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709,827. The studies reported a total of 45,844 new cases of diabetes during a follow-up period ranging from five to 30 years. The data indicate that smokers have a 44 percent increased risk of developing type 2 diabetes compared with nonsmokers. Further analyses suggested a dose-response relationship, with the association stronger for heavy smokers (20 or more cigarettes per day; 61 percent increased risk) than for lighter smokers (29 percent increased risk). The association also was weaker for former smokers (23 percent increased risk) than for active smokers. The researchers pointed out that observational primary studies cannot prove causality, but that these studies met several recommended criteria for causation. “First, there is an appropriate temporal relationship: the cigarette smoking preceded diabetes incidence in all studies,” the researchers wrote. “Second, the findings are consistent with a dose-response relationship, with stronger associations for heavy smokers relative to lighter smokers and for active smokers relative to former smokers. Third, there is theoretical biological plausibility for causality, in that smoking may lead to insulin resistance or inadequate compensatory insulin secretion responses according to several but not all studies,” the researchers noted. “Conversely, there are also possible noncausal explanations for this association,” the researchers continued. “Smoking is often associated with other unhealthy behaviors that favor weight gain and/or diabetes, such as lack of physical activity, poor fruit and vegetable intake
and high alcohol intake. “Considering the consistent finding of increased diabetes incidence associated with active cigarette smoking across a large number of studies, we believe that there is no need for further cohort studies to test this hypothesis,” the researchers wrote. “However, there is a need for studies that include detailed measurement and adjustment for potential confounding factors such as socioeconomic status, education and exercise with a goal of establishing whether the association with smoking is causal.”
JADAPreview COMING IN MARCH
dPit-and-fissure sealants dSalivary dysfunction and quality of life in Sjögren syndrome dDirect pulp capping with mineral trioxide aggregate dThe use of a brief relaxation method in the treatment of dental anxiety Look for this and more in the March issue of JADA. OLDER ADULTS BENEFIT MOST FROM FLUORIDATION
lder adults benefit more significantly from fluoridation than do children, according to a study published in the Fall issue of Journal of Public Health Dentistry. Dr. Gerardo Maupomé, Indiana University School of Dentistry, Indianapolis, and colleagues investigated whether access to fluoridated community water reduced the number of restorations placed in and asso-
O
ciated costs incurred by children, adults and older adults. All three groups benefited, with older adults benefiting the most. All study participants were members of a dental health maintenance organization and, as such, had access to dental care through dental insurance. “Our finding that fluoridated water lowered the number of dental fillings confirms studies [of] younger people but breaks new ground [for] older individuals,” said Dr. Maupomé. “While those we studied had dental insurance, many older adults, who are often retired, don’t have dental insurance, and so prevention of decay is very important. “Community water fluoridation is a sound public health investment for people of all ages,” said Dr. Maupomé. “Much of the focus of research on community water fluoridation has been on children. There has been significantly less research on adults and even less on older adults. “[People] are keeping their teeth through adulthood into their older years,” said Dr. Maupomé. “We need to study dental health through all decades of life.” The Centers for Disease Control and Prevention provided funding for this study to Kaiser Permanente through a contract with the Alliance for Community Health Plans. Compiled by Janice Snider, senior editor.
MEETINGS
dThe American Association for Dental Research will hold its 37th Annual Meeting & Exhibition April 2-5 in Dallas. For more information, visit “www.aadronline.org”. dThe American Association for Endodontists will hold its annual
JADA, Vol. 139 http://jada.ada.org Copyright ©2008 American Dental Association. All rights reserved.
February 2008
133
709,827. The studies reported a total of 45,844 new cases of diabetes during a follow-up period ranging from five to 30 years. The data indicate that smokers have a 44 percent increased risk of developing type 2 diabetes compared with nonsmokers. Further analyses suggested a dose-response relationship, with the association stronger for heavy smokers (20 or more cigarettes per day; 61 percent increased risk) than for lighter smokers (29 percent increased risk). The association also was weaker for former smokers (23 percent increased risk) than for active smokers. The researchers pointed out that observational primary studies cannot prove causality, but that these studies met several recommended criteria for causation. “First, there is an appropriate temporal relationship: the cigarette smoking preceded diabetes incidence in all studies,” the researchers wrote. “Second, the findings are consistent with a dose-response relationship, with stronger associations for heavy smokers relative to lighter smokers and for active smokers relative to former smokers. Third, there is theoretical biological plausibility for causality, in that smoking may lead to insulin resistance or inadequate compensatory insulin secretion responses according to several but not all studies,” the researchers noted. “Conversely, there are also possible noncausal explanations for this association,” the researchers continued. “Smoking is often associated with other unhealthy behaviors that favor weight gain and/or diabetes, such as lack of physical activity, poor fruit and vegetable intake
and high alcohol intake. “Considering the consistent finding of increased diabetes incidence associated with active cigarette smoking across a large number of studies, we believe that there is no need for further cohort studies to test this hypothesis,” the researchers wrote. “However, there is a need for studies that include detailed measurement and adjustment for potential confounding factors such as socioeconomic status, education and exercise with a goal of establishing whether the association with smoking is causal.”
JADAPreview COMING IN MARCH
dPit-and-fissure sealants dSalivary dysfunction and quality of life in Sjögren syndrome dDirect pulp capping with mineral trioxide aggregate dThe use of a brief relaxation method in the treatment of dental anxiety Look for this and more in the March issue of JADA. OLDER ADULTS BENEFIT MOST FROM FLUORIDATION
lder adults benefit more significantly from fluoridation than do children, according to a study published in the Fall issue of Journal of Public Health Dentistry. Dr. Gerardo Maupomé, Indiana University School of Dentistry, Indianapolis, and colleagues investigated whether access to fluoridated community water reduced the number of restorations placed in and asso-
O
ciated costs incurred by children, adults and older adults. All three groups benefited, with older adults benefiting the most. All study participants were members of a dental health maintenance organization and, as such, had access to dental care through dental insurance. “Our finding that fluoridated water lowered the number of dental fillings confirms studies [of] younger people but breaks new ground [for] older individuals,” said Dr. Maupomé. “While those we studied had dental insurance, many older adults, who are often retired, don’t have dental insurance, and so prevention of decay is very important. “Community water fluoridation is a sound public health investment for people of all ages,” said Dr. Maupomé. “Much of the focus of research on community water fluoridation has been on children. There has been significantly less research on adults and even less on older adults. “[People] are keeping their teeth through adulthood into their older years,” said Dr. Maupomé. “We need to study dental health through all decades of life.” The Centers for Disease Control and Prevention provided funding for this study to Kaiser Permanente through a contract with the Alliance for Community Health Plans. Compiled by Janice Snider, senior editor.
MEETINGS
dThe American Association for Dental Research will hold its 37th Annual Meeting & Exhibition April 2-5 in Dallas. For more information, visit “www.aadronline.org”. dThe American Association for Endodontists will hold its annual
JADA, Vol. 139 http://jada.ada.org Copyright ©2008 American Dental Association. All rights reserved.
February 2008
133