Oral Health Status and Salivary Properties in Relation to Gluten Free Diet in Children With Celiac Disease.

Oral Health Status and Salivary Properties in Relation to Gluten Free Diet in Children with Celiac Disease.

Filed under: Eating Disorders

J Pediatr Gastroenterol Nutr. 2013 Feb 10;
Shetyer E, Berson T, Lachmanovitz O, Hidas A, Wilschanski M, Menachem M, Shachar E, Shapira J, Steinberg D, Moskovitz M

BACKGROUND:: Patients with Celiac Disease (CD) have a wide variety of symptoms, from being asymptomatic to having chronic diarrhea, abdominal pain and extra-intestinal symptoms. In the oral cavity, enamel defects and recurrent aphthous stomatitis are the most common symptoms. AIM:: To assess oral health, bacterial colonization and salivary buffering capacity of patients with CD at diagnosis were compared with CD patients on gluten free diet (GFD) and healthy children. METHODS:: Three groups were prospectively investigated: newly diagnosed celiac disease, celiac disease treated with GFD and a control group. All children were examined by pediatric dentists and saliva samples were collected for bacterial and pH analysis. RESULT:: Ninety children were enrolled in the study, thirty in each group. A higher prevalence of enamel hypoplasia (66%) was found in celiac children. Plaque Index was significantly lower in the celiac treated group, which correlated with oral health behavior: teeth brushing and frequency of eating between meals. Children on GFD brushed their teeth and used fluoride significantly more often than other children in the study. No difference between groups was found in snacks consumption, Mutans Streptococci and Lactobacilli counts in saliva, as well as pH and buffer capacity, CONCLUSIONS:: A lower degree of plaque was found in celiac children on GFD. This finding could not be explained by salivary properties or bacteria, but rather by better oral hygiene. The results should raise the awareness of pediatric gastroenterologists to oral health related issues in children with CD.
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Oral and dental restoration of wide alveolar cleft using distraction osteogenesis and temporary anchorage devices.

Filed under: Eating Disorders

J Craniomaxillofac Surg. 2013 Feb 9;
Rachmiel A, Emodi O, Gutmacher Z, Blumenfeld I, Aizenbud D

Closure of large alveolar clefts and restoration by a fixed bridge supported by implants is a challenge in cleft alveolus treatment. A major aesthetic concern with distraction osteogenesis is obtaining a predictable position of the implant in relation to the newly generated bony alveolar ridge. We describe the treatment of a large cleft alveolus and palate reconstruction by distraction osteogenesis utilizing temporary anchorage devices (TADs) followed by a fixed implant-supported bridge. The method consists of segmental bone transport by distraction osteogenesis using a bone-borne distractor to minimize the alveolar cleft, followed by closure of the residual small defect by bone grafting three months later. During the active transport distraction, TADs were used exerting multidirectional forces to control the distraction vector forward and laterally for better interarch relation. A vertical alveolar distraction of the newly reconstructed bone of 15 mm facilitated optimal implant placement. The endosseous implants were osteointegrated and supported a fixed dental prosthesis. In conclusion, the large cleft alveolus defect was repaired in three dimensions by distraction osteogenesis assisted by TADs, and the soft tissues expanded simultaneously. Endosseous implants were introduced in the newly reconstructed bone for a fixed dental prosthesis enabling, rehabilitation of aesthetics, eating and speaking.
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Food insecurity with past experience of restrained eating is a recipe for increased gestational weight gain.

Filed under: Eating Disorders

Appetite. 2013 Feb 9;
Laraia B, Epel E, Siega-Riz AM

Food insecurity is linked to higher weight gain in pregnancy, as is dietary restraint. We hypothesized that pregnant women exposed to marginal food insecurity, and who reported dietary restraint before pregnancy, will paradoxically show the greatest weight gain. Weight outcomes were defined as total kilograms, observed-to-recommended weight gain ratio, and categorized as adequate, inadequate or excessive weight gain based on 2009 Institute of Medicine guidelines. A likelihood ratio test assessed the interaction between marginal food insecurity and dietary restraint and found significant. Adjusted multivariate regression and multinomial logistic models were used to estimate weight gain outcomes. In adjusted models stratified by dietary restraint, marginal insecurity and low restraint was significantly associated with lower weight gain and weight gain ratio compared to food secure and low restraint. Conversely, marginal insecurity and high restraint was significantly associated with higher weight gain and weight gain ratio compared to food secure and high restraint. Marginal insecurity with high restraint was significantly associated with excessive weight gain. Models were consistent when restricted to low-income women and full-term deliveries. In the presence of marginal food insecurity, women who struggle with weight and dieting issues may be at risk for excessive weight gain.
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