Thursday, February 26, 2009

Modern lifestyle prevents tooth decay

New research has found that modern lifestyle habits may play a bigger role than food alone, when it comes to tooth decay.

A review of the scientific evidence over the past 150 years found that the effects of fluoride toothpaste, good oral hygiene and health education, may override the effects of food alone on tooth decay. The research is published online in a Supplement to the journal Obesity Reviews.

Professor Monty Duggal, an author of the review explained 'Nowadays, it's not enough to just look at what we eat when talking about tooth decay, as other factors seem to be as important. Fluoride toothpaste changes the effect that some foods have on the teeth, as do other good oral hygiene practices'.

He added 'Future research should investigate a number of lifestyle factors together with different foods that might affect tooth decay. Times have changed and with that, the foods we eat, and how we care for our teeth'.

Professor Duggal is a consultant and head of paediatric dentistry at Leeds dental institute. He has published over 65 research papers in international scientific journals.

The overall aim of the review was to look at the evidence for the claim that sugar was the main cause of dental caries (tooth decay). The authors concluded that out of 31 studies carefully reviewed, the majority did not find a relationship between the amount of sugar consumed and dental caries, but the frequency of consumption may be important.

Thanks to dental health education most people now know the best way to prevent tooth decay is to brush with fluoride toothpaste twice a day, especially before going to bed. Rates of tooth decay have fallen dramatically over the past 20 years.

Wednesday, February 25, 2009

Durability Of Dental Fillings Can Be Improved

Durability Of Dental Fillings Improves If The Enzyme Activity Of Teeth Is Inhibited

A dental filling is more durable if the enzyme activity of the tooth can be inhibited. Professor Leo Tjaderhane of the Department of Pedodontics, Cariology and Endodontology at the University of Oulu, together with wide international collaborative team, has been developing this method with funding from the Academy of Finland.

Composite dental fillings have one problematic feature, in that the bond between the filling and the dental tissue deteriorates over time – in fact, sometimes by as much as 50 per cent in one year. As the bond deteriorates, it may allow bacteria to enter and this brings a high risk of further tooth decay.

Professor Tjäderhane has researched the occurrence of certain enzymes, matrix metalloproteinases (MMPs), in the dental tissue and their role in dental conditions. The MMPs break down the extracellular matrix, including collagen, which is a major component of dentin. As a result of international research collaboration, Tjäderhane's research team has shown that human dentin contains the key MMP for breaking down collagen. The bonding of composite resins with dental tissue is based on the use of collagen bonds, and the tooth's own MMPs are responsible in part for the deterioration of the bond over time. By inhibiting the activity of these enzymes, the research team has succeeded in significantly slowing down the deterioration of the bond between dental tissue and a composite filling, and in some cases to prevent deterioration completely.

The best results have been obtained in clinical trials, where deterioration of the bond has been more or less completely prevented. MMP enzyme activity in the tooth can be rapidly and easily inhibited when a filling is put in place by using chlorhexidine, a substance which is already on hand at all dental practices. This means that the research results are immediately applicable in dental care for the best benefit of the patients. The research in question also strongly indicates that MMP inhibitors might help slow down tooth decay. These observations are based only on animal testing so far, so further research on the subject will be needed before pratical applications can be made available

Tuesday, February 24, 2009

Dentist Trains Others At Special Olympics

Sanford Fenton, D.D.S., could feel the electricity in the air.

Everywhere he turned, he saw smiling faces as his ears filled with the excited voices of this year’s athletes in the 2009 Special Olympics World Winter Games held Feb. 17-13 in Idaho.

Fenton, chair of pediatric dentistry at The University of Texas Dental Branch at Houston, played a vital role in trying to keep the teeth in those smiling faces healthy through free dental screenings of the athletes.

As a global clinical adviser for Special Olympics, Fenton also trained 35 pediatric and general dentists who will become local clinical directors around the world.

“They left with knowledge on how to treat patients with developmental and intellectual disabilities,” Fenton said. “I, along with the trainees, performed oral screenings for the athletes. We also talked to them about oral hygiene and good nutrition. During the examination, the athletes were also fitted for mouth guards for the games.”

If an athlete needed further dental care, 270 volunteers were standing by to provide dental treatment in a mobile dental van, local dental offices or, if necessary, transportation to an emergency center.

“One of the athletes I examined had a serious infection in his mouth. He needed immediate treatment and was placed on antibiotics. He was also scheduled to see an oral surgeon for multiple extractions,” Fenton said.

Of the athletes at the games, typically 45 percent have untreated decay and up to 60 percent have excessive periodontal disease, while 13 to 15 percent of the athletes report mouth pain, Fenton said.

Trainees learned how to initiate, coordinate and implement Special Olympics Special Smiles Programs in their local communities. They also learned hands-on how to manage the behaviors of individuals with intellectual disabilities.

Steven Hackmyer, D.D.S, associate professor of pediatric dentistry at the UT Dental Branch, was a trainee this year. “The experience of being trained, as well as being part of the games, was truly phenomenal. It was the experience of a lifetime and one I will always remember,” Hackmyer said. “Meeting, examining and teaching oral care to the athletes, most of whom did not speak English, was quite enjoyable and wonderful. It was rewarding to see the impact and difference we had on so many of the athletes.”

Friday, February 20, 2009

New approach to dental visits may ease kids' fears

For many children, a trip to the doctor or dentist is a stressful experience. The sensory environment (i.e., the sounds, smells, and lights associated with the clinical setting) can cause a child's anxiety levels to rise. This is especially true in children with developmental disabilities who may have difficulty understanding the unfamiliar clinical environment. A new study soon to be published in The Journal of Pediatrics explores the relationship between the sensory environment and anxiety levels in children.

Dr. Michele Shapiro of the Issie Shapiro Educational Center and colleagues from Hebrew University in Israel studied the effects of the sensory environment on a child's anxiety levels during two separate routine cleaning visits to the dentist. The researchers observed 35 children between the ages of 6-11 years, 16 of whom were developmentally disabled. They measured the anxiety levels of the children during each visit using a behavior checklist and monitored each child's electro-dermal activity, an objective measure of arousal.

The first trip included the typical sensory experiences of a dental office, including fluorescent lighting and the use of an overhead dental lamp. During the second trip, however, the researchers created a sensory adapted environment that modified the experience of the children. No overhead lighting was used, a slow moving repetitive color lamp was added, and the dental hygienist wore a special LED headlamp that directed the light into the child's mouth. The children listened to soothing music and were wrapped in a heavy vest that created a "hugging" effect. The dental chair itself was also modified to produce a vibration.

Dr. Shapiro and her colleagues found that anxiety levels decreased in all children when the sensory adapted environment was used. The duration of anxious behavior dropped significantly, from an average of 3.69 minutes to 1.48 minutes in typical children. The decreased anxiety levels were even more notable in children with developmental disability, with averages dropping from 23.44 minutes to 9.04 minutes. Dr. Shapiro and her colleagues are hopeful that this new method may have a potential use in other medical settings as well. As Dr. Shapiro notes, "This new approach may even replace sedatives and other invasive procedures in the future."

Wednesday, February 18, 2009

HPV Lesion Can Be Identified at the Dentist

Human Papillomavirus (HPV) Lesion Identified at the Dentist

Human papillomavirus (HPV) is a group of viruses that includes more than 100 different strains or types and is the most common sexually transmitted virus. The American Social Health Association (ASHA) reports that 75 percent or more of sexually active Americans will contract HPV sometime in their lives. HPV is most commonly attributed to causing cervical cancer and genital warts, but did you know HPV also causes oral cancer?

According to a study in the September/October 2008 issue of General Dentistry, the clinical, peer-reviewed journal of the Academy of General Dentistry (AGD), oral HPV can be detected using a very familiar, conventional device that patients may already experience in your mouth during routine procedures. This device is the VELscope. It’s the fun wand that emits a bright, indigo blue light. If you’ve ever had a cavity, your dentist may have used the VELscope to set/harden the material used to fill the cavity.

John C. Comisi, DDS, FAGD, author of the study, discovered that the blue light emitted from the VELscope also detects cancerous oral tissue. The study explains that when emitting a specific wavelength of light into the mouth, oral fluorescence occurs, which in turn causes the tissue to emit its own light (this is called natural fluorescence). The VELscope produces a blue light that excites the oral tissue cells. Healthy cells will fluoresce back and appear green in color, while damaged and unhealthy cells will not fluoresce and thus appear as black or dark maroon areas against the green surrounding tissue.

“Surgery can remove cancerous lesions, but typically if they are found at a late stage, the surgery can be extensive,” says Dr. Comisi. “Only early detection can help to minimize the extent of surgery needed to eradicate the disease. The earlier a lesion is detected, the higher the rate of survival,” he adds.

The Oral Cancer Foundation says that more than 34,000 Americans will be diagnosed with oral or pharyngeal cancer this year. Of those 34,000 newly diagnosed individuals, only half will be alive in 5 years. It will cause over 8,000 deaths—killing roughly 1 person per hour, 24 hours per day. The Oral Cancer Foundation warns that oral cancer is typically hard to diagnose because in early stages, it may not be noticed by the patient. The next time you visit your dentist, ask about oral cancer screening—most people receive one during their regular dental checkup but do not realize it. AGD spokesperson, Eugene Antenucci, DMD, FAGD, says, “Dentists have a unique ability to diagnose disease at an early stage. All dentists are trained to do comprehensive oral screening examinations—each individual practitioner decides on how to implement their training in their practices.”

Numerous studies have shown a connection to oral and overall health. That is why it is important to disclose all health related problems to a dentist—including STDs. “Web site educational information also proves helpful in informing and educating patients regarding diseases such as HPV, its mode of transmission, means of prevention, and the need for regular examinations utilizing technologies such as VELscope for early detection,” says Dr. Antenucci.

Saturday, February 14, 2009

Periodontitis & heart attack share genetics

Periodontitis and myocardial infarction: A shared genetic predisposition

A mutual epidemiological relationship between aggressive periodontitis and myocardial infarction has already been shown in the past. Scientists at the universities of Kiel, Dresden, Amsterdam and Bonn have now presented the first evidence of a shared genetic variant on chromosome 9, which maps to a genetic region that codes for the "antisense RNA" Anril, as reported in the latest edition of the specialist journal PLoS Genetics.

The first author, Dr Arne Schaefer from the Institute for Clinical Molecular Biology at Kiel University, sees clear similarities in the genetic predisposition: "We have examined the aggressive form of periodontitis, the most extreme form of periodontitis which is characterized by a very early age of onset. The genetic variation associated with this clinical picture is identical to that of patients who suffer from cardiovascular disease and have already had a myocardial infarction."

Because it has to be assumed that there is a causal connection between periodontitis and myocardial infarction, periodontitis should be taken seriously by dentists and diagnosed and treated at an early stage. "Aggressive periodontitis has shown itself to be associated not only with the same risk factors such as smoking, but it shares, at least in parts, the same genetic predisposition with an illness that is the leading cause of death worldwide.," warned Schaefer. Knowledge of the risk of heart attacks could also induce patients with periodontitis to keep the risk factors in check and take preventive measures.

Tuesday, February 10, 2009

Barriers to Dental Care for 12 Million Children

As the nation begins to focus its attention on the prospects of major health care reforms, one important aspect of health must not be overlooked – access to affordable dental care for children. If left untreated, tooth decay in childhood can lead to lifelong tooth and gum problems, hospitalizations and emergency room visits, delayed physical development and loss of school days.

A new report released today reveals that nearly 12 million children in the United States experience serious barriers to getting much needed dental care due to lack of insurance coverage, cost of care and difficulty finding providers who accept their insurance.

“In this poll, we wanted to understand the patterns of dental care for children,” says Matthew Davis, M.D., M.A.P.P., director of the C.S. Mott Children’s Hospital National Poll on Children’s Health. “We asked parents how they access dental health services: whether they had problems accessing services, how often they took their children to the dentist, and whether they experienced barriers to receiving that care.”

The poll found that 57 percent of parents say their children began going to the dentist by age 3, and that 82 percent receive regular dental care, defined by going to the dentist at least once per year.

“When we looked at factors associated with not getting regular dental care,” Davis says, “one factor that leapt out at us was being uninsured for dental care. We found that while overall, 18 percent of all kids did not get regular dental care, for children without coverage, over 40 percent did not get regular dental care.”

The report also shows that cost was a major concern for parents seeking dental health care for their children. For uninsured children, when out-of-pocket costs were more than $25, only 78 percent received regular dental care as compared to 92 percent of children receiving care when visits cost $25 or less.

In addition, for 14 percent of parents whose children have public health insurance, parents reported difficulty finding a dentist who accepts their insurance, compared to only 8 percent for privately insured children.

The National Poll on Children’s Health also finds:

• 16 percent of children have no dental insurance coverage.
• Only 58 percent of children with no dental insurance receive dental care.
• Children with no dental health coverage are 3 to 4 times more likely to have no regular dental care when compared with children on private or public dental health insurance.
• 12 percent of parents have not obtained the dental care they thought their children needed. Of those children, 9 percent have private insurance, 13 percent have public insurance, and 22 percent are children without insurance.
• Nearly one quarter of parents report “costs too much” as a big problem in getting dental care for their children.
• 13 percent of parents report their “child doesn’t like going to the dentist” is a big problem in getting dental care for their children.

“The good news is that over 80 percent of children are getting regular dental care and that only 16 percent of children have no dental coverage. These numbers are better than expected based on other national numbers from past years. The bad news in terms of children’s oral health is that we still have big gaps when it comes to kids without dental insurance getting the care they need,” Davis says.

Methodology:
For its report, the C.S. Mott Children’s Hospital National Poll on Children’s Health used data from a national online survey conducted in August 2008 in collaboration with Knowledge Networks, Inc. The survey was administered to a random sample of 2,245 adults, ages 18 and older, who are a part of Knowledge Network’s online KnowledgePanel®. For this analysis, a subset of parents with children age 3-17 years was used (n=1,608). The sample was subsequently weighted to reflect U.S. population figures from the U.S. Census Bureau. The margin of sampling error is plus or minus 2 to 7 percentage points, depending on the question.

To learn more about Knowledge Networks, visit www.knowledgenetworks.com.

Men, Women Differ in Oral Health Care Habits

Survey Finds Smile Is “Most Attractive” Physical Feature

Valentine’s Day is around the corner, and what do people find most attractive in others? The smile. A national survey from the American Dental Association and Crest® and Oral B® finds that the smile outranked eyes, hair and the body as the most attractive physical feature.

Yet men and women differ when it comes to taking care of their teeth and gums. The nationally representative survey of 1,000 Americans ages 18 and older found 86 percent of women brush their teeth twice or more a day, yet only 66 percent of men do so.

The survey also found that women say they change their toothbrush or power toothbrush head every 3-4 months on average, yet men hang on to theirs an average of 5 months. The ADA recommends replacing toothbrushes every 3-4 months or when the bristles become frayed since frayed and worn bristles decrease cleaning effectiveness.

Sadly, all Americans need to do a better job of flossing their teeth. Only half of those surveyed (49 percent) say they floss their teeth once a day or more often. And 1 out of 3 people surveyed think a little blood in the sink after brushing their teeth is normal, yet it’s not—it could signal gum disease or another health problem.

Oral health is an important part of overall health. Regular dental check-ups are important not only to diagnose and treat gum disease and tooth decay, but also because some diseases or medical conditions, such as oral cancer, have symptoms that can appear in the mouth.

Growing research indicates there may be an association between oral health and serious health conditions such as cardiovascular disease and diabetes, underscoring the importance of good oral hygiene habits.

“We need to constantly get the word out how important it is to stay on top of your oral health,” says Dr. Ada Cooper, an ADA consumer advisor and practicing dentist in New York City. “Brushing twice a day with fluoride toothpaste, flossing daily, eating a balanced diet, and visiting your dentist regularly can help keep your smile healthy.”

For more information on the survey findings and other oral health information, visit the American Dental Association’s Web site at: www.ada.org

Saturday, February 7, 2009

Maintaining Healthy Teeth and Gums

Maintaining Healthy Teeth and Gums Is a Wise Investment

Reducing stress can positively affect your oral health, and potentially your bottom line.

Faced with plummeting investments and an unsteady job market, many Americans are feeling the effects of the recent economic crisis. In fact, a recent study by the American Psychological Association found that over 80 percent of Americans rank money and the economy as significant causes of stress. And while chronic stress can lead to a host of health problems, including a weakened immune system and increased blood pressure, it can also take its toll on periodontal health. If left untreated, periodontal disease may result in even more serious, and potentially expensive, overall health complications.

Stress and Your Smile
According to David Cochran, DDS, PhD, President of the American Academy of Periodontology and Chair of the Department of Periodontics at the University of Texas Health Science Center at San Antonio, stress can make an individual more susceptible to harmful habits that negatively impact oral health. “Stress may lead an individual to abuse tobacco or alcohol, and to possibly even neglect his or her oral hygiene. These lifestyle choices are known risk factors for the development of periodontal disease, which has been connected to several other chronic diseases, including heart disease and diabetes.”
A study published in the February 2009 Journal of Periodontology (JOP) confirmed that stress may interfere with oral hygiene. In the study, 56 percent of participants self-reported that stress led them to neglect regular brushing and flossing. In addition, the hormone cortisol may also play a role in the connection between stress and gum disease. Chronic stress is associated with higher and more prolonged levels of cortisol; previous research has found that increased amounts of cortisol in the bloodstream can lead to a more destructive form of periodontal disease.

“During periods of high stress such as what we are currently experiencing in this economic climate, individuals should seek healthy sources of relief such as regular exercise, eating a balanced diet, and getting adequate sleep,” says Dr. Cochran. “Doing so can help maintain a healthy mouth, and potentially help ward off other negative health concerns.”

Preserve Your Gum Line, Improve Your Bottom Line

Reducing stress in an effort to avoid gum disease may not only help sustain overall health, but it might also help your pocketbook as well. A study published in the November 2007 Journal of Periodontology found that preventing periodontal disease may be one way to help lower your total health care expenses. In the study, patients with severe periodontal disease had 21 percent higher health care costs as compared to those with no periodontal disease. Severe periodontal disease (periodontitis) involves bone loss and diminished tissue attachment around the teeth. And since past research has shown that periodontal disease may lead to other serious health conditions, striving to maintain oral health may help diminish the need to incur additional health care expenses, and ultimately help reduce overall health care spending.

“In these stressful times I encourage my patients to pay even more attention to their teeth and gums,” says Dr. Cochran. “And in turn, since preventing gum disease may help reduce overall health care expenses, maintaining a healthy mouth may actually be a stress reliever in itself.”

Wednesday, February 4, 2009

Periodontal treatment during pregnancy

The American Academy of Periodontology issues statement on periodontal treatment during pregnancy

Research recently presented at the annual meeting of the Society for Maternal-Fetal Medicine found that routine periodontal treatment in pregnant women did not reduce the risk of preterm deliveries. Some previous studies in this area have suggested that periodontal therapy during pregnancy can lessen the chance of adverse pregnancy outcomes.

While the American Academy of Periodontology (AAP) has not yet received the opportunity to review the complete study findings, it continues to urge women to care for their periodontal health while pregnant, through regular tooth brushing and flossing, and routine visits to a dental professional, such as a periodontist, to screen for periodontal disease.

These study results demonstrate the need for additional research to clarify the potential impact that periodontal disease has on the risk of preterm births; and if needed, what periodontal treatment modalities are most effective in helping to prevent premature deliveries.

As the organization representing over 8,000 dentists specially trained in the diagnosis, treatment and prevention of periodontal disease, the AAP is eager to analyze the complete study results, and provide women with accurate and effective recommendations on the management of periodontal disease during pregnancy.