People with fewer teeth prone to die of heart disease: study

People with fewer teeth prone to die of heart disease: study

AFP) – Apr 12, 2010

STOCKHOLM — People with dented smiles run a far greater risk of dying of heart disease than those who still have all their pearly whites, a Swedish researcher said Monday.

"Cardiovascular disease and in particular coronary heart disease is closely related to the number of teeth" that a person has left, Anders Holmlund told AFP, explaining the results of a Swedish study to be published in the Journal of Periodontology.

"A person with fewer than 10 of their own teeth has a seven times higher risk for death by coronary heart disease than a person of the same age and of the same sex with more than 25 teeth left," Holmlund said.

Although many studies published in the past 15 years have showed a link between oral health and cardiovascular disease, Holmlund's study shows a direct relationship between cardiovascular disease and the number of teeth in a person's mouth.

The study, conducted with colleagues Gunnar Holm and Lars Lind, surveyed 7,674 women and men, most suffering from periodontal disease, for an average of 12 years, and examined the cause of death of the 629 people who died during the period.

For 299 of the subjects, the cause of death was cardiovascular disease.

The theory connecting teeth numbers and heart disease, Holmlund explained, maintains that "infections in the mouth and around the teeth can spill over to the systemic circulation system and cause a low graded chronic inflammation," which is known to be a risk factor for heart attacks and other cardiovascular episodes.

The number of natural teeth a person had left "could reflect how much chronic inflammation one has been exposed to in a lifetime," he added.

The study had been limited by the fact that it had not been possible to adjust the results for socio-economic factors and to fully adjust them according to other cardiovascular risk factors, he acknowledged.

Heart disease is the number one killer worldwide, claiming upward of 17 million lives every year according to the World Health Organisation.

Research links diabetes and oral inflammatory diseases

Research links diabetes and oral inflammatory diseases.


A large majority of patients with diabetes, the fastest-growing disease in the world, also suffer from oral inflammatory diseases, according to a Canadian study that predicts that the interaction of the two diseases will have a growing impact on both dental and overall healthcare.

"More and more, dental and other healthcare professionals will be required to collaborate to create teams dedicated to the management of people with diabetes at both the community and patient levels, given the interactions between oral inflammation and the comorbidities associated with diabetes," wrote lead study author Anthony Iacopino, D.M.D., Ph.D. (Canadian Journal of Diabetes, September 2009, pp. 146-147).

The authors noted that 75% of diabetics also have gingivitis and periodontitis.

"Yet it also goes without saying that by providing dental care to improve both 'oral' and 'systemic' health, healthcare professionals must remember that 'health is health' and 'disease is disease,' regardless of anatomical location," the authors pointed out.

Don Friedlander, D.D.S., an Ottawa, Ontario, dentist and president of the Canadian Dental Association (CDA), notes that oral health is a component of overall health.

"What we're beginning to understand more and more are the linkages with good general health," he told the Vancouver Sun. "Correlations and associations have been found between poor oral health and many systemic diseases such as cardiovascular disease, diabetes, respiratory problems, and preterm births."

Robert MacGregor, D.D.S., a Nova Scotia dentist and vice president of the CDA, says that in addition to the connection between oral and heart health, "recent research shows that people with oral bacteria and periodontal disease seem more prone to respiratory illness and having babies with low birth weights. And it has long been known that uncontrolled diabetes can lead to aggressive periodontal disease and vice versa," according to the Sun story.

Many chronic inflammatory diseases and conditions have been shown to share common physiological and biochemical bases (especially periodontitis and diabetes), including related underlying pathophysiological mechanisms and risk factors, according to the study authors. "Indeed, the risk factors for cardiovascular disease (a major complication of diabetes) and periodontitis are virtually identical," they wrote.

The researchers noted that diabetes predisposes patients to oral infection, and once the infection is established, it exacerbates diabetes-related hyperglycemia and may even predispose otherwise healthy individuals to develop diabetes.

Patients with diabetes have elevated serum levels of low-density lipoprotein cholesterol and triglycerides (even when blood glucose levels are well-controlled), and these can alter immune cell function via the upregulation of proinflammatory cytokines and downregulation of growth factors, Dr. Iacopino wrote.

This predisposes diabetics to chronic inflammation, progressive tissue breakdown, and diminished tissue repair -- a process that is critically important for periodontal tissues, which are under continual assault by substances emanating from oral biofilms. Hence, periodontitis is more severe and rapidly progressive in people with diabetes compared to people without diabetes, the researchers concluded.

Additionally, periodontitis induces general increases in systemic inflammation and even insulin resistance, along with the potential to destroy pancreatic beta cells. Perhaps this explains why periodontitis has a deleterious effect on diabetes-induced hyperlipidemia, immune cell function, tissue repair, and glucose metabolism, the study authors found.

Studies have shown that when periodontitis is treated, diabetes disease parameters improve.

"All healthcare professionals must recognize that there is no 'trap door' at the mouth," the authors warned. "Oral health is one constituent of general health, existing within the health-disease continuum and requiring attention by all healthcare professionals. Indeed, there is no better model for the concept of interprofessional care than the diabetes-periodontitis axis."

AAP Boston

I am at the American Academy of Periodontology annual meeting in Boston. It has been a very interesting meeting. Ray Yukna spoke today after the general assembly on a pannel on lasers along with Dr Greenwell who is also a Lanaper and Dr Romanos. Yesterday Dr. Lloyd Tilt spoke the first Periodontist to have the Periolase he gave his 10 year data. Interesting that they placed him under Inovations in Periodontics. Evan though the specialty is less than 100 years old.

Associate member of the American Academy of Periodontology

I have been honored with an Associate membership in the Prestigous AAP American Academy of Periodontics.

AAP Meeting in Boston

At the AAP don't forget to catch Ray Yukna on Saturday 1 pm this is the Corp sponsored program. then again you can see him 2pm.

MILLENNIUM DENTAL TECHNOLOGIES

Outstanding Clinical and Human Histologic

Outcomes with the PerioLase® Nd:YAG Laser

Speaker: Raymond A. Yukna

The Laser-Assisted New Attachment Procedure

(LANAP™) using the Nd:YAG laser in a specific

patented protocol has been evaluated as a single

visit treatment of periodontal pockets with the goal

of obtaining new attachment. Clinical success is

supported by human histology showing new

cementum and new connective tissue attachment.

Then Monday at 10:15.

CTS1: LASER APPLICATIONS: AN EVIDENCEBASED

APPROACH TO CLINICAL PRACTICE

10:15 - 11:45 am

Program Track: Treatment of Inflammatory

Periodontal Diseases

Moderator: Timothy P. Walsh

Speakers: Bobby L. Butler, Henry Greenwell,

George E. Romanos, Raymond A. Yukna

Lasers have been used in dentistry for many years.

Historically, lasers have been shown to be used primarily

for soft tissue procedures. The clinical benefits of lasers

have led to FDA clearance for numerous uses of such in

periodontics and implant dentistry.

Educational Objectives:

• Understand different laser wavelengths and their

interactions with hard and soft tissue, including the

applications of varying wavelengths and treatment

protocols to treat periodontitis.

• Discuss tissue biotypes and case selections for open

and closed crown lengthening.

• Demonstrate long-term success for treating failing

implants with lasers.

Laser Gum Surgery

LANAP at the AAP meeting

I hope you have the oportunity to go to the AAP this year.


lloyd Tilt will be speaking on Sunday he will show his 10 year data.

I guess in Perio 10 years is considered innovative?

IP2: INNOVATIONS IN PERIODONTICS SESSION 2
10:15 - 11:45 am




http://perio.org/meetings/am/2009AdvanceProgram.pdf

Interesting thing about periodontists is all available accounts seem to suggest that Dr. Grace Rogers may have been the first practicing Periodontist in 1914.




You would think 10 years of data would be allot considering periodontics has been existence less than 100 years.

Though, it is still considered INOVATIVE?

Who Was the First Periodontist?

Who Was the First Periodontist?

Many people have wondered, who was the first periodontist? Upon hearing this question, many have wondered, what is a periodontist? Well, we are going to discuss those questions and many more throughout the course of this article, to the best of our abilities concerning the documented evidence.

We know that periodontal disease has been a problem for people all throughout history. You see, as a specialty, periodontics – the study of periodontal disease, periodontitis, et cetera – has a very long and very full history. That history covers the whole of civilization.

There is evidence that even back in prehistoric times, our ancestors had some problems with their teeth. For example, people in the early Egyptian and Middle Eastern cultures had oral health problems. How do we know this? Well, for one thing, there is written evidence and skeletal remains which show the existence of periodontal disease.

In histories pertaining to ancient Chinese and Indian cultures, there exists evidence of periodontal diseases like scurvy. Within those same histories, there were actually pieces of advice pertaining to the importance of cleaning one’s teeth! The evidence piles up through history, from ancient Greek and Roman to Renaissance Europe. The diseases themselves were well described in the records available, as well treatments and methods of prevention.
However, the first periodontist came quite a bit later – not until the early twentieth century, in fact. Now, it stands to reason that periodontists likely existed before this; they simply were not documented. They may have gone by a different title. Around about 1914, however, all available accounts seem to suggest that Dr. Grace Rogers may have been the first practicing periodontist.
Given the long history of documented periodontal diseases and care, however, it only stands to reason that, in the equally long history of dentistry, other people must have practiced periodontology. We simply do not have the records of those possible forebears.
Disclaimer: If you have or think you might have gum disease or any other health problem, please visit your dentist or periodontist for advice, diagnosis and treatment. This article is for information purposes only and does not intend to provide advice, diagnosis or treatment for any health condition.

Periodontal disease a risk marker for stroke

Periodontal disease a risk marker for stroke.

Men with a history of bone loss due to periodontitis run a higher risk of having a stroke, according to a study in the Annals of Neurology (May 28, 2009).

The potential role of periodontitis in the risk of cardiovascular disease has received much attention in the past decade, and evidence of an association between periodontitis and cerebrovascular disease, especially ischemic stroke, has been stronger compared to other types of cardiovascular disease, the study authors noted.

Although the link has been reported before, their research examined the clinical measures of periodontitis as opposed to self-reports or other assessments not involving periodontal probing, lead study author Thomas Dietrich, D.M.D., of the University of Birmingham School of Dentistry said.

The researchers analyzed data from 1,137 men in the Veterans Affairs Normative Aging Study, an ongoing study that began in the 1960s with healthy volunteers from the greater Boston area. Participants underwent medical and dental exams every three years for an average of 24 years.

A trained periodontist conducted the dental exams, including full mouth radiographs and periodontal probing at each tooth. Cerebrovascular disease was defined as a stroke or transient ischemic attack.

Dr. Dietrich and his colleagues evaluated the incidence of cerebrovascular events in relation to mean radiographic alveolar bone loss (a measure of periodontitis history) and cumulative periodontal probing depth (a measure of current periodontal inflammation).

Bone loss key

Overall, 80 incident cases of cerebrovascular disease occurred during a combined 27,506 person-years, and periodontal bone loss was "significantly associated" with an increased hazard rate of cerebrovascular disease, according to the researchers. They found a stronger effect among men younger than 65 compared to older men.

In comparison, periodontal probing depth was not associated with a significantly increased rate of cerebrovascular disease.

The exact mechanism of the association is unclear, said Dr. Dietrich, noting that both causal and noncausal factors may explain it.

There could be direct or indirect effects of the periodontal infection and inflammatory response, or some people may have an increased proinflammatory susceptibility that could contribute to both cerebrovascular disease and periodontal disease, the authors wrote. Current epidemiologic studies are not able to differentiate between these causal and noncausal pathways, even with perfect control of all established cardiovascular risk factors.

And why was periodontal bone loss significantly associated with an increased hazard rate of cerebrovascular disease, while periodontal probing depth was not?

"This is more consistent with a noncausal mechanism, since treatment of periodontitis or tooth loss would not affect the underlying susceptibility to inflammatory disease," Dr. Dietrich said.

A significant link was found between history of periodontitis as measured by alveolar bone loss and incidence of cerebrovascular disease in men, independent of established cardiovascular risk factors, the authors noted. Furthermore, they found evidence for a stronger association between periodontal bone loss and incidence of cerebrovascular disease among younger men.

"Even if this association was predominantly noncausal, periodontitis could be an important marker of risk for cerebrovascular disease, given its relatively high prevalence and the strength of the association," they concluded.

Large epidemiologic studies using molecular and genetic approaches in various populations are necessary to determine the strength of the association between periodontitis and cerebrovascular disease and to elucidate its biologic basis, they added.

Tooth decay, bleeding gums may herald chronic ills

NEW YORK (Reuters Health) - Our modern dental woes have a lot do to with modern whole-body ills like heart disease and diabetes, according to the author of a review of decades' worth of studies on diet and health.

The culprit in both cases? The so-called fermentable carbohydrates forming the foundation of the modern diet, says Dr. Philippe P. Hujoel of the University of Washington School of Dentistry in Seattle. These include sugars and starchy foods that break down into sugars in the mouth, as well as tropical fruits and dried fruits.

Hujoel argues in the Journal of Dental Research that gum disease and tooth decay should be seen as "alarm bells" that signal a person is at risk of heart disease, diabetes and other chronic health problems.

In recent years, Hujoel argues, fat has replaced fermentable carbohydrates as the enemy, which has led to the promotion of heavy carbohydrate consumption-and in turn the need for dental interventions like sealant and fluoride to prevent tooth decay.

Studies have shown development of gum disease within days of a person upping their sugar intake, which then improves within weeks of a person cutting out carbs. If such high-fermentable carbohydrate diets continue, Hujoel argues, their associated chronic illnesses take hold.

"Clearly, the dental alarm bell has an extremely low threshold for activation; the response occurs in days, weeks or, at most, years, as opposed to the decades it takes for systemic (diseases) to become clinically apparent," he writes.

Hujoel calls for research to investigate the question of whether diets that are good for our teeth are also good for our overall health. If the answer is yes, he adds, "dental diseases could become increasingly regarded as the early marker of adverse lifestyle choices," and could also offer clues to understanding other systemic illnesses such as Alzheimer's disease.

SOURCE: Journal of Dental Research, July 1, 2009.

http://www.reuters.com/article/healthNews/idUSTRE56Q4RM20090727

Certain Oral Bacteria Linked To Obesity

Certain Oral Bacteria Linked To Obesity

Investigators at the Forsyth Institute are focusing on the possible role of oral bacteria as a potential direct contributor to obesity. It seems likely that certain bacterial species could serve as biological indicators of a developing overweight condition.

Researchers J.M. Goodson, D. Groppo, S. Halem and E. Carpino measured salivary bacterial populations of overweight women. Saliva was collected from 313 women with a body mass index between 27 and 32, and bacterial populations were measured by DNA probe analysis. Levels in this group were compared with data from a population of 232 healthy individuals from periodontal disease studies. The median percentage difference of seven of the 40 bacterial species measured was greater than 2 percent in the saliva of overweight women. Classification tree analysis of salivary microbiological composition revealed that 98.4 percent of the overweight women could be identified by the presence of a single bacterial species (Selenomonas noxia) at levels greater than 1.05 percent of the total salivary bacteria. Analysis of these data suggests that the composition of salivary bacteria changes in overweight women.

Of even greater interest, and the subject of future research, is the possibility that oral bacteria may participate in the pathology that leads to obesity. The complete research study is published in the June issue of the International and American Associations for Dental Research's Journal of Dental Research.

Source: Journal of Dental Research

Los Angeles Gum Surgery

AGD panel to discuss perio, heart disease link

AGD panel to discuss perio, heart disease link

The connection between periodontal disease and cardiovascular disease will be the topic of a panel discussion on the growing need for dentists and physicians to collaborate at this week's Academy of General Dentistry (AGD) annual meeting.

Marvin Slepian, M.D., and Neil Gottehrer, D.D.S., will lead an "Oral/Body Inflammation Connection" discussion during the meeting in Baltimore.

"It is critical for all dentists and physicians to collaborate in helping patients reduce inflammation, which can become a target factor for cardiovascular disease," Dr. Slepian stated in a press release.

Information presented during this session will provide dentists with hands-on knowledge regarding how to communicate with physicians to collaborate and create more proactive management periodontal disease treatment plans (including nonsurgical options), which can then improve periodontal and associated physical health by reducing cardiovascular disease.

"This is a landmark course being presented, and I am honored to be holding the discussion with my colleague, Dr. Slepian," Dr. Gottehrer stated in the release. "We hope to provide groundbreaking and useful information to attendees to help them improve the overall health of their patients and to build an increased awareness about the connection between periodontal disease and cardiovascular disease that many, if not most, patients are unaware of."

Along with a panel of seven other doctors, Drs. Gottehrer and Slepian will identify the categories by grade of periodontal disease and the risks of disease to the patient, describe uniform treatment for all stages of both periodontal disease and cardiovascular disease, and suggest a successful hygiene program to improve dental care given to patients.

LANAP Dentist

LANAP in the News

Laser gum surgery Los Angeles

Laser periodontal therapy effective alternative to surgery

Laser periodontal therapy effective alternative to surgery

Laser periodontal therapy is an effective alternative to scalpel/suture surgery for treating gum disease, according to a new study in the International Journal of Periodontics & Restorative Dentistry.

Led by Raymond A. Yukna, D.M.D., M.S., the histological split mouth design study looked at twelve single-rooted teeth with moderate to advanced chronic periodontitis. Six teeth were given Laser Assisted New Attachment Procedure (LANAP) using the PerioLase MVP-7 by Millennium Dental Technologies, while the other six received scaling and root planing only.

After three months, all LANAP-treated teeth showed regeneration of root surface (cementum) and new connective tissue attachment (CTA), whereas none of the control teeth effectively showed new attachment or regeneration.

"These positive results support the concept that LANAP can be associated with cementum-mediated new connective tissue attachment and apparent periodontal regeneration of diseased root surfaces in humans,” said Dr. Yukna in a press release. "Recent years have seen major advancements in periodontal technology, and this study is a successful demonstration of using a free-running pulsed Nd:YAG laser applying the specific LANAP protocol."

"The publication of this study addresses many of the concerns held by the dental community," said Michael Minailo, president and CEO of Millennium Dental Technologies. "With growing demand and continued scientific support, we expect to see significant momentum in 2009."

http://www.drbicuspid.com/index.aspx?sec=nws&sub=rad&pag=dis&ItemId=300317

LANAP in the NEWS

This is Dr Robert Gregg speaking on LANAP with ABC NEWS






LANAP

Brushing teeth boosts sperm count

Brushing teeth boosts sperm count
Mar 2009


Brushing your teeth twice a day can boost your sperm count. That's according to the British Dental Health Foundation (BDHF) who have advised reaching for a toothbrush after research found that infertile men are far more likely to suffer from gum disease. A study of 56 men aged between 23-52 by the Bikur Holim Hospital, Jerusalem, and the Hebrew University Hadassah School of Dental Medicine found that more than half the men with low sperm counts or no sperm at all displayed developed gum disease.

The BDHF will begin its annual National Smile Month campaign on 17 May 2009, highlighting gum disease's links to overall health under the slogan: ‘Look after yourself, brush for health'.Gum disease has been linked to heart disease, diabetes and strokes and now infertility.

Chief executive of the Foundation Dr Nigel Carter said: ‘Brushing your teeth may not sound sexy, but this study shows its importance to male fertility. Factor in the benefits of good oral health for an attractive smile and to stop bad breath and it's time men picked up their toothbrush.' The Israeli study showed that half the men suffered from gingivitis, and two thirds of these men had low sperm counts. Gingivitis causes inflammation characterised by bleeding gums and soreness.One third of the men suffered periodontal disease, which affects the tissues supporting the teeth and can lead to tooth loss. Half of the men with no sperm count had chronic periodontal disease.

LANAP DENTIST