The role of home care therapy in periodontal disease treatment and management.

Home care therapy is indispensable to manage periodontal disease successfully. Often, during and following initial periodontal treatment, it is unclear how much of the clinical improvement was due to patients' home care or to professional intervention, as these two therapeutic components are often amalgamated in clinical practice as well as in studies. In this case series, four patients with periodontal disease received education on using oral hygiene devices and used them competently prior to initiation of professional periodontal treatment. The changes in their clinical presentations, solely attributed to their home care therapy, were documented. The rationale and suggested clinical guidelines are also presented. Conclusion: Home care therapy is an indispensable but often overlooked step in the successful management of periodontal diseases. Ideally, this step should be solidified prior to proceeding with any professional treatment. By motivating patients to participate in the treatment more actively, clinicians can significantly improve the outcome and longevity of their professional interventions.

Cadmium induces impaired glucose tolerance in rat by down-regulating GLUT4 expression in adipocytes.

Cadmium (Cd) has been known to cause hyperglycemia with diabetes-related complications in experimental animals; however, the molecular basis underlying this Cd-induced hyperglycemia is not known. Here, we report the novel finding that the impaired glucose tolerance (IGT) in rats induced by CdCl(2) is accompanied by a drastic (by as much as 90%) and dose-dependent reduction in GLUT4 protein and GLUT4 mRNA levels in adipocytes. The effect was specific to GLUT4; neither GLUT1 nor insulin-responsive aminopeptidase in adipocytes was affected. GLUT2 in hepatocytes was also not affected. Interestingly, the effect on GLUT4 was also specific to adipocytes; the muscle tissues of the Cd-treated rats showed only a slight (<25%) reduction in GLUT4 protein level with no change in GLUT4 message level, and again with no change in GLUT1 protein and its message levels. Although the insulin-induced GLUT4 translocation in adipocytes was not affected by the Cd treatment, the 3-O-methy-D-glucose flux in insulin-stimulated adipocytes of Cd-treated rat was drastically reduced. Together these findings clearly demonstrate that Cd induces IGT in rats by selectively down-regulating GLUT4 expression in adipocytes.