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 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The goal of this study was to determine the prevalence and incidence of periodontal disease and its relationship with non-insulin-dependent diabetes mellitus (NIDDM). Two thousand two hundred seventy-three Pima Indians (949 men, 1324 women) aged greater than or equal to 15 yr from the Gila River Indian Community in Arizona were examined between 1983 and 1989. Periodontal disease was diagnosed by tooth loss and by percentage of interproximal crestal alveolar bone loss ascertained from panoramic radiography. Subjects with little or no evidence of periodontal disease were classified as nondiseased. Thus, the incidence of advanced periodontal disease was determined. The age- and sex-adjusted prevalence of periodontal disease at first dental examination was 60% in subjects with NIDDM and 36% in those without. Twenty-two new cases developed in a subset of 701 subjects (272 men, 429 women) aged 15-54 yr who initially had little or no evidence of periodontal disease and had at least one additional dental examination. The incidence of periodontal disease in this group was similar in men and women (incidence-rate ratio 1.0, 95% confidence interval [Cl] 0.5-1.9, controlled for age and diabetes). Higher age predicted a greater incidence of periodontal disease (chi 2 = 30.6, df = 3, P less than 0.001, controlled for sex and diabetes). The rate of periodontal disease in subjects with diabetes was 2.6 times (95% Cl 1.0-6.6, controlled for age and sex) that observed in those without. Although periodontal disease was common in nondiabetic Pima Indians, in whom most of the incident cases occurred, diabetes clearly conferred a substantially increased risk. Thus, periodontal disease should be considered a nonspecific complication of NIDDM.
Diabetes Care 1990 Aug
PMID:Periodontal disease and NIDDM in Pima Indians. 220 17

Although the premature loss of primary teeth in conjunction with early eruption may be of no clinical significance, the loss of primary or permanent teeth in the absence of trauma should not be overlooked by the clinician. Premature loss of teeth associated with systemic disease usually results from some change in the immune system or connective tissue. This chapter presented some conditions associated with loosening and/or premature loss of teeth that may be encountered in children and adolescents. The most common of these conditions appear to be hypophosphatasia and early-onset periodontitis. Other less common conditions were described to aid in forming a differential diagnosis. Other diseases that may manifest with severe oral infection, such as Wiskott-Aldrich syndrome, diabetes mellitus, or herpes zoster, could result in early tooth loss.
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PMID:Premature exfoliation of teeth in childhood and adolescence. 799 95

With the increasing number of diabetics in an aging population and controversial research reports on the relationship of diabetes to periodontitis, clarification of diabetes as a risk factor for periodontitis would be helpful. This review notes variations in type, metabolic control, and duration of diabetes and highlights the results of studies that have considered these variations. Diabetics who maintained reasonably good metabolic control had not lost more teeth or experienced more periodontal attachment loss than non-diabetics, although they had more periodontal pockets. Poorly-controlled diabetics with extensive calculus on their teeth had more periodontitis and tooth loss than well-controlled diabetics or non-diabetics. Long-duration diabetics were also at greater risk for periodontitis. Mechanisms by which diabetes may contribute to periodontitis include vascular changes, neutrophil dysfunction, altered collagen synthesis, and genetic predisposition. Minimizing plaque and calculus in the oral cavity through careful self-care and regular professional care is important to reduce the risk of periodontitis in diabetics.
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PMID:Diabetes--a risk factor for periodontitis in adults? 804 69

The NHANES I Epidemiologic Follow-up Study (NHEFS) of 1982-84 collected longitudinal data from 10,523 individuals initially seen during the first National Health and Nutrition Examination Survey (NHANES I) of 1971-75. Among this additional data was information on the incidence of total tooth loss during the 10 years between the surveys, which could then be added to NHANES I data to identify risk factors. In this analysis, a series of bivariate analyses were carried out, followed by logistic regression analysis to assess the simultaneous effect of major variables. Results showed that 7.4 percent of dentate Americans aged 25-74 at NHANES I became edentulous over the next 10 years. In bivariate analyses, the incidence of edentulism was correlated with baseline measures of lower income and education status, poorer oral health, self-perceptions of poor general health and oral health, absence of a regular dentist, and a lower number of remaining teeth at baseline. No correlation was found with gender and geographic region, nor with self-reported diabetes and arthritis, and age was not a factor when the number of remaining teeth at baseline were taken into account. In a logistic regression model assessing the effect of these variables simultaneously, none of the demographic variables retained significance; the only variable statistically significant in both age groups was the number of teeth remaining at baseline. Other significant variables in younger persons were higher periodontal disease scores, perceived poor dental health, perceived need for extractions, history of smoking, and low ascorbic acid intake. Some of these variables were reflections of negative health behavior and attitudes rather than direct correlates. Principal findings from this study were the importance of early tooth loss in eventual edentulism and the virtual disappearance of gender and age as determinants of total tooth loss.
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PMID:Risk factors for total tooth loss in the United States; longitudinal analysis of national data. 816 92

People with diabetes may be at increased risk for periodontal disease. This study compared the periodontal health of diabetic and employed adults. While tooth loss and gingival attachment was similar for both groups, diabetics had a greater prevalence and extent of periodontal pockets. Diabetics with poor metabolic control and calculus also had more periodontitis.
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PMID:Periodontitis and tooth loss: comparing diabetics with the general population. 827 62

In this cross-sectional study of Floridians aged 65 yr or older, 600 persons were interviewed to identify the characteristics of individuals who survived into old age with an intact or nearly intact dentition. Persons with total or partial tooth loss reported less frequent dental care, less ability to pay dental care fees, less frequent dental hygiene, and were more likely to have been smokers or diabetic. Persons with tooth loss also had less positive attitudes toward dentists and dental care. These cross-sectional findings are consistent with tooth loss being the result of disease-, behavior-, and attitude-related causes, and/or their interactions. Tobacco use, diabetes, and infrequent oral hygiene and dental care may increase risk for dental disease; decreased ability to pay for dental treatment may impair utilization of non-extraction treatment options, and negative attitudes toward dental treatment may influence the desire for non-extraction treatment options. Research targeted toward modifying attitudes toward dental treatment may be useful in preventing or delaying tooth loss, and measurement of attitudes may be a useful way to identify individuals at the greatest risk for tooth loss for intervention studies.
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PMID:Attitudinal and behavioral characteristics of older Floridians with tooth loss. 830 18

Although it is accepted that the primary cause of periodontitis is bacterial infection of long duration, there are a number of risk factors which may increase the probability of recurrence of periodontal disease during supportive periodontal care. The risk may in such cases be caused by other factors than poor oral hygiene measures per se. Cross-sectional and longitudinal studies show conflicting results concerning age as a risk factor for periodontal disease. The effect of smoking on the periodontal tissues has been discussed for decades and only lately has it been possible to demonstrate that smokers definitely have more periodontal problems than non-smokers. Another important risk factor for periodontitis relates to the insulin dependent and non-insulin dependent forms of diabetes mellitus. Poorly-controlled long-duration diabetics have more periodontitis and tooth loss than well-controlled or non-diabetics. Finally, the issue of compliance deserves attention. The medical literature has suggested that patients with chronic illnesses tend to comply poorly, especially if the disease is not perceived to be particularly threatening, if the therapy is time-consuming, or if the symptoms are non-disturbing. Suggestions for improved compliance are called for.
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PMID:Risk assessment of recurrence of disease during supportive periodontal care. Epidemiological considerations. 870 83

A few recent studies have shown associations between poor oral health and coronary heart disease (CHD). The objective of this study was to examine the incidence of CHD in relation to number of teeth present and periodontal disease, and to explore potential mediators of this association, in a prospective cohort study. This study is a part of the ongoing Health Professionals Follow-Up Study (HPFS). Participants included a US national sample of 44,119 male health professionals (58% of whom were dentists), from 40 to 75 years of age, who reported no diagnosed CHD, cancer, or diabetes at baseline. We recorded 757 incident cases of CHD, including fatal and non-fatal myocardial infarction and sudden death, in six years of follow-up. Among men who reported pre-existing periodontal disease, those with 10 or fewer teeth were at increased risk of CHD compared with men with 25 or more teeth (relative risk = 1.67; 95% confidence interval, 1.03 to 2.71), after adjustment for standard CHD risk factors. Among men without pre-existing periodontal disease, no relationship was found (relative risk = 1.11; 95% confidence interval, 0.74 to 1.68). The associations were only slightly attenuated after we controlled for dietary factors. No overall associations were found between periodontal disease and coronary heart disease. Tooth loss may be associated with increased risk of CHD, primarily among those with a positive periodontal disease history; diet was only a small mediator of this association.
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PMID:Poor oral health and coronary heart disease. 895 14

Periodontal disease, a frequent complication of diabetes mellitus, is the major cause of tooth loss. However, studies on neutrophil function in patients with this condition have yielded contradictory findings. The NADPH oxidase activity of 40 diabetic patients with periodontosis who were on metabolic control was evaluated and compared with that in 40 healthy subjects. Superoxide anion production was measured by a photometric method, with NBT reduction at 490 nm in a microplate reader and by a microscopic method, with a percentage of positive PMNs with granules of formazan in the cytoplasm. When the PMN respiratory burst was activated by phorbol myristate acetate (PMA), a protein kinase C (PKC) soluble activator, superoxide production of diabetics (4.31 +/- 1.67 A x 10(-3)/min) and normal subjects (4.25 +/- 1.25 A x 10(-3)/min) was comparable by photometric method, whereas a significantly defective response to opsonized zymosan was observed when the microscopic method was used (58 +/- 17% in diabetics and 66 +/- 18% in controls; p = 0.05). Therefore in patients with diabetes the impact on PMN function is of multifactorial origin, and is probably correlated to the glucose level and to glycation of PMN protein, such as NADPH oxidase or myeloperoxidase. Alternatively, glucose in PMN may be reduced by aldose reductase to polyols, and this pathway requires NADPH, the coenzyme for the respiratory burst. Moreover, we found that superoxide production in response to opsonized zymosan was reduced in diabetic patients. The activation of protein tyrosine kinase (PTK) is an important mechanism underlying transmembrane signaling and, moreover, protein tyrosine phosphorylations, stimulated by zymosan receptor-mediated activation, might be caused by the activation of specific PTK, whereas activation by PMA is probably mediated through another PKC type.
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PMID:Respiratory burst of neutrophils in diabetic patients with periodontal disease. 970 64

Older adults present special problems for the dentist trying to establish or reestablish esthetics. Periodontal diseases are of concern for this population since tooth loss from these widespread problems increases with age. In general, this loss occurs because of increased exposure time to pathogenic bacteria, not some change inherent in the body brought on by the aging process. The profession has begun to place more emphasis on systemic risk factors and their role in modifying periodontal inflammation. The current thinking is that bacteria are necessary to initiate and sustain periodontal diseases, but the clinical manifestation is dictated to a significant extent by systemic factors. Smoking, diabetes, and being positive for the interleukin-1 genotype predispose the patient to developing more severe disease. For those older adults who lose teeth, dental implants have emerged as reliable replacements, and concerns about placing these devices in patients who have lost teeth as a result of periodontitis appear to be largely unfounded.
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PMID:Periodontal diseases and dental implants in older adults. 1032 Nov 96


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