Family Life could effect Childrens Oral Health

NEW YORK, N.Y., USA: The interaction between parents could have an impact on the oral health of their children, researchers from the New York University College of Dentistry have found. A greater incidence of verbal or physical aggression between partners correlated with increased oral health problems in children. The researchers are now developing an intervention for couples whose relationship discord may impact the oral health of their infants.

Mental health has much to do with dental health, according to Professors Richard Heyman and Amy Smith Slep, psychologists and co-directors of the Family Translational Research Group within the Department of Cariology and Comprehensive Care at NYUCD. Heyman and Smith Slep aim at understanding how psychological factors affect oral health, especially in relation to the causes of early childhood caries.

For the study, the researchers collected data on nearly 150 families. They took blood and saliva samples, conducted physical exams, and administered questionnaires. The researchers found that children whose parents were verbally or physically aggressive towards each other were more likely to suffer from oral health problems.

"There are two hypotheses about how oral health is affected by parental discord," Heyman said. "First, lax supervision of children, as an outgrowth of discord, directly impacts children in that they eat sugary cereals and beverages, and do not brush. The second is a biological response. There is strong research showing that family conflict and stress affect the immune system."

"Lax parenting may be an even stronger influence on tooth decay than violent behavior," said Dr. Mark Wolff, professor and chair of the Department of Cariology and Comprehensive Care and associate dean for Predoctoral Clinical Education at the NYUCD, who was also involved in the study. "Allowing children to eat sugary food is something seen even among well-educated people. We have to understand the psychological causation of tooth decay to prevent it. A simple lecture on brushing isn't going to improve things. You have to change parenting behaviors."

Heyman, Smith Slep and Wolff have now teamed up with Dr. Ananda Dasanayake, professor of Epidemiology and Health Promotion, to adapt and test an intervention, developed in Australia, for couples whose relationship discord may impact the oral health of their very young children.

This project is the first to intervene with new parents at multiple levels to prevent childhood caries. It is hoped that, by improving noxious family environments, instilling daily oral health-promoting behaviors in children, and encouraging parents to bring the child to regular dental checkups, the children's early oral health will be demonstrably better than is typical.

For the testing currently being conducted, up to 30 families are being recruited from maternity wards at Bellevue Hospital Center and Stony Brook University Hospital in New York. The researchers are seeking families whose newborn children are already considered at high risk for poor oral health owing to low family incomes, parents who have no more than a high school education, and at least one non-European American parent. Couples who participate will watch DVD segments on conflict resolution and healthy parenting. They will also be assigned a coach, who will check in and help them improve their conflict-resolution and parenting skills. Additionally, they will complete a workbook that reinforces those messages with exercises.

The couples' intervention takes place over eight sessions, timed to intersect with the developmental stages of their infant, from three to 12 months. This timing covers the period of tooth eruption and transition to recommended dental visits. It also covers both the newborn and toddler periods, and allows families breaks between sessions and time to review material and solidify their skills. To examine the impact on oral health, dental exams will be performed on the children at 15 months.

The researchers will look for early childhood caries and contributing factors, such as bacteria and salivary hormones related to stress.

Dr. Caroline Wallace DDS

103 South Colorado Street

Salem , Virginia, 24153

540-387-3844

Untreated Periodontitis may Complicate Pregnancy

CLEVELAND, Ohio, USA: A recent study has investigated the association between periodontitis and women's health issues. The researchers focused on adverse pregnancy outcomes in particular and found that periodontitis, depending on the severity, may be linked to preeclampsia, preterm birth and low birth weight of the child, among others.

By reviewing 61 journals and about 100 articles, Charlene Krejci, associate professor at the Case Western Reserve University School of Dental Medicine found that a considerable body of periodontal literature generally associates hormonal changes in women with the inflammatory disease.

In the early 1980s already, a study of 54 pregnant and 23 nonpregnant women revealed levels of Bacteroides species 55 times higher in the pregnant group. In addition, women who received contraceptive therapy were found to have a sixteenfold higher level of the same bacteria compared with the control group.

More recently, in a study of 366 pregnant women, researchers found various oral bacteria in the amniotic fluid of women whose pregnancies were complicated by preterm birth. A subsequent pilot study suggested that nonsurgical periodontal therapy could lower the rate of preterm birth.

Moreover, a study of 124 women revealed that periodontitis was significantly more prevalent in women who had preterm low birth weight (PLBW) infants than in women whose infants had a normal birth weight. The subjects diagnosed with periodontitis were 7.5 times more likely to have PLBW infants.

Krejci found that hormonal changes during puberty, menstruation, pregnancy and menopause, and those accompanying the use of hormone supplements cause an increase in the number of oral bacteria, which enter the blood and negatively impact on certain female health issues.

In addition to regular brushing and flossing, Krejci recommends visiting the dentists at least twice a year, and more often if women are pregnant, suffer from bone loss or gum problems.

The study was published in the first 2012 issue of the Oral Health and Preventive Dentistry journal. 

Dr. Caroline Wallace DDS

Complete Dental Care

103 South Colorado Street

Salem, Virginia , 24153

540-387-3844

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