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Diabetes can cause serious problems in your mouth |  Case studies
Diabetes more info | Dentists Can Screen for Diabetes


A new report suggests that treating gum disease in patients who have diabetes with
procedures such as cleanings and periodontal scaling is linked to 10 to 12 percent
lower medical costs per month.

The findings are encouraging but the study was not designed to firmly establish
cause and effect, said George Taylor, University of Michigan associate professor of
dentistry, who also has an appointment in epidemiology in the U-M School of Public
Health. Taylor led the research project to investigate whether routine, non-surgical
treatment for gum disease is linked to lower medical care costs for people with diabetes.

In periodontal disease, the body reacts to the bacteria causing the gum infection
by producing proteins or chemicals called inflammatory mediators. Ulcers and open
sores in the gums become passageways for these proteins and for the bacteria themselves
to enter the body’s blood circulation. These inflammatory mediators, as well as some
parts of the bacteria, prevent the body from effectively removing glucose, or sugar,
from the blood.

The higher level of blood sugar is known as poor diabetes control. Poor diabetes control
leads to serious diabetes complications such as vision disorders, cardiovascular and
kidney disease and amputations, among others.

Cleanings and other non-surgical periodontal treatment remove the harmful bacteria,
Taylor said. We believe this helps prevent the body from producing those harmful chemicals
that can enter the systemic circulation and contribute to poorer diabetes control.

Blue Care Network provided U-M researchers data from 2,674 patients aged 18-64 who were
enrolled in BCN between 2001 and 2005 and had at least 12 consecutive months of medical,
dental, and pharmaceutical coverage.

We found insured adults with diabetes in Michigan who received routine periodontal
treatment, such as dental cleanings and scaling, have significantly lower medical care
costs than those who do not, Taylor said. These results could be meaningful to
individuals, employers, health care providers and insurers.
The study showed that medical care costs decreased by an average of 11 percent per month
for patients who received one or two periodontal treatment procedures annually compared
to those who received none. For patients receiving three or four annual treatments,
costs decreased nearly 12 percent.

The study also showed that combined medical and pharmaceutical monthly costs were 10
percent lower for patients who received one or two periodontal procedures annually.

Posted in Diabetic Health Tips, Teeth

Diabetes can trigger periodontal problems in children

WEDNESDAY, Feb. 15, 2006 (HealthDay News)
Diabetes' links to gum disease are well-known, but a new study shows it can trigger
periodontal problems in children as young as 6.  Prior to this study, experts believed
the destruction of gums in people with diabetes started at a much later age, and then
increased as they grew older.

In the study, researchers at Columbia University Medical Center in New York City assessed
dental cavities and periodontal disease in 182 children and adolescents (aged 6 to 18)
with diabetes, and in 160 young people without diabetes.

Reporting in the February issue of Diabetes Care, the team found that youngsters with
diabetes had much more dental plaque and gingival inflammation than those without diabetes.
Early signs of gum disease were found in nearly 60 percent of the 6- to 11-year-old children
with diabetes, compared to about 30 percent of nondiabetic children in the same age group.
Nearly 80 percent of the 12-to-18-year-olds had early signs of gum disease.

"Our research illustrates that programs to prevent and treat periodontal disease should be
considered a standard of care for young patients with diabetes," principal investigator
Ira B. Lamster, dean of the College of Dental Medicine, said in a prepared statement.
"Other studies have shown that patients with diabetes are significantly less likely than
those without diabetes to have seen a dentist within the past year," study co-author
Dr. Robin Goland, co-director of the Naomi Berrie Diabetes Center, said in a prepared
statement.

"This was due to a perceived lack of need, so clearly it's important that physicians and
dentists and their patients with diabetes learn that they need to focus extra attention
on oral health," Goland said.

This study is ongoing, and will eventually include 700 volunteers

From: Judy Carroll
To: periotherapistgroup
Sent: Wednesday, April 09, 2008 7:09 AM
Subject: [periotherapist] diabetes, insulin resistance, obesity, and perio

Insulin resistance mediates the relationship between obesity and periodontal disease

Obesity Is a Significant Predictor of Periodontal Disease The relationship between
periodontal disease, obesity and insulin resistance was examined in the Third National
Health and Nutrition Examination Survey (NHANES III). CHICAGO  February 21, 2006

People have a new reason to stick to their New Year’s resolution to lose excess weight
besides fitting into the latest fashion trends. Researchers from University at Buffalo
found that obesity is a significant predictor for periodontal disease, independent of age,
gender, race, ethnicity, and smoking. This study printed in a recent supplement to the
Journal of Periodontology (JOP).

Furthermore, analysis of this national sample suggests that insulin resistance mediates
the relationship between obesity and periodontal disease. It was found that the severity
of periodontal attachment loss increased proportionally with increasing insulin resistance.
In addition, the number of teeth lost increased significantly with increasing levels of
insulin resistance. Individuals in the highest insulin resistance category lost 1.1 more
teeth compared to individuals in the lowest category.

“People who have a higher body mass index produce cytokines (hormone-like proteins),
that lead to systemic inflammation and insulin resistance, said Robert J. Genco, vice
provost at the University at Buffalo and editor of the JOP. "We propose that chronic
stimulation and secretion of proinflammatory cytokines associated with periodontal
infection also occurs, contributing to insulin resistance, which may further predispose
to diabetes mellitus.

Genco and his research team recently showed that diabetics with periodontal disease
may have greater mortality from diabetic complications such as cardiovascular disease
and kidney complications than diabetics with little or no periodontal disease.

The presence of periodontal infection combined with obesity may contribute to type 2
diabetes and its complications, such as coronary heart disease, said Kenneth A. Krebs,
DMD and AAP president. Although further studies are needed, people should remember that
living a healthy lifestyle along with daily brushing and flossing and visiting your oral
health care provider is always in fashion.

DIABETES POWERPOINT PRESENTATIONS

Practical Aspects of Insulin Pumping
Managing Glycemia with Sports and Exercise
How Diabetes Care Impacts Kids and Families
Screening for Eye and Kidney Complications and Dyslipidemia
Genetics, Pre-diabetes and Prevention of Type 1 Diabetes
"Closing the Loop with Insulin Pumps and Glucose Sensors"
Intensive Outpatient Treatment of Children with Diabetes
Enhancing Patient-Provider Communication
Family Approach to Diabetes Management
Practical Aspects of Continuous Glucose Monitoring
Eating Disorders
Celiac Disease and Diabetes
Diabetes Control: Goals and Reality
Diabetes Control: Goals and Reality 2
Top 10 Techniques for Hitting Glycemic Goals
Schools, Rules and Diabetes
Depression and Diabetes: Clinical Assessment and Pharmacotherapy
Sex Education and Pregnancy in Type 1 Diabetes
Management of Type 2 Diabetes in Youth
Diabetic Ketoacidosis Prevention and Treatment
Continuous Glucose Monitoring
A Look into the Future

DIABETES AND DENTAL HEALTH - ARTICLES

Most common dental problems associated with diabetes
Dental care for diabetic patients
Dental care and diabetes
Tooth loss among diabetic patients
Diabetes affects dental health
Diabetes-Related dental problems - symptoms, causes and prevention ...
Dental Distress and TMJ Disorder
Good Oral Care, Not Antibiotics, can Prevent Dental-related Heart Problems
Dental Caries Increments and Related Factors in Children with Type ...
Attributions to dental and diabetes health outcomes
Brazilian Dental Journal - Salivary characteristics of diabetic ...
Both dental and diabetes self-efficacy scores were related to oral health habits ..... 
Treating Diabetic Dental Patients: A Global Problem
Does periodontal disease cause type 2 diabetes?
 Possible link between periodontal disease and coronary heart disease
Periodontal Infections and Coronary Heart Disease
TOOTH LOSS AMONG DIABETIC PATIENTS
Prevent diabetes problems: Keep your teeth and gums healthy
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