According to the authors, the significant association between PDs and AMD only in the youngest individuals can be explained either by PDs having a role in the earlier stages of AMD or by covariates increasing with age diluting the effect of PDs on individuals 60 years and older.
Although the link between the two is still unclear, PD and AMD share similar risk factors such as inflammation disorders, advanced age, smoking habits and diabetes, said the authors. More studies are needed for better understanding of the relationship between PD and AMD. – by Kaitlin McGee
Brushing teeth frequently is linked with lower risks of atrial fibrillation and heart failure, according to a study published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).
Previous research suggests that poor oral hygiene leads to bacteria in the blood, causing inflammation in the body. Inflammation increases the risks of atrial fibrillation (irregular heartbeat) and heart failure (the heart’s ability to pump blood or relax and fill with blood is impaired). This study examined the connection between oral hygiene and occurrence of these two conditions.
The retrospective cohort study enrolled 161,286 participants of the Korean National Health Insurance System aged 40 to 79 with no history of atrial fibrillation or heart failure. Participants underwent a routine medical examination between 2003 and 2004. Information was collected on height, weight, laboratory tests, illnesses, lifestyle, oral health, and oral hygiene behaviours.
During a median follow-up of 10.5 years, 4,911 (3.0%) participants developed atrial fibrillation and 7,971 (4.9%) developed heart failure.
Tooth brushing three or more times a day was associated with a 10% lower risk of atrial fibrillation and a 12% lower risk of heart failure during 10.5-year follow up. The findings were independent of a number of factors including age, sex, socioeconomic status, regular exercise, alcohol consumption, body mass index, and comorbidities such as hypertension.
While the study did not investigate mechanisms, one possibility is that frequent tooth brushing reduces bacteria in the subgingival biofilm (bacteria living in the pocket between the teeth and gums), thereby preventing translocation to the bloodstream.
Senior author Dr. Tae-Jin Song of Ewha Womans University, Seoul, Korea noted that the analysis was limited to one country and as an observational study does not prove causation. But he added: “We studied a large group over a long period, which adds strength to our findings.”
An accompanying editorial states: “It is certainly too early to recommend tooth brushing for the prevention of atrial fibrillation and congestive heart failure.” It adds: “While the role of inflammation in the occurrence of cardiovascular disease is becoming more and more evident, intervention studies are needed to define strategies of public health importance.”
Yoonkyung Chang, Ho Geol Woo, Jin Park, Ji Sung Lee, Tae-Jin Song. Improved oral hygiene care is associated with decreased risk of occurrence for atrial fibrillation and heart failure: A nationwide population-based cohort study. European Journal of Preventive Cardiology, 2019; 204748731988601 DOI: 10.1177/2047487319886018
Nearly a year ago, StyleBlueprint’s Director of Marketing, Megan Casey, was attending an event hosted at the Koch Aesthetic Dentistry space. Over casual conversation, Dr. Koch and his team’s warmth and kindness made Megan feel comfortable discussing an issue she’s been dealing with for quite a while: chronic jaw pain.
“I started experiencing occasional popping in my jaw all the way back in high school, typically while I chewed my food. My mom had the same issue, though, so I didn’t think much of it,” Megan shares. “Over the last 10 years or so, I’ve also developed the habit of clenching my teeth when I’m stressed, which frequently made my jaw feel sore. I knew it had gotten worse last year when my jaw would hurt while eating salads or sandwiches.”
In addition to the pain, the shape of Megan’s face had slowly transformed over time, taking on a more square shape around her jawline. So, after listening to Megan’s symptoms and assessing her jawline, Dr. Koch suggested an unusual but effective treatment option: Botox™.
“TMJ is actually an abbreviation for the jaw joint itself: TemporoMandibular Joint. The lower jaw is a two-part hinge that fits into the upper jaw compartments (part of the skull) to open and close the mouth. These hinges are controlled by several sets of muscles that bring the lower teeth up to the upper teeth,” explains Dr. Koch. “In a healthy state, these muscles are only active during chewing and swallowing. When people are clenching their jaws or grinding their teeth (during the day or at night), these muscles are active much more than that, and they will get stronger and larger, and they are capable of exerting much more force on the joint, the teeth, and the skull.”
Keeping that in mind, it makes sense, then, that Botox™ could be an effective treatment. “It works on the nerve endings to affect the release of the neurotransmitter the causes the muscles to contract,” says Dr. Koch. “The nerve generates a new nerve ending, which functions normally, and the muscle contraction goes back to normal, a process that takes about three months.”
Intrigued, Megan immediately made an appointment for the following morning to get started on this treatment plan. The first of three treatments begins with several photos showcasing the “before” look of the jaw. “I was a little anxious at the thought of changing the shape of my face dramatically, but the potential benefits of being pain-free and preventing future dental procedures caused by clenching outweighed the cosmetic concern,” says Megan.
After the initial photos are taken, Botox™ is injected into the masseter muscles and hairline above the ear. The amount of botox varies depending on the patient, but Megan was given four injections on each side. Although the injections are not necessarily enjoyable, Megan notes that the pain was minimal, and aside from a few tiny bruises along her jawline that disappeared within a day or two, there were virtually no side effects.
Megan, seated, consults with Dr. Koch prior to her treatment.
While initially, Megan did not notice much, if any, difference in the shape of her face, an effect Dr. Koch noted before treatment, she did realize a significant decrease in popping and felt relatively pain-free. In fact, by the time Megan went in for her second treatment, she could feel the Botox™ wearing off, and her jaw pain began to return, though not nearly as bad as before she started the treatment regimen.
At the second treatment appointment, Dr. Koch noticed a minimal difference in the size of each of Megan’s masseter muscles, so he opted to inject slightly more Botox™. Four weeks later, Megan was completely pain-free and had stopped clenching her jaw as frequently. It was at this point that she noticed a slimming in her jawline, as well.
The photo on the left shows Megan before any treatments, and the photo on the right shows Megan eight weeks after her first treatment. You can clearly notice the decreased size of her jawline.
“By the time the third appointment rolled around, I was in awe over the shape of my face,” says Megan, explaining that she still feels like herself and the change is not that dramatic that friends and family take a notice, but the before and after images offer stunning perspective of the impact the treatment made. “I trusted Dr. Koch and his team. It made sense to me that a dentist would be the best person to give Botox™ for this particular treatment as there is an underlying medical issue, not just a cosmetic concern,” Megan shares.
Because Dr. Koch is an expert in every facial bone and muscle, Megan felt comfortable and taken care of, and she appreciated that nothing was sugarcoated in regards to cost or time it would take to achieve the desired results. “Plus, have you seen their office? It feels much more like a spa than a dentist’s office,” she says. “I liked to arrive early to chat with Rebekah at the front desk and to enjoy a little rest in the waiting room.”
You can visibly see the transformation in jaw size and shape from before treatments began (left) to two weeks after Megan’s third and final treatment (right).
“I love that this treatment had two successful outcomes — less pain and a slimmer jawline. I had no idea Botox™ could handle this issue, but I’m sure glad it does,” she concludes. To maintain its effectiveness, Megan will receive approximately 10 injections every 2-3 months to keep the masseter muscles from getting too strong again.
“Botox™ is entirely reversible because it will always wear off as the body makes new nerve endings,” Dr. Koch adds. “Over the years, there have been other treatments that are not reversible which have been used to treat TMJ problems, such as grinding down the teeth, surgery, various types of splints, orthodontics, and drug therapies. Sometimes these can be effective and indicated, but when they are not, they involve a great deal of time and cost, and may not even offer relief. It is therefore very important to consult with someone/a team that fully understands the problem and comes up with a diagnosis and a plan that makes sense to you before proceeding with any treatment.”
Tooth enamel is the hardest substance in the human body, but, until now, no one knew how it managed to last a lifetime. The authors of a recent study conclude that enamel’s secret lies in the imperfect alignment of crystals.
If we cut our skin or break a bone, these tissues will repair themselves; our bodies are excellent at recovering from injury.
Tooth enamel, however, cannot regenerate, and the oral cavity is a hostile environment.
Every mealtime, enamel is put under incredible stress; it also weathers extreme changes in both pH and temperature.
Despite this adversity, the tooth enamel that we develop as a child remains with us throughout our days.
The secrets of enamel
With assistance from researchers at the Massachusetts Institute of Technology (MIT) in Cambridge and the University of Pittsburgh, PA, Prof. Gilbert took a detailed look at the structure of enamel.
The team of scientists has now published the results of its study in the journal Nature CommunicationsTrusted Source.
Enamel is made up of so-called enamel rods, which consist of hydroxyapatite crystals. These long, thin enamel rods are around 50 nanometers wide and 10 micrometers long.
By using cutting edge imaging technology, the scientists could visualize how individual crystals in tooth enamel are aligned. The technique, which Prof. Gilbert designed, is called polarization-dependent imaging contrast (PIC) mapping.
Before the advent of PIC mapping, it was impossible to study enamel with this level of detail. “[Y]ou can measure and visualize, in color, the orientation of individual nanocrystals and see many millions of them at once,” explains Prof. Gilbert.
“The architecture of complex biominerals, such as enamel, becomes immediately visible to the naked eye in a PIC map.”
When they viewed the structure of enamel, the researchers uncovered patterns. “By and large, we saw that there was not a single orientation in each rod, but a gradual change in crystal orientations between adjacent nanocrystals,” explains Gilbert. “And then the question was, ‘Is this a useful observation?'”
The importance of crystal orientation
To test whether the change in crystal alignment influences the way that enamel responds to stress, the team recruited help from Prof. Markus Buehler of MIT. Using a computer model, they simulated the forces that hydroxyapatite crystals would experience when a person chews.
Within the model, they placed two blocks of crystals next to each other so that the blocks touched along one edge. The crystals within each of the two blocks were aligned, but where they came in contact with the other block, the crystals met at an angle.
Throughout several trials, the scientists altered the angle at which the two blocks of crystals met. If the researchers perfectly aligned the two blocks at the interface where they met, a crack would appear when they applied pressure.
When the blocks met at 45 degrees, it was a similar story; a crack appeared at the interface. However, when the crystals were only slightly misaligned, the interface deflected the crack and prevented it from spreading.
This finding spurred further investigation. Next, Prof. Gilbert wanted to identify the perfect angle of interface for maximum resilience. The team could not use computer models to investigate this question, so Prof. Gilbert put her trust in evolution. “If there is an ideal angle of misorientation, I bet it’s the one in our mouths,” she decided.
To investigate, co-author Cayla Stifler returned to the original PIC mapping information and measured the angles between adjacent crystals. After generating millions of data points, Stifler found that 1 degree was the most common size of misorientation, and the maximum was 30 degrees.
This observation agreed with the simulation — smaller angles seem better able to deflect cracks.
“The study found psoriasis patients who rated their gum health as poor or very poor exhibited significantly more severe psoriasis symptoms than those with healthy gums.”
read the full study:
Scientists from King’s College London found that being overweight or obese was undoubtedly associated with having tooth wear. Significantly, they also found that the increased consumption of sugary soft drinks may be a leading cause of the erosion of tooth enamel and dentin in obese patients.
Drawing on data from the National Health and Nutrition Examination Survey 2003-2004, they analysed a representative sample of survey participants of 3,541 patients in the United States. Patient BMI and the level of tooth wear were the exposure and outcome measurements in the analysis. The intake of sugar-sweetened acidic drinks was recorded through two non-consecutive 24-hour recall interviews where the patients were asked to provide details of diet intake across these two days.
“It is the acidic nature of some drinks such as carbonated drinks and acidic fruit juices that leads to tooth wear,” said lead author Dr Saoirse O’Toole from King’s College London.
Tooth wear is ranked as the third most important dental condition, after cavities and gum disease and the consumption of acidic food and drink is a leading cause of this. Obese patients also have other risk factors such as increased likelihood of gastric reflux disease (heartburn) which was controlled for in this study.
Previous research from King’s has found that tooth wear affects up to 30% of European adults. It is the premature wearing of teeth due to the softening of the dental enamel from dietary or gastric acids, combined with wear and tear. It occurs when the outer layer (enamel) of the tooth slowly dissolves. This can lead to changes in the shape or appearance of teeth, and they can become sensitive when eating or drinking cold food and drinks. At its worst, the tooth structure can gradually wear away. Severe Erosive Tooth Wear reduces quality of life and can mean complex and costly procedures, costing up to £30,000 per patient. Tooth wear is preventable and changes to consumption habits can help stop people from getting it or making it worse.
Source: King’s College London. “Soft drinks found to be the crucial link between obesity and tooth wear.” ScienceDaily. ScienceDaily, 28 October 2019. <www.sciencedaily.com/releases/2019/10/191028075946.htm>.
New findings related to tooth regeneration in mice could offer insights into how human teeth could potentially be regenerated.
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more and more deaths from lung illness reported with links to vaping
Forbes (10/18, Debter) states that “SmileDirectClub has faced intense opposition from the nation’s dentists and orthodontists since it was founded in 2014. The American Dental Association issued a resolution ‘strongly discouraging’ people from using the service and submitted complaints to the Federal Trade Commission and the Food & Drug Administration. One of the primary criticisms is that by cutting out orthodontists and dentists, it is providing an insufficient level of care. Industry groups have argued that the company takes shortcuts in its initial consultations, such as not requiring a dental exam, and does not provide the customer with direct access to a dentist or orthodontist, making it difficult for a customer to address questions or concerns. SmileDirectClub’s ‘disregard for consumer health and safety, on the one hand, and its persistent deceptive acts to drive high volume sales, on the other, together form the foundation of the company’s business model,’ reads the complaint submitted to the FTC.”
Fortune (10/18) reports, “For SmileDirectClub shareholders, there hasn’t been much to smile about lately. Last month, the so-called teledentistry company went public, and got its proverbial teeth knocked in. Shares took another hit…after California Governor Gavin Newsom signed a bill that would add more regulations to the emerging sector in the state. The American Dental Association hailed the bill, the first of its kind in the nation, as a victory for consumers. It added legislators in Massachusetts have something similar in the works.”
Barron’s (10/18, Liu) states, “The company was built on a disruptive brand of orthodontia that’s closer to shopping for sunglasses than visiting a dentist. Customers go to a SmileDirect store or take an at-home mold of their teeth. From there, the company creates a plastic aligner that customers can wear to bed. The American Dental Association has asked the Federal Trade Commission to ‘investigate false and misleading claims’ from SmileDirect.”