Diabetes, periodontitis, and the subgingival microbiota

Both type 1 and type 2 diabetes have been associated with increased severity of periodontal disease for many years. More recently, the impact of periodontal disease on glycaemic control has been investigated. The role of the oral microbiota in this two-way relationship is at this stage unknown. Further studies, of a longitudinal nature and investigating a wider array of bacterial species, are required in order to conclusively determine if there is a difference in the oral microbiota of diabetics and non-diabetics and whether this difference accounts, on the one hand, for the increased severity of periodontal disease and on the other for the poorer glycaemic control seen in diabetics

Pregnancy, Parity and Periodontal Disease

The belief that a woman's dental health is likely to deteriorate through having children remains common and may originate from the old wives' tale "a tooth per child". As recently as 2005, about 1 in 5 US mothers believed this. Epidemiological studies have suggested an association between parity (the number of times a women has given birth) and tooth loss, and parity and periodontal attachment loss, but none has determined whether this association is causal. A number of studies have reported greater severity and extent of gingival inflammation during pregnancy. While not offering evidence that the association is cause, these findings have fuelled the hypothesis that pregnancy and parity are risk factors for periodontal disease. This article is protected by copyright. All rights reserved

Diabetes, periodontitis, and the subgingival microbiota

Both type 1 and type 2 diabetes have been associated with increased severity of periodontal disease for many years. More recently, the impact of periodontal disease on glycaemic control has been investigated. The role of the oral microbiota in this two-way relationship is at this stage unknown. Further studies, of a longitudinal nature and investigating a wider array of bacterial species, are required in order to conclusively determine if there is a difference in the oral microbiota of diabetics and non-diabetics and whether this difference accounts, on the one hand, for the increased severity of periodontal disease and on the other for the poorer glycaemic control seen in diabetics

Does having children affect women's oral health? A longitudinal study

Many believe women's oral health deteriorates as a result of having children. If so, such associations should exist among women but not among men. The aims of this study were to investigate whether number of children is associated with experience of dental disease and tooth loss among both men and women and to examine whether this association is affected by other variables of interest. This study used data from the Dunedin Multidisciplinary Health and Development study, a longitudinal study of 1037 individuals (48.4% female) born from April 1972 to March 1973 in Dunedin, New Zealand, who have been examined repeatedly from birth to age 45 years. Data were available for 437 women and 431 men. Those with low educational attainment were more likely to have more children and began having children earlier in life. Having more children was associated with experiencing more dental caries and tooth loss by age 45, but this association was dependent on the age at which the children were had. Those entering parenthood earlier in life (by age 26) had poorer dental health than those entering parenthood later in life, or those without children. There was no association between number of children and periodontal attachment loss (PAL). Low educational attainment, poor plaque control, never routine dental attendance, and smoking (for PAL) were associated with PAL, caries experience, and tooth loss. Social factors associated with both the timing of reproductive patterns and health behaviors influence the risk of dental disease and its management

Quantifying the Association Between Self-Reported Diabetes and Periodontitis in the New Zealand Population

This study aims to investigate the association between diabetes and periodontitis in the New Zealand (NZ) adult population. Data from two NZ national surveys (N = 2,048) were analyzed to compare estimates of the strength of the association between diabetes and periodontitis using two multivariate epidemiologic approaches (cohort and matched case-control studies). This was possible because the first survey provided participants for the second survey. Periodontitis cases were identified using 14 case definitions, including six severe definitions. The cohort study identified those with diabetes in 2006/07 and those with periodontitis in 2009 to determine the patients with diabetes odds of having periodontitis, using logistic regression modeling (adjusting for smoking status, sociodemographic, and dental characteristics). The matched case-control study identified cases of severe periodontitis in 2009 and compared their 2006/07 diabetic status with that of controls (individually matched on age group, sex, and socioeconomic status). Conditional logistic regression modeling was used for the case-control study, adjusting for ethnicity, smoking status, and dental characteristics. Overall, 3.6% of the periodontally examined adults reported having diabetes. There was no sex difference in diabetes prevalence, but it was greater in older age groups. Depending on the definition of periodontitis used, there were different estimates of risk for periodontitis, with odds ratios ranging from 1.91 (P = 0.01) to 3.51 (P = 0.22) using the cohort study approach. Diabetes was associated with a greater risk of having periodontitis using only two of the 14 periodontitis case definitions. No association was observed using the matched case-control study. The diabetes-periodontitis association in the NZ population remains unclear. This study demonstrates that the determination of the strength of a putative association is method dependent

Periodontal Diseases in an Omani Adult Population: A Preliminary Study

Background: Data on the periodontal status of the adult population in the Arab world are scarce. The aim of this pilot study is to assess the prevalence, extent, and severity of periodontal diseases in an adult group from Oman. Methods: This is a cross-sectional study of 319 teachers who were randomly sampled from the list of teachers from the Muscat region schools in Oman. Dental caries, tooth loss, and periodontal attachment loss (AL) were recorded for each of the participants. A questionnaire collected data on participants' sociodemographic characteristics, dentalcare characteristics, self-rated periodontal status, and selfrated well-being. Results: A total of 99% of participants had at least one site with probing depth (PD) or clinical AL of >= 3 mm. More than one third (36%) of participants had at least one site with AL >= 5 mm, and 12% had at least one site with AL >= 6 mm; for PD, the prevalence estimates were 26% and 8%, respectively, and a gradient by age group was evident across the different thresholds. Regarding the extent of disease, 17.6% of sites had PD >= 3 mm, and 21% of sites had AL >= 3 mm. Conclusions: The prevalence, extent, and severity of periodontitis were higher than estimates reported from industrialized countries, such as Australia, New Zealand, and the United States. This is of concern, especially when considering the relatively young age of the study population. Because of this high prevalence, investigation of periodontitis in a national sample of Omanis is desirable to confirm the findings of this study

Evaluating the efficiency of caries removal using an Er:YAG laser driven by fluorescence feedback control

Introduction: Caries lesions in dental hard tissues autofluoresce when exposed to light of certain wavelengths, whereas sound tissues do not, and this can be used as an in vitro histological marker for dental caries. Detection of auto fluorescence is the basis of KaVo DIAGNOdent (TM) technology, and provides objective feedback control of laser-stimulated ablation of dental caries for the KaVo Key Laser 3 (TM). This Er:YAG laser operates at 2940 nm wavelength, and is effective at removal of infected dental hard tissues. Micro-computed tomography (micro-CT) allows the non-invasive investigation of three-dimensional structures and analysis of mineral density profiles of dentine following laser ablation. Objective: To evaluate removal of infected, demineralised dentine by Er:YAG irradiation with a laser feedback mechanism, using micro-CT. Design: 27 carious teeth (1 control) and 1 sound tooth, treated with the KaVo Key Laser 3 (TM) using a KaVo (TM) non-contact 2060 handpiece at specific feedback settings, were examined using a Skyscan 1172 Micro-CT, to observe the efficiency of demineralised dentine removal. Grey scale images obtained were colour rendered to assist detection of demineralised tissue if present. Results: Complete removal of demineralised tissue occurred with laser-stimulated ablation under feedback control at values of 7 and 8 when measured by micro-CT. At greater values, removal of demineralised dentine was incomplete. Conclusion: Examination of dental tissues by micro-CT allowed determination of the efficiency of Er:YAG laser-stimulated ablation. Feedback control of the KaVo Key Laser 3 (TM) appeared to operate like a cut-off switch when infected dentine was eliminated, at a threshold of between 6 and 7. (C) 2012 Elsevier Ltd. All rights reserved

Psychosocial aspects of periodontal disease diagnosis and treatment: A qualitative study

Patient-reported outcomes have attracted interest as there has been a shift from clinician-centric endpoints. This qualitative study aimed to develop an understanding of the psychosocial impact of periodontitis and its treatment. Fourteen adults were asked to document their experiences of untreated periodontitis and non-surgical periodontal therapy at a university clinic, using written or audio-recorded diaries. The diary data were then used as a framework for semi-structured qualitative interviews, conducted at the completion of initial non-surgical treatment. Inductive thematic content data analysis was employed. Three themes illustrated the detrimental impact of periodontitis: "concealment," "having a guilty conscience" and "patient comfort as paramount." These were related to a core underlying concept, "progression to a more positive outlook," which described a distinct shift in participants' attitudes and optimism after their periodontal treatment. Despite finding treatment unpleasant, the participants described profound positive influences on their social well-being, self-esteem, mood, work, relationships and outlook. This study illustrated the broad psychosocial impact of periodontitis. The findings suggest that the benefits of periodontal treatment extend beyond improvements in traditional biomedical indicators to those which are more relevant and desirable to patients