Tongue and Lip Piercings Can Aggravate Periodontal Disease

MedicalResearch.com Interview with:
“Tongue Ring!” by ethan lindsey is licensed under CC BY 2.0Prof. Dr. med. dent. Clemens Walter

Deputy Clinical Director & Director Postgraduate Program in Periodontology (SSP/BZW)
Board Certified Periodontist (D, CH)
Department of Periodontology, Endodontology and Cariology
University Center for Dental Medicine (UZB)

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

Response: For periodontal diseases we have some important risk factors – such as tobacco use or insufficient oral hygiene. However, in some cases these factors do not explain the disease in a given patient. Therefore there is an ongoing need to analyse the pattern of periodontal destruction in each individual. Some years ago, a young female patient presenting an unusually severe periodontal destruction was referred to our department. The patient was periodontally healthy with the exception of the lower incisor teeth. We could not identify any known risk factors. The patient had a tongue piercing.

MedicalResearch.com: What kind of treatment was performed? 

Response: Non-surgical and advanced surgical treatment was performed and was not successful. The young female patient lost teeth. Since then, I have been curious about this association and started to collect cases.

MedicalResearch.com: What are the main findings of your research presented at Europerio9 in Amsterdam?

Response: We presented a poster on a retrospective study. We found an association between oral piercings and increased periodontal inflammation, as evident by increased bleeding on probing and increased probing depth and/or attachment loss.

The closer teeth were to a tongue piercing, the more affected they were.

MedicalResearch.com: Would you like to explain your study?

Response: For this study, 18 patients (14 female) with a tongue and/or lip piercing from our database of more than 1400 patients treated in our service were included. The mean age of this population was 28,3 + 7.7 years. Three out of 18 patients wore both, i.e. a total of 14 tongue piercings and 7 lip piercings were assessed. Clinical parameters and the maximum wearing time of the lip and/or tongue piercing were recorded. Periodontal findings in teeth close to the piercing were compared to teeth not affected by the piercing. 

MedicalResearch.com: Why you choose to perform retrospective study?

Response: Due to ethical considerations, it seems impossible to conduct a prospective study. Therefore the suitable design to answer our question was a retrospective study/ case series 

MedicalResearch.com: What should readers take away from your report?

Response: Oral piercings have a negative impact on periodontal and dental health.

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

Response: We now try to create awareness about the consequences of piercings for oral health and we counsel our patients to remove piercings in order to decrease the risk for dental and periodontal complications. 

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

Response: Yes, our study started as research project, performed by undergraduate students. We are happy to see, that a discussion on oral piercings and its negative effects is now initiated by this project. 

Citation:

EuroPerio9 Abstract 409 –
Calderaro S, Schmidt JC, Weiger R, Walter C
A retrospective study on the association between oral piercings and clinical signs of periodontal inflammation

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Minerals in Baby Teeth Predictive of Autism Spectrum Disorder

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.

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Sugar-Sweetened Beverages During Adolescence Linked To Dental Cavities

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.

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Wine Might Be Good For Dental Health

MedicalResearch.com Interview with:
“Wine” by Uncalno Tekno is licensed under CC BY 2.0
M.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.  Continue reading

Scientists Develop Self-Healing Dental Enamel By Mimicking Epidermal Layers

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.  Continue reading

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

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.

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