> Mark & Steven Bornfeld DDS > http://www.dentaltwins.com > Brooklyn, NY > 718-258-5001 I just found this link. This explains how diabetes may adversely affect gum health
http://www.healthsystem.virginia.edu/uvahealth/adult_diabetes/oral.cfm
-Sue
Mark & Steven Bornfeld - 15 Dec 2005 23:02 GMT >>>>>I have both ... >>>>> [quoted text clipped - 52 lines] > > -Sue Thanks for the link. Yes, that is the working presumption, that vascular function is impaired. But that doesn't really tell us what is going on. There is a heavy immunological component to the periodontitis process. For that matter, I've heard that there is an immunological component to diabetes. Some (IIRC type I) diabetics require a significantly higher amount of insulin to control blood glucose than a normal person produces. Even very fine control of blood glucose does not eliminate many of the late sequellae of DM. This is important stuff. Diabetes research doesn't get the flashy media coverage that cancer, heart disease or HIV research gets, but I believe it's still the 4th leading cause of death in the U.S.
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
Sue - 16 Dec 2005 00:27 GMT > >>>>>I have both ... > >>>>> [quoted text clipped - 68 lines] > > --
> Mark & Steven Bornfeld DDS > http://www.dentaltwins.com > Brooklyn, NY > 718-258-5001 Dr. Bornfeld,
Thank you. Yes. Diabetes awareness is so important! Diabetes Type II is on the rise as our obesity rates climb. Diabetes is often a comorbidity found in combination with metabolic syndrome, CAD, heart disease and/or heart failure... as well as periodontal disease... and can cause additional problems, such as you mentioned: glaucoma, cataracts, peripheral neuropathy....
We provide an insulin pump and a continuous glucose monitor device, so we are doing our part in education and awareness (I hope).
You said: "I've heard that there is an immunological component to diabetes."
Reply. The immunological component of ALL of these diseases interests me greatly. The role that proinflammatory cytokines play in the pathological disease process (both of autoimmune and other origin) has become a great topic of research.
We now believe that compensatory mechanisms (in heart failure):
i.e. immunological, sympathetic adrenergic, and renin-angiotensin system responses all interact with and augment one another.
Although these are necessary repsonses for maintaining adequate cardiac output in the failing heart, on a cellular level, these are doing great harm (remodeling of cardiac tissue, hypertrophy and dilation, apoptosis, breakdown of myocardial collagen by metalloproteinases, etc.)
So we try ot block someof these mechnisms using drugs (B-Blockers, ACE inhibitors, angiotensin receptor blockers, etc.)
However in retrospect, we have found that blocking some of these pathways can actually be dangerous too. Enbrel (a TNF-alpha inhibitor) works well in RA patients, but in clinical study it actually caused increased mortality in heart failure patients. (bummer)
IMHO we need to learn how to modulate the immune response, not stomp it out.
-Sue
Sue - 15 Dec 2005 22:01 GMT > > I have both ... > > [quoted text clipped - 14 lines] > Brooklyn, NY > 718-258-5001 Speculative as well -chronic pancreatitis can cause diabetes. Diabetics are more prone to periodontitis than non-diabetics
-chronic pancreatitis is often caused by heavy alcohol and tobacco use... and we all know the association of these habits and periodontitis
-chronic pancreatitis results in poor lipid metabolism as well as poor glycemic control. Perhaps the latter may have an indirect effect on gum health
-Sue
ckouza@eudoramail.com - 16 Dec 2005 07:43 GMT > Speculative. What do you think isn't being absorbed that would > contribute to periodontitis? I don't know ... just a shot in the dark. I left out some things: I've never drunk alcohol or smoked (second-hand smoke as a kid); I have recurring moderate colitis; I may have primary schlerosing cholangitis (if so, I've been in remission for almost a decade); I don't take mulitvitamins or herbs or anything like that (besides, multivitamins trigger my pancreatitis ... I think it's the minerals); I'm 30 and I've only had two fillings.
Yeah, I know, it's a big mess ... But, over time I've optimized my diet to minimize any pancreatic issues (i.e. no fatty meals, nothing fortified with iron, calcium, etc.. And everything else seems to be in long-term remission.
On second thought, my hypothesis is probably flimsy at best ... because my dental "issues" seemed to arise quickly when I turned 28 or 29. Still, I can't see how flossing twice a day will help. I floss every night. I drink mostly water ... no sugary beverages. I don't eat many sweets. I assume my dentist and hygenist are adequate (on-campus USC faculty group practice -- every three months).
Sue - 16 Dec 2005 15:30 GMT > > Speculative. What do you think isn't being absorbed that would > > contribute to periodontitis? [quoted text clipped - 18 lines] > sweets. I assume my dentist and hygenist are adequate (on-campus USC > faculty group practice -- every three months). To the originator of this thread,
I am sorry. I did not mean to imply that you personally were a heavy drinker or smoker, I was just speculating on disease association, based upon population statisitcs.
As far as your gums go... I do not know if dentists agree with this, but I have done this in the past when my gums bled a little after flossing. It seemed to help a lot:
I would swish hydrogen peroxide in my mouth for about 10 minutes. I would do this daily and within 3-4 days my gums stopped bleeding. So maybe it might help a little?
Best wishes,
Sue (nondentist)
kureforcrohns@sbcglobal.net - 16 Dec 2005 16:28 GMT Long and boring and time perhaps better spent elsewhere. Skip this post if you have heard of crohns and teeth before It is not just teeth and crohns, it is crohns of the digestive system, crohns of the confusion and depression of the mind, crohns of the eyes, crohns of Pyoderma Gangreosum ) or crohns of whatever else you can think of that the body is capable of going haywire. Subect: O/T perhaps depending on how you look at crohns illness and how it affects the teeth. If your dental issues arised quickly at a certain age, it is possible it is due to Regional Enteritis, now called Crohns Illness. The clue is that you had colitis on and off. Crohns symptoms are sometimes subtle (as in the teeth and gums) in addition to colitis or a myriad of other symptoms not recognized as from crohns. My gums started bleeding one day for no reason (never did before) but knew what caused it. Crohns is a strange malady, manmade, brought on by a person you would know and be in some kind of relationship with that happens to be on a stimulant. The person plus the stimulant can transmit harm via mind/body connection to an innocent person not on meds (you). Stimulants are anti-depressants, anti-anxiety drugs, xanax, buspar, depakote, flexeril, marijuana, cocaine, herbs w/stimulants, kava kava, st johns wort etc. etc. etc. Stranger still is the fact that you need not be in the same room to be affected, you can be miles apart. Only the mind connection is at work. hardly anyone can believe what one person ingests can harm another, but scientific or not, that is the crux of the problem. Solving this problem could also help the pancreatitis. Try to relate, at least to rule out this factor.. I could be wrong in your case, but I think not. You cannot do any harm by relating to this, crohns is a problem affecting the immune system. A good diet is important, but getting to the root of the problem is what will put you in a neutral state as you once were. Good luck. Dentists, physicians, do not consider this a valid theory. Even Northwestern Medical School thinks crohns is caused by a genetic factor. It is an almost impossible theory for the researchers, etc, to accept. But considering the numbers of sufferers should say something about the cause possibly being weird, and simple or difficult depending on how one views the progress of crohns. Treatment is improving, but why should millions have to be treated . Gail Michael
> > Speculative. What do you think isn't being absorbed that would > > contribute to periodontitis? [quoted text clipped - 18 lines] > sweets. I assume my dentist and hygenist are adequate (on-campus USC > faculty group practice -- every three months). Sue - 16 Dec 2005 19:25 GMT > > Speculative. What do you think isn't being absorbed that would > > contribute to periodontitis? [quoted text clipped - 18 lines] > sweets. I assume my dentist and hygenist are adequate (on-campus USC > faculty group practice -- every three months). If multivitamins trigger your pancreatitis and you do not eat anything fortified with iron or calcium, how do you get sufficient vit D and calcium? Maybe Gail can chime in here, but it seems like you may be vitamin deficient.
It does sound like you may be immunosuppressed. I think that is what Gail was mentioning. Do you know if your pancreatitis is of autoimmune origin? You mentioned primary schlerosing cholangitis. Were you ever diagnosed? If so did you receive treatment? If so, what was done?
Just curious. Thanks,
Sue (non-dentist and non-doctor)
kureforcrohns@sbcglobal.net - 16 Dec 2005 23:14 GMT Sue,
You are the first person, more or less, that gives any credibility to what I write about crohns. It is simply a misunderstood situation that can and does happen to millions of people here and other parts of the world. And if a person finds that it is a helpful message, very seldom do they acknowledge it. And the research involves billions of dollars. Talking to someone at Northwestern University saying that it is genetic, is exactly how little is known. That is such an impossible cause to crohns. The dentist did clean my teeth at the time, but I have tried to steer the illness in another direction, by drinking skim milk and taking calcium. However, I do not wish to tell this person what to do as everyone must find what works best for them. So variable are the symptoms and workings of crohns. It would be of benefit if the person relates to this (after ruling out any organic illness) to detach their self from anyone on stimulants. It is sad, that we must drop friendships for this strange reason. On upon one examination, I was found to have a trace of diabetes. Fortunately that was not the case upon further testing. But this is an example of what can happen when under the influence of stimulants. The enormity and ignorance of the problem is something that no one wishes to even understand. It is just an illness that makes no sense, and some of the treatments they come up with make as little sense. Or at least in the complexity. Remicade is a favorite treatment, a $5,000 to $10,000 process. Some medications are bound to help, but nothing can take the place of awareness. It will continue to be an escalating problem until someone can figure it out and be a better messenger than I. I am sorry this person's problem is periodontitis, that is one of the difficult symptoms. Regular cleanings will help, but as you say, Sue, Vitamin D and calcium is necessary unless the diet is so good as to make up for its lack. I think this subject is not entirely correct for this newsgroup. In fact, I don't know where there is an audience for this subject. Even people with crohns reject it. The dentist can only treat what he sees, I don't think the underlying factors are known to them. Some people never have heard of crohns so it is really not a mainstream illness. I keep wondering if it is even taught in medical school. Out of necessity the GI physician must become familiar with it. The dentists have no reason to think along these lines. Talk about a saviour, this condition desperately needs one. Gail
Sue - 18 Dec 2005 18:16 GMT > Sue, > [quoted text clipped - 36 lines] > Talk about a saviour, this condition desperately needs one. > Gail Hi Gail,
Thank you. I only wish that a physician could come here and and speak to these discussions.
One thing I would like to mention to dentists here and this is NOT meant in disrespect. When someone suffers from a debilitating chronic illness, oftentimes a peroson becomes somewhat of an expert on this illness. Granted these "patients" may not carry the credentials (MD title), but they become active researchers into their own illness.
I have a friend whose son developed seizures at 6 months. These were not controlled by medications and he was left with severe brain damage. He was also diagnosed with autism. My college-degreed friend (but not an MD) has researched everything under the sun related to autism. Her husband is a dentist and has reviewed much of what she has found.
Together they have become "experts" and their own advocates re: their son's affiction.
Never underestimate a patient's ability to understand their own illness.
Respectfully, Sue PS Gail I wish you well. I am sorry that I cannot be a savior for crohn's diesase, as i do not have the proper credentials, but I sincerely wish you well. We are here to listen to and respect one another, IMHO. ... and I can do that.
Whamatus - 18 Dec 2005 18:26 GMT >Hi Gail, > >Thank you. I only wish that a physician could come here and and speak >to these discussions. This is a Dental group. Duh !
>One thing I would like to mention to dentists here and this is NOT >meant in disrespect. B*llSh*t.
Go back to the Crohns group. / -- Whamatus wubbabubbazG@RBAGEyahoo.com
ckouza@eudoramail.com - 17 Dec 2005 01:09 GMT > how do you get sufficient vit D and calcium? I should have gotten a blood workup before I posted here ... However, being a male 30 year old, it's improbable that I'm calcium deficient.
Yeah, I was diagnosed with PSC almost ten years ago. I was on prednisone and azathioprene for a couple years, and the drug that pre-dated Asacol. I'm currently on a very low dose of Asacol -- one pill a day (my GI doctor has given me the latitude to adjust Asacol dosage as needed).
I'm glad to know there are people thinking about new connections on this board. We're venturing outside of dentistry here, but modern medicine is all about interdisciplinary analysis.
A suggestion for Sdores, who is trying to save her teeth: While perusing the FDA Advisor, I noticed that decapinol has been granted approval ... I don't know much about it, but it may be worth a try.
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