Improved General and Oral Health in Diabetic Patients by an Okinawan-Based Nordic Diet:A Pilot Study

Periodontal disease, periodontitis as well as the preceding gingivitis, has been associated with both obesity and diabetes. Studies have shown that diet changes can lead to a lower incidence of such inflammation. The aim of the present case series over four weeks was to study the effects on medical and dental conditions in patients with type 2 diabetes of the consumption of the Okinawan-based Nordic Diet (OBND®). Medical and dental examinations were performed to estimate the general health and gingivitis/periodontitis. Serum cytokine levels were assessed using Luminex technology. Eight of ten study participants completed the study. All participants lost weight (p = 0.012). Six out of seven that were treated with insulin could reduce their insulin intake after two weeks with OBND®. The reduction was about 16 units which corresponds to a 34% relative reduction compared to the starting point (range 15–63%). Fasting blood glucose values fell (p = 0.035). Hemoglobin A1c (HbA1c) (p = 0.01), triglycerides (p = 0.05), and low-density lipoprotein (LDL) (p = 0.05) were also reduced. Bleeding on probing changed from ~28% before any dietary changes to ~13% after two weeks with OBND® (p = 0.01). The reduction in gingival bleeding was as substantial as might be expected from one session of professional tooth cleaning. Markers of inflammation were also reduced. The OBND® thus showed significant promise in alleviating the impact of diabetes on dental as well as general health

Alpha-1-antitrypsin deficiency and periodontitis, a pilot study

Proteases are capable of tissue breakdown. Plasma and gingival crevicular fluid (GCF) contain antiproteases, such as alfa-1-antitirypsin (AAT). Lack of AAT may lead to periodontal destruction. The aim was to study if periodontal parameters and elastase in GCF and plasma are different in AAT deficient subjects compared to subjects without AAT deficiency. Material & methods: 30 subjects were included, 20 of whom with severe AAT deficiency. Ten of them suffered from chronic obstructive pulmonary disease (group 1) and 10 were asymptomatic (group 2). Ten control subjects (group 3) were recruited from a public dental clinic. The examination comprised GCF, Gingival index (GI), Plaque Index (PlI), probing pocket depth (PPD) and radiography. GCF was collected with paper strips (Periopaper®). Plasma AAT concentration was measured by nephelometry and AAT in GCF with ELISA. Elastase activity and protein in plasma and GCF were determined by spectrophotometry. Results: The mean values for GI, PlI, PPD and the radiological measurements did not show any statistically significant differences between the groups. AAT in GCF and plasma did not show any significant difference between group 1 and 2 but a statistical difference in comparison with group 3. Elastase in GCF and plasma did not show any difference between the three groups. In conclusion no differences were found between AAT deficient subjects and healthy controls in this limited material

Assessment of carotid calcifications on panoramic radiographs in relation to other used methods and relationship to periodontitis and stroke: a literature review

OBJECTIVES To assess the literature on carotid calcifications defined from panoramic radiographs (PMX) and concurrent diagnosis of stroke and periodontitis. MATERIALS AND METHODS A literature search screening for publications using search terms such as PMX and carotid calcification, stroke and periodontitis was performed in November 2012. RESULTS A total of 189 articles were retrieved, among which 30 were included in the review. The sensitivity for PMX findings of carotid calcifications (CC) compared to a diagnosis by Doppler sonography varied between 31.1-100%. The specificity for PMX findings of carotid calcifications compared to a diagnosis by Doppler sonography varied between 21.4-87.5%. Individuals with CC findings from PMX have more periodontitis and risk for stroke. CONCLUSIONS There is a shortage of well-designed studies in older dentate individuals assessing the associations between periodontitis and radiographic evidence of CC and in relation to stroke or other cardiovascular diseases. STATEMENT OF CLINICAL RELEVANCE: Carotid calcifications are prevalent in patients with periodontitis and such individuals may have an increased risk for stroke. The absence of signs of carotid calcification on panoramic radiographs is indicative of no calcification of carotid arteries

Sensory acceptance of a diet designed to counteract obesity, diabetes and periodontaldisease

A modified Nordic diet, developed by Igelösa Life Science AB, was tested in a clinical pilot study including ten individuals with type 2 diabetes during two weeks. The diet was based on locally produced, traditional ingredients such as intact grains, vegetables, legumes, root vegetables, fish, poultry, fruit and nuts. The intake of sugar, red meat and dairy products was restricted. One of the aims of the study was to study the sensory acceptance of the diet. The study was designed as a case-series. The diet was provided, ready-made and free of charge, to both the experimental subjects (N=10) and their partners (N=5). Two subjects were excluded due to heath implications, not related to the diet. The sensory acceptance was measured through questionnaire data and two focus groups (before and after the 2-week test period, 20 minutes each). Partners were invited to participate in the focus group interviews. Data from the questionnaire showed a high degree of liking for most meals. The result of the focus groups indicated the importance of the every-day meal as a social activity. They further expressed satisfaction with sensory properties and the perceived health benefits of the Igelösa diet but also some frustration regarding small portions, too little salt and somewhat unfamiliar ingredients. Sensory acceptance for diets nutritionally designed for weight reduction and/or maintenance is  a key factor. Despite the low number of participants, the pilot study indicate that the Igelösa diet is well accepted. An innovation of the study was that both the experimental subjects and their partners received the diet. The participants stated that this was supportive, facilitating adherence and promoting long-term impact on health. Habits, such as poor diet, can only be defeated by a concerted team effort and our work provide a glimpse of the potential benefits   of this shared approach

Sensory acceptance of a diet designed to counteract obesity, diabetes and periodontaldisease

A modified Nordic diet, developed by Igelösa Life Science AB, was tested in a clinical pilot study including ten individuals with type 2 diabetes during two weeks. The diet was based on locally produced, traditional ingredients such as intact grains, vegetables, legumes, root vegetables, fish, poultry, fruit and nuts. The intake of sugar, red meat and dairy products was restricted. One of the aims of the study was to study the sensory acceptance of the diet. The study was designed as a case-series. The diet was provided, ready-made and free of charge, to both the experimental subjects (N=10) and their partners (N=5). Two subjects were excluded due to heath implications, not related to the diet. The sensory acceptance was measured through questionnaire data and two focus groups (before and after the 2-week test period, 20 minutes each). Partners were invited to participate in the focus group interviews. Data from the questionnaire showed a high degree of liking for most meals. The result of the focus groups indicated the importance of the every-day meal as a social activity. They further expressed satisfaction with sensory properties and the perceived health benefits of the Igelösa diet but also some frustration regarding small portions, too little salt and somewhat unfamiliar ingredients. Sensory acceptance for diets nutritionally designed for weight reduction and/or maintenance is  a key factor. Despite the low number of participants, the pilot study indicate that the Igelösa diet is well accepted. An innovation of the study was that both the experimental subjects and their partners received the diet. The participants stated that this was supportive, facilitating adherence and promoting long-term impact on health. Habits, such as poor diet, can only be defeated by a concerted team effort and our work provide a glimpse of the potential benefits   of this shared approach

Supra- and sub-gingival instrumentation of periodontitis with the adjunctive treatment of a chloramine - a one-year randomized clinical trial study

Periodontitis is a bacterial-induced disease and for this reason controlling the microbiota is a necessity. Therapy includes self-performed daily oral hygiene in combination with supra- and sub-gingival instrumentation. An adjunctive antimicrobial agent may improve the outcome.Aims To assess whether a chloramine (Perisolv (R)) has an adjunctive effect to non-surgical periodontal therapy and whether non-surgical periodontal therapy affects quality of life.Material and MethodsThirty-eight patients were randomized to a test or a control group. Clinical indices were performed at baseline and at three and twelve months. In the test group, Perisolv (R) was applied initially and after the sub-gingival instrumentation in pathological pockets. Oral health-related quality of life was measured with the Oral Health Impact Profile (OHIP) instrument at baseline and twelve months.Results In both groups, an initial probing pocket depth (PPD) of > 4 mm and bleeding on probing (BOP) were statistically reduced (p < 0.002 and p < 0.002 respectively) at twelve months and after adjustment for Bonferroni. There were no significant differences between the test and the control group in terms of the number of PPD, BOP or plaque index, or in the mean OHIP score.Conclusions Chloramine did not have an adjunctive effect, but the overall therapy was significantly efficacious both clinically and in terms of quality of life

Supra- and sub-gingival instrumentation of periodontitis with the adjunctive treatment of a chloramine - a one-year randomized clinical trial study

Periodontitis is a bacterial-induced disease and for this reason controlling the microbiota is a necessity. Therapy includes self-performed daily oral hygiene in combination with supra- and sub-gingival instrumentation. An adjunctive antimicrobial agent may improve the outcome.Aims To assess whether a chloramine (Perisolv (R)) has an adjunctive effect to non-surgical periodontal therapy and whether non-surgical periodontal therapy affects quality of life.Material and MethodsThirty-eight patients were randomized to a test or a control group. Clinical indices were performed at baseline and at three and twelve months. In the test group, Perisolv (R) was applied initially and after the sub-gingival instrumentation in pathological pockets. Oral health-related quality of life was measured with the Oral Health Impact Profile (OHIP) instrument at baseline and twelve months.Results In both groups, an initial probing pocket depth (PPD) of > 4 mm and bleeding on probing (BOP) were statistically reduced (p < 0.002 and p < 0.002 respectively) at twelve months and after adjustment for Bonferroni. There were no significant differences between the test and the control group in terms of the number of PPD, BOP or plaque index, or in the mean OHIP score.Conclusions Chloramine did not have an adjunctive effect, but the overall therapy was significantly efficacious both clinically and in terms of quality of life

Carotid calcifications in panoramic radiographs are associated with future stroke or ischemic heart diseases : a long-term follow-up study

OBJECTIVE: To assess if carotid calcifications detected in panoramic radiographs are associated with future events of stroke, and/or ischemic heart diseases over 10-13 years in individuals between 60 and 96 years. MATERIALS AND METHODS: Baseline (2001-2004) panoramic radiographs were assessed for evidence of carotid calcifications from individuals with no previous history of stroke and/or ischemic heart diseases. A radiopaque nodular mass adjacent to the cervical vertebrae, at or below the intervertebral space C3-C4, was interpreted as carotid calcification. Annual medical records were searched for ICD 10 codes through 2014. RESULTS: Signs of carotid calcification was demonstrated in 238/635 (37.5%) of the study individuals. Signs of carotid calcification was associated with future stroke and/or ischemic heart diseases (χ2 = 9.1, OR 1.6, 95% CI 1.2, 2.2, p < 0.002). In individuals 60-72 years, a significant association between radiographic signs of carotid calcification and stroke and/or ischemic heart diseases (χ2 = 12.4, OR 2.4, 95% CI 1.5, 4.0, p < 0.000) (adjusted for high blood pressure, diabetes type 2, BMI; OR 1.9, 95% CI 1.1, 3.5, p = 0.03). Individuals (60-72 years) with radiographic evidence of carotid calcifications had a mean cumulative stroke and/or ischemic heart diseases survival time of 12.1 years compared to those without such evidence (13.0 years) (log rank Mantel-Cox χ2 = 10.7, p = 0.001). CONCLUSIONS: Evidence of carotid calcifications in panoramic radiographs is associated with an event of stroke and/or ischemic heart diseases in 60-96-year-old individuals. CLINICAL RELEVANCE: Radiographic evidence of carotid calcifications is associated with stroke and/or ischemic heart diseases. Patients with signs of carotid calcifications should therefore be referred for medical examination

Alpha-1-antitrypsin deficiency and periodontitis, a pilot study

The aim of this study was to investigate if periodontal parameters and elastase in gingival crevicular fluid (GCF) are different in alpha-1-antitrypsin deficient (AATD) subjects compared to subjects with normal AAT level. Thirty subjects were included, 20 of whom with severe AATD, phenotype PiZZ. Ten AATD subjects suffered from chronic obstructive pulmonary disease (COPD, group 1) and 10 were asymptomatic (group 2). Ten control subjects, phenotype PiMM, (group 3) were recruited from a public dental clinic. The examination comprised of sampling of GCF, Gingival Index (GI), Plaque Index (PII), probing pocket depth (PPD) and radiography. GCF was collected with paper strips (Periopaper (R)). Plasma AAT concentration was measured by nephelometry and AAT in GCF with ELISA. Elastase activity and protein in GCF were determined by spectrophotometry. The mean values for GI, PII, PPD and the radiological measurements did not show any statistically significant differences between the groups. AAT in plasma and GCF demonstrated very low values in groups 1 and 2 with no significant difference between these groups but a statistical difference in comparison with group 3. Elastase in GCF did not show any difference between the three groups. In conclusion, neither the periodontal parameters nor the elastase in GCF were different in AATD subjects, phenotype PiZZ, when compared to subjects with normal AAT level, phenotype PiMM, in this material

Oral health status among 60-year-old individuals born in 1941-1943 and 1954-1955 and 81-year-old individuals born in 1922-1924 and 1933-1934, respectively : a cross-sectional study

Objective This study aimed to analyze the oral health status of four different birth cohorts: two cohorts of 60-year-olds born in 1941-1943 and 1954-1955 and 2 cohorts of 81-year-olds born in 1920-1922 and 1933-1934. Material and methods The study was based on data from an ongoing longitudinal population project, The Swedish National Study on Aging and Care (SNAC). Oral health status was repeatedly examined clinically and radiographically in 2001-2003 and 2014-2015, including 60- and 81-year-olds, in total 412 individuals. Statistical analyses were performed using independent-samples t test and Pearson's chi(2) test. Results More individuals were dentate in 2014-2015 compared to 2001-2003 in the two age groups: 60 and 81 years (p &lt; 0.001 for both). The mean number of teeth increased in the 60-year-olds from 24.2 to 27.0 and in the 81-year-olds from 14.3 to 20.2. The numbers of at least one intact tooth increased for both age groups (p &lt; 0.001 and p &lt; 0.004, respectively). In the age groups 81 years, there was an increase in having at least one PPD &gt;= 6 mm (p &lt; 0.016) and bone loss &gt;= 5 mm (p &lt; 0.029) between the two examinations. No such differences were found in the age groups of 60 years. Conclusion Over 13 years, oral health improved for both 60- and 81-year-old age groups. The most significant changes were in the 81-year-olds where oral health had improved except for periodontal status.open access</p