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Medical Forum / General / Dentistry / December 2005

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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.

Signature

/

Amatus

/

>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.

Signature

/

Amatus

/

> 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)

***************************************************

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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