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NKF: CKD Patients Often Dodge the Dentist - get those fangs checked.

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Pendrag0n

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Jul 22, 2012, 3:55:25 AM7/22/12
to
I had no idea poor dental health had a detrimental effect on CKD. As
one who tends to avoid the dentist at all costs its a bit of a
shocker.




http://www.medpagetoday.com/MeetingCoverage/NKF/26213

NKF: CKD Patients Often Dodge the Dentist
By Ed Susman, Contributing Writer, MedPage Today
Published: May 01, 2011
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of
Medicine, University of California, San Francisco and Dorothy Caputo,
MA, RN, BC-ADM, CDE, Nurse Planner
Take Posttest
Action Points

Note that this study was published as an abstract and presented at a
conference. These data and conclusions should be considered to be
preliminary until published in a peer-reviewed journal.

Explain that patients with chronic kidney disease were less likely to
visit the dentist than those without the disease.


LAS VEGAS -- Patients with chronic kidney disease were less likely to
visit the dentist, possibly increasing the burden of their disease,
researchers reported at the National Kidney Foundation Spring Clinical
Meetings.

Previous studies have shown a correlation between periodontal disease
and CKD, said Vanessa Grubbs, MD, assistant professor of medicine at
San Francisco General Hospital and the University of California at San
Francisco. Maintaining dental health through regular dental visits may
play a vital role in reducing the burden of the inflammatory disease
process.

Grubbs and colleagues found that patients with CKD were 58% less
likely [OR=0.42, 95% CI (0.33 to 0.53)] than patients without CKD to
have visited the dentist during four years follow-up.

"We have identified a group of people who have a lot of chronic kidney
disease and they don't go to the dentist," she told MedPage Today.
"This may be a missed opportunity because, if they went to the
dentist, at least someone is taking care of their mouth and they get
rid of that chronic inflammatory burden."

Grubbs and colleagues scrutinized the records of 6,484 patients
randomly selected from the San Francisco Department of Public Health
Community Health Network. They included patients with at least one
year of follow-up, but overall, the cohort had about 4.5 years of
follow-up between January 2005 and May 2010, she said. They identified
2,235 patients (34.5%) with CKD, which they defined as an average
glomerular filtration rate of less than 60 ml/min/1.73m2.

Of all the patients included in the study, 500 (7.7%) had seen a
dentist at least once during the follow-up period, Grubbs reported.
Ninety-four (4.2%) patients with CKD had paid a visit to the dentist
versus 405 (9.5%) of the 4,249 of the patients without kidney disease.

When the researchers looked at different ethnic groups in the overall
patient population, African Americans and Hispanics were more likely
to have visited a dentist than Caucasians. African Americans were 2.5
times more likely to have seen a dentist than Caucasians; Hispanics
were 2.1 times more likely to have seen a dentist than Caucasians.

However, African Americans with chronic kidney disease were 46% less
likely to have seen a dentist than blacks without CKD. Hispanics with
CKD were 50% less likely to have seen a dental professional than
Hispanics who did not have CKD.

Grubbs said she uncovered this preliminary data as part of her
research on the potential link between periodontal disease and CKD.

"It is an interesting observation that periodontitis is an example of
a chronic inflammatory disease that may have a negative impact on
kidney function over the long term," commented Jeffrey Berns, MD,
associate chief of renal, electrolyte, and hypertension division of
the Perelman Center for Advanced Medicine at the University of
Pennsylvania in Philadelphia.

Berns told MedPage Today that current medical literature contains
reports that link periodontal disease and kidney disease. "There is
the feeling that having any chronic inflammatory disease – dental
disease being a good example of one – might confer some risk due to
inflammatory chemicals in the bloodstream. Periodontitis would be
something that is a low-grade chronic inflammation that people may not
attend to, but clearly is associated with inflammatory response," he
said.

"It's a complicated issue. There are ethnic issues and access to care
issues," Berns also noted.

Grubbs had no disclosures.

Berns disclosed financial relationships with Amgen, Wyeth, Litholink,
and Affymax.


Primary source: National Kidney Foundation
Source reference:
Grubbs V, et al "Missed opportunity? -- Dental visits by chronic
kidney disease status in underserved patients" NKF 2011; Abstract 73.

Alan S

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Jul 22, 2012, 8:46:00 AM7/22/12
to
On Sun, 22 Jul 2012 08:55:25 +0100, Pendrag0n <nom...@thnx.com> wrote:

>I had no idea poor dental health had a detrimental effect on CKD. As
>one who tends to avoid the dentist at all costs its a bit of a
>shocker.
>
Not just kidney disease.

I had periodontal disease two decades before I was diagnosed with Type
2. That caused me to do a little research almost ten years back when I
was first diagnosed.

As a consequence this was one of my first blog posts:
http://loraldiabetes.blogspot.com/2006/11/teeth-gums-diabetes-and-death.html


Cheers, Alan, T2, Australia.
d & e; metformin 2000mg
--
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (ADA Standards of Medical Care in Diabetes 2012)
http://loraltravel.blogspot.com/ (Mostar, Bosnia and Herzegovina)

Alan S

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Jul 22, 2012, 8:59:57 AM7/22/12
to
On Sun, 22 Jul 2012 08:55:25 +0100, Pendrag0n <nom...@thnx.com> wrote:

>I had no idea poor dental health had a detrimental effect on CKD. As
>one who tends to avoid the dentist at all costs its a bit of a
>shocker.

Not just CKD.

I have periodontal disease so I did some research several years ago,
after my type 2 diagnosis.

This was one of my earliest blog posts:
http://loraldiabetes.blogspot.com/2006/11/teeth-gums-diabetes-and-death.html

Look after those pearly whites, folks.

Alan S

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Jul 22, 2012, 9:00:53 AM7/22/12
to
On Sun, 22 Jul 2012 22:59:57 +1000, Alan S
<loralgtwei...@gmail.com> wrote:

>On Sun, 22 Jul 2012 08:55:25 +0100, Pendrag0n <nom...@thnx.com> wrote:
>
>>I had no idea poor dental health had a detrimental effect on CKD. As
>>one who tends to avoid the dentist at all costs its a bit of a
>>shocker.
>
>Not just CKD.
>
>I have periodontal disease so I did some research several years ago,
>after my type 2 diagnosis.
>
>This was one of my earliest blog posts:
>http://loraldiabetes.blogspot.com/2006/11/teeth-gums-diabetes-and-death.html
>
>Look after those pearly whites, folks.
>
>Cheers, Alan, T2, Australia.
>d & e; metformin 2000mg

Oops - ignore the duplication; I've been too long away :)

Pendrag0n

unread,
Jul 22, 2012, 9:25:24 AM7/22/12
to
On Sun, 22 Jul 2012 22:46:00 +1000, Alan S
<loralgtwei...@gmail.com> wrote:

>On Sun, 22 Jul 2012 08:55:25 +0100, Pendrag0n <nom...@thnx.com> wrote:
>
>>I had no idea poor dental health had a detrimental effect on CKD. As
>>one who tends to avoid the dentist at all costs its a bit of a
>>shocker.
>>
>Not just kidney disease.
>
>I had periodontal disease two decades before I was diagnosed with Type
>2. That caused me to do a little research almost ten years back when I
>was first diagnosed.
>
>As a consequence this was one of my first blog posts:
>http://loraldiabetes.blogspot.com/2006/11/teeth-gums-diabetes-and-death.html
>
>
>Cheers, Alan, T2, Australia.
>d & e; metformin 2000mg

Scandalous we're not told about this.

That's a Good tip with the salt mouthwash even as a regular mouthwash
"DO rinse with warm salt water after each meal ( half teaspoon of salt
per glass of warm water)"

Any of that other junk will end up causing lesions and cancers so
steer well clear. Not sure if corsydol is *safe* though.

Pendrag0n

unread,
Jul 22, 2012, 9:25:47 AM7/22/12
to
On Sun, 22 Jul 2012 23:00:53 +1000, Alan S
<loralgtwei...@gmail.com> wrote:

>On Sun, 22 Jul 2012 22:59:57 +1000, Alan S
><loralgtwei...@gmail.com> wrote:
>
>>On Sun, 22 Jul 2012 08:55:25 +0100, Pendrag0n <nom...@thnx.com> wrote:
>>
>>>I had no idea poor dental health had a detrimental effect on CKD. As
>>>one who tends to avoid the dentist at all costs its a bit of a
>>>shocker.
>>
>>Not just CKD.
>>
>>I have periodontal disease so I did some research several years ago,
>>after my type 2 diagnosis.
>>
>>This was one of my earliest blog posts:
>>http://loraldiabetes.blogspot.com/2006/11/teeth-gums-diabetes-and-death.html
>>
>>Look after those pearly whites, folks.
>>
>>Cheers, Alan, T2, Australia.
>>d & e; metformin 2000mg
>
>Oops - ignore the duplication; I've been too long away :)
>
>Cheers, Alan, T2, Australia.
>d & e; metformin 2000mg

Too much corsydol :)

Dennis R

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Jul 23, 2012, 4:20:15 PM7/23/12
to
In article <8bun08lv2km6tl7o0...@4ax.com>,
loralgtwei...@gmail.com says...
>
> On Sun, 22 Jul 2012 22:59:57 +1000, Alan S
> <loralgtwei...@gmail.com> wrote:
>
> >On Sun, 22 Jul 2012 08:55:25 +0100, Pendrag0n <nom...@thnx.com> wrote:
> >
> >>I had no idea poor dental health had a detrimental effect on CKD. As
> >>one who tends to avoid the dentist at all costs its a bit of a
> >>shocker.
> >
> >Not just CKD.
> >
> >I have periodontal disease so I did some research several years ago,
> >after my type 2 diagnosis.
> >
> >This was one of my earliest blog posts:
> >http://loraldiabetes.blogspot.com/2006/11/teeth-gums-diabetes-and-death.html
> >
> >Look after those pearly whites, folks.
> >
> >Cheers, Alan, T2, Australia.
> >d & e; metformin 2000mg
>
> Oops - ignore the duplication; I've been too long away :)
>
> Cheers, Alan, T2, Australia.
> d & e; metformin 2000mg

Alan:

Good to see you back.

Pen: One of the first things on the medical checklist if you end up
looking for a kidney transplant either prior to dialysis (living donor)
or after dialysis (living or non-living donor) is a complete "all
clear" from a dentist, as well as a colonoscopy for those of us over 50.

Dennis (Type 2, Kidney Transplant 1995, Dialysis 2011)

Pendrag0n

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Jul 24, 2012, 1:32:25 AM7/24/12
to
On Mon, 23 Jul 2012 16:20:15 -0400, Dennis R <ds_r...@yahoo.ca>
wrote:
Oh dear I haven't had the all clear from a dentist ever I don't think.
Though I do have good teeth and they all seem strong enough and white.
They do often bleed though and I hate flossing with the string,but do
use the sticks occasionally. Must get in the habit of doing it each
day. I suppose the main problem is I don't really get why we do it
apart from getting the food out from between them. I mean its not
going to get rid of the rock hard plaque is it? Anything else I am
missing I wonder!

Dennis R

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Jul 25, 2012, 5:21:24 PM7/25/12
to
In article <1kcs08tc5p39liau5...@4ax.com>, nom...@thnx.com
says...
You would need a cleaning / scaling to remove as much of the plaque as
possible. Afterwards, brushing and flossing keeps the plaque from
building up as fast. More importantly, brushing keeps the gums healthy.
It does not matter how healthy your teeth are if the gums themselves get
diseased or recede - then the teeth can fall out. Fixing and preventing
this becomes very expensive.

Maybe just as important is the risk of serious bacterial infections that
can attack the heart (myopathy). They can enter the body through
bleeding gums, and then spread throughout the body. From my friends
dealing with heart transplants, they were not a joke.

Dennis (Kidney Transplant 1995, Dialysis 2011)

Pendrag0n

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Jul 25, 2012, 5:26:26 PM7/25/12
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On Wed, 25 Jul 2012 17:21:24 -0400, Dennis R <ds_r...@yahoo.ca>
How to brush and floss though? I always thought a hard brushing did
the trick. Obviously not. Is an electric toothbrush better really?


~ky~

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Jul 25, 2012, 6:45:16 PM7/25/12
to
> How to brush and floss though? I always thought a hard brushing did
> the trick. Obviously not. Is an electric toothbrush better really?
>
>

https://www.google.ca/search?q=Is+an+electric+toothbrush+better&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a


Chico

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Jul 25, 2012, 7:52:28 PM7/25/12
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Pendrag0n

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Jul 26, 2012, 2:08:35 AM7/26/12
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It would seem electric is best. But I am keen to hear what people do
that do not have dental problems and the techniques used. I always
rinse my mouth after eating, especially sweet things as well. And I
use an electric tooth brush in the morning and manual in the evening,
because each brushes differently. I found in not alternating that when
I did need to change the method the gums would bleed again simply due
to the change, so there is obviously some benefit to alternating.

Having said all this what's strange since I had my loose back molar
out, my gums have not bleed anywhere, even at the front which were
quite bad at times. So how on earth does that work! Unless the salt
water mouthwash really does work big time, its been a few days since I
stopped though.

Pendrag0n

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Jul 26, 2012, 2:12:34 AM7/26/12
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Ah yes that's what I use. Handy little things, though not sure we have
a colour coding system here (UK)

That's handy then and so your dentist has confirmed in flossing with
these that they obviously work? Which would be a relief I must say.

I don't change the brush regularly because it still seems pretty
stiff, but now you mention it...................................

Alan S

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Jul 26, 2012, 6:24:35 AM7/26/12
to
You beat me to it. I do the same.

Cheers, Alan, T2, Australia.
d & e; metformin 2000mg
--
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (Taxes For Our Own Good)

Alan S

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Jul 26, 2012, 6:24:52 AM7/26/12
to
Same here.

Cheers, Alan, T2, Australia.
d & e; metformin 2000mg
--
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (Taxes For Our Own Good)

Maya Zuiderweg

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Jul 26, 2012, 10:44:33 AM7/26/12
to
Pendrag0n heeft uiteengezet op 26-7-2012 :
> On Wed, 25 Jul 2012 15:45:16 -0700, "~ky~"
> <Beac...@NOSPAMcyber-rights.net> wrote:
>
>>> How to brush and floss though? I always thought a hard brushing did
>>> the trick. Obviously not. Is an electric toothbrush better really?
>>>
>>>
>>
>> https://www.google.ca/search?q=Is+an+electric+toothbrush+better&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a
>>
>
> It would seem electric is best. But I am keen to hear what people do
> that do not have dental problems and the techniques used. I always
> rinse my mouth after eating, especially sweet things as well. And I
> use an electric tooth brush in the morning and manual in the evening,
> because each brushes differently. I found in not alternating that when
> I did need to change the method the gums would bleed again simply due
> to the change, so there is obviously some benefit to alternating.

Hi Pendrag0n, here is a person without dental problems (mostly).
I brush twice day, morning and before bed. Both times manual.
After meals I make sure that I have a big cup of lukewarm tea, without
suger.
After eating fruit or drinking juice I make sure that I also have
lukewarm tea (dentists orders, because after eating fruit or a fruity
juice the sourness is bad for the teeth and/or gums). After the
juice-bit, plain lukewarm water tastes better to me though, and is also
okay.
I dont floss, I use toothpicks, but the dentist says I should use them
more often, otherwise I will get more plaque.
When back from the dentist I DO "toothpick" a lot after meals.
Later I dont ;-)

Last years I didnt have any problems re the dental bit of me :-)

Maya

Maya Zuiderweg

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Jul 26, 2012, 10:46:33 AM7/26/12
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Pendrag0n stelde dit idée voor :
My dentists tells me (and my husband) to *never* use a stiff brush,
rather a soft one.
Maya


Pendrag0n

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Jul 26, 2012, 11:42:14 AM7/26/12
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Hello Maya,

I suspect my sweet tooth is to blame in all areas. I drink black tea
as I am vegggie, but no sugar...yuk!!! lol Mind you that's interesting
the dentist recommended it, and it obviously works :)

I also wonder if here in the UK the dentists actually *claim* more is
wrong then there is in reality just to get more money! Call me a cynic
if you must, amongst other things.

Pendrag0n

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Jul 26, 2012, 11:45:02 AM7/26/12
to
On Thu, 26 Jul 2012 16:46:33 +0200, Maya Zuiderweg
<$no_spam#ma_dot_zuiderweg_@_me_dot_com#maps_on$> wrote:

>Pendrag0n stelde dit id�e voor :
I did hear that. When I say stiff I mean medium really. Interesting
again your dentist actually suggest a soft one, which implies we
really should be brushing gently rather than vigorously. I am trying
that idea now, along with salt mouth washes. Though I do wonder how
much salt might be absorbed through the mouth in doing this, which is
a bit naughty.

Maya Zuiderweg

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Jul 26, 2012, 12:08:46 PM7/26/12
to
Pendrag0n had uiteengezet :
> On Thu, 26 Jul 2012 16:46:33 +0200, Maya Zuiderweg
> <$no_spam#ma_dot_zuiderweg_@_me_dot_com#maps_on$> wrote:
>
>> Pendrag0n stelde dit idée voor :
Not medium either, just soft.
Vigorously brushing has brought me troubles, I'm a stickler for doing
it *very* right, so after the gums around that one tooth began to bleed
I even brushed _more_ vigorous.
Dentist called me a fanatic and told me to use soft brushes and when a
gum around a tooth began bleeding to _not_ ignore the pain, but give it
a rest. I once even overdid it big time, had to use clorohexidrin for
10 days instead of brushing. :/
Learned my lesson, softly does it. But Pendrag0n, "gently brushing" (as
you said) isnt okay either. Methinks its more: thoroughly. Take 3
minutes with an electric one (my husband uses/does that).
M.


Maya Zuiderweg

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Jul 26, 2012, 12:13:30 PM7/26/12
to
Pendrag0n schreef :
I drink mint tea. Doesnt need any sugar ;-)

>Mind you that's interesting
> the dentist recommended it, and it obviously works :)
>
> I also wonder if here in the UK the dentists actually *claim* more is
> wrong then there is in reality just to get more money! Call me a cynic
> if you must, amongst other things.

One cant be too careful with them docs.
I'm a cynic too wrt them.
My dentist seems to be an exception.

M.


Pendrag0n

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Jul 26, 2012, 2:14:38 PM7/26/12
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On Thu, 26 Jul 2012 18:08:46 +0200, Maya Zuiderweg
<$no_spam#ma_dot_zuiderweg_@_me_dot_com#maps_on$> wrote:

>Pendrag0n had uiteengezet :
>> On Thu, 26 Jul 2012 16:46:33 +0200, Maya Zuiderweg
>> <$no_spam#ma_dot_zuiderweg_@_me_dot_com#maps_on$> wrote:
>>
>>> Pendrag0n stelde dit id�e voor :
I agree. Now.

Pendrag0n

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Jul 26, 2012, 2:16:27 PM7/26/12
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On Thu, 26 Jul 2012 18:13:30 +0200, Maya Zuiderweg
yeah it does lol But I shall try. I recall my first black cup of tea
(with sugar of course) yuk...but no I realise just how much of the
flavour milk hides. I guess the same might be said of sugar. I'll let
you know. Be great if I could lose my sweet tooth.

Chico

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Jul 26, 2012, 2:19:40 PM7/26/12
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I'm in the OK.

>That's handy then and so your dentist has confirmed in flossing with
>these that they obviously work? Which would be a relief I must say.
>
>I don't change the brush regularly because it still seems pretty
>stiff, but now you mention it...................................

As others have confirmed, my dentist recommends a medium. It's
surprising, if you try a new medium after 3 months, how soft the one
you've been using seems.
--

Chico the Dog

Pendrag0n

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Jul 26, 2012, 2:30:49 PM7/26/12
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Actually I think my brush is well over a year old, probably at least
two!! lol

Maya Zuiderweg

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Jul 26, 2012, 6:05:08 PM7/26/12
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Dont make the tea too strong then, you'll get used to it more quickly.
> But I shall try. I recall my first black cup of tea
> (with sugar of course) yuk...but no I realise just how much of the
> flavour milk hides. I guess the same might be said of sugar. I'll let
> you know. Be great if I could lose my sweet tooth.

Ehmmm, its meant to be about not loosing any tooth lol

M.


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