Monday, April 26, 2010

Are periodontal disease and prostatitis linked?

Researchers from Case Western Reserve University School of Dental Medicine and University Hospitals Case Medical Center report initial results from a small sample that inflammation from gum disease and prostate problems just might be linked. They discuss their new evidence in the Journal of Periodontology, the official journal of the American Academy of Periodontology.

The researchers compared two markers: the prostate-specific antigen (PSA) used to measure inflammation levels in prostate disease, and clinical attachment level (CAL) of the gums and teeth, which can be an indicator for periodontitis.

A PSA elevation of 4.0 ng/ml in the blood can be a sign of inflammation or malignancy. Patients with healthy prostate glands have lower than 4.0ng/ml levels. A CAL number greater than 2.7 mm indicates periodontitis.

Like prostatitis, periodontitis also produces high inflammation levels.

"Subjects with both high CAL levels and moderate to severe prostatitis have higher levels of PSA or inflammation," stated Nabil Bissada, chair of the department of periodontics in the dental school.

Bissada added that this might explain why PSA levels can be high in prostatitis, but sometimes cannot be explained by what is happening in the prostate glands.

"It is something outside the prostate gland that is causing an inflammatory reaction," he said.

Because periodontitis has been linked to heart disease, diabetes and rheumatoid arthritis, the researchers felt a link might exist to prostate disease.

Thirty-five men from a sample of 150 patients qualified for the study, funded by the department of periodontology at the dental school. The participants were selected from patients at the University Hospitals Case Medical Center with mild to severe prostatitis, who had undergone needle biopsies and were found to have inflammation and in some patients, malignancies.

The participants were divided into two groups: those with high PSA levels for moderate or severe prostatitis or a malignancy and those with PSA levels below 4 ng/ml. All had not had dental work done for at least three months and were given an examination to measure the gum health.

Looking at the results, the researchers from the dental school and the department of urology and the Institute of Pathology at the hospital found those with the most severe form of the prostatitis also showed signs for periodontitis.

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Other authors on the paper, "Association between Periodontal Disease and Prostate-Specific Antigen Levels in Chronic Prostatitis Patients," were: Nishant Joshi, Sena Narendran, Rick Jurevic and Robert Skillicorn from the CWRU dental school; and Donald Bodner and Gregory T. MacLennon from the University Hospitals Case Medical Center.

Friday, April 16, 2010

Researchers find susceptibility for caries, gum disease in genes

Certain genetic variations may be linked to higher rates of tooth decay and aggressive periodontitis, according to two recently published papers by researchers at the University of Pittsburgh School of Dental Medicine and their collaborators.

Alexandre R. Vieira, D.D. S., Ph.D., senior author of both papers and an assistant professor of oral biology, and his colleagues at the School of Dental Medicine found that the rate of dental caries was influenced by individual variations, or polymorphisms, in a gene called beta defensin 1(DEFB1), which plays a key role in the first-line immune response against invading germs. The findings are available online in the Journal of Dental Research.

"We were able to use data gathered from our Dental Registry and DNA Repository, the only one of its kind in the world, to see if certain polymorphisms were associated with the development of caries," Dr. Vieira said. "This could help us find new ways to treat people who are particularly susceptible to tooth decay, a problem that afflicts millions of Americans."

For the study, the researchers analyzed nearly 300 anonymous dental records and accompanying saliva samples from the registry, assigning each case a DMFT score based on the presence of decayed teeth, missing teeth due to caries, and tooth fillings, as well as a DMFS score, based on decayed teeth, missing teeth, and filled surface of a tooth. In general, individuals with fewer caries have lower DMFT and DMFS scores.

Saliva samples contained one of three variants, dubbed G-20A, G-52A and C-44G, of the DEFB1 gene. Individuals who carried a G-20A copy had DMFT and DMFS scores that were five-times higher than for people who had other variants. The G-52A polymorphism was associated with lower DMFT scores.

"It's possible that these variations lead to differences in beta defensin's ability to inhibit bacterial colonization," Dr. Vieira said. "In the future, we might be able to test for these polymorphisms as clinical markers for caries risk."

In a second paper, published last week in PLoS One, Dr. Vieira, colleagues at Pitt and collaborators in Brazil studied saliva samples of 389 people in 55 families to look for genetic links to aggressive periodontitis, which is rapid and severe destruction of the gums and bone that starts at a young age and is thought to be more common in Africans and those of African descent. Brazil's population is composed primarily of Caucasians of Portuguese ancestry, Africans and native Indians.

They found hints of an association between the disease and the FAM5C gene. While further testing did not find any mutations or polymorphisms that bore out a relationship, other experiments showed elevated levels of FAM5C expression, or activation, in areas of diseased periodontal tissue compared to healthy tissue.

"The FAM5C gene recently was implicated in cardiovascular disease, in which inflammation plays a role, just as in periodontitis," Dr. Vieira said. "More research is needed to see if variation in the gene is associated with different activity profiles."

Tuesday, April 13, 2010

Drinking Tap Water May Help You Avoid Dentist’s Drill

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Highly Preventable Oral Disease Affects Millions

Tooth decay affects children in the United States more than any other chronic infectious disease, according to the Centers for Disease Control and Prevention (CDC). The CDC states that tooth decay, if left untreated, can cause pain and infections that hinder eating, speaking, playing and learning. The controlled addition of a fluoride compound to public water supplies is considered to be the most cost-effective way to prevent cavities and fight tooth decay, according to a study published in the January/February 2010 issue of General Dentistry, the Academy of General Dentistry’s (AGD) peer-reviewed clinical journal.

“Fluoride makes the entire tooth structure more resistant to decay and promotes remineralization, which aids in repairing early decay before damage is even visible,” said C.H. Chu, BDS, PhD, MAGD, ABGD, lead author of the study. “Studies have confirmed the most effective source of fluoride to be water fluoridation.”

More than 144 million United States residents in more than 10,000 communities drink fluoridated tap water, providing an automatic defense against the harmful ingredients that cause such a preventable oral health disease.

“Instead of drilling holes to fix cavities, dentists would rather educate the public on how to avoid developing tooth decay in the first place,” said Cynthia Sherwood, DDS, FAGD, spokesperson for the AGD. “Drinking tap water to receive fluoride is safe, and it’s easier on your wallet than going to the dentist for a filling.”

The second-most effective source of fluoride is varnish. Varnish, applied quickly and easily by a dentist, is one of the most concentrated products available commercially. Varnishes that contain sodium fluoride adhere to tooth surfaces when saliva is present, providing an excellent fluoride treatment.

Keeping fluoride in the mouth enhances its ability to arrest demineralization and promote remineralization, and varnishes are better for this purpose than fluoridated drinking water or toothpaste. Fluoride varnishes are typically used for patients who don’t receive enough fluoride from other sources.

“The bland flavor and simplicity of the varnish method also makes it well-tolerated by young children and special needs patients,” Dr. Chu said.

Dr. Chu looked at the effectiveness of fluoride in specialty milk and salt products, toothpaste, mouthrinse and gum, but found that only the water fluoridation and varnish methods had the ability to reduce cavities by more than 30 percent.

Patients who suspect that they have a cavity should visit a general dentist right away.

To learn more about fluoride and tooth decay, visit www.KnowYourTeeth.com.

Give Dirty Mouths a Brush

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Toothpaste with Triclosan/Copolymer Kills Harmful Germs

The human mouth is home to an estimated 800 to 1,000 different kinds of bacteria. The warm and moist environment, along with hard tooth surfaces and soft tissues, prove to be optimal factors in boosting germ growth. Many of these bacteria are harmful and can form a film on teeth called “dental plaque,” which causes cavities, gingivitis and eventually more severe kinds of gum disease.

Toothpaste that contains triclosan/copolymer is better than regular fluoride toothpastes at killing the kinds of bacteria that live in people’s mouths, according to a study published in the January/February 2010 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD).

“Manufacturers add specific agents to toothpastes to provide added benefits to consumers,” said Joseph J. Zambon, DDS, PhD, one of the study’s authors and a distinguished teaching professor at the University at Buffalo School of Dental Medicine. “The best known agent is fluoride, which was added to toothpaste to prevent cavities. Triclosan added to toothpaste has been shown in a number of clinical studies to inhibit plaque and gingivitis. The copolymer helps to keep triclosan in your mouth for a longer period of time, which boosts its ability to inhibit oral bacteria.”

The triclosan/copolymer toothpaste and two fluoride toothpastes were tested on several different kinds of lab-grown bacteria that mimic germs found in the mouth. The tests were also done on bacteria taken from the mouths of human volunteers.

“Repetitive testing shows that toothpaste with triclosan/copolymer outperformed the fluoride-only toothpastes when it came to inhibiting the growth of bacteria,” Dr. Zambon said.

Along with brushing teeth twice a day, the AGD recommends the daily use of floss and a mouth rinse to reduce dental plaque and kill germs in the mouth.

“The importance of killing germs is that if you can keep your mouth relatively clean, you can minimize the likelihood of cavities and gum disease, as well as the unpleasantness of bad breath,” said Paul Bussman, DMD, FAGD, spokesperson for the AGD.

To learn more about good oral hygiene and health, visit www.KnowYourTeeth.com.

Thursday, April 8, 2010

American Dental Association unveils new Web site

After a year and a half of extensive research, planning and design, the American Dental Association today announced the unveiling of its new, enhanced Web site, ADA.org,encompassing the latest elements of Web-development technology.

“The new ADA.org represents the collective input from our members and the public and provides enhanced navigation tools for easier access to the wealth of oral health information we have online ,” said Dr. Ronald L. Tankersley, ADA president. “This information includes tools needed for practice management and continuing education as well as news about the latest developments in oral health care.”
Source for professional information; enhanced Find-a-Dentist feature
ADA.org is the dentist’s source for professional oral health information. For example, under the tabs:

· “Professional Resources,” members will find an updated Member Center with a dental practice hub that includes tips and tools to thrive in challenging economic times. An enhanced Find-a-Dentist feature, with updated profile information and photos, will also enable colleagues and patients greater opportunities to connect with them.
· “Education and Careers” includes information about licensure and education and online CE opportunities.
· “Science and Research” features evidence-based dentistry resources and dental standards.
· “Advocacy” addresses the ADA’s advocacy efforts on behalf of the dental profession on Capitol Hill and in state capitols across the country.

Many ADA members refer patients to ADA.org for oral health information. Housed under “Public Resources”, the redeveloped site will continue to offer news and extensive information on hundreds of dental topics, ranging from basic dental care to baby’s first tooth to gum disease to tooth whitening. These topics also include an extensive video collection of various oral health subjects. The public also will find the site easier to navigate, making it more effective and easier for consumers to obtain needed oral health information.

“Refinements to ADA.org will continue as we build on our efforts to make our general and proprietary oral health information easily attainable for ADA members,” added Dr. Tankersley. “This will assist members in offering the highest level of patient care and maintaining thriving practices.”

Tuesday, April 6, 2010

Mouth Breathing Can Cause Major Health Problems


Dentists May Be First to Diagnose Patients Who Mouth Breathe




For some, the phrase “spring is in the air” is quite literal. When the winter snow melts and flowers bloom, pollen and other materials can wreak havoc on those suffering from seasonal allergies, usually causing a habit called “mouth breathing.” The physical, medical and social problems associated with mouth breathing are not recognized by most health care professionals, according to a study published in the January/February 2010 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD). Dentists typically request that their patients return every six months, which means that some people see their dentist more frequently than they see their physician. As a result, dentists may be the first to identify the symptoms of mouth breathing. And, because dentists understand the problems associated with mouth breathing, they can help prevent the adverse effects.

“Allergies can cause upper airway obstruction, or mouth breathing, in patients,” said Yosh Jefferson, DMD, author of the study. “Almost every family has someone with mouth breathing problems.”

Over time, children whose mouth breathing goes untreated may suffer from abnormal facial and dental development, such as long, narrow faces and mouths, gummy smiles, gingivitis and crooked teeth. The poor sleeping habits that result from mouth breathing can adversely affect growth and academic performance. As Dr. Jefferson notes in his article, “Many of these children are misdiagnosed with attention deficit disorder (ADD) and hyperactivity.” In addition, mouth breathing can cause poor oxygen concentration in the bloodstream, which can cause high blood pressure, heart problems, sleep apnea and other medical issues.

“Children who mouth breathe typically do not sleep well, causing them to be tired during the day and possibly unable to concentrate on academics,” Dr. Jefferson said. “If the child becomes frustrated in school, he or she may exhibit behavioral problems.”

Treatment for mouth breathing is available and can be beneficial for children if the condition is caught early. A dentist can check for mouth breathing symptoms and swollen tonsils. If tonsils and/or adenoids are swollen, they can be surgically removed by an ear-nose-throat (ENT) specialist. If the face and mouth are narrow, dentists can use expansion appliances to help widen the sinuses and open nasal airway passages.

“After surgery and/or orthodontic intervention, many patients show improvement in behavior, energy level, academic performance, peer acceptance and growth,” says Leslie Grant, DDS, spokesperson for the AGD. “Seeking treatment for mouth breathing can significantly improve quality of life.”

At this time, many health care professionals are not aware of the health problems associated with mouth breathing. If you or your child suffers from this condition, speak with a health care professional who is knowledgeable about mouth breathing.

To learn more about oral health, visit www.KnowYourTeeth.com.