Teens who lose teeth to decay and injury nearly twice as likely to be bullied

 

Adolescents who lose teeth due to decay or trauma are 42 percent more likely to be bullied, according to new collaborative research from the University of Sydney and the University of Melbourne. 

 

Published in JDR Clinical & Translational Research, the paper analysed data from 4400 children in The Longitudinal Study of Australian Children, following their health outcomes from childhood (eight- to nine-year-olds) to adolescence (14- to 15-year-olds). 

 

Senior author Associate Professor Ankur Singh, Chair of Lifespan and Oral Health at the School of Dentistryand member of the Charles Perkins Centre said: “Tooth loss isn’t only a dental issue, it’s a social one too. For teenagers, it can have significant psychological impacts at a crucial time in their development.”

 

Around 10 percent of children in Australia have lost teeth through decay or injury, with children from lower socioeconomic backgrounds, as well as rural or remote areas, the most likely to have experienced tooth loss. 

 

“Poor oral health impacts nutrition, sleep, self-confidence and overall wellbeing, as well as being linked to heart disease and high blood pressure. To address these issues, the government needs to invest in prevention programs tackling oral and improve equitable access to dental care, especially in rural and remote areas and in low-income communities,” Associate Professor Singh said. 

 

Recent research suggests that bullying is widespread, with 70 percent of children aged 12-13 experiencing at least one incident of bullying a year. 

 

Within Australia, 28 percent of year eight students (aged 12 to 13) said they were bullied every month, with 8 percent saying they were bullied every week. 

 

First author Yuxi Li, PhD candidate at the University of Melbourne, said: “Anyone who has been bullied at school can testify to what an awful experience it can be. 

 

“As well poor psychological outcomes, bullying can also have adverse physical outcomes such as overweight and obesity. 

 

“We hope that this study will raise awareness about the link between oral health, bullying and young people’s overall wellbeing.”

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Journal

JDR Clinical & Translational Research

DOI

10.1177/23800844251357941 

Children with sickle cell disease face higher risk of dental issues, yet many don’t receive needed care

 

New study finds that fewer than half of children with sickle cell disease and Medicaid in Michigan received dental services

Peer-Reviewed Publication

Michigan Medicine - University of Michigan

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ANN ARBOR, Mich. – Children with sickle cell disease are more likely to have dental problems — but fewer than half of those covered by Michigan Medicaid got dental care in 2022, according to a new study.

The findings, led by Michigan Medicine and non-profit RAND Corporation, appear in JAMA Network Open.

“Sickle cell disease is known to increase the risk of dental complications in children, which underscores the importance of preventive dental care for this population,” said senior author Sarah Reeves, Ph.D., M.P.H., an associate professor of pediatrics and epidemiology at the U-M Medical School and the Susan B. Meister Child Health Evaluation and Research (CHEAR) Center.

“Our findings show that we need to take steps to make sure kids with this condition get the dental care they need—by helping dentists feel more prepared to treat them and making sure doctors know how important dental health is for these children."

Sickle cell disease is an inherited blood disorder that affects roughly 2,000 newborns a year in the U.S. It affects red blood cells, causing them to become misshapen and block blood flow, which can lead to pain, strokes, and other serious health problems.

Dental health is particularly important for children with the condition because of its reciprocal relationship with the disease, Reeves says. Infections cause inflammation and stress in the body, which can lead to the sickling of red blood cells.  

“Oral infections are especially dangerous for people with sickle cell disease because they can trigger or worsen symptoms and serious complications,” Reeves said.

“Preventative dental care helps reduce the risk of pain crises and hospitalizations.”

Researchers analyzed use of dental care for 1,096 children with both sickle cell disease and Michigan Medicaid, and 1.18 million children with Michigan Medicaid.

More than 40% of children in both groups were aged 6-14 years. Children with sickle cell disease in Michigan have comparable rates of dental service utilization to the general pediatric Medicaid population. Overall, less than half of children with or without out sickle cell disease and Medicaid received any type of dental care, including preventive services and treatment.

Reeves said several factors limit access to dental care for children with sickle cell disease, including a shortage of dentists who accept Medicaid and a lack of clear guidelines for treating these patients.

The study highlights the need for targeted solutions, she says, such as better provider training and stronger communication between medical and dental professionals to ensure children with the condition get the care they need.

“Given increased risk of oral health problems among patients with sickle cell disease we need focused efforts to expand access to dental services for them,” she said.

“There are many reasons why dental care rates are low in this group. Future research should look at what those barriers are and how we can overcome them to improve care for this vulnerable population.”

 

Oral health treatment in patients due for surgery= much lower rates of postoperative pneumonia and shorter hospital stays

Article URL: http://plos.io/3JzmJ5G 

Oral care protocol

The institutional oral care protocol was implemented at least 2 weeks before surgery in patients with sufficient preoperative time, typically during outpatient visits prior to hospitalization. This protocol initially comprised a comprehensive oral evaluation, including dental radiography, periodontal tissue examination, oral hygiene assessment, and identification of potential sources of infection such as dental caries and periodontal disease. To achieve oral bacterial control, dental practitioners treat infected teeth; dental hygienists remove plaque and calculus using ultrasonic scalers and manual instruments; mechanical tooth surface cleaning with fluoride-containing paste; tongue coating removal; and ultrasonic denture cleaning.

Patients received detailed instructions on self-care practices. This instruction encompasses dental plaque and food debris removal from tooth surfaces and interdental areas through appropriate brushing techniques supplemented by auxiliary cleaning devices such as interdental brushes and dental floss. The patients were advised to clean their oral mucosa using tongue and sponge brushes, maintain dentures with specialized cleansing agents, and use chlorhexidine-containing mouthwash rinses.

In patients with insufficient preoperative time, a single session of mechanical tooth surface cleaning was performed. When required, custom mouthpieces were fabricated to prevent tooth displacement during endotracheal intubation. Patients who declined the oral care protocol underwent surgery without implementing these preventive measures.

Ozempic mouth

 Ozempic, a medication used for weight management and type 2 diabetes, can cause oral side effects known as "Ozempic mouth." 

Common Oral Side Effects: 

• Dry mouth (xerostomia)
• Bad breath (halitosis)
• Altered taste
• Tongue changes (e.g., burning, tingling, numbness)
• Gum inflammation (gingivitis)
Increased risk of cavities 

Causes: 

Ozempic reduces appetite and promotes weight loss, which can lead to: 

Decreased saliva production, resulting in dry mouth.
Changes in oral bacteria, contributing to bad breath.
Alterations in taste perception.
Inflammation of the tongue and gums. 

Management: 

Stay hydrated by drinking plenty of fluids. 
Use over-the-counter saliva substitutes or mouthwashes. 
Practice good oral hygiene by brushing and flossing regularly. 
See a dentist for professional cleanings and dental examinations. 
Consider consulting with a healthcare professional about adjusting the dosage or switching to a different medication if oral side effects become bothersome. 

Note: 

Ozempic mouth is typically a temporary side effect that resolves once the medication is discontinued. However, it's important to be aware of these potential oral issues and take appropriate measures to manage them effectively. 

Dental fear is widespread—But most people want treatment

 Nearly three out of four adults fear going to the dentist, according to a new study published in the Journal of the American Dental Association.

While dental fear is common, the study—led by researchers at NYU College of Dentistry—also found that most individuals are interested in treatment to overcome it.

People who are anxious about going to the dentist often avoid routine cleanings and care, only visiting a dentist when issues arise. This creates a cycle of fear, as the lack of preventive care can compromise oral health, leading to more fear-inducing pain, infections, and dental work.

“A better understanding of dental fear—and how to increase access to effective treatments for it—holds promise for improving oral and overall health,” said Richard Heyman, a professor in the NYU Dentistry Center for Oral Health Policy and Management and co-director of the NYU Dentistry Family Translational Research Group.

High rates of dental fear

Earlier research shows that more than a quarter of the US population is anxious about going to the dentist, but many of these studies were conducted decades ago. To assess the current state of dental fear, researchers at NYU College of Dentistry surveyed a group of 1,003 adults that was representative of the US population based on age, gender, race, education level, region, and household income.

They found that dental fear is even more widespread than previously thought: 72.6 percent reported some amount of dental fear, with 45.8 percent saying they have moderate fear and 26.8 percent reporting severe fear. 

When those with moderate or severe fear were asked whether they would be interested in a free, brief treatment for dental fear that could be completed at home, the majority (71.2 percent) expressed interest. (Those who were not interested indicated skepticism about whether the treatment would be effective, reported satisfaction with their current coping strategies, or had concerns about time.)

“While dental fear is highly treatable, few professionals have received relevant training or offer treatment. Brief, virtual dental fear treatments using apps and telehealth have the potential to reach many people, regardless of where they live,” said Heyman. 

Heyman and his colleagues have developed a program called Dental FearLess that uses an app and, if needed, a one-on-one telehealth session, to treat dental fear using principles of cognitive behavioral therapy and mindfulness. In a pilot study, half of participants were no longer fearful after completing the program, which continues to be studied in an ongoing clinical trial.

“While the widespread prevalence of dental fear suggests it may actually be growing in the general population, we are making progress in expanding the access to treatment,” added Heyman.

The role of memory in dental fear

Given how common dental fear is, NYU Dentistry researchers are also working to better understand how it emerges. Prior research shows that more than half of those who have high levels of dental fear have had negative experiences at the dentist, often as a child or adolescent, but little attention has been paid to the role of memory in developing and maintaining these fears. 

“Memories of traumatic dental care can be remarkably vivid and tend to have lifelong implications,” said Kelly Daly, an assistant research scientist in NYU Dentistry’s Family Translational Research Group.

To explore the connection between memory and dental fear, Daly and her colleagues analyzed survey data and written reflections from parents about their own dental fear as well as their children’s fear; the findings are published in the journal Oral.

They found that many people with dental fear have memories of pain and negative interactions with dentists—including some behaviors that have since fallen out of favor, such as a dentist putting a hand over a child’s mouth to stop disruptive behavior, a technique that has been removed from clinical guidelines. Patients also recounted experiences that led them to perceive dentists as untrustworthy, whether they felt humiliation, that they were not being listened to or believed, or that dentists were recommending unnecessary treatments. 

“The salience of these memories—particularly ones from childhood—and ways that lifelong oral healthcare can be compromised are important lessons for practicing dental providers,” said Daly. “Many of these negative experiences can be avoided with open and transparent communication between providers and patients.”

Toothpaste made from your hair provides natural root to repair teeth

 

In a new study published today, scientists discovered that keratin, a protein found in hair, skin and wool, can repair tooth enamel and stop early stages of decay.

The King’s College London team of scientists discovered that keratin produces a protective coating that mimics the structure and function of natural enamel when it comes into contact with minerals in saliva.

Dr Sherif Elsharkawy, senior author and consultant in prosthodontics at King’s College London, said: “Unlike bones and hair, enamel does not regenerate, once it is lost, it’s gone forever.”

Acidic foods and drinks, poor oral hygiene, and ageing all contribute to enamel erosion and decay, leading to tooth sensitivity, pain and eventually tooth loss.

While fluoride toothpastes are currently used to slow this process, keratin-based treatments were found to stop it completely. Keratin forms a dense mineral layer that protects the tooth and seals off exposed nerve channels that cause sensitivity, offering both structural and symptomatic relief.

The treatment could be delivered through a toothpaste for daily use or as a professionally applied gel, similar to nail varnish, for more targeted repair. The team is already exploring pathways for clinical application and believes that keratin-based enamel regeneration could be made available to the public within the next two to three years.

In their study, published in Advanced Healthcare Materials, the scientists extracted keratin from wool. They discovered that when keratin is applied to the tooth surface and comes into contact with the minerals naturally present in saliva, it forms a highly organised, crystal-like scaffold that mimics the structure and function of natural enamel.

Over time, this scaffold continues to attract calcium and phosphate ions, leading to the growth of a protective enamel-like coating around the tooth. This marks a significant step forward in regenerative dentistry.

Sara Gamea, PhD researcher at King’s College London and first author of the study, added: “Keratin offers a transformative alternative to current dental treatments. Not only is it sustainably sourced from biological waste materials like hair and skin, it also eliminates the need for traditional plastic resins, commonly used in restorative dentistry, which are toxic and less durable. Keratin also looks much more natural than these treatments, as it can more closely match the colour of the original tooth.”

As concerns grow over the sustainability of healthcare materials and long-term fluoride use, this discovery positions keratin as a leading candidate for future dental care. The research also aligns with broader efforts to embrace circular, waste-to-health innovations, transforming what would otherwise be discarded into a valuable clinical resource.

Sara Gamea said: “This technology bridges the gap between biology and dentistry, providing an eco-friendly biomaterial that mirrors natural processes.”

Dr Elsharkawy concluded: “We are entering an exciting era where biotechnology allows us to not just treat symptoms but restore biological function using the body’s own materials. With further development and the right industry partnerships, we may soon be growing stronger, healthier smiles from something as simple as a haircut.”

Link to paper: https://advanced.onlinelibrary.wiley.com/doi/10.1002/adhm.202502465

Arginine dentifrices significantly reduce childhood caries

 

The International Association for Dental, Oral, and Craniofacial Research (IADR) and the American Association for Dental, Oral, and Craniofacial Research (AADOCR) have announced the publication of a new study in JDR Clinical & Translational Research that demonstrates that arginine dentifrices reduce dental caries in children with active caries as much as, or more than, a sodium fluoride dentifrice, depending on the arginine concentration.

Dental caries remain a significant oral health burden globally. Scientific evidence has demonstrated the dose-dependent, anticaries action of fluoride; however, more effective, comprehensive, and alternative prevention strategies should be investigated. The study, “Arginine Dentifrices and Childhood Caries Prevention: A Randomized Clinical Trial” by Wei Lin, Sichuan University, et al. carried out a two-year, phase III, double-blind, three-arm, parallel-group, randomized controlled trial from April 15, 2019 through March 12, 2022 across three centers in China. Six thousand children aged 10–14 with two or more active caries lesions were assigned one of three study dentifrices: 8.0% arginine, 1.5% arginine, and 0.32% NaF as a positive control. The primary efficacy outcomes were incremental DMFS (decayed, missing, and filled surfaces) and DMFT (decayed, missing, and filled teeth) caries indices scores after two years of product use.

After two years, the 8.0% arginine-containing dentifrice demonstrated a statistically significant 26.0% reduction in DMFS and 25.3% in DMFT scores vs. the 0.32% NaF control. No statistical difference was measured between the 1.5% arginine-containing dentifrice and the 0.32% NaF control in DMFS and DMFT. This clinical study confirms that depending on the concentration, arginine dentifrices are as effective, or more effective, than a sodium fluoride dentifrice in providing anti-caries protection in children with active caries.

Maple compound offers new way to fight tooth decay

 

 — A new study in the journal Microbiology Spectrum highlights the potential of using a natural compound from maple to combat the bacteria responsible for tooth decay: Streptococcus mutans. The compound, epicatechin gallate, is a powerful and safe alternative to traditional plaque-fighting agents. Its natural abundance, affordability and lack of toxicity make it especially promising for inclusion in oral care products such as mouthwashes, offering a safer option for young children, who often accidentally swallow mouthwash.

The new study emerged as an offshoot of research into natural compounds that inhibit biofilm formation in Listeria monocytogenes, a foodborne pathogen. As is often the case in science, the researchers made an unexpected observation that Listeria readily forms biofilms on plant materials, including most wood, but seems to avoid certain types, especially maple. This piqued the researchers’ curiosity. They isolated polyphenolic compounds from maple that inhibit Listeria attachment and biofilm formation. They also identified their target: sortase A, an enzyme that anchors adhesins to the bacterial cell wall. When sortase A is inhibited, these adhesins are not anchored in the bacterial cell wall, impairing the ability of Listeria to attach to surfaces and form biofilms. That discovery led the researchers to investigate whether similar mechanisms exist in related bacteria. Sortase A in Streptococcus species, which is Listeria’s cousin in the Bacillota phylum, turned out to be quite similar. One species in particular, Streptococcus mutans, stood out because it causes dental caries, commonly known as cavities. 

“Since S. mutans initiates cavities by forming biofilms (plaques) on teeth and producing acid that destroys tooth enamel, we asked: could maple polyphenols also inhibit S. mutans biofilms? That question drove this study,” said corresponding study author Mark Gomelsky, Ph.D., Martha Gilliam Professor of Microbiology and Director of the Microbiology Program at the University of Wyoming.

The researchers first used computer modeling to see whether maple polyphenols could bind to the sortase A enzyme from S. mutans, and discovered that they did. Next, they purified the sortase A in the lab and confirmed that these compounds inhibit its activity in a test tube. Finally, they assessed whether maple polyphenols block S. mutans from forming biofilms on plastic teeth and on hydroxyapatite disks—a stand-in for real tooth enamel— and discovered they worked there too. 

“In a way, this study felt almost too easy. Everything fell into place just as we predicted. That’s a rare experience in science, and probably the first time it’s happened in my 35-year research career,” Gomelsky said. “We discovered that several polyphenols present in maple wood or maple sap can inhibit the sortase enzyme in S. mutans, which in turn prevents this cavity-causing bacterium from attaching to tooth surfaces.” Interestingly, the most potent inhibitor was (-)-epicatechin gallate (ECG), a compound also present in green and black tea, though in much higher amounts in tea than in maple sap. Drinking green tea has long been associated with lower rates of cavities, and its main polyphenol, (-)-epigallocatechin gallate (EGCG), has been used in dental products. The researchers found that EGCG does inhibit S. mutans biofilms, but it’s not nearly as effective as ECG. This raises the intriguing possibility that the moderate effects seen with EGCG-based dental products may be due to using the suboptimal compound, instead of the more potent ECG.

“Our findings suggest that ECG or other edible polyphenols with anti-sortase activity could be added to dental products to help prevent cavities through an antibiofilm mechanism,” Gomelsky said. “This is different from traditional approaches, which rely on killing bacteria with alcohol, disinfectants or essential oils, or on fluoride to remineralize enamel. The antibiofilm approach using edible polyphenols is especially appealing for young children. For example, young children can’t use conventional mouthwashes because they might swallow them and risk toxicity. A safer alternative, such as a mouthwash containing an effective dose of an edible polyphenol, could provide protection without harmful side effects.”

Gomelsky said they are actively developing plant polyphenol-based dental products through a startup founded by University of Wyoming students and the first author of this study, Ahmed Elbakush, Ph.D. 

Polygenic architecture of dental caries: single nucleotide polymorphisms in genetic epidemiology

 

Peer-Reviewed Publication

Xia & He Publishing Inc.

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image: 

The figure illustrates the major categories of genes that may influence susceptibility to dental caries, organized by their biological functions and pathways. These groups include: (1) Enamel formation genes, which play roles in the development and mineralization of the tooth enamel and dentin; (2) Immune response genes, involved in innate and adaptive immune mechanisms that modulate the host response to cariogenic bacteria; (3) Saliva-related genes, which influence the composition, flow, and buffering capacity of saliva, impacting oral microbiota and caries risk; (4) Taste perception genes, which may affect dietary preferences and sugar intake, indirectly influencing caries development; Each group contributes to different aspects of carie

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Credit: Luiz Alexandre Chisini

Dental caries remains a significant global public health burden, affecting billions worldwide despite preventive measures. While behavioral and socioeconomic factors are primary drivers, individual susceptibility varies markedly among those with similar risk profiles. This review synthesizes evidence establishing a substantial genetic component in caries etiology, mediated through polygenic mechanisms and epistatic interactions across key biological pathways.

Genetic Pathways and Key Findings

1. Tooth Mineralization Genes:

• Key Genes: AMBN, AMELX, ENAM, MMPs (e.g., MMP2, MMP20), KLK4, TFIP11, BMP7, *DLX3/DLX4*.

• Mechanism: Variants alter enamel/dentin structure and mineralization, increasing susceptibility to acid demineralization. Epistatic interactions (e.g., *TUFT1-MMP2-TFIP11*, *MMP2-BMP7*) significantly influence lifelong caries trajectories, often undetected by single-SNP analyses. Meta-analyses confirm associations (e.g., AMELX OR=1.78, TFIP11 OR=1.64).

2. Taste Perception Genes:

• Key Genes: TAS2R38 (bitter), TAS1R2, TAS1R3 (sweet).

• Mechanism: SNPs (e.g., TAS2R38 rs713598) alter taste sensitivity, influencing sugar preference and intake. The CG genotype of rs713598 is protective (OR=0.35). TAS1R3 rs307355 shows dose-dependent caries risk across life stages, with epistasis between *TAS1R2/TAS1R3*. GWAS consistently implicate TAS2R genes.

3. Salivary Genes:

• Key Genes: CA6, AQP5, MUC5B.

• Mechanism: Variants impact saliva flow, buffering capacity (CA6), and antimicrobial properties (MUC5B). CA6 rs17032907-TT increases risk 3.23-fold; AQP5 variants are protective (OR=0.75). Reduced MUC5B facilitates S. mutans adhesion. GWAS link CA12 (salivary buffering) to caries.

4. Immune Response Genes:

• Key Genes: MBL2, LTF, DEFB1.

• Mechanism: Polymorphisms impair innate immunity (e.g., MBL2 rs11003125-CG/GG), reducing antimicrobial action against cariogenic biofilms. Pooled MBL2 SNPs increase risk (homozygote OR=2.12; heterozygote OR=2.22).

Genome-Wide vs. Candidate Gene Studies

• GWAS identified novel loci (AJAP1, ADAMTS3, ISL1, BCOR) beyond traditional pathways, implicating odontogenesis, neural function, and immune regulation. Taste (TAS2R) and mineralization (*DLX3/DLX4*) pathways were validated.

• Limited Overlap: Discrepancies arise from GWAS' stringent significance thresholds, phenotypic heterogeneity (DMFT vs. ICDAS), population stratification, and inadequate power/corrections in candidate studies.

Critical Methodological Challenges

1. Population Stratification: Inadequate control for genetic ancestry confounds associations. Self-reported race is insufficient; genomic control (e.g., PCA) is essential.

2. Hardy-Weinberg Equilibrium (HWE): Deviations may indicate genotyping errors or bias; pre-analysis HWE checks are crucial.

3. Linkage Disequilibrium (LD): Failure to account for LD biases epistasis and association results.

4. Multiple Testing: Bonferroni corrections are fundamental but rarely applied, inflating false positives (e.g., only 17% of candidate studies corrected adequately).

5. Epistasis: Single-SNP analyses overlook complex interactions; advanced models (e.g., polygenic risk scores) are needed.

Conclusions and Future Directions

Dental caries is a polygenic trait shaped by interactions across enamel integrity, taste preference, salivary function, and immunity. Future studies must:

• Employ larger, diverse cohorts with standardized phenotyping.

• Integrate epistasis, gene-environment interactions, and polygenic risk scores.

• Rigorously address ancestry, LD, HWE, and multiple testing.

• Prioritize translational applications, such as genetic panels for high-risk identification and personalized prevention.

 

Full text

https://www.xiahepublishing.com/1555-3884/GE-2025-00018