Monthly Archives

April 2013

brushing and flossing

Brushing and Flossing

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brushing and flossingThe single best thing you can do to lower your risk of gum disease is to brush twice a day and floss once a day. Many people skip the flossing, but this is an essential part of your gum disease prevention routine. Brushing alone cannot get below the gum line or between teeth, and it’s below the gum line that gum disease flourishes. When you floss, you can remove the plaque and bacteria that hides in the gum pockets and inflames the soft tissues of your mouth. Don’t skimp on the flossing; make sure to floss once every 24 hours.

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Mouthwash with Iodine Linked to LDL Cholesterol

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Study Finds New Iodine Mouthwash May Impact LDL Cholesterol

Mouthwash DangersCleaning your mouth and cleaning your arteries could be as simple as a once-a-day oral rinse if additional studies confirm preliminary findings about a new product.

Biomedical Development Corporation (BDC) on April 23 will present data to the American Academy of Oral Medicine showing that its oral rinse was safe and effective at fightinggingivitis in a recent clinical trial. But the most surprising finding of the study was that users of the oral rinse showed lower LDLcholesterol levels than the placebo group.

“We didn’t expect to see any difference in LDL cholesterol,” said Dr. Charles Gauntt, the study’s principal investigator. “We expected to see improvements in oral health, and we did. But we also monitored a number of biological markers for inflammation. The results showed the oral rinse had no adverse effects and users exhibited lower levels of LDL, or what many people know as bad cholesterol. This definitely merits further study.”

The three-month, phase II trial was funded by the National Heart, Lung and Blood Institute (NHLBI). The trial was preceded by a phase I clinical trial for safety and a phase II pilot efficacy clinical trial. Another, longer phase II trial is now under way and will evaluate gingivitis patients over a six-month period. This new trial, conducted by the Center for Oral Health Research at the University of Kentucky, will monitor gingivitis and LDL cholesterol levels as the previous trial did. The NHLBI is funding the research, which is also supported by the Kentucky SBIR/STTR Matching Funds Program.

BDC’s product is designed as a once-daily, 30-second oral rinse. The active ingredient is a proprietary formula based on iodine. The National Institutes of Health Office of Dietary Supplements fact sheet on iodine addresses a variety of important roles for iodine in the human body, from helping the thyroid function properly to appearing to play a part in the body’s immune response system. About 40 percent of the world’s population is thought to be at risk of iodine deficiency.

Gauntt also notes that iodine is known to be effective in inactivating viruses, bacteria and fungus. He is intrigued by recent clinical studies showing what appears to be a closer link between oral health and cardiovascular health. Although scientists cannot yet fully explain how the two are connected, there is ample statistical evidence to suggest that gum disease andheart disease are closely related. According to the American Academy of Periodontology, people with periodontal disease (gum disease) are almost twice as likely to have coronary artery disease. The academy also notes that one study showed stroke victims were more likely than the general population to also have oral infections.

Gauntt believes that future research might make it much clearer that a healthy mouth, free of gum disease and its associated toxins and bacteria, is critical to a healthy cardiovascular system. Although further study is required, he adds, he believes BDC’s oral rinse may eventually prove to be an important tool in keeping both mouths and cardiovascular systems healthy, in addition to proper nutrition and exercise.

Phyllis Siegel, CEO of BDC, said that while results of its ongoing clinical trials are pending, a specific formulation of the product called iCLEAN®, designed for general mouth cleaning, will soon be available.

Report by MNT

Wisdom Teeth

Dental Anesthesia May Affect Wisdom Teeth In Children

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Wisdom TeethResearchers from Tufts University School of Dental Medicine have discovered a statistical association between the injection of local dental anesthesia given to children ages two to six and evidence of missing lower wisdom teeth. The results of this epidemiological study, published in the April issue of The Journal of the American Dental Association, suggest that injecting anesthesia into the gums of young children may interrupt the development of the lower wisdom tooth.

“It is intriguing to think that something as routine as local anesthesia could stop wisdom teeth from developing. This is the first study in humans showing an association between a routinely- administered, minimally-invasive clinical procedure and arrested third molar growth,” said corresponding author, Anthony R. Silvestri, D.M.D., clinical professor in the department of prosthodontics and operative dentistry at Tufts University School of Dental Medicine.

Wisdom teeth are potentially vulnerable to injury because their development – unlike all other teeth – does not begin until well after birth. Between two and six years of age, wisdom tooth (third molar) buds begin to develop in the back four corners of the mouth, and typically emerge in the late teens or early adulthood. Not everyone develops wisdom teeth, but for those who do, the teeth often become impacted or problematic.

The American Association of Oral and Maxillofacial Surgeons reports that nine out of 10 people will have at least one impacted wisdom tooth, which can cause bad breath, pain, and/or infection. For this reason, many dentists recommend surgery to remove wisdom teeth to prevent disease or infection.

A developing wisdom tooth, called a bud, is vulnerable to injury for a relatively long time because it is tiny, not covered by bone, and only covered by a thin layer of soft tissue. When a tooth bud first forms, it is no bigger than the diameter of the dental needle itself. The soft tissue surrounding the budding tooth is close to where a needle penetrates when routine dental anesthesia is injected in the lower jaw, for example when treating cavities.

Using the Tufts digital dental record system, the researchers identified records of patients who had received treatment in the Tufts pediatric dental clinic between the ages of two and six and who also had a dental x-ray taken three or more years after initial treatment in the clinic. They eliminated records with confounding factors, such as delayed dental development, and analyzed a total of 439 sites where wisdom teeth could develop in the lower jaw, from 220 patient records.

Group one, the control group (376 sites), contained x-rays of patients who had not received anesthesia on the lower jaw where wisdom teeth could develop. Group two, the comparison group (63 sites), contained x-rays from patients who had received anesthesia.

In the control group, 1.9% of the sites did not have x-ray evidence of wisdom tooth buds. In contrast, 7.9% of the sites in the comparison group – those who had received anesthesia – did not have tooth buds. The comparison group was 4.35 times more likely to have missing wisdom tooth buds than the control group.

“The incidence of missing wisdom teeth was significantly higher in the group that had received dental anesthesia; statistical evidence suggests that this did not happen by chance alone. We hope our findings stimulate research using larger sample sizes and longer periods of observation to confirm our findings and help better understand how wisdom teeth can be stopped from developing,” Silvestri continued. “Dentists have been giving local anesthesia to children for nearly 100 years and may have been preventing wisdom teeth from forming without even knowing it. Our findings give hope that a procedure preventing third molar growth can be developed.”

Silvestri has previously published preliminary research on third molar tooth development, showing that third molars can be stopped from developing when non- or minimally-invasive techniques are applied to tooth buds.

Report by MedicaL News Today

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Test for Measuring Dental Mercury Questioned in Overestimating Exposure

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hailey idaho dentistA common test used to determine mercury exposure from dental amalgam fillings may significantly overestimate the amount of the toxic metal released from fillings, according to University of Michigan researchers. Scientists agree that dental amalgam fillings slowly release mercury vapor into the mouth. But both the amount of mercury released and the question of whether this exposure presents a significant health risk remain controversial. Public health studies often make the assumption that mercury in urine (which is composed mostly of inorganic mercury) can be used to estimate exposure to mercury vapor from amalgam fillings. These same studies often use mercury in hair (which is composed mostly of organic mercury) to estimate exposure to organic mercury from a person’s diet. But a U-M study that measured mercury isotopes in the hair and urine from 12 Michigan dentists found that their urine contained a mix of mercury from two sources: the consumption of fish containing organic mercury and inorganic mercury vapor from the dentists’ own amalgam fillings. “These results challenge the common assumption that mercury in urine is entirely derived from inhaled mercury vapor,” said Laura Sherman, a postdoctoral research fellow in the Department of Earth and Environmental Sciences and lead author of a paper in the journal Environmental Science & Technology. A final version of the paper has been published online. “These data suggest that in populations that eat fish but lack occupational exposure to mercury vapor, mercury concentrations in urine may overestimate exposure to mercury vapor from dental amalgams. This is an important consideration for studies seeking to determine the health risks of mercury vapor inhalation from dental amalgams,” said U-M biogeochemist Joel D. Blum, a co-author of the paper and a professor in the Department of Earth and Environmental Sciences. The study by Sherman, Blum and their colleagues demonstrates that mercury isotopes can be used to more accurately assess human exposure to the metal – and the related health risks – than traditional measurements of mercury concentrations in hair and urine samples. Specifically, isotopes provide a novel chemical tracer that can be used to “fingerprint” both organic mercury from fish and inorganic mercury vapor from dental amalgams. Mercury is a naturally occurring element, but more than 2,000 tons are emitted into the atmosphere each year from human-generated sources such as coal-fired power plants, small-scale gold-mining operations, metals and cement production, incineration and caustic soda production. This mercury is deposited onto land and into water, where micro-organisms convert some of it to methylmercury, a highly toxic organic form that builds up in fish and the animals that eat them, including humans. Effects on humans include damage to the central nervous system, heart and immune system. The developing brains of fetuses and young children are especially vulnerable. Inorganic mercury can also cause central nervous system and kidney damage. Exposure to inorganic mercury occurs primarily through the inhalation of elemental mercury vapor. Industrial workers and gold miners can be at risk, as well as dentists who install mercury amalgam fillings – though dentists have increasingly switched to resin-based composite fillings and restorations in recent years. About 80 percent of inhaled mercury vapor is absorbed into the bloodstream in the lungs and transported to the kidneys, where it is excreted in urine. Because the mercury found in urine is almost entirely inorganic, total mercury concentrations in urine are commonly used as an indicator, or biomarker, for exposure to inorganic mercury from dental amalgams. But the study by Sherman, Blum and their colleagues suggests that urine contains a mix of inorganic mercury from dental amalgams and methylmercury from fish that undergoes a type of chemical breakdown in the body called demethylation. The demethylated mercury from fish contributes significantly to the amount of inorganic mercury in the urine. The U-M scientists relied on a natural phenomenon called isotopic fractionation to distinguish between the two types of mercury. All atoms of a particular element contain the same number of protons in their nuclei. However, a given element can have various forms, known as isotopes, each with a different number of neutrons in it nucleus. Mercury has seven stable (nonradioactive) isotopes. During isotopic fractionation, different mercury isotopes react to form new compounds at slightly different rates. The U-M researchers relied on a type of isotopic fractionation called mass-independent fractionation to obtain the chemical fingerprints that enabled them to distinguish between exposure to methylmercury from fish and mercury vapor from dental amalgam fillings.

From: Medical News Today

 

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Tooth Loss may raise risk of Heart Disease

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dental newsThere’s more evidence of the health problems that stem from poor oral health.

A new study by researchers at the Swedish college Uppsala University found that tooth loss and gum disease raise the risk of heart disease and diabetes. The research team determined that missing teeth increased the enzyme levels of a specific enzyme. It was also discovered that this enzyme raised the risk of inflammation and hardening in the arteries.

The risk increased for every missing tooth. There were even new risk factors added, including high blood pressure, bad cholesterol and the circumference of the waist. The people with fewer teeth were also at an increased risk of suffering from diabetes. Each missing tooth made the person 11 percent more likely to develop diabetes.

Despite the many recent studies that have linked heart health and overall health, there isn’t much data from patients diagnosed with heart problems and how gum disease impacted them before their heart problems.

The best way to avoid any possible health effects from poor oral health is to visit the dentist on a regular basis.

 

From: Dentistry Today

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Oral Health for Adults with Special Needs

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family dental | dentist in sun valley idahoThe Challenges Of Improving The Oral Health Of Adults With Special Needs

Article by Medical News Today

A comprehensive study using electronic dental records to profile the oral health status of adults with intellectual and developmental disabilities (I/DD) has concluded that access to specialized dental care alone is not sufficient to meet the community’s substantial oral health needs. The findings, published as the cover article in the August issue of The Journal of the American Dental Association, provide a foundation for further investigation into the significant oral health needs of adults with I/DD and the development of preventive oral health strategies.

The study of dental records of 4,732 people, led by dentists and public health professionals at Tufts University School of Dental Medicine (TUSDM) and Tufts University School of Medicine (TUSM), was conducted at the Tufts Dental Facilities Serving People with Special Needs (TDF), a network of Massachusetts dental clinics that provides oral health care to people with disabilities.

Each year, Tufts’ program, which is recognized by the Association of State & Territorial Dental Directors as a national model, serves more than 7,000 patients at seven clinics in Massachusetts. The findings released today are the first of a three-part study conducted by principal investigators John Morgan, D.D.S., associate professor in the department of public health and community service at TUSDM, and Paula Minihan, Ph.D., M.P.H., assistant professor in the department of public health and community medicine at TUSM.

“People with intellectual and developmental disabilities are more likely to have poor oral hygiene, periodontal disease and untreated tooth decay than the general population,” said Morgan. “Our findings highlight the need for greater awareness of the unique and complex dental health care needs of this population. The roles of the patient, care giver and dental provider are all vital in developing preventive strategies to improve oral health.”

Morgan and colleagues analyzed clinical and demographic data documented in electronic dental records over a one-year period. They investigated oral health conditions (e.g. dental caries (cavities), periodontal (gum) disease, etc.), age, gender, ability to receive dental examinations and procedures, level of disability, and type of residence. Of the 4,732 patients whose records were reviewed, 61% were reported to have a mild to moderate disability, and 39% were assessed as having a severe disability. Dental records revealed a high burden of oral disease, including dental caries (cavities), periodontitis (gum disease) and missing teeth.

Nearly 25% of the patients had a limited ability to accept any dental intervention and required specialized resources, such as general anesthesia. Almost 40% of all patients able to accept dental treatment required some form of behavioral assistance. These behavioral challenges pose difficulties for dental staff when providing diagnostic and therapeutic procedures. “Behavioral challenges present barriers to good oral health and overall health,” Morgan said. “Often patients with significant developmental disabilities cannot tolerate complex and time consuming dental treatments.”

“From a public health perspective, our findings signal the need for the development of best practices for dental treatment guidelines that promote and protect the oral health of this vulnerable population,” said co-investigator Aviva Must, Ph.D., professor and dean of public health and professional degree programs at TUSM. “Further research is required to identify and develop risk-based preventive interventions to manage oral diseases for people with intellectual or developmental disabilities and maximize the role of the dental professional, patient, and caregiver in promoting oral health.”