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Published in: Current Oral Health Reports 1/2016

01-03-2016 | Systemic Diseases (M Bartold, Section Editor)

Diet, Obesity, Diabetes, and Periodontitis: a Syndemic Approach to Management

Authors: Maria Emanuel Ryan, Veena Raja

Published in: Current Oral Health Reports | Issue 1/2016

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Abstract

A healthy diet is important to the maintenance of good general health. An imbalanced diet can increase risk for the development of obesity and insulin resistance which can eventually lead to the onset of diabetes. Nutrition, obesity, and diabetes are all known risk factors for periodontal diseases. Periodontitis in turn is a risk factor for the development of diabetes and can complicate the management of those who suffer from obesity and/or diabetes. The interplay of these three common chronic inflammatory diseases suggests that a syndemic approach to prevention and management would best address the shared risk for all of these diseases and help to break the cycle of pro-inflammatory events leading to chronic inflammation as assessed by elevations in C-reactive protein, driven by elevations in cytokines such as IL-6 and TNF-α as well as oxidative stress. These interactions may synergistically increase risk for cardiovascular disease, the number one cause of death worldwide. Oral health care providers can play a major role, as members of an interdisciplinary team of healthcare providers, in addressing this syndemic.
Literature
1.
go back to reference Mendis S, Puska P, Norrving B. Global atlas on cardiovascular disease prevention and control. World Health Organization. 2011. Mendis S, Puska P, Norrving B. Global atlas on cardiovascular disease prevention and control. World Health Organization. 2011.
2.
go back to reference Sidi AD, Ashley FP. Influence of frequent sugar intakes on experimental gingivitis*. J Periodontol. 1984;55(7):419–23.CrossRefPubMed Sidi AD, Ashley FP. Influence of frequent sugar intakes on experimental gingivitis*. J Periodontol. 1984;55(7):419–23.CrossRefPubMed
3.
go back to reference Baumgartner S, Imfeld T, Schicht O, Rath C, Persson RE, Persson GR. The impact of the stone age diet on gingival conditions in the absence of oral hygiene. J Periodontol. 2009;80(5):759–68.CrossRefPubMed Baumgartner S, Imfeld T, Schicht O, Rath C, Persson RE, Persson GR. The impact of the stone age diet on gingival conditions in the absence of oral hygiene. J Periodontol. 2009;80(5):759–68.CrossRefPubMed
4.
go back to reference Who J, Consultation FE. Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser. 2003; 916(i-viii). Who J, Consultation FE. Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser. 2003; 916(i-viii).
5.••
go back to reference World Health Organization. Guideline: sugars intake for adults and children. World Health Organization. 2015. The objective of this guideline is to provide recommendations on the consumption of free sugars to reduce the risk of noncommunicable diseases in adults and children, with a particular focus on the prevention and control of weight gain and dental caries. World Health Organization. Guideline: sugars intake for adults and children. World Health Organization. 2015. The objective of this guideline is to provide recommendations on the consumption of free sugars to reduce the risk of noncommunicable diseases in adults and children, with a particular focus on the prevention and control of weight gain and dental caries.
6.••
go back to reference Elwakeel NM, Hazaa HH. Effect of omega 3 fatty acids plus low-dose aspirin on both clinical and biochemical profiles of patients with chronic periodontitis and type 2 diabetes: a randomized double blind placebo-controlled study. J Periodontal Res. 2015. The aim of this study was, first, to investigate the effect of omega 3 (ω3) fatty acids plus low-dose aspirin with closed debridement in the treatment of patients with periodontitis and type 2 diabetes mellitus (DM), and second, to estimate the expression of monocyte chemoattractant protein-3 (MCP-3) in response to the supposed modulatory therapy. Elwakeel NM, Hazaa HH. Effect of omega 3 fatty acids plus low-dose aspirin on both clinical and biochemical profiles of patients with chronic periodontitis and type 2 diabetes: a randomized double blind placebo-controlled study. J Periodontal Res. 2015. The aim of this study was, first, to investigate the effect of omega 3 (ω3) fatty acids plus low-dose aspirin with closed debridement in the treatment of patients with periodontitis and type 2 diabetes mellitus (DM), and second, to estimate the expression of monocyte chemoattractant protein-3 (MCP-3) in response to the supposed modulatory therapy.
7.•
go back to reference Hooper L, Abdelhamid A, Moore HJ, Douthwaite W, Skeaff CM, Summerbell CD. Effect of reducing total fat intake on body weight: systematic review and meta-analysis of randomised controlled trials and cohort studies. BMJ. 2012 Dec 6; 345. The objective of this systematic review is to assess the effect of reduction or modification of dietary fat intake on total and cardiovascular mortality and cardiovascular morbidity. Hooper L, Abdelhamid A, Moore HJ, Douthwaite W, Skeaff CM, Summerbell CD. Effect of reducing total fat intake on body weight: systematic review and meta-analysis of randomised controlled trials and cohort studies. BMJ. 2012 Dec 6; 345. The objective of this systematic review is to assess the effect of reduction or modification of dietary fat intake on total and cardiovascular mortality and cardiovascular morbidity.
8.
go back to reference Fats FA. Fatty acids in human nutrition. Report of an expert consultation. Food and Nutrition paper. 2010; 91. Fats FA. Fatty acids in human nutrition. Report of an expert consultation. Food and Nutrition paper. 2010; 91.
9.
go back to reference Nishida C, Uauy R. WHO scientific update on health consequences of trans fatty acids: introduction. Eur J Clin Nutr. 2009;63:S1–4.CrossRefPubMed Nishida C, Uauy R. WHO scientific update on health consequences of trans fatty acids: introduction. Eur J Clin Nutr. 2009;63:S1–4.CrossRefPubMed
10.
go back to reference Merchant AT, Pitiphat W, Franz M, Joshipura KJ. Whole-grain and fiber intakes and periodontitis risk in men. Am J Clin Nutr. 2006;83(6):1395–400.PubMed Merchant AT, Pitiphat W, Franz M, Joshipura KJ. Whole-grain and fiber intakes and periodontitis risk in men. Am J Clin Nutr. 2006;83(6):1395–400.PubMed
11.•
go back to reference Zong G, Holtfreter B, Scott AE, Völzke H, Petersmann A, Dietrich T, Newson RS, Kocher T. Serum vitamin B12 is inversely associated with periodontal progression and risk of tooth loss: a prospective cohort study. J Clin Periodontol. 2015. The aim of this study is to investigate the association of serum vitamin B12 with the progression of periodontitis and risk of tooth loss in a prospective cohort study. Zong G, Holtfreter B, Scott AE, Völzke H, Petersmann A, Dietrich T, Newson RS, Kocher T. Serum vitamin B12 is inversely associated with periodontal progression and risk of tooth loss: a prospective cohort study. J Clin Periodontol. 2015. The aim of this study is to investigate the association of serum vitamin B12 with the progression of periodontitis and risk of tooth loss in a prospective cohort study.
12.
go back to reference Neiva RF, Al-Shammari K, Nociti Jr FH, Soehren S, Wang HL. Effects of vitamin-B complex supplementation on periodontal wound healing. J Periodontol. 2005;76(7):1084–91.CrossRefPubMed Neiva RF, Al-Shammari K, Nociti Jr FH, Soehren S, Wang HL. Effects of vitamin-B complex supplementation on periodontal wound healing. J Periodontol. 2005;76(7):1084–91.CrossRefPubMed
13.
go back to reference Neiva RF, Steigenga J, Al-Shammari KF, Wang HL. Effects of specific nutrients on periodontal disease onset, progression and treatment. J Clin Periodontol. 2003;30(7):579–89.CrossRefPubMed Neiva RF, Steigenga J, Al-Shammari KF, Wang HL. Effects of specific nutrients on periodontal disease onset, progression and treatment. J Clin Periodontol. 2003;30(7):579–89.CrossRefPubMed
14.
go back to reference Hildebolt CF. Effect of vitamin D and calcium on periodontitis. J Periodontol. 2005;76(9):1576–87.CrossRefPubMed Hildebolt CF. Effect of vitamin D and calcium on periodontitis. J Periodontol. 2005;76(9):1576–87.CrossRefPubMed
15.
go back to reference Miley DD, Garcia MN, Hildebolt CF, Shannon WD, Couture RA, Anderson Spearie CL, et al. Cross-sectional study of vitamin D and calcium supplementation effects on chronic periodontitis. J Periodontol. 2009;80(9):1433–9.PubMedCentralCrossRefPubMed Miley DD, Garcia MN, Hildebolt CF, Shannon WD, Couture RA, Anderson Spearie CL, et al. Cross-sectional study of vitamin D and calcium supplementation effects on chronic periodontitis. J Periodontol. 2009;80(9):1433–9.PubMedCentralCrossRefPubMed
16.
go back to reference Meisel P, Schwahn C, Luedemann J, John U, Kroemer HK, Kocher T. Magnesium deficiency is associated with periodontal disease. J Dent Res. 2005;84(10):937–41.CrossRefPubMed Meisel P, Schwahn C, Luedemann J, John U, Kroemer HK, Kocher T. Magnesium deficiency is associated with periodontal disease. J Dent Res. 2005;84(10):937–41.CrossRefPubMed
17.••
go back to reference Milward MR, Chapple IL. The role of diet in periodontal disease. Clin Dent Health. 2013;52:18–21. This review highlights the role of nutrition in periodontal disease including nutritional mechanisms of inflammation and the impact of diet on oxidative stress. Dietary recommendations are made for periodontal disease management. Milward MR, Chapple IL. The role of diet in periodontal disease. Clin Dent Health. 2013;52:18–21. This review highlights the role of nutrition in periodontal disease including nutritional mechanisms of inflammation and the impact of diet on oxidative stress. Dietary recommendations are made for periodontal disease management.
18.
go back to reference Friedman JM, Halaas JL. Leptin and the regulation of body weight in mammals. Nature. 1998;395(6704):763–70.CrossRefPubMed Friedman JM, Halaas JL. Leptin and the regulation of body weight in mammals. Nature. 1998;395(6704):763–70.CrossRefPubMed
20.
go back to reference Johnson RB, Serio FG. Leptin within healthy and diseased human gingiva. J Periodontol. 2001;72(9):1254–7.CrossRefPubMed Johnson RB, Serio FG. Leptin within healthy and diseased human gingiva. J Periodontol. 2001;72(9):1254–7.CrossRefPubMed
21.•
go back to reference Shimizu I, Yoshida Y, Katsuno T, Minamino T. Adipose tissue inflammation in diabetes and heart failure. Microbes Infect. 2013;15(1):11–7. Adipose tissue inflammation induces systemic insulin resistance in persons with obesity and heart failure, and has a crucial role in the progression of these diseases. Chronic inflammatory processes share a common mechanism in which increased production of reactive oxygen species activates p53 and NF-κB signaling, leading to up-regulation of pro-inflammatory cytokine expression and impairment of glucose metabolism. Since inhibition of these processes could slow the progression of various diseases, targeting adipose inflammation has the potential to become a new therapeutic approach for diabetes and heart failure.CrossRefPubMed Shimizu I, Yoshida Y, Katsuno T, Minamino T. Adipose tissue inflammation in diabetes and heart failure. Microbes Infect. 2013;15(1):11–7. Adipose tissue inflammation induces systemic insulin resistance in persons with obesity and heart failure, and has a crucial role in the progression of these diseases. Chronic inflammatory processes share a common mechanism in which increased production of reactive oxygen species activates p53 and NF-κB signaling, leading to up-regulation of pro-inflammatory cytokine expression and impairment of glucose metabolism. Since inhibition of these processes could slow the progression of various diseases, targeting adipose inflammation has the potential to become a new therapeutic approach for diabetes and heart failure.CrossRefPubMed
22.
go back to reference Preshaw PM, Taylor JJ. How has research into cytokine interactions and their role in driving immune responses impacted our understanding of periodontitis? J Clin Periodontol. 2011;38(s11):60–84.CrossRefPubMed Preshaw PM, Taylor JJ. How has research into cytokine interactions and their role in driving immune responses impacted our understanding of periodontitis? J Clin Periodontol. 2011;38(s11):60–84.CrossRefPubMed
23.
go back to reference Lundin M, Yucel-Lindberg T, Dahllöf G, Marcus C, Modéer T. Correlation between TNFa in gingival crevicular fluid and body mass index in obese subjects. Acta Odontol. 2004;62(5):273–7.CrossRef Lundin M, Yucel-Lindberg T, Dahllöf G, Marcus C, Modéer T. Correlation between TNFa in gingival crevicular fluid and body mass index in obese subjects. Acta Odontol. 2004;62(5):273–7.CrossRef
24.
go back to reference Saito T, Shimazaki Y, Koga T, Tsuzuki M, Ohshima A. Relationship between upper body obesity and periodontitis. J Dent Res. 2001;80(7):1631–6.CrossRefPubMed Saito T, Shimazaki Y, Koga T, Tsuzuki M, Ohshima A. Relationship between upper body obesity and periodontitis. J Dent Res. 2001;80(7):1631–6.CrossRefPubMed
25.
go back to reference Saito T, Shimazaki Y, Kiyohara Y, Kato I, Kubo M, Iida M, et al. Relationship between obesity, glucose tolerance, and periodontal disease in Japanese women: the Hisayama study. J Periodontal Res. 2005;40(4):346–53.CrossRefPubMed Saito T, Shimazaki Y, Kiyohara Y, Kato I, Kubo M, Iida M, et al. Relationship between obesity, glucose tolerance, and periodontal disease in Japanese women: the Hisayama study. J Periodontal Res. 2005;40(4):346–53.CrossRefPubMed
26.
go back to reference Boesing F, Patiño JS, Da Silva VR, Moreira EA. The interface between obesity and periodontitis with emphasis on oxidative stress and inflammatory response. Obes Rev. 2009;10(3):290–7.CrossRefPubMed Boesing F, Patiño JS, Da Silva VR, Moreira EA. The interface between obesity and periodontitis with emphasis on oxidative stress and inflammatory response. Obes Rev. 2009;10(3):290–7.CrossRefPubMed
27.
go back to reference Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab. 2004;89(6):2548–56.CrossRefPubMed Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab. 2004;89(6):2548–56.CrossRefPubMed
28.
go back to reference Mavri A, Alessi MC, Bastelica D, Geel-Georgelin O, Fina F, Sentocnik JT, et al. Subcutaneous abdominal, but not femoral fat expression of plasminogen activator inhibitor-1 (PAI-1) is related to plasma PAI-1 levels and insulin resistance and decreases after weight loss. Diabetologia. 2001;44(11):2025–31.CrossRefPubMed Mavri A, Alessi MC, Bastelica D, Geel-Georgelin O, Fina F, Sentocnik JT, et al. Subcutaneous abdominal, but not femoral fat expression of plasminogen activator inhibitor-1 (PAI-1) is related to plasma PAI-1 levels and insulin resistance and decreases after weight loss. Diabetologia. 2001;44(11):2025–31.CrossRefPubMed
29.
go back to reference Ryo M, Nakamura T, Kihara S, Kumada M, Shibazaki S, Takahashi M, et al. Adiponectin as a biomarker of the metabolic syndrome. Circ J. 2004;68(11):975–81.CrossRefPubMed Ryo M, Nakamura T, Kihara S, Kumada M, Shibazaki S, Takahashi M, et al. Adiponectin as a biomarker of the metabolic syndrome. Circ J. 2004;68(11):975–81.CrossRefPubMed
30.
go back to reference Yamaguchi N, Hamachi T, Kamio N, Akifusa S, Masuda K, Nakamura Y, et al. Expression levels of adiponectin receptors and periodontitis. J Periodontal Res. 2010;45(2):296–300.CrossRefPubMed Yamaguchi N, Hamachi T, Kamio N, Akifusa S, Masuda K, Nakamura Y, et al. Expression levels of adiponectin receptors and periodontitis. J Periodontal Res. 2010;45(2):296–300.CrossRefPubMed
31.
go back to reference Bokarewa M, Nagaev I, Dahlberg L, Smith U, Tarkowski A. Resistin, an adipokine with potent proinflammatory properties. J Immunol. 2005;174(9):5789–95.CrossRefPubMed Bokarewa M, Nagaev I, Dahlberg L, Smith U, Tarkowski A. Resistin, an adipokine with potent proinflammatory properties. J Immunol. 2005;174(9):5789–95.CrossRefPubMed
32.
go back to reference Saito T, Shimazaki Y. Metabolic disorders related to obesity and periodontal disease. Periodontol. 2007;43(1):254–66.CrossRef Saito T, Shimazaki Y. Metabolic disorders related to obesity and periodontal disease. Periodontol. 2007;43(1):254–66.CrossRef
33.
go back to reference World Health Organization. Obesity and overweight. Fact sheet N 311. Updated Jan 2015. World Health Organization. Obesity and overweight. Fact sheet N 311. Updated Jan 2015.
34.
go back to reference Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, et al. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med. 2001;161(13):1581–6.CrossRefPubMed Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH, et al. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med. 2001;161(13):1581–6.CrossRefPubMed
35.
go back to reference Al-Zahrani MS, Bissada NF, Borawski EA. Obesity and periodontal disease in young, middle-aged, and older adults. J Periodontol. 2003;74(5):610–5.CrossRefPubMed Al-Zahrani MS, Bissada NF, Borawski EA. Obesity and periodontal disease in young, middle-aged, and older adults. J Periodontol. 2003;74(5):610–5.CrossRefPubMed
36.
go back to reference Genco RJ, Grossi SG, Ho A, Nishimura F, Murayama Y. A proposed model linking inflammation to obesity, diabetes, and periodontal infections. J Periodontol. 2005;76(11-s):2075–84.CrossRefPubMed Genco RJ, Grossi SG, Ho A, Nishimura F, Murayama Y. A proposed model linking inflammation to obesity, diabetes, and periodontal infections. J Periodontol. 2005;76(11-s):2075–84.CrossRefPubMed
37.
go back to reference Reeves AF, Rees JM, Schiff M, Hujoel P. Total body weight and waist circumference associated with chronic periodontitis among adolescents in the United States. Arch Pediatr Adolesc Med. 2006;160(9):894–9.CrossRefPubMed Reeves AF, Rees JM, Schiff M, Hujoel P. Total body weight and waist circumference associated with chronic periodontitis among adolescents in the United States. Arch Pediatr Adolesc Med. 2006;160(9):894–9.CrossRefPubMed
38.
go back to reference Ekuni D, Yamamoto T, Koyama R, Tsuneishi M, Naito K, Tobe K. Relationship between body mass index and periodontitis in young Japanese adults. J Periodontal Res. 2008;43(4):417–21.CrossRefPubMed Ekuni D, Yamamoto T, Koyama R, Tsuneishi M, Naito K, Tobe K. Relationship between body mass index and periodontitis in young Japanese adults. J Periodontal Res. 2008;43(4):417–21.CrossRefPubMed
39.
go back to reference Modéer T, Blomberg C, Wondimu B, Lindberg TY, Marcus C. Association between obesity and periodontal risk indicators in adolescents. Int J Pediatr Obes. 2011;6(2Part2):e264–70.CrossRefPubMed Modéer T, Blomberg C, Wondimu B, Lindberg TY, Marcus C. Association between obesity and periodontal risk indicators in adolescents. Int J Pediatr Obes. 2011;6(2Part2):e264–70.CrossRefPubMed
40.••
go back to reference Dahiya P, Kamal R, Gupta R. Obesity, periodontal and general health: relationship and management. Indian J Endocrinol Metab. 2012;16(1):88. This article focuses on the role of obesity and obesity-related diseases (diabetes and coronary heart disease) as contributors to periodontal disease and vice versa. Mechanisms linking obesity with periodontitis are discussed with a focus on adipose tissue-derived cytokines and hormones. The role of the physician and dentist in managing obesity and periodontal disease is discussed.PubMedCentralCrossRefPubMed Dahiya P, Kamal R, Gupta R. Obesity, periodontal and general health: relationship and management. Indian J Endocrinol Metab. 2012;16(1):88. This article focuses on the role of obesity and obesity-related diseases (diabetes and coronary heart disease) as contributors to periodontal disease and vice versa. Mechanisms linking obesity with periodontitis are discussed with a focus on adipose tissue-derived cytokines and hormones. The role of the physician and dentist in managing obesity and periodontal disease is discussed.PubMedCentralCrossRefPubMed
41.
go back to reference Chaffee BW, Weston SJ. Association between chronic periodontal disease and obesity: a systematic review and meta-analysis. J Periodontol. 2010;81(12):1708–24.PubMedCentralCrossRefPubMed Chaffee BW, Weston SJ. Association between chronic periodontal disease and obesity: a systematic review and meta-analysis. J Periodontol. 2010;81(12):1708–24.PubMedCentralCrossRefPubMed
42.••
go back to reference Gorman A, Kaye EK, Apovian C, Fung TT, Nunn M, Garcia RI. Overweight and obesity predict time to periodontal disease progression in men. J Clin Periodontol. 2012;39(2):107–14. The aim of this study is to examine whether overweight and obesity indicators - body mass index (BMI), waist circumference (WC), and WC-to-height ratio - predict progression of periodontal disease in men. The conslusion is that both overall obesity and central adiposity are associated with an increased hazards of periodontal disease progression events in men.PubMedCentralCrossRefPubMed Gorman A, Kaye EK, Apovian C, Fung TT, Nunn M, Garcia RI. Overweight and obesity predict time to periodontal disease progression in men. J Clin Periodontol. 2012;39(2):107–14. The aim of this study is to examine whether overweight and obesity indicators - body mass index (BMI), waist circumference (WC), and WC-to-height ratio - predict progression of periodontal disease in men. The conslusion is that both overall obesity and central adiposity are associated with an increased hazards of periodontal disease progression events in men.PubMedCentralCrossRefPubMed
43.•
go back to reference Jiménez A, Casamitjana R, Flores L, Viaplana J, Corcelles R, Lacy A, et al. Long-term effects of sleeve gastrectomy and Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus in morbidly obese subjects. Ann Surg. 2012;256(6):1023–9. The objective of this study is to identify the rates and the predictors of long-term remission and the recurrence of type 2 diabetes mellitus (T2DM) after Roux-en-Y gastric bypass (RYGBP) or sleeve gastrectomy (SG). The conclusions are that Roux-en-Y gastric bypass and SG are associated with comparable remission rates of T2DM. However, insufficient weight loss or weight regain in those with a more advanced disease may hamper the benefits of these surgical techniques on T2DM. Jiménez A, Casamitjana R, Flores L, Viaplana J, Corcelles R, Lacy A, et al. Long-term effects of sleeve gastrectomy and Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus in morbidly obese subjects. Ann Surg. 2012;256(6):1023–9. The objective of this study is to identify the rates and the predictors of long-term remission and the recurrence of type 2 diabetes mellitus (T2DM) after Roux-en-Y gastric bypass (RYGBP) or sleeve gastrectomy (SG). The conclusions are that Roux-en-Y gastric bypass and SG are associated with comparable remission rates of T2DM. However, insufficient weight loss or weight regain in those with a more advanced disease may hamper the benefits of these surgical techniques on T2DM.
44.
go back to reference Morita I, Okamoto Y, Yoshii S, Nakagaki H, Mizuno K, Sheiham A, et al. Five-year incidence of periodontal disease is related to body mass index. J Dent Res. 2011;90(2):199–202.CrossRefPubMed Morita I, Okamoto Y, Yoshii S, Nakagaki H, Mizuno K, Sheiham A, et al. Five-year incidence of periodontal disease is related to body mass index. J Dent Res. 2011;90(2):199–202.CrossRefPubMed
45.
go back to reference Suvan J, D'Aiuto F, Moles DR, Petrie A, Donos N. Association between overweight/obesity and periodontitis in adults. A systematic review. Obes Rev. 2011;12(5):e381–404.CrossRefPubMed Suvan J, D'Aiuto F, Moles DR, Petrie A, Donos N. Association between overweight/obesity and periodontitis in adults. A systematic review. Obes Rev. 2011;12(5):e381–404.CrossRefPubMed
46.
go back to reference Wood N, Johnson RB, Streckfus CF. Comparison of body composition and periodontal disease using nutritional assessment techniques: third National Health and Nutrition Examination Survey (NHANES III). J Clin Periodontol. 2003;30(4):321–7.CrossRefPubMed Wood N, Johnson RB, Streckfus CF. Comparison of body composition and periodontal disease using nutritional assessment techniques: third National Health and Nutrition Examination Survey (NHANES III). J Clin Periodontol. 2003;30(4):321–7.CrossRefPubMed
47.
go back to reference Al-Zahrani MS, Borawski EA, Bissada NF. Periodontitis and three health-enhancing behaviors: maintaining normal weight, engaging in recommended level of exercise, and consuming a high-quality diet. J Periodontol. 2005;76(8):1362–6.CrossRefPubMed Al-Zahrani MS, Borawski EA, Bissada NF. Periodontitis and three health-enhancing behaviors: maintaining normal weight, engaging in recommended level of exercise, and consuming a high-quality diet. J Periodontol. 2005;76(8):1362–6.CrossRefPubMed
48.
go back to reference Weyant RJ, Newman AB, Kritchevsky SB, Bretz WA, Corby PM, Ren D, et al. Periodontal disease and weight loss in older adults. J Am Geriatr Soc. 2004;52(4):547–53.CrossRefPubMed Weyant RJ, Newman AB, Kritchevsky SB, Bretz WA, Corby PM, Ren D, et al. Periodontal disease and weight loss in older adults. J Am Geriatr Soc. 2004;52(4):547–53.CrossRefPubMed
49.••
go back to reference Lakkis D, Bissada NF, Saber A, Khaitan L, Palomo L, Narendran S, et al. Response to periodontal therapy in patients who had weight loss after bariatric surgery and obese counterparts: a pilot study. J Periodontol. 2012;83(6):684–9. Periodontitis and obesity are both chronic health problems, and the literature supports an association between the two. Weight loss after bariatric surgery (BS) has been shown to decrease overall mortality as well as the development of new health-related conditions in morbidly obese patients. This study which aims to assess whether significant weight loss would improve the response to non-surgical periodontal therapy in obese patients. The authors conclude an improved response to non-surgical periodontal therapy is observed in obese patients who had significant weight loss after BS compared with obese patients who did not have such a surgery.CrossRefPubMed Lakkis D, Bissada NF, Saber A, Khaitan L, Palomo L, Narendran S, et al. Response to periodontal therapy in patients who had weight loss after bariatric surgery and obese counterparts: a pilot study. J Periodontol. 2012;83(6):684–9. Periodontitis and obesity are both chronic health problems, and the literature supports an association between the two. Weight loss after bariatric surgery (BS) has been shown to decrease overall mortality as well as the development of new health-related conditions in morbidly obese patients. This study which aims to assess whether significant weight loss would improve the response to non-surgical periodontal therapy in obese patients. The authors conclude an improved response to non-surgical periodontal therapy is observed in obese patients who had significant weight loss after BS compared with obese patients who did not have such a surgery.CrossRefPubMed
50.••
go back to reference Mendis S, Armstrong T, Bettcher D, Branca F, Lauer J, Mace C, Poznyak V, Riley L, Silva VD, Stevens G, Tang KC. GLOBAL STATUS REPORT on noncommunicable diseases 2014. World Health Organization. 2015. This global status report on prevention and control of noncommunicable diseases (NCD, 2014), is framed around the nine voluntary global targets. The report provides data on the current situation, identifying bottlenecks as well as opportunities and priority actions for attaining the targets. The 2010 baseline estimates on NCD mortality and risk factors are provided so that countries can report on progress, starting in 2015. In addition, the report also provides the latest available estimates on NCD mortality (2012) and risk factors, 2010-2012. Mendis S, Armstrong T, Bettcher D, Branca F, Lauer J, Mace C, Poznyak V, Riley L, Silva VD, Stevens G, Tang KC. GLOBAL STATUS REPORT on noncommunicable diseases 2014. World Health Organization. 2015. This global status report on prevention and control of noncommunicable diseases (NCD, 2014), is framed around the nine voluntary global targets. The report provides data on the current situation, identifying bottlenecks as well as opportunities and priority actions for attaining the targets. The 2010 baseline estimates on NCD mortality and risk factors are provided so that countries can report on progress, starting in 2015. In addition, the report also provides the latest available estimates on NCD mortality (2012) and risk factors, 2010-2012.
51.•
go back to reference World Health Organization. Global health estimates: deaths by cause, age, sex and country, 2000-2012. Geneva: WHO; 2014. The WHO Global Health Estimates provide a comprehensive and comparable assessment of mortality and loss of health due to diseases and injuries for all regions of the world. World Health Organization. Global health estimates: deaths by cause, age, sex and country, 2000-2012. Geneva: WHO; 2014. The WHO Global Health Estimates provide a comprehensive and comparable assessment of mortality and loss of health due to diseases and injuries for all regions of the world.
53.
go back to reference Roglic G, Unwin N, Bennett PH, Mathers C, Tuomilehto J, Nag S, et al. The burden of mortality attributable to diabetes realistic estimates for the year 2000. Diabetes Care. 2005;28(9):2130–5.CrossRefPubMed Roglic G, Unwin N, Bennett PH, Mathers C, Tuomilehto J, Nag S, et al. The burden of mortality attributable to diabetes realistic estimates for the year 2000. Diabetes Care. 2005;28(9):2130–5.CrossRefPubMed
54.
go back to reference Morrish NJ, Wang SL, Stevens LK, Fuller JH, Keen H, WHO Multinational Study Group. Mortality and causes of death in the WHO multinational study of vascular disease in diabetes. Diabetologia. 2001;44(2):S14–21.CrossRefPubMed Morrish NJ, Wang SL, Stevens LK, Fuller JH, Keen H, WHO Multinational Study Group. Mortality and causes of death in the WHO multinational study of vascular disease in diabetes. Diabetologia. 2001;44(2):S14–21.CrossRefPubMed
55.•
go back to reference US Department of Health and Human Services. National Diabetes Information Clearinghouse (NDIC), US National Institute of Diabetes and Digestive and Kidney Diseases. Causes of Diabetes. 2014. This report defines diabetes and discusses the causes of type 1, type 2, and gestational diabetes. The report describes genetic, environmental, and other factors associated with the development of diabetes. US Department of Health and Human Services. National Diabetes Information Clearinghouse (NDIC), US National Institute of Diabetes and Digestive and Kidney Diseases. Causes of Diabetes. 2014. This report defines diabetes and discusses the causes of type 1, type 2, and gestational diabetes. The report describes genetic, environmental, and other factors associated with the development of diabetes.
56.•
go back to reference Diabetes- Diabetes mellitus, Causes of Diabetes, Type of Diabetes, Signs of Diabetes. Disease and Symptoms. Loss of weight allegiance. 2014. Facts on diabetes including symptoms, risk factors, treatments, complications and prevention. Diabetes- Diabetes mellitus, Causes of Diabetes, Type of Diabetes, Signs of Diabetes. Disease and Symptoms. Loss of weight allegiance. 2014. Facts on diabetes including symptoms, risk factors, treatments, complications and prevention.
57.
go back to reference Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393.PubMedCentralCrossRef Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393.PubMedCentralCrossRef
58.
go back to reference Löe H. Periodontal disease: the sixth complication of diabetes mellitus. Diabetes Care. 1993;16(1):329–34.CrossRefPubMed Löe H. Periodontal disease: the sixth complication of diabetes mellitus. Diabetes Care. 1993;16(1):329–34.CrossRefPubMed
59.
go back to reference Ryan ME, Carnu O, Kamer A. The influence of diabetes on the periodontal tissues. J Am Dent Assoc. 2003;134:34S–40.CrossRefPubMed Ryan ME, Carnu O, Kamer A. The influence of diabetes on the periodontal tissues. J Am Dent Assoc. 2003;134:34S–40.CrossRefPubMed
60.
go back to reference Lalla E, Cheng B, Lal S, Kaplan S, Softness B, Greenberg E, et al. Diabetes mellitus promotes periodontal destruction in children. J Clin Periodontol. 2007;34(4):294–8.CrossRefPubMed Lalla E, Cheng B, Lal S, Kaplan S, Softness B, Greenberg E, et al. Diabetes mellitus promotes periodontal destruction in children. J Clin Periodontol. 2007;34(4):294–8.CrossRefPubMed
61.
go back to reference Cianciola LJ, Park BH, Bruck E, Mosovich L, Genco RJ. Prevalence of periodontal disease in insulin-dependent diabetes mellitus (juvenile diabetes). J Am Dent Assoc. 1982;104(5):653–60.CrossRefPubMed Cianciola LJ, Park BH, Bruck E, Mosovich L, Genco RJ. Prevalence of periodontal disease in insulin-dependent diabetes mellitus (juvenile diabetes). J Am Dent Assoc. 1982;104(5):653–60.CrossRefPubMed
62.
go back to reference Salvi GE, Carollo-Bittel B, Lang NP. Effects of diabetes mellitus on periodontal and peri-implant conditions: update on associations and risks. J Clin Periodontol. 2008;35(s8):398–409.CrossRefPubMed Salvi GE, Carollo-Bittel B, Lang NP. Effects of diabetes mellitus on periodontal and peri-implant conditions: update on associations and risks. J Clin Periodontol. 2008;35(s8):398–409.CrossRefPubMed
63.
go back to reference Chávarry NG, Vettore MV, Sansone C, Sheiham A. The relationship between diabetes mellitus and destructive periodontal disease: a meta-analysis. Oral Health Prev Dent. 2009;7(2):107–27.PubMed Chávarry NG, Vettore MV, Sansone C, Sheiham A. The relationship between diabetes mellitus and destructive periodontal disease: a meta-analysis. Oral Health Prev Dent. 2009;7(2):107–27.PubMed
65.
go back to reference Shlossman M, Knowler WC, Pettitt DJ, Genco RJ. Type 2 diabetes mellitus and periodontal disease. J Am Dent Assoc. 1990;121(4):532–6.CrossRefPubMed Shlossman M, Knowler WC, Pettitt DJ, Genco RJ. Type 2 diabetes mellitus and periodontal disease. J Am Dent Assoc. 1990;121(4):532–6.CrossRefPubMed
66.
go back to reference Tsai C, Hayes C, Taylor GW. Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population. Community Dent Oral Epidemiol. 2002;30(3):182–92.CrossRefPubMed Tsai C, Hayes C, Taylor GW. Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population. Community Dent Oral Epidemiol. 2002;30(3):182–92.CrossRefPubMed
67.
go back to reference Salvi GE, Brown CE, Fujihashi K, Kiyono H, Smith FW, Beck JD, et al. Inflammatory mediators of the terminal dentition in adult and early onset periodontitis. J Periodontal Res. 1998;33(3):212–25.CrossRefPubMed Salvi GE, Brown CE, Fujihashi K, Kiyono H, Smith FW, Beck JD, et al. Inflammatory mediators of the terminal dentition in adult and early onset periodontitis. J Periodontal Res. 1998;33(3):212–25.CrossRefPubMed
68.
go back to reference Engebretson S, Chertog R, Nichols A, Hey-Hadavi J, Celenti R, Grbic J. Plasma levels of tumour necrosis factor-α in patients with chronic periodontitis and type 2 diabetes. J Clin Periodontol. 2007;34(1):18–24.CrossRefPubMed Engebretson S, Chertog R, Nichols A, Hey-Hadavi J, Celenti R, Grbic J. Plasma levels of tumour necrosis factor-α in patients with chronic periodontitis and type 2 diabetes. J Clin Periodontol. 2007;34(1):18–24.CrossRefPubMed
69.
go back to reference Mealey BL, Ocampo GL. Diabetes mellitus and periodontal disease. Periodontol. 2007;44(1):127–53.CrossRef Mealey BL, Ocampo GL. Diabetes mellitus and periodontal disease. Periodontol. 2007;44(1):127–53.CrossRef
70.••
go back to reference Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012;91(10):914–20. This study estimated the prevalence, severity, and extent of periodontitis in the adult U.S. population, with data from the 2009 and 2010 National Health and Nutrition Examination Survey (NHANES) cycle. This survey has provided direct evidence for a high burden of periodontitis in the adult U.S. population.CrossRefPubMed Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012;91(10):914–20. This study estimated the prevalence, severity, and extent of periodontitis in the adult U.S. population, with data from the 2009 and 2010 National Health and Nutrition Examination Survey (NHANES) cycle. This survey has provided direct evidence for a high burden of periodontitis in the adult U.S. population.CrossRefPubMed
71.••
go back to reference World Health Organization. Oral Health Fact Sheet. n. 318, April 2012. Public health solutions for oral diseases are most effective when they are integrated with those for other chronic diseases and with national public health programmes. The WHO Global Oral Health Programme aligns its work with the strategy of chronic disease prevention and health promotion. Emphasis is put on developing global policies in oral health promotion and oral disease prevention. World Health Organization. Oral Health Fact Sheet. n. 318, April 2012. Public health solutions for oral diseases are most effective when they are integrated with those for other chronic diseases and with national public health programmes. The WHO Global Oral Health Programme aligns its work with the strategy of chronic disease prevention and health promotion. Emphasis is put on developing global policies in oral health promotion and oral disease prevention.
72.
go back to reference Nowjack-Raymer RE, Sheiham A. Association of edentulism and diet and nutrition in US adults. J Dent Res. 2003;82(2):123–6.CrossRefPubMed Nowjack-Raymer RE, Sheiham A. Association of edentulism and diet and nutrition in US adults. J Dent Res. 2003;82(2):123–6.CrossRefPubMed
73.
go back to reference Cutler CW, Shinedling EA, Nunn M, Jotwani R, Kim BO, Nares S, et al. Association between periodontitis and hyperlipidemia: cause or effect? J Periodontol. 1999;70(12):1429–34.CrossRefPubMed Cutler CW, Shinedling EA, Nunn M, Jotwani R, Kim BO, Nares S, et al. Association between periodontitis and hyperlipidemia: cause or effect? J Periodontol. 1999;70(12):1429–34.CrossRefPubMed
74.
go back to reference Cutler CW, Iacopino AM. Periodontal disease: links with serum lipid/triglyceride levels? Review and new data. J Int Acad Periodontol. 2003;2:47–51. Cutler CW, Iacopino AM. Periodontal disease: links with serum lipid/triglyceride levels? Review and new data. J Int Acad Periodontol. 2003;2:47–51.
75.
go back to reference Festa A, D’Agostino R, Howard G, Mykkänen L, Tracy RP, Haffner SM. Chronic subclinical inflammation as part of the insulin resistance syndrome the Insulin Resistance Atherosclerosis Study (IRAS). Circulation. 2000;102(1):42–7.CrossRefPubMed Festa A, D’Agostino R, Howard G, Mykkänen L, Tracy RP, Haffner SM. Chronic subclinical inflammation as part of the insulin resistance syndrome the Insulin Resistance Atherosclerosis Study (IRAS). Circulation. 2000;102(1):42–7.CrossRefPubMed
76.
go back to reference Ryan ME. Prevalence and risk factors for periodontal disease in people with diabetes. In American Diabetes Association, 68th Scientific Session. 2008. Ryan ME. Prevalence and risk factors for periodontal disease in people with diabetes. In American Diabetes Association, 68th Scientific Session. 2008.
77.
go back to reference Kornman KS, Crane A, Wang HY, Giovlne FS, Newman MG, Pirk FW, et al. The interleukin-1 genotype as a severity factor in adult periodontal disease. J Clin Periodontol. 1997;24(1):72–7.CrossRefPubMed Kornman KS, Crane A, Wang HY, Giovlne FS, Newman MG, Pirk FW, et al. The interleukin-1 genotype as a severity factor in adult periodontal disease. J Clin Periodontol. 1997;24(1):72–7.CrossRefPubMed
78.
go back to reference Demmer RT, Jacobs DR, Desvarieux M. Periodontal disease and incident type 2 diabetes results from the first national health and nutrition examination survey and its epidemiologic follow-up study. Diabetes Care. 2008;31(7):1373–9.PubMedCentralCrossRefPubMed Demmer RT, Jacobs DR, Desvarieux M. Periodontal disease and incident type 2 diabetes results from the first national health and nutrition examination survey and its epidemiologic follow-up study. Diabetes Care. 2008;31(7):1373–9.PubMedCentralCrossRefPubMed
80.
go back to reference Hotamisligil GS, Spiegelman BM. Tumor necrosis factor α: a key component of the obesity-diabetes link. Diabetes. 1994;43(11):1271–8.CrossRefPubMed Hotamisligil GS, Spiegelman BM. Tumor necrosis factor α: a key component of the obesity-diabetes link. Diabetes. 1994;43(11):1271–8.CrossRefPubMed
81.••
go back to reference Khosravi R, Ka K, Huang T, Khalili S, Nguyen BH, Nicolau B, Tran SD. Tumor necrosis factor-α and interleukin-6: potential interorgan inflammatory mediators contributing to destructive periodontal disease in obesity or metabolic syndrome. Mediat Inflamm. 2013; Pg1-6. The connections between destructive periodontal disease and systemic conditions, such as obesity or metabolic syndrome, are complex and potentially multidirectional. This review largely focuses on TNF- α and IL-6, inflammatory mediators, as potential common risk factors and does not exclude other biological mechanisms. Khosravi R, Ka K, Huang T, Khalili S, Nguyen BH, Nicolau B, Tran SD. Tumor necrosis factor-α and interleukin-6: potential interorgan inflammatory mediators contributing to destructive periodontal disease in obesity or metabolic syndrome. Mediat Inflamm. 2013; Pg1-6. The connections between destructive periodontal disease and systemic conditions, such as obesity or metabolic syndrome, are complex and potentially multidirectional. This review largely focuses on TNF- α and IL-6, inflammatory mediators, as potential common risk factors and does not exclude other biological mechanisms.
82.
go back to reference Taylor GW, Burt BA, Becker MP, Genco RJ, Shlossman M, Knowler WC, et al. Severe periodontitis and risk for poor glycemic control in patients with non-insulin-dependent diabetes mellitus. J Periodontol. 1996;67(10s):1085–93.CrossRefPubMed Taylor GW, Burt BA, Becker MP, Genco RJ, Shlossman M, Knowler WC, et al. Severe periodontitis and risk for poor glycemic control in patients with non-insulin-dependent diabetes mellitus. J Periodontol. 1996;67(10s):1085–93.CrossRefPubMed
83.
go back to reference Thorstensson H, Kuylenstiema J, Hugoson A. Medical status and complications in relation to periodontal disease experience in insulin-dependent diabetics. J Clin Periodontol. 1996;23(3):194–202.CrossRefPubMed Thorstensson H, Kuylenstiema J, Hugoson A. Medical status and complications in relation to periodontal disease experience in insulin-dependent diabetics. J Clin Periodontol. 1996;23(3):194–202.CrossRefPubMed
84.
go back to reference Saremi A, Nelson RG, Tulloch-Reid M, Hanson RL, Sievers ML, Taylor GW, et al. Periodontal disease and mortality in type 2 diabetes. Diabetes Care. 2005;28(1):27–32.CrossRefPubMed Saremi A, Nelson RG, Tulloch-Reid M, Hanson RL, Sievers ML, Taylor GW, et al. Periodontal disease and mortality in type 2 diabetes. Diabetes Care. 2005;28(1):27–32.CrossRefPubMed
85.
go back to reference Shultis WA, Weil EJ, Looker HC, Curtis JM, Shlossman M, Genco RJ, et al. Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes. Diabetes Care. 2007;30(2):306–11.CrossRefPubMed Shultis WA, Weil EJ, Looker HC, Curtis JM, Shlossman M, Genco RJ, et al. Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes. Diabetes Care. 2007;30(2):306–11.CrossRefPubMed
86.
go back to reference Singer M. Introduction to syndemics: a critical systems approach to public and community health. John Wiley & Sons 2009. Singer M. Introduction to syndemics: a critical systems approach to public and community health. John Wiley & Sons 2009.
87.••
go back to reference Levine RS. Obesity, diabetes and periodontitis–a triangular relationship? Br Dent J. 2013;215(1):35–9. Recent research suggests that periodontitis may adversely affect glycemic control, which can be improved by periodontal treatment with reduced risk of diabetic co-morbidity, thereby creating a two-way relationship. Furthermore it appears possible that periodontitis may stimulate inflammatory change in adipose tissue, creating a triangular self-generating cycle of morbidity linking obesity, diabetes and periodontal disease described within this article.CrossRefPubMed Levine RS. Obesity, diabetes and periodontitis–a triangular relationship? Br Dent J. 2013;215(1):35–9. Recent research suggests that periodontitis may adversely affect glycemic control, which can be improved by periodontal treatment with reduced risk of diabetic co-morbidity, thereby creating a two-way relationship. Furthermore it appears possible that periodontitis may stimulate inflammatory change in adipose tissue, creating a triangular self-generating cycle of morbidity linking obesity, diabetes and periodontal disease described within this article.CrossRefPubMed
88.
go back to reference Hein C, Small D. Combating diabetes, obesity, periodontal disease and interrelated inflammatory conditions with a syndemic approach. Grand Rounds Oral Sys Med. 2006;2:36–47. Hein C, Small D. Combating diabetes, obesity, periodontal disease and interrelated inflammatory conditions with a syndemic approach. Grand Rounds Oral Sys Med. 2006;2:36–47.
89.••
go back to reference Bullon P, Newman HN, Battino M. Obesity, diabetes mellitus, atherosclerosis and chronic periodontitis: a shared pathology via oxidative stress and mitochondrial dysfunction? Periodontol. 2014;64(1):139–53. Host inflammation response mechanisms largely shared by the body's different tissues and systems with possible linkages among chronic periodontitis and other chronic systemic diseases are discussed. This review considers the mounting evidence that the basis for the inter-relationships between chronic periodontitis and atheromatous disease and diabetes lie at a fundamental intracellular level, namely oxidative stress and mitochondrial dysfunction, as a meeting background among such chronic diseases and periodontitis.CrossRef Bullon P, Newman HN, Battino M. Obesity, diabetes mellitus, atherosclerosis and chronic periodontitis: a shared pathology via oxidative stress and mitochondrial dysfunction? Periodontol. 2014;64(1):139–53. Host inflammation response mechanisms largely shared by the body's different tissues and systems with possible linkages among chronic periodontitis and other chronic systemic diseases are discussed. This review considers the mounting evidence that the basis for the inter-relationships between chronic periodontitis and atheromatous disease and diabetes lie at a fundamental intracellular level, namely oxidative stress and mitochondrial dysfunction, as a meeting background among such chronic diseases and periodontitis.CrossRef
90.•
go back to reference Chapple IL, Milward MR, Ling-Mountford N, Weston P, Carter K, Askey K, et al. Adjunctive daily supplementation with encapsulated fruit, vegetable and berry juice powder concentrates and clinical periodontal outcomes: a double-blind RCT. J Clin Periodontol. 2012;39(1):62–72. A double-blind randomized controlled trial to determine whether dietary supplementation with fruit/vegetable/berry juice powder concentrates, simultaneously with non-surgical periodontal therapy, improved 2-month treatment outcomes. The conclusions are that adjunctive juice powder concentrates appear to improve initial pocket depth reductions in nutritionally replete patients, where plasma micronutrient bioavailability is attainable. Definitive multicentre studies in untreated and treated patients are required to ascertain the clinical significance of such changes.PubMedCentralCrossRefPubMed Chapple IL, Milward MR, Ling-Mountford N, Weston P, Carter K, Askey K, et al. Adjunctive daily supplementation with encapsulated fruit, vegetable and berry juice powder concentrates and clinical periodontal outcomes: a double-blind RCT. J Clin Periodontol. 2012;39(1):62–72. A double-blind randomized controlled trial to determine whether dietary supplementation with fruit/vegetable/berry juice powder concentrates, simultaneously with non-surgical periodontal therapy, improved 2-month treatment outcomes. The conclusions are that adjunctive juice powder concentrates appear to improve initial pocket depth reductions in nutritionally replete patients, where plasma micronutrient bioavailability is attainable. Definitive multicentre studies in untreated and treated patients are required to ascertain the clinical significance of such changes.PubMedCentralCrossRefPubMed
91.
go back to reference Williams RC, Mahan CJ. Periodontal disease and diabetes in young adults. J Am Med Assoc. 1960;172(8):776–8.CrossRefPubMed Williams RC, Mahan CJ. Periodontal disease and diabetes in young adults. J Am Med Assoc. 1960;172(8):776–8.CrossRefPubMed
92.
go back to reference Iwamoto Y, Nishimura F, Nakagawa M, Sugimoto H, Shikata K, Makino H, et al. The effect of antimicrobial periodontal treatment on circulating tumor necrosis factor-alpha and glycated hemoglobin level in patients with type 2 diabetes. J Periodontol. 2001;72(6):774–8.CrossRefPubMed Iwamoto Y, Nishimura F, Nakagawa M, Sugimoto H, Shikata K, Makino H, et al. The effect of antimicrobial periodontal treatment on circulating tumor necrosis factor-alpha and glycated hemoglobin level in patients with type 2 diabetes. J Periodontol. 2001;72(6):774–8.CrossRefPubMed
93.
go back to reference Janket SJ, Wightman A, Baird AE, Van Dyke TE, Jones JA. Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies. J Dent Res. 2005;84(12):1154–9.PubMedCentralCrossRefPubMed Janket SJ, Wightman A, Baird AE, Van Dyke TE, Jones JA. Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies. J Dent Res. 2005;84(12):1154–9.PubMedCentralCrossRefPubMed
94.••
go back to reference Corbella S, Francetti L, Taschieri S, Siena F, Fabbro MD. Effect of periodontal treatment on glycemic control of patients with diabetes: a systematic review and meta-analysis. J Diabetes Investig. 2013;4(5):502–9. The aim of this study was to investigate whether non-surgical periodontal treatment reduces glycated hemoglobin (HbA1c) and fasting plasma glucose levels in diabetic patients. The meta-analysis showed that non-surgical periodontal treatment improves metabolic control in patients with both periodontitis and diabetes. Corbella S, Francetti L, Taschieri S, Siena F, Fabbro MD. Effect of periodontal treatment on glycemic control of patients with diabetes: a systematic review and meta-analysis. J Diabetes Investig. 2013;4(5):502–9. The aim of this study was to investigate whether non-surgical periodontal treatment reduces glycated hemoglobin (HbA1c) and fasting plasma glucose levels in diabetic patients. The meta-analysis showed that non-surgical periodontal treatment improves metabolic control in patients with both periodontitis and diabetes.
95.••
go back to reference Engebretson S, Kocher T. Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis. J Clin Periodontol. 2013;40(s14):S153–63. This update examines the effect of periodontal treatment on diabetes outcomes. The conclusion is that modest reduction in HbA1c observed as a result of periodontal therapy in subjects with type 2 diabetes is consistent with previous systematic reviews. Despite this finding, there is limited confidence in the authors’ own conclusion due to a lack of multi-centre trials of sufficient sample size. Engebretson S, Kocher T. Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis. J Clin Periodontol. 2013;40(s14):S153–63. This update examines the effect of periodontal treatment on diabetes outcomes. The conclusion is that modest reduction in HbA1c observed as a result of periodontal therapy in subjects with type 2 diabetes is consistent with previous systematic reviews. Despite this finding, there is limited confidence in the authors’ own conclusion due to a lack of multi-centre trials of sufficient sample size.
96.••
go back to reference Wang X, Han X, Guo X, Luo X, Wang D. The effect of periodontal treatment on hemoglobin A1c levels of diabetic patients: a systematic review and meta-analysis. 2014. This review demonstrates that periodontal treatment leads to a reduction of HbA1c in diabetic patients with periodontitis, with improvement of periodontal status for three months after treatment. But the treatment may have no obvious effect on glycaemic control six months after treatment. This is the first systematic review that takes into account the results from the 2013 “Diabetes and Periodontal Therapy Trial” (DPTT) published in the Journal of the American Medical Association. The results from this large randomized controlled trial failed to demonstrate a significant effect of periodontal treatment on glycaemic control among diabetic patients. Wang X, Han X, Guo X, Luo X, Wang D. The effect of periodontal treatment on hemoglobin A1c levels of diabetic patients: a systematic review and meta-analysis. 2014. This review demonstrates that periodontal treatment leads to a reduction of HbA1c in diabetic patients with periodontitis, with improvement of periodontal status for three months after treatment. But the treatment may have no obvious effect on glycaemic control six months after treatment. This is the first systematic review that takes into account the results from the 2013 “Diabetes and Periodontal Therapy Trial” (DPTT) published in the Journal of the American Medical Association. The results from this large randomized controlled trial failed to demonstrate a significant effect of periodontal treatment on glycaemic control among diabetic patients.
97.
go back to reference Grossi SG, Skrepcinski FB, DeCaro T, Robertson DC, Ho AW, Dunford RG, et al. Treatment of periodontal disease in diabetics reduces glycated hemoglobin. J Periodontol. 1997;68(8):713–9.CrossRefPubMed Grossi SG, Skrepcinski FB, DeCaro T, Robertson DC, Ho AW, Dunford RG, et al. Treatment of periodontal disease in diabetics reduces glycated hemoglobin. J Periodontol. 1997;68(8):713–9.CrossRefPubMed
98.
go back to reference Engebretson SP, Hey-Hadavi J, Celenti R, Lamster IB. Low-dose doxycycline treatment reduces glycosylated hemoglobin in patients with type 2 diabetes: a randomized controlled trial. J Dent Res. 2003; 82. Engebretson SP, Hey-Hadavi J, Celenti R, Lamster IB. Low-dose doxycycline treatment reduces glycosylated hemoglobin in patients with type 2 diabetes: a randomized controlled trial. J Dent Res. 2003; 82.
99.
go back to reference Payne JB, Golub LM, Stoner JA, Lee HM, Reinhardt RA, Sorsa T, et al. The effect of subantimicrobial-dose–doxycycline periodontal therapy on serum biomarkers of systemic inflammation: a randomized, double-masked, placebo-controlled clinical trial. J Am Dent Assoc. 2011;142(3):262–73.PubMedCentralCrossRefPubMed Payne JB, Golub LM, Stoner JA, Lee HM, Reinhardt RA, Sorsa T, et al. The effect of subantimicrobial-dose–doxycycline periodontal therapy on serum biomarkers of systemic inflammation: a randomized, double-masked, placebo-controlled clinical trial. J Am Dent Assoc. 2011;142(3):262–73.PubMedCentralCrossRefPubMed
100.
go back to reference Brown DL, Desai KK, Vakili BA, Nouneh C, Lee HM, Golub LM. Clinical and biochemical results of the metalloproteinase inhibition with subantimicrobial doses of doxycycline to prevent acute coronary syndromes (MIDAS) pilot trial. Arterioscler Thromb Vasc Biol. 2004;24(4):733–8.CrossRefPubMed Brown DL, Desai KK, Vakili BA, Nouneh C, Lee HM, Golub LM. Clinical and biochemical results of the metalloproteinase inhibition with subantimicrobial doses of doxycycline to prevent acute coronary syndromes (MIDAS) pilot trial. Arterioscler Thromb Vasc Biol. 2004;24(4):733–8.CrossRefPubMed
101.
go back to reference Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405–12.PubMedCentralCrossRefPubMed Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405–12.PubMedCentralCrossRefPubMed
102.
go back to reference Jeffcoat M, Tanna N, Hall M, Hedlund C, Hahn M, Young J, Genco R. Periodontal therapy reduces the cost of medical care in diabetics. In International Association of Dental Research Annual Meeting. 2011. Jeffcoat M, Tanna N, Hall M, Hedlund C, Hahn M, Young J, Genco R. Periodontal therapy reduces the cost of medical care in diabetics. In International Association of Dental Research Annual Meeting. 2011.
103.••
go back to reference Jeffcoat MK, Jeffcoat RL, Gladowski PA, Bramson JB, Blum JJ. Impact of periodontal therapy on general health: evidence from insurance data for five systemic conditions. Am J Prev Med. 2014;47(2):166–74. Treatment of periodontal disease may lessen the adverse consequences of some chronic systemic conditions. The purpose of this study was to estimate the effects of periodontal therapy on medical costs and hospitalizations among individuals with diagnosed type 2 diabetes; coronary artery disease; cerebral vascular disease; rheumatoid arthritis (RA); and pregnancy in a retrospective observational cohort study. Statistically significant reductions in both outcomes were reported for all cohorts with the exception of the RA cohort. Jeffcoat MK, Jeffcoat RL, Gladowski PA, Bramson JB, Blum JJ. Impact of periodontal therapy on general health: evidence from insurance data for five systemic conditions. Am J Prev Med. 2014;47(2):166–74. Treatment of periodontal disease may lessen the adverse consequences of some chronic systemic conditions. The purpose of this study was to estimate the effects of periodontal therapy on medical costs and hospitalizations among individuals with diagnosed type 2 diabetes; coronary artery disease; cerebral vascular disease; rheumatoid arthritis (RA); and pregnancy in a retrospective observational cohort study. Statistically significant reductions in both outcomes were reported for all cohorts with the exception of the RA cohort.
104.
go back to reference Kunzel C, Lalla E, Albert DA, Yin H, Lamster IB. On the primary care frontlines: the role of the general practitioner in smoking-cessation activities and diabetes management. J Am Dent Assoc. 2005;136(8):1144–53.CrossRefPubMed Kunzel C, Lalla E, Albert DA, Yin H, Lamster IB. On the primary care frontlines: the role of the general practitioner in smoking-cessation activities and diabetes management. J Am Dent Assoc. 2005;136(8):1144–53.CrossRefPubMed
105.
go back to reference Kunzel C, Lalla E, Lamster IB. Management of the patient who smokes and the diabetic patient in the dental office. J Periodontol. 2006;7(3):331–40.CrossRef Kunzel C, Lalla E, Lamster IB. Management of the patient who smokes and the diabetic patient in the dental office. J Periodontol. 2006;7(3):331–40.CrossRef
Metadata
Title
Diet, Obesity, Diabetes, and Periodontitis: a Syndemic Approach to Management
Authors
Maria Emanuel Ryan
Veena Raja
Publication date
01-03-2016
Publisher
Springer International Publishing
Published in
Current Oral Health Reports / Issue 1/2016
Electronic ISSN: 2196-3002
DOI
https://doi.org/10.1007/s40496-016-0075-1

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