What is the uvula and what purpose does it serve?

The uvula is the structure seen hanging down from the soft palate in the middle of the throat at the back of the mouth.  It gets blamed for causing snoring, and is sometimes removed to treat snoring.  Unfortunately, other structures can often contribute to snoring or more severe conditions, such as obstructive sleep apnea, can fail to respond to removing the uvula.  It is also painful to remove.  Why is it there in the first place?  The palate and uvula serve to help direct airflow through the nose down to the voicebox and lungs.  These structures serve as a valve to close off the airway when speaking or swallowing, so that things do not go up the nose.  My kids can still have this happen if they laugh too hard while drinking.  While we do not use the uvula much with speaking English, other languages, such as Spanish, French and Hebrew, use "uvular consonants".  "Drilling your r's" in Spanish is a typical use.  The uvula is also active in yodeling.  The uvula can occasionally swell up, most commonly from being sucked down the throat while snoring, or stretched during upper endoscopies.

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia, 24153

540-387-3844

Pacifiers could harm your childs dental health.....

COLUMBUS, Ohio, USA: Researchers have found that children who are learning to walk are at the highest risk of injury from baby bottles, sippy cups and pacifiers. For the first time, they analyzed nationwide statistical data from the last 20 years and found that, on average, 2,270 injuries related to these products are treated in U.S. emergency rooms every year.

The study conducted by researchers at the Research Institute at Nationwide Children's Hospital in Columbus, Ohio suggests that between January 1991 and December 2010 an estimated 45,398 children under three required treatment in an emergency room owing to baby bottles, pacifiers and sippy cups.

According to the study, approximately two-thirds of injuries occurred among children aged one, a period of development associated with unsteady walking. The researchers found that 86 percent of the injuries were the result of falls while using the product. More than 70 percent of the injuries caused by falls affected the mouth and teeth of the toddlers, followed by lacerations of the head, face or neck (20 percent).

Baby bottles were involved in about 66 percent of the injuries. Pacifiers accounted for 20 percent of the injuries and sippy cups for 14 percent. Pacifiers were associated with soft-tissue and dental injuries, in particular.

"The permanent front teeth begin to develop in an infant's jaws soon after birth and the crown of the permanent tooth does not complete development until a child is three or four years old. If the toddler falls and injures a baby tooth, that tooth can get pushed up into the jaw and disrupt the development of the permanent tooth to follow. The risk is greatest when a baby tooth is injured before the child is three years of age and if the baby tooth is pushed up into the gums or completely knocked out," said Dr. Dennis McTigue, pediatric dentist at Nationwide Children's Hospital.

The researchers said that, currently, there are few formal recommendations regarding the ages at which children should discontinue using these products. Although the American Academy of Pediatric Dentistry and the American Academy of Pediatrics recommend using lidless cups by 12 months of age to prevent dental caries, and limiting pacifier use after six months to prevent infections, the products tend to be used at least until the age of two, the researchers said.

"Educating parents and caregivers about the importance of transitioning their children away from these products at the ages recommended by the AAP and AAPD could prevent up to 80 percent of the injuries related to baby bottles, pacifiers and sippy cups," study co-author Dr. Laura McKenzie suggested.

There is a need for further research into the nature of these injuries and prevention strategies, the researchers concluded.

Statistics were obtained from the National Electronic Injury Surveillance System operated by the U.S. Consumer Product Safety Commission.

Dr. Caroline Wallace DDS
Complete Dental Care
103 South Colorado Street
Salem, Virginia, 24153
540-387-3844

Oral Bacteria can cause Artificial Joint Failure

CLEVELAND, Ohio, USA: Study results have suggested that periodontal bacteria can migrate from the mouth to the synovial cavity, which might be the reason for the failure of artificial joints. In recent DNA tests, researchers detected the same bacterial DNA in synovial fluid and dental plaque in 14 percent of patients with arthritis and periodontitis.



The study was conducted by researchers at the Case Western Reserve University's School of Dental Medicine and the University Hospitals Case Medical Center.

"For a long time, we have suspected that these bacteria were causing problems in arthritis patients, but never had the scientific evidence to support it," said Prof. Nabil Bissada, chair of the Department of Periodontics at the dental school.

In order to prove their bacterial translocation hypothesis, the researchers investigated the presence of bacterial DNA in synovial fluid and periodontal tissue samples from 36 patients with periodontal disease and arthritis. Five of the subjects showed a direct DNA link between the bacteria in the fluid and plaque. The researchers detected identical bacterial DNA in two patients with rheumatoid arthritis and three patients with osteoarthritis who were also diagnosed with periodontitis.

"The oral–synovium translocation could be due to the periodontal disease the patients had. In the presence of periodontal disease, the quantity of oral bacteria increases dramatically. This, in combination with inflamed gums, increases the chance of oral bacteria entering the circulation, leading to systemic dissemination," the researchers said.

"On the basis of our present and previous studies, we suggest that patients with arthritis or failed prosthetic joints be examined for the presence of periodontal disease and be treated accordingly," the researchers concluded.

According to the researchers, this data is the first genetically proven evidence that oral bacteria can migrate to the synovium in humans. Nevertheless, Bissada admitted that larger studies, with control groups, are required to corroborate the findings.

The case study group consisted of nine men and 27 women, aged between 45 and 84, with a mean age of 61.6 years. Eleven of the patients were diagnosed with rheumatoid arthritis and 25 with osteoarthritis.

The study was published in the April issue of the Journal of Clinical Rheumatology.

Dr. Caroline Wallace DDS
Complete Dental Care
103 South Colorado Street
Salem, Virginia, 24153
540-387-3844

Sport drinks will cause damage to your teeth....

A recent study published in the May/June 2012 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry, found that an alarming increase in the consumption of sports and energy drinks, especially among adolescents, is causing irreversible damage to teeth - specifically, the high acidity levels in the drinks erode tooth enamel, the glossy outer layer of the tooth.

"Young adults consume these drinks assuming that they will improve their sports performance and energy levels and that they are 'better' for them than soda," says Poonam Jain, BDS, MS, MPH, lead author of the study. "Most of these patients are shocked to learn that these drinks are essentially bathing their teeth with acid."

Researchers examined the acidity levels in 13 sports drinks and nine energy drinks. They found that the acidity levels can vary between brands of beverages and flavors of the same brand. To test the effect of the acidity levels, the researchers immersed samples of human tooth enamel in each beverage for 15 minutes, followed by immersion in artificial saliva for two hours. This cycle was repeated four times a day for five days, and the samples were stored in fresh artificial saliva at all other times.

"This type of testing simulates the same exposure that a large proportion of American teens and young adults are subjecting their teeth to on a regular basis when they drink one of these beverages every few hours," says Dr. Jain.

The researchers found that damage to enamel was evident after only five days of exposure to sports or energy drinks, although energy drinks showed a significantly greater potential to damage teeth than sports drinks. In fact, the authors found that energy drinks caused twice as much damage to teeth as sports drinks.

With a reported 30 to 50 percent of U.S. teens consuming energy drinks, and as many as 62 percent consuming at least one sports drink per day, it is important to educate parents and young adults about the downside of these drinks. Damage caused to tooth enamel is irreversible, and without the protection of enamel, teeth become overly sensitive, prone to cavities, and more likely to decay.

"Teens regularly come into my office with these types of symptoms, but they don't know why," says AGD spokesperson Jennifer Bone, DDS, MAGD. "We review their diet and snacking habits and then we discuss their consumption of these beverages. They don't realize that something as seemingly harmless as a sports or energy drink can do a lot of damage to their teeth."

Dr. Bone recommends that her patients minimize their intake of sports and energy drinks. She also advises them to chew sugar-free gum or rinse the mouth with water following consumption of the drinks. "Both tactics increase saliva flow, which naturally helps to return the acidity levels in the mouth to normal," she says.

Also, patients should wait at least an hour to brush their teeth after consuming sports and energy drinks. Otherwise, says Dr. Bone, they will be spreading acid onto the tooth surfaces, increasing the erosive action.


Dr. Caroline Wallace DDS
Complete Dental Care
103 South Colorado Street
Salem, Virginia, 24153
540-387-3844

Your Dental Health and your Heart

The American Association for Dental Research (AADR) acknowledged the very comprehensive review of the literature undertaken by the American Heart Association (AHA) on the relationship between periodontal disease and heart disease. The review titled "Periodontal disease and atherosclerotic vascular disease: Does the evidence support an independent association?: A scientific statement from the American Heart Association" was published online in Circulation.

The review assessed, 1) whether available data supported an independent association between atherosclerotic vascular disease (ASVD) and periodontal disease, and 2) whether available data supported that periodontal treatment might modify ASVD risks or outcomes.

The extensive review of current literature - including more than 40 epidemiologic observational studies - did indeed support an association between periodontal disease and ASVD independent of known cofounders. "The validation of an association between periodontal disease and heart disease from the American Heart Association is an important statement from a public policy perspective," said AADR President Rena D'Souza. While the association has been demonstrated, the literature review failed to support either a cause-effect relationship, or that periodontal treatment might prevent ASVD or modify its outcome.

AADR has many members who are researching the association between oral health and cardiovascular health, but long-term studies on the association between periodontal infection and cardiovascular disease or long-term periodontal treatment intervention studies on cardiovascular health are certainly understudied. Hence, it was not surprising that the authors failed to find evidence in the literature demonstrating either causality or a treatment effect.

Importantly, the AHA review highlighted significant gaps in our scientific understanding of the interaction of oral health and ASVD and articulated that well-designed, controlled interventional studies would be required to further elucidate our understanding of these interactions.

"Further research on the association of oral health and cardiovascular disease is critical," stated D'Souza. "By harnessing today's epidemiologic, genomic, proteomic, microbiologic and immunologic tools with data examining environmental interactions and bioinformatics approaches, we can advance our understanding of this important association that has such clear public health implications."

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia, 24153

540-387-3844