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Oral surgeons may one day have an easier, less costly approach to one important aspect of dental restoration, thanks to a newly patented process developed by researchers at Missouri University of Science and Technology (Missouri S&T).
The process computerizes the method for creating a dental bar, also called an over-denture. For dental restoration procedures, the device is the bridge connecting dental implants to dentures.
The computerized approach was developed by Dr. Ming Leu, the Keith and Pat Bailey Missouri Distinguished Professor of Integrated Product Manufacturing at Missouri S&T, and one of Leu’s former students, Amit Gawate, who received a master’s degree in mechanical engineering from Missouri S&T in 2005. Leu and Gawate were recently awarded a patent for their process.
Typically, a dental technician creates the device through a laborious manual process that involves molding and casting. But Leu’s approach is entirely digital and automated.
“This method can reduce the cost as well as the time involved” in fabricating dental bars, Leu says.
The conventional approach involves first making an impression of the area of the mouth where a denture would be placed, then casting a model of the gums and implants. From there, technicians design and fabricate the dental bar from a metal material.
Rather than making a physical model, Leu’s process uses digital imaging technology to take a picture of a patient’s mouth. From there, computer algorithms – developed by Leu and Gawate – crunch the image data to create a computer-aided design model of the actual dental bar. That model can then be fabricated using either an “additive manufacturing” or a computer-numerically controlled (CNC) machining process.
“Additive manufacturing is a way of making a part by adding material, one layer at a time, rather than removing material, as you would do with machining,” he says. The process uses less material than machining or other processes and can be easily tailored to individualized parts of different geometries, Leu adds.
An expert in manufacturing, Leu first became interested in dental surgery after a prosthodontist contacted Leu about some previous research with additive manufacturing. In 2000, Leu developed a way to create prototypes of manufactured parts out of ice, a method he called “rapid freeze prototyping,” and the prosthodontist thought the approach would be a cost-effective way to make models for dental surgery. Together, they obtained funding from the National Science Foundation to investigate the approach. From there, Leu developed the computer-aided method for dental bar design.
Tuesday, August 10, 2010
Friday, August 6, 2010
Six Dental Myths Debunked
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Brushing, flossing, and twice-yearly dental check-ups are standard for oral health care, but there are more health benefits to taking care of your pearly whites than most of us know. In a review article, a faculty member at Tufts University School of Dental Medicine (TUSDM) debunks common dental myths and outlines how diet and nutrition affects oral health in children, teenagers, expectant mothers, adults and elders.
Myth 1: The consequences of poor oral health are restricted to the mouth
Expectant mothers may not know that what they eat affects the tooth development of the fetus. Poor nutrition during pregnancy may make the unborn child more likely to have tooth decay later in life. “Between the ages of 14 weeks to four months, deficiencies in calcium, vitamin D, vitamin A, protein and calories could result in oral defects,” says Carole Palmer, EdD, RD, professor at TUSDM and head of the division of nutrition and oral health promotion in the department of public health and community service. Some data also suggest that lack of adequate vitamin B6 or B12 could be a risk factor for cleft lip and cleft palate formation.
In children, tooth decay is the most prevalent disease, about five times more common than childhood asthma. “If a child’s mouth hurts due to tooth decay, he/she is less likely to be able to concentrate at school and is more likely to be eating foods that are easier to chew but that are less nutritious. Foods such as donuts and pastries are often lower in nutritional quality and higher in sugar content than more nutritious foods that require chewing, like fruits and vegetables,” says Palmer. “Oral complications combined with poor diet can also contribute to cognitive and growth problems and can contribute to obesity.”
Myth 2: More sugar means more tooth decay
It isn’t the amount of sugar you eat; it is the amount of time that the sugar has contact with the teeth. “Foods such as slowly-dissolving candies and soda are in the mouth for longer periods of time. This increases the amount of time teeth are exposed to the acids formed by oral bacteria from the sugars,” says Palmer.
Some research shows that teens obtain about 40 percent of their carbohydrate intake from soft drinks. This constant beverage use increases the risk of tooth decay. Sugar-free carbonated drinks and acidic beverages, such as lemonade, are often considered safer for teeth than sugared beverages but can also contribute to demineralization of tooth enamel if consumed regularly.
Myth 3: Losing baby teeth to tooth decay is okay
It is a common myth that losing baby teeth due to tooth decay is insignificant because baby teeth fall out anyway. Palmer notes that tooth decay in baby teeth can result in damage to the developing crowns of the permanent teeth developing below them. If baby teeth are lost prematurely, the permanent teeth may erupt malpositioned and require orthodontics later on.
Myth 4: Osteoporosis only affects the spine and hips
Osteoporosis may also lead to tooth loss. Teeth are held in the jaw by the face bone, which can also be affected by osteoporosis. “So, the jaw can also suffer the consequences of a diet lacking essential nutrients such as calcium and vitamins D and K,” says Palmer.
“The jawbone, gums, lips, and soft and hard palates are constantly replenishing themselves throughout life. A good diet is required to keep the mouth and supporting structures in optimal shape.”
Myth 5: Dentures improve a person’s diet
If dentures don’t fit well, older adults are apt to eat foods that are easy to chew and low in nutritional quality, such as cakes or pastries. “First, denture wearers should make sure that dentures are fitted properly. In the meantime, if they are having difficulty chewing or have mouth discomfort, they can still eat nutritious foods by having cooked vegetables instead of raw, canned fruits instead of raw, and ground beef instead of steak. Also, they should drink plenty of fluids or chew sugar-free gum to prevent dry mouth,” says Palmer.
Myth 6: Dental decay is only a young person’s problem
In adults and elders, receding gums can result in root decay (decay along the roots of teeth). Commonly used drugs such as antidepressants, diuretics, antihistamines and sedatives increase the risk of tooth decay by reducing saliva production. “Lack of saliva means that the mouth is cleansed more slowly. This increases the risk of oral problems,” says Palmer. “In this case, drinking water frequently can help cleanse the mouth.”
Adults and elders are more likely to have chronic health conditions, like diabetes, which are risk factors for periodontal disease (which begins with an inflammation of the gums and can lead to tooth loss). “Type 2 diabetes patients have twice the risk of developing periodontal disease of people without diabetes. Furthermore, periodontal disease exacerbates diabetes mellitus, so meticulous oral hygiene can help improve diabetes control,” says Palmer.
This article appears in the July/August issue of Nutrition Today.
Palmer CA, Burnett DJ, Dean B. July/August 2010. Nutrition Today. 45(4): 154-164. “It’s More than Just Candy: Important Relationships between Nutrition and Oral Health.” doi: 10.1097/NT.0b013e3181e98969
Brushing, flossing, and twice-yearly dental check-ups are standard for oral health care, but there are more health benefits to taking care of your pearly whites than most of us know. In a review article, a faculty member at Tufts University School of Dental Medicine (TUSDM) debunks common dental myths and outlines how diet and nutrition affects oral health in children, teenagers, expectant mothers, adults and elders.
Myth 1: The consequences of poor oral health are restricted to the mouth
Expectant mothers may not know that what they eat affects the tooth development of the fetus. Poor nutrition during pregnancy may make the unborn child more likely to have tooth decay later in life. “Between the ages of 14 weeks to four months, deficiencies in calcium, vitamin D, vitamin A, protein and calories could result in oral defects,” says Carole Palmer, EdD, RD, professor at TUSDM and head of the division of nutrition and oral health promotion in the department of public health and community service. Some data also suggest that lack of adequate vitamin B6 or B12 could be a risk factor for cleft lip and cleft palate formation.
In children, tooth decay is the most prevalent disease, about five times more common than childhood asthma. “If a child’s mouth hurts due to tooth decay, he/she is less likely to be able to concentrate at school and is more likely to be eating foods that are easier to chew but that are less nutritious. Foods such as donuts and pastries are often lower in nutritional quality and higher in sugar content than more nutritious foods that require chewing, like fruits and vegetables,” says Palmer. “Oral complications combined with poor diet can also contribute to cognitive and growth problems and can contribute to obesity.”
Myth 2: More sugar means more tooth decay
It isn’t the amount of sugar you eat; it is the amount of time that the sugar has contact with the teeth. “Foods such as slowly-dissolving candies and soda are in the mouth for longer periods of time. This increases the amount of time teeth are exposed to the acids formed by oral bacteria from the sugars,” says Palmer.
Some research shows that teens obtain about 40 percent of their carbohydrate intake from soft drinks. This constant beverage use increases the risk of tooth decay. Sugar-free carbonated drinks and acidic beverages, such as lemonade, are often considered safer for teeth than sugared beverages but can also contribute to demineralization of tooth enamel if consumed regularly.
Myth 3: Losing baby teeth to tooth decay is okay
It is a common myth that losing baby teeth due to tooth decay is insignificant because baby teeth fall out anyway. Palmer notes that tooth decay in baby teeth can result in damage to the developing crowns of the permanent teeth developing below them. If baby teeth are lost prematurely, the permanent teeth may erupt malpositioned and require orthodontics later on.
Myth 4: Osteoporosis only affects the spine and hips
Osteoporosis may also lead to tooth loss. Teeth are held in the jaw by the face bone, which can also be affected by osteoporosis. “So, the jaw can also suffer the consequences of a diet lacking essential nutrients such as calcium and vitamins D and K,” says Palmer.
“The jawbone, gums, lips, and soft and hard palates are constantly replenishing themselves throughout life. A good diet is required to keep the mouth and supporting structures in optimal shape.”
Myth 5: Dentures improve a person’s diet
If dentures don’t fit well, older adults are apt to eat foods that are easy to chew and low in nutritional quality, such as cakes or pastries. “First, denture wearers should make sure that dentures are fitted properly. In the meantime, if they are having difficulty chewing or have mouth discomfort, they can still eat nutritious foods by having cooked vegetables instead of raw, canned fruits instead of raw, and ground beef instead of steak. Also, they should drink plenty of fluids or chew sugar-free gum to prevent dry mouth,” says Palmer.
Myth 6: Dental decay is only a young person’s problem
In adults and elders, receding gums can result in root decay (decay along the roots of teeth). Commonly used drugs such as antidepressants, diuretics, antihistamines and sedatives increase the risk of tooth decay by reducing saliva production. “Lack of saliva means that the mouth is cleansed more slowly. This increases the risk of oral problems,” says Palmer. “In this case, drinking water frequently can help cleanse the mouth.”
Adults and elders are more likely to have chronic health conditions, like diabetes, which are risk factors for periodontal disease (which begins with an inflammation of the gums and can lead to tooth loss). “Type 2 diabetes patients have twice the risk of developing periodontal disease of people without diabetes. Furthermore, periodontal disease exacerbates diabetes mellitus, so meticulous oral hygiene can help improve diabetes control,” says Palmer.
This article appears in the July/August issue of Nutrition Today.
Palmer CA, Burnett DJ, Dean B. July/August 2010. Nutrition Today. 45(4): 154-164. “It’s More than Just Candy: Important Relationships between Nutrition and Oral Health.” doi: 10.1097/NT.0b013e3181e98969
Tuesday, August 3, 2010
Tongue Piercing May Cause Gapped Teeth
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Could cost thousands of dollars in orthodontic repairs
Mark this one down as a parental nightmare.
First, your child gets her tongue pierced. Then, as if you needed something else, she starts "playing" with the tiny barbell-shaped stud, pushing it against her upper front teeth. And before you know it, she forces a gap between those teeth -- a fraction-of-an-inch gap that may cost thousands of dollars in orthodontic bills to straighten.
How and why this happens has been documented in a case study by University at Buffalo researchers published in the July issue of the Journal of Clinical Orthodontics.
"It is a basic tenet of orthodontic that force, over time, moves teeth," explains the study's primary investigator, Sawsan Tabbaa, DDS, MS, assistant professor of orthodontics at the UB School of Dental Medicine.
Tabbaa notes that a previous UB dental school survey study of Buffalo high school students revealed that the presence of a barbell implant/stud caused a damaging habit whereby subjects pushed the metal stud up against and between their upper front teeth, a habit commonly referred to among the students as "playing."
"And it happened in very high percent of the cases," said Tabbaa.
That repeated "playing" with the stud may result in a gap as is demonstrated in Tabbaa's current case study.
The study involved a 26- year-old female patient examined at UB's orthodontic clinic who complained that a large space had developed between her upper central incisors or upper front teeth. The patient also had a tongue piercing that held a barbell-shaped tongue stud.
The tongue was pierced seven years earlier and every day for seven years she had pushed the stud between her upper front teeth, creating the space between them and, subsequently, habitually placing it in the space. The patient did not have a space between her upper front teeth prior to the tongue piercing.
"The barbell is never removed because the tongue is so vascular that leaving the stud out can result in healing of the opening in the tongue, said Tabbaa, "so it makes perfect sense that constant pushing of the stud against the teeth -- every day with no break -- will move them or drive them apart."
The patient provided the research team with photos that demonstrated she had no diastema, or space, prior to having her tongue pierced. For the purposes of treating this patient's space, it was assumed that positioning of the tongue stud between the maxillary central incisors or "playing" caused the midline space.
Her treatment involved a fixed braces appliance to push the front teeth back together.
Tongue piercing can result in serious injury not just to teeth but has also been associated with hemorrhage, infection, chipped and fractured teeth, trauma to the gums and, in the worst cases, brain abscess, said Tabbaa.
"The best way to protect your health, your teeth and your money is to avoid tongue piercing."
Could cost thousands of dollars in orthodontic repairs
Mark this one down as a parental nightmare.
First, your child gets her tongue pierced. Then, as if you needed something else, she starts "playing" with the tiny barbell-shaped stud, pushing it against her upper front teeth. And before you know it, she forces a gap between those teeth -- a fraction-of-an-inch gap that may cost thousands of dollars in orthodontic bills to straighten.
How and why this happens has been documented in a case study by University at Buffalo researchers published in the July issue of the Journal of Clinical Orthodontics.
"It is a basic tenet of orthodontic that force, over time, moves teeth," explains the study's primary investigator, Sawsan Tabbaa, DDS, MS, assistant professor of orthodontics at the UB School of Dental Medicine.
Tabbaa notes that a previous UB dental school survey study of Buffalo high school students revealed that the presence of a barbell implant/stud caused a damaging habit whereby subjects pushed the metal stud up against and between their upper front teeth, a habit commonly referred to among the students as "playing."
"And it happened in very high percent of the cases," said Tabbaa.
That repeated "playing" with the stud may result in a gap as is demonstrated in Tabbaa's current case study.
The study involved a 26- year-old female patient examined at UB's orthodontic clinic who complained that a large space had developed between her upper central incisors or upper front teeth. The patient also had a tongue piercing that held a barbell-shaped tongue stud.
The tongue was pierced seven years earlier and every day for seven years she had pushed the stud between her upper front teeth, creating the space between them and, subsequently, habitually placing it in the space. The patient did not have a space between her upper front teeth prior to the tongue piercing.
"The barbell is never removed because the tongue is so vascular that leaving the stud out can result in healing of the opening in the tongue, said Tabbaa, "so it makes perfect sense that constant pushing of the stud against the teeth -- every day with no break -- will move them or drive them apart."
The patient provided the research team with photos that demonstrated she had no diastema, or space, prior to having her tongue pierced. For the purposes of treating this patient's space, it was assumed that positioning of the tongue stud between the maxillary central incisors or "playing" caused the midline space.
Her treatment involved a fixed braces appliance to push the front teeth back together.
Tongue piercing can result in serious injury not just to teeth but has also been associated with hemorrhage, infection, chipped and fractured teeth, trauma to the gums and, in the worst cases, brain abscess, said Tabbaa.
"The best way to protect your health, your teeth and your money is to avoid tongue piercing."
Pilot safety protocol could help dentists reduce errors
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Pilots and dentists have more in common than one might think: Both jobs are highly technical and require teamwork. Both are subject to human error where small, individual mistakes may lead to catastrophe if not addressed early.
A dental professor at the University of Michigan and two pilot-dentists believe that implementing a checklist of safety procedures in dental offices similar to procedures used in airlines would drastically reduce human errors.
Illustration by Maria Gunnes Sibbel
Crew Resource Management empowers team members to actively participate to enhance safety using forward thinking strategies, said Russell Taichman, U-M dentistry professor and director of the Scholars Program in Dental Leadership. Taichman co-authored the study, "Adaptation of airline crew resource management (CRM) principles to dentistry," which will appear in the August issue of the Journal of the American Dental Association.
Airlines implemented CRM about 30 years ago after recognizing that most accidents resulted from human error, said co-author Harold Pinsky, a full-time airline pilot and practicing general dentist who did additional training at U-M dental school.
"Using checklists makes for a safer, more standardized routine of dental surgery in my practice," said David Sarment, a third co-author on the paper. Sarment was on the U-M dental faculty full-time before leaving for private practice. He is also a pilot and was taught to fly by Pinsky.
CRM checklists in the dentist's office represent a major culture shift that will be slow to catch on, but Pinsky thinks it's inevitable.
"It's about communication," Pinsky said. "If I'm doing a restoration and my assistant sees saliva leaking, in the old days the assistant would think to themselves, 'The doctor is king, he or she must know what's going on.'" But if all team members have a CRM checklist, the assistant is empowered to tell the doctor if there is a problem. "Instead of the doctor saying, 'Don't ever embarrass me in front of a patient again,' they'll say, 'Thanks for telling me.'"
At each of the five stages of the dental visit, the dental team is responsible for checking safety items off a codified list before proceeding. Pinsky said that while he expects each checklist to look different for each office, the important thing is to have the standards in place.
Studies show that CRM works. Six government studies of airlines using CRM suggest safety improvements as high as 46 percent. Another study involving six large corporate and military entities showed accidents decreased between 36-81 percent after implementing CRM. In surgical settings, use of checklists has reduced complications and deaths by 36 percent.
Many other industries: hospitals; emergency rooms; and nuclear plants look to the airline industry to help craft CRM programs, but dentistry hasn't adopted CRM, said Pinsky.
For the next step, the co-authors hope to design a small clinical trial in the dental school to test CRM, Taichman said
Pilots and dentists have more in common than one might think: Both jobs are highly technical and require teamwork. Both are subject to human error where small, individual mistakes may lead to catastrophe if not addressed early.
A dental professor at the University of Michigan and two pilot-dentists believe that implementing a checklist of safety procedures in dental offices similar to procedures used in airlines would drastically reduce human errors.
Illustration by Maria Gunnes Sibbel
Crew Resource Management empowers team members to actively participate to enhance safety using forward thinking strategies, said Russell Taichman, U-M dentistry professor and director of the Scholars Program in Dental Leadership. Taichman co-authored the study, "Adaptation of airline crew resource management (CRM) principles to dentistry," which will appear in the August issue of the Journal of the American Dental Association.
Airlines implemented CRM about 30 years ago after recognizing that most accidents resulted from human error, said co-author Harold Pinsky, a full-time airline pilot and practicing general dentist who did additional training at U-M dental school.
"Using checklists makes for a safer, more standardized routine of dental surgery in my practice," said David Sarment, a third co-author on the paper. Sarment was on the U-M dental faculty full-time before leaving for private practice. He is also a pilot and was taught to fly by Pinsky.
CRM checklists in the dentist's office represent a major culture shift that will be slow to catch on, but Pinsky thinks it's inevitable.
"It's about communication," Pinsky said. "If I'm doing a restoration and my assistant sees saliva leaking, in the old days the assistant would think to themselves, 'The doctor is king, he or she must know what's going on.'" But if all team members have a CRM checklist, the assistant is empowered to tell the doctor if there is a problem. "Instead of the doctor saying, 'Don't ever embarrass me in front of a patient again,' they'll say, 'Thanks for telling me.'"
At each of the five stages of the dental visit, the dental team is responsible for checking safety items off a codified list before proceeding. Pinsky said that while he expects each checklist to look different for each office, the important thing is to have the standards in place.
Studies show that CRM works. Six government studies of airlines using CRM suggest safety improvements as high as 46 percent. Another study involving six large corporate and military entities showed accidents decreased between 36-81 percent after implementing CRM. In surgical settings, use of checklists has reduced complications and deaths by 36 percent.
Many other industries: hospitals; emergency rooms; and nuclear plants look to the airline industry to help craft CRM programs, but dentistry hasn't adopted CRM, said Pinsky.
For the next step, the co-authors hope to design a small clinical trial in the dental school to test CRM, Taichman said
Link between gum inflammation and Alzheimer's disease
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NYU dental researchers have found the first long-term evidence that periodontal (gum) disease may increase the risk of cognitive dysfunction associated with Alzheimer's disease in healthy individuals as well as in those who already are cognitively impaired.
The NYU study offers fresh evidence that gum inflammation may contribute to brain inflammation, neurodegeneration, and Alzheimer's disease.
The research team, led by Dr. Angela Kamer, Assistant Professor of Periodontology & Implant Dentistry, examined 20 years of data that support the hypothesis of a possible causal link between periodontal disease and Alzheimer's disease.
"The research suggests that cognitively normal subjects with periodontal inflammation are at an increased risk of lower cognitive function compared to cognitively normal subjects with little or no periodontal inflammation," Dr. Kamer said.
Dr. Kamer's study, conducted in collaboration with Dr. Douglas E. Morse, Associate Professor of Epidemiology & Health Promotion at NYU College of Dentistry, and a team of researchers in Denmark, builds upon a 2008 study by Dr. Kamer which found that subjects with Alzheimer's disease had a significantly higher level of antibodies and inflammatory molecules associated with periodontal disease in their plasma compared to healthy people.
Dr. Kamer's latest findings are based on an analysis of data on periodontal inflammation and cognitive function in 152 subjects in the Glostrop Aging Study, which has been gathering medical, psychological, oral health, and social data on Danish men and women. Dr. Kamer examined data spanning a 20-year period ending in 1984, when the subjects were all 70 years of age. The findings were presented by Dr. Kamer at the 2010 annual meeting of the International Association for Dental Research July 16, in Barcelona, Spain.
Dr. Kamer's team compared cognitive function at ages 50 and 70, using the Digit Symbol Test, or DST, a part of the standard measurement of adult IQ. The DST assesses how quickly subjects can link a series of digits, such as 2, 3, 4, to a corresponding list of digit-symbol pairs, such as 1/-,2/┴ ... 7/Λ,8/X,9/=.
Dr. Kamer found that periodontal inflammation at age 70 was strongly associated with lower DST scores at age 70. Subjects with periodontal inflammation were nine times more likely to test in the lower range of the DST compared to subjects with little or no periodontal inflammation.
This strong association held true even in those subjects who had other risk factors linked to lower DST scores, including obesity, cigarette smoking, and tooth loss unrelated to gum inflammation. The strong association also held true in those subjects who already had a low DST score at age 50.
Dr. Kamer plans to conduct a follow-up study involving a larger, more ethnically diverse group of subjects, to further examine the connection between periodontal disease and low cognition.
NYU dental researchers have found the first long-term evidence that periodontal (gum) disease may increase the risk of cognitive dysfunction associated with Alzheimer's disease in healthy individuals as well as in those who already are cognitively impaired.
The NYU study offers fresh evidence that gum inflammation may contribute to brain inflammation, neurodegeneration, and Alzheimer's disease.
The research team, led by Dr. Angela Kamer, Assistant Professor of Periodontology & Implant Dentistry, examined 20 years of data that support the hypothesis of a possible causal link between periodontal disease and Alzheimer's disease.
"The research suggests that cognitively normal subjects with periodontal inflammation are at an increased risk of lower cognitive function compared to cognitively normal subjects with little or no periodontal inflammation," Dr. Kamer said.
Dr. Kamer's study, conducted in collaboration with Dr. Douglas E. Morse, Associate Professor of Epidemiology & Health Promotion at NYU College of Dentistry, and a team of researchers in Denmark, builds upon a 2008 study by Dr. Kamer which found that subjects with Alzheimer's disease had a significantly higher level of antibodies and inflammatory molecules associated with periodontal disease in their plasma compared to healthy people.
Dr. Kamer's latest findings are based on an analysis of data on periodontal inflammation and cognitive function in 152 subjects in the Glostrop Aging Study, which has been gathering medical, psychological, oral health, and social data on Danish men and women. Dr. Kamer examined data spanning a 20-year period ending in 1984, when the subjects were all 70 years of age. The findings were presented by Dr. Kamer at the 2010 annual meeting of the International Association for Dental Research July 16, in Barcelona, Spain.
Dr. Kamer's team compared cognitive function at ages 50 and 70, using the Digit Symbol Test, or DST, a part of the standard measurement of adult IQ. The DST assesses how quickly subjects can link a series of digits, such as 2, 3, 4, to a corresponding list of digit-symbol pairs, such as 1/-,2/┴ ... 7/Λ,8/X,9/=.
Dr. Kamer found that periodontal inflammation at age 70 was strongly associated with lower DST scores at age 70. Subjects with periodontal inflammation were nine times more likely to test in the lower range of the DST compared to subjects with little or no periodontal inflammation.
This strong association held true even in those subjects who had other risk factors linked to lower DST scores, including obesity, cigarette smoking, and tooth loss unrelated to gum inflammation. The strong association also held true in those subjects who already had a low DST score at age 50.
Dr. Kamer plans to conduct a follow-up study involving a larger, more ethnically diverse group of subjects, to further examine the connection between periodontal disease and low cognition.
Wednesday, July 7, 2010
1 in 4 Californian children have never seen a dentist, study finds
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Lack of dental care continues to be a significant problem for American children, who miss about 1.6 million school days each year due to dental disease.
A new study published in the July issue of the journal Health Affairs reveals that in California, nearly 25 percent of children have never seen a dentist and that disparities exist across race, ethnicity and type of insurance when it comes to the duration between dental care visits.
The study, "Racial and Ethnic Disparities in Dental Care for Publicly Insured Children," examines barriers to dental care among California children age 11 and under, using data from the 2005 California Health Interview Survey. The study contains data on nearly 11,000 children.
Researchers Nadereh Pourat, of the UCLA Center for Health Policy Research, and Len Finocchio, of the California HealthCare Foundation, found that Latino and African American children with all types of insurance were less likely than Asian American and white children to have visited the dentist in the previous six months — or even in their entire lifetime.
Similarly, researchers found that Latino and African American children in public insurance programs, including Medicaid and the Children's Health Insurance Program (CHIP), went to the dentist less often than white and Asian American children with the same insurance coverage. Overall, children with private insurance saw a dentist more often than those with Medicaid or CHIP.
"The findings suggest that having insurance isn't always enough," said Pourat, Ph.D., director of research planning at the UCLA Center for Health Policy Research. "We need to address the other barriers that keep children from getting the help they need."
The authors note the findings raise concerns about Medicaid's ability to address disparities in dental care access. Ultimately, they observe, more strategic efforts are necessary to overcome systemic barriers to care, including raising reimbursement rates paid to dentists who serve the Medicaid population and increasing the number of participating Medicaid providers.
"These findings indicate that many poor children in California do not make routine dental visits or simply never receive any dental care," said Finocchio, Dr.P.H., senior program officer at the California HealthCare Foundation. "Even with Medicaid coverage, there are tremendous barriers to getting services."
Despite the disparities, the authors say, having any form of dental insurance significantly increases the odds of seeing a dentist on a regular basis. The studied showed that 54 percent of privately insured children and 27 percent of publicly insured children had seen the dentist during the previous six months, compared with 12 percent of children without dental coverage.
"The data tell us that Medicaid and CHIP have improved children's ability to get dental care," Pourat said. "However, both programs need to do more to reduce disparities."
Lack of dental care continues to be a significant problem for American children, who miss about 1.6 million school days each year due to dental disease.
A new study published in the July issue of the journal Health Affairs reveals that in California, nearly 25 percent of children have never seen a dentist and that disparities exist across race, ethnicity and type of insurance when it comes to the duration between dental care visits.
The study, "Racial and Ethnic Disparities in Dental Care for Publicly Insured Children," examines barriers to dental care among California children age 11 and under, using data from the 2005 California Health Interview Survey. The study contains data on nearly 11,000 children.
Researchers Nadereh Pourat, of the UCLA Center for Health Policy Research, and Len Finocchio, of the California HealthCare Foundation, found that Latino and African American children with all types of insurance were less likely than Asian American and white children to have visited the dentist in the previous six months — or even in their entire lifetime.
Similarly, researchers found that Latino and African American children in public insurance programs, including Medicaid and the Children's Health Insurance Program (CHIP), went to the dentist less often than white and Asian American children with the same insurance coverage. Overall, children with private insurance saw a dentist more often than those with Medicaid or CHIP.
"The findings suggest that having insurance isn't always enough," said Pourat, Ph.D., director of research planning at the UCLA Center for Health Policy Research. "We need to address the other barriers that keep children from getting the help they need."
The authors note the findings raise concerns about Medicaid's ability to address disparities in dental care access. Ultimately, they observe, more strategic efforts are necessary to overcome systemic barriers to care, including raising reimbursement rates paid to dentists who serve the Medicaid population and increasing the number of participating Medicaid providers.
"These findings indicate that many poor children in California do not make routine dental visits or simply never receive any dental care," said Finocchio, Dr.P.H., senior program officer at the California HealthCare Foundation. "Even with Medicaid coverage, there are tremendous barriers to getting services."
Despite the disparities, the authors say, having any form of dental insurance significantly increases the odds of seeing a dentist on a regular basis. The studied showed that 54 percent of privately insured children and 27 percent of publicly insured children had seen the dentist during the previous six months, compared with 12 percent of children without dental coverage.
"The data tell us that Medicaid and CHIP have improved children's ability to get dental care," Pourat said. "However, both programs need to do more to reduce disparities."
Friday, July 2, 2010
Rapily Assess Children's Tooth Decay Risk
Researchers at the Oregon Health & Science University School of Dentistry have determined that ATP-driven (adenosine triphosphate-driven) bioluminescence -- a way of measuring visible light generated from ATP contained in bacteria -- is an innovative tool for rapidly assessing in children at the chair-side the number of oral bacteria and amount of plaque that can ultimately lead to tooth decay.
The study is published online in the May-June 2010 issue of Pediatric Dentistry.
Caries (microbial disease) prevention is one of the most important aspects of modern dental practice. Untreated, large numbers of cariogenic bacteria adhere to teeth and break down the protective enamel covering, resulting in lesions and cavities. There is a critical need in dentistry to develop better quantitative assessment methods for oral hygiene and to determine patient risk for dental caries, because disease as well as restorative treatment results in the irreversible loss of tooth structure. Previous caries risk assessments have focused on social, behavioral, microbiologic, environmental and clinical variables.
The goal of the OHSU study was to examine the use of microbiological testing, specifically ATP-driven bioluminescence, for quantifying oral bacteria, including plaque streptococci, and assessment of oral hygiene and caries risk. Thirty-three randomly selected OHSU pediatric patients, ages 7 to 12, were examined, and plaque specimens, in addition to saliva, were collected from one tooth in each of the four quadrants of the mouth. The oral specimens were then assessed to count total bacteria and streptococci and subjected to ATP-driven bioluminescence.
The OHSU team found statistical correlations, linking ATP to the numbers of total bacteria and oral streptococci. Their data indicated that ATP measurements have a strong statistical association with bacterial numbers in plaque and saliva specimens, including numbers for oral streptococci, and may be used as a potential assessment tool for oral hygiene and caries risk in children.
"The use of ATP-driven bioluminescence has broad implications in dentistry and medicine and can be used translationally in the clinic to determine the efficacy of interventional therapies, including the use of mouth rinses and perhaps in the detection of bacterial infections in periodontal and other infectious diseases," noted Curt Machida, Ph.D., principal investigator and OHSU professor of integrative biosciences and pediatric dentistry.
The OHSU team included Machida; Shahram Fazilat, D.D.S., a 2008 pediatric dentistry graduate; Rebecca Sauerwein, research assistant in integrative biosciences; Jennifer McLeod, a fourth-year dental student who recently graduated; Tyler Finlayson, second-year dental student; Emilia Adam, D.D.S., M.P.H., a second-year pediatric dentistry resident who recently graduated; John Engle, D.D.S., interim chair of the Department of Pediatric Dentistry; Prashant Gagneja, D.D.S., associate professor of pediatric dentistry; Tom Maier, Ph.D., assistant professor of integrative biosciences and oral pathology and radiology.
The research was funded by Oral BioTech, the OHSU School of Dentistry, and the Oregon Clinical and Translational Research Institute, which is funded by a grant from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH). Established in September 2006 through the NIH's Clinical and Translational Science Award (CTSA) program, OCTRI is a unique partnership between OHSU and Kaiser Permanente Center for Health Research -- bringing together an academic medical center and an innovative managed care organization. OCTRI's mission is to improve human health by enhancing clinical and translational research. OCTRI works with institutional partners, community organizations, and industry to engage communities in clinical research efforts and to reduce the time it takes for laboratory discoveries to become treatments for patients.
The study is published online in the May-June 2010 issue of Pediatric Dentistry.
Caries (microbial disease) prevention is one of the most important aspects of modern dental practice. Untreated, large numbers of cariogenic bacteria adhere to teeth and break down the protective enamel covering, resulting in lesions and cavities. There is a critical need in dentistry to develop better quantitative assessment methods for oral hygiene and to determine patient risk for dental caries, because disease as well as restorative treatment results in the irreversible loss of tooth structure. Previous caries risk assessments have focused on social, behavioral, microbiologic, environmental and clinical variables.
The goal of the OHSU study was to examine the use of microbiological testing, specifically ATP-driven bioluminescence, for quantifying oral bacteria, including plaque streptococci, and assessment of oral hygiene and caries risk. Thirty-three randomly selected OHSU pediatric patients, ages 7 to 12, were examined, and plaque specimens, in addition to saliva, were collected from one tooth in each of the four quadrants of the mouth. The oral specimens were then assessed to count total bacteria and streptococci and subjected to ATP-driven bioluminescence.
The OHSU team found statistical correlations, linking ATP to the numbers of total bacteria and oral streptococci. Their data indicated that ATP measurements have a strong statistical association with bacterial numbers in plaque and saliva specimens, including numbers for oral streptococci, and may be used as a potential assessment tool for oral hygiene and caries risk in children.
"The use of ATP-driven bioluminescence has broad implications in dentistry and medicine and can be used translationally in the clinic to determine the efficacy of interventional therapies, including the use of mouth rinses and perhaps in the detection of bacterial infections in periodontal and other infectious diseases," noted Curt Machida, Ph.D., principal investigator and OHSU professor of integrative biosciences and pediatric dentistry.
The OHSU team included Machida; Shahram Fazilat, D.D.S., a 2008 pediatric dentistry graduate; Rebecca Sauerwein, research assistant in integrative biosciences; Jennifer McLeod, a fourth-year dental student who recently graduated; Tyler Finlayson, second-year dental student; Emilia Adam, D.D.S., M.P.H., a second-year pediatric dentistry resident who recently graduated; John Engle, D.D.S., interim chair of the Department of Pediatric Dentistry; Prashant Gagneja, D.D.S., associate professor of pediatric dentistry; Tom Maier, Ph.D., assistant professor of integrative biosciences and oral pathology and radiology.
The research was funded by Oral BioTech, the OHSU School of Dentistry, and the Oregon Clinical and Translational Research Institute, which is funded by a grant from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH). Established in September 2006 through the NIH's Clinical and Translational Science Award (CTSA) program, OCTRI is a unique partnership between OHSU and Kaiser Permanente Center for Health Research -- bringing together an academic medical center and an innovative managed care organization. OCTRI's mission is to improve human health by enhancing clinical and translational research. OCTRI works with institutional partners, community organizations, and industry to engage communities in clinical research efforts and to reduce the time it takes for laboratory discoveries to become treatments for patients.
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