Using mouthrinse reduces plaque and gingivitis more than toothbrushing alone

New research published in the January/February 2013 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD), indicates that the use of a germ-killing mouthrinse in addition to regular toothbrushing can significantly reduce plaque and gingivitis, more so than brushing alone.

"It's simple—mouthrinses can reach nearly 100 percent of the mouth's surfaces, while brushing focuses on the teeth, which make up only 25 percent of the mouth," says Christine A. Charles, RDH, BS, lead author of the study and director of Scientific and Professional Affairs, Global Consumer Healthcare Research and Development, Johnson & Johnson Consumer and Personal Products Worldwide.

"Even with regular brushing and flossing, bacteria often are left behind." The General Dentistry study found that using a germ-killing mouthrinse twice a day, in addition to regular brushing, can significantly reduce the occurrence of plaque, as well as gingivitis—the beginning stage of gum disease. The six-month study included 139 adults with mild to moderate plaque and gingivitis who were separated into two groups. Members of the first group brushed their teeth and rinsed with a germ-killing mouthrinse twice daily; members of the second group brushed their teeth and rinsed with a placebo mouthrinse twice daily.

"Results show that the group using a germ-killing mouthrinse reduced its occurrence of plaque by up to 26.3 percent," says AGD Spokesperson Janice Pliszczak, DDS, MS, MBA, MAGD. "Furthermore, that same group showed a 20.4 percent reduction in gingivitis." Additionally, following the six-month study, nearly 100 percent of participants using the germ-killing mouthrinse showed a reduction in gingivitis, while only 30 percent of the placebo group experienced similar results. "The study demonstrates the oral health benefits of regular and consistent daily use of a germ-killing mouthrinse," says Ms. Charles.

"Most people brush their teeth for less than 1 minute, when, at the very least, they should be brushing for 2 minutes. Additionally, only 2 to 10 percent of people floss regularly and effectively," adds Dr. Pliszczak. "Adding a germ-killing mouthrinse twice a day to your daily routine is another way to attack the germs that can cause significant oral health problems." Dr. Pliszczak notes that not all mouthrinses are formulated to kill germs—some are meant for anti-cavity or whitening purposes—so be sure to read product labels.

Being overweight linked to higher risk of gum disease

Impacting approximately one-third of the U.S. population, obesity is a significant health concern for Americans. It's a risk factor for developing type 2 diabetes, heart disease, and certain forms of cancer, and now, according to an article published in the January/February 2013 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD), it also may be a risk factor for gum disease.

"We know that being overweight can affect many aspects of a person's health," says Charlene Krejci, DDS, MSD, lead author of the article. "Now researchers suspect a link exists between obesity and gum disease. Obese individuals' bodies relentlessly produce cytokines, proteins with inflammatory properties. These cytokines may directly injure the gum tissues or reduce blood flow to the gum tissues, thus promoting the development of gum disease."

Half of the U.S. population age 30 and older is affected by gum disease—a chronic inflammatory infection that impacts the surrounding and supporting structures of the teeth. Gum disease itself produces its own set of cytokines, which further increases the level of these inflammatory proteins in the body's bloodstream, helping to set off a chain reaction of other inflammatory diseases throughout the body. Research on the relationship between obesity and gum disease is still ongoing.

"Whether one condition is a risk factor for another or whether one disease directly causes another has yet to be discovered," says AGD Spokesperson Samer G. Shamoon, DDS, MAGD. "What we do know is that it's important to visit a dentist at least twice a year so he or she can evaluate your risks for developing gum disease and offer preventive strategies."

The best way to minimize the risk of developing gum disease is to remove plaque through daily brushing, flossing, rinsing, and professional cleanings. "A dentist can design a personalized program of home oral care to meet each patient's specific needs," says Dr. Shamoon.

Nature-inspired advance for treating sensitive teeth

Taking inspiration from Mother Nature, scientists are reporting an advance toward preventing the tooth sensitivity that affects millions of people around the world. Their report on development of the substance, similar to the adhesive that mussels use to attach to rocks and other surfaces in water, appears in the journal ACS Applied Materials & Interfaces. Quan-Li Li, Chun Hung Chu and colleagues explain that about 3 out of every 4 people have teeth that are sensitive to hot, cold, sweet or sour foods and drinks. It occurs when the hard outer enamel layer on teeth and the softer underlying dentin wear away, stimulating the nerves inside. Some sugar-free gums and special toothpastes can help reduce that tooth hyper-sensitivity. However, Li and Chu cite the need for substances that rebuild both enamel and dentin at the same time. To meet that challenge, they turned to a sticky material similar to the adhesive that mussels use to adhere to surfaces. They reasoned that it could help keep minerals in contact with dentin long enough for the rebuilding process to occur. They describe laboratory tests that involved bathing human teeth with worn-away enamel and dentin in liquid containing the sticky material and minerals. Teeth bathed in the sticky material and minerals reformed dentin and enamel. However, teeth bathed just in minerals reformed only enamel. The gooey substance "may be a simple universal technique to induce enamel and dentin remineralization simultaneously," they concluded.

Inflamed gums caused by severe periodontal disease could lead to erection problems

Men in their thirties who had inflamed gums caused by severe periodontal disease were three times more likely to suffer from erection problems, according to a study published in the Journal of Sexual Medicine. Turkish researchers compared 80 men aged 30 to 40 with erectile dysfunction with a control group of 82 men without erection problems. This showed that 53 per cent of the men with erectile dysfunction had inflamed gums compared with 23 per cent in the control group. When the results were adjusted for other factors, such as age, body mass index, household income and education level, the men with severe periodontal disease were 3.29 times more likely to suffer from erection problems than men with healthy gums. "Erectile dysfunction is a major public health problem that affects the quality of life of some 150 million men, and their partners, worldwide," says lead author Dr. Faith Oguz from Inonu University in Malatya, Turkey. "Physical factors cause nearly two-thirds of cases, mainly because of problems with the blood vessels, with psychological issues like emotional stress and depression accounting for the remainder. "Chronic periodontitis (CP) is a group of infectious diseases caused predominantly by bacteria that most commonly occur with inflammation of the gums. "Many studies have reported that CP may induce systemic vascular diseases, such as coronary heart disease, which have been linked with erection problems." The average age of the men in both groups was just under 36 and there were no significant differences when it came to body mass index, household income and education. Their sexual function was assessed using the International Index of Erectile Function and their gum health using the plaque index, bleeding on probing, probing depth and clinical attachment level. "To our knowledge, erectile dysfunction and CP in humans are caused by similar risk factors, such as ageing, smoking, diabetes mellitus and coronary artery disease," says Dr. Oguz. "We therefore excluded men who had systemic disease and who were smokers from this study. "We particularly selected men aged between 30 and 40 to assess the impact of CP on erectile dysfunction without the results being influenced by the effects of ageing. "The result of our study support the theory that CP is present more often in patients with erectile dysfunction than those without and should be considered as a factor by clinicians treating men with erection problems."

Vitamin D = lower rates of tooth decay

A new review of existing studies points toward a potential role for vitamin D in helping to prevent dental caries, or tooth decay. The review, published in the December issue of Nutrition Reviews, encompassed 24 controlled clinical trials, spanning the 1920s to the 1980s, on approximately 3,000 children in several countries. These trials showed that vitamin D was associated with an approximately 50 percent reduction in the incidence of tooth decay. "My main goal was to summarize the clinical trial database so that we could take a fresh look at this vitamin D question," said Dr. Philippe Hujoel of the University of Washington, who conducted the review. While vitamin D's role in supporting bone health has not been disputed, significant disagreement has historically existed over its role in preventing caries, Hujoel noted. The American Medical Association and the U.S. National Research Council concluded around 1950 that vitamin D was beneficial in managing dental caries. The American Dental Association said otherwise – based on the same evidence. In 1989, the National Research Council, despite new evidence supporting vitamin D's caries-fighting benefits, called the issue "unresolved." Current reviews by the Institute of Medicine, the U.S. Department of Human Health and Service and the American Dental Association draw no conclusions on the vitamin D evidence as it relates to dental caries. "Such inconsistent conclusions by different organizations do not make much sense from an evidence-based perspective," Hujoel said. The trials he reviewed increased vitamin D levels in children through the use of supplemental UV radiation or by supplementing the children's diet with cod-liver oil or other products containing the vitamin. The clinical trials he reviewed were conducted in the United States, Great Britain, Canada, Austria, New Zealand and Sweden. Trials were conducted in institutional settings, schools, medical and dental practices, or hospitals. The subjects were children or young adults between the ages of 2 and 16 years, with a weighted mean age of 10 years. Hujoel's findings come as no surprise to researchers familiar with past vitamin D studies. According to Dr. Michael Hollick, professor of medicine at the Boston University Medical Center, "the findings from the University of Washington reaffirm the importance of vitamin D for dental health." He said that "children who are vitamin D deficient have poor and delayed teeth eruption and are prone to dental caries." The vitamin D question takes on greater importance in the light of current public health trends. Vitamin D levels in many populations are decreasing while dental caries levels in young children are increasing. "Whether this is more than just a coincidence is open to debate," Hujoel said. "In the meantime, pregnant women or young mothers can do little harm by realizing that vitamin D is essential to their offspring's health. Vitamin D does lead to teeth and bones that are better mineralized." Hujoel added a note of caution to his findings: "One has to be careful with the interpretation of this systematic review. The trials had weaknesses which could have biased the result, and most of the trial participants lived in an era that differs profoundly from today's environment. " Hujoel has joint appointments as a professor in the University of Washington School of Dentistry's Department of Oral Health Sciences and as an adjunct professor of epidemiology in the UW School of Public Health. His research has concentrated on nutrition with a focus on low-carbohydrate diets, harmful effects of diagnostic radiation, and evidence-based methodology and applications. His research has also covered sugar substitutes, the use of antibiotics in the treatment of periodontal disease, and cleft lip and cleft palate. He has also studied the link between dental disease and systemic disease, as well as trends in disease prevalence.

Fear of the dentist is passed on to children by their parents

The father acts as an intermediary for dentist fear between both mother and children Fear of visiting the dentist is a frequent problem in paediatric dentistry. A new study confirms the emotional transmission of dentist fear among family members and analyses the different roles that mothers and fathers might play. A new study conducted by scientists at the Rey Juan Carlos University of Madrid highlights the important role that parents play in the transmission of dentist fear in their family. Previous studies had already identified the association between the fear levels of parents and their children, but they never explored the different roles that the father and the mother play in this phenomenon. América Lara Sacido, one of the authors of the study explains that "along with the presence of emotional transmission of dentist fear amongst family members, we have identified the relevant role that fathers play in transmission of this phobia in comparison to the mother." Published in the "International Journal of Paediatric Dentistry", the study analysed 183 children between 7 and 12 years and their parents in the Autonomous Community of Madrid. The results were in line with previous studies which found that fear levels amongst fathers, mothers and children are interlinked. A key factor: the father The authors confirmed that the higher the level of dentist fear or anxiety in one family member, the higher the level in the rest of the family. The study also reveals that fathers play a key role in the transmission of dentist fear from mothers to their children as they act as a mediating variable. "Although the results should be interpreted with due caution, children seem to mainly pay attention to the emotional reactions of the fathers when deciding if situations at the dentist are potentially stressful," states Lara Sacido. Consequently, transmission of fear from the mother to the child, whether it be an increase or reduction of anxiety, could be influenced by the reactions that the father displays in the dentist. Positive emotional contagion Amongst the possible implications of these results, the authors outline the two most salient: the need to involve mothers and especially fathers in dentist fear prevention campaigns; and to make fathers to attend the dentist and display no signs of fear or anxiety. "With regard to assistance in the dental clinic, the work with parents is key. They should appear relaxed as a way of directly ensuring that the child is relaxed too," notes the author. "Through the positive emotional contagion route in the family, the right attitude can be achieved in the child so that attending the dentist is not a problem," she concludes.

Gum Disease Bacteria Linked To Pancreatic Cancer Risk

The British Dental Health Foundation believes new scientific research presented is a further indication of a possible link between pancreatic cancer and gum disease. The latest research, presented in the journal Gut, found one of the bacterium key in the development of gum disease was associated with a two-fold increase in risk for pancreatic cancer. The study also discovered those with non-harmful oral bacteria had a 45 per cent lower risk of pancreatic cancer. Although researchers cannot confirm whether gum disease contributes towards a higher risk of developing pancreatic cancer, the research is a further indication of a potential link between the two diseases. Previous research has also drawn an association between bacteria responsible for gum disease and pancreatic cancer, although in both cases it remains unclear whether the presence of particular types of bacteria are a cause or effect of pancreatic cancer. The paper's corresponding author Dominique Michaud, epidemiologist at Brown University, commented: "This is not an established risk factor. But I feel more confident that something is going on. It's something we need to understand better." Co-lead author Jacques Izard, of the Forsyth Institute and Harvard University concurred. He said: "We need to further investigate the importance of bacteria in pancreatic cancer beyond the associated risk." Pancreatic cancer accounted for 7,901 deaths in 20104, while only four per cent of people in England survived the disease for more than five years. Given these statistics, Chief Executive of the British Dental Health Foundation, Dr Nigel Carter OBE, believes any link between the two diseases should provide a timely reminder about the importance of good oral health. Dr Carter said: "This research provides further ammunition to the growing belief these two diseases could be related. "There is no escaping the fact poor oral health has some role to play, as a number of studies are now starting to show. What we must remember is oral health is relatively simple to maintain. The Foundation's three key messages - brushing your teeth for two minutes twice a day using a fluoride toothpaste, cutting down on how often you have sugary foods and drinks and visiting the dentist regularly, as often as they recommend - are a great starting point for maintaining good oral health. "If you have swollen gums that bleed regularly when brushing, bad breath, loose teeth or regular mouth infections appear, it is likely you have gum disease. If any of these symptoms persist, your dentist may be able to help you."