Dental infections in kids tied to heart disease risk in adulthood

😷 Children who develop cavities and gum disease may be more likely to develop risk factors for heart attacks and strokes decades later than kids who have good oral health, according to a recent study conducted by JAMA Network Open.

Keep reading as Reuters discussed the complete findings of this study. The Woodview Oral Surgery Team

(Reuters Health) – Children who develop cavities and gum disease may be more likely to develop risk factors for heart attacks and strokes decades later than kids who have good oral health, a recent study suggests.

Researchers did dental exams for 755 children in 1980, when they were eight years old on average, then followed them through 2007 to see how many of them developed risk factors for heart attacks and strokes like high blood pressure, elevated cholesterol, high blood sugar, and hardening of the arteries.

Overall, just 33 kids, or 4.5 percent, had no signs of bleeding, cavities, fillings, or pockets around teeth that can signal gum disease. Almost six percent of the kids had one of these four signs of oral infections, while 17 percent had two signs, 38 percent had three signs, and 34 percent had all four signs.

Kids who had even one sign of oral infection were 87 percent more likely to develop what’s known as subclinical atherosclerosis: structural changes and thickening in the artery walls that aren’t yet serious enough to cause complications.

Children with all four signs of poor oral health were 95 percent more likely to develop this type of artery damage.

Oral infections are among the most common causes of inflammation-induced diseases worldwide, and periodontal disease in adults has long been linked to an increased risk of cardiovascular disease, researchers note in JAMA Network Open.

Most people get cavities and gum disease for the first time in childhood, and these conditions can develop into more serious infections and tooth loss if they aren’t properly treated, the study authors note. Treating these oral health problems in childhood can also reduce inflammation and other risk factors for hardening of the arteries.

“This emphasizes how important good oral hygiene and frequent check-ups with a dentist starting early in life are for general health,” said lead study author Pirkko Pussinen of the University of Helsinki in Finland.

“The children with a healthy mouth had a better cardiovascular risk profile (lower blood pressure, body mass index, glucose, and cholesterol) throughout the whole follow-up period,” Pussinen said by email.

More than four in five kids had cavities and fillings, and 68 percent of them also had bleeding during dental exams. Slight pocketing around the gums was observed in 54 percent of the kids, although it was more often found in boys than in girls.

Both cavities and pocketing that can signal gum disease were associated with thickening of walls of the carotid arteries, blood vessels in the neck that carry blood from the heart to the brain. This indicates the progression of atherosclerosis and an increased risk of heart attacks and strokes.

The study wasn’t a controlled experiment designed to prove whether or how cavities or other oral health problems might directly cause heart attacks or strokes. Not everyone with subclinical atherosclerosis or other risk factors will go on to have a heart attack or stroke.

Poor oral health in childhood was also associated with an increase in blood pressure and body mass index in early adulthood, noted co-author of an accompanying editorial Dr. Salim Virani of Baylor College of Medicine and the Michael E. DeBakey VA Medical Center in Houston.

“These could themselves be associated with poor heart health in adulthood,” Virani said by email. Systemic inflammation associated with poor oral health is also linked to heart disease and stroke, Virani added.

“Either the relationship shown in this study is causal or there are yet unmeasured confounders (risk factors) that are associated with both poor oral health as well as future risk of cardiovascular disease,” Virani said. “For example, could poor oral health be a marker of poor nutrition which itself is associated with cardiovascular disease, or could poor oral health be a marker of lower socioeconomic status which itself may be associated with a higher risk of cardiovascular disease in the future?”

Source: https://www.reuters.com/article/us-health-kids-mouth/dental-infections-in-kids-tied-to-heart-disease-risk-in-adulthood-idUSKCN1S62L6

Dentists without drills: Minimally invasive dentistry is on the rise

By: Katharine Gammon, USC News

😷 Are you afraid to go to the dentist or do you have phobia on dental drills? Well, not anymore!

Microdentistry is now part of the University of Southern California dental curriculum, and its focus on stopping cavities early and without drills can make a big difference for patients with dental anxiety. Learn more! The Woodview Oral Surgery Team

Ariella Glodowski could see on her X-rays that she had small caries lesions forming — even though they weren’t large, painful or even visible to the naked eye. The early detection gave the then-third-year dental student an opportunity to experience firsthand a minimally invasive dental procedure called resin infiltration, where early caries lesions are infused with resin rather than drilled and filled.

In December, she had the procedure, which she noted was nearly pain-free. “It was like a normal procedure except there was no drilling involved,” she said. “It was relaxing, to some extent, because there were no sharp objects involved, just some pressure.”

She was also relieved to know that she wasn’t losing any tooth structure to the drill. Often, when dentists complete traditional dental restorations they can end up removing healthy tooth tissue, which can result in more damage over time.

Minimally invasive dentistry: Leaving the drill behind

Resin infiltration is part of a growing trend in microdentistry, also known as minimally invasive dentistry, said Jin-Ho Phark, an associate professor of clinical dentistry at the Herman Ostrow School of Dentistry of USC and the dentist who performed Glodowski’s procedure.

“Patients tend to associate dentists with drilling, and they don’t like that,” he said. Plus, every time dentists complete a restoration, they have to drill away a little more of each tooth. Over time and multiple procedures, there is less and less healthy tooth structure to work with. “So,” he said, “we have been trying for a while to reduce the amount of drilling while still taking care of the disease.”

Caries and tooth decay can take a long time to develop. There might be many years before a patient feels any pain or physical evidence of a cavity due to caries, Phark explained. The trick to minimally invasive dentistry is to catch the decay before it becomes a big problem and stop it in the early stages.

“In the past, the standard was to wait until the lesion was big enough to be worthy to be drilled into,” Phark said. “With the new technique, we can stop the cavity early on and prevent it from breaking down and needing a filling at a later time.”

A dentist can use a special liquid resin to infuse into the lesions, which are porous. “We fill those pores with this resin,” Phark said. “It acts, in a way, like a sealant, and it’s a very preventive measure.”

Dentists have been using sealants to cover the grooves on chewing surfaces, and now they are using them to close up lesions developing between teeth. They apply the resin onto the tooth’s surface, and a network of pores within the enamel force the resin deep into the tooth. “After that, we harden the resin with blue light,” he said.

New in minimally invasive dentistry: silver diamine fluoride

In situations where the caries lesion has already progressed further and turned into a visible cavity, another minimally invasive dentistry technique gaining in popularity is the use of silver diamine fluoride. Though used internationally for years to stop caries progression, it has only recently been approved by the U.S. Food and Drug Administration for use in tooth sensitivity.

In its off-label usage, the antimicrobial, remineralizing compound is painted onto a tooth’s surface where cavitated lesions are visible, effectively halting any further caries cavitation. The method has been widely used in children or patients who might have a fear of the drill, Phark said. One negative side effect is that the compound can leave teeth blackened at the application site, which is why it has been widely adopted for children’s primary teeth, where it is only a temporary problem.

First in the nation? USC

USC is the first school to teach minimally invasive dental techniques on a large scale, already starting on the pre-clinical level. So far, these techniques have been offered only to patients in special clinics or advanced programs, such as advanced operative and adhesive dentistry. However, last fall Phark started teaching them to the first-year class in a new module called Cariology and Microdentistry. Once this class enters the clinic, they will be performing this kind of treatment on a regular basis.

Glodowski is excited to experience it firsthand and also to offer more drill-free options to her patients in the future as the technique becomes widely available. “Patients are going to be really happy that this is a possibility that works for them, especially if they have phobias about drilling,” she said. “It offers a more conservative approach, which is what we’re trying to strive for.”

Phark said resin infiltration, resin sealants, and silver diamine fluoride shouldn’t be expected to replace good oral hygiene and other healthy habits. Dental teams should start a larger conversation around health, which might even include having a nutritionist as part of the practice. “We are trying to be more and more preventive in the case of tooth decay and fight the causes of this disease, rather than patching up the consequences by drilling and filling,” he said.

The new cardiology curriculum is also paired with the implementation of new caries detection methods that use near-infrared, laser fluorescence and even the use of dental microscopes. This will help to detect and monitor such caries lesions more reliably.

The “death spiral of a tooth”

Part of what students learn is how to look at a patient’s history and ask questions to determine their risk of developing cavities. They also are trained to assess if patients have enough saliva, as saliva contains minerals that have a protective function for teeth.

There are very few downsides to the resin infiltration, though Phark said that some people don’t like the rubber dam that dentists have to place over the tooth to make sure there is no saliva and blood getting into the preparation. In addition, after the resin is placed, dentists can’t see it on an X-ray; they can still see the dark spot of the lesion, and they have to compare the size of the lesion to make sure the resin seal is working.

Still, the technique is far better than composite fillings, which last an average of five-to-seven years. “A young patient, a teenager, is going to live another 80 years,” Phark said. “You would replace that multiple times? And every time it gets bigger.”

He calls it the death spiral of a tooth: starting with a small filling, then a bigger filling and eventually a partial crown or a crown. “We are trying to stop this cycle that the tooth is going down from the beginning,” he said. “It’s especially important for adolescents.”

“This is a really exciting innovation,” said Glodowski, whose X-rays show the lesion isn’t growing under the resin. “I hope it will become more widely used in the future.”

Source: https://news.usc.edu/157157/minimally-invasive-dentistry-no-drilling/

Genetic make-up has little impact on dental health, a new study finds

By: University of Melbourne, Medical Xpress

📃 A new study has found genetic makeup does not predispose people to tooth decay, however, the research did find that children with overweight mothers are more likely to have cavities.

🤰 A research conducted by Murdoch Children’s Research Institute found a link between the mother’s health and lifestyle during pregnancy and the child’s future dental health, with obesity in pregnancy a definite marker for increased risk of child tooth decay. Learn more about this surprising news via Medical Xpress – Medical and Health News! The Woodview Oral Surgery Team

The paper, published in the latest edition of Pediatrics, estimates that one in three Australian children have tooth decay by the time they start school.

Lead researcher Dr. Mihiri Silva, from the Murdoch Children’s Research Institute, said the study looked at the teeth of 173 sets of twins (identical and non-identical) from pregnancy through to six years of age.

“How genetics impacts on dental health has not often been studied,” Dr. Silva said. “This is the first twin study that looks at both genetics and early life risk factors, such as illness and lifestyle.

“We found that identical twins, with identical genomes, have varying degrees of decay. This means that environmental factors, like a lack of fluoride in water, seem to be the prime cause of cavities not genetic makeup.”

However, Dr. Silva said the research did find a link between the mother’s health and lifestyle during pregnancy and the child’s future dental health, with obesity in pregnancy a definite marker for increased risk of child tooth decay.

“The relationship between maternal obesity and child tooth decay is complex,” Dr. Silva said. “Perhaps the mother’s weight has a biological influence on the developing fetus or perhaps the risk of decay rises because of increased sugar consumption in that household.”

One in three of the twins studied (32.2 per cent) had dental decay, and almost one in four (24.1 per cent) had advanced decay.

Dr. Silva said it was important that people don’t think of tooth decay as genetic.

“If people think the health of their teeth is down to their genetic make-up, they may not be prepared to make important lifestyle changes,” she said.

“Our findings also reinforce how important it is for pediatricians and other health professionals to educate children to start preventive measures early in life, prior to the onset of damage to dental tissues.”

Dr. Silva said tooth decay was a serious health problem, because there was a clear link between child cavities and developing diabetes and cardiovascular disease later in life.

“Tooth decay is also the leading cause of preventable hospital stays for Australian children,” Dr. Silva said.

According to 2011 Victorian Department of Health statistics, more than 26 000 Australians under the age of 15 are admitted to hospital to treat tooth decay every year.

Dr. Katrina Scurrah, from Twins Research Australia and the School of Population and Global Health at the University of Melbourne, said the study illustrated the advantages of studying twins to find out about health conditions and the importance of considering the effects of early life risk factors as well as genes.

But she said it’s important to try to replicate these findings in other studies that follow children through to adulthood and to explore other risk factors for dental decay.

This latest study in Pediatrics collected data about the twins at 24 and 36-weeks’ gestational age, at birth, 18 months and six years of age. This included a dental examination at age six.

Questionnaires about the mother’s weight, illnesses, medication use, vitamin D levels, stress, alcohol intake, and smoking were collected during pregnancy.

Source: https://medicalxpress.com/news/2019-04-genetic-make-up-impact-dental-health.html

Charcoal Kinds of Toothpaste ‘Don’t Whiten Teeth’

By: BBC News

⚠️ Charcoal-based toothpaste, which claims to whiten teeth, is a “marketing gimmick” which could increase the risk of tooth decay and staining, says a review in the British Dental Journal.

The charcoal products, which are increasingly popular, often contain no fluoride to help protect the teeth. And there is no scientific evidence to back up the claims they make, the authors say. Also, excessive brushing with them can do more harm than good. Instead, they advise people to go to their dentist for advice on bleaching, or whitening, their teeth. The Woodview Oral Surgery Team

And they say it is better to stick to using a regular fluoride-based toothpaste.

Charcoal was first used for oral hygiene purposes in ancient Greece, as a way of removing stains from teeth and disguising unpleasant odours from diseased gums.

Celebrity effect

Dr Joseph Greenwall-Cohen, co-author of the study from the University of Manchester Dental School, said “more and more shops are selling charcoal-based toothpastes and powders”, including Superdrug, Boots and Tesco, after celebrities had started talking about using them.

But he said the claims they made had been found to be unproven by a 2017 US review of 50 products.

Some said they were “anti-bacterial” or “anti-fungal”, that they helped with “tooth whitening” and would “reduce tooth decay”.

The review said people were brushing regularly with the charcoal-based products in the hope that they would offer “a low cost, quick-fix, tooth-whitening option”.

But too much brushing could lead to tooth wear and more sensitive teeth and, with few of the products containing fluoride or making the ingredient inactive, any protection from tooth decay was limited, it said.

‘Don’t believe the hype’

“When used too often in people with fillings, it can get into them and become difficult to get out,” Dr Greenwall-Cohen said.

“Charcoal particles can also get caught up in the gums and irritate them.”

He said charcoal toothpastes and powders were more abrasive than regular toothpastes, potentially posing a risk to the enamel and gums.

The charcoal contained in today’s toothpastes is usually a fine powder form of treated charcoal, the review says.

Charcoal can be made from materials including nutshells, coconut husks, bamboo and peat, and possibly wood and coal.

Prof Damien Walmsley, from the British Dental Association, said: “Charcoal-based kinds of toothpaste offer no silver bullets for anyone seeking a perfect smile, and come with real risks attached.

“So don’t believe the hype. Anyone concerned about staining or discolored teeth that can’t be shifted by a change in diet, or improvements to their oral hygiene, should see their dentist.”

Source: https://www.bbc.com/news/health-48216116