Failure of Dental Fillings Is At Least Partially Genetically Determined

MedicalResearch.com Interview with:
“Dental Mold_002” by Ano Lobb is licensed under CC BY 2.0
Alexandre R. Vieira, DDS. MS, PhD
Professor, Director of Clinical Research,  Director of Student Research
Department of Oral Biology
Center for Craniofacial and Dental Genetics
Department of Pediatric Dentistry
School of Dental Medicine
Department of Human Genetics
Graduate School of Public Health
Clinical and Translational Sciences Institute
University of Pittsburgh 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: One aspect is the dilemma between continuing to use dental amalgams and the perception that composite resins are not as durable.

We show that composite resin restorations can perform similarly to dental amalgams for the first 5 years. But the most remarkable is that composite resin failures may be related to certain individual risk factors, such as genetic variation.

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Antibiotics Prescribed By Dentists May Contribute To C.diff Infections

MedicalResearch.com Interview with:

Stacy Holzbauer, DVM, MPH, DACVPM CDC Career Epidemiology Field Officer (CEFO) Commander, USPHS Minnesota Department of Health St. Paul, MN

Dr. Holzbauer

Stacy Holzbauer, DVM, MPH, DACVPM
CDC Career Epidemiology Field Officer (CEFO)
Commander, USPHS
Minnesota Department of Health
St. Paul, MN

MedicalResearch.com: What is the background for this study?

  • Antibiotics are not harmless drugs—Clostridium difficile infection, which can sometimes cause a deadly diarrhea, is a complication of antibiotic use and can occur after even one dose of an antibiotic.
  • The Minnesota Department of Health (MDH) is part of the larger Centers for Disease Control and Prevention (CDC) Emerging Infections Program (EIP). The healthcare-associated infection component of CDC’s EIP engages a network of state health departments and their academic medical center partners to help answer critical questions about emerging HAI threats including Clostridium difficile also known as “C. diff.”
  • In Minnesota, the majority of C. diff infections occur outside the hospital and are driven by antibiotic use in community or outpatient settings. In addition to routine surveillance data, we interview patients with C. diff who were not hospitalized prior to their infection to identify potential risks for developing C. diff infection, including identifying antibiotics received outside of routine healthcare settings.
  • Dentists prescribe approximately 10% of the antibiotics in outpatient settings, which was over 24 million prescriptions in 2013. When asked about their prescribing practices in a 2015 survey with the Minnesota Dental Association, 36% of dentists surveyed prescribed antibiotics for dental conditions that are generally not recommended to receive antibiotics according to American Dental Association (ADA) guidelines.

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Periodontal Disease is Associated with Higher Risk of Cancer in Postmenopausal Women

MedicalResearch.com Interview with:

Jean Wactawski-Wende, PhD Dean, SUNY Distinguished Professor Professor, Department of Epidemiology and Environmental Health School of Public Health and Health Professions University of Buffalo

Dr. Wactawski-Wende

Jean Wactawski-Wende, PhD
Dean, SUNY Distinguished Professor
Professor, Department of Epidemiology and Environmental Health
School of Public Health and Health Professions
University of Buffalo

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There has been a growing interest in the role of periodontal disease in system chronic diseases, including cancer. We explored the association of periodontal disease history and incident cancer in the women’s health initiative study of postmenopausal women. We found that women reporting periodontal disease history were at increased risk of developing cancer overall. In addition they were found to have significant increased risk of specific cancers including cancers of the lung, breast, esophagus, gallbladder and melanoma. The risk persisted after control for many other factors. In addition, the risk was seen in women regardless of their smoking history. Both ever smokers and never smokers were found to have increased risk of cancer associated with periodontal disease history.

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Diabetes Alters Oral Microbiome Leading to Periodontal Disease

MedicalResearch.com Interview with:

Dana T. Graves DDS Department of Periodontics School of Dental Medicine University of Pennsylvania Philadelphia, PA

Dr. Graves

Dana T. Graves DDS
Department of Periodontics
School of Dental Medicine
University of Pennsylvania
Philadelphia, PA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It was previously thought that diabetes did not have a significant effect on oral bacteria. We found that diabetes caused a change in the composition of the oral bacteria. This change caused resulted in a bacterial composition that was more pathogenic and stimulated more inflammation in the gums and greater loss of bone around the teeth.

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Engineering New Vasculature Could Revolutionize Root Canal Surgery

MedicalResearch.com Interview with:
Avathamsa Athirasala, MSE and
Luiz E. Bertassoni, DDS PhD

Biomaterials and Biomechanics, School of Dentistry
Center for Regenerative Medicine, School of Medicine
Biomedical Engineering, School of Medicine
Portland OR 97201 USA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Current clinical practices for root canal treatment involve replacing the damaged tissue with inert, synthetic materials. While these procedures are able to arrest infection and decay in the tooth, they do not restore its biological function causing it to become weaker and more prone to fractures.

We are focused on the regeneration of pulp tissue instead and in this study, we have developed a strategy to apply tissue-engineering concepts to engineer dental pulp-like tissue constructs, complete with blood vessels, which can, in principle, integrate with existing vasculature when introduced at the site of injury and form healthy pulp tissue. Continue reading

Frequent Marijuana Use Linked To Increased Risk of Severe Periodontal Disease

MedicalResearch.com Interview with:

Jaffer A Shariff DDS MPH cert.DPH Periodontal Resident | Research Scientist Division of Periodontics, Columbia University College of Dental Medicine New York

Dr. Shariff

Jaffer A Shariff DDS MPH cert.DPH
Periodontal Resident | Research Scientist
Division of Periodontics,
Columbia University College of Dental Medicine
New York

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Marijuana use for both medical and recreational purposes has become increasingly common in recent years; it is the most commonly used recreational drug in the United States. Subsequent increase in its legalization among countries including the United States for recreational purposes, poses an emergent oral and periodontal health concerns.

Our study revealed that frequent recreational marijuana users exhibited deeper periodontal probing depths, clinical attachment loss and higher odds of having severe periodontal disease than the non-frequent users, even after controlling for other risk factors linked to gum disease, such as cigarette smoking.

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In Accordance With Guidelines, Fewer Low Risk Patients Receiving Antibiotics Before Dental Procedures

MedicalResearch.com Interview with:

Daniel C. DeSimone, M.D.</strong> Infectious Diseases Fellowship, Year 2 Mayo Clinic

Dr. DeSimone

Daniel C. DeSimone, M.D.
Infectious Diseases Fellowship, Year 2
Mayo Clinic

MedicalResearch.com: What is the background for this study?

Response: For over 50 years, the American Heart Association (AHA) has recommended antibiotics to be given to patients with certain cardiac conditions prior to invasive dental procedures (dental cleanings, extractions, root canals) with the hope to prevent infective endocarditis–a potentially deadly infection of the heart valves. Prevention of this infection was preferred to treatment of an established infection due to its high morbidity and mortality rates. However, in 2007, experts found that there was very little, if any, evidence that showed antibiotics prophylaxis prevented infective endocarditis prior to invasive dental procedures. Given this, the AHA revised its guidelines, significant reducing the number of patients where antibiotic prophylaxis would be given–as routine daily activities such as chewing food, tooth brushing, and flossing were much more likely to cause infective endocarditis than a single dental procedure.

For over 50 years, patients with cardiac conditions that placed them at “moderate risk” and/or “high risk” were to receive antibiotics prior to dental procedures. In 2007, the “moderate risk” group were to no longer receive antibiotic prophylaxis. This is a significantly large proportion of patients–approximately 90% of all patients who would have received antibiotic prophylaxis. Given the drastic changes made in 2007, there was concern among the medical and dental communities about whether we were leaving patients “unprotected” and at risk for infective endocarditis. Thankfully, several population based studies from our group and others across the United States have not shown an increase in the rate of infective endocarditis. However, the question remained, “Are providers following the 2007 AHA guidelines?” and “Are patients still receiving antibiotics prior to dental procedures when its no longer indicated by the guidelines?”.

This was the main focus of our paper. We were able to go into the local dental offices and at the same time, have full access to their medical records. Every dental visit between 2005 and 2015 at their dental office was reviewed; the type of dental visit, whether they received antibiotic prophylaxis or not. In addition, we could confirm their cardiac conditions that would place them at “moderate risk” or “high risk” compared to the general population.

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Oral Bacteria Linked to Cardiovascular Disease

MedicalResearch.com Interview with:
Bradley F. Bale, M.D.

Texas Tech Health Science Center
School of Nursing, Lubbock, Texas
1002 Montrose Drive
Gallatin, TN 37066

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It has been known for some time that periodontal disease is associated with higher risk for arterial disease.  It was shown decades ago that the germs in the mouth frequently seed into our blood stream with simple activities such as chewing and brushing our teeth.  During the last decade, it was discovered certain high risk periodontal pathogens are associated with various cardiovascular (CV) risk factors such as blood pressure, lipid levels, insulin resistance and endothelial dysfunction.  These studies elucidated that the CV risk stems from the bacteria involved in the periodontal disease and not the clinical signs such as pocket depth, bleeding of gums and loose teeth.

The above knowledge demonstrated that high risk periodontal pathogens can adversely influence two of the three elements in the atherogenic triad.  Those factors are concentration of apoB and endothelial inflammation and dysfunction.  Then approximately two years ago it was published that the high risk pathogen Porphyromonas  gingivalis (P.g.) can enhance the third element.  This portion is the transformation of contractile smooth muscle cells (SMCs) in the medial layer of artery into migratory secretory SMCs.  These morphed cells enter the deep layer of the intima and enrich it with proteoglycans which are the ‘velcro’ that traps cholesterol particles in the arterial wall and initiates the formation of arterial disease.  At that point, there was solid evidence that the high risk pathogens boost every element in the triad to create atherosclerosis.  With that knowledge these pathogens must be considered a contributory cause of arterial disease.  When a condition is causal it demands diagnosis and management to reduce the disease risk.

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Gum Disease Linked to Autoimmunity in Rheumatoid Arthritis

MedicalResearch.com Interview with:

Maximilian F. Konig, MD Department of Medicine Massachusetts General Hospital Harvard Medical School

Dr. Maximilian F. Konig

Maximilian F. Konig, MD
Division of Rheumatology,
Johns Hopkins University School of Medicine
Current affiliation:
Department of Medicine
Massachusetts General Hospital
Harvard Medical School

MedicalResearch.com: What is the background for this study?

Response:The idea that rheumatoid arthritis (RA), an autoimmune disease that leads to chronic joint inflammation and destruction, may be initiated by a bacterial infection is not novel, but has been posited for more than a century. Based on the clinical observation that patients with RA frequently have severe periodontal disease (gum disease), gum inflammation has long been thought to contribute to disease development in RA. However, limited understanding of the mechanisms that fuel and sustain the autoimmune attack in RA made it difficult to pinpoint a specific bacterial trigger.

In recent years, our understanding of the abnormal immune response that attacks the joints in patients with RA has grown exponentially, and we now know that disease-specific autoantibodies (ACPAs) target modified self-proteins (this modification is known as citrullination). It is this abnormal immune response against citrullinated proteins that appears to drive the joint (and sometimes lung) inflammation seen in rheumatoid arthritis. Recent studies from our laboratory at The Johns Hopkins University (led by principle investigator Felipe Andrade, MD, PhD) suggested that an immune cell called the neutrophil, which normally protects us from infection at sites like the oral cavity or anywhere else in the body, also appears to be the source of the proteins attacked in RA. We were therefore interested to understand what drives the association of gum disease, an inflammation commonly triggered by bacteria, with RA.

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Dental Occlusion Affects Standing Balance in Unstable Conditions

MedicalResearch.com Interview with:
Sonia Julià-Sánchez, Ph.D
.
Departament de Fisiologia i Immunologia
Universitat de Barcelona

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Contradictory results are still reported on the influence of dental occlusion on the balance control. While most literature have evaluated this relationship in static conditions with inconclusive results, the topic is still a matter of debate. However, less research has focused on the correlation of dental occlusion and balance control in unstable surfaces, even though the higher sensitivity of the unstable platforms to examine individual responses to translational and angular perturbations.

Moreover, when we talk about the influence of dental occlusion on the body balance, the study of the specific malocclusal traits influencing balance control should be of extremely importance to apply the proper treatment.

Our study was focused on the influence of dental occlusion and specific malocclusal traits on the body balance control at extreme levels of stability. We found that body balance was significantly influenced by dental occlusion in unstable conditions.
Moreover, specific occlusal traits significantly influencing postural control were: Angle Class, crowding, midline deviation, crossbite, anterior open bite and overjet.

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Regular Dental Check Ups Linked To Lower Risk of Pneumonia

MedicalResearch.com Interview with:
Michelle E. Doll, M.D., M.P.H.

Assistant Professor
Associate Hospital Epidemiologist
Department of Internal Medicine
Division of Infectious Diseases
North Hospital
Richmond, VA 23298-0019

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There are many studies that show that poor oral health is associated with systemic conditions including bacterial pneumonias. Many find this link surprising, but considering that the airways are a direct conduit between the oral cavity and the lungs, saliva containing oral bacteria is able to track down into the lungs via aspiration. Previous studies have found that good oral health seems to prevent pneumonias in people susceptible to lung infections, possibly because the types and quantities of bacteria residing in the mouth are different in people with healthy versus unhealthy teeth.

In my infectious disease clinical practice, I am often frustrated by my inability to assist patients with dental problems. Many of my patients are immunosuppressed, and when they have tooth decay for which they are unable to get timely dental care, I worry about consequences of untreated dental disease; lack of access to dental care is common in the United States. For these reasons, we decided to use data from the Medical Expenditure Panel Survey (MEPS) to determine whether dental care is preventive for bacterial pneumonia. The MEPS database is a large, nationwide survey administered by the Agency for Healthcare Research and Quality (AHRQ), with comprehensive insurance data including dental insurance and access. We found that those who never see the dentist were 86% more likely to get pneumonia in a year, compared to those who visit the dentist for routine check-ups twice a year or more. Furthermore, even those who visit the dentist less than once yearly were at smaller but still significantly increased risk of pneumonia compared to those who see the dentist more frequently.

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Community Dental Program May Reduce Emergency Dental Admissions

MedicalResearch.com Interview with:
Jonathon P. Leider, PhD
Department of Health Policy and Management
Johns Hopkins University
Baltimore, MD

MedicalResearch.com: What is the background for this study?

Response: The increasing utilization of Emergency Departments (ED) for the treatment of non-urgent and non-traumatic dental conditions among adults in the United States is an increasing policy issue. Research shows that seeking dental care in an ED is often more expensive and less effective when compared to a traditional dental office. Seeking care in the ED for non-traumatic dental conditions is more frequent among low income individuals and people in rural areas, who must often overcome insufficient dental coverage and access to receive office-based care.

Under the Affordable Care Act, there has been considerable expansion in state Medicaid dental coverage for adults. However, not all states are participating in the expansion or extension of dental benefits and dental professional shortage areas are fairly common– over 4,900 exist in the United States. Innovative programs are needed to effectively address the challenges low income individuals in rural areas encounter accessing care. Our study examined the expansion of a Community Dental Program (CDP) in rural Western Maryland and its impact on dental-related visits at a regional ED.

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Dental Occlusion Can Influence Standing Balance

MedicalResearch.com Interview with:
Sonia Julià-Sánchez, PhD
Universitat de Barcelona

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Over the last few years, a growing interest has focused on the potential correlation between the stomatognathic system and the body balance. While this relationship is still a subject for debate, it is well known that sensory information contributes differently on the postural control regulation depending on the conditions of the surface area. Therefore, we hypothesized that dental occlusion may contribute differently on the body balance control depending on the stability condition (stable versus unstable) and that influence might be more evident in fatigue conditions due to reorganization of the sensory information sources.

In the current study we aimed to determine whether:

(i) dental occlusion influences body balance in stable and unstable surfaces, and

(ii) the influence of dental occlusion on the balance control comes strongly into effect under fatigue conditions.

Our results showed that dental occlusion influenced balance control, at unstable level, both at rest and fatigue condition. However, when measuring at stable level, the influence of dental occlusion only reached significance in fatigue condition.

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Severe Periodontitis Associated with Insulin Resistance

MedicalResearch.com Interview with:

In-Seok Song, DDS, PhD Clinical Assistant Professor Oral and Maxillofacial Surgeon Department of Dentistry, Korea University Anam Hospital, Seoul, Republic of Korea

In-Seok-Song

In-Seok Song, DDS, PhD
Clinical Assistant Professor
Oral and Maxillofacial Surgeon
Department of Dentistry, Korea University Anam Hospital,
Seoul, Republic of Korea

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Periodontitis is a well-known cause of various systemic diseases including cardiovascular disease, type 2 diabetes. As for type 2 diabetes, insulin resistance is responsible for the low-grade systemic inflammation, which can deteriorate body function throughout pancreatic β-cell dysfunction and impaired fasting glucose. There are emerging evidences that insulin resistance is a cause of periodontal disease progression among Korean adults as well as other citizens including American, French, Finnish, and the British.

In this study, we hypothesized that insulin resistance aggravates the severity of periodontitis. We investigated the associations between type 2 diabetes, insulin resistance, and severe periodontitis. The associations between severe periodontitis and insulin resistance in non-obese adults with normal body mass index (BMI) or waist circumference (WC) were also evaluated.

We found that non-abdominal obese adults with insulin resistance were more likely to have severe periodontitis compared to metabolically healthy adults with normal waist circumference. Insulin resistance without abdominal obesity can be considered an independent risk factor of severe periodontitis.

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Apical Periodontitis Significantly Associated With Cardiovascular Diseases

MedicalResearch.com Interview with:

John Liljestrand, DDS Department of Oral and Maxillofacial Diseases University of Helsinki

Dr. John Liljestrand

John Liljestrand, DDS
Department of Oral and Maxillofacial Diseases
University of Helsinki

MedicalResearch.com: What is the background for this study?

Response: There is an increased amount of evidence supporting the hypothesis that oral inflammations increase the risk for cardiovascular diseases (CVDs). The association between marginal periodontitis, a common inflammatory disease in the tooth supporting tissues, and CVDs is well established. The link is thought to depend on transient but repeated bacteremia, endotoxemia and an increased systemic inflammatory burden.

Apical periodontitis is a common manifestation of an endodontic infection, most often caused by dental caries. It is an inflammatory reaction surrounding the root tip of a tooth and it restrains the dental infection from spreading into the bone. Apical periodontitis is similar to marginal periodontitis regarding its microbial profile and ability to increase systemic inflammatory markers. Therefore, it is justified to suggest that apical periodontitis might also increase the risk for CVDs. There is only a minor amount of publications on this topic and further research is still needed. 
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Poor Oral Health in Hospitalized Patients Associated With Dementia and Kidney Disease

MedicalResearch.com Interview with:

Danielle Mairead Maire Ni Chroinin, MB BCh BAO BMedSc MD MRCPI FRACP Staff Specialist in Geriatric Medicine Liverpool Hospital and Senior Conjoint Lecturer UNSW

Dr. Danielle Ni-Chroinin

Danielle Mairead Maire Ni Chroinin,
MB BCh BAO BMedSc MD MRCPI FRACP

Staff Specialist in Geriatric Medicine
Liverpool Hospital and Senior Conjoint Lecturer UNSW

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Oral disease may have a large impact on older persons’ health and wellbeing, causing pain, impairing speech, adversely affecting nutrition, contributing to systemic infection and harming self-esteem. However, this important issue may be neglected in the acute hospital setting. Our aim was to investigate oral health status and abnormalities in older patients admitted acutely to hospital, exploring the association with medical co-morbidities. We included all individuals aged 70 and older admitted to a geriatric service over 3 months (N=202), and evaluated oral health using a simple bedside tool the Oral Health Assessment Tool (OHAT).

Overall, we found that poor oral health was not uncommon, and was associated with dementia and renal impairment. This association persisted even after adjustment for anticholinergic medication and oral pH, highlighting that patients with these conditions may be particularly vulnerable.

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Bacteria Causing Dental Caries Transmitted From Family and Friends

MedicalResearch.com Interview with:

Stephanie S. Momeni, MS, MBA Doctoral Candidate, Department of Biology DART Trainee, Department of Pediatric Dentistry & IOHR UAB School of Dentistry Birmingham, Alabama 35294-0007

Dr. David Macintyre

Stephanie S. Momeni, MS, MBA
Doctoral Candidate, Department of Biology
DART Trainee, Department of Pediatric Dentistry & IOHR
UAB School of Dentistry
Birmingham, Alabama 35294-0007

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study was a small part of a large scale of S. mutans in a group of high-caries risk children and their household family members in Perry County, Alabama, USA. Overall dental caries is a dietary and infectious disease that we seek to understand better. We found only 34 rep-PCR genotypes for over 13,000 bacterial isolates from over 594 individual subjects. With so much commonality we wanted to determine if any conclusions could be made about transmission.

The key findings are:
• Children having multiple S. mutans genotypes were 2.3 times more likely to have dental caries.
• Analysis for transmission performed from two perspectives (by child and by genotype) indicating 63% of children shared at least 1 genotype with their mother, but 72% of children had at least 1 genotype not shared with any household family members.
• Child-to-child transmission of some genotypes is highly probable.
• About 1/3 of isolates observed were transient, and may confound the search for strains associated with tooth decay.

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Chronic Periodontal Disease Quadruples Risk of Lacunar Stroke

MedicalResearch.com Interview with:

Dr. Yago Leira, DDS Pre-Doc researcher at Health Research Institute of Santiago de Compostela (Spain) and Department of Periodontology, Faculty of Medicine and Dentistry University of Santiago de Compostela (Spain)

Dr. Yago Leira

Dr. Yago Leira, DDS
Pre-Doc researcher at Health Research Institute of Santiago de Compostela (Spain) and Department of Periodontology, Faculty of Medicine and Dentistry
University of Santiago de Compostela (Spain)

MedicalResearch.com: What is the background for this study?

Response: Periodontal disease is a chronic oral inflammatory disease caused by bacterial infection, which affects 20% to 50% of the adult population. Lacunar stroke, a type of cerebral small vessel disease, is responsible for almost 25% of the ischaemic strokes. It may be hypothesized that chronic periodontitis leads to a low-grade state of systemic inflammation altering endothelial function and blood vessels health, which could be related to the onset of atherosclerosis. Moreover, lacunar stroke could be linked with an inflammation process that can be associated with endothelial dysfunction.

In the last decade, several observational studies have suggested an association between periodontal disease and ischaemic stroke. However, none of them have studied the relationship between chronic periodontitis and lacunar stroke independently of known vascular risk factors that both diseases may share (e.g., ageing, hypertension, diabetes mellitus or hypercholesterolemia).

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Periodontal Disease Linked To Increased Mortality in Chronic Kidney Disease Patients

MedicalResearch.com Interview with:

Mr Praveen Sharma BDS, MJDF (RCS Eng.), FHEA NIHR Doctoral Research Fellow Clinical Lecturer in Restorative Dentistry University of Birmingham School of Dentistry Birmingham, UK

Mr. Praveen Sharma

Mr Praveen Sharma BDS, MJDF (RCS Eng.), FHEA
NIHR Doctoral Research Fellow
Clinical Lecturer in Restorative Dentistry
University of Birmingham School of Dentistry
Birmingham, UK

MedicalResearch.com: What is the background for this study? 

Mr. Sharma: There is robust evidence that patients with severe gum disease have higher levels of background inflammation in their bodies as a result and if the gum disease is treated that inflammation reduces. Therefore it appears that severe gum disease may be a “co-morbidity” for other chronic non-communicable diseases of ageing. The idea for this study was born out of some on-going research at the University of Birmingham, in collaboration with the Queen Elizabeth Hospital’s Renal Research team, investigating the links between gum disease (periodontitis) and chronic kidney disease (CKD). We found that patients with CKD were more likely to have periodontitis and severe periodontitis compared to a local, control population. Also, patients with CKD and worse periodontal health were more likely to have worse kidney and vascular function  compared to those with better periodontal health. These findings led us to believe that periodontitis might be associated with increased mortality in patients with CKD, which is why we performed the current study. The current study confirmed our hypothesis.

MedicalResearch.com:  What are the main findings? 

Mr. Sharma: We found that the mortality rate of patients with CKD increased by 28% over a 10 year period if they also had periodontitis. Surprisingly, this increase is similar to that seen in patients with CKD who have diabetes instead of periodontitis.

MedicalResearch.com: What should clinicians and patients take away from your report? 

Mr. Sharma:  The main message from this study is that diseases in one part of the body, such as the mouth, have the potential to influence other parts of the body and ultimately the person as a whole. Periodontitis is common, and severe disease affects 11% of adults globally. It is preventable and also treatable, but the mouth is often ignored in this context.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Mr. Sharma:  It is yet to be seen whether the treatment of periodontitis has a beneficial impact on the general health and lifespan or indeed quality of life for patients with CKD and that research in underway at the University of Birmingham’s Dental School, funded by the NHS.

MedicalResearch.com: Is there anything else you would like to add? 

Mr. Sharma:  Like all clinical researchers, our ultimate aim is to improve the health and wellbeing of patients and we are grateful to our volunteer patients, without whom, this work would not be possible.

Citation:

J Clin Periodontol. 2016 Feb;43(2):104-13. doi: 10.1111/jcpe.12502. Epub 2016 Feb 18.

Association between periodontitis and mortality in stages 3-5 chronic kidney disease: NHANES III and linked mortality study.

Sharma P1, Dietrich T1, Ferro CJ2, Cockwell P2, Chapple IL1.

 

Fewer Teeth Linked To Greater Cognitive Decline

MedicalResearch.com Interview with:

Elham Emami, DDS, MSc, PhD Professeure agrégée Faculté de médecine dentaire École de santé publique, Département de médecine sociale et préventive Université de Montréal Montréal (Québec) Canada

Dr. Elham Emami

Elham Emami, DDS, MSc, PhD
Director , Oral Health and Rehabilitation Research Unit & Associate Professor
Faculty of Dental Medicine & School of Public Health
Université de Montréal
Adjunct Professor McGill University

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Emami: Over the past 20 years, scientific evidence has shown that oral and general health are closely linked. Recently, studies have shown that there is also a link between the number of teeth an older person has and his/her cognitive status.

We carried out a meta-analysis using the data from these latter studies. Our results indicate that, taking into account socioeconomic differences and other potential confounding variables, a person with less than 20 teeth has a 20% greater risk of having cognitive decline (HR= 1.26, 95% CI = 1.14 to 1.40) and dementia (HR = 1.22, 95% CI = 1.04 to 1.43) than someone who has 20 or more teeth.

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Complement Inhibitor Reverses Periodontitis

MedicalResearch.com Interview with:

George Hajishengallis, D.D.S., Ph.D., Thomas W. Evans Centennial Professor University of Pennsylvania Penn Dental Medicine - Microbiology Philadelphia, PA 19104-6030

Dr. George Hajishengallis

George Hajishengallis, D.D.S., Ph.D.,
Thomas W. Evans Centennial Professor
University of Pennsylvania
Penn Dental Medicine – Microbiology
Philadelphia, PA 19104-6030

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Hajishengallis: The current study is the result of eight years of collaboration with my colleague at Penn Medicine, Dr. John D. Lambris. In our earlier mechanistic studies, we have shown that complement, a system of innate immunity and inflammation, is critically involved in the pathogenesis of periodontitis, an oral inflammatory disease that leads to the destruction of the tissues (gums and bone) that support the teeth. C3 is the central component of the complement system, where all activation pathways converge. Therefore, we reasoned that blocking C3 with an appropriate inhibitor could block the development of periodontitis. The results of this study confirmed our hypothesis. Indeed, by administering the C3 inhibitor Cp40 to the periodontal tissue just once a week reversed naturally occurring chronic periodontitis in a preclinical model. Specifically, Cp40 inhibited pre-existing gingival inflammation (as determined by both clinical and laboratory assessment) and the formation of osteoclasts, that is, the cells involved in the resorption of bone.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Hajishengallis: Although in this study Cp40 was successfully applied as a stand-alone treatment, it can be envisioned as an adjunctive therapy to the management of human chronic periodontitis. Cp40 has now been developed for human clinical applications (AMY-101; Amyndas Pharmaceuticals). Future clinical trials could investigate the potential of Cp40/AMY-101 to inhibit periodontal inflammation and bone loss compared to scaling and root planing, whereas in very severe cases of the disease, the drug could be combined with scaling and root planing and compared to periodontal surgery, in an effort to obviate the need for a surgical approach.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Hajishengallis: There are different candidate approaches for the treatment of periodontitis. Our current work shows that strategies that aim to control the host inflammatory response have a great therapeutic potential. Future research should focus on translating important findings from preclinical models to the clinic. Dissecting mechanisms of disease is very important but translating this type of research into new and effective therapies is even more significant.

MedicalResearch.com: Is there anything else you would like to add?

Dr. Hajishengallis: As I alluded to earlier, Cp40/AMY-101 has a great potential to find application as a novel anti-inflammatory treatment for periodontitis. Periodontitis has a serious public health impact and economic burden, therefore, we need innovative treatments adjunctive to existing therapies – such as mechanical removal of the tooth-associated biofilm – which are not always sufficient to control periodontitis. This drug would not necessarily be implemented in a therapeutic setting (as used in our study) but could also be provided on a preventive basis to high-risk individuals for periodontitis, such as cigarette smokers and diabetic patients. Since Cp40/AMY-101 is intended for local treatment of human periodontitis,potential safety considerations are unlikely to apply, although of course this will need to be verified.  It should be noted though that no adverse effects were observed in the preclinical studies. 

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

J Clin Periodontol. 2016 Mar;43(3):238-49. doi: 10.1111/jcpe.12507. Epub 2016 Mar 3.

Inhibition of pre-existing natural periodontitis in non-human primates by a locally administered peptide inhibitor of complement C3.

Maekawa T1,2, Briones RA3, Resuello RR4, Tuplano JV4, Hajishengallis E5, Kajikawa T1, Koutsogiannaki S6, Garcia CA3, Ricklin D6, Lambris JD6,Hajishengallis G1.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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George Hajishengallis, D.D.S., Ph.D. (0). Complement Inhibitor Reverses Periodontitis MedicalResearch.com

Quitting Smoking Can Restore Normal Bacteria To Oral Microbiome

MedicalResearch.com Interview with:
Jiyoung Ahn, PhD, RD, MS
Associate Professor of Population Health
Associate Director of Population Sciences,
NYU Perlmutter Cancer Center  and
Brandilyn Peters (post-doctoral fellow, lead author)
NYU Langone School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Oral bacteria play important roles in oral health, and can influence the health of other body systems as well. We were interested in studying how cigarette smoking affects oral bacteria. To do this, we examined the oral bacteria in mouthwash samples from 112 current smokers, 571 former smokers, and 521 people who never smoked. We found that the mouth bacterial composition of current smokers differed dramatically from those who never smoked. However, the mouth bacterial composition of former smokers was similar to that of never smokers, suggesting that quitting can restore the oral bacteria back to a healthy state.

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Bacteria P. gingivalis Could Be Risk Factor for Esophageal Cancer

MedicalResearch.com Interview with:

Dr. Huizhi Wang Assistant Professor Department of Oral Immunology and Infectious Diseases University of Louisville School of Dentistry Louisville, KY

Dr. Huizhi Wang

Dr. Huizhi Wang
Assistant Professor
Department of Oral Immunology and Infectious Diseases
University of Louisville School of Dentistry
Louisville, KY 

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Wang: Esophageal cancer is the eighth most frequent tumor and sixth leading cause of cancer death worldwide, characterized by rapid development and poor prognosis, including high mortality. Whereas the majority of cases occur in Asia, particularly in central China, recent data suggest that the frequency of new cases is rising in Western Europe and the USA. Mounting evidence suggests a causal relationship between specific bacterial infections and the development of certain malignancies. However, the possible role of the keystone periodontal pathogen, Porphyromonas gingivalis, in esophageal squamous cell carcinoma (ESCC) was unknown before our study. We found P. gingivalis infects epithelium of cancerous tissues up to 61%, as compared with 12% of adjacent tissues and non-infected in normal esophageal mucosa. A similar distribution of lysine-specific gingipain, a catalytic endoprotease uniquely secreted by P. gingivalis, and P. gingivalis DNA was observed. Moreover, we found infection of P. gingivalis was positively associated with the multiple clinicopathologic characteristics, including differentiation status, metastasis, and overall survival rate.  Continue reading

Mouth Bacteria Linked to Stroke And Stroke-Related Dementia

MedicalResearch.com Interview with:

Dr. Robert Friedland MD Mason C. and Mary D. Rudd Endowed Chair In Neurology Professor, Dept. of Neurology University of Louisville Health Care Outpatient Center Louisville, KY 40292

Dr. Robert Friedland

Dr. Robert Friedland MD
Mason C. and Mary D. Rudd Endowed Chair In Neurology
Professor, Dept. of Neurology
University of Louisville Health Care Outpatient Center
Louisville, KY 40292

Medical Research: What is the background for this study? What are the main findings?

Dr. Robert Friedland: Oral infectious diseases are associated with stroke. Previous research by this group has shown that oral bacteria, cnm-positive Streptococcus mutans, was associated with cerebral microbleeds and intracerebral hemorrhage. We developed this study to investigate the roles of this bacteria in patients entering the hospital for all types of stroke. Among the patients who experienced intracerebral hemorrhage (ICH), 26 percent were found to have a specific bacterium in their saliva, cnm-positive S. mutans. Among patients with other types of stroke, only 6 percent tested positive for the bacterium. We also evaluated MRIs of study subjects for the presence of cerebral microbleeds (CMB), small brain hemorrhages which may cause dementia and also often underlie ICH. We found that the number of CMBs was significantly higher in subjects with cnm-positive S. mutans than in those without.
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New Teeth: Why Can’t We Be More Like Sharks?

MedicalResearch.com Interview with:

Shark Teeth: lower jaw with 4 tooth rows and 4 tooth series labeled. "Series 1" contains the functional teeth at the front of the jaw. Wikipedia Image

Shark Teeth: lower jaw with 4 tooth rows and 4 tooth series labeled. “Series 1” contains the functional teeth at the front of the jaw. Wikipedia Image

Gareth J. Fraser, Ph.D
Lecturer in Zoology
Department of Animal and Plant Sciences
Alfred Denny Building
University of Sheffield
Western Bank Sheffield UK

MedicalResearch: What is the background for this study? What are the main findings?

 

 

Dr. Fraser: Our study shows how sharks develop their formidable, continuously regenerative conveyor belt-like dentition. We show how sharks make and regenerate their teeth utilising a core set of highly conserved genes shared among all vertebrates, including humans. This network of genes has been making teeth in vertebrates for over 400 million years. This report suggests that all teeth are made with this same group of genes. Sharks have an incredible ability to rapidly regenerate their dentition throughout life, and these genes are essential for this process of regeneration.

If we compare this process to mammals where the regenerative system is greatly reduced with only two sets of teeth, then we can begin to understand why humans have lost the ability to regenerate their dentition more than once. The beauty of studying natural systems like the shark dentition is that we can learn the basic science behind how teeth are naturally regenerated. This is important to human dental health as we can use these natural systems of tooth regeneration to learn about the essential cells and genes that regulate the process of natural tooth regeneration.

In the future, this research could facilitate the development of new dental therapies helping humans to regrow natural teeth when required.

Citation:

Liam J. Rasch, Kyle J. Martin, Rory L. Cooper, Brian D. Metscher, Charlie J. Underwood, Gareth J. Fraser. An ancient dental gene set governs development and continuous regeneration of teeth in sharks.
Developmental Biology, 2016; DOI:10.1016/j.ydbio.2016.01.038

Dr. Gareth Fraser (2016). New Teeth: Why Can’t We Be More Like Sharks? 

Periodontal Disease Linked to Breast Cancer Risk in Postmenopausal Women

Jo Freudenheim, PhD UB Distinguished Professor and Interim Chair Department of Epidemiology and Environmental Health School of Public Health and Health Professions University at Buffalo Buffalo, NY

Dr. Jo Freudenheim

MedicalResearch.com Interview with:
Jo Freudenheim, PhD
UB Distinguished Professor and Interim Chair
Department of Epidemiology and Environmental Health
School of Public Health and Health Professions
University at Buffalo
Buffalo, NY

Medical Research: What is the background for this study? What are the main findings?

Dr. Freudenheim: There have been a number of studies that have shown an association between periodontal disease and chronic diseases, particularly stroke and heart attacks. There is also some newer evidence that periodontal disease is associated with cancer, particularly cancers of the gastrointestinal tract. Ours is the first large prospective study of periodontal disease and breast cancer.

This was part of a study of more than 70,000 postmenopausal women from throughout the United States, the Women’s Health Initiative. Women provided information about their health and other related factors and then those women were followed to see who developed certain diseases.

We found that women who had been told that they had periodontal disease were more likely to develop breast cancer. In particular, women who were former smokers (quit within the last 20 years) and who had periodontal disease were at increased breast cancer risk. There was a similar increase in risk for current smokers with periodontal disease but it was not statistically significant. (There was a relatively small number of current smokers in the WHI study.)

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Secondhand Smoke Exposure Doubles Risk of Cavities in Children

Dental Cavity Wikipedia

Dental Cavity
Wikipedia

MedicalResearch.com Interview with:
Koji Kawakami, MD, PhD
Professor and Chair, Department of Pharmacoepidemiology and Clinical Research Management
Graduate School of Medicine and Public Health
Director, Science for Innovation Policy Unit, Center for Promotion of Interdisciplinary Education and Research
Kyoto University Kyoto city
Kyoto Japan

Medical Research: What is the background for this study? What are the main findings?

Dr. Kawakami: The prevalence of caries in deciduous teeth in developed countries remains high, while established measures for caries prevention in young children is limited to sugar restriction, oral fluoride supplementation and fluoride varnish. In this study of 76920 children in Japan, exposure to tobacco smoke at 4 months of age, which was experienced by half of all children of that age, was associated with an increased risk of caries in deciduous teeth by approximately 2-fold.

Medical Research: What should clinicians and patients take away from your report?

Dr. Kawakami: Our findings would support extending public health and clinical interventions to reduce secondhand smoke. For example, the chance of education on the harm of secondhand smoke would increase if dentists become aware of the caries risk due to secondhand smoke as well as tobacco smoking of their patients.

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Periodontal Disease Increases Inflammation and Cardiovascular Disease Risk

Boxi Zhang  PhD Student  School of Health and Medical Sciences Örebro University  MedicalResearch.com Interview with:
Boxi Zhang  PhD Student 
School of Health and Medical Sciences
Örebro University  

Medical Research: What is the background for this study? What are the main findings?

Response: In the past decade, many studies raise concerns about the increased prevalence of cardiovascular disease and mortality among patients with periodontitis. Porphyromonas gingivalis is the major pathogen causing periodontal disease. This bacterium also plays a significant role in the pathogenesis of atherosclerosis. In this study, we infect human aortic smooth cells with P. gingivalis and show that this periodontal pathogen affects gene and protein expression in human aortic smooth muscle cells associated with increased inflammation and atherosclerosis.

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Wild Blueberry Polyphenols May Help Fight Periodontal Disease

Daniel Grenier, Ph.D. Professeur titulaire Oral Ecology Research Group, Faculty of Dentistry, and Institute of Nutrition and Functional Foods, Université Laval Quebec City, QC, Canada

MedicalResearch.com Interview with:
Daniel Grenier, Ph.D.

Professeur titulaire
Oral Ecology Research Group, Faculty of Dentistry, and  Institute of Nutrition and Functional Foods, Université Laval
Quebec City, QC, Canada

Medical Research: What is the background for this study?
Dr. Grenier: Periodontal diseases (gingivitis and periodontitis) are major public health problems because of their high prevalence and incidence in all regions of the world. According to epidemiological studies, approximately 5% of North Americans suffer from severe generalized periodontitis, which can lead to tooth loss, while mild to moderate periodontitis affects up to 35% of adults. Given emerging data indicating that there is a relationship between periodontal diseases and systemic health problems such as diabetes, cardiovascular diseases, and preterm birth, studies on preventive and therapeutic strategies targeting periodontal diseases are highly relevant.

Medical Research: What are the main findings?

Dr. Grenier: Using various in vitro models, we brought clear evidence that a blueberry extract enriched in proanthocyanidins can act on the two etiological components of periodontal disease. We first showed that these polyphenols inhibit the growth of Fusobacterium nucleatum as well as its ability to form a biofilm, which can provide to the bacterium a resistance to antimicrobial agents and immune cells. Interestingly, F. nucleatum has been associated with various forms of periodontitis as well as to a number of extra-oral infections, including endocarditis, inflammatory bowel disease, and brain abscesses. Moreover, the blueberry extract attenuated the inflammatory response of human macrophages challenged with F. nucleatum, resulting in a decreased secretion of inflammatory cytokines (IL-1β, IL-6, TNF-α) and tissue destructive enzymes (MMP-8, MMP-9). Evidence was brought that this property is likely related to the ability of the blueberry polyphenols to block the activation of the NF-κB signaling pathway that play a key role in inflammatory reactions.

Over the last decade, my laboratory has been investigating the potential benefits of various classes of polyphenols for oral health. Polyphenols are a large group of natural substances found in plants and characterized by the presence of more than one phenol unit per molecule. Given that wild blueberries (Vaccinium angustifolium Ait), a popular berry fruit in Quebec, are particularly rich in a specific class of polyphenols, called proanthocyanidins, we tested their effect on the two major etiological factors involved in the pathogenesis of periodontitis: a limited group of Gram negative anaerobic bacteria, and an uncontrolled host immune response to these pathogens that results in the secretion of high amounts of inflammatory mediators which modulate the progression and severity of periodontitis.

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Some Periodontal Bacteria May Be Cancer-Promoting

Xiaodan Mai MBBS University at Buffalo, The State University of New York Buffalo, NYMedicalResearch.com Interview with:
Xiaodan Mai MBBS
University at Buffalo, The State University of New York
Buffalo, NY

MedicalResearch: What is the background for this study? What are the main findings?

Response: Periodontal disease is a condition that is highly prevalent amongst the elderly, and is characterized by chronic polymicrobial infection and inflammation of gum tissue. Periodontal disease has been associated with increased cancer risk, and these findings may be partially explained by extra-oral translocation of subgingival bacteria that subsequently modulates host cell environment and function. However, there is limited research on whether the presence of certain subgingival bacteria influences cancer risk. .

Oral bacteria have been categorized into color-coded complexes by their timing of colonization and strength of association with periodontal disease. Using data from an ancillary study of the Women’s Health Initiative conducted in Buffalo, New York (a cohort of 1300 postmenopausal women), we therefore investigated the associations between the presence of three early-colonizing periodontal pathogens (Fusobacterium nucleatum, Prevotella intermedia, and Campylobacter rectus, i.e., “orange complex” bacteria moderately associated with PD), the presence of two late-colonizing periodontal pathogens (Porphyromonas gingivalis, Tannerella forsythia, i.e., “red complex” bacteria strongly associated with PD) in dental plaque and cancer risk. We found borderline associations between presence of any early-colonizing pathogens and increased risk of total cancer and lung cancer. Individual pathogens were not associated with total cancer or site-specific cancers when analyzed singly. Presence of any pathogens or presence of any late-colonizing pathogens was not associated with total or site-specific cancer.

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Oral Health Often Overlooked By Health Care Practitioners

Judith Haber, PhD, APRN, BC, FAAN Associate Dean, Graduate Programs The Ursula Springer Leadership Professor in Nursing New York, NY 10003MedicalResearch.com Interview with:
Judith Haber, PhD, APRN, BC, FAAN
Associate Dean, Graduate Programs
The Ursula Springer Leadership Professor in Nursing
New York, NY 10003

Medical Research: What is the background for this study? What are the main findings?

Dr. Haber: The background of the project originally aligns with publication of the Surgeon General’s Report (2000), challenging health providers to think about the “mouth as a window to the body”.  More recent Institute of Medicine (IOM) reports, Advancing Oral Health in America (2011) and Improving Access to Oral Health Care for Vulnerable and Underserved Populations (2011) highlighted the extant problems with oral health access, oral health disparities and outcomes and the potential role of the primary care workforce in addressing this population health issue.  However, there is a dearth of curricular focus on oral health in the curriculum of health professionals.  The IOM challenged the Health Resource and Service Administration (HRSA) to convene an Expert Panel to develop interprofessional oral health core clinical (IPOHCC) competencies; the report, Integrating Oral Health and Primary Care Practice, delineating the IPOHCC competencies, was published in 2014.   Our HRSA funded initiative, Teaching Oral-Systemic Health (TOSH), focuses on building interprofessional oral health workforce capacity with a special focus on the nursing, medical and dental professions.  We have operationalized the IPOHCC competencies by transforming the HEENT component of the health history, physical exam, risk assessment, diagnosis, and management plan, including collaboration and referral, to the HEENOT approach.  When a health professional uses the HEENOT approach, he or she cannot forget about oral health.

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Despite Claims, Xylitol May Not Help Prevent Tooth Decay

Xylitol Wikipedia

Xylitol
Wikipedia

MedicalResearch.com Interview with:
Philip Riley
Cochrane Oral Health Group, School of Dentistry
The University of Manchester
Manchester, UK

Medical Research: What is the background for this study? What are the main findings?

Response: As tooth decay is still so prevalent worldwide, despite being entirely preventable, it is worth assessing the evidence for other adjunctive ways for the public to help prevent the disease. Manufacturers of xylitol products commonly make the claim that this natural sweetener prevents tooth decay, and we felt that the public deserved to know if the best quality evidence backs up such claims.

We found that there was a lack of evidence from randomised controlled trials (the best type of study design for testing the effects of interventions) to prove that xylitol products can prevent tooth decay. We found some low quality evidence suggesting that xylitol added to fluoride toothpaste may reduce tooth decay in children’s permanent teeth by 13% over a 3 year period when compared to fluoride toothpaste without xylitol. However, these findings should be interpreted with caution and may or may not be generalizable to other populations. There was insufficient evidence to conclude that xylitol in chewing gums, lozenges, candies/sweets, syrups and wipes can prevent tooth decay in children or adults

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Tooth Enamel Defects May Reflect Perinatal Exposure to Bisphenol A

Sylvie Babajko, PhD Centre de Recherche des Cordeliers Inserm UMR_S 1138 Laboratoire de Physiopathologie Orale Moléculaire 75006 Paris cedex 06MedicalResearch.com Interview with:
Sylvie Babajko, PhD
Centre de Recherche des Cordeliers
Inserm UMR_S 1138
Laboratoire de Physiopathologie Orale Moléculaire
75006 Paris cedex 06

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Babajko: The environment has become increasingly contaminated by various pollutants. This has led to an increase in the incidence and gravity of known pathologies and/or the emergence of new pathologies. In 2001, a distinct enamel pathology called molar incisor hypomineralization (MIH) was described. It is diagnosed by white to brown creamy lesions affecting permanent first molars and frequently permanent incisors too. These teeth are sensitive and susceptible to caries. MIH prevalence turns around 15-18 % of 6 to 9 years-old children in studied populations all over the world. To date, MIH etiology remains unclear. However, given that MIH affects those teeth that are undergoing mineralization around the time of birth, MIH is indicative of some adverse event(s) occurring during early childhood that impact on enamel development. Interestingly, susceptibility to BPA in human is the highest during the same period of time.

Our experimental data (1, 2) showed that BPA may be a causal agent of MIH and that BPA irreversibly impacts amelogenesis via steroid hormone pathway. Continue reading

Periodontitis Linked To Larger Myocardial Infarct Size

Dr. Francisco Mesa Department of Periodontics, School of Dentistry, University of Granada, Spain

MedicalResearch.com Interview with:
Dr. Francisco Mesa
Department of Periodontics,
School of Dentistry, University of Granada, Spain



Medical Research: What is the background for this study? What are the main findings?

Dr. Mesa: The size of an acute myocardial infarct (AMI) is one of the determinants of its severity, i.e., the degree of myocardial necrosis. This necrosis is indicated by peak troponin I levels in the blood. Among the acute myocardial infarct patients in our study, mediated regression analysis demonstrated that troponin I levels were higher, i.e., the infarct size was larger, in those with chronic periodontitis.

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Does Dental Trauma Play A Role in Oral Cavity Cancer?

MedicalResearch.com Interview with:
Brendan J. Perry, BSc, MBBS
Princess Alexandra Hospital
Brisbane, Queensland, Australia

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Brendan J. Perry: Oral cavity cancer is usually attributed to the “Five S’s” – smoking, spirits (alcohol), spices, syphillis and sharp (or septic) teeth. Cigarettes and alcohol are the most important recognised factors. Spices, such as betel nut, and syphillis are known carcinogens but are not commonly seen in western practice. The role of chronic dental trauma on the mucosa of the mouth to cause cancer has only been examined in a limited number of studies previously and its importance has not been elucidated and has never really affected clinical practice.

This retrospective review examined the position in the oral cavity where cancers occurred with respects to smoking status and other variables over a 10 year period in a major Australian hospital. The edge of the tongue, a site of potential dental trauma, was the most common site affected, accounting for 35% of oral cavity cancers in smokers. However, in lifelong non-smokers without other significant risk factors, 65% of cancers occurred on the edge of the tongue. A significant number also occurred on the buccal mucosa (inner lining of cheek) which is also exposed to dental trauma, but to a much lesser degree than the more mobile tongue. The floor of the mouth and the alveolar ridge (gums) were also common sites of cancer, but tended to occur in an older age group. This is possibly due to irritation caused by the movement of dentures in this age group against these areas of the mouth.

We also found that males had an equal chance of developing oral cavity versus oropharyngeal cancer (255 cases vs 265). However, females are almost twice as likely to develop an oral cavity cancer than an oropharyngeal cancer (135 cases vs 69), and this ratio jumps to 4 times the risk for lifelong non-smoking females (53 vs 12). Although a lot of attention has been given to HPV in causing oropharyngeal cancer, for non-smokers, especially females, it appears that oral cavity cancer is a more common disease, and also that chronic dental trauma may be a significant contributing factor.
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Dietary Sugar Increases Dental Decay Even With Fluoride Use

Professor Aubrey Sheiham Emeritus Professor of Dental Public Health Department of Epidemiology & Public Health, University College London, WC1E 6BT. UK.MedicalResearch.com Interview with:
Professor Aubrey Sheiham
Emeritus Professor of Dental Public Health
Department of Epidemiology & Public Health,
University College London, WC1E 6BT. UK.


Medical Research: What are the main findings of the study?

Prof Sheiham: There is a robust log-linear relationship of caries to sugar intakes from zero to 10% of sugars as a proportion of total energy intake. Furthermore our analyses showed that sugar intakes of 10%E sugars intake that is currently recommended as an upper limit for free sugars by the WHO and the Scientific Advisory Committee on Nutrition in England would induce a very costly burden of caries in most populations. Second, we found that free sugars* in the diet should make up no more than 3% of total energy intake. Above that level they cause a significant level of tooth decay across the lifecourse of most people in the developed world. Third, we were able to show that despite widescale fluoride use from both toothpastes and drinking water the mean numbers of decayed, missing and filled teeth (DMFT) and decayed and filled surfaces (DFS) for adults increased with sugar use despite the presence of fluoride.

*Free sugars are defined by the World Health Organisation Nutrition Guidance Adivisory Group as follows: “Free sugars include monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit concentrates.” Continue reading

SSRIs May Increase Risk Of Dental Implants Failure

Faleh Tamimi, BDS, PhD Assistant Professor, Faculty of Dentistry Strathcona Anatomy & Dent, Montreal, Quebec CanadaMedicalResearch.com Interview with:
Faleh Tamimi, BDS, PhD
Assistant Professor,
Faculty of Dentistry
Strathcona Anatomy & Dent,
Montreal, Quebec Canada

Medical Research: What are the main findings of the study?

Dr. Tamimi: The main finding was that SSRIs usage was associated with an increased risk of dental implants failure.
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Power Toothbrushes Can Harbor Surprising Number Of Bacteria

Donna Warren Morris, RDH, Med Professor, Dean's Academy of Distinguished Teaching Scholars Houston, TX 77054  MedicalResearch.com Interview with: 
Donna Warren Morris, RDH, Med
Professor, Dean’s Academy of Distinguished Teaching Scholars
Houston, TX 77054

Medical Research: What are the main findings of the study?

Answer: Power toothbrushes can harbor microorganisms that have been shown to cause disease and infections. A solid-head design was found to have less growth of microorganisms than two others with hollow head designs.
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Tooth Loss Associated with Risk Factors for Coronary Heart Disease

Dr Ola Vedin University of Uppsala, SwedenMedicalResearch.com Interview with:
Dr Ola Vedin
University of Uppsala, Sweden

 

MedicalResearch.com: What are the main findings of the study?

Dr. Vedin: That self-reported tooth loss as a marker of periodontal disease is common in patients with established coronary heart disease and is associated with higher levels of LDL cholesterol, glucose levels, systolic blood pressure and waist circumference as well as diabetes and smoking, i.e. risk factors for coronary heart disease. Gum bleeding, another marker of periodontal disease, was associated with higher levels of LDL cholesterol and systolic blood pressure. In summary, patients with few remaining teeth and gum bleeding demonstrated a heavier burden of cardiovascular risk factors.

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Periodontitis: New Classification Based on Gene Expression

Dr. Panos N. Papapanou: Professor of Dental Medicine; Chairman, Section of Oral and Diagnostic Sciences Director, Division of Periodontics Section of Oral and Diagnostic Sciences, College of Dental Medicine, Columbia University, New York, NY, USAMedicalResearch.com Interview with:
Dr. Panos N. Papapanou:
Professor of Dental Medicine;
Chairman, Section of Oral and Diagnostic Sciences
Director, Division of Periodontics Section of Oral and Diagnostic Sciences,
College of Dental Medicine, Columbia University, New York, NY

MedicalResearch.com: What are the main findings of the study?

Dr. Papapanou: Gene expression signatures in gum tissues obtained from patients with periodontitis identified two fairly robust clusters, suggesting potential differences in pathobiologic processes between the two groups. In addition, the two clusters displayed differences in important features of the disease (e.g., the extent and severity of periodontitis, and the level of colonization by periodontal bacteria). These findings indicate that gene expression patterns may form the basis for a novel, pathobiology-based classification of periodontitis.

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Should Dental Extractions Be Done Prior to Heart Surgery?

Dr. Kendra J. Grim Department of Anesthesiology Mayo Clinic, Rochester, MN 55905MedicalResearch.com Interview with:
Dr. Kendra J. Grim
Department of Anesthesiology
Mayo Clinic, Rochester, MN 55905


MedicalResearch.com
: What are the main findings of the study?

Dr. Grim: “The current guidelines say that if possible, treating the dental problems that patients have before heart surgery is best, to try to prevent both early and late heart infections. But the data is very unclear, because it’s very difficult to study. We found in our study that their risk of serious complications after having teeth removed may be higher than we thought. We were primarily looking at stroke, heart attack, renal failure and death. We found that actually the incidence of having one of those major morbidities was 8 percent.  Of that 8 percent, we had six patients, or 3 percent, of the total group who died between their dental surgery and scheduled heart surgery, so these patients never made it to their heart surgery. An additional 3 percent of patients died after heart surgery. “

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Oral Health and Diabetes: Effects of Health Coaching

ayse_basak_cinarMedicalResearch.com Interview with:
Ayse Basak Cinar, Assistant Professor
The Department of Odontology
The Faculty of Medical and Health Resources
2200 Copenhagen N Denmark

MedicalResearch.com:  What are some of the unique or enlightening findings of this study that haven’t been published before?

Answer:  To our knowledge, this is the first randomized controlled intervention study comparing the impact of individualized Health Coaching (HC) to formal Health Education (HE); applying HC as a holistic intervention for management of more than one specific type of chronic disease, namely oral health and diabetes management.

The present study has two phases [the Turkish Phase, Turkey (2010-2012) and the Danish Phase, Denmark (2012- …)]. The unique/enlightening figures from the Turkish phase as follows:

The HC group compared to the HE group had significantly higher improvement at;

HbA1c* (reduction: 0, 8% vs. 0%), and Periodontal Attachment Loss (PAL) (56% vs. 26%), (p≤0.01)

Tooth Brushing Self-Efficacy (TBSE) (increase: 61% vs.25%) and stress (reduction: 16% vs. 1%), (p≤0.01).
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Dental Caries and Head and Neck Cancer

Mine Tezal, DDS, PhD Oral Biology University at Buffalo NYS Center of Excellence in Bioinformatics and Life SciencesMedicalResearch.com Interview with:
Mine Tezal, DDS, PhD
Oral Biology
University at Buffalo
NYS Center of Excellence in Bioinformatics and Life Sciences


MedicalResearch.com: What are the main findings of the study?  

Dr. Tezal: We observed an inverse association between dental caries and head and neck cancer (HNSCC), which persisted among never smokers and never drinkers. Besides untreated caries, two other objective measures of long-standing caries history (endodontic treatments and crowns) were also inversely associated with HNSCC with similar effect sizes, supporting the validity of the association.  Missing teeth was associated with increased risk of HNSCC in univariate analyses, but after adjustment for potential confounders, its effect was attenuated and was no longer statistically significant.

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