Dr Ronan Kennedy BDS (QUB)
Edenderry
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News - November 2024
Global strategies are needed to reduce inappropriate antibiotic use
The World Health Organization annually publishes data on defined daily dose per 1,000 inhabitants per day (DID) for antibiotics, allowing for the monitoring of antibiotic prescribing patterns. However, this data is not reported specifically for dentistry. Depending on the country, dental professionals account for about 10% of outpatient antibiotic prescriptions. Researchers in Spain set out to map the DID of antibiotics prescribed by dentists.
The results underscore the urgent need for more detailed data on antibiotic prescribing practices, global strategies to monitor and reduce inappropriate antibiotic use, and the integration of dental practices into broader antibiotic stewardship efforts.
The researchers at the Faculty of Health Sciences of the Catholic University of Murcia analysed data from 12 countries. They found that the DID for antibiotics prescribed by dentists was generally low, often below 2.11, except in South Korea, where it reached up to 6.97. The data reveal a trend of decreasing antibiotic prescriptions over the last decade in many countries, such as England and Germany, although there was an increase during the Covid-19 pandemic.
The findings highlight the problem of inappropriate or unnecessary antibiotic prescription in dentistry. Dentists often prescribe antibiotics for dental conditions where their use may not be clinically justified, such as for unnecessary prophylactic treatment. Studies cited in the article have shown that a substantial portion of antibiotic prescriptions by dentists in the US, Croatia and Lebanon did not align with recommended guidelines.
The authors also advocated for initiatives involving continued training in antibiotic stewardship and regular updates to clinical guidelines to help practitioners distinguish between cases that warrant antibiotic use and those that do not. Furthermore, the implementation of standardised data reporting using DID is recommended. This measure allows for more accurate comparison of antibiotic usage across different regions and times, facilitating better monitoring of antibiotic consumption trends and informing policy.
The study ‘Mapping worldwide antibiotic use in dental practices: A scoping review’, was published in Antibiotics.
Probiotics may improve the oral microbiome
Schoolchildren in India recently took part in a study evaluating whether probiotics could prove a benefit to their overall oral health. After taking a probiotic product called EvoraPlus for a month, the children were tested and found to have lower levels of harmful oral bacteria and increased salivary pH, thus creating a healthier oral microbiome.
Based at the Bhabha College of Dental Sciences in Bhopal, the researchers selected the EvoraPlus tablet because it combines three naturally occurring strains of beneficial bacteria: Streptococcus oralis, Streptococcus uberis, and Streptococcus rattus. These bacteria work synergistically to maintain a balanced oral ecosystem, potentially displacing harmful bacteria linked to caries, such as Streptococcus mutans.
The research involved 40 caries-free children aged 12-14. The participants were split into two main groups: Group A, in which total bacterial counts were assessed; and, Group B, in which S. mutans levels were evaluated. Both groups were further divided into control subgroups (A1 and B1) that did not receive the probiotic, and test subgroups (A2 and B2) that consumed the EvoraPlus tablet for 30 days. Saliva samples were collected and analysed at the start and end of the study to measure bacterial counts and pH levels.
Results indicated significant reductions in both total bacterial counts and S. mutans levels in the groups taking the EvoraPlus tablets compared with the controls. The probiotic groups also exhibited a significant increase in salivary pH, indicating a shift towards a less acidic oral environment. The findings suggest that oral probiotic formulations like EvoraPlus can effectively reduce cariogenic bacteria and support a healthier oral ecosystem. The study, ‘EvoraPlus oral probiotic tablet: New paradigm for caries prevention in children’, was published in the International Journal of Clinical Pediatric Dentistry.
From https://www.dental-tribune.com/news/probiotics-may-improve-the-oral-microbiome/
AI tools for dental anaesthesiology are promising but need work
Large language models (LLMs), a type of artificial intelligence (AI) tool, are gaining popularity across medical disciplines, including dental anaesthesiology, for their potential to enhance information gathering, patient care and educational practices. A new study from Japan has evaluated the usefulness of major LLMs in dental anaesthesiology and concluded that, while LLMs like ChatGPT‑4 and Claude 3 Opus show promise, further advancements in model training and prompt engineering and the availability of high-quality, field-specific information are essential for their effective integration into dental anaesthesiology.
The LLMs selected by the researchers also included Gemini 1.0 and were utilised on the board certification examination of the Japanese Dental Society of Anesthesiology. The goal was to assess the utility of these models by comparing their accuracy in answering examination questions, offering insights into their application in dental anaesthesiology.
The study used 295 multiple-choice questions from the examination, spanning 2020 to 2022. The questions were manually input into the LLMs without specialised prompt engineering. ChatGPT‑4 achieved the highest accuracy (51.2%), followed by Claude 3 Opus (47.4%), whereas Gemini 1.0 lagged significantly behind (30.3%). ChatGPT‑4 and Claude 3 Opus performed particularly well in areas like systemic management and pain management. However, all the models demonstrated overall accuracy rates below 60%, suggesting limitations in their current utility for clinical decision-making in dental anaesthesiology.
Despite limitations, the study highlighted the potential of LLMs to support dental anaesthesiology practice, particularly in administrative tasks such as documentation. However, it also cautioned against relying on them for complex clinical decisions owing to risks like “hallucinations”, where models generate plausible but incorrect responses.
The study, ‘Evaluating large language models in dental anesthesiology: A comparative analysis of ChatGPT‑4, Claude 3 Opus, and Gemini 1.0 on the Japanese Dental Society of Anesthesiology board certification exam’, was published in Cureus.
From https://www.dental-tribune.com/news/llms-for-dental-anaesthesiology-are-promising-but-need-work/
Study compares effect of electronic cigarettes, cigarettes, waterpipes and smokeless tobacco on dental implants
Smokers have been shown to have a higher chance of developing peri-implant disease. However, there is a lack of research comparing cigarettes with popular alternative products that contain nicotine in this regard. To fill the gap, a recent study has compared the effects of electronic cigarettes, waterpipes, cigarettes and smokeless tobacco on the peri-implant mucosa. The researchers reported that e-cigarettes caused the least harm to the soft tissue around dental implants compared with the other three nicotine-containing products examined in the study.
According to lead author Dr Orsolya Vámos from the Department of Prosthodontics at Semmelweis University in Budapest, some nicotine-containing products, such as waterpipes and smokeless tobacco, are often incorrectly perceived as less harmful than traditional cigarettes and have thus grown in popularity in recent years. She explained that the components found in tobacco smoke can induce inflammation in the gums and that nicotine constricts blood vessels, thus reducing blood flow to the tissue and hindering the healing process after implant placement.
To compare the effect of nicotine-containing products on peri-implant tissue, the researchers conducted a systematic review of the literature and then a network meta-analysis of the eligible 32 studies.
The data showed that non-smokers had the smallest marginal bone loss, whereas the majority of nicotine-containing product users had significantly higher marginal bone loss compared with non-smokers. In general, most nicotine-containing product users presented with worse peri-implant parameters compared with non-smokers. However, e-cigarette users did not show significant differences from non-smokers in many outcomes.
The study, titled ‘The effect of nicotine-containing products on peri-implant tissues: A systematic review and network meta-analysis’, was published in Nicotine and Tobacco Research.
Protect your teeth with fruit: antimicrobial effects found in biomass compounds
Periodontal (gum) disease is an inflammatory disease caused by a periodontal pathogenic bacteria infection that affects oral and internal health. Good oral care is essential for prevention, but most over-the-counter oral hygiene products are disinfectants that can be highly irritating. This makes them unsuitable for use by young children and the elderly, who are susceptible to periodontal disease.
To find an antibacterial that is easy to use and effective in preventing gum disease at all ages, Prof. Shigeki Kamitani of Japan’s Osaka Metropolitan University's Graduate School of Human Life and Ecology led a research team in verifying the antibacterial effect of seven different compounds.
Prunin laurate (Pru-C12) and its analogs were tested against the periodontal pathogenic bacteria, Porphyromonas gingivalis.
The results showed that while several of the compounds inhibited bacterial growth, Pru-C12, which can be derived from biomass such as that of citrus plants and coconut-derived components, had the highest antimicrobial effect.
"Pru-C12 is tasteless and hypoallergenic," Prof. Kamitani stated: "If its safety in humans is confirmed in the future, it could be an inexpensive antimicrobial solution”.
From https://www.sciencedaily.com/releases/2024/08/240828114424.htm
Dental experts share the devilish drinks that will impact your mouth
The drinks you consume can have a significant impact on your oral health. According to the Oral Health Foundation, certain drinks can pose serious threats to your teeth and gums, leading to issues such as tooth decay, enamel erosion, and gum disease. Dental experts are now shedding light on these 'devilish drinks' that can negatively affect your smiles.
Fizzy drinks
Fizzy drinks generally contain a lot of sugar and can damage your teeth. If you drink fizzy drinks regularly, it's not good for your teeth. Besides the high sugar content, the acidity in fizzy drinks is another problem.
Energy drinks
Energy drinks are packed with sugar, acid, and usually a lot of caffeine. According to the Oral Health Foundation, the caffeine in these drinks can make your mouth really dry. Without enough saliva, which protects the teeth, you're more likely to have dental problems.
Cocktails
Cocktails, often made with alcohol, fruit juices, syrups, or sugary sodas, can expose your teeth to a lot of acid. This, along with the high sugar content, can lead to increased tooth sensitivity and decay. Plus, spirits can dry out your mouth, leading to bad breath.
Wine
Wine can have a detrimental effect on your mouth, both red and white. Wine’s alcoholic content can dry out your mouth and it is often highly acidic too.
Fruit juices
Fruit juice can be seen to be very healthy for your body, however it may not always be the case for your mouth. Fruit juices and smoothies often contain a lot of free sugars. Vitamins and minerals found in fruit juice can be great for your overall health but the levels of acidity and sugar can be detrimental for your teeth.
The Oral Health Foundation says that water and milk are the best tooth-friendly choices when it comes to drinks.
Botulinum toxin in dentistry: study shows trends in applications
The use of botulinum toxin (BT), commonly referred to as Botox, is gaining traction in the dental field, offering both therapeutic and cosmetic uses. Although initially known for its cosmetic applications, BT has evolved into a versatile tool in dentistry, addressing different oral health issues. A recent study from India has reviewed its current applications.
BT is now used to treat bruxism and temporomandibular disorder (TMD) by relaxing the masseter muscles, reducing clenching and grinding and leading to improvements in pain relief and jaw function. For bruxism and TMD patients who have not responded well to typical therapeutic alternatives, BT injections can provide a minimally invasive therapy that helps suppress soft-tissue activation, lessen muscle tonicity and significantly diminish the severity of symptoms.
Moreover, the authors reported that BT can support favourable outcomes for dental implants for this same reason. A primary cause of implant failure is the lack of osseointegration, sometimes resulting from strong masticatory forces in patients with abnormal masticatory habits.
BT injections also have application in surgery for oral and maxillofacial fractures, alleviating tension in hyperactive muscles of the periodontal apparatus during periodontal procedures. Additionally, the authors noted that intraoperative BT injections reduce muscular activity, lowering tension and promoting better healing at the surgical site.
The study also reported the use of BT to reduce the appearance of excessive gingival display by relaxing the upper lip muscles, and to address a number of conditions involving the salivary glands and trismus.
The study, titled ‘Botox: Current and emerging trends for dental practitioners in esthetic dentistry’, was published online in Cureus.
From https://www.dental-tribune.com/news/botulinum-toxin-in-dentistry-study-shows-trends-in-applications/
Romania tops EU list of dental graduates
High educational standards and affordable tuition fees make Romania an attractive destination for aspiring dental professionals from around the world. According to new data from Eurostat, the country remains the top producer of dental graduates in the EU by population, followed by Portugal and Bulgaria.
The 2022 data shows that Romania produced 1,878 dental graduates, or 9.86 per 100,000 inhabitants. In second and third place, Portugal and Bulgaria recorded 942 and 518 dental graduates, or 9.05 and 7.80 per 100,000 inhabitants, respectively.
According to the Societatea Română de Stomatologie, the Romanian society of stomatology, there were 12 dental schools in Romania in 2023, seven of which had been established in recent years. Students can study dental medicine in Romanian, English or French.
Romania’s number of dental graduates per 100,000 inhabitants has been experiencing a slight decline since 2020, when it reached 10.48, and those of Portugal and Bulgaria have experienced modest gains. A notable increase was recorded in Croatia, where the number of dental graduates nearly doubled to 196 from 100 between 2020 and 2022.
The 27 EU countries in 2022 produced an estimated 14,313 dental graduates, up slightly from 13,938 in 2021 and representing 3.20 per 100,000 inhabitants. Germany, being the most populous EU member, recorded 2,504 graduates, or 2.99 per 100,000 inhabitants. Spanish and Poland produced 1,852 and 1,203 graduates, respectively.
Eurostat data from 2021 shows that Greece had the highest number of practising dentists per 100,000 inhabitants, at 130.2, followed by Portugal with 117.8 and Cyprus with 111.0. Romania and Bulgaria had 109.9 and 103.5, respectively.
From https://www.dental-tribune.com/news/romania-tops-eu-list-of-dental-graduates/
Half skip toothbrushing once a week, finds charity census
New data collected by the Oral Health Foundation shows over half of adults (54%) admit to skipping brushing their teeth at least once a week. The charity’s findings also reveal one-in-six (16%) skip toothbrushing at least three times a week. Of particular concern is the revelation that people are almost twice as likely to skip brushing before bed (28%) compared to in the morning (15%). Dr Nigel Carter, Chief Executive of the Oral Health Foundation, expresses worry regarding the findings and explains why the nighttime brush is so important: “The extent to which we are neglecting our oral hygiene is extremely troubling. Skipping brushing sessions, especially on a regular basis, significantly increases the risk of plaque build-up, which is the primary cause of tooth decay and gum disease. This can lead to painful and costly dental issues if left unchecked. The bedtime brush is arguably the most crucial of the day. Throughout the day, bacteria and food particles build up in the mouth, and failing to remove them before bedtime allows these harmful substances to wreak havoc overnight”.
The charity’s data also looked into the frequency of toothbrushing and reveals that 24% of UK adults brush their teeth only once a day, with as few as 68% adhering to the recommended twice-daily brushing regimen.
Dr Carter adds: “Brushing only once a day significantly increases the likelihood of plaque buildup and the development of dental problems. Failing to brush twice daily leaves the mouth susceptible to bacterial overgrowth and increases the risk of bad breath, tooth decay, and gum disease”.
From https://www.dentalhealth.org/news/half-skip-toothbrushing-once-a-week-finds-charity-census
Major contributors revitalise WHO global strategy for oral health
The World Health Organization (WHO) has unveiled a new global oral health action plan, seeking to improve oral health outcomes and reduce the burden of oral disease worldwide by 2030. Part of a greater plan to integrate oral health into the universal health coverage framework and address the social and commercial determinants of oral health, the new action plan aims to enable people to achieve the best possible standard of oral health, thus improving their overall well-being and ability to participate fully in society.
Oral disease affects around 3.5 billion people worldwide and, despite being preventable for the most part, remains widespread owing to various risk factors and socioeconomic variables. The WHO strategy is the first concrete step towards implementing the World Health Assembly’s resolution on oral health, which was adopted in 2021. It outlines actions for WHO member states, international partners, civil society and the private sector. The overarching goal is to foster a comprehensive and coordinated approach to improving oral health around the world.
The actions the WHO will take according to the plan:
- 1. Developing ambitious national responses to promote oral health.
- 2. Reducing the incidence of oral disease and oral health inequalities.
- 3. Strengthening efforts to integrate oral health into universal health coverage.
- 4. Establishing a framework for tracking progress, including specific targets and indicators, by 2030.
It will take serious collaboration with a number of stakeholders, according to WHO, to achieve a global difference in oral health. One key stakeholder, FDI World Dental Federation, has contributed to the action plan, helping to ensure that the strategy is effective and can better meet the diverse needs of different populations.
Matcha mouthwash inhibits bacteria that causes periodontitis
Periodontitis is an inflammatory gum disease driven by bacterial infection and left untreated it can lead to complications including tooth loss. The disease has also been associated with diabetes, preterm birth, cardiovascular disease, rheumatoid arthritis and cancer. One of the chief bacterial culprits behind periodontitis is the bacterium Porphyromonas gingivalis.
Matcha, a finely ground green tea powder, may help keep P. gingivalis at bay. In Microbiology Spectrum, researchers in Japan report that matcha inhibited the growth of P. gingivalis in lab experiments. In addition, in a clinical study involving 45 people with periodontitis, people who used matcha mouthwash showed significantly lower levels of P. gingivalis in saliva samples than at the start of the study.
A previous study on mice found that green tea extract can inhibit the growth of pathogens, including E. coli. Matcha, which is used in traditional ceremonies and for flavoring in beverages and sweets, is made from raw leaves of C. sinensis. For the new study, researchers from the Nihon University School of Dentistry at Matsudo, the National Institute of Infectious Disease in Tokyo and other institutions carried out a series of in vitro experiments to test the efficacy of a matcha solution against 16 oral bacterial species, including three strains of P. gingivalis. Within two hours, nearly all the cultured P. gingivalis cells had been killed by the matcha extract, and after four hours of exposure, all the cells were dead.
From https://www.sciencedaily.com/releases/2024/05/240521124410.htm
Hidden challenges of tooth loss and dentures revealed in new study
Improvements in dental care, more people living longer and the social value placed on having a healthy smile has led to people keeping their own teeth longer, but it has also led to an increasing number of people needing some kind of restoration work, including crowns, bridges and implants.
A lot of these treatments remain unobtainable for many due to their high cost. Removable dentures are often the only viable option for anyone experiencing tooth loss. A new study by researchers at the University of Sheffield's Healthy Life Span Institute and the School of Clinical Dentistry has highlighted the emotional struggles and hidden challenges patients experience when having dentures fitted. This is the first study to map out the patient journey and how this experience can affect the overall success of the treatment.
The study found that patients think about their denture journey in four stages: 1) tooth loss – the initial stage where patients lose their teeth; 2) the emotional tunnel, which focuses on the emotional rollercoaster of tooth loss, including self-consciousness, depression, and struggles with dentures; 3) prosthetic hope, which represents the hope and optimism patients feel when getting dentures; and, 4) prosthetic compromise leading to managing disclosure – this final stage acknowledges that dentures take some getting used to.
Lead researcher Barry Gibson, Professor in Medical Sociology at the University of Sheffield said: “Tooth loss can be hugely traumatic and this study has uncovered just how challenging it is for people needing partial dentures. Feelings such as embarrassment or shame can significantly affect the process of having dentures made and fitted. On top of this if they don't fit properly this can make everyday activities such as speaking, eating and drinking very difficult, which affects a person's quality of life”.
From: https://www.sciencedaily.com/releases/2024/06/240606152301.htm
Low-cost liquid tames tooth decay
An inexpensive, cavity-fighting liquid called silver diamine fluoride (SDF) works as well as dental sealants to keep tooth decay at bay in a school cavity prevention and treatment programme, according to a new study by researchers at New York University (NYU) College of Dentistry.
The study, which followed more than 4,000 elementary school students for four years and is published in JAMA Pediatrics, shows that SDF is an effective alternative to sealants, and can increase access to dental care while reducing costs.
Dental caries (cavities) is the most prevalent chronic disease in children and can lead to pain, school absences, and lower academic performance. To prevent cavities, especially among children less likely to see a dentist, the Centers for Disease Control and Prevention (CDC) supports the use of school sealant programmes. In sealant programmes, dental professionals visit schools to apply a thin, protective coating to the surface of teeth that hardens and safeguards against decay.
Researchers at NYU College of Dentistry led CariedAway, the nation's largest school-based cavity prevention study, to compare the use of SDF and traditional sealants. The study included approximately 4,100 children in New York City elementary schools.
At each school visit, either sealants or SDF were applied followed by fluoride varnish. The researchers reported last year in the journal JAMA Network Open that a single treatment of either SDF or a sealant prevented 80% of cavities and kept 50% of existing cavities from worsening two years later. The team continued their study for another two years, and in their study published in JAMA Pediatrics, found that SDF and sealants prevented roughly the same number of cavities after children were followed for a total of four years. Moreover, both sealants and SDF reduced the risk of decay at each follow-up visit.
From https://www.sciencedaily.com/releases/2024/03/240304135748.htm
New method to test for oral cancer
Oral cancers and precancerous mouth lesions are considered especially difficult to diagnose early and accurately. But a team of researchers, led by a clinician scientist at the Case Western Reserve University (CWRU) School of Dental Medicine in Ohio in the United States, has discovered a non-invasive, low-cost test to detect oral cancer, monitor precancerous lesions and determine when a biopsy is warranted.
Their findings, published the journal Cell Reports Medicine, are based on a scoring system linked to the levels of two proteins in cells brushed from suspicious oral lesions of patients at dental clinics or the ear, nose and throat department at university hospitals (UH).
One of the proteins (hBD-3) is expressed at high levels in early-stage oral cancer, while the second (hBD-2) is low or unchanged. The ratio of hBD-3 to hBD-2 in the lesion site generates a score, called the beta defensin index (BDI). A score above a predetermined threshold implies cancer; anything below does not.
"When we first discovered hBD-3, we saw it acted as a 'good guy’, involved in wound-healing and killing microbes," said Aaron Weinberg, chair of the Department of Biological Sciences at the CWR School of Dental Medicine and the study's lead researcher.
He explained that when they found hBD-3 was regulated the same way certain cells grow uncontrollably, they started studying it in the context of oral cancer: “We found it was not only promoting tumor growth but it was overexpressed in the early stages of the disease, while another member, hBD-2, wasn't changing. This difference in levels of expression of the two proteins compared to the opposite side in the same patient led us to examine the BDI's ability to distinguish cancer from benign lesions”.
From: https://www.sciencedaily.com/releases/2024/03/240304135753.htm
Dublin scientists extract genetic secrets from 4,000-year-old teeth to illuminate the impact of changing human diets over the centuries
Researchers at Trinity College Dublin have recovered remarkably preserved microbiomes from two teeth dating back 4,000 years. Genetic analyses of these microbiomes reveal major changes in the oral microenvironment from the Bronze Age to today.
The study, carried out in collaboration with archaeologists from the Atlantic Technological University and the University of Edinburgh, was published Molecular Biology and Evolution. The authors identified several bacteria linked to gum disease and provided the first high-quality ancient genome of Streptococcus mutans, the major culprit behind tooth decay.
While S. mutans is very common in modern mouths, it is exceptionally rare in the ancient genomic record.
The sampled teeth were part of a larger skeletal assemblage excavated from Killuragh Cave, Co. Limerick, by the late Peter Woodman of University College Cork. While other teeth in the cave showed advanced dental decay, no cavities were visible on the sampled teeth. However, one tooth produced an unprecedented amount of S. mutans DNA, a sign of an extreme imbalance in the oral microbial community.
"We were very surprised to see such a large abundance of S. mutans in this 4,000-year-old tooth," said Dr Lara Cassidy, an assistant professor in Trinity's School of Genetics and Microbiology, and senior author of the study, "It is a remarkably rare find and suggests this man was at a high risk of developing cavities right before his death”.
The team also found evidence to support the "disappearing microbiome" hypothesis, which proposes modern microbiomes are less diverse than those of our ancestors. This is cause for concern, as biodiversity loss can impact human health.
Very few full genomes from oral bacteria have been recovered prior to the Medieval era. By characterising prehistoric diversity, the authors were able to reveal dramatic changes in the oral microenvironment that have happened since.
From: https://www.sciencedaily.com/releases/2024/03/240327124735.htm
When it comes to bad breath, some bacterial interactions really stink
Researchers from Japan report that a particular combination of bacteria in our mouths may be responsible for producing some very unpleasant smells. In a study published last month in mSystems, researchers from Osaka University revealed that the interaction between two common types of oral bacteria leads to the production of a chemical compound that is a major cause of bad breath.
Bad breath is caused by volatile compounds that are produced when bacteria in the mouth digest substances like blood and food particles. One of the worst smelling of these compounds is methyl mercaptan (CH3SH), which is produced by microbes that live around the teeth and on the surface of the tongue. However, little is known about which specific bacterial species are involved in this process.
Lead author of the study Takeshi Hara, said: "Most previous studies investigating CH3SH-producing oral bacteria have used isolated enzymes or relatively small culture volumes. In this study, we aimed to create a more realistic environment in which to investigate CH3SH production by major oral bacteria”.
To do this, the researchers developed a large-volume anaerobic co-culture system that enabled them to test interactions between multiple different types of bacteria that live in the mouth.
Masae Kuboniwa, senior author said: "The results were very intriguing. We found that Fusobacterium nucleatum produces large quantities of CH3SH in response to Streptococcus gordonii, another oral bacterium”.
Hara said: "Taken together, these findings suggest that CH3SH production in the mouth is driven by the interaction between S. gordonii and F. nucleatum".
Understanding how these two bacterial species work together to cause bad breath could be helpful in developing ways to treat or even prevent bad breath.
Available at: https://www.sciencedaily.com/releases/2024/02/240215113707.htm
Bacteria in the mouth linked to pulmonary fibrosis survival
Bacteria in the mouth may play a role in survival from idiopathic pulmonary fibrosis (IPF), a serious chronic lung disease, finds a new study led by researchers from the University of Michigan (UM) and the University of Virginia (UV) in the United States.
The findings come from a larger analysis of the role of the lung microbiome and IPF.
Working under the hypothesis that treatment with antibiotics could improve outcomes in patients with the disease, the CleanUP-IPF study includes the collection of cheek swabs and other samples to examine changes in bacterial populations.
Dr David O'Dwyer of the Division of Pulmonary and Critical Care Medicine at UM Medical School, partnering with Drs John Kom and Imre Noth of UV, saw an opportunity to also study the role of the oral microbiome in lung disease, as it is now generally accepted that bacteria from the mouth and throat are a major contributor to the lung microbiome.
Using 16S rRNA analysis and other genetic techniques, the team extracted DNA from the cheek swabs to look for clues.
Surprisingly, they found that one bacterial species, Streptococcus mitis, tended to dominate in certain patients with IPF who were not treated with antibiotics. What's more, those patients had better lung function and less severe disease – and ultimately, were more likely to survive. To date, research has shown that a more diverse set of bacteria in the lungs and the gut is reflective of better health. That does not hold true for the mouth, however, noted O'Dwyer. Streptococcus mitis tends to act as a gatekeeper toward other bacterial threats, including those that can cause periodontal disease, he said.
Available at: https://www.sciencedaily.com/releases/2024/02/240207120349.htm
No health without oral health: new report sheds light on the true impact of oral disease
A new report 'Time to Put Your Money Where Your Mouth Is: Addressing Inequalities in Oral Health’ looks at the need for a joined-up approach between policy, public health initiatives and clinical practice to address the challenges facing oral health.
Published by the European Federation of Periodontology (EFP), in collaboration with Economist Impact, the report investigates the impact of gum disease and tooth decay, and the urgent need to address existing inequalities.
Dr Nigel Carter, Chief Executive of the Oral Health Foundation, was part of the editorial team for the report and believes the shift in understanding oral diseases as preventable non-communicable diseases (NCDs) is crucial: “Neglecting the impact of oral health and its shared risk factors with other NCDs is a missed opportunity for comprehensive healthcare planning. Urgent action is needed to boost public awareness on the relationship between oral health and overall well-being”.
Presented by the EFP in Brussels, the report also expressed concerns that clinical care for tooth decay remains largely focused on a “repair approach”. Analysis found that decades of oral care focus has been placed on reactive, not preventive, measures. It also revealed limited preventive training and inadequate incentives for health professionals.
The report also laid bare the economic burden of oral disease. Direct global treatment costs due to the three most common oral conditions (tooth decay, severe gum disease, and severe tooth loss) were estimated at €330 billion yearly, representing around 5% of worldwide health expenditure.
Economist Impact modelled the cost savings associated with preventive strategies. They found that implementing preventive interventions could reduce rates of tooth decay by as much as 30% while substantially cutting costs.
Available at: https://www.dentalhealth.org/news/no-health-without-oral-health-new-report-sheds-light-on-the-true-impact-of-oral-disease
Newly discovered autoimmune disorder disrupts tooth enamel development
Enamel, the hardest and most mineral-rich substance in the human body, covers and protects our teeth. But in one of every 10 people this layer appears defective, failing to protect the teeth properly. As a result, teeth become more sensitive to heat, cold and sour food, and they may decay faster. In most cases, the cause of the faulty enamel production is unknown.
Now, a study by Prof. Jakub Abramson and his team at the Weizmann Institute of Science, published recently in Nature, may shed light on this problem by revealing a new children's autoimmune disorder that hinders proper tooth enamel development. The disorder is common in people with a rare genetic syndrome and in children with celiac disease. These findings could help develop strategies for early detection and prevention of the disorder.
A strange phenomenon was identified in people with a rare genetic disorder known as APS-1. Although the enamel layer of their milk teeth forms normally, something causes its faulty development in their permanent teeth. Since people with APS-1 suffer from a variety of autoimmune diseases, Abramson and his team hypothesised that the observed enamel defects may also be of an autoimmune nature – in other words, that their immune system could be attacking their own proteins or cells that are necessary for enamel formation.
In their new study, scientists from Abramson's lab in Weizmann's Immunology and Regenerative Biology Department, led by research student Yael Gruper, sought to work out how mutations in the Aire gene lead to deficient tooth enamel production.
Online: https://www.sciencedaily.com/releases/2023/12/231213112542.htm
Viking dentistry was surprisingly advanced
Viking Age teeth from Varnhem bear witness to surprisingly advanced dentistry. This has been shown in a study carried out at the University of Gothenburg in Sweden. The study examined 3,293 teeth from 171 individuals among the Viking Age population of Varnhem in Västergötland, Sweden.
The site is known for extensive excavations of Viking and medieval environments, including tombs where skeletons and teeth have been preserved well in favorable soil conditions.
The research team from the University of Gothenburg's Institute of Odontology worked with an osteologist from Västergötland's Museum.
The teeth underwent clinical examinations using standard dentistry tools under bright light.
A number of X-ray examinations were also performed. The results, which have been published in PLOS ONE, show that 49% of the Viking population had one or more caries lesions. However, children with milk teeth – or with both milk and adult teeth – were entirely caries-free.
Tooth loss was also common among adults. The studied adults had lost an average of 6% of their teeth, excluding wisdom teeth, over their lifetimes. The findings suggest that caries, tooth infections, and toothache were common among the Viking population in Varnhem.
However, the study also reveals examples of attempts to look after teeth in various ways.
Carolina Bertilsson, a dentist and Associate Researcher, and the study's corresponding author, said: "There were several signs that the Vikings had modified their teeth, including evidence of using toothpicks, filing front teeth, and even dental treatment of teeth with infections".
One sign of more sophisticated procedures was molars with filed holes, from the crown of the tooth and into the pulp, probably in order to relieve pressure and alleviate severe toothache due to infection.
Carolina continues: "This study provides new insights into Viking oral health, and indicates that teeth were important in Varnhem's Viking culture. It also suggests that dentistry in the Viking Age was probably more sophisticated than previously thought”.
Online: https://www.sciencedaily.com/releases/2023/12/231214132600.htm
Toothbrushing tied to lower rates of pneumonia among hospitalised patients
A new study by investigators from Brigham and Women's Hospital (BWH) in the US and Harvard Pilgrim Health Care Institute examined whether daily toothbrushing among hospitalised patients is associated with lower rates of hospital-acquired pneumonia and other outcomes. The team combined the results of 15 randomised clinical trials that included more than 2,700 patients and found that hospital-acquired pneumonia rates were lower among patients who received daily toothbrushing compared to those who did not. The results were especially compelling among patients on mechanical ventilation. Their results are published in JAMA Internal Medicine.
Corresponding author Michael Klompas, MD, MPH, hospital epidemiologist and an infectious disease physician in the Department of Medicine at BWH and Professor of Population Medicine at Harvard Pilgrim Health Care Institute, said: "The signal that we see here towards lower mortality is striking – it suggests that regular toothbrushing in the hospital may save lives. It's rare in the world of hospital preventative medicine to find something like this that is both effective and cheap. Instead of a new device or drug, our study indicates that something as simple as brushing teeth can make a big difference”.
Hospital-acquired pneumonia occurs when bacteria in the mouth enter a patient's airways and infect their lungs. Patients experiencing frailty or with a weakened immune system are particularly susceptible to developing hospital-acquired pneumonia.
However, adopting a daily toothbrushing regimen can decrease the amount of bacteria in the mouth, potentially lowering the risk of hospital-acquired pneumonia from occurring.
The team conducted a systematic review and meta-analysis to determine the association between daily toothbrushing and hospital-acquired pneumonia.
Online: https://www.sciencedaily.com/releases/2023/12/231218125919.htm
Splatter study examines infection control during oral surgery
A study from the University of Minnesota School of Dentistry and published in Clinical Oral Investigations examined the patterns of splatter contamination created by rotary instruments and irrigation during oral surgery. This study is the first to examine rotary instrumentation splatter created during oral surgery procedures, and its findings provide several key suggestions for the future of oral surgery and improving safety measures for both providers and patients.
The study involved an experiment on manikins, otherwise known as patient simulators, in the University of Minnesota’s Oral and Maxillofacial Surgery operatories. Researchers simulated the surgical extraction of four molars in different quadrants with one operator and one assistant with four combinations of operations: saline with a self-irrigating drill; hydrogen peroxide with a self-irrigating drill; saline with hand irrigation; or, hydrogen peroxide with hand irrigation.
A total of 52 procedures were completed and splatter was collected on glass fibre prefilters, which were allowed to dry before being photographed under ultraviolet (UV) light. The study found that the most splatter occurred on the patient's chest, followed by the assistant's face shield. The operator's face shield was also splattered, as were face masks and corners of the operatory. Also, the difference between assistant irrigation and self-irrigating drills was marginally significant, but found that using hydrogen peroxide to irrigate instead of saline increased the area of droplet splatter.
While hydrogen peroxide rinses were used throughout the Covid-19 pandemic as a pre-procedural rinse, this study is the first to report an enhancing effect of irrigation using hydrogen peroxide on the formation of splatter, and suggests that hydrogen peroxide actually increases the risk of spreading droplets when it's used to irrigate.
The study also offers important insights for the use of personal protective equipment in oral surgery. Given the high level of splatter on the operator and assistant's face shields, practitioners may consider continuing to use face shields.
The authors suggest further approaches could include additional studies of the effects of irrigants and irrigation methods on viral load and surface stability of viruses, and testing of frequently-touched locations.
Online: https://medicalxpress.com/news/2023-11-first-of-its-kind-splatter-infection-oral-surgery.html
Proof of concept of new material for long-lasting relief from dry mouth conditions
A novel aqueous lubricant technology designed to help people who suffer from a dry mouth is between four and five times more effective than existing commercially available products, according to laboratory tests.
Developed by scientists at the University of Leeds, the saliva substitute is described as comparable to natural saliva in the way it hydrates the mouth and acts as a lubricant when food is chewed.
Under a powerful microscope, the molecules in the substance, known as a microgel, appear as a lattice-like network or sponge, which bind onto the surface of the mouth. Surrounding the microgel is a polysaccharide-based hydrogel that traps water. This dual function will keep the mouth feeling hydrated for longer.
Results from the laboratory evaluation show benchmarking of the microgel-reinforced hydrogel-based aqueous lubricant against commercial saliva substitutes, and are reported in the journal Scientific Reports.
The novel microgel comes in two forms: one made with a dairy protein; and, the other a vegan version using a potato protein.
The new substance was benchmarked against eight commercially available saliva substitutes. All the benchmarking was done in a laboratory on an artificial tongue-like surface and did not involve human subjects.
With the commercially available products, between 23 and 58% of the lubricant was lost. With the saliva substitute developed at Leeds, the figure was just 7%. The dairy version slightly outperformed the vegan version.
Dr Olivia Pabois, a Research Fellow at Leeds and first author, said: "The test results provide a robust proof of concept that our material is likely to be more effective under real-world conditions and could offer relief up to five times longer than the existing products. The results of the benchmarking show favourable results in three key areas. Our microgel provides high moisturisation, it binds strongly with the surfaces of the mouth and is an effective lubricant, making it more comfortable for people to eat and talk”.
Online: https://medicalxpress.com/news/2023-11-proof-concept-material-relief-dry.html
A healthy mouth helps to maintain balanced metabolic profiles
Common oral infections, periodontal diseases and caries are associated with inflammatory metabolic profiles related to an increased risk of cardiometabolic diseases, a new study suggests. Oral infections also predicted future adverse changes in metabolic profiles. The study was a collaborative effort by an international team of researchers from the University of Eastern Finland and the University of Helsinki in Finland, the Karolinska Institutet in Sweden, and the Medical University of Graz in Austria.
The association between oral infections and adverse metabolic profiles was observed in the Finnish Health 2000/2011 and Parogene study cohorts and was published in the Journal of Dental Research.
The present study comprised 452 middle-aged and elderly Parogene patients and 6,229 participants of the population-based Health-2000 survey. In 2011, 4,116 Health-2000 participants provided a follow-up serum sample. Serum concentrations of 157 metabolites reflecting the risk of chronic diseases, such as lipid and glucose metabolites, ketone bodies and amino acids, were determined with an NMR spectroscopy method.
The study had a cross-sectional part analysing the association between the metabolic measures with prevalent oral health, and a prospective part examining whether oral infections predict the levels of metabolic measures in the follow-up.
Among 157 metabolic measures, increased periodontal probing depth was associated with 93 measures, bleeding on probing with 88, and periodontal inflammation burden with 77. Among the caries-related parameters, root canal fillings were associated with 47 metabolic measures, inadequate root canal fillings with 27, and caries lesions with eight. In the prospective analyses, caries was associated with 30 metabolites and bleeding on probing with eight. These metabolic measures were typical of inflammation, thus showing positive associations with fatty acid saturation degree and very low density lipoprotein (VLDL) parameters, and negative associations with high density lipoprotein (HDL) parameters.
"Oral infections may partially explain unhealthy lipid profiles," says Adjunct Professor Aino Salminen from the University of Helsinki.
Online: https://www.sciencedaily.com/releases/2023/11/231116141003.htm
Killer smile? An oral pathogen increases heart attack damage, study reveals
In a study published in September 2023 in the International Journal of Oral Science, researchers from Tokyo Medical and Dental University (TMDU) have revealed that a common oral pathogen can stop cardiac myocytes from repairing themselves after a heart attack caused by coronary heart disease.
Heart attacks occur when blood flow in the coronary arteries is blocked, resulting in an inadequate supply of nutrients and oxygen to the heart muscle, and ultimately death of cardiac myocytes. To prevent this, cardiac myocytes use a process known as autophagy to dispose of damaged cellular components, keeping them from causing cardiac dysfunction.
"Previous studies have shown that the periodontal pathogen Porphyromonas gingivalis, which has been detected at the site of occlusion in myocardial infarction, can exacerbate post-infarction myocardial fragility," says lead author of the study Yuka Shiheido-Watanabe. "However, the mechanisms underlying this effect remained unknown”.
To investigate this, the researchers created a version of P. gingivalis that does not express gingipain, its most potent virulence factor, which an earlier study showed can inhibit cells from undergoing programmed cell death in response to injury. They then used this bacterium to infect cardiac myocytes or mice.
"The results were very clear," explains Yasuhiro Maejima, corresponding author. "The viability of cells infected with the mutant bacterium lacking gingipain was much higher than that of cells infected with the wild-type bacterium. In addition, the effects of myocardial infarction were significantly more severe in mice infected with wild-type P. gingivalis than in those infected with the mutant P. gingivalis lacking gingipain”.
Given that P. gingivalis appears to have a substantial impact on the cardiac muscle's ability to heal itself after a heart attack, treating this common oral infection could help reduce the risk of fatal heart attack.
Online: https://medicalxpress.com/news/2023-10-killer-oral-pathogen-heart-reveals.html.
Combined treatment takes a bite out of tooth decay
The sting of a toothache or the discovery of a cavity is a universal dread. Dental caries, more commonly known as tooth decay, is an insidious adversary, taking a toll on millions of mouths worldwide. Caries can lead to pain, tooth loss, infection, and in severe cases, even death.
Some state that current treatments do not sufficiently control biofilm, the main culprit behind dental caries, and prevent enamel demineralisation at the same time. This dual dilemma becomes particularly pronounced in high-risk populations where the onset of the disease can be both rapid and severe.
Now, a study from a team of researchers led by Hyun (Michel) Koo of the University of Pennsylvania's School of Dental Medicine in collaboration with David Cormode of Penn's Perelman School of Medicine and School of Engineering and Applied Science has unveiled an unexpected synergy in the battle against dental caries.
Their research revealed that the combination of ferumoxytol (Fer) and stannous fluoride (SnF2) could provide at a potent tool in the fight against dental caries. Their findings were published in Nature Communications.
Their findings include the ability of Fer to stabilize SnF2, the heightened catalytic activity of Fer when combined with SnF2, and the formation of a protective Fe/Sn/F-rich film on tooth enamel, which can serve as a shield against further demineralisation. What's more, this combined therapy doesn't disrupt the ecological balance of the oral microbiota and has no adverse side effects on the surrounding host tissues.
The researchers also note that, beyond this protective and proactive measure, an intriguing secondary benefit surfaced. Many children with severe tooth decay also suffer from iron deficiency anaemia. Using Fer might address the dental and anaemia concerns simultaneously.
Looking ahead, further research is required into the exact mechanisms of interaction between SnF2 and Fer, the reactive oxygen species generation process, and the formation and efficacy of the protective enamel film.
Online: https://medicalxpress.com/news/2023-10-combined-treatment-tooth-decay.html.
Pandemic impact: decline in preventive oral health services raises concerns
New research from Delta Dental on oral healthcare during the Covid-19 pandemic, published recently by the Journal of the American Dental Association, reported a significant decrease in the provision of preventive oral healthcare services when compared to pre-pandemic levels.
The study, ‘Impact of the Covid-19 pandemic on oral healthcare use in the United States through December 2021’, showed that there were significant decreases in preventive dental services that persisted for more than a year, particularly across all age groups under 65. These could reflect, in part, anecdotal reports of loss of employer-sponsored dental benefits, reluctance to seek care due to concerns about Covid-19 exposure, or staff shortages at dental offices. Study authors also found a significant increase in the delivery of night guards to adult patients. This may indicate a rise in stress-related teeth grinding that can crack or fracture teeth.
The research assessed the effects of the Covid-19 pandemic on oral healthcare using national insurance claims data. The research team analysed claims by quarter from 2017 to 2019 and from July 2020 to December 2021, including 600 million submitted procedure codes. The study team intends to conduct follow-up research that will explore national oral health claims data from 2022.
Student researchers turn to lotus plant to design fog-free personal protective equipment
Under the direction of Praveen Arany, Ph.D., associate professor of oral biology, students at the University of Buffalo School of Dental Medicine created free face shields and comfort bands as a type of personal protective equipment (PPE) with 3D printers that were eventually used by some 3,000 dental professionals in university centres across the US. However, first the students had to figure out how to prevent the shields from fogging up, which makes it hard for wearers to see.
Commercially available antifogging solutions found in eyeglasses and car exteriors were not suitable due to their potential to irritate the skin or cause sickness if inhaled or ingested. However, lotus leaves provided a eureka moment for the researchers.
After looking at several formulations of wax that would keep the PPE clear and non-toxic, the research team discovered that a combination of carnauba and beeswax created optimal results.
"With a couple of adjustments, the condensation just rolled off," Arany said.
The researchers' discovery is explained in a paper published in Peer J Materials Science and authored by students Succhay Gadhar, Shaina Chechang and Philip Sales, with Arany.
Although clinical professionals are currently not required to wear PPE, this could change if the spread of the new coronavirus variant, BA.2.86, results in healthcare settings adopting stricter cautionary measures.
"The design principles are there," Arany said. "It's something we could manufacture again if and when needed”.
Online: https://medicalxpress.com/news/2023-09-student-lotus-fog-free-personal-equipment.html
Why grinding your teeth might not always be a bad thing
According to the Council of Dentists in Spain, bruxism is the dental diagnosis that has increased the most since the pandemic, almost quadrupling. In fact, its incidence among the population has gone from 6% to 23%.
We all know what this behaviour basically entails – clenching or grinding one's teeth. In recent years, the concept has changed and is now classified into two distinct forms: sleep bruxism; and, awake bruxism.
In the latter case, the person may be aware of their behaviour and, thus be able to stop it.
In some clinical settings, both types can be considered a risk factor or sign of underlying disease, such as headaches or temporomandibular disorders. And there is always the possibility that these two varieties of bruxism will have negative consequences: they can cause tooth wear and fractures, as well as muscle or joint pain.
Current research implies another important modification to the concept of bruxism: it is no longer considered a pathology but a mere motor activity. That is to say, it does not have to be harmful in and of itself.
A 2020 study concluded that waking bruxism could be a stress release mechanism. And secondly, the variety that occurs while we sleep seems to be related to gastric reflux and obstructive sleep apnoea. Some authors hypothesise that it could play a protective role against the effects of both disorders.
With that in mind, perhaps one of the most effective treatments is biofeedback. This consists of having patients learn to identify and reduce muscle tension by adopting a jaw resting position with the use of an electromyograph, a device that measures the electrical activity of the muscles.
Many people are unaware of the fact that for the jaw to be relaxed and at rest, there should be no contact between the teeth. The easiest way to detect if we are clenching our teeth is to put ‘post-it’ notes in visible places to act as a reminder. And, since stress is chronically present in our lives, we should regularly undertake relaxation techniques and techniques to control the bracing of jaw muscles.
Online: https://medicalxpress.com/news/2023-09-teeth-bad.html
Capsaicin drops – a new strategy for treating burning mouth syndrome
Burning mouth syndrome (BMS) is a chronic condition characterised by a burning pain in the mouth, sometimes accompanied by numbness.
BMS is often considered a perplexing condition because the intensity of pain rarely corresponds to the clinical signs of the disease.
Medical and dental interventions, as well as the use of certain medications, can lead to burning mouth pain. This involves evaluating whether the pain may originate from issues affecting the entire body (systemic causes) or from conditions affecting the areas around the mouth (peripheral causes).
Currently, there are no effective treatment regimens for this patient group. Various medications are used to treat BMS, including benzodiazepines, gabapentin, tricyclic antidepressants, antipsychotics, antioxidants, and behavioural therapies.
One remedy that has some effect is alphalipoic acid, an antioxidant. According to Associate Professor Preet Bano Singh of the Faculty of Dentistry in the University of Oslo, approximately 60% of her patients respond positively to this treatment. For the remaining 40%, it has little or no effect.
"Capsaicin is a chemical compound naturally found in chilli peppers. It acts as an 'awakener' for specific receptors in the body that transmit pain and temperature signals. These receptors are called 'TRPV1 receptors’," Singh explains.
The challenge is how to keep the active substance where it should be. When capsaicin is applied to the mouth, it is often washed away by saliva and quickly disappears when the tongue moves. Therefore, researchers are working on finding a way to prolong the presence of capsaicin in the mouth.
Online: https://medicalxpress.com/news/2023-09-capsaicin-dropsa-strategy-mouth-syndrome.html.
Study finds stem-cell derived organoids that secrete tooth enamel proteins
Organoids have now been created from stem cells to secrete the proteins that form dental enamel, the substance that protects teeth from damage and decay. Tooth enamel protects teeth from the mechanical stresses incurred by chewing and helps them resist decay.
Enamel is made during tooth formation by specialised cells called ameloblasts. When tooth formation is complete, these cells die off. Consequently, the body has no way to repair or regenerate damaged enamel, and teeth can become prone to fractures or subject to loss.
To create ameloblasts in the laboratory, Researchers from the University of Washington first had to understand the genetic programme that drives foetal stem cells to develop into these highly specialised enamel-producing cells. To do this, they used a technique called single-cell combinatorial indexing RNA sequencing (sci-RNA-seq), revealing what genes are active at different stages of a cell's development.
By performing sci-RNA-seq on cells at different stages of human tooth development, the researchers were able to obtain a series of snapshots of gene activation at each stage.
The researchers were able to coax undifferentiated human stem cells into becoming ameloblasts. They did this by exposing the stem cells to chemical signals that were known to activate different genes in a sequence that mimicked the path revealed by the sci-RNA-seq data.
While conducting this project, the scientists also identified another cell type called a subodontoblast for the first time, which they believe is a progenitor of odontoblasts, a cell type crucial for tooth formation.
The researchers found that these cell types could be induced to form small, three-dimensional, multicellular mini-organs called organoids. These organised themselves into structures similar to those seen in developing human teeth and secreted three essential enamel proteins: ameloblastin; amelogenin; and, enamelin. These proteins would then form a mineralisation process that is essential for forming enamel.
The research team now hopes to refine the process to make enamel comparable in durability to that found in natural teeth and develop ways to use this enamel to restore damaged teeth.
Online: https://www.sciencedaily.com/releases/2023/08/230814122258.htm
Teeth could preserve antibodies hundreds of years old
A new study has found that teeth could be capable of preserving antibodies for hundreds of years, allowing scientists to investigate the history of infectious human diseases.
Antibodies are proteins produced by the immune system as a natural response to infectious organisms like viruses and bacteria. Their job is to recognise these microbes so that the immune system can attack them and clear them from the body.
In the new paper from a team led by researchers from the University of Nottingham, published by iScience, antibodies extracted from 800-year-old, medieval, human teeth were found to still be fit enough for scientists to find viral proteins in them.
This expands the study of ancient proteins, referred to as palaeoproteomics, potentially allowing experts to analyse how human antibody responses developed through history.
Palaeoproteomics has already successfully recovered and identified ancient proteins after preservation in the dental enamel of an ancient rhinoceros dating back as far as 1.7 million years ago. In this new study, the authors also found preliminary evidence that, like the medieval human teeth, mammoth bones nearly 40,000 years old appear to preserve stable antibodies.
This science has previously been applied by the Nottingham team to the analysis of other disease-associated proteins recovered from archaeological human bones and teeth to allow identification of an unusual ancient form of the skeletal disorder Paget's disease.
Online: https://www.sciencedaily.com/releases/2023/08/230816114136.htm
A simple mouth rinse could spot early heart disease risk
Periodontitis is a common infection of the gums that has previously been linked to the development of cardiovascular disease. A team of scientists from Canadian universities set out to study young, healthy people without diagnosed periodontal issues to determine whether lower levels of oral inflammation can be clinically relevant to cardiovascular health.
To identify key indicators of cardiovascular risk, the team used pulse-wave velocity to measure the stiffness of arteries and flow-mediated dilation to measure of how well arteries can dilate to allow for higher blood flow. These processes measure arterial health directly, showing that stiff and poorly functioning arteries raise a patient’s risk of cardiovascular disease.
The scientists recruited 28 non-smokers between 18 and 30, with no comorbidities or medications that could affect cardiovascular risk and no reported history of periodontal disease. They were asked to fast for six hours, except for drinking water, prior to visiting the lab. At the lab, participants rinsed their mouths with water before rinsing their mouths with saline, which was collected for analysis. Participants then laid down for 10 minutes for an electrocardiogram, and stayed lying down for another 10 minutes so that the scientists could take their blood pressure, flow-mediated dilation, and pulse-wave velocity.
The scientists found that high white blood cells in saliva had a significant relationship to poor flow-mediated dilation, suggesting these people may be at elevated risk of cardiovascular disease. However, there was no relationship between white blood cells and pulse wave velocity, so longer-term impacts on the health of the arteries had not yet taken place.
The scientists hypothesised that inflammation from the mouth, leaking into the vascular system, impacts the ability of arteries to produce the nitric oxide that allows them to respond to changes in blood flow.
Online: https://medicalxpress.com/news/2023-08-simple-mouth-early-heart-disease.html
Dietary restrictions could reduce periodontal disease
Since it has been evidenced that periodontitis results in local and systemic inflammation, researchers have recently examined the effects of dietary restrictions on both treatment response and inflammation in periodontal disease. The study, which is the first systematic review to assess the possible effect of dietary restrictions on periodontal disease, found that restricting calorie intake can help improve the periodontal condition by reducing local and systemic inflammation.
The review included four animal studies and two studies in humans. The researchers found that certain approaches to dietary or caloric restriction may affect periodontal conditions by reducing local and systemic inflammation and improving clinical parameters, thus minimising periodontal disease progression when compared with such progression when a normal diet is followed.
However, the researchers noted that the findings should be interpreted with caution since the systematic review only included a limited number of studies, the majority of which were conducted on animal models. Additionally, the human studies were methodologically simple studies with only a four-month follow-up period. Therefore, the researchers believe that further studies in the area should be undertaken.
Online: https://uk.dental-tribune.com/news/dietary-restrictions-could-reduce-periodontal-disease/
New study on AI and ChatGPT outlines its role in shaping the future of dentistry
ChatGPT is an artificial intelligence (AI)-powered language model, capable of generating human-like text based on context and past conversations. A new study from researchers in China investigates the future applications of AI, and ChatGPT, within dentistry.
Research, published in the International Journal of Oral Science provides an insight into its potential use in dentistry.
The study authors suggest that ChatGPT has served as a valuable tool to assist medical education for more effective instruction and analysis of teacher–student interaction. Medical writing can be assisted or even accomplished by ChatGPT, which enables efficient documentation. Furthermore, language challenges in medical research or clinical processes can be alleviated by ChatGPT.
They continue to observe that AI technology has promoted clinical applications by improving patient outcomes, streamlining processes, and reducing costs. In clinical practice, AI has achieved striking success in analysing patient data.
Equipped with a cross-modal encoder, a single large language model (LLM) can manage multi-source data and conduct advanced natural language reasoning to perform complex clinical operations. This has the potential to revolutionise dental diagnosis and treatment, which indicates a promising avenue for clinical application and research in dentistry. However, the researchers caution that challenges with AI in dentistry may include data privacy, data quality, and model bias.
As technology continues to evolve, we can expect to see even more innovative applications of AI in clinical settings, ultimately leading to more effective healthcare services tailored to the needs of patients.
Toothpaste containing synthetic tooth minerals can prevent cavities as effectively as fluoride
Can we improve on the toothpaste we use to maintain clean teeth, preventing medical issues that spiral from poor dental health? Most toothpastes use fluoride, a powerful tool for oral hygiene. However, fluoride can pose health problems in some cases, especially for children who consume too much by swallowing toothpaste. In the search for alternatives, a team of international scientists and Polish clinicians have identified a hydroxyapatite toothpaste that works just as well as fluoride toothpaste to protect against cavities.
To see if it would help patients without specific dental conditions, the clinicians recruited 189 adults aged 18-45 to take part in an 18-month double blind, randomised, clinical trial. They aimed to see all patients through to the end of the study without an increase in cavities.
A total of 171 patients completed the trial, evenly split between the hydroxyapatite toothpaste group and the control group with fluoridated toothpaste. All patients had at least ten teeth without cavities, were willing to use an electric toothbrush, and had no pre-existing tooth problems in need of treatment. Patients were provided with electric toothbrushes and replacement heads for these, as well as neutrally packaged toothpaste that could have contained either the hydroxyapatite toothpaste or a fluoride toothpaste. Neither patients nor examiners knew which toothpaste a given patient was using, and patients used no other oral care products.
At the end of the trial, the scientists found that nearly 90% of patients in both groups had no new cavities. There was no statistical difference in efficacy between the patients using a hydroxyapatite toothpaste and the control group using a fluoride toothpaste: both worked equally well.
New tooth decay treatment guideline released
A new American Dental Association (ADA) clinical practice guideline suggests conservative methods to treat tooth decay in primary and permanent teeth could lead to better outcomes when used with common restorative materials like fillings or caps. An expert panel of dentists developed the first-ever guideline on this topic after extensive review of approximately 300 published studies.
The guideline, published in the July issue of the Journal of the American Dental Association, contains 16 recommendations regarding treatment of moderate and advanced tooth decay in primary and permanent teeth that have not received endodontic treatment, such as a root canal. It indicates conservative carious tissue removal (CTR), in which a dentist removes infected tissue while preserving as much of the original tooth structure as possible, is less likely to result in adverse outcomes like nerve exposure or a failed filling.
The recommendations also identify selective CTR as an effective treatment option in most cases of moderate or advanced decay in primary and permanent teeth. This method involves removing most, but not all, of the decayed tissue before sealing the tooth with a filling or cap. The bacteria left behind under the new filling or cap no longer has what it needs to multiply, which stops tooth decay.
Additionally, the guideline affirms the efficacy of the most common restorative materials for treating moderate or advanced tooth decay, such as tooth-coloured fillings, silver-coloured fillings (amalgam) or preformed caps in children. It suggests specific materials for primary and permanent teeth, depending on the extent of the decay.
The new restoration guideline and existing recommendations on non-restorative treatment for tooth decay can be found at: ada.org/cariesguidelines.
Online: https://medicalxpress.com/news/2023-06-tooth-decay-treatment-guideline.html
Dentistry team uses artificial intelligence for early detection of gum inflammation
A study led by researchers at the Faculty of Dentistry of the University of Hong Kong (HKU), in collaboration with multiple international institutions has successfully demonstrated the use of artificial intelligence (AI) in detecting gum inflammation, also known as gingivitis, from intraoral photographs.
The study, published in the International Dental Journal, shows that AI algorithms can analyse patients' intraoral photographs to detect signs of inflammation like redness, swelling, and bleeding along the gum margin with more than 90% accuracy, matching the visual examination of a dentist. This innovative technology enables population-wide monitoring of gum health and paves the way for more personalised dental care.
The study involved developing and testing an AI model using a dataset of over 567 images of gums with varying degrees of inflammation and is one of the first to explore the use of AI in detecting gum inflammation.
The use of AI in dentistry has been gaining momentum in recent years, with researchers exploring various applications of the technology, from detecting cavities to predicting treatment outcomes to biomimetic design of artificial teeth.
The collaborative nature of this study is a testament to the power of interdisciplinary research and knowledge exchange. By bringing together experts from different fields and regions, the researchers can develop an AI model that could accurately detect gum inflammation, with important implications for public health and well-being.
Dentists identify new bacterial species involved in tooth decay
Collaborating researchers from the University of Pennsylvania School of Dental Medicine and the Adams School of Dentistry and Gillings School of Global Public Health at the University of North Carolina (UNC), have discovered that a bacterial species called Selenomonas sputigena (S. sputigena) can have a major role in causing tooth decay.
In the study, the researchers showed that S. sputigena, previously associated only with gum disease, can work as a key partner of Selenomonas mutans (S. mutans), which greatly enhances its cavity-making power.
The UNC researchers took samples of plaque from the teeth of 300 children aged three to five years, half of whom had caries, and analysed the samples using an array of advanced tests. The tests included sequencing of bacterial gene activity in the samples, analyses of the biological pathways implied by this bacterial activity, and even direct microscopic imaging. The researchers then validated their findings on a further set of 116 plaque samples from three to five year olds.
The data showed that although S. sputigena is only one of several caries-linked bacterial species in plaque besides S. mutans, and does not cause caries on its own, it has a striking ability to partner with S. mutans to boost the caries process.
The findings show a more complex microbial interaction than was thought to occur, and provide a better understanding of how childhood cavities develop, an understanding that could lead to better ways of preventing cavities. The researchers now plan to study in more detail how this anaerobic, motile bacterium ends up in the aerobic environment of the tooth surface.
Study shows internal fixation surgery linked with improvement in long jaw patients' quality of life
A study published in Clinical Oral Investigations and led by Dr Mike Y.Y. Leung, clinical associate professor in oral and maxillofacial surgery, Faculty of Dentistry, the University of Hong Kong, compared the changes of patients' quality of life (QoL) after receiving intraoral vertical ramus osteotomy (IVRO) or sagittal split ramus osteotomy (SSRO) as the treatment for mandibular prognathism. The condition is a facial deformity and affects the chewing function, facial aesthetics, and self-esteem of the individual, as well as causing jaw joint pain. The correction of mandibular prognathism requires orthognathic surgery, which involves creating a split in the jawbone(s) and fixation in a planned position.
A total of 98 patients were randomised to receive IVRO (49 patients) or SSRO (49 patients) as the mandibular setback procedure of their orthognathic surgery. Patient QoL was assessed by two self-administered questionnaires, namely a 14-item Short-Form Oral Health Impact Profile (OHIP-14) to evaluate the oral health-related QoL, and a 36-item Short-Form Health Survey (SF-36), to evaluate the physical and mental health-related QoL. The longitudinal changes of the patients' QoL were analysed and compared up to two postoperative years.
The study found that after an early recovery period from the surgery, the oral health-related QoL in patients in both IVRO and SSRO groups was significantly better from post-operative three months onward when compared to the pre-operative status, and it continued to improve steadily afterwards. In addition, it was found that patients who underwent surgery at a younger age had a better oral health-related QoL during the postoperative period.
Online: https://medicalxpress.com/news/2023-05-internal-fixation-surgery-linked-jaw.html
Ability to chew properly may improve blood sugar levels in patients with type 2 diabetes
A study, published in PLOS ONE, demonstrates that patients with type 2 diabetes (T2B) who have full chewing function have a blood glucose level that is significantly lower than patients whose ability to chew effectively is impaired.
The retrospective study looked at data gathered from 94 patients with T2D who had been seen at an outpatient clinic in a hospital in Istanbul, Turkey. The patients were divided into two groups. The first group included patients who had good "occlusal function", i.e., enough teeth placed properly and making contact in such a way that a person can chew their food well. That group's blood glucose level was 7.48. The second group couldn't chew well, if at all, because they were lacking some or all of those teeth; their blood glucose level was almost 2% higher, at 9.42.
Experts suggest this is because nutrients that are important to reduce blood glucose levels include fibre, which is obtained through chewing appropriate foods. Chewing has also been reported to stimulate reactions in the intestine that lead to increased insulin secretion.
"Our findings show there is a strong association between mastication and controlling blood glucose levels among T2D patients," said University of Buffalo researcher Mehmet A. Eskan. This study did not find any independent variables that could affect blood glucose levels among the subjects because there were no statistical differences among subjects regarding body mass index (BMI), sex, smoking status, medications, or infection as indicated by white blood cell count (WBC) at the baseline.
Researchers identify new metric to articulate relationship between nerve density and oral cancer
Researchers at the University of Michigan Rogel Cancer Center and the School of Dentistry have identified a new metric to articulate the relationship between nerve density and oral cancer. The study, published in Clinical Cancer Research, investigated normalised nerve density to translate previous mechanistic studies into a context that could be used in the clinic.
The team looked at the relationship between the density of nerves within a tumour and the tumour's growth. The oral cavity has several regions, each with different functions. Given these variations, looking at nerve density of the tumour without considering the normal innervation of the different areas in the oral cavity and each individual's variation to assess whether a tumour is aggressive, leaves an inaccurate picture.
To account for this, the team created a standardised metric for nerve density to clarify the variation in distribution of nerves in the oral cavity, called normalised nerve density, and showed its importance in tumour progression.
"We showed that tumours with high normalised nerve density seem to be associated with poor survival for patients with tongue cancer, which is the most common type of oral cancer," Dr Nisha D'Silva explained.
They used adjacent tissue to compare and determine a "normalised" density for different regions in the oral cavity.
Additionally, the team explored the use of artificial intelligence to measure normalised nerve density, which could facilitate the use of this metric in clinical practice.
If researchers can figure out which cancers will behave more aggressively from the outset, then they could treat the tumours more aggressively from the beginning. Normalised nerve density provides researchers with another data point to determine the best course of treatment.
Online: https://medicalxpress.com/news/2023-05-metric-articulate-relationship-nerve-density.html
Orthodontics inspires new approach to help bones mend themselves
Young babies and newborn mice can naturally heal damage to the bones that form the top of the skull, but this ability is lost in adults. In a new study published in Proceedings of the National Academy of Sciences, University of Pittsburgh researchers developed a novel approach that promoted bone regeneration in mice without implantation of bone tissue or biomaterials. The technique uses a device similar to an orthodontic wire used to realign teeth to carefully stretch the skull along its sutures, activating skeletal stem cells that reside in these wiggly seams. In adult mice, the technique repaired damage to the skull that otherwise would not have healed on its own.
In mice, which have very similar skull development to humans, the researchers used a so-called bone distraction device to carefully apply a controlled pulling force to the calvarial bones, strong enough to slightly widen the sutures but not enough to cause a fracture. Using single-cell RNA sequencing and live-imaging microscopy, they found that the number of stem cells in the expanded sutures of these animals quadrupled. As a result, mice treated with the device regenerated bone to heal a large defect in the skull.
The researchers are investigating how their findings could be used to inform novel therapies in people, not just to heal skull injuries but also fractures in long bones such as the femur. Bone distraction devices are already used to treat certain conditions such as a birth defect called craniosynostosis, in which the calvarial bones fuse too early, so expanding this technique to promote bone regeneration could be a future focus of clinical trials.
From: https://www.sciencedaily.com/releases/2023/04/230414113455.htm
Diabetes and toothlessness together worsen cognitive decline
A growing connection among diabetes, oral health, and dementia highlights the importance of dental care and diabetes management as we age. Having both diabetes and tooth loss contributes to worse cognitive function and faster cognitive decline in older adults, according to the study, ‘Diabetes, Edentulism, and Cognitive Decline: A 12-Year Prospective Analysis’, published in a special issue of the Journal of Dental Research.
While both diabetes and missing teeth are risk factors for dementia, little research has focused on the effects of having both conditions in the course of cognitive decline. To address this gap, Prof. Bei Wu, the study’s lead author, and her colleagues turned to the University of Michigan’s Health and Retirement Study, analysing 12 years of data (2006-2018) from the longitudinal study in order to observe cognitive changes over time.
The researchers included 9,948 older adults who were grouped by age in their analysis. The study included measures of memory and cognitive function, assessed every two years, along with questions about tooth loss, diabetes, and other health and demographic factors.
They found that older adults aged 65-84 with both diabetes and complete tooth loss had worse cognitive function than their counterparts without either condition. Over time, older adults aged 65-74 with diabetes alone experienced accelerated cognitive decline, and those aged 65-84 without any teeth also experienced accelerated cognitive decline, but older adults aged 65-74 with both diabetes and complete tooth loss had the fastest rate of cognitive decline.
For older adults with both poor oral health and diabetes, the researchers stress the importance of regular dental visits, adherence to diabetes treatment and self-care to control blood sugar levels, and cognitive screenings in primary care settings.
LED imaging visually confirms oral suction device efficacy in droplet and aerosol reduction
Many infectious diseases, such as Covid-19, are known to spread through aerosols and droplets suspended in the air. Therefore, it is necessary to fully understand the hazards of aerosols and droplets presented during dental treatment.
Using a dental air turbine and a mannequin, researchers at Tohoku University in Japan recreated the droplets and aerosols that occur during dental procedures. Key tools in the experiment were the high-sensitivity camera and high-intensity LED light source, which allowed for high-quality images of droplet spreading during the simulated procedure, which was previously difficult to do in real-time without dye.
Extra-oral suction (EOS) and intra-oral suction (IOS) were used to determine how well these devices work. Using these techniques, the researchers reduced droplet and aerosol spread within the air by 97.8% when both EOS and IOS were used, and a 92.1% using IOS alone.
The researchers found that a patient’s treatment can alter the directionality or spread of the droplets. For example, it was discovered that treatments for cavities on the anterior teeth are most likely to be associated with droplet spreading. Furthermore, the correct placement of oral suction devices is important, with the most effective positioning of the EOS device found to be about 10cm away from the patient's mouth at a 0o angle.
While this study confirmed the effectiveness of IOS and EOS at reducing droplets in the air during dental treatment, some limitations will require future testing. The mannequin could not simulate breathing, which may produce differing results. Further investigations using a patient model will be required to clarify the efficacy of these oral suction devices.
The results of this study were published in the Journal of Prosthodontic Research.
Taskforce backs the benefits of teledentistry to improve global oral care outcomes
A global taskforce of academic experts has concluded that teledentistry has the ability to give millions more people around the world regular access to dental services.
Brought together by the Oral Health Foundation and Unilever, the group found that teledentistry has the potential to remove or reduce many of the major barriers associated with access to oral healthcare, specifically in developing and emerging countries. The panel determined that teledentistry can be an effective method for education, dental referrals, early detection of disease, treatment planning and compliance, and treatment viability. Teledentistry was deemed especially useful where the access to dental professionals is limited or not evenly spread over a country or region. It was also seen as a cost-saving measure for the patient and the dental clinic.
While investigating the main barriers to dental access, a low number of qualified dentists in developing nations was listed as a substantial problem. The analysis revealed significant opportunities for evidence-based oral health advice that can be delivered by implementing specific teledentistry models.
To tackle many of the barriers associated with dental access, Pepsodent has launched a teledentistry initiative across Indonesia and Vietnam. The project aims to reduce oral diseases among the most vulnerable people by making dental access more inclusive, readily available, and financially affordable. The group investigated the major global barriers to accessing dental care and reviewed the most recent publications on teledentistry projects. The panel then suggested possible outcomes, as well as practical implications of delivering teledentistry services around the world.
Periodontal disease is more common in patients with rheumatoid arthritis, according to new study
Exposing the immune system to citrullinated bacterial proteins is seen as a trigger for rheumatoid arthritis (RA). The anti-citrullinated protein antibodies (ACPAs) seen in many RA patients, which serve as a diagnostic marker, may have their origin in periodontal disease, researchers said.
Traces of bacteria associated with periodontal disease have been found in samples collected from rheumatoid arthritis patients.
The research group wrote in Science Translational Medicine: "Our findings indicate that damage of the oral mucosal barrier mediated by [periodontal disease] results in repeated, spontaneous translocation of citrullinated oral bacteria to the blood, which trigger innate and adaptive immune responses in RA associated with systemic disease flares".
Researchers conducted a series of studies in several patient cohorts. Their findings confirmed that oral bacterial components (especially from Streptococcus species) entered the circulation at higher rates in the RA patients with periodontal disease compared to those without. The researchers also determined that during RA clinical exacerbations, expression spiked for genes associated with inflammatory monocyte responses in synovial tissue, but only in the patients with periodontal disease. Tracing the connection between the two conditions could help develop therapies for rheumatoid arthritis, while the approach that led to the study could prove fruitful in other disease contexts, such as cancer.
Soft gums are prone to inflammation
Researchers from Tohoku University's Graduate School of Dentistry in Japan have discovered that softer gums hinder the development of gingiva fibroblasts -- the cells that help produce the fibres that hold our teeth in place.
The tissue area that surrounds our teeth is known as the gingiva, and healthy teeth will nestle firmly into the gums thanks to the many gingival fibres that connect the tooth to the gingiva. It was discovered that gingiva stiffness influences the properties of gingival fibroblasts, which in turn affect whether inflammation is likely to occur and make gingival fibres difficult to form.
Associate Prof. Masahiro Yamada, along with his colleague Prof. Hiroshi Egusa, also from the Tohoku University's Graduate School of Dentistry, created an artificial culture environment that simulated soft or hard gingiva and cultured human gingival fibroblasts on them. They discovered that hard gingiva-simulated stiffness activated an intracellular anti-inflammatory system in the gingival fibroblasts that prevented inflammation. Yet, soft gingiva-simulated stiffness suppressed the fibroblastic anti-inflammatory system. This increased the likelihood of inflammation and resulted in less collagen synthesis.
Associate Prof. Masahiro Yamada explains: "Our research is the first to demonstrate the biological mechanisms at play in regard to a patient's gingival properties. The results are expected to accelerate the development of advanced biomaterials to control local inflammation or microdevices that simulate the microenvironment of inflammatory conditions”.
Their findings were published in the journal Scientific Reports on January 24, 2023.
From: https://www.sciencedaily.com/releases/2023/03/230310103440.htm
New study looks at factors that influence willingness to attend dental check-ups
Researchers in Japan have found that the patients who are most likely to schedule a dental check-up are those who understand the benefit of check-ups in preventing disease and those who have existing positive oral health behaviours.
Evaluations included an oral examination and questionnaire that went beyond enquiring about oral health status and behaviours to asking about participants’ willingness to improve their overall health according to a particular health belief model, as well as their response to a risk aversion scenario.
The results indicated that when the participants were more likely to see themselves facing a risk of a negative health outcome in addition to seeing a clear benefit, they were more motivated to engage in preventive health actions. The researchers also found a significant positive association between willingness to have a dental check-up and the oral health behaviours of flossing or using interdental brushes.
The team suggested that the correlation was due to self-efficacy, a concept in the health model that deals with confidence that one can take the actions necessary for producing a certain outcome. It would be expected that risk aversion would drive people to adopt healthy behaviours; however, risk aversion was not demonstrated to be a factor in scheduling dental check-ups.
The study, titled ‘The impact of oral health behaviours, health belief model, and absolute risk aversion on the willingness of Japanese university students to undergo regular dental check-ups: A cross-sectional study’, was published in the International Journal of Environmental Research and Public Health.
Study establishes patient motivations for seeking clear aligner therapy across five European countries
There is increasing demand for clear aligner therapy (CAT) for mild to moderate malocclusion in adults. However, there is a lack of information on the motivations of adults seeking CAT, as well as their socio-demographic information and oral health status across countries. Researchers in Germany compared adult patients in Austria, Germany, Italy, Poland and Spain. They found that adult patients who are dissatisfied with their appearance and who generally have good oral health are more likely to seek CAT.
The main demographic findings were that adults seeking CAT were mostly younger than 35 and female. Patients in Italy and Germany were the youngest, the majority being in the 18- to 35-year-old age group. The highest proportion of men seeking CAT was in Italy and the lowest in Poland.
When it came to motivation, crowding was the top reason, but this was more frequent among the Spanish and Italian patients, and tooth spacing was a more common reason among the German and Austrian patients. Men more often gave spacing as their primary motive, and women more frequently indicated crowding.
The researchers noted that the patients had an overall better quality of oral health than the general population, likely because they are more concerned about their oral health as evidenced by seeking CAT. As the treatment is mostly an out-of-pocket expense, the researchers also noted that the socioeconomic status of the patients likely differs from that of the general population.
The records from CAT provider, DrSmile were compiled from over 500 associated practitioners across Europe. The resulting sample size was 15,015 patients. The study, titled ‘Who seeks clear aligner therapy? A European cross-national real-world data analysis’, was published in Life.
School dental programme prevents 80% of cavities with one-time, non-invasive treatment
In a study of nearly 3,000 schoolchildren, silver diamine fluoride (SDF) – a liquid that is brushed onto teeth to prevent cavities or keep them from worsening – was as effective against cavities as dental sealants, the standard of care. A single dose of either topical treatment given in primary schools prevented roughly 80% of cavities and kept 50% of cavities from worsening.
The findings, published in JAMA Network Open, offer an efficient and cost-effective approach to improving children's oral health through school-based care. Dental caries (cavities) is the most common chronic disease in children, and those from low-income families are twice as likely to have cavities as those from higher-income families. Without proper and timely intervention, cavities can lead to severe infections, reduce children's quality of life, and are associated with lower student academic performance and school attendance.
CariedAway is a randomised trial comparing the effectiveness of two cavity-prevention techniques: a ‘simple’ treatment using SDF and fluoride varnish; and, a ‘complex’ treatment using traditional glass ionomer sealants and fluoride varnish. Both are non-invasive and applied to the surface of teeth to prevent and arrest cavities in children, but for the same time and cost, providers can treat more children with the simpler SDF therapy.
The study included 2,998 children in kindergarten through to third grade at 47 New York City schools. The schools were randomised to receive either the simple or complex treatment. Two years later, researchers returned to each school for follow-up.
They found that both the simple and complex treatments were successful: just one cavity prevention treatment prevented more than 80% of cavities (81% for SDF and 82% for sealants) and stopped half of cavities from progressing (56% for SDF and 46% for sealants).
From: https://www.sciencedaily.com/releases/2023/02/230210145811.htm
Study examines public perceptions regarding sustainable dentistry
A study from researchers at the University of Sheffield has sought to examine how the general public perceives the push for sustainability within the dental profession and to better understand what compromises will be accepted in the name of environmentally friendly dentistry.
Data regarding the participants’ views about sustainable dentistry, as well as demographic data and information about the participants’ overall oral health, was collected between August 2020 and February 2021. In total, 344 adults responded to the survey.
Overall, the researchers found that participants responded quite positively to sustainable dentistry and were “moderately willing to compromise time and convenience”. They were somewhat likely to agree to pay more and receive potentially less durable dental treatment if it meant that the treatment would be more environmentally conscious. Respondents were least likely to accept compromises regarding the appearance of their teeth or their oral health status, whereas those having better self-rated oral health were more likely to view sustainable dentistry in a positive light.
Older respondents were less likely to want to compromise their time and convenience than younger respondents, whereas women displayed more positive attitudes regarding sustainable dentistry than men did.
In their discussion, the authors recognised a number of limitations regarding their study, including the relative homogeneity of respondents, the lack of measuring household income or socio-economic status and the focus on participants’ willingness to make compromises rather than on their actual behaviour.
The study titled ‘Exploring attitudes towards more sustainable dentistry among adults living in the UK’, was published online in the British Dental Journal.
Oral bacteria may give rise to brain abscesses, study shows
In a recent study, researchers investigated the role of oral bacteria in the development of brain abscesses. They found that samples of brain abscesses where no primary source of infection was identified contained a high number of oral bacteria and reasoned that bacteria that cause oral infections could also contribute to patients developing brain abscesses. The researchers concluded that maintaining good oral health may help prevent the development of brain abscesses in some individuals.
The researchers examined the records of 87 patients with brain abscesses admitted to a single UK neurosurgical unit over 16 years. They used microbiological data obtained from abscess sampling and peripheral cultures to categorise the species of bacteria where no primary source of infection was identified (in 52 of the patients) or where an infective source for their brain abscesses was identified (in 35 of the patients). The microbiological data were then screened to identify common oral bacteria in each group.
The findings showed that the 52 patients in the first group were about three times as likely to have oral bacteria present in their samples. They had a significantly higher number of Streptococcus anginosus.
In light of the findings, the authors argued that the oral cavity might be a source of infection in patients with brain abscesses of unknown origin and argued that it should be of utmost importance to carefully review the oral health of brain abscess patients.
In order to help establish the causal link between oral health and brain abscesses and to develop prevention strategies, the researchers believe that future studies should include oral screening and microbiome analysis.
From: https://uk.dental-tribune.com/news/oral-bacteria-may-give-rise-to-brain-abscesses-study-shows/
Gum infection may be a risk factor for heart arrhythmia, researchers find
Periodontitis, a gum disease, can lead to a litany of dental issues from bad breath to bleeding and lost teeth. Now, researchers at Hiroshima University in Japan have found that it could be connected to even more severe problems in the heart.
In a study published in JACC: Clinical Electrophysiology, the team found a significant correlation between periodontitis and fibrosis – scarring to an appendage of the heart's left atrium that can lead to an irregular heartbeat called atrial fibrillation – in a sample of 76 patients with cardiac disease.
First author Shunsuke Miyauchi said: "Periodontitis is associated with a long-standing inflammation, and inflammation plays a key role in atrial fibrosis progression and atrial fibrillation pathogenesis. We hypothesized that periodontitis exacerbates atrial fibrosis. This histological study of left atrial appendages aimed to clarify the relationship between clinical periodontitis status and degree of atrial fibrosis”.
The left atrial appendages were surgically removed from the patients, and the researchers analysed the tissue to establish the correlation between severity of the atrial fibrosis and severity of the gum disease. They found that the worse the periodontitis, the worse the fibrosis, suggesting that the inflammation of gums may intensify inflammation and disease in the heart.
According to author Yukiko Nakano, improving risk factors such as weight, activity levels, tobacco and alcohol use, and periodontal care could aid in comprehensive atrial fibrillation management. However, she cautioned that this study did not establish a causal relationship, meaning that while gum disease and atrial fibrosis degrees of severity appear connected, researchers have not found that one definitively leads to the other.
From: https://www.sciencedaily.com/releases/2023/01/230127131143.htm
DIY ortho poses a ‘critical’ danger to public health
DIY orthodontics is a one size fits all approach to reshaping and altering the appearance of your mouth. Often this is done without seeing a dentist and simply by using a 3D scan of your mouth to make aligners, which are then posted to you. This can cause a critical danger to people’s health, according to the latest episode of The Oral Health Podcast.
In the first of a two-part series on the rise of direct-to-consumer orthodontics, the Oral Health Foundation presents the many pitfalls and highlights severe concerns around the growing trend.
Karen Coates, an oral health educator and registered dental nurse describes how DIY orthodontics can cause long-term and irreparable damage to the mouth, jaw, and gums – and often leads to people going away unhappy and in a poorer state of health than before treatment. This can include everything from pain in eating to needing surgery to correct past mistakes.
Karen said: “This is not simple treatment. It cannot be done overnight. Step back and think. Would I let someone who was not qualified do fillings on me? Orthodontics is the same, it really is a feat of engineering. You have to rotate teeth, you are pushing them back and pushing them forward, but you don’t want all of them to move”.
The podcast discussed how orthodontists will give you a realistic look at what can be done and if you go DIY, you will not have the same level of care during and after the treatment. The Oral Health Podcast is available to download and stream on all major platforms.
From: https://www.dentalhealth.org/news/diy-ortho-poses-a-critical-danger-to-public-health
New customisable, strontium-filled scaffold could improve dental implant healing
A team of University at Buffalo (UB) researchers in the US has developed a new strontium-loaded scaffold that can be personalised to fit any size dental implant and could help improve healing and tissue attachment in patients.
The success of dental implants is dependent on the growth and adhesion of soft tissues to the implant surface. Previous research by UB investigators found that strontium, a bone-seeking element that improves bone density and strength, also supports soft tissue function. Strontium, they discovered, can promote the function of fibroblasts – a type of cell that forms connective tissues and plays a critical role in wound healing.
The new study, published in the Journal of Biomedical Materials Research, found that scaffolds loaded with strontium promoted wound healing by stimulating gingival fibroblast activity.
Lead investigator, Michelle Visser said: "Scaffold materials have been explored to promote bone and skin wound healing, but adaptations for the oral cavity are limited. These novel scaffolds represent a system for effective strontium release in the oral cavity”.
To produce the scaffolds the researchers developed reusable, ring-shaped templates and moulds. The flexible hydrogel scaffolds are infused with a range of strontium concentrations that are released in an initial burst over 24 hours, followed by a sustained dosage over four days with minimal toxicity. Tested in the laboratory, the strontium-loaded scaffolds increased the cellular activity of isolated gingival fibroblast cells, while the hydrogel scaffold alone had little effect on the cells.
From: https://www.sciencedaily.com/releases/2022/12/221209153110.htm
Removable partial dentures may improve mortality among partially edentulous adults
In a recent study, researchers reported that using removable partial dentures may have long-term benefits in reducing mortality among adults with a non-functional dentition, but cautioned that further research is needed.
The researchers used data from the Third National Health and Nutrition Examination Survey conducted by the National Center for Health Statistics, a division of the US Centers for Disease Control and Prevention, and linked it to publicly viewable mortality files for the period up to 2019. For the purpose of the study, they included 1,246 partially edentulous adults with fewer than 20 teeth whose use of removable partial dentures and dentition status had been determined by clinical examination.
The findings showed that removable partial denture wearers experienced a 26% increase in survival time. Additionally, the researchers observed that for every 7.5 individuals treated with removable partial dentures, one death would be prevented after ten years of treatment.
Discussing the study, lead author Dr Nasir Zeeshan Bashir, a researcher at the University of Leeds in the UK, explained that the study did not specifically assess why dentures have this effect. However, he noted that a few hypotheses were put forward in the discussion section of the study: “Firstly, eating a well-balanced diet is difficult when you are lacking many teeth, as fibrous foods like vegetables can be tough to chew. By restoring the dentition, it has been shown that masticatory efficiency increases and, therefore, it may be that these patients with dentures have an improved diet. Secondly, it could be that those patients who wear and use their dentures regularly are well motivated in other aspects of their general health”.
The study, titled ‘Removable partial dentures and mortality among partially edentulous adults’, was published in the Journal of Dentistry.
Research identifies potential novel treatment for managing gum disease
Research identifies potential novel treatment for managing gum disease
A study from King’s College London has shed light on the role that a type of cell plays in the progression of periodontal (gum) disease and how it could provide an avenue for therapeutic intervention.
The research team identified and described the role of a cell known as a telocyte in regulating the inflammatory process that occurs during gum disease. According to the authors, telocytes are thought to be involved in direct cell–cell communication between macrophages, a kind of white blood cell involved in the response to an infection or an accumulation of damaged and dead cells. Macrophages that promote an inflammatory response are known as M1 macrophages, whereas M2 macrophages work to counteract inflammation and encourage tissue repair. The balance between M1 and M2 macrophages is crucial for effectively regulating the body’s immune response.
Using single-cell RNA sequencing and cellular assays, the researchers identified the role of telocytes in regulating the M1–M2 macrophage balance in gum disease and demonstrated their natural ability to shift macrophages from an M1 to an M2 state. This ability to facilitate these transitions could provide a possible strategy for the future treatment of gum disease.
“I hope this study can not only lead to a greater understanding of periodontal disease but also provide an impetus for others to study the potential roles played by telocytes in other tissues,” noted Dr Paul Sharpe, professor of craniofacial biology at King’s College London and co-author of the study.
The study, titled ‘Telocytes regulate macrophages in periodontal disease’, was published online on October 4, 2022 in eLife.
The researchers recently received funding from UK Research and Innovation’s Engineering and Physical Sciences Research Council impact acceleration account, and they plan to develop a prototype of this device within a year.
New hope for patients with severe bone loss
An innovative technology developed at Tel Aviv University (TAU), Israel will enable bone regeneration to correct large defects by means of a special hydrogel. Following successful tests in an animal model, the researchers now plan to move forward to clinical trials.
The study was conducted by researchers from TAU's Maurice and Gabriela Goldschleger School of Dental Medicine, led by Prof. Lihi Adler-Abramovich and Dr Michal Halperin-Sternfeld in collaboration with other. The paper was published in the Journal of Clinical Periodontology.
Prof. Adler-Abramovich said: "Small bone defects, such as fractures, heal spontaneously, with the body restoring the lost bone tissue. The problem begins with large bone defects. In many cases, when substantial bone loss results from tumour resection (removal by surgery), physical trauma, tooth extraction, gum disease or inflammation around dental implants, the bone is unable to renew itself. In the current study, we developed a hydrogel that mimics the natural substances in the extracellular matrix of bones, stimulating bone growth and reactivating the immune system to accelerate the healing process”.
The researchers explain that the extracellular matrix is the substance surrounding our cells, providing them with structural support. Every type of tissue in our body has a specific extracellular matrix consisting of suitable substances with the right mechanical properties. The new hydrogel has a fibrillary structure that mimics that of the extracellular matrix of the natural bone. Furthermore, it is rigid, thus enabling the patient's cells to differentiate into bone-forming cells.
From: https://www.sciencedaily.com/releases/2022/11/221109124400.htm.
Using vapes may set the stage for dental decay
A vaping habit could lead to a tarnished smile, and more frequent dentist visits. Research by Tufts University School of Dental Medicine in Boston found patients who said they used vaping devices were more likely to have a higher risk of developing cavities (caries).
The findings of this study serve as an alert that this once seemingly harmless habit may be very detrimental, says Karina Irusa, assistant professor of comprehensive care and lead author on the paper. The study was published in the Journal of the American Dental Association.
Over the last few years, public awareness has increased about the dangers of vaping to systemic health -- particularly after the use of vaping devices was tied to lung disease. Some dental research has shown ties between e-cigarette use and increased markers for gum disease, and separately, damage to tooth enamel.
Irusa says that the recent Tufts finding may be just a hint of the damage vaping causes to the mouth. "The extent of the effects on dental health, specifically on dental decay, are still relatively unknown," she says, "At this point, I'm just trying to raise awareness".
Irusa and her colleagues analysed data from more than 13,000 patients older than 16 who were treated at Tufts dental clinics from 2019-2022. There was a statistically significant difference in dental cavity risk levels between the e-cigarette/vaping group and the control group, Irusa found. Some 79% of the vaping patients were categorised as having high-caries risk, compared to just about 60% of the control group.
From: https://www.sciencedaily.com/releases/2022/11/221123125126.htm.
Harnessing “positive stress” to boost tooth tissue regeneration
A study by researchers from the University of Hong Kong has shown that “positive stress” can be utilised to enhance the therapeutic potential of tooth stem cells by increasing their resistance to injury and disease. According to the university, the study is the first to show that preconditioning tooth stem cells to stress can cause their adaptive mechanisms to boost the regeneration of tooth pulp tissue.
The research team aimed to develop an approach to regenerating lost tooth pulp in damaged teeth through the use of a preconditioning protocol to genetically modify tooth cells. The modifications caused the cells to mimic a responsive state for low oxygen conditions, activating a protein that induces adaptive changes.
Co-author of the study Dr Yuanyuan Han explained: “As this protein was reported to activate several key adaptive mechanisms, we wondered whether this phenomenon can be applied to improve cell survival following transplantation until a sufficient blood supply is achieved”.
She said: “[These] cells activate a metabolic mechanism to produce energy under low oxygen conditions and scavenge harmful metabolites produced in stress conditions”.
Dr Waruna Dissanayaka, lead author of the study, said: “Interestingly, we also found that preconditioned cells significantly enhanced the dental hard tissue formation within the regenerated pulp tissue”.
Pointing out that prior research has already revealed that cells possess a number of adaptive mechanisms for stress and that these are regulated by genes in our DNA, Dr Dissanayaka posited: “If we can activate these genes, downstream expression of specific proteins can prime the cells [to be] less vulnerable to injury.”
The study, titled “HIF-1α stabilization boosts pulp regeneration by modulating cell metabolism”, was published in the Journal of Dental Research.
From: https://www.dental-tribune.com/news/harnessing-positive-stress-to-boost-tooth-tissue-regeneration/
Researchers developing rapid test for periodontal disease
The link between periodontal disease and a range of systemic health conditions such as cardiovascular disease, type 2 diabetes and rheumatoid arthritis is well established. Researchers from the University of Birmingham are in the process of developing a rapid test for identifying the presence of periodontal disease.
The device is being developed by Prof. Tim Albrecht from the University’s School of Chemistry, together with Dr Melissa Grant from the School of Dentistry. It consists of a specialised probe and detector that provides a measurement of certain protein-based biomarkers that indicate both the presence and progression of periodontal disease. This biomarker panel was discovered and validated in a study published in the Journal of Clinical Periodontology by a team of researchers led by Dr Grant.
Prof. Albrecht said: “We believe the device we are prototyping will be the first dental probe that can identify periodontal disease in this way. It will detect periodontitis quickly and easily in a variety of healthcare settings, opening up opportunities for monitoring and early intervention in the patients with comorbid disease, who would benefit most from rapid treatment for periodontitis”.
Dr Grant added: “The ability to detect and profile disease biomarkers in real time will allow monitoring for disease severity, and in particular the transition between milder and more severe forms of gum disease. This will benefit not only dental health, but also reduce costs and capture patients for whom periodontal treatment may, in the long run, be lifesaving”.
The researchers recently received funding from UK Research and Innovation’s Engineering and Physical Sciences Research Council impact acceleration account, and they plan to develop a prototype of this device within a year.
From: https://www.dental-tribune.com/news/researchers-developing-rapid-test-for-periodontal-disease/
No adverse effects of early fluoride exposure found on childhood development
An Australian study published in the Journal of Dental Research has provided evidence that exposure to fluoridated water is not negatively associated with child emotional and behavioural development, or executive functioning in adolescence.
The study by Prof. Loc Do of the University of Queensland and colleagues examined the effect of early childhood exposure to water fluoridation on measures of school-age executive functioning and emotional and behavioural development. Children aged five to ten years at the baseline were contacted again after seven to eight years.
Per cent lifetime exposed to fluoridated water (%LEFW) from birth to the age of five years was estimated from residential history and postcode-level fluoride levels in public tap water. Measures of children's emotional and behavioural development were assessed by a strength and difficulties questionnaire (SDQ), and executive functioning was measured by Behaviour Inventory of Executive Functioning (BRIEF).
A total of 2,682 children completed the SDQ and BRIEF. Those with lower %LEFW tended to have poorer scores. Multivariable regression models reported no association between exposure to fluoridated water and the SDQ and BRIEF scores. Low household income, identifying as indigenous, and having a neurodevelopmental diagnosis were associated with poorer SDQ/BRIEF scores.
The study concluded that exposure to fluoridated water during the first five years of life was not associated with altered measures of child emotional and behavioural development and executive functioning. Children who had been exposed to fluoridated water for their whole early childhood had their measures of emotional, behavioural development and executive functioning at least equivalent to that of children who had no exposure to fluoridated water.
From: https://www.sciencedaily.com/releases/2022/10/221011120109.htm
Dentists across Scotland are testing AI programme that can identify dental cavities
A pioneering study is being carried out across dental practices in Scotland, in which software-driven by artificial intelligence (AI) is helping practitioners locate caries (cavities) more effectively. The programme, AssistDent, was developed by Manchester Imaging, a spin-off company from a collaboration between dentistry and imaging sciences at the University of Manchester.
Aimed at early detection, AssistDent utilises machine learning algorithms to evaluate dental radiographs to note or confirm areas of potential enamel-only proximal caries. With early identification of dental caries, patients can avoid fillings through preventive care such as fluoride treatments.
With more than 65 practices and 200 dentists serving over half a million patients across Scotland, Clyde Munro Dental Group is using AssistDent in a pilot test with five of its dentists located across Scotland. Fiona Wood, the chief operating officer for Clyde Munro, explained the use of AI as a powerful tool for prevention, stating: “The AI is a useful tool to show and demonstrate to patients areas of dental need or concern to give the patient the chance to reverse enamel changes with support from Clyde Munro dentists.”
AssistDent’s capability has been evaluated in peer-reviewed research conducted by experts from the University of Manchester’s dental school and published in the British Dental Journal. In the study, the group that used AssistDent found 76% of the caries previously identified by expert dentists on 24 bitewing radiographs, compared with 44% of the problem areas found by the group that did not utilise the AI software. The researchers concluded that AssistDent significantly improves dentists’ ability to identify enamel-only proximal caries.
People who receive periodontal care have better outcomes after heart attack, study finds
The conventional wisdom is that medical and dental care are related, but less is known about how dental care relates to health outcomes after acute incidents like heart attacks. University of Michigan (UM) researchers studied patients receiving periodontal care, dental cleanings or no dental care during 2016-2018 and who had acute myocardial infarction (heart attack) in 2017.
They found that patients who had heart attacks and received periodontal maintenance care had the shortest length of stay in the hospital, and more follow-up visits. The longest length of stay was experienced by the no-dental-care group.
"After controlling for several factors, the periodontal care group had higher odds of having post-hospital visits," said study co-author Romesh Nalliah, associate dean for patient services at the UM School of Dentistry.
There was no statistically significant difference between the other groups (active periodontal care and regular care) compared to the no-care group.
The study, published in the Journal of the American Dental Association, did not establish a causal relationship between periodontal disease and heart disease, but research like this adds weight to the understanding that there is an association between oral health and overall health, Nalliah said.
There are 800,000 myocardial infarctions in the United States annually, and those with periodontal disease are at increased risk for hospitalisation after a heart attack, he said.
Nalliah said improved communication between medical and dental teams could help with early intervention to ensure stable periodontal health in patients who have risk factors for heart disease.
From: https://www.sciencedaily.com/releases/2022/09/220915123722.htm
Gel treats gum disease by fighting inflammation
A topical gel that blocks the receptor for a metabolic by-product called succinate treats gum disease by suppressing inflammation and changing the makeup of bacteria in the mouth, according to a new study led by researchers at New York University (NYU) College of Dentistry and published in Cell Reports.
The research, conducted in mice and using human cells and plaque samples, lays the groundwork for a non-invasive treatment for gum disease that people could apply to the gums at home to prevent or treat gum disease.
Gum disease is one of the most prevalent inflammatory diseases, affecting nearly half of adults 30 and older. It is marked by three components: inflammation; an imbalance of unhealthy and healthy bacteria in the mouth; and, destruction of the bones and structures that support the teeth.
"No current treatment for gum disease simultaneously reduces inflammation, limits disruption to the oral microbiome, and prevents bone loss. There is an urgent public health need for more targeted and effective treatments for this common disease," said Yuqi Guo, an associate research scientist in the Department of Molecular Pathobiology at NYU Dentistry and the study's co-first author.
Past research has linked increased succinate -- a molecule produced during metabolism -- to gum disease, with higher succinate levels associated with higher levels of inflammation. Guo and her colleagues at NYU Dentistry also discovered in 2017 that elevated levels of succinate activate the succinate receptor and stimulate bone loss. These findings made the succinate receptor an appealing target for countering inflammation and bone loss -- and potentially stopping gum disease in its tracks.
From: https://www.sciencedaily.com/releases/2022/09/220920115604.htm
Dentistry study shows how 'positive stress' can boost tooth tissue regeneration
Stress is typically thought of as a negative phenomenon, but researchers at Hong Kong University (HKU) Dentistry found "positive stress" that can induce good changes in tooth stem cells to make them more resistant to injury and disease.
The study, published in the Journal of Dental Research, is the first to show that adaptive mechanisms in tooth stem cells induced by preconditioning to stress can boost the tooth pulp tissue regeneration. The researchers found that oxidative stress caused by a low-oxygen environment can elicit a protective response to make tooth stem cells less vulnerable to harm.
The research team led by Dr Waruna Dissanayaka, Assistant Professor in Oral Biosciences, aims to develop an approach to regenerate lost tooth pulp, which could revitalise the tooth and enable it to function normally.
The research team developed a preconditioning protocol that modified the cells genetically to mimic a responsive state for low oxygen conditions in order to activate a protein that induces adaptive changes in the cells.
Dr Yuanyuan Han, a co-investigator of the team pointed out: "As this protein was reported to activate several key adaptive mechanisms, we wondered whether this phenomenon can be applied to improve cell survival following transplantation until a sufficient blood supply is achieved”.
Dr Dissanayaka plans to utilise the knowledge of specific genes and proteins responsible for inducing cell survival to identify drugs that can be used in clinical tissue regeneration. He believes these new findings will promote the development of new strategies to enhance the therapeutic potential of tooth stem cells.
From: https://medicalxpress.com/news/2022-09-dentistry-positive-stress-boost-tooth.html
Dental biorhythm is associated with adolescent weight gain, study finds
Research led by the University of Kent has discovered evidence of a biorhythm in human primary teeth that is associated with weight gain during adolescence. An international research team led by Dr Patrick Mahoney at Kent's School of Anthropology and Conservation discovered the biorhythm in primary 'milk' molars, Retzius periodicity (RP), is related to aspects of physical development during early adolescence. A faster dental biorhythm produced smaller gains in weight and mass.
RP forms through a circadian-like process, occurring with a repeat interval that can be measured with a resolution of days. The rhythm relates to the period in which tooth enamel forms and is consistent within the permanent molars of individuals that do not retain evidence of developmental stress. The human modal RP has a near seven-day cycle but can vary from five to 12 days.
The first-of-its-kind research published by Nature's Communications Medicine found that adolescents with a faster biorhythm (five- or six-day cycle) weighed less, gained the least weight, and had the smallest change in their body mass index over a 14-month period compared to those with a slower biorhythm. Those with a slow biorhythm (seven- or eight-day cycle) produced the greatest weight gain.
Dental histologists have known about the biological rhythm for over 100 years, but its significance for body mass and growth emerged recently in studies that compare mammalian species. Research has now focused on the meaning of the rhythm for humans. Rapid change in body size is a natural consequence of adolescence, but excessive weight gain during puberty can have vast consequences for health, such as obesity in adulthood.
From: https://www.sciencedaily.com/releases/2022/08/220822091057.htm
Water fluoridation: effective prevention for tooth decay and a win for the environment, research shows
Trinity College Dublin researchers, collaborating with University College London, have demonstrated for the first time the low environmental footprint of water fluoridation compared to other preventive measures for tooth decay. The study is published in the British Dental Journal.
Researchers quantified the environmental impact of water fluoridation for an individual five-year-old child over a one-year period and compared this to the traditional use of fluoride varnish and toothbrushing programmes, which take place in selected schools across the UK, and internationally.
Today, over 35% of the world's population have access to water fluoridation, with studies showing significant reductions in dental caries. While data on the clinical effectiveness and cost analysis of water fluoridation are available, there have been no data regarding its environmental impact up to now.
To quantify this impact, the research team performed a life cycle assessment (LCA) by carefully measuring the combined travel, weight and amounts of all products and the processes involved in all three preventive programmes (toothbrushing, fluoride varnish programmes and water fluoridation).
The results of the study, led by Brett Duane, Associate Professor in Dental Public Health at Trinity College, concluded that water fluoridation had the lowest environmental impact in all categories studied, and had the lowest disability-adjusted life years impact when compared to all other community-level caries prevention programmes. The study also found that water fluoridation gives the greatest return on investment.
Considering the balance between clinical effectiveness, cost effectiveness and environmental sustainability, researchers believe that water fluoridation should be the preventive intervention of choice.
From: https://www.sciencedaily.com/releases/2022/08/220829194742.htm
Study examines link between dry mouth and dry eyes
Though dry eye disease and xerostomia (dry mouth) have both been studied extensively independently of each other, their relationship remains relatively unexplored. A recent study of 150 randomly selected 65-year-olds in Norway has, therefore, examined this link and found that a correlation exists between the two conditions.
Researchers from the University of Oslo’s Faculty of Dentistry and the Norwegian Dry Eye Clinic collaboratively carried out the cross-sectional study. Potential study subjects were randomly chosen from the Norwegian tax registry and invited to participate in an initial examination.
Each participant underwent subjective and objective dry eye assessments at the Norwegian Dry Eye Clinic. This involved several questionnaires and a clinical examination. Subsequently, the study subjects were orally examined at the research clinic at the University of Oslo’s Faculty of Dentistry and asked to complete an additional questionnaire on the frequency of the oral dryness they experienced. Each participant’s xerogenic medication intakes and histories of systemic disease were also recorded.
According to the study authors, a significant positive correlation was found between dry eye and xerostomia symptoms among the study’s participants. Through examinations, the two conditions were demonstrated to coexist pathologically in 4% of the study’s subjects, whereas those with current or former systemic diseases were very likely to experience symptoms of dry eye disease and xerostomia.
The study, titled ‘The relationship between ocular and oral dryness in a cohort from the 65-year-old population in Norway’, was published online in Scientific Reports.
From: https://www.dental-tribune.com/news/study-examines-link-between-dry-mouth-and-dry-eyes/
Artificial intelligence may automate design of biomimetic single-tooth protheses
Even with the support of modern computer-aided design (CAD)/computer-aided manufacturing (CAM) technology, creating a dental prosthesis is still time-consuming, resulting in more chair time and high costs for patients. To facilitate the design of molar crowns, researchers from the Faculty of Dentistry at the University of Hong Kong (HKU) and the Department of Computer Science of Chu Hai College of Higher Education in Hong Kong collaborated to develop a novel approach using artificial intelligence (AI).
In order to restore the patient’s original appearance, masticatory function and general oral health, dental protheses should have the same occlusal morphology and 3D position of the natural teeth. These can be deduced for a missing tooth from those of the surrounding dentition because the teeth of an individual are all controlled by the same set of genes and exposed to the same oral environment. The researchers hypothesised that AI could thus generate the design for a single-tooth prothesis based on the characteristics of the remaining dentition.
The research team used a machine learning approach called a generative adversarial network (GAN) to train and validate their AI system and have tested it on 175 participants. The system was able to reconstruct the shape of a natural tooth and automate the process of dental protheses design based only on the digital model of the patient’s dentition.
The study, titled ‘Artificial intelligence-designed single molar dental prostheses: A protocol of prospective experimental study’, was published online in PLOS ONE.
Microrobotics in endodontic treatment, diagnostics
Biofilm not fully cleared from the nooks and crannies of the root canal system remains a leading cause of treatment failure and persistent endodontic infections, and there are limited means to diagnose or assess the efficacy of disinfection. One day, clinicians may have a new tool to overcome these challenges in the form of microrobots.
In a proof-of-concept study, researchers from Penn Dental Medicine in the US and its Center for Innovation & Precision Dentistry (CiPD), have shown that microrobots can access the difficult to reach surfaces of the root canal with controlled precision, treating and disrupting biofilms and even retrieving samples for diagnostics, enabling a more personalised treatment plan. The Penn team shared their findings on the use of two different microrobotic platforms for endodontic therapy in the August issue of the Journal of Dental Research.
In both platforms, the building blocks for the microrobots are iron oxide nanoparticles (NPs) that have both catalytic and magnetic activity and have been FDA approved for other uses. In the first platform, a magnetic field is used to concentrate the NPs in aggregated microswarms and magnetically control them to the apical area of the tooth to disrupt and retrieve biofilms through a catalytic reaction. The second platform uses 3D printing to create miniaturised helix-shaped robots embedded with iron oxide NPs. These helicoids are guided by magnetic fields to move within the root canal, transporting bioactives or drugs that can be released on site.
From: https://www.sciencedaily.com/releases/2022/08/220809141136.htm
Dental teams can be ‘vital link’ in caring for patients with eating disorders
Dental teams are in the ideal position to identify and act on early signs of eating disorders, says the Oral Health Foundation in the UK. Around nine-in-ten (90%) patients with bulimia and one-in-five (20%) with anorexia suffer from enamel erosion. Tooth decay, sensitive teeth, dry mouth and enlarged salivary glands are also frequent.
The Oral Health Foundation believes that thousands of undiagnosed eating disorder can be picked up during regular dental check-ups by dentists, dental hygienists, therapists, and dental nurses.
Chief executive of the Oral Health Foundation, Dr Nigel Carter, says: “During the routine dental examination, dental teams carry out checks on the hard and soft tissues of the mouth and look for signs of tooth erosion. They will also look for possible injuries to the mouth which could have been induced by inserting foreign objects that cause a person to vomit”.
He continued: “If they suspect that a person might be suffering from an eating disorder, they will be able to talk calmly through the clinical signs they are seeing in the mouth. They might also speak about prescribing a high fluoride toothpaste or varnish to protect your teeth from decay.
“The more open and honest patients can be with their dental team, the better they will be able to help. Your dental team can be trusted to help you and will not judge you over any symptoms you are having”.
Diabetes may weaken teeth and promote tooth decay
People with both type 1 and type 2 diabetes are prone to tooth decay, and a new study from Rutgers School of Dental Medicine in the United States may explain why: reduced strength and durability of enamel and dentine (the hard substance under enamel that gives structure to teeth).
Researchers induced type 1 diabetes in 35 mice and used a Vickers microhardness tester to compare their teeth with those of 35 healthy controls over 28 weeks. Although the two groups started with comparable teeth, enamel grew significantly softer in the diabetic mice after 12 weeks, and the gap continued to widen throughout the study. Significant differences in dentine microhardness arose by week 28.
Mohammad Ali Saghiri, an assistant professor of restorative dentistry at the Rutgers School of Dental Medicine said: "We've long seen elevated rates of cavity formation and tooth loss in patients with diabetes, and we've long known that treatments such as fillings do not last as long in such patients, but we did not know exactly why".
The study advances a multiyear effort by Saghiri and other researchers to understand how diabetes affects dental health and to develop treatments that counter its negative impact. Previous studies have established that people with both types of diabetes have significantly elevated rates of most oral health issues, both in the teeth and the soft tissues that surround them. Saghiri and other researchers also have demonstrated that diabetes can interfere with the ongoing process of adding minerals to teeth as they wear away from normal usage.
From: https://www.sciencedaily.com/releases/2022/05/220531161127.htm
Shapeshifting microrobots can brush and floss teeth
A shapeshifting robotic microswarm may one day act as a toothbrush, rinse, and dental floss in one. The technology, developed by a multidisciplinary team at the University of Pennsylvania, is poised to offer a new and automated way to perform the mundane but critical daily tasks of brushing and flossing. It's a system that could be particularly valuable for those who lack the manual dexterity to clean their teeth effectively themselves.
The building blocks of these microrobots are iron oxide nanoparticles that have both catalytic and magnetic activity. Using a magnetic field, researchers could direct their motion and configuration to form either bristle-like structures that sweep away dental plaque from the broad surfaces of teeth, or elongated strings that can slip between teeth like a length of floss. In both instances, a catalytic reaction drives the nanoparticles to produce antimicrobials that kill harmful oral bacteria on site.
Experiments using this system on mock and real human teeth showed that the robotic assemblies can conform to a variety of shapes to nearly eliminate the sticky biofilms that lead to cavities and gum disease. The Penn team shared their findings establishing a proof of concept for the robotic system in the journal ACS Nano.
The customisable nature of the system, the researchers say, could make it gentle enough for clinical use, but also personalised, able to adapt to the unique topographies of a patient's oral cavity.
To advance this technology to the clinic, the Penn team is continuing to optimise the robots' motions and considering different means of delivering the microrobots through mouth-fitting devices.
They're eager to see their device help patients.
From: https://www.sciencedaily.com/releases/2022/07/220705194142.htm
Remote orthodontics: BOS releases new guidance on teledentistry
The British Orthodontic Society (BOS) has recently released guidance on teledentistry and remote interactions in orthodontic care. The guidance is planned to help orthodontic providers and their teams gain a deeper understanding of the scope of teledentistry services and technologies for orthodontic care.
According to the guidance, dental professionals can greatly benefit from teledentistry. For one, it has the potential to enhance patient care and help achieve desired treatment outcomes. When integrated into orthodontic care, teledentistry can also offer improved accessibility and patient satisfaction. Most importantly, it decreases the number of physical appointments, culminating in reduced environmental impact and less face-to-face contact, a benefit that has gained increased value during the Covid-19 pandemic.
According to the BOS, clinicians should be made aware of some core principles when conducting a remote orthodontic consultation. For example, it is vital that all diagnostic and prescriptive decisions are made by a registered treating orthodontist or a dentist who has proper training and skills and is directly involved in the monitoring of orthodontic care.
It also points out certain patient rights. It explains that patients who are undergoing treatment should receive the contact information of the responsible clinician and be able to make direct contact or arrange face-to-face appointments when required. In the case of clear aligner treatment, patients should also be informed not only about the benefits but also about the limitations of such treatment and made aware that they are going to receive a medical procedure involving a medical device.
From: https://uk.dental-tribune.com/news/remote-orthodontics-bos-releases-new-guidance-on-teledentistry/
Novel PCR test expected to improve oral cancer detection and treatment
Seeking to improve oral cancer detection and treatment, researchers from Queen Mary University of London have developed the first polymerase chain reaction (PCR) test for oral cancer detection. Besides yielding rapid results, the test, called the quantitative Malignant Index Diagnosis System (qMIDS), is cost-efficient and easy to use and could relieve pressure on healthcare services.
According to the National Health Service, mouth cancer is the sixth most common cancer in the world. In the UK, around 8,300 cases of mouth cancer are detected every year. Although seven in ten of these cancer cases start with pre-malignant lesions, only one in ten such lesions will develop into cancer.
Until now, researchers have not been able to find an optimal way to identify the lesions that could become cancerous. One method has been to use a grading system to examine tissue samples under a microscope. However, the malignancy grading system often lacks accuracy and precision.
Senior researcher Dr Iain Hutchison, professor of oral and maxillofacial surgery at Queen Mary, said: “qMIDS will help us identify patients with pre-malignancies that will never transform into cancer, so they can be reassured and discharged from hospital review. Patients with high-risk pre-malignancy can have minor surgery to remove the lesion before it has transformed into cancer, thereby curing the patient and saving them major surgery, which in turn reduces health service costs. It is a powerful tool especially when used in conjunction with conventional histopathology assessment.”
Gum Health Day 2022 focuses on new guidelines for periodontal disease prevention and treatment
Treat your gums was the slogan for Gum Health Day 2022, a worldwide awareness campaign organised by the European Federation of Periodontology (EFP), which took place on May 12. It is aimed at informing the public about the detrimental effects of periodontal (gum) disease on both oral and overall health and calls for its prevention, early detection and effective treatment, focusing on the EFP’s recent clinical practice guidelines on periodontitis treatment. The hashtag is #TreatYourGums.
Although still poorly recognised by the public, periodontal diseases are chronic inflammatory conditions that affect many adults worldwide. Besides its oral health effects, periodontal disease is linked to major systemic health issues, including diabetes, cardiovascular diseases, chronic kidney disease, adverse pregnancy outcomes, rheumatoid arthritis, Alzheimer’s disease, erectile dysfunction, certain forms of cancer and more severe Covid-19 outcomes.
Dr Moritz Kebschull, professor of restorative dentistry at the University of Birmingham said: “This year’s campaign focuses heavily on the treatment part—we know that millions of people suffer from gum diseases that can be treated effectively. Treat your gums calls for this treatment—with all the documented positive effects for the mouth and whole body—to actually happen”.
Prof. Kebschull noted: “The new EFP-produced clinical practice guidelines on the treatment of all four stages of periodontitis are a crucial development, as they are the first high-quality international guidelines to outline a structured and easily implemented pathway for the efficient and effective treatment of gum disease”.
Less antibiotic use in dentistry gave no increase in endocarditis
Sweden is one of the few countries that have removed the dental health recommendation to give prophylactic antibiotics to people at a higher risk of infection of the heart valves, so-called infective endocarditis. Since the recommendation was removed in 2012, there has been no increase in this disease, a registry study from Karolinska Institutet published in the journal Clinical Infectious Diseases shows.
Infective endocarditis is a rare but life-threatening disease caused by bacterial infection of the heart valves that affects some 500 people a year in Sweden. Individuals with congenital heart disease, prosthetic heart valves or previous endocarditis are at higher risk of infection.
People at a higher risk of infective endocarditis in Sweden used to receive the antibiotic amoxicillin as a prophylactic ahead of certain dental procedures, such as tooth extraction, tartar scraping and surgery. This recommendation was lifted due to a lack of evidence that the treatment was necessary and to help prevent antibiotic resistance by reducing antibiotic use. A collaborative project involving researchers from Karolinska Institutet has now studied how the decision has affected the incidence of infective endocarditis.
Niko Vähäsarja, the study's corresponding author, said: "We can only see small, statistically non-significant variations in morbidity, nothing that indicates a rise in this infection in the risk group since 2012. Our study therefore supports the change in recommendation".
After the change in recommendation in 2012, prescriptions of amoxicillin in dentistry declined by approximately 40%. However, the study is unable to demonstrate that this was an effect of the amended recommendation and amoxicillin has other uses in dental medicine.
From: https://www.sciencedaily.com/releases/2022/02/220217141205.htm
Nocturnal teeth grinding can damage temporomandibular joints
Nocturnal teeth grinding and clenching of the upper and lower jaw are known as sleep bruxism and can have consequences for health. In dental science, the question of whether sleep bruxism is associated with the development or progression of temporomandibular joint (TMJ) disorders is controversial. In a study conducted at the University Clinic of Dentistry of the Medical University of Vienna, it was found that certain tooth shapes and locations could lead to TMJ problems as a result of bruxism. The research findings were published in the Journal of Advanced Research.
The often immense pressure exerted on tooth surfaces and on the jaws is thought to cause various dental health problems and can also result in pain in the jaw muscles and headaches. Researchers led by Benedikt Sagl in Vienna have now investigated whether sleep bruxism can also have a negative impact on the TMJ structures. Their research was based on the theory that specific combinations of tooth shape and tooth location during grinding have an influence on the mechanical load on the temporomandibular joint and can thus be considered a risk factor for TMJ disorders.
"Our results show that both the inclination and location of the wear facets have an influence on the strength of the mechanical load on the temporomandibular joint," explained Sagl, "However, it would appear that the decisive factor is the steepness of the grinding facet. The flatter the tooth, the higher the loading on the joint and therefore the higher the risk of a TMJ disorder”.
From: https://www.sciencedaily.com/releases/2022/03/220303112217.htm
Researchers take important step towards development of biological dental enamel
There is no natural alternative to synthetic filling materials, but a new 3D model with human dental stem cells could change this in the future. The results of the research led by Prof. Hugo Vankelecom and Prof. Annelies Bronckaers have been published in Cellular and Molecular Life Sciences.
The team led by Prof. Vankelecom developed a 3D research model with stem cells from the dental follicle, a membranous tissue surrounding unerupted human teeth.
Prof. Vankelecom said: "By using dental stem cells, we can develop other dental cells with this model, such as ameloblasts that are responsible for enamel formation”.
Each day, our teeth are exposed to acids and sugars from food that can cause damage to our enamel. Enamel cannot regenerate, which makes an intervention by the dentist necessary.
Doctoral student Lara Hemeryck explained: "In our new model, we have managed to turn dental stem cells into ameloblasts that produce enamel components, which can eventually lead to biological enamel. That enamel could be used as a natural filling material to repair dental enamel. The advantage is that in this way, the physiology and function of the dental tissue is repaired naturally, while this is not the case for synthetic materials. Furthermore, there would be less risk of tooth necrosis, which can occur at the contact surface when using synthetic materials”.
Not only would dentists be able to help their patients with this biological filling material, the 3D cell model could have applications in other sectors as well. For example, it could help the food industry to examine the effect of particular food products on dental enamel, or toothpaste manufacturers to optimise protection and care.
From: https://www.sciencedaily.com/releases/2022/04/220421094131.htm
How oral bacteria suppress protection against viral growth
Researchers from the University of Louisville (UofL) School of Dentistry in the US and their colleagues have discovered details of how proteins produced by oral epithelial cells protect humans against viruses entering the body through the mouth. They also found that oral bacteria can suppress the activity of these cells, increasing vulnerability to infection.
A family of proteins known as interferon lambdas produced by epithelial cells in the mouth serve to protect humans from viral infection, but the oral bacteria Porphyromonas gingivalis reduces the production and effectiveness of those important frontline defenders.
"Our studies identified certain pathogenic bacterial species, P. gingivalis, which cause periodontal disease, can completely suppress interferon production and severely enhance susceptibility to viral infection," said Juhi Bagaitkar, assistant professor in the UofL Department of Oral Immunology and Infectious Disease, "These resident oral plaque bacteria play a key role in regulating anti-viral responses”.
The mouth often is a gateway into the body for viruses that infect the gastrointestinal tract and lungs such as Covid-19, human immunodeficiency virus (HIV), herpes simplex, and cancer-causing viruses such as human papillomavirus (HPV).
P. gingivalis, a common oral bacterium that causes gum disease, has been linked to numerous other diseases, including Alzheimer's disease and rheumatoid arthritis. Recent clinical studies have shown that immune suppression in patients with periodontitis can enhance susceptibility to HIV, herpes simplex and HPV.
Improved understanding of how interferons provide broad antiviral protection and activate antiviral genes to protect people from viruses, as well as how P. gingivalis compromises their protection, may lead researchers to clinical approaches to increase that protection.
From: https://www.sciencedaily.com/releases/2022/01/220105094341.htm
Poor oral health may increase risk of severe Covid-19 for cardiac patients
Previous studies have linked poor oral hygiene with hyper-inflammation and cardiovascular disease. Similarly, the severity of Covid-19 has been associated with hyper-inflammatory responses. Thus, researchers at Cairo University in Egypt have investigated whether there is a correlation between poor oral health and greater Covid-19 severity in patients with cardiovascular disease. They found that oral health status is an additional risk factor for such patients.
Using a questionnaire, the researchers evaluated oral health status, severity of Covid-19 symptoms, duration of recovery and C-reactive protein (CRP) levels in 308 Covid-19-positive patients and an additional 86 such patients with cardiovascular disease. The latter were the subject of a subgroup analysis. The impact of oral health on Covid-19 severity was assessed using an oral health score, and the effects of oral health on CRP levels and recovery time were assessed as secondary end points.
According to the researchers, the correlation between oral health and Covid-19 severity showed a significant inverse relationship, as did the correlation between oral health and recovery time and CRP levels. Poor oral health correlated with increased CRP levels and delayed recovery, especially in patients with cardiac disease.
Dr Ahmed Mustafa Basuoni, cardiology consultant at the University said: “Oral tissues could act as a reservoir for SARS-CoV-2 [Covid-19], developing a high viral load in the oral cavity. Therefore, we recommended maintenance of oral health and improving oral hygiene measures, especially during Covid-19 infection”.
Simple measures like practising proper oral hygiene, raising awareness of oral health importance, regular dental visits (especially in patients with cardiovascular disease), and using antimicrobial mouthwashes could help in preventing or decreasing the severity of Covid-19 disease.
Top five “must have” design features for a child’s electric toothbrush
Electric toothbrushes can remove up to twice as much plaque as a manual brush, so one could be seen as a good investment. The UK’s Oral Health Foundation has released its top-five design features for electric toothbrushes for children.
The most important element of a child’s toothbrush is the size of the head and the type of bristles it uses. The ideal children’s toothbrush should have a small head with soft bristles, suitable for the age of the child.
The handle of a children’s toothbrush is important because a good grip can help them clean their teeth more effectively. Some more colourful designs can also help to motivate children into brushing twice a day.
Pressure sensors let you know when you are brushing too hard. This often comes in the form of a warning light that appears on the handle when too much force is applied.
Research by the Oral Health Foundation shows that many children prefer an electric toothbrush simply because it has a popular character on it. These characters are often stickers that are applied to the toothbrush, which can be swapped whenever the child wants to.
Many children’s toothbrushes now come with two-minute timers. These are either in-built into the handle, are a clock or sand timer you can place in the bathroom, or connected by a mobile app.
There are lots of free apps for parents to download on their phones that can help make brushing fun for children. Adding this extra level of interactivity can help children with better brushing habits.
From: https://www.dentalhealth.org/news/top-five-must-have-design-features-for-electric-toothbrushes
Disarming a blood-clotting protein prevents gum disease in mice
Blocking the function of a blood-clotting protein prevented bone loss from periodontal (gum) disease in mice, according to research led by scientists at the National Institute of Dental and Craniofacial Research (NIDCR) in the USA. Drawing on animal and human data, the researchers found that build-up of the protein, called fibrin, triggers an overactive immune response that damages the gums and underlying bone. The study, which was published in Science, suggests that suppressing abnormal fibrin activity could hold promise for preventing or treating periodontal disease.
At sites of injury or inflammation, fibrin normally plays a protective role, helping to form blood clots and activating immune cells to fight infection. But too much fibrin has been linked with health problems, including a rare form of severe gum disease due to a condition called plasminogen (PLG) deficiency. In affected people, mutations in the PLG gene lead to fibrin build-up and disease at various body sites, including the mouth.
To explore the connection between abnormal fibrin buildup and severe gum disease, the scientists studied PLG deficiency in mice and analysed human genetic data.
Like humans with the condition, PLG-deficient mice developed severe gum disease, including periodontal bone loss and elevated levels of fibrin in the gums. The mice's gums were crowded with immune cells called neutrophils, which are also found at high levels in common forms of severe gum disease.
Neutrophils typically defend the oral cavity from harmful microbes. But an excessive neutrophil response is thought to cause tissue damage. To find out if fibrin was driving this overactive response, the researchers impaired its ability to interact with (bind to) protein receptors on neutrophils. The weakened binding between fibrin and neutrophils completely prevented periodontal bone loss in PLG-deficient mice.
From: https://www.sciencedaily.com/releases/2021/12/211223143106.htm
Obesity raises the risk of gum disease by inflating growth of bone-destroying cells
Chronic inflammation caused by obesity may trigger the development of cells that break down bone tissue, including the bone that holds teeth in place, according to new University at Buffalo (UB) research that sought to improve understanding of the connection between obesity and gum disease.
The study, completed in an animal model and published in the Journal of Dental Research, found that excessive inflammation resulting from obesity raises the number of myeloid-derived suppressor cells (MDSCs), a group of immune cells that increase during illness to regulate immune function. MDSCs develop into a range of different cell types, including osteoclasts (a cell that breaks down bone tissue). Bone loss is a major symptom of periodontal (gum) disease and may ultimately lead to tooth loss.
Keith Kirkwood, professor of oral biology in the UB School of Dental Medicine says: "Although there is a clear relationship between the degree of obesity and periodontal disease, the mechanisms that underpin the links between these conditions were not completely understood”.
The study examined two groups of mice fed vastly different diets over the course of 16 weeks: one group with a low-fat diet that derived 10% of energy from fat; and, another group with a high-fat diet that drew 45% of energy from fat.
The investigation found that the high-fat diet group experienced obesity, more inflammation and a greater increase of MDSCs in the bone marrow and spleen compared to the low-fat diet group. The high-fat diet group also developed a significantly larger number of osteoclasts and lost more alveolar bone (the bone that holds teeth in place).
From: https://www.sciencedaily.com/releases/2021/11/211112083106.htm/
A chewing gum that could reduce Covid-19 transmission
A chewing gum laced with a plant-grown protein serves as a "trap" for the SARS-CoV-2 (Covid-19) virus, reducing viral load in saliva and potentially tamping down transmission, according to a new study.
The work, led by Henry Daniell at Penn's School of Dental Medicine could lead to a low-cost tool in the arsenal against the Covid-19 pandemic. The study was published in the journal Molecular Therapy.
Daniell says: "SARS-CoV-2 replicates in the salivary glands, and we know that when someone who is infected sneezes, coughs, or speaks some of that virus can be expelled and reach others. This gum offers an opportunity to neutralise the virus in the saliva, giving us a simple way to possibly cut down on a source of disease transmission”.
Prior to the pandemic, Daniell had been studying the angiotensin-converting enzyme 2 (ACE2) protein in the context of treating hypertension. Daniell's past work on ACE2 proved fortuitous in the context of the Covid-19 pandemic. The receptor for ACE2 on human cells also happens to bind the Covid-19 spike protein. Other research groups have shown that injections of ACE2 can reduce viral load in people with severe infections.
To test the chewing gum, the team grew ACE2 in plants, paired with another compound that enables the protein to cross mucosal barriers and facilitates binding, and incorporated the resulting plant material into cinnamon-flavoured gum tablets. Incubating samples obtained from nasopharyngeal swabs from Covid-positive patients with the gum, they showed that the ACE2 present could neutralise Covid-19 viruses.
From: https://www.sciencedaily.com/releases/2021/12/211203151425.htm
Covid-19: Study shows benefits of local exhaust ventilation in dental settings
One of the main ways in which Covid-19 is communicated is through airborne respiratory droplets—droplets that can be dispersed as a result of dental procedures. In a new study, researchers from Newcastle University examined the applicability of local exhaust ventilation (LEV) systems for controlling the dispersion of these droplets and aerosols and found that they could be quite valuable for this purpose.
According to James Allison, lead author of the study and a clinical research fellow at the university’s School of Dental Sciences, LEV is often referred to as extra-oral scavenging or suction when used in dental settings. While such systems are employed in other industries to reduce exposure to airborne contaminants, their use is not currently commonplace in dentistry. To investigate the potential benefits of LEV systems in dentistry, Allison and a research group conducted experiments on dental mannequins in both an open-plan dental clinic and a single surgical room.
Ten-minute crown preparations were conducted in the open-plan clinic using an air turbine handpiece, and full-mouth ultrasonic scaling was conducted over the same duration in the surgery. In both settings, fluorescein was added as a tracer to the instruments’ irrigation reservoirs and an LEV system with HEPA filters and a flow rate of 5,000L/minute was used.
Overall, it was found that using the LEV system reduced aerosol dispersion from the air turbine handpiece by 90% within 0.5m of the procedure—a figure that increased to 99% for the ultrasonic scaler within the same proximity. For the air turbine handpiece, the detection of larger droplets within 0.5m was also reduced by 95%.
Heartburn drugs may have unexpected benefits on gum disease
The use of heartburn medication is associated with decreased severity of gum disease, according to a recent University at Buffalo (UB) study. The research found that patients who used proton pump inhibitors (PPIs) – a class of drugs commonly prescribed to treat heartburn, acid reflux and ulcers – were more likely to have smaller probing depths in the gums (the gap between teeth and gums). When gums are healthy, they fit snuggly against the teeth. However, in the presence of harmful bacteria, the gap deepens, leading to inflammation, bone loss and periodontitis, also known as gum disease.
The findings, published last month in Clinical and Experimental Dental Research, may be linked to the side effects of PPIs, which include changes in bone metabolism and in the gut microbiome, says lead investigator Lisa M. Yerke, DDS, clinical assistant professor in the Department of Periodontics and Endodontics at the UB School of Dental Medicine: "PPIs could potentially be used in combination with other periodontal treatments; however, additional studies are first needed to understand the underlying mechanisms behind the role PPIs play in reducing the severity of periodontitis”.
The study sought to determine whether a relationship exists between PPI use and gum disease. The researchers analysed clinical data from more than 1,000 periodontitis patients either using or not using PPIs. Probing depths were used as an indicator of periodontitis severity.
The researchers theorised that PPIs' ability to alter bone metabolism or the gut microbiome, as well as potentially impact periodontal microorganisms, may help lessen the severity of gum disease.
From: https://www.sciencedaily.com/releases/2021/10/211013114036.htm
Baby teeth may one day help identify kids at risk for mental disorders later in life
Teeth contain growth lines that may reveal clues about childhood experiences. A team analysed 70 primary teeth collected from 70 children enrolled in the Children of the 90s study based at the University of Bristol.
The results of this study could one day lead to the development of a tool for identifying children who have been exposed to early-life adversity, which is a risk factor for psychological problems.
Senior author Erin C. Dunn was intrigued to learn that anthropologists have long studied the teeth of people from past eras to learn about their lives. Exposure to sources of physical stress can affect the formation of dental enamel and result in pronounced growth lines within teeth, called stress lines. Thicker stress lines are thought to indicate more stressful life conditions.
Dunn developed a hypothesis that the width of one line, called the neonatal line (NNL), might serve as an indicator of whether an infant's mother experienced high levels of psychological stress during pregnancy and in the early period following birth.
To test this hypothesis, the width of the NNL was measured using microscopes. Mothers completed questionnaires during and shortly after pregnancy. Children whose mothers had lifetime histories of severe depression or other psychiatric problems, as well as mothers who experienced depression or anxiety at 32 weeks of pregnancy, were more likely than other kids to have thicker NNLs. Meanwhile, children of mothers who received significant social support shortly after pregnancy tended to have thinner NNLs.
If the findings of this research can be replicated in a larger study, Dunn believes that the NNL and other tooth growth marks could be used in the future to identify children who have been exposed to early life adversity. Dunn says: "Then we can connect those kids to interventions, so we can prevent the onset of mental health disorders”.
From: https://www.sciencedaily.com/releases/2021/11/211110104603.htm
New technique helps researchers understand how acid damages teeth
The University of Surrey and the School of Dentistry at the University of Birmingham have developed a new technique to improve understanding of how acid damages teeth at the microstructural level.
The researchers performed a technique called "in situ synchrotron x-ray microtomography" at Diamond Light Source, a special particle accelerator. Electrons were accelerated to near lightspeed to generate bright x-rays that were used to scan dentine samples while they were being treated with acid. This enabled the team to build clear 3D images of dentine's internal structure with sub-micrometre resolution. By analysing these images, the researchers conducted the first-ever time-resolved 3D study of the dentine microstructural changes caused by acid.
The study, published in Dental Materials, highlights that acid dissolves the minerals in different structures of dentine at different rates. This research aims to develop knowledge that will lead to new treatments that can restore the structure and function of dentine.
Dr Tan Sui, Senior Lecturer in Materials Engineering at the University of Surrey, who led the research group, said: "Relatively little is known about how exactly acid damages the dentine inside our teeth at a microstructural level. This new research technique changes that and opens the possibility of helping identify new ways to protect dental tissues and develop new treatments".
This research is part of an ongoing collaboration with Prof. Gabriel Landini and Dr Richard Shelton at the School of Dentistry, University of Birmingham.
From: https://www.sciencedaily.com/releases/2021/10/211014141919.htms
The tooth on how the pandemic has affected our smiles
Survey data collected by the Oral Health Foundation and Align Technology has found the impact of the pandemic on the way UK adults view their smiles. More than half (58%) of British adults surveyed responded that they have changed the way they see their smile as a result of online video calls, with a third (33%) now more aware of the colour of their teeth and nearly a quarter (24%) more conscious about the alignment. The research shows that one-in-ten (11%) UK adults feels self-conscious seeing their smile during an online meeting.
The smile is one of the most important assets we have and is how we communicate our thoughts, emotions and feelings towards one another. Because of its prominence, and importance, the smile can also be a great source of concern for some people.
Dr Nigel Carter OBE of the Oral Health Foundation said: "The colour and shape of our teeth are the first things we tend to notice and feeling self-conscious is quite normal. What we must remember, however, is that the most important part of the smile is its health".
A healthy mouth can be achieved through an effective oral health routine at home as well as regular dental visits. The key components of an effective oral health routine are brushing twice a day with a fluoride toothpaste for two minutes, cleaning in between teeth daily with interdental brushes or floss, and cutting down on how much and how often you have sugary foods and drinks.
From: https://www.dentalhealth.org/news/the-tooth-on-how-the-pandemic-has-affected-our-smiles
Occupational risk of dentists examined in new study
The widespread availability of vaccines in developed nations has significantly changed the risk of dentists contracting Covid-19 in a workplace setting. Prior to this, however, dentists and other workers in occupations that typically involve close contact were widely believed to be at a relatively high risk of developing Covid-19. A new study out of Norway has sought to examine this idea further by comparing how this risk differed across occupations between the country’s two Covid-19 waves in 2020.
The study was conducted by researchers from the Norwegian Institute of Public Health, who used data from an emergency preparedness register for Covid-19 to form an observational study covering the entire Norwegian population between February 26 and December 18, 2020. The occupational groups chosen were: health (including dentists); teaching; retail; tourism and travel; catering; and, recreation and beauty. They were selected based on their high likelihood of direct, close contact with other people.
The researchers estimated and then compared the total number of confirmed Covid-19 cases per 1,000 employed individuals for each of the country’s two Covid-19 waves — the first spanning from February 26 to July 17 and the second from July 18 to December 18. In total, just over 3.5 million Norwegian residents of working age were studied.
According to the study’s findings, during the first wave, dentists, doctors, nurses and other healthcare professionals were approximately 2-3.5 times more likely to develop Covid-19 than all other Norwegians of working age. During the second wave, however, whereas doctors were moderately more likely to test positive for Covid-19, dentists were found to be no more likely to contract the virus than the average employed individual.
From: https://www.dental-tribune.com/news/occupational-risk-of-dentists-in-norway-examined-in-new-study/
IDS 2021 attracted 23,000 visitors from 114 countries
A total of 830 companies from 59 countries participated in the International Dental Show (IDS) 2021 in a gross exhibition space of 115,000 m² in Cologne, Germany. There were 228 exhibitors and five additionally represented companies from Germany, together with 591 exhibitors and six additionally represented companies from abroad. The foreign share of company participation was 72%. Including estimates for the last day of the fair, more than 23,000 trade show visitors from 114 countries attended IDS 2021. Of these visitors, around 57% came from abroad — from Europe, especially Italy, France, the Netherlands and Eastern Europe, as well as from the Middle East and overseas.
This IDS was the first to be held in a hybrid format, so that visitors who were unable to travel owing to restrictions were still able to participate digitally. IDSconnect, the digital platform of the fair, featured 77 exhibitors from 16 countries with 88 daily contributions and 1,310 minutes of broadcast time. Oliver Frese, chief operating officer of Koelnmesse, commented on the hybrid format in a press release: "We offered the physical meeting place here in Cologne in the exhibition halls and, in addition, the digital platform IDSconnect with added opportunities for presentations and networking, which was very well received”.
Mark Stephen Pace, chairman of the executive board of the Association of the German Dental Industry said: "Optimism has returned within the international dental family. We held intensive discussions with interested visitors and most of them ultimately came to make investment decisions".
The next IDS will take place from March 14-18, 2023.
From: https://www.dental-tribune.com/news/ids-2021-attracted-23000-visitors-from-114-countries/
Smart dental implants
Researchers are developing a smart dental implant that resists bacterial growth and generates its own electricity through chewing and brushing to power a tissue-rejuvenating light. The innovation could extend the usable life of an implant.
Implants represent a leap of progress over dentures or bridges, fitting much more securely and designed to last 20 years or more. But often implants fall short of that expectation, instead needing replacement in five to 10 years due to local inflammation or gum disease, necessitating a repeat of a costly and invasive procedure for patients.
Geelsu Hwang, an assistant professor in the University of Pennsylvania School of Dental Medicine, who has a background in engineering that he brings to his research on oral health issues, says: "We wanted to address this issue, and so we came up with an innovative new implant".
The novel implant would implement two key technologies, Hwang says. One is a nanoparticle-infused material that resists bacterial colonisation. And the second is an embedded light source to conduct phototherapy, powered by the natural motions of the mouth, such as chewing or toothbrushing. In a paper in the journal ACS Applied Materials & Interfaces and a 2020 paper in the journal Advanced Healthcare Materials, Hwang and colleagues lay out their platform, which could one day be integrated not only into dental implants but other technologies, such as joint replacements.
"We wanted an implant material that could resist bacterial growth for a long time because bacterial challenges are not a one-time threat," Hwang says.
The power-generating property of the material was sustained and in tests over time the material did not leach or harm gum tissue, and demonstrated a good level of mechanical strength.
From: https://www.sciencedaily.com/releases/2021/09/210909141258.htm
Since periodontitis (gum disease) has been linked to systemic health conditions, including heart disease, diabetes, cancer and Alzheimer’s disease, research is continually being conducted to better understand its causes. To this end, a new Japanese study has interrogated the associations between genetic polymorphisms — the most common type of human genetic variation — oral microbiome statuses, and the development of periodontitis.
A team of researchers spread across several Japanese universities conducted the study. They first performed a cross-sectional analysis, during which they genotypically analysed 14,539 participants and carried out saliva sampling of a group of 385. Of this group, 22 individuals were retained for the study and divided into a periodontitis group and a control group based on their periodontal status.
The researchers explained that the development of infections, oral or otherwise, is affected by genetic differences among individuals, as these differences can affect susceptibility to certain pathogens and the likelihood of contracting certain diseases.
Upon examination, the research team found that the beta diversity of the microbes — the ratio between regional and local microbe species diversity — was significantly different between the periodontitis group and control group. Two bacterial families (Lactobacillaceae and Desulfobulbaceae), as well as the bacterium Porphyromonas gingivalis, were found only in the periodontitis group. However, no relationship was found to exist between genetic polymorphism and periodontal status, suggesting that the make-up of one’s oral microbiome plays a greater role in periodontal health than genes do.
The study was published the International Journal of Environmental Research and Public Health.
Pulling wisdom teeth can improve long-term taste function, research finds
Patients who had their wisdom teeth extracted had improved tasting abilities decades after having the surgery, a new Penn Medicine, USA study published in the journal Chemical Senses found. The findings challenge the notion that removal of wisdom teeth, only has the potential for negative effects on taste, and represent one of the first studies to analyse the long-term effects of extraction on taste.
Senior author Richard L. Doty, PhD, director of the Smell and Taste Center at the University of Pennsylvania said: "Prior studies have only pointed to adverse effects on taste after extraction and it has been generally believed that those effects dissipate over time. This new study shows us that taste function can actually slightly improve between the time patients have surgery and up to 20 years later. It's a surprising but fascinating finding that deserves further investigation to better understand why it's enhanced and what it may mean clinically”.
Doty and co-author Dane Kim evaluated data from 1,255 patients who had undergone a chemosensory evaluation at Penn's Smell and Taste Center over the course of 20 years. Among that group, 891 patients had received wisdom tooth extractions and 364 had not.
The "whole-mouth identification" test incorporates five different concentrations of sucrose, sodium chloride, citric acid, and caffeine. The extraction group outperformed the control group for each of the four tastes. The study suggests that people who have received extractions in the distant past experience, on average, an enhancement (typically a 3-10% improvement) in their ability to taste.
From: https://www.sciencedaily.com/releases/2021/06/210628170521.htm
Tooth loss associated with increased cognitive impairment, dementia
Tooth loss is a risk factor for cognitive impairment and dementia – and with each tooth lost, the risk of cognitive decline grows, according to a new analysis led by researchers at NYU Rory Meyers College of Nursing and published in JAMDA: The Journal of Post-Acute and Long-Term Care Medicine. However, this risk was not significant among older adults with dentures, suggesting that timely treatment with dentures may protect against cognitive decline.
Prior studies show a connection between tooth loss and diminished cognitive function, with researchers offering a range of possible explanations for this link. For one, missing teeth can lead to difficulty chewing, which may contribute to nutritional deficiencies or promote changes in the brain. A growing body of research also points to a connection between gum disease – a leading cause of tooth loss – and cognitive decline. In addition, tooth loss may reflect life-long socioeconomic disadvantages that are also risk factors for cognitive decline.
Dean's Professor in Global Health at NYU Rory Meyers College of Nursing, Bei Wu and her colleagues conducted a meta-analysis using longitudinal studies of tooth loss and cognitive impairment. The 14 studies included in their analysis involved a total of 34,074 adults and 4,689 cases of people with diminished cognitive function.
The researchers found that adults with more tooth loss had a 1.48 times higher risk of developing cognitive impairment and 1.28 times higher risk of being diagnosed with dementia, even after controlling for other factors.
However, adults missing teeth were more likely to have cognitive impairment if they did not have dentures (23.8%) compared to those with dentures (16.9%); a further analysis revealed that the association between tooth loss and cognitive impairment was not significant when participants had dentures.
From: https://www.sciencedaily.com/releases/2021/07/210708083904.htm
New report aims to improve VR use in healthcare education
A new report that could help improve how immersive technologies such as virtual reality (VR) and augmented reality (AR) are used in healthcare education and training has been published.
Prof. David Peebles, Director of the University of Huddersfield’s Centre for Cognition and Neuroscience, and Huddersfield PhD graduate Matthew Pears contributed to the report. The work also involved another PhD researcher, Yeshwanth Pulijala, and Prof. Eunice Ma.
With only a relatively small number of dental schools in the UK, the quartet visited seven dental schools in India in early 2017 to test their VR-based training materials on students.
The report argues for greater standardisation of how to use immersive technologies in healthcare training and education. As Prof. Peebles explained: "Immersive technology is becoming increasingly popular and, as the technology is advancing, it's becoming clear that there is great potential to make training more accessible and effective”.
He continued: "Developing immersive training materials can be very time-consuming and difficult to evaluate properly. Getting surgeons and medical students to take time out to test your VR training is challenging. In our case we were lucky to have a surgeon, Prof. Ashraf Ayoub, a Professor of Oral and Maxillofacial Surgery at the University of Glasgow, who granted us permission to film a surgical procedure that was then transformed into a 3D environment to train students about situation awareness while in the operating theatre”.
Prof. Peebles hopes the work so far will provide a basis for more investigations that could help get the most from the potential that VR and immersive technology have to offer.
From: https://www.sciencedaily.com/releases/2021/07/210706115417.htm
