Treating gum disease linked to lower medical costs for patients with diabetes
A new report suggests that treating gum disease in patients who have diabetes with procedures such as cleanings and periodontal scaling is linked to 10 to 12 percent lower medical costs per month.
The findings are encouraging but the study was not designed to firmly establish cause and effect, said George Taylor, University of Michigan associate professor of dentistry, who also has an appointment in epidemiology in the U-M School of Public Health. Taylor led the research project to investigate whether routine, non-surgical treatment for gum disease is linked to lower medical care costs for people with diabetes.
In periodontal disease, the body reacts to the bacteria causing the gum infection by producing proteins or chemicals called inflammatory mediators. Ulcers and open sores in the gums become passageways for these proteins and for the bacteria themselves to enter the body's blood circulation. These inflammatory mediators, as well as some parts of the bacteria, prevent the body from effectively removing glucose, or sugar, from the blood.
The higher level of blood sugar is known as poor diabetes control. Poor diabetes control leads to serious diabetes complications such as vision disorders, cardiovascular and kidney disease and amputations, among others.
"Cleanings and other non-surgical periodontal treatment remove the harmful bacteria," Taylor said. "We believe this helps prevent the body from producing those harmful chemicals that can enter the systemic circulation and contribute to poorer diabetes control."
Blue Care Network provided U-M researchers data from 2,674 patients aged 18-64 who were enrolled in BCN between 2001 and 2005 and had at least 12 consecutive months of medical, dental, and pharmaceutical coverage.
"We found insured adults with diabetes in Michigan who received routine periodontal treatment, such as dental cleanings and scaling, have significantly lower medical care costs than those who do not," Taylor said. "These results could be meaningful to individuals, employers, health care providers and insurers."
The study showed that medical care costs decreased by an average of 11 percent per month for patients who received one or two periodontal treatment procedures annually compared to those who received none. For patients receiving three or four annual treatments, costs decreased nearly 12 percent.
The study also showed that combined medical and pharmaceutical monthly costs were 10 percent lower for patients who received one or two periodontal procedures annually.
"The results of our analyses provide additional evidence supporting a beneficial role for periodontal treatment in improving overall health for people with diabetes," Taylor said. The findings could fuel changes in policies and practices for diabetes patients and their insurers.
Friday, December 26, 2008
Monday, December 22, 2008
New Tooth Cavity Protection Discovered
Clarkson University Center for Advanced Materials Processing Professor Igor Sokolov and graduate student Ravi M. Gaikwad have discovered a new method of protecting teeth from cavities by ultrafine polishing with silica nanoparticles.
The researchers adopted polishing technology used in the semiconductor industry (chemical mechanical planarization) to polish the surface of human teeth down to nanoscale roughness. Roughness left on the tooth after the polishing is just a few nanometers, which is one-billionth of a meter or about 100,000 times smaller than a grain of sand.
Sokolov and Gaikwad showed that teeth polished in this way become too “slippery” for the "bad" bacteria that is responsible for the destruction of dental enamel. As a result the bacteria can be removed fairly easily before they cause damage to the enamel.
Although silica particles have been used before for tooth polishing, polishing with nanosized particles has not been reported. The researchers hypothesized that such polishing may protect tooth surfaces against the damage caused by cariogenic bacteria, because the bacteria can be removed easily from such polished surfaces.
The Clarkson researchers' findings were published in the October issue of the Journal of Dental Research, the dentistry journal with the top worldwide scientific impact index.
Sokolov is a professor of physics, professor of chemical and biomolecular science, and director of Clarkson's Nanoengineering and Biotechnology Laboratories Center (NABLAB). This is one of the first research projects performed in the recently established NABLAB.
Gaikwad is a graduate student in physics.
Read more at http://jdr.iadrjournals.org/cgi/content/short/87/10/980.
The researchers adopted polishing technology used in the semiconductor industry (chemical mechanical planarization) to polish the surface of human teeth down to nanoscale roughness. Roughness left on the tooth after the polishing is just a few nanometers, which is one-billionth of a meter or about 100,000 times smaller than a grain of sand.
Sokolov and Gaikwad showed that teeth polished in this way become too “slippery” for the "bad" bacteria that is responsible for the destruction of dental enamel. As a result the bacteria can be removed fairly easily before they cause damage to the enamel.
Although silica particles have been used before for tooth polishing, polishing with nanosized particles has not been reported. The researchers hypothesized that such polishing may protect tooth surfaces against the damage caused by cariogenic bacteria, because the bacteria can be removed easily from such polished surfaces.
The Clarkson researchers' findings were published in the October issue of the Journal of Dental Research, the dentistry journal with the top worldwide scientific impact index.
Sokolov is a professor of physics, professor of chemical and biomolecular science, and director of Clarkson's Nanoengineering and Biotechnology Laboratories Center (NABLAB). This is one of the first research projects performed in the recently established NABLAB.
Gaikwad is a graduate student in physics.
Read more at http://jdr.iadrjournals.org/cgi/content/short/87/10/980.
Wednesday, December 17, 2008
Dieting May Cut Risk for Gum Disease
For men, especially older men, dieting may help reduce the risk of gum disease more than for women, according to a new study by researchers at the University of Maryland, Baltimore and other institutions.
The study, published in the journal Nutrition, also provides the latest clue to a powerful link between chronic inflammation and poor health, according to Mark Reynolds, DDS, PhD, associate professor at the Dental School, part of UMB.
“Chronic inflammation appears to be an important factor underlying aging and many age-related disorders, and dietary restriction has been shown to reduce the risk for chronic disease and promote longevity in multiple animal models,” says Reynolds, who is chair of the Department of periodontics at the School.
The study, of 81 rhesus monkeys at the National Institutes of Health, showed that males fed a diet of 30 percent fewer calories for 13 to 17 years had significantly lower levels of a gum-damaging condition known as periodontal pocketing, less immune response to invading bacteria, and higher inflammatory molecules than males fed a normal diet. Periodontal inflammation and disease start from bacteria.
Also, for the monkeys not fed the reduced-calorie diet, males showed “significantly greater periodontal breakdown” than females. Consistent with previous studies of humans, the monkeys in the study showed an increasing degree of gum problems as they aged.
Aging and obesity are associated with increased biological signs of overall inflammation and periodontal disease in humans, says Reynolds. Although about one-third of adults aged 30 to 90 have periodontitis, attempts to study humans directly have been hampered by the environmental complexities of oral diseases and factors such as smoking.
Non-human primates, such as rhesus monkeys, are an important model for studying inflammatory gum disease and oral infections in humans, says Reynolds.
Reynolds studies the role of inflammation in periodontal disease, including modifiable risk factors such as nutrition. Periodontal disease is one of the few inflammatory conditions that can be readily seen and studied in humans and other animals.
Reynolds was at the National Institute on Aging (NIA) before joining the faculty at the Dental School in 1999. Continuing research verified that the monkeys develop visible gum disease, and the NIA awarded John Novak, BDS, LDS, RCS, MS, at the University of Kentucky; Reynolds; and others a five-year grant for their study.
Men develop higher rates of periodontal and coronary heart disease than do women on the whole, says Reynolds. A major question has been: how much do modifiable risk factors, such as smoking, physical inactivity, and obesity, contribute to the male-female gap? Or, is this difference in risk a natural occurrence between males and females? The monkey study seems to point to a genetic basis for the difference in risk, he says, reflecting underlying differences in how males and females respond to injury and inflammation.
He adds, “An understanding of such sex differences will become increasingly more important in the selection of treatments as we move toward personalized medicine based on individual genetic profiles.”
The study appears in the Oct. 15 online issue of Nutrition, and will appear in the January hard copy. Along with Novak and Reynolds, the study team included other researchers from the Maryland Dental School and the University of Kentucky, as well as researchers at the Virginia Commonwealth University, the National Institute of Aging, and Louisiana State University.
The study, published in the journal Nutrition, also provides the latest clue to a powerful link between chronic inflammation and poor health, according to Mark Reynolds, DDS, PhD, associate professor at the Dental School, part of UMB.
“Chronic inflammation appears to be an important factor underlying aging and many age-related disorders, and dietary restriction has been shown to reduce the risk for chronic disease and promote longevity in multiple animal models,” says Reynolds, who is chair of the Department of periodontics at the School.
The study, of 81 rhesus monkeys at the National Institutes of Health, showed that males fed a diet of 30 percent fewer calories for 13 to 17 years had significantly lower levels of a gum-damaging condition known as periodontal pocketing, less immune response to invading bacteria, and higher inflammatory molecules than males fed a normal diet. Periodontal inflammation and disease start from bacteria.
Also, for the monkeys not fed the reduced-calorie diet, males showed “significantly greater periodontal breakdown” than females. Consistent with previous studies of humans, the monkeys in the study showed an increasing degree of gum problems as they aged.
Aging and obesity are associated with increased biological signs of overall inflammation and periodontal disease in humans, says Reynolds. Although about one-third of adults aged 30 to 90 have periodontitis, attempts to study humans directly have been hampered by the environmental complexities of oral diseases and factors such as smoking.
Non-human primates, such as rhesus monkeys, are an important model for studying inflammatory gum disease and oral infections in humans, says Reynolds.
Reynolds studies the role of inflammation in periodontal disease, including modifiable risk factors such as nutrition. Periodontal disease is one of the few inflammatory conditions that can be readily seen and studied in humans and other animals.
Reynolds was at the National Institute on Aging (NIA) before joining the faculty at the Dental School in 1999. Continuing research verified that the monkeys develop visible gum disease, and the NIA awarded John Novak, BDS, LDS, RCS, MS, at the University of Kentucky; Reynolds; and others a five-year grant for their study.
Men develop higher rates of periodontal and coronary heart disease than do women on the whole, says Reynolds. A major question has been: how much do modifiable risk factors, such as smoking, physical inactivity, and obesity, contribute to the male-female gap? Or, is this difference in risk a natural occurrence between males and females? The monkey study seems to point to a genetic basis for the difference in risk, he says, reflecting underlying differences in how males and females respond to injury and inflammation.
He adds, “An understanding of such sex differences will become increasingly more important in the selection of treatments as we move toward personalized medicine based on individual genetic profiles.”
The study appears in the Oct. 15 online issue of Nutrition, and will appear in the January hard copy. Along with Novak and Reynolds, the study team included other researchers from the Maryland Dental School and the University of Kentucky, as well as researchers at the Virginia Commonwealth University, the National Institute of Aging, and Louisiana State University.
Tuesday, December 16, 2008
Link between inflamed gums and heart disease
Scientists find link between inflamed gums and heart disease
New article in the FASEB Journal shows that proper dental care can reduce the risk of atherosclerosis, a leading cause of heart disease
The next person who reminds you to floss might be your cardiologist instead of your dentist. Scientists have known for some time that a protein associated with inflammation (called CRP) is elevated in people who are at risk for heart disease. But where's the inflammation coming from? A new research study by Italian and U.K. scientists published online in The FASEB Journal shows that infected gums may be one place. Indeed, proper dental hygiene should reduce the risk of atherosclerosis, stroke and heart disease independently of other measures, such as managing cholesterol.
"It has been long suspected that atherosclerosis is an inflammatory process, and that periodontal disease plays a role in atherosclerosis," said Mario Clerici, M.D., a senior researcher on the study. "Our study suggests that this is the case, and indicates that something as simple as taking good care of your teeth and gums can greatly reduce your risk of developing serious diseases."
To reach this conclusion, the scientists examined the carotid arteries of 35 otherwise healthy people (median age 46) with mild to moderate periodontal disease before and after having their periodontal disease treated. One year after treatment, the scientists observed a reduction in oral bacteria, immune inflammation and the thickening of the blood vessels associated with atherosclerosis.
"Because many Americans have some form of gum disease, this research can't be brushed aside," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "As it turns out, the health of our blood vessels could be hanging by the proverbial thread: dental floss."
New article in the FASEB Journal shows that proper dental care can reduce the risk of atherosclerosis, a leading cause of heart disease
The next person who reminds you to floss might be your cardiologist instead of your dentist. Scientists have known for some time that a protein associated with inflammation (called CRP) is elevated in people who are at risk for heart disease. But where's the inflammation coming from? A new research study by Italian and U.K. scientists published online in The FASEB Journal shows that infected gums may be one place. Indeed, proper dental hygiene should reduce the risk of atherosclerosis, stroke and heart disease independently of other measures, such as managing cholesterol.
"It has been long suspected that atherosclerosis is an inflammatory process, and that periodontal disease plays a role in atherosclerosis," said Mario Clerici, M.D., a senior researcher on the study. "Our study suggests that this is the case, and indicates that something as simple as taking good care of your teeth and gums can greatly reduce your risk of developing serious diseases."
To reach this conclusion, the scientists examined the carotid arteries of 35 otherwise healthy people (median age 46) with mild to moderate periodontal disease before and after having their periodontal disease treated. One year after treatment, the scientists observed a reduction in oral bacteria, immune inflammation and the thickening of the blood vessels associated with atherosclerosis.
"Because many Americans have some form of gum disease, this research can't be brushed aside," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "As it turns out, the health of our blood vessels could be hanging by the proverbial thread: dental floss."
Thursday, December 11, 2008
Toothbrushing prevents hospital-borne pneumonia
Hospital-borne infections are a serious risk of a long-term hospital stay, and ventilator-associated pneumonia (VAP), a lung infection that develops in about 15% of all people who are ventilated, is among the most dangerous. With weakened immune systems and a higher resistance to antibiotics, patients who rely on a mechanical ventilator can easily develop serious infections — as 26,000 Americans do every year.
Thanks to a proven new clinical approach developed by Tel Aviv University nurses, though, there is a new tool for stopping the onset of VAP in hospitals.
This new high-tech tool? An ordinary toothbrush.
Three Times a Day Keeps Pneumonia Away
“Pneumonia is a big problem in hospitals everywhere, even in the developed world,” says Nurse Ofra Raanan, the chief researcher in the new study and a lecturer at Tel Aviv University’s Department of Nursing. “Patients who are intubated can be contaminated with pneumonia only 2 or 3 days after the tube is put in place. But pneumonia can be effectively prevented if the right measures are taken.”
Raanan, who works at the Sheba Academic School of Nursing at The Chaim Sheba Medical Center, collaborated with a team of nurses at major medical centers around Israel. The nurses found that if patients — even unconscious ones — have their teeth brushed three times a day, the onset of pneumonia can be reduced by as much as 50%.
A Pioneering Study with Measurable Effects
It’s difficult to quantify the effects precisely, the researchers say. “While the research shows a definite improvement in reducing the incidence of hospital-borne pneumonia, it’s hard to say by exactly how much toothbrushing prevents VAP,” says Raanan, but the published evidence shows a direct correlation for intubated patients.
“Sometimes, however, doctors and nurses do everything right and the patient still gets pneumonia. But this approach will certainly improve the odds for survival.”
Normally, the teeth and oral cavity in a healthy mouth maintain a colony of otherwise harmless bacteria. Infection takes root when a breathing tube allows free passage of the “good” bacteria into the lower parts of the lung. The bacteria travel in small water droplets through the tube and colonize the lung. Once there, the bacteria take advantage of a patient’s weakened immune system and multiply. A regular toothbrushing kills the growth and subsequent spread of the bacterium that leads to VAP.
Augmenting the Preventative Routine
There are additional steps for preventing the onset of VAP. Today, nurses typically use a mechanical suction device to remove secretions from the mouth and throat. They also put patients in a seated position and change the position every few hours. Toothbrushing, say Tel Aviv University nurses, should be added to the routine.
Although nurses in some American hospitals already practice toothbrushing on ventilated patients, these new results may convince medical centers around the world to invest more resources in this routine practice, thereby saving lives.
The research and recommendations are scheduled for publication in a leading nursing journal.
Thanks to a proven new clinical approach developed by Tel Aviv University nurses, though, there is a new tool for stopping the onset of VAP in hospitals.
This new high-tech tool? An ordinary toothbrush.
Three Times a Day Keeps Pneumonia Away
“Pneumonia is a big problem in hospitals everywhere, even in the developed world,” says Nurse Ofra Raanan, the chief researcher in the new study and a lecturer at Tel Aviv University’s Department of Nursing. “Patients who are intubated can be contaminated with pneumonia only 2 or 3 days after the tube is put in place. But pneumonia can be effectively prevented if the right measures are taken.”
Raanan, who works at the Sheba Academic School of Nursing at The Chaim Sheba Medical Center, collaborated with a team of nurses at major medical centers around Israel. The nurses found that if patients — even unconscious ones — have their teeth brushed three times a day, the onset of pneumonia can be reduced by as much as 50%.
A Pioneering Study with Measurable Effects
It’s difficult to quantify the effects precisely, the researchers say. “While the research shows a definite improvement in reducing the incidence of hospital-borne pneumonia, it’s hard to say by exactly how much toothbrushing prevents VAP,” says Raanan, but the published evidence shows a direct correlation for intubated patients.
“Sometimes, however, doctors and nurses do everything right and the patient still gets pneumonia. But this approach will certainly improve the odds for survival.”
Normally, the teeth and oral cavity in a healthy mouth maintain a colony of otherwise harmless bacteria. Infection takes root when a breathing tube allows free passage of the “good” bacteria into the lower parts of the lung. The bacteria travel in small water droplets through the tube and colonize the lung. Once there, the bacteria take advantage of a patient’s weakened immune system and multiply. A regular toothbrushing kills the growth and subsequent spread of the bacterium that leads to VAP.
Augmenting the Preventative Routine
There are additional steps for preventing the onset of VAP. Today, nurses typically use a mechanical suction device to remove secretions from the mouth and throat. They also put patients in a seated position and change the position every few hours. Toothbrushing, say Tel Aviv University nurses, should be added to the routine.
Although nurses in some American hospitals already practice toothbrushing on ventilated patients, these new results may convince medical centers around the world to invest more resources in this routine practice, thereby saving lives.
The research and recommendations are scheduled for publication in a leading nursing journal.
Thursday, December 4, 2008
Philadelphia dentist and motivational speaker
A little down in the mouth? Dr. Joe Capista knows where you are coming from... but won't let you stay there. That's because Dr. Capista, a dentist by training, is emerging as the most in-demand motivational speaker and author to come out of Philadelphia since fellow healthcare-professional-turn-personal-motivator Pat Croce hit the scene.
Dr. Capista is using his unlikely rise to fame as a way for others to transform their lives, achieve balance, and succeed in their personal and professional lives. His book, What Can a Dentist Teach You About Business, Life and Success?, reached top-selling status on Amazon.com this year. He has parlayed that success into a series of national speaking engagements and media appearances.
In the beginning of his career, Dr Capista worked endless hours, in cramped offices trying to make a career in general dentistry. The work was good, but it limited his worldview and sapped his energy. For the next 25 years of his life, Dr. Capista practiced general dentistry and learned to apply certain techniques through the use of consultants and mentors on how to grow a successful business.
In the year 2002 at age 52, Dr. Capista decided to expand in his profession to help advance his practice to the next level. He spent $300,000 and three years learning cosmetic dentistry and improving the systems he uses for everything-from how he meets, greets, and treats his patients, to the way he markets his practice. The process allowed him to grow his dental practice in Broomall, Pa., into one of the most successful, systemized small businesses in the country.
But, it's not dentists that he wants to talk to. Rather, Dr. Capista's message is broader and for everyone. In fact, he uses his background as a dentist to convince audiences that if he can do it, anyone can.
"Think about it. There's not another business in the world where your customer hates the experience and pays for it," says Dr. Capista in his trademark rapid-fire style. "I started at a disadvantage, and had to learn how to understand and read people, and gain their trust and confidence in order to help them with their treatments."
It's just that type of insight Dr. Capista imparts to audiences as diverse as sales people, corporate executives, religious groups, college students, and of course, the interested dentist, who might want to emulate Dr. Capista's success.
It's a message with teeth. "My book and talks have really struck home with anyone who wants to achieve more in life, but doesn't know how. That was my early experience, and it took me a lifetime to figure out how to systemize my life so that I could replicate success, and give myself more balance both personally and professionally."
For more information about Dr. Joe Capista or to interview/book Dr. Joe Capista, contact Jackie Zima at 610-228-2138, 215-534-2973 (cell), or write to Jackie@GregoryFCA.com.
ABOUT DR. JOE CAPISTA
Dr. Joe Capista, founder and president of Williamsburg Dental, a 5-Star dental practice located in Broomall, Pennsylvania. Williamsburg Dental is recognized as one of the most successful dental practices in the entire United States. For the fifth year running, Dr. Capista has been named The Cosmetic Dentist of the Philadelphia Sixers Dancers and just recently recognized as the 2008 Small Business Person of the Year. For over three decades, Dr. Capista has dedicated himself to the study of the power and impact of the mind and spirit in creating success both personally and professionally. Dr. Capista's success philosophy is simple; combine your deepest passion, develop solid business principles while striving for balance in all areas of your life.
Dr. Capista is using his unlikely rise to fame as a way for others to transform their lives, achieve balance, and succeed in their personal and professional lives. His book, What Can a Dentist Teach You About Business, Life and Success?, reached top-selling status on Amazon.com this year. He has parlayed that success into a series of national speaking engagements and media appearances.
In the beginning of his career, Dr Capista worked endless hours, in cramped offices trying to make a career in general dentistry. The work was good, but it limited his worldview and sapped his energy. For the next 25 years of his life, Dr. Capista practiced general dentistry and learned to apply certain techniques through the use of consultants and mentors on how to grow a successful business.
In the year 2002 at age 52, Dr. Capista decided to expand in his profession to help advance his practice to the next level. He spent $300,000 and three years learning cosmetic dentistry and improving the systems he uses for everything-from how he meets, greets, and treats his patients, to the way he markets his practice. The process allowed him to grow his dental practice in Broomall, Pa., into one of the most successful, systemized small businesses in the country.
But, it's not dentists that he wants to talk to. Rather, Dr. Capista's message is broader and for everyone. In fact, he uses his background as a dentist to convince audiences that if he can do it, anyone can.
"Think about it. There's not another business in the world where your customer hates the experience and pays for it," says Dr. Capista in his trademark rapid-fire style. "I started at a disadvantage, and had to learn how to understand and read people, and gain their trust and confidence in order to help them with their treatments."
It's just that type of insight Dr. Capista imparts to audiences as diverse as sales people, corporate executives, religious groups, college students, and of course, the interested dentist, who might want to emulate Dr. Capista's success.
It's a message with teeth. "My book and talks have really struck home with anyone who wants to achieve more in life, but doesn't know how. That was my early experience, and it took me a lifetime to figure out how to systemize my life so that I could replicate success, and give myself more balance both personally and professionally."
For more information about Dr. Joe Capista or to interview/book Dr. Joe Capista, contact Jackie Zima at 610-228-2138, 215-534-2973 (cell), or write to Jackie@GregoryFCA.com.
ABOUT DR. JOE CAPISTA
Dr. Joe Capista, founder and president of Williamsburg Dental, a 5-Star dental practice located in Broomall, Pennsylvania. Williamsburg Dental is recognized as one of the most successful dental practices in the entire United States. For the fifth year running, Dr. Capista has been named The Cosmetic Dentist of the Philadelphia Sixers Dancers and just recently recognized as the 2008 Small Business Person of the Year. For over three decades, Dr. Capista has dedicated himself to the study of the power and impact of the mind and spirit in creating success both personally and professionally. Dr. Capista's success philosophy is simple; combine your deepest passion, develop solid business principles while striving for balance in all areas of your life.
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