Dental News Report: June 2019

Monday, June 17, 2019

Poor oral health linked to a 75% increase in liver cancer risk

The study, by researchers at Queen's University Belfast, analysed a large cohort of over 469,000 people in the UK, investigated the association between oral health conditions and the risk of a number of gastrointestinal cancers, including liver, colon, rectum and pancreatic cancer. Models were applied to estimate the relationship between cancer risk and self-reported oral health conditions, such as painful or bleeding gums, mouth ulcers and loose teeth.
Whilst no significant associations were observed on the risk of the majority gastrointestinal cancers and poor oral health, a substantial link was found for hepatobiliary cancer.
"Poor oral health has been associated with the risk of several chronic diseases, such as heart disease, stroke and diabetes", explained Dr Haydée WT Jordão, from the Centre of Public Health at Queen's University Belfast and lead author of the study. "However, there is inconsistent evidence on the association between poor oral health and specific types of gastrointestinal cancers, which is what our research aimed to examine."
Of the 469,628 participants, 4,069 developed gastrointestinal cancer during the (average) six-year follow up. In 13% of these cases, patients reported poor oral health. Participants with poor oral health were more likely to be younger, female, living in deprived socioeconomic areas and consumed less than two portions of fruit and vegetables per day.
The biological mechanisms by which poor oral health may be more strongly associated with liver cancer, rather than other digestive cancers, is currently uncertain. One explanation is the potential role of the oral and gut microbiome in disease development. "The liver contributes to the elimination of bacteria from the human body", stated Dr Haydée WT Jordão. "When the liver is affected by diseases, such as hepatitis, cirrhosis or cancer, its function will decline and bacteria will survive for longer and therefore have the potential to cause more harm. One bacteria, Fusobacterium nucleatum, originates in the oral cavity but its role in liver cancer is unclear. Further studies investigating the microbiome and liver cancer are therefore warranted."
Another theory in explaining the higher cancer risk due to poor oral health suggests that participants with a high number of missing teeth may alter their diet, consuming softer and potentially less nutritious foods, which in turn influence the risk of liver cancer².
Liver cancer is the sixth bigger cancer killer in the EU, claiming the lives of almost 60,000 people per year³. The five-year survival rate for the disease across Europe is just 11%⁴ and approximately 9 in 10 cases are in individuals over the age of 55 ref media pack³. It is believed that up to half of cases of liver cancer are preventable, with risk factors often relating to lifestyle, such as overweight or obesity, smoking and alcohol consumption.

Friday, June 14, 2019

Braces won't always bring happiness

Research undertaken at the University of Adelaide overturns the belief that turning your crooked teeth into a beautiful smile will automatically boost your self-confidence.

The study, carried out by Dr Esma Dogramaci and Professor David Brennan from the University of Adelaide's Dental School, followed 448 13-year-olds from South Australia in 1988 and 1989. By the time that they turned 30 in 2005 and 2006 more than a third of them had received orthodontic treatment.
"The study, which is the first of its type undertaken in Australia and only the second in the world, examined if having braces lead to a greater level of happiness or psychosocial outcomes, later in life," says Dr Dogramaci.
"There was a pattern of higher psychosocial scores in people who did not have orthodontic treatment meaning people who hadn't had braces fitted were significantly more optimistic than the ones that did have braces.
"Those who didn't have braces had varying levels of crooked teeth, just like those who had braces treatment -- ranging from mild through to very severe."
The study looked at four psychosocial aspects: how well people felt they coped with new or difficult situations and associated setbacks; how much they felt that could take care of their own health; the support the person believed they received from their personal network and finally their own level of optimism.
"These indicators were chosen because they are important for psychosocial functioning and are relevant to health behaviours and health outcomes; since the core research question was the impact of braces treatment on patients' self-confidence and happiness in later life," says Dr Dogramaci.
Fourth year dental student Alex Furlan has never had braces fitted: "My orthodontist recommended that I have braces fitted but I'm quite happy without them. I've never felt the need to straighten my teeth -- I can get on in life without having perfectly straight teeth," he says.
"A lot of people are convinced that if they have braces, they will feel more positive about themselves and do well, psychosocially, in later life. This study confirmed that other factors play a role in predicting psychosocial functioning as adults -- braces as a youngster was not one of them," says Dr Dogramacci.
"But brushing at least twice a day and seeing a dentist regularly were amongst the factors related to better psychosocial scores."
"On a population level, those who have never had braces were more positive than those who had braces. While experiencing braces treatment won't guarantee happiness later in life, brushing teeth twice a day and seeing a dentist for regular check-ups will help to keep you healthy and happy."

Story Source:
Materials provided by University of Adelaide. Note: Content may be edited for style and length.

Journal Reference:

Esma J. Doğramacı, David S. Brennan. The long‐term influence of orthodontic treatment on adults’ psychosocial outcomes. An Australian cohort study. Orthodontics & Craniofacial Research, 2019; DOI: 10.1111/ocr.12327

Cite This Page:

University of Adelaide. "Braces won't always bring happiness." ScienceDaily. ScienceDaily, 13 June 2019. .

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Wednesday, June 12, 2019

Ways to prevent lung disease in dentistry professionals

**IMAGE:** Fotinos Panagakos, the WVU School of Dentistry's associate dean of research, has teamed up with researchers at NIOSH to study the respiratory exposures that dentists and dental technicians face on... view more

Credit: WVU

Inhaling dangerous particulates is a hazard of coal mining, mold remediation, sandblasting ... and dentistry.
Fotinos Panagakos, associate dean of research at the West Virginia University School of Dentistry, is collaborating with a team at the National Institute for Occupational Safety and Health to study how microscopic, airborne particulates and gases might be generated during dental procedures. NIOSH--a division of the Centers for Disease Control and Prevention--is funding the project.
"When a dentist is drilling into your tooth, they're using water with suction, so the suction system will capture most of the particulate matter. And if it does go into the air, they're wearing a mask that should prevent the moisture and particulates from going through," Panagakos said. "It's really all the other work that they do outside of the mouth--grinding things, polishing things, modifying appliances, pouring and trimming plaster, often without a suction system to pull particulates away, and many times not wearing any respiratory protection--that are of concern."
Pangakos and his collaborators--including Randall Nett and Brie Blackley, of NIOSH--are assessing how dental professionals come into contact with vapors, gases and airborne dusts in dental clinics. At five WVU teaching clinics and 29 private dental clinics that collaborate with the dental school's Department of Dental Practice and Rural Health, they will measure the size and concentration of particulates in real time during common dental procedures. They will also characterize the particulates' and gases' chemical composition. The samples they'll analyze are diverse: metals, dust, silica, volatile organic compounds and anesthetic gases.
Going beyond the clinics' workstations, the researchers will evaluate the ventilation at each clinic they visit. "In some smaller clinics, it could be that their setting is in a strip mall, say, and the ventilation systems have not been evaluated," said Blackley, a research industrial hygienist. "We will characterize not only the potential exposures that are present but what actions can be taken to mitigate them."
The impetus of the study was a cluster of dental professionals diagnosed with the same chronic lung condition--idiopathic pulmonary fibrosis--at a single Virginia clinic. IPF is characterized by scarring in the lungs. It makes patients progressively short of breath and can call for supplemental oxygen, mechanical ventilation or a lung transplant. It's commonly fatal within two to five years, and it has no cure.
"Idiopathic means we don't know what causes it," said Nett, who leads the Field Studies Branch of the NIOSH Respiratory Health Division and investigated the cluster of cases when it came to light. "That's part of the reason why we want to understand better what dental personnel are exposed to in the first place."
Sometimes the only personal protection dentists have in the lab is the surgical masks they wear when they treat patients. But "that mask is really not designed to eliminate the kind of particulate matter that eventually could cause this problem," Panagakos said.
Whatever the researchers discover, they plan to collaborate with the American Dental Association and the WVU School of Dentistry to share their results with dental professionals.
"We don't want to just point to a potential hazard and say, 'Here's a problem.' We want to be able to characterize exposures and recommend actions that dental personnel could take to protect themselves," Blackley said.
"If you're in a dental lab facility where a dental lab technician works, they probably have a higher level of preventive measures in place. Here at the Dental School, our labs are equipped along those lines," Panagakos said. "But if you're at a dental office, there's probably very little protection, if any."

Monday, June 10, 2019

Undetected diabetes linked to heart attack and gum disease

People with undetected glucose disorders run a higher risk of both myocardial infarction and periodontitis, according to a study published in the journal Diabetes Care by researchers at Karolinska Institutet in Sweden. The results demonstrate the need of greater collaboration between dentistry and healthcare, say the researchers, and possibly of screening for diabetes at dental clinics.
Severe periodontitis is already known to be associated with a higher risk of myocardial infarction and lowered glucose tolerance, and diabetes to be more common in people who have suffered a heart attack.
The researchers behind these earlier findings have now studied whether undetected glucose disorders (dysglycaemia) - that is, a reduced ability to metabolise sugar - is linked to both these conditions: myocardial infarction and periodontitis. The results are published in the journal Diabetes Care.
The study was a collaboration between cardiologists and dentists at Karolinska Institutet and was based on data from a previous study called PAROKRANK. It included 805 myocardial infarction patients from 17 Swedish cardiology clinics and 805 controls, who were matched by age, sex and post code. The patients' periodontitic status was assessed with X-rays and dysglycaemic status with glucose load tests.
Participants with a diabetes diagnosis were excluded from the study, which left 712 patients and 731 controls with data on both periodontitic status and glucose status, the latter of which was divided into three categories: normal, reduced glucose tolerance, newly detected diabetes. Comparisons were made after adjusting for age, sex, smoking habits, education and civil status.
The study shows that previously undetected glucose disorders, which include diabetes and impaired glucose tolerance, were linked to myocardial infarction. It was roughly twice as common for myocardial infarction patients to have undetected dysglycaemia as for healthy controls, confirming the research group's earlier findings. Myocardial infarction affects approximately 30,000 people in Sweden annually.
Undetected diabetes was also found to be linked to severe periodontitis. When myocardial infarction patients and controls were analysed separately, the association was clearer in the patients than in the controls, which is possibly because many of the controls were very healthy and few had severe periodontitis and undetected diabetes.
"Our findings indicate that dysglycaemia is a key risk factor in both severe periodontitis and myocardial infarction and that the combination of severe periodontitis and undetected diabetes further increases the risk of myocardial infarction," says the study's lead author Anna Norhammar, cardiologist and Associate Professor at Karolinska Institutet's Department of Medicine in Solna.
The results substantiate previously known links between periodontitis and diabetes and show that such an association also exists in previously unknown diabetes.
According to the researchers, the findings should make diabetes specialists consider their patients' dental health and the need for closer collaboration with dentists.
"The PAROKRANK study is a good example of such collaboration," says the present study's senior author Lars Rydén, Professor at Karolinska Institutet's Department of Medicine in Solna and chair of the academically initiated PAROKRANK study.
"Our study shows that undetected glucose disorders are common in two major diseases - myocardial infarction and periodontitis," says Dr Norhammar. "Many people visit the dentist regularly and maybe it's worth considering taking routine blood-sugar tests in patients with severe periodontitis to catch these patients."
One of the study's limitations is that despite the large number of participants, the number of patients and controls with severe periodontitis and undetected diabetes was low. The observed differences in the links between undetected diabetes and severe periodontitis in patients and controls can therefore be attributable either to the low number of patients or to genuine differences in correlation.

Monday, June 3, 2019

Brush your teeth -- postpone Alzheimer's

You don't only avoid holes in your teeth by keeping good oral hygiene, Norwegian researchers have discovered a clear connection between gum disease and Alzheimer's disease
The researchers have determined that gum disease (gingivitis) plays a decisive role in whether a person developes Alzheimer´s or not.
"We discovered DNA-based proof that the bacteria causing gingivitis can move from the mouth to the brain," says researcher Piotr Mydel at Broegelmanns Research Laboratory, Department of Clinical Science, University of Bergen (UiB).
The bacteria produces a protein that destroys nerve cells in the brain, which in turn leads to loss of memory and ultimately, Alzheimer´s.
Brush your teeth for better memory Mydel points out that the bacteria is not causing Alzheimer´s alone, but the presence of these bacteria raise the risk for developing the disease substantially and are also implicated in a more rapid progression of the disease. However, the good news is that this study shows that there are some things you can do yourself to slow down Alzheimer´s.
"Brush your teeth and use floss". Mydel adds that it is important, if you have established gingivitis and have Alzheimer´s in your family, to go to your dentist regularly and clean your teeth properly.
New medicine being developed Researchers have previously discovered that the bacteria causing gingivitis can move from the mouth to the brain where theharmful enzymes they excrete can destroy the nerve cells in the brain. Now, for the first time, Mydel has DNA-evidence for this process from human brains. Mydel and his colleagues examined 53 persons with Alzheimer´s and discovered the enzyme in 96 per cent of the cases.According to Mydel, this knowledge gives researchers a possible new approach for attacking Alzheimer´s disease.
"We have managed to develop a drug that blocks the harmful enzymes from the bacteria, postponing the development of Alzheimer´s. We are planning to test this drug later this year, says Piotr Mydel.
Facts: Gingivitis

The bacteria Porphyromonas gingivalis (P.gingivalis) is one of the main causes to infection in the gums.
The bacteria causes chronic infection in the gums, but can move to the brain where it can damage nerve cells in the brain.
Circa 50 per cent of the population have this bacteria in one or another form.
Circa 10 per cent of the ones having this bacteria will develop serious gum disease, loose teeth, and have an increased risk of developing Alzheimer´s disease.
In addition to Alzheimers, the bacteria is linked to rheumatism, COPD and esophageal cancer.

Dental News Report