Periodontitis/Diabetes Link

Evidence of the link between periodontal disease and diabetes continues to grow, as indicated in a recent article by Robert Finn of Elsevier’s Global Medical News. Diabetes appears to induce periodontal disease or cause it to worsen in some patients, but periodontal disease seems to worsen glycemic control.

Evidence to support this conclusion stems in part from the “Scottsdale Project”.  The project consisted of 18 physicians, dentists, and other independent experts who met in Scottsdale, Arizona in April 2007 to review the strength of evidence for associations among periodontitis, diabetes, and cardiovascular disease. Participants conducted a systematic review of 118 published articles in an attempt to answer eight focused questions. 

Other data comes from analyses of the third National Health and Nutrition Examination Survey.

Read the full article, which contains additional resources, here.

Information on the connection between periodontits and systemic diseases was also discussed in an earlier post on this blog.

Relationship Between Periodontal Disease and Chronic Diseases

The association between periodontal diseases and systemic conditions such as heart disease and stroke, and a higher risk of preterm low birth-weight babies, is garnering attention in the media. Similarly, recognition of the threats posed by periodontal diseases to patients with chronic diseases such as diabetes, respiratory diseases and osteoporosis is acknowledged.

The following are some links to recent stories and resources on these topics:

• Recent publications in PubMed.
• Colgate White Papers:  Markers of Systemic Bacterial Exposure in Periodontal Disease and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis
• MedlinePlus: Gum Care Helps Control Type 2 Diabetes and Its Complications , Gum Disease Might Boost Cancer Risk,
• American Academy of Periodontolgy:  The Mouth/Body Connection
• National Diabetes Information Clearinghouse:  Prevent diabetes problems: Keep your teeth and gums healthy
• American Heart Association: Good dental hygiene may help prevent heart infection
• American Dental Association:  Periodontal Disease and Systemic Conditions ; Dentists discuss oral health at landmark meeting

Dental Amalgam and Health Issues

Update:  The FDA has set a deadline for its reclassification of dental amalgam.  See the ADA News Press Release. 

Ongoing concern over the use of mercury amalgam as a dental filling centers around possible long-term health effects which may be associated with constant mercury exposure.

In 2002, the Food and Drug Administration (FDA) called for a reclassification of dental amalgam and its components. A final ruling will be issued in July 2008 on the basis of empirical data and scientific evidence.

In a recent press release, the American Dental Association (ADA) stated that “dental amalgam remains a safe, affordable and durable cavity filling choice for dental patients“.

The following is a list of links to resources and research pertaining to this issue:

• Clinical trials indexed in PubMed.
• Recent articles indexed in PubMed.
• Consumer information from the FDA.
• FDA dental products panel meeting documents.
• FDA amalgam classifications.
• Overview from the ADA
• From the National Library of Medicine Environmental Health and Toxicology.

ADA Developing Evidence Based Dentistry Website

On March 27, 2008 the ADA conducted an evidence based dentistry (EBD) workshop to teach critical summary skills. Participants learned to write critical summaries of systematic reviews. These summaries will be a key feature of a new website focusing specifically on EBD. An additional workshop will be held in June.

The ADA has created a temporary web page as they work to develop an enhanced EBD website. This new content area features a searchable directory of systematic reviews, a glossary of terms, and additional resources on evidence-based dentistry. The project is supported with a grant from the National Library of Medicine.

Read more about the workshop here.

If you are interested in learning more about EBD or using EBD resources, please contact us.

Cannabis Smoking Increases Risk of Periodontal Disease

Tobacco smoking has been a known risk factor for periodontitis but it was uncertain whether or not cannabis use was harmful.  Essential Evidence Plus reviews a recent cohort study, published in the Journal of the American Medical Association, which concluded that regular marijuana smoking increases the risk of periodontal disease and subsequent loss of teeth.

Read the full review here.

A list of additional articles on this topic may be found in PubMed.

Oral Health Reviews

The Cochrane Collaboration has recently updated or published the following reviews:

• Interventions for replacing missing teeth: hyperbaric oxygen therapy for irradiated patients who require dental implants
• Interventions for replacing missing teeth: maintaining health around dental implants
• Interventions for the management of submucous cleft palate
• Full-mouth disinfection for the treatment of adult chronic periodontitis

Cochrane Reviews are based on the best available information about healthcare interventions. They explore the evidence for and against the effectiveness and appropriateness of treatments (medications, surgery, education, etc) in specific circumstances.

The Cochrane Oral Health Group website provides a full list of currently published reviews.

The library subscribes to the full text of Cochrane reviews. To access select “Cochrane Library” from the sidebar on the Miner Library page.

MedEdPORTAL Partners with the American Dental Education Association

Academic medicine and dentistry have come together to share teaching resources across universities and throughout the world!

The American Dental Education Association (ADEA) and the Association of American Medical Colleges (AAMC) have formed a partnership that will allow the AAMC to expand MedEdPORTAL to include dental education resources. Beginning April 15, MedEdPORTAL will begin accepting submissions from dental professionals.

MedEdPORTAL is a tool designed to help faculty publish and share educational resources.  This tool serves as a prestigious publishing venue through which faculty may disseminate their educational works.  Any medical educator may submit materials to be considered for publication on MedEdPORTAL.

For additional information:

• Read the full release here.
• Search the MedEdPORTAL here.
• To publish resources, you must first create an account.

Burning Mouth Syndrome

BMJ has updated its reviews of Burning Mouth Syndrome.

This latest review addresses the question:  What are the effects of treatments for burning mouth syndrome?

You can read the entire review here.

DentistLinx: a Comprehensive News Portal for Dental Professionals

Are you looking for a way to stay up-to-date on the latest information in your field of interest?  MDLinx employs a team of physicians and nurses who review articles from journals and serious press, then categorize the articles by specialty and sub-specialty.  Each review contains a brief abstract.

You can sign up to receive email updates on selected areas of interest.  For more information, or to register, click here.

New Review: Treatment of Adult Chronic Periodontitis

The Cochrane Oral Health Group has published a new review “Full-mouth disinfection for the treatment of adult chronic periodontitis”.  The objective of the review was to evaluate the effectiveness of full-mouth disinfection or full-mouth scaling compared to conventional quadrant scaling for periodontitis.

Read the abstract here.

Clinical Recommendations for Sealants

Q&A on evidence-based clinical recommendations for sealants

To assist dentists in using the new Evidence-Based Clinical Recommendations for the Use of Pit-and-Fissure Sealants, the ADA has developed a set of questions and answers to aid dentists in interpreting the new guidelines and discussing them with patients.

Read about the recommendations here.

For more information on Evidence Based Dentistry visit this posting.

Evidence Based Dentistry Resources

The ADA has compiled an A-Z list  of published systematic reviews that have direct clinical relevance to dentistry. Each topic has links to abstracts of the systematic reviews available on PubMed. View the list here.

The ADA has also added a new Evidence Based Dentistry content area to its website. The section includes links to clinical recommendations, terminology and EBD conferences.

In addition, Miner Library Online provides a list of resources for Evidence Based Healthcare.

Recent Systematic Reviews

BMJ Clinical Evidence, a decision support resource, contains reviews on the following:

Aphthous ulcers (recurrent)

Burning mouth syndrome

Candidiasis (oropharyngeal)

Halitosis

Impacted wisdom teeth

Access onsite or off site with your library account.