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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diabetes mellitus, is a common chronic disease, and its prevalence in the United States, particularly type 2 diabetes, is increasing. Complications associated with diabetes impose a heavy burden on many people, especially among certain minority populations. Periodontal diseases, dental caries, and tooth loss also are common conditions in the United States, but their prevalence is generally decreasing. Nevertheless, among important subgroups of the population, particularly certain minority and economically disadvantaged groups, there is a disproportionately higher burden of periodontal diseases, dental caries, and tooth loss. This article reviews the post-1960 English-language literature on the relationship between diabetes and oral health, specifically focusing on periodontal disease, dental caries, and tooth loss. Substantial evidence exists to support the role of diabetes and poorer glycemic control as important risk factors for periodontal disease. Additionally, the evidence provides support for viewing the relationship between diabetes and periodontal diseases as bidirectional. However, additional research is necessary to firmly establish that treating periodontal infections can contribute to glycemic control management and possibly to the reduction of type 2 diabetes complications. The literature does not describe a consistent relationship between type 2 diabetes and dental caries. It reports increased, decreased, and similar caries experiences between those with and without diabetes. This review suggests that currently there is insufficient evidence to determine whether a relationship between diabetes and risk for coronal or root caries exists. Most of the reviewed studies reported greater tooth loss in people with diabetes. However, the differences were slight and not significant in several of the reports. Furthermore, this review of the association between diabetes and tooth loss reveals that valid population-based evidence generalizable to the US population is sparse. Further investigations of the association of diabetes with dental caries and tooth loss are warranted. If adverse effects of diabetes on dental caries and/or tooth loss are substantiated, the results of such studies would help design intervention studies to prevent or reduce the occurrence of dental caries and tooth loss in people with diabetes. These results also may affect existing clinical practice protocols and promote new public policy related to diabetes.
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PMID:Diabetes, periodontal diseases, dental caries, and tooth loss: a review of the literature. 1564 24

Lifestyle is an expression of individual choices and their interaction with the environment and is closely associated with risks for obesity, diabetes, and cardiovascular disorders. If taken cumulatively this syndrome may be referred to as "diabesity." The escalating prevalence of obesity among both children and adults is one modifiable dominant risk factor in this triad. An increase in body weight of approximately 2.2 pounds (1 kg) has been shown to increase risk for diabetes by 4.5%. Alternatively, a 5% to 10% decrease in body weight improves diabetes control. The metabolic syndrome of diabetes has been described as a consortium of conditions including dyslipidemia, hypertension, and abdominal obesity. In randomized controlled clinical trials, dietary and physical activity interventions have been shown to be effective in decreasing risk for, as well as delaying conversion to, these disorders. Since 1977, 4 hallmark multisite clinical trials have been conducted in the United States, the United Kingdom, and Finland confirming that improved glycemic and hypertensive control of patients through lifestyle interventions can have positive effects on associated complications and longitudinal outcomes. A fifth robust and well-controlled study is currently being conducted in multiple sites in the United States. Dietary behaviors are modulating factors not only in these metabolic and systemic conditions but also in risk for oral diseases such as dental caries. The association between obesity, diabetes, cardiovascular diseases, and oral health status may be linked by these lifestyle behaviors. Promotion of weight management involves approaches that include diet, physical activity, and behavior modification. Established effective guidelines within these domains may be applicable to current practice and future studies designed to examine the associations between diabesity and oral health status.
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PMID:Lifestyle interventions for "diabesity": the state of the science. 1564 26

Dental caries and periodontitis are initiated by specific bacteria and modified by host and environmental factors. Individuals have great differences in their rates of disease progression, but a small set of risk factors, such as smoking and diabetes, can distinguish patients at high risk for more severe disease. The application of information about factors that influence disease can be used to improve disease prevention and management. Knowledge of when specific information may be valuable should lead to the optimal management of individual patients. The use of diagnostic and prognostic tests and their application to the assessment and management of dental caries and periodontitis are the focus of this review.
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PMID:Diagnostic and prognostic tests for oral diseases: practical applications. 1589 32

Sugars ingested outside of meals play an important role in the etiology of caries. In this respect, sugar substitutes present a very interesting alternative. In addition to the recommendations and usual care to their patients, dental surgeons also have to inform them on a dietetic level. Chewing sugar-free chewing gum after any light meal when it is not followed by a brushing presents a real interest. The authors describe the different polyols and their respective uses. Polyols are widely found in foodstuffs (sweets, chewing-gum, biscuits, cooked meals for diabetic), pharmaceutical products (syrups, pastilles to be sucked, various medicines), non-pharmaceutical chemists (toothpastes, mouth-washes...). By the light of the most recent published works, the particular properties of xylitol are described. Polyols are more particularly indicated for sugar-eater or sick children (syrups), and for those carrying a hight risk of developing caries (progressive polycaries, hyposialie...). Therefore polyols are not only a means of stabilizing some pathologies (diabetes, obesity) but also a weapon in the prevention of dental caries.
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PMID:[The polyols in pediatric dentistry: advantages of xylitol]. 1596 35

This paper outlines the burden of oral diseases worldwide and describes the influence of major sociobehavioural risk factors in oral health. Despite great improvements in the oral health of populations in several countries, global problems still persist. The burden of oral disease is particularly high for the disadvantaged and poor population groups in both developing and developed countries. Oral diseases such as dental caries, periodontal disease, tooth loss, oral mucosal lesions and oropharyngeal cancers, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)-related oral disease and orodental trauma are major public health problems worldwide and poor oral health has a profound effect on general health and quality of life. The diversity in oral disease patterns and development trends across countries and regions reflects distinct risk profiles and the establishment of preventive oral health care programmes. The important role of sociobehavioural and environmental factors in oral health and disease has been shown in a large number of socioepidemiological surveys. In addition to poor living conditions, the major risk factors relate to unhealthy lifestyles (i.e. poor diet, nutrition and oral hygiene and use of tobacco and alcohol), and limited availability and accessibility of oral health services. Several oral diseases are linked to noncommunicable chronic diseases primarily because of common risk factors. Moreover, general diseases often have oral manifestations (e.g. diabetes or HIV/AIDS). Worldwide strengthening of public health programmes through the implementation of effective measures for the prevention of oral disease and promotion of oral health is urgently needed. The challenges of improving oral health are particularly great in developing countries.
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PMID:The global burden of oral diseases and risks to oral health. 1621 Nov 57

Pulpal inflammation is primarily caused by coronal caries, and leads to root canal therapy (RCT). Chronic inflammation has been associated with various cardiovascular diseases. This study evaluates the association between pulpal inflammation (using RCT as a surrogate) and incident coronary heart disease (CHD). We report results among males from the Health Professionals Follow-Up Study (HPFS), excluding participants with prior cardiovascular disease or diabetes. We obtained RCT data from the HPFS cohort (n = 34,683). Compared to men without RCT, those with >/=1 RCT had a multivariate RR of 1.21 (95% CI 1.05-1.40) for CHD. The association was limited to dentists (RR = 1.38; 95% CI 1.14-1.67). There was no association among nondentists (RR = 1.03). Dental caries was not associated with CHD. The results suggest a possible modest association between pulpal inflammation and CHD.
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PMID:Pulpal inflammation and incidence of coronary heart disease. 1642 54

The aim of this study was to investigate the relationship among type 1 diabetes mellitus, dental caries, and salivary status in children. The study comprised 68, 10-15-yr-old diabetics, and 68, age- and gender-matched non-diabetic controls. Diabetics were categorized into well-to-moderately controlled (HbA1c < 9.0%) and poorly controlled (HbA1c >or= 9.0%) groups. Caries was recorded by assessing lesion activity at non-cavitated and cavity levels. Teeth were examined visually for the presence of dental plaque. Saliva was analyzed for unstimulated and stimulated flow rates, buffer effect, mutans streptococci, lactobacilli, and yeasts. Diabetics had fewer caries and plaque, lower salivary flow rates and buffer effect, and more frequent growth of yeasts than their non-diabetic controls. Well-to-moderately controlled diabetics had fewer decayed surfaces and lower counts of mutans streptococci and yeasts than poorly controlled diabetics, but the level of metabolic control of diabetes had no influence on salivary flow rates and buffer effect. High caries levels in diabetics were significantly associated with age, plaque score, and decreased unstimulated salivary flow rate, but were not associated with the level of metabolic control of diabetes. High caries experience in this study population could be related to plaque accumulation and/or to changes in saliva induced by diabetes mellitus.
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PMID:Dental caries and salivary status in children with type 1 diabetes mellitus, related to the metabolic control of the disease. 1646 Mar 35

The purpose of this study was to examine oral cavity condition, identify microorganisms and evaluate interrelation between protozoans, bacteria and fungi occurring in mouths of insuline treated diabetics. 30 men and women, 25-60 years old, were clinically assessed for their oral cavity condition including pH range. Fifteen of them were the insuline treated diabetics. Swabs taken of different sites of periodontium, dental plaques and dental pockets collected from each patients were used for detection and identification of protozoans, bacteria and fungi. Mucosal inflammation, dental caries, loose teeth, periodontitis were observed in the diabetic patients, whereas the oral cavities were generally in better condition in the control patients. Prevalence of the protozoan parasites Entamoeba gingivalis and Trichomonas tenax was higher in the control patients than in the diabetics (26.6% and 13.3%, respectively). Fecal bacteria Enterococcus fecalis, E. faecium, Klebsiella pneumoniae occurred with significantly higher frequency in the insuline treated patients (60%) than in the control (6.6%). Various Candida albicans strains were more often found in the diabetic (53.2%) than in the control patients (13.3%). The results of our studies show a clear interrelation between alteration of oral health and the occurrence of microorganisms in the insuline treated diabetics. Metabolic disease that causes serious multi-organ disturbances as well as insulinotherapy are the very important factors changing oral cavity ecology of the persons with diabetes mellitus; decresed pH (the average 5.5) may inhibit development of infection with protozoans in the oral cavity of these patients and favour subclinical infections with other microorganisms. Thus, in the insuline treated diabetics, examination of mouths with regard to the occurrence of opportunistic fecal bacteria and fungi, particularly before a therapy with antibiotics is strongly recommended.
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PMID:[Occurrence of oral subclinical infections in insulin treated diabetics]. 1685 22

Subjects with diabetes mellitus (DM) are more prone to certain disturbances of oral cavity but there are controversies concerning caries. This cross-sectional study investigated the frequency of caries and associated factors, in a sample of population with or without type 1 DM, including non-diabetic (53 women, 31 men) and 30 diabetic subjects (19 women, 11 men) aged 17-28 years. Diagnosis of dental caries was based on the DMF-T index (D= decay; M= miss; F= fill; T= teeth); in addition, a plaque control record (PCR) was obtained. A preponderance of female sex was found within the groups studied but such proportions did not differ when comparing diabetic and non-diabetic groups. Mean ages were 21.0 +/- 2.2 and 19.5+/-1.8 years, respectively for subjects without and with DM (p< 0.05). Education level was higher in the non-diabetic group as well as the DMF-T index (10.5 +/-5.8 vs. 6.7+/-5.7, p< 0.01). Linear regression analysis (n= 114) showed significant associations of DMF-T with age, sucrose intake, daily frequency of tooth brushing, of dental floss use, PCR and of visits to the dentist. By ANOVA model with age as a covariate the non-diabetic condition (p= 0.047), sucrose index and PCR (r(2)= 0.820) were independently associated with the DMF-T. In the diabetic-specific model, with only the diabetic subjects included and sucrose index as a covariate, DM duration, fundus abnormality and PCR were significantly associated with the presence of caries (r(2)= 0.816). The sample of type 1 diabetic subjects suggest that they are less prone to caries than non-diabetics, despite having a higher frequency of meals, less tooth brushing and dental floss use. We speculate that DM duration may contribute to the occurrence of caries and restricted sucrose consumption to lower frequency of caries in diabetic subjects.
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PMID:[Study on the frequency of caries and associated factors in type 1 diabetes mellitus]. 1693 93

Approximately 7% of pregnant women develop gestational diabetes mellitus (GDM), a usually transient form of diabetes mellitus, because of the production of some placental and maternal adipose tissue elaborated hormones that alter glucose metabolism. In most women the disorder resolves at delivery, but within 10 years 50% to 70% of these women go on to develop type 2 diabetes. The identification of women with past medical histories of GDM is a clinically useful marker for alerting the dentist to patients at heightened risk of occult type 2 diabetes, with a possible greater risk of developing periodontal disease and dental caries. Screening these patients for diabetes and establishing a preventative dental regimen may result in reducing the number of women with undiagnosed diabetes and diabetes-associated dental and cardiovascular diseases.
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PMID:A past medical history of gestational diabetes: its medical significance and its dental implications. 1723 28


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