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The effects of pregnancy on oral health
Even though most people are aware that good oral health is essential for the overall health of both mother and child, misunderstandings about the safety of dental care during pregnancy may cause pregnant women to avoid seeing their dentist. The fact is that dentists can create a treatment plan that is safe, effective, and essential for combating the adverse effects of oral disease during pregnancy.
During the course of pregnancy, a woman’s oral health can undergo significant changes. According to an article published in the November/December 2010 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD), pregnant women can experience gingivitis, pregnancy tumors, and mild to severe gingival enlargement.
Clinically, pregnancy gingivitis is no different than non-pregnancy gingivitis. Patients will experience redness and inflammation of the gums, bleeding on probing, and increased tooth mobility. Between 30 and 100 percent of pregnant women will experience varying degrees of gingivitis.
“Although bleeding and inflammation of the gums has been noted in all trimesters of pregnancy, it typically disappears three to six months after delivery, provided that proper oral hygiene measures are implemented,” says Crystal L. McIntosh, DDS, MS, lead author of the article. “Good oral hygiene and visits to a dentist can help to alleviate gum inflammation.”
Pregnancy tumors are reported by 10 percent of pregnant women. These tumors, which are not cancerous, appear as a growth in the mouth and usually disappear after the child is born. They typically are painless and purple or red in color, but they can exhibit spontaneous bleeding.
“If a pregnancy tumor is painful, bleeds severely, or interferes with eating, surgical removal is the treatment of choice,” says AGD spokesperson Robert Roesch, DDS, MAGD.
Gingival enlargement, which is an overgrowth or an increase in the size of the gums, occurs less frequently than gingivitis and pregnancy tumors. In severe cases, the gums can “grow” to cover the teeth completely.
“Pregnancy gingivitis and gingival enlargement are thought to be the result of a heightened response to bacteria in the mouth,” says Dr. Roesch. “That’s why it is extremely important to educate and motivate patients to maintain good oral hygiene during pregnancy.”
If proper oral hygiene is not initiated prior to or during pregnancy, conditions such as gingivitis, pregnancy tumors, and gingival enlargement can worsen as the pregnancy progresses. Pregnant women should maintain their regular, semi-annual checkups and consult a dentist if they notice any changes in their oral health.Expecting? Don’t Neglect Your Teeth
The effects of pregnancy on oral health
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CHICAGO (November 23, 2010) – Even though most people are aware that good oral health is essential for the overall health of both mother and child, misunderstandings about the safety of dental care during pregnancy may cause pregnant women to avoid seeing their dentist. The fact is that dentists can create a treatment plan that is safe, effective, and essential for combating the adverse effects of oral disease during pregnancy.
During the course of pregnancy, a woman’s oral health can undergo significant changes. According to an article published in the November/December 2010 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD), pregnant women can experience gingivitis, pregnancy tumors, and mild to severe gingival enlargement.
Clinically, pregnancy gingivitis is no different than non-pregnancy gingivitis. Patients will experience redness and inflammation of the gums, bleeding on probing, and increased tooth mobility. Between 30 and 100 percent of pregnant women will experience varying degrees of gingivitis.
“Although bleeding and inflammation of the gums has been noted in all trimesters of pregnancy, it typically disappears three to six months after delivery, provided that proper oral hygiene measures are implemented,” says Crystal L. McIntosh, DDS, MS, lead author of the article. “Good oral hygiene and visits to a dentist can help to alleviate gum inflammation.”
Pregnancy tumors are reported by 10 percent of pregnant women. These tumors, which are not cancerous, appear as a growth in the mouth and usually disappear after the child is born. They typically are painless and purple or red in color, but they can exhibit spontaneous bleeding.
“If a pregnancy tumor is painful, bleeds severely, or interferes with eating, surgical removal is the treatment of choice,” says AGD spokesperson Robert Roesch, DDS, MAGD.
Gingival enlargement, which is an overgrowth or an increase in the size of the gums, occurs less frequently than gingivitis and pregnancy tumors. In severe cases, the gums can “grow” to cover the teeth completely.
“Pregnancy gingivitis and gingival enlargement are thought to be the result of a heightened response to bacteria in the mouth,” says Dr. Roesch. “That’s why it is extremely important to educate and motivate patients to maintain good oral hygiene during pregnancy.”
If proper oral hygiene is not initiated prior to or during pregnancy, conditions such as gingivitis, pregnancy tumors, and gingival enlargement can worsen as the pregnancy progresses. Pregnant women should maintain their regular, semi-annual checkups and consult a dentist if they notice any changes in their oral health.
Wednesday, November 24, 2010
Osteoporosis Drug Builds Bone in Patients With Gum Disease
Science News
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A drug marketed to grow bone in osteoporosis patients also works to heal bone wounds in gum disease patients, a University of Michigan study suggests.
"This new approach for the treatment of periodontal disease could allow us to rebuild some of the bone that is lost due to periodontal disease, which until this point has been very difficult to achieve," said Jill Bashutski, clinical assistant professor at the U-M School of Dentistry and first author on the study. "Current treatments to re-grow bone around teeth affected with gum disease have limited success rates."
The findings are significant because gum disease is the leading cause of tooth loss in adults and is associated with a host of other health problems. Periodontal disease results in loss of teeth and can be devastating because it compromises speaking as well as eating, which can in turn contribute to poor nutrition.
The generic name of the drug is teriparatide and it is marketed by Eli Lilly and Co. under the trade name Forteo. It's a type of parathyroid hormone and the only anabolic (meaning it grows bone) osteoporosis drug approved on the market in the United States. Typically, osteoporosis drugs work by preventing bone loss.
The study appears online in the New England Journal of Medicine Oct. 16 and in the print edition Oct. 28. The study was presented Oct. 16 in Toronto at the annual meeting of the American Society for Bone and Mineral Research.
The study took place at the School of Dentistry's Michigan Center for Oral Health Research, where patients with severe chronic gum disease received the traditional treatment for gum disease, which is periodontal surgery on one-quarter of the mouth. Half of the patients took a six-week course of teriparatide by injection into the skin over the abdomen or stomach, plus calcium and vitamin D supplements, while the other half received a placebo.
After one year, researchers saw a 29 percent improvement in bone-level measurements on x-rays in the teriparatide group, versus a 3 percent improvement in the placebo group, a 10-fold increase.
"I think one really interesting aspect of this study is that even a short dosing of this drug had benefits that lasted a year," said Laurie McCauley, U-M professor and chair of periodontics and oral medicine, and principal investigator on the study.
McCauley's research lab has spent nearly two decades studying how parathyroid hormone works. Animal models suggest that it works even better in certain bone wound-healing situations, such as those that involve surgery, than in osteoporosis, which is a diminishing of the bone rather than a wound.
"There was speculation that the bone that forms in a wound like a fracture or inflammatory disease condition might be more responsive to being built back than other bone," said McCauley, who noted that this proved true in the experimental group.
McCauley said the next step is for U-M researchers to test whether the treatment could be delivered locally to target site-specific bone healing. Forteo is not FDA approved for uses other than osteoporosis, but another possible application could be to help grow bone around dental implants.
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A drug marketed to grow bone in osteoporosis patients also works to heal bone wounds in gum disease patients, a University of Michigan study suggests.
"This new approach for the treatment of periodontal disease could allow us to rebuild some of the bone that is lost due to periodontal disease, which until this point has been very difficult to achieve," said Jill Bashutski, clinical assistant professor at the U-M School of Dentistry and first author on the study. "Current treatments to re-grow bone around teeth affected with gum disease have limited success rates."
The findings are significant because gum disease is the leading cause of tooth loss in adults and is associated with a host of other health problems. Periodontal disease results in loss of teeth and can be devastating because it compromises speaking as well as eating, which can in turn contribute to poor nutrition.
The generic name of the drug is teriparatide and it is marketed by Eli Lilly and Co. under the trade name Forteo. It's a type of parathyroid hormone and the only anabolic (meaning it grows bone) osteoporosis drug approved on the market in the United States. Typically, osteoporosis drugs work by preventing bone loss.
The study appears online in the New England Journal of Medicine Oct. 16 and in the print edition Oct. 28. The study was presented Oct. 16 in Toronto at the annual meeting of the American Society for Bone and Mineral Research.
The study took place at the School of Dentistry's Michigan Center for Oral Health Research, where patients with severe chronic gum disease received the traditional treatment for gum disease, which is periodontal surgery on one-quarter of the mouth. Half of the patients took a six-week course of teriparatide by injection into the skin over the abdomen or stomach, plus calcium and vitamin D supplements, while the other half received a placebo.
After one year, researchers saw a 29 percent improvement in bone-level measurements on x-rays in the teriparatide group, versus a 3 percent improvement in the placebo group, a 10-fold increase.
"I think one really interesting aspect of this study is that even a short dosing of this drug had benefits that lasted a year," said Laurie McCauley, U-M professor and chair of periodontics and oral medicine, and principal investigator on the study.
McCauley's research lab has spent nearly two decades studying how parathyroid hormone works. Animal models suggest that it works even better in certain bone wound-healing situations, such as those that involve surgery, than in osteoporosis, which is a diminishing of the bone rather than a wound.
"There was speculation that the bone that forms in a wound like a fracture or inflammatory disease condition might be more responsive to being built back than other bone," said McCauley, who noted that this proved true in the experimental group.
McCauley said the next step is for U-M researchers to test whether the treatment could be delivered locally to target site-specific bone healing. Forteo is not FDA approved for uses other than osteoporosis, but another possible application could be to help grow bone around dental implants.
Taking a Closer Look at Plaque
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A team of University of Rochester scientists is using the technique of Raman spectroscopy to study two common dental plaque bacteria, Streptococcus sanguis and mutans. The relative balance of the two may be an indicator of a patient's oral health and risk for tooth decay -- Streptococcus sanguis is associated with "healthy" plaque, while mutans is associated with tooth decay.
Raman spectroscopy offers the potential to analyze samples of the bacterium in a simple, rapid and quantitative manner as compared to microbiology techniques, including the ability to study spatial distributions of bacterial species, living or dead, within samples.
"We're using Raman spectroscopy to study these oral bacterial biofilms, essentially observing how two species scatter light into shifted wavelengths in a unique way. We can then use these characteristic spectra to identify 'unknown' samples of these species," says Brooke Beier, a Ph.D. candidate at the University of Rochester's Institute of Optics. "Studying the spatial distributions of the good vs. bad bacteria under various growth conditions may help scientists determine more effective treatments to prevent tooth decay."
With the ability to identify biofilm samples by species, the researchers can now move on to the study of biofilms grown from a mixture of liquid cultures, where the two species may interact as they grow together.
A team of University of Rochester scientists is using the technique of Raman spectroscopy to study two common dental plaque bacteria, Streptococcus sanguis and mutans. The relative balance of the two may be an indicator of a patient's oral health and risk for tooth decay -- Streptococcus sanguis is associated with "healthy" plaque, while mutans is associated with tooth decay.
Raman spectroscopy offers the potential to analyze samples of the bacterium in a simple, rapid and quantitative manner as compared to microbiology techniques, including the ability to study spatial distributions of bacterial species, living or dead, within samples.
"We're using Raman spectroscopy to study these oral bacterial biofilms, essentially observing how two species scatter light into shifted wavelengths in a unique way. We can then use these characteristic spectra to identify 'unknown' samples of these species," says Brooke Beier, a Ph.D. candidate at the University of Rochester's Institute of Optics. "Studying the spatial distributions of the good vs. bad bacteria under various growth conditions may help scientists determine more effective treatments to prevent tooth decay."
With the ability to identify biofilm samples by species, the researchers can now move on to the study of biofilms grown from a mixture of liquid cultures, where the two species may interact as they grow together.
Substantial Consumption of Fluoride Increases Chance of Mild Fluorosis
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Young children who consume substantial amounts of fluoride through infant formula and other beverages mixed with fluoridated water or by swallowing fluoride toothpaste have an increased chance of developing mild enamel fluorosis, according to research published in the October issue of The Journal of the American Dental Association and supported by the National Institute of Dental and Craniofacial Research. However, experts say, children can continue using fluoridated water and fluoride toothpaste because fluoride has been proven to prevent tooth decay, and mild fluorosis does not negatively affect dental health or quality of life.
"Nearly all of the fluorosis in our study participants was mild. A recent review of the effects of mild dental fluorosis on oral health-related quality of life concluded that the effect of mild fluorosis was not adverse and could even be favorable," according to the study. "This suggests that concerns about mild dental fluorosis may be exaggerated. Therefore, no general recommendations to avoid use of fluoridated water in reconstituting infant formula are warranted. "
According to the American Dental Association, mild enamel fluorosis appears as barely noticeable faint white lines or streaks on tooth enamel that may occur when children ingest excess fluoride while their teeth are developing.
Researchers concluded that substantial fluoride consumption from beverages with fluoridated water, including infant formula, by children between the ages of 3 to 9 months, elevates a child's prospect of developing mild enamel fluorosis. Substantial fluoride consumption from beverages with fluoridated water and from fluoride toothpaste by children between the ages of 16 to 36 months also elevates a child's probability of developing mild enamel fluorosis.
The American Academy of Pediatrics recommends breastfeeding for infants. If parents are concerned about reducing the chances of their infants developing mild fluorosis through consuming substantial amounts of infant formula mixed with fluoridated water, the researchers suggest that they consult with their family dentist or physician. The researchers also encourage parents to follow recommendations to use small (smear or pea-sized) amounts of fluoridated toothpaste and ensure proper supervision of the child's tooth brushing.
Researchers recruited mothers of newborn infants from eight Iowa hospital postpartum wards between 1992 and 1995 for their children's participation in what would become known as the Iowa Fluoride Study, an investigation of dietary and non-dietary fluoride exposures, dental fluorosis and dental cavities. Researchers sent questionnaires to the parents at regular intervals and 630 children underwent visual dental examinations using standardized techniques and portable equipment. The leader of the research team was Steven M. Levy, D.D.S., M.P.H., the Wright-Bush-Shreves Endowed Professor of Research in the Department of Preventive and Community Dentistry at the University of Iowa's College of Dentistry and Professor of Epidemiology at the College of Public Health.
Young children who consume substantial amounts of fluoride through infant formula and other beverages mixed with fluoridated water or by swallowing fluoride toothpaste have an increased chance of developing mild enamel fluorosis, according to research published in the October issue of The Journal of the American Dental Association and supported by the National Institute of Dental and Craniofacial Research. However, experts say, children can continue using fluoridated water and fluoride toothpaste because fluoride has been proven to prevent tooth decay, and mild fluorosis does not negatively affect dental health or quality of life.
"Nearly all of the fluorosis in our study participants was mild. A recent review of the effects of mild dental fluorosis on oral health-related quality of life concluded that the effect of mild fluorosis was not adverse and could even be favorable," according to the study. "This suggests that concerns about mild dental fluorosis may be exaggerated. Therefore, no general recommendations to avoid use of fluoridated water in reconstituting infant formula are warranted. "
According to the American Dental Association, mild enamel fluorosis appears as barely noticeable faint white lines or streaks on tooth enamel that may occur when children ingest excess fluoride while their teeth are developing.
Researchers concluded that substantial fluoride consumption from beverages with fluoridated water, including infant formula, by children between the ages of 3 to 9 months, elevates a child's prospect of developing mild enamel fluorosis. Substantial fluoride consumption from beverages with fluoridated water and from fluoride toothpaste by children between the ages of 16 to 36 months also elevates a child's probability of developing mild enamel fluorosis.
The American Academy of Pediatrics recommends breastfeeding for infants. If parents are concerned about reducing the chances of their infants developing mild fluorosis through consuming substantial amounts of infant formula mixed with fluoridated water, the researchers suggest that they consult with their family dentist or physician. The researchers also encourage parents to follow recommendations to use small (smear or pea-sized) amounts of fluoridated toothpaste and ensure proper supervision of the child's tooth brushing.
Researchers recruited mothers of newborn infants from eight Iowa hospital postpartum wards between 1992 and 1995 for their children's participation in what would become known as the Iowa Fluoride Study, an investigation of dietary and non-dietary fluoride exposures, dental fluorosis and dental cavities. Researchers sent questionnaires to the parents at regular intervals and 630 children underwent visual dental examinations using standardized techniques and portable equipment. The leader of the research team was Steven M. Levy, D.D.S., M.P.H., the Wright-Bush-Shreves Endowed Professor of Research in the Department of Preventive and Community Dentistry at the University of Iowa's College of Dentistry and Professor of Epidemiology at the College of Public Health.
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