The Periodontal Health, Heart Health Connection

What’s Good For Your Heart

Periodontal Health Linked to Heart Health

More and more, patients and practitioners are realizing that good at-home oral health habits are important for more than just nice-looking teeth. Keeping teeth healthy and clean is also important for maintaining good heart health.

According to a recent study published in the Journal of Periodontology, people with periodontal disease are at a higher risk for developing cardiovascular disease than those with healthy gums. The study found that study participants with gum disease had higher levels of harmful bacteria in the bloodstream – up to four times more than study participants with healthy gums.

Researchers at Columbia University School of Public Health found similar results, reinforcing doctors’ longstanding belief that periodontal health is directly linked to cardiovascular health.

Columbia University researchers looked at three forms of bacteria common in patients with gum disease and found that patients with one or any combination of the three bacteria also had hardening of the arteries.

These are just two examples of dozens of ongoing studies that continue to link good oral health with good heart health.
Patient education is key in this area, since the average patient will simply assume that brushing and flossing teeth is only essential to maintaining healthy teeth and gums. Incentive to be more proactive at brushing and flossing may increase should patients have a better understanding of how their oral health affects their overall health, including the link between periodontal health and heart health.

It’s a simple formula – good oral care can help maintain a healthy heart.

Doctors Explain Dangers of Prolonged Bottle Use

Well-Worth 5 Minutes

Doctors Explain Dangers of Prolonged Bottle Use

Helping protect children from tooth decay, iron deficiency and obesity is all within the hands of willing and capable physicians, according to a study published in the July 12, 2010 edition of Pediatrics.

Researchers at St. Michael’s Hospital and the Hospital for Sick Children found that family doctors and pediatricians who, at 9-month well-baby visits offered a brief discussion of the dangers of prolonged bottle use, experienced a 60 percent drop in the number of children still using bottles at 3 years old.

That, according to Jonathon Maguire, M.D., a pediatrician at St. Michael’s and the lead author of the study, was a profound return on investment for 5 minutes of education.

Most of the babies whose parents received the advice stopped using the bottle by their first birthday, compared to 16 months for babies whose parents received no instruction, Dr. Maguire said.

The American Academy of Pediatrics recommends complete bottle weaning for healthy children by 15 months, but many doctors and parents are unaware of this, Dr. Maguire said. Many parents continue bottle feeding well past that time, even until their children are 3 or 4 years old.

“This shows it’s possible for health professionals to positively influence the health behaviour of young children before they develop unhealthy habits and will hopefully lead to healthier children and healthier adults that they become.”

New Study from University of North Carolina Confirms Dental Bib Clips Contaminated

New Study from University of North Carolina Confirms Dental Bib Clips Contaminated

Researchers at the University of North Carolina at Chapel Hill has shown that unsterilized bib clips pose a significant hygiene risk.

UNC researchers in the school’s oral microbiology lab found that one in five bib clips sampled from hygiene and dental operatories showed a measurable presence of staphylococci, streptococci, pseudomonas, and the enteric bacteria E. coli.

These microorganisms were not just from skin but also from saliva and/or plaque, skin, or water lines. These findings are logical, as chains and clips are seldom sterilized, are touched by gloved and ungloved hygienists and dentists, and are used on many patients throughout each day.

Bib chains tested in the hygiene environment were found to have equal growth as those in an operative, periodontic/endodontic environment.

To avoid clip contamination:

• Sterilize clips between patients. Perhaps the best way to do this is to have several clips available in each work station at the start of each day.

• Use disposable clips, or bibs that don’t require clips.

• Use clips and chains that have fewer surfaces in which debris can accumulate.

Children With Special Needs Also Have Special Oral Care Needs

Handle with Care

Children with Special Needs Also Have Special Oral Care Needs

Treating patients with special needs simply isn’t the same as treating other children. Some children may not be able to sit still long enough for a full treatment. Others may struggle with the sensory issues the dental office presents – new smells and sounds along with bright lights might simply overwhelm them.

Now the May/June 2010 issue of General Dentistry reports that children’s special needs, including behavioral issues, cognitive disorders, genetic disorders and systemic diseases may increase a child’s risk of developing tooth decay and other oral diseases.

According to the article, the special diets, frequent use of medicines and lack of proper oral hygiene all add up to a significant challenge in maintaining good oral health.

For example, some parents may not know that special diets for children with below-average weight or unique food allergies can unintentionally promote tooth decay. Underweight children may be directed to consume drinks containing high amounts of carbohydrates, which can cause demineralization of teeth.Medications can also be a source of concern. Because children often find it difficult to swallow pills, many of their medicines may utilize flavored, sugary syrups. When parents or guardians give these syrups to a child, especially at bedtime, the sugars can pool around the child’s teeth and gums, promoting decay.

Adult caregivers and parents also need to help children with special needs brush their teeth, not only to overcome the dietary issues, but also to help overcome dexterity issues faced by children with special needs.

Taking children with special health care needs to the dentist is as important as caring for their other medical needs, the article concludes.

Study Links Hypertension, Periodontal Bacteria

More Research Regarding the Relationship Between Oral Health and Cardiovascular Health

Study Links Hypertension, Periodontal Bacteria

The hundreds of bacteria in the human mouth are there for a reason. Many of them are completely innocuous bacteria that like the conditions of the human mouth – it is, after all, warm, dark and wet, which are ideal conditions for growing many types of bacteria.

A handful of the bacteria in the mouth help support the health of teeth and gums. Another handful of bacteria found in the human mouth can be harmful not only to oral health, but to the health of the body as a whole.

Researchers believe that the true link between oral health and heart health lies in the balance of those bacteria.
A recent study published in the May 5, 2010 edition of the Journal of Hypertension revealed that those with significantly higher levels of periodontal bacteria in plaque samples of those with hypertension.

Seven investigators from Columbia University, the University of Miami, the University of Minnesota, and the French School of Public Health collected 4,533 subgingival plaque samples from 653 patients enrolled in the Oral Infections and Vascular Disease Epidemiology Study (INVEST). They analyzed the samples for the presence of 11 different species of periodontal bacteria, including Actinomyces naeslundii and Prevotella intermedia.

The researchers, led by Moise Desvarieux, M.D., Ph.D., found that the odds ratio for prevalent hypertension was 3.05 among the patients in the highest tertile of bacterial burden compared to those in the lowest tertile.

The team found that, after adjusting for conventional risk factors, the mean systolic blood pressure increased significantly with increasing cumulative bacterial burden, at 136, 138, and 143 mmHg for the first, second, and third tertile, respectively (p = 0.0004). The diastolic blood pressure also increased significantly, at 77, 79, and 81 mmHg, respectively.

The prevalence of hypertension was 57%, 62%, and 68%, respectively. This translated into more than threefold higher odds of hypertension between the third and first tertiles; after further adjustment for white blood cell count and titer of hs-CRP, this rose to 3.93. The increase between the first and third tertiles in both hypertension and diastolic blood pressure was more than twice as large for men as for women, while the increase in systolic blood pressure was nearly three times as large in men.

Researchers Link Obesity, Tooth Decay in Toddlers

Researchers Link Obesity, Tooth Decay in Toddlers

Researchers at the University of Buffalo, NY, studied the relationship between tooth decay and obesity in children who were 2 to 5 years old. In doing so, they found a direct relationship between obesity and tooth decay.

“Poor eating habits may play a role in both tooth decay and obesity in preschoolers,” the study’s lead author, Kathleen Bethin, MD, PhD, said. “Dental decay is the most common chronic disease of childhood, and obesity in youth is a growing problem. To prevent these problems, the dentist’s office may be an important place to educate families about nutrition,” Bethin is a pediatrician at Women and Children’s Hospital of Buffalo and an associate professor of pediatrics at the University of Buffalo in New York.

With funding from the New York State Department of Health, the doctors at the Women and Children’s Hospital of Buffalo and University of Buffalo studied the relationship between poor dental health and overweight in 65 children who were 2 to 5 years old. All children needed dental work due to decay and had their dental procedure and blood work performed while they were under anesthesia.

Each child’s height and weight were measured before the procedure to calculate the body mass index, or BMI. For most people, BMI reliably indicates the amount of body fat. Also, the child’s guardian completed a questionnaire about the child’s recent average daily food consumption.

The data showed that 18 of the 65 children, approximately 28 percent, had a BMI above the 85th percentile, which Bethin noted might be higher if the children hadn’t been fasting.

The data also revealed that many of the children were eating far more calories than the recommended 1200 calories per day, with some eating upwards of nearly 1600 calories daily.

Study Finds Dentists Uniquely Positioned to Help Smokers Quit

Study Finds Dentists Uniquely Positioned to Help Smokers Quit

Smokers whose dentists offer intervention strategies like nicotine patches or lozenges are far more likely to quit according to a report published in the May issue of the American Journal of Public Health.

In the largest study of its kind, University of Arizona researchers have proven the effectiveness of quit-tobacco interventions in public dental care settings serving low-income patients. People who received an intervention – advice and assistance including nicotine patches or lozenges – were two to three times more likely to have quit smoking 7.5 months afterward than participants who received the usual care, the journal explained.

“The dental setting is different from a medical clinic in that physicians can’t pull out a lung and show the patient the damage caused by smoking. The oral health team has a unique opportunity to show the immediate effects of smoking or tobacco use to their patients,” said lead researcher Judith Gordon, an associate professor in the University of Arizona’s department of family and community medicine.

What Gordon found is that dentists and hygienists are able to simply able to had patients a mirror and show them exactly how smoking is impacting their oral health. Once patients see the damage, the dental staff can explain the long-term risk of cancers of the mouth and throat.

Another reason researchers believe the trained dental clinics were so successful in encouraging patients to quit is that dentists usually see their patients more often than doctors do.

Funded by the National Institutes of Health National Cancer Institute, the study involved 14 federally funded community health center dental clinics in Mississippi, New York and Oregon that serve racially/ethnically diverse patients.

In randomly selected clinics, staff members were trained to provide interventions as recommended by the U.S. Public Health Service. The training included a 3-hour, in-service workshop on integrating and delivering a brief, tailored tobacco intervention including self-help materials, referral to a tobacco quit line, as well as training on the proper use of nicotine replacement therapy.

Mother’s Oral Hygiene Directly Impacts Child’s Oral Health

Bacteria, Habits Influence Oral Health

Mother’s Oral Hygiene Directly Impacts Child’s Oral Health

A recent study of pediatric dentistry from the Virginia Commonwealth University found that not only does a mother’s oral health impact a healthy pregnancy, it also impacts the overall health of the child.

“Ideally, the oral health education for any family will begin with prenatal education and the establishment of a dental home by the time the child is 12 to 18 months of age,” says Tegwyn Brickhouse, study author. “Many people don’t realize that the oral health of the mother affects both the infant’s future oral health and the child’s overall health.”

Mothers share their oral health habits with their children, setting an example of the importance of regular brushing and flossing. And mothers who visit the dentist regularly are far more likely to make sure their kids get to the dentist both at a young age and at regular intervals.

It’s recommended that children see a dentist at about age 1, or within 6 months of getting their first tooth, and every six months after that to assess teeth for decay, examine bite and evaluate oral health concerns, like use of bottles and sippy cups and thumb sucking.

It’s also been determined that if mothers’ mouths are harboring high levels of the harmful bacteria Streptococcus mutans, it’s likely that her child’s mouth is too.

Streptococcus mutans is a bacteria commonly found in human mouths. S. mutans produces lactic acid which erodes tooth enamel allowing for increased tooth decay.

S. mutans can be transmitted from a mother or another caregiver to an infant or child via saliva. For instance, by allowing infants or children to put their fingers in the parent’s mouth and then into their own mouths, testing the temperature of a bottle with the mouth, sharing forks and spoons, sharing food and “cleaning” a pacifier or a bottle nipple that has fallen by sucking on it before giving it back to the infant or child.

Study Links Obesity, Oral Bacteria

Groundbreaking Research from the Forsyth Institute

Study Links Obesity, Oral Bacteria

Researchers at the Harvard-affiliated Forsyth Institute have discovered new links between specific oral bacteria and obesity according to the Journal of Dental Research.

The study found that the makeup of salivary bacteria in overweight women differs from that of those who are not overweight, leading researchers to suspect that oral bacteria may be contributing to the obesity epidemic.

Forsyth Institute researchers collected saliva samples from women with body mass indexes both in the overweight range and in the healthy weight range and found that more than 98% of the overweight women had a bacteria called Selenomonas noxia at levels greater than 1.05% of their total salivary bacteria. Women in the healthy weight range had little or no Selenomonas noxia in their salivary bacteria.

Researchers noted that the reasons for a relationship between obesity and oral bacteria are likely complex. The observed relationship may be circumstantial as being related to diet or opportunistic due to metabolic changes. In the next phase of this research, they plan to further examine this relationship by initially conducting a controlled cohort study to see if this initial observation can be reproduced. In addition, they hope to conduct longitudinal studies in children to see if oral infection relates to weight gain. Ultimately, the development of strategies to eliminate specific oral bacteria would be required to provide definitive evidence that certain oral bacteria may be responsible for weight gain.

This work was supported in part by Interleukin Genetics and a grant from the National Institute of Dental and Craniofacial Research.

The Forsyth Institute is the world’s leading independent organization dedicated to scientific research and education in oral health and related biomedical sciences.

Dentists Help Doctors Co-Manage Osteoporosis

Bone-Loss Associated with Both Periodontal Disease and Osteoporosis

Dentists Help Doctors Co-Manage Osteoporosis

Dentists might be able to help prevent bone loss in the mouths of patients with osteoporosis by helping keep periodontal disease at bay, according to a study published in the Journal of Periodontology.

Researchers involved in the 2007 study examined more than 1,200 postmenopausal women looking for a potential association between the bacteria responsible for periodontal disease and bone loss in the oral cavity.

The study showed that women with harmful bacteria in their mouths were also more likely to already have bone loss in their mouths, which, left untreated, could lead to tooth loss.

A follow-up study concluded that tooth loss could be managed and even reduced if periodontal disease is under control in those patients who suffer osteoporosis.

Additional studies have concluded that estrogen deficiency not only increases the progression of osteopenia and osteoporosis – it also contributes to periodontal disease. The study concluded that decreasing gingival inflammation is critical to reduce the amount of attachment loss in women with signs of osteoporosis. Researchers found that protecting the fibers and bone that support the teeth significantly reduced the risk of tooth loss.

These studies draw researchers to the conclusion that postmenopausal women, and especially those with signs of osteoporosis, must work diligently with their dental team to help prevent bone loss in the oral cavity and tooth loss.  One way to do that is to help manage the harmful bacteria known to cause periodontal disease.