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Yu SY, Lee SK, Yang B, Lee H, Jeon HJ, Lee DH. Glycemic Control and Oral Health Outcomes in Patients With Diabetes: Insights From a Nationwide Korean Survey. J Korean Med Sci 2024; 39:e209. [PMID: 38915285 PMCID: PMC11196857 DOI: 10.3346/jkms.2024.39.e209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/04/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Diabetes is recognized as a risk factor for various inflammatory conditions, including periodontitis. There exists a bidirectional relationship between glycemic control and oral health in individuals with diabetes. This study aimed to analyze the link between glycemic control and oral health status among Korean patients with diabetes. METHODS Using data from a population-based nationwide survey conducted between 2007 and 2019, we identified 70,554 adults with diabetes-related information. The study population included 9,090 individuals diagnosed with diabetes and 61,164 healthy controls. The association between glycemic control, defined by mean glycated hemoglobin (HbA1c) values, and various oral health measures, such as tooth brushing frequency, periodontitis, denture wearing, Decayed, Missing, and Filled Teeth (DMFT) index, number of remaining teeth, and past-year dental clinic visits, was evaluated using multivariate logistic regression analyses. RESULTS Compared to the control group, patients with diabetes exhibited a higher prevalence of periodontitis (88.6% vs. 73.3%), complete dentures (5.0% vs. 1.5%), and elevated DMFT index (33.2% vs. 26.7%) (all P < 0.001). Multivariate analyses revealed significant associations between diabetes and several oral health factors: denture status (No denture: adjusted odds ratio [aOR], 0.784; 95% confidence interval [CI], 0.627-0.979), and having fewer permanent teeth (0-19) (aOR, 1.474; 95% CI, 1.085-2.003). Additionally, a positive correlation was found between higher HbA1c levels and the risk of having fewer remaining teeth (0-19) (HbA1c < 6.5%: aOR, 1.129; 95% CI, 0.766-1.663; 6.5% ≤ HbA1c < 8.0%: aOR, 1.590; 95% CI, 1.117-2.262; HbA1c ≥ 8%: aOR, 1.910; 95% CI, 1.145-3.186) (P for trends = 0.041). CONCLUSION We found a positive association between diabetes and poor oral health, as well as a noteworthy relationship between reduced permanent teeth (≤ 19) and glycemic control. These insights emphasize the critical role of oral health management in diabetic care and underscore the importance of maintaining effective glycemic control strategies for overall health and well-being in patients with diabetes.
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Affiliation(s)
- Song-Yi Yu
- Department of Prosthodontics, Dental Clinic Center, Chungbuk National University Hospital, Cheongju, Korea
| | - Sun-Kyung Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- Department of Mathematics, College of Natural Sciences, Hanyang University, Seoul, Korea
| | - Bumhee Yang
- Division of Pulmonary Medicine, Department of Internal Medicine, Chungbuk National University College of Medicine and Chungbuk National University Hospital, Cheongju, Korea
| | - Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hyun Jeong Jeon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungbuk National University College of Medicine and Chungbuk National University Hospital, Cheongju, Korea
| | - Dong-Hwa Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungbuk National University College of Medicine and Chungbuk National University Hospital, Cheongju, Korea.
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Xue Y, Tang Y, Ren Z, Linke L, Liu Y, Xie J. Association between blood ethylene oxide levels and the prevalence of periodontitis: evidence from NHANES 2013-2014. Clin Oral Investig 2024; 28:293. [PMID: 38695956 DOI: 10.1007/s00784-024-05690-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 04/24/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND The study aimed to establish a link between blood ethylene oxide (EO) levels and periodontitis, given the growing concern about EO's detrimental health effects. MATERIALS AND METHODS The study included 1006 adults from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) dataset. We assessed periodontitis prevalence across groups, used weighted binary logistic regression and restricted cubic spline fitting for HbEO-periodontitis association, and employed Receiver Operating Characteristic (ROC) curves for prediction. RESULTS In the periodontitis group, HbEO levels were significantly higher (40.57 vs. 28.87 pmol/g Hb, P < 0.001). The highest HbEO quartile showed increased periodontitis risk (OR = 2.88, 95% CI: 1.31, 6.31, P = 0.01). A "J"-shaped nonlinear HbEO-periodontitis relationship existed (NL-P value = 0.0116), with an inflection point at ln-HbEO = 2.96 (EO = 19.30 pmol/g Hb). Beyond this, ln-HbEO correlated with higher periodontitis risk. A predictive model incorporating sex, age, education, poverty income ratio, alcohol consumption, and HbEO had 69.9% sensitivity and 69.2% specificity. The model achieved an area under the ROC curve of 0.761. CONCLUSIONS These findings suggest a correlation between HbEO levels and an increased susceptibility to periodontitis.
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Affiliation(s)
- Yan Xue
- Department of Pediatrics, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, 610031, China
- Medical Research Center, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China
| | - Yujing Tang
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, 610031, China
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, 610031, China
- Medical Research Center, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China
| | - Zhengyun Ren
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, 610031, China
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, 610031, China
- Medical Research Center, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China
| | - Li Linke
- Department of Pediatrics, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, 610031, China
- Medical Research Center, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China
| | - Yanjun Liu
- Institute of Biomedical Engineering, College of Medicine, Southwest Jiaotong University, Chengdu, Sichuan, 610031, China.
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, 610031, China.
- The Third People's Hospital of Chengdu, Sichuan, 610031, China.
| | - Jiang Xie
- Department of Pediatrics, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China.
- The Third People's Hospital of Chengdu, Sichuan, 610031, China.
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Chen A, Ng ST, Goh V, Siu SC, Yeung K, Tsang YC, Wang Q, Leung WK. Assessing oral health and the minimally important differences in oral health-related quality of life of non-diabetic and diabetic patients: a cross-sectional study. Aust Dent J 2024. [PMID: 38525834 DOI: 10.1111/adj.13017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Non-diabetics and diabetics might have different oral health problems and impacts on their oral health-related quality of life (OHRQoL). Comparison of oral health status and coping strategies between these patients, and evaluation of factors associated with OHRQoL might facilitate better treatment planning for improved patient-centred outcome. METHODS One hundred and eleven non-diabetics and 107 diabetics attending a public hospital were clinically examined and evaluated for coping strategies (abbreviated coping orientation to problems experienced) and OHRQoL [short-form oral health impact profile (OHIP-14S)]. Factors associated with OHRQoL were analysed through correlation/partial correlation. Minimally important differences (MID) of OHIP-14S were calculated to confirm associations between attachment loss, caries, and tooth loss with OHRQoL. RESULTS Non-diabetics had worse periodontal status. Diabetics had more missing teeth. Non-diabetics and diabetics employed maladaptive coping to manage oral health problems. Overall, non-diabetics reported worse OHRQoL. Determination of MID showed that non-diabetics with high-severe attachment loss and <20 teeth experienced poorer OHRQoL. Diabetics with caries, high-severe attachment loss, and <25 teeth experienced poorer OHRQoL. CONCLUSION Different factors were associated with OHRQoL of non-diabetics and diabetics. Delivery of treatment aimed at maintaining teeth in a periodontally healthy and caries free state, and provision of more chewing units might help improve OHRQoL of diabetics. © 2024 Australian Dental Association.
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Affiliation(s)
- A Chen
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - S T Ng
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - V Goh
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - S-C Siu
- Department of Medicine and Rehabilitation, Integrated Diabetes Mellitus Research and Training Centre, Tung Wah Eastern Hospital, Hospital Authority, Hong Kong, SAR, China
| | - Kws Yeung
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Y C Tsang
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Q Wang
- Department of Prosthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - W K Leung
- Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
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Ghanem AS, Nagy AC. Oral health's role in diabetes risk: a cross-sectional study with sociodemographic and lifestyle insights. Front Endocrinol (Lausanne) 2024; 15:1342783. [PMID: 38516406 PMCID: PMC10955347 DOI: 10.3389/fendo.2024.1342783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/20/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction Diabetes, a key chronic non-communicable disease, poses a substantial public health burden. The role of oral health as a determinant in the epidemiology of diabetes mellitus, particularly in the Central Eastern European region, remains underexplored. This research aims to examine the impact of specific oral health parameters, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on diabetes prevalence. Additionally, it seeks to clarify the moderating effects of socio-demographic and lifestyle variables on this relationship. Materials and methods Data were extracted from the 2014 and 2019 datasets of the Hungarian European Health Interview Survey, comprising a combined nationally representative sample of 11,429 participants. Descriptive statistics were presented as weighted proportions and unweighted counts, and weighted Pearson's chi-squared tests were employed for assessing associations and goodness-of-fit. Significant predictors were integrated into weighted multiple logistic regression models for analysis. Sensitivity analysis was then conducted to confirm the robustness of the findings. Results The study identified 'Bad' self-perceived oral health as a diabetes risk (OR=1.35; 95% CI: [1.04-1.75]), with filled teeth being protective (0.65 [0.51-0.84]). Subgroup analysis revealed higher diabetes odds among individuals with primary education (1.41 [1.02-1.96]) and rural residents with tooth loss from decay (3.54 [1.36-9.19]). The bootstrap analysis with 1,000 iterations reaffirmed the model's stability and predictive accuracy for diabetes. Discussion Enhanced oral health is associated with lower risk factors for diabetes. This research highlights the importance of including oral health measures in comprehensive diabetes management approaches.
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Affiliation(s)
| | - Attila Csaba Nagy
- Department of Health Informatics, Institute of Health Sciences, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
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Gupte R, Shetty M, Hegde C. Influence of wearing complete denture on the glycemic control, serum lipid, and proteins in patients with diabetes. J Indian Prosthodont Soc 2023; 23:259-265. [PMID: 37929365 PMCID: PMC10467312 DOI: 10.4103/jips.jips_284_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 10/05/2023] Open
Abstract
Aims The aim of this study was to assess the impact of prosthodontic rehabilitation on glycemic and lipid control in functionally and completely edentulous patients with diabetes. Setting and Design An in vivo study conducted with the intention of studying the potential link between edentulism and impaired masticatory efficiency with the nutritional status in diabetic patients. Materials and Methods A total of 20 diabetic patients based on the inclusion criteria were selected. They were rehabilitated using a removable prosthesis, and observations were made across three parameters - glycosylated hemoglobin (HbA1C), serum cholesterol (S col), and serum protein (SP) at three stages - baseline, 3 months, and 6 months posttreatment. This was done to gauge the impact of the prosthetic rehabilitation on their health due to an increased masticatory efficiency potentially causing changes in dietary patterns. Statistical Analysis Used •Inter group comparison (>2 groups) was done using one way ANOVA followed by pair wise comparison using post hoc test. •Intra group comparison was done using repeated measures ANOVA (for>2 observations) followed by post Hoc test. For all the statistical tests, P < 0.05 was considered to be statistically significant, keeping α error at 5% and β error ati20%, thus giving a power to the study as 80%. Results Hba1c at the baseline had a mean value of 8.04%, which reduced to 7.87% at the 3-month stage and 7.38% at the 6-month stage. S col at the baseline had a mean of 151.6 mg/dL; at the 3-month follow-up, it was 166.5 mg/dL, and at the 6-month follow-up, it was 173.95 mg/dL. SP had a mean baseline value of 6.38 mg/dL, which progressed to 6.67 mg/dL at the 3-month stage and 6.97 at the 6-month stage. Conclusion Within the limitations of this study, it can be concluded that after 6 months of prosthetic rehabilitation in edentulous/functionally edentulous patients: There was a reduction in HbA1c (8.04%-7.38%); however, it was found to be statistically insignificant at that stage There was an increase in S col (151.6 mg/dL-173.95 mg/dL); it was found to be statistically significant There was an increase in SP (6.38 mg/dL-6.97 mg/dL); however, it was found to be statistically insignificant at that stage.
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Affiliation(s)
- Rishabh Gupte
- Department of Prosthodontics and Crown and Bridge, AB Shetty Memorial Institute of Dental Sciences, Nitte Deemed to be University, Mangalore, Karnataka, India
| | - Manoj Shetty
- Department of Oral Implantology, AB Shetty Memorial Institute of Dental Sciences, Nitte Deemed to be University, Mangalore, Karnataka, India
| | - Chethan Hegde
- Department of Prosthodontics and Crown and Bridge, AB Shetty Memorial Institute of Dental Sciences, Nitte Deemed to be University, Mangalore, Karnataka, India
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Matsuyama Y, Jürges H, Listl S. Causal Effect of Tooth Loss on Cardiovascular Diseases. J Dent Res 2023; 102:37-44. [PMID: 36081340 DOI: 10.1177/00220345221120164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Many studies suggest associations between oral health and cardiovascular diseases, but there is a lack of causal evidence. Exploiting exogenous variation in tooth loss in US adults due to differential childhood exposure to fluoridated water, this study investigated the causal effect of tooth loss on cardiovascular diseases. A total of 722,519 participants in the Behavioral Risk Factor Surveillance System (BRFSS) waves 2006, 2008, or 2010 (birth years 1940-1978) were included in the analytical sample. To identify the effect of tooth loss on having a history of coronary heart disease (CHD) or stroke, instrumental variable analysis exploited childhood exposure to drinking water fluoride as an instrument. The weighted prevalence of CHD and stroke histories was 5.1% and 2.1%, respectively. First-stage regression indicated that childhood exposure to drinking water fluoride was a strong instrument for the number of lost teeth in adulthood (coefficient -0.61; 95% confidence interval [CI] -0.80, -0.41; F = 37.47). The probability of CHD was significantly higher by 1.04 percentage points (95% CI 0.57, 1.50) per lost tooth. The effect of tooth loss on stroke was significant only for people aged ≥60 y (coefficient 0.93 percentage points; 95% CI 0.14, 1.71). These findings are supportive of a causal effect of tooth loss on cardiovascular diseases among US adults, particularly in older age.
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Affiliation(s)
- Y Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Japan
| | - H Jürges
- Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | - S Listl
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry-Quality and Safety of Oral Healthcare, Nijmegen, the Netherlands
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Mengozzi A, Carli F, Pezzica S, Biancalana E, Gastaldelli A, Solini A. High exposure to phthalates is associated with HbA1 c worsening in type 2 diabetes subjects with and without edentulism: a prospective pilot study. Diabetol Metab Syndr 2022; 14:100. [PMID: 35858871 PMCID: PMC9301841 DOI: 10.1186/s13098-022-00875-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Phthalates exposure and complete edentulism are related to both low socioeconomic status. No study by far has verified if and to what extent these two conditions are related. We aimed to explore their potential association and interplay in the metabolic control and cardiovascular risk profile. METHODS In our small (n = 48) prospective pilot study twenty-four patients with type 2 diabetes (DnE) and twenty-four patients with type 2 diabetes and edentulism (DE) followed for 19 ± 2 months were treated according to best clinical standards. Phthalates' exposure was evaluated by urinary concentration of di-2-ethylhexylphthalate (DEHP), metabolites, i.e. mono 2-ethylhexyl phthalate (MEHP), mono-2-ethyl-5-oxohexyl phthalate (MEOHP) and mono 2-ethyl-5-hydroxyhexyl phthalate (MEHHP). RESULTS No association between phthalates and edentulism was found, nor did edentulism affect glucose control. Higher phthalates exposure was associated with a glycated haemoglobin worsening. This association was found for all the measured phthalates metabolites, both as a whole (DEHP; r = 0.33, p = 0.0209) and individually: MEHP (r = 0.41, p = 0.0033), MEHHP (r = 0.32, p = 0.028), MEOHP (r = 0.28, p = 0.0386). CONCLUSIONS Phthalates are not associated with edentulism but predict the worsening of glucose control in subjects with type 2 diabetes. These findings might prove relevant in identifying novel biomarkers of cardiometabolic risk. Further studies are needed to validate our results and estimate the true potential of phthalates in terms of risk assessment.
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Affiliation(s)
- Alessandro Mengozzi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
- Sant'Anna School of Advanced Studies, Pisa, Italy.
| | - Fabrizia Carli
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Samantha Pezzica
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Edoardo Biancalana
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Amalia Gastaldelli
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
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Tavares RDCR, Ortigara GB, Tatsch KF, Ferreira CM, Boligon J, Moreira CHC. Association between periodontitis and glycated hemoglobin levels in individuals living in rural Southern Brazil. Clin Oral Investig 2021; 25:6901-6907. [PMID: 34059955 DOI: 10.1007/s00784-021-03980-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/05/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To estimate the prevalence of prediabetes in individuals with moderate or severe periodontitis and to verify the association between periodontitis and glycated hemoglobin levels. MATERIAL AND METHODS A cross-sectional study was conducted including individuals age 18-93 years from a representative sample residing in rural Southern Brazil. Data collection included full mouth periodontal clinical examinations, laboratory screens, and structured questionnaires. Glycemic levels were based on glycated hemoglobin. Periodontitis case definition was based on criteria established by the Centers for Disease Control and Prevention and the American Academy of Periodontology. A logistic regression model adjusted for body mass index was used to estimate odds ratios (OR) and 95% confidence intervals (CI). The association between periodontal parameters and changes in glycated hemoglobin levels was evaluated using linear regression models. RESULTS A higher prevalence of prediabetes was observed among individuals with moderate (39.6%) and severe periodontitis (49.7%) than in individuals with mild (23.8%) or no periodontitis (27.8%). Adjusting for body mass index, individuals with severe periodontitis exhibited a 2.5 greater chance of being prediabetic (OR=2.5; 95% CI: 1.3-4.9) that was significantly associated with an increase of 0.10% in HbA1c. CONCLUSION Severe periodontitis was associated with elevated blood glucose levels. Individuals with this condition having a higher percentage HbA1c are more likely to be prediabetic. CLINICAL RELEVANCE This study highlights the importance of the clinicians' awareness of the association between severe periodontitis and prediabetes allowing its early detection in the dental office.
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Affiliation(s)
- Rodrigo da Cunha Rossignollo Tavares
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Gabriela Barbieri Ortigara
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Karen Finger Tatsch
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Ciandra Miraglia Ferreira
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Jociana Boligon
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Carlos Heitor Cunha Moreira
- Post-Graduate Program in Oral Science (Periodontology Unit), School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
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Jacob L, Shin JI, Oh H, López-Sánchez GF, Smith L, Haro JM, Koyanagi A. Association between diabetes and edentulism and their joint effects on health status in 40 low and middle-income countries. BMJ Open Diabetes Res Care 2021; 9:9/1/e002514. [PMID: 34620622 PMCID: PMC8499266 DOI: 10.1136/bmjdrc-2021-002514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 09/26/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Previous studies on the diabetes-edentulism relationship have yielded conflicting results. Therefore, the goal of this study was to investigate the association between diabetes and edentulism, and their joint effects on health status in adults from 40 low and middle-income countries (LMICs). RESEARCH DESIGN AND METHODS Data from the World Health Survey were used for this cross-sectional study (2002-2004). Forty countries (18 low-income and 22 middle-income countries) were included. Edentulism and diabetes were assessed using yes-no questions based on self-report. Health status was assessed in seven different domains (self-care, pain/discomfort, cognition, interpersonal activities, sleep/energy, affect, and perceived stress). The association between diabetes (exposure) and edentulism (outcome) was analyzed using multivariable logistic regression models, while their joint effects on health status were assessed using multivariable linear regression models. RESULTS There were 175 814 adults aged ≥18 years included in this study (mean (SD) age 38.4 (16.0) years; 49.3% men). Overall, the prevalence of edentulism was 6.0% and diabetes was 2.9%. There was a positive and significant association between diabetes and edentulism in the overall sample (OR=1.40, 95% CI 1.18 to 1.66), in low-income countries (OR=1.78, 95% CI 1.21 to 2.62) and in middle-income countries (OR=1.24, 95% CI 1.04 to 1.47). In addition, people with comorbid diabetes and edentulism had worse health status in the domains of cognition, sleep/energy, and perceived stress, compared with those with diabetes only. CONCLUSIONS Diabetes was positively associated with edentulism in this sample of more than 175 000 individuals living in LMICs. Providing oral care to individuals with diabetes may potentially lead to a reduction in their risk of edentulism.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University-Cambridge Campus, Cambridge, UK
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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Fischer RG, Gomes Filho IS, Cruz SSD, Oliveira VB, Lira-Junior R, Scannapieco FA, Rego RO. What is the future of Periodontal Medicine? Braz Oral Res 2021; 35:e102. [PMID: 34586216 DOI: 10.1590/1807-3107bor-2021.vol35.0102] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/03/2021] [Indexed: 01/14/2023] Open
Abstract
In the last five decades, considerable progress has been made towards understanding the etiology and pathogenesis of periodontal diseases and their interactions with the host. The impact of an individual periodontal condition on systemic homeostasis became more evident because of this knowledge and prompted advances in studies that associate periodontitis with systemic diseases and conditions. The term Periodontal Medicine describes how periodontal infection/inflammation can affect extraoral health. This review presents the current scientific evidence on the most investigated associations between periodontitis and systemic diseases and conditions, such as cardiovascular diseases, diabetes, preterm birth and low birth weight, and pneumonia. Additionally, other associations between periodontitis and chronic inflammatory bowel disease, colorectal cancer, and Alzheimer's disease that were recently published and are still poorly studied were described. Thus, the aim of this review was to answer the following question: What is the future of Periodontal Medicine? Epidemiological evidence and the evidence of biological plausibility between periodontitis and general health reinforce the rationale that the study of Periodontal Medicine should continue to advance, along with improvements in the epidemiological method, highlighting the statistical power of the studies, the method for data analysis, the case definition of periodontitis, and the type of periodontal therapy to be applied in intervention studies.
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Affiliation(s)
- Ricardo Guimarães Fischer
- Universidade do Estado do Rio de Janeiro - UERJ, Department of Periodontology, Rio de Janeiro, RJ, Brazil
| | - Isaac Suzart Gomes Filho
- Universidade Estadual de Feira de Santana - UEFS, Department of Health, Feira de Santana, BA, Brazil
| | - Simone Seixas da Cruz
- Universidade Federal do Recôncavo da Bahia - UFRB, Health Sciences Center, Santo Antônio de Jesus, BA, Brazil
| | - Victor Bento Oliveira
- Universidade Federal do Ceará - UFC, Faculty of Pharmacy, Dentistry and Nursing, Graduate Program in Dentistry, Fortaleza, CE, Brazil
| | | | - Frank Andrew Scannapieco
- The State University of New York, Univeristy at Buffalo, School of Dental Medicine, Department of Oral Biology, Buffalo, NY, USA
| | - Rodrigo Otávio Rego
- Universidade Federal do Ceará - UFC, School of Dentistry, Department of Dentistry, Sobral, CE, Brazil
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Andrade CAS, Paz JLC, de Melo GS, Mahrouseh N, Januário AL, Capeletti LR. Survival rate and peri-implant evaluation of immediately loaded dental implants in individuals with type 2 diabetes mellitus: a systematic review and meta-analysis. Clin Oral Investig 2021; 26:1797-1810. [PMID: 34586502 PMCID: PMC8479496 DOI: 10.1007/s00784-021-04154-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/16/2021] [Indexed: 11/29/2022]
Abstract
Objectives To evaluate the survival rate, success rate, and peri-implant biological changes of immediately loaded dental implants (ILs) placed in type 2 diabetic patients (DM2). Materials and methods The present study was registered on PROSPERO and followed the PRISMA checklist. The search was performed by the first reviewer in January 2021. The electronic databases used were MEDLINE via PubMed, Cochrane, BVS, Web of Science, Scopus, LIVIVO, and gray literature. The risk of bias analysis was performed using an instrument from the Joanna Briggs Institute. Results A total of 3566 titles and abstracts were obtained. The qualitative synthesis included 7 studies, while the quantitative synthesis included 5 studies. The meta-analysis of IL in individuals with DM2 compared to nondiabetic individuals showed no significant difference among the groups regarding the survival rate of dental implants (RR = 1.00, 95% CI 0.96–1.04; p = 0.91; I2 = 0%), even if the patient had poor glycemic control (RR = 1.08, 95% CI 0.87–1.33; p = 0.48; I2 = 70%). Meta-analysis of marginal bone loss in IL compared to conventional loading in DM2 patients also showed no significant difference (mean difference = − 0.08, 95% CI − 0.25–0.08; p = 0.33; I2 = 83%). Conclusions Type 2 diabetes mellitus does not seem to be a risk factor for immediately loaded implants if the glycemic level is controlled, the oral hygiene is satisfactory, and the technical steps are strictly followed. Clinical relevance Rehabilitation in diabetic individuals is more common due to the highest prevalence of edentulism in this population. It is essential to establish appropriate protocols for loading dental implants. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04154-6.
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Affiliation(s)
| | - João Lucas Carvalho Paz
- Department of Periodontology and Implant Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil
| | - Gabriel Simino de Melo
- Faculty of Medicine and Dentistry, Postgraduate Department, São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Nour Mahrouseh
- Faculty of Medicine, Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hajdú-Bihar, Hungary
| | | | - Lucas Raineri Capeletti
- Department of Periodontology and Implant Dentistry, Instituto Aria, Brasília, Distrito Federal, Brazil.,Department of Dentistry, Universidade Federal de Goiás (UFG), Goiânia, Goiás, Brazil
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Parolini F, Biancalana E, Rossi C, Raggi F, Mengozzi A, Solini A. Clinical and epigenetic determinants of edentulism in type 2 diabetic subjects referring to a tertiary center. J Diabetes Complications 2021; 35:107910. [PMID: 33757716 DOI: 10.1016/j.jdiacomp.2021.107910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/12/2021] [Accepted: 03/09/2021] [Indexed: 12/21/2022]
Abstract
AIMS Edentulism, extreme consequence of severe periodontitis, carries a high cardiovascular and all-cause death risk. The prevailing phenotype of edentulous patients with type 2 diabetes (T2D) has never been defined, neither it is known whether an epigenetic signature of such condition exists. METHODS We collected clinical and biochemical data and administered a questionnaire on oral health in 248 consecutive T2D individuals. Vital status was checked after 17 ± 7 months. miRNAs involved in periodontal inflammation were measured. RESULTS Forty-seven patients (19%) were edentulous (ED), a higher prevalence than in the Italian general population (10.9% from ISTAT data). ED were older, with low level of instruction and higher fasting glucose vs not edentulous (noED). Participants displayed a scarce awareness of the association periodontitis-T2D. ED showed a specific epigenetic signature (lower miR214-5p and higher miR126-5p urinary levels). At the follow-up, metabolic profile similarly improved in ED and noED; death occurrence was similar. CONCLUSIONS In this cohort of T2D, age is the only variable associated with edentulism; such condition displays an epigenetic signature, independent of the clinical phenotype; awareness of the clinical relevance and implications of periodontitis and edentulism are scarce. However, edentulism does not mark an increased rate of micro-macrovascular complications or mortality.
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Affiliation(s)
- Federico Parolini
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Edoardo Biancalana
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Chiara Rossi
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Italy
| | - Francesco Raggi
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Italy
| | | | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Italy.
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Casanova-Rosado AJ, Casanova-Rosado JF, Minaya-Sánchez M, Robles-Minaya JL, Casanova-Sarmiento JA, Márquez-Corona MDL, Pontigo-Loyola AP, Isla-Granillo H, Mora-Acosta M, Márquez-Rodríguez S, Medina-Solís CE, Maupomé G. Association of Edentulism with Various Chronic Diseases in Mexican Elders 60+ Years: Results of a Population-Based Survey. Healthcare (Basel) 2021; 9:healthcare9040404. [PMID: 33916223 PMCID: PMC8066655 DOI: 10.3390/healthcare9040404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 12/17/2022] Open
Abstract
Objective: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. Material and Methods: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). Results: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98); 56.2% were women. Chronic diseases’ prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p < 0.05) and depression in men aged 70 years and over (p < 0.0001) were associated with higher prevalence of edentulism. Conclusions: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.
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Affiliation(s)
- Alejandro José Casanova-Rosado
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (A.J.C.-R.); (M.M.-S.); (J.L.R.-M.); (J.A.C.-S.)
| | - Juan Fernando Casanova-Rosado
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (A.J.C.-R.); (M.M.-S.); (J.L.R.-M.); (J.A.C.-S.)
- Correspondence: (J.F.C.-R.); (C.E.M.-S.)
| | - Mirna Minaya-Sánchez
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (A.J.C.-R.); (M.M.-S.); (J.L.R.-M.); (J.A.C.-S.)
| | - José Luís Robles-Minaya
- School of Dentistry, Autonomous University of Campeche, Campeche 24039, Mexico; (A.J.C.-R.); (M.M.-S.); (J.L.R.-M.); (J.A.C.-S.)
| | | | - María de Lourdes Márquez-Corona
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - América Patricia Pontigo-Loyola
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - Horacio Isla-Granillo
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - Mariana Mora-Acosta
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - Sonia Márquez-Rodríguez
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
| | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico; (M.d.L.M.-C.); (A.P.P.-L.); (H.I.-G.); (M.M.-A.); (S.M.-R.)
- Advanced Studies and Research Center in Dentistry “Dr. Keisaburo Miyata”, School of Dentistry, Autonomous University of State of Mexico, Toluca 50000, Mexico
- Correspondence: (J.F.C.-R.); (C.E.M.-S.)
| | - Gerardo Maupomé
- Richard M. Fairbanks School of Public Health, Indiana University/Purdue University, Indianapolis, IN 46202, USA;
- Indiana University Network Science Institute, Bloomington, IN 47408, USA
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Abstract
The elderly individual is becoming the most common patient in clinical practice due to the increasing average life span, especially in developed countries. The current elderly patients are different from those of some decades ago. They usually have an active social life, want to be informed, and are actively involved in the current society with consequent high expectations for medical and dental treatment. However, not all the elderly patients are like this. Some of them show limited financial resources, reduced mental and manual skills, and poor motivation. The purpose of this communication is to make a brief characterization of the new elderly population in view of prosthetic and dental management.
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Battancs E, Gheorghita D, Nyiraty S, Lengyel C, Eördegh G, Baráth Z, Várkonyi T, Antal M. Periodontal Disease in Diabetes Mellitus: A Case-Control Study in Smokers and Non-Smokers. Diabetes Ther 2020; 11:2715-2728. [PMID: 32975709 PMCID: PMC7547922 DOI: 10.1007/s13300-020-00933-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 09/15/2020] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION It is well established that periodontal disease (PD) and diabetes mellitus (DM) can have a detrimental effect on each other's disease course, and that cigarette smoking exacerbates both conditions. However, literature on the periodontal status of smokers with DM is scarce, and the studies conducted to date did not use healthy controls or non-smokers with DM as controls. Consequently, the individual effects of smoking and DM on PD are difficult to untangle and estimate. METHODS A total of 128 participants were recruited to this study and their data analyzed. They were assigned to four groups: smoking patients with DM (SDM); non-smoking patients with DM (NSDM); smokers without DM (control group, SC) and (4) non-smokers without DM (control group, NSC). Each group consisted of 32 age-matched participants. The periodontal status of the participants was assessed by full oral examination. To express periodontal status, we used the four-stage classification introduced by Fernandes and colleagues (J Periodontol. 80(7):1062-1068, 2009). The control of DM was estimated by measuring hemoglobin A1c (HbA1c) levels in the peripheral blood. RESULTS A significant difference in the severity of PD was found between the SC and NSC groups (p = 0.027) and between the NSC and SDM groups (p = 0.000), while the difference between the NSDM and SDM groups approached significance (p = 0.052). No person in the smoker groups could be classified as having a healthy periodontal status. The four-stage classification followed a normal distribution in the healthy, non-smoking controls (NSC). Smoking caused a shift toward medium-severe PD, while a marked shift toward the most severe stage was observed when both smoking and DM were present (SDM). There was no significant association between the type of DM and periodontal status, nor between diabetes control and the severity of PD. Persons in the SDM group had significantly fewer teeth than those in the NSC group (mean ± standard deviation: 16.0 ± 7.9 vs. 20.7 ± 5.6; p = 0.02). CONCLUSION Smoking damages the periodontium of even healthy individuals, but the damage is multiplied in a smoker who has DM, even though the effect of DM alone on periodontium health is relatively mild. Our results suggest a synergy between DM and smoking in terms of damage to the periodontal tissues, but the limited sample size of this study does not allow any hard conclusion to be drawn.
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Affiliation(s)
- Emese Battancs
- Department of Esthetic and Operative Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Dorottya Gheorghita
- Department of Esthetic and Operative Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Szabolcs Nyiraty
- Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Csaba Lengyel
- Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Gabriella Eördegh
- Faculty of Health Sciences and Social Studies, University of Szeged, Szeged, Hungary
| | - Zoltán Baráth
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Tamás Várkonyi
- Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Márk Antal
- Department of Esthetic and Operative Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary.
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Afsaneh Abadi P, Koopaie M, Montazeri R. Comparison of salivary nitric oxide and oral health in diabetic patients with and without xerostomia. Diabetes Metab Syndr 2020; 14:11-15. [PMID: 31809967 DOI: 10.1016/j.dsx.2019.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Diabetes mellitus (DM) is a chronic multi-systemic metabolic disorder; diabetic patients are more prone to xerostomia and oral health problems than others. There are evidences that nitric oxide (NO) plays an important role in healthy salivary gland function, prevention of insulin resistance and progression of diabetes mellitus. The aim of this study was to compare the salivary NO level between type 2 diabetic (T2DM) patients with and without xerostomia. METHODS In this case control study, 70 patients with T2DM, which were matched according to age, sex, type of disease control, were enrolled conveniently. The subjects based on abeslang test were allocated to the two groups; 35 patients with xerostomia and 35 patients without xerostomia. Unstimulated whole saliva was collected by spitting method. NO levels was measured by ELISA method using Griess reaction. Data was analyzed using t-test, ANOVA and logistic regression analysis to examine the association of salivary NO and xerostomia. RESULTS The mean and standard deviation of salivary NO in the diabetic subjects with xerostomia was significantly lower than diabetic subjects without xerostomia (138 ± 94.58 μmol/L vs. 356.61 ± 302.81 μmol/L (P-value = 0.001). In logistic regression analysis, salivary NO level was associated with 0.994 fold decreased risk of xerostomia in diabetic subjects after adjustment for age, gender, FBS and HbA1c. CONCLUSIONS The present study indicates salivary nitric oxide level was a predictor of xerostomia in diabetic patients. More longitudinal studies are necessary to understand the association of salivary NO level with diabetes-induced xerostomia.
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Affiliation(s)
| | - Maryam Koopaie
- Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Roshanak Montazeri
- Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Reid J, Koopu P, Burkhardt N, Stewart T, Anderson A, Harwood M. Oral and dental health and health care for Māori with type 2 diabetes: A qualitative study. Community Dent Oral Epidemiol 2019; 48:101-108. [PMID: 31657040 DOI: 10.1111/cdoe.12501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 08/07/2019] [Accepted: 09/26/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Type 2 diabetes mellitus (T2DM) and periodontal disease are two highly prevalent, directly and independently associated long-term conditions that disproportionately impact Indigenous Māori in New Zealand (NZ). Although poorly understood, a number of social and biological mechanisms connect these conditions. This qualitative study explored experiences of T2DM and oral and dental (hereafter oral/dental) health; access to oral/dental health care; whether participants' experiences supported or challenged existing evidence; and sought suggestions for improving oral/dental health in a high-deprivation rural area of Northland, NZ. METHODS Participants (n = 33) meeting the study criteria: self-identified Māori ethnicity, aged ≥ 18-years with glycated haemoglobin (HBA1c) >65 mmol/L were recruited via the local primary care clinic in September-December 2015; two left the study prior to data collection. During face-to-face semi-structured interviews, participants (n = 31) were asked How does diabetes affect your teeth? and When did you last access dental care? Kaupapa Māori (KM) theory and methodology provided an important decolonizing lens to critically analyse the fundamental causes of Indigenous health inequities. RESULTS Independent analysis of qualitative data by three KM researchers identified four themes: access barriers to quality care; pathways to edentulism; the 'cost' of edentulism; and, unmet need. Results contributed towards informing Mana Tū-an evidence-based KM programme for diabetes in primary care-to be introduced in this and other communities from 2018. CONCLUSIONS Oral health is integral to diabetes management, and vice versa. Subsidized specialist referrals for oral-dental health care for Māori with T2DM could improve glycaemic control and diabetes outcomes and reduce diabetes-related complications among this population.
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Affiliation(s)
- Jennifer Reid
- c/- Te Kupenga Hauora Māori, Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Pauline Koopu
- Senior Dentist, Paediatric Services, Greenlane Clinical Centre, Auckland, New Zealand
| | | | - Tereki Stewart
- Mana Tū, National Hauora Coalition, Auckland, New Zealand
| | - Anneka Anderson
- c/- Te Kupenga Hauora Māori, Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Matire Harwood
- c/- Te Kupenga Hauora Māori, Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Mana Tū, National Hauora Coalition, Auckland, New Zealand
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Rohani B. Oral manifestations in patients with diabetes mellitus. World J Diabetes 2019; 10:485-489. [PMID: 31558983 PMCID: PMC6748880 DOI: 10.4239/wjd.v10.i9.485] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/19/2019] [Accepted: 08/27/2019] [Indexed: 02/05/2023] Open
Abstract
The purpose of this article was to increase the knowledge about oral manifestations and complications associated with diabetes mellitus. An overview was performed on Google, especially in recent reliable papers in relation to diabetes mellitus and its oral manifestations (keywords were “diabetes mellitus”, “oral manifestations”, and “oral complications”). Data were collected and the results were declared. Diabetes mellitus is one of the most common chronic disorders characterized by hyperglycemia. This disease can have many complications in various regions of the body, including the oral cavity. The important oral manifestations and complications related to diabetes include xerostomia, dental caries, gingivitis, periodontal disease, increased tendency to oral infections, burning mouth, taste disturbance, and poor wound healing. Oral complications in diabetic patients are considered major complications and can affect patients’ quality of life. There is evidence that chronic oral complications in these patients have negative effects on blood glucose control, so prevention and management of the oral complications are important.
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Affiliation(s)
- Bita Rohani
- Department of Oral Medicine, Faculty of Dentistry, Aja University of Medical Sciences, Tehran 1919141171, Iran
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Yao H, Xu D, Zhu Z, Wang G. Gestational diabetes mellitus increases the detection rate and the number of oral bacteria in pregnant women. Medicine (Baltimore) 2019; 98:e14903. [PMID: 30882709 PMCID: PMC6426525 DOI: 10.1097/md.0000000000014903] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
In the present study, we aimed to investigate the association between gestational diabetes mellitus (GDM) and the oral microbial imbalance in the second trimester of pregnancy.Three hundred thirtyone women in the second trimester of pregnancy who underwent prenatal examinations at the Third Affiliated Hospital of Soochow University from February 2018 to August 2018 were included in this study. Personal parameters including the age, education level, and body mass index (BMI) at 28 weeks of gestation were recorded. Gestational diabetes mellitus (GDM) was diagnosed according to the Standards of Medical Care in Diabetes-2011 recommended by American Diabetes Association (ADA). After the significant difference of each parameter was erased by a propensity-score matched (PSM) analysis at a 1:1 ratio, the oral health conditions and the oral flora in pregnant women with GDM were compared with those in nondiabetic pregnant women.Our data demonstrated that 65 of the 331 pregnant women (19.6%) were diagnosed with GDM. Results from the matched data including 59 matched pairs of pregnant women showed that the gingival index (GI), plaque index (PI), tooth mobility degree (TMD), probing depth (PD), and bleeding on probing (BOP) of pregnant women with GDM were higher or more severe than those of nondiabetic pregnant women (P < .05). The detection rate of tuberculosis bacilli, Black-pigmented bacteria, and Capnocytophaga in pregnant women with GDM was higher than those in nondiabetic pregnant women (P = .000, P = .026, and P = .030, respectively). In addition, pregnant women with GDM had fewer oral streptococci (P = .000) and lactobacilli (P = .000) and more oral anaerobic bacteria (P = .000), tuberculosis bacilli (P = .000), Black-pigmented bacteria (P = .007), Capnocytophaga (P = .000), and actinomycetes (P = .000).The detection rate and the number of oral bacteria in pregnant women with GDM were higher than those in nondiabetic pregnant women in the second trimester of pregnancy.
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Araújo AAD, Morais HBD, Medeiros CACXD, Brito GADC, Guedes PMM, Hiyari S, Pirih FQ, Araújo Júnior RFD. Gliclazide reduced oxidative stress, inflammation, and bone loss in an experimental periodontal disease model. J Appl Oral Sci 2019; 27:e20180211. [PMID: 30810635 PMCID: PMC6382321 DOI: 10.1590/1678-7757-2018-0211] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/26/2018] [Indexed: 12/17/2022] Open
Abstract
Objective The aim of this study was to evaluate the effects of gliclazide on oxidative stress, inflammation, and bone loss in an experimental periodontal disease model. Material and Methods Male albino Wistar rats were divided into no ligature, ligature, and ligature with 1, 5, and 10 mg/kg gliclazide groups. Maxillae were fixed and scanned using micro-computed tomography to quantify linear and bone volume/tissue volume (BV/TV) and volumetric bone loss. Histopathological, immunohistochemical and immunofluorescence analyses were conducted to examine matrix metalloproteinase-2 (MMP-2), cyclooxygenase 2 (COX-2), cathepsin K, members of the receptor activator of the nuclear factor kappa-Β ligand (RANKL), receptor activator of nuclear factor kappa-Β (RANK), osteoprotegerin (OPG) pathway, macrophage migration inhibitory factor (MIF), superoxide dismutase-1 (SOD-1), glutathione peroxidase-1 (GPx-1), NFKB p 50 (Cytoplasm), NFKB p50 NLS (nuclear localization signal), PI3 kinase and AKT staining. Myeloperoxidase activity, malondialdehyde and glutathione levels, while interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) levels were evaluated by spectroscopic ultraviolet-visible analysis. A quantitative reverse transcription polymerase chain reaction was used to quantify the gene expression of the nuclear factor kappa B p50 subunit (NF-κB p50), phosphoinositide 3-kinase (PI3k), protein kinase B (AKT), and F4/80. Results Micro-computed tomography showed that the 1 mg/kg gliclazide treatment reduced linear bone loss compared to the ligature, 5 mg/kg gliclazide, and 10 mg/kg gliclazide treatments. All concentrations of gliclazide increased bone volume/tissue volume (BV/TV) compared to the ligature group. Treatment with 1 mg/kg gliclazide reduced myeloperoxidase activity, malondialdehyde, IL-1β, and TNF-α levels (p≤0.05), and resulted in weak staining for COX-2, cathepsin k, MMP-2, RANK, RANKL, SOD-1, GPx-1,MIF and PI3k. In addition, down-regulation of NF-κB p50, PI3k, AKT, and F4/80 were observed, and OPG staining was strong after the 1 mg/kg gliclazide treatment. Conclusions This treatment decreased neutrophil and macrophage migration, decreased the inflammatory response, and decreased bone loss in rats with ligature-induced periodontitis.
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Affiliation(s)
- Aurigena Antunes de Araújo
- Universidade Federal do Rio Grande do Norte, Programa de Pós-Graduação em Ciências Farmacêuticas, Programa de Pós-Graduação em Saúde Pública, Departamento de Biofísica e Farmacologia, Natal, Rio Grande do Norte, Brasil
| | - Helicarlos Batista de Morais
- Universidade Federal do Rio Grande do Norte, Programa de Pós-Graduação em Saúde Pública, Natal, Rio Grande do Norte, Brasil
| | - Caroline Adisson Carvalho Xavier de Medeiros
- Universidade Federal do Rio Grande do Norte, Programa de Pós-Graduação RENORBIO, Programa de Pós-Graduação em Biologia, Departamento de Biofísica e Farmacologia, Natal, Rio Grande do Norte, Brasil
| | - Gerly Anne de Castro Brito
- Universidade Federal do Ceará, Programa de Pós-Graduação em Farmacologia, Programa de Pós-Graduação em Morfologia, Departamento de Morfologia, Fortaleza, Ceará, Brasil
| | - Paulo Marcos Matta Guedes
- Universidade Federal do Rio Grande do Norte, Programa de Pós-Graduação em Biologia Parasitária, Departamento de Microbiologia e Parasitologia, Natal, Rio Grande do Norte, Brasil
| | - Sarah Hiyari
- University of California, School of Dentistry, Section of Periodontics, Los Angeles, California, United States of America
| | - Flávia Q Pirih
- University of California, School of Dentistry, Section of Periodontics, Los Angeles, California, United States of America
| | - Raimundo Fernandes de Araújo Júnior
- Universidade Federal do Rio Grande do Norte, Departamento de Morfologia, Porgrama de Pós-Graduação em Biologia Funcional e Estrutural, Programa de Pós-Graduação em Ciências da Saúde, Natal, Rio Grande do Norte, Brasil
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Ayoade F, Olayiwola A, Li A. "Holes" in the Jaw-A Report of Two Cases of Periapical Actinomycosis. Diseases 2018; 6:E79. [PMID: 30200654 PMCID: PMC6164221 DOI: 10.3390/diseases6030079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/01/2018] [Accepted: 09/05/2018] [Indexed: 12/28/2022] Open
Abstract
Periapical actinomycosis is a relatively rare form of cervicofacial actinomycosis, which typically involves the periapical region with subsequent potential spread to the jaw bones. We hereby present two cases of periapical actinomycosis. Both patients presented with jaw pain and "holes" in their gum and lacked the characteristic clinical features commonly seen in cervicofacial actinomycosis such as jaw mass, draining ulcers, sinuses and fistulae. The first patient was an immunocompetent host with chronic stable medical conditions but with a rather bad dentition requiring multiple recent teeth extractions. The second patient was edentulous, had refractory multiple myeloma, was on low-dose chronic steroids and pomalidomide therapy and therefore relatively immunocompromised. Both cases of actinomycosis were diagnosed by jaw bone histopathology, which showed characteristic sulfur granules and embedded Actinomyces-like organisms. The two patients had excellent clinical response to six months of penicillin therapy without any need for surgical intervention. The cases remind clinicians of including actinomycosis in the differential diagnosis of periapical lesions and illustrates the possibility of achieving cure with non-surgical treatment.
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Affiliation(s)
- Folusakin Ayoade
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
| | - Ayoola Olayiwola
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
| | - Ailing Li
- Dianon Labcorp, Tampa, FL 33607, USA.
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