Dental Hygiene Is Not Just For Cavities

Most of us are aware that poor dental hygiene can lead to tooth decay, gum disease and bad breath - but not brushing your teeth could also have consequences for more serious illnesses. In this spotlight feature, to coincide with National Dental Hygiene Month, we peer beneath the plaque to investigate what other - perhaps unexpected - health conditions are affected by poor dental health. Alzheimer's disease In 2010, researchers from New York University (NYU) concluded that there is a link between gum inflammation and Alzheimer's disease, after reviewing 20 years of data on the association. However, the number of participants in the NYU study was fairly small. The researchers analyzed data from 152 subjects enrolled in the Glostrop Aging Study - a study looking at psychological, medical and oral health in Danish men and women. The study spanned a 20-year period and ended in 1984, when the subjects were all over the age of 70. Comparing cognitive function at ages 50 and 70, the NYU team found that gum disease at the age of 70 was strongly associated with low scores for cognitive function. Study participants were nine times more likely to have a score in the lower range of the cognitive test - the "digit symbol test" (DST) - if they had inflammation of the gums. Although this study took into account potentially confounding factors like obesity, cigarette smoking and tooth loss unrelated to gum inflammation, there was still a strong association between low DST score and gum inflammation. In 2013, UK-based researchers from the University of Central Lancashire (UCLan) built on the findings of this study, by comparing brain samples from 10 living patients with Alzheimer's with 10 brain samples from people who did not have the disease. Analysis showed that a bacterium - Porphyromonas gingivalis - was present in the Alzheimer's brain samples but not in the samples from the brains of people who did not have Alzheimer's. What was interesting was that P. gingivalis is usually associated with chronic gum disease. The team followed up this research in 2014 with a new mouse study, the results of which were published in the Journal of Alzheimer's Disease. Medical News Today spoke to co-author Dr. Sim K. Singhrao regarding the findings. Dr. Singhrao says that there is sufficient scientific evidence to show that two of the three gum disease-causing bacteria are capable of motion (or "motile") and have been consistently found in brain tissue. "These motile bacteria can leave the mouth and enter the brain via two main routes," he explains. "They can use their movement capability to directly enter the brain. One of the paths taken is to crawl up the nerves that connect the brain and the roots of teeth. The other path is indirect entry into the brain via the blood circulation system." In a patient who has bleeding gums, says Dr. Singharo, the gum disease-causing bacteria will enter the blood stream every time they clean their mouth and even when they eat food. He continues: "P. gingivalis is particularly interesting as it has found ways to hitch a lift from red blood cells when in the blood stream and instead of getting 'off the red blood cell bus' in the spleen, they choose to get off in the brain at an area where there are no immune checkpoints. From there, they spread to the brain at their will. In addition, in older individuals, the blood vessels tend to enlarge and become leaky." "The published work confirmed P. gingivalis placed in the mouths of mice finds its way to the brain once gum disease becomes established first," Dr. Singhrao concludes. "Furthermore, our hypothesis is strengthened by the recent results demonstrating that the chemicals released by the brain's immune system in response to P. gingivalis reaching the brain 'inadvertently' damage functional neurons in the area of the brain related to memory." Pancreatic cancer A research team from Harvard School of Public Health in Boston, MA, were the first to report strong evidence on a link between gum disease and pancreatic cancer, back in 2007. The type of gum inflammation associated with pancreatic cancer in the study was periodontitis, which affects the tissue that support the teeth and can cause loss of bone around the base of the teeth. The other main kind of gum disease - gingivitis; where the tissue around the teeth becomes inflamed - was not linked to increased cancer risk. However, gingivitis can lead to periodontitis if persistent. Gingivitis happens when bacteria in the plaque around the base of the teeth build up due to bad dental hygiene. Examining data on gum disease from the Health Professionals Follow-Up Study, which involved a cohort of more than 51,000 men and began collecting data in 1986, the Harvard researchers found that men with a history of gum disease had a 64% increased risk of pancreatic cancer compared with men who had never had gum disease. The greatest risk for pancreatic cancer among this group was in men with recent tooth loss. However, the study was unable to find links between other types of oral health problems - such as tooth decay - and pancreatic cancer. The researchers suggest that there may be a link between high levels of carcinogenic compounds found in the mouths of people with gum disease and pancreatic cancer risk. They argue that these compounds - called nitrosamines - may react to the digestive chemicals in the gut in a way that creates an environment favorable to the development of pancreatic cancer. However, a follow-up study from the team in 2012 was unable to prove whether the periodontitis bacteria are a cause or result of pancreatic cancer - the study could only prove that the two were linked. "This is not an established risk factor," admitted author Dominique Michaud. "But I feel more confident that something is going on. It's something we need to understand better." Heart disease Perhaps more well established is the association between dental hygiene and heart disease. "The mouth is probably the dirtiest place in the human body," said Dr. Steve Kerrigan. In 2008, MNT reported on research from joint teams at the University of Bristol in the UK and the Royal College of Surgeons in Dublin, Ireland, who found that people with bleeding gums from poor dental hygiene could be increasing their risk of heart disease. The researchers found that heart disease risk increased because - in people who have bleeding gums - bacteria from the mouth is able to enter the bloodstream and stick to platelets, which can then form blood clots, interrupting the flow of blood to the heart and triggering a heart attack. "The mouth is probably the dirtiest place in the human body," said Dr. Steve Kerrigan from the Royal College of Surgeons, explaining that there are up to 700 different types of bacteria co-existing in our mouths. Prof. Howard Jenkinson, from the University of Bristol, added: "Cardiovascular disease is currently the biggest killer in the western world. Oral bacteria such as Streptococcus gordonii and Streptococcus sanguinis are common infecting agents, and we now recognise that bacterial infections are an independent risk factor for heart diseases." The Bristol University researchers investigated how the bacteria interact with platelets by mimicking the pressure inside the blood vessels and the heart. Prof. Jenkinson's team found that the bacteria use the platelets as a defense mechanism. By clumping the platelets together, the bacteria are able to completely surround themselves. This platelet armor shields the bacteria from attack by immune cells and makes them less detectable to antibiotics. Although some of the associations we have looked at in this spotlight feature are still under investigation, good dental hygiene remains important for lowering risk of a variety of conditions. The American Dental Hygienists' Association (ADHA) recommend that we should brush for 2 minutes, twice daily. The ADHA guidelines also stress the importance of flossing daily and rinsing with mouthwash.

Type 2 Diabetes And Your Gum's Health

Going to the dentist isn't fun for anyone, but for those with periodontal disease related to type 2 diabetes, a new research discovery may have them smiling. In a report appearing in the August 2014 issue of the Journal of Leukocyte Biology, one of the most important blood cells involved in the human immune response, B cells, are shown to promote inflammation and bone loss in type 2 diabetes-associated periodontal disease. These findings support the idea that treatments that manipulate the responses of B cells may treat or prevent this complication. "Our study identified common inflammatory mechanisms shared by type 2 diabetes and periodontal disease. It paves the way for the development of novel therapeutics which aim to simultaneously treat both type 2 diabetes and its complications," said Min Zhu, Ph.D., a researcher involved in the work from the department of microbiology at Boston University School of Medicine in Boston, Massachusetts. To make this discovery, scientists used an experimental model (mouse model) of periodontal disease and applied it to two groups. The first group had a genetic alteration that knocked out all B cells. The second group had normal B cell levels. When fed a low-fat diet, without development of obesity and type 2 diabetes, both groups demonstrated a similar extent of oral bone loss and inflammation. However, when they were fed a high-fat diet, became obese and developed type 2 diabetes, oral bone loss and inflammation occurred in the normal group with B cells, but did not develop in the group with the altered gene to knock out the B cells. This suggests that the B cell-response might be a viable target for pharmacological intervention in both type 2 diabetes and periodontal disease, as well as potentially in other type 2 diabetes complications. "This is an exciting study that helps us better understand why some complications related to type 2 diabetes occur," said John Wherry, Ph.D., Deputy Editor of the Journal of Leukocyte Biology. "For those who are dealing with periodontal disease related to type 2 diabetes, this is especially exciting. B cell targeting drugs are available for B cell cancers and these new findings could open the door for applying new B cell-based treatment strategies for periodontal diseases and perhaps other inflammatory conditions."

Sports Drinks And Teeth

Dental researchers at the University of Adelaide are warning parents of the dangers of soft drinks, fruit juice, sports drinks and other drinks high in acidity, which form part of a "triple-threat" of permanent damage to young people's teeth. For the first time, researchers have been able to demonstrate that lifelong damage is caused by acidity to the teeth within the first 30 seconds of acid attack. The researchers say drinks high in acidity combined with night-time tooth grinding and reflux can cause major, irreversible damage to young people's teeth. "Dental erosion is an issue of growing concern in developed countries, and it is often only detected clinically after extensive tooth wear has occurred," says Dr Sarbin Ranjitkar, corresponding author of a paper on tooth enamel erosion published in the Journal of Dentistry. Dr Ranjitkar is a member of the University's Craniofacial Biology Research Group, which is part of the Centre for Orofacial Research and Learning. The research was conducted by School of Dentistry Honors student Chelsea Mann. "Such erosion can lead to a lifetime of compromised dental health that may require complex and extensive rehabilitation - but it is also preventable with minimal intervention," Dr Ranjitkar says. Dr Ranjitkar says the number of cases of tooth erosion from the consumption of acidic beverages is on the rise in children and young adults. "Often, children and adolescents grind their teeth at night, and they can have undiagnosed regurgitation or reflux, which brings with it acidity from the stomach. Combined with drinks high in acidity, this creates a triple threat to young people's teeth which can cause long-term damage," he says. Dr Ranjitkar says parents should minimize consumption of any kind of soft drinks, sports drink, fruit juice or acidic foods to their children. "Our research has shown that permanent damage to the tooth enamel will occur within the first 30 seconds of high acidity coming into contact with the teeth. This is an important finding and it suggests that such drinks are best avoided. "If high acidity drinks are consumed, it is not simply a matter of having a child clean their teeth an hour or 30 minutes later and hoping they'll be okay - the damage is already done," he says. Dr Ranjitkar suggests children consume fresh fruit instead of drinking fruit juice. "Although fresh fruit is naturally acidic, it is a healthier option to fruit juice, which can have additional food acids in it. "The important thing to appreciate is that there is a balance between acids and host protection in a healthy mouth. Once that balance is shifted in favor of the acids, regardless of the type of acid, teeth become damaged," he says.

Adult Stem Cells Could Treat Tooth Loss

Pioneering techniques aiming to grow new teeth from a patient's own stem cells will be on display at the Royal Society's Summer Science Exhibition which opens to the public on 1 July 2014. Bioengineered stem cell teeth could challenge the use of artificial dental implants. Worldwide we spend more on dentistry than we do on many medical treatments. Everyone in the developed world will receive dental treatment at some point and it doesn't come cheap - current implants to replace broken or decayed teeth cost around £2000. Screwed directly into the jaw, they fail to reproduce the normal connection between teeth and bone and might work loose in less than 30 years. Scientists are developing an innovative procedure that would use cells from adult patients to grow full functioning teeth in situ. The treatment could be working in mice in 5 years according to exhibit leader Professor Paul Sharpe, Dickinson Professor of Craniofacial Biology at King's College London Dental Institute. Teeth can be grown from embryonic cells but Professor Sharpe says a treatment using only adult cells and growth-stimulating chemical factors that are already regulated for use in treatment, has a much better chance of ever making it to market. 'It's very easy to grow teeth from embryonic cells in a lab environment but if it's going to cost £50,000 per implant it will never make it into clinical use,' says Professor Sharpe. Embryonic cells are surrounded by ethical controversy and could not be collected in the numbers necessary for approved large scale treatment in patients. Adult cells are a more accessible option and, if the patient's own cells are used, they could also negate the need for a lifetime of immunosuppressant drugs to avoid rejection. 'We're focused on an end point for patients and to replace current implants, a stem cell therapy needs to be price competitive. Patients are not going to pay for a treatment that costs 10 times as much as an implant. Realistically they would probably pay for a treatment that costs twice or three times as much because a bioengineered tooth would last forever. But to reach that point we need to go back to basics using only growth factors which are already regulated, and we need to use accessible cells from adults - that's where the challenge lies'. To grow a new tooth requires two types of cell, epithelial cells and mesenchymal stem cells. One of these types of cells must send instructions to the other cell population to begin creating the different cell types and tissues needed in teeth. Professor Sharpe's team have already shown that epithelial cells collected from adult patients' gum tissues during routine dental surgery can respond to instructions from embryonic mesenchymal cells to growth of teeth. The team is now searching for a source of mesenchymal cells from adults that will trigger the same responses. One source might be stem cells in adult bone marrow or teeth themselves, but these cells lose their ability to produce other types of tissue after 24 hours in culture. Professor Sharpe is working with Dr Abigail Tucker to figure out how to reawaken the properties of the cells to grow diverse tissue and unlock their ability to grow new teeth. Dr Tucker studies the replacement of teeth in the animal kingdom. Sharks and snakes grow teeth on a conveyer belt, constantly replacing those that are broken or fall out. New teeth grow in the dental lamina - a tissue packed with stem cells which die off in humans as soon as adult teeth come through. Dr Tucker studies the signals from cells in the stem cell rich dental lamina, to see how they trigger the formation of new teeth in these animals. Her work on signalling might help Professor Sharpe replicate the signals and perhaps revive the potency of adult cells to grow new teeth. 'We've shown in the lab that you can use epithelial adult cells with tooth-inducing mesenchymal cells from embryos and we've shown that embryonic epithelial cells with mesenchymal adult cells can grow new teeth. Now we need to combine adult epithelial and adult mesenchymal cells. It's one of the last pieces of the puzzle'.

Tooth Stem Cells Aid Strokes

The team, from the University of Adelaide in Australia, publish their results in the journal Stem Cell Research & Therapy. Led by Dr. Kylie Ellis, of the university's Adelaide Research & Innovation (ARI), the researchers say interest in using dental pulp stem cells for post-stroke neurological recovery has been growing, following successful pre-clinical studies. "The reality is," says Dr. Ellis, "treatment options to the thousands of stroke patients every year are limited." She explains that the main available drug treatment has to be dispensed within hours of a stroke, but most people do not have access to the treatment within that window, as they sometimes do not seek help immediately after a stroke occurs. In the lab, the research team was able to show that stem cells taken from teeth can flourish and "form complex networks of brain-like cells." Though the cells did not grow into full neurons, the team believes with time and the right conditions, it will happen. Dr. Ellis adds: "Stem cells from teeth have great potential to grow into new brain or nerve cells, and this could potentially assist with treatments of brain disorders, such as stroke." Discovery could yield 'tailor-made brain therapy' Along with her colleagues, Dr. Ellis has been working on a model in the lab for treatment in humans. She notes that, in this research, she and her team discovered that teeth-derived stem cells developed into cells closely resembling neurons. She says they do this by creating an environment for the cells as close to the normal brain environment as they possibly can. She adds that "instead of becoming cells for teeth, they become brain cells." Dr. Ellis and her team say they would like to have the capability to use a patient's own stem cells for "tailor-made brain therapy that doesn't have the host rejection issues commonly associated with cell-based therapies." Additionally, the bonus in using this tailor-made therapy is that it could mean a treatment option is available "months or even years after the stroke has occurred," Dr. Ellis adds. And beyond stroke therapy, they say their work with dental pulp stem cells creates the potential for exploring other common brain disorders in the lab, possibly yielding other new treatments. "What we developed wasn't identical to normal neurons," says Dr. Ellis, "but the new cells shared very similar properties to neurons. They also formed complex networks and communicated through simple electrical activity, like you might see between cells in the developing brain." In other stem cell research news, Medical News Today recently reported on a breakthrough study, in which researchers created the first disease-specific embryonic stem cell line with two sets of chromosomes. They said their findings could yield patient-specific therapies for type 1 diabetes. Meanwhile, researchers from another study created the first stem cell model for bipolar disorder, which they say could lead to new treatments

Tooth Loss Linked to Depression and Anxiety

At the 43rd Annual Meeting & Exhibition of the American Association for Dental Research (AADR), held in conjunction with the 38th Annual Meeting of the Canadian Association for Dental Research, R. Constance Wiener, from West Virginia University, Morgantown, presented a research study titled "Association of Tooth Loss and Depression and Anxiety." Tooth loss from caries and periodontal disease is an outcome from complex, chronic conditions. Several biopsychosocial factors are involved, including accessing care. Individuals reporting dental anxiety may avoid dental care; and individuals with depression may be negligent in self-care. In this study, researchers examined a potential association of tooth loss with depression and anxiety. The Behavioral Risk Factor Surveillance System (BRFSS) Survey is a complex, telephone survey of the Centers for Disease Control and Prevention and state health departments. In this study, the researchers used the BRFSS 2010 data (451,075 respondents). Analysis involved frequency, Chi square analysis, and complex survey logistic regression. Participants eligibility included being 19 years or older, and having complete data on depression, anxiety and tooth loss. There were 76,292 eligible participants; and 13.4% of participants reported anxiety, 16.7% reported depression, and 5.7% reported total tooth loss. The sample was evenly distributed between males and females; there were 68.7% non-Hispanic whites, 12.7% non-Hispanic blacks, 12.5% Hispanics, and 6.8% other. In Chi-square analysis by tooth loss: depression, anxiety, and a combined category of depression or anxiety were significantly different in tooth loss verses participants without the conditions. At the conclusion of this national study, the researchers found that depression and anxiety are associated with tooth loss. Funding for this study was provided by the National Institutes of Health National Institute of General Medical Sciences of the, U54GM104942.

Smoking And Taste Alteration

In a recent study it was noted that tobacco's chemicals are already known to cause a loss of taste in smokers, as well as structural changes to the fungiform papillae of the tongue - where taste buds are found. What has been unknown is to what extent smokers' taste range is affected, whether it returns to normal upon quitting smoking and if so, how long that takes. Taste buds are largely responsible for conveying sweet, sour, bitter, salty and metallic sensations. According to the Centers for Disease Control and Prevention (CDC), the responsibilities of the taste system include:  Triggering digestive systems that change secretions of saliva, stomach acid and pancreatic juices  Enhancing feelings of pleasure and satiety when eating  Determining quality of foods and determining "good" tasting foods from "bad" ones, which could have potential toxins. To further investigate the changes in taste buds caused by smoking, Jacob and colleagues tested the ability of 451 study participants to recognize and rate intensity of the four basic tastes - sweet, sour, bitter and salty. Tobacco product accumulation could impede taste bud regeneration Smokers may not be able to fully taste the bitterness of coffee, researchers say. Dividing the participants into three groups (smokers, non-smokers and former smokers), the team conducted the voluntary tests during three separate and consecutive "World No-Tobacco Days." A person's ability to recognize salty, sweet or sour tastes was not influenced by smoking status, the researchers say. However, smoking status did affect their ability to taste the bitterness in caffeine. While bitter receptors in the tongue are normally able to detect this sensation in even low concentrations, nearly 20% of smokers were not able to correctly identify the taste. Of the former smokers, 26.5% were not able to identify the taste, while only 13.4% of the non-smokers were unable to correctly identify the bitter samples. Speaking about their findings, Jacob says: "We consider that the perception of bitter taste should be examined more closely, both as a tool for smoking cessation or for preventing smoking initiation. More generally, it should be worthwhile to consider the role of chemosensory perceptions in smoking behavior." The team believes the accumulation of some tobacco products in the body could impede taste buds regenerating, which could still affect a person's ability to recognize certain tastes after they have quit smoking. In the world of taste bud studies, recent research has reported on a digital taste simulator that can produce the four main elements of taste. Researchers say it could one day be used to improve or regenerate sense of taste in cancer patients whose taste buds have been impaired by chemotherapy.

Premie's And Their Teeth

Our knowledge about premature children, and their physical and mental development as they grow up, is constantly growing. In recent years several studies of children's dental health have been published by researchers at the Faculty of Odontology in Malmö. Liselotte Paulsson-Björnsson, a specialist in orthodontics, has studied 80 children born before week 33 of pregnancy. "We have examined how their teeth are developing and, among other things, we've looked at their bites. We've also checked their need for orthodontic adjustments and found that it is greater than in the control group, children born at full term," she says. The children participating in the various studies were born in the mid 1990s and were examined when they developed their first permanent teeth at the age of eight to ten. The first permanent teeth are the front teeth in the upper and lower jaw and the so-called six-year molars, the first big molars. The results show that the teeth of premature children were up to ten percent smaller compared with the control group. The earlier the children were born the smaller their teeth were. "When we examined the children we also saw that their teeth were farther apart," says Liselotte Paulsson-Björnsson, who stresses that having small teeth as such is not a serious problem, but it can be aesthetically problematic to have large gaps between your teeth. "But these problems can be addressed. We can move teeth if the gaps between them are too large, and there is also good material to extend teeth if they're too small." Disturbances in the teeth's mineralization phase can also lead to spots on the front teeth, but this is also a problem that can be dealt with using cosmetic dental treatments. Liselotte Paulsson-Björnsson is now planning new studies to follow these children into their teens. Among other things, she will be studying whether all permanent teeth are affected in terms of size, or only the ones that are formed in connection with birth. She also wants to study the children's quality of life in relation to their dental status. "But as care of premature children is under constant development, it's not possible to automatically transfer my findings to children being born prematurely now," she says

New Gel Causes The Body To Form Teeth

A bit of pressure from a new shrinking, sponge-like gel is all it takes to turn transplanted unspecialized cells into cells that lay down minerals and begin to form teeth. The bioinspired gel material could one day help repair or replace damaged organs, such as teeth and bone, and possibly other organs as well, scientists from the Wyss Institute for Biologically Inspired Engineering at Harvard University, Harvard School of Engineering and Applied Sciences (SEAS), and Boston Children's Hospital report recently in Advanced Materials. "Tissue engineers have long raised the idea of using synthetic materials to mimic the inductive power of the embryo," said Don Ingber, M.D., Ph.D., Founding Director of the Wyss Institute, Judah Folkman Professor of Vascular Biology at Harvard Medical School, Professor of Bioengineering at SEAS, and senior author of the study. "We're excited about this work because it shows that it really is possible." Embryonic tissues have the power to drive cells and tissues to specialize and form organs. To do that, they employ biomolecules called growth factors to stimulate growth; gene-activating chemicals that cause the cells to specialize, and mechanical forces that modulate cell responses to these other factors. But so far tissue engineers who want to build organs in the laboratory have employed only two of the three strategies - growth factors and gene-activating chemicals. Perhaps as a result, they have not yet succeeded in producing complex three-dimensional tissues. A few years ago, Ingber and Tadanori Mammoto, M.D., Ph.D., Instructor in Surgery at Boston Children's Hospital and Harvard Medical School, investigated a process called mesenchymal condensation that embryos use to begin forming a variety of organs, including teeth, cartilage, bone, muscle, tendon, and kidney. In mesenchymal condensation, two adjacent tissue layers - loosely packed connective-tissue cells called mesenchyme and sheet-like tissue called an epithelium that covers it - exchange biochemical signals. This exchange causes the mesenchymal cells to squeeze themselves tightly into a small knot directly below where the new organ will form. By examining tissues isolated from the jaws of embryonic mice, Mammoto and Ingber showed that when the compressed mesenchymal cells turn on genes that stimulate them to generate whole teeth composed of mineralized tissues, including dentin and enamel. Inspired by this embryonic induction mechanism, Ingber and Basma Hashmi, a Ph.D. candidate at SEAS who is the lead author of the current paper, set out to develop a way to engineer artificial teeth by creating a tissue-friendly material that accomplishes the same goal. Specifically, they wanted a porous sponge-like gel that could be impregnated with mesenchymal cells, then, when implanted into the body, induced to shrink in 3D to physically compact the cells inside it. To develop such a material, Ingber and Hashmi teamed up with researchers led by Joanna Aizenberg, Ph.D., a Wyss Institute Core Faculty member who leads the Institute's Adaptive Materials Technologies platform. Aizenberg is the Amy Smith Berylson Professor of Materials Science at SEAS and Professor of Chemistry and Chemical Biology at Harvard University. They chemically modified a special gel-forming polymer called PNIPAAm that scientists have used to deliver drugs to the body's tissues. PNIPAAm gels have an unusual property: they contract abruptly when they warm. But they do this at a lukewarm temperature, whereas the researchers wanted them to shrink specifically at 37°C - body temperature - so that they'd squeeze their contents as soon as they were injected into the body. Hashmi worked with Lauren Zarzar, Ph.D., a former SEAS graduate student who's now a postdoctoral associate at Massachusetts Institute of Technology, for more than a year, modifying PNIPAAm and testing the resulting materials. Ultimately, they developed a polymer that forms a tissue-friendly gel with two key properties: cells stick to it, and it compresses abruptly when warmed to body temperature. As an initial test, Hashmi implanted mesenchymal cells in the gel and warmed it in the lab. Sure enough, when the temperature reached 37°C, the gel shrank within 15 minutes, causing the cells inside the gel to round up, shrink, and pack tightly together. "The reason that's cool is that the cells are alive," Hashmi said. "Usually when this happens, cells are dead or dying." Not only were they alive - they activated three genes that drive tooth formation. To see if the shrinking gel also worked its magic in the body, Hashmi worked with Mammoto to load mesenchymal cells into the gel, then implant the gel beneath the mouse kidney capsule - a tissue that is well supplied with blood and often used for transplantation experiments. The implanted cells not only expressed tooth-development genes - they laid down calcium and minerals, just as mesenchymal cells do in the body as they begin to form teeth. "They were in full-throttle tooth-development mode," Hashmi said. In the embryo, mesenchymal cells can't build teeth alone - they need to be combined with cells that form the epithelium. In the future, the scientists plan to test whether the shrinking gel can stimulate both tissues to generate an entire functional tooth.

"Big Tooth" Is Watching You !

Researchers at the National University of Taiwan have developed a “smart” tooth device that monitors an individual ‘s oral habits by recording movement of the jaw and generating data that is fed to a computer via the tooth’s sensor , then paired with an oral action . The device can be used as a detachable fake tooth or inserted in a crown , allowing doctors to track chewing , drinking , eating , coughing and even smoking – and (hopefully) allow them help treating a wide range of problems . In testing the device , the researchers asked 8 volunteers to perform 30 – second tasks such as chewing gum , reading aloud , drinking a bottle of water and coughing . The device was able to determine what action each volunteer performed with 94% accuracy . Because the mouth is “an opening into human health” , the researchers contend the device has the potential to enhance existing healthcare monitoring applications such as dietary tracking.

New Study About Heart Surgery And Infected Teeth

Abscessed or infected teeth are often removed before heart surgery, as this decreases the risk of infection during surgery and decreases the risk of an inflammation of the inner layer of the heart - called endocarditis - following surgery. But although it is standard practice to remove bad teeth prior to heart surgery, there is only limited evidence that supports this practice. The new study set out to evaluate what harms may be associated with dental extraction before cardiovascular surgery. "Guidelines from the American College of Cardiology and American Heart Association label dental extraction as a minor procedure, with the risk of death or non-fatal heart attack estimated to be less than 1%," says study author and anesthesiologist Dr. Mark M. Smith, from the Mayo Clinic in Rochester, MN. "Our results, however, documented a higher rate of major adverse outcomes, suggesting physicians should evaluate individualized risk of anesthesia and surgery in this patient population," he adds. Heart attack, stroke, kidney failure and death Dr. Smith and his colleagues found that 8% of patients who had teeth removed prior to heart surgery experienced adverse outcomes. These included heart attack, stroke, kidney failure and death. Overall, 3% of patients died after dental extraction and before the heart surgery could take place. But this study did have some limitations. Co-author and cardiac surgeon Dr. Joseph A. Dearani says: "With the information from our study we cannot make a definitive recommendation for or against dental extraction prior to cardiac surgery. We recommend an individualized analysis of the expected benefit of dental extraction prior to surgery weighed against the risk of morbidity and mortality as observed in our study." Established thinking on dental surgery and cardiac surgery is changing The results of the Mayo Clinic study contribute to an ongoing departure in current thinking on the relationship between dental surgery and cardiac surgery. "'Accepted wisdom' leads surgeons to request dental reviews prior to cardiac surgery in many thousands of patients annually around the world," says Dr. Michael Jonathan Unsworth-White, from Derriford Hospital in Plymouth, UK. "Dr. Smith's group asks us to question this philosophy. It is a significant departure from current thinking." Writing in a linked comment, Dr. Unsworth-White draws parallels with another recent change of consensus. In patients undergoing dental work who have existing heart problems, it has previously been standard practice to prescribe prophylactic antibiotics. Again, this was because there is a known link between dental bacteremia and endocarditis. But more recent studies have suggested that the potential side effects of these antibiotics may outweigh the benefits. Dr. Unsworth-White explains: "The American Heart Association and the National Institute for Health and Clinical Excellence in the UK have withdrawn support for this practice of prophylactic antibiotics because the danger from overuse of antibiotics outweighs any other potential risks. Regular tooth brushing, flossing, and even chewing gum are now recognized to dislodge as much, if not more, bacteremia than most dental procedures."

Gum Disease Bacteria Cause Cancer

Researchers from Case Western Reserve University have discovered how byproducts in the form of small fatty acids from two bacteria prevalent in gum disease incite the growth of deadly Kaposi's sarcoma-related (KS) lesions and tumors in the mouth. The discovery could lead to early saliva testing for the bacteria, which, if found, could be treated and monitored for signs of cancer and before it develops into a malignancy, researchers say. "These new findings provide one of the first looks at how the periodontal bacteria create a unique microenvironment in the oral cavity that contributes to the replication the Kaposi's sarcoma Herpesvirus (KSHV) and development of KS," said Fengchun Ye, the study's lead investigator from Case Western Reserve School of Dental Medicine's Department of Biological Sciences. The discovery is described in The Journal of Virology article, "Short Chain Fatty Acids from Periodontal Pathogens Suppress HDACs, EZH2, and SUV39H1 to Promote Kaposi's Sarcoma-Associated Herpesvirus Replication." The research focuses on how the bacteria, Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn), which are associated with gum disease, contribute to cancer formation. Ye said high levels of these bacteria are found in the saliva of people with periodontal disease, and at lower levels in those with good oral health - further evidence of the link between oral and overall physical health. KS impacts a significant number of people with HIV, whose immune systems lack the ability to fight off the herpesvirus and other infections, he said. "These individual are susceptible to the cancer," Ye said. KS first appears as lesions on the surface of the mouth that, if not removed, can grow into malignant tumors. Survival rates are higher when detected and treated early in the lesion state than when a malignancy develops. Also at risk are people with compromised immune systems: people on medications to suppress rejection of transplants, cancer patients on chemotherapies and the elderly population whose immune systems naturally weaken with age. The researchers wanted to learn why most people never develop this form of cancer and what it is that protects them. The researchers recruited 21 patients, dividing them into two groups. All participants were given standard gum-disease tests. The first group of 11 participants had an average age of 50 and had severe chronic gum disease. The second group of 10 participants, whose average age was about 26, had healthy gums, practiced good oral health and showed no signs of bleeding or tooth loss from periodontal disease. The researchers also studied a saliva sample from each. Part of the saliva sample was separated into its components using a spinning centrifuge. The remaining saliva was used for DNA testing to track and identify bacteria present, and at what levels. The researchers were interested in Pg's and Fn's byproducts of lipopolysaccharide, fimbriae, proteinases and at least five different short-chain fatty acids (SCFA): butyric acid, isobutryic acid, isovaleric acid, propionic acid and acetic acid. After initially testing the byproducts, the researchers suspected that the fatty acids were involved in replicating KSHV. The researchers cleansed the fatty acids and then introduced them to cells with quiescent KSHV virus in a petri dish for monitoring the virus' reaction. After introducing SCFA, the virus began to replicate. But the researchers saw that, while the fatty acids allowed the virus to multiple, the process also set in motion a cascade of actions that also inhibited molecules in the body's immune system from stopping the growth of KSHV. "The most important thing to come out of this study is that we believe periodontal disease is a risk factor for Kaposi sarcoma tumor in HIV patients," Ye said. With that knowledge, Ye said those with HIV must be informed about the importance of good oral health and the possible consequences of overlooking that area .

New Candy Reduces Cavities

Our mouths are a delicate balance of good and bad bacteria. When we clean our teeth, the aim is to knock out cavity-causing bacteria, while allowing beneficial oral bacteria to thrive. Now, researchers have developed a sugar-free candy, which contains dead bacteria that bind to bad bacteria, potentially reducing cavities. The importance of good oral health has been emphasized by doctors for years. Poor oral health has been linked to many conditions, from Alzheimer's disease to pancreatic cancer, not to mention cardiovascular disease. To promote better oral health, a team from the Berlin-based firm Organobalance GmbH, Germany, created a new candy, which they claim reduced levels of 'bad' bacteria in study subjects' mouths. Their research was published in Probiotics and Antimicrobial Proteins. They note that after we eat, bacteria on the surface of the teeth release acid, which can dissolve the tooth enamel, leading to cavities. The most common strain of this "bad" bacteria is called Mutans streptococci. However, the researchers say that in previous studies with rats, another bacteria called Lactobacillus paracasei has been shown to reduce levels of the cavity-causing bacteria, decreasing the number of cavities in the rodents. The team, led by Christine Lang, believe that by binding with M. streptococci, the L. paracasei bacteria prevent this bad bacteria from reattaching to the teeth, causing it to get washed away by saliva. Dentists normally suggest staying away from sweets, but a newly created sugar-free bacteria-containing candy reduced levels of bad oral bacteria. In a pilot trial involving 60 subjects, Lang and her team tested whether their sugar-free candy, which contained heat-killed samples of L. paracasei DSMZ16671, reduced levels of bad oral bacteria. One-third of the subjects ate candies with 1 mg of L. paracasei, while another third ate candies with twice this amount (2 mg). The final third served as a control group and ate candies that were similar in taste but that contained no bacteria. In total, all subjects ate five candies during the 1.5-day study. They were not allowed to perform any oral hygiene activities during this time, and they were also not allowed to consume coffee, tea, wine or probiotic foods. Results showed that nearly 75% of the participants who ate candies with the good bacteria had "significantly lower" levels of Mutans streptococci in their saliva than before, compared with the control group. Additionally, the subjects who ate candy with 2 mg of L. paracasei had a reduction in bad bacteria levels after eating only one piece of candy. The researchers write: "We think it remarkable that this effect was observed after exposure to only five pieces of candy containing 1 or 2 mg of dead L. paracasei DSMZ16671 consumed in 1.5 days." They say that by using dead bacteria, they avoided problems that live bacteria might have caused. They also note that the L. paracasei does not bind with beneficial oral bacteria, which is why this is a better cavity prevention method than other probiotics. "Additionally," they add, "sugar-free candies stimulate saliva flow, a benefit to oral health."

Whats In Your Food ?

In our modern and fast-paced lives, it may be difficult to keep a healthy balance of nutrients in our food. Sugar is one of these nutrients, and the cells in our body would die without it. Consuming too much sugar, however, raises the risk of several problems, including poor dental health, obesity and type 2 diabetes. To keep control of sugar levels, it helps to know just how much sugar there is in the food we eat. Here, we have listed the sugar content of numerous everyday foods, both processed and natural ones. What is sugar? Sugar is a simple carbohydrate that belongs to a class of chemically-related sweet-flavored substances. It comes in many different forms. The three main types of sugar are sucrose, lactose, and fructose. Even though our cells need sugar (glucose) to survive, consuming too much of it can cause numerous different health problems. Added sugar contains no beneficial nutrients and in excess only contributes to tooth decay, diabetes, and obesity. The American Heart Association (AHA) have said that added sugars "contribute zero nutrients" and are just empty calories "that can lead to extra pounds, or even obesity, thereby reducing heart health." Being aware of the existing and added sugar contents of the foods and drinks we consume is vital for our health - even more so today because so many products have sugar added to them. The AHA currently recommends that men consume no more than 150 calories from added sugar per day, and women 100 calories. Nutritionists strongly recommend against consuming more than 13 teaspoons a day. Sugar content in common foods and drinks To help you keep track of how much sugar you're consuming we've listed some common everyday foods and drinks, together with their sugar content. Some of these may surprise you: How much sugar do chocolates and candy contain? Milk chocolate bar (44g) - 5.75 teaspoons of sugar Snickers bar (57g) - 7 teaspoons of sugar Milky Way bar (58g) - 8.5 teaspoons of sugar Marshmallows (100g) - 14.5 teaspoons of sugar Caramel piece (10g) - 1.7 teaspoons of sugar Butterfinger bar (60g) - 6.9 teaspoons of sugar Dove chocolate bar (37g) - 5 teaspoons of sugar Starburst packet (45 grams) - 5.5 teaspoons of sugar Twix bar - 2.75 teaspoons of sugar M&Ms packet (45 grams) - 5.75 teaspoons of sugar Boiled sweets bag (100 grams) - 11.5 teaspoons of sugar How much sugar do soft drinks contain? Coca cola (one can) - 7 teaspoons of sugar Red Bull (one can) - 7.5 teaspoons of sugar Lemonade (one glass) - 5.5 teaspoons of sugar Orange squash (one glass) - 2.5 teaspoons of sugar Hot chocolate (one mug) - 4.5 teaspoons of sugar Fruit smoothie (one glass) - 3.5 teaspoons of sugar A study published in Circulation, the journal of the American Heart Association, identified a link between drinking more than one soft drink a day and increased risk of developing heart disease and diabetes. How much sugar do breakfast cereals contain? Alpen - 5 teaspoons of sugar Cheerios - 1.1 teaspoons of sugar Corn Flakes - 2.4 teaspoons of sugar Cocoa Krispies - 9.6 teaspoons of sugar Froot Loops - 10.6 teaspoons of sugar Raisin Bran - 7.8 teaspoons of sugar Frosted Flakes - 8.9 teaspoons of sugar Honey Smacks - 14 teaspoons of sugar Rice Krispies - 2.5 teaspoons of sugar Special K - 3 teaspoons of sugar Wheaties - 3.8 teaspoons of sugar Trix - 8 teaspoons of sugar Lucky Charms - 9 teaspoons of sugar Rice Chex - 2 teaspoons of sugar Wheat Chex - 2.6 teaspoons of sugar Corn Chex - 2.8 teaspoons of sugar Honey Nut Cheerios - 8.25 teaspoons of sugar Reese's Puffs - 8.9 teaspoons of sugar Golden Grahams - 8.8 teaspoons of sugar Cocoa Puffs - 9.3 teaspoons of sugar Cookie Crisp - 8.7 teaspoons of sugar Shredded Wheat - 0.1 teaspoons of sugar Cocoa Pebbles - 8.6 teaspoons of sugar Banana Nut Crunch - 4.7 teaspoons of sugar In June 2012, researchers from Yale Rudd Center for Food Policy & Obesity revealed that even though cereals aimed at kids had become more nutritious, cereal companies (such as Kellogg, General Mills, and Post) had increased their advertising spending considerably. Cereal advertising aimed at children increased by 34% between 2008 and 2011. Marlene Schwartz, deputy director of the Rudd Center, said: "While cereal companies have made small improvements to the nutrition of their child-targeted cereals, these cereals are still far worse than the products they market to adults. They have 56% more sugar, half as much fiber, and 50% more sodium. The companies know how to make a range of good-tasting cereals that aren't loaded with sugar and salt. Why can't they help parents out and market these directly to children instead?" How much sugar does fruit contain? Fruits contain fructose, a type of sugar. Fresh fruit have no "added sugar", but as you can see below, their levels of sugar range from 1 teaspoon per 100 grams in cranberries to 4 teaspoons in grapes. Mangos - 3.2 teaspoons of sugar Bananas - 3 teaspoons of sugar Apples - 2.6 teaspoons of sugar Pineapples - 2.5 teaspoons of sugar Grapes - 4 teaspoons of sugar Lemons - 0.6 teaspoons of sugar Kiwi fruit - 2.3 teaspoons of sugar Apricots - 2.3 teaspoons of sugar Strawberries - 1.3 teaspoons of sugar Raspberries - 1 teaspoon of sugar Blueberries - 1.7 teaspoons of sugar Cranberries - 1 teaspoons of sugar Tomatoes - 0.7 teaspoons of sugar How much sugar do cakes and desserts contain? Banoffee pie (1 medium portion) - 4.25 teaspoons of sugar Carrot cake (1 medium slice) - 3 teaspoons of sugar Custard (1 medium portion) - 3.25 teaspoons of sugar Chocolate mousse (1 medium portion) - 3 teaspoons of sugar Cornetto (1 cone) - 3 teaspoons of sugar Donut (1 jam doughnut) - 3.5 teaspoons of sugar Fruit pie (1 medium portion) - 3.5 teaspoons of sugar Fruit cake (1 medium slice) - 5 teaspoons of sugar Muffin (one chocolate chip muffin) - 4.75 teaspoons of sugar Ice cream (1 scoop) - 3 teaspoons of sugar Rice pudding (1 portion) - 3.75 teaspoons of sugar Sponge cake (1 medium slice) - 5.5 teaspoons of sugar Swiss roll (1 roll) - 2.5 teaspoons of sugar Why Should I monitor my sugar intake? The American Heart Association has urged people to cut their added sugar intake because of evidence that it can cause the following health conditions: Obesity - Scientists at the Medical Research Council found that eating more sugar is associated with obesity. High blood pressure - A high-fructose diet raises blood pressure in men, according to research reported at the American Heart Association's 63rd High Blood Pressure Research Conference. Heart disease - Researchers at the Emory University School of Medicine and the US Centers for Disease Control and Prevention (CDC), found that people who consume higher amounts of added sugar are more likely to have heart disease risk factors. Type 2 diabetes - Research conducted at the University of California-San Francisco indicates that sugar intake could be directly linked to type 2 diabetes. Added sugar consumption far too high The U.S. Centers for Disease Control and Prevention (CDC) reported that far too many Americans are consuming too many calories from added sugars. The report revealed that nearly 13% of adults' total caloric intake are coming from sources such as sugar and high fructose corn syrup. Consumers need information on "Added Sugars" Dr Aseem Malhotra, a cardiologist, wrote in the BMJ (British Medical Journal) last month that dietary advice on added sugar is damaging people's health. Dr. Malhotra said "not only has this advice been manipulated by the food industry for profit but it is actually a risk factor for obesity and diet related disease." Food labels in the USA and Europe contain only information on total sugars per serving, and tell us nothing about added sugar. "It is therefore almost impossible for consumers to determine the amount of added sugars in foods and beverages." Prof. Tim Noakes, Director at the Research Unit for Exercise Science and Sports Medicine, University of Cape Town, South Africa, wrote in the same journal "Sugary sports drinks are promoted as essential for athletic performance, but are used predominantly by those without real athletic aspirations. Users need to understand that exercise may not protect them from the negative consequences of an excessive sugar intake." In the video below, Dr. Miriam Vos, assistant professor of pediatrics (gastroenterology) at Emory University School of Medicine explains what "added sugars" are and how they are different from the natural sugars we find in fruit or milk .