Thursday, August 17, 2017

Oral and Dental Problems That May Signal Child Abuse and Neglect


A report from the American Academy of Pediatrics and the American Academy of Pediatric Dentistry in the August 2017 Pediatrics (published online July 31) aims to help identify problems involving a child's teeth, gums and mouth that may be signs of physical or sexual abuse and neglect. According to the updated clinical report, "Oral and Dental Aspects of Child Abuse and Neglect," injuries and infections in and around the mouth appear often in children who are maltreated. These may occur when caregivers react violently during developmentally normal fussiness at mealtime or bedtime, for example.

Symptoms that may be signs of child abuse or neglect include:
  • bruises on the lips, gums, tongue, lips or soft tissue inside the mouth from eating utensils or a bottle during forced feeding;
  • burns or blisters from scalding liquids or fractures to teeth, facial or jaw bones or scars or blackened teeth from previous injuries;
  • skin irritation, bruising or scarring at the corners of the mouth, which could be from gags applied to the mouth in forceful attempts to quiet a child;
  • injuries to the back of the throat, sometimes intentionally inflicted to make a child cough up or vomit blood or create other symptoms that would require medical attention and care;
  • injuries and infections tied to forced oral sex, such as tears and other signs of trauma inside the mouth or sores or rashes caused by sexually transmitted disease.
  • bite marks inside the mouth from the child's own teeth, which sometimes are caused by physical or sexual abuse.
In cases of dental neglect, authors note, untreated cavities and gum disease interfere with a child's ability to eat, communicate, grow and develop properly. The report also describes the connection between bullying and dental health, citing research indicating that children with mouth or dental abnormalities are frequent targets of bullying and face increased risk of depression and suicidal thoughts or actions.

In addition, the estimated 100,000 U.S. children involved in sex trafficking or forced prostitution each year have oral and dental problems from abuse and from malnutrition, which can lead to poorly formed teeth, cavities, infections and tooth loss.

Tuesday, August 15, 2017

Chewing gum rapid test for inflammation

Dental implants occasionally entail complications: Six to fifteen percent of patients develop an inflammatory response in the years after receiving a dental implant. This is caused by bacteria destroying the soft tissue and the bone around the implant in the worst case.
In future, patients will benefit from a quick and affordable method assessing whether they carry such bacteria: using a chewing gum based diagnostic test developed by a pharmaceutical research team at the Julius-Maximilians-Universität (JMU) Würzburg in Bavaria, Germany.

In practice, the test works as follows: If there is an inflammation in the oral cavity, a bittering agent is released while chewing the gum. Patients can then visit their dentist who confirms the diagnosis and treats the disease. This type of early detection aims at preventing serious complications such as bone loss.

"Anyone can use this new diagnostic tool anywhere and anytime without any technical equipment," Professor Lorenz Meinel says; he is the head of the JMU Chair for Drug Formulation and Delivery. He developed the new diagnostic tool with Dr. Jennifer Ritzer and her team; the invention is currently featured in an article in the journal Nature Communications.

Enzymes release bitter taste
The scientific background: In the presence of inflammatory conditions, specific protein-degrading enzymes are activated in the mouth. In just five minutes, these enzymes also break down a special ingredient of the chewing gum, thereby releasing a bittering agent that could not be tasted before.
Meinel's team provided the proof that this principle actually works. First studies using the saliva of patients were conducted at Merli Dental Clinic in Rimini.

Company establishment planned
To launch the chewing gum into the market, Meinel's team plans to set up a company. The professor assumes that it will take two to three years until the gum is commercially available.
Chewing gum rapid tests for other medical applications are presently under development. "We hope to be able to diagnose other diseases with our "anyone, anywhere, anytime" diagnostics to identify and adress these diseases as early as possible," Meinel explains.

Monday, August 14, 2017

High sugar consumption gives rise to dental treatment costs in the billions



Worldwide, people are eating far too much sugar. This has negative consequences for their teeth and for their purses: seen at the global level, the costs of dental treatment are currently running at around 172 billion US dollars (128 billion euros). In Germany alone, these amount to 17.2 billion euros (23 billion US dollars) a year. These are the results of a joint study conducted by the Martin Luther University Halle-Wittenberg (MLU) and the Biotechnology Research and Information Network AG (BRAIN AG) published in the International Journal of Dental Research. The work was carried out within the strategic alliance NatLifE 2020 and was co-financed by the German Federal Ministry of Education and Research (BMBF).

For their work the researchers evaluated representative data on the prevalence of caries, inflammation of the gums (parodontitis) and tooth loss, corresponding costs of treatment and the disease burden, as well as data on sugar consumption, in 168 countries for the year 2010. On the basis of this data they calculated the share of total costs attributable to excessive consumption of sugar. In addition to white household sugar, the researchers also focused their attention, in the analysis, to "hidden" sugar that is contained in many processed products, such as soft drinks, ketchup, ice cream and frozen foods, as well as breads, cakes and pastries.

"The data shows a clear correlation between the consumption of sugar and the incidence of caries, parodontitis and, as a result, tooth loss," said the lead author of the study, Dr Toni Meier from the Institute of Agricultural and Nutritional Sciences at the MLU. "For every additional 25 grams of sugar consumed per person and day - which amounts to roughly eight sugar-cubes or a glass of sweetened lemonade - the costs of dental treatment in high-income countries increase on average by 100 US dollars (75 euros) per person and year."

In Germany, the average daily sugar consumption lies between 90 and 110 grams per person. The costs of treatment amount to 281 US dollars (210 euros) per person and year. This puts Germany in the group of countries with the highest costs of treatment per person and year. Other countries "in the group" are Switzerland (402 US dollars, 300 euros), Denmark (238 US dollars, 178 euros) and the USA (185 US dollars, 138 euros). "If the target of 50 grams of sugar per person and day set by the World Health Organization could be reached, this would result in savings in the costs of treatment within Germany of 150 euros (201 US dollars) per person and year. Extrapolating this figure to the federal level shows annual potential savings of approximately 12 billion euros, or 16 billion US dollars," added Meier. A low-sugar diet is becoming increasingly difficult, however, since almost all processed products in the supermarket contain large quantities of added sugars.

The highest levels of sugar-related dental illness were observed by the researchers in Guatemala, Mauretania and Mexico. "Newly industrialised countries such as India, Brazil and Mexico, but also Pakistan and Egypt, could avoid an excessive burden of illness and of health care costs by anchoring the topic in their health and nutritional policies at an early stage," said the co-author of the study and nutrition scientist, Professor Gabriele Stangl of the MLU. This objective could be achieved by way of educational campaigns or by special taxation on high-calorie food. Such a sugar tax was introduced in Mexico in 2014 and already after one year was proving to be effective: the consumption of sugar-sweetened beverages had decreased by five percent. In the second year this decrease even doubled to ten percent.

"To be able to reduce the burden of nutrition-related illnesses, a balanced mix of educational work and food-policy initiatives, along with innovative technological solutions, are needed," said the co-author of the study, Dr Katja Riedel, joint coordinator of the NatLifE 2020 innovative alliance and program manager of system-products nutrition at BRAIN AG. The alliance co-financed by the German Federal Ministry of Education and Research aims, with the help of biotechnology and the understanding of biological systems, to develop a new generation of sustainably produced and biological active substances for foods and cosmetics and thereby to make a contribution towards improving human nutrition, health and well-being.

Monday, August 7, 2017

Man loses feeling in legs after long-term denture fixative use


A 62-year-old man lost the feeling in both his legs after the regular long term use of a denture fixative containing zinc, reveal doctors writing in the online journal BMJ Case Reports.

The man was referred to a neurology clinic after developing numbness, pain and weakness in his legs. The symptoms, which had lasted for more than six months, stopped him from leaving the house.
An MRI (magnetic resonance imaging) scan revealed spinal cord abnormalities and after several tests he was diagnosed with copper deficiency myelopathy (CDM).

CMD is a neurological disorder which can cause loss of feeling and numbness in the arms and legs.
The man explained that he had been using 2-4 tubes of denture fixative that contained zinc every week for the past 15 years because of his ill-fitting false teeth.

Excess zinc intake can interfere with the absorption of copper, leading to neurological problems, in rare cases.

The man was advised to stop using the fixative and given copper supplements to treat his symptoms. But he didn't recover completely, and the doctors warn that irreversible nerve damage may be a consequence of a delayed diagnosis of CDM.

Wednesday, August 2, 2017

An end to cavities for people with sensitive teeth?


An ice cold drink is refreshing in the summer, but for people with sensitive teeth, it can cause a painful jolt in the mouth. This condition can be treated, but many current approaches don't last long. Now researchers report in the journal ACS Applied Materials & Interfaces the development of a new material with an extract from green tea that could fix this problem -- and help prevent cavities in these susceptible patients.  

Tooth sensitivity commonly occurs when the protective layers of teeth are worn away, revealing a bony tissue called dentin. This tissue contains microscopic hollow tubes that, when exposed, allow hot and cold liquids and food to contact the underlying nerve endings in the teeth, causing pain. Unprotected dentin is also vulnerable to cavity formation. Plugging these tubes with a mineral called nanohydroxyapatite is a long-standing approach to treating sensitivity. But the material doesn't stand up well to regular brushing, grinding, erosion or acid produced by cavity-causing bacteria. Cui Huang and colleagues wanted to tackle sensitivity and beat the bacteria at the same time.

The researchers encapsulated nanohydroxyapatite and a green tea polyphenol -- epigallocatechin-3-gallate, or EGCG -- in silica nanoparticles, which can stand up to acid and wear and tear. EGCG has been shown in previous studies to fight Streptococcus mutans, which forms biofilms that cause cavities. Testing on extracted wisdom teeth showed that the material plugged the dentin tubules, released EGCG for at least 96 hours, stood up to tooth erosion and brushing and prevented biofilm formation. It also showed low toxicity. Based on these findings, the researchers say the mate

Tuesday, August 1, 2017

History of gum disease increases cancer risk in older women


Postmenopausal women who have a history of gum disease also have a higher risk of cancer, according to a new study of more than 65,000 women.

The study, led by researchers at the University at Buffalo, is the first national study of its kind involving U.S. women, and the first to focus specifically on older women. It's also the first study to find an association between periodontal disease and gallbladder cancer risk in women or men. The findings were published today (Aug. 1) in the journal Cancer Epidemiology, Biomarkers & Prevention.

"This study is the first national study focused on women, particularly older women," said Jean Wactawski-Wende, the study's senior author.

"Our study was sufficiently large and detailed enough to examine not just overall risk of cancer among older women with periodontal disease, but also to provide useful information on a number of cancer-specific sites," added Wactawski-Wende, dean of UB's School of Public Health and Health Professions and a professor of epidemiology and environmental health.

The study included 65,869 postmenopausal women enrolled in the Women's Health Initiative, an ongoing national prospective study designed to investigate factors affecting disease and death risk in older American women. The average age of the participants was 68, and most were non-Hispanic white women.

As part of a follow-up health questionnaire, participants were asked "Has a dentist or dental hygienist ever told you that you had periodontal or gum disease?"

Women who reported a history of gum disease had a 14 percent increased risk of overall cancer. Of the 7,149 cancers that occurred in the study participants, the majority -- or 2,416 -- were breast cancer.

"There is increasing evidence that periodontal disease may be linked to an increased cancer risk and this association warrants further investigation," said the paper's first author, Ngozi Nwizu, who worked on the research while completing her residency in oral and maxillofacial pathology in UB's School of Dental Medicine and her doctorate in pathology (cancer epidemiology) at UB's Roswell Park Cancer Institute Graduate Division. Nwizu is now an assistant professor of oral and maxillofacial pathology at the University of Texas Health Science Center at Houston.

The risk associated with periodontal disease was highest for esophageal cancer, the researchers reported. "The esophagus is in close proximity to the oral cavity, and so periodontal pathogens may more easily gain access to and infect the esophageal mucosa and promote cancer risk at that site," Wactawski-Wende said.

Gallbladder cancer risk also was high in women who reported a history of gum disease. "Chronic inflammation has also been implicated in gallbladder cancer, but there has been no data on the association between periodontal disease and gallbladder risk. Ours is the first study to report on such an association," Nwizu said.

The esophageal and gallbladder cancer findings are significant, Nwizu said. "Esophageal cancer ranks among the most deadly cancers and its etiology is not well known, but chronic inflammation has been implicated," she said.

"Certain periodontal bacteria have been shown to promote inflammation even in tiny amounts, and these bacteria have been isolated from many organ systems and some cancers including esophageal cancers. It is important to establish if periodontal disease is an important risk of esophageal cancer, so that appropriate preventive measures can be promoted."

Periodontal disease also was associated with total cancer risk among former and current smokers.
The findings for this particular age group are significant because they offer a window into disease in a population of Americans that continues to increase as people live longer lives.

"The elderly are more disproportionately affected by periodontal disease than other age groups, and for most types of cancers, the process of carcinogenesis usually occurs over many years," said Nwizu. "So the adverse effects of periodontal disease are more likely to be seen among postmenopausal women, simply because of their older age."

Wednesday, July 12, 2017

Diabetes causes shift in oral microbiome that fosters periodontitis

A new study led by University of Pennsylvania researchers has found that the oral microbiome is affected by diabetes, causing a shift to increase its pathogenicity. The research, published in the journal Cell Host & Microbe this week, not only showed that the oral microbiome of mice with diabetes shifted but that the change was associated with increased inflammation and bone loss. 


"Up until now, there had been no concrete evidence that diabetes affects the oral microbiome," said Dana Graves, senior author on the new study and vice dean of scholarship and research at Penn's School of Dental Medicine. "But the studies that had been done were not rigorous."
Just four years ago, the European Federation of Periodontology and the American Academy of Periodontology issued a report stating there is no compelling evidence that diabetes is directly linked to changes in the oral microbiome. But Graves and colleagues were skeptical and decided to pursue the question, using a mouse model that mimics Type 2 diabetes.
"My argument was that the appropriate studies just hadn't been done, so I decided, We'll do the appropriate study," Graves said.
Graves co-authored the study with Kyle Bittinger of the Children's Hospital of Philadelphia, who assisted with microbiome analysis, along with E Xiao from Peking University, who was the first author, and co-authors from the University of São Paulo, Sichuan University, the Federal University of Minas Gerais and the University of Capinas. The authors consulted with Daniel Beiting of Penn Vet's Center for Host-Microbial Interactions and did the bone-loss measurements at the Penn Center for Musculoskeletal Diseases. 
The researchers began by characterizing the oral microbiome of diabetic mice compared to healthy mice. They found that the diabetic mice had a similar oral microbiome to their healthy counterparts when they were sampled prior to developing high blood sugar levels, or hyperglycemia. But, once the diabetic mice were hyperglycemic, their microbiome became distinct from their normal littermates, with a less diverse community of bacteria.
The diabetic mice also had periodontitis, including a loss of bone supporting the teeth, and increased levels of IL-17, a signaling molecule important in immune response and inflammation. Increased levels of IL-17 in humans are associated with periodontal disease.
"The diabetic mice behaved similar to humans that had periodontal bone loss and increased IL-17 caused by a genetic disease," Graves said.
The findings underscored an association between changes in the oral microbiome and periodontitis but didn't prove that the microbial changes were responsible for disease. To drill in on the connection, the researchers transferred microorganisms from the diabetic mice to normal germ-free mice, animals that have been raised without being exposed to any microbes. 
These recipient mice also developed bone loss. A micro-CT scan revealed they had 42 percent less bone than mice that had received a microbial transfer from normal mice. Markers of inflammation also went up in the recipients of the diabetic oral microbiome.
"We were able to induce the rapid bone loss characteristic of the diabetic group into a normal group of animals simply by transferring the oral microbiome," said Graves.
With the microbiome now implicated in causing the periodontitis, Graves and colleagues wanted to know how. Suspecting that inflammatory cytokines, and specifically IL-17, played a role, the researchers repeated the microbiome transfer experiments, this time injecting the diabetic donors with an anti-IL-17 antibody prior to the transfer. Mice that received microbiomes from the treated diabetic mice had much less severe bone loss compared to mice that received a microbiome transfer from untreated mice. 
The findings "demonstrate unequivocally" that diabetes-induced changes in the oral microbiome drive inflammatory changes that enhance bone loss in periodontitis, the authors wrote.
Though IL-17 treatment was effective at reducing bone loss in the mice, it is unlikely to be a reasonable therapeutic strategy in humans due to its key role in immune protection. But Graves noted that the study highlights the importance for people with diabetes of controlling blood sugar and practicing good oral hygiene.
"Diabetes is one of the systemic disease that is most closely linked to periodontal disease, but the risk is substantially ameliorated by good glycemic control," he said. "And good oral hygiene can take the risk even further down."

Friday, July 7, 2017

New dental materials developed to stop degradation of demineralized dentin



 
A: Demineralized dentin with a number of collagen fibres, that if not preserved and remineralized, these can be degraded by the action of the dentinal proteolytic enzymes. B: Dentin treated with resin with fluoride-containing bioactive glass, which presents mineral precipitations – signs of remineralization.
 
Credit: Image courtesy of Asociación RUVID
 
Salvatore Sauro, Professor of dental biomaterials and minimally invasive dentistry at CEU Cardenal Herrera University, in Spain, has collaborated with several researchers from Finland, Brazil, Belgium, Germany and the UK on the development of innovative dental biomaterials for the regeneration of dental hard tissues.

Bacterial plaque causes tooth decay due to acids produced by different bacteria species; this has trigged an intense research activity for the development of novel restorative biomaterials with protective and self-healing remineralizing properties. In this new study, Salvatore Sauro, a professor of CEU Cardenal Herrera University (Spain) specialized in the development of innovative dental biomaterials, has collaborated with several researchers from Finland, Brazil, Belgium, Germany and the United Kingdom in order to accomplish this target. Indeed, this international group of research generated two new dental restorative biomaterials containing bioactive glasses, and assessed their effectiveness in reducing the enzymatic auto-degradation of collagen fibres and evoking their remineralization.

The aim of the study was to evaluate the inhibition of endogenous proteolytic enzymes of dentin and the remineralization induced by two different innovative experimental resins containing bioactive glasses: one containing micro-particles of Bioglass 45S5 and the other one containing micro-particles of an experimental bioactive glass enriched with fluoride and high amount of phosphates. Their anti-degradation effects was evaluated on completely demineralized human dentin specimens after immersion in artificial saliva for a period of thirty days by means of an immunohistochemical process. The remineralization evoked by such experimental bioactive resins was also evaluated by means of infrared spectroscopy and scanning electron microscopy.

Greater effectiveness with fluoride and phosphates

According to Professor Salvatore Sauro and his co-authors, " the resin-based material containing the experimental bioactive glass enriched with fluoride and phosphates resulted to be more efficient in inhibiting the enzymatic-mediated degradation of demineralized dentine collagen, and more bioactive than the one containing Bioglass 45S5. This was mainly due to the fluoride ions as well as to the large amount of phosphates released by the material, which accelerated dentin remineralization and reduced the degradation of demineralized dentin collagen via inhibition of matrix metalloproteinases and cysteine cathepsins.

This type of experimental bioactive material would therefore be more suitable for the development of new restorative dental materials for the clinical treatment of the dental caries.

Publication in the Journal of Dental Research

Professor Sauro perform his research activity mainly at CEU Cardenal Herrera University, (Spain) as well as at King's College London (UK) where he has an honorary position as research senior lecturer. He spends most of his time in the development of minimally invasive treatments and therapeutic bioactive dental composites for the treatment and restoration of caries affected dentin, such as those tested in this study -- which seem to be able to prevent the degradation of dentin collagen and evoke the remineralization of demineralized dental tissues. In this study, Dr Salvatore Sauro collaborated with researchers from the Department of Restorative Dentistry of the University of Turku (Finland); the Faculty of Dentistry of the University of Fortaleza (Brazil); the Biomaterials Group of the University of Ghent (Belgium); the Friedrich Schiller University of Jena (Germany); and the Dental Institute of King's College London (United Kingdom), institution of which Salvatore Sauro is a Visiting Senior Lecturer.

The study is published in the Journal of Dental Research.

Tuesday, June 20, 2017

Blocking yeast-bacteria interaction may prevent severe biofilms that cause childhood tooth decay


Though most tooth decay can be blamed on bacteria, such as Streptococcus mutans, the fungus Candida albicans may be a joint culprit in an alarmingly common form of severe tooth decay affecting toddlers known as early childhood caries.
In earlier research, a team from the University of Pennsylvania School of Dental Medicine had found that C. albicans, a type of yeast, took advantage of an enzyme produced by S. mutans to form a particularly intractable biofilm. In a new study, the researchers have pinpointed the surface molecules on the fungus that interact with the bacterially-derived protein. Blocking that interaction impaired the ability of yeast to form a biofilm with S. mutans on the tooth surface, pointing to a novel therapeutic strategy.
"Instead of just targeting bacteria to treat early childhood caries, we may also want to target the fungi," said Hyun (Michel) Koo, senior author on the study and a professor in the Department of Orthodontics and Divisions of Pediatric Dentistry and Community Oral Health. "Our data provide hints that you might not need to use a broad spectrum antimicrobial and might be able to target the enzyme or cell wall of the fungi to disrupt the plaque biofilm formation."
Koo collaborated on the work with Penn Dental's Geelsu Hwang, the first author and a research assistant professor, as well as Yuan Liu, Dongyeop Kim and Yong Li. Damian J. Krysan of the University of Rochester was also a coauthor.
The research appears in the journal PLOS Pathogens.
Candida can't effectively form plaque biofilms on teeth on its own nor can it bind S. mutans, unless in the presence of sugar. Young children who consume sugary beverages and foods in excess are at risk of developing early childhood caries. Koo's team had previously discovered that an enzyme, GftB, secreted by S. mutans, uses sugar from the diet to manufacture glue-like polymers called glucans. Candida promotes this process, resulting in a sticky biofilm that allows the yeast to adhere to teeth and to bind to S. mutans.
The researchers suspected that the outer portion of the Candida cell wall, composed of molecules called mannans, might be involved in binding GftB. To gain a more detailed understanding of the interaction between the yeast and the enzyme, the researchers measured the binding strength between various mutant Candida strains and GtfB using biophysical methods. Such measurements were developed by Hwang, who has a background in engineering and is applying his unique expertise to advance dental science.
Koo, Hwang and colleagues found that the enzyme bound much more weakly to mutants that lacked components of the mannan layer than the wild-type Candida. The team next looked at the abilities of the mutant Candida to form biofilms with S. mutans in a laboratory assay. The mutants that had impaired binding with GftB were mostly unable to form biofilms with S. mutans, resulting in significantly fewer Candida cells and reduced production of the sticky glucans molecules.
Using another biophysical technique, the researchers tested how stable the biofilms were when attached to a tooth-like surface. While low-shear stress, roughly equivalent to the force generated by taking a drink of water, removed only a quarter of the wild-type biofilm, the same force removed 70 percent of the biofilms with mutant Candida. When the forces were increased to the equivalent of a vigorous mouth rinse, the mutant biofilms were almost completely dislodged.
To ensure their findings translated to in vivo conditions, they examined biofilm formation in a rodent model that can mimic the development of early childhood caries. When animals were infected with both S. mutans and either the wild type or defective mutant yeast strains, the researchers observed clear differences. While biofilm formation was abundant if the wild-type yeast was used, it was substantially reduced in animals infected with the mutant strain. A more precise analysis revealed that the these defective biofilms completely lacked viable Candida cells and S. mutans were reduced by more than five-fold.
The findings point to a new direction for treatment of early childhood caries. The current standard of care, beyond the use of fluoride as a preventive approach, is to target only the bacteria with antimicrobials, or to use surgical interventions if the tooth decay has become too severe.
"This disease affects 23 percent of children in the United States and even more worldwide," said Koo. "In addition to fluoride, we desperately need an agent that can target the disease-causing biofilms and in this case not only the bacterial component but also the Candida."
Koo and colleagues are now working on novel therapeutic approaches for targeted interventions, which can be potentially developed for clinical use.

Wednesday, June 14, 2017

Visiting virtual beach improves patient experiences during dental procedures


Imagine walking along a South Devon beach on a lovely day. The waves are lapping on the shore, rabbits are scurrying in the undergrowth, and the bells of the local church are mingling with the calls of the seagulls. Then, as you turn to continue along the coast path feeling calm and relaxed you suddenly hear your dentist say "Fine, all done, you can take the headset off now". For patients at one dental practice in Devon, England, such Virtual Reality encounters are resulting in demonstrably better experiences in the dentist's chair. 
A link to what the patient sees is here - https://youtu.be/n5kjETt8cZI.
In a study published today (Wednesday 14th June 2017) in the journal Environment & Behaviour, a team of researchers at the Universities of Plymouth, Exeter and Birmingham worked with Torrington Dental Practice in Devon to find out whether experiences like these could improve the patient's experience during routine dental procedures, such as fillings and tooth extractions. 
Patients, who had agreed to take part in the study were randomly allocated to one of three conditions: a) standard care (i.e. normal practice), b) a virtual walk around Wembury beach in Devon (using a headset and handheld controller), or c) a walk around an anonymous virtual reality city. Results found that those who 'walked' around Wembury were less anxious, experienced less pain, and had more positive recollections of their treatment a week later, than those in the standard care condition. These benefits were not found for those who walked around the virtual city. 
Dr. Karin Tanja-Dijkstra was the lead author of the study. She said: "The use of virtual reality in health care settings is on the rise but we need more rigorous evidence of whether it actually improves patient experiences. Our research demonstrates that under the right conditions, this technology can be used to help both patients and practitioners."
The authors of the research stress that the type of virtual reality environment the patient visits is important. Virtual Wembury was created by Professor Bob Stone and colleagues at the University of Birmingham, and the fact that only patients who visited Wembury, and not the virtual city, had better experiences than standard care is consistent with a growing body of work that shows that natural environments, and marine environments in particular, can help reduce stress and anxiety. 
Co-author Dr. Mathew White from the University of Exeter explained: "We have done a lot of work recently which suggests that people are happiest and most relaxed when they are at the seaside. So it seemed only natural to investigate whether we could "bottle" this experience and use it to help people in potentially stressful healthcare contexts." 
Dr Sabine Pahl, the project's coordinator at the University of Plymouth, added: "That walking around the virtual city did not improve outcomes shows that merely distracting the patients isn't enough, the environment for a patient's visit needs to be welcoming and relaxing. It would be interesting to apply this approach to other contexts in which people cannot easily access real nature such as the workplace or other healthcare situations."
The Torrington Practice dentist involved in the research, Melissa Auvray, agreed: "The level of positive feedback we got from patients visiting Virtual Wembury was fantastic. Of course, as dentists we do our very best to make the patient feel as comfortable as possible but we are always on the look out for new ways to improve their experiences." 
Professor David Moles from the University of Plymouth added "This research is one of a number of initiatives we at Plymouth University Peninsula School of Dentistry have been working on alongside the fabulous team at Torrington Dental Practice and it clearly demonstrates the benefits that can be achieved when academics work in partnership with clinicians in order to address problems that really matter to patients."
The team are hoping to now investigate whether Virtual Wembury can help patients in other medical contexts and whether certain additions to the virtual environment could make the experience even better.

Monday, June 12, 2017

Study: Use of prefabricated blood vessels may revolutionize root canals


While root canals are effective in saving a tooth that has become infected or decayed, this age-old procedure may cause teeth to become brittle and susceptible to fracture over time. Now researchers at OHSU in Portland, Oregon, have developed a process by which they can engineer new blood vessels in teeth, creating better long-term outcomes for patients and clinicians.
Their findings will publish online in the journal Scientific Reports on June 12, 2017. 
More than 15 million root canals are conducted annually in the United States. The current procedure involves removing infected dental tissues and replacing them with synthetic biomaterials covered by a protective crown. 
"This process eliminates the tooth's blood and nerve supply, rendering it lifeless and void of any biological response or defense mechanism. Without this functionality, adult teeth may be lost much sooner, which can result in much greater concerns, such as the need for dentures or dental implants," says principal investigator Luiz Bertassoni, D.D.S., Ph.D., assistant professor of restorative dentistry in the OHSU School of Dentistry, and assistant professor of biomedical engineering in the OHSU School of Medicine.
To address this issue, Bertassoni and colleagues used a 3D printing-inspired process -- based on their previous work fabricating artificial capillaries -- to create blood vessels in the lab. They placed a fiber mold made of sugar molecules across the root canal of extracted human teeth and injected a gel-like material, similar to proteins found in the body, filled with dental pulp cells. The researchers removed the fiber to make a long microchannel in the root canal and inserted endothelial cells isolated from the interior lining of blood vessels. After seven days, dentin-producing cells proliferated near the tooth walls and artificial blood vessels formed inside the tooth.
"This result proves that fabrication of artificial blood vessels can be a highly effective strategy for fully regenerating the function of teeth," says Bertassoni, who also serves as an honorary lecturer in Bioengineering at University of Sydney-School of Dentistry. "We believe that this finding may change the way that root canal treatments are done in the future."

Common periodontal pathogen may interfere with conception in women


According to a study carried out at the University of Helsinki, Finland, a common periodontal pathogen may delay conception in young women. This finding is novel: previous studies have shown that periodontal diseases may be a risk for general health, but no data on the influence of periodontal bacteria on conception or becoming pregnant have been available.

"Our results encourage young women of fertile age to take care of their oral health and attend periodontal evaluations regularly", says periodontist and researcher Susanna Paju, University of Helsinki.

Study population comprised 256 healthy non-pregnant women (mean age 29.2 years, range 19 to 42) who had discontinued contraception in order to become pregnant. They were enrolled from the general community from Southern Finland. Clinical oral and gynecological examinations were performed. Detection of major periodontal pathogens in saliva and analysis of serum and saliva antibodies against major periodontal pathogens as well as a vaginal swab for the diagnosis of bacterial vaginosis at baseline were carried out.

Subjects were followed-up to establish whether they did or did not become pregnant during the observation period of 12 months.

Porphyromonas gingivalis, a bacterium associated with periodontal diseases, was significantly more frequently detected in the saliva among women who did not become pregnant during the one-year follow-up period than among those who did. The levels of salivary and serum antibodies against this pathogen were also significantly higher in women who did not become pregnant.

Statistical analysis showed that the finding was independent of other risk factors contributing to conception, such as age, current smoking, socioeconomic status, bacterial vaginosis, previous deliveries, or clinical periodontal disease.

Women who had P. gingivalis in the saliva and higher saliva or serum antibody concentrations against this bacterium had a 3-fold hazard for not becoming pregnant compared to their counterparts. Increased hazard was nearly to 4-fold if more than one of these qualities and clinical signs of periodontitis were present.

"Our study does not answer the question on possible reasons for infertility but it shows that periodontal bacteria may have a systemic effect even in lower amounts, and even before clear clinical signs of gum disease can be seen", says Dr. Paju. "More studies are needed to explain the mechanisms behind this association."

Infertility is a major concern, and increasing healthcare resources are needed for infertility treatments. More attention should be paid to the potential effects of common periodontal diseases on general health. Young women are encouraged to take care of their oral health and maintain good oral hygiene also when they are planning pregnancy, suggests Dr. Paju.

Wednesday, May 24, 2017

Recreational cannabis, used often, increases risk of gum disease


Columbia University dental researchers have found that frequent recreational use of cannabis--including marijuana, hashish, and hash oil--increases the risk of gum disease.
The study was published in the March issue of the Journal of Periodontology.
Periodontal (gum) disease is an inflammatory reaction to a bacterial infection below the gum line. Left untreated, gum disease can lead to receding gums and tooth loss. Longstanding periodontal disease has also been associated with a number of non-oral health issues, from preterm labor during pregnancy to heart disease.
Jaffer Shariff, DDS, MPH, a postdoctoral resident in periodontology at Columbia University School of Dental Medicine (CDM) and lead author, noticed a possible link between frequent recreational cannabis use and gum disease during his residency at a community-based dental clinic in Manhattan.
"It is well known that frequent tobacco use can increase the risk of periodontal disease, but it was surprising to see that recreational cannabis users may also be at risk," said Dr. Shariff. "The recent spate of new recreational and medical marijuana laws could spell the beginning of a growing oral public health problem."
Dr. Shariff and colleagues from CDM analyzed data from 1,938 U.S. adults who participated in the Centers for Disease Control's 2011-2012 National Health and Nutrition Examination Survey, administered in collaboration with the American Academy of Periodontology. Approximately 27 percent of the participants reported using cannabis one or more times for at least 12 months.
Periodontal exams focus on a patient's gum tissue and connection to the teeth. Among other assessments, periodontists look for plaque, inflammation, bleeding, and gum recession. The clinician uses a probe to measure the space between teeth and their surrounding gum tissue. 
Healthy gums fit a tooth snugly, with no more than one to three millimeters of space, known as pocket depth, between the tooth and surrounding gum tissue. Deeper pockets usually indicate presence of periodontitis. 
Among the study participants, frequent recreational cannabis users had more sites with pocket depths indicative of moderate to severe periodontal disease than less frequent users.
"Even controlling for other factors linked to gum disease, such as cigarette smoking, frequent recreational cannabis smokers are twice as likely as non-frequent users to have signs of periodontal disease," said Dr. Shariff. "While more research is needed to determine if medical marijuana has a similar impact on oral health, our study findings suggest that dental care providers should ask their patients about cannabis habits."
Commenting on the study, Dr. Terrence J. Griffin, president of the American Academy of Periodontology, said, "At a time when the legalization of recreational and medical marijuana is increasing its use in the United States, users should be made aware of the impact that any form of cannabis can have on the health of their gums."

Tuesday, May 23, 2017

Dentists in good compliance with American Heart Association guidelines, according to Rochester epidemiology project



In the first study examining dental records in the Rochester Epidemiology Project, results show that dentists and oral surgeons are in good compliance with guidelines issued by the American Heart Association (AHA) in 2007, describing prophylactic antibiotic use prior to invasive dental procedures.

The Rochester Epidemiology Project is a collaboration of medical and dental care providers in Minnesota and Wisconsin. With patient agreement, the organizations link medical, dental, surgical procedures, prescriptions, and other health care data for medical research.

Prior to 2007, the AHA guidelines recommended prophylactic antibiotics for patients with cardiac conditions who were at moderate or high risk of developing infective endocarditis -- a potentially deadly infection of the heart valve. After 2007, AHA recommended that only high-risk patients receive the antibiotics. This group represents a very small fraction of the individuals receiving antibiotics before 2007, says Daniel DeSimone, M.D., study lead author and infectious diseases and hospital internal medicine physician at Mayo Clinic. The study will be released May 23 online in Mayo Clinic Proceedings.

Earlier studies by Dr. DeSimone's team determined the incidence of infective endocarditis in Olmsted County before and after 2007, using Rochester Epidemiology Project data. They found no significant increase in cases of infective endocarditis following the introduction of updated AHA guidelines.

However, "the major limitation of these studies was the lack of access to dental records," says Dr. DeSimone.

"The inclusion of dental records in the Rochester Epidemiology Project provides a unique opportunity unlike any population health database in the United States," he says.

"The primary criticism of the earlier studies was, 'Are dentists actually following the 2007 AHA guidelines, or do patients continue to receive antibiotics when no longer indicated?'" reports Dr. DeSimone. "How could we prove that dentists were actually following the guidelines, rather than assuming they were? Now we can."

Dr. DeSimone also says, there are a number of health risks for patients when taking antibiotics. "Plus overuse of antibiotics can result in increased bacterial resistance, which is a widespread public health problem," he says.

In addition, while the cost to patients might only be a few dollars a dose, Dr. DeSimone says that when added up, this group of moderate-risk patients could spend well over $100 million per year.

"Using the Rochester Epidemiology Project, we have shown that the new guidelines were very helpful in reducing unnecessary antibiotic use and related issues, without an increase in new cases of infective endocarditis."

Although this was the first study using the newly linked dental records, it was just one of more than 2,600 medical research publications using the Rochester Epidemiology Project. Using medical and dental records, researchers can identify what causes diseases and how patients with certain diseases respond to surgery, medication or other interventions. They also can determine what the future holds for patients with specific diseases or medical conditions.


Friday, May 19, 2017

Extra weight may increase dental risks


Being overweight or obese was linked with an increased likelihood of having poor oral health in a recent study.

In the study of 160 participants, those with BMI ?23 had generally more severe periodontitis, total inflammatory dental diseases, and leukocyte counts than normal weight individuals. Patients who were obese (BMI ?25) had almost a 6-times increased risk for severe periodontitis compared with normal weight participants. Altered inflammatory molecules that are associated with obesity may play a role.

The results are published in Oral Diseases.

Wednesday, May 10, 2017

Grape seed extract could extend life of resin fillings


A natural compound found in grape seed extract could be used to strengthen dentin -- the tissue beneath a tooth's enamel -- and increase the life of resin fillings, according to new research at the University of Illinois at Chicago College of Dentistry.

No filling lasts forever, whether it's composite-resin or amalgam. But dentists find amalgam -- a combination of mercury, silver, tin or other materials -- easier to use and less costly. Plus, it can last 10 to 15 years or more. Composite-resin fillings are more aesthetically pleasing because the mixture of plastic and fine glass particles can be colored to match a patient's teeth. However, the fillings typically last only five to seven years.

In research published in the Journal of Dental Research, Ana Bedran-Russo, associate professor of restorative dentistry, describes how grape seed extract can make composite-resin fillings stronger, allowing them to last longer. The extract, Bedran-Russo said, can increase the strength of the dentin, which comprises the majority of the calcified extracellular tissue of teeth, forming the layer just beneath the hard external enamel.

Dentin is mostly made of collagen, the main structural protein in skin and other connective tissues. Resins have to bind to the dentin, but the area between the two, or the interface, is a weak point, causing restorations to breakdown, Bedran-Russo said.

"When fillings fail, decay forms around it and the seal is lost. We want to reinforce the interface, which will make the resin bond better to the dentin," she said. "The interface can be changed through the use of new natural materials."

More than 90 percent of adults between the ages of 20 and 64 have cavities, according to a federal report. A cavity is a hole that forms in the tooth when acid produced by bacteria erodes the minerals faster than the tooth can repair itself. The dentist removes the decay, or caries, with a drill and seals the hole with a filling.

Secondary caries and margin breakdown are the most frequent causes of failed adhesive restorations, Bedran-Russo said. Despite numerous advances in dental restorative materials, degradation of the adhesive interface still occurs.

Bedran-Russo has discovered that damaged collagen can repair itself with a combination of plant-based oligomeric proanthocyanidins -- flavonoids found in most foods and vegetables -- and extracts from grape seeds. Interlocking the resin and collagen-rich dentin provides better adhesion and does not rely on moisture.

"The stability of the interface is key for the durability of such adhesive joints, and hence, the life of the restoration and minimizing tooth loss," Bedran-Russo said.

One of the possible benefits of using grape seed extract is that it prevents tooth decay, she said. She and Guido Pauli, professor of medicinal chemistry and pharmacognosy in the UIC College of Pharmacy, recently collaborated on another study that showed extract from the root bark of Chinese red pine trees has similar properties to the grape seed extract.

Wednesday, March 29, 2017

Gum disease, tooth loss may increase postmenopausal women's risk of death


Gum disease and tooth loss may be associated with a higher risk of death in postmenopausal women but not increased cardiovascular disease risk, according to new research in Journal of the American Heart Association, the open access journal of the American Heart Association/American Stroke Association.
Loss of all natural teeth also was linked with an increased risk of death in postmenopausal women, according to the study led by researchers at the University at Buffalo.
Periodontal disease, a chronic inflammatory disease of the gum and connective tissue surrounding the teeth, affects nearly two-thirds of U.S. adults 60 and older. The loss of all one's teeth, called edentulism, impacts about one-third of U.S. adults 60 and older and often results from periodontal disease.
"Beside their negative impact on oral function and dietary habits, these conditions are also thought to be related to chronic diseases of aging," said Michael J. LaMonte, PhD, study author and research associate professor of epidemiology and environmental health in UB's School of Public Health and Health Professions.
Researchers analyzed the health information from the Women's Health Initiative program -- a study of 57,001 women, 55 years and older.
"Previous studies included smaller sample sizes or had limited numbers of cardiovascular disease events for analysis. Ours is among the largest and focuses exclusively on postmenopausal women in whom periodontitis, total tooth loss and cardiovascular disease is high nationally," LaMonte said.
In 6.7-year follow up of postmenopausal women studied, they found:
  • There were 3,589 cardiovascular disease events and 3,816 deaths.
  • History of periodontal disease was associated with a 12 percent higher risk of death from any cause. 
  • Loss of all natural teeth was associated with a 17 percent higher risk of death from any cause. The risk of death associated with periodontal disease was comparable regardless of how often women saw their dentists.
  • Women who had lost their teeth were older, had more CVD risk factors, less education and visited the dentist less frequently compared to women with their teeth.
"Our findings suggest that older women may be at higher risk for death because of their periodontal condition and may benefit from more intensive oral screening measures," LaMonte said.
"However, studies of interventions aimed at improving periodontal health are needed to determine whether risk of death is lowered among those receiving the intervention compared to those who do not. Our study was not able to establish a direct cause and effect."

New research comes to terms with old ideas about canker sores


A burning pain sensation - and treatments that do not work. This is what daily life is like for many of those who suffer from recurrent aphthous stomatitis. Research from the Sahlgrenska Academy now sheds new light on the reasons behind this condition found in the mouth.
"There are many misconceptions regarding the reasons for the ulcers and the care of this patient category is hugely neglected despite the fact that many suffer a great deal from their symptoms. Patients may experience a general feeling of illness, and they have difficulties in eating and speaking and may not be able to go to school or work for several days due to the lesions," says Maria Bankvall, dentist and postdoctoral researcher in Odontology.
Mouth blisters, cold sores or apthae are words that are normally used to describe this specific type of lesion, which in medical terms is called recurrent aphthous stomatitis (RAS). The condition is considered one of the most common lesions of the oral mucosa found in the world today.
The lesions have a typical appearance with a red halo surrounding a whitish area, and they can appear anywhere in the non-keratinized mucosa, i.e., on the inside of the cheeks and lips, at the floor of the mouth, on the sides of the tongue and in the throat.
Lots of different causes
The lesions smart and burn and can be greatly disabling for anyone affected. Today there is no cure, instead treatment strategies are aimed at relieving the symptoms using none prescription and/or prescription drugs. 
"For a long time, it was believed that this condition was due to a virus, in the same way as mouth herpes, and many physicians and dentists treat aphthous stomatitis and herpes in the same way, also because it can be difficult to clinically distinguish the two conditions. The patient is often given anti-viral medication, which is a suitable treatment for herpes, but does not relieve aphthous stomatitis," says Maria Bankvall.
"RAS should probably not be regarded as a specific disease but as a general symptom of the body due to an imbalance similar to a headache or a fever," says Maria Bankvall. Her research points to the fact that there is great complexity and multiple interacting factors. 
Hereditary is an important factor as well as the bacterial flora in the mouth, our immune system and environmental factors. The thesis presents a theoretic frame for causality based on existing research and their own patient studies.
Genes and bacterial flora
A number of different genes have been identified as being of importance. The research also shows that the bacterial flora in the healthy oral mucosa seems to differ in people with RAS compared to healthy control subjects.
A certain sub-group of patients may also suffer from a food allergy, but we do not know that much about tolerance mechanisms in the mouth. The importance of the immune system in the oral cavity has also been studied in the thesis, initially with experiments on mice. 
"Today there is a great deal of knowledge regarding the two major conditions in the oral cavity, i.e., caries and periodontitis. However, there are still large information gaps when it comes to different types of oral mucosal lesions. Hopefully, our conclusions can contribute to increasing the knowledge regarding the most common lesions that affect this part of the mouth," says Maria Bankvall.

Friday, March 24, 2017

New study identifies successful method to reduce dental implant failure


UNIVERSITY OF PLYMOUTH
IMAGE
IMAGE: NEW NANOCOATING SHOWS PROMISE IN DENTAL IMPLANT PROTECTION. view more 
CREDIT: UNIVERSITY OF PLYMOUTH
According to the American Academy of Implant Dentistry (AAID), 15 million Americans have crown or bridge replacements and three million have dental implants -- with this latter number rising by 500,000 a year. The AAID estimates that the value of the American and European market for dental implants will rise to $4.2 billion by 2022.
Dental implants are a successful form of treatment for patients, yet according to a study published in 2005, five to 10 per cent of all dental implants fail.
The reasons for this failure are several-fold - mechanical problems, poor connection to the bones in which they are implanted, infection or rejection. When failure occurs the dental implant must be removed.
The main reason for dental implant failure is peri-implantitis. This is the destructive inflammatory process affecting the soft and hard tissues surrounding dental implants. This occurs when pathogenic microbes in the mouth and oral cavity develop into biofilms, which protects them and encourages growth. Peri-implantitis is caused when the biofilms develop on dental implants.
A research team comprising scientists from the School of Biological Sciences, Peninsula Schools of Medicine and Dentistry and the School of Engineering at the University of Plymouth, have joined forces to develop and evaluate the effectiveness of a new nanocoating for dental implants to reduce the risk of peri-implantitis.
The results of their work are published in the journal Nanotoxicology.
In the study, the research team created a new approach using a combination of silver, titanium oxide and hydroxyapatite nanocoatings.
The application of the combination to the surface of titanium alloy implants successfully inhibited bacterial growth and reduced the formation of bacterial biofilm on the surface of the implants by 97.5 per cent.
Not only did the combination result in the effective eradication of infection, it created a surface with anti-biofilm properties which supported successful integration into surrounding bone and accelerated bone healing.
Professor Christopher Tredwin, Head of Plymouth University Peninsula School of Dentistry, commented: "In this cross-Faculty study we have identified the means to protect dental implants against the most common cause of their failure. The potential of our work for increased patient comfort and satisfaction, and reduced costs, is great and we look forward to translating our findings into clinical practice."
The University of Plymouth was the first university in the UK to secure Research Council Funding in Nanoscience and this project is the latest in a long line of projects investigating nanotechnology and human health.
Nanoscience activity at the University of Plymouth is led by Professor Richard Handy, who has represented the UK on matters relating to the Environmental Safety and Human Health of Nanomaterials at the Organisation for Economic Cooperation and Development (OECD). He commented: "As yet there are no nano-specific guidelines in dental or medical implant legislation and we are, with colleagues elsewhere, guiding the way in this area. The EU recognises that medical devices and implants must: perform as expected for its intended use, and be better than similar items in the market; be safe for the intended use or safer than an existing item, and; be biocompatible or have negligible toxicity."
He added: "Our work has been about proving these criteria which we have done in vitro. The next step would be to demonstrate the effectiveness of our discovery, perhaps with animal models and then human volunteers."
Dr Alexandros Besinis Lecturer in Mechanical Engineering at the School of Engineering, University of Plymouth, led the research team. He commented: "Current strategies to render the surface of dental implants antibacterial with the aim to prevent infection and peri-implantitis development, include application of antimicrobial coatings loaded with antibiotics or chlorhexidine. However, such approaches are usually effective only in the short-term, and the use of chlorhexidine has also been reported to be toxic to human cells. The significance of our new study is that we have successfully applied a dual-layered silver-hydroxyapatite nanocoating to titanium alloy medical implants which helps to overcome these risks."

Wednesday, March 8, 2017

Study links changes in oral microbiome with metabolic disease/risk for dental disease


A team of scientists from The Forsyth Institute and the Dasman Diabetes Institute in Kuwait have found that metabolic diseases, which are characterized by high blood pressure, high blood sugar, and obesity -- leads to changes in oral bacteria and puts people with the disease at a greater risk for poor oral health. This study of more than 8,000 ten year olds in Kuwait showed that metabolic diseases lead to increases in salivary glucose; alterations of the bacteria found in the mouth; and increased risk of cavities and gum disease. This work reinforces the need for preventive dental care and greater integration between medical and dental care. 



The study, titled, "The Salivary Microbiome is altered in the Presence of High Salivary Glucose," can be found on PLOS ONE. Over the past ten years, it has become clear that defining a "healthy" microbiome is a critical step for discovering how variations in the bacteria found in and on our body contribute to both disease and wellbeing. While scientists now know a great deal about what bacteria live in our mouth and throughout the body, it is still unclear whether differences in the human microbiome that are seen in many disease states are a symptom of the disease or part of the underlying cause. 
"The mouth represents a rich microbiome that is easily accessible," said Dr. Max Goodson, the study's lead author. "Our research is providing further evidence of the connections between the mouth and some of society's most costly and deadly systemic diseases--and of the importance of using the mouth as a tool for preventive health." 

Summary of Study
We measured the glucose concentration, bacterial counts, and relative frequencies of 42 bacterial species in whole saliva samples from 8,173 Kuwaiti adolescents (mean age 10.00 ± 0.67 years) using DNA probe analysis. In addition, clinical data related to obesity, dental caries, and gingivitis were collected. Data were compared between adolescents with high salivary glucose (HSG); glucose concentration and those with low salivary glucose. Investigators found that HSG was associated with dental caries and gingivitis in the study population. The overall salivary bacterial load in saliva decreased with increasing salivary glucose concentration. Under HSG conditions, the bacterial count for 35 (83%) of 42 species was significantly reduced, and relative bacterial frequencies in 27 species (64%) were altered, as compared with LSG conditions. These alterations were stronger predictors of high salivary glucose than measures of oral disease, obesity, sleep or fitness. These observations clearly indicate that metabolic diseases, such as diabetes, that produce elevated glucose in blood and saliva can significantly alter the oral microflora. 
Samples were obtain through the Forsyth Kuwait Healthy Life Study, is a longitudinal cohort investigation of more than 8,000 children. Forsyth has worked with The Dasman Diabetes Institute and the Kuwait/Forsyth School program to conduct a clinical investigation of the development of obesity, metabolic syndrome and type 2 diabetes in Kuwaiti children. During the five-year study, the body weight, height, blood pressure and fitness were measured, oral disease was evaluated, nutritional information was collected, questionnaires on sleep and medical history were answered and saliva was collected for analysis.


Tooth loss linked to an increased risk of dementia


In a study of 1566 community-dwelling Japanese elderly who were followed for 5 years, the risk of developing dementia was elevated in individuals with fewer remaining teeth. 
Individuals with 10-19, 1-9, and no teeth had 62%, 81%, and 63% higher risks of dementia, respectively, than individuals with >20 teeth. Likewise, an inverse association was observed between the number of remaining teeth and the risk of developing Alzheimer's disease. 
"Our findings emphasize the clinical importance of dental care and treatment, especially in terms of maintenance of teeth from an early age for reducing the future risk of dementia," said Dr. Tomoyuki Ohara, co-author of the Journal of the American Geriatrics Society study.

Wednesday, February 22, 2017

Researchers find association between gum disease and ischemic stroke risk

Adults with gum, or periodontal, disease may be at greater ischemic stroke risk, according to research presented at the American Stroke Association's International Stroke Conference 2017.


Researchers assessed 6,711 adults, who had not had a stroke, for periodontal disease and categorized the adults according to whether they had mild, moderate or severe periodontal disease. They followed patients for 15 years for the incidence of stroke, also documenting the stroke subtype based on cause.
A total of 299 ischemic strokes occurred during the 15 years, including 47 percent that were thrombotic stroke, from a clot within the brain's blood vessels; 26 percent that were cardioembolic, when a blood clot forms in the heart; and 20 percent that were lacunar strokes, which occurs when there is a blockage of small arteries that supply blood to the brain.
They found:
Participants with mild periodontal disease were 1.9 times more likely to have an ischemic stroke than those without periodontal disease. Those with moderate periodontal disease had 2.1 times higher ischemic stroke risk and adults with severe gum disease were 2.2 times more likely to suffer an ischemic stroke than those who had no periodontal disease.
The association between increasing levels of periodontal disease and stroke risk was most pronounced in the cardioembolic and thrombotic stroke subtypes.
The graded association between the level of gum disease and incident ischemic stroke, supports a possible causal association between gum disease and ischemic stroke, researchers said.



Estrogen therapy shown effective in reducing tooth and gum diseases in postmenopausal women


Estrogen therapy has already been credited with helping women manage an array of menopause-related issues, including reducing hot flashes, improving heart health and bone density, and maintaining levels of sexual satisfaction. Now a new study suggests that the same estrogen therapy used to treat osteoporosis can actually lead to healthier teeth and gums. The study outcomes are being published online today in Menopause, the journal of The North American Menopause Society (NAMS).
As estrogen levels fall during menopause, women become more vulnerable to numerous health issues, including loss of bone mineral density which can lead to osteoporosis. Around the same time, changes in oral health also are common as teeth and gums become more susceptible to disease, which can lead to inflammation, pain, bleeding, and eventually loose or missing teeth.
In the Menopause article "Association between osteoporosis treatment and severe periodontitis in postmenopausal women," 492 postmenopausal Brazilian women aged 50 to 87 years, 113 in osteoporosis treatment and 379 not treated, were evaluated to determine whether osteoporosis treatment could help increase the bone mineral density in their jaws and, subsequently, improve overall oral health.
The study found that the rate of occurrence of severe periodontitis was 44% lower in the postmenopausal osteoporosis-treatment group than in the untreated group. Treatment consisted of systemic estrogen alone or estrogen plus progestin, as well as calcium and vitamin D supplements, for a minimum of six months.
"Osteoporosis can occur throughout the body, including the jaw, and lead to an increased risk of periodontal disease," says Dr. JoAnn Pinkerton, NAMS executive director. "This study demonstrates that estrogen therapy, which has proven to be effective in preventing bone loss, may also prevent the worsening of tooth and gum disease. All women, but especially those with low estrogen or on bisphosphonate treatment for osteoporosis, should make good dental care a part of their healthy lifestyles."