Enamel, the hardest and most mineral-rich substance in the human body, covers and protects our teeth. But in one of every 10 people this layer appears defective, failing to protect the teeth properly. As a result, teeth become more sensitive to heat, cold and sour food, and they may decay faster. In most cases, the cause of the faulty enamel production is unknown.

Now, a study by Prof. Jakub Abramson and his team at the Weizmann Institute of Science, published recently in Nature, may shed light on this problem by revealing a new children’s autoimmune disorder that hinders proper tooth enamel development. The disorder is common in people with a rare genetic syndrome and in children with celiac disease. These findings could help develop strategies for early detection and prevention of the disorder.

A strange phenomenon was identified in people with a rare genetic disorder known as APS-1. Although the enamel layer of their milk teeth forms normally, something causes its faulty development in their permanent teeth. Since people with APS-1 suffer from a variety of autoimmune diseases, Abramson and his team hypothesised that the observed enamel defects may also be of an autoimmune nature – in other words, that their immune system could be attacking their own proteins or cells that are necessary for enamel formation.

In their new study, scientists from Abramson’s lab in Weizmann’s Immunology and Regenerative Biology Department, led by research student Yael Gruper, sought to work out how mutations in the Aire gene lead to deficient tooth enamel production.

Online: https://www.sciencedaily.com/releases/2023/12/231213112542.htm

Viking Age teeth from Varnhem bear witness to surprisingly advanced dentistry. This has been shown in a study carried out at the University of Gothenburg in Sweden. The study examined 3,293 teeth from 171 individuals among the Viking Age population of Varnhem in Västergötland, Sweden.

The site is known for extensive excavations of Viking and medieval environments, including tombs where skeletons and teeth have been preserved well in favorable soil conditions.

The research team from the University of Gothenburg’s Institute of Odontology worked with an osteologist from Västergötland’s Museum.

The teeth underwent clinical examinations using standard dentistry tools under bright light.

A number of X-ray examinations were also performed. The results, which have been published in PLOS ONE, show that 49% of the Viking population had one or more caries lesions. However, children with milk teeth – or with both milk and adult teeth – were entirely caries-free.

Tooth loss was also common among adults. The studied adults had lost an average of 6% of their teeth, excluding wisdom teeth, over their lifetimes. The findings suggest that caries, tooth infections, and toothache were common among the Viking population in Varnhem.

However, the study also reveals examples of attempts to look after teeth in various ways.

Carolina Bertilsson, a dentist and Associate Researcher, and the study’s corresponding author, said: “There were several signs that the Vikings had modified their teeth, including evidence of using toothpicks, filing front teeth, and even dental treatment of teeth with infections”.

One sign of more sophisticated procedures was molars with filed holes, from the crown of the tooth and into the pulp, probably in order to relieve pressure and alleviate severe toothache due to infection.

Carolina continues: “This study provides new insights into Viking oral health, and indicates that teeth were important in Varnhem’s Viking culture. It also suggests that dentistry in the Viking Age was probably more sophisticated than previously thought”.

Online: https://www.sciencedaily.com/releases/2023/12/231214132600.htm

A new study by investigators from Brigham and Women’s Hospital (BWH) in the US and Harvard Pilgrim Health Care Institute examined whether daily toothbrushing among hospitalised patients is associated with lower rates of hospital-acquired pneumonia and other outcomes. The team combined the results of 15 randomised clinical trials that included more than 2,700 patients and found that hospital-acquired pneumonia rates were lower among patients who received daily toothbrushing compared to those who did not. The results were especially compelling among patients on mechanical ventilation. Their results are published in JAMA Internal Medicine.

Corresponding author Michael Klompas, MD, MPH, hospital epidemiologist and an infectious disease physician in the Department of Medicine at BWH and Professor of Population Medicine at Harvard Pilgrim Health Care Institute, said: “The signal that we see here towards lower mortality is striking – it suggests that regular toothbrushing in the hospital may save lives. It’s rare in the world of hospital preventative medicine to find something like this that is both effective and cheap. Instead of a new device or drug, our study indicates that something as simple as brushing teeth can make a big difference”.

Hospital-acquired pneumonia occurs when bacteria in the mouth enter a patient’s airways and infect their lungs. Patients experiencing frailty or with a weakened immune system are particularly susceptible to developing hospital-acquired pneumonia.

However, adopting a daily toothbrushing regimen can decrease the amount of bacteria in the mouth, potentially lowering the risk of hospital-acquired pneumonia from occurring.

The team conducted a systematic review and meta-analysis to determine the association between daily toothbrushing and hospital-acquired pneumonia.

Online: https://www.sciencedaily.com/releases/2023/12/231218125919.htm

A study from the University of Minnesota School of Dentistry and published in Clinical Oral Investigations examined the patterns of splatter contamination created by rotary instruments and irrigation during oral surgery. This study is the first to examine rotary instrumentation splatter created during oral surgery procedures, and its findings provide several key suggestions for the future of oral surgery and improving safety measures for both providers and patients.

The study involved an experiment on manikins, otherwise known as patient simulators, in the University of Minnesota’s Oral and Maxillofacial Surgery operatories. Researchers simulated the surgical extraction of four molars in different quadrants with one operator and one assistant with four combinations of operations: saline with a self-irrigating drill; hydrogen peroxide with a self-irrigating drill; saline with hand irrigation; or, hydrogen peroxide with hand irrigation.

A total of 52 procedures were completed and splatter was collected on glass fibre prefilters, which were allowed to dry before being photographed under ultraviolet (UV) light. The study found that the most splatter occurred on the patient’s chest, followed by the assistant’s face shield. The operator’s face shield was also splattered, as were face masks and corners of the operatory. Also, the difference between assistant irrigation and self-irrigating drills was marginally significant, but found that using hydrogen peroxide to irrigate instead of saline increased the area of droplet splatter.

While hydrogen peroxide rinses were used throughout the Covid-19 pandemic as a pre-procedural rinse, this study is the first to report an enhancing effect of irrigation using hydrogen peroxide on the formation of splatter, and suggests that hydrogen peroxide actually increases the risk of spreading droplets when it’s used to irrigate.

The study also offers important insights for the use of personal protective equipment in oral surgery. Given the high level of splatter on the operator and assistant’s face shields, practitioners may consider continuing to use face shields.

The authors suggest further approaches could include additional studies of the effects of irrigants and irrigation methods on viral load and surface stability of viruses, and testing of frequently-touched locations.

Online: https://medicalxpress.com/news/2023-11-first-of-its-kind-splatter-infection-oral-surgery.html

A novel aqueous lubricant technology designed to help people who suffer from a dry mouth is between four and five times more effective than existing commercially available products, according to laboratory tests.

Developed by scientists at the University of Leeds, the saliva substitute is described as comparable to natural saliva in the way it hydrates the mouth and acts as a lubricant when food is chewed.

Under a powerful microscope, the molecules in the substance, known as a microgel, appear as a lattice-like network or sponge, which bind onto the surface of the mouth. Surrounding the microgel is a polysaccharide-based hydrogel that traps water. This dual function will keep the mouth feeling hydrated for longer.

Results from the laboratory evaluation show benchmarking of the microgel-reinforced hydrogel-based aqueous lubricant against commercial saliva substitutes, and are reported in the journal Scientific Reports.

The novel microgel comes in two forms: one made with a dairy protein; and, the other a vegan version using a potato protein.

The new substance was benchmarked against eight commercially available saliva substitutes. All the benchmarking was done in a laboratory on an artificial tongue-like surface and did not involve human subjects.

With the commercially available products, between 23 and 58% of the lubricant was lost. With the saliva substitute developed at Leeds, the figure was just 7%. The dairy version slightly outperformed the vegan version.

Dr Olivia Pabois, a Research Fellow at Leeds and first author, said: “The test results provide a robust proof of concept that our material is likely to be more effective under real-world conditions and could offer relief up to five times longer than the existing products. The results of the benchmarking show favourable results in three key areas. Our microgel provides high moisturisation, it binds strongly with the surfaces of the mouth and is an effective lubricant, making it more comfortable for people to eat and talk”.

Online: https://medicalxpress.com/news/2023-11-proof-concept-material-relief-dry.html

Common oral infections, periodontal diseases and caries are associated with inflammatory metabolic profiles related to an increased risk of cardiometabolic diseases, a new study suggests. Oral infections also predicted future adverse changes in metabolic profiles. The study was a collaborative effort by an international team of researchers from the University of Eastern Finland and the University of Helsinki in Finland, the Karolinska Institutet in Sweden, and the Medical University of Graz in Austria.

The association between oral infections and adverse metabolic profiles was observed in the Finnish Health 2000/2011 and Parogene study cohorts and was published in the Journal of Dental Research.

The present study comprised 452 middle-aged and elderly Parogene patients and 6,229 participants of the population-based Health-2000 survey. In 2011, 4,116 Health-2000 participants provided a follow-up serum sample. Serum concentrations of 157 metabolites reflecting the risk of chronic diseases, such as lipid and glucose metabolites, ketone bodies and amino acids, were determined with an NMR spectroscopy method.

The study had a cross-sectional part analysing the association between the metabolic measures with prevalent oral health, and a prospective part examining whether oral infections predict the levels of metabolic measures in the follow-up.

Among 157 metabolic measures, increased periodontal probing depth was associated with 93 measures, bleeding on probing with 88, and periodontal inflammation burden with 77. Among the caries-related parameters, root canal fillings were associated with 47 metabolic measures, inadequate root canal fillings with 27, and caries lesions with eight. In the prospective analyses, caries was associated with 30 metabolites and bleeding on probing with eight. These metabolic measures were typical of inflammation, thus showing positive associations with fatty acid saturation degree and very low density lipoprotein (VLDL) parameters, and negative associations with high density lipoprotein (HDL) parameters.

“Oral infections may partially explain unhealthy lipid profiles,” says Adjunct Professor Aino Salminen from the University of Helsinki.

Online: https://www.sciencedaily.com/releases/2023/11/231116141003.htm

In a study published in September 2023 in the International Journal of Oral Science, researchers from Tokyo Medical and Dental University (TMDU) have revealed that a common oral pathogen can stop cardiac myocytes from repairing themselves after a heart attack caused by coronary heart disease.

Heart attacks occur when blood flow in the coronary arteries is blocked, resulting in an inadequate supply of nutrients and oxygen to the heart muscle, and ultimately death of cardiac myocytes. To prevent this, cardiac myocytes use a process known as autophagy to dispose of damaged cellular components, keeping them from causing cardiac dysfunction.

“Previous studies have shown that the periodontal pathogen Porphyromonas gingivalis, which has been detected at the site of occlusion in myocardial infarction, can exacerbate post-infarction myocardial fragility,” says lead author of the study Yuka Shiheido-Watanabe. “However, the mechanisms underlying this effect remained unknown”.

To investigate this, the researchers created a version of P. gingivalis that does not express gingipain, its most potent virulence factor, which an earlier study showed can inhibit cells from undergoing programmed cell death in response to injury. They then used this bacterium to infect cardiac myocytes or mice.

“The results were very clear,” explains Yasuhiro Maejima, corresponding author. “The viability of cells infected with the mutant bacterium lacking gingipain was much higher than that of cells infected with the wild-type bacterium. In addition, the effects of myocardial infarction were significantly more severe in mice infected with wild-type P. gingivalis than in those infected with the mutant P. gingivalis lacking gingipain”.

Given that P. gingivalis appears to have a substantial impact on the cardiac muscle’s ability to heal itself after a heart attack, treating this common oral infection could help reduce the risk of fatal heart attack.

Online: https://medicalxpress.com/news/2023-10-killer-oral-pathogen-heart-reveals.html.

The sting of a toothache or the discovery of a cavity is a universal dread. Dental caries, more commonly known as tooth decay, is an insidious adversary, taking a toll on millions of mouths worldwide. Caries can lead to pain, tooth loss, infection, and in severe cases, even death.

Some state that current treatments do not sufficiently control biofilm, the main culprit behind dental caries, and prevent enamel demineralisation at the same time. This dual dilemma becomes particularly pronounced in high-risk populations where the onset of the disease can be both rapid and severe.

Now, a study from a team of researchers led by Hyun (Michel) Koo of the University of Pennsylvania’s School of Dental Medicine in collaboration with David Cormode of Penn’s Perelman School of Medicine and School of Engineering and Applied Science has unveiled an unexpected synergy in the battle against dental caries.

Their research revealed that the combination of ferumoxytol (Fer) and stannous fluoride (SnF2) could provide at a potent tool in the fight against dental caries. Their findings were published in Nature Communications.

Their findings include the ability of Fer to stabilize SnF2, the heightened catalytic activity of Fer when combined with SnF2, and the formation of a protective Fe/Sn/F-rich film on tooth enamel, which can serve as a shield against further demineralisation. What’s more, this combined therapy doesn’t disrupt the ecological balance of the oral microbiota and has no adverse side effects on the surrounding host tissues.

The researchers also note that, beyond this protective and proactive measure, an intriguing secondary benefit surfaced. Many children with severe tooth decay also suffer from iron deficiency anaemia. Using Fer might address the dental and anaemia concerns simultaneously.

Looking ahead, further research is required into the exact mechanisms of interaction between SnF2 and Fer, the reactive oxygen species generation process, and the formation and efficacy of the protective enamel film.

Online: https://medicalxpress.com/news/2023-10-combined-treatment-tooth-decay.html.

New research from Delta Dental on oral healthcare during the Covid-19 pandemic, published recently by the Journal of the American Dental Association, reported a significant decrease in the provision of preventive oral healthcare services when compared to pre-pandemic levels.

The study, ‘Impact of the Covid-19 pandemic on oral healthcare use in the United States through December 2021’, showed that there were significant decreases in preventive dental services that persisted for more than a year, particularly across all age groups under 65. These could reflect, in part, anecdotal reports of loss of employer-sponsored dental benefits, reluctance to seek care due to concerns about Covid-19 exposure, or staff shortages at dental offices. Study authors also found a significant increase in the delivery of night guards to adult patients. This may indicate a rise in stress-related teeth grinding that can crack or fracture teeth.

The research assessed the effects of the Covid-19 pandemic on oral healthcare using national insurance claims data. The research team analysed claims by quarter from 2017 to 2019 and from July 2020 to December 2021, including 600 million submitted procedure codes. The study team intends to conduct follow-up research that will explore national oral health claims data from 2022.

Online: https://www.dentistrytoday.com/pandemic-impact-decline-in-preventive-oral-health-services-raises-concerns/.

Under the direction of Praveen Arany, Ph.D., associate professor of oral biology, students at the University of Buffalo School of Dental Medicine created free face shields and comfort bands as a type of personal protective equipment (PPE) with 3D printers that were eventually used by some 3,000 dental professionals in university centres across the US. However, first the students had to figure out how to prevent the shields from fogging up, which makes it hard for wearers to see.

Commercially available antifogging solutions found in eyeglasses and car exteriors were not suitable due to their potential to irritate the skin or cause sickness if inhaled or ingested. However, lotus leaves provided a eureka moment for the researchers.

After looking at several formulations of wax that would keep the PPE clear and non-toxic, the research team discovered that a combination of carnauba and beeswax created optimal results.

“With a couple of adjustments, the condensation just rolled off,” Arany said.

The researchers’ discovery is explained in a paper published in Peer J Materials Science and authored by students Succhay Gadhar, Shaina Chechang and Philip Sales, with Arany.

Although clinical professionals are currently not required to wear PPE, this could change if the spread of the new coronavirus variant, BA.2.86, results in healthcare settings adopting stricter cautionary measures.

“The design principles are there,” Arany said. “It’s something we could manufacture again if and when needed”.

Online: https://medicalxpress.com/news/2023-09-student-lotus-fog-free-personal-equipment.html



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