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                                     DENTAL  Updated Weekly! 2006

Oral health is the gateway to overall health!

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             Many Americans suffer from a reduced quality of life due to oral
             and facial pain.*

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 Invisalign and Invisalign Express "Invisible Braces" is now offered in our office!

December 2006
Consumer Reports Evaluates Toothpastes

Consumer Reports (CR) found that most toothpastes carry a prominent, but misleading claim - whitening teeth. The fine print reveals that most products whiten by removing stains, not by lightening the base color of the teeth. In their tests of 41 toothpastes, no correlation was found between these claims and stain-removing ability. Even those containing peroxide did no better at bleaching out stains than others. Only one toothpaste stood out as a stain remover: Ultrabrite All in One Advanced Whitening (without peroxide). At 28˘ per ounce, roughly one-tenth the cost of the priciest brand, it was one of the least expensive products. CR advised consumers to follow the American Dental Association's to use a product containing fluoride.

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Antacids May Fight Gingivitis

Chemicals commonly used to treat heartburn also display fighting power against the oral bacteria linked with gum disease, according to researchers at the University of Rochester Medical Center. The team studied a compound known as lansoprazole, part of a family known as benzimidazoles that already have a range of uses, primarily controlling stomach hyperacidity and killing bacteria responsible for stomach ulcers. This compound is showing potent antimicrobial actions that interfere with other types of bacteria that cause plaque buildup and gingivitis. The research, supported by the National Institute of Dental and Craniofacial Research, "shows promise for preventing cavities and providing protective benefits to guard against gingivitis."

TIP: Watch for developing research. (Source: University of Rochester Medical School,, November 2006, Archives of Oral Biology.)

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American Dental Association: Fluoride and Infant Formula

The American Dental Association (ADA) has issued guidelines regarding fluoride intake for infants and children. The interim guidelines report that ”recent studies cited in the report of the National Research Council (NRC), ‘Fluoride in Drinking Water: A Scientific Review of EPA's Standards,' have raised the possibility that infants could receive a greater than optimal amount of fluoride through liquid concentrate or powdered baby formula that has been mixed with water containing fluoride during a time that their developing teeth may be susceptible to enamel fluorosis.”
For the complete ADA position statement click

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Cold Plasma to Replace Dentist's Drill?

Bio-medical research and the advent of cold plasma needles could eliminate the need for drilling teeth. A physicist based at the Eindhoven University of Technology in the Netherlands started development of the device three years ago. Using a needle with a drop of plasma comes in contact with the affected part of the mouth and is cold and painless to the touch. Plasma is ionized gases in a state of high temperature. Researchers are experimenting with a hand-held device that can localize plasma to kill bacteria, including Streptococcus mutans bacteria.

(Source: DentalCompare Orthodontic Newsletter, 11/14/06)

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High Doses of Pain Drugs Increase Heart Attack Risk
The Commission on Human Medicines is issuing guidance to doctors regarding high daily doses of common painkillers such as ibuprofen. The British Medical Journal published research in June 2006 which indicated that taking the drugs meant an extra three people out of one thousand would develop a higher risk of heart attacks or strokes. The Medicines and Healthcare Products Regulatory Agency, which oversees the safety of drugs used in the United Kingdom, advises that the lowest effective doses of non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, should be taken for the shortest time necessary. However, the European Medicines Agency (EMEA) has decided that the benefits of NSAIDs still outweigh any increased risks.

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Check Your Child's Brushing

Listerine has introduced Agent Cool Blue© mouth rinse.  It has a chemical in it that identifies the bacterial buildup that we call plaque.   

Here’s how it works:  after brushing (and, for those old enough to do it,  flossing), you rinse with Agent Cool Blue.  Any area you missed will show a blue stain.  Brush and floss away the stain, and you get the areas you were missing.   If you suspect that your child is trying to pull a fast one on you by brushing quickly and poorly,  a surprise post-brushing inspection with Agent Cool Blue will reveal the truth.

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Survival Guide for Your Smile!

There is one thing that seems to unite us all:  comfort food.

Cold weather and sweets go hand-in-hand, let's take a moment to think about what it’s doing to your teeth. How Could Something So Good be So Bad?

Sugar can wreck havoc with your teeth. Bacteria in your mouth use your sweets as energy, growing and multiplying faster than they would otherwise. Some bond with the sugar to form a sticky glue called plaque. Plaque, in turn, produces acid. The acid dissolves the minerals that make your tooth enamel hard, and the surface becomes porous. The acid causes these tiny holes in the enamel to become bigger until one large hole appears. This is a cavity.

All we can do is try to minimize the damage. Don’t let your holiday routine interrupt your dental care regimen. Brush your teeth at least twice a day with a fluoride toothpaste and floss at least once.

If you decide to indulge in more sweets than usual, it’s a good idea to brush more often. If you don’t have your toothbrush on hand, rinse your mouth out with warm water. Certain sugar-free gums can help as well. Choose those with Xylitol, an artificial sweetener that can help prevent tooth decay. And finally, try to mix up your snacks. If you’re eating a sugary treat, try to also eat a bit of cheese (or a similar protein) as well and have a happy Jesus birthday celebration.


November 2006

What foods cause tooth decay in children?

Many different types of food can cause tooth decay, not just candy. Foods that are high in carbohydrates, as well as some fruits, liquids, peanut butter, crackers and potato chips are culprits. Factors that cause tooth decay include the frequency in which the foods are eaten and the time they remain as particles in the mouth.

Can decay affect infants?
Yes. Tooth decay in infants and young children most often occurs in the upper front teeth, but also may affect other teeth. Sometimes parents do not realize that a baby's teeth can decay soon after they first appear. The decay may even enter the underlying bone structure, which can hamper development of the permanent teeth. This problem is frequently referred to as baby bottle tooth decay. This kind of decay is caused by long-term exposure of a child's teeth to liquids containing sugars. When a child consumes a sugary liquid, acid attacks the teeth and gums and causes decay.

Are children safe from soda and other beverages?
Dentists believe that kids who consume too much soda and not enough nutritional beverages are prone to tooth decay in addition to serious ailments later in life, such as diabetes and osteoporosis. Drinking carbonated soft drinks regularly can contribute to the erosion of tooth enamel. Soft drinks contain sticky sugars that bacteria in our mouths use as an energy source. They break down into acids and adhere to tooth surfaces.

How does bacteria hurt teeth?
Decay is caused by bacteria that feed on any food that contains sugars and carbohydrates. Decay occurs when solid or liquid food particles are left unswallowed and cling to the teeth or gums for long periods. Bacteria in the mouth use sugars to produce acid that attacks the enamel of the teeth, softening and then eroding them. Enamel breakdown leads to cavities. If erosion spreads beneath the enamel, pain and sensitivity may eventually result. This can cause nerve infection, which can result in the need for a root canal.

My children rarely drink soda. Are they still at risk for tooth decay?
Yes, any prolonged exposure to soda can cause damage. Sipping a soft drink all afternoon is more harmful to your teeth than drinking a large soda with a meal and then not drinking any soda for the rest of the day. While many dentists advocate drinking nutritional beverages, such as milk, many agree soda should be consumed from a can rather than a bottle with a replaceable cap to discourage prolonged exposure to soda.

How can children prevent damage to their teeth?
Children at school should rinse their mouth with water after meals, leaving their teeth free of sugar and acid. Children also should seek sources of fluoridation. If you purchase bottled water, be sure that it is fluoridated. Encourage children to drink tap or fountain water. Use a straw when drinking soda to keep sugar away from teeth. Remember, bottled juices are not a good alternative due to the high sugar content. Regular dental check-ups, combined with brushing with fluoride toothpaste also will help protect children's teeth.

How can you help your child prevent tooth decay?
Parents should take their infant to the dentist just after the first tooth appears. Brushing teeth after meals, regular flossing and fluoride treatments are the best ways to prevent tooth decay. Children should also be supervised as they brush. A good rule of thumb is that when children can dress themselves and tie their own shoes, then they are ready to brush unsupervised. Children should be supervised in proper flossing techniques until the age of 10. If you have any concerns about your child's dental health or want some tips on preventing tooth decay, ask your dentist.
The AGD 11/06

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Mother of 5-year-old with rotted teeth faces court

The mother of a 5-year-old Bethlehem boy whose teeth were so badly rotted from a lack of dental care that he had to have 12 teeth pulled faces Northampton County Court action on charges of endangering his welfare. Eneida Resto, 43, of 1235 Livingston St. waived her right to a preliminary hearing today. She is free on $25,000 bail. Police said the boy, whose name they withheld, could not eat properly because of the extreme pain and decay in his teeth. All of his molars had to be removed. He will probably continue to need extensive orthodontic care, police wrote in an affidavit.

According to court records:

The boy had complained of pain in his mouth and headaches since the summer of 2005. A dentist who treated him in February and pulled his teeth was so concerned about the boy's condition that he contacted the Northampton County Children, Youth and Families Division.
Investigator Glennie Racz interviewed Resto about her son's lack of dental care. Resto said she had been aware of his tooth decay for months, but had not attempted to get dental care for him until December.
"Rivera said she was aware of her son's teeth decaying and causing him pain, but felt like they were baby teeth and going to fall out on their own and there was no reason for dental care," according to the police affidavit.
In February, Racz contacted Dr. Talel Noumeh, who said the boy was a patient. Noumeh, who has offices in Allentown and Phillipsburg, told investigators that on Dec. 10, the boy had a total of 11 severe cavities in his front and back teeth. Noumeh said he recommended the boy see a specialist for follow-up treatment.
It's not clear in the affidavit what Noumeh did for the boy.
Noumeh told Racz that if the boy's cavities weren't treated, he would experience a high degree of pain and lose his teeth or could get an infection. Noumeh said he did not see or treat the boy after Dec. 12.
On Feb. 17, the boy was treated by Dr. Nicholas Prusack of Allen Oral Surgery Associates in Salisbury Township, police said. Prusack said he removed 12 of the boy's teeth, including all of his molars.
Prusack wrote a letter to Racz on Feb. 25, saying he was concerned about the child's welfare. Prusack said the boy's dental condition resulted from his lack of dental care and it would have taken two to three years for his teeth to reach such an advanced stage of decay.
Prusack told investigators that in his opinion, if he hadn't removed the boy's teeth the boy could have been hospitalized in six months for treatment of massive dental abscesses.
The boy has eight teeth remaining, but his ability to chew food is limited due to a lack of molars. Bethlehem police Investigator Thomas Galloway said the boy is now in foster care through the Children
, Youth and Families Division.,0,2913263.story?coll=all-topnews-pointers

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ADA Oral-System Connection

ADA’s study of oral-system disease connections October’s

RDH Magazine, September 2006,  Healthy Gums, Healthy Life

Healthy Gums, Healthy Life award of Distinction for 2006.

Scientific American Presents Oral and Whole Body Health

Enjoy this special supplement of Scientific American compliments of Crest and Oral-B. To order free copies: Gum Disease Can Trigger Host of Problems

Experts say an unhealthy, bacteria-filled mouth can also lead to a host of problems throughout the body, such as heart disease, diabetes, blood infection and even low birth-weight babies. And the culprit, more often than not, is gum disease. Gum disease is suspected of contributing to ailments through the bloodstream. Bacteria from the mouth flood into the circulatory system and travel to other parts of the body, causing widespread inflammation. (Dennis Thompson, HealthDay Reporter, 10/14/06.)

Wall Street Journal, September 2006, Health Plans Expand Dental Benefits

Author M.P. McQueen describes how the “mounting evidence linking poor oral hygiene to a range of expensive medical problems,” is causing insurers to look at a patient’s health in new ways.

Pennwell’s Grand Rounds in Oral/Systemic Medicine

“Dentists and physicians are on the cusp of an emerging science called oral systemic medicine that treats the whole patient with the aim to identify, manage and prevent diseases and chronic health conditions.” Healthy Teeth, Healthy Heart

Men under age fifty with advanced periodontal disease were found to be 2.6 times more likely to die prematurely and 3 times more likely to die of heart disease compared to men with healthy teeth and gums.” “Flossing regularly can make your RealAge® as much as 6.4 years younger.” Smart Practice 10/06

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October 2006

Traveling and Teeth Cleaning

While temporary travel restrictions barring liquids and gels onboard airplanes have been relaxed, there are still other options for travelers to keep their teeth clean and healthy. As oral health care professionals, why not help your patients who travel with some of these convenient ideas for clean teeth on the go.

bulletPack  travel toothbrushes in your carry on bag
bulletChew sugarless gum with xylitol to stimulate gums and remove trapped food particles
bulletUse dental floss or perio aids
bulletRinse teeth with water and drink plenty of it

For more on travel and dental health see: Emergency Travel Kits

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Tongue Scrapers only Slightly Reduce Bad Breath

At least 40 million Americans suffer from halitosis. Unfortunately, there is no standard treatment for it.According to a study in the September/October issue of General Dentistry, the Academy of General Dentistry’s (AGD) clinical, peer-reviewed journal, halitosis is a term used to describe any disagreeable odor of expired air.  Bad breath is a generally accepted term for foul smells emanating from the mouth.  Oral malodor is a term reserved for unpleasant smells originating from the oral cavity. A common reason for bad breath is post-nasal drip, which coats the back area of the tongue with bacteria-rich mucous, A tongue scraper is often effective in relieving oral malodor caused by sinus drainage.

The study reviewed literature examining the effects of using tongue scrapers to brush the tongue, rather than using a toothbrush to scrape the tongue.  Data revealed that a tongue cleaner/scraper demonstrated a significant difference in reducing volatile sulfur compounds (VSC) levels, which are produced when bacteria and amino acids interact to produce bad breath.  Though there is no standard treatment, bacteria-causing halitosis can be reduced by brushing or scraping the middle and back of the tongue.  Tongue scraping can lower VSC concentration, subsequently reducing oral malodor.  However, that reduction is only short-term, and not an absolute solution for eliminating malodor. 

Despite the short-term reduction, tongue scrapers are a good tool for the short-term.  Tongue cleaners and scrapers are straightforward and comfortable to use, easy to transport, and inexpensively priced. Cleaning the tongue is quickly and easily accomplished. Everyone from children to elders should be able to incorporate this technique into their oral care regimen.

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Pediatric HIV: Oral lesions are commonly associated with the disease

Across the globe, the presence of HIV is wide-spread, 500,000 children died from disease-related cases in that year alone. In the United States, 90 percent of infected children are infected by the disease through birth.

The effects of the disease on children differ greatly from those in adults, according to a report/study that appears in the July/August 2006 issue of General Dentistry. Type, severity and progression are all factors that differ, depending on the age at which one contracts the disease.Children do not demonstrate HIV-specific symptoms as adults do, their bodies will most likely display an infection or weakness instead of common HIV signs.”

The place where this most commonly occurs is in the mouth. There are many variations of the way lesions appear, but a few common types are: candidiasis, or “thrush,” a fungal yeast infection; salivary gland enlargement; herpes simplex virus; inflammation of the gingiva; and canker sores. Orofacial manifestations of HIV are common in pediatric HIV infection, it is important to be aware of these signs, as they may serve as both a marker of infection and predictor of HIV progressing to AIDS.

What to do:

• Visit your general dentist. They handle the majority of dental emergencies.
• If you fear that your child or teen might be at risk, have them tested as soon as possible. The sooner a child is diagnosed, the sooner treatment can begin.
• Communicate with your dentist if the child has HIV. It will alert them to look closely for signs of disease, plus allow them to provide the best possible treatment 10/06

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September 2006

Steroid-Abusing Athletes Risk Gum Disease

Illegal anabolic steroids may pump up athletes’ gums as well as their muscles according to Turkey’s Journal of Periodontology author Onur Ozcelik, DDS, PhD. The overgrown gums make it easier for bacteria in plaque to accumulate placing steroid users at risk for severe gum infection. The study compared bodybuilders who had been using steroids for less than one year with 20 bodybuilders who had never used steroids. Participants were between the ages of 17 to 29. Steroid users were found to have:
  1. Significantly thicker gums (an average score of 1 vs. 0.3; P<.001)
  2. More gingival encroachment onto teeth (an average score of 0.9 vs. 0.2; P<.001)
  3. More overall gingival enlargement (average score 0.9 vs. 0.3; P<.001)  Smart Practice News 9/06

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Whole Grains Lower Gum Disease Risk

Eating whole grains lowers a person’s risk of developing diabetes or heart disease. New study findings suggest that a diet rich in whole grains may also lower the likelihood of periodontitis. Dr. Anwar T. Merchant of McMaster University in Canada followed more than 34,000 men aged 40-75 over a 14-year period. During that time, 1,897 men were diagnosed with periodontitis; those who reported eating the most brown rice, dark breads and other whole grains (3 servings/day) were 23% less likely to develop heart disease than those who ate less than one daily serving of whole grains

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ADA Testifies Before FDA on Dental Filling Safety Story Receives Widespread Media Coverage

The U.S. Food and Drug Administration is holding a two-day panel meeting today and tomorrow to gather facts and opinions regarding dental amalgam. ADA representatives, as well as a number of witnesses from other dental organizations, are testifying at the meeting. Numerous other individuals will also testify, including two international participants describing the basis for their countries' regulation of amalgam. Time has been set aside for comments from the public, and we expect a number of dental amalgam opponents will share their views.

The FDA has prepared a draft report in advance of the meeting that supports the safety of dental amalgam. No specific FDA regulatory action is expected; however, this meeting has received widespread media coverage due primarily to Associated Press and CBS network radio stories. Both stories cited the ADA's position that the weight of scientific evidence indicates dental amalgam is a safe and effective restorative material. NBC Nightly News is also covering this story, and may air its segment tomorrow night.

*        Dentists welcome this review of the science by the FDA.
*        The overwhelming weight of scientific evidence, including two recent clinical trials published in the Journal of the American Medical Association, support the safety and effectiveness of dental amalgam.
*        Dental amalgam contains elemental mercury combined with other metals such as silver, copper, tin and zinc, which forms a safe, stable cavity-filling material. It's important to note that dental amalgam has entirely different properties than mercury by itself.
*        Amalgam is one of several safe, effective materials to fill cavities. Other materials include gold and tooth-colored fillings.

More information:

*        A news release about the FDA meeting and testimony from our three representatives is posted on <> .
*        Dental Filling Options: information for patients <> 
*        An ADA press statement <>  on the dental amalgam clinical trials published in the Journal of the American Medical Association.
*        A Journal of the American Dental Association patient page entitled,  <> When A Filling Needs to be Replaced

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August 2006

One lollipop in the morning, one at night more cavities, mom!

Yep, that's true if Max Anderson's little company is in fact on target. 20 pops for ten bucks.  Repeat four times a year and you chase out
the evil strep bugs.  After ten days, you can't culture streps. Ingredients hydrogenated starch hydrolysate, citric acid, orange  flavor, acesulfame potassium.  Herbal ingredients include extract of  Sophora flavescens and Glycyrrhiza uralensis. (The last, incidentally, you'll recognize as licorice.)
HSH is a conglomerate, usually, of the non-cariogenic sorbitol, maltitol, etc polyols.

The key to making the product work is the time-intensive extraction and elution technology.  Your regular licorice won't cut the mustard. It's an ethanol extraction.  Sadly, the ethanol must be discarded in the process. Sophora flavescens, far as I can figure out, is Japanes yew and is  also under a bunch of research as an anti-cancer agent. In any event, the final product, Dr. John's Herbal Candy (Grand  Rapids, MI), is the result of a trip to China that eventually produced 100 different herbs that had some bioactivity.  9600 experiments elucidated the anti-strep properties.  There is other research ongoing with relatively short chain peptides 20 amino acids that can keep them from sticking to the enamel.Keep your eyes peeled for STAMPS, specifically targeted antimicrobial peptides.  Looks promising but maybe too costly to produce.So far, the STAMPS can kill streps, lactobacilli and sobrinus.It's not gonna be a good thing to be a strep in the near future. bill domb8/06 IDF
order them through Max: Dr. Maxwell H Anderson President, C3 Jian, Inc. 872 Three Crabs Road Sequim, WA 98382 Phone: 360-681-5033 Fax:     360-681-5324 Cell:     206-499-7616

Steroid Abuse Harms Gingival Tissues

Researchers from the Cukurova University, Turkey, have found that  prolonged use of anabolic androgenic steroid (AAS) is closely  associated with significant levels of gingival enlargement,  according to a new study published in the Journal of Periodontology.  Additionally, gingival inflammation was higher in the AAS user group compared to the non-AAS users. The researchers examined 24 athletes  between the ages of 17 and 29 who had been using AAS for more than  one year. All subjects were examined for plaque levels, gingival  inflammation and gingival enlargement. The results were then  compared with a control group of 20 bodybuilders who had never used  AAS drugs and matched for age, educational level and oral habits  according to the data obtained from the AAS user group.

Gingival overgrowth is a condition in which the gingival tissues  become swollen and grow over the teeth which makes it easier for  bacteria found in plaque to accumulate and attack supporting  structures of the teeth, potentially leading to severe periodontal  infection. People taking AAS without medical supervision, should be informed of the adverse effects and strongly encouraged to begin a  cessation program, experts say. 05.07.2006 Dental Tribune

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Treating the “New” Old

Baby boomers are the “new” old and are markedly different than previous generations, according to the U.S. Census Bureau’s report on the aging population.
They are more prosperous, better educated and healthier, and those differences will accelerate as the first boomers hit retirement in 2011.
In the survey, 24% of the general dentists indicate that just 5% of their elderly patients are edentulous. More than half indicate that 10% or
fewer of their elderly patients are edentulous. As more older patients keep their teeth longer, the risk of root caries and periodontal disease increases.
Currently, about 30% of the 65 and older population is totally edentulous. The most common oral conditions present in elderly patients include:
Root caries 37%
Xerostomia 24%
Periodontal disease 21%
Erosion/abrasion 13%
Other 6%

Smart Practice eletter 8/14/06

Facts on Floss

Informative points about dental floss:

bullet Marks from “flossing" have been found on the teeth of early humans.
bulletNew Orleans dentist Levi Parmly invented dental floss, a silken thread around 1815.
bulletThe first commercially available dental floss was an unwaxed silk floss, released in 1882 by Codman and Shurtleft Co., a Randolph, MA firm.
bulletDr. Charles Bass, a medical doctor, is credited with making flossing an integral part of dental hygiene. He also developed nylon floss as a replacement for silk floss.
bulletWax floss was introduced in the 1940s, and tape floss was introduced in the 1950s. Soon after came flavored (cinnamon, mint) floss.
bulletThis year the average American will spend $7 on dental floss. In 2001 Americans bought 1.9 million miles of floss.
bulletWomen are almost twice as likely to floss their teeth as men.
(Source: May/June 2006 The Dental Assistant)

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Canadians Scientists “Re-grow” Teeth?

Researchers at the University of Alberta in Edmonton filed patents in the U.S. for a tool based on low-intensity pulsed ultrasound technology that can “re-grow” teeth. The tiny ultrasound machine gently massages gums and stimulates tooth growth from the root once inserted into a person’s mouth, mounted on braces or a removable plastic crown. To stimulate growth, the wireless devise must be activated for 20 minutes each day for four months. (Source: American Journal of Orthodontics and Dentofacial Orthopedics)

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Periodontal Disease Increases Health Care Costs

Researchers find prevention of periodontal disease may lead to saving of not only dental care but also medical care. Investigators presented data at the 84th General Session of the International Association for Dental Research based on health, dental examinations and health insurance claims of 4,285 civil officers aged 40-59 years. Over the 3.5-year period, those with severe periodontitis accrued 21% higher total costs than those with no pathological pocket (pocket depth less than 4 mm). The admission rates of those with severe periodontitis were high for both sexes. In males, the dental costs for this group were approximately two-fold higher than those with no pathological pockets.

(Source: 7/4/06)

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July 2006

Knives Being Used as Floss

Thought you’d seen it all? A survey by the British Dental Health Foundation has found that more than 60% of people use whatever comes into their hand to clean food debris stuck in between their teeth. Items like screwdrivers, scissors, earrings, needles and knives are commonly used. Worse yet, 23% leave food stuck in between their teeth, giving rise to oral health problems and bad breath. The foundation is launching an educational campaign to promote the use of dental floss.

Smart Practice 7/06

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New Anti-Smoking Pill

Now there’s an FDA approved tablet shown to help more than 1 in 5 smokers quit.  Varenicline is the first new prescription drug for smoking cessation approved in nearly a decade and only the second stop-smoking drug that is nicotine-free. In 1997, the FDA approved bupropion, an antidepressant sold as Wellbutrin and then rebranded as Zyban.

Varenicline works in two ways, by cutting the pleasure of smoking and reducing the withdrawal symptoms. Pfizer will market the drug as a twice-daily tablet, intended for adults only, as Chantix™. (Source:

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Dentistry, a Trusted Profession!

More Americans trust the advice they get from their dentists than from nearly all other professionals, a 2006 Harris Poll shows. More than 2,300 U.S. adults ranked 11 different professions in terms of the trust they place in the advice those professionals give. Dentists came in just shy of physicians, and well above many others:

“Completely trust”
Bankers and financial advisors
Insurance agents
Real estate brokers

 Smart Practice newsletter 7/06

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Blood vessel walls altered by periodontal disease

Half of the people diagnosed with cardiovascular disease do not have the classic risk factors of smoking, high cholesterol, lack of  exercise or genetics. Athersclerosis is an inflammatory disease with  the immune response believed to be involved in the formation and growth of atheromas.

Chronic infections, like periodontal disease, may be involved with  artheroma formation. A review of laboratory studies concludes that  P. gingivalis can invade endothelial cells, the cells that comprise  blood vessel walls. P. gingivalis can trigger the release of specific substances from the endothelial cells that begin artheroma formation.

The link between periodontal disease and heart disease becomes clearer when we understand how oral bacteria  may change blood vessel walls. Periodontal infection may be the first step in the development of an arthroma.

Gibson, F., Yumoto, H., Takahashi, Y., Chou, H., Genco, C.: Innate  Immune Signaling and Porphromonas Gingivalis Accelreated  Atherosclerosis. J Dent Research 85: 106-121, 2006. cited
PeriReports 2006; 18(4.

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Dentists Discover Alarming Rise In Eating Disorders

San Diego - Healthy and beautiful looking teeth have a dramatic effect on a person's attractiveness to others as well as on his or  her own self-image and self-esteem. Studies have shown that  appearance will have a strong effect on social and career success by  influencing how a person is perceived.

Yet many women (and men) who are desperate to attain the perfect  image will destroy a beautiful smile, ruining their dental health  while literally risking their own lives to be thin. A study by the  National Association of Anorexia Nervosa and Associated Disorders  reported that 5% to 10% of anorexics die within 10 years of
contracting the disease. Up to 20% will be dead within 20 years. For  women ages 15 to 24 years old the death rate associated with  anorexia is 12 times higher than the death rate of all other causes  combined.

Starvation can cause major organs to shut down. A heart attack is  one of the most common causes of death from those suffering with an  eating disorder. People can die from eating disorders at any body  weight. Since depression accompanies anorexia, suicide is also a  risk factor. Approximately 25% of all anorexics attempt suicide, and
about 50% of anorexic deaths result from suicide.As society's obsession with body image continues to grow, so does  the prevalence of eating disorders. It is now estimated that eleven  million Americans have an eating disorder.

Eating disorders often remain extremely hidden. Sufferers take great  pains to hide their symptoms and activities due to the shame and  stigma of their disease. The deterioration of dental health due to  eating disorders is a critically important clue to successfully  recognizing when someone may be affected by an eating disorder such
as anorexia or bulimia.

Observing these symptoms could reveal the effects of eating disorders on dental health:

Erosion of teeth enamel by stomach acid brought into the mouth due to purging
Accelerated tooth decay and gum disease
Infected nerves
Cracked and painful lips, tongue and gums
Bruised mouth and gums
Dry mouth and swollen salivary glands due to frequent vomiting
Deterioration of bones and gums supporting the teeth due to lack of nutrition
According to the Institute of Dental Research and Colgate Oral  Pharmaceuticals, 28% of bulimia cases are first diagnosed during  dental exams. Yet in a study conducted by Old Dominion University,  fewer than 33% of dentists and 43% of dental hygienists currently  assess patients for eating disorders. Worse yet, fewer than 20% of
dentists and 17% of dental hygienists refer these patients for  treatment.

Since the destruction of teeth and gums from anorexia and bulimia  can start as early as three months after extreme dieting  or "purging" (vomiting), dentists and dental hygienists may be the  first health care providers to see the physical and oral effects of  eating disorders. The effects of eating  disorders on dental health are devastating. The pain and discomfort  of poor dental health can significantly add to the physical and  emotional suffering of a person with an eating disorder.

Dental health professionals can be valuable allies in the fight to identify and treat eating disorders. Early  diagnosis, referrals and treatment can significantly increase the  chances of recovery for people suffering from eating disorders. If  we can raise awareness, we'll get help to a greater number of people  suffering from this devastating illness before it's too late.

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June 2006

Dental Tourism

Seeking dental care from dentist in other countries....India, Africa, Mexico, Thailand, Hungary and Cost Rica is not advised by the American Dental Association.  Here are the reasons why:

bulletThey do not met the accepted standards of care.
bulletThere is no guarantee for the work done.
bulletYou may have to pay much more to fix problems that these dentist caused upon returning to the United States.
bulletThere is no one to follow-up on your care over time.
bulletWho will maintain the responsibility for the case if it is completed outside the United States.  May US dentists are reluctant to take ownership of dental cases that were performed outside the U.S because they are unaware of which systems were involved  and do not have the opportunity to consult with the dentist who performed the work.
bulletA large amount of dental work is done within a short time.
bulletThe foreign dentist may not speak your language and communication issues will occur that can affect your care.
bulletMany insurance companies only pay benefits for services rendered in the US.
bulletForeign based dentist do not need to comply with infection control standards that protect you.
bulletThere may be no state or federal laws regulating the foreign dentist practice and review committees.

Dental Tourism. AGD pg 2 Dentalnotes Sumer 2006

May 2006

Ozone in Dentistry?

Ozone therapy is used in the dental industry in Europe and Canada. Shirley Gutkowski, RDH, BSDH, writing in Contemporary Oral Hygiene predicts that it will be available in the US within about a year. As the pH of the mouth fluctuates throughout the day, tooth enamel can break down and rebuild. If it continues to breakdown, bacteria creates a hole in the tooth. If bacteria is detected early, the application of bactericides can create an environment that promotes the remineralization of enamel. Ozone is a strong bactericidal agent that destroys the cellular membrane of Streptococcus mutan, the main cause of enamel caries. Ozone is also deadly to other microbes living in toxic biofilms. “Sterilization with ozone destroys the colony-forming units, the niche, and other bacteria associated with dental disease ... and the enamel can begin to heal.” (COH, 12/05)

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FDA Rejects Health Claim for Green Tea

There is no credible scientific evidence that drinking green tea reduces the risk of heart disease, federal regulators said Tuesday in rejecting a petition that sought to allow tea labels to make that claim.

The Food and Drug Administration said it reviewed 105 articles and other publications submitted as part of the petition but could find no evidence to support claims of the beverage's health benefits.

``FDA concludes there is no credible evidence to support qualified health claims for green tea or green tea extract and a reduction of a number of risk factors associated with CVD'' or cardiovascular disease, Barbara O. Schneeman, director of the agency's Office of Nutritional Products, Labeling and Dietary Supplements, wrote in a letter denying the petition. The FDA posted the letter to its Web site Tuesday.

Ito En Ltd., a Japanese company that bills itself as the world's largest green tea company, and its U.S. subsidiary, Ito En (North America) Inc., petitioned the FDA in June 2005, seeking to make the claim that drinking at least five ounces of green tea a day may reduce the risk of heart disease.

A message left for a spokesman for Ito En (North America) Inc. was not immediately returned late Tuesday. A message left for the AAC Consulting Group, a Rockville, Md. company that filed the actual petition, also was not immediately returned.

Green tea is brewed from the leaves of Camellia sinensis, also known as Thea sinensis. Unlike black and oolong tea, green tea is made from unfermented tea leaves.

The FDA previously has said that green tea likely does not reduce breast, prostate or any other type of cancer risk.

Nonetheless, the belief that drinking green tea confers health benefits has driven its popularity over the last decade, the Tea Association of the United States has said.

A health claim, in the language of the FDA, characterizes the relationship between a substance and a reduction in the risk of contracting a particular disease.

On the Net:  Food and Drug Administration:

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April 2006

JAMA Publishes Dental Amalgam Studies

Chicago, April 18, 2006—The results of two independent and well-designed studies published in tomorrow's Journal of the American Medical Association add to the substantial body of peer-reviewed scientific literature that supports the safety of dental amalgam as an option for patients and their dentists in treating dental decay.

The published studies measure whether children with dental amalgam fillings experienced any adverse effects related to neurobehavioral, neuropsychological (IQ) and kidney function. They found that there was no difference in neurological performance and kidney function in children who have amalgam fillings compared to a control group with composite (white) fillings.

These studies support the existing scientific understanding that the minute amount of mercury released by amalgams during such common activities as eating and drinking does not affect health adversely. Both studies support the continued use of dental amalgam as an important treatment option.

Dental amalgam contains elemental mercury combined with other metals such as silver, copper, tin and zinc to form a safe, stable alloy that dentists have used for generations to restore teeth damaged by decay.

The bottom line for consumers: Dental amalgam remains among several safe, effective options for treating dental decay. Of course, the best option is still to prevent dental disease through brushing, flossing and regular dental visits. For comprehensive information about fillings and all other aspects dental care and oral health, ask your dentist and visit

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Saliva Component May Predict Future Oral Bone Loss

Researchers at the University at Buffalo have identified two components of saliva that may serve as the basis for novel tests to determine the risk for future loss of the bone that holds teeth in place. By comparing dental X-rays of 100 patients with analyses of their saliva, they found that higher-than-normal levels of salivary protein called IL-1 beta were associated with increased bone loss. For more details on their findings go to:

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Early Warning Signs of Oral Cancer
Any lesions on the face, neck, or in the mouth that do not heal within two weeks. These lesions are often not painful.
Swellings, lumps or bumps on the lips, gums, or other areas inside the mouth.
White patches, red patches, red and white patches, or dark patches on the tissue on the cheeks, tongue, floor of mouth, or palate.
Repeated bleeding in the oral tissues
Numbness, loss of feeling or pain in any area of the face, mouth or neck

Reducing Your Risk For Oral Cancer

Stop or limit use of tobacco products, including cigarettes, pipes, cigars, and chewing tobacco
Consume alcoholic beverages in moderation
Protect your lips from excessive exposure to sunlight by using a sunscreen with a sun protection factor (SPF) of at least 12
Ensure that dentures fit properly and are not irritating the gums or cheeks

See slide show on how to do a self examination:

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Prevalence of Overweight Children, Teens and Men in U.S. Continues to Rise Though Rate May Be Leveling Off for Women
The prevalence of overweight and obesity among children and adolescents and obesity among men increased significantly between 1999and 2004, according JAMA.

Obesity continues to be a leading public health concern in the United States. Between 1980 and 2002, obesity prevalence doubled in adults aged 20 years or older and overweight prevalence tripled in children andadolescents aged 6 to 19 years.

Staff from Centers for Disease Control and Prevention, Hyattsville, Md., and colleagues examined data on national measurements of weight and height in 2003-2004 and compared these data with estimates from 1999-2000 and 2001-2002 to determine if the overweight trend is continuing. The data consisted of weight and height measurements from 3,958 children and adolescents aged 2 to 19 years and
4,431 adults aged 20 years or older obtained in 2003-2004 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the U.S. population. Overweight among children and adolescents was defined as at or above the 95^th percentile of the sex-specific body mass index (BMI) for age growth charts based on data collected between 1963 and 1994. Body mass index is calculated as weight in kilograms divided by the square of height in meters. Obesity among adults was defined as a BMI of 30 or higher; extreme obesity was defined as a BMI of 40 or higher.

The researchers found that 17.1 percent of children and adolescents aged 2 to 19 years were overweight and 32.2 percent of adults aged 20 years or older were obese in 2003-2004. The prevalence of extreme obesity among adults was 4.8 percent. There was a significant increase in the  prevalence of overweight in female children and adolescents from 13.8 percent in 1999-2000 to 16 percent in 2003-2004. There was also an increase in the prevalence of overweight in male children and adolescents from 14.0 percent to 18.2 percent.

Among men, the prevalence of obesity increased significantly between 1999-2000 (27.5 percent) and 2003-2004 (31.1 percent). Among women, no significant increase in obesity was observed between 1999-2000 (33.4 percent) and 2003-2004 (33.2 percent). The prevalence of extreme obesity in 2003-2004 was 2.8 percent in men and 6.9 percent in women.

In 2003-2004, significant differences in obesity prevalence remained by race/ethnicity and by age. Approximately 30 percent of non-Hispanic white adults were obese as were 45 percent of non-Hispanic black adults and 36.8 percent of Mexican Americans. Among adults aged 20 to 39 years, 28.5 percent were obese while 36.8 percent of adults aged 40 to 59 years and 31.0 percent of those aged 60 years or older were obese in 2003-2004.

Journal of the American Medical Association on"Prevalence of Overweight and Obesity in the United States, 1999-2004"by CL Ogden, MD Carroll, LR Curtin, MA McDowell, CJ Tabak, and KM Flegal (JAMA. 2006;295:1549-1555). To contact Cynthia L. Ogden, Ph.D., call the National Center for Health Statistics Press Office at 301-458-4800.

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Drinking pink liquid may lead to a black tongue

Dentists are often the first to diagnose and treat oral reactions, especially since many reactions occur with any medications used in excess, or in combinations with other drugs, such as vitamins and herbs.The mouth can react differently to drugs and those reactions can vary in significance.

An adverse reaction depends on the drugs you use. Too much bismuth subsalicylate, for example, can turn your tongue black, but the reaction is temporary and harmless,  Also, too much antibiotic usage can do the same thing and give you a black, hairy-looking tongue. And, any acidic type of medication can cause canker sores, including chewable vitamin C.

Most of these reactions, however, cannot be prevented, but early recognition, appropriate treatments, and changing drug regimens can eliminate them. Your dentist can help, both in diagnosing drug interactions and in writing prescriptions that would be good to take in order to avoid side effects. Some side effects are not dangerous and others are, depending on the extent of drug administered and the kind of drug that is used. Don’t forget that vitamins in excess become drugs and can cause serious damage and injury.

How to avoid and treat an oral reaction to medication:
• Let your dentist know what drugs, vitamins, and herbs you regularly take.
• Visit your dentist when you suspect that a reaction is occurring to medication you are taking.
• Use vitamins, herbs, and over-the-counter medications only as directed by your physician. AGD 4/06

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Oral and Dental Health

(Data are for U.S. for year indicated)

Health care use

Percent of children ages 2-17 with a dental visit in the past year: 75 (2003)

Percent of adults ages 18-64 with a dental visit in the past year: 65 (2003)

Percent of adults ages 65 and over with a dental visit in the past year: 58 (2003)

Source: Health, United States: 2005, table 84

More data

Untreated dental caries by age, sex, race, and Hispanic origin, (1971-74, 1988-94, 1999-2002)

Source: Health, United States: 2005, table 85

Frequencies and percents of hearing trouble, vision trouble, and absence of teeth by age, sex, and race/ethnicity

Source: Summary Health Statistics for U.S. Adults, National Health Interview Survey, 2003, tables 11, 12

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Licorice Root Prevents Tooth Decay

   Licorice root is the peeled or unpeeled dried root of the licorice plant (Glycyrrhiza glabra). The primary active component of licorice
root is a substance called glycyrrhizin. Licorice root is the peeled or  unpeeled dried root of the licorice plant (Glycyrrhiza glabra). The  primary active component of licorice root is a substance called glycyrrhizin. Side effects and possible risks: Taking licorice over a prolonged period of time can lead to  potentially serious side effects, including high blood pressure, salt  and water retention, swelling, depletion of potassium, headache,  and/or sluggishness.1 Glycyrrhizin can worsen ascites, the  accumulation of fluid in the abdominal cavity, a condition that can  be caused by cirrhosis.2 The herb also can interact with certain  drugs, such as diuretics, digitalis, antiarrhythmic agents, and corticosteroids.

 Radix glycyrrhizae. In: WHO Monographs on Selected Medicinal Plants. Vol. 1. Geneva, Switzerland: World Health Organization;  1999:183-194.
 Lewis JH. Licorice for hepatitis C: yum-yum or just ho-hum? The  American Journal of Gastroenterology. 2001;96(8):2291-2292.

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Lush Black Toothgel
Maybe this black-is-chic thing is going too far. Black lipstick is one thing, but black tooth gel? The mad scientists at Lush have come
up with just that. It looks like caviar in a tube, but in fact it tastes delicately citrusy, with flavors of lime, tangerine and houji
tea. What makes it black is charcoal, which makes for an excellent all-purpose cleaner (a fact probably discovered by someone who went camping and forgot the dish soap). It also absorbs odors.

Aimed especially at coffee and red wine drinkers (that would be most of us), the gel leaves the mouth feeling fresh, without that cloying
mint flavour. Keep a tube in your handbag and you'll always have a conversation starter for the ladies' room.
For store information visit, $5.95 for 18 grams.

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March 2006

Red Wine May Ward Off Gum Disease

Red wine may help keep gums healthy and strong. Though the results have so far only been borne out in the test tube, a team of Canadian scientists believe antioxidant components in red wine and grape seeds have anti-inflammatory effects that may ward off periodontal troubles. "Our findings demonstrate that red wine polyphenols have potent antioxidant properties," conclude researchers led by Dr. Fatiah Chandad from the Universite Laval in Quebec City.

Experts believe that upwards of 80 percent of Americans are estimated to have some form of gum disease, either in the relatively mild form known as gingivitis or in a more serious form, known as periodontitis. Periodontitis (meaning "around the tooth") is linked to poor oral hygiene. It is a chronic infection involving bacteria present in plaque that persistently coats teeth.

According to the AADR, approximately 15 percent of Americans between the ages of 21 and 50 suffer from this harshest form of gum disease. Among adults over the age of 50, 65 percent are affected. Smokers, diabetics and those taking steroids, oral contraceptives and certain cancer drugs are a higher risk for developing periodontitis, often in the absence of any obvious warning signs. And gum disease's effect may extend beyond the mouth: Recent research has indicated that the inflammation and immune responses which accompany serious gum infection may also provoke an increased risk for diabetes, heart disease and birthing abnormalities among periodontal patients.

However, the Quebec researchers say laboratory tests conducted on mouse cell samples revealed that antioxidants found in red wine known as polyphenols may help limit the severity of bacteria-linked gum inflammation.They note that inflammation is the immune system's natural response to the presence of such bacteria, Unfortunately, that response also involves the accelerated production of unhealthy molecules called "free radicals." The production of too many free radicals can lead to a further weakening of gums. The result is inflammation, bleeding, and a gradual tissue and bone decay that can ultimately result in the loss of one or more affected teeth.

But Houde and her colleagues found that -- in the test tube, at least -- red wine polyphenols inhibit key proteins at the cellular level to slow free radical production. They speculate that red wine's antioxidant punch could be a useful weapon in the fight against gum disease. y. "Many antioxidants have been tested in humans, and they have not been too effective," Genco stressed. "We've been very disappointed, so we have to be very careful. So, while this study is an interesting first start, the key now is clinical trials in humans."

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Living Taste Cells Produced Outside The Body 

Researchers from the Monell Chemical Senses Center have succeeded in growing mature taste receptor cells outside the body and for the first time have been able to successfully keep the cells alive for a prolonged period of time.
These cells contain the receptors that detect taste stimuli: sweet, sour, salty, bitter, and umami (savory). Each taste receptor cell lives for only about 10-14 days. By producing new taste cells in an in vitro system, our results demonstrate that direct stimulation from nerves is not necessary to generate taste cells from precursors. Another important avenue for research aims to help people who have lost their sense of taste from radiation or diseases. Identification of factors that promote taste cell regeneration and growth may provide new avenues of treatment for these patients.

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Periodontitis may influence the effectiveness of antibiotics used to prevent recurrent cardiovascular events, report researchers
in the Jan. 4 online issue of the journal Atherosclerosis.

A research team led by Dr. Susanna Paju, Institute of Dentistry, University of Helsinki, Finland, examined 141 patients who were
hospitalized for acute cardiovascular events such as myocardial infarction or unstable angina pectoris. In a double-blind trial,
researchers registered the recurrence of new cardiovascular events over one year of observation after the patients received a three-
month course of clarithromycin or a placebo. Researchers used radiographs to evaluate the status of the patients' teeth and tooth-
supporting tissues. They also assessed the presence of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in
the patients' saliva and measured the serum antibodies for these bacteria.

They found that patients with no signs of periodontitis were more likely to avoid experiencing new cardiovascular events. Seventy-nine percent of these patients did not experience a new cardiovascular event, compared with 74 percent of edentulous patients and 66 percent of patients with periodontitis.

The differences were even more noticeable in patients younger than 65 years. Ninety percent of patients without periodontitis did not
experience a new cardiovascular event compared with 64 percent of patients with periodontitis and 50 percent of edentulous patients.

Researchers concluded that patients younger than 65 years who have periodontitis may have a five-fold increase in the risk of
recurrent, acute cardiovascular events compared with healthy people.

The study was funded in part by the Academy of Finland, Helsinki.J Am Dent Assoc, Vol 137, No 3, 308-309.

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Long-Term Clinical Effects of a Chlorhexidine Varnish Implemented Treatment Strategy for Chronic Periodontitis

Scaling and root planing in combination with oral hygiene monitoring are still considered the therapeutic standards for periodontitis. The
purpose of this study was to investigate, over a 9-month period, the clinical benefits of a treatment strategy for chronic periodontitis
based on a combination of sequential scaling and root planing and subgingival chlorhexidine varnish administration.

This randomized controlled, single blind, parallel trial included 26 volunteers with chronic periodontitis. The control group
received oral hygiene instructions and was scaled and root planed in two sessions. The test group received the same instructions and
treatment; however, all pockets were additionally disinfected using a highly concentrated chlorhexidine varnish. Clinical response
parameters were recorded at baseline and at 1, 3, 6, and 9 months.

 Both treatment strategies showed significant reductions in probing depth and gains in clinical attachment at study termination
in comparison with baseline. However, combination therapy resulted in a significant additional pocket reduction of 0.62 mm . Initially deep pockets  around multirooted teeth seemed to benefit most from the combination strategy, resulting in an additive pocket reduction of 1.06 mm  and a clinical attachment gain of 0.54 mm in comparison to scaling and root planing alone. These findings suggest that the outcome of initial periodontal therapy may benefit from the adjunctive subgingival administration of a highly concentrated chlorhexidine varnish.

Jan Cosyn et al.Journal of Periodontology 2006, Vol. 77, No. 3, Pages 406-415

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Light Therapy May Combat Gum Disease

Dr. Nikos Soukos, director of the Applied Molecular Photomedicine Laboratory at the Forsyth Institute in Boston, was a principal investigator in a recent study of how light therapy could combat oral bacteria associated with gum disease. He states, “Some of the key bacterial pathogens associated with periodontitis produce and accumulate compounds that are sensitive to light … when exposed to particular wavelengths of light, a percentage was eradicated within seconds.” The findings of the study suggests that blue light may be useful in preventing, controlling or treating periodontitis while also increasing the proportion of potentially helpful bacteria. Free research abstract:

Americans:  Calories Don't Add Up 

Drink Soda? Don't Do This For 1 Hour

If you drink a soda to quench your thirst, do not rush to brush after you drain that can.

Why? Carbonated drinks are highly acidic and have the potential to damage a tooth's enamel. Brushing right after you drink can exacerbate this. Instead, wait 30 to 60 minutes to brush, according to new research from dentists at Goettingen University in Germany. Waiting to brush after drinking a soda actually is three to five times more effective at protecting enamel from the erosive effects of carbonated drinks, reports Reuters.

Soda is so acidic that it can actually dissolve the upper layers of the tooth. Thomas Attin, director of the university's department for tooth protection, explained that waiting to brush allows the tooth enamel to mount its own defense against acidic erosion, typically through protective agents in the saliva that help repair and rebuild damaged tooth enamel. Brushing too soon not only destroys this opportunity, but also brushes off the affected layers of the teeth. The research, which was presented at the annual meeting of the German Association for Tooth Protection, was awarded a prize from chewing gum maker Wrigley.

Should you just give up soda altogether and drink juice instead? Maybe not. The dental school faculty at South Africa's University of Stellenbosch did a comparison test on the effects of orange juice, apple juice, Pepsi Cola, and Diet Pepsi. (Although these researchers used Pepsi products, the differences between them and other popular brands of soda--for the purposes of this test on dental health--are not significant.)

While fruit juices definitely provide more vitamins than soda, they are also acidic and that can cause demineralization and softening of the teeth.

HealthScoutNews reports the results: Orange juice and Pepsi were equally harmful to teeth, followed next by apple juice. Diet Pepsi was not only the least likely drink to soften the teeth, but also the least likely to cause cavities.


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February 2006

February 3, 2006 Give Kids a Smile® Day
February, 2006 National Children's Dental Health Month

 Association between Dental Caries Activity and Coronary  Heart Disease Severity
The link between dental diseases and a wide range of systemic  medical conditions has recently acquired increased attention.
Periodontal disease, in particular, has been implicated as a marker of cardiac disease. Dental caries, the most common oral infection,  should be considered as a potential risk factor for all systemic  diseases. Few studies have investigated this association. To investigate the potential relationship between dental caries  activity, dental plaque levels and presence of mutans streptococci (Ms) in saliva (independent variables) and coronary  heart disease (CHD) severity (dependent variable). Methods: 219 cardiac patients in a hospital cardiac clinic were included. Dental  caries activity was evaluated by the "D" or "untreated" component of the DMFT index , dental plaque was measured according to the Turesky  index, and the number (CFU\ml) of salivary Ms were measured on
MSB-agar. CHD severity was assessed according to extent of vessel  blockage; function and size of left ventricle

According to results of LV-Gram catheterization; Stress tests were categorized by physiological symptoms of CHD; previous
hospitalization (due to CHD) was recorded. Results: Previously hospitalized patients due to CHD had 3.03 untreated carious teeth as
compared with 1.84 among patients not previously hospitalized (Mann-Whitney, p=0.032). Levels of MS were lowest among patients who had no coronary blockage: 11.63 million CFU\ml, as compared to patients with single, double, or triple vessel blockage: 12.97,
30.64, 21.11 million CFU\ml respectively (ANOVA, p=0.031). Plaque index levels were lowest among patients with no coronary blockage (2.80) as compared with patients with single, double or triple vessel blockage: 3.56, 3.31, 3.54 respectively (ANOVA, p=0.049).
Conclusions: These data consistently indicate a potential association between dental caries activity and CHD severity and emphasize the role of preventive dentistry in the promotion of general health.

H.D. SGAN-COHEN1, M.N. SELA1, M. ANGIE1, and M. MOSSERI2, 1Hebrew University - Hadassah School of Dental Medicine, Jerusalem, Israel, 2Hebrew University - Hadassah School of Medicine, Jerusalem, Israel Seq #56 - Epidemiology10:45 AM-12:45 PM, Thursday, 10 March 2005 Baltimore Convention Center 331

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Prevention of Periodontal Disease

An inverse association between calcium intake and periodontitis prevalence was recently reported. Dairy products are rich sources of calcium and other important nutrients. To date, it appears that the relationship between the intake of dairy products and periodontitis has not been investigated. The purpose of the present study was to examine whether or not there is an association between the intake of dairy products and periodontitis prevalence.

A total of 12,764 individuals who participated in the Third National Health and Nutrition Examination Survey were included in this study. Individuals who had at least one site with an attachment loss ˇÝ3 mm and a probing depth ˇÝ4 mm were considered to have periodontitis. The intake of dairy products was categorized into
quintiles. Descriptive statistics and logistic regression models were used for data analyses.

Prevalence of periodontitis was 41% lower for individuals in the highest quintile of intake of dairy products than those in the lowest quintile. After adjusting for known and suspected periodontitis risk factors (age, gender, race\ethnicity,cigarette smoking, education, diabetes, poverty index, vitamin use, body mass index, physical activity, time since the last dental visit, dental calculus, and gingival bleeding), individuals in the highest
quintile of intake of dairy products were 20% less likely to have periodontitis than those in the lowest quintile (P = 0.024 for trend).The results of this study showed an inverse association between the intake of dairy products and prevalence of periodontitis.

Increased Intake of Dairy Products Is Related to Lower Periodontitis Prevalence - Mohammad S. Al-Zahrani Journal of Periodontology 2006, Vol. 77, No. 2, Pages 289-294

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Cavity-fighting candy.
A recent discovery in dental care could soon make it possible. Researchers at Stony Brook University have found a new way to fight
tooth decay by mimicking the powerful re-mineralizing benefits of saliva, long known to naturally protect teeth from harmful, cavity-
causing bacteria.

A two-year study in the latest issue of the Journal of Clinical Dentistry found that CaviStat, a calcium/arginine-based product, was
more effective than fluoride in fighting tooth decay when used in toothpaste form. The study, involving 726 children, found the group
using CaviStat had 58 percent fewer cavities than those using over-the-counter fluoride toothpaste.

While BasicMints, Ortek's first candy-based product, is not yet available, the Roslyn Heights-based company sells CaviStat toothpaste
as DenClude for sensitive teeth and ProClude, a polishing paste used by dental hygienists. People will be able to have two candies in the morning and two candies at night, which should dramatically reduce tooth decay. It gives us an alternative toluoride.
Clinical trial results, which uncovered no side effects from CaviStat, still require additional studies to confirm results.

Dental plaque, a sticky biofilm of bacteria that grows on tooth surfaces, starts when sugars are broken down to acids, which erode
teeth over time. CaviStat contains arginine, an amino acid in saliva, which breaks down to produce acid-neutralizing alkali. CaviStat can be considered to be a super-saliva complex that picks up where fluoride has left off.

2006 Newsday Inc.BY CURTIS L. TAYLOR  January 19, 2006

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Compounds In Liquorice Root May Help Fight Tooth Decay

Compounds isolated from liquorice root may help prevent cavities, according to researchers at the University of California, Los Angeles. In test tube studies, the scientists showed that an extract from a plant root that is used to make liquorice sweets and other products contains at least two compounds that appear to be potent inhibitors of Streptococcus mutans, a major cause of dental caries.

More studies are needed before it is proven that the compounds effectively fight cavities in humans If further studies show promise, the liquorice compounds could eventually be used as cavity-fighting components in mouthwash or toothpaste. In addition to being used as flavoring and sweetening agents in sweets, tobaccos and
beverages, compounds derived from liquorice root have been shown to help fight inflammation, viruses, ulcers and even cancer.
Feb. 24 print version of the Journal of Natural Products, a monthly peer-reviewed joint publication of the American Chemical Society and the American
Society of Pharmacognosy.
Tuesday 24th January 2006

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Reader’s Digest Dental Story

December 2005’s Reader’s Digest  featured, “The Checkup That Can Save Your Life,” which delves into the relationship between oral and systemic health through case reports and research results. The subhead, “The dentist may be the most important doctor you see this year” ... And the article concludes “ … as medical science reaffirms that head and body are indeed connected, there’s more reason than ever to brush twice a day, floss daily, and get dental checkups every six months or see a dentist promptly if you have a problem.”

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Association Between Periodontitis and Rheumatoid Arthritis

An Australian study published in the Journal of Periodontology found that participants who had rheumatoid arthritis were more than twice as likely to have periodontal disease with moderate to severe jawbone loss as patients in the control group. In addition, they averaged 11.6 missing teeth compared with 6.7 in the control group. A higher percentage of participants with rheumatoid arthritis had deeper pocketing. Researchers are not stating that the relationship between the two diseases is causal; however, some scientists think a bacterial infection may trigger the disease process in some with rheumatoid arthritis. 2/06

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Diabetic Child and Gum Disease
Periodontal destruction can start very early in life in children with diabetes, according 
to study findingspublished in the February issue of Diabetes Care. The results also show that 
periodontal changes can become more prominent in adolescence.
Dr. Evanthia Lalla and colleagues from Columbia University Medical Center, New York, 
assessed dental caries and periodontal disease in  182 diabetic children between 6 and 
18 years of age and in 160 nondiabetic controls.
No significant differences were observed between cases and controls in regard to dental caries.
On the other hand, children with diabetes had significantly more dental plaque and 
higher gingival inflammation levels compared with nondiabetic controls. Children with diabetes
 also had a significantly greater number of teeth with evidence of attachment loss (5.8 versus 
1.5 in controls).
A highly significant correlation remained between diabetes and periodontitis after controlling 
for age, sex, ethnicity, gingival bleeding, and frequency of dental visits 
(odds ratio 5.23; p < 0.001). This was especially true in the 12- to 18-year-olds.
Body mass index was significantly correlated with the number of affected teeth in children 
with diabetes, but no correlation was observed with duration of diabetes or mean HbA1c.
"As periodontal diseases are largely preventable and progression of destruction can be best 
arrested when identified in early stages, screening for periodontal changes and 
implementing prevention and treatment programs should be considered as a standard of care for 
young patients with diabetes," Dr. Lalla's team advises.
"This becomes even more important," they point out, "in the light of the emerging view that 
control of periodontal infections in adults with diabetes can further have a positive 
effect on the level of metabolic control in these individuals." (Reuters Health) Feb 07
Diabetes Care 2006;29:295-299.

January 2006

Gum disease may weaken heart meds

Finnish researchers are linking periodontitis, or gum disease, with the long-term effectiveness of antibiotics that prevent heart attacks. Scientists in Helsinki gave 141 patients with and without periodontitis a three-month course of treatment with antibiotics made
to decrease the recurrence of cardiovascular events. The double-blind trial then registered the recurrence of new cardiovascular events
over the course of one year. According to the article, which is in the journal Atherosclerosis, 79 percent of patients without gum disease went a year without new heart problems. That number dropped to 74 percent in the patients without teeth and 66 percent in those with periodontitis. Periodontitis destroys the soft tissue and bone that support your teeth and can cause tooth loss.

The researchers said this is the first time dental infections have been linked to the effectiveness of long-term treatment with these antibiotics. But other research has recently linked gum disease with
an increase risk for heart disease, stroke and premature births.

Sat 07 Jan 2006 01:13 PM CST WASHINGTON DC (myDNA News)

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Full-mouth Tooth Extraction Lowers Systemic Inflammatory and Thrombotic Markers of Cardiovascular Risk

Prior studies of a link between periodontal and cardiovascular disease have been limited by being predominantly observational. We used a treatment intervention model to study the relationship between periodontitis and systemic inflammatory and thrombotic cardiovascular indicators of risk. We studied 67 adults with advanced periodontitis requiring full-mouth tooth extraction. Blood samples were obtained: (1) at initial presentation, immediately prior to treatment of presenting symptoms; (2) one to two weeks later, before all teeth were removed; and (3) 12 weeks after full-mouth tooth extraction. After full-mouth tooth extraction, there was a significant decrease in C-reactive protein, plasminogen activator inhibitor-1 and fibrinogen, and white cell and platelet counts. This study shows that
elimination of advanced periodontitis by full-mouth tooth extraction reduces systemic inflammatory and thrombotic markers of cardiovascular risk. Analysis of the data supports the hypothesis that  treatment of periodontal disease may lower cardiovascular risk.

B.A. Taylor1,*, G.H. Tofler2, H.M.R. Carey1, M.-C. Morel-Kopp2, S. Philcox2, T.R. Carter1, M.J. Elliott1, A.D. Kull2, C. Ward2, and K. Schenck3
1 Sydney Dental Hospital, 2 Chalmers Street, Surry Hills NSW 2010, Australia; 2 Royal North Shore Hospital, New South Wales, Australia; and
3 Department of Oral Biology, University of Oslo, Norway* corresponding author,

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Oral Sex and Braces-BEWARE!

Sex Warning For Teenagers With Braces

Metal braces can scratch genital areas or rip a hole in a condom, increasing the potential for sexually transmitted diseases such as HIV/AIDS, cautions Boston cosmetic dentist Helaine Smith. She has issued a warning to teenagers engaging in sexual practices such as oral sex or French kissing, saying they should be cautious if they or their partners wear metal braces on their teeth.

Metal braces can scratch delicate genital areas, tear sensitive mouth tissues, or rip a hole in a condom. Such incidents increase the potential for sexually transmitted diseases and blood-borne pathogens, including HIV/AIDS, chlamydia, and hepatitis B and C.

Most teens and young adults don't realize that metal dental braces can do some damage,. `And while new dental
technologies such as Invisalign and plastic braces have been introduced, the fact is, many dentists still rely on the traditional metal braces and their nickel titanium brackets, wires, and ties. Even plastic braces still use metal wires and ties that can cause damage.

Because the metal brackets and wires can catch on the thin latex of condoms and dental dams and cause microscopic tears, Dr. Smith advises teens and young adults to carefully consider whether to engage in oral sex with partners who wear wire braces. Safer sex practices also include changing the condom before engaging in another sexual activity in order to reduce the risk of STDs and/or unintended pregnancy – even if one thinks the condom has not been damaged.

Dental dams, which are also made of latex, are used when performing oral sex on a woman and protect against herpes and genital warts. Dr. Smith advises young adults to also exercise caution when participating in long kissing sessions with partners who wear braces because the brackets can tear delicate mouth tissues and increase the exposure to blood-borne pathogens and STDs such as HIV/AIDs. 1/06

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 Sodium Bicarbonate and Hydrogen Peroxide: The Effect on the Growth of Streptococcus mutans

 This  experiment studied the effects of sodium bicarbonate and hydrogen peroxide on the cariogenic bacteria Streptococcus mutans through analysis with a spectrophotometer. The growth of S. mutans was analyzed using seven different environments. Twelve wells in each of the seven rows of a multi-well plate were used to incubate the test materials. In combinations of 10 µl distilled water, 100 µl broth, 10 µl 10% sucrose, 10 µl S. mutans, 10 µl 10% sodium bicarbonate, and 10 µl 3% hydrogen peroxide, seven different environments were created for testing. Environments had either sodium bicarbonate or hydrogen peroxide with S. mutans, or a
combination of sodium bicarbonate and hydrogen peroxide with S. mutans. The plate was incubated at 37°C and measured at 0, 18, 20,
22, 24, 26, 28, 30, and 42 hours by optical density with a spectrophotometer.

Results showed bacterial growth was prevented by sodium bicarbonate, hydrogen peroxide, and the combination of sodium
bicarbonate and hydrogen peroxide. Although hydrogen peroxide is bacteriocidal and sodium bicarbonate is bacteriostatic, there were no significant differences among the three treatment groups
in spectrophotometer readings at any of the nine readings over 42 hours.

There was no significant difference among the effects of hydrogen peroxide, sodium bicarbonate, or the sodium bicarbonate and
hydrogen peroxide combination, as measured by optical density. The hydrogen peroxide, sodium bicarbonate, and the sodium bicarbonate and hydrogen peroxide combination prevented bacterial growth of S. mutans. The results show that products containing these agents have
the ability to stop the growth of S. mutans. Products containing sodium bicarbonate and/or hydrogen peroxide may be useful to caries- prone patients. More studies are needed to confirm these results on patients.

Author(s): Kelly J Silhacek RDH, BS ; Kristin R Taake RDH, BS Source: Journal of Dental Hygiene      Volume: 79 Number: 4 Page: 7
Publisher: American Dental Hygienists' Association

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Study links Tooth Loss, Heart Disease

A new study shows a progressive association between tooth loss and cardiovascular disease, even among nonsmokers.  According to  December 2005 American Journal of Preventive Medicine, researchers analyzed data from more than 40,000 responders ages 40-79 in the 1999-2002 Behavioral Risk Factor Surveillance System Study.

Heart disease was found in 4.7 % of the respondents without tooth loss, 5.7% of those missing 1-5 teeth, 7.5% missing 6-31 teeth and 8.5% with total tooth loss.  The finding after adjusting for sex, race and ethnicity, education, marital status, diabetes, smoking status, alcohol consumption, high blood pressure, high blood cholesterol and body mass index and the correlation between tooth loss and hart disease heal when smoking status was considered.  Smoking has strong relationships to both tooth loss and heart disease.  Nonetheless, when this study stratified by age group and smoking status, a significant association remained between tooth loss and heart disease among respondents aged 40-59 years who have never smoked.  These results are consistent with previous studies that link gum disease and tooth loss to an increased risk of atherosclerosis and heart disease. ADA News pg 15, 1/06.

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According to the results, long-term antibiotic medication would prevent myocardial infarcts in patients that do not have periodontitis, or related signs of inflammation such as disease-causing bacteria or antibodies to those bacteria. Periodontitis appears to be such a significant chronic infection that the effect of antibiotic treatment in preventing cardiovascular events is lost in patients that suffer from it. During one year of observation, patients with no signs of periodontitis were more likely to avoid new cardiovascular events. A total of 79% survived without a new cardiovascular event compared with 74% of patients without teeth and 66% of those with periodontitis.
The article Paju S, Pussinen PJ, Sinisalo J, Mattila K, Dogan B, Ahlberg J, Valtonen V, Nieminen MS, Asikainen S. Clarithromycin reduces
recurrent cardiovascular events in patients without periodontitis is published online before print in the journal Atherosclerosis on the 4th
of January!&_cdi=4878&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=4fe8808ca115aea2ca1bcdd906008882

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Infant Antibiotic Use Linked To Later Dental Problems

Infants who are given the antibiotic amoxicillin are at an increased risk of dental problems later in life, University of Iowa researcherssuggest. Amoxicillin is one of the most common antibiotics used among children, for conditions such as middle ear infections.

The BBC reports that the researchers say the drug appears to be linked to enamel damage in permanent teeth. Enamel defects can showclinical signs ranging from barely noticeable white flecks, to pits and brown stains.

The study found that the more children took the drug, the more teeth were affected, but a UK expert said it was more likely the diseases
themselves had caused the damage, rather than the drug. The researchers followed 579 infants from birth until they were 32 months old, using questionnaires every three to four months to gather information on fluoride intake and amoxicillin use.

By the age of one, three-quarters of the subjects had used amoxicillin. By 32 months, 91% had used amoxicillin. It was found that amoxicillin use from three to six months doubled the risk of dental fluorosis. This condition is usually linked to exposure to
excess levels of fluoride in which the normal maturation of dental enamel is blocked due to disruption of the ameloblasts - the cells
which produce the enamel.

Writing in Archives of Pediatrics and Adolescent Medicine, the team led by Dr Liang Hong, said, `The results of our study show that
amoxicillin use during early infancy seems to be linked to dental fluorosis on both permanent first molars and maxillary central incisors. Duration of amoxicillin use was related to the number of early-erupting permanent teeth with fluorosis.'

`Amoxicillin use in infancy could carry some heretofore undocumented risk to the developing teeth. While the results of this
one study do not warrant recommendations to cease use of amoxicillin early in life, they do further highlight the need to use antibiotics
judiciously, particularly during infancy.'

Dr Paula Waterhouse, a dental paediatrician at the University of Newcastle, took issue with the research findings. She said research
had shown that problems with enamel maturation were more likely in children who suffer from infections. She told the BBC News website, `My feeling is that despite in-depth statistical analyses it is likely to be the illness itself which is causing the developmental defects in enamel.'

Monday 3rd October 2005 cited

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Sodium Bicarbonate and Hydrogen Peroxide: The Effect on the Growth of Streptococcus mutans

This in vitro experiment studied the effects of sodium bicarbonate and hydrogen peroxide on the cariogenic bacteria Streptococcus mutans through analysis with a spectrophotometer.: The growth of S. mutans was analyzed using seven different environments.
Results showed bacterial growth was prevented by sodium bicarbonate, hydrogen peroxide, and the combination of sodium
bicarbonate and hydrogen peroxide. There was no significant difference among the effects of hydrogen peroxide, sodium bicarbonate, or the sodium bicarbonate and hydrogen peroxide combination, as measured by optical density. The hydrogen peroxide, sodium bicarbonate, and the sodium bicarbonate and hydrogen peroxide combination prevented bacterial growth of S. mutans. The results show that products containing these agents have the ability to stop the growth of S. mutans. Products containing sodium bicarbonate and/or hydrogen peroxide may be useful to caries- prone patients.

Author(s): Kelly J Silhacek RDH, BS ; Kristin R Taake RDH, BS Source: Journal of Dental Hygiene      Volume: 79 Number: 4 Page: 7
Publisher: American Dental Hygienists' Association

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New Saliva/Cardiovascular Kit in Testing

A self-contained saliva test kit that allows dentists to determine whether a patient has periodontal or cardiovascular disease, biomarkers is currently undergoing preliminary testing at the University of Michigan. The kit is designed to eliminate the need for dentists to send a patient's saliva sample to a laboratory, thus allowing clinicians to offer same-day results to their patients. Researchers hope to determine just how much of a link there is between a person's saliva and their blood, as well as how it may be affecting their overall health. University of Michigan News Service:

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Oral piercing, typically involving the tongue and/or the lip, has been associated with periodontal complications. The purpose of this study was to compare the prevalence of gingival recession on the buccal aspect of mandibular central incisors in subjects with lower lip piercing and in controls.

Methods: Twenty-nine young adults with lip piercing (mean age: 21.8; 15 females) and 29 without (mean age: 22.3; 15 females) were recruited from the community and examined for gingival recession on the buccal aspect of the mandibular central incisors. Results:
There were no demographic (age, gender distribution) differences between the 2 groups of subjects. Prevalence of recession among
subjects with lip piercing (41.4%) was significantly greater than among controls (6.9%) (p=0.0022). The average recession depth was more than double in subjects with piercing compared to controls  Length of time of wear was the only significantly associated demographic variable.

Conclusions: These results indicate that lip piercing is strongly associated with increased prevalence and severity of gingival recession on the buccal aspect of mandibular central incisor teeth. Increased time of wear is associated with increased prevalence of recession.

K.I. BLAIR, M.P. CARR, R.G. RASHID, and D.N. TATAKIS, Ohio State University, Columbus, USA
Supported by the Sections of Primary Care and Periodontology,


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Check out the latest dental news for 2005 at:  Dental News 2005
Check out the latest dental news for 2004 at:  Dental News 2004
Check out the latest dental news for 2003 at:  Dental News 2003
Check out the latest dental news for 2002 at : Dental News 2002
Check out the latest dental news for 2001 at:  Dental News 2001
Check out the latest dental news  for 2000 at: Dental News 2000

January 11, 2007

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