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Soundaram B, Murali CR, Ajithkumar M, Anjali A, JothiPriya D, Vikraman S. Evaluation of Oral Microflora-Related to Dental Caries and Salivary pH in type II Diabetic Patients. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1843-S1849. [PMID: 38882806 PMCID: PMC11174317 DOI: 10.4103/jpbs.jpbs_1291_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 06/18/2024] Open
Abstract
Background Diabetes mellitus is one of the chronic diseases and a group of metabolic disorders characterized by a high blood sugar level over a prolonged period. The present study aimed to evaluate and correlate HbA1c, salivary pH, and oral bacterial microflora (streptococcus and lactobacillus colony-forming unit (CFU)) related to dental caries in normal, controlled, and uncontrolled type II diabetic patients. Materials and Methods A total of 90 samples were taken for this study. The HbA1c test was recorded and grouped into three (normal, prediabetic, and diabetic). CFUs (streptococcus and lactobacillus) were evaluated by the spit-and-swab method. Salivary pH was measured with a pH strip with color coding. By using the post hoc test, the P-value was significant. Results The CFU of streptococcus and lactobacillus in the saliva spit and swab method is statistically significant for P <0.005 and P <0.01 among normal, prediabetic, and diabetic groups. In diabetic patients, there is a higher incidence of dental caries (s.d. 6.7), a higher CFU (s.d. 6194.5) in the bacterial microflora, and a lower salivary pH (s.d. 0.6) than in prediabetic and normal patients. Conclusion From the present study, we conclude that there is a slight increase in the CFU of Streptococcus mutans in diabetic patients compared to non-diabetic patients. This CFU increase and decrease in salivary PH were strongly associated with increased dental caries in diabetic patients.
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Affiliation(s)
- Balasubramanian Soundaram
- Department of Oral Pathology, CSI College of Dental Science and Research, Madurai, Tamil Nadu, India
| | - C R Murali
- Department of Oral Pathology, Best Dental Science College and Hospital, Madurai, Tamil Nadu, India
| | - Muthuraj Ajithkumar
- Department of Oral Pathology, Best Dental Science College and Hospital, Madurai, Tamil Nadu, India
| | - Arutchelvan Anjali
- Department of Oral Pathology, Best Dental Science College and Hospital, Madurai, Tamil Nadu, India
| | - DanPasko JothiPriya
- Department of Oral Pathology, Best Dental Science College and Hospital, Madurai, Tamil Nadu, India
| | - Sethuraman Vikraman
- Department of Oral Pathology, Best Dental Science College and Hospital, Madurai, Tamil Nadu, India
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Žiūkaitė L, Weijdijk LPM, Tang J, Slot DE, van der Weijden GAF. Edentulism among diabetic patients compared to non-diabetic controls: A systematic review and meta-analysis. Int J Dent Hyg 2024; 22:3-14. [PMID: 37890036 DOI: 10.1111/idh.12762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 06/08/2023] [Accepted: 09/06/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVE The purpose of this paper is to systematically and critically appraise the available scientific evidence concerning the prevalence of edentulism among diabetic patients compared to non-diabetic people. METHODS MEDLINE-PubMed and Cochrane-CENTRAL databases were comprehensively searched up to April 2023 to identify appropriate studies. The inclusion criteria were observational studies conducted in human subjects ≥18 years of age with the primary aim of investigating the prevalence of edentulism among diabetic patients. Based on the extracted data, a meta-analysis was performed. Recommendations based on the body of evidence were formulated using the GRADE approach. RESULTS Independent screening of 2085 unique titles and abstracts revealed seven publications that met the eligibility criteria. Study size ranged from 293 to 15,943 participants. Data from all seven studies were suitable for meta-analysis. Overall, 8.3% of the studied population was edentulous. The weighted mean prevalence of edentulism among diabetic and non-diabetics was 14.0% and 7.1%, respectively. The overall odds ratio for diabetic patients to be edentulous as compared to non-diabetics was 2.39 (95% CI [1.73, 3.28], p < 0.00001). CONCLUSION There appears to be moderate certainty that the risk of being edentulous for diabetic patients compared to non-diabetic people is significant, but the odds ratio is estimated to be small.
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Affiliation(s)
- Laura Žiūkaitė
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lotte P M Weijdijk
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Oral and Maxillofacial Surgey, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Univsersiteit Amsterdam, Amsterdam, The Netherlands
| | - Jennifer Tang
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dagmar Else Slot
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G A Fridus van der Weijden
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Kaur J, Pruthi GK, Kapoor HS, Narang V, Kaur A, Gupta A. Knowledge, attitude and awareness among diabetic vs. non-diabetic patients about the association between diabetes and oral health. Indian J Dent Res 2023; 34:232-236. [PMID: 38197337 DOI: 10.4103/ijdr.ijdr_788_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
Background Global prevalence of diabetes is rapidly increasing with an estimate to affect 593 million worldwide by 2035. Current evidence clearly states an association between oral diseases and diabetes mellitus with manifestations like periodontitis, peri-implantitis, xerostomia, etc. Despite this obvious link, knowledge, awareness and attitude of general population towards this are not fully understood. Aims To assess public knowledge and awareness on association between diabetes and oral health and assess their attitude towards oral hygiene care and maintenance. Methods and Materials A three-part structured questionnaire was developed with multiple choice questions and circulated among patients visiting a private dental college. A total of 502 questionnaires were evaluated, and results were statistically analysed. Statistical Analysis Used Student-t test and Chi-square test using SPSS software. Results Majority of the participants were male and lived in urban area. 41.8% respondents had diabetes, out of which 86.7% had no awareness of the type. A significant number of non-diabetic individuals had awareness of excessive sugar intake as a cause of diabetes. Greater number of diabetic patients (96.7%) reported dry mouth, whereas only 53.3% had periodontal complications. 90% participants use tooth brush as oral hygiene aid. Only 10.6% participants follow regular dental visits. Majority of subjects (60.6%) listed their friends and family as major source of information. Conclusion More people are aware of systemic complications of diabetes as compared to oral problems. A better interdisciplinary relationship is required among dentists and physicians to improve knowledge and awareness of general population.
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Affiliation(s)
- Jaswinder Kaur
- Department of Prosthodontics and Crown & Bridge, Baba Jaswant Singh Dental College, Hospital and Research Institute, Ludhiana, Punjab, India
| | | | | | - Vishwas Narang
- Department of Prosthodontics and Crown & Bridge, Baba Jaswant Singh Dental College, Hospital and Research Institute, Ludhiana, Punjab, India
| | - Akaljot Kaur
- Department of Prosthodontics and Crown & Bridge, Baba Jaswant Singh Dental College, Hospital and Research Institute, Ludhiana, Punjab, India
| | - Aakash Gupta
- Department of Conservative Dentistry and Endodontics, The Tooth Koncept Dental Clinic, Ludhiana, Punjab, India
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Gregorczyk-Maga I, Kania M, Sulik-Tyszka B, Namysł M, Sepioło A, Romaniszyn D, Jachowicz-Matczak E, Wójkowska-Mach J. Oral Myco- and Bacteriobiota and Yeast Infections in Mechanically Ventilated COVID-19 Patients. Microorganisms 2023; 11:1442. [PMID: 37374944 DOI: 10.3390/microorganisms11061442] [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] [Received: 04/29/2023] [Revised: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 06/29/2023] Open
Abstract
Critically ill COVID-19 patients requiring mechanical ventilation in the intensive care unit are at risk of developing invasive candidiasis. In this study we aimed to (1) characterize oral cultivable mycobiota of mechanically ventilated adult COVID-19 patients in an ICU setting by sampling four distinct oral niches in two fixed time points with regards to oral health status, (2) investigate Candida spp. infections in this population, and (3) compare oral mycobiota with selected bacteriobiota strains during the observation in the ICU. We recruited 56 adult COVID-19 patients who qualified for mechanical ventilation. Patients received either standard or extended oral care procedures with tooth brushing. Oral samples were taken first within 36 h and after 7 days of intubation. Yeast-like fungi were identified by MALDI/TOF mass spectrometry. Yeast infection cases were retrospectively analyzed. Candida spp. in oral sampling was identified in 80.4% and 75.7%, C. albicans in 57.1% and 61.1%, and non-albicans Candida species in 48.2% and 47.2% patients at baseline and follow-up, respectively. There were no differences in the overall CFU counts of Candida spp. species and individual Candida species in oral samples, both at baseline and follow-up. At baseline, a higher prevalence of Candida spp. was associated with a higher identification rate of Lactobacillus spp. (64.4% vs. 27.3%, p = 0.041). At follow-up, there was a borderline lower prevalence of Candida spp. in patients with Lactobacillus spp. identified (57.1% vs. 87.0%, p = 0.057). The incidence rate of candidiasis was 5.4% and the incidence density was 3.1/1000 pds. In conclusion, non-albicans Candida species in oral samples were identified in nearly half of patients. Oral health was moderately impaired. A high incidence of yeast infections, including invasive cases, in patients hospitalized in the ICU due to COVID-19 and requiring mechanical ventilation was noted. Severe COVID-19 and disease-specific interventions within the ICU possibly played a major role promoting Candida spp. infections.
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Affiliation(s)
- Iwona Gregorczyk-Maga
- Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, ul. Montelupich 4, 31-155 Kraków, Poland
| | - Michal Kania
- Doctoral School of Medicine and Health Sciences, Jagiellonian University Medical College, ul. św. Anny 12, 31-008 Kraków, Poland
- Chair of Metabolic Diseases, Faculty of Medicine, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688 Kraków, Poland
| | - Beata Sulik-Tyszka
- Department of Dental Microbiology, Medical University of Warsaw, Banacha 1A, 02-097 Warsaw, Poland
| | - Magdalena Namysł
- Department of Microbiology, University Hospital in Krakow, Jakubowskiego Street 2, 30-688 Kraków, Poland
| | - Anna Sepioło
- Department of Microbiology, University Hospital in Krakow, Jakubowskiego Street 2, 30-688 Kraków, Poland
| | - Dorota Romaniszyn
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, ul. Czysta 18, 31-121 Kraków, Poland
| | - Estera Jachowicz-Matczak
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, ul. Czysta 18, 31-121 Kraków, Poland
| | - Jadwiga Wójkowska-Mach
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, ul. Czysta 18, 31-121 Kraków, Poland
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Zheng Y, Li Z, Liu C, Fan X, Luo Z, Li Z, Wu YL. Multi-functional nanogel with cascade catalytic performance for treatment of diabetic oral mucosa ulcer. Front Bioeng Biotechnol 2023; 11:1194398. [PMID: 37288357 PMCID: PMC10242068 DOI: 10.3389/fbioe.2023.1194398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/10/2023] [Indexed: 06/09/2023] Open
Abstract
Introduction: Diabetic oral mucosa ulcers face challenges of hypoxia, hyperglycemia and high oxidative stress, which result in delayed healing process. Oxygen is regarded as an important substance in cell proliferation, differentiation and migration, which is beneficial to ulcer recovery. Methods: This study developed a multi-functional GOx-CAT nanogel (GCN) system for the treatment of diabetic oral mucosa ulcers. The catalytic activity, ROS scavenge and oxygen supply ability of GCN was validated. The therapeutic effect of GCN was verified in the diabetic gingival ulcer model. Results: The results showed that the nanoscale GCN was capable of significantly eliminating intracellular ROS, increasing intracellular oxygen concentration and accelerating cell migration of human gingival fibroblasts, which could promote diabetic oral gingival ulcer healing in vivo by alleviating inflammation and promoting angiogenesis. Discussion: This multifunctional GCN with ROS depletion, continuous oxygen supply and good biocompatibility, which might provide a novel therapeutic strategy for effective treatment of diabetic oral mucosa ulcers.
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Affiliation(s)
- Yanfen Zheng
- Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Stomatological Hospital of Xiamen Medical College, Xiamen, Fujian, China
- China and Fujian College Engineering Research Center for Dental Biomaterials, Xiamen, China
| | - Zhiguo Li
- Fujian Provincial Key Laboratory of Innovative Drug Target Research, State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China
| | - Chuyi Liu
- Fujian Provincial Key Laboratory of Innovative Drug Target Research, State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China
| | - Xiaotong Fan
- Institute of Sustainability for Chemicals, Energy and Environment (ISCE2), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Zheng Luo
- Fujian Provincial Key Laboratory of Innovative Drug Target Research, State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Zibiao Li
- Institute of Sustainability for Chemicals, Energy and Environment (ISCE2), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Institute of Materials Research and Engineering (IMRE), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
- Department of Materials Science and Engineering, National University of Singapore, Singapore, Singapore
| | - Yun-Long Wu
- Fujian Provincial Key Laboratory of Innovative Drug Target Research, State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Xiamen University, Xiamen, China
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Shin YM, Mun KH. Glucose as a Risk Factor for Periodontitis in Kidney Transplantation Patients. Transplant Proc 2023; 55:350-353. [PMID: 36813693 DOI: 10.1016/j.transproceed.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/29/2022] [Accepted: 01/24/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND Various factors including diabetes and oxidative stress are associated with periodontal inflammation. End-stage renal disease causes various systemic abnormalities in patients, including cardiovascular disaese, metabolic abnormalities, and infection. Even after kidney transplantation (KT), these factors are known to be associated with inflammation. Our study, therefore, aimed to study risk factors associated with periodontitis in KT patients. METHODS Patients who visited Dongsan Hospital, Daegu, Korea since 2018 and have undergone KT were selected. As of November 2021, 923 participants, with full data including hematologic factors were studied. Periodontitis was diagnosed based on residual bone level in panoramic views. Patients were studied by the presence of periodontitis. RESULTS From 923 KT patients, 30 were diagnosed with periodontal disease. Fasting glucose levels were higher in patients with periodontal disease, and total bilirubin levels were lower. When divided by fasting glucose levels, high glucose level showed increase of periodontal disease with odds ratio of 1.031 (95% confidence interval 1.004-1.060). After adjusting for confounders, the results were significant with odds ratio of 1.032 (95% CI 1.004-1.061). CONCLUSIONS Our study showed that KT patients, of whom uremic toxin clearance has been revolted, are yet at risk of periodontitis by other factors, such as high blood glucose levels.
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Affiliation(s)
- Y M Shin
- Department of Dentistry, Keimyung University School of Medicine, Daegu, Korea
| | - K H Mun
- Department of Preventive Medicine, Inje University College of Medicine, Busan, Korea.
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Ferizi L, Bimbashi V, Kelmendi J. Association between metabolic control and oral health in children with type 1 diabetes mellitus. BMC Oral Health 2022; 22:502. [PMID: 36384715 PMCID: PMC9670584 DOI: 10.1186/s12903-022-02555-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 11/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background Type 1 diabetes mellitus is the most common chronic disease and can be reflected in the oral cavity. The aim of this study was to analyze the impact of metabolic control on saliva, dental caries, dental plaque, gingival inflammation, and cariogenic bacteria in saliva. Methods A case–control epidemiologic study was performed on children with type 1 diabetes (ages 10–15 years) separated into two groups: 34 children with good metabolic control of glycated hemoglobin (HbA1c < 7.5%) and 46 children with poor metabolic control of glycated hemoglobin (HbA1c > 7.5%). Oral status was assessed using the Decay, Missing, and Filled Teeth index for permanent teeth (DMFT), plaque index and gingival index. The stimulated salivary flow rate was measured, and the colonies of Streptococcus mutans and Lactobacillus in saliva were determined. The observed children answered questions related to their frequency of brushing habits, dental visits and parents’ education. Mann–Whitney U Test, Chi-Square test and Fisher’s exact test were used in the statistical analyses. The significance level was set at p < 0.05. Results The children with diabetes with poor metabolic control had significantly higher values of the DMFT index, plaque index, and gingival index, more colonies, and a higher risk of Streptococcus mutans and Lactobacillus than the children with diabetes with good metabolic control (p < 0.001). The level of metabolic control of diabetes had no influence on salivary flow rates (p > 0.05). The majority of both groups with good and poor metabolic control brushed their teeth once per day, and they visited the dentist only when necessary (61.3%). However, the parents of children in both groups had medium to low levels of education, without any significant difference between groups (p > 0.05). Conclusion The results indicate that children with diabetes have a lower level of oral hygiene and are potentially to dental caries and periodontal diseases, mainly when their metabolic disorder is uncontrolled.
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Mandura RA, El Meligy OA, Attar MH, Alamoudi RA, Dafar AO, Rajeh MT, Kayal RA, Farsi NM. Assessment of Oral Hygiene, Gingival, and Periodontal Health, and Teeth Eruption among Type 1 Diabetic Saudi Children. Int J Clin Pediatr Dent 2022; 15:711-716. [PMID: 36866125 PMCID: PMC9973077 DOI: 10.5005/jp-journals-10005-2462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Aims and objectives To determine the differences between type 1 diabetic children and healthy children regarding oral hygiene, gingival and periodontal health, and permanent teeth eruption.Materials and methods: A case-control study was conducted on 80 children (40 type 1 diabetic children and 40 healthy children) aged 6-12-year-old. The groups were further divided into subgroups (early and late mixed dentition). All study aspects were examined clinically using the simplified oral hygiene index, Löe and Silness gingival index, clinical attachment loss (CAL), and Logan and Kronfeld stages for tooth eruption. The data were analyzed using Fisher's exact test, chi-squared test, and logistic regression models. A p-value of ≤0.05 was the threshold for statistical significance. Results No significant difference was found between diabetic and healthy children regarding oral hygiene and gingival health. Most children had poor oral hygiene (52.5% in the case group and 60% in the control group), with fair gingival health (70% in the case group and 55% in the control group). Diabetic children had significantly (p = 0.05) more periodontitis than healthy children. Teeth in the advanced stage of the eruption were significantly higher in diabetic than control subjects (p = 0.048 in stage V and p = 0.003 in stage VI). Older diabetic children in late mixed dentition exhibited accelerated eruption. Conclusion Periodontitis was significantly more common in diabetic than in healthy children. The advanced stage of the eruption was significantly higher in diabetic than in control subjects. Clinical significance Type 1 diabetic children had more periodontal disease and advanced stage of permanent teeth eruption compared to healthy children. Therefore, periodic dental evaluation and a strong preventive plan for diabetic children is crucial. How to cite this article Mandura RA, El Meligy OA, Attar MH, et al. Assessment of Oral Hygiene, Gingival, and Periodontal Health, and Teeth Eruption among Type 1 Diabetic Saudi Children. Int J Clin Pediatr Dent 2022;15(6):711-716.
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Affiliation(s)
- Rafif A Mandura
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Omar A El Meligy
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Moaz H Attar
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rana A Alamoudi
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amal O Dafar
- Department of Oral and Maxillofacial Surgery, King Fahad Hospital, Jeddah, Saudi Arabia
| | - Mona T Rajeh
- Department of Preventive Dentistry, College of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Rayyan A Kayal
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Najat M Farsi
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Devadiga TJ, Godil AZ, Wadwan SA, Kazi AI, Dugal RJ, Khan MAA. Diabetes and Edentulism: A Survey on Oral Health-Related Quality of Life in Indian Sub-Population. Indian J Endocrinol Metab 2022; 26:594-600. [PMID: 39005522 PMCID: PMC11245285 DOI: 10.4103/ijem.ijem_278_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/05/2022] [Accepted: 08/26/2022] [Indexed: 02/05/2023] Open
Abstract
Aims The current study was conducted to assess the oral health-related quality of life in completely edentulous and diabetes mellitus (DM) patients. The null hypothesis of the survey is that there is no effect of both edentulism and diabetes on the oral health-related quality of life of patients. Settings and Design A descriptive cross-sectional study. Methods and Materials Test Groups: The study population was divided into three groups: • Group 1: Non-diabetic patients, wearing a complete denture. • Group 2: Diabetic patients, wearing a complete denture. • Group 3: Diabetic, completely dentulous patients. Sample Size: In total, 332 (200 males and 132 females) patients. Methodology of the Survey Telephonic and interview methods of surveying were employed to evaluate patients. Statistical Analysis Used The mean values, standard deviation (SD) and P value were calculated using a one-way analysis of variance (ANOVA). The level of significance was set at 5% (*P value < 0.05, ***P value < 0.001, NS: statistically non-significant). The higher the score, the higher the impact and vice-versa. Inter-group comparisons were done with post-hoc Bonferroni's test for multiple group comparisons. Results Data collected from the survey were statistically significant, results were noted between the completely edentulous patients wearing dentures and diabetic dentulous patients. Though DM is a potent risk factor for periodontitis, leading to edentulism, statistical analysis of this study suggested that the oral health-related quality of life was affected significantly only due to edentulism and not due to DM. This is indicative of the fact that the quality of the prostheses itself determines the overall oral health-related quality of life, irrespective of whether the patient is a diabetic or not. Therefore, it can be said that the present trends of prosthodontic management of patients with DM are successfully restoring the patients physiological, psychological as well as social needs. Conclusions Complete edentulism is the terminal outcome of a multifactorial process involving biological factors and patient-related factors. Diabetes and edentulism are both potential comorbid factors governing the oral health-related quality of life. The correlation between the two is complex and needs a thorough evaluation to improve the overall health of patients in the current clinical practice.
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Affiliation(s)
- Trupti J Devadiga
- Department of Prosthodontics, M.A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Aamir Z Godil
- Department of Prosthodontics, M.A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Sanaa A Wadwan
- Department of Prosthodontics, M.A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Arshi I Kazi
- Department of Prosthodontics, M.A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Ramandeep J Dugal
- Department of Prosthodontics, M.A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Mohammed Aatif A Khan
- Department of Prosthodontics, M.A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
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Vasudevan AC, Sridhar N, Bhat V, Bhat M. Correlation of Carbonic Anhydrase VI Enzyme, Total Proteins, Antioxidant Levels of Saliva and Dental Caries in Caries-Free and Caries-Active Children - A Case-Control Study. Contemp Clin Dent 2022; 13:315-321. [PMID: 36686992 PMCID: PMC9855257 DOI: 10.4103/ccd.ccd_276_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/19/2021] [Accepted: 07/04/2021] [Indexed: 12/24/2022] Open
Abstract
Background and Objectives Factors in the biofilm influence the induction and advancement of the carious process. This study was done to relate and assess the levels of enzyme carbonic anhydrase VI, total protein, and antioxidants (superoxide dismutase [SOD], catalase, lipid peroxidase, and uric acid) in caries-free and caries-active children. Methods This case-control study comprised 60 children of age group 6-12 years who were evaluated for decayed missing filled teeth (dmft)/DMFT criteria and distributed into two groups: Group 1 - caries active (case) and Group 2 - caries free (control) for saliva collection with 30 participants in each of the above groups. Stimulated saliva was obtained, and the samples were then evaluated using biochemical lab tests. The data were then statistically evaluated using independent t-test. Results Catalase in the caries-free group was significantly higher, but the concentration of carbonic anhydrase (CAVI) enzyme, total protein, and other antioxidant enzyme activity was enhanced in caries-active children in which uric acid demonstrated a statistically significant difference with higher levels in caries-active group. Conclusion There is an increased concentration of CAVI enzyme in caries-active group and total protein showed a linear relation with caries activity. Antioxidant parameters such as SOD and lipid peroxidase were increased with caries activity. Uric acid was significantly higher in the caries-active group, whereas catalase showed an indirect relation with dental caries. Significant variations in the levels of these parameters imply that the levels of these components of saliva can act as strong markers of caries status in children.
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Affiliation(s)
- Anjana Cherath Vasudevan
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nekkanti Sridhar
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vinutha Bhat
- Department of Biochemistry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Meghana Bhat
- Department of Biochemistry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Body Mass Index as a Proxy Indicator for Poor Oral Hygiene Habits in Adult Diabetic Patients. Zdr Varst 2022; 61:209-215. [PMID: 36348968 PMCID: PMC9597898 DOI: 10.2478/sjph-2022-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 09/06/2022] [Indexed: 01/12/2023] Open
Abstract
AIM To analyse if body mass index (BMI) could be used as a fast proxy indicator of poor oral hygiene habits (POHH) among the adult population with diabetes mellitus. METHODS Adults, aged 25-74, from the Slovenian 2016 nationwide cross-sectional survey based on the Countrywide Integrated Non-Communicable Disease Intervention (CINDI) Health Monitor methodology, who reported being diabetic, were included in the study (n=560). We assessed the relationship between POHH and BMI, adjusted to confounders, using multiple binary logistic regression. RESULTS In the total sample, the POHH prevalence was 50.9%. Taking into account BMI, POHH prevalence in participants with normal BMI values was only 37.8%, in the overweight group it was 1.22-times higher (46.0%), while in the obese group it was 1.63-times higher (61.6%) (p<0.001). Also, the odds for POHH were 2.64-times higher in the obese group in comparison to the normal BMI group (95% CI: 1.55-4.51; p<0.001). After adjustment for confounders, this OR decreased only moderately (OR=2.45; 95% CI: 1.35-4.44; p=0.003). CONCLUSIONS BMI could be used as a readily assessable, fast, simple, and cheap tool indicating higher odds for having POHH among the diabetic population. By defining the high-risk group it could be easier for physicians and dentists to take further referrals and actions for promoting oral health in this group. The suggested tool can save time and could have an important positive impact on the quality of life of diabetics, as well as on health expenditures.
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Comparison of the Response to Pulpal Sensibility Tests in Well-Controlled and Uncontrolled Type II Diabetes Mellitus Patients: A Cross-Sectional Study. Int J Dent 2022; 2022:6197070. [PMID: 36148044 PMCID: PMC9489380 DOI: 10.1155/2022/6197070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 08/07/2022] [Accepted: 08/18/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction Diabetes mellitus is a metabolic disorder in which impairment of sensory fibers would be anticipated. The present study would assess the dental pulp response to cold and EPT sensibility tests in patients with type 2 diabetes, both well-controlled and uncontrolled. Materials and Methods One hundred two maxillary central incisors, belonging to participants aged 35–67 years, were included in this survey. At last, 51 diabetic patients were allocated to each group of well-controlled (HbA1C < 7) and uncontrolled (HbA1C ≥ 7). Electric and cold pulpal vitality tests were conducted for all teeth. Statistical analysis was performed with Student's t-test, the chi-square test, and the multiple linear regression model. A P value less than 0.05 was considered significant. Results Based on the results of this study, the mean value of response to EPT was 4.51 ± 2.06 and 4.41 ± 1.85 in well-controlled and uncontrolled diabetic patients, respectively. Also, the pulpal responses to cold and EPT tests had no significant differences between the two groups (P > 0.05). Conclusion Tooth responses to the cold and EPT sensibility tests were not different in well-controlled and uncontrolled diabetic patients. Despite no statistically significant correlation, male diabetic patients in the uncontrolled group showed a lower sensory response threshold to EPT compared to a well-controlled group.
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Hu H, Lai T, Farid F. Feasibility Study of Constructing a Screening Tool for Adolescent Diabetes Detection Applying Machine Learning Methods. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22166155. [PMID: 36015915 PMCID: PMC9416136 DOI: 10.3390/s22166155] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/02/2022] [Accepted: 08/15/2022] [Indexed: 06/02/2023]
Abstract
Prediabetes and diabetes are becoming alarmingly prevalent among adolescents over the past decade. However, an effective screening tool that can assess diabetes risks smoothly is still in its infancy. In order to contribute to such significant gaps, this research proposes a machine learning-based predictive model to detect adolescent diabetes. The model applies supervised machine learning and a novel feature selection method to the National Health and Nutritional Examination Survey datasets after an exhaustive search to select reliable and accurate data. The best model achieved an area under the curve (AUC) score of 71%. This research proves that a screening tool based on supervised machine learning models can assist in the automated detection of youth diabetes. It also identifies some critical predictors to such detection using Lasso Regression, Random Forest Importance and Gradient Boosted Tree Importance feature selection methods. The most contributing features to Youth diabetes detection are physical characteristics (e.g., waist, leg length, gender), dietary information (e.g., water, protein, sodium) and demographics. These predictors can be further utilised in other areas of medical research, such as electronic medical history.
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Affiliation(s)
- Hansel Hu
- Atlas Advisors, Australia Pty Ltd., Sydney, NSW 2000, Australia
| | - Tin Lai
- School of Computer Science, Faculty of Engineering, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Farnaz Farid
- Cybersecurity and Behavioural Science, School of Social Sciences, Western Sydney University, Penrith, NSW 2751, Australia
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Dental management of patients with sensory impairments. Br Dent J 2022; 233:627-633. [PMID: 36307700 PMCID: PMC9615611 DOI: 10.1038/s41415-022-5085-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/06/2022] [Indexed: 01/12/2023]
Abstract
This article discusses the different types of sensory impairments and their aetiology. It considers how the oral health status in patients with sensory impairments is impacted by their disability and the barriers these patients face in dental care. It also discusses legislation relevant to dental care professionals when caring for patients with disabilities, including the Mental Capacity Act (2005), the Equality Act (2010) and the Accessible Information Standard (2016). Finally, it provides recommendations to dental care professionals on how they can best manage patients with sensory impairments and communicate with them effectively in order to provide them with quality dental care.
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Ramani KR, Reddy KVK. Prevalence of calcified carotid artery atheromas on digital panoramic radiographs in type 2 diabetic and non-diabetic patients. JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2022. [DOI: 10.4103/jiaomr.jiaomr_332_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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The assessment of the relationship between the severity of gingivitis and the glycosylated hemoglobin levels in adolescent and adult patients with type 1 diabetes. POSTEP HIG MED DOSW 2021. [DOI: 10.2478/ahem-2021-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstrakt
Background
Diabetes and periodontitis belong to the group of civilizational diseases, which are not associated with any specific bacterial or viral infection but with the rapid development of civilization and technological advances that affect comfort and quality of life. Civilizational diseases occur in highly developed and developing societies. Glycosylated hemoglobin A1c (HbA1c) is one of the standard indicators for the assessment of metabolic compensation in diabetes that reflects the risk of disease complications. One of the significant complications of diabetes that manifests in the oral cavity is gingival and periodontal inflammation, which is directly related to increased insulin resistance and worsened diabetes compensation. Factors influencing inflammation are the patient’s age, directly linked with fine motor skills when it comes to cleaning teeth, and patients’ awareness related to cause-and-effect relationship between dental hygiene, gingival and periodontal inflammation, and HbA1c testing during routine check-ups.
Objectives
To compare the relationship between gingival inflammation and metabolic compensation (HbA1c levels), depending on the patient’s age.
Materials and methods
The study involved 100 patients (50 adolescents and 50 adults, 42 M; 58 F) with type 1 diabetes. The study group was divided according to sex and age into 19 male adolescent patients (10–18 years old; mean age 15.5) and 23 male adult patients (19–45 years old; mean age 27.1). The mean duration of diabetes was 7 years in the group of adolescents and 11 years in the group of adults. The HbA1c levels and gingival index (GI) were measured in all patients. The obtained results were statistically analyzed.
Results
By comparing the study groups, higher HbA1c values were reported in the group of adolescents. HbA1c has been shown to correlate with the GI in adolescents and adults. Despite poorer compensation for diabetes (higher HbA1c), GI values were similar in adolescents and adults.
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Madhuri M, Kulkarni S, Doshi D, Reddy S, Adepu S, Reddy S. Oral health status and self- assessment of oral health risk factors among South Indian diabetic patients. Indian J Dent Res 2021; 32:140-146. [PMID: 34810379 DOI: 10.4103/ijdr.ijdr_508_18] [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: 11/04/2022] Open
Abstract
Background The disease profile of the world is changing at an astonishingly fast rate. It is essential that the impending nature of chronic disease is recognized and acted on urgently. India leads the world with the largest number of diabetics earning the dubious distinction of being termed the "diabetic capital" of the world. Aim To assess and compare the oral health status and related oral health risk factors among diabetic patients in Hyderabad and Secunderabad. Settings A cross sectional study was carried out in various diagnostic centers among 801 patients aged 30 years and above. Methods and Materials Oral health status and self-assessed data on related oral risk factors were measured using modified World Health Organization (WHO) assessment form and oral health questionnaire for adults 2013. Statistical Analysis Comparison of mean scores of the variables based on gender was assessed using ANOVA. Statistical significance was set at p < 0.05. Results Females had higher proportion of untreated caries (362; 85%) and DMFT (Decayed, Missing and Filled Teeth; 375; 88%) compared to males. On the basis of loss of attachment, the mean number of sextants with no loss of attachment was mostly noted among female subjects. Conclusion In the present study, though gingivitis was seen in higher percentage (82%), the presence of periodontal disease was relatively low (68.3%). It can be concluded that diabetic subjects may have poor oral health.
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Affiliation(s)
- Mukkavilli Madhuri
- Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Suhas Kulkarni
- Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Dolar Doshi
- Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Srikanth Reddy
- Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Srilatha Adepu
- Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Sahithi Reddy
- Department of Public Health Dentistry, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
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18
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State of Evidence on Oral Health Problems in Diabetic Patients: A Critical Review of the Literature. J Clin Med 2021; 10:5383. [PMID: 34830663 PMCID: PMC8618619 DOI: 10.3390/jcm10225383&set/a 912874875+940716348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Diabetes mellitus (DM) is a global health problem, having recognized that in the next 20 years the number of diabetic patients in the world will increase to 642 million. DM exerts enormous repercussions on general health diabetic (especially derived from vascular, cardiac, renal, ocular, or neurological affectation). It entails in addition a high number of deaths directly related to the disease, as well as a high health care cost, estimated at $673 billion annually. Oral cavity is found among all the organs and systems affected in the course of DM. Important pathologies are developed with higher prevalence, such as periodontitis (PD), alterations in salivary flow, fungal infections, oral cancer, and oral potentially malignant disorders (OPMD). It has been proven that PD hinders the metabolic control of DM and that the presence of PD increases the possibility for developing diabetes. Despite the relevance of these oral pathologies, the knowledge of primary care physicians and diabetes specialists about the importance of oral health in diabetics, as well as the knowledge of dentists about the importance of DM for oral health of patients is scarce or non-existent. It is accepted that the correct management of diabetic patients requires interdisciplinary teams, including dentists. In this critical review, the existing knowledge and evidence-degree on the preventive, clinical, diagnosis, prognosis, and therapeutic aspects of oral diseases that occur with a significant frequency in the diabetic population are developed in extension.
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State of Evidence on Oral Health Problems in Diabetic Patients: A Critical Review of the Literature. J Clin Med 2021. [DOI: 10.3390/jcm10225383
expr 893869204 + 932072443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Diabetes mellitus (DM) is a global health problem, having recognized that in the next 20 years the number of diabetic patients in the world will increase to 642 million. DM exerts enormous repercussions on general health diabetic (especially derived from vascular, cardiac, renal, ocular, or neurological affectation). It entails in addition a high number of deaths directly related to the disease, as well as a high health care cost, estimated at $673 billion annually. Oral cavity is found among all the organs and systems affected in the course of DM. Important pathologies are developed with higher prevalence, such as periodontitis (PD), alterations in salivary flow, fungal infections, oral cancer, and oral potentially malignant disorders (OPMD). It has been proven that PD hinders the metabolic control of DM and that the presence of PD increases the possibility for developing diabetes. Despite the relevance of these oral pathologies, the knowledge of primary care physicians and diabetes specialists about the importance of oral health in diabetics, as well as the knowledge of dentists about the importance of DM for oral health of patients is scarce or non-existent. It is accepted that the correct management of diabetic patients requires interdisciplinary teams, including dentists. In this critical review, the existing knowledge and evidence-degree on the preventive, clinical, diagnosis, prognosis, and therapeutic aspects of oral diseases that occur with a significant frequency in the diabetic population are developed in extension.
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20
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González-Moles MÁ, Ramos-García P. State of Evidence on Oral Health Problems in Diabetic Patients: A Critical Review of the Literature. J Clin Med 2021; 10:5383. [PMID: 34830663 PMCID: PMC8618619 DOI: 10.3390/jcm10225383] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/09/2021] [Accepted: 11/13/2021] [Indexed: 12/24/2022] Open
Abstract
Diabetes mellitus (DM) is a global health problem, having recognized that in the next 20 years the number of diabetic patients in the world will increase to 642 million. DM exerts enormous repercussions on general health diabetic (especially derived from vascular, cardiac, renal, ocular, or neurological affectation). It entails in addition a high number of deaths directly related to the disease, as well as a high health care cost, estimated at $673 billion annually. Oral cavity is found among all the organs and systems affected in the course of DM. Important pathologies are developed with higher prevalence, such as periodontitis (PD), alterations in salivary flow, fungal infections, oral cancer, and oral potentially malignant disorders (OPMD). It has been proven that PD hinders the metabolic control of DM and that the presence of PD increases the possibility for developing diabetes. Despite the relevance of these oral pathologies, the knowledge of primary care physicians and diabetes specialists about the importance of oral health in diabetics, as well as the knowledge of dentists about the importance of DM for oral health of patients is scarce or non-existent. It is accepted that the correct management of diabetic patients requires interdisciplinary teams, including dentists. In this critical review, the existing knowledge and evidence-degree on the preventive, clinical, diagnosis, prognosis, and therapeutic aspects of oral diseases that occur with a significant frequency in the diabetic population are developed in extension.
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Affiliation(s)
- Miguel Ángel González-Moles
- School of Dentistry, University of Granada, 18010 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Pablo Ramos-García
- School of Dentistry, University of Granada, 18010 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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21
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Lim J, Park H, Lee H, Lee E, Lee D, Jung HW, Jang IY. Longitudinal impact of oral health on geriatric syndromes and clinical outcomes in community-dwelling older adults. BMC Geriatr 2021; 21:482. [PMID: 34481482 PMCID: PMC8418721 DOI: 10.1186/s12877-021-02416-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 08/04/2021] [Indexed: 02/03/2023] Open
Abstract
Background Oral health is essential for daily living and plays a pivotal role in overall health conditions and well-being. This study evaluated the impact of self-reported oral health on geriatric conditions, institutionalization, and mortality. Methods This study analyzed the population of the Aging Study of Pyeongchang Rural Area that had undergone geriatric assessments between 2016 and 2017. The oral health status of the participants was determined using three items from the General Oral Health Assessment Index, and the participants were classified into three groups according to the total sum of the scores as good (3), fair (4–7), or poor (8–15). The outcomes were the incidence of geriatric syndromes at 2 years and the composite outcome of mortality and institutionalization. Results Among the 1189 participants, 44.1 % were women, and the mean age of the study population was 75.0 years. Good, fair, and poor oral health were observed in 597 (50.2 %), 406 (34.1 %), and 186 (15.6 %) individuals, respectively. Worsening oral health status was associated with the incidences of various geriatric syndromes at follow-up, and these associations were attenuated after adjusting for baseline demographic and geriatric parameters. Similarly, the significant association between baseline oral health status and the incidence of the composite outcome was attenuated after adjusting for demographic and geriatric parameters. Conclusions Oral health affected the geriatric health conditions in this prospective, longitudinal cohort of community-dwelling older adults. The correlations and interactions of oral health status with other functional parameters may deserve consideration as a geriatric domain. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02416-2.
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Affiliation(s)
- Jihye Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Hyungchul Park
- Department of Gastroenterology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Heayon Lee
- Divison of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021 Tongil-ro, Jingwan-dong, Eunpyeong-gu, Seoul, South Korea
| | - Eunju Lee
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Danbi Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Hee-Won Jung
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea.
| | - Il-Young Jang
- Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea. .,PyeongChang Health Center and County Hospital, 11 Noseong-ro, Pyeongchang-eup, Pyeongchang-gun, Gangwon-do, Gangneung, Republic of Korea.
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22
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Chen Y, Zhang P, Luman ET, Griffin SO, Rolka DB. Incremental Dental Expenditures Associated With Diabetes Among Noninstitutionalized U.S. Adults Aged ≥18 Years Old in 2016-2017. Diabetes Care 2021; 44:1317-1323. [PMID: 33905345 PMCID: PMC8247485 DOI: 10.2337/dc20-2744] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/15/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Diabetes is associated with poor oral health, but incremental expenditures for dental care associated with diabetes in the U.S. are unknown. We aimed to quantify these incremental expenditures per person and for the nation. RESEARCH DESIGN AND METHODS We analyzed data from 46,633 noninstitutionalized adults aged ≥18 years old who participated in the 2016-2017 Medical Expenditure Panel Survey. We used two-part models to estimate dental expenditures per person in total, by payment source, and by dental service type, controlling for sociodemographic characteristics, health status, and geographic variables. Incremental expenditure was the difference in predicted expenditure for dental care between adults with and without diabetes. The total expenditure for the U.S. was the expenditure per person multiplied by the estimated number of people with diabetes. Expenditures were adjusted to 2017 USD. RESULTS The mean adjusted annual diabetes-associated incremental dental expenditure was $77 per person and $1.9 billion for the nation. Of this incremental expenditure, 51% ($40) and 39% ($30) were paid out of pocket and by private insurance, 69% ($53) of the incremental expenditure was for restorative/prosthetic/surgical services, and adults with diabetes had lower expenditure for preventive services than those without (incremental, -$7). Incremental expenditures were higher in older adults, non-Hispanic Whites, and people with higher levels of income and education. CONCLUSIONS Diabetes is associated with higher dental expenditures. These results fill a gap in the estimates of total medical expenditures associated with diabetes in the U.S. and highlight the importance of preventive dental care among people with diabetes.
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Affiliation(s)
- Yu Chen
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
| | - Ping Zhang
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
| | - Elizabeth T Luman
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
| | - Susan O Griffin
- Division of Oral Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Deborah B Rolka
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA
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Mannakandath ML, Kamran MA, Udeabor SE, Hameed MS, Ajmal M, Alshahrani I. Effect of ultrasonic scaling with adjunctive photodynamic therapy on the treatment of gingival inflammation among diabetic patients undergoing fixed orthodontic treatment. Photodiagnosis Photodyn Ther 2021; 35:102360. [PMID: 34052421 DOI: 10.1016/j.pdpdt.2021.102360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/02/2021] [Accepted: 05/21/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The aim of the present clinical trial was to evaluate the effect of methylene blue-mediated antimicrobial photodynamic therapy (aPDT) on the gingival and immunological parameters in diabetic adolescent patients undergoing fixed orthodontic treatment. METHODS The selected 40 participants were randomized equally into two groups; Group I (ultrasonic scaling + oral hygiene instructions) and Group II (ultrasonic scaling/oral hygiene instructions + aPDT). Serum HbA1c levels was assessed for all the participants at chairside. Plaque index (Pi), and bleeding on probing (BOP) were analyzed. Moreover, the assessment of crevicular fluid matrix metalloproteinase 8 (MMP-8) and macrophage inflammatory protein 1 alpha (MIP-1α) was performed using enzyme-linked immunosorbent assay technique. All measurements were recorded at baseline, 6 weeks, and 12 weeks follow-up periods, respectively. Intergroup comparisons for p-value were computed using Mann-Whitney test and Wilcoxon singed ranks test to compute p-value for intra-group comparisons. Stepwise logistic regression analysis was used to identify explanatory variables for reduction in plaque scores and bleeding on probing, after controlling for the effects of other covariates. Odds ratios and 95% confidence intervals were used to assess the direction and strength for associations. Significance level was set at 5% for all analyses. RESULTS All 40 individuals completed the clinical trial. There was a statistically significant reduction in Pi and BOP in both Group I and Group II from baseline to 12 weeks of follow up (P<0.05). However, there was slight reduction in the plaque scores in Group-II as compared to Group-I at 12 weeks visit (P<0.05). There was also a statistically significant difference for BOP when Group-I was compared with Group-II on 12 weeks follow up assessment (P<0.05). HbA1c assessment indicated no statistically significant difference either within or between groups at any time point (P>0.05). Both MMP-8 and MIP-1α reported a significant decrease for both Groups I and II at 6 weeks and 12 weeks follow-up periods in comparison to baseline (P<0.05). Inter-group comparison indicated a statistically significant difference noted at both 6 weeks follow up that was maintained at 12 weeks follow up (P<0.05). The logistic regression analysis revealed that even after controlling the mean BMI as a predictor, the change of biomarker levels along with the improvement in plaque scores and bleeding on probing was not significant (p> 0.05). CONCLUSION aPDT significantly improved bleeding on probing and proinflammatory biomarkers among diabetic adolescent patients undergoing fixed orthodontic therapy.
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Affiliation(s)
- Master Luqman Mannakandath
- Department of Oral Diagnosis and Oral Biology, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Muhammad Abdullah Kamran
- Department of Pediatric and Orthodontic Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia.
| | - Samuel Ebele Udeabor
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammad Shahul Hameed
- Department of Diagnostic Sciences and Oral Biology, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Muhammed Ajmal
- Department of Diagnostic Sciences and Oral Biology, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Ibrahim Alshahrani
- Department of Pediatric and Orthodontic Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
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24
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Catamo E, Tornese G, Concas MP, Gasparini P, Robino A. Differences in taste and smell perception between type 2 diabetes mellitus patients and healthy controls. Nutr Metab Cardiovasc Dis 2021; 31:193-200. [PMID: 33500104 DOI: 10.1016/j.numecd.2020.08.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS The senses of taste and smell are essential determinants of food choice, which in turn may contribute to the development of chronic diseases, including diabetes. Although past studies have evaluated the relationship between type 2 diabetes mellitus (DM2) and senses disorders, this relationship remains controversial. In this study, we evaluated taste and smell perception in DM2 patients and healthy controls (HC). Moreover, we analyzed the association of chemosensory impairments with anthropometric and clinical outcomes (e.g. Body Mass Index (BMI), Fasting blood glucose (FBG), drugs, cardiovascular diseases (CVD), and hypertension) in DM2 patients. METHODS AND RESULTS The study included 94 DM2 patients and 244 HC. Taste recognition for 6-n-propylthiouracil (PROP), quinine, citric acid, sucrose, and sodium chloride (NaCl) compounds was assessed using a filter paper method, while smell recognition of 12 odorants was performed using a Sniffin' sticks test. We found that a higher percentage of DM2 patients showed identification impairment in salt taste (22% vs. 5%, p-value<0.0009) and smell recognition (55% vs. 27%, p-value = 0.03) compared to HC. We also observed that 65% of hypertensive DM2 subjects presented smell identification impairment compared to 18% of non-hypertensive patients (p-value = 0.019). Finally, patients with impairments in both taste and smell showed elevated FBG compared to patients without impairment (149.6 vs.124.3 mg/dL, p-value = 0.04). CONCLUSION The prevalence of taste and smell identification impairments was higher in DM2 patients compared to HC, and a possible relationship with glycemic levels emerged.
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Affiliation(s)
- Eulalia Catamo
- Institute for Maternal and Child Health - IRCCS ''Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy.
| | - Gianluca Tornese
- Institute for Maternal and Child Health - IRCCS ''Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy
| | - Maria P Concas
- Institute for Maternal and Child Health - IRCCS ''Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy
| | - Paolo Gasparini
- Institute for Maternal and Child Health - IRCCS ''Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy; Department of Medical Sciences, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy
| | - Antonietta Robino
- Institute for Maternal and Child Health - IRCCS ''Burlo Garofolo", Via dell'Istria 65/1, 34137, Trieste, Italy
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Goldoni R, Farronato M, Connelly ST, Tartaglia GM, Yeo WH. Recent advances in graphene-based nanobiosensors for salivary biomarker detection. Biosens Bioelectron 2021; 171:112723. [PMID: 33096432 PMCID: PMC7666013 DOI: 10.1016/j.bios.2020.112723] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/09/2020] [Accepted: 10/11/2020] [Indexed: 12/11/2022]
Abstract
As biosensing research is rapidly advancing due to significant developments in materials, chemistry, and electronics, researchers strive to build cutting-edge biomedical devices capable of detecting health-monitoring biomarkers with high sensitivity and specificity. Biosensors using nanomaterials are highly promising because of the wide detection range, fast response time, system miniaturization, and enhanced sensitivity. In the recent development of biosensors and electronics, graphene has rapidly gained popularity due to its superior electrical, biochemical, and mechanical properties. For biomarker detection, human saliva offers easy access with a large variety of analytes, making it a promising candidate for its use in point-of-care (POC) devices. Here, we report a comprehensive review that summarizes the most recent graphene-based nanobiosensors and oral bioelectronics for salivary biomarker detection. We discuss the details of structural designs of graphene electronics, use cases of salivary biomarkers, the performance of existing sensors, and applications in health monitoring. This review also describes current challenges in materials and systems and future directions of the graphene bioelectronics for clinical POC applications. Collectively, the main contribution of this paper is to deliver an extensive review of the graphene-enabled biosensors and oral electronics and their successful applications in human salivary biomarker detection.
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Affiliation(s)
- Riccardo Goldoni
- George W. Woodruff School of Mechanical Engineering, Institute for Electronics and Nanotechnology, Atlanta, GA, 30332, USA; School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Marco Farronato
- Department of Medicine, Surgery, and Dentistry, Università Degli Studi di Milano, Milan, Italy; Maxillofacial and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Italy
| | - Stephen Thaddeus Connelly
- Department of Oral & Maxillofacial Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Gianluca Martino Tartaglia
- Department of Medicine, Surgery, and Dentistry, Università Degli Studi di Milano, Milan, Italy; Maxillofacial and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Italy
| | - Woon-Hong Yeo
- George W. Woodruff School of Mechanical Engineering, Institute for Electronics and Nanotechnology, Atlanta, GA, 30332, USA; Wallace H. Coulter Department of Biomedical Engineering, Parker H. Petit Institute for Bioengineering and Biosciences, Atlanta, GA, 30332, USA; Center for Human-Centric Interfaces and Engineering, Neural Engineering Center, Institute for Materials, Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
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Chaudhuri S, Sanyal P, Srirammohan P. Oral health complications in type 2 diabetes: A hospital-based observational study among beneficiaries of employees state insurance in Puducherry, India. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2021. [DOI: 10.4103/injms.injms_8_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ahmad R, Haque M. Oral Health Messiers: Diabetes Mellitus Relevance. Diabetes Metab Syndr Obes 2021; 14:3001-3015. [PMID: 34234496 PMCID: PMC8257029 DOI: 10.2147/dmso.s318972] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/19/2021] [Indexed: 12/13/2022] Open
Abstract
This article aims to narrate the various oral complications in individuals suffering from diabetes mellitus. Google search for "diabetes mellitus and oral complications" was done. The search was also carried out for "diabetes mellitus" and its oral complications individually. Diabetes mellitus is a chronic metabolic disorder that is a global epidemic and a common cause of morbidity and mortality in the world today. Currently, there are about 422 million cases of diabetes mellitus worldwide. Diabetic patients can develop different complications in the body such as retinopathy, neuropathy, nephropathy, cardiovascular disease. Complications in the oral cavity have been observed in individuals suffering from diabetes mellitus. A study noted that more than 90% of diabetic patients suffered from oral complications. Another research has shown a greater prevalence of oral mucosal disorders in patients with diabetes mellitus than non-diabetic population: 45-88% in patients with type 2 diabetes compared to 38.3-45% in non-diabetic subjects and 44.7% in type 1 diabetic individuals compared to 25% in the non-diabetic population. Oral complications in people with diabetes are periodontal disease, dental caries, oral infections, salivary dysfunction, taste dysfunction, delayed wound healing, tongue abnormalities, halitosis, and lichen planus. The high glucose level in saliva, poor neutrophil function, neuropathy, and small vessel damage contribute to oral complications in individuals with uncontrolled diabetes. Good oral health is imperative for healthy living. Oral complications cause deterioration to the quality of life in diabetic patients. Complications like periodontal disease having a bidirectional relationship with diabetes mellitus even contribute to increased blood glucose levels in people with diabetes. This article intends to promote awareness regarding the oral health of diabetics and to stress the importance of maintaining proper oral hygiene, taking preventive measures, early detection, and appropriate management of oral complications of these patients through a multidisciplinary approach.
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Affiliation(s)
- Rahnuma Ahmad
- Department of Physiology, Medical College for Women and Hospital, Dhaka, Bangladesh
| | - Mainul Haque
- The Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, 57000, Malaysia
- Correspondence: Mainul Haque The Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, 57000, Malaysia Email
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Khazaal SS, Talha MH, Raheem AA. Pathogenic bacteria of diabetic-associated infections and their pathogenesis. REVIEWS IN MEDICAL MICROBIOLOGY 2021; 32:22-27. [DOI: 10.1097/mrm.0000000000000222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Martins RARC, Costa FWG, Silva SM, Silva PGDB, Carvalho FSR, Fonteles CSR, Ribeiro TR. Salivary immunoglobulins (A, G, and M) in type 1 diabetes mellitus patients: A PROSPERO-registered systematic review and meta-analysis. Arch Oral Biol 2020; 122:105025. [PMID: 33341591 DOI: 10.1016/j.archoralbio.2020.105025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 11/28/2020] [Accepted: 12/06/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the difference in the salivary levels of immunoglobulins between patients with type 1 diabetes mellitus (DM1) and healthy controls. DESIGN This systematic review was registered on the PROSPERO (CRD42020159198) database. All references were cross-checked and the risk of bias assessment was conducted using the Newcastle-Ottawa Scale. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to appraise the quality of evidence. The standardized mean difference and Cohen's d as the effect size were used in the meta-analysis. I-square statistics was used to estimate heterogeneity. Analysis was performed using the RevMan® software (p < 0.05) with a 95 % confidence interval. RESULTS Of the total 92 articles, 9 were selected for this study. The meta-analysis included 333 DM1 patients and 325 healthy controls. DM1 patients showed a significant reduction in salivary flow (p = 0.0008; Cohen's d= -0.19, CI 95 %= -0.33, -0.05), although not significant enough to modify the IgA concentration (p = 0.120; Cohen's d = 0.58, CI 95 %= -0.15, 1.32). However, DM1 increased IgA concentration by reducing salivary flow (Cohen's d = 0.84; CI 95 % = 0.36, 1.32), with a strong estimate of effect (p = 0.0006). Regarding IgG, no significant change was noted with DM1 in the patient's saliva (p = 0.420). Furthermore, there was no significant variation in the salivary IgM levels (p = 0.300). CONCLUSIONS The data suggest that the salivary levels of the evaluated immunoglobulins do not seem to be altered in DM1 patients when compared to that in healthy controls. However, the increase in IgA salivary concentration was dependent on total protein estimation.
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Affiliation(s)
- Renata Asfor Rocha Carvalho Martins
- Department of Clinical Dentistry, School of Dentistry, Federal University of Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, CEP: 60430-160, Fortaleza, Ceará, Brazil.
| | - Fábio Wildson Gurgel Costa
- Department of Clinical Dentistry, School of Dentistry, Federal University of Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, CEP: 60430-160, Fortaleza, Ceará, Brazil.
| | - Sara Maria Silva
- Department of Clinical Dentistry, School of Dentistry, Federal University of Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, CEP: 60430-160, Fortaleza, Ceará, Brazil.
| | | | - Francisco Samuel Rodrigues Carvalho
- Division of Oral and Maxillofacial Surgery, School of Dentistry, Federal University of Ceará CampusSobral, Rua Conselheiro José Júlio, S/N, Centro, CEP: 62010-820, Sobral, Ceará, Brazil.
| | - Cristiane Sá Roriz Fonteles
- Department of Clinical Dentistry, School of Dentistry, Federal University of Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, CEP: 60430-160, Fortaleza, Ceará, Brazil.
| | - Thyciana Rodrigues Ribeiro
- Department of Clinical Dentistry, School of Dentistry, Federal University of Ceará, Rua Monsenhor Furtado, s/n, Rodolfo Teófilo, CEP: 60430-160, Fortaleza, Ceará, Brazil.
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Diabetes Mellitus and Periapical Abscess: A Cross-sectional Study. J Endod 2020; 46:1605-1609. [DOI: 10.1016/j.joen.2020.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/23/2020] [Accepted: 08/13/2020] [Indexed: 12/29/2022]
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Focal Infection and Periodontitis: A Narrative Report and New Possible Approaches. Int J Microbiol 2020; 2020:8875612. [PMID: 33488729 PMCID: PMC7803120 DOI: 10.1155/2020/8875612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/29/2020] [Accepted: 10/17/2020] [Indexed: 12/13/2022] Open
Abstract
The "focal infection theory" is a historical concept based on the assumption that some infections may cause chronic and acute diseases in different districts of the body. Its great popularity spanned from 1930 to 1950 when, with the aim to remove all the foci of infection, drastic surgical interventions were performed. Periodontitis, a common oral pathology mainly of bacterial origin, is the most evident example of this phenomenon today: in fact, bacteria are able to migrate, develop and cause health problems such as cardiovascular and respiratory diseases, diabetes, and osteoporosis. The aim of this narrative report is to verify the hypothesis of the association between oral infections and systemic diseases by different ways of approach and, at the same time, to propose new kinds of treatment today made possible by technological progress. The analysis of the literature demonstrated a strong relationship between these conditions, which might be explained on the basis of the recent studies on microbiota movement inside the body. Prevention of the oral infections, as well as of the possible systemic implications, may be successfully performed with the help of new technologies, such as probiotics and laser.
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Kim SY, Kim JS, Byon MJ, Kang HK, Kim JB. Association of Insufficient or Excess Sleep with Type 2 Diabetes Mellitus in the Presence of Periodontitis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207670. [PMID: 33096670 PMCID: PMC7589109 DOI: 10.3390/ijerph17207670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/13/2020] [Accepted: 10/19/2020] [Indexed: 11/16/2022]
Abstract
We aimed to investigate the effects of sleep duration on impaired fasting glucose and diabetes in Korean adults with periodontal disease. This cross-sectional study was performed using data for 10,465 subjects aged >19 years who completed the periodontal examination and questionnaires in the Sixth Korea National Health and Nutrition Examination Survey (2013-2015). The effect of sleep was confirmed by a complex-sample multinomial logistic regression analysis. Confounding variables were age, sex, household income, education level, smoking status, and sleep duration. Of all participants, 25.7% had periodontitis, of which 28.6% had fasting serum glucose disorder and 14.2% had diabetes. Among participants with periodontitis, the prevalence of diabetes was 1.49 times higher in participants with an average sleep duration of ≥8 h than those with an average sleep duration of 6-7 h. The prevalence of diabetes among participants without periodontitis was 1.49 times and 1.57 times higher in participants with an average sleep duration of ≤5 and ≥8 h, respectively, than those with an average sleep duration of 6-7 h. We found that altered sleep duration may be a risk factor for diabetes and that proper sleep duration is important to control diabetes incidence.
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Affiliation(s)
- Se-Yeon Kim
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Yangsan 50612, Korea; (S.-Y.K.); (J.-S.K.); (M.-J.B.)
| | - Ji-Soo Kim
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Yangsan 50612, Korea; (S.-Y.K.); (J.-S.K.); (M.-J.B.)
| | - Min-Ji Byon
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Yangsan 50612, Korea; (S.-Y.K.); (J.-S.K.); (M.-J.B.)
- BK21 FOUR Project, School of Dentistry, Pusan National University, Yangsan 50612, Korea
| | - Hyun Kyung Kang
- Department of Dental Hygiene, Silla University, Baekyang-daero, 700, Sasang-gu, Busan 46958, Korea;
| | - Jin-Bom Kim
- Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Yangsan 50612, Korea; (S.-Y.K.); (J.-S.K.); (M.-J.B.)
- BK21 FOUR Project, School of Dentistry, Pusan National University, Yangsan 50612, Korea
- Correspondence: ; Tel.: +82-51-510-8223
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Iscan TA, Ozsin-Ozler C, Ileri-Keceli T, Guciz-Dogan B, Alikasifoglu A, Uzamis-Tekcicek M. Oral health and halitosis among type 1 diabetic and healthy children. J Breath Res 2020; 14:036008. [PMID: 32340013 DOI: 10.1088/1752-7163/ab8d8b] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM To evaluate the oral health status, oral health related habits and halitosis of children with and without type 1 diabetes. MATERIALS AND METHODS In this study the oral health status of children with and without type 1 diabetes were evaluated by using different indices (dmft/DMFT, International Caries Detection and Assessment System(ICDAS) II, pufa, gingival and periodontal indices). Halitosis was determined by organoleptic assessment and sulfur monitoring. RESULTS One hundred children with the age range between 6-13 years, 50 type 1 diabetics (24 boys,26 girls) with mean age (±sd) of 10.3 ± 2.1 years and 50 healthy (30 boys, 20 girls) with mean age (±sd) of 9.9 ± 1.5 years, participated in the study. The median values of dmft and dmfs was lower in children with type 1 diabetes, while for DMFT and DMFS indices were similar with the healthy group. Cavitated caries lesions were observed in 60.0% of children with diabetes and in 58.0% of healthy children. According to the ICDAS II index, 42.0% of children with diabetes and 56.0% of healthy children had severe decay. The mean plaque index was statistically significantly less in diabetic children (p = 0.04). In 12.0% of children with type 1 diabetes and in 18.0% of healthy children, volatile sulfur compounds (VSC) were determined to be ≥150 ppb and the most diagnosed score was 1 in both groups. In diabetic children with the cut off value of 7.5% HbA1c, there was no statistically significant difference in oral health indices results and VSC scores. CONCLUSION Findings of the present study are insufficient to support a significant effect of diabetes on increasing the risk of oral and periodontal diseases. Nonetheless, it is important to emphasize the importance of oral and dental health, regular oral care and dental visits both to the patients with type 1 diabetes and their parents.
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Affiliation(s)
- Tayyibe Aslihan Iscan
- Department of Pediatric Dentistry, Hacettepe University Faculty of Dentistry, Ankara, Turkey
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Nori H, Hajifattahi F, Moezzi ghadim N, Alirezaei S. Evaluation of Patients’ Awareness of Their Blood Pressure and Blood Glucose at the Dental Faculty of Islamic Azad University of Medical Sciences, Tehran, Iran, in 2018. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2020. [DOI: 10.29252/jrdms.5.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Dhir S, Bansal S, Wangnoo S. Diabetes Mellitus and Periodontitis: Relevance of the Diabolic Duo in India. APOLLO MEDICINE 2020. [DOI: 10.4103/am.am_118_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Abstract
Periodontitis and diabetes are complex chronic diseases, linked by an established bidirectional relationship. Risk for periodontitis is increased two to three times in people with diabetes compared to individuals without, and the level of glycaemic control is key in determining risk. In people who do not have diabetes, periodontitis is associated with higher glycated haemoglobin (HbA1c) and fasting blood glucose levels, and severe periodontitis is associated with increased risk of developing diabetes. In people with type 2 diabetes, periodontitis is associated with higher HbA1c levels and worse diabetes complications. Treatment of periodontitis in people with diabetes has been shown to result in improved glycaemic control, with HbA1c reductions of 3-4 mmol/mol (0.3-0.4%) in the short term (3-4 months) post-treatment. Given that treatment of periodontitis results in clinically relevant reductions in HbA1c, the dental team has an important role in the management of patients with diabetes. Improved interprofessional working in relation to diabetes and periodontitis has been advocated by professional and scientific organisations, though practical and systemic barriers make this challenging. This paper reviews current evidence linking periodontitis and diabetes, and considers the role of the dental team in the wider context of management of patients with diabetes and periodontitis.
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The Connection of Periodontal Disease and Diabetes Mellitus: The Role of Matrix Metalloproteinases and Oxidative Stress. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.2478/sjecr-2019-0051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Abstract
Diabetes mellitus, a chronic disease considered by the World Health Organization to be an epidemic, is now recognized as one of the factors behind the onset of periodontal disease. The connection between periodontal disease, which is an irreversible inflammatory disease of the supporting tissue of the teeth, and systemic diseases is reflected in the existence of common risk factors, subgingival dental biofilm, as a constant source of proinflamma-tory cytokines synthesized intensely in inflammatory periodontium. Diabetes mellitus leads to increased oxidative stress in periodontal tissues causing worsening of the disease and periodontopathy exacerbates deficiency of pancreatic β-cells. The most important role in primary inflammatory response in the pathogenesis of periodontopathy is played by neutrophils. Neutrophils cause periodontium destruction by the release of enzymes (matrix metalloproteinases), cytotoxic substances (free radicals, reactive oxygen and nitrogen species) and the expression of membrane receptors. Matrix metalloproteinases within the “protease network” are critical to many physiological and pathological processes, including immunity, inflammation, bone resorption and wound healing. Matrix metalloproteinases levels are elevated in patients with metabolic syndrome and diabetes mellitus, which may contribute to more frequent complications. In this paper, the review of available literature data shows the correlation between periodontal disease and diabetes mellitus, as well as the role of matrix metalloproteinases and oxidative stress in these. In this regard, determining the value of matrix metalloproteinases may be helpful in the diagnosis of periodontal disease complicated by diabetes mellitus. Also, the parameters of oxidative stress could help to clarify the mechanisms of pathogenesis and etiology of periodontal disease, or indicate the potential benefit of antioxidant supplementation in these individuals. As the role of matrix metalloproteinases has not been fully clarified in the pathogenesis of periodontopathy, additional studies will be needed to indicate their importance.
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Sampath A, Weerasekera M, Dilhari A, Gunasekara C, Bulugahapitiya U, Fernando N, Samaranayake L. Type 2 diabetes mellitus and oral Candida colonization: Analysis of risk factors in a Sri Lankan cohort. Acta Odontol Scand 2019; 77:508-516. [PMID: 31145647 DOI: 10.1080/00016357.2019.1607547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aims: Oral candidiasis is a major oral manifestation of uncontrolled diabetes mellitus, and a number of cofactors are associated with the pathogenesis of this infection. Here, we describe the prevalence of oral Candida in a Sri Lankan cohort of type 2 diabetes mellitus and risk factors that predispose them to this common fungal infection. Methods: A case-control study was conducted in 250 diabetics with type 2 diabetes and 81 nondiabetic controls. Clinical and demographic data were collected using an interviewer administered questionnaire, and patient records. Oral rinse samples were collected to determine the candidal carriage, and the resultant yeast growth was quantified and speciated using multiplex-PCR and phenotypic analyses. Chi-square test (χ2 test) and Fisher exact test were used for the determination of the significant relationships between risk factors and oral candidiasis. Results: The oral prevalence of Candida species among both groups was similar (81%) although a significantly higher proportion of diabetics (32.8%) yielded >2000 CFU/mL of yeasts compared with only 12.3% of the healthy controls (p < .05). Significant associations were noted between oral candidal carriage amongst diabetics, and (i) denture wearing, (ii) female gender and (iii) cigarette smoking (all, p < .05). Amongst both groups, C.albicans was the most common Candida species isolated followed by C. parapsilosis, C. tropicalis and C. glabrata. Conclusions: The oral infestation of Candida in our Sri Lankan cohort of diabetics is significantly higher than their healthy counterparts, and co-carriage of multiple yeast species is a common finding in the study population. As there are no previous such reports of the latter phenomenon particularly from the Asian region it is noteworthy, mainly in view of the recent data on the emergence of drug-resistant yeast species the world over.
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Affiliation(s)
- Asanga Sampath
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Manjula Weerasekera
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Ayomi Dilhari
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Chinthika Gunasekara
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | | | - Neluka Fernando
- Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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Verhulst MJL, Teeuw WJ, Gerdes VEA, Loos BG. Self-reported oral health and quality of life in patients with type 2 diabetes mellitus in primary care: a multi-center cross-sectional study. Diabetes Metab Syndr Obes 2019; 12:883-899. [PMID: 31354324 PMCID: PMC6590843 DOI: 10.2147/dmso.s207087] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/03/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Guidelines for primary diabetes care recommend to pay attention to oral health in patients with diabetes mellitus type 2 (T2DM). However, research about dental care utilization and the extent of problems regarding oral health in these patients is limited. Purpose: To assess self-reported oral health, general health-related quality of life (QoL) and oral health-related QoL in patients with T2DM who regularly attend a family physician office. Methods: Family physician offices were recruited in the area of Amsterdam, the Netherlands, as part of a cluster-randomized controlled trial. At these offices, patients with T2DM were included by family physicians and/or nurse practitioners. Patient data on general characteristics, self-reported oral health (including periodontitis), general health-related QoL (SF-36) and oral health-related QoL (OHIP-NL14) were collected. Results: Twenty-four family physician offices participated, who enrolled 764 patients with T2DM (mean age: 65.9±10.7 years, 56% male, 16% smoker). Almost 11% of the patients were metabolically poorly controlled (HbA1c >63 mmol/mol), 39% were obese (body mass index≥30 kg/m2), 37% had hypertension (systolic blood pressure ≥140 mmHg) and 44% had dyslipidemia (LDL-cholesterol >2.5 mmol/L). About a quarter (24%) reported not to visit a dentist regularly and 30% did not have dental insurance coverage. Furthermore, 16% of the patients were edentulous and having full dental prostheses, while 29% had a partial dental prosthesis. Pain in the mouth, dry mouth and bad breath were reported by 15%, 37% and 12% of the patients, respectively. Almost 70% suffered from periodontitis. Oral health-related QoL was impaired in 19% of the patients, and those subjects also had worse general health-related QoL. Conclusion: Almost a quarter of patients with T2DM at Dutch family physician offices does not visit the dentist regularly. The estimated prevalence of periodontitis is particularly high, but other oral health complaints and impaired oral health-related QoL are also relatively common.
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Affiliation(s)
- Martijn JL Verhulst
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Wijnand J Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Victor EA Gerdes
- Department of Vascular Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
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Khozeimeh F, Tahani B, Saberi Z, Gholi A. Evaluation of Knowledge, Attitudes and Oral Health-related Nutritional Performance of Diabetic Patients Referred to the Diabetes Research Center in Isfahan-Iran, 2016. Open Dent J 2019. [DOI: 10.2174/1874210601913010165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Type II diabetes is a chronic disease, with an ever-increasing incidence, concomitant with an increase in the number of the elderly. It is one of the conditions that can affect the orodental health. In general, the diabetes-related oral problems include dental caries, xerostomia, oral candidiasis, periodontal diseases and consumption of inappropriate foodstuff.
Objective:
The aim of this study was to evaluate knowledge, attitudes and oral health-related nutritional performance of diabetic patients referred to the diabetes center research in Isfahan-Iran, 2016.
Methods:
In the present cross-sectional study, 362 diabetic subjects (142 females and 220 males) referred to the Research Center for Endocrine Glands and Metabolism in Isfahan, were evaluated after being selected by simple random sampling technique. The frequency distribution of demographic data (gender, marital status, occupation, affliction with orodental diseases, disease history, and use of medications and supplements) were evaluated. The relationships of the variables above and the knowledge, attitude and performance scores of the subjects were evaluated. Data were analyzed with independent t-test, Pearson’s correlation coefficient and Spearmen’s correlation coefficient.
Results:
There were no significant relationships between orodental diseases and the mean scores of knowledge, attitudes and performance of the subjects. The mean scores of knowledge, attitudes and performance of the subjects were 33.8 ± 11.2, 53.311.01 and 53.7 ± 6.9 out of 100, respectively.
Conclusion:
The oral-health related nutritional knowledge of diabetic subjects was poor. Programs should be prepared to improve the knowledge and oral health-related nutritional performance of diabetic patients.
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Nishimaki F, Yamada SI, Kawamoto M, Sakurai A, Hayashi K, Kurita H. Relationship Between the Quantity of Oral Candida and Systemic Condition/Diseases of the Host: Oral Candida Increases with Advancing Age and Anemia. Mycopathologia 2019; 184:251-260. [PMID: 30825055 DOI: 10.1007/s11046-019-00326-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 02/18/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND The impact of host systemic conditions/diseases on the prosperity of oral Candida colonies remains unclear. The aim of the present study was to investigate whether a relationship exists between the quantity of oral Candida and the systemic condition/diseases of the host. PATIENTS AND METHODS The cross-sectional relationship between Candida mannan concentrations and health check-up results was analyzed in consideration of local conditions that influence the prevalence of oral Candida. RESULTS Candida mannan concentrations correlated with age, the number of untreated decayed teeth, number of prosthetic teeth, salivary pH, HbA1c, and the red blood cell count in a univariate analysis. In a multivariate analysis, Candida mannan concentrations correlated with age, the number of untreated decayed teeth, number of prosthetic teeth, salivary pH, and the red blood cell count. Candida mannan concentrations were higher in subjects older than 80 years, with a higher number of either untreated or prosthetic teeth, with a lower salivary pH, and with a decreased red blood cell count. Mannan concentrations were slightly higher in subjects with elevated HbA1c. CONCLUSIONS The present results suggest a close relationship between the quantity of oral Candida and the systemic condition/diseases of the host. Oral Candida may increase in immunocompromised hosts.
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Affiliation(s)
- Fumihiro Nishimaki
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Shin-Ichi Yamada
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan.
| | - Makiko Kawamoto
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Akinari Sakurai
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Kiyonori Hayashi
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
| | - Hiroshi Kurita
- Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan
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Trigeminal nociceptive function and oral somatosensory functional and structural assessment in patients with diabetic peripheral neuropathy. Sci Rep 2019; 9:169. [PMID: 30655584 PMCID: PMC6336810 DOI: 10.1038/s41598-018-37041-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 11/28/2018] [Indexed: 02/04/2023] Open
Abstract
This case-control study primarily compared the trigeminal nociceptive function, the intraoral somatosensory profile and possible structural nerve changes between diabetic peripheral neuropathy (DPN, n = 12) patients and healthy participants (n = 12). The nociceptive blink reflex (nBR) was recorded applying an electrical stimulation over the entry zone of the right supraorbital (V1R), infraorbital (V2R) and mental (V3R) and left infraorbital (V2L) nerves. The outcomes were: individual electrical sensory (I0) and pain thresholds (IP); root mean square (RMS), area-under-the-curve (AUC) and onset latencies of R2 component of the nBR. Furthermore, a standardized full battery of quantitative sensory testing (QST) and intraepidermal nerve fibre density (IENFD) or nerve fibre length density (NFLD) assessment were performed, respectively, on the distal leg and oral mucosa. As expected, all patients had altered somatosensory sensitivity and lower IENFD in the lower limb. DPN patients presented higher I0, IP, RMS and AUC values (p < 0.050), lower warm detection thresholds (WDT) (p = 0.004), higher occurrence of paradoxical heat sensation (PHS) (p = 0.040), and a lower intraoral NFLD (p = 0.048) than the healthy participants. In addition, the presence of any abnormal intraoral somatosensory finding was more frequent in the DPN patients when compared to the reference group (p = 0.013). Early signs of trigeminal nociceptive facilitation, intraoral somatosensory abnormalities and loss of intraoral neuronal tissue can be detected in DPN patients.
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Thoppay J, Desai B. Oral burning: local and systemic connection for a patient-centric approach. EPMA J 2019; 10:1-11. [PMID: 30984309 DOI: 10.1007/s13167-018-0157-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/20/2018] [Indexed: 12/24/2022]
Abstract
Burning symptoms in the oral cavity are caused by a range of systemic and local factors, in addition to the neuropathic pain disorder burning mouth syndrome (BMS). Patients may state oral burning as a standalone symptom or may report as a secondary symptom in association with other factors, most commonly with oral dryness, oral mucosal lesions, or certain systemic conditions. There is a level of uncertainty in the presentation of this condition which creates a diagnostic challenge from both the patient's perspective and the practitioner evaluating these individuals. The diagnoses are complicated due to the lack of a clear definition of BMS and clinical guidelines to distinguish BMS from other conditions that are responsible for oral burning symptoms. A clinician should be able to differentiate oral burning from burning mouth syndrome. This integrative review discusses on local and systemic etiologies of oral burning based on current evidence that needs to be excluded for a diagnosis of BMS. It also provides an algorithm for diagnostic workup and therapeutic management to medical providers for patients experiencing oral burning symptoms. This comprehensive system provides a systematic stepwise workup in diagnosing and managing patients presenting with a complaint of oral burning that optimally meets a predictive, preventive, and personalized medicine (PPPM) approach.
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Affiliation(s)
- Jaisri Thoppay
- 1Oral Medicine, Orofacial Pain and Geriatric Programs, Virginia Commonwealth University, Richmond, VA USA
| | - Bhavik Desai
- 2Oral Health and Diagnostic Sciences, Oral Medicine Section, Dental College of Georgia at Augusta University, Augusta, GA USA
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Verhulst MJL, Loos BG, Gerdes VEA, Teeuw WJ. Evaluating All Potential Oral Complications of Diabetes Mellitus. Front Endocrinol (Lausanne) 2019; 10:56. [PMID: 30962800 PMCID: PMC6439528 DOI: 10.3389/fendo.2019.00056] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/22/2019] [Indexed: 12/13/2022] Open
Abstract
Diabetes mellitus (DM) is associated with several microvascular and macrovascular complications, such as retinopathy, nephropathy, neuropathy, and cardiovascular diseases. The pathogenesis of these complications is complex, and involves metabolic and hemodynamic disturbances, including hyperglycemia, insulin resistance, dyslipidemia, hypertension, and immune dysfunction. These disturbances initiate several damaging processes, such as increased reactive oxygen species (ROS) production, inflammation, and ischemia. These processes mainly exert their damaging effect on endothelial and nerve cells, hence the susceptibility of densely vascularized and innervated sites, such as the eyes, kidneys, and nerves. Since the oral cavity is also highly vascularized and innervated, oral complications can be expected as well. The relationship between DM and oral diseases has received considerable attention in the past few decades. However, most studies only focus on periodontitis, and still approach DM from the limited perspective of elevated blood glucose levels only. In this review, we will assess other potential oral complications as well, including: dental caries, dry mouth, oral mucosal lesions, oral cancer, taste disturbances, temporomandibular disorders, burning mouth syndrome, apical periodontitis, and peri-implant diseases. Each oral complication will be briefly introduced, followed by an assessment of the literature studying epidemiological associations with DM. We will also elaborate on pathogenic mechanisms that might explain associations between DM and oral complications. To do so, we aim to expand our perspective of DM by not only considering elevated blood glucose levels, but also including literature about the other important pathogenic mechanisms, such as insulin resistance, dyslipidemia, hypertension, and immune dysfunction.
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Affiliation(s)
- Martijn J. L. Verhulst
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
- *Correspondence: Martijn J. L. Verhulst
| | - Bruno G. Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
| | - Victor E. A. Gerdes
- Department of Vascular Medicine, Amsterdam UMC, Amsterdam, Netherlands
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, Netherlands
| | - Wijnand J. Teeuw
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, Netherlands
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GOMES MF, GOULART MDGV, GIANNASI LC, HIRAOKA CM, MELO GDFS, ZANGARO RA, NÓBREGA CJP, SALGADO MAC. Effects of the photobiomodulation using different energy densities on the periodontal tissues under orthodontic force in rats with type 2 diabetes mellitus. Braz Oral Res 2018; 32:e61. [DOI: 10.1590/1807-3107bor-2018.vol32.0061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 05/14/2018] [Indexed: 01/15/2023] Open
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The Influence of Type 1 Diabetes Mellitus on Dental Caries and Salivary Composition. Int J Dent 2018; 2018:5780916. [PMID: 30369949 PMCID: PMC6189668 DOI: 10.1155/2018/5780916] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/26/2018] [Indexed: 11/29/2022] Open
Abstract
Diabetes mellitus is the most common chronic disease that affects the oral health. The aim of the study is to evaluate the dental caries, salivary flow rate, buffer capacity, and Lactobacilli in saliva in children with type 1 diabetes mellitus compared to the control group. Methods. The sample consisted of 160 children of 10 to 15 years divided into two groups: 80 children with type 1 diabetes mellitus and 80 children as a control group. Dental caries was assessed using the DMFT index for permanent dentition. Stimulated saliva was collected among all children. Salivary flow rate and buffer capacity were measured, and the colonies of Lactobacillus in saliva were determined. The observed children have answered a number of questions related to their dental visits and parents' education. The data obtained from each group were compared statistically using the chi-square test and Mann–Whitney U-test. The significant level was set at p < 0.05. Results. DMFT in children with type 1 diabetes was significantly higher than that in the control group (p < 0.001). Diabetic children have a low level of stimulated salivary flow rate compared to control children (0.86 ± 0.16 and 1.10 ± 0.14). The buffer capacity showed statistically significant differences between children with type 1 diabetes and control group (p < 0.001). Also, children with type 1 diabetes had a higher count and a higher risk of Lactobacillus compared to the control group (p < 0.05 and p < 0.001). Conclusion. The findings we obtained showed that type 1 diabetes mellitus has an important part in children's oral health. It appears that children with type 1 diabetes are exposed to a higher risk for caries and oral health than nondiabetic children.
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Salivary glucose levels and oral candidal carriage in Type 2 diabetics. J Oral Biol Craniofac Res 2018; 8:158-164. [PMID: 30191100 DOI: 10.1016/j.jobcr.2016.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 11/07/2016] [Indexed: 11/23/2022] Open
Abstract
Background To assess the correlation between salivary glucose and blood glucose levels in diabetics and non diabetics and to study the association between salivary glucose levels and oral candidal carriage in patients with Type 2 diabetes mellitus. Material and method The study sample was divided into two groups, control and study group. The study group was again divided into two separate groups controlled diabetics and uncontrolled diabetics. Blood and saliva samples (for fasting and postprandial) were taken from each individual. Results The salivary glucose levels, highly correlated with blood glucose levels in both diabetic as well as non diabetics subjects. Salivary candidal carriage was more in oral cavity of Type 2 diabetic subjects than control subjects. Conclusion Saliva has the potential to be used as a noninvasive tool to monitor glycemic status of diabetic patients.
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Latti BR, Kalburge JV, Birajdar SB, Latti RG. Evaluation of relationship between dental caries, diabetes mellitus and oral microbiota in diabetics. J Oral Maxillofac Pathol 2018; 22:282. [PMID: 30158791 PMCID: PMC6097371 DOI: 10.4103/jomfp.jomfp_163_16] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background: Diabetes mellitus is a metabolic disease leading to abnormal fat, carbohydrate and protein metabolism. Reduced salivary flow rate caused by hyperglycemia is characteristic mainly for periods of poor metabolic control of diabetes, thereby facilitating the growth of aciduric bacteria and caries-lesion development. The objective of our study was to evaluate the effects of diabetes mellitus on dental caries micro-organisms responsible for caries. Materials and Methods: This study was carried out on 60 subjects consisting of 2 groups. The Group A (study group) consisted of 30 subjects with diabetes mellitus and dental caries, and the Group B (control group) consisted of 30 subjects with dental caries but no systemic disease. DFS/dfs index in all subjects was evaluated and compared. Unstimulated salivary flow was collected and levels of Streptococcus mutans were analyzed. Results: It was found that the fasting blood sugar in Group A subjects because of which there was increased streptococcus mutans count and hence high caries index as compared to that of Group B. Conclusion: From our study, we could conclude that with increased age, blood sugar levels, DMFT values, dental caries increases in diabetics than in normal (control) subjects and therefore relationship does exist between diabetis mellitus, oral microbiota and dental caries.
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Affiliation(s)
| | - Jitendra V Kalburge
- Department of Oral and Maxillofacial Pathology, Government Dental College and Hospital, Jamnagar, Gujrat, India
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Awareness of oral complications and oral hygiene habits of subjects with diagnosed Diabetes Mellitus. BALKAN JOURNAL OF DENTAL MEDICINE 2018. [DOI: 10.2478/bjdm-2018-0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background/Aim: The aim was to evaluate Diabetes Mellitus (DM) patients' awareness of their risk for oral and dental complications, to evaluate their oral health behaviors, assess their sources of related information, and to detect the influence of their awareness on oral health and dental management. Material and Methods: Total of 240 DM patients presenting to a university outpatient dental facility for routine care completed a self-administered questionnaire about demographic socioeconomic characteristics, oral health care and awareness on oral complications of DM. Dental status of each patient was recorded. Data were analyzed with Chi- square test; p was set as 0.05. Results: The patients' mean age was 52.85 years; the majority had Type 2 DM (72.1%) and 61.7% were females. Two thirds of the patients had tooth loss; 65% brushed daily and used toothpick for interproximal cleaning (35%). Only 12.9% had regular dental visits and 37.5% reported their oral health as 'poor'. DM patients rarely received guidance from their health care professionals regarding their oral health (28.3%). Even though 62.5% were aware of oral complications of DM, only 46.3% knew that oral health may affect DM. The patients with Type 1 and Type 2 DM had similar perceptions about their oral health status (p=0.15>0.05). However, insulin users were more aware of the interaction between oral health and DM (p>0.05), and were more likely to consider their oral health as 'poor' (p>0.05). Conclusions: DM patients' awareness of the effect of DM on oral health was higher than that of the effect of oral health on DM management. Medical health care providers were failing to provide the necessary information regarding these issues when compared to dentists.
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Nabee Z, Jeewon R, Pugo-Gunsam P. Oral dysbacteriosis in type 2 diabetes and its role in the progression to cardiovascular disease. Afr Health Sci 2017; 17:1082-1091. [PMID: 29937879 PMCID: PMC5870297 DOI: 10.4314/ahs.v17i4.16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Salivary changes and proliferation of specific bacterial communities are known to result in oral disease which may adversely impact on systemic conditions like diabetes and cardiovascular diseases. Objectives This study reports on the changes in oral ecology of healthy and diseased adults and the possible role in disease causation. Methods The study comprised 150 participants divided into control (healthy), diabetic and cardiac groups. After dental examination for (Decayed Missing Filled Teeth (DMFT) and Oral Rating Index (ORI), stimulated saliva was sampled to determine flow rate and buffering capacity. Salivary microbial load of Streptococcus mutans and Lactobacilli were subsequently quantified. Results DMFT, ORI, buffering capacity and flow rate were inferior for both diabetic and cardiac patients, who had higher bacterial counts (p<0.05). Long standing diabetics harboured a higher load of Streptococcus mutans. The microbial load of Streptococcus mutans in cardiac patients was double that of diabetics. Conclusion Disruption in the salivary environment and changes in microbial ecology with increased load of cariogenic bacteria were found in diabetic and cardiac patients. This study brings forward new evidence of a markedly higher load of Streptococcus mutans in cardiac patients which may underlie the progression of diabetes to cardiovascular disease in this population.
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Affiliation(s)
- Ziad Nabee
- Department of Biosciences, Faculty of Science, University of Mauritius, Reduit, Mauritius
- Department of Health Sciences, Faculty of Science, University of Mauritius, Reduit, Mauritius
| | - Rajesh Jeewon
- Department of Health Sciences, Faculty of Science, University of Mauritius, Reduit, Mauritius
| | - Prity Pugo-Gunsam
- Department of Biosciences, Faculty of Science, University of Mauritius, Reduit, Mauritius
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