Wednesday, May 24, 2017
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
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
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.