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April 28, 2016RcollMedia

DIABETES LIFESTYLE – January 9 2016

Feature

*Did you know that people withe diabetes are 2 to 3 times more likely to suffer from gum disease or periodontitis?
DR CHUNG KONG MUN, Partner & Dentist at Robertson Choo Oehlers Lee & Lye Pte Ltd tells us more about gum disease and the importance of oral care.

Like diabetes, gum disease is noted for its silence. Almost everyone is aware of tooth decay but the fact remains that gum disease or periodontitis is the major cause of tooth loss in adults above 30 years. Most tend to overlook the common signs of gum disease which includes loose teeth, gum recession, bleeding gums, gum infection, bad breath, teeth shifting their position etc.

It would appear that diabetes and gum disease have little to do with each other. However, research have shown the truth to be otherwise. Now we know that people who have diabetes are 2 to 3 times more likely to suffer from gum disease or periodontitis. Furthermore, people with diabetes who have untreated gum disease tend to require more medication to control their sugar levels.Finally, people with diabetes who have managed to treat and control their gum disease are likely to experience an improvement of their HbA1c ratio.

Therefore, it pays to screen for presence of gum disease. In this way, gum disease can be detected and diagnosed early. Early detection of gum disease translates into relatively simple and effective therapy. This is preferred; as opposed to delayed diagnosis where complications occur and more complex therapy is often required.Gum disease when diagnosed early and managed appropriately will help one to avoid tooth loss and/or expensive dental treatment.

People with diabetes have to be disciplined in monitoring their blood sugar levels.*In similar fashion, those with gum disease need to have regular reviews by the dentist or periodontist to reduce the risk of recurrence. The good news for people with diabetes is that if they keep to their preventive maintenance dental visits and have proper daily oral hygiene, they can be confident in preventing tooth loss due to periodontal disease.

The Professional advise is: Develop and maintain a long term strategy with your dentist who will assist you in keeping your gums healthy and preventing or reducing the risk of recurrence of gum disease.

Why is it important for people with diabetes to keep their blood sugars controls?

*Because high blood sugar levels impair your ability to heal from oral infections, you’re more likely to develop gum disaese than someone without diabetes
*Uncontrolled Diabetes makes treating gum disease more difficult
*Gum Disease progresses more than twise as fast in people with diabetes as in those without.
*High blood glucose can cause dry mouth, a condition that’s usually uncomfortable and sometimes painful.
*Bacteria in the Pockets between your teeth and gums thrive on sugar. If not controlled, they in turn, produce acid,which erodes the tooth enamel and causes decay.

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January 1, 2016RcollMedia

Dent O’ tips……….
Dear Colleague,
We value the referring relationship with your clinic. As part of our goal to support and develop this, we are happy to launch our professional newsletter, where we feature latest information on a variety of topics that are relevant to dental practice today. We hope that you will find these extracts informative and useful in the management of your patients.
With warmest regards,
RCOLL Pte Ltd.

Saliva (part 1)
Of all the organs in the craniofacial-oral-dental complex, it is perhaps the salivary glands and their remarkable secretory product, saliva, that forge the strongest link between oral and systemic health. Salivary function is extremely sensitive to changes in our general well-being, ranging from subtle effects of over-the-counter cold medications to the devastation of life-threatening disease.

Even the ancients recognized an association between the human condition and saliva, which served as judge and jury in cases of wrong-doing. A suspect was given a mouthful of dry rice. If his anxiety reduced his saliva flow so that he could not swallow it the verdict was guilty as charged. To this day, “cotton mouth” betrays all of us at some point in our lives, signaling to the world that our nerves have taken control.

Gatekeeper
With its vast antimicrobial arsenal, saliva represents a remarkable evolutionary selective advantage for the host against invading pathogens such as HIV, the fungus Candida albicans, and a host of bacteria associated with oral and systemic diseases. Secretory antibodies, for example, directed against viral pathogens such as poliovirus and cold viruses, as well as the anti-HIV agent SLPI, are found in saliva. Large salivary glycoproteins called mucins appear to have antiviral properties as do cystatins, a family of cysteine-rich proteins that are active against herpes viruses.

Saliva also contains histatins, anti-fungal proteins that are potent inhibitors of candida, which is normally kept in check at extremely low levels in the mouth. When the oral balance is upset, however, by HIV infection or other immunosuppressive and debilitating disorders, antifungal defenses are overwhelmed and candida flourishes uncontrolled.

Reinforcing saliva’s antiviral and antifungal activity are salivary constituents that thwart bacterial attack. These enzymes destroy the opposition by various mechanisms, including degrading bacterial membranes, inhibiting the growth and metabolism of certain bacteria, and disrupting vital bacterial enzyme systems.

Functioning in concert, these and other protective factors in saliva help to maintain the oral environment in optimal working order and restore it to more normal conditions when disturbed. But protection of the oral tissues reflects only one dimension of this versatile fluid and its constituents. Research has found a new role for saliva as an effective laboratory tool.

New Diagnostics
Long known primarily for its protective and lubricating properties, saliva is now meeting the demand for inexpensive, noninvasive, and easy-to-use diagnostic aids for oral and systemic diseases, and for assessing risk behaviors such as tobacco and alcohol use. Detection of HIV by the presence of virus-specific antibodies in saliva, for example, has led to the development of commercially available test kits. These offer the sensitivity of a blood test, but without the discomfort of a needle stick.

The strong correlation between HIV antibodies in saliva and serum has spurred the use of saliva as a monitor for other viral antibodies and antigens. Experimental salivary assays have already been developed for detecting antibodies for measles, mumps and rubella. Saliva is also reliable in diagnosing viral hepatitis A, B and C in laboratory tests.

As an investigational diagnostic aid and potential monitor of disease progression, saliva has been used increasingly in systemic disorders that affect salivary composition and gland function, including Alzheimer’s disease, Sjogren’s syndrome, cystic fibrosis, diabetes, and diseases of the adrenal cortex. Saliva is also proving to be an effective tool to monitor levels of hormones and therapeutic medications — as well as the presence of illicit drugs.

Research opportunities abound to develop more sensitive and specific assays to measure and understand changes in saliva beyond oral and systemic diseases to areas such as genetic defects, nutritional status, and age-specific changes.

Salivary Gland Dysfunction
Although viewed as champions of the oral cavity, the salivary glands are not spared insult disease. The parotid, submandibular, and sublingual glands that comprise the major salivary glands are directly affected by a variety of conditions, including infection(such as mumps), obstructions, developmental disorders, and tumors. Two major diseases, cystic fibrosis (CF) and Sjogren’s syndrome, can devastate these vital glands.

In cystic fibrosis, a defect in chloride ion transport causes exocrine gland secretions, including saliva, to be thick and viscid and leads to chronic lung disease and pancreatic insufficiency. Studies of salivary acinar (salt and water secreting) cells, a convenient model for exploring mechanisms of chloride ion transport, have greatly expanded the understanding of exocrine gland transport systems in human salivary glands. The identification of the defective gene in cystic fibrosis has also led to clinical trials using gene therapy to treat this disorder.

Note: Extracted from National Institute of Dental & Craniofacial Research, USA website.

19 Tanglin Road, ff05-39/43, Tanglin Shopping Centre, Singapore 247909 Tel: 7373833;Fax:7332965; After Ofc Hrs: 5330088 E-Mail: rcoll@pacific.net.sg

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July 29, 2007RcollMedia

thesundaytimes – July 29 2007

Need a good reason to floss? Research shows that unhealthy gums can lead to strokes and even cancer

GUSTAVQ Rodriguez had expected numerous physical exams and blood tests before checking into the hospital last year for a long-awaited kidney transplant. But he was bewildered when he was told to see a dentist.

“My gums were really bad, but I didn’t know that mattered,” says Mr Rodriguez, 26, of Long Beach, California. “They said I had to be bacteria-free before my surgery. I learnt a lot… like every little thing in your body counts.”

And as doctors and dentists now suspect, gum disease is no lit- tie thing.

“For years the mouth was never considered a part of the body,” says Dr Salomon Amar, a periodentist at Boston University. Gum disease was not considered something that could have any impact.

But recently- a study published in New England Journal of Medicine found “that treating severe gum disease can improve the “function of blood vessel walls. improving heart health.

And in last April’s issue of Journal of Periodontology, two studies found Periodontal bacteria (bugs normally found in inflamed gums) in the arteries of people with heart disease and in the placentas of pregnant women with high blood pressure.

Gum problems begin when the bacteria in plaque, the sticky film that forms on teeth, persists long enough to inflame the gums.

Usually, inflammation is considered a positive response to bacteria — a sign that the body is fighting back. But if inflammation rages unchecked, it does more harm than good. Other than bleeding, gum disease has few symptoms and rarely causes much discomfort. “The gums do not hurt until it is too late,”
Dr Amar says.

Well before the gums or teeth start to hurt, the dual forces of infection and inflammation in the mouth appear to hitch a ride in the bloodstream and travel to other parts of the body, wreaking havoc once there.

One-of the most well-established links between gum disease and secondary infection, for example, is among people with mitral heart defects. Doctors have long warned valve patients to take antibiotics before teeth cleanings so that the bacterial disruption in mouth will not travel through the bloodstream to infect the valve.

The other theory of how gum disease inflicts damage elsewhere in the body involves inflammation. Bacteria in plaque release toxins that cause the immune system to produce chemicals called cytokines.

In excess, cytokines can increase inflammation and damage tissues throughout the body. Inflammation in general (no matter how it starts) is now considered a Prime culprit in the development of many illnesses, including heart disease and some types of cancer.

“The key in gum disease is chronic inflammation,” says Preston D.Miler Jr., president of the American of Academy of Periodontology. “when it becomes chrome, it begins to release substances that tissue.”

Doctors at the University of Southern California have also connected a common virus, cytomegalovirus. to gum disease and complications in kidney transplantation.

Studies show that people with severe gum disease have significantly higher rates of cardiovascular disease.

Besides influencing blood vessel walls, byproduct from the bacterial infection the bloodstream and trigger livers release of a substance C-reactive protein, studies suggested. C-reactive protect thought to inflame arteries and mote blood clot formation.

Intriguing links can drawn between gum disease abetes. Diabetics tend to be more severe gum disease and it at an earlier age than without diabetes, research. Having gum disease increase amount of time a diabetic’s sugar remains high. But diabetic who receive good periodontal ligament have a better response betes therapies.

ST Fl WARNING: SIDE EFFECTS OF GUM DISEASE
RESEARCH compiled over the last five years suggests that gum disease — especially if it persists for long without treatment — can lead to diabetes, cardiovascular disease and stroke, pregnancy complications, and perhaps even Alzheimer disease, osteoporosis and some types of cancers.

Infections in the mouth also may increase the risk to people undergoing several types of surgery.

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December 22, 2006RcollMedia

PRIME | JAN∙FEB 2007

BY DR CHUNG KONG MUN

SMILE, GROWING OLD DOES NOT MEAN TOOTH LOSS

From the natural means of healthy living to intervention via cosmetic medicine and surgery. we are constantly trying to turn back the clock against the relentless process of growing old. In the end, our attempts yield only limited success.

Yes, our eyesight will dim, our hearing will deteriorate, muscles will weaken and wrinkles will become more apparent – all these and more are part of the ageing process. Contrary to an old but popular belief, tooth loss is not part of growing old. In fact, our teeth are designed to last us a lifetime. Having a smile with our natural teeth, and strong and healthy gums should be within reach for most people.

Too often, older folks assume that loose teeth result in tooth loss and wearing dentures is a foregone conclusion. This is far from true; gum disease is well, a disease. Most of us know about tooth decay and how certain bacteria in our mouths can produce acids to dissolve tooth enamel to form cavities in our teeth, thus causing toothache and if untreated, tooth loss. However, very few understand or have even heard about gum disease.

What is periodontitis?

The gum disease that should concern us is not gingivitis (a superficial gum infection around the teeth) but periodontitis. It is essentially a chronic inflammatory disease with dental plaque (a bio-film of bacteria found on tooth surfaces) being identified as a major contributory factor.

Simply put, periodontitis is a disease that involves three major factors: Genetic in which scientists have evidence to suggest that only some people born with certain genetic factors will be prone to developing periodontitis; the presence of certain “bad” bacteria in our mouth and the lack of good oral hygiene leading to the accumulation of dental plaque and sub gingival calculus.

Besides bleeding from the gums, bad breath or bad taste in our mouth, there are no other significant symptoms. Once established, periodontitis will progress silently with short episodes of acute infections. During acute infections, there is a tendency for gums to swell with a build-up of pus and this causes pain and discomfort.

Most people in this region would assume that the gum swelling is due to “heatiness”. If the swelling is “disturbed”, the pus may be discharged and the swelling will go down, leading to the thinking that the problem has been solved. While the swelling may subside after the pus is discharged, periodontitis continues to fester and the disease worsens. Bone loss around the teeth will continue, resulting in a loss of support for the gums and manifesting itself as gum recession. The recession of gums will lead to spaces or gaps forming between teeth as well as “longer looking teeth”, hence the expression “Long in the tooth”!

The root surfaces of our teeth will be exposed and this is likely to make our teeth hypersensitive, particularly to colder food and drinks. Furthermore, the root surfaces of our teeth are more prone to acid attacks from bacteria. This may also lead to an increased risk of decay occurring around the roots of our teeth.

Among the signs of periodontal disease are bad taste or breath, bleeding gums, receding gums, loose teeth, tender or swollen gums, pus from gums, change in the way teeth meet when biting, and spaces or gaps appearing between teeth. However, most of these signs are easy to miss or even dismiss. Due to ignorance, most do not consult dentists until discomfort or pain is felt. Periodontitis is a “silent” disease as opposed to tooth decay where a small cavity can potentially cause a severe toothache. Therefore, we must be vigilant in checking for signs of periodontitis.

Active surveillance through regular dental maintenance by dentists will help pick up early signs of periodontitis. This will enable dentists to treat the problem early. More complicated and expensive treatment to save our teeth could then be avoided. To check for periodontitis, a thorough clinical examination using a special probe to check for gum pockets around the teeth as well as X-rays is essential for an accurate diagnosis.

Can medications affect your gums?
Many types of medications can have significant implications for conditions in our mouths. More than 300 different types of medication (for example, diuretics, anti-hypertensives, anti-depressants, anti-psychotics and anti-cholinergics) have been identified to have an impact on salivary glands, causing the flow rate to be reduced.

Our saliva plays an important role in maintaining conditions that are conducive to good oral health. It too provides protection against disease-causing micro- organisms, while facilitating our speech, singing or playing of wind instruments. Besides containing enzymes that help digest our food, saliva also has lysozymes, antibodies and other active agents that kill or reduce the growth of bacteria. Finally, our saliva acts as buffering agents that neutralise acids produced by decay-causing bacteria.

Therefore, good saliva flow is important and will help keep our mouth moist and healthy.

But when we need to take certain medications that reduce saliva flow, it is important to take appropriate counter-measures. For example, if we take sweet foods, we should rinse and even brush our teeth immediately to wash away sugary residues. Use fluoridated mouth rinses to provide the additional fluoride for strengthening our

Periodontitis is a “silent disease as opposed Lo loolh decay where a small cavity can potentially cause a severe toothache. Therefore, we must be vigilant in checking for signs ofperiodontitis.

enamel against acid attacks. There are also oral antiseptic mouth rinses that can help reduce the number of oral bacteria by more than 99%. Suitable mouth rinses include those containing chlorhexidine like Esemdent or Bactidol or those containing essential oils like Usterine.

Other medications like nifedipine (heart drug), cyclosporine (anti-rejection drug) and phenytoin (anti- epileptic drug) can cause gums to swell. Most patients taking these medications need to take them long-term if not for life. Therefore, good oral hygiene is essential to help reduce the risk of drug-induced gum swellings. In addition to keeping excellent oral hygiene, regular dental maintenance visits to monitor closely gum conditions will help keep gum swellings at bay. However, if gum swellings are established and remain despite good home care and professional cleaning, minor gum surgery may be required.

Related medical conditions
Recent research has revealed a connection between periodontal disease and other systemic disease conditions. Growing evidence indicate that diabetic conditions cause various detrimental changes from defective blood capillaries to problems with immune defence mechanisms. It has been shown that diabetics are two to three times more likely to develop serious periodontal disease. Diabetics are prone to infections and since periodontitis is a chronic infection, it calls for early diagnosis and appropriate treatment. With good oral hygiene and regular dental maintenance, periodontal disease can be prevented and even diabetics can enjoy good gum health.

More recently, research has also linked untreated periodontal disease with pre-term labour/low birth weight babies, cardiovascular disease and stroke. How these associations work and their implications are still unknown. More research is needed in this area.

Where there is no specific “cure” for periodontitis, effective treatment, active surveillance and preventive maintenance can control this disease and maintain our gums’ well being. Your dentist or periodontist is in the best position to help diagnose and treat periodontal disease, before providing a tailored preventive maintenance programme that suits your disease profile and relative risk for recurrence.

While it is important to brush our teeth daily, we can also cause problems with the wrong technique or habit of brushing teeth. For example, if we use the wrong type oftoothbrush or over-brush, we can slowly cause gum recession. Get coached on tooth brushing and flossing, and use the right technique! Today, we have a wide range of oral hygiene aids to help us maintain clean and healthy teeth and gums.

Remember, being toothless is not part of ageing; our teeth can be maintained and kept functional throughout our lives so that we can always enjoy our food!
Dr Chung Kong Mun is a consultant periodontist ar Pacific Healthcare Specialist Centre.

Goodbye,
teething problems
8 golden tips to better dental care…

1 Brush before breakfast and before sleeping to reduce bacteria count and acidity. 2 Special care is needed if you take long-term medication for diabetes, hypertension, depression, coronary heart disease, stroke, arthritis, etc.
3 See your dentist regularly for preventive maintenance to detect problems early or even prevent them.
4 Be alert to signs of periodontal (gum) disease.
5 Be careful when eating foods with bones and seeds as your teeth become more brittle.
6 Remove dentures for soaking overnight to avoid denture stomatitis and fungal infections.
7 Avoid over-brushing by using a soft-bristle brush. Age- related gum recession will leave exposed roots more vulnerable to over-brushing.
8 Drink more water if your medication or medical condition causes dry mouth.

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August 31, 2005RcollMedia

The Straits Times August 31 , 2005

Have You Say Treat dentists as coaches in oral care
The choice of headlines “How to avoid your dentist” (MYB, Aug 17) has done a great disservice to dentistry and the concept of preventive dentistry or medicine.

Adding more insult to injury is your tag “so you can visit them only when absolutely necessary”. Our community’s mindset and attitude towards health care is dismal; there is also a serious lack of awareness.

Consider this: would you rather pay to see a dentist to hear him say after a check-up and the routine cleaning that you have a clean bill of oral health or to have to rush to the dentist because it is “absolutely” necessary, already knowing that he or she will have bad news for you?

Personally, I would happily pay regularly to get news than have a situation of pain or emergency, and then be faced with a huge bill for treatment. We send our cars for regular preventive maintenance precisely to avoid going to the workshop only when absolutely necessary.

Your writer said it well in that one’s mouth can definitely be the bulletin board of bad lifestyle choices (a telling reflection of cui general health).

It’s not beneficial to make our patients hope that their oral hygiene is up to “expectations”.

Patients should consider dentists as coaches in oral care techniques, rather than feel they have to meet expectations. Even Tiger Woods needs the services of a coach!

The article is timely as it focuses on gum disease. Tooth decay and gum disease are the two major causes of tooth loss in adults.

Everyone knows about tooth dray but few know about gum disease — the silent killer of our teeth.

While gum disease is not linked to the ageing process, its prevalence does increase with age. A wealth of public information about gum disease can be found on the website W .perio. org

-Dr Chung Kong Mun

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January 7, 2002RcollMedia

FORTUNE JAN 7,2002

I have a mouth only a dentist could love. It contains a state-of- the-art ceramic bridge, porcelain crowns, the fanciest inlays, the priciest onlays—$24,076 of repairs and gear in just the past three years. As the daughter of a dentist, 1 know teeth. I knocked out my permanent central incisors at age eight. I broke my jaw. the right condial, al 29. Did I mention that titanium plates fasten my anterior choppers to my maxilla?

While I hope that your mouth is not the costly war zone mine has been (in three years, I’ve spent $12,613 out of pocket), you too need to invest to ensure that your teeth last all your life. “The baby-boom generation is the first lo hold on to their teeth,” says Dr. Frederick Eichmiller, director of the American Dental Association’s Paffenbarger Research Center in Gaithersburg, Md. “Half the previous generation had dentures by their 60s. Thanks to fluoride and advances in technology, about a quarter of baby-boomers will.”

Your gums, not your teeth, are your first line of defense. Seventy per cent of lost teeth have mi cavities, according to Dr. Robert Pick, a Chicago periodontist and spokesman for the ADA. Gum disease afflicts four of five adults, he says, and attacks insidiously, eroding the hone and tissue that anchor your teeth. “It doesn’t just like high blood pressure and high cholesterol don’t hurt.” Gum disease may even kill: Some researchers believe it stimulates plaque buildup in the arteries, increasing the risk of stroke and heart attack.

Keeping gums healthy involves flossing every day (no-brainer) and making sure your dentist, at every checkup, does a periodontal ‘probe. He inserts a measuring device below your gum line; it’s painless, but if the dentist can delve four millimeters or more, you may be in trouble. Surgery can stop, and sometimes even reverse, gum damage. One tooth- saving procedure involves cutting a flap in the gum and injecting regenerative gels to get the bone growing again. This can cost up to $8,000, but it can save previous teeth.

The biggest recent advance in dentistry is implants. Only a few years ago, to replace a missing tooth you would have had to settle for a crown and bridge—a false tooth that attaches lo (and requires the dentist to cut down) adjacent living teeth. Implants, by contract. fasten directly to the bone: they don’t disturb to the bone; they don’t disturb neighboring teeth. Implants aren’t for everyone; you need substantial bone to mount the new tooth. And they’re expensive. Dr. Jonathan Levine, my fancy Fifth Avenue prosthodontist, quotes $5,000 per tooth for the package, including surgery—but this is no more than the amount he charges to replace a tooth with a three-unit bridge. “In the long run, implants save you time and money because you’re not committing the adjacent teeth to future dental work,” Levine says. And if you take proper care of your gums, implants should last 20 years-plus, at least as long as crowns.

There’s even better technology in the pipeline. In the coming year, dentists will begin using “smart” fillings and cement lo re- verse tooth decay. These materials release calcium phosphate, which dissolves from the tooth as a cavity forms. “The restorative materials literally rebuild the tooth,” says the ADA’S Eichmiller. More is on the horizon, including controlled-release fluoride systems and compounds to repair deep cavities that currently would require root canal. Depending how far technology takes us—and how far ethicists allow dentistry to go in areas like stemcell research—eventually you may be able to get a tooth bud implanted to regenerate a missing tooth. That means teething could become a welcome part of mildlife. -PATRICIA SELLERS

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March 15, 1999RcollMedia

THE STRAITS TIMES : Monday, March 15, 1999

I HAVE followed with interest the debate initiated by MP Tan Cheng Bock’s call to the Government to tone down its call on the need for foreign talent and reassure Singaporeans that they come first, and the responses to it by journalist Rahul Pathak in The New Paper and Minister of Information and the Arts George Yeo in Parliament.

I support the recruitment of foreign talent as the Government pushes our country into a knowledge-based economy. However, I agree totally with Dr Tan’s call to think Singaporeans first as this is borne out by several facts.

First, all Singaporean males have to serve two to two-and-a-half years of National Service. This translates into two years of significant opportunity cost.

They enter the job market two years later and also lose two years of job experience, with lasting implications in promotions and benefits.

Second, all Singaporean males have to be operationally ready NSmen for several more years during their working life.

Thirdly, and most importantly, all Singaporeans have duty and responsibility to defend Singapore with life and limb.

Therefore, I think it is not wrong to ask our Government to reassure us that our Singapore passports count.

I am not suggesting any handouts, but I am confident that our Government is capable of drawing up innovative schemes and programmes to achieve the desired effect.

Yes, we should still continue to attract foreign talent and press ahead with our strategy for a knowledge-based economy, but this needs to be balanced by stark facts — that 17 per cent of our new graduates, as well as retrenched Singaporeans, have yet to find jobs.

CHUNG KONG MXJN

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February 18, 1998RcollMedia

THE STRAITS TIMES, WEDNESDAY. FEBRUARY 18,1998

PHILADELPHIA — Worried about a heart attack? You should exercise, eat right and keep your teeth clean, re- searchers have said.

University of Minnesota researchers reported recently that bacteria found in plaque can cause blood platelets to clump up — the first stage towards a blood dot that could cause a heart attack or stroke.

“We know a great deal about risk factors for atherosclerosis and heart attacks, but no1 the actual causes,” Dr Mark Herzberg, a professor of preventive sciences at the University of Minnesota, told the American Association for the Advancement of Science.

His team took the germs found in dirty and diseased gums, including strains of Streptococcus and Porphyromonas bacteria, arid infused them into rabbits.

The rabbits also had faster heart and breathing rates. Using a different bacterium did not have these effects.

Dr Herzberg said he wanted to terminate unfortunate rabbits more to see if they suffer heart attacks when the bacteria were infused.

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December 11, 1997RcollMedia

The Strait Times,Thursday,December11, 1997
TUMINAH SAPAWI
Take special care of your gums and teeth if you are a diabetic. This is because you have an increased risk of developing gum disease, which can be come severe if the diabetes is left untreated.

Severe gum disease also known as periodontal disease, can, in turn, make your diabetes worse, says Dr Chung Kong Mun, president of the newly-registered Society of Periodontology, Singapore.

However, not many people are aware that one condition can affect the other, he adds. To spread the word, a public forum on diabetes and gum disease will be held on Sunday. It is organised jointly by the new group and the Diabetic Society of Singapore.

Besides highlight the relationship between the two diseases, the forum hopes to improve people’s awareness of the need for early diagnosis and preventive care and treatment of periodontal disease in diabetic patients.

Dr Chung says that past research has shown that diabetic patients are 2.6 times more likely to contract severe gum disease than non- diabetics.

This is because people with diabetes arc susceptible to sores, wounds and inflammation because their condition weakens the nerve cells. Gum disease is a form of inflammation which occurs in the mouth.

Also, there is a type of white blood cell in the body’s defence system (its technical name is polymorphonuclear leukocyte) which is important in maintaining healthy gums, and is impaired easily in a diabetic patient. This, in turn, leads to infection. A diabetic patient’s wounds also take longer to heal.
An infection explains Dr Warren Lee, president of the Diabetic Society of Singapore, whether in the mouth or other parts of the body, affects the control of blood sugar. This is because when there is an infection the body produces certain stress hormones, which leads to higher resistance to insulin.
This in turn, can lead to a higher blood sugar level, which can affect other organs in the body, such as the blood vessels, kidney the heart and even the brain, adversely. Dr Lee, a paediatric endocrinologist specialising in child diabetes, says: “People with diabetes should actually realise that it’s not just a simple matter of taking medication and eating less sugar.

“They should also maintain a healthy lifestyle with exercise, as well as proper care of their teeth, which will reduce the risk of complication.”

The situation can get even worse, if a patient with bad oral hygiene loses his teeth. It would be harder for him to eat the healthy foods with a high-fibre content that are recommended for such patients, added Dr Lee.

Dr Chung cited a recent study conducted in the United Stated, which concluded that severe periodontitis contributed to poor blood sugar control.

He suggested that physicians treating patients with diabetes should be alert to signs of severe gum disease. Here, the two disciplines work separately. Physicians treating diabetic patients do not usually check the gum condition of their patients.

*We hope to change ‘ this,’ said Dr Chung. “We are not expecting physicians to be able to diagnose gum disease but to recommend that the patient go for dental check-ups for any inflammation.”

The forum will be held at Hotel Intercontinental Singapore this Sunday at 3.30pm. There is a fee of $10 for those who are not members of the Diabetic Society of Singapore and NTUC Club. Call 450-6132 for details.

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January 1, 1995RcollMedia

HMDP Fellowship in Advanced Periodontics

I was attached to the Periodontology Department at Eastman Dental Centre, New York from June 1993.

My time was spent in periodontal clinics and the laboratory doing basic, pre-clinical animal and human clinical studies. The remainder of the time was spent at special seminars and lectures by invited speakers.

This attachment provided me with a chance to learn the latest techniques in hard and soft guided tissue regeneration and various protocols in cell and molecular biology experiments.

After a 13-month stay in New York, it was time to leave for Boston where I spent 3 months on an Academy of Medicine Fellowship as a visiting fellow at Harvard School of Dental Medicine and the Institute of Molecular Biology.

This attachment has benefitted me greatly and I will have much to contribute to my department.

Chung Kong Mun

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