Cannabis use disorder triples risk of oral cancer

Peer-Reviewed Publication

University of California - San Diego

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A recent study by researchers at the University of California San Diego School of Medicine has found that individuals with cannabis use disorder (CUD) are more than three times more likely to develop oral cancer within five years compared to those without CUD. The study highlights the potential long-term health risks associated with problematic cannabis use.

In 2022, 17.7 million people reported daily or near-daily cannabis use. Though CUD requires a formal diagnosis and not all cannabis users develop the disorder, recent research suggests that as many as 3 in 10 cannabis users will develop CUD.

As cannabis becomes more widely available and socially accepted, it is essential to understand its potential health risks. While many consider cannabis to be safer than other drugs, such as tobacco and alcohol, there are still many unknowns about the health impacts of cannabis, particularly how the drug influences cancer risk. The new study sought to determine the relationship between CUD and oral cancer, for which tobacco smoking is known to be a significant risk factor.

“Cannabis smoke contains many of the same carcinogenic compounds found in tobacco smoke, which have known damaging effects on the epithelial tissue that lines the mouth," said Raphael Cuomo, Ph.D. associate professor in the Department of Anesthesiology at UC San Diego School of Medicine and member of UC San Diego Moores Cancer Center. "These findings add to a growing body of evidence suggesting that chronic or problematic cannabis use may contribute to cancer risk in tissues exposed to combustion products."

By analyzing the electronic health records from over 45,000 patients, of whom 949 developed CUD, Cuomo found:

• After adjusting for age, sex, body mass index and smoking status, people had a 325 percent  times higher likelihood of contracting oral cancer within five years compared to those without CUD.
• Tobacco smokers with CUD were 624 percent more likely to contract oral cancer within five years compared to tobacco smokers without CUD.

Because the association between CUD and oral cancer remained even after controlling for smoking status, and because CUD was associated with greater oral cancer risk even when the analysis was restricted to smokers, the researchers hypothesize that there may be other factors underlying this risk in addition to smoke inhalation. For example, THC, the active compound in cannabis is known to have immune-suppressing effects, which may contribute to increased cancer risk.

While more research is needed to fully explain the association between cannabis and oral cancer, the study's results have immediate implications for cancer screening practices and public health messaging. In particular, the findings emphasize the need for further research on the long-term effects of cannabis use and the importance of integrating oral health awareness into substance use disorder treatment and counseling.

The study, published online in Preventive Medicine Reports, reported no external funding or conflicts of interest. 

Why you may get future vaccines via dental floss

 

Peer-Reviewed Publication

North Carolina State University

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Researchers have demonstrated a novel vaccine delivery method in an animal model, using dental floss to introduce vaccine via the tissue between the teeth and gums. The testing found that the new technique stimulates the production of antibodies in mucosal surfaces, such as the lining of the nose and lungs. 

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Credit: Jie Sun, NC State University

Researchers have demonstrated a novel vaccine delivery method in an animal model, using dental floss to introduce vaccine via the tissue between the teeth and gums. The testing found that the new technique stimulates the production of antibodies in mucosal surfaces, such as the lining of the nose and lungs.

“Mucosal surfaces are important, because they are a source of entry for pathogens, such as influenza and COVID,” says Harvinder Singh Gill, corresponding author of a paper on the work. “However, if a vaccine is given by injection, antibodies are primarily produced in the bloodstream throughout the body, and relatively few antibodies are produced on mucosal surfaces.

“But we know that when a vaccine is given via the mucosal surface, antibodies are stimulated not only in the bloodstream, but also on mucosal surfaces,” says Gill, who is the Ronald B. and Cynthia J. McNeill Term Professor in Nanomedicine at North Carolina State University. “This improves the body’s ability to prevent infection, because there is an additional line of antibody defense before a pathogen enters the body.”

This is where the junctional epithelium comes in. The term epithelium applies to the tissue that lines the surface of your body parts, such as the lining of your lungs, stomach and intestines. Most epithelial tissues include robust barriers that are designed to keep bad things – from viruses to dirt – from entering your blood stream. But the junctional epithelium is different.

The junctional epithelium is a thin layer of tissue located in the deepest part of the pocket between the tooth and the gum, and it lacks the barrier features found in other epithelial tissues. The lack of a barrier allows the junctional epithelium to release immune cells to fight bacteria – you find these immune cells in your saliva, as well as between your teeth and gums.

“Because the junctional epithelium is more permeable than other epithelial tissues – and is a mucosal layer – it presents a unique opportunity for introducing vaccines to the body in a way that will stimulate enhanced antibody production across the body’s mucosal layers,” says Gill.

To determine the viability of delivering vaccines via the junctional epithelium, the researchers applied vaccine to unwaxed dental floss and then flossed the teeth of lab mice. Specifically, the researchers compared antibody production in mice that received a peptide flu vaccine via flossing the junctional epithelium; via the nasal epithelium; or via placing vaccine on the mucosal tissue under the tongue.

“We found that applying vaccine via the junctional epithelium produces far superior antibody response on mucosal surfaces than the current gold standard for vaccinating via the oral cavity, which involves placing vaccine under the tongue,” says Rohan Ingrole, first author of the paper, who was a Ph.D. student under Gill at Texas Tech University. “The flossing technique also provides comparable protection against flu virus as compared to the vaccine being given via the nasal epithelium.”

“This is extremely promising, because most vaccine formulations cannot be given via the nasal epithelium – the barrier features in that mucosal surface prevent efficient uptake of the vaccine,” Gill says. “Intranasal delivery also has the potential to cause the vaccine to reach the brain, which can pose safety concerns. However, vaccination via the junctional epithelium offers no such risk. For this experiment, we chose one of the few vaccine formulations that actually works for nasal delivery because we wanted to see how junctional epithelium delivery compared to the best-case scenario for nasal delivery.”

The researchers also tested whether the junctional epithelium delivery method worked for three other prominent classes of vaccines: proteins, inactivated viruses and mRNA. In all three cases, the epithelial junction delivery technique produced robust antibody responses in the bloodstream and across mucosal surfaces.

The researchers also found that, at least in the animal model, it didn’t matter whether food and water were consumed immediately after flossing with the vaccine – the immune response was the same.

But while regular floss serves as an adequate vaccine delivery method for lab mice, the researchers know it’s not practical to ask people to hold vaccine-coated floss in their fingers. To address that challenge the researchers used a floss pick. A floss pick consists of a piece of floss stretched between two prongs that can be held by a handle.

Specifically, the researchers coated the floss in floss picks with fluorescent food dye. The researchers then recruited 27 study participants, explained the concept of applying vaccine via floss, and asked the participants to try to deposit the food dye in their epithelial junction with a floss pick.

“We found that approximately 60% of the dye was deposited in the gum pocket, which suggests that floss picks may be a practical vaccine delivery method to the epithelial junction,” Ingrole says.

“We’re optimistic about that work and – depending on our findings – may then move toward clinical trials,” Gill says.

While there are still many questions that need to be answered before the floss technique can be considered for clinical use, the researchers think there could be significant advantages beyond the improved antibody response on mucosal surfaces.

“For example, it would be easy to administer, and it addresses concerns many people have about being vaccinated with needles,” Gill says. “And we think this technique should be comparable in price to other vaccine delivery techniques.

There are also some drawbacks. For example, this technique would not work on infants and toddlers who do not yet have teeth.

“In addition, we would need to know more about how or whether this approach would work for people who have gum disease or other oral infections,” Gill says.

The paper, “Floss-based vaccination targets the gingival sulcus for mucosal and systemic immunization,” is published in the journal Nature Biomedical Engineering. Co-authors of the paper include Akhilesh Kumar Shakya, Chang Hyun Lee and Lazar Nesovic of Texas Tech; Gaurav Joshi of Texas Tech and NC State; and Richard Compans of Emory University.

The study was supported in part by the National Institutes of Health (NIH) under grants R01AI137846 and R01DE033759, and by funds from the Whitacre Endowed Chair in Science and Engineering at Texas Tech University.

Gill, Ingrole and Shakya are co-inventors on a patent related to targeting the junctional epithelium for vaccination.

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Journal

Nature Biomedical Engineering

DOI

10.1038/s41551-025-01451-3

Transforming implant success: How gum tissue expert consensus may change dentistry

 

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Decision tree of PIKM augmentation at second-stage surgerye.

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Credit: International Journal of Oral Science

Long-term success of dental implants depends not just on bone integration but also on the health of surrounding gum tissue. Yet, gum augmentation practices often vary, leading to inconsistent outcomes. A new expert consensus offers standardized surgical guidelines for enhancing keratinized mucosa (KM) during second-stage implant surgery—a key moment when soft tissue can be managed before prosthetics are placed. The study evaluates commonly used procedures, including flap repositioning, grafting, and synthetic materials, to help clinicians choose the right approach for each patient. This consensus marks a turning point in soft tissue management, aiming to reduce complications, improve aesthetics, and ensure lasting implant stability.

Dental implants have revolutionized oral rehabilitation, but their longevity depends on more than just a strong anchor in bone. The soft tissue that surrounds the implant—specifically the band of keratinized mucosa (KM) —acts as a barrier against bacteria and mechanical stress. When this tissue is too narrow, patients face higher risks of inflammation, discomfort, and tissue breakdown. Despite the development of several surgical methods for KM augmentation, clinicians face confusion due to differing techniques and unclear protocols. These inconsistencies, combined with growing patient expectations, highlight a clear need: to define evidence-based, practical strategies for regenerating this critical tissue zone.

In June 2025, a multidisciplinary team of oral health experts across China released a consensus report (DOI: 10.1038/s41368-025-00379-3) in the International Journal of Oral Science on optimizing peri-implant keratinized mucosa (PIKM) augmentation. Led by Sichuan University, the report synthesizes clinical data and surgical experience to offer standardized recommendations for soft tissue management during second-stage implant procedures. By clarifying when and how to use methods such as apically repositioned flaps (ARF), free gingival grafts (FGG), and soft tissue substitutes, the consensus provides clinicians with a decision-making roadmap to improve long-term implant outcomes.

The expert group assessed four mainstream surgical techniques—ARF, FGG, SFGG, and soft tissue substitutes—detailing their indications, benefits, and drawbacks. FGG remains the gold standard, reliably increasing KM width and thickness, but at the cost of significant donor site trauma and esthetic mismatches. ARF offers a less invasive alternative with good color integration but depends heavily on existing tissue. SFGG, involving thin strips of grafted tissue, reduces donor morbidity and improves aesthetics when combined with collagen matrices, though it is more technique-sensitive.

The consensus also introduces a decision tree to guide surgeons based on implant location, residual KM width, and patient preferences. For example, FGG is advised in cases with <2 mm of KM, especially in the lower jaw. ARF is suited for the upper back teeth, while aesthetic concerns in the front teeth call for SFGG with tissue substitutes. Factors such as gingival thickness, surgical experience, and cost are also considered. The result is a practical clinical tool for tailoring surgeries to individual needs, helping ensure both biological health and cosmetic satisfaction.

“Soft tissue is the unsung hero of implant dentistry,” says Prof. Quan Yuan and Dr. Shiwen Zhang, lead authors of the consensus. “For years, we focused mainly on bone integration, but healthy gum tissue is equally essential for long-term implant success. This report offers a unified guide based on evidence and clinical wisdom, helping clinicians make informed, patient-centered decisions. With clearer strategies, we can now deliver not just function but also comfort and beauty.”

This consensus fills a critical gap in implant dentistry, offering clinicians a clear and adaptable framework for soft tissue regeneration. It promotes consistency in treatment planning, streamlines surgical decision-making, and aligns procedures with both patient expectations and anatomical realities. Beyond immediate clinical impact, the report sets the stage for future innovation. Researchers are encouraged to develop biomaterials that balance predictability with esthetics, and to pursue long-term trials to validate outcomes. Digital imaging, tissue engineering, and individualized care models will likely play central roles in the next wave of implant success stories—stories that begin with the right soft tissue foundation.

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References

DOI

10.1038/s41368-025-00379-3

Original Source URL

https://doi.org/10.1038/s41368-025-00379-3

What ever-growing incisors can teach us about genetic disease

 

Teeth may seem like static fixtures, but a new collaboration between engineers and clinicians is proving just how dynamic, informative and medically significant our teeth can be.

In a recent study, published in the American Chemical Society’s ACS Applied Materials & Interfaces, engineers and dentists come together to uncover how teeth, as biological material, hold key information for understanding rare craniofacial disorders that develop during childhood. Kyle Vining, Assistant Professor in Materials Science and Engineering (MSE) and in Preventative and Restorative Science at Penn Dental Medicine, leads this interdisciplinary team, which includes Yuchen (Tracy) Jiang, a former master’s student in MSE, Kei Katsura, a pediatric dentist and KL2 postdoctoral research scholar at Children’s Hospital of Philadelphia (CHOP) and the Institute of Translational Medicine and Therapeutics at Penn, and Elizabeth Bhoj, Assistant Professor of Pediatrics in Penn Medicine and the Division of Human Genetics at CHOP. 

Through their new methodology and by leveraging unique characteristics of rodent teeth, the team was able to combine materials science, mineralogy and human genetics to map out the properties of enamel and dentin development. Their methods have the potential to provide new insights into identifying and treating both rare craniofacial diseases in children and more common dental cavities.

“People often assume that if you understand bone, you understand teeth,” says Vining. “But that’s not necessarily the case. Teeth have a different composition, require different analytical tools and behave differently during development. What’s exciting is that by using mouse incisors to study enamel formation over time, we do not need to extract baby or adult teeth to understand those characteristics.”

Teeth, Rocks and Cross-Disciplinary Tools

The project is centered on a deceptively simple question: How do teeth mineralize? Surprisingly, scientists don’t have a full picture of how this essential process unfolds. 

“This is an exciting step in determining how teeth develop and harden,” says Katsura. “Tooth mineralization is such an intricate process with many hidden secrets we get to uncover. Although we still don’t fully understand how teeth mineralize, our long-term hope is to apply this knowledge to the clinic, helping people who are more susceptible to dental cavities, specifically those with rare genetic syndromes.”

To answer this question, researchers borrowed a surprising tool from geology: the nanoindenter, a device traditionally used to test the hardness of rocks. Now, instead of probing granite or sandstone, the team uses it to analyze tiny sections of tooth enamel, but it wasn’t a straightforward task.

“Sample preparation was one of the most challenging parts,” says Jaing, the lead author on the paper. “Tooth is such a hard and heterogeneous material. It’s layered, shifting and biological. Embedding it properly for testing took a lot of troubleshooting.”

But once they got it right, the insights flowed. Using nanoindentation, scanning electron microscopy, energy dispersive spectroscopy (EDS) and even Raman spectroscopy, the team measured everything from tooth enamel’s elasticity and stiffness to mineral contents. Their samples, postnatal day 12 mouse teeth, were carefully chosen to be old enough for the enamel to have formed, but not so old that the bones became too hard to section.

What Can Teeth Tell Us About Disease?

While Jiang and Vining analyzed the physical properties of teeth, Katsura brought in the biological side: mouse models of Mendelian genetic disorders, many of which mimic the human versions of craniofacial syndromes. Bhoj provided further expertise on these rare diseases, helping guide the project toward real-world clinical applications.

“These disorders are hard to treat in part because little attention is paid to the oral cavity, so we don’t always know how dental and oral conditions relate to the systemic issues these children face,” says Katsura. “But we’re showing that materials science can help us find part of the answer.”

One major challenge? Teeth start developing in utero, making early study difficult. But by examining how structure changes during development, and linking it with function, researchers hope to eventually backtrack from a fully developed tooth to better understand what went wrong along the way.

“We’re excited to be able to integrate tools of materials science to learn about the properties of tooth development,” says Vining. “Our work lays the foundation for further studies that could lead to diagnostic tools or even new materials for fillings that prevent decay.”

Taking New Research and Mindsets Forward

This work is already informing the team’s future work on genetic craniofacial diseases in mice. Long term, the researchers envision their tools used in dental clinics to screen for enamel defects, assess treatment outcomes or even predict disease risk. 

And the project isn’t just breaking scientific ground, it’s also reshaping how researchers think about collaboration. Jiang, who trained as a materials scientist, reflects on her experience working outside her comfort zone.

“You don’t need to have everything figured out before working on a project. I’ve learned that growth happens along the way and that learning from collaborators is one of the most valuable parts of scientific research,” she says. “The most exciting discoveries come from different people bringing different strengths. 

This work was partially supported by the Joseph and Josephine Rabinowitz Award for Excellence in Research from Penn Dental Medicine. This work was partly carried out at the Singh Center for Nanotechnology, supported by the NSF National Nanotechnology Coordinated Infrastructure Program under grant NNCI-2025608. Research reported in this publication was supported in part by a NIDCR Supplement from the National Center for Advancing Translational Sciences of the National Institutes of Health under award number KL2TR001879.

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Journal

ACS Applied Materials & Interfaces

DOI

10.1021/acsami.5c08408 

Uncovering the relationship between oral function and lifestyle-related diseases

 The term ‘oral health’ refers to the health of the mouth, teeth, gums, and other related structures, and it is closely linked with our well-being and quality of life. Recently, there has been a lot of interest in understanding how oral health is linked to and influences our overall health. For example, it was found that gum disease may be associated with various diseases such as diabetes and kidney disease. Poor oral health can also affect a person’s diet, which further increases a person’s risk of developing lifestyle-related diseases such as diabetes and heart disease.

Now, in a new study published online in the Journal of Oral Rehabilitation on April 17, 2025, a team of researchers led by Professor and Chairman Mitsuyoshi Yoshida and his colleagues from the Department of Dentistry and Oral-Maxillofacial Surgery, School of Medicine, Fujita Health University, Japan, have examined the association between oral health and different lifestyle-related diseases. This study was conducted in cooperation with Fujita Health University International Medical Center, with Director Hitomi Sasaki.

“Our main aim was to investigate the link between oral health and blood test results for glucose metabolism, lipid levels, and kidney function,” says Prof. Yoshida.

In this study, the researchers examined 118 individuals aged 50 or above who had undergone regular health check-ups. More specifically, they collected information from dental examinations in 2021, as well as annual physical examinations in 2021 and 2023. These individuals were subjected to seven different oral function tests to gauge their oral health—these included measurements of tongue coating index (TCI) (an indicator of oral hygiene), oral dryness, the number of remaining functional teeth, maximum tongue pressure, masticatory function, swallowing problem, and oral diadochokinesis (OD), a test that measures the speed and accuracy with which a person can repeat certain syllables.

In addition, the participants were divided into two groups based on whether their blood test results (including fasting blood glucose and cholesterol) were within the reference range or not. The resulting statistical analyses showed many interesting links between the oral function test results and blood test results.

Notably, the group with fasting blood glucose and HbA1c (which reflects the average blood sugar levels across 2−3 months) levels outside the reference range had significantly lower numbers of remaining teeth and OD values compared to the group with values within the reference range. Similarly, the group with cholesterol values outside the standard range had higher levels of TCI and lower OD values. The group with non-standard values of estimated glomerular filtration rate (a test that measures kidney function) also showed significant differences in some of the oral function tests. These findings indicate an important link between oral health and overall health, highlighting the need for implementing oral function tests during health check-ups for better health promotion.

“Overall, our results suggest that a decline in oral function can be a risk factor for lifestyle-related diseases. Thus, maintaining good oral health is the first step in maintaining overall health. We believe this study is an achievement that will pave the way for Japan’s vision of introducing and supporting universal dental health check-ups,” concludes Prof. Yoshida.

Online toolkit to help parents of autistic children improve dental health

 A new, free, online support package aims to empower parents of young autistic children to look after their dental health – and reduce levels of tooth decay and surgery. 

It follows a study led by the University of Leeds, which highlights the oral health challenges faced by autistic children. The research team has collaborated with autistic youngsters, their families, and early-years professionals to co-design the support package, following parents’ calls for autism-specific advice on how to improve oral health habits. The toothPASTE website provides parents with practical, tailored solutions focusing on: toothbrushing, going to the dentist, and eating and drinking. It features videos, downloadable resources, and a forum where parents can share their experiences and advice.  

Challenges faced by parents with autistic children 

One in four autistic children have tooth decay by the age of five – similar to the wider childhood population – but they are less likely to visit the dentist and twice as likely to need dental treatment under general anaesthetic.  

Poor oral health in childhood has lifelong impacts. Establishing optimal oral health habits –   brushing twice a day with fluoride toothpaste, limiting sugary foods and drinks, and going to the dentist – are critical. However, for families of autistic children, building and keeping these habits can be more difficult. This is due to additional challenges such as communication difficulties, sensory sensitivities, and restricted or repetitive behaviours.  

For example, sensory differences can make toothbrushing painful or repulsive. Dental visits can also be overwhelming, with bright lights, unfamiliar smells, strange tastes, and unexpected sounds or touch. Some autistic people experience social communication differences, making it hard for them to express if they are in dental pain. In addition, repetitive behaviours or strong preferences may lead to limited diets, often high in sugar, which can increase the risk of tooth decay. 

The impact of decay is far-reaching, affecting self-esteem, speech, eating, sleeping, and quality of life. But it can also affect a child’s school attendance, impacting negatively on life outcomes. 

Peter Day, Professor of Children's Oral Health and Consultant in Paediatric Dentistry at Leeds, said: “Tooth decay is a major health problem, but it is preventable. Establishing optimal habits in early life provides the foundations for long term oral health and reduces the impact of tooth decay on autistic children, their families, the NHS and wider society.” 

He added: “In the long term, we hope to see a reduction in the number of autistic children that need dental care in hospital, and we hope our findings will help early-years professionals and dental teams support parents with their autistic child’s oral health needs.”   

Anne-Marie Kilgallon, of Mirfield, West Yorkshire, has two autistic sons, both of whom had multiple teeth extracted under general anaesthetic when they were still in primary school.    

She said: “To be told your children need teeth removing at the ages of eight and 10 is incredibly hard. 

“Had this kind of support been around back then, I truly believe Tolan and Fredi wouldn't have had to go through that. We are just one example – there are so many families facing the same challenges. 

“If we’d had access to the right education and support around oral health, tailored to their additional needs, I honestly believe we could have avoided such a traumatic experience for both of our boys.”  

Designed with parents, for parents 

Dr Amrit Chauhan, Lecturer in Qualitative Methodology and Autism-related Oral Health Research within the School of Dentistry and a Chartered Psychologist at Leeds, who co-led the research, said: “We want to help parents feel more confident in caring for their young autistic children’s teeth. That’s why families of autistic children have been involved from the start of the study, and we have very much been led by them on what they want.” 

“We know that most parents already have a good idea of what they should be doing, like brushing twice a day with fluoride toothpaste – it’s more about finding practical ways to get there.  

“Every family is at a different point in their journey, and every child’s needs are unique. So, on the website, we break things down into small, manageable steps. We take a gentle, gradual approach, recognising that for some children, making even one small change might take weeks or even months – and that’s okay.” 

The Leeds team collaborated with researchers from the University of Manchester and University of Sheffield on the project, which was funded by the National Institute for Health and Care Research (NIHR) and West Yorkshire NHS Integrated Care Board. It is hoped the project will help reduce health inequalities. 

Much-needed support 

Nikki Pickles, family support manager for AWARE (Airedale and Wharfedale Autism Resource), whose son is autistic, led the project’s Patient and Public Involvement group. She said: “We work with hundreds of families every year and challenges with toothbrushing and oral health are extremely widespread. Parents frequently share their daily struggles and concerns with us.  

“It can feel like a very lonely battle. They’re desperate for support, so we think this will be an amazing asset. There is no other resource like this. 

“It is easy to navigate and provides useful strategies, plus advice based on the most up-to date oral health research, all specifically tailored for our cohort of families. We are really excited and super proud to be part of the project.” 

Underpinned by inclusive research 

The toothPASTE website was created following in-depth research featuring interviews with minimally-verbal autistic children. They used Talking Mats - visual communication aids - to describe their sensory difficulties, with one child describing toothpaste as an “explosion in the mouth”.  

The study also involved interviews with families and early-years professionals to explore both the barriers to, and the factors that support, the development of optimal oral health habits. Co-design workshops followed, with parents, early-years professionals and national stakeholders. 

Dr Shannu Bhatia, President, British Society of Paediatric Dentistry (BSPD), said: “BSPD welcomes the toothPASTE website with tools to help parents and carers of autistic children and young people navigate a journey of good oral health. 

“The research that has gone into the toothPASTE website has enabled the development of a set of well-targeted tools to support neurodivergent young people and will really help their parents and carers.  

“We know that supporting neurodivergent children and those with additional sensory requirements can present specific challenges, so guidance to help all children achieve healthy teeth and gums, is something BSPD is keen to support.” 

The website is accessible to all, which means it can be used by those without a formal autism diagnosis, and it will be continuously refined to ensure its effectiveness. The team will continue working with families, dental professionals, the National Autistic Society, Autistica and Government bodies to share their findings and undertake further research to maximise the site’s effectiveness.  

CASE STUDY, WITH PICS 

Anne-Marie Kilgallon’s two autistic sons were just eight and 10 and when they had to have multiple teeth extracted under general anaesthetic.  

Had the toothPASTE support package been around when they were little, she believes it could have prevented their pain and resulting surgery. 

The 46-year-old, who co-founded The Whole Autism Family support group with husband Martin in 2015, said: “I wish we’d had that resource when the boys were tiny: it would have made such a huge difference to our lives.”  

She added: “To be told your children need teeth removing at the ages of eight and 10 is incredibly hard. 

“Had this kind of support been around back then, I truly believe Tolan and Fredi wouldn't have had to go through that. We are just one example – there are so many families facing the same challenges. 

“I know lots of children that have had teeth extracted, and not just one tooth: Tolan had five, Fredi had seven. I know another child that had eight. 

“But that's the end result. Had we been educated on how to deal with their specific issues around oral health and had this resource, I honestly believe that we wouldn't have had to put our children through these traumatic surgeries.” 

Life-changing for families 

Anne-Marie, of Mirfield, West Yorkshire, says the website will be life-changing for the hundreds of families she works with, whose children’s dental health is a major problem.  

She said: “Tooth brushing is probably in the top 10 concerns for parents we support. It’s a battle and one they have to deal with every single day. I’ve had mums in floods of tears, not knowing what to do. 

“As parents, we're all trying to do our very best, but I think I think lots of professionals that work with children like Fredi and Tolan could do with more support or more understanding of some of the battles that we face.” 

Tolan, now 15, is non-speaking and Fredi, now 13, uses echolalia - repeating others’ speech - to communicate, although he doesn’t always fully understand the words he is saying. Both boys have learning disabilities and attend a SEN school in Leeds.  

When they were younger, the family used a picture system to help with learning and to communicate. They helped the children understand aspects of daily life such as taking off their coats, or how to use cutlery. Both boys had extreme oral sensitives, which resulted in a restricted diet, using food as a reward and an extreme dislike of toothbrushing. 

They were eventually referred to a dentist who specialised in SEND (special educational needs and disability), who suggested strategies such as changing toothbrushes; oral sensitivity exercises, non-flavoured toothpaste, distractions and brushing at different times of the day. 

Instant, accessible support 

Anne-Marie said: “These are all covered on the website, which looks amazing. What that does is it gives everyone immediate access to expert advice and peer support, rather than having to wait for a referral or just suffering in silence.  

“I love the videos on there. I found them really useful, and I think lots of the families that I support would find them extremely beneficial too. I think there should really be a pack, when you get a diagnosis for a child, and for that to have a sign pointing to the website would be absolutely amazing.”  

 

AI system for single-tooth prediction of early childhood caries detection with over 90% accuracy

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HKU Dentistry developed Spatial-MiC, the world’s first AI system for early childhood caries detection at the single-tooth resolution.

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Credit: The University of Hong Kong

Early childhood caries (ECC)—the world’s most prevalent chronic childhood disease—disproportionately targets specific teeth, a mystery that has remained unresolved until now. A collaborative research team from the Faculty of Dentistry of the University of Hong Kong (HKU), Chinese Academy of Sciences (CAS-QIBEBT), Qingdao Stomatological Hospital, and Qingdao Women and Children's Hospital has made a groundbreaking discovery that could revolutionise the prevention of childhood tooth decay. The team has developed the world’s first artificial intelligence (AI) system capable of predicting early childhood caries risk for individual teeth based on microbial characteristics, achieving an accuracy rate of over 90%. This pioneering study was published in Cell Host & Microbe.

The research was led by Professor Shi Huang, Assistant Professor in Microbiology from the Division of Applied Oral Sciences and Community Dental Care at the HKU Faculty of Dentistry. The team also includes Yufeng Zhang, a PhD student from the same faculty, Professor Jian Xu from CAS-QIBEBT, Dr Fei Teng from Qingdao Stomatological Hospital, and Dr Fang Yang from Qingdao Women and Children's Hospital.

The research team conducted the most comprehensive analysis to date of tooth-specific microbial communities in young children aged 3-5 years, using an innovative approach that combined cutting-edge 16S rRNA sequencing with shotgun metagenomics for microbial compositional and functional analysis. By tracking 2,504 individual tooth plaque samples from 89 preschoolers over nearly a year, they uncovered distinct patterns that foretell dental decay.

At the heart of the discovery is a remarkable anterior-to-posterior microbial gradient in healthy mouths. The study found that front teeth (incisors) naturally harbour different bacterial communities than back teeth (molars), creating a predictable spatial pattern across the mouth. This gradient, maintained by factors like saliva flow and tooth anatomy, becomes disrupted when cavities begin to form. The researchers identified specific bacterial shifts that occur well before visible decay, including the migration of incisor-associated microbes to molar sites and vice versa.

The team's most significant achievement was developing Spatial-MiC, the world’s first AI system that predicts cavity risks in individual teeth based on complex microbial communities. The system analyses these microbial patterns to assess cavity risk. By combining data from a tooth's microbial community with information from its neighbours, Spatial-MiC achieved 98% accuracy in detecting existing cavities and 93% accuracy in predicting cavities two months before they became clinically apparent. This represents a major improvement over current whole-mouth assessment methods, which often miss early warning signs.

The implications for children's dental health are profound. ECC affects over 70% of 5-year-olds in China and remains the most common chronic childhood disease worldwide. Current prevention strategies typically treat all teeth equally, despite clear differences in susceptibility. This research paves the way for precision dentistry approaches that could provide targeted preventive care to high-risk teeth before damage occurs.

“These findings fundamentally change how we understand tooth decay,” Professor Huang explained. “We've moved from seeing cavities as inevitable to being able to predict and prevent them at the microbial level, tooth by tooth.”

The team envisions a future where the system could be expanded to validate the approach in diverse populations. The ultimate goal is to develop clinical tests that bring the technology into dental offices worldwide. As Dr Yang, the first author noted, “This isn't just about better dental care. It's about giving children healthier starts in life by preventing pain, infections, and the developmental impacts of severe tooth decay in a more precise manner.”

Link to research: https://doi.org/10.1016/j.chom.2025.05.006