Forsyth Institute Receives $20.7 to Fight Periodontal Disease

The Forsyth Institute , the world’s leading independent, oral health research organization, has received $20.7 million to fight periodontal disease. Three related projects will study periodontal disease progression from microbiological, genetic, host immune response and clinical perspectives. This research, funded by the National Institute of Dental and Craniofacial Research (NIDCR), will take place over a four-year period. The ultimate goal is to gain an understanding of why people develop gum disease, how the disease progresses, how to predict active disease before it occurs, and ultimately, how therapies can be developed to improve periodontal and overall health.

According to the Forsyth Institute, forty percent of adults in the United States have some form of periodontal disease. It is one of the most common infectious diseases and, in its more severe forms, causes loss of the bone that supports the teeth. In addition, there are strong associations between periodontal disease and systemic diseases including diabetes, metabolic syndrome, cardiovascular disease, pre-term birth, and certain cancers.

Previous work at Forsyth has demonstrated that the progression of the disease is not continuous, but is episodic. Thus, to understand its pathogenesis, patients must be studied to identify sites in the mouth that are undergoing active disease progression, which is the focus of these studies.  The Forsyth projects, respectively led by Dr. Ricardo Teles, Director of the Center for Clinical and Translational Research; Dr. Bruce Paster, Head, Department of Molecular Genetics; and Dr. Jorge Frias-Lopez, Assistant Member of Staff, Department of Molecular Genetics, will examine clinical parameters, expression of host derived molecules, bacterial ecology, and bacterial gene expression during active disease. It will also seek to identify biomarkers in blood, saliva, and gingival crevicular fluid (a fluid that oozes from the gum margin) samples from 500 individuals, both with and without existing gum disease. The data gathered by Forsyth’s scientists as well as aliquots of the samples will be made available to the scientific community and will represent the largest available information base and depository of samples for periodontal disease.

“The knowledge developed through these three linked projects will provide unique and extraordinarily valuable insights into the periodontal disease process, as well as serve as a one of a kind resource to the scientific community,” said Philip Stashenko, President and CEO of The Forsyth Institute. “This work represents the multidisciplinary epitome of periodontal disease research. We may be able to finally lay a firm foundation to understand why periodontal disease progresses. It is extremely rare for three projects to receive awards linked to one clinical trial, and this support from NIDCR is a testament to the promise of this research.”

The three projects were funded due to the strength of each projects and the overall potential impact of the collaborative research. The Forsyth team will also work with four other oral health research centers around the country. The Michigan Center for Oral Health Research is the first clinical research partner. Four additional research facilities will join the project shortly.

Asthma Not Linked to Tooth Decay

Contrary to what you may have heard before, there’s no link between asthma and tooth decay in children, according to a study that appeared in the September issue of the Journal of the American Dental Association.

The findings challenge some previous research suggesting that children with asthma may be more likely to develop cavities. These studies had suggested that children who use nebulizers to control their asthma may inadvertently increase their frequency of exposure to sugars because these nebulizers use fructose to deliver therapy. This increased frequency and amount of certain sugars consumed are major factors leading to cavities

For the new study, researchers analyzed 27 studies in papers published between 1976 and March 2010.

“We found little evidence to suggest that asthma causes tooth decay. In fact, the two largest studies we reviewed found that children with asthma appear to have fewer cavities than others. This may be because their parents are used to taking them to health-care providers, and routinely bring them to the dentist,” study author Gerardo Maupome, a professor of preventive and community dentistry at the Indiana University School of Dentistry, said in a university news release.

“The notion that there is a link between asthma and tooth decay may have its origin in anecdotal statements by emergency room workers who see children with poorly managed asthma. These children could also be more likely to have poorly managed dental conditions, and therefore tooth decay,” Maupome said. “It’s reasonable to believe that poor clinical management may be associated with both conditions, not the asthma that is causing the cavities.”

While not apparently associated, tooth decay and asthma are the two most prevalent chronic childhood diseases in the United States.

Study Finds Hormones, Number of Pregnancies Affects Women’s Risk of Caries

Dr. John Lukacs, Ph.D., a professor of anthropology at the University of Oregon, believes that he has found the reason that women tend to have more cavities than men, and why some women tend to have more cavities than others.

According to Lukac, male and female children seem to have a similar number of caries. The numbers start to change, however, as children become adolescents because of the dramatic increase of estrogen in females as they mature.

Women become even more prone to caries throughout their childbearing years, particularly during times of pregnancy, which are, coincidentally, times of increased estrogen production. In fact, women’s estrogen levels increase steadily during pregnancy until birth.  

According to Lukacs, females produce less saliva than men. Saliva has two important components: enzymes that break down complex sugars in the mouth, and antibodies that attack the microbes responsible for cavities. Having less saliva, then, puts women at a much greater risk for developing cavities.

In addition, it appears women’s saliva has less of an antimicrobial effect when they are pregnant.

To add insult to injury, women often crave sugary, high-energy, high-carbohydrate foods during pregnancy, so when they eat these foods, their saliva has less of a protecting effect, and their teeth are already at risk from the increased estrogen.

“The role of female-specific factors has been denied by anthropologists, yet they attain considerable importance in the model proposed here, because the adoption of agriculture is associated with increased sedentism and fertility,” Lukacs concluded in the October 2008 issue of Current Anthropology. “I argue that the rise of agriculture increased demands on women’s reproductive systems, contributing to an increase in fertility that intensified the negative impact of dietary change on women’s oral health. The combined impacts of increased fertility, dietary changes and division of labor during the move into agricultural societies contributed to the widespread gender differential observed in dental caries rates today… If hormonal and physiological factors work in an independent or additive manner, their impact on women’s oral health could be significant. The fact that women’s caries experience increases with age at a greater rate than men’s in diverse ethnic groups from different ecological and cultural settings supports this interpretation.”

Australian Dental Association Calls Sports Drinks “Decay in a Bottle”

A new study conducted by the Australian Dental Association found that 68 percent of children showed some sign of tooth erosion, the pattern of which is similar to that seen in wine drinkers.

The study, which included more than 700 children ages six to 15, has effectively shown that the increase in consumption of sports drinks – much more so than sodas and juice drinks – is profoundly affecting the future health of children’s teeth.

Former Queensland Dental Association president Martin Webb said that these drinks may be called “decay in a bottle,” with their high acidity and sugar content that override the mouth’s natural defenses.

“Energy drinks are high in sugar content and quite high in acid, the ingredients of erosion,” Webb explained. He also said that athletes could rehydrate better with water than with these drinks. Lactic acid build-up from sport is present in the mouth and when sugar is added through the energy drinks, the effect is to demineralize the teeth. Unless plenty of water is taken and salivation is stimulated, a layer is stripped from the teeth. It does not come back.

“We also see the degree of erosion that’s caused when people drink large quantities of orange juice and black cola drinks. It strips a thin layer off the teeth,” Webb said.

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.”

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.

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.

When Someone Asks…

Have You Heard of Oral Care Probiotics?

Our bodies are homes to thousands of bacteria. Many of those bacteria simply live in and on our bodies because they are simply a convenient environment in which to live. Some of the bacteria in and on our bodies can be harmful (think of skin infections) while still others are beneficial (think of how bacteria in the gut are said to aid in digestion).

Probiotics are live microbial organisms that are naturally present throughout the body. They are often referred to as “beneficial” or “good” bacteria. Because there are bacterial colonies throughout the body, there are different types of probiotics to support good health.

Oral Care Probiotics

There has been much media attention given to the effectiveness of probiotics of to assist in digestion. So, too, are there probiotics that can help support gum and tooth health by competing with harmful bacteria for both nutrients and space in the mouth. In doing so, oral care probiotics also help eliminate the bacteria that creates the volatile sulfur compounds responsible for bad breath.

Oral care probiotics are available in the convenient, easy-to-use, travel-friendly form of mints to be taken twice per day after brushing. Called EvoraPlus, these probiotic mints are available at many major retailers and online.

EvoraPlus also offers a completely safe and natural way to gently whiten teeth to their maximum potential by producing a byproduct of a continuous low dose of natural hydrogen peroxide. Because it is such a low dose of hydrogen peroxide, there are none of the negative side effects associated with using other over-the-counter whitening products, which instead employ high doses of harsh, chemical hydrogen peroxide.

EvoraPlus oral care probiotics offer a cutting edge solution for tooth and gum health, fresher breath and naturally whiter teeth.

An Often Unconsidered Condition

Dry Mouth Linked to Tooth Decay

Saliva. It’s the miracle liquid that helps wash away cavity-causing bacteria and food debris, all the while protecting your tooth enamel.

Research shows that hundreds – up to even 1,000! – of commonly prescribed medications cause dry mouth, reducing the flow of saliva and exponentially increasing the risk of tooth decay.

Research shows that hundreds – up to even 1,000! – of commonly prescribed medications cause dry mouth, reducing the flow of saliva and exponentially increasing the risk of tooth decay. Researchers say that anything that curbs the flow of saliva in the mouth should be of major concern to dentists and hygienists

“Our saliva washes away sugars and other substances that help promote cavities. It neutralizes the acids in our mouths,” says Gene Watson, D.D.S., Ph.D., is director of the Salivary Dysfunction Center at the University of Rochester Medical Center. “Saliva is concentrated with minerals like calcium and phosphate. When you eat sugar, bacteria on your teeth produce acid that demineralizes the teeth a little bit, but then the saliva flows in and replaces the layer that has been removed.”

Researchers say millions of people are at heightened risk for tooth decay because of the medicines they take, particularly the elderly, many of whom take several medications that stem the flow of saliva.

One medication commonly prescribed for Attention Deficit Hyperactivity Disorder can also cause dry mouth and increase risk of excessive carries development in the children who take it.

Aside from discontinuing use of the medications, patients can make several changes that can reduce their risk of excessive tooth decay at the hands of reduced saliva flow:

1.    Brush their teeth more often and very gently to ensure enamel isn’t damaged.
2.    Have teeth checked every six months without fail. Sometimes a problem will be detected that would require a change in medication to preserve the health of the teeth.
3.    If medications causing dry mouth simply cannot be changed, consider prescribing medications that can increase saliva production to offset the effects of the other medications.