Novacain And Missing Wisdom Teeth

Researchers from Tufts University School of Dental Medicine have discovered a statistical association between the injection of local dental anesthesia given to children ages two to six and evidence of missing lower wisdom teeth. The results of this epidemiological study, published in the April issue of The Journal of the American Dental Association, suggest that injecting anesthesia into the gums of young children may interrupt the development of the lower wisdom tooth. "It is intriguing to think that something as routine as local anesthesia could stop wisdom teeth from developing. This is the first study in humans showing an association between a routinely- administered, minimally-invasive clinical procedure and arrested third molar growth," said corresponding author, Anthony R. Silvestri, D.M.D., clinical professor in the department of prosthodontics and operative dentistry at Tufts University School of Dental Medicine. Wisdom teeth are potentially vulnerable to injury because their development - unlike all other teeth - does not begin until well after birth. Between two and six years of age, wisdom tooth (third molar) buds begin to develop in the back four corners of the mouth, and typically emerge in the late teens or early adulthood. Not everyone develops wisdom teeth, but for those who do, the teeth often become impacted or problematic. The American Association of Oral and Maxillofacial Surgeons reports that nine out of 10 people will have at least one impacted wisdom tooth, which can cause bad breath, pain, and/or infection. For this reason, many dentists recommend surgery to remove wisdom teeth to prevent disease or infection. A developing wisdom tooth, called a bud, is vulnerable to injury for a relatively long time because it is tiny, not covered by bone, and only covered by a thin layer of soft tissue. When a tooth bud first forms, it is no bigger than the diameter of the dental needle itself. The soft tissue surrounding the budding tooth is close to where a needle penetrates when routine dental anesthesia is injected in the lower jaw, for example when treating cavities. Using the Tufts digital dental record system, the researchers identified records of patients who had received treatment in the Tufts pediatric dental clinic between the ages of two and six and who also had a dental x-ray taken three or more years after initial treatment in the clinic. They eliminated records with confounding factors, such as delayed dental development, and analyzed a total of 439 sites where wisdom teeth could develop in the lower jaw, from 220 patient records. Group one, the control group (376 sites), contained x-rays of patients who had not received anesthesia on the lower jaw where wisdom teeth could develop. Group two, the comparison group (63 sites), contained x-rays from patients who had received anesthesia. In the control group, 1.9% of the sites did not have x-ray evidence of wisdom tooth buds. In contrast, 7.9% of the sites in the comparison group - those who had received anesthesia - did not have tooth buds. The comparison group was 4.35 times more likely to have missing wisdom tooth buds than the control group. "The incidence of missing wisdom teeth was significantly higher in the group that had received dental anesthesia; statistical evidence suggests that this did not happen by chance alone. We hope our findings stimulate research using larger sample sizes and longer periods of observation to confirm our findings and help better understand how wisdom teeth can be stopped from developing," Silvestri continued. "Dentists have been giving local anesthesia to children for nearly 100 years and may have been preventing wisdom teeth from forming without even knowing it. Our findings give hope that a procedure preventing third molar growth can be developed." Silvestri has previously published preliminary research on third molar tooth development, showing that third molars can be stopped from developing when non- or minimally-invasive techniques are applied to tooth buds.

Breath Test Reveals Alot

In The Endocrine Society's Journal of Clinical Endocrinology & Metabolism 26 March online issue, researchers from the Cedars-Sinai Medical Center in Los Angeles report how people with high levels of both hydrogen and methane in their breath are more likely to have a higher body mass index (BMI) and a higher proportion of body fat. They suggest the presence of certain bacteria in the gut causes it to extract more calories from food, adding to weight gain. Lead author Ruchi Mathur, director of the Diabetes Outpatient Treatment and Education Center in the Division of Endocrinology at Cedars-Sinai, says in a statement: "This is the first large-scale human study to show an association between gas production and body weight," adding that "this could prove to be another important factor in understanding one of the many causes of obesity." Mathur and her colleagues tested the exhaled breath of 792 people and found four patterns: normal breath, or breath containing higher levels of methane, higher levels of hydrogen, or higher levels of both gases. And the participants' whose breath had higher levels of both methane and hydrogen were the ones significantly more likely to have a higher BMI and higher proportions of body fat. A gut bacterium called Methanobrevibacter smithii is responsible for most of the methane produced in the human gut. Mathur says that usually bacteria like M. smithii are beneficial because they help extract energy and nutrients from food. But if there is too much M. smithii, it alters the energy balance so as to make the person more likely to put on weight. It does not do this directly, but by the effect it has on neighbouring bacteria, the researchers suggest. M. smithii produces methane by scavenging hydrogen from other microrganisms. The researchers propose that this gives hydrogen- producing bacteria a boost, making them more efficient so as to extract more nutrients and calories from food. It is this, which eventually leads to weight gain, says Mathur. Mathur is also working on another study that seeks to confirm the link between M. smithii, obesity and pre-diabetes. On that study the participants are given a dose of antibiotics to wipe out the bacterium so that researchers can compare how efficiently they digest food when they have the bacterium in their gut to when they do not. Mathur says we are only "beginning to understand the incredibly complex communities that live inside of us". "If we can understand how they affect our metabolism, we may be able to work with these microscopic communities to positively impact our health," she adds. Several examples of the surprising ways gut bacteria influence the human body have emerged in recent years. For instance, an animal study published in the Journal of Proteome Research in February 2012, suggests that gut bacteria may play a role in obesity by slowing down the activity of energy-burning brown fat. And in a study published in February 2013, US scientists describe how gut bacteria form part of a complex system that maintains the body's blood pressure.

Sleep Apena and Children

Obstructive sleep apnea, a common type of sleep-disordered breathing (SDB), has been linked to elevated rates of ADHD-like behavioral issues in kids, in addition to learning and adaptive problems. The findings were published in the journal Sleep and came about after a five-year study which analyzed data from a longitudinal cohort called the Tucson Children's Assessment of Sleep Apnea Study (TuCASA). The study assessed Caucasian and Hispanic kids ranging in age from 6 to 11 years to measure the incidence and prevalence of SDB and its consequences on neurobehavioral functioning. Michelle Perfect, PhD, the study's lead author and assistant professor in the school psychology program in the department of disability and psychoeducational studies at the University of Arizona in Tucson, said: "This study provides some helpful information for medical professionals consulting with parents about treatment options for children with SDB that, although it may remit, there are considerable behavioral risks associated with continued SDB. School personnel should also consider the possibility that SDB contributes to difficulties with hyperactivity, learning and behavioral and emotional deregulation in the classroom." The study consisted of 263 kids who participated in a sleep study and a neurobehavioral test of assessments which included youth and parent-documented rating scales. The outcomes revealed that 23 kids had incident sleep apnea that developed during the trial period, while 21 kids had persistent sleep apnea for the entire length of the study. An additional 41 children who started out with sleep apnea stopped having breathing issues during sleep when examined at the five-year follow-up. In children with incident sleep apnea, the risk of having behavioral issues was four to five times higher. In kids with persistent sleep apnea, that risk was six times higher. Compared with children who never experienced SDB, those with sleep apnea were more inclined to have parent-documented issues in the areas of: • attention • disruptive behaviors • hyperactivity • social competency • self-care • communication Kids with persistent sleep apnea were shown to be seven times more likely to have parent-documented learning issues and three times more likely to earn grades of C or under. Research reported at the 24th annual meeting of the Associated Professional Sleep Societies in 2010, revealed that the academic grades of children with sleep apnea are worse than students who do not have sleep-related breathing problems. The authors noted that this was the first sleep-related study to utilize a standardized survey to measure adaptive functioning in normal youths with and without SDB.