At Risk for Prediabetes or Diabetes?

pricked finger

Not sure if you’re at risk of developing type 2 diabetes?  The American Diabetes Association (ADA) wants to help you with its “Alert Day,” slated for March 28.

The ADA has a free, quick, and anonymous risk test available you can use to find if you’re at risk for type 2 diabetes. If you are, their site can help you learn how to decrease your risk. Certainly there are many outlets, that offer good information, tips to help you maintain a healthy weight, make better food choices, incorporate exercise and ways to maintain motivation. To reclaim and maintain your health you’ll need to identify what works best for you. Could be a supportive friend who will take a daily walk with you or a one day a week dinner party with friends interested in healthy cooking–let it be unique to you.

Whether you take a holistic approach or a more traditional one, we believe Alert Day serves a critical function in bringing a much needed awareness to the diabetes epidemic. The CDC estimates that 29 million Americans have diabetes yet only 21 million have been diagnosed. That means that 8.1 million remain undiagnosed.

If you’re concerned that one of them could be you

  1. Schedule a dental exam and hygiene visit.
    The latest science indicates that dentists can play a vital role in diagnosing diabetes. If you have gum disease, science now indicates it could mean you already have diabetes or that it’s immanent.

  2. See another health care provider.
    A health care provider can evaluate and monitor your level of risk. They can also support you in developing a lifestyle that may improve your disease profile. This is critical because diabetes is a disease of chronic inflammation. As such, it affects the entire body. Systematically, it has been linked other diseases of chronic inflammation, such as

    • Cardiovascular disease.
    • Obesity.
    • Stroke.
    • Some cancers.
    • Periodontal disease.
  3. Do your research and make necessary changes.
    There is good information out there. Through the years, we’ve put together our own library on health and wellness. Much of it is geared toward eating better, exercising more, and improving diseases of chronic inflammation. Since the health of your mouth is vital to your overall health, we’ve made it easy to search our blog by topic anytime. Here’s a sampling of entries that can help you learn more about the systematic nature of diabetes. Check them out, because whether it’s  March 28th’s Alert Day, or any other day, we think it makes for some pretty good reading:

    Image by Alisha Vargas

The Mouth-Body Connection: Obesity and Gum Disease

obese man in waiting areaThe numbers are not encouraging.

According to the latest numbers from Gallup and Healthways, the US obesity rate has climbed once again, nearing 28%. That’s more than one in four of us. Not just overweight but obese. Here in Texas, the rate is even higher: 30%.

Meanwhile, cancer specialists speaking at the annual meeting of the American Society of Clinical Oncology in Chicago cautioned that obesity may overtake smoking as the leading cause of cancer within the decade. According to Harvard oncology specialist Jennifer Ligibel, the relationship between the two conditions is “clear.”

“It’s the case with breast cancer, a prostate cancer, cancer of the colon and all the gynaecological cancers,” she said. She highlighted research showing that obesity increased the risk of womb cancer sixfold.

Experts said obesity was driving cancer because it results in hormones imbalances that can fuel tumour growth.

Cancer and obesity are also both inflammatory conditions – like periodontal disease, which has also been linked to both.

The obesity link, in particular, has been highlighted by recent studies, such as the new research review just published in the Journal of Clinical Periodontology. The studies that met the authors’ criteria included more than 42,000 subjects and all together showed that those

who became overweight and obese presented higher risk to develop new cases of periodontitis…compared with counterparts who stayed in normal weight.

A review in the Journal of Periodontology similarly found “that overweight, obesity, weight gain, and increased waist circumference may be risk factors for development of periodontitis or worsening of periodontal measures.”

Research published earlier this year in the same journal found more pronounced markers of periodontitis (advanced gum disease) among those who were overweight and less physically fit.

So are exercise and more healthful eating the ticket? Perhaps not entirely. For one of the other findings in the Gallup/Healthways report was that social and economic factors may be fueling the rise in obesity rates, as well. Environmental factors also play a role. For instance, a new study in Environmental Health Perspectives showed how BPA may be contributing to the obesity crisis, as well:

The study is the first to find that people’s bodies metabolize bisphenol-A (BPA) — a chemical found in most people and used in polycarbonate plastic, food cans and paper receipts — into something that impacts our cells and may make us fat.

The research, from Health Canada, challenges an untested assumption that our liver metabolizes BPA into a form that doesn’t impact our health.

“This shows we can’t just say things like ‘because it’s a metabolite, it means it’s not active’,” said Laura Vandenberg, an assistant professor of environmental health at the University of Massachusetts Amherst who was not involved in the study. “You have to do a study.”

Like most modern chronic health problems, obesity is multifactoral. But eating better and getting more active do make a great start. Ramped up oral hygiene and nutritional therapy can offer big help, as well, in putting the brakes on chronic inflammation.

Image by Tony Alter

Green Tea for Healthy Gums

green tea leaves in bowlTeeth alone don’t make a smile. They need healthy gum and bone tissue to support them. The way to do that, of course, is through optimal hygiene, nutrition and overall healthy habits. Supplements, herbal medicaments and other natural substances can give a boost to those measures. Case in point? Green tea.

We’ve looked before at some of the oral health benefits of green tea. Now a more recent study – small but compelling – adds to the earlier evidence.

Subjects were split into two groups. One brushed with conventional fluoride and triclosan toothpaste; the other brushed with a green tea paste. After four weeks, the researchers looked for changes in several aspects of oral health, including pocket depth, bleeding upon probing, plaque and clinical attachment level (an estimate of a tooth’s stability). Both groups showed improvement in most areas, but by the end of the study, the green tea group had improved more.

The research was published in the International Journal of Dental Hygiene.

One of the virtues of green tea is that it is loaded with antioxidants that help keep your body’s cells healthy. It may boost levels of glutathione, a super antioxidant that is especially helpful in heavy metals detox. It is also has antimicrobial properties, having been shown effective in controlling growth of Candida – a yeast which may team up with S. mutans to make tooth decay even worse.

And, of course, green tea’s benefits are hardly limited to the mouth.

Despite the benefits, some find it hard to drink green tea on a regular basis. They may not be big fans of tea. They may find the mild flavor gets boring after a while. But whether you’re a novice tea drinker or an old pro, there are lots of ideas and recipes out there for jazzing up your brew. Here are a few for starters:

And keep in mind that there are other ways to enjoy green tea beyond brewing it. For instance, you could cook a green tea cake or Japanese green tea rice ororor

Image: Brandie Kajino

Stress & Periodontal Disease

stressed out personAs we mentioned last time, stress may increase your chances of developing poor oral health.

Recent research out of Tufts University shows that emotional and oral health are connected, as both bruxism (teeth grinding) and gum disease may be triggered by stress.

Stress can even the most oral-health conscious person to become lax about oral hygiene. Ineffective flossing and brushing allows bacteria to build up in your mouth.

Consider: More than 150 species of bacteria live in a person’s mouth. As many as a billion bacteria can cover the surface of a tooth in forming biofilm (plaque). That bacteria releases toxins whose goal, says Tufts professor Evangelos Papathanasiou, “is to create more space so more bacteria can form.”

Those toxins attack your gums, creating holes where the bacteria live and reproduce. In turn, your gums swell. Your body, trying to reduce the irritants, may actually hurt itself.

In a perfect world, immune cells and bacteria are in balance and thus protect teeth and gums. At a certain point, however, immune cells become so numerous that they begin to inflame tissue and hasten disease rather than prevent it—the same way an allergic reaction can cause the body more harm than good. At this point, gingivitis, which is reversible, gives way to bone loss around teeth and full-blown periodontitis, which is not.

Fueling inflammation are the hormones that spike when you’re stressed. One of these is cortisol, which helps you deal by increasing your energy, memory, and pain tolerance. But while it may sound like there’s only an upside, it, too, can cause problems.

When cortisol is produced peripherally in the gums, it stimulates mast cells to produce more proteins, simultaneously increasing inflammation and the progression of periodontal disease.

What’s more, gum disease increases your chances of developing infection elsewhere in your body.

The oral cavity works as a continuous source of infectious agents, and its state often reflects succession of systemic pathologies and various aspects affecting the disease progression must be considered before planning a true treatment plan.

There also appears to be a link between stress and bruxism, which can further put your gums at risk. Bruxism is the habit – often unconscious – of grinding teeth, which some have suggested may be a coping mechanism for stress. It can also do a real number on your teeth and gums. Not only can it wear down the teeth and damage enamel; the excess pressure inflames your gums, as well.

Even after all that, it’s important to remember that not all stress is bad. Sometimes it helps you survive. Your stress response can help you rescue a kitten or finish the annual report before the deadline.

But stress shouldn’t consume your life. Most health conditions linked to stress happen when you are exposed to daily pressure, known as chronic stress:

This is stress resulting from repeated exposure to situations that lead to the release of stress hormones. This type of stress can cause wear and tear on your mind and body. Many scientists think that our stress response system was not designed to be constantly activated. This overuse may contribute to the breakdown of many bodily systems.

While chronic stress is not good, you can control how you respond or cope. Typically, there are two response types: 1) emotion-focused coping and 2) problem-based coping. Emotion-focused coping may address your emotional needs and keep your mind off of the experience, but it’s often at the expense of finding a solution. In comparison, problem-based coping searches for practical solutions, but often does not do enough to soothe and calm your emotions.

Both responses may be appropriate, but again, it depends on your situation.

The main thing is that coping skills matter. One study found that poor coping skills may double your likeliness of developing a periodontal disorder. Another found that coping style can affect the severity of gum disease.

But again, how you deal depends on your specific situation and needs. Still, some general guidelines may be helpful to most anyone:

Obesity & Oral Disease: A Weighty Connection

Though you often hear people talk about “science” as kind of a single, solid body of fact, it’s actually a process and a way of understanding the world. Ideas are tested and retested. Evidence builds up – sometimes in support of a hypothesis, sometimes against – but until it reaches critical mass on one side or another, the mixed results of scientific research can sometimes seem confusing.

Consider a trio of studies published over the past several months on the long-observed relationship between oral health and obesity.

One study, published in the Journal of Evidence-Based Dental Practice, found that obese children tended to have more cavities, though results varied according to socio-economic status. Parents’ income levels seemed to predict preventive oral health practices such as home hygiene and regular dental visits.

Another study – this, in PLoS ONE – came to a contrary conclusion, finding that Kuwaiti children who were obese actually had fewer cavities than their slender peers. No explanation was given for this surprising result.

The finding of an inverse obesity-dental decay relationship contradicts the obesity-sugar and the obesity-dental decay relationship hypotheses. Sugar is well recognized as necessary and sufficient for dental decay. Sugar is also hypothesized to be a leading co-factor in obesity. If the later hypothesis is true, one would expect dental decay to increase with obesity. This was not found. The reasons for this inverse relationship are not currently clear.

Then there was the research published in the European Archives of Paediatric Dentistry. This study found that while obese children don’t necessarily have a higher risk of tooth decay, they do seem to have a higher risk of dental erosion.

5411920162_852d19475c_bOf course, as enamel is lost and dentin is exposed, the affected teeth become much more vulnerable to decay.

Overall, though, the research generally supports some connection between obesity and caries (that’s the dentist’s term for cavities). And if you think about it, this makes a lot of sense. After all, the mouth is where eating begins, and the foods most prone to add to your fat stores – sugary, starchy, hyper-processed carbs – are the exact same foods that can lead to dental problems.

Some, of course, are more damaging than others. Soda may be one of the worst offenders, though fruit juice is not so much better. A single 12 ounce serving of pop can contain more than 50 grams of the stuff; juice-based drinks fall into the same range. (Tropicana Farmstand, for instance, contains just a half teaspoon less than a regular Coke.)

This sugar is the preferred fuel of the microbes that colonize into the tooth-coating biofilms we call “plaque.” The metabolic waste they produce is highly acidic, and that’s what ultimately damages teeth, making them vulnerable decay.

Add to that the phosphoric acid found in soda, and you get a real recipe for disaster.

But it’s not just soda that’s the problem. All highly processed carbs and sugars tend to stick to the teeth, especially along the gum line, feeding those oral pathogens, helping them to thrive.

These are also the kinds of foods that fuel chronic inflammation – a key player in both obesity and gum disease. Not only are they themselves triggering but they also often displace healthier foods from the diet, such as vegetables, whole grains, unprocessed meats and healthy fats such as omega 3s. In light of this, it’s not especially surprising that research has found obesity to be a predictor of periodontal disease.

That said, being obese doesn’t necessarily doom you to oral health problems – or vice versa. But the presence of both together does suggest that the reason may be shared triggers such as diet.

Even though there may not be a causal connection, healthy choices can impact both. This doesn’t mean that one solution exits, but changing your diet and exercising more are fantastic steps towards better oral, heart, and overall health.

For starters, instead of eating sugars, refined flours, and starches, fill your diet with:

  • Vegetables
  • Fresh fruits (not canned)
  • Natural fats from foods like like nuts, avocados, fish, and olive oil
  • Unprocessed meats (found in the meat aisle, not the deli)
  • Whole grains

Finally, remember to clean your teeth and gums regularly. No matter what you eat, your teeth need brushing at least twice a day and flossing once a day.

Image by Jacob Deatherage, via Flickr

Take Care of Your Teeth, Save on Medical Costs

The mouth, as they say, is a window to your body’s health. Problems there can – and do – contribute to a wide variety of chronic health issues elsewhere in the body.

piggy bank on dollar billsSo is it any wonder that taking care of your teeth and gums can help you save money on medical costs?

Recently, a dental insurance company studied the relationship between medical spending and periodontal care – the treatment of gum disease, which most Americans have to some degree. (Spit blood while you brush or floss? Gum disease is an issue for you.) The results might surprise you:

Periodontal treatment was associated with statistically significant decreases in annual medical costs:

  • Patients with diabetes: 40% or $2,840 per year decrease
  • Patients with cerebral vascular disease: 41% or $5,681 per year decrease
  • Patients with coronary artery disease: 11% or $1,090 per year decrease
  • Patients who became pregnant: 74% or $2,433 per year decrease

 

Hospitalizations decreased, as well – by as much as 39% for individuals with type 2 diabetes and 29% for those with heart disease.

The common denominator of periodontal and systemic conditions? Chronic inflammation. Keep that in check, and you go a long way toward improving both your oral and overall health. You’ll find some great, natural ways of fighting it here and here and here.

To learn about other relationships between your teeth and the other organs, tissues and systems in your body, see our previous post on the meridian system. Then explore further with our online meridian tooth chart.

Image via Flickr