Friday, August 17, 2018
Friday, August 10, 2018
Friday, July 27, 2018
Summer Vacation is Here, Yeah!
We are off for the one week when the entire staff takes a summer vacation. The staff is off to many different areas of the country with family and friends.
We will return on Monday August 6th!
Happy Summer To You All
Monday, July 16, 2018
BACTERIA THAT CAUSES ADVANCED GUM DISEASE FOUND IN LARGE AMOUNTS IN PATIENTS WITH RHEUMATOID ARTHRITIS
Individuals at risk of rheumatoid arthritis (RA) have increased levels of gum disease and disease-causing bacteria, according to a study presented at the Annual European Congress of Rheumatology (EULAR 2018).
“It has been shown that RA-associated antibodies, such as anti-citrullinated protein antibodies, are present well before any evidence of joint disease. This suggests they original from a site outside of the joints,” said lead author Kulveer Mankia, MD, of the Leeds Institute of Rheumatic and Muscoskeletal Medicine and the Leeds Biomedical Research Centre.
“Our study is the first to describe clinical periodontal disease and the relative abundance of periodontal bacterial in these at-risk individuals. Our results support the hypothesis that local inflammation at mucosal surfaces, such as the gums in this case, may provide the primary trigger for the systemic autoimmunity seen in RA,” Mankia said.
RA is a chronic inflammatory disease that affects the joints, causing pain and disability. It also can affect internal organs. While it is more common in older people, there also is a high prevalence in young adults, adolescents, and even children, and it affects women more frequently than men.
The prevalence of gum disease is increased in patients with RA and could be a key initiator of RA-related autoimmunity. This is because autoimmunity in RA is characterized by an antibody response to citrullinated proteins, and the oral bacterium Porphyromonas gingivalis (Pg) is the only human pathogen known to express an enzyme that can generate citrullinated proteins.
“We welcome these data in presenting concepts that may enhance clinical understanding of the key initiators of rheumatoid arthritis,” said Robert Landewé, MD, PhD, chair of the Scientific Programme Committee with EULAR. “This is an essential step towards the ultimate goal of disease prevention.”
In the study, dentists diagnosed clinical gum disease in significantly more at-risk individuals than in healthy controls (73% versus 38%). Also, the percentage of sites with clinical attachment level of ≥2 mm, pocket depth of ≥4 mm, bleeding on probing, periodontal disease (PDD), and active periodontal disease were all significantly greater in the at-risk individuals compared to controls. In non-smokers, PDD and active PDD were more prevalent in at-risk individuals compared to controls.
DNA was isolated from the subgingival plaque, next to the gums, of each participant and used to measure the levels of three types of bacteria, Pg, Aggregatibacter actinomycetemcomitans (Aa), and Filifactor Alocis. Results showed that there was increased abundance of both Pg and Aa in at-risk individuals. But in at-risk individuals, only Pg was significantly increased at healthy dental sites and was associated with the overall extent of gum disease.
The study included 48 at-risk individuals (positive test for anti-citrullinated protein antibodies, musculoskeletal symptoms but no clinical synovitis), 26 patients with RA, and 32 healthy controls. The three groups were balanced for age, gender, and smoking. At-risk individuals underwent ultrasound assessment to assess for subclinical synovitis. Only two were found to have ultrasound synovitis. Dentists examined six sites per tooth in each participant, and a clinical consensus was reached in each by three dentists.
02 Jul 2018 Dentistry Today Industry News
Friday, June 29, 2018
Today's article is from studies that were recently presented at the European Federation of Periodontology’s EuroPerio9 conference, June 20 to June 23 in Amsterdam.
Though considered trendy and fashionable in some circles, tongue piercings may affect nearby gums and teeth. We have seen multiple cases in our practice of severe damage to the periodontium from these fashion statements. In some cases the damage occurred very quickly, within the first months of the piercing.
“My interest in piercings began when a young female patient presenting unusually severe periodontal destruction was referred to my clinic,” said Clemens Walter, DMD, of the Department of Periodontology, Endodontology, and Cariology at the University of Basel in Switzerland and author of the first study.
“The patient was periodontally healthy with the exception of the lower incisor teeth. We could not identify any known risk factors. The patient had a tongue piercing. Nonsurgical and advanced surgical treatment was performed and was not successful. The patient lost teeth. Since then, I have been curious about this association and started to collect cases,” Walter said.
The 18 subjects in Walter’s study, including 14 females, were drawn from a database of more than 1,400 patients treated at the university. The mean age was 28.3 years, ±7.7 years. Three of the patients wore both a lip and a tongue piercing, for a total of 14 tongue piercings and seven lip piercings.
Clinical parameters and the maximum wearing time of the lip and/or tongue piercing were recorded. Periodontal findings in the teeth close to the piercing were compared to teeth not affected by the piercing.
“Due to ethical considerations, it seems impossible to conduct a prospective study. Therefore, the suitable design to answer our question was a retrospective study/case series,” said Walter.
“We found an association between oral piercings and increased periodontal inflammation, as evident by increased bleeding on probing and increased probing depth and/or attachment loss. The closer teeth were to a tongue piercing, the more affected they were,” said Walter.
|recession and bone loss caused by a lip piercing|
“Acknowledging the growing data from all over the world, we now try to create awareness about the consequences of piercings for oral health, and we counsel our patients to remove piercings in order to decrease the risk for dental and periodontal complications,” said Walter.
Dr. Bernard Loir of Brussels found repeated gum damage due to the chronic pressure of metal against teeth and gums during tongue movements in speaking, eating, or swallowing in a pair of female patients, age 27 and 32.
This gum damage also was associated with gum bleeding and infection, causing deep lingual infrabony lesions and periodontitis. The tongue piercings were used for eight to 10 years and finally removed after abscesses, teeth mobility, and migration.
“The lesions were localized on the lower incisor’s lingual side, close to a tongue piercing (the most frequent oral localization of these devices, followed by the lip),” said Loir.
“Periodontal complications occurred in a location hardly visible for the patient, and as these teeth have very short roots, tooth mobility and tooth loss in the aesthetic area may be quickly encountered, an uncomfortable situation for such young and mostly female patients,” said Loir.
“For both patients, time consuming and costly surgical treatment and antibiotics were needed, and complete regeneration of the lost tissue could not be achieved,” Loir said.
“Young patients with oral piercings should be made aware of the local and global health risks they take by wearing these useless devices, especially if they compound the risk by smoking and a lack of proper dental hygiene. Piercings interfere daily with chewing, swallowing, and speaking, and the rate of complications is very high in the available literature,” said Loir.
“Early complication is usually infection due to lack of hygiene in the piercing saloon or when done by the patients themselves with nonsterile material. Bleeding and swelling of the tongue is also very common and may represent a danger for a patient with cardiovascular disease, but late complications also occur, such as swallowing the jewelry, teeth chipping, and gum recession with lip piercings,” Loir said.
“Other complications occur in a more silent mode, such as lingual gum recession and bone loss, causing tooth mobility, migration, and loss. Other life-threatening diseases such as viral contamination (hepatitis, papilloma virus), endocarditis, and cerebral abscesses have also been registered,” said Loir.
“While awareness with respect to oral complications associated with piercings seems to be slowly increasing, there is yet much to be done,” said Walter. “We are continuing with our research and hope to recruit more patients in order to increase our database.”
My advice to all people considering a perioral or tongue piercing is very simple, just don't do it. And for all those who have already taken the leap and had the piercing done, your best bet it to promptly remove it. If you've noticed any changes in the condition of your gum near your piecing make an appointment with a periodontist to get the damaged treated, it might not be too late to save the affected teeth.
Friday, June 22, 2018
Study pinpoints genetic connections to perio and coronary artery disease in addition to lifestyle factors
Friday, June 15, 2018
“Smart Tooth” Detects Periodontitis
Researchers from the Washington University School of Medicine in St. Louis and the School of Engineering & Applied Science are developing “smart tooth” technology that could be used to detect the early signs of certain diseases such as periodontitis and diabetes in high-risk patients by analyzing saliva or gingival crevicular fluid.
“Salivary-based biosensors have generated a lot of interest because of their potential for wide applications in medicine,” said Erica Lynn Scheller, DDS, PhD, assistant professor of medicine, cell biology, and physiology at the School of Medicine. “We’re initially working to develop a biological sensor that measures specific peptides active in periodontal disease, and that would be used in combination with a wireless device to retrieve that data.”
“It’s like an electronic tooth,” said Shantanu Chakrabartty, MS, PhD, professor of electrical and systems engineering in the School of Engineering & Applied Science and a partner on the project, currently funded by a four-year, $1.5 million grant from the National Institutes of Health.
The “smart tooth” is a tiny sensor and electronic chip that’s about a few millimeters cubed in volume. Designed to be inserted inside the gumline or as part of a dental appliance, it features bio-recognition elements that measure disease-specific peptides, which are natural or synthetic groups of amino acids.
As a first attempt, the researchers will work toward monitoring peptides related to bone breakdown in periodontitis. A wireless ultrasound device would then read the peptide levels and connect to the medical data cloud. However, chemistry remains one of the project’s biggest challenges.
“You only have a finite number of bio-recognition elements conjugated to the transducer if you are using an antibody that is specific to these peptides,” said Srikanth Singamaneni, MS, PhD, associate professor of mechanical engineering and materials science. “They get saturated fairy quickly. The question is, how do you refresh those sensors? That’s one of the aspects we are working to address with this project.”
The researchers say that developing a new, minimally invasive system that can detect and monitor gum disease and the effectiveness of treatment would be beneficial to the 64 million United States residents with periodontal disease and to their dentists. Also, the researchers are interested in developing other applications for the technology that, while likely years away, could go well beyond the dentist’s chair.
“We’re developing this sensing platform that can be expanded to include additional tracking for inflammatory markers, stress markers, and diabetes monitoring,” said Scheller. “Really, anything you can think of that you’d want to track in the oral cavity, we’re developing both the platform and the specific application.”