Author Interviews, Dental Research, JAMA, OBGYNE, Pediatrics, Vitamin D / 06.08.2019

MedicalResearch.com Interview with: Hans Bisgaard, DMSc, MD Head of COPSAC, Professor Professor of Pediatrics, University of Copenhagen Founder and Head of the Copenhagen Prospective Studies on Asthma in Childhood; Gentofte Hospital, University of Copenhagen and Naestved Hospital MedicalResearch.com: What is the background for this study? Response: Enamel defects is a global health challenges affecting typically 1/3 of school children and more in some regions. It leads to break down of the teeth and caries later on. MedicalResearch.com: What are the main findings? Response: Supplementation with high-dose vitamin D compared to standard dose in the third pregnancy trimester in a mother child cohort of 588 pairs lead to a significant reduction of enamel defects. Enamel defects was found in 28% of children by age 6 after standard dose of vitamin D supplementation (400 i.u.), compared to 15% after 7-fold higher dose vitamin D. 
Author Interviews, Cancer Research, Dental Research, Opiods / 23.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50367" align="alignleft" width="200"]Praveen Arany, DDS, PhD Department of Oral Biology School of Dental Medicine University of Buffalo Dr. Arany[/caption] Praveen Arany, DDS, PhD Department of Oral Biology School of Dental Medicine University of Buffalo MedicalResearch.com: What is the background for this study? How is the light treatment delivered? Response: Cancers are usually treated with chemotherapy and/or radiation to destroy the tumor cells. However, an unfortunate side-effect of these treatments is pain and ulcers in the mouth due to breakdown of normal protective responses. Light has various applications in human health and normal physiology. Two good examples are vision and sunlight-Vitamin D for bone and health. The use of low dose light to alleviate pain or inflammation and promote tissue healing is termed Photobiomodulation (PBM) Therapy. This treatment can be provided with lasers or LED devices at specific wavelength (color) and dose (power). This treatment is currently being provided by a health care provider - usually a laser - either nurse or dentist prior or during the cancer treatments. There are several exciting innovation where take-home, self-use devices are becoming available.
Author Interviews, Dental Research, Opiods, Pain Research / 05.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50123" align="alignleft" width="200"]Dr. Stuart Lieblich, DMD Oral and maxillofacial surgeon  Avon, CT Dr. Lieblich[/caption] Dr. Stuart Lieblich, DMD Oral and maxillofacial surgeon  Avon, CT MedicalResearch.com: What is the background for this study? How does EXPAREL® differ from other pain medication for dental work or other short-term procedures? Response: This study analyzed the use of opioids and non-opioid options for postsurgical pain following third molar extraction (wisdom teeth removal). Our research team reviewed data from 600 patients who underwent third molar extraction, with 300 patients having received non-opioid option EXPAREL (bupivacaine liposome injectable suspension) and 300 patients that did not receive an infiltration of EXPAREL. The study aimed to show that reducing opioid prescriptions following this procedure may decrease opioid-related adverse events and the risk of opioid dependence.
Author Interviews, Dental Research, Stem Cells / 05.07.2019

MedicalResearch.com Interview with: [caption id="attachment_50108" align="alignleft" width="200"]Dr. Ivan V. Reva.jpeg Dr. Reva[/caption] Dr. Ivan V. Reva Senior Researcher, Laboratory of Cellular and Molecular Neurobiology School of Biomedicine, Far Eastern Federal University (FEFU)  MedicalResearch.com: What are the prerequisites for this study?  Response: The existence of congenital and acquired malformations of the teeth and jaws and the many shortcomings of artificial implants dictate the search for alternative methods of treatment of adentia. The prerequisites were the study of the development of the human gastrointestinal tract in the embryonic period, since it is during this period that all the most significant events occur in the structuring of all parts of the gastrointestinal tract, especially the oral cavity, the knowledge of which is necessary for developing a strategy for regenerative medicine. This is associated with obtaining ideas about cell-cell interactions for the cultivation of bioengineering structures of various sections of the gastrointestinal tract, including jaws and teeth. growing-new-teethIt was noted that the differentiation of the structures of the developing jaws is ahead of other divisions. The presence of chromophobic spindle-shaped cells migrating in the direction of the tooth rudiments and their location in the region surrounding the enamel organ indicates intercellular interactions in the development of teeth in humans that differ from these processes in lower vertebrates. At the present stage, it is known that ectomesenchyme is involved in cell assemblies participating in the development of dentin.
Author Interviews, Dental Research / 02.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49434" align="alignleft" width="200"]Dr. Katie Suda, PharmD, M.S. Associate ProfessorCollege of PharmacyUniversity of Illinois at Chicago Dr. Suda[/caption] Dr. Katie Suda, PharmD, M.S.  Associate Professor College of Pharmacy University of Illinois at Chicago  MedicalResearch.com: What is the background for this study? Response: Dentists prescribe approximately 1 in every 10 antibiotics in the United States and are the top specialty prescriber. Dentists are the primary prescriber of clindamycin in the U.S., which is associated with a high risk of C. difficile infection (an overgrowth of bacteria in the GI tract that can cause a life-threatening infection). Clinical guidelines recommend that patients with specific cardiac conditions receive a dose of antibiotics prior to undergoing invasive dental procedures to prevent infective endocarditis (an infection of the heart values). Taking a dose of antibiotics prior to a dental visit is referred to as antibiotic prophylaxis. Starting in 2007, these guidelines were narrowed secondary to poor evidence on the effectiveness of antibiotic prophylaxis and the risk of antibiotic-related adverse events. Antibiotic adverse events include antibiotic resistance, C. difficile infection, and other general adverse events (nausea, vomiting, diarrhea). While significant research has been conducted on unnecessary prescribing of antibiotics by medical providers, little work has described appropriateness of prescribing by dentists. We assessed if antibiotics prescribed for prophylaxis prior to dental procedures were consistent with clinical guidelines.
Author Interviews, Dental Research, Opiods, Pain Research / 23.05.2019

MedicalResearch.com Interview with: Dr. Katie Suda, PharmD, M.S. Associate Professor College of Pharmacy University of Illinois at Chicago Dr. Susan Rowan, DDS Clinical Associate Professor, Executive Associate Dean of Clinical Affairs College of Dentistry University of Illinois at Chicago,  MedicalResearch.com: What is the background for this study?  Dr. Katie Suda: Dentists treat a lot of pain – we have all probably had the experience of a terrible tooth ache. All dentists treat pain worldwide so we would not expect a large difference in which pain medication is prescribed. However, our results show that US dentists prescribe opioids more frequently than is likely needed. This is especially true because studies have shown that non-opioid pain medications are similar or more effective for the treatment of oral pain. 
Author Interviews, Dental Research, Genetic Research / 28.04.2019

MedicalResearch.com Interview with: [caption id="attachment_48895" align="alignleft" width="200"]Katrina Scurrah MDMelbourne School of Population and Global Health Dr. Scurrah[/caption] Katrina Scurrah PhD Senior Research Fellow (Biostatistician), Twins Research Australia, and Melbourne School of Population and Global Health, The University of Melbourne and Honorary Fellow, Murdoch Childrens Research Institute. MedicalResearch.com: What is the background for this study? Response: Oral health is an important component of general health and yet dental caries (decay) is still common in children (affecting up to one in three 5-6 year old children in Australia). Although we know that some genetic and lifestyle factors (such as diet) are important risk factors for caries, the relative importance of these is still unclear.  Risk factors from pregnancy and very early childhood (even before teeth appear) might also be important. This study is the first to include prospectively measured data on health and well-being from pregnancy, birth and early childhood in a study of twin children. We analysed data from a cohort of 172 pairs of twin children to assess the effects of genes and environment on susceptibility to dental caries at six years-of-age.
AACR, Author Interviews, Cancer Research, Dental Research, Pancreatic, Race/Ethnic Diversity / 28.03.2019

MedicalResearch.com Interview with: [caption id="attachment_48243" align="alignleft" width="189"]Dr. Julie Palmer Dr. Palmer[/caption] Julie R. Palmer, ScD Professor, Boston University School of Medicine Associate Director, Slone Epidemiology Center at Boston University Boston, MA 02118  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Since 1995, 59,000 African American women from all regions of the U.S. have participated in a Boston University research study of the health of Black women.  Study participants complete mailed or online questionnaires every two years. Our major goal is to identify modifiable risk factors for cancers and nonmalignant conditions that disproportionately affect African Americans (e.g., pancreatic cancer, early-onset breast cancer, type 2 diabetes, uterine fibroids).  The reasons for the higher incidence of pancreatic cancer in African Americans relative to non-Hispanic White women in the U.S. are unknown. I was aware that several recent studies in predominantly White populations had observed a higher incidence of pancreatic cancer in those who had reported poor oral health and wondered whether the higher prevalence of poor oral health among African Americans could play a role in their higher incidence of pancreatic cancer.  We had already asked about gum disease, periodontal disease, and adult tooth loss in several rounds of data collection. After rigorous analysis, we found that women who reported any adult tooth loss had about two times the risk of future development of pancreatic cancer compared with those who had no tooth loss and had never reported periodontal disease. The estimated risk was even greater for those who had lost five or more teeth. A similar association was observed for reports of periodontal disease, but the association was not statistically significant.
Author Interviews, Dental Research, JAMA, Opiods, Pediatrics / 03.12.2018

MedicalResearch.com Interview with: [caption id="attachment_46275" align="alignleft" width="200"]Alan Schroeder MD Associate chief for research Division of pediatric hospital medicine Lucile Packard Children’s Hospital Stanford Dr. Schroeder[/caption] Alan Schroeder MD Associate Chief for Research Division of pediatric hospital medicine Lucile Packard Children’s Hospital Stanford MedicalResearch.com: What is the background for this study? What are the main findings? Response: Third molar “wisdom teeth” extractions are one of the most common surgeries performed in adolescents and young adults, but an adequate appraisal of risks and benefits is lacking. Most patients who undergo this procedure are exposed to opioids post-operatively. We demonstrate that, for privately-insured opioid-naïve patients 16-25 years of age, exposure to opioids from a dental provider is associated with persistent use at 90-365 days in 7% of patients and a subsequent diagnosis relating to abuse in 6% of patients. In contrast persistent use and abuse were significantly lower in control patients not exposed to dental opioids (0.1% and 0.4%, respectively). The median number of pills dispensed for the initial prescriptions was 20.
Author Interviews, Dental Research, Heart Disease, Infections / 05.11.2018

MedicalResearch.com Interview with: [caption id="attachment_45675" align="alignleft" width="169"]Martin H. Thornhill MBBS, BDS, PhD, MSc, FDSRCS(Edin), FDSRCSI, FDSRCS(Eng) Professor of Translational Research in Dentistry Academic Unit of Oral & Maxillofacial Medicine Surgery & Pathology, University of Sheffield School of Clinical Dentistry  Prof. Thornhill[/caption] Martin H. Thornhill MBBS, BDS, PhD, MSc, FDSRCS(Edin), FDSRCSI, FDSRCS(Eng) Professor of Translational Research in Dentistry Academic Unit of Oral & Maxillofacial Medicine Surgery & Pathology, University of Sheffield School of Clinical Dentistry  MedicalResearch.com: What is the background for this study?   Response: Infective endocarditis is an infection of the heart valves that has a high death rate (around 30% in the first year). It requires intensive treatment often involving replacement of affected heart valves and frequently results in serious long-term illness and disability in those who survive as well as an increased risk of re-infection and high healthcare costs. In ~40% of cases, bacteria from the mouth are implicated as the causal organism. Because of this, guideline committees around the world recommended that all those at risk of infective endocarditis should receive antibiotic prophylaxis before undergoing invasive dental procedures. Due to a lack of evidence for efficacy, however, guideline committees started to limit the use of antibiotic prophylaxis. And in 2007, the American Heart Association (AHA) guideline committee recommended that antibiotic prophylaxis should continue for those at high-risk but should cease for those at moderate risk of endocarditis. Most guideline countries around the world followed suite. Except in the UK, where the National Institute for Health and Care Excellence (NICE) recommended that the use of antibiotic prophylaxis should completely stop in 2008.
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Dental Research / 24.10.2018

MedicalResearch.com Interview with: "Still from "My Dental Hell(th)"" by littledropofpoison is licensed under CC BY 2.0Rita Del Pinto, MD University of L'Aquila Department of Life, Health and Environmental Sciences, L'Aquila - Italy  MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a wealth of literature in support of a role for inflammation behind cardiovascular risk factors and diseases. One relatively poorly explored field is that of oral diseases, namely periodontitis, as a potential source of low-grade, chronic inflammation. Previous studies had described a beneficial effect of periodontal treatment on blood pressure; we extended current knowledge with our findings on over 3600 treated hypertensive adults with and without periodontitis, showing a significant benefit over systolic blood pressure behavior and control in the presence of a good periodontal health. 
Author Interviews, Dental Research, JAMA, Opiods / 09.08.2018

MedicalResearch.com Interview with: [caption id="attachment_43721" align="alignleft" width="144"]Calista Harbaugh, MD House Officer, General Surgery Clinician Scholar, National Clinician Scholars Program Research Fellow, Michigan Opioid Prescribing Engagement Network University of Michigan Dr. Harbaugh[/caption] Calista Harbaugh, MD House Officer, General Surgery Clinician Scholar, National Clinician Scholars Program Research Fellow, Michigan Opioid Prescribing Engagement Network University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Wisdom tooth extractions is one of the most common procedures among teens and young adults, with more than 3.5 million young people having wisdom teeth pulled every year. This procedure is commonly paired with a prescription for opioid pain medication. As the opioid epidemic sweeps the nation, we must pay attention to the long term effects of opioid prescribing for even routine procedures. This is particularly important for wisdom tooth extraction where there is evidence that opioid pain medications may be no more effective than anti-inflammatories alone. Using commercial insurance claims, we evaluated the association between receiving an opioid prescription with wisdom tooth extraction and developing new persistent opioid use in the year after the procedure. We found nearly a 3-fold increase in odds of persistent opioid use, attributable to whether or not an opioid was prescribed. This translates to nearly 50,000 young people developing new persistent opioid use each year from routine opioid prescribing for wisdom tooth extraction.
Author Interviews, Autism, Dental Research, Mineral Metabolism, Pediatrics / 31.05.2018

MedicalResearch.com Interview with: “baby teeth” by Thomas Ricker is licensed under CC BY 2.0Christine Austin PhD Department of Environmental Medicine and Public Health Icahn School of Medicine at Mount Sinai New York, NY 10029 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown that some metals (nutrients and toxicants) are absorbed and metabolized differently in children with autism spectrum disorder compared to neuro-typical children. However, it is not known when this dysregulation occurs and it is incredibly difficult to study prenatal metal metabolism. Teeth, which begin forming prenatally, grow by adding a new layer every day, much like the yearly growth rings in trees. Each layer formed captures many of the chemicals circulating in the body at the time. We have developed a method to measure metals in these layers to build a timeline of metal exposure during the prenatal and early childhood period. We found that the cycles of copper and zinc metabolism were disrupted in children with ASD and used this feature to develop a method to predict the emergence of autism spectrum disorder with 90% accuracy.
Author Interviews, Dental Research, Pain Research, University of Pittsburgh / 03.05.2018

MedicalResearch.com Interview with: “Dental Exam” by 807th Medical Command (Deployment Support) is licensed under CC BY 2.0Paul A. Moore, DMD, PhD, MPH School of Dental Medicine University of Pittsburgh  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Effective pain management is a priority in dental practice. Government and private agencies highlight the need to provide optimal pain relief, balancing potential benefits and harms of both opioid and nonopioid analgesic agents. The purpose of our study is to summarize the available evidence on the benefits and harms of analgesic agents, focusing on preexisting systematic reviews. We found combinations of ibuprofen and acetaminophen as having the highest association with treatment benefit in adult patients and the highest proportion of adult patients who experienced maximum pain relief. Diflunisal, acetaminophen, and oxycodone were found to have the longest duration of action in adult patients. Medication and medication combinations that included opioids were among those associated most frequently with acute adverse events in both child and adult-aged patient populations.
Author Interviews, Dental Research, Pediatrics, Sugar / 29.03.2018

MedicalResearch.com Interview with: “Caries” by COM SALUD Agencia de comunicación is licensed under CC BY 2.0Teresa A. Marshall, PhD Professor in the Department of Preventive and Community Dentistry University of Iowa College of Dentistry Iowa City MedicalResearch.com: What is the background for this study? Response: Dental caries is a process during which oral bacteria ferment carbohydrates to produce acid. The acid demineralizes enamel and/or dentin at the tooth surface leading to white spots and eventually cavitation in the tooth. Added sugars – those not naturally present in foods or beverages, but rather added during processing – are the primary type of carbohydrate associated with caries. Sugar-sweetened beverages (SSBs; beverages with added sugars) are the food/beverage category most associated with dental caries. Historically, fluoride has protected against caries through remineralization of the enamel. However, there has been some question as to whether fluoride’s ability to protect against caries is overwhelmed by the quantity of added sugars currently consumed. Oral hygiene behaviors – brushing and flossing – are thought protect against caries by disrupting the oral bacteria on the tooth. Most studies have investigated dietary factors and caries during early childhood, with less attention paid to caries during adolescence. Our objective was to identify associations between longitudinal beverage intakes and adolescent caries experience, while also considering fluoride intake and tooth brushing behaviors. We followed a group of children from birth through age 17 years; during this time period, we looked at their beverage intakes, fluoride intakes and brushing behaviors every 3-6 months. We calculated their average milk, 100% juice, SSB, water/water-based beverage and fluoride intakes from 6 months through 17 years, and daily tooth brushing from 1 through 17 years.
Alcohol, Author Interviews, Dental Research, Probiotics / 22.02.2018

MedicalResearch.com Interview with: “Wine” by Uncalno Tekno is licensed under CC BY 2.0M.Victoria Moreno-Arribas Spanish National Research Council | CSIC  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Recent discoveries indicate polyphenols might also promote health by actively interacting with bacteria in the gut. Also, the intake of specific polyphenol-rich beverages and foods helps the maintenance of digestive health and prevention of disease status. However, the knowledge of the effects of polyphenols in relation to the prevention of dental diseases is still at an early stage. The use of antiseptics and/or antibiotics in the prevention and treatment of periodontal diseases can lead to unwanted effects. Therefore, there is a need to develop novel antimicrobial strategies useful for the prevention and management of these diseases. Oral epithelial cells normally constitute a physical barrier that prevents infections, but bacterial adhesion to host tissues constitutes a first key step in the infectious process. With the final goal to elucidate the health properties of wine polyphenols at oral level, we studied their properties as an anti-adhesive therapy for periodontal and cariogenic prevention, as well as the combined action between wine polyphenols and oral probiotic strains in the management of microbial-derived oral diseases. In particular, we checked out the effect of two red wine polyphenols, as well as commercially available grape seed and red wine extracts, on bacteria that stick to teeth and gums and cause dental plaque, cavities and periodontal disease. Also, oral metabolism of polyphenols, including both oral microbiota and human mucosa cells, was investigated. 
Author Interviews, Dental Research, Technology / 02.02.2018

MedicalResearch.com Interview with: “chipped tooth” by bagaball is licensed under CC BY 2.0Dr. Ming Yang Key Laboratory of Microsystems and Microstructures Manufacturing, Harbin Institute of Technology, Harbin, China  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Self-healing materials and coatings are smart solutions to environmental and energy problems. There are heavy demands for these materials in many productions such as consumer electronics, the automotive industry and healthcare. Current coatings that can self-heal are typically soft. This means they are not as anti-scratch as rigid surfaces and the benefit of the ability to repair themselves could be overwhelmed by their limited robustness vulnerable to normal mechanical contact. It would be very useful to have a self-healing coating with a hardness that can be comparable or even outperform rigid coatings. This is normally difficult because mechanical hardness and self-healing are two conflicting properties with the opposite dependence on polymer dynamics. One good example in this context is many soft tissues can self-heal, but a notable exception is tooth enamel, which is the hardest part in our body but has no way to recover after decay. A new design will be needed to circumvent the fundamental limitation. We find that by mimicking the structure of epidermis, it is possible to combine two contradictory properties into an artificial coating, namely, self-healing ability and high hardness. The success relies on the placement of a hard layer containing graphene oxide on top of a soft sublayer with a seamless interface for interlayer diffusion. This allows a similar healing mechanism as that in skin, but the coating is not soft and has a hardness that even approaches tooth enamel. 
Author Interviews, Dental Research, Genetic Research / 07.11.2017

MedicalResearch.com Interview with: “Dental Mold_002” by Ano Lobb is licensed under CC BY 2.0Alexandre 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.
Author Interviews, C. difficile, CDC, Dental Research, Infections / 09.10.2017

MedicalResearch.com Interview with: [caption id="attachment_37324" align="alignleft" width="200"]Stacy Holzbauer, DVM, MPH, DACVPM CDC Career Epidemiology Field Officer (CEFO) Commander, USPHS Minnesota Department of Health St. Paul, MN Dr. Holzbauer[/caption] 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.
AACR, Author Interviews, Cancer Research, Dental Research, Menopause / 02.08.2017

MedicalResearch.com Interview with: [caption id="attachment_36194" align="alignleft" width="200"]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[/caption] 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.
Author Interviews, Dental Research, Microbiome, University of Pennsylvania / 14.07.2017

MedicalResearch.com Interview with: [caption id="attachment_35928" align="alignleft" width="140"]Dana T. Graves DDS Department of Periodontics School of Dental Medicine University of Pennsylvania Philadelphia, PA Dr. Graves[/caption] 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.
Author Interviews, Dental Research, Technology / 14.06.2017

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.
Author Interviews, Cannabis, Columbia, Dental Research / 26.05.2017

MedicalResearch.com Interview with: [caption id="attachment_34867" align="alignleft" width="150"]Jaffer A Shariff DDS MPH cert.DPH Periodontal Resident | Research Scientist Division of Periodontics, Columbia University College of Dental Medicine New York Dr. Shariff[/caption] 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.
Author Interviews, Dental Research, Heart Disease, Infections, Mayo Clinic / 24.05.2017

MedicalResearch.com Interview with: [caption id="attachment_34829" align="alignleft" width="150"]Daniel C. DeSimone, M.D.</strong> Infectious Diseases Fellowship, Year 2 Mayo Clinic Dr. DeSimone[/caption] 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.
Author Interviews, Dental Research, Heart Disease / 13.04.2017

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.
Author Interviews, Brigham & Women's - Harvard, Dental Research, Infections, Rheumatology, Science / 17.12.2016

MedicalResearch.com Interview with: [caption id="attachment_30609" align="alignleft" width="200"]Maximilian F. Konig, MD Department of Medicine Massachusetts General Hospital Harvard Medical School Dr. Maximilian F. Konig[/caption] 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.
Author Interviews, Dental Research / 07.11.2016

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.
Author Interviews, Dental Research, Infections / 27.10.2016

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 Fort Wayne Dentist might have to employ different strategies. 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.
Author Interviews, Dental Research / 15.10.2016

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.