Dental Health Inequalities Most Evident In Young Children

Inequalities in dental health are most evident in three to six-year-old children, with preschoolers in socioeconomically disadvantaged families having a more than four times higher risk of tooth decay compared to age cohorts with better living conditions, according to new research from the University of Gothenburg in Gothenburg, Sweden. “We shouldn’t forget that most kids have healthy teeth, but there is a minor group of children who we see at the dental clinic repeatedly, and who have a lot of cavities,” says Ann-Catrin André Kramer, a doctor of dental medicine and a registered dental hygienist.

The dental health of 300,988 individuals aged three to 19 years in the Västra Götaland region of Sweden was studied. The analyses are based on data from the Swedish Public Dental Service and private dental care providers that treat children and young people in the region, as well as information from Statistics Sweden, including information about household finances and education level. The research confirms that from an international perspective, children and young people in Sweden generally have good dental health. However, despite the fact that the Swedish government has provided free dental care to children and young people for decades, large discrepancies in dental health do exist.

Children and adolescents living in rural areas had a lower risk of cavities than their age cohorts in larger towns and cities. There were also differences in caries experience among children of different genders. “It was interesting that the girls had a lower risk of cavities than boys during adolescence, with a reverse pattern before adolescence when girls exhibited a higher risk for caries experience compared to boys,” Kramer added. “This trend had not been observed previously. The question is whether this pattern can be linked to behavior such as diet and oral hygiene habits, or if something biological is occurring in the body. As yet, we have no answers, but the pattern is definitely there, and we really need to investigate it further.”

Tracking Preschool Dental Health

Ten percent of seven to nine-year-olds exhibited tooth decay in their permanent teeth, and two-thirds of older teenagers had cavities or fillings. The results indicate that children in families with limited socioeconomic resources were most at risk of caries experience. This was especially true of preschool-aged children. A smaller sub-study also tracked the dental health of young children during their preschool years. The findings showed that children who already had cavities when they were three years old had developed considerably more tooth decay by the time they turned six, compared to children who were cavity-free at the start of the study. Only half of the children included in the study showed no signs of tooth decay in their primary teeth by the time they reached six years of age.

“This situation is very demanding for both patients and dentists, and we need to consider how we can reach the groups who are most in need of dental care,” Kramer said. “Perhaps we can further develop inter-professional efforts and work with other healthcare professionals and schools to remedy this problem. Children should be taught that brushing their teeth is every bit as important as washing their hands, which is something they learn to do at a young age.”

The Link Between Gum Disease And Rheumatoid Arthritis

The results of a study – presented recently at the Annual European Congress of Rheumatology – demonstrates increased levels of gum disease and disease-causing bacteria in individuals at risk of rheumatoid arthritis (RA). “It has been shown that RA-associated antibodies, such as anti-citrullinated protein antibodies, are present well before any evidence of joint disease. This suggests they originate from a site outside of the joints,” said study author Dr. Kulveer Mankia of Leeds Institute of Rheumatic and Muscoskeletal Medicine and the Leeds Biomedical Research Centre. “Our study is the first to describe clinical periodontal disease and the relative abundance of periodontal bacteria in these at-risk individuals. Our results support the hypothesis that local inflammation at mucosal surfaces – such as the gums in this case – may provide the primary trigger for the systemic autoimmunity seen in RA.”

Rheumatoid arthritis is a chronic inflammatory disease that affects a person’s joints, causing pain and disability. It can also affect internal organs. Rheumatoid arthritis is more common in older people, but there is also a high prevalence in young adults, adolescents and even children – and it affects women more frequently than men. The prevalence of gum disease is increased in patients with RA and could be a key initiator of RA-related autoimmunity. This is because autoimmunity in RA is characterized by an antibody response to citrullinated proteins and the oral bacterium Porphyromonas gingivalis (Pg) is the only human pathogen known to express an enzyme that can generate citrullinated proteins.

The Study                                 

“We welcome these data in presenting concepts that may enhance clinical understanding of the key initiators of rheumatoid arthritis,” said Professor Robert Landewé, Chairperson of the Scientific Program Committee, EULAR. “This is an essential step towards the ultimate goal of disease prevention.” The study included 48 at-risk individuals with a positive test for anti-citrullinated protein antibodies, musculoskeletal symptoms but no clinical synovitis, 26 patients with RA, and 32 healthy controls. The three groups were balanced for age, gender and smoking. At-risk individuals underwent ultrasound assessment to assess for subclinical synovitis; only two were found to have ultrasound synovitis. Dentists examined six sites per tooth in each participant and a clinical consensus was agreed in each by three dentists.

Study: Can A New Material Regenerate Dental Enamel?

Researchers at Queen Mary University of London have developed a new way to grow mineralized materials which could regenerate hard tissues such as dental enamel and bone. Enamel – located on the outer part of our teeth – is the hardest tissue in the body and enables our teeth to function for a large part of our lifetime despite biting forces, exposure to acidic foods and drinks, and extreme temperatures. This performance results from its highly organized structure. Unlike other tissues of the body, enamel cannot regenerate once it is lost, which can lead to pain and tooth loss. These problems affect more than 50 percent of the world’s population and so finding ways to recreate enamel has long been a major need in dentistry.

The study, published in Nature Communications, shows that this new approach can create materials with remarkable precision and order that look and behave like dental enamel. The materials could be used for a wide variety of dental complications such as the prevention and treatment of tooth decay or tooth sensitivity – also known as dentin hypersensitivity. “This is exciting because the simplicity and versatility of the mineralization platform opens up opportunities to treat and regenerate dental tissues,” says Dr. Sherif Elsharkawy, a dentist and first author of the study from Queen Mary’s School of Engineering and Materials Science. “For example, we could develop acid resistant bandages that can infiltrate, mineralize, and shield exposed dentinal tubules of human teeth for the treatment of dentin hypersensitivity.”

The Key Discovery

The mechanism that has been developed is based on a specific protein material that is able to trigger and guide the growth of apatite nanocrystals at multiple scales – similarly to how these crystals grow when dental enamel develops in our body. This structural organization is critical for the outstanding physical properties exhibited by natural dental enamel. “A major goal in materials science is to learn from nature to develop useful materials based on the precise control of molecular building-blocks,” added lead author Professor Alvaro Mata, from Queen Mary’s School of Engineering and Materials Science. “The key discovery has been the possibility to exploit disordered proteins to control and guide the process of mineralization at multiple scales. Through this, we have developed a technique to easily grow synthetic materials that emulate such hierarchically-organized architecture over large areas and with the capacity to tune their properties.”

Enabling control of the mineralization process opens the possibility to create materials with properties that mimic different hard tissues beyond enamel such as bone and dentin. As such, the work has the potential to be used in a variety of applications in regenerative medicine. In addition, the study also provides insights into the role of protein disorder in human physiology and pathology.

Dentists See Increase In Dental Caries

Former New York City Mayor Michael Bloomberg was so adamant about the effect of soda consumption  on the health of New Yorkers that he tried tirelessly but unsuccessfully to impose a soda tax in New York much to the dismay of many New Yorkers. Now he seems adamant to spend more of his own money having just  launched a $3 million television advertising blitz in the Chicago area  using his own personal money in support of the “Cook County sweetened beverage tax.”

His aim, the same as his aim in New York, is to reduce the effect of soda consumption on children and teens in working class backgrounds  particularly since it is a known fact that 40 percent of them will develop type-2 diabetes in their lifetime.  Now he is trying to do the same in Cooke County, Illinois. This looks like it might be more than possible as  Berkeley, California was the first community in the United States that passed a  targeted tax on soda in 2014.

As the summer comes to an end, sports drink manufacturers will be high-fiving after another record breaking years of sales for sugar-based sports drinks. However, many dentists are seeing the effects of dental caries mostly among young men and women under the age of 30 who are the prime target for consumption. PepisCo’s Gatorade brand has become the undisputed leader in these sugar-based sports drinks that are prevalent in the U.S. market. A  recent report by Euromonitor International shows that Gatorade captured a 77 percent market share of the $6.8 billion industry in 2014, according to the Wall Street Journal.

As the carbonated drink industry becomes more aware of people’s aversion to aspartame, they have been making significant inroads into the sports drink and fruit juice industry with  Coca-Cola acquiring a 30 percent stake in Suja Juice – a  manufacturer of California-based organic juices that uses HPP technology. Suja Juice generated $42 million in revenue in 2014.

Sugar-Based Beverages

However, dentists are quick to point out that these organic juices have sometimes just as high sugar content as sports drink and the effect can be seen in the dental chair increasingly. Between 1989 and 2008 the average consumption of sugar-based beverages increased by 60 percent in the age group six to 11. The percentage of children consuming them grew 79 percent to 91 percent during that time period. The production in the U.S. for sugar-based ‘soda pop’ is staggering. The beverage industry produces 10.4 billion gallons of soda pop each year. This is enough to serve every American a 12 ounce can every day for a whole year.

Dr. David Pinkhsaov spends a lot of his  time preaching common sense guidelines to children and their parents at his practice Right Family Dental P.C.  in the Bronx. He uses hard facts to break it down to children and parents where they see that soda consumption is a problem. “ I tell my patients how much sugar they are consuming when they drink sodas and most are very alarmed,” says Dr. Pinkhasov. “When you drink a can of soda you are consuming 150 calories, 90 percent of this being derived from high fructose corn syrup. Let’s forget about the obesity problem in New York for a minute, the damage that can happen to your teeth over time is huge. Once you consume one of these drinks the sugar entering your mouth combines with the bacteria present – this is when acids are created that attack your teeth. This period lasts for about 20 minutes with the end result after over consumption being that there is enamel erosion and your teeth and are then very vulnerable. “

His partner, Violeta Skevas, DDS, says she sees no change in the trend and points to recent industry figures such as the  2013 study which showed that  manufacturers of soft drinks spent a staggering $866 million dollars in advertising across all types of media. “This is a huge amount of money, but more worrying than this is the effect that this can have on our economy – we spend nearly $200 billion in the U.S. treating the obesity epidemic. It has a trickle down effect for all us – higher taxes, higher health insurance, everything. We see a lot of patients coming in with an emergency toothache or root canals and many have failed root canals, so there is really no option other than extraction or dental implants. In many of these patients we see that there is over consumption of sports and sugar-based drinks that patients use for hydration in the New York heat. In my opinion the overconsumption of sports drinks can contribute greatly to dental caries.”

The overconsumption of sugar-based drinks seems to be the same all over New York. Jim Sarji, DDS of Advanced Gentle Dentistry of Park Slope, says he sees patients, many of whom are very athletic but now realize that overconsumption of sugar-based sports drinks has had a debilitating effect on their teeth and are now looking to remedy it.  “For some people it is not unusual for them to drink one of these sports drinks a day, sometimes more on a hot day. This is a lot of sugar.”

The Vicious Circle

David Pinkhasov, DDS  says that  the effects of sugar consumption in the Bronx has undoubtedly led to the high incidence of type-2 diabetes which he bases on the medical evidence he has read and the effects of which he sees every day. “There is a large incidence of periodontal disease in the Bronx. This is largely due to the high incidence of type-2 diabetes. If you have type-2 diabetes then you are more prone to periodontal disease and if you have periodontal disease this can exacerbate your diabetes. It is a vicious circle.”

He is quick to point out a recent Epi Data Brief published by the New York Department of Health and Mental Hygiene in 2015 which stated that 47 percent of adults ages 30 and older in New York City  have periodontitis (gum disease) and that 26 percent of these adults in the age range  20 to 64 have untreated caries (cavities) which can lead to tooth loss, pain, infection and trouble eating and speaking.

Dr. Steven Cisternas  of Richmond Hill Dental Design Studio and Bay Dental sees a similar situation at his Staten Island practice. “The over-consumption of these drinks can be seen daily when I step out of my office and walk down the street. Everybody is drinking sports drinks, especially the younger generation and especially in the heat.” He offers some advice for those unwilling to give up sports drinks to reduce the harmful effects: “Always use a straw to minimize contact with your teeth, limit your consumption to below 12 ounces a day, never consume before going to bed, and always drink water after consumption only brushing one hour afterwards due to the fact that your enamel will be temporarily weakened.”

Dr. Arkadiy Takhalov of Dr. T’s Pediatrics has a completely different philosophy. “We start educating parents when they first come into their office with their newborns. We point out the amount of sugar in these drinks and that even apple juice has a huge amount of sugar for a young child. This can damage the first set of teeth and the second set of teeth. Milk is a better option and is more nutritious. The American Academy of Pediatrics warns that children drinking a lot of juice, even just an eight-ounce sugar sweetened drink can increase a child’s odds that they will become obese by 60 percent. Education of young mothers is the key.”

Study: Oral Health Problem Looms For Aging Population

Urgent attention needs to be paid to frail older New Zealanders’ oral health, a University of Otago study has highlighted. In a world first, Otago researchers surveyed the oral health of 987 people living in aged residential care and found those with dementia, and older men in general, have dirtier and more decayed teeth. Otago Head of Department of Oral Sciences and lead author, Professor Murray Thomson, describes poor oral health as one of the “geriatric giants” with the situation a “major clinical and public health problem which is going to get worse.”

Older people have higher rates of cognitive and physical impairments that can adversely affect their oral self-care and complicate the provision of oral care, he says. “Neither the aged care sector nor the dental profession, in most countries, is prepared. Not only do we have more and more older people every year, but more and more people are entering old age with their own teeth, rather than full dentures, as was the situation just a couple of decades ago. “In some ways, dentistry has been a victim of its success – we have long emphasized the idea of ‘teeth for life’ without much thought to what happens towards the end of life. We also now know that half of those in old age will end up in residential aged care, and that more and more of those will have some form of dementia.”

Professor Thomson believed that “slow progress” was being made in the area. “It’s a very complex situation involving a lot of players – the aged care sector, the Ministry of Health, the dental profession, and the public. An encouraging sign is the inclusion of oral health in New Zealand’s Healthy Ageing Strategy. That’s a starting point, but there is a lot of work to be done,” he says.

Greater Rates Of Tooth Decay

Of those examined in the study – representative of the more than 14,000 New Zealanders living in aged care – recently published in the journal Gerodontology, about half had severely impaired cognitive function, and more than a third required fillings or extractions. Those with severely impaired cognitive function had greater numbers of teeth with decay. They also had higher oral debris scores, reflecting poorer daily oral hygiene care.

Professor Thomson says greater rates of tooth decay can result in dental and facial infections, poorer quality of life, malnutrition and difficulties in communication. The researchers also found that even the most cognitively impaired participants were able to be examined fairly easily, meaning that regular, routine removal of oral debris by carers should not be difficult. “The issue that we currently face is that much of that debris removal is not being done, and this, along with frequent exposure to sugary, over-processed meals and snacks, and poor salivary function, is enabling plaque and dental caries to flourish in aged residential care populations.”

For those wanting to improve or maintain their oral health, Professor Thomson has some simple advice: brush twice daily; clean carefully between the teeth at least two to three times per week; avoid having sweet drinks or snacks between meals – and that includes sugar in tea or coffee – it takes only a couple of days to get used to not having it; and avoid smoking. “For people who have poor oral health in middle age, it is not going to be any better in old age, and an honest, open conversation with a dentist about the options, which may include complete extraction, may be a very good idea.”

Study: 3-D Printed Dentures Could Fight Off Infections

Nearly two-thirds of the U.S. denture-wearing population suffer frequent fungal infections that cause inflammation, redness and swelling in the mouth. To better treat these infections – called denture-related stomatitis – University at Buffalo researchers have turned to 3-D printers, using the machines to build dentures filled with microscopic capsules that periodically release Amphotericin B, an antifungal medication.

A study describing the work, recently published in Materials Today Communications, found that the drug-filled dentures can reduce fungal growth. Unlike current treatment options, such as antiseptic mouthwashes, baking soda and microwave disinfection, the new development can also help prevent infection while the dentures are in use.

“The major impact of this innovative 3-D printing system is its potential impact on saving cost and time,” says Praveen Arany, DDS, Ph.D., the study’s senior author and an assistant professor in the Department of Oral Biology in the UB School of Dental Medicine. The technology allows clinicians to rapidly create customized dentures chair-side, a vast improvement over conventional manufacturing that can vary from a few days to weeks.

Applications from this research could be applied to various other clinical therapies, including splints, stents, casts and prosthesis. “The antifungal application could prove invaluable among those highly susceptible to infection, such as the elderly, hospitalized or disabled patients,” Arany says. The dental biomaterials market – worth more than $66 billion in 2015 – is expected to grow 14 percent by 2020. A large part of the industry is focused on dental polymers, particularly the fabrication of dentures.

UB researchers printed their dentures with acrylamide, the current go-to material for denture fabrication. The study sought to determine if these dentures maintained the strength of conventional dentures and if the material could effectively release antifungal medication.

Testing The Strength And Medication

To test the strength of the teeth, researchers used a flexural strength testing machine to bend the dentures and discover their breaking points. A conventional lab-fabricated denture was used as a control. Although the flexural strength of the 3-D printed dentures was 35 percent less than that of the conventional pair, the printed teeth never fractured.

To examine the release of medication in the printed dentures, the team filled the antifungal agent into biodegradable, permeable microspheres. The microspheres protect the drug during the heat printing process, and allow the release of medication as they gradually degrade.

The investigation involved the development of an innovative form of acrylamide designed to carry antifungal payloads, and a novel syringe pump system to combine the dental polymer and microspheres during the printing process.

The dentures were tested with one, five and 10 layers of material to learn if additional layers would allow the dentures to hold more medication. The researchers found the sets with five and 10 layers were impermeable and were not effective at dispensing the medication. Release was not hindered in the more porous single layer, and fungal growth was successfully reduced.

Future research aims to reinforce the mechanical strength of 3-D printed dentures with glass fibers and carbon nanotubes, and focus on denture relining – the readjustment of dentures to maintain proper fit.

Wisdom Teeth: Detecting Disease With Tooth Sensors

An interdisciplinary team of researchers from Washington University School of Medicine in St. Louis and the School of Engineering & Applied Science is redefining the notion of a wisdom tooth. The team is developing a smart-tooth technology that could someday be used to detect early signs of certain diseases in high-risk patients by analyzing saliva or gingival crevicular fluid.

“Salivary-based biosensors have generated a lot of interest because of their potential for wide applications in medicine,” said Erica Lynn Scheller, who trained as a dentist and is now an assistant professor of medicine and of cell biology and physiology in the School of Medicine. “We’re initially working to develop a biological sensor that measures specific peptides active in periodontal disease and that would be used in combination with a wireless device to retrieve that data.”

“It’s like an electronic tooth,” said Shantanu Chakrabartty, professor of electrical & systems engineering in the School of Engineering & Applied Science and a partner on the project, currently funded by a four-year, $1.5 million grant from the National Institutes of Health.

Measuring Disease-Specific Peptides
That electronic tooth is actually a tiny sensor and an electronic chip, about a few millimeters-cube in volume. It is designed to be inserted inside the patient’s gum line or as part of a dental appliance, and contains bio-recognition elements that measure disease-specific peptides, which are natural or synthetic groups of amino acids. As a first attempt, the research team will work toward monitoring peptides related to bone breakdown during periodontitis, a dental disease that can lead to loosening and loss of teeth. A wireless ultrasound device would then be used to read the peptide levels and connect to the medical data-cloud.

Right now, one of the project’s biggest challenges is chemistry. “You only have a finite number of bio-recognition elements conjugated to the transducer if you are using an antibody that is specific to these peptides,” said Srikanth Singamaneni, associate professor of mechanical engineering & materials science. “They get saturated fairly quickly. The question is how do you refresh those sensors? That’s one of the aspects we are working to address with this project.”

The research team says developing a new, minimally invasive system that can detect and monitor gum disease and the effectiveness of treatment would be beneficial to the 64 million U.S. residents with periodontal disease and to their dentists. The researchers also are interested in developing other applications for the technology that, while likely years away, could go well beyond the dentist’s chair.

“We’re developing this sensing platform that can be expanded to include additional tracking for inflammatory markers, stress markers and diabetes monitoring,” Scheller said. “Really, anything you can think of that you’d want to track in the oral cavity, we’re developing both the platform and the specific application.”

Tooth-Mounted Sensors Track What You Eat

Monitoring in real time what happens in and around our bodies can be invaluable in the context of health care or clinical studies, but not so easy to do. That could soon change thanks to new, miniaturized sensors developed by researchers at the Tufts University School of Engineering that, when mounted directly on a tooth and communicating wirelessly with a mobile device, can transmit information on glucose, salt and alcohol intake. In research to be published soon in the journal Advanced Materials, researchers note that future adaptations of these sensors could enable the detection and recording of a wide range of nutrients, chemicals and physiological states.

Previous wearable devices for monitoring dietary intake suffered from limitations such as requiring the use of a mouth guard, bulky wiring, or necessitating frequent replacement as the sensors rapidly degraded. Tufts engineers sought a more adoptable technology and developed a sensor with a mere 2mm x 2mm footprint that can flexibly conform and bond to the irregular surface of a tooth. In a similar fashion to the way a toll is collected on a highway, the sensors transmit their data wirelessly in response to an incoming radiofrequency signal.

The sensors are made up of three sandwiched layers: a central “bioresponsive” layer that absorbs the nutrient or other chemicals to be detected, and outer layers consisting of two square-shaped gold rings. Together, the three layers act like a tiny antenna, collecting and transmitting waves in the radiofrequency spectrum. As an incoming wave hits the sensor, some of it is cancelled out and the rest transmitted back, just like a patch of blue paint absorbs redder wavelengths and reflects the blue back to our eyes.

Detecting And Measuring Nutrients

The sensor, however, can change its “color.” For example, if the central layer takes on salt, or ethanol, its electrical properties will shift, causing the sensor to absorb and transmit a different spectrum of radiofrequency waves, with varying intensity. That is how nutrients and other analytes can be detected and measured.

“In theory we can modify the bioresponsive layer in these sensors to target other chemicals – we are really limited only by our creativity,” said Fiorenzo Omenetto, Ph.D., corresponding author and the Frank C. Doble Professor of Engineering at Tufts. “We have extended common RFID – radiofrequency ID – technology to a sensor package that can dynamically read and transmit information on its environment, whether it is affixed to a tooth, to skin, or any other surface.”

Use Of Nanotechnology In Orthodontic Treatment

The field of science and technology has seen radical advancements and one such progression in the field of material science is nanotechnology. Nanotechnology deals with structure at the Nano scale and is one of the most crucial advancements of the 21st century, due to its economic and scientific potential. With the advent of nanotechnology, it has been applied in various fields in orthodontics from the coating of the surface to the innovation of new materials.

What Are Nano Particles?
Nano particles are particles produced in a calculated manner that has a typical dimension of 1 to 100 nm and has properties that are not shared by particles which do not belong to the nanoscale particles with the same chemical structure.

Application Of Nanotechnology In Orthodontics
Nanotechnology is used in the field of orthodontics to sustain good oral health. Silver nanoparticles are used as antimicrobial agents in the manufacturing of cement and resin bases of dentures, root canal columns and orthodontic sealants. The antimicrobial property in the particles decreases the build-up of plaque around the brackets. With the help of nanotechnology, we can reduce the friction and scuffing that happens to the mouth because of the braces. Nanotechnology is being used to make braces more friction resistance while also maintaining transparency. Researchers are still working on using NiTi nanotechnology that can give the dental wire shape-memory and super flexible properties.

  • Nano Coatings in Arch Wires to Reduce Friction – Friction in the mouth is a major problem during orthodontic treatment. Nano coatings are used either on the bracket surface or NiTi wires to prevent abrasion.
  • Orthodontic Brackets – The material with which the bracket is made contains polysulfone with hard aluminia nanoparticles for strength, decreased friction and biocompatibility while maintaining the transparency of the bracket.
  • Nanoparticles Application as Antimicrobial Agent – Cavities and white spot lesions are common problems while undergoing orthodontic treatment due to the accumulation of plaque around the brackets. Silver, gold, silica, copper, nitrogen with titanium dioxide and zinc oxide nanoparticles have been coated on both brackets to prevent tooth decay during orthodontic treatment.

Uses Of Nanoparticles In Dentistry
Nanoparticles have been used for administering local anesthesia, diagnosis and cure of oral cancer and dressing wounds. Nanoparticles are used in dental materials which are used for restoration and dental procedures. They react effectively with microbial membrane and provide a larger surface area for anti-microbial activity.

There has been a lot of exploration on the application of nanotechnology in orthodontics and there’s a lot more work which needs to be done. Extensive research and improvisation in the field of nanotechnology is constantly being done so that the clinical application is available at a fair price to both the orthodontist and the patients.

Author Bio:

Dr. Satish Pai – an Ivy League trained dentist and faculty member at Columbia University believes that a perfect smile not only makes a person look great but feel great while boosting confidence.  As the founder of Putnam Orthodontics, he is dedicated to not only creating perfect smiles for his patients but also educating people with his engaging articles about all things related to a perfect smile and oral health. Spending time with his family always brings a smile to his face. In his free time, you can find him golfing, doing yoga or surfing.

Blasting Dental Plaque With Microbubbles

Whether through an accident or a disease, teeth loss can cause many inconveniences. Dental implants such as crowns, however, have allowed people to overcome most of these and live a better quality of life.

But just like normal teeth, these dental implants require proper care and oral hygiene to prevent further complications, such as the inflammation of the tissues surrounding the implants. While the buildup of dental plaque sticks mainly to the crown, it also adheres to the exposed parts of the screw that holds the dental fixture in place, and these are much harder to clean because they contain microgrooves that make them fit better into the upper or lower jaw bones.

Hitoshi Soyama from Tohoku University and his team from Showa University in Japan conducted a study to look for better ways for dentists to remove this plaque and prevent complications. The team wanted to study the efficiency of a cavitating jet, where high-speed fluid is injected by a nozzle through water to create very tiny bubbles of vapor. When these bubbles collapse, they produce strong shockwaves that are able to remove contaminants.

The Cavitating Jet

The team compared the cleaning effect of a cavitating jet to that of a water jet, which has been used for a long time to remove plaque from dental implants to keep them clean. They grew a biofilm over three days within the mouths of four volunteers, then proceeded to clean that with the two different methods, measuring the amount of plaque remaining at several time intervals.

While there was little difference between the amounts of dental plaque removed by both methods after one minute of cleaning, that changed after longer exposure. After three minutes, the cavitating jet had removed about a third more plaque than the water jet did, leaving little plaque stuck to the implant at the end of the experiment. The cavitating jet was also able to remove the plaque not only from the root section of the screws, but also from the harder-to-reach crest section, though to a lesser extent.

“Conventional methods cannot clean plaques on the surface of dental implants very well, so this new method could give dentists a new tool to better manage these fixtures which are becoming more common,” says Soyama.

Previous research has shown that water flow exerts shear stress to remove the biofilm. In addition to this shear effect, the cavitating jet also produces a considerable force when the bubbles collapse that is able to remove particles from the biofilm and carry them away. The researchers suggest that the two processes probably work in synergy to make the cavitating jet superior to the water jet when cleaning the plaque off the irregular surface of dental implants.

The Fight Against Tooth Decay Gets Help With A New Smart Material

When patients go to the dentist to fill a cavity, they’re trying to solve a problem – not create a new one. But many dental patients get some bad news: bacteria can dig under their tooth-colored fillings and cause new cavities, called recurrent caries. These recurrent caries affect 100 million patients every year and cost an additional $34 billion to treat.

Now, a research collaboration between the Department of Materials Science & Engineering, Faculty of Dentistry, and the Institute of Biomaterials and Biomedical Engineering at the University of Toronto has resulted in a novel way to minimize recurrent caries.

In a recent paper published in the journal Scientific Reports, professors Ben Hatton, Yoav Finer and Ph.D. student Cameron Stewart tackled the issue and proposed a novel solution: a filling material with tiny particles made by self-assembly of antimicrobial drugs, designed to stop bacteria in its tracks. These particles may solve one of the biggest problems with antibacterial filling materials: how do you store enough drug within the material to be effective for someone’s entire life?

Fighting Cavity-Causing Bacteria

“Adding particles packed with antimicrobial drugs to a filling creates a line of defense against cavity-causing bacteria,” says Hatton. “But traditionally there’s only been enough drug to last a few weeks. Through this research we discovered a combination of drugs and silica glass that organize themselves on a molecule-by-molecule basis to maximize drug density, with enough supply to last years.” This discovery of using antimicrobials which self-assemble means the team can pack 50 times as much of the bacteria-fighting drugs into the particles.

“We know very well that bacteria specifically attack the margins between fillings and the remaining tooth to create cavities,” says Finer. “Giving these materials an antimicrobial supply that will last for years could greatly reduce this problem.”

Looking ahead, the research team plans on testing these new drug-storing particles in dental fillings, monitoring their performance when attacked by bacteria and saliva in the complex environment in the mouth. With some fine-tuning, this new “smart” material could create a stronger filling and fewer trips to the dentist.

5 Different Types Of Braces And Which Is Right For You

Are you thinking of getting braces?

Well luckily for you, this is the perfect time to get braces due to the various options that are available nowadays to straighten your teeth as compared to the traditional metal braces that were available a couple of years back. There is a vast variety of braces available that are great improvements of the traditional metal braces making it easy for you to tackle various orthodontic problems that you may face.

If you’re not familiar with orthodontics then all these choices can be confusing initially. The best way to clear this up is by prioritizing what’s important to you in your treatment.

5 Types Of Braces Available

  1. Lingual Braces

Lingual braces are similar to traditional metal braces with the exception of the brackets and the wires being installed at the back of your teeth. The installation and maintenance can be a bit tough due to the positioning of it but it will serve its purpose. Due to its unique placement and installation process, it usually costs a bit more and can be a bit strenuous to wear initially, but this is best for people who want to maintain an aesthetic appearance of their mouths.

  1. Ceramic Braces

These braces have different kinds of names, some of which are aesthetic braces, tooth-colored braces, porcelain braces or clear braces. Ceramic braces are the same as traditional metal braces with the sole exception that they are designed to blend in with your natural tooth color, making them less visible.

Ceramic braces are a great choice for adults or teens who want to minimize the appearance of their braces. These types of braces will give you a cosmetic experience while wearing braces. These types of braces are much more likely to break than their traditional counterparts so it is not recommended to have these types of braces installed when a lot of pressure is needed to move your teeth.

  1. Self-Ligating Braces

These types of braces are currently very popular with orthodontists as it requires less dental visits and gentler treatment. Self-ligating braces produce quicker results as the teeth move without needing to be adjusted. This type of movement asserts less pressure and friction on your teeth, making it less painful for your gums. Fewer trips to your dentist will cost you less money and less time.

  1. Invisalign Braces

These are a clear kind of braces that you can opt for instead of metal braces. They are made up of clear plastic aligners that are similar to mouth guards which have been specially designed for your mouth. Invisalign aligners can be removed when eating, brushing and cleaning but you will need to switch out your aligner every fortnight. Each new aligner is designed to increase the adjustment of your teeth more and more.

Aligners are generally recommended by an orthodontist for ongoing use after finishing your orthodontic treatment. These aligners will maintain your teeth’s positions till they have settled into their intended positions.

  1. Traditional Metal Braces

Traditional braces are made of high-grade stainless steel and have metal brackets that are attached to each tooth using a kind of cement. These brackets are then connected with one another with a thin archwire. This will put pressure on your teeth to move slowly into their intended positions.

The archwires are connected to the brackets with tiny elastics which are known as ligatures or o-rings which will be switched out each time your dentist tightens your braces. Traditional metal braces are still the most common braces in use today and are both an excellent and practical option for people who suffer from complicated tooth and jaw problems.

You have a wide variety of braces to choose from nowadays and are no longer limited to the large metal braces that have adorned every crooked set of teeth and been the object of ridicule for close to five decades now. Whatever your age, if you need braces now, there is a much wider variety to choose from.

Author Bio:

Sharon Williams’ day job is to handle digital marketing for Koch Orthodontics in Loganville, GA. With a flair for creating compelling content that clears the clutter and connects with the audience in an instant, she writes about dental topics to educate and help her readers. She truly believes that a genuine smile can win a million hearts and talks to her readers about improving their smiles and overall dental health, as well as enhancing their overall lifestyle. In her free time, she likes to organize small meets in her neighbourhood where she brings people together to discuss various topics that she writes about.

Orthodontic Treatment: How To Reduce The Risk Of Periodontal Disease And Avoid Tooth Loss

Even with regular brushing, flossing and daily oral care, plaque can build up and harden to form what is known as tartar, as well as increase the risk for gum disease and cavities. Orthodontic treatment can help improve the form and function of your teeth and gums, and treat oral problems caused by improper positioning of teeth, decay, overbites, and underbites.

In the early stage of gum disease, also known as gingivitis, it is possible to reverse the damage and, in certain cases, it is also possible to eliminate the disease completely. However, an early diagnosis and timely intervention are vital to reducing the chances of gingivitis and prevent it from progressing into periodontal disease.

Factors That Increase The Risk Of Periodontal Disease 

  • Lack of Oral Hygiene

Neglecting the importance of good dental care leads to poor oral hygiene. Moreover, failure to floss and brush regularly, and the inability to keep up with regular dental visits, leaves you susceptible to periodontal disease.

  • Smoking and Chewing Tobacco

The link between cancer and tobacco consumption is long established, but did you know that smoking and chewing tobacco also increase the risk of heart disease, lung disease and gum disease? Not only does tobacco consumption give rise to gum infections, but it also increases the chance of gingivitis gradually developing into periodontitis.

  • Family History

If gingivitis runs in your family, it leaves you vulnerable to developing gingivitis. According to research published by the American Academy of Periodontology, 30% of the population is genetically predisposed to gingivitis if close family members are suffering from this oral condition.

  • Hormonal Fluctuations

Hormonal changes occurring during puberty, pregnancy, and menopause affect all the tissues of the body including gum tissues, so if you experience increased gum sensitivity, it may be an underlying sign of gradually developing gum disease. Pay special attention to your daily oral care and visit a dentist for an early diagnosis.

  • Certain Drugs

Certain medicines that are prescribed for treating depression, various heart conditions, and convulsions can adversely affect your oral health, so if you are on any medication, make sure your dentist knows about it.

  • Stress

Stress impairs your immunity and leaves you vulnerable to oral infections. Whether your stress is caused by work or triggered by personal issues, it contributes to teeth clenching,  which causes tissue damage and aggravates impending gum disease.

  • Crooked and Misaligned Teeth

Overlapping and crooked teeth are a challenge to clean, increasing the risk of cavities and gingivitis.

  • Poor Nutrition

A daily diet that lacks in essential vitamins and nutrients takes a toll on the immune system making it difficult to ward off infections. Excessive intake of sugary foods and sweet beverages causes the build-up of plaque which eventually triggers gum disease.

How Orthodontic Treatment Helps Cure Periodontal Disease

Braces are designed to correct teeth alignment issues and improve the health of teeth and gums. Whether your teeth are misaligned or you have crowding issues, braces can gradually alter the position and spacing of teeth, improve their stability, and decrease the risk of gum disease caused by crowded, uneven teeth. An ideal candidate for braces can be of any age, however, the orthodontic treatment approach will vary depending on the time when the braces are used.

Braces can not only align the adjacent teeth and close small gaps but also open up the unsightly space left by missing teeth and make more room for a restoration procedure. Braces also work to prevent the surrounding teeth from shifting into the space created by missing teeth and help prevent many oral problems.

Invisalign Aligners – An Ideal Option For Those Who Have Periodontal Disease

While braces efficiently straighten crooked teeth, they could have complications especially if you are suffering from gum disease. Periodontal disease is caused by plaque build-up which weakens the gum tissues and eventually erodes the surrounding bone structure, but it can be brought under control using clear aligners. Invisalign aligners minimize gum infection flare-ups and are especially beneficial for patients suffering from gum disease as they can be easily removed for brushing and flossing.

Orthodontic treatment can also correct oral problems arising in patients with missing teeth. It can also close a gap that is created is missing teeth using braces, if the tooth is not to be replaced.

Author Bio: 

Emily Taylor found the perfect fit for herself as the online marketing manager at Thurman Orthodontics in Fresno CA as she believes that a great smile does more than just make a person look great – it makes them feel great as well. The power of a smile has always been a mystery to Emily and she loves researching and writing about it. She loves to write about everything to do with a healthy bite and a beautiful smile – whether is it ways to achieve it or the importance of it in the various aspects of life. What brings a big smile on Emily’s face is her family and surfing. She also likes to bake for her children and co-workers – they call her the cookie fairy!

Dentists Get Cracking On The Stem Cell Front

Stem cells. Few research discoveries hold as much promise of single-handedly expanding medical treatment options as they do. Miraculously able to act as transformers – either re-creating or morphing into a variety of cell types found within the organisms they originate from – stem cells offer humanity hope for new, more effective therapies against a number of chronic and terminal diseases. And finding them is surprisingly easy.

“Stem cells can be extracted from nearly any living tissue,” says Dr. James Mah, director of UNLV’s advanced education program in orthodontics, doctor of dental surgery, and dental researcher. “In fact, stem cells can even be found in tissues of the deceased.” But in spite of all their potential, there’s a catch: “The biggest challenges with stem cells are gathering enough of them to work with and keeping them viable until they are needed,” Dr. Mah said.

He and UNLV biomedical sciences professor Karl Kingsley – along with a handful of undergraduate, graduate, and postdoctoral dental students – decided to take on this challenge, cutting their teeth in stem cell research by exploring those pearly whites in new ways. In the process, they developed a new method for extracting large numbers of stem cells they could then preserve from a surprisingly abundant source: wisdom teeth.

“More and more adults – approximately 5 million throughout the country – have their wisdom teeth, or third molars, removed,” Kingsley said. “Extracting teeth is relatively common among patients undergoing orthodontic treatments. And the majority of those teeth are healthy, containing viable tooth root pulp that offers opportunities for reproducing cells that have been damaged or destroyed by injuries or disease.”

A Tough Nut To Crack

Tooth root pulp is home to two types of prized stem cells. The first, pluripotent stem cells, have the ability to become any cell in the organism from which they’re drawn. The second, multi-potent stem cells, transform into specific types of cells within that organism. Knowing where to find these cells was one thing. Recovering them, the researchers knew, would be another.

Common methods for extracting root pulp involve drilling into, removing the top of, or shattering the tooth. Each method has its detriments, Dr. Mah said, all of which lead to a low stem-cell recovery rate: damaging heat from drilling, corrosive elements in the water teeth are rinsed in, contaminating enamel particulates, and more. So the researchers sought to discover how to extract pulp in a manner that consistently produced a higher yield. “Initially, the answer seemed simple: crack the tooth in half like a nut and remove the pulp,” Dr. Mah said.

Unfortunately, teeth have irregular surfaces and non-uniform shapes, so cracking teeth usually produces the same shattering effect as a hammer, thereby reducing the number of viable stem cells.

Happy Ghag, then a dental student working with Dr. Mah and Kingsley on the project, thought he might have solution to the dilemma. He approached Mohamed Trabia, UNLV Howard R. Hughes College of Engineering’s associate dean for research, graduate studies, and computing, and Brendan O’Toole, Mendenhall Innovation Program director and mechanical engineering researcher, to discuss fracture analysis.

“Happy had reviewed fracture mechanics literature and decided on a technique that scored the tooth to enable a clean break, similar to the process for custom-cut glass,” O’Toole said. After a few discussions, some of Engineering’s personnel helped Ghag fabricate the device.

The completed instrument, which the research team facetiously dubbed the Tooth Cracker 5000, uses a clamp to hold a tooth in position for a cutting tool to score the surface and a blade to crack it. The result: a perfectly halved tooth, with immediate access to undamaged and uncontaminated root pulp. For O’Toole, this was just another successful collaboration between the two units, as mechanical engineering had been interacting with the School of Dental Medicine’s orthodontic program for a few years.

“Orthodontics, by definition, is a bioengineering topic,” O’Toole said. “They design and place mechanisms in people’s mouths that help move teeth into optimum position. The interaction between our departments makes a lot of sense.” With the Tooth Cracker 5000 complete, Dr. Mah and Kingsley tested the fracture rate of 25 teeth, achieving a 100 percent rate of success. The fracture idea and design prototype had worked perfectly.

Excavating For Success

Now that the researchers had cracked the challenge of accessing the root pulp, it was on to determining how many viable stem cells they could recover from the fractured teeth. Average pulp recovery rates employing common extraction methods – shattering, drilling, etc. – come in at around 20 percent, Dr. Mah noted.

It was time to test the mettle of their new fracture method. Dr. Mah and Kingsley dyed 31 fractured teeth pulp samples to highlight any viable stem cells the teeth contained. Dead cells would turn blue when exposed to the dye. Living cells would appear clear. They looked under the microscope. Eighty percent of their extracted cells remained clear after the dye was introduced.

“Saying the test results were promising is a gross understatement,” Dr. Mah said. “We realized we’d invented an extraction process that produced four times the recovery success rate for viable stem cells. The potential application is enormous.”

Replicating For A Rainy Day

After mastering fracturing and extraction, it was time for the team to determine what kind of stem cells could be harvested and how best to store them.

Normal cells within the body typically die after 10 replications or passages, whereas stem cells can replicate indefinitely, Kingsley indicated. To isolate the stem cells from the rest of the root pulp, the researchers harvested cells from the pulp and cultured them on a petri dish. Once the cells covered the dish, they split the culture in half and repeated the process between 10 and 20 times.

By the end of the culturing, all non-stem cells had expired. Kingsley captured the remaining stem cells and collected their ribonucleic acid (RNA), which is converted into proteins that become biomarkers his team could use to characterize each stem cell type and its respective rate of replication.

“Scientists around the world are trying to figure out what type of stem cells can be coaxed into becoming new cells or different tissue types,” Kingsley said. “We already know some populations of dental pulp stem cells can be converted into neurons, which could become therapies for cognitive diseases such as Alzheimer’s or Parkinson’s.”

Kingsley noted that teams of scientists around the world are working with animal models to test using stem cells to treat neurological conditions. Early indications, he said, are positive. Although there is still a need for additional tests, Kingsley indicated that the next logical step in this research would be to test stem cells in humans to treat any number of chronic illnesses people face.

“There are potential applications of stem cells for multiple diseases, including cancer, arthritis, and lung disease,” Kingsley said. “The next challenge is reliably collecting the stem cells early enough and storing them successfully so they can be used when needed.”

Preserving The Prize

According to multiple studies, the number of pluripotent stem cells found in teeth decrease dramatically after adults reach the age of 30, Kingsley said. However, people could donate stem cells found in their teeth much like they may donate their blood prior to a surgical procedure or preserve their umbilical cords. If people elected to have their wisdom teeth removed or were having a root canal performed, their stem cells could be harvested at that time and stored for future use.

Creating that possibility has led Dr. Mah and Kingsley to the next step in their research: the cryogenic process. “There is no standard cryogenesis, or freezing process, for storing stem cells,” Kingsley said. “There are multiple organizations that collect and freeze teeth for future studies and use, but there is no evidence about the long-term effects of cryopreservation. We can’t answer yet just how long the cells will survive.”

In 2011, dental student Allison Tomlin studied different populations of stem cells and their viability after being thawed. Every year since, Kingsley and his team have thawed a portion of Tomlin’s sample and evaluated the viability of remaining stem cells.

Initial findings – which Kingsley, Tomlin, and R. Michael Sanders, clinical sciences professor in the dental school, published in their Biomaterials and Biomechanics in Bioengineering article The Effects of Cryopreservation on Human Dental Pulp-derived Mesenchymal Stem Cells – indicate that rapidly dividing cells have higher rates of viability year after year compared to slower dividing cells. If these results remain constant, the stem cells could be sorted before the freezing process based on when they might be needed.

“The work Dr. Kingsley and I are doing is part of a paradigm shift,” Dr. Mah said. “Our fracturing process could hasten the collection and cryogenesis process, thereby preserving a high stem-cell count that furthers research into how using these cells can aid healing and potentially cure diseases.”

Synthetic Tooth Enamel May Lead To More Resilient Structures

Unavoidable vibrations, such as those on airplanes, cause rigid structures to age and crack, but researchers at the University of Michigan may have an answer for that – design them more like tooth enamel, which could lead to more resilient flight computers, for instance. Most materials that effectively absorb vibration are soft, so they don’t make good structural components such as beams, chassis or motherboards. For inspiration on how to make hard materials that survive repeated shocks, the researchers looked to nature.

“Artificial enamel is better than solid commercial and experimental materials that are aimed at the same vibration damping,” said Nicholas Kotov, the Joseph B. and Florence V. Cejka Professor of Chemical Engineering. “It’s lighter, more effective and, perhaps, less expensive.”

Evolution’s Design

He and his team didn’t settle on enamel immediately. They examined many structures in animals that had to withstand shocks and vibrations: bones, shells, carapaces and teeth. These living structures changed from species to species and over the eons. Tooth enamel told a different story. Under an electron microscope, it shared a similar structure whether it came from a Tyrannosaurus, a walrus, a sea urchin or Kotov himself – he contributed his own wisdom tooth to the effort. “To me, this is opposite to what’s happening with every other tissue in the process of evolution,” he said. “Their structures diversified tremendously but not the structure of enamel.”

Evolution had hit on a design that worked for pretty much everyone with teeth. And unlike bone, which can be repaired, enamel had to last the lifetime of the tooth – years, decades or longer still. It must withstand repeated stresses and general vibrations without cracking. Enamel is made of columns of ceramic crystals infiltrated with a matrix of proteins, set into a hard protective coating. This layer is sometimes repeated, made thicker in the teeth that have to be tougher.

The reason why this structure is effective at absorbing vibrations, Kotov explained, is that the stiff nanoscale columns bending under stress from above create a lot of friction with the softer polymer surrounding them within the enamel. The large contact area between the ceramic and protein components further increases the dissipation of energy that might otherwise damage it.

Recreating Enamel

Bongjun Yeom, a postdoctoral researcher in Kotov’s lab, recreated the enamel structure by growing zinc oxide nanowires on a chip. Then he layered two polymers over the nanowires, spinning the chip to spread out the liquid and baking it to cure the plastic between coats. It took 40 layers to build up a single micrometer, or one thousandth of a millimeter, of enamel-like structure. Then, they laid down another layer of zinc oxide nanowires and filled it in with 40 layers of polymer, repeating the whole process up to 20 times.

Even molecular or nanoscale gaps between the polymer and ceramic would reduce the strength of material and the intensity of the friction, but the painstaking layering ensured the surfaces were perfectly mated. “The marvelous mechanical properties of biological materials stem from great molecular and nanoscale adaptation of soft structures to hard ones and vice versa,” Kotov said.

Kotov’s group demonstrated that their synthetic tooth enamel approached the ability of real tooth enamel to defend itself from damage due to vibrations. Computer modeling of the synthetic enamel, performed by researchers at Michigan Technological University and the Illinois Applied Research Institute, confirmed that the structure diffused the forces from vibrations through the interaction between the polymer and columns.

From the project’s inception as a challenge from the Defense Advanced Research Projects Agency, Kotov worked with fellow materials heavyweights Ellen Arruda, U-M professor of mechanical engineering, and Anthony Waas, the Felix Pawlowski Collegiate Professor Emeritus.

Kotov hopes to see the synthetic enamel deployed in airplanes and other environments in which vibrations are inescapable, protecting structures and electronics. The challenge, he said, will be automating the production of the material.

The paper is titled Abiotic Tooth Enamel and will be published in the journal Nature.