Showing posts with label health. Show all posts
Showing posts with label health. Show all posts
What Your Dental Health Says About You
Sunday, May 18, 2014
Common oral problems have been linked to heart disease, diabetes, premature birth, and more.
Its easy to ignore the effects of poor oral hygiene because theyre hidden in your mouth. But gum disease produces a bleeding, infected wound thats the equivalent in size to the palms of both your hands, says Susan Kara bin, (Doctor of Dental Surgery) DDS, a New York periodontist and president of the American Academy of Period ontology.
"If you had an infection that size on your thigh, youd be hospitalized," Karabin says. "Yet people walk around with this infection in their mouth and ignore it. Its easy to ignore because it doesnt hurt ... but its a serious infection, and if it were in a more visible place, it would be taken more seriously."
You may think that the worst consequence of poor dental health would be lost teeth and painful times in the dentists chair. But some studies have linked common oral problems to illnesses, including heart disease, stroke, diabetes, premature birth, osteoporosis, and even Alzheimers disease. In most cases, the strength and exact nature of the link is unclear, but they suggest that dental health is important for preserving overall health.
"We need to educate the public that the mouth isnt disconnected to the rest of the body," says Sally Cram, DDS, a periodontist in Washington, D.C., and spokeswoman for the American Dental Association.
How Gum Disease Spreads
Periodontal disease is an infection caused by unhealthy bacteria that lodge between the teeth and gums. Simply brushing your teeth is enough to put some of those bacteria into your bloodstream, says Robert J. Genco, DDS, PhD, an oral biologist at the University of Buffalo. The bacteria then travel to major organs where they can spur new infections.
Inflammation also plays a role in spreading the effects of bad oral health. Red and swollen gums signal the bodys inflammatory response to periodontal bacteria. "If you have inflammation in your mouth, certain chemicals are produced in response that can spread [through the bloodstream] and wreak havoc elsewhere in the body," Cram says.
Evidence is mounting of the importance of the "mouth-body connection," as it is known, as dental problems are being linked to a growing list of other ailments.
Oral Health and Diabetes
Karabin has diagnosed several cases of diabetes from her dentists chair. "When I see a patient with multiple abscesses in their mouth ... I immediately think diabetes. I will send that patient for a glucose tolerance test." Nearly one-third of people with diabetes are unaware that they have it, and dentists can play a big role in diagnosing these patients, Genco says.
Diabetes and gum disease can interact in a vicious circle. Infections of any kind, including gum disease, cause the body to produce proteins called cytokines, which increase insulin resistance and make blood sugar more difficult to control, Karabin says. Conversely, uncontrolled diabetes impairs the bodys healing mechanism, which makes it harder to control gum disease, Cram says.
Diabetic patients who avoid dentists out of fear or anxiety will have problems that go beyond tooth loss, says John Buse, MD, PhD, director of the Diabetes Care Center at the University of North Carolina School of Medicine. "You probably wont be able to do a good job taking care of diabetes unless you go to a dentist."
Gum disease may also speed the progression to full-blown diabetes in the 54 million Americans who are classified as prediabetic. According to the American Diabetes Association, many people first become aware they have diabetes when they develop dental disease.
In a 2007 study, Danish researchers compared prediabetic rats with gum disease to prediabetic rats without gum disease. The rats with gum disease soon displayed increased insulin resistance and other signs of progression toward type 2 diabetes.
Oral Health and Heart Disease
People with periodontal disease are nearly twice as likely to suffer from coronary artery disease as those without, according to the American Academy of Periodontology. One theory is that oral bacteria attach to fatty plaques in the coronary arteries and contribute to the clots that can lead to heart attacks. Another is that inflammation increases plaque buildup.
Although evidence has been mixed, more than 20 "good-sized" studies have demonstrated the relationship between gum disease and heart disease, Genco says. But that relationship is still not confirmed as with other known risk factors such as smoking or obesity. Genco is planning a major study to see whether treating gum disease can forestall a second heart attack in people who have already had one.
Recent analysis suggests that common oral problems could increase the risk of cardiac problems. Indra Mustapha, DDS, a periodontist who teaches at Howard University in Washington, D.C., and colleagues analyzed the results of other research studies and found that periodontal disease with signs of bacterial exposure was associated with greater risk of heart disease.
The American Heart Association states, "At this time, promoting dental treatment expressly to prevent atherosclerotic cardiovascular disease and/or acute cardiovascular events is not recommended."
Oral Health and Premature Birth
"Ob-gyns always knew that preterm and low-birth-weight births could be triggered by infections in the body," says Karabin. "They looked for urinary tract infections and throat infections, but never really thought about the mouth until a periodontic researcher looked into it."
Karabin says that severe periodontal disease in the mother may lead to an increase in the risk of premature birth. Remember those cytokines? Turns out they also increase the level of the hormone prostaglandin, which triggers labor, says Karabin. Fortunately, studies show that early treatment of gum disease and improved oral hygiene in women can reduce their risk of premature birth.
Other conditions that indicate a link between dental health and overall health include:
Osteoporosis. Osteoporosis and tooth loss often go hand in hand because the same decrease in mineral density that boosts the risk of hip and other fractures affects the jawbone and teeth. Measures taken to prevent or treat osteoporosis in postmenopausal women are likely to also help prevent severe gum disease, Genco says.
Rheumatoid arthritis. A study released in June 2008 found that patients with rheumatoid arthritis (RA) were nearly eight times more likely to have periodontal disease. RA, like periodontal disease, is an inflammatory disorder, which may help explain the link, Karabin says.
Alzheimers disease. A 2005 study of identical twins showed that in twin pairs where one had dementia and the other didnt, the ones with dementia were four times more likely to have gum disease by midlife. The study doesnt say that good oral heath prevents Alzheimers, but that inflammation early in life can have severe consequences later.
Healthy Mouth, Healthy Body
With the mouth and body so closely linked, dentists and physicians should collaborate more closely, Karabin says. "Physicians need to be trained to examine the mouth, and dentists need to understand more about systemic disease so they can pick up on some of the cues."
The findings also serve to bring home the importance of oral hygiene. Brush twice a day with a toothbrush with soft or medium bristles, Genco says. Clean between your teeth daily with floss, or try some of the interdental picks available at drugstores. If your gums bleed with flossing and dont stop after three to four days, see your dentist
readmore
Its easy to ignore the effects of poor oral hygiene because theyre hidden in your mouth. But gum disease produces a bleeding, infected wound thats the equivalent in size to the palms of both your hands, says Susan Kara bin, (Doctor of Dental Surgery) DDS, a New York periodontist and president of the American Academy of Period ontology.
"If you had an infection that size on your thigh, youd be hospitalized," Karabin says. "Yet people walk around with this infection in their mouth and ignore it. Its easy to ignore because it doesnt hurt ... but its a serious infection, and if it were in a more visible place, it would be taken more seriously."
You may think that the worst consequence of poor dental health would be lost teeth and painful times in the dentists chair. But some studies have linked common oral problems to illnesses, including heart disease, stroke, diabetes, premature birth, osteoporosis, and even Alzheimers disease. In most cases, the strength and exact nature of the link is unclear, but they suggest that dental health is important for preserving overall health.
"We need to educate the public that the mouth isnt disconnected to the rest of the body," says Sally Cram, DDS, a periodontist in Washington, D.C., and spokeswoman for the American Dental Association.
How Gum Disease Spreads
Periodontal disease is an infection caused by unhealthy bacteria that lodge between the teeth and gums. Simply brushing your teeth is enough to put some of those bacteria into your bloodstream, says Robert J. Genco, DDS, PhD, an oral biologist at the University of Buffalo. The bacteria then travel to major organs where they can spur new infections.
Inflammation also plays a role in spreading the effects of bad oral health. Red and swollen gums signal the bodys inflammatory response to periodontal bacteria. "If you have inflammation in your mouth, certain chemicals are produced in response that can spread [through the bloodstream] and wreak havoc elsewhere in the body," Cram says.
Evidence is mounting of the importance of the "mouth-body connection," as it is known, as dental problems are being linked to a growing list of other ailments.
Oral Health and Diabetes
Karabin has diagnosed several cases of diabetes from her dentists chair. "When I see a patient with multiple abscesses in their mouth ... I immediately think diabetes. I will send that patient for a glucose tolerance test." Nearly one-third of people with diabetes are unaware that they have it, and dentists can play a big role in diagnosing these patients, Genco says.
Diabetes and gum disease can interact in a vicious circle. Infections of any kind, including gum disease, cause the body to produce proteins called cytokines, which increase insulin resistance and make blood sugar more difficult to control, Karabin says. Conversely, uncontrolled diabetes impairs the bodys healing mechanism, which makes it harder to control gum disease, Cram says.
Diabetic patients who avoid dentists out of fear or anxiety will have problems that go beyond tooth loss, says John Buse, MD, PhD, director of the Diabetes Care Center at the University of North Carolina School of Medicine. "You probably wont be able to do a good job taking care of diabetes unless you go to a dentist."
Gum disease may also speed the progression to full-blown diabetes in the 54 million Americans who are classified as prediabetic. According to the American Diabetes Association, many people first become aware they have diabetes when they develop dental disease.
In a 2007 study, Danish researchers compared prediabetic rats with gum disease to prediabetic rats without gum disease. The rats with gum disease soon displayed increased insulin resistance and other signs of progression toward type 2 diabetes.
Oral Health and Heart Disease
People with periodontal disease are nearly twice as likely to suffer from coronary artery disease as those without, according to the American Academy of Periodontology. One theory is that oral bacteria attach to fatty plaques in the coronary arteries and contribute to the clots that can lead to heart attacks. Another is that inflammation increases plaque buildup.
Although evidence has been mixed, more than 20 "good-sized" studies have demonstrated the relationship between gum disease and heart disease, Genco says. But that relationship is still not confirmed as with other known risk factors such as smoking or obesity. Genco is planning a major study to see whether treating gum disease can forestall a second heart attack in people who have already had one.
Recent analysis suggests that common oral problems could increase the risk of cardiac problems. Indra Mustapha, DDS, a periodontist who teaches at Howard University in Washington, D.C., and colleagues analyzed the results of other research studies and found that periodontal disease with signs of bacterial exposure was associated with greater risk of heart disease.
The American Heart Association states, "At this time, promoting dental treatment expressly to prevent atherosclerotic cardiovascular disease and/or acute cardiovascular events is not recommended."
Oral Health and Premature Birth
"Ob-gyns always knew that preterm and low-birth-weight births could be triggered by infections in the body," says Karabin. "They looked for urinary tract infections and throat infections, but never really thought about the mouth until a periodontic researcher looked into it."
Karabin says that severe periodontal disease in the mother may lead to an increase in the risk of premature birth. Remember those cytokines? Turns out they also increase the level of the hormone prostaglandin, which triggers labor, says Karabin. Fortunately, studies show that early treatment of gum disease and improved oral hygiene in women can reduce their risk of premature birth.
Other conditions that indicate a link between dental health and overall health include:
Osteoporosis. Osteoporosis and tooth loss often go hand in hand because the same decrease in mineral density that boosts the risk of hip and other fractures affects the jawbone and teeth. Measures taken to prevent or treat osteoporosis in postmenopausal women are likely to also help prevent severe gum disease, Genco says.
Rheumatoid arthritis. A study released in June 2008 found that patients with rheumatoid arthritis (RA) were nearly eight times more likely to have periodontal disease. RA, like periodontal disease, is an inflammatory disorder, which may help explain the link, Karabin says.
Alzheimers disease. A 2005 study of identical twins showed that in twin pairs where one had dementia and the other didnt, the ones with dementia were four times more likely to have gum disease by midlife. The study doesnt say that good oral heath prevents Alzheimers, but that inflammation early in life can have severe consequences later.
Healthy Mouth, Healthy Body
With the mouth and body so closely linked, dentists and physicians should collaborate more closely, Karabin says. "Physicians need to be trained to examine the mouth, and dentists need to understand more about systemic disease so they can pick up on some of the cues."
The findings also serve to bring home the importance of oral hygiene. Brush twice a day with a toothbrush with soft or medium bristles, Genco says. Clean between your teeth daily with floss, or try some of the interdental picks available at drugstores. If your gums bleed with flossing and dont stop after three to four days, see your dentist
Disease and Population Health Management Programs Do NOT Exclude Other Conditions
Tuesday, May 13, 2014
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| Playing whacamole |
"Health care blogging will never lead any serious beer money."
"Disease management coaching focuses exclusively on just one disease."
These are three falsehoods that bubble up in the unlikeliest of places, including cable news outlets, replying to the DMCB spouses asking "and what did you do today?" and webinars, webcasts and other educational meetings about population health and disease management.
While the Disease Management Care Blog finds all three vexing, the most irksome is the canard that the commercial health coaching service providers purposely limit their programs to just one chronic condition, like diabetes, weight loss or readmission prevention.
While that may have been the case in the earliest versions of disease management, that narrow approach was dropped years ago. Thats because patients typically seek advice for a wide range of overlapping concerns and the good nurses hired by the vendors will respond to them. The vendors also understand that their shared risk and performance guarantees depend on claims expense that is driven by the synergies of multiple co-morbidities.
While a purchaser, insurer or accountable provider organization may start out with a focus on a population defined by a single condition - such as diabetes mellitus - that doesnt mean their protocols and care plans wont span the continuum of care and include hypertension, tobacco abuse, depression, housing, chatting about the grandkid and responding to concerns whether this will be finally be NBA superstar LeBron James year.
And the published literature supports the DMCBs contention that modern population health management is multifaceted. Examples include this seven-condition program for dually eligible Medicaid beneficiaries in Georgia, this Midwest employer-sponsored program that enrolled persons with multiple care needs and this physician-focused program that used pay-for-performance to improve measures across multiple conditions. Check out some vendor web sites and youll see erences to "whole person health," the "interrelated aspects of social, emotional, and physical health" and "a holistic view of member health across internal and external care management initiatives."
That being said, the DMCB knows that perception and reality can be two different things. Given the whac-a-mole persistence of the "single disease" myth, the DMCB says the population health management community may benefit clarifying the broadness as well as the depth of their offerings as they continue to build their brand.
Image from Wikipedia
Vitamin K2 The Missing Link to Perfect Health
Saturday, May 10, 2014
Almost a century ago, in the early part of the 20th century, a dentist named Weston A. Price performed some of the most important research in the history of nutrition and health science. As a dentist, he was concerned about the epidemic of dental deformities, like crooked teeth and cavities, so he set out to find traditional societies all over the globe didnt suffer from such problems. Sure enough, he found several "primitive" societies isolated from the industrialized world who, despite a complete lack of dental hygiene, had perfectly straight teeth and little to no tooth decay. And beyond that, chronic diseases like cancer and heart disease were completely absent. He showed that, like all other animals, humans are healthy and robust when they eat, move, and live the way theyre designed. Then, he watched as these healthy societies became civilized, adopted white flour and sugar, and their health declined.
That is Weston A. Price in a nutshell, but I encourage you to read his book "Nutrition and Physical Degeneration" for the full story. Although the societies Price studied ate a variety of diets, he noticed something that they all shared... all of these diets were particularly high in three fat-soluble vitamins: A, D, and something he called "Activator X". He determined that these three vitamins were critical and worked in synergy for tooth and bone formation, as well as general health. After returning to America, Price applied what he had learned on his own patients. He used a combination of high-vitamin butter oil (Activator X) and cod liver oil (A and D) to successfully prevent and reverse dental cavities in many of his patients. Pretty amazing huh? These three vitamins, when used in conjunction, can reverse cavities. Fast forward to today... has anyone in the medical profession ever heard of this research? Probably not. To them, crooked teeth are just genetic, and the only way to fix a cavity is to get a filling. Oh how wrong they are...
Price never identified this mystery vitamin he called "Activator X". Weve all heard of vitamins A and D, but Activator X seems to have been lost in time. Until now, that is. Science has now uncovered its true identity, and research is beginning to confirm what Price learned almost a century ago. Activator X is... Vitamin K2.
You could obviously start eating the foods listed above, that will surely help. Get a hold of some local, pastured eggs, or some grass-fed butter like Kerrygold. Theyre high in vitamins A and K2, plus they taste good. You could also get a K2 supplement (menatetranone, or MK-4, is the one you want). That would likely help; after all, it worked in the osteoporosis studies. But remember, since they work in synergy, A, D, and K2 function best when theyre in balance with each other... there must be a way to get all three of them in one place. And there is! Remember the butter oil/cod liver oil blend I mentioned that Dr. Price used in his practice? Well, lucky for us, Green Pasture produces that very same product today. Sure its a little expensive, but its top quality and it makes getting your A, D, and K2 extremely easy. Now you dont have to choke down goose liver. Youre welcome.
So go out and get your K2, however it is you choose to do it. Eat goose liver, pig out on fish eggs, whatever you want to do... just do it! You cant afford not to. Your arteries and bones will thank you. And you will thank them. And you will both live a long, healthy, happy life together, just you and your arteries and bones. And hopefully a spouse... and her arteries and bones. And kids with perfect faces and teeth. Maybe grandkids... okay you get the point. Get your K2 on!
readmore
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| Traditional Swiss: ornery because they got all them teeth but no toothbrush |
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| Modernized Swiss: even West Virginia doesnt want them |
That is Weston A. Price in a nutshell, but I encourage you to read his book "Nutrition and Physical Degeneration" for the full story. Although the societies Price studied ate a variety of diets, he noticed something that they all shared... all of these diets were particularly high in three fat-soluble vitamins: A, D, and something he called "Activator X". He determined that these three vitamins were critical and worked in synergy for tooth and bone formation, as well as general health. After returning to America, Price applied what he had learned on his own patients. He used a combination of high-vitamin butter oil (Activator X) and cod liver oil (A and D) to successfully prevent and reverse dental cavities in many of his patients. Pretty amazing huh? These three vitamins, when used in conjunction, can reverse cavities. Fast forward to today... has anyone in the medical profession ever heard of this research? Probably not. To them, crooked teeth are just genetic, and the only way to fix a cavity is to get a filling. Oh how wrong they are...
Price never identified this mystery vitamin he called "Activator X". Weve all heard of vitamins A and D, but Activator X seems to have been lost in time. Until now, that is. Science has now uncovered its true identity, and research is beginning to confirm what Price learned almost a century ago. Activator X is... Vitamin K2.
As I explained in my previous post on dairy fat, vitamin K2 is not the vitamin K youve heard of... thats K1. Vitamin K2 is a whole different animal. Thankfully, we now have some exciting modern research touting the benefits of K2. The research generally falls into two categories, let me know if any of this sounds familiar...
Cardiovascular Disease (heart disease and stroke)
There have been observational studies done in humans, and a few controlled, clinical trials in rats. In humans, high dietary K2 intake is strongly associated with a reduction in cardiovascular disease risk (1, 2, 3). In one study, men with the highest K2 intake had a whopping 51% lower risk of heart disease and a 26% lower risk of death from all causes than men with the lowest K2 intake. There is no such association with K1 intake.
In rats, supplementation of vitamin K2 has been shown to prevent, and even reverse plaque buildup in the coronary arteries (4, 5). No joke. Reverse plaque buildup. Read the articles, the proof is there. Although this cant quite be extrapolated to humans, it sounds promising doesnt it? Just imagine the headline... "Lipitor Becomes Obselete in Light of Miracle Vitamin". All we need is someone to do the research. And then someone to fight the ensuing big pharma backlash. But perhaps Im getting ahead of myself... suffice it to say, at the very least, K2 prevents plaque buildup.
Bone Development and Maintenance
Vitamin K2 is absolutely essential in infancy and childhood for proper skull development (6, 7). Full skull development allows plenty of space for teeth to grow in straight. In addition, your full cheekbones and straight set of pearly whites will no doubt make you more physically attractive, and lets not underestimate the importance of that (8). This is some key information no parent should go without.
In older adults, several clinical trials have been conducted in which post-menopausal women were given supplemental vitamin K2. A meta-analysis of this research shows that K2 supplementation reduces bone loss and prevents osteoporosis as we age, as well as significantly reduces the risk of incident fractures (9). Does anybody know any grandmas and grandpas out there who are taking K2? I certainly dont. I think its time to change that.
The Big Picture
Lets tie these two ideas together, because they are, in fact, two sides to the same coin. Research shows a clear connection between arterial calcification (plaque buildup) and osteoporosis (10). The two frequently occur together, and both are rooted in the same issue: the failure of the body to use calcium effectively. Allow me to explain... vitamin K2s main function in the body is to deposit calcium in appropriate locations, such as in the bones and teeth, and prevent it from depositing in locations where it does not belong, such as the coronary arteries. Double whammy. Just like Price said. But K2 doesnt work in isolation; modern science also confirms Prices idea that K2 works in synergy with vitamins A and D. We now know, for example, that A and D promote cellular production of a protein called osteocalcin, which, with the help of K2, organizes calcium and phosphorous deposition into bones and teeth. Proper osteocalcin functioning means that your bones and teeth are making the most of the calcium youve got coming in. Then we also have something called matrix GLA protein (MGP), which has the same relationship with A, D, and K2. This protein, however, actively prevents arterial calcification, directly fighting the process that causes cardiovascular disease. Given these mechanisms, it should be no surprise that K2 improves the outcomes in both heart disease and osteoporosis. Looks like Price was on to something eh?
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| Mother Goose, with a liver full of K2 |
K2 in the Diet
Okay, lets play a game. I tell you the food sources of vitamin K2, and you tell me whether or not the average American is getting enough of it. Ready... set... go! (11,12)
- Goose liver
- Grass-fed butter and cream
- Grass-fed milk and cheese
- Free-range egg yolks
- Fish eggs
You could obviously start eating the foods listed above, that will surely help. Get a hold of some local, pastured eggs, or some grass-fed butter like Kerrygold. Theyre high in vitamins A and K2, plus they taste good. You could also get a K2 supplement (menatetranone, or MK-4, is the one you want). That would likely help; after all, it worked in the osteoporosis studies. But remember, since they work in synergy, A, D, and K2 function best when theyre in balance with each other... there must be a way to get all three of them in one place. And there is! Remember the butter oil/cod liver oil blend I mentioned that Dr. Price used in his practice? Well, lucky for us, Green Pasture produces that very same product today. Sure its a little expensive, but its top quality and it makes getting your A, D, and K2 extremely easy. Now you dont have to choke down goose liver. Youre welcome.
So go out and get your K2, however it is you choose to do it. Eat goose liver, pig out on fish eggs, whatever you want to do... just do it! You cant afford not to. Your arteries and bones will thank you. And you will thank them. And you will both live a long, healthy, happy life together, just you and your arteries and bones. And hopefully a spouse... and her arteries and bones. And kids with perfect faces and teeth. Maybe grandkids... okay you get the point. Get your K2 on!
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