Take the Quiz for better Dental Health

Americans need a serious brush-up when it comes to their oral health.  On average, Americans scored a "D" on a series of questions such as how often to brush, what age a child should first visit a dentist and what causes cavities.

Take the dental quiz

Q:  How often should you brush your teeth?
A:  Although 90% of survey respondents believe they should brush after every meal, the ADA recommends brushing only twice a day.

Q:  How often should you replace your toothbrush?
A:  65% of respondents believe they should replace their toothbrush twice a year.  The ADA recommends replacing your toothbrush every 3 - 4 months or sooner if the bristles become frayed.

Q:  When should you take your child to the dentist for the first time?
A:  75% of respondents don't know that a child's first trip to the dentist should be within 6 months after their first tooth appears, usually by the children's first birthday

Q:  Are the germs that cause cavities contagious?
A:  Yes!  59% of respondents don't realize that cavity-causing germs can be passed from person to person.  Parents and caregivers can pass bacteria that cause cavities to their children by pre-chewing food or sharing utensils.

Q:  How often should you floss your teeth?
A:  53% of respondents think you should floss twice a week.  The ADA recommends flossing every day.  When you skip flossing, you miss cleaning more than 40% of the tooth surface.

Q:  Are refined sugars more harmful to teeth than natural sugars?
A:  67% of respondents think refined sugars are more harmful than natural sugar.  The truth is that all sugar can promote tooth decay.  Frequency of exposure increases risk.

Facts:
9 out of 10 adults ages 20-64 have had cavities in their permanent teeth.
Dental disease is the most common chronic disease suffered by children.
Nearly 1/2 of children ages 2-11 years old have had cavities in their baby teeth.


Check out www.MouthHealthy.org for more information.  The new website is organized by life stages and includes information on the top 10 dental symptoms, how to handle emergencies and A-Z oral health topics.

Dr. Caroline Wallace DDS
 Complete Dental Care
 Salem, Virginia

Men Are More Likely to Have Oral HPV than Women

A rise in oral sex may be pushing up HPV infection rates in men, along with head and neck

Oral infections of human papillomavirus, or HPV, affect nearly 7% of Americans and are significantly more common in men than in women, according to a new Centers for Disease Control and Prevention study.

The study, which is the first to examine the prevalence of oral HPV in the U.S., found that three times as many men (10%) as women (3.6%) have HPV infections. The data may help to explain why the incidence of head and neck cancers has been increasing, particularly in males, even as smoking rates are on the decline.

For the study, CDC researchers plumbed data on 5,579 people aged 14 to 69 who participated in the National Health and Nutrition Examination Survey in 2009 and 2010. The participants answered extensive questionnaires about their sexual behavior and gave oral cell samples for analysis for HPV.

The researchers found that the risk of oral HPV infection increased with the number of sexual partners a person had: it was eight times higher in people who had ever had sex versus not, and as high as 20% in people who had had more than 20 sexual partners in their lifetime. The data indicate that “oral HPV infection is predominantly sexually transmitted,” through oral sex, not passed through casual contact like kissing, the authors concluded.

The CDC researchers also found that HPV infections peaked in two age groups: 30-to-34-year-olds, who had a 7.3% chance of infection, and 60-to-64-year-olds, who were 11.4% likely to be infected. It’s not clear why older people had higher rates of oral HPV, but the authors offered some possible theories: perhaps it’s because older people came of age at a time when there were fewer concerns about sexually transmitted infections, or perhaps latent HPV infections are becoming reactivated as the immune system weakens with age.

HPV is the most commonly sexually transmitted virus in the U.S. At least half of all sexually active people will acquire an infection at some point in their lives. Most will clear the virus on their own, but persistent infections can cause cancer, including cervical, vulvar, vaginal, anal and penile cancers. Oral infection with a high-risk strain of HPV can cause oropharyngeal cancers — cancers of the tonsils, upper throat and base of the tongue.

Rates of oral HPV infection are substantially lower than genital infections — which can be as high as 42% in women in their 20s, for example — but they are becoming increasingly troublesome. While HPV is best known as the virus that causes cervical cancer in women, because of better screening, the rate of such cancers has declined. Meanwhile, the rate of oral cancers is on the rise: a study published in October in the Journal of Clinical Oncology found that HPV-related oropharyngeal cancers increased 225% between 1984-89 and 2000-04. In 1984-89, about 16% of oropharyngeal cancers tested HPV-positive; by 2000-04, the proportion of HPV-positive cancers had risen to 72%, accounting for more oral cancer than smoking.

Overall, the risk was greatest and rising in men, the study found, possibly because of increasing rates of oral sex. The data indicate that the burden of HPV-related cancer may shift from women to men, with the number of HPV-positive oral cancers potentially eclipsing that of invasive cervical cancers within 10 years.

That supports efforts to boost HPV vaccination, suggest the authors of the current CDC study, published online by the Journal of the American Medical Association. Public health officials recommend that girls aged 11 or 12 be immunized with either of two approved HPV vaccines, Gardasil or Cervarix, which both protect against HPV 16 and 18, the strains that cause most cervical cancers. (Gardasil also protects against HPV strains 6 and 11, which cause 90% of genital warts cases.) Girls aged 13 to 26 should also be immunized if they haven’t been already.

The advice extends to boys as well, but only one of the shots, Gardasil, has been tested and approved for males to protect against warts and anal cancer. Boys are advised to receive the vaccine at age 11 or 12, or between ages 13 and 21 if they haven’t already been immunized. The primary reason for the advice is to protect adolescents and young adults from infection with the high-risk strains of cancer-causing HPV before they become sexually active.

It’s not clear whether the vaccines can also protect against oral cancers. More research is needed to figure that out. But researchers speculate that if the vaccine reduces rates of HPV in women, it can in turn help reduce the risk of infection in men.

Dr. Caroline Wallace DDS

 Complete Dental Care

 Salem, Virginia

 

Using Teeth to Restore Hearing

One day in 2006, stuck in bumper-to-bumper Bay Area traffic, Amir Abolfathi had a eureka moment. Formerly vice president of R&D for Invisalign, a company known for transparent dental braces, he had recently been chatting with a friend who was working on hearing aids. Abolfathi knew that bone was a good sound conductor. What if he could somehow make a removable oral hearing aid—one that could channel sound from wearers’ teeth to their ear through the bones in their head?

That moment of freeway inspiration gave rise to the SoundBite, a device designed for sufferers of single-sided deafness, which strikes about 50,000 people every year in the U.S. After his friend, Michael Benninger, an otolaryngologist at the Cleveland Clinic in Ohio, told him it could really help to solve the problem, Abolfathi set about turning his idea into reality. The biggest challenge was miniaturization, so he opted for a piezoelectric actuator, which needs very little power to generate the vibrations that travel through bone. That allowed him to use a much smaller battery, making the entire insert compact enough to fit comfortably in the mouth.

Invention: SoundBite
Inventor: Amir Abolfathi
Cost: $19 million
Time: 4 years
Is It Ready Yet? 1 2 3 4 5

Made of acrylic, SoundBite snaps onto a user’s molars. A tiny microphone worn in the deaf ear wirelessly beams incoming sound to an electronic receiver in the molar insert, which transmits sound waves from the teeth through the bones in the jaw to the cochlea, the part of the ear that processes sound. (Traditional hearing aids only amplify sound, so they don’t work for people with non-functioning cochlea.) The battery lasts for six to eight hours at a time and can be recharged in a wall outlet.

How SoundBite Works: A microphone in the deaf ear beams incoming sound to a receiver on the acrylic tooth insert (placed on either side), which transmits it through the jaw to the cochlea.  Paul Wootton

The best remedy for single-sided deafness currently on the market is a bone-anchored hearing aid (BAHA), which, like the SoundBite, uses direct bone conduction to deliver sound to the cochlea. But BAHA installation involves surgically implanting a titanium post into the base of the skull. Other noninvasive tooth-based systems have been attempted, but none was ever fully developed and brought to market.
The SoundBite restores hearing just as effectively as a BAHA but requires no surgery. Instead it can be popped in and out of the mouth like a retainer. In clinical trials that wrapped up in February, patients typically reported that it restored from 80 to 100 percent of their hearing in the deaf ear and that they scarcely noticed they were wearing it. Lawrence Lustig, the director of the University of California at San Francisco Cochlear Implant Center, is so impressed with the SoundBite that he says he’ll recommend it to people who would otherwise have to undergo surgery.

If the device secures FDA approval as anticipated, it will hit the market this summer for around $6,000. (Surgery for a BAHA can run well over $10,000.) Abolfathi’s company, Sonitus Medical, plans to negotiate with insurance providers to reimburse patients for at least part of the cost. Abolfathi is also investigating other applications for the technology, including wireless, water-safe MP3 players and stealth communication for intelligence personnel. But even if those don’t pan out, he’s satisfied to know that he’s already improved people’s lives. “One patient just e-mailed and told me, ‘I saw Avatar, and it was great. I hadn’t been to a movie in years.’”

Dr. Caroline Wallace DDS

Complete Dental Care

Salem , Virginia

Aspirin may prevent throat cancer .....

BOSTON, Mass., USA: U.S. researchers have found evidence that taking anti-inflammatory drugs and aspirin in particular reduces the risk of Barrett's esophagus (BE), a medical condition that is the largest known risk factor for esophageal cancer. In a recently published study, they found that aspirin users were 44 percent less likely to have BE compared with nonusers.
Researchers from the Massachusetts General Hospital Institute for Technology Assessment analyzed 434 patients diagnosed with BE between 1997 and 2010 for factors that might be used in the screening and management of the condition, including age, sex, body mass index, medical and social history, as well as medications.

Among other findings, the study revealed that current aspirin users had a lower risk for developing BE than nonusers and that men were more than three times more likely to develop BE than women.

"The protective effect of aspirin use appears robust because the analyses suggests a dose–response relationship in which high-dose aspirin was significantly associated with decreased BE risk," said Dr. Chin Hur, assistant professor of medicine at Harvard Medical School and director of GI Health Outcomes Research at the Massachusetts General Hospital Gastrointestinal Unit.

Although previous research has analyzed nonsteroidal anti-inflammatory drugs and aspirin chemoprevention for esophageal cancer or BE progression, the current study is one of the few to explore whether the drugs can prevent BE.

Hur warned however that it would not be advisable at this stage to start taking aspirin at higher doses if preventing BE is the only goal. "If additional data confirms our findings and an individual at higher risk for development of BE and esophageal cancer also could derive additional benefits, most notably cardiovascular, aspirin could be a consideration," he added.

According to the World Health Organization, esophageal cancer is the eighth most common cancer worldwide, with 481,000 new cases estimated in 2008, and the sixth most common cause of death from cancer, with 406,000 deaths. This type of cancer is two to four times more common among men than women, and more than 80 percent of the cases and of the deaths have occurred in developing countries, the organization stated.

The study was published in the July issue of the Clinical Gastroenterology and Hepatology journal.

Dr. Caroline Wallace DDS
Complete Dental Care
Salem, Virginia

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