Thursday, October 27, 2011

Healthy mouth bacteria provide ideal conditions for gum disease


Normal bacteria which live in our mouths provide the catalyst for the development of gum disease, a debilitating condition which leads to painful gums and the loosening of teeth, new research from Queen Mary, University of London has found.

The unexpected finding could pave the way for the development of preventative measures in tackling gum, or periodontal disease*, by manipulating the normal bacteria in the same way that probiotic yoghurt works to protect the intestine.

Researchers at Queen Mary's Blizard Institute, including Medical Research Council Clinical Research Training Fellow Mark Payne, worked with scientists in the US; they published their findings in the journal Cell Host and Microbe today (Oct. 27).

The scientists introduced the oral bacterium Porphyromonas gingivalis to mice living in two different test conditions. The mice with normal bacteria in their mouths developed periodontal bone loss but the mice raised under germ-free conditions, in the absence of any normal bacteria, remained disease-free.

Professor Mike Curtis, Director of the Blizard Institute and co-author on the paper, said when the oral bacterium P. gingivalis was introduced under normal conditions "it stimulated the growth of normal bugs leading to a large increase in the number of those organisms already there".

"P. gingivalis was introduced at very low levels yet it had a major affect on both the immune system and the inflammatory system," he said.

"This oral bacterium only appears in small numbers but appears to have a major influence on the overall ecology. It has a keystone effect in a community – working in the same way that starfish, which have relatively small numbers, control the shell fish communities in the sea.

Professor Curtis said although the findings were encouraging in terms of understanding the way gum disease develops, there was still "some way to go" before there was a similar product on the market for gum disease as a probiotic yoghurt is available for the intestine.

"Now we know that periodontal disease only develops through P. gingivalis interacting with the existing bacteria in our mouths, we need to understand the role played by our normal bacteria in both the development of disease and protection from it," he said.

"This may then provide the means to develop preventative measures for the disease."

Professor Farida Fortune, Dean for Dentistry at Queen Mary said the research was encouraging for people who suffer from gum disease which results in bleeding gums and ultimately loose teeth which cause difficulty in both speaking and eating.

"The public still need to be mindful of the way they look after their teeth and gums," she said.

"People need to pay more attention to their oral hygiene. Their local hygienist, dental therapist and dentist can all assist in teaching them effective cleaning techniques. Just these simple preventative measures, as well as not smoking, will go some way to helping them avoid developing gum disease."

Prenatal exposure to dental amalgam


Dental amalgams contain approximately 50
percent metallic mercury and emit mercury vapor during the life of
the restoration. Controversy surrounds whether fetal exposure to
mercury vapor resulting from maternal dental amalgam
restorations has neurodevelopmental consequences.


The authors determined maternal amalgam restoration
status during gestation (prenatal exposure to mercury vapor [Hg0])
retrospectively in 587 mother-child pairs enrolled in the Seychelles
Child Development Study, a prospective longitudinal cohort study of
the effects of prenatal and recent postnatal methylmercury (MeHg)
exposure on neurodevelopment. They examined covariate-adjusted
associations between prenatal maternal amalgam restoration status
and the results of six age-appropriate neurodevelopmental tests
administered at age 66 months. The authors fit the models without
and with adjustment for prenatal and recent postnatal MeHg
exposu metrics.


The mean number of maternal amalgam restorations
present during gestation was 5.1 surfaces (range, 1-22) in the 42.4
percent of mothers who had amalgam restorations. The authors
found no significant adverse associations between the number of
amalgam surfaces present during gestation and any of the six
outcomes, with or without adjustment for prenatal and postnatal
MeHg exposure. Results of analyses with the secondary metric,
prenatal amalgam occlusal point scores, showed an adverse
association in boys only on a letter- and word-identification subtest
of a frequently used test of scholastic achievement, whereas girls
scored better on several other tests with increasing exposure.
Conclusions. This study’s results provide no support for the
hypothesis that prenatal Hg0 exposure arising from maternal dental
amalgam restorations results in neurobehavioral consequences in
the child.

Nearly half of Ontario seniors do not see dentists regularly

Poor oral health tied to chronic disease and worse overall health

TORONTO -- Forty-five per cent of Ontarians 65 years and older did not see a dentist in the last year, increasing their risk of chronic diseases and a reduced quality of life , a new study by researchers at St. Michael's Hospital, Women's College Hospital and the Institute for Clinical and Evaluative Sciences (ICES) shows.

"Poor oral health can contribute to many serious medical conditions and affect a person's ability to chew and digest food properly, leading to inadequate nutrition," explains Dr. Arlene Bierman, principal investigator of the study. "With dental services not covered under our universal health-insurance program and many older adults not visiting dentists regularly , the findings suggest we need to rethink the services we provide to help keep seniors healthy as they age."

According to the researchers, women make up the majority of the older population. They are more likely to have two or more chronic conditions than men, report more disability and chronic pain, and are less likely to be physically active.

"A focus on prevention and health promotion can help older women remain active and independent as they age as too many are physically inactive and do not eat enough fruits and vegetables ," said Dr. Paula Rochon, study investigator and senior scientist at Women's College Research Institute. "Yet, what we do know is that it's never too late to improve quality of life and health for women, regardless of age. In fact, a focus on strategies to improve health in the older population can help prevent chronic disease and its associated complications."

The findings are detailed in a report of the POWER (Project for an Ontario Women's Health Evidence-Based Report) Study — a joint study from St. Michael's Hospital and ICES. The study is the first in the province to provide a comprehensive overview of women's health in relation to income, education, ethnicity and geography. Findings can be used by policymakers and health-care providers to improve access, quality and outcomes of care for Ontario women. The Older Woman's Health report examines quality and outcomes of care among older women and men in home care, long-term care and in the community. The POWER Study was funded by Echo: Improving Women's Health in Ontario, an agency of the Ontario Ministry of Health and Long-Term Care.

"Since women comprise the majority of the older population in Ontario, we need to be paying closer attention to the specific care and service needs of older women," says Pat Campbell, CEO of Echo. "The POWER Study Older Women's Health report provides key suggestions on how we can begin to do this."

Findings of the POWER Study released today include:

- About 60 per cent of older women reported that they were physically inactive compared to 48 per cent of men.
- Less than 45 per cent of older adults took steps to improve their health in the previous 12 months.
- Nearly 67 per cent of women ages 80 and older reported functional limitations and more than 1 in 3 low-income women reported their activities were limited by pain.
-= Nearly 60 per cent of women admitted to the hospital for heart failure are age 80 and older, and 90 per cent are age 65 and older.

Many health-care providers have little training in the care of older adults -- there are only 1 to 5 geriatricians per 100,000 adults 65 and older in some areas of the province.

Women have different patterns of illness and health-care needs compared to men. According to the researchers, previous generations of women had fewer opportunities and financial resources and less education than women today, and are less likely to pay for supportive care and access to health services that are not publicly funded.

Tuesday, October 25, 2011

Modest Improvement in Temporomandibular Disorder–Related Pain Associated With Use of Hard Stabilization Appliances Compared With Use of Nonoccluding A


Question: Among patients with temporomandibular
disorders (TMDs), does the use of intraoral orthopedic
appliances (IOAs) reduce pain compared with the use of
a placebo control or other treatments for TMD or no


The results of the study, published in The Journal
of the American Dental Association November Issue,
present limited evidence that use of HSAs leads to
modest improvement in TMD-related pain treatment
efficacy compared with use of NOAs or receiving
no therapy.

There was weak evidence regarding the use of
other types of appliances, including soft stabilization
appliances and anterior bite appliances,in reducing
TMD-related pain compared with notherapy; however,
close monitoring is recommended,as these appliances
might be associated with more adverse events than HSAs.

Many Young Children Off to a Poor Start with Dental Health


Dental visits are recommended to begin by age 1, but a new poll shows most children age 1-2 have not received appropriate oral health care

Although child health experts recommend that children begin oral health care by age 1 or when their first teeth emerge, a new report from the C.S. Mott Children’s Hospital National Poll on Children’s Health shows that most children ages 1-2 have not yet started seeing a dentist.

In May 2011, the National Poll on Children’s Health asked parents of children ages 1-5 about dental health care for young children. The poll found that only 23% of 1-year-olds had been to the dentist and only 44% of 2-year-olds had been to the dentist.

“Dental problems such as early childhood caries (cavities in the baby teeth) are the leading cause of chronic disease for young children,” says Sarah Clark, M.P.H., Associate Director of the Child Health Evaluation and Research (CHEAR) Unit at the University of Michigan. “Most dental problems can be prevented through good oral health care.”

Parents may not be aware of recommendations for early dental health care and finding a dentist who will see young children – especially those covered by Medicaid – is a long standing problem in some communities. To address these issues, pediatricians and health care providers are now seen as important partners in oral health and are encouraged to discuss oral health during well-child visits.

“Well-child visits are critical to making sure that parents understand their role in preventing dental problems, such as how to clean the child’s baby teeth and the importance of avoiding sugary beverages and bottles in the crib,” says Clark. “Well-child visits are also a key opportunity for a health professional to examine the child’s baby teeth and make sure that children with early signs of decay are strongly encouraged to see a dentist.”

However, when parents of 1-2 year olds were asked about dental health activities that occurred at their child’s most recent well-child visit, less than half of parents said their health care providers talked to them about cleaning the teeth or taking their child to the dentist and 1 in 3 children did not have their teeth examined at all by their health care provider.

“We know that not all children will see a dentist at age 1, but on the other hand, almost all children have well-child visits with a pediatrician or other health care provider,” Clark continues. “The results of this poll indicate that we need to improve the way oral health issues are addressed during well-child visits so that parents fully understand the need for good oral health care.”

Full report


Monday, October 24, 2011

U.S. State Department Reviewing Ban on Mercury Fillings


For the first time in history, the U.S. Department of State (DOS) is evaluating international regulations that would ban mercury-containing products including silver/amalgam dental fillings, which contain 50% mercury and are already in the mouths of more than 122 million Americans.

The DOS will present their official position on the use of mercury in amalgam fillings and other medical devices at a stakeholder meeting on Monday, October 24th, from 11:00 AM to 12:30 PM at the DOS headquarters on 2201 C Street, N.W., Washington, D.C.  Members of the International Academy of Oral Medicine and Toxicology (IAOMT) will attend the meeting to encourage a ban on mercury/silver dental amalgam fillings.

The U.S. government's monumental decision about mercury fillings is being made in preparation for the third session of the United Nations Environmental Programme (UNEP) Intergovernmental Negotiating Committee (INC3), scheduled for later this month in Nairobi, Kenya.  The committee was created with the specific purpose of developing a global, legally-binding instrument on mercury due to its significant negative effect on human health and the environment.

Mercury, a potent neurotoxin used in dental amalgam fillings, can damage the brain, kidneys, and nervous system, and is particularly harmful to the fetus and young children. Substantial, peer-reviewed, scientific evidence proving these dangers is documented in IAOMT's Petition for Reconsideration, which was filed with the United States Food and Drug Administration (FDA) in 2009.

The hazards of mercury filings have also been addressed by other international groups.  In 1991, the World Health Organization (WHO) concluded that dental amalgam is "the greatest source of mercury exposure for the general population, exceeding those from food and air."

In the United States, President Obama has recognized the hazards of mercury since 2008, and he emphasized the need to protect children from being exposed to mercury in his September 8, 2011 speech to Congress.

Yet, no actions to defend the American public from the known risks of mercury/silver dental fillings have been taken, although a recent submission by the U.S. to UNEP's Intergovernmental Negotiating Committee supports "further consideration of dental amalgam by the INC...with the goal of potential or gradual phasedown of dental amalgam and ongoing research for affordable, viable alternatives."

Such a position is unacceptable to Dr. David Kennedy, past president of IAOMT, who explains, "Using the excuse of alternative materials to further delay protecting the public is illogical because safe alternatives to mercury fillings have already been used for more than 20 years."

Leo Cashman, executive director and volunteer for the non-profit, consumer advocacy group Dental Amalgam Mercury Solutions (DAMS), agrees: "Dental amalgam is not viable when the costs of mercury poisoning to the individual, to families, and to the healthcare industry are considered."

"If we accept the current treaty language of UNEP, WHO, and the U.S. State Department, as well as their associated health declarations that I completely disagree with, the treaty will be about an 'infinite phase down' which won't even begin phasing down mercury/silver amalgam dental filling placement until 2020 the soonest, but more likely 2030, with requested exemptions by the FDI", says Dr. David Simone, who will be representing IAOMT at the DOS meeting. He reiterates, "The way it stands now, the UNEP Mercury Instrument is designed to keep placing mercury amalgams in all populations for another 20 years at least."

Freya Koss, President of the PA Coalition for Mercury-Free Dentistry, was diagnosed with myasthenia gravis after having an old mercury amalgam filling drilled out and replaced with a new one, and she will be at the meeting to insure that the DOS keeps mercury fillings in a proposed ban portion of the INC treaty.

Marie Flowers, President of Dental Amalgam Mercury Solutions (DAMS), experienced neurological symptoms following the removal of a mercury amalgam filling and will likewise be at the DOS meeting on Monday.  Flowers has commented, "The U.S. lags behind countries such as Sweden, who initiated a mercury phase out in 1987, followed by Denmark and Norway, who banned dental mercury amalgam in 2009.

Nashville's Fox 17 anchor Stacy Case told her personal story of mercury poisoning to the FDA at a recent Town Meeting in San Francisco: "I had four amalgams unsafely removed and replaced with four shiny mercury fillings, and I got out of bed one day and couldn't walk."  However, Case recovered from her diagnosis of multiple sclerosis after her fillings were safely removed.  Her message to the U.S. government is clear: "Use your power and position for good.  Please right this wrong!"

IAOMT and other groups are strongly urging the DOS to support the position of the U.S. Government as stated in February 2009 by Nancy Sutley, Chair of the White House Council on Environmental Quality, who announced, "Mercury poses a serious threat to public health in communities around the world...The United States will play a leading role in working with other nations to craft a global, legally binding agreement that will prevent the spread of mercury into the environment and improve the health of workers, pregnant women, and children throughout the world."

Monday's DOS meeting about the U.S. position on the INC treaty will set the international stage for the future of mercury in dentistry, which many hope will be the end of drilling a potent neurotoxin into the mouths of an unsuspecting international public.  

Friday, October 21, 2011

Tissue Graft Prevents Gum Recession After Tooth Implant

When a tooth is replaced with an implant, receding of the gums can become a concern. This leaves areas of root exposed and can be painful for the patient. While a single tooth replacement performed as an immediate, one-step process is an accepted treatment, gum recession occurs more often with this method of implant.

The current issue of the Journal of Oral Implantology reports on a case series of 10 patients who received a single immediate tooth replacement in conjunction with subepithelial connective tissue graft. The tissue graft has proven successful in making gingival, or gum, tissue more resistant to recession.

In the immediate tooth replacement procedure, a failing tooth is removed and an implant is immediately placed into the socket. For the tissue graft, tissue is harvested from the palate using a single incision. The graft material is inserted into a prepared space between the labial bony plate and the gingiva of the extraction site. The graft preserves soft tissue levels, making the gum less likely to recede.

Marginal bone level is another way to gauge the success of an implant. A more recent suggestion, which this study evaluates, is that this bone level can be influenced by the way the implant and abutment connect. “Platform switching”—which refers to the size discrepancy between these two components—can be beneficial in maintaining the marginal bone level.

In this study, patients were evaluated before surgery, at the time of tooth replacement, and at three, six, and twelve months after surgery. One implant failed early in the process, but at one year the remaining nine patients showed good integration of tissue and tooth with minimal loss of marginal bone level or facial gingival level. The authors concluded that with proper implant position and the placement of graft material, a favorable success rate can be achieved.

Full text of the article: “Immediate Single Tooth Replacement With Subepithelial Connective Tissue Graft Using Platform Switching Implants: A Case Series

About Journal of Oral Implantology
The Journal of Oral Implantology is the official publication of the American Academy of Implant Dentistry and of the American Academy of Implant Prosthodontics. It is dedicated to providing valuable information to general dentists, oral surgeons, prosthodontists, periodontists, scientists, clinicians, laboratory owners and technicians, manufacturers, and educators. The JOI distinguishes itself as the first and oldest journal in the world devoted exclusively to implant dentistry. For more information about the journal or society, please visit:

Friday, October 14, 2011

Certain Mouth Bacteria Signal Pancreatic Cancer


Particular types of mouth bacteria, some of which are found in gum disease, are associated with the development of pancreatic cancer, indicates a small study published online in the journal Gut.

The finding opens up the possibility of curbing the progress of one of the most difficult cancers to treat, by altering the balance of bacteria, say the authors. Pancreatic cancer usually spreads very quickly, and only around one in 20 patients is still alive five years after diagnosis.

The authors base their findings on an initial comparison of the bacteria found in the spit of 10 patients with pancreatic cancer, which had not yet spread, and 10 healthy people, matched for age and sex.

They found significant differences between the bacterial colonies in the two groups, with 31 additional species and 25 fewer species in the spit of the cancer patients.

They then checked spit samples from a further 28 pancreatic cancer patients and 28 healthy people to verify their findings.

And they checked tissue samples from 28 patients with chronic inflammation of the pancreas (chronic pancreatitis), which is associated with an increased risk of developing pancreatic cancer. Among six suspicious species, two -- Neisseria elongata and Streptococcus mitis -- showed up significantly less often in the mouths of the cancer patients than in those of their healthy peers, while levels of another species -- Granulicatella adjacens -- were significantly higher.

The combination of N Elongata and S mitis accurately differentiated between healthy patients and those with cancer in more than 80% cases.

Furthermore, they found similar differences in the prevalence of S mitis and G adjacens between the chronic pancreatitis samples and the spit of healthy people.

It is as yet unclear whether the presence of particular types of bacteria are a cause or effect of pancreatic cancer, say the authors. But their findings back previous research, which has implicated bacteria in the development of pancreatic diseases.

They go on to suggest that levels of certain bacteria could be used as a non-invasive and credible screen for pancreatic cancer, with the promise of earlier detection for a disease that has no clear symptoms in its early stages.