Brewster MA Dentist Has Another Happy Dental Implant Patient

Summer Time Prevention

Bursting the Bubble The popularity of soft drinks during the summer increases year after year, due in part to their sweet taste, and in part to the aggressive advertising campaigns run by soda companies. The amount of soda consumed by the average American every year is staggering – over 50 gallons per person. Soft drinks are a danger to oral health due to the high amounts of sugar and acids. Because of their liquid nature, gulping down soft drinks is equivalent to bathing teeth in a solution of acids and sugar. Over time, even the relatively mild acids in soft drinks can eat away and weaken tooth enamel, making teeth more susceptible to decay and damage. Another indirect effect of soda consumption is the reduced consumption of other, healthier drinks. The reduced consumption of milk has led to a deficiency in the intake of important vitamins and minerals. Calcium, in particular, is important to the maintenance of strong teeth and bones. Without a sufficient supply of calcium, the body cannot properly maintain the integrity of teeth – combined with the damaging effects of the sugar and acid in popular soft drinks, and it is easy to see why dentists are concerned. Lowering or eliminating soft drink consumption entirely is not a very likely solution. Sodas are so prevalent in the American diet that elimination is simply unrealistic. Therefore, if you are concerned about the effect of soft drinks on your oral health, consider the following steps. First, take a good look at your brushing and flossing habits. These are vital if you are to counteract the negative effects of soft drinks. Second, try to reduce your soft drink consumption as much as possible, and replace it with beneficial liquids such as milk or fluoridated water. Third, if you must drink sodas, use a straw when possible, to minimize contact with your teeth. A timely visit to the dentist is always a key factor in maintaining good oral and dental health.

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