Dental fillings could last twice as long

A team of researchers with the OHSU School of Dentistry in Portland, Oregon, have created a filling material that's two times more resistant to breakage than standard fillings, according to a study published by the journal Scientific Reports. The new filling uses the additive thiourethane, which is also in protective coatings for cars and decks.

The team also has developed an adhesive that's 30 percent stronger after six months in use than adhesives that are currently used to keep fillings in place. This new adhesive was described in a recent study published in the journal Dental Materials.

Combined, the new adhesive and the composite are designed to make longer-lasting dental restorations.

"Today's dental restorations typically only last seven to 10 years before they fail," said Carmem Pfeifer, D.D.S., Ph.D., corresponding author of the studies published in Scientific Reports and Dental Materials. Pfeifer is an associate professor of restorative dentistry (biomaterials and biomechanics) in the OHSU School of Dentistry.

"They crack under the pressure of chewing, or have gaps form between the filling and the tooth, which allow bacteria to seep in and a new cavity to form," Pfeifer said. "Every time this happens, the tooth under the restorations becomes weaker and weaker, and what starts as a small cavity may end up with root canal damage, a lost tooth or even life-threatening infections.

"Stronger dental materials mean patients won't have to get fillings repaired or replaced nearly as often," she said. "This not only saves them money and hassle, but also prevents more serious problems and more extensive treatment."

The adhesive described in the Dental Materials study uses a specific kind of polymer -- known as (meth)acrylamides -- that is much more resistant to damage in water, bacteria and enzymes in the mouth than standard adhesives currently used in dentistry. The composite material described in Scientific Reports uses thiourethane, which holds up much better to chewing.

Cancer and Dental Health

More than one-third of all cancer patients develop complications that affect the mouth, according to the National Institute of Dental and Craniofacial Research. These mild to severe side effects can include mouth sores, infection, dry mouth, sensitive gums and jaw pain.

Your mouth health is an important part of your overall health, so make your dentist part of your cancer care team. If you don’t have a regular dentist, use the ADA Find-A-Dentist tool to search for an ADA member dentist in your area.

Cancer and its treatments, like chemotherapy, can weaken your immune system. If your mouth is not as healthy as possible prior to your cancer treatment, you may be more susceptible to infection. If the infection is serious enough, it can delay your cancer treatment.

In addition, radiation therapy, especially in the area of the head and neck, can damage salivary glands which can cause thick, sticky saliva and extreme dry mouth. A dry mouth can increase your chances of tooth decay and infection.

Elite athletes have poor oral health despite brushing twice daily

The findings, published in the British Dental Journal, highlight potential for improvement as most of the athletes expressed an interest in changing their oral hygiene behavior to improve their oral health.

The UCL Eastman Dental Institute research team surveyed 352 Olympic and professional athletes across 11 sports, including cycling, swimming, rugby, football, rowing, hockey, sailing and athletics, when they provided dental check-ups for male and female athletes measuring tooth decay, gum health and acid erosion.

The researchers also asked athletes what they did to keep their mouth, teeth and gums healthy.

The dental check-ups revealed substantial amounts of oral disease as reported in a 2018 paper, finding that nearly half (49.1%) had untreated tooth decay, the large majority showed early signs of gum inflammation, and almost a third (32%) reported that their oral health had a negative impact on their training and performance.

Elite athletes have poor oral health despite their efforts to care for their teeth: this new study found that 94% reported brushing their teeth at least twice a day, and 44% reported regularly cleaning between their teeth (flossing) -- substantially higher figures than for the general population (75% for twice-daily brushing and 21% for flossing).

The researchers found that the athletes regularly use sports drinks (87%), energy bars (59%) and energy gels (70%), which are known to damage teeth.

Scientists uncover key new molecules that could help to tackle tooth loss and regeneration

Now new research published in the Journal of Dental Research has shed light on the science behind the formation of the periodontal ligament, which helps keep the tooth stable in the jawbone. This improved understanding will also help scientists work towards regenerating the tissues that support teeth.

The study, led by the Universities of Plymouth and Geneva, shows how a signalling pathway called Notch, which is known to be activated in stem cells and cancer, is important for periodontal ligament development.

Abnormal activation or inhibition of certain signalling pathways can lead to cancer and other conditions, including problems with tissue regeneration.

A key finding in the new study, which was conducted in rodent teeth, is that Lamin A, a cell nuclear protein, is a direct target of Notch pathway.

Lamin A is best known for its mutated form progerin, which causes fatal 'early ageing' disease, Progeria syndrome -- but by uncovering its involvement in periodontal ligament formation, scientists have better insight into how molecules function during tissue regeneration, and how the process could be affected during disease.

Corresponding author Dr Bing Hu, Associate Professor of Oral and Dental Health Research in Peninsula Dental School at the University of Plymouth, said: "The periodontal ligament starts to properly hold the tooth in the jawbone when a tooth breaks out and becomes functional.

"Understanding the mechanisms of how periodontal ligaments develop and the molecules that assist the tissue becoming mature is really important for our understanding of tissue regeneration and repair.

"The next steps are for us to see if and how the molecules we have identified in this study can be translated into a human-only model and, in turn, how they are affected in both healthy and diseased conditions."

Dr Hu is also part of the University's Institute of Translational and Stratified Medicine (ITSMed).

This research is a part of the MD-PhD thesis of Dr Balázs Dénes of the University of Geneva, entitled Post-emergent tooth eruption: eruption rate, periodontal ligament maturation and cell signalling, directed by Professor Stavros Kiliaridis.

Dr Dénes said: "We believe that our findings are an important stepping stone to better dental treatments in situations involving the periodontal ligament, such as gum disease (periodontitis), tooth restoration by dental implants or orthodontic tooth movement."

As we age, oral health plays increasing role in overall health

In a review article recently published in the Journal of the American Geriatrics Society, the authors outline the potential complications that can arise from poor oral hygiene in older adults and cite the role of all health care professionals in working to promote good oral hygiene in this population.

"All health care professionals should work to promote good oral hygiene for their older patients," said Dr. Patrick Coll, professor of family medicine and medicine at the UConn School of Medicine and lead author of the review article. They "should consider an oral examination during an annual wellness visit, especially for those patients who are not receiving regular dental care."

The need is evident, say the authors. Data from the National Center for Health Statistics indicates that the prevalence of cavities is more than twice as high in older adults than younger adults. The prevalence of periodontitis -- a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth -- also increases with age. As many as 64% of older adults in the U.S. have periodontitis.

Periodontitis is associated with a variety of medical conditions including cardiovascular disease and diabetes. Patients with replacement heart valves and prosthetic joints should be particularly careful regarding their oral hygiene, according to the authors.

It is well recognized that manipulation of teeth and their support structures can result in bacteria present in the oral cavity being released into the bloodstream, which may lead to infections in parts of the body far removed from the oral cavity.

Link between obesity and gum disease

The connection between obesity and gum disease isn't as simple as cause-and-effect, said Andres Pinto, professor of oral and maxillofacial medicine and diagnostic sciences at the Case Western Reserve University School of Dental Medicine and co-author of the study published in the British Dental Journal.

Instead, the relationship centers on what both diseases have in common: inflammation.

Examining a plethora of existing studies, researchers found that data showing increased body mass index, waist circumference and percentage of body fat to be associated with an increased risk to develop gum disease, also known as periodontitis. Most studies analyzed data from population subsets at one point in time, as opposed to studying the same population over a longer period.

They concluded that changes in body chemistry affect metabolism, which, in turn causes inflammation -- something present in both maladies.

"Periodontal disease occurs in patients more susceptible to inflammation -- who are also more susceptible to obesity," Pinto said.

This information can inform how health-care professionals plan treatments for patients suffering from obesity and/or gum disease, Pinto said.

"Oral health-care professionals need to be aware of the complexity of obesity to counsel their patients about the importance of an appropriate body weight and maintaining good oral hygiene," he said.

Pinto said further research on the relationship between gum disease and obesity is needed, noting there is, at this point, limited evidence to recommend changes in treatment planning.

"There is a thought, from the clinical perspective, that if you treat one of the issues, it may impact the other," he said. "This is the big question. For example, if we treat obesity successfully, will this impact periodontal disease to the point of being of clinical relevance compared to control population. The jury is still out given the paucity of controlled, well designed, clinical trials on this issue."

Hurricane Dorian Closure

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Congrats to Brooke Hartman for winning the whitening kit for donating to Feeding Northeast Florida!