Dental News

Article by Dr Shveta Setia Thareja – Prosthodontist

Maintaining proper dental care for children is crucial for their overall health and well-being. Many parents, however, struggle to determine the right approach and often lack awareness of the most effective methods. To help parents navigate this important aspect of their child’s health, here are some pointers and recommendations to ensure optimal dental care from infancy to early childhood.

For New-borns:

1. Start Early: Even before your baby’s first tooth appears, it’s important to establish good oral hygiene habits. Gently wipe your baby’s gums with a clean damp cloth twice a day to remove bacteria and residue.
2. First Dentist Visit: Schedule your child’s first dentist visit after their first tooth erupts. This early introduction helps familiarize them with dental care and allows the dentist to monitor their oral health development.

For Children Below Two Years of Age:

1. Appropriate Toothpaste: When brushing your baby’s teeth, use a tiny smear of non-fluoridated toothpaste specifically designed for young children. Avoid using excessive amounts to minimize the risk of swallowing toothpaste.
2. Sips of Water: After each milk feed, offer your child small sips of water to rinse their mouth and prevent milk from lingering on their teeth, which can contribute to tooth decay.

For Children Around Two Years of Age:

1. Bottle Avoidance: Discourage putting your child to sleep with a bottle, as prolonged exposure to milk or sugary liquids can harm their teeth. Transition to a sipper cup with a straw or hard spout to minimize liquid contact with their teeth.
2. Teach Spitting: Once your child is around two years old, introduce the concept of spitting while brushing. When they learn to spit, switch to using a minimum of 1000 ppm fluoride toothpaste to protect their teeth against decay.
3. Regular Dental Visits: Schedule regular visits to the dentist every three months to monitor your child’s oral health, identify any potential issues early on, and receive professional guidance on dental care practices.
4. Limit Sugary Liquids: Avoid giving your child sugary drinks or juices that can sit on their teeth for extended periods. These liquids can erode the enamel and lead to tooth decay. This condition, known as “bottle mouth” or “baby bottle tooth decay,” can cause discolored, pitted, and cavity-prone teeth.

Important Points to Remember:

1. Twice-Daily Brushing: Encourage your child to brush their teeth twice a day, ideally after breakfast and before bedtime. Pay special attention to the time between breakfast and lunch, as food particles left in the mouth during this period can promote tooth decay.
2. Mouthwashes and Rinsing: Consider incorporating mouthwashes or warm saline water rinses after meals to maintain oral hygiene. This practice helps rinse away food particles and reduces the risk of bacterial growth.
3. Duration of Brushing: Ensure your child brushes their teeth for 1-2 minutes during each session. This duration allows for effective cleaning and plaque removal.
4. Post-Meal Rinse: Encourage your child to rinse their mouth with water after meals or consuming sugary drinks or sweets. This habit helps remove debris and reduces the chances of dental issues.
5. Fiber-Rich Diet: Include fiber-rich foods like cucumber, celery, and carrots in your child’s diet. These foods help maintain dental health by promoting saliva production and aiding in cleaning teeth naturally.
6. Address Tooth Decay: Never ignore signs of tooth decay in children. If detected, take immediate preventive measures to halt its progression. Early intervention is crucial for preventing further damage and ensuring optimal oral health.

By following these guidelines and maintaining regular dental care practices, parents can provide their children with a strong foundation for a lifetime of healthy smiles and overall oral well-being. Remember, establishing good dental habits early on sets the stage for a lifetime of oral health.

Periodontitis, often known as gum disease, can cause a variety of dental issues, ranging from bad breath to bleeding and tooth loss. Researchers at Hiroshima University determined that it may be linked to considerably more significant diseases elsewhere in the body, specifically the heart.

The team discovered a significant correlation between periodontitis and fibrosis (scarring to an appendage of the heart’s left atrium that can lead to an irregular heartbeat called atrial fibrillation) in a sample of 76 patients with cardiac disease in a study published in JACC: Clinical Electrophysiology.

“Periodontitis is associated with a long-standing inflammation, and inflammation plays a key role in atrial fibrosis progression and atrial fibrillation pathogenesis,” said first author Shunsuke Miyauchi, assistant professor with the Hiroshima University’s Health Service Center.

He is also affiliated with the university’s Graduate School of Biomedical and Health Sciences, adding, “We hypothesized that periodontitis exacerbates atrial fibrosis. This histological study of left atrial appendages aimed to clarify the relationship between clinical periodontitis status and degree of atrial fibrosis.”

The patients’ left atrial appendages were surgically removed, and the tissue was studied to determine the relationship between the severity of the atrial fibrosis and the severity of the gum disease. They discovered that the worse the periodontitis, the worse the fibrosis, implying that gum inflammation may exacerbate inflammation and illness in the heart.

“This study provides basic evidence that periodontitis can aggravate atrial fibrosis and can be a novel modifiable risk factor for atrial fibrillation,” said corresponding author Yukiko Nakano, a cardiovascular medicine professor at Hiroshima University’s Graduate School of Biomedical and Health Sciences.

Periodontal care, in addition to decreasing other risk factors such as weight, activity levels, and cigarette and alcohol use, according to Nakano, could benefit in the overall therapy of atrial fibrillation. However, she emphasised that this study did not show a causal association, which means that while gum disease and the severity of atrial fibrosis appear to be linked, researchers have not found that one causes the other.

“Further evidence is required for establishing that periodontitis contributes to the atrial fibrosis in a causal manner and that periodontal care can alter fibrosis,” Nakano said, adding, “One of our goals is to confirm that periodontitis is a modifiable risk factor for atrial fibrillation and to promote dental specialists’ participation in comprehensive atrial fibrillation management. Periodontitis is an easily modifiable target with lower cost among known atrial fibrillation risk factors. Thus, the achievement of this study series may bring benefits for many people worldwide.”

Following that, the researchers stated that they intend to undertake additional clinical trials to see whether periodontal intervention reduces the occurrence of atrial fibrillation and improves patient outcomes.

Researchers at Sweden’s Karolinska Institutet have discovered the bacteria most commonly seen in severe oral infections. There haven’t been many studies like this one, so the researchers are hopeful that it can offer more insight on the association between oral bacteria and other illnesses. The study was published in Microbiology Spectrum.

Previous study has found clear links between oral health and common diseases such as diabetes, cancer, cardiovascular disease, and Alzheimer’s disease. However, few long-term studies have been undertaken to identify the exact bacteria prevalent in diseased oral- and maxillofacial regions.

Researchers at Karolinska Institutet found the most common bacteria after analysing samples obtained from patients with serious oral infections at Karolinska University Hospital in Sweden between 2010 and 2020. The research groups of Professor Margaret Sallberg Chen and adjunct Professor Volkan Ozenci collaborated on this project.

“We’re reporting here, for the first time, the microbial composition of bacterial infections from samples collected over a ten-year period in Stockholm County,” says Professor Sallberg Chen of the Department of Dental Medicine at Karolinska Institutet. “The results show that several bacterial infections with link to systemic diseases are constantly present and some have even increased over the past decade in Stockholm.”

Involvement in other illnesses
Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria were the most prevalent bacterial phyla found in the samples, whereas Streptococcus spp, Prevotella spp, and Staphylococcus spp were the most common genera.

“Our results provide new insight into the diversity and prevalence of harmful microbes in oral infections,” says Professor Sallberg Chen. “The finding isn’t only of importance to dental medicine, it also helps us understand the role of dental infection in patients with underlying diseases. If a certain bacterium infects and causes damage in the mouth, it’s very likely that it can be harmful to tissues elsewhere in the body as the infection spreads.”

The researchers have previously demonstrated that the presence of oral bacteria in the pancreas correlates with the severity of pancreatic tumours. The study included 1,014 samples from the same number of patients, 469 women and 545 men, using a mass-spectrometric technology called MALDI-TOF, which quickly detects individual live bacteria in a sample but is seldom used in dental care.

“Our study was a single centre epidemiology study and to ensure the validity of the results we need to make more and larger studies,” says Volkan Ozenci at the Department of Laboratory Medicine, Karolinska Institutet. “We now hope that dentists will collaborate with clinical microbiology laboratories more to gain a better understanding of the bacteria that cause dental infections, to improve diagnostics and therapeutic management of oral infections.”

A vaping habit may result in a stained smile and more trips to the dentist.

Tufts University School of Dental Medicine researchers discovered that patients who admitted to using vaping devices were more likely to develop cavities. There are a lot of teeth that are at risk because 9.1 million American adults and 2 million teenagers use tobacco-based vaping products, according to CDC studies.

According to Karina Irusa, assistant professor of comprehensive care and the paper’s primary author, the findings of this study on the correlation between vaping and the risk of caries—the dental term for cavities—serve as a warning that this once-seemingly innocent behaviour may be seriously harmful.

The American Dental Association Journal released the findings.

Since the use of vaping devices was associated with lung disease, the public’s awareness of the risks of vaping to overall health has grown. Some dental studies have linked e-cigarette use to higher levels of gum disease indicators and, separately, to erosion of the enamel, the outer layer of the tooth. Irusa claims that even dentists haven’t given much attention to the link between using e-cigarettes and oral health.

Irusa says that the recent Tufts finding maybe just a hint of the damage vaping causes to the mouth. “The extent of the effects on dental health, specifically on dental decay, are still relatively unknown,” she says. “At this point, I’m just trying to raise awareness,” among both dentists and patients.

Irusa claims that this study is the first to precisely look into the link between using e-cigarettes and vaping and a higher risk of developing cavities. More than 13,000 patients over the age of 16 who had treatment at Tufts dentistry clinics between 2019 and 2022 had their data examined by her and her colleagues.

Irusa discovered that there was a statistically significant difference in the risk levels of dental caries between the e-cigarette/vaping group and the control group, even though the vast majority of the patients claimed not to use vapes.

Approximately 79 per cent of the vaping patients and only roughly 60 per cent of the control group were classified as having a high caries risk. Although nicotine-containing devices are more prevalent, the patients who vaped were not questioned whether they utilised THC- or nicotine-containing devices.

“It’s important to understand this is preliminary data,” Irusa says. “This is not 100 per cent conclusive, but people do need to be aware of what we’re seeing.” Further studies need to be done, and Irusa wants to take a closer look at how vaping affects the microbiology of saliva.

The sweet substance and viscosity of vaping liquid, which when aerosolized and subsequently breathed through the mouth, clings to the teeth, is one factor why using e-cigarettes could increase the risk of cavities.

The characteristics of e-cigarettes with sweet flavours have been compared to those of gummy candies and acidic beverages in a 2018 study that was published in the journal PLOS One. It has been demonstrated that vaping aerosols alter the oral microbiota, making germs that cause decay more hospitable. Additionally, it’s been noticed that vaping seems to promote decay in places where it doesn’t typically happen, including the bottom margins of front teeth. It has an aesthetic cost, according to Irusa.

Dentists should frequently inquire about e-cigarette usage as part of a patient’s medical history, according to Tufts researchers. That includes paediatric dentists who treat teenagers; in 2021, 7.6 per cent of middle- and high-school students reported using e-cigarettes, according to the FDA/CDC.

A “more stringent caries care approach” that can include prescription-strength fluoride toothpaste and fluoride rinse, in-office fluoride applications, and more frequent exams than twice a year is also recommended for patients who use e-cigarettes.

“It takes a lot of investment of time and money to manage dental caries, depending on how bad it gets,” Irusa says. “Once you’ve started the habit, even if you get fillings, as long as you continue, you’re still at risk of secondary caries. It’s a vicious cycle that will not stop.”

Researchers claim that water fluoridation is less harmful to the environment than other tooth decay prevention techniques. The study’s results further support the need for water fluoridation programmes to reduce dental decay, especially in the most susceptible populations.

Fluoridation of water has been hailed as one of the most important 20th-century public health initiatives. The role of healthcare and disease prevention in the climate catastrophe, however, must be investigated as it gets worse. The time for action is now. This urgency led researchers to estimate the environmental effects of water fluoridation for a single five-year-old child over the course of a year. They did this by drawing comparisons to the conventional application of fluoride varnish and toothbrushing campaigns, both in the UK and overseas.

Today, fluoridated water is available to more than 35% of the world’s population, and studies show that tooth decay has significantly decreased. There is currently no proof of the environmental effects of water fluoridation, despite statistics on the clinical efficacy and cost-benefit analyses being accessible.

The research team methodically calculated the combined travel, weight, and quantities of all objects and activities engaged in all three preventative programmes in order to conduct a Life Cycle Assessment (LCA) to evaluate this impact (toothbrushing, fluoride varnish programmes, and water fluoridation). The team used the Ecoinvent database to determine environmental outputs like carbon footprint, the amount of water needed for each product, and land use. Data were placed into a specific environmental application (OpenLCA).

The results of the study, which were led by Brett Duane, Associate Professor in Dental Public Health at Trinity College, showed that water fluoridation had the least adverse effects on the environment of all the categories examined and the least adverse effects on disability-adjusted life years of all the community-level caries prevention programmes. The study also found that fluoridating drinking water offers the best return on investment.

Due to the balance of clinical effectiveness, financial effectiveness, and environmental sustainability, researchers believe that water fluoridation should be the preventative intervention of choice.

This study strengthens the argument for water fluoridation programmes around the world to reduce dental decay, especially in the most vulnerable populations.

“As the climate situation increases, we must identify techniques to prevent disease in order to decrease the environmental impact of our health-care systems,” said Associate Professor Duane. This study unequivocally demonstrates that water fluoridation is an efficient preventative measure with a minimal carbon footprint.

There should be increased efforts to encourage access to this technique, said Professor Paul Ashley, Senior Clinical Lecturer (Honorary NHS Consultant) at the University College London Eastman Dental Institute.

When people first meet you, they notice your smile. People want healthy, dazzling white teeth so they may feel more confident when they flash wide-mouthed, eye-crinkling smiles.

Whitening methods, on the other hand, can damage enamel, creating cavities and discoloration, while toothpaste only eliminates surface stains. A novel hydrogel treatment that whitens teeth without hurting them and disintegrates cavity-forming biofilms has been found by researchers. The study’s findings were published in the journal ACS Applied Materials & Interfaces.

According to the American Dental Association, daily brushing and flossing are effective techniques to prevent cavities from developing. These treatments, however, do not properly whiten teeth. Consumers frequently seek for over-the-counter or professional treatments that mix hydrogen peroxide-containing gels and blue light, resulting in a chemical reaction that eliminates stains.

This combination eliminates the majority of the discolouration but produces reactive oxygen species that can degrade enamel. Previously, Xiaolei Wang, Lan Liao, and colleagues altered titanium dioxide nanoparticles to create a less harmful tooth-whitening procedure. This approach nevertheless necessitated the use of high-intensity blue light, which might harm adjacent skin and eyes. As a result, the researchers sought a substance that, when triggered by green light, would both whiten teeth and prevent cavities.

The researchers created a thick combination of bismuth oxychloride nanoparticles, copper oxide nanoparticles, and sodium alginate. The combination was then uniformly coated over the surface of teeth adhered to a slide before being sprayed with a calcium chloride solution, resulting in a highly adherent hydrogel.

The substance was then tested on teeth stained with coffee, tea, blueberry juice, and soy sauce and put in a lab dish. The teeth were brighter over time after treatment with the hydrogel and green light, and there was no enamel damage. Another series of trials revealed that the treatment destroyed 94% of bacteria in biofilms.

The scientists utilised the novel approach on mice whose mouths were injected with cavity-forming bacteria to demonstrate that the therapy may work on teeth in vivo. The green-light triggered hydrogel significantly prevented the formation of mild and deep cavities on the surface of the animals’ teeth. According to the researchers, its safe, brush-free method both prevents cavities and whitens teeth.

Many things might have a negative influence on your oral health, ranging from bad eating habits to insufficient brushing and poor dental cleanliness. Your mental wellness has a huge impact on your oral health. People who suffer from stress, anxiety, depression, or other mental health concerns may be more prone to developing dental problems for a variety of reasons.

People who suffer from dental anxiety may avoid going to the dentist or having dental operations. According to experts, it might be the result of a larger mental health issue, such as general anxiety disorder, or a history of poor encounters at a dental clinic.

People who are depressed or nervous may make poor eating choices or fail to pay attention to nutrition, causing their oral health to deteriorate.

“Mental illnesses such as anxiety and depression can lead to several problems which may lead to consumption of sugary foods or beverages that can cause tooth decay and cavities. Depressed people have poor nutrition, which can affect the surface enamel of the teeth,” says Dr Karishma Jaradi, Head Dental Surgeon- Dentzz Dental.

It is also common for a person with depression to lose interest in daily activities which includes brushing or taking shower.

According to a CDC study, children with heart issues are more likely to suffer cavities, toothaches, or bleeding gums.

If oral bacteria enter the circulation, children with heart disease may be predisposed to additional illnesses such as infective endocarditis, according to the study. The uncommon illness causes inflammation in the inner lining of the heart and can be fatal.

“Therefore, preventive dental care (i.e., check-ups, dental cleaning, radiographs, fluoride treatment, or sealant) to maintain oral health is important,” the study authors wrote.

The study compared the oral health status and recent dental treatment of children with and without cardiac problems using data from the National Survey of Children’s Health from 2016 to 2019.

Approximately 10% of children and teens ages 1-17 with heart disorders had “poor” to “good” oral health, compared to 5% of children without heart problems. Around 17% of people with heart disease also exhibited signs of poor oral health, such as damaged teeth or cavities.

Children with a heart disease had poorer dental health, as did those with lower home finances and intellectual and developmental difficulties.

Furthermore, one in every six children with heart disease had not had preventative dental treatment in the previous 12 months.

Children with heart issues may be more prone to poor dental health and cavities for a variety of reasons, according to Karrie Downing, the study’s primary author and a CDC researcher. They may have had surgeries or other treatments that make caring for their teeth and gums more difficult.

Children with heart issues may also have developmental or intellectual difficulties that make dental care more difficult, both at home and at the dentist’s office, according to her.

Heart drugs can also cause problems, according to Downing, since some produce dry mouth, which can lead to cavities.

Alene D’Alesio, DMD, chief of paediatric dentistry at Children’s Hospital of Pittsburgh, who was not involved in the study, told UPI that parents may help their children by urging them to drink more water and avoid juices and sugary drinks.

“I don’t want anyone to think that heart disease equals cavities,” she said.

D’Alesio also suggested that parents watch their children’s brushing and flossing habits and consider purchasing an electric toothbrush or floss pick to assist them maintain good oral health. Children with heart issues may also require more frequent dental visits, according to her.