4 oral healthcare points for your pregnant patients

1. Oral health can affect pregnancy outcome

A pregnant women’s oral health can affect the outcome of her pregnancy. Studies have found associations between periodontal infections and preterm birth, or babies being born early. However, research has not shown that pregnancy outcomes improve with dental treatment.

“A mother who has poor oral health has a greater chance of transmitting cavity-causing bacteria to her newborn, even when the newborn doesn’t have teeth.”— Melanie Mayberry, DDS

“Poor oral health can negatively impact birth outcomes,” Dr. Mayberry told DrBicuspid.com.

Avoiding chronic inflammation and maintaining good nutrition are other important factors during pregnancy, as well as at other times, she said.

Pediatric dentist Anupama Tate, DMD, MPH, emphasized the connection between the mouth and the entire body. She is an associate professor of pediatrics at George Washington University School of Medicine and the director of advocacy and research in the division of oral health at Children’s National Medical Center in Washington, DC.

“Poor oral health for a pregnant woman could be linked to birth complications like pre-eclampsia, preterm birth, and low birth-weight infants,” she said.

2. Dental treatment is safe

Studies have found that obtaining dental care, whether regular cleanings, placement of fillings, teeth extractions, imaging, or other procedures, is safe during pregnancy, and dentists and obstetricians who spoke with DrBicuspid.comrecommended it.

“Dental treatment during pregnancy, including dental radiographs with proper shielding and local anesthetics, is safe during all trimesters,” Dr. Tate said.

She also recommended proper oral hygiene using fluoridated toothpaste, chewing sugar-free gum, and eating small amounts of nutritious food throughout the day to help minimize caries risk.

Oral health for oral health’s sake is important, said Kim Boggess, MD. She is an obstetrician/gynecologist (ob/gyn) and a professor of maternal fetal medicine at the University of North Carolina at Chapel Hill School of Medicine.

Dr. Boggess recommended routine dental care when pregnant women are due for a cleaning or checkup but delaying x-rays until after the first trimester.

“Urgent problems that include pain or fever should be addressed immediately regardless of trimester,” she noted.

Keeping the mouth as healthy as possible and free of caries and disease during pregnancy can reduce the chances of pain, infection, swelling, or chronic inflammation that might cause a woman to use antibiotics or an analgesic for a significant period of time, Dr. Mayberry noted.

3. What is normal?

While some oral health changes are normal during pregnancy, losing a tooth is not, the healthcare practitioners advised.

Some changes commonly occur during pregnancy that affect oral health, explained Renee Samelson, MD, an ob/gyn at the Albany Medical Center in New York. These include periodontal disease, increased food cravings and snacking that can affect caries risk, nausea and vomiting, and increased salivation and gum sensitivity.

Vomiting can bring up acid from the stomach. After vomiting, a pregnant woman should rinse her mouth with water mixed with 1 tsp of baking soda, or just plain water, to get rid of the acid, the dentists and ob/gyns recommended. Brushing teeth should be postponed for an hour after vomiting to minimize dental erosion, Dr. Tate said.

Despite and because of these issues, the dentists and ob/gyns advised that continuing with regular toothbrushing and flossing during pregnancy is important. Using mouthwash containing cetylpyridinium chloride can help eliminate bacteria associated with inflammation that can affect gums, Dr. Samelson added.

4. Untreated problems can be passed on

Untreated oral health problems in a mother can be passed on to her baby, experts noted. They also emphasized that early child caries is a preventable infectious disease.

Pediatric dentist Rocio Quinonez, DMD, MPH, an associate professor at the University of North Carolina at Chapel Hill School of Dentistry, discussed the connection between maternal and pediatric oral health, which is not yet completely understood.

“Mothers with cavities have kids with cavities,” Dr. Quinonez said. “There is a biological connection.”

Adults can transmit caries-causing bacteria to children in their households through common activities, such as tasting hot food before letting their child eat it or putting a pacifier in their mouth to clean it off, Dr. Samelson explained. This can affect children’s primary and permanent teeth.

Xylitol and secondarily sorbitol have been found to block the growth of Streptococcus mutans and prevent glucose metabolization, which can help avoid caries, she said. With the exception of gum containing xylitol or sorbitol, she recommended that patients and their children limit consumption of anything that sticks to teeth, which could include dried fruit or certain prenatal vitamins, and brush teeth or chew xylitol gum afterward.

Overall, maintaining good oral health during pregnancy is key but perhaps not as compelling as other aspects of healthcare during the prenatal period.
for more tips, go to: www.drbicuspid.com

Kid-Tested, Dentist-Approved: 6 Teeth Cleaning Tips from Dentist Parents

Click here for more Family Dentistry

As a parent, you may have more in common with your dentist than you think. Many moms and dads—even dentists—struggle to keep their children’s mouths and teeth clean. ADA dentist Dr. Gene Romo is a father of four – ages 13, 10, 8 and 2. “As you can imagine, there can be a wide range of behavior on who wants to brush and who doesn’t in our house,” he says. “I’m not just a dentist, I’m their dad, so making sure they’re establishing good habits early on is important to me.”

To keep your family’s smiles strong, try some of tricks of the trade from dentist moms and dads:

Establish a Fun Family Routine

In Dr. Romo’s house, there’s one rule everyone follows: “You have to brush before bed, and you can’t leave the house in the morning until you brush,” he says. “The most important thing is to make sure your family is brushing for 2 minutes, twice a day.”

Young kids love to imitate their parents, so take the opportunity to lead by example. “One thing I did with all my kids was play a game with them, kind of like monkey-see, monkey-do. We all have our toothbrushes, and they follow what I do,” he says. “When I open my mouth, they open their mouths. When I start brushing my front teeth, they start brushing their front teeth – and so on all the way until it’s time to rinse and spit. It’s just a fun way to teach them how to brush properly, and we get to spend a little time together, too.”

Making brushing a family affair also helps you keep an eye out for healthy habits. “Some kids want to do everything themselves, even toothpaste, so you can watch to make sure they’re not using more than they should – a rice-sized smear for kids 2 and under and a drop the size of a pea for kids 3 and up,” he says. “You can also do a quick final check for any leftover food when brush time is done.”

Try a New Angle

When her daughter was only 6 months old, ADA dentist Dr. Ruchi Sahota asked her husband to hold her while she brushed or brushed when her daughter was laying down. “You can see their teeth from front to back the best at that time,” she says.

If your child is old enough to stand and wants to brush in the bathroom, ADA dentist Dr. Richard Price suggests a different method. “Stand behind your child and have him or her look up at you,” he says. “This causes the mouth to hang open and allows you to help them brush more easily.”

Bigger Kids, Bigger Challenges

Checking up on your child’s daily dental hygiene habits doesn’t end as they get older. It’s more challenging when they get their driver’s license and head off to college, says ADA dentist Dr. Maria Lopez Howell. “The new drivers can drive through any fast food spot for the kinds of food and beverages that they can’t find in a health-minded home,” she says. “The new college student is up late either studying or socializing. They don’t have a nightly routine, so they may be more likely to fall asleep without brushing.”

While your children are still at home, check in on their brushing and talk to them about healthy eating, especially when it comes to sugary drinksor beverages that are acidic. After they leave the nest, encourage good dental habits through care packages with toothbrushes, toothpaste or interdental cleaners like floss with the ADA Seal of Acceptance. And when they’re home on break, make sure they get to the dentist for regular checkups! Or if school break is too hectic– you can find a dentist near campus to make sure they are able to keep up with their regular visits.

Play Detective…

As your children get older, they’re probably taking care of their teeth away from your watchful eye. Dr. Romo asks his older children if they’ve brushed, but if he thinks he needs to check up on them, he will check to see if their toothbrushes are wet. “There have been times that toothbrush was bone dry,” he says. “Then I’ll go back to them and say, ‘OK, it’s time to do it together.’”

If you think your child has caught on and is just running their toothbrush under water, go one step further. “I’ll say, ‘Let me smell your breath so I can smell the toothpaste,’” he says. “It all goes back to establishing that routine and holding your child accountable.”

…And Save the Evidence

It could be as simple as a piece of used floss. It sounds gross, but this tactic has actually helped Dr. Lopez Howell encourage teens to maintain good dental habits throughout high school and college.

To remind them about the importance of flossing, Dr. Lopez Howell will ask her teenage patients to floss their teeth and then have them smell the actual floss. If the floss smells bad, she reminds them that their mouth must smell the same way. “It’s an ‘ah-ha’ moment,” Dr. Lopez Howell explains. “They do not want to have bad breath, especially once they see how removing the smelly plaque might improve their social life!”

Above All, Don’t Give Up

If getting your child to just stand at the sink for two minutes feels like its own accomplishment (much less brush), you’re not alone. “It was so difficult to help my daughter to brush her teeth because she resisted big time,” says ADA dentist Dr. Alice Boghosian. Just remember to keep your cool and remain persistent.

“Eventually, brushing became a pleasure,” Dr. Boghosian says. She advises parents to set a good example by brushing with their children. “Once your child is brushing on their own, they will feel a sense of accomplishment – and you will too!”

From the American Dental Association

These States Are the Happiest and Healthiest

David Johnson
Feb 01, 2017

Have you gone to the dentist in the past 12 months?

Your answer to that question is a key predictor of your health and livelihood, according to a new report from Gallup and Healthways that ranks states by well-being. “People who go to the dentist are generally better at evaluating their lives and in control of their health, while poor oral health is linked to many serious physical issues downstream,” said lead Gallup researcher Dan Witters.

That question was just one of 55 on a Gallup survey taken by more than 177,000 Americans last year, which the group used to determine respondents’ physical, emotional, financial, community and social well-being.

read the rest at Time…

Infrequently Asked Questions: Why do we have wisdom teeth?

And what makes them so wise?

With millions of wisdom teeth extracted every year, it’s worth asking: If they’re such a (potential) danger to our health, why do we have them at all?

Curious, we reached out to Jefferson University Hospital’s Robert Diecidue, chairman of oral and maxillofacial surgery, and Daniel Taub, vice chair of oral and maxillofacial surgery, for the 411 on those stubborn third molars.

Why do we have wisdom teeth?

The world is full of questions we all want answers to but are either too embarrassed, time-crunched or intimidated to actually ask. With Infrequently Asked Questions, we set out to answer those shared curiosities.
The diet of our earlier ancestors was quite different from the one we have today. It consisted mainly of coarse food like raw meat, nuts, leaves and roots, which required extensive mastication force. Therefore, their bodies were suited with larger jaws that provided enough spacing to accommodate three pairs of molar teeth on each dental arch. Nowadays we boil, steam, bake, chop, cook, cut and dice almost every meal, making unnecessary an extra set of molars. With the evolution of the human race and the change in our diet, our jaws have become smaller and thinner providing no room for the third molars. Evolutionary biologists now classify wisdom teeth as vestigial organs or body parts that have become functionless due to evolution.

So they’re a product of evolution, then?

Yes. Our oldest ancestors relied more heavily on their larger jaws and teeth to be able to consume a tough and chewy diet consisting of leaves, roots and raw meats. Having 32 teeth was advantageous for greater chewing surface area. Having all 32 teeth was also advantageous just in terms of numbers and in the situation when a tooth — or teeth — were lost, there would be other teeth to chew [with]. Over time, man’s jaw has become smaller in size, possibly to accommodate a larger brain and cranium, or due to change in diet. As this has occurred, the jaw, in many cases, has become too small for the wisdom teeth to erupt.

Do all people get four?

Although most people typically get all four wisdom teeth, about 9 to 30 percent of Americans of European descent will get fewer than the ‘standard four.’ About 11 to 40 percent of African Americans and Asian Americans will develop fewer than four. Topping the list is the Inuit population of Alaska and Canada, who seem to develop missing one or more wisdom teeth 45 percent of the time. Some people are even lucky enough to develop extra, or supernumerary, wisdom teeth which are referred to as fourth molars. This happens about 2.1 percent of the time and most often occurs in the maxilla or top jaw.

Why are they more likely to not grow in straight — need to be taken out?

If there is inadequate arch space in the upper and lower arches, the jaws, this may prevent the wisdom teeth from erupting fully. Thus, space constraints may cause wisdom teeth to grow in at different angles. Once they come in partially, the overlying gum tissue can become infected due to food impaction in the area, as the wisdom teeth are hard to clean, thus they need to be removed in a timely fashion when patients are young and at the peak of their healing ability.

Why are they called wisdom teeth? Will I be less wise without them?

Third molars have been referred to as ‘wisdom teeth’ since the 17th century. In fact, initially, they were termed ‘teeth of wisdom’ and then later changed to ‘wisdom teeth’ in the 19th century. Eruption of these teeth is between the ages of 17 and 25 when a person reaches adulthood. Linguistic experts agree that they are called wisdom teeth because they appear once the brain undergoes full development. Research shows the brain does not achieve full maturation until the age of 25. Having your wisdom teeth extracted does not mean you will lose your wisdom, but you may lose some of the problems associated with them — such as pain, infection and bad breath.

How can people monitor or take care of their wisdom teeth properly?

Seeing your general dentist every six months is a great start. They will take radiographs, evaluate for decay, gingival health and help reinforce proper oral hygiene. The teeth can be monitored via routine, dental x-rays, panorex radiography or new technology 3D scanners (CBCT). If your wisdom teeth are not impacted, a functional occlusion routine evaluation by your general dentist along with radiographs are a great way to monitor wisdom teeth. If they have any concerns, they will refer you to an oral and maxillofacial surgeon for further evaluation and treatment.

By Brandon Baker
Originally published in the Philly Voice

12 Tips for a Healthy Halloween

Halloween Sweets

Halloween is around the corner, which for most children means bags of free candy and a chance to build a stockpile of sweets for the winter. No surprise, Halloween can also present parents with a variety of health and safety challenges. “It’s OK to eat that candy on Halloween but it’s important to have a plan,” says ADA dentist Dr. Ana Paula Ferraz-Dougherty.

Here’s how you can help your family stay MouthHealthy on Halloween and year-round.

1. Time It Right

Eat Halloween candy (and other sugary foods) with meals or shortly after mealtime. Saliva production increases during meals. This helps cancel out acids produced by bacteria in your mouth and rinse away food particles.

2. Stay Away from Sweet Snacks

Snacking can increase your risk of cavities, and it’s double the trouble if you keep grabbing sugary treats from the candy bowl. ”Snacking on candy throughout the day is not ideal for your dental health or diet,” Dr. Ferraz-Dougherty says.

3. Choose Candy Carefully

Avoid hard candy and other sweets that stay in your mouth for a long time. Aside from how often you snack, the length of time sugary food is in your mouth plays a role in tooth decay. Unless it is a sugar-free product, candies that stay in the mouth for a long period of time subject teeth to an increased risk for tooth decay.

4. Avoid Sticky Situations

Sticky candies cling to your teeth. The stickier candies, like taffy and gummy bears, take longer to get washed away by saliva, increasing the risk for tooth decay.

5. Have a Plan

It’s tempting to keep that candy around, but your teeth will thank you if you limit your stash. “Have your family pick their favorites and donate the rest,” Dr. Ferraz-Dougherty says. “Look for organizations that help you donate candy to troops overseas, like Operation Gratitude, or see if your dentist has a candy take-back program.”

6.Drink More Water

Drinking fluoridated water can help prevent tooth decay. If you choose bottled water, look for kinds that are fluoridated.

7. Maintain a Healthy Diet

Your body is like a complex machine. The foods you choose as fuel and how often you “fill up” affect your general health and that of your teeth and gums.

8. Stay Away from Sugary Beverages

This includes soda, sports drinks and flavored waters. When teeth come in frequent contact with beverages that contain sugar, the risk of tooth decay is increased.

9. Chew Gum with the ADA Seal

Chewing sugarless gum for 20 minutes after meals helps reduce tooth decay, because increased saliva flow helps wash out food and neutralize the acid produced by bacteria. “You might even want to think about giving sugarless gum out as a treat instead of candy,” says Dr. Ferraz-Dougherty. Find one with the ADA Seal.

10. Brush Twice a Day

Brush your teeth twice a day for two minutes with an ADA-accepted fluoride toothpaste. Remember, replace your toothbrush every three or four months, or sooner if the bristles are frayed. A worn toothbrush won’t do a good job of cleaning your teeth.

11. Clean Between Your Teeth

Floss your teeth once a day. Decay-causing bacteria get between teeth where toothbrush bristles can’t reach. Flossing helps remove plaque and food particles from between the teeth and under the gum line.

12. Visit an ADA Dentist

Regular visits to your ADA-member dentist can help prevent problems from occurring and catch those that do occur early, when they are easy to “treat.”

Why taking a selfie while brushing your teeth could be good for you!

Teeth have been big news lately. First, there was the issue of whether flossing really helps lower the risk for tooth decay and gingivitis. And now, questions about how often we really need to get dental X-rayshave made the news. The bottom line is that, clinically, these are complex issues that can’t easily be reduced to a simple soundbite.

Maybe it’s time to take a step back and talk about something we can all agree on – toothbrushing.

As a dentist, educator and clinical researcher (an academic dentist sounds so, well, dismissive), I was involved in a very small study, conducted in India, that examined whether taking a smart phone video selfie might help people learn to brush their teeth in a more effective manner. Well, can it help? Short answer: Maybe. Longer answer: It’s complicated, too.

A little selfie-consciousness may be good

Our recent study was conducted by three dentists from India, another researcher from the United States and me. We examined the feasibility of using smart phone video “selfies” to help improve toothbrushing technique.

We conducted a small proof-of-concept study, to determine whether toothbrushing with selfie-taking is worth studying further. As part of the study, Indian dental students were given a one-time toothbrushing training session. Then over two weeks, they recorded – on their phones in the privacy of their own home – five toothbrushing selfies.

Later, the dentist researchers from India reviewed and characterized the selfies. With further analyses from my US colleague, we found some changes and variation over time in the quality and accuracy of toothbrushing.

These changes may suggest that participants were trying to create a new habit, trying to change their behavior, almost as if, while taking the selfie, someone was watching them.

The thought was that by using selfies, participants were more self-conscious about changing their ingrained toothbrushing approach and so may have been better able to “override” their habitual way of brushing. Also, the participants may have had more fun or been more curious about doing a sometimes mundane task.

Habits are hard to change. One needs to overcome “muscle memory” to establish a new behavior. So relearning or retraining, just as with any sports-related skill, may be a gradual process, one prone to trial, error, forgetting and relapse. Some of our data might generally support this. But, based on our pilot study, it seems like adding the selfie to the mix could help people learn, well, new tricks.

Why toothbrushing matters

Why bother brushing our teeth? Oral health is a significant part of overall health. Oral hygiene such as tooth-brushing and flossing, physically cleaning between teeth, can help prevent gum disease and, to a degree, perhaps tooth decay. Cavities can occur between your teeth, where food particles and bacterial debris can linger because a toothbrush often can’t reach into these areas. Your dentist takes X-rays, also known as bite wings, in part to look for tooth decay in these areas. Tooth loss, especially of ones seen when smiling and talking, can lead to a lowered self-esteem and feeling self-conscious in social situations.

Tooth loss can also lead to poor physical health. For example, it can encourage a “softer” diet with fewer fruits, nuts and vegetables. Such food intake can promote a host of diseases and conditions, including weight gain, diabetes and heart disease. And of course, there’s tooth pain, which can be exquisite.

Effective toothbrushing can remove bacteria and organic debris known as dental plaque. Brushing with toothpaste also helps deliver topical fluoride to the teeth, which helps arrest and even reverse early forms of tooth decay.

Persons with risk factors for tooth decay, such as those who consume high levels of processed sugars, do not drink fluoridated water, have infrequent dental visits and have poor toothbrushing habits (lower skill level and less frequent brushing), may benefit from learning more effective oral hygiene techniques.

Having a lower income is associated with many of these risk factors, but most people – regardless of income – can probably improve their oral hygiene skills. And, over the long haul, this could help people keep more teeth and have better oral health.

It’s most important to brush your teeth at night, when your salivary flow goes down. Salivary flow helps buffer the acidic content in your mouth. If you have food particles in your mouth, then certain bacteria use these sugars (almost any carbohydrate) to grow and then give off a form of acid as a byproduct. And it’s this acid that causes tooth decay.

The same goes for kids. Ideally, brush their teeth after breakfast and at night before bed. Most kids can’t brush well until around the age where they can tie their shoes, so an adult will usually do a better job up to that point.

How should you brush? Sometimes people hear different advice from different dentists or hygienists. There is really no “one size fits all” approach, but there are key themes to effective tooth-brushing.

With a soft toothbrush, use gentle, small, circular motions on each tooth, and (using a two-finger “pencil grip” – not too much force) aim the bristles gently at a 45-degree angle where the tooth meets the gum tissue. Pay attention to all tooth surfaces, including the cheek side, the tongue side and the biting surface of each tooth.

Share your selfie – with your dentist or hygienist.

childdental

While ours is very a preliminary study, it opens a door.

But keep in mind, it’s not just the taking of the selfie alone. You will need to review it with your dentist or dental hygienist to get tips on how to improve and on the most important things to work on. Over time, this new, more effective brushing style could become your default habit. But then, you may need another selfie every so often, to make sure that you’re not slipping back into old habits.

An application of the toothbrushing selfie is that technology could be used to evaluate, monitor and permit providers to give real-time, convenient oral hygiene feedback to people across periods of time. This can help put a greater emphasis on prevention, which, at a minimum, should promote good dental checkups and could help keep costs down.

Another application is to remotely screen any number of children in rural areas. A five-second selfie of all the teeth, when reviewed by a dentist, could help identify those who need more immediate or even urgent dental intervention.

Future studies could allow individuals to review their own toothbrushing and critique themselves, and providers could “chime in” with positive comments and suggestions at regular intervals. This could help us understand how behavior change works and what approaches work best for whom.

There are a number of possible applications. The caveat, however, is that confidentiality and legal concerns would have to be ironed out first.

But, again, this was just an initial study, a first step. We established that people could take selfies at home and that we could and later analyze how well they brushed.

That gives us dentists something to smile about.

by Lance Vernon
Senior instructor, Case Western Reserve University

Cross-posted from The Conversation

Hidden Tooth Infections Boost Heart Disease Risk

Could an undetected infection at the root of a tooth be putting you at risk of heart disease? A Finnish study suggests it may.

“Acute coronary syndrome is 2.7 times more common among patients with untreated teeth in need of root canal treatment than among patients without this issue,” says researcher John Liljestrand.

Infection of the root of a tooth is most often caused by tooth decay.

The study included 508 Finnish patients with a mean age of 62 who were experiencing heart symptoms at the time of the study.

The coronary arteries of the patients were examined using angiography, and 36 percent of them were found to be suffering from stable coronary artery disease, 33 percent were undergoing acute coronary syndrome, and 31 percent did not suffer from coronary artery disease to a significant degree.

Their teeth were examined using panoramic tomography of the teeth and jaws. As many as 58 percent were found to be suffering from one or more inflammatory lesions.

The researchers also discovered that dental root tip infections were connected with a high level of serum antibodies related to the bacteria that cause such infections. This shows that oral infections affect other parts of the body as well.

Gum disease, such as periodontitis, is regarded as an independent risk factor for coronary artery disease and diabetes. Infections of root tips have been studied relatively little in this context, even though they appear to be connected with low-grade inflammation as well.

Cardiovascular diseases cause more than 30 percent of deaths globally. They can be prevented by a healthy diet, weight control, exercise and not smoking. With regard to the health of the heart, measures should be taken to prevent or treat oral infections, as they are very common and often asymptomatic. Root canal treatment of an infected tooth may reduce the risk of heart disease, but the researchers note that more research is needed.

Sealants are a Proven and Effective Therapy for Preventing Cavities in Children and Teens

Study: Sealants may reduce caries by up to 80%

By Tony Edwards, Editor in Chief, www.drbicuspid.com

August 5, 2016 — Sealants may reduce carious lesions on the occlusal surfaces of permanent molars by up to 80%, according to a study jointly published by the ADA and the American Academy of Pediatric Dentistry (AAPD).

The authors of the review, hailing from multiple dental schools, organizations, and institutes, sought to summarize the available evidence regarding the effectiveness of dental sealants for preventing pit-and-fissure occlusal caries in primary and permanent molars on children, adolescents, and adults to develop a joint evidence-based clinical practice guideline (Journal of the American Dental Association, August 2016, Vol. 147:8, pp. 631-645).

“Sealants are a proven and effective therapy for preventing cavities in children and teens,” stated lead author Timothy Wright, DDS, in a release from the ADA and AAPD. “The joint report reaffirms that sealants should be a routine part of cavity prevention, as children with sealants are up to 80% less prone to cavities compared to those without them.”

Caries prevalence

In the U.S., nearly a quarter of children and more than half of adolescents have caries in their permanent teeth, according to data from the National Health and Nutrition Examination Survey 2011-2012. Pits and fissures on occlusal surfaces, especially those on permanent molars, increase the risk of these patients developing carious lesions, the authors noted.

“The joint report reaffirms that sealants should be a routine part of cavity prevention.”
— Timothy Wright, DDS, lead study author

The researchers started with more than 2,800 published studies from 1976 through 2016 for their systemic review and reduced the number to 24, including only parallel and split-mouth randomized controlled trials with at least two years of follow-up. They included studies whose authors reported sealant-effectiveness data compared with a control without sealants, fluoride varnishes, or other head-to-head comparisons.

In comparing sealant use versus nonuse, the researchers reviewed nine studies with a total of 3,542 participants. They found that those who received sealants reduced their risk of developing new carious lesions by 76% (95% confidence interval [CI]: 0.19-0.30; p < 0.00001) compared with participants who did not receive sealants.

The researchers also compared sealant use versus fluoride varnishes by reviewing three studies with a total of 1,715 participants. They found that those who received sealants had a 73% reduction in the risk of developing new carious lesions (95% CI: 0.11-0.69; p = 0.006) compared with participants who received fluoride varnishes.

Age of studies

The authors acknowledged several limitations with the review, including an inability to contact primary authors of the studies if there were issues related to risk of bias, as some of the trials were more than 20 years old. They also noted an inability to assess publication bias by means of using a funnel plot owing to the limited number of included studies per outcome.

More research is needed to provide more data about the merits of the different types of sealant materials, the authors noted.

“Available evidence suggests that sealants are effective and safe to prevent or arrest the progression of noncavitated carious lesions compared with a control without sealants or fluoride varnishes,” they concluded.

Survey: More pregnant women in U.S. visiting a dentist

May 16, 2016
By Michelle Manchir

The number of pregnant women in the U.S. going to the dentist has increased 5.5 percent over the last year, according to survey data released in May from Delta Dental Plans Association.

In 2015, 57.5 percent of mothers in the United States reported they visited the dentist during their pregnancy, Delta Dental Plans Association said. The 2016 survey results show that number has increased to 63 percent.

“This is positive news and we’re glad expectant mothers are increasingly visiting the dentist. Oral health issues have a heightened risk of occurring during pregnancy, so being aware and on top of these is crucial,” said Dr. Bill Kohn, Delta Dental Plans Association’s vice president of dental science and policy, in a news release.

Most women who reported seeing a dentist during pregnancy — 37 percent — said it was a routine checkup, while 13 percent said they wanted to address a particular oral health issue and six percent said they wanted to discuss what to expect when it came to oral health while pregnant.

The survey was conducted between Dec. 16, 2015, and Jan. 14, 2016, among a nationally representative group of 1,307 parents of children ages 6-12.

Dental professionals can use ADA’s consumer website, MouthHealthy.org, to help inform patients about what’s safe and healthy for them during pregnancy.

For more information, visit MouthHealthy.org/pregnancy.

In 2015, The Journal of the American Dental Association published research that showed it’s safe for pregnant women to undergo dental treatment with local anesthetics.

The researchers compared the pregnancy outcomes between a group of women exposed to dental treatment with anesthetics and a control group that did not have treatment. The study showed that exposure to dental care and local anesthetics during pregnancy is not associated with increased risk for major medical problems in newborns.

Gum diseases could open the body to a swarm of infections

Mouth microbes may be connected to a variety of illnesses, more and more studies are showing.

Dental care has been disconnected from general health care for many years now, but the more you start to think about it, the stranger it seems. After all, you don’t really separate any other branch of medicine so… why teeth? It all started in the 19th century, following conflicts between surgeons and dentists in England. The conflict was carried on in the United States, after medicine became linked to employer insurance and Medicare. The fissure between medicine and dentistry widened, until it was irreparable. Medicine was split into dental care and all the rest… and has remained so to this day. But is it really fair to exclude dental care from the rest of health care?

When Salomon Amar, a periodontal specialist at Boston University, began exploring links between oral bacteria and heart disease in animal studies in the late 1990s, reactions were unfriendly. Skepticism, in all its forms, was the general response – why would a dentist become involved in heart disease studies? But Amar was’t alone. Wenche Borgnakke, a dental researcher at the University of Michigan in Ann Arbor, has been making the same case for years, pointing to several published studies. Especially, a study published last year in the journal Medicine highlights that patients on dialysis who received periodontal treatment had an almost 30 percent lower risk of pneumonia and hospitalization from infections. Furthermore, a recent study found that gum problems is associated with a 10% higher mortality.

The scale seems to be tipping the other way, as more and more physicians are noticing connections between oral hygiene and general health. Says Jean Wactawski-Wende, a cancer epidemiologist at the State University of New York at Buffalo:

“The more I work on oral health and cancer, the more I think, ‘Oh my gosh, I’ve got to keep my teeth clean.’ ”

Plaque seems to one of the main culprits, and that makes a lot of sense – after all, it’s a thick layer of bacteria inside your mouth.

“If you do not brush your teeth, it will sit there and accumulate. As that plaque gets thicker and thicker, there is less and less oxygen in the deepest layers,” Borgnakke says. Safely sheltered, the innermost plaque starts to favor anaerobic bacteria, which, when they escape into the blood, can survive in the oxygen-starved nooks and crannies deep inside the body.
While many questions still remain, and the relationship between gum health and overall health remains an open question, there is growing evidence that you gums can open the body to a swarm of infections. The science is not yet clear on it, but in the mean time, it’s better to be safe and sorry. Clean your gums, you may be helping your entire body.

by Mihai Andrei
April 8, 2016

Source: G. Hajishengallis/Nat. Rev. Immuno. 2015