Search

Aim To provide a narrative review of the role of macro- and micronutrients in relation to dental caries, gingival bleeding and destructive periodontal disease. Materials & Methods This review is based on systematic reviews (when available) and comparative human studies. Results Dental caries cannot develop without the presence of dietary fermentable carbohydrates, in particular sugar. The susceptibility to develop caries in the presence of carbohydrates may be influenced by genetics and micronutrients such as vitamin D. Gingival bleeding and destructive periodontal disease are sensitive markers to both abnormalities in macronutrient content (excessive carbohydrates or poly-unsaturated fat intake, deficient protein intake) and micronutrient intake (e.g. vitamin C and B12). Conclusion Dental caries and periodontal diseases are a sensitive alarm bell for an unhealthy diet, which predicts the future onset of the diseases of civilizations. [ABSTRACT FROM AUTHOR]

Background: Knowledge of typical medication use among patients with chronic periodontitis or destructive periodontal disease is limited. The aim of this study was to associate periodontitis severity with the use of different classes of medications. Methods: Patients (N = 12,631) who had medical, dental, and pharmaceutical coverage with a health maintenance organization and whose severity of destructive periodontal disease was diagnosed by a dentist or specialist were included in the study. The rate of drug use over 7 years was related to the severity of destructive periodontal disease by means of Poisson regression models. Results: Individuals with moderate to advanced periodontitis had significantly lower fill rates for the respiratory agents (antihistamines: -23%, 95% confidence interval [CI]: -10% to -34%; decongestants: -24%, 95% CI: -13% to -34%; and cough/cold medications: -12%, 95% CI: -3% to -21%) and anti-infective agents (antibiotics: -12%, 95% confidence interval:-6% to - 18%; urinary anti-infectives: -36%, 95% CI: -6% to -56%; and topical antibiotics: -18%, 95% CI: -5% to -29%). Conclusions: More severe periodontitis was a marker for reduced medication use for allergies and infections. The associations between destructive periodontal disease, infections, allergies, and the hygiene hypothesis need further exploration. [ABSTRACT FROM AUTHOR]

The goal of this study was to assess whether interruption of care for chronic periodontitis during pregnancy increased the risk of low-birthweight infants. A population-based case-control study was designed with 793 cases (infants < 2,500 g) and a random sample of 3,172 controls (infants ≥ 2,500 g). Generalized estimating equation models were used to relate periodontal treatment history to low birthweight risk and to common risk factors. The results indicate that periodontal care utilization was associated with a 2.35-fold increased odds of self-reported smoking during pregnancy (95% confidence interval: 1.48–3.71), a 2.19-fold increased odds for diabetes (95% confidence interval: 1.21–3.98), a 3.90-fold increased odds for black race (95% confidence interval: 2.31–6.61), and higher maternal age. After adjustment for these factors, interruption of periodontal care during pregnancy did not lead to an increased risk for a low-birthweight infant when compared to women with no history of periodontal care (odds ratio, 0.96; 95% confidence interval, 0.60–1.52). In conclusion, women receiving periodontal care had genetic and environmental characteristics, such as smoking, diabetes and race, that were associated with an increased risk for low-birthweight infants. Periodontal care patterns, in and of themselves, were unrelated to low-birthweight risk. [ABSTRACT FROM AUTHOR]

Compares destructive periodontal disease and periodontal atrophy. Clinical conditions of alveolar bone loss; Differences between the treatments and the economics of periodontal atrophy and destructive periodontal disease; Medical features of destructive periodontal disease and periodontal atrophy; Diagnosis of abnormal pocket depth in destructive periodontal disease.

Background: A genetic test for a composite interleukin-1 (IL-1) genotype is being marketed to predict risk for progression of periodontal disease. The objective of this study was to determine the clinical scenario required to produce cost-effective results with the use of IL-1 testing to identify high-risk patients. Methods: A disease simulation model was developed using decision-analytic techniques and a 30-year time frame. Results: Using different modeling scenarios, the genetic test produced results ranging from cost savings of $830,140 and 52.8 fewer cases of severe periodontitis to increased costs of $300,430 and 3.6 additional cases of severe periodontitis (per 1,000 patients). Three parameters in the analysis were highly influential: 1) the compliance rate for maintenance therapy in test positive versus non-tested patients; 2) the effectiveness of non-surgical therapy; and 3) the relative risk of disease progression for test positive patients. Conclusion: The model produced a wide range of outcomes reflecting our incomplete understanding of the biology, optimal treatment, and genetic susceptibility of periodontal diseases. However, the model demonstrates that three clinical parameters are highly influential in determining if IL-1 testing can be implemented in a primary care setting in a cost-effective manner. [ABSTRACT FROM AUTHOR]

The article discusses the link between destructive periodontal disease (DPD) and cannabis and tobacco smoking. One study involving 903 participants revealed that both cannabis and tobacco smoking were associated with a greater incidence of DPD prior to the age of 32, with tobacco use being perhaps the chief risk factor. The study adds to a growing body of evidence that DPD detected in early childhood can be a harbinger of unhealthy lifestyles. Consequently, the capacity for early detection by the dental profession is considerable.