37% of Americans don’t know that poor oral health has been associated with stroke, heart disease and diabetes. - ADA
As scientific research confirms more and more connections between oral health and overall well-being, the role of dentists is changing. To keep up with the latest dental research and technology, please subscribe to this blog. Thank you for your time and interest.
- Neal B. Graber, DMD (firstname.lastname@example.org)
November 10, 2013 - Back in 2004, the National Institute for Dental and Craniofacial Research released a survey indicating that 92% of adults (and 42% of children) have tooth decay. Greater than 90% of adults have gum disease. Worst of all, over 65% of 15 year olds have active gum disease. (Their study excluded the five percent of the population that does not have any teeth.) More recent research demonstrates a clear relationship between decreased saliva production and the increase in gum disease associated with aging.
One method of increasing saliva involves swishing oil in the mouth. While some cultures have been "pulling oil" for generations, the taste and texture of a mouthful of oil takes getting used to for most people. Instead, I recommend starting with a simple technique of swishing saliva vigorously in your mouth for a minute or two. Not only does this increase the amount of saliva in your mouth, dilute acid and remineralize teeth - it also aids digestion in the stomach. So, give your saliva production a boost and we can help you monitor your progress during your next visit. (Please note that your diet must include enough healthy minerals to enable your saliva to support remineralization.) For further information, see the OraWellness video "Mouth Probiotics," which explains how and why saliva works to improve oral health.
This research is ongoing, so stay tuned for more compelling reasons to swish. Meanwhile, I continue to follow the progress in the field of salivary diagnostics with great interest. Invasive blood tests require a visit to a doctor, take time to analyze and often only detect the presence of advanced disease. Therefore, salivary diagnostic tools show promise as a rapid, automated and portable means of monitoring health. With this in mind, NIH funded “Salivary biomarkers for early oral cancer detection” and “Salivary proteomic and genomic biomarkers for primary Sjogren’s Syndrome” in 2010. These two studies were among the first to catalog the genes and proteins that are expressed in saliva.
This September, for the first time, the National Institutes of Health (NIH) funded research to develop biological markers in saliva for disease detection. The NIH granted $5 million to the University of California Los Angeles School of Dentistry to develop biological markers in saliva as a means of creating tests that identify stomach cancer and other systemic diseases.
Dr. David T. Wong, one of my mentors, a pioneer in salivary diagnostics and the University of California Los Angeles School of Dentistry's associate dean of research, explains, "Saliva can be used for oral disease detection. Great. But if saliva can be used to detect non-oral disease, systemic disease, that really puts it in a different place in terms of clinical impact."
Ongoing studies indicate that patterns in saliva samples may be useful for detecting cancers, heart disease, diabetes, periodontal diseases and other conditions in a matter of minutes. In the future, as technical devices continue to become smaller, dentists may be able to connect a monitor to a patient's tooth to register medication levels and biomarkers for specific diseases.
To learn more about hormones and antibodies that can be detected in human saliva, watch this educational video that was released two weeks ago to explain the clinical application of these new salivary diagnostic tools.
May 6, 2013 - According to an article in the Family section of The New York Times, pregnant women are not getting appropriate dental care due to misinformation on the part of the patient, her gynecologist and/or her dentist.
"Delaying oral care can have serious consequences. Gingivitis, or gum inflammation, affects 60 to 75 percent of pregnant women, and left unchecked, it can become periodontal disease. Untreated periodontal disease can lead to tooth loss. And a mother with active tooth decay can spread cavity-causing bacteria to her child through saliva, perpetuating poor oral health."
At the Dental Center of Huntington, we recommend that all patients who are trying to get pregnant (or already pregnant) continue with routine hygiene appointments and necessary treatment. Some patients choose to come for cleanings every three months to avoid gingivitis, which is more common in pregnant women due to hormonal changes that cause inflammation and reduce the body's immune response to oral bacteria. Digital X-rays and select antibiotics may be needed to diagnose and treat infections during pregnancy in order to reduce the chance of preterm birth.
For the safety and comfort of pregnant patients, we recommend getting in and out of the dental chair slowly. In addition, we keep the chair more elevated than usual and position patients who are late into the second or third trimester on their left side to relieve any pressure on the vena cava. We recommend that patients suffering from morning sickness or snacking throughout the day take precautions to avoid acid erosion as detailed in the Dental Care and Pregnancy section of this site.
November 27, 2012 - The December issue of Nutrition Reviews includes an analysis of previous studies of approximately 3,000 children from the United States, Great Britain, Canada, Austria, New Zealand and Sweden from the 1920s to 1980s. These trials link vitamin D with approximately a 50 percent reduction in the incidence of tooth decay.
While the role of vitamin D in supporting bone health remains undisputed, its role in preventing dental caries has drawn disparate conclusions from the American Medical Association and the U.S. National Research Council, the Institute of Medicine, the U.S. Department of Human Health and Service and the American Dental Association.
"Such inconsistent conclusions by different organizations do not make much sense from an evidence-based perspective," said Dr. Philippe Hujoel, who conducted the review while serving as a professor in the University of Washington School of Dentistry's Department of Oral Health Sciences and as an adjunct professor of epidemiology in the UW School of Public Health. The trials he reviewed increased vitamin D levels in children through the use of supplemental UV radiation or by supplementing the children's diet with cod-liver oil or other products containing the vitamin.
Hujoel's findings come as no surprise to researchers familiar with past vitamin D studies. According to Dr. Michael Hollick, professor of medicine at the Boston University Medical Center, "the findings from the University of Washington reaffirm the importance of vitamin D for dental health." He said that "children who are vitamin D deficient have poor and delayed teeth eruption and are prone to dental caries."
The vitamin D question takes on greater importance in the light of current public health trends. Vitamin D levels in many populations are decreasing while dental caries levels in young children are increasing.
"Whether this is more than just a coincidence is open to debate," Hujoel said. "In the meantime, pregnant women or young mothers can do little harm by realizing that vitamin D is essential to their offspring's health. Vitamin D does lead to teeth and bones that are better mineralized."
Hujoel added a note of caution to his findings: "One has to be careful with the interpretation of this systematic review. The trials had weaknesses which could have biased the result, and most of the trial participants lived in an era that differs profoundly from today's environment."
April 11, 2012 - We recognize that many patients are concerned by the results of a study published in the scientific journal Cancer, which associates yearly or more frequent dental X-rays with an increased risk of developing meningioma. Resources and expert opinions cited by the American Dental Association, American Academy of Oral and Maxillofacial Radiology and the American Cancer Society lead Dr. Graber to question the validity of the Cancer study pending further research.
At the Dental Center of Huntington, we made the investment in Dexis digital X-ray technology in 2008 to minimize patient exposure to radiation. Dr. Graber uses previous radiographs whenever possible, and relies on new X-rays when necessary for diagnosis and treatment. In general, our office follows the American Dental Association recommendations, which suggests routine mouth X-rays every two to three years for healthy adults, every one to two years for children and every 1.5 to three years for teenagers. (Children require more frequent X-rays because of their developing teeth and jaws and increased likelihood for cavities.)
Below are two experts' takes on the study's potential flaws:
According to Dr. Alan Lurie, a Ph.D. radiation biologist who specializes in cancer induction and is president of the American Academy of Oral and Maxillofacial Radiology, the study has a serious flaw. “They’re asking people to remember (in some cases) a couple of radiographs they had 30 years earlier when they were kids. They’re not going to be able to tell you what kind of X-ray machine was used…what kind of film, were there any retakes?"
Dr. Lurie adds that radiation levels from dental X-rays when some of the participants were younger was much greater than is used now.
"They found a small risk (from) a pair of bitewings, but not a full mouth series, which is multiple bitewings. That inconsistency is impossible to understand to me," said Lurie.
The main weakness is the failure of the researchers to obtain any of the patient’s dental records to verify that the number of X-rays they reported having was true, echoes Dr. Richard Besser, ABC News' chief health and medical editor.
The following press release was issued on April 10, 2012 by the American Dental Association:
The American Dental Association (ADA) is aware of a recent study that associates yearly or more frequent dental X-rays to an increased risk of developing meningioma, the most commonly diagnosed brain tumor. The ADA’s long-standing position is that dentists should order dental X-rays for patients only when necessary for diagnosis and treatment. Since 1989, the ADA has published recommendations to help dentists ensure that radiation exposure is as low as reasonably achievable.
The ADA has reviewed the study and notes that the results rely on the individuals’ memories of having dental X-rays taken years earlier. Studies have shown that the ability to recall information is often imperfect. Therefore, the results of studies that use this design can be unreliable because they are affected by what scientists call "recall bias." Also, the study acknowledges that some of the subjects received dental X-rays decades ago when radiation exposure was greater. Radiation rates were higher in the past due to the use of old X-ray technology and slower speed film. The ADA encourages further research in the interest of patient safety.
As part of the ADA’s recommendations to minimize radiation exposure, the ADA encourages the use of abdominal shielding (e.g., protective aprons) and thyroid collars on all patients. In addition, the ADA recommends that dentists use E or F speed film, the two fastest film speeds available, or a digital X-ray.
In addition to the X-ray recommendations, the ADA’s Council on Scientific Affairs will publish clinical guidance on the use of cone-beam computed tomography in an upcoming issue of The Journal of the American Dental Association. The ADA will share these recommendations as soon as they are available.
Dental X-rays are valuable in helping dentists detect and treat oral health problems at an early stage. Many oral diseases can’t be detected on the basis of a visual and physical examination alone, and dental X-rays are valuable in providing information about a patient’s oral health such as early-stage cavities, gum diseases, infections or some types of tumors. How often dental X-rays should be taken depends on the patient’s oral health condition, age, risk for disease and any signs and symptoms of oral disease that the patient might be experiencing.
The ADA encourages patients to talk to their dentists if they have questions about their dental treatment. As a science-based organization, the ADA fully supports continuing research that helps dentists deliver high-quality oral health care safely and effectively.
Mariana Contente Rangel Henriques
March 7, 2012 - With the emergence of Candida infections that are resistant to traditional antifungal therapies, there is an increasing need for alternative approaches. Professor Mariana Henriques, University of Minho, and her colleagues plan to test silver nanoparticles in mouthwash and dentures as a potential preventative measure against yeast infections caused by Candida albicans and Candida glabrata.
Professor Henriques and her team, who published their research in Letters in Applied Microbiology today, looked at the use of different sizes of silver nanoparticles to determine their anti-fungal properties against these two yeasts, which cause oral thrush and dental stomatitis, a painful infection affecting around seven out of ten denture wearers. These infections are difficult to treat because the microorganisms involved form biofilms.
Since these promising studies are in the early stages, safety trials need to be carried out before these products can be brought to market.
"Painless" Plasma Brush Undergoing Human Clinical Trials
December 20, 2011 - University of Missouri engineers have partnered with a research team at Nanova, Inc. to pioneer the plasma brush, a dental tool which uses a chemical reaction to disinfect and clean cavities for fillings. In addition to its bacteria-killing properties, the “cool flame” forms a better bond for cavity fillings.
“No side effects have been reported during the lab trials, and we expect the human trials to help us improve the prototype,” said Qingsong Yu, associate professor of mechanical and aerospace engineering of MU, and Meng Chen, chief scientist from Nanova, Inc., which holds a co-patent for the plasma brush with MU.
Hao Li, associate professor of mechanical and aerospace engineering in the MU College of Engineering notes, “A tooth can only support two or three restorations before it must be pulled. Our studies indicate that fillings are 60 percent stronger with the plasma brush, which would increase the filling lifespan. This would be a big benefit to the patient, as well as dentists and insurance companies.”
Human clinical trials are expected to begin in early 2012 at the University of Tennessee-Memphis. Pending favorable results of the study and FDA approval, the plasma brush could be available to dentists as early as the end of 2013.
November 7, 2011 - This morning's edition of National Public Radio (NPR) suggests that vaccinating 11 and 12-year-old boys (as well as girls) against human papillomavirus may be easier than getting girls to take the full three-shot series of the HPV vaccine over a six-month period before becoming sexually active. Diseases like HPV or herpes are skin-to-skin transmitted, so condoms are not 100 percent effective in preventing transmission. Therefore, there are a whole range of sexual behaviors that can transit HPV. Many people incorrectly assume that the vaccine only protects against cervical cancer, but HPV causes cancer of the cervix, vagina and vulva, penile cancer, anal cancer and cancers of the head and neck.
According to NPR, around 50,000 Americans will get head and neck cancers this year, versus 12,000 cervical cancers and 1,400 penile cancers. The CDC notes that at least 50 percent of sexually active people will have genital HPV at some point in their lives.
The Dental Center of Huntington recommends that all patients with HPV have oral cancer screenings during their regularly scheduled cleanings. Meanwhile, we recommend that all parents consider administering the HPV vaccination to 11 and 12-year-old boys and girls.
October 13, 2011 - According to a study of twenty people published in the journal Gut, certain types of mouth bacteria, some of which are found in gum disease, are linked to the development of pancreatic cancer. This preliminary study compared bacteria found in the saliva of ten pancreatic cancer patients whose cancer had not yet spread with ten healthy people matched by age and sex. The findings, which demonstrated substantial variations of bacterial colonies, were verified by a follow-up study on 28 new participants in each group. The authors are hopeful that their research will pave the way for a new treatment approach for pancreatic cancer based on altering the balance of bacteria.
Additionally, examination of tissue samples from 28 patients with chronic inflammation of the pancreas, which is linked to an increased risk of developing pancreatic cancer, revealed six suspicious species, including Neisseria elongata and Streptococcus mitis. The findings confirmed an 80% difference of the Neisseria elongata and Streptococcus mitis combination between healthy patients and those with cancer. The researchers discovered similar differences in the prevalence of S mitis and Granulicatella adjacens between the chronic pancreatitis samples and healthy people's saliva.
Further investigation will be necessary to prove that the presence of specific bacteria types are the cause or effect of pancreatic cancer. However, these findings support earlier research, which showed that bacteria have an impact in the development of pancreatic diseases. In the future, particular types of bacteria may be used as a non-invasive and reliable screen for early detection of pancreatic cancer, thereby dramatically improving the survival rate, which is currently over five years after diagnosis for only one in twenty patients.
Xylitol Helps Prevent Acid Erosion
September 13, 2011 - Based on the clinical recommendations by a multi-disciplinary panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs, we suggest that adults and children over the age of five who are at a higher risk for cavities use sugar-free polyol gum, lozenges or hard candy after meals to prevent cavities in addition to regular brushing, flossing and professsional cleanings. Polyol is a low-calorie sweeter such as xylitol, sorbitol or mannitol, which is not broken down by bacteria in the mouth and therefore does not contribute to tooth decay. These natural sweeteners prevent bacteria from sticking to the teeth and help keep a neutral pH level in the mouth, which prevents cavities.
The panel's recommendations are based on a review of evidence from 71 published articles that described 50 randomized controlled trials and 15 nonrandomized studies to assess the effectiveness of various non-fluoride agents in preventing cavities.
Kyle Willis died from a tooth infection.
August 31, 2011 - Kyle Willis, a 24-year-old father, died Wednesday from a tooth infection.
Family members said Willis' wisdom tooth started hurting two weeks ago. Despite a dentist's recommendation to extract the tooth, Willis ignored the pain since he was out of work and didn't have health insurance.
Once Willis started getting headaches and his face began to swell, he went to the emergency room at University Hospital in Cincinnati where he received prescriptions for an antibiotic and pain medication. But he couldn't afford to pay for both, so he chose the pain medication, which unfortunately did nothing to keep the infection from spreading to his brain.
For more information, read the original story by NBC affiliate WLWT.
Kelly Swanson and Kim Cephas test infant saliva.
August 15, 2011 - A recent University of Illinois study confirms the presence of bacteria associated with early childhood caries (ECC) in infant saliva. According to the Centers for Disease Control and Prevention, cavities are the most prevalent infectious disease in American children.
"The soft tissues in the mouth appear to serve as reservoirs for potential pathogens prior to tooth eruption. By the time a child reaches kindergarten, 40 percent have dental cavities," explains University of Illinois professor and lead researcher Kelly Swanson. Adding, "Populations who are of low socioeconomic status, who consume a diet high in sugar, and whose mothers have low education levels are 32 times more likely to have this disease."
Researchers are trying to determine how to manipulate the bacterial community in infants before tooth eruption to prevent future cavities. Meanwhile, parents should minimize sugary snacks and drinks in addition to wiping babies' gums clean and brushing erupting teeth.
Dr. Mark S. Chambers, DMD, MS
April 27, 2011 - The
American Dental Association (ADA) asked the Food and Drug Administration to
include warning labels describing potential oral complications on medications
that cause chronic dry mouth. According to the ADA, medicines including
antihistamines, decongestants, painkillers, high blood pressure medications and
antidepressants have been recognized as a primary cause of chronic dry mouth.
Individuals who take multiple cardiovascular medications, tricyclic
antidepressants, anti-psychotic agents, central analgesics and/or anti-allergy
medications are at a particularly high risk for dental caries, oral
candidiasis, glossitis, mucosal infections and impaired chewing or
swallowing. "Without the cleansing
effects of saliva, chronic dry mouth [xerostemia] can lead to tooth decay,
inflammation or infection of the mouth, throat or tongue, impaired chewing or
swallowing and other maladies. These potential effects should be listed on the
warning labels of drugs commonly associated with dry mouth," said the
letter signed by ADA President Raymond F. Gist and Executive Director Kathleen
T. O’Loughlin. According to an earlier
study published in Head & Neck, twice-weekly acupuncture treatments
relieved debilitating symptoms of chronic dry mouth among patients receiving
radiation treatment for head and neck cancer. "The quality of life
in patients with radiation-induced xerostomia is profoundly impaired,"
said Dr. Mark S. Chambers, the senior author of the study and a professor
in the Department of Dental Oncology at The University of Texas M.D. Anderson
Cancer Center. "Symptoms can include altered taste acuity, dental decay,
infections of the tissues of the mouth and difficulty with speaking, eating and
swallowing. Conventional treatments have been less than optimal,
providing short-term response at best." The potential harm caused by chronic dry
mouth is another reason to ensure that you update your list of current
medications before every dental visit. Dr. Neal B. Graber and his staff
need to be made aware of relevant medical conditions in order to minimize the
negative impact on your oral health caused by certain medicines.
April 27, 2011 - The American Dental Association (ADA) asked the Food and Drug Administration to include warning labels describing potential oral complications on medications that cause chronic dry mouth. According to the ADA, medicines including antihistamines, decongestants, painkillers, high blood pressure medications and antidepressants have been recognized as a primary cause of chronic dry mouth. Individuals who take multiple cardiovascular medications, tricyclic antidepressants, anti-psychotic agents, central analgesics and/or anti-allergy medications are at a particularly high risk for dental caries, oral candidiasis, glossitis, mucosal infections and impaired chewing or swallowing.
"Without the cleansing effects of saliva, chronic dry mouth [xerostemia] can lead to tooth decay, inflammation or infection of the mouth, throat or tongue, impaired chewing or swallowing and other maladies. These potential effects should be listed on the warning labels of drugs commonly associated with dry mouth," said the letter signed by ADA President Raymond F. Gist and Executive Director Kathleen T. O’Loughlin.
According to an earlier study published in Head & Neck, twice-weekly acupuncture treatments relieved debilitating symptoms of chronic dry mouth among patients receiving radiation treatment for head and neck cancer.
"The quality of life in patients with radiation-induced xerostomia is profoundly impaired," said Dr. Mark S. Chambers, the senior author of the study and a professor in the Department of Dental Oncology at The University of Texas M.D. Anderson Cancer Center. "Symptoms can include altered taste acuity, dental decay, infections of the tissues of the mouth and difficulty with speaking, eating and swallowing. Conventional treatments have been less than optimal, providing short-term response at best."
The potential harm caused by chronic dry mouth is another reason to ensure that you update your list of current medications before every dental visit. Dr. Neal B. Graber and his staff need to be made aware of relevant medical conditions in order to minimize the negative impact on your oral health caused by certain medicines.
February 22, 2011 - According to Dr. Maura Gillison of Ohio State University, the human papilloma virus (HPV) causes 64 percent of oral, head and neck cancers in the United States. The Oral Cancer Foundation states that approximately 37,000 people in the United States were diagnosed with oral cancer in 2010, and HPV-related cancers have been increasing worldwide.
Gillison notes that a Swedish research team found 23 percent of oral cancer tumors in 1970 were positive for HPV, a statistic that rose to 93 percent by 2005.
"An individual who has six or more lifetime partners — on whom they've performed oral sex – has an eightfold increase in risk compared to someone who has never performed oral sex," she explained.
Research is being conducted to determine whether the HPV vaccine may help prevent oral cancer as well as cervical cancer. Ask your pediatrician whether he/she recommends the vaccine.
Note: Some of Gillison's research is funded by Merck, the pharmaceutical company that makes Gardasil.
Marjorie Jeffcoat, DMD
February 14, 2011 - A new study funded by the Commonwealth of Pennsylvania and The Procter & Gamble Company suggests that non-alcohol antibacterial mouth rinse containing cetylpyridinium chloride (CPC) decreases the incidence of preterm birth by reducing the severity of periodontal disease.
"This research demonstrated that reducing the severity of periodontal disease has a direct correlation with preterm birth," said Marjorie Jeffcoat, D.M.D., one of the study's authors. "Preterm birth is the major cause of perinatal mortality and morbidity worldwide and still difficult to predict and prevent. So, when we found that something as simple as mouthwash could change the outcomes, we were very excited."
Dr. Anthony M. Iacopino of the Canadian Dental Association, who was not involved with the study, adds that other research indicates that bacteria from a pregnant women's mouth can cause inflammation in the fetus and in the placenta, leading to premature birth.
February 13, 2011 - A study* by Sweden's Karolinska Institutet of more than three thousand patients suggests that women may be over 11 times more likely to suffer from breast cancer if they have missing teeth and gum disease (gingivitis).
According to chief executive of the British Dental Health Foundation Dr. Nigel Carter, "If future studies can also testify to the link between missing teeth and breast cancer, more has to be done to raise public awareness on the issue. The British Dental Health Foundation has a history of campaigning for better oral health, and the findings presented in the study indicate another clear link between your general and oral health."
This study is one of the first to be published that links gingivitis and breast cancer. Previous studies by the National Periodontal Disease Coalition (NPDC) show linkages or associations between periodontal disease and complications of stroke, heart disease, pre-term and low-weight births, diabetes and respiratory diseases such as pneumonia. There is also evidence of links between gum disease and cancers of the colon and pancreas.
The best way to prevent gum disease is to brush, floss and have professional dental cleanings at least twice every year. If you notice the early signs of gum disease - red, bleeding gums, contact a dentist immediately.
* Study by Birgitta Söder, Maha Yakob, Jukka H. Meurman, Leif C. Andersson, Björn Klinge and Per-Östen Söder.
CIGNA Dental Oral Health Integration Program Coverage Changes
January 3, 2011 - To improve people's overall health through better oral health, the CIGNA Dental Oral Health Integration Program is now available to all CIGNA dental customers with qualifying medical conditions, regardless of enrollment in a CIGNA medical plan. Additional benefits include access to fluoride treatment and sealants, special discounts for prescription and non-prescription products and behavioral health information for conditions impacting oral health.
"Working with the experts on CIGNA's Dental Clinical Advisory Panel, we created the program in response to emerging evidence that demonstrates a connection between oral health and other health conditions," said Dr. Miles Hall, chief dental clinical director for CIGNA. "Now we have the opportunity to help even more people understand that good oral health can have a positive impact on good overall health, while also offering even more resources and tools to help customers."
Research has linked gum disease to complications with heart disease, stroke, diabetes, preterm birth, pre-eclampsia and other health issues. Additionally, studies have shown that patients with head and neck cancer radiation, organ transplants and chronic kidney disease are frequently prone to dry mouth, which puts them at a higher risk for cavities.
At the Dental Center of Huntington, Dr. Graber hopes this policy change will force insurance carriers who currently do not provide comprehensive coverage to follow CIGNA's lead. After all, prevention is more cost-effective than treatment.
Costa Mesa Resolution to Ban Dental Mercury Fillings
California already has declared the mercury in amalgam to be a reproductive toxin and the Dental Board of California requires dentists to distribute a fact sheet to each patient disclosing amalgam’s risks. The U.S. Food and Drug Administration will hold hearings at the end of 2010 to consider banning amalgam for children and pregnant women and the E.P.A. announced in October that it would require dentists to install technology to catch waste mercury before it goes down the drain and into the water supply.
Costa Mesa City Council Member Gary Monahan said that dentists and their staff members will benefit because without mercury vapors, dental offices will be a much safer workplace environment. He also noted that consumers have been deceived by the term “silver fillings” and explained that a 2006 poll showed that over 80% of California residents would pay more to get non-mercury fillings but only 40% of them knew that amalgam’s main component was mercury.
Dr. Neal B. Graber uses composite fillings for improved health and better aesthetics. Since amalgam fillings eventually leak mercury, we recommend replacing amalgam fillings with composite. Connecticut passed a law banning the sale of products containing 250 parts per million of mercury after July 1, 2004. Amalgam fillings contain 500,000 parts per million of mercury. Each filling has about 3/4 of a gram of mercury, the same as a mercury thermometer, also banned under the statute. For more information, visit the FDA Web site's page featuring Questions and Answers on Dental Amalgam.
HPV and Oral Cancer
November 5, 2010 - According to the National Cancer Institute, oral cancers associated with the Human Papilloma Virus (HPV) have skyrocketed in recent years. In fact, about 70 percent of all newly diagnosed cases of oral cancer are attributable to HPV infection, usually by sexual activity—the same factor responsible for the majority of cervical cancer cases in women. Perhaps the only encouraging news comes from a study by Dr. Angela Hong of the University of Sydney, which suggests that people with HPV-type oral cancer have a greater survival rate than those with HPV-negative oral cancer.
According to Dr. Hong, "HPV status is now the strongest predictor of whether a patient will survive oropharyngeal cancer or whether the disease will return. Various clinical trials are now in development to tailor treatment according to HPV status of tumors."
Risk factors besides exposure to the HPV-16 virus include the use of tobacco, alcohol consumption. However, 25% of oral cancer victims do not have any risk factors. Therefore, Dr. Neal B. Graber recommends Oral CDx screening to all patients, especially anyone with HPV and/or early warning signs in the mouth such as a persistent sore throat, sores, lumps, bumps or red and white patches that have not healed after three weeks.
A new British Dental Association guide for dental professionals warns that the proportion of patients with oral cancer who die is higher than for cervical, breast or prostate cancer. Oral cancer is 90% curable when found in its early stages. Unfortunately, 70% of oral cancers are diagnosed in the late stages, leading to a five-year survival rate of 57%. In the United States, one person dies from oral cancer every hour of the day.The only way to combat the rise in oral cancer cases is to ensure early detection by scheduling regular dental visits, which include an oral cancer-specific examination. Some physicians are recommending the HPV vaccine to girls and boys now that the rate of oral cancers due to HPV have nearly doubled in this generation, particularly among young non-smokers.
Visit www.oralcancer.org or contact Dr. Graber for more information.
"Nanostructured Assemblies for Dental Application"
May 27, 2010 - In the June issue of the journal ACS Nano, “Nanostructured Assemblies for Dental Application,” scientists describe a first-of-its-kind, nano-sized dental film that shows early promise for regenerating pulp tissue to revitalize diseased and injured teeth.
Currently, root canal procedures help prevent tooth loss in millions of people each year. Nadia Benkirane-Jessel and her colleagues' study introduces a new modality in regenerative endodontics, which may enable dentists to replace diseased tissue with healthy pulp tissue. Their research study uses nanostructured multilayered films containing an anti-inflammatory agent as a new biomaterial for endodontic regeneration.
Another application of the nanostructured films involves placing melanocyte-stimulating hormone (MSH) next to a cavity, to enable cells inside the teeth to regenerate. For the research, also published in ACS Nano, French scientists applied the film or gel (both of which contained MSH) to mice teeth that already had cavities. One month later, the cavities were gone. Clinical trials will likely continue for several years before the breakthrough films become available.
According to the American Academy of Pediatric Dentistry, nearly 50 percent of children have tooth decay before age five.
After aggressive lobbying by the Maine Dental Association (MDA), the Maine legislature passed a bill that prohibits insurance companies from setting restrictions on the age children can be enrolled in their parents' dental plans. According to the MDA, the largest provider of dental benefits in the state was not offering coverage for children under the age of four.
Despite the age restrictions for children to be enrolled in that dental insurance plan, the American Dental Association recommends a child visit the dentist by his or her first birthday.
"With the passage of this bill, the playing field in the dental benefits world is now leveled and all dental benefit plans must make dependent coverage available to children from birth and are forbidden to place arbitrary age limits on initial entry into a dental plan," Dr. Jonathan Shenkin, president of the Maine Dental Association, said. "We are aware that similar practices with dental benefits are occurring in other New England states, and we hope that our legislation in Maine paves the way for other states to end this practice of setting age restrictions for enrollment into dental benefit plans."