Wednesday, November 25, 2009

Dentists Can Help Prevent Heart Attacks

Dentists can help to identify patients who are in danger of dying of a heart attack or stroke, reveals a new study from the Sahlgrenska Academy. Thanks to the study, six men who thought they were completely healthy were able to start preventive treatment in time.

"Dentists are really proud of their profession and feel no need to encroach upon doctors' territory," says senior dental officer and professor Mats Jontell at the Sahlgrenska Academy. "However, we wanted to find out if we as a profession could identify patients at risk of cardiovascular disease."

The study involved 200 men and women over the age of 45 who did not have any known cardiovascular problems. During a routine visit to their normal dentists in Borås and Gothenburg they were also checked out for known risk factors for cardiovascular disease.

"These risk factors are not normally manifested in the mouth, which is why the dentists went beyond their normal check-up routine," says Jontell. "They also took the patients' blood pressure and checked total cholesterol and blood sugar levels."

The risk of a fatal cardiovascular disease was calculated using a software known as HeartScore. The dentists felt that twelve men had a ten per cent risk of developing a fatal cardiovascular disease over the next ten years and advised them to see their doctors. Six of the twelve were subsequently prescribed medication to lower their blood pressure.

"Dentists regularly see a very large percentage of the Swedish population, and if there is sufficient interest they could also screen for cardiovascular risk factors which, untreated, could lead to a heart attack or stroke," says Jontell.

Tuesday, November 24, 2009

Oral health legislation

by Sterling K. Speirn, president and CEO of the W.K. Kellogg Foundation:

The W.K. Kellogg Foundation commends Congress for its recognition of the urgent need to comprehensively and substantially strengthen oral health care for our most vulnerable children.

Most recently, the Senate version of health reform represents a high water mark for oral health legislation, with more than two dozen important provisions aimed at improving oral health care, which include:

Expanding insurance coverage for pediatric oral health services and eligibility for preventive oral health services without co-payments.

Launching new dental disease prevention initiatives including public education, school- based sealant programs in all 50 states, and research grants for dental caries management.

Addressing critical dental care workforce issues and the cultural competence and diversity of the provider teams through expanded training programs and education resources for general, pediatric and public health dentists and for the exploration of new solutions for dental professionals to reach rural and underserved areas.

Access issues are particularly severe in many rural and urban communities, and particularly impact children and families of color. The rate of untreated decay in American Indian and Alaska Native children is more than 3 times higher than that of all children in the United States. It is known that those who lack affordable health insurance are at increased risk for unmet dental needs, and together with children from poor and/or minority families, these two categories amount to 52 percent of children in this country.

Untreated dental disease many times leads to serious, life-threatening medical situations. For too long, oral health has long been separated from the rest of the body in most health policy conversations, even though oral health is essential to overall health.

We are pleased that Congress is bringing oral health into the conversation to improve our nation's overall health. These issues have historically received broad bi-partisan support, and we look forward to continued progress.

The W.K. Kellogg Foundation supports children, families, and communities as they strengthen and create conditions that propel vulnerable children to achieve success as individuals and as contributors to the larger community and society. Improving oral health for children and families is an important component of our work to improve overall health, eliminate racial disparities in health, and provide needed health care to those who are underserved.

Monday, November 23, 2009

Long-Term Cavity Protection

Tooth-Binding Micelles Containing Antimicrobials May Provide Long-Term Cavity Protection

A new study suggests that tooth-binding micelles (or particles) may provide long-term cavity protection by adhering to tooth surfaces and gradually releasing encapsulated antimicrobials. Formulation of a mouthwash-based delivery system is anticipated, ultimately simplifying application and increasing at-home patient compliance. The researchers from the University of Nebraska Medical Center, Omaha and the University of Florida, Gainesville report their findings in the November 2009 issue of the journal Antimicrobial Agents and Chemotherapy.

One of the main contributing factors to dental cavities is overpopulation of acid-producing bacteria in the oral cavity that causes localized destruction of compromised dental hard tissue. Due to the episodic nature of cavities, long-term benefits of periodic treatments administered during routine office visits are minimal. Other delivery systems developed to maintain drug concentrations, including bioadhesive tablets, patches, films, and gels, aren't very effective on the tooth surface and often cause irritation resulting in poor patient compliance. Emphasis on the need for therapeutic strategies that target the bacterial aspect of the disease and a delivery platform that would maintain the drug concentration on the tooth surface is warranted.

In the study tooth-binding micelles (molecular particles) were developed and encapsulated with farnesol, an antimicrobial recently found to be effective against the cavity causing bacterium Streptococcus mutans UA159. When tested on a model tooth surface the micelles were able to swiftly bind and gradually release the encapsulated farnesol. Additionally, biofilm inhibition studies of the farnesol-containing tooth-binding micelles demonstrated that they were able to inhibit S. mutans UA159 at much higher levels than untreated blank control micelles.

"A tooth-binding micelle delivery platform for the prevention and treatment of dental carries has been designed and prepared in this study," say the researchers. "It is anticipated that the tooth-binding micelles have the potential to be formulated into mouth rinses that may have the merits of simple application, cultural acceptance, and improved patient compliance."

Saturday, November 14, 2009

Mouth Is Indicator of Overall Health,

— One day in medical clinics, the big picture of a patient's state of health may be found in little pictures from the mouth, says Li Mao, MD, a new professor at the University of Maryland Dental School.

The mouth or oral cavity area is an excellent indicator of the whole body's health, says Mao, who is the chair of the new Department of Oncology and Diagnostic Sciences at the School.

Mao recently joined the Dental School to be at the forefront of a movement to retool dental education, he says, to make dentists practice more within the bigger health care community.

Future lung cancer prevention trials, for example, could soon be designed so that surface tissues inside the cheek could be checked to detect tobacco-induced damage in the lungs, according to a study led by Mao last year published in the journal Cancer Prevention Research.

"We hypothesized that tobacco-induced molecular alterations in the oral epithelium are similar to those in the lungs," says Mao. "This might have broader implications for using the mouth as a diagnostic indicator for general health."

University of Maryland Dental School Dean Christian S. Stohler, DMD, DrMedDent, a leader in the movement to retool dental education, says, "I feel that dentists should play a major role in prevention of cancer and Dr. Mao is the leading oral cancer researcher in the country. He crosses the bridge between medicine and dentistry. Being a physician helps expand dental health care and he wants to change how patients are being treated because his background is in head and neck cancer."

Mao believes that system biology-based approaches -- the pinpointing of molecular changes in living tissue -- is becoming an important technology in cancer studies and biomarker discovery. He says that 50 percent of oral cancer patients get diagnosed too late.

Monday, November 9, 2009

Mercury in Older Fillings Unlikely to be Toxic

Amid the on-going controversy over the safety of mercury-containing dental fillings, a University of Saskatchewan research team has shed new light on how the chemical forms of mercury at the surface of fillings change over time.

Their work, just published in the American Chemical Society journal Chemical Research in Toxicology, shows that the surface forms of mercury in older “silver” fillings (also known as amalgams) may be less toxic than previously thought.

“The dental amalgam on the surface of an old tooth filling may have lost as much as 95 per cent of its mercury but what’s left is in a form that is unlikely to be toxic in the body,” said U of S Canada Research Chair Graham George who led the study.

But the team cautions that due to the significant mercury loss over time, human exposure to mercury lost from fillings is “still of concern” and that further research is needed to determine when, how and in what form mercury is lost from fillings.

Mercury-based fillings have been used by dentists to repair teeth for well over a century. But in recent decades, their use has become controversial due to concerns about exposure to potentially toxic mercury.

“Mercury can potentially exist in several different chemical forms, each with a different toxicity,” said George. “Prior to our work, little was known about how the chemical forms of mercury in dental amalgam might change over time.”

The team used a special X-ray technique at the Stanford Sychrotron Radiation Lightsource to probe the amount and chemical nature of mercury at the surface of both freshly prepared metal fillings and aged fillings (about 20 years old) obtained from the U of S dental clinic’s tooth bank.

While the fresh fillings contained metallic mercury, which can be toxic, aged fillings contained a form of mercury called beta-mercuric sulfide or metacinnabar which is unlikely to be toxic in the body. For this reason, grinding or polishing during dental cleaning is unlikely to cause any toxic effects.

But of potential greater concern is the nature of the surface mercury lost from fillings. This may be due to evaporation (with subsequent inhalation and leaching of mercury into saliva), exposure to some kinds of dental hygiene products such as those containing peroxides, exposure to certain sulphur-containing foods (such as onion and garlic or coffee), or other factors.

“Possibly this missing mercury is in the less toxic form of mercury (metacinnabar) abraded from the surface of the filling. Or alternatively, it may be mercury lost prior to formation of the metacinnabar through various types of exposures,” said George.

In North America, the traditional view is that the advantages of mercury-containing amalgam outweigh any possible health risks, and for this reason, mercury-containing dental amalgams are still widely used.

Look ma, no mercury in fillings!

Tooth enamel is hardest material in the human body because it's made almost entirely of minerals. As tough as it may be, however, enamel can be broken down by bacteria, forming cavities and eventually destroying the tooth. That's why dentists repair cavities by filling them with a material to replace the lost enamel. The most common such restorative is a material invented in the 19th-century known as amalgam -- the classic silver-black fillings many people have.

Amalgam works well because it is very durable, easy to use, and cheap. The dark fillings are sometimes unsightly, however, and they contain mercury. Because of the mercury, amalgam has raised health and environmental questions -- though according to the American Dental Association, the scientific consensus is that the material poses no health hazards. Dentists would love to have a perfectly white material that mimics natural enamel for repairing cavities in teeth, but for the most part, they still use amalgam. Other filling materials have been developed in recent years, but they often have problems with shrinkage or durability.

Kent Coulter and his colleagues at Southwest Research Institute in San Antonio have developed a new proof-of-concept dental restorative material under a program funded by the National Institutes of Health that seeks to replace amalgam with other materials. They will describe the material on November 9 at a meeting of the scientific society AVS in San Jose. The new fillings are made with a plastic-like material containing zirconia nanoplatelets -- tiny crystals made of the same sort of material used to make fake diamonds and gem stones. Unlike their costume jewelry cousins, the zirconia nanoplatelets super hard because of a difference in the particular arrangements of the atoms in the material.

Coulter and his colleagues designed a way to make a roll of this material under vacuum. They envision that this material would be lifted from the roll and packed in a dental cavity and then cured -- using an ultraviolet lamp or some other means -- so that it hardens in place without shrinking. In San Jose, they will describe how they have been developing and testing the performance of these materials in the laboratory. Its use is still several years away from the dentist's chair, however, and the next steps will be first to see if the new material performs as hoped for people with cavities.

Abstract: http://www.avssymposium.org/Open/SearchPapers.aspx?PaperNumber=NS+BI-MoM-1

Thursday, November 5, 2009

Dentists Can Identify Risk for Heart Attack

A new study indicates dentists can play a potentially life-saving role in health care by identifying patients at risk of fatal heart attacks and referring them to physicians for further evaluation.

Published in the November issue of the Journal of the American Dental Association, followed 200 patients (101 women and 99 men) in private dental practices in Sweden whose dentists used a computerized system, “HeartScore,” to calculate the risk of a patient dying from a cardiovascular event within a 10-year period.

Designed by the European Society of Cardiology, HeartScore measures cardiovascular disease risk in persons aged 40-65 by factoring the person’s age, sex, total cholesterol level, systolic blood pressure and smoking status.

Patients with HeartScores of 10 percent or higher, meaning they had a 10 percent or higher risk of having a fatal heart attack or stroke within a 10-year period, were told by dentists to seek medical advice regarding their condition.

Twelve patients in the study, all of them men, had HeartScores of 10 percent or higher. All women participating in the study had HeartScores of 5 percent or less.
Of the 12 male patients with HeartScores of 10 percent or higher, nine sought further evaluation by a medical care provider who decided that intervention was indicated for six of the patients. Two patients did not follow the dentist’s recommendation to seek further medical evaluation and one patient was only encouraged by his dentist to discontinue smoking. Physicians for three patients were not able to confirm their risk for cardiovascular disease,

All 200 patients enrolled in the study were 45 years of age or older with no history of cardiovascular disease, medications for high blood pressure, high cholesterol or diabetes and had not visited a physician during the previous year to assess their glucose, cholesterol or blood pressure levels.

The study’s authors conclude that oral health care professionals can identify patients who are unaware of their risk of developing serious complications as a result of cardiovascular disease and who are in need of medical interventions.
According to the authors, “With emerging data suggesting an association between oral and non-oral diseases, and with the possibility of performing chairside screening tests for diseases such as cardiovascular disease and diabetes, oral health care professionals may find themselves in an opportune position to enhance the overall health and well-being of their patients.”

Wednesday, November 4, 2009

Hybrid composite for root canal treatment

Unrelenting toothache means a visit to the dentist is inevitable, and if the tooth decay is really bad root canal treatment is often the only option. The dentist first removes the nerve completely and then closes the ensuing canal with a filler. This must be airtight to prevent bacteria from entering and causing renewed inflammation. On the other hand, the material must also be removable. If the natural crown is severely damaged, the dentist will anchor a root post in the previously filled canal using dental cement. The post provides an anchor for the composite material used to rebuild the remaining part of the tooth, the core, which serves as the base for the core build-up material and the prosthetik treatment e.g. a crown. In root canal procedures, therefore, various materials are combined, each fulfilling different requirements. The problem is that the materials are not always compatible with each other or do not bond properly with the hard dental tissue. As a result, the post may break, the core and the crown may not adhere to the post properly, and the expensive crown may need replacing. Such faults are not rare and generally occur in the single-digit percent range.

Researchers at the Fraunhofer Institute for Silicate Research ISC in Würzburg working in collaboration with their research partners at VOCO GmbH have now developed a material that can be used for all the components used in root canal treatment. "The basis of this material is provided by ORMOCER®s," explains Dr. Herbert Wolter, group manager at the ISC. "We have combined these ORMOCER®s with various nano- and microparticles to achieve the highly diverse properties needed." Materials used in filling the root canal, for instance, should not shrink as they harden, should form an airtight bond with the dental material and be visible in x-rays. The material used to rebuild the tooth, on the other hand, should have the same properties as the tooth itself. "Hybrid materials are well suited to these requirements. For instance, they only shrink by about 1.3 percent as they harden, while standard materials generally shrink by 2 to 4 percent. ORMOCER®s can also be adapted to adhere to the different parts of the tooth," says Wolter. VOCO GmbH is already producing dental preparations and product development is making good progress. Market launch could therefore be just a few years away.

Videos Online For Patient Education

Family & Cosmetic Dentistry of Fairfield CT offers videos and images for dental conditions and procedures, enabling the office to make patient education very easy with visual, engaging treatment plans, for greater comprehension and compliance. To help patients better understand procedures, and to put them at ease, Dr. Mariana Conant has launched 3 new websites to help educate her patients looking for answers on the following 3 major procedures; Dental Implants, Tooth Whitening, and Braces.

http://www.dentalimplantsfairfeild.com - explains in detail the process in which a missing tooth is fixed as well as information on dentures and bridges:



http://www.toothwhiteingfairfeild.com - offers ideas on whitening your smile.

http://www.clearbracesfairfield.com - teaches you everything you need to know about braces, both metal and clear brace technologies.

Studies show that most people put off visiting a dental office because they aren't sure what to expect and they are terrified. The videos offer details on exactly what you can expect, in a clear and informative format.

Dr. Mariana Conant's office created the 3 websites to help educate patients. Dr. Conant said "Over the years we have watched expressions of fear, doubt and worry cross our patient's face when we mention certain dental procedures". "With the launch of our website patients can watch in the comfort of their own home with calm and relief as they feel no pressure or anxiety."

Family & Cosmetic Dentistry of Fairfield offers cosmetic procedures such as ZOOM! Whitening and Dr. Mariana Conant also performs cosmetic treatments such as Fillings, Crowns, Bridges, Dentures, Dental Implants & Veneers.

Tuesday, November 3, 2009

Guideline on oral health for people with diabetes

New clinical guidelines released by the International Diabetes Foundation (IDF) emphasize the importance of periodontal health for people with diabetes. Diabetes affects approximately 246 million people worldwide, and this number is only expected to increase. The IDF is an organization of 200 national diabetes associations from 160 countries.

The new IDF oral health clinical guideline supports what research has already suggested: that management of periodontal disease - which affects the gums and other supporting tissues around the teeth - can help reduce the risk of developing diabetes; and can also help people with diabetes control their blood sugar levels. Studies have suggested there is a two-way relationship between diabetes and periodontal disease, and the IDF guideline outlines helpful guidance for health professionals who treat people living with and at risk for diabetes.

The IDF guideline contains clinical recommendations on periodontal care, written in collaboration with the World Dental Federation (FDI), that encourage health professionals to conduct annual inquiries for symptoms of periodontal disease such as swollen or red gums, or bleeding during tooth brushing; and to educate their patients with diabetes about the implications of the condition on oral health, and especially periodontal health.

"Everyone should maintain healthy teeth and gums to avoid periodontal disease, but people with diabetes should pay extra attention," said Samuel Low, DDS, MS, Associate Dean and professor of periodontology at the University of Florida College of Dentistry, and President of the American Academy of Periodontology (AAP). "Periodontal disease triggers the body's inflammatory response which can affect insulin sensitivity and ultimately lead to unhealthy blood sugar levels. Establishing routine periodontal care is one way to help keep diabetes under control."

In recognition of American Diabetes Month, the American Academy of Periodontology commends the International Diabetes Foundation on the release of the Guideline on Oral Health for People with Diabetes, and supports its encouragement of continued collaboration and communication between diabetes and oral healthcare professionals.

In addition to helping increase awareness about the importance of oral care for people with diabetes, Dr. Low believes the guideline presents more opportunities for medicine and dentistry to work together. "I know that these clinical recommendations will be helpful for those professionals who work with and treat people with diabetes. I also encourage the medical and dental communities to work together to provide the best possible care for our patients."