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Dentists Journal

Baby teeth may one day help identify kids at risk for mental disorders later in life

The team analysed 70 primary teeth collected from 70 children enrolled in the Children of the 90s study (also known as the Avon Longitudinal Study of Parents and Children) based at the University of Bristol. Parents donated primary teeth (specifically, the pointed teeth on each side of the front of the mouth known as canines) that naturally fell out of the mouths of children aged 5 to 7.

The results of this study could one day lead to the development of a much-needed tool for identifying children who have been exposed to early-life adversity, which is a risk factor for psychological problems, allowing them to be monitored and guided towards preventive treatments, if necessary.

The origin of this study traces back several years, when senior author Erin C. Dunn, ScD, MPH, learned about work in the field of anthropology that could help solve a longstanding problem in her own research. Dunn is a social and psychiatric epidemiologist and an investigator in MGH's Psychiatric and Neurodevelopmental Genetics Unit. She studies the effects of childhood adversity, which research suggests is responsible for up to one-third of all mental health disorders.

Dunn is particularly interested in the timing of these adverse events and in uncovering whether there are sensitive periods during child development when exposure to adversity is particularly harmful. Yet Dunn notes that she and other scientists lack effective tools for measuring exposure to childhood adversity. Asking people (or their parents) about painful experiences in their early years is one method, but that's vulnerable to poor recall or reluctance to share difficult memories. "That's a hindrance for this field," says Dunn.

However, Dunn was intrigued to learn that anthropologists have long studied the teeth of people from past eras to learn about their lives. "Teeth create a permanent record of different kinds of life experiences," she says.

Exposure to sources of physical stress, such as poor nutrition or disease, can affect the formation of dental enamel and result in pronounced growth lines within teeth, called stress lines, which are similar to the rings in a tree that mark its age. Just as the thickness of tree growth rings can vary based on the climate surrounding the tree as it forms, tooth growth lines can also vary based on the environment and experiences a child has in utero and shortly thereafter, the time when teeth are forming. Thicker stress lines are thought to indicate more stressful life conditions.

Dunn developed a hypothesis that the width of one variety in particular, called the neonatal line (NNL), might serve as an indicator of whether an infant's mother experienced high levels of psychological stress during pregnancy (when teeth are already forming) and in the early period following birth.

To test this hypothesis, Dunn and two co-lead authors -- postdoctoral research fellow Rebecca V. Mountain, PhD, and data analyst Yiwen Zhu, MS, who were both in the Psychiatric and Neurodevelopmental Genetics Unit at the time of the study -- led a team that analysed the teeth. The width of the NNL was measured using microscopes.

Mothers completed questionnaires during and shortly after pregnancy that asked about four factors that are known to affect child development: stressful events in the prenatal period, maternal history of psychological problems, neighbourhood quality (whether the poverty level was high or it was unsafe, for instance), and level of social support.

Several clear patterns emerged. Children whose mothers had lifetime histories of severe depression or other psychiatric problems, as well as mothers who experienced depression or anxiety at 32 weeks of pregnancy, were more likely than other kids to have thicker NNLs.

Meanwhile, children of mothers who received significant social support shortly after pregnancy tended to have thinner NNLs. These trends remained intact after the researchers controlled for other factors that are known to influence NNL width, including iron supplementation during pregnancy, gestational age (the time between conception and birth) and maternal obesity.

No one is certain what causes the NNL to form, says Dunn, but it's possible that a mother experiencing anxiety or depression may produce more cortisol, the "stress hormone," which interferes with the cells that create enamel. Systemic inflammation is another candidate, says Dunn, who hopes to study how the NNL forms.

And if the findings of this research can be replicated in a larger study, she believes that the NNL and other tooth growth marks could be used in the future to identify children who have been exposed to early life adversity. "Then we can connect those kids to interventions," says Dunn, "so we can prevent the onset of mental health disorders, and do that as early on in the lifespan as we possibly can."

Dunn is also an associate professor of Psychiatry at Harvard Medical School. Mountain is now a postdoctoral research fellow at Maine Medical Center Research Institute. Zhu is now a doctoral student at the Harvard T.H. Chan School of Public Health.

(06/20/2022)
by Science Daily

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What Is Tooth Dilaceration?

There are many ways that your teeth malformations can affect you or your child. What is tooth dilaceration? What causes curved tooth roots? We’ve got the answers to your top questions, so you know what’s going on with you or your child’s tooth.

Tooth Dilaceration: What You Need to Know

If the crown (top) or root of a tooth has an irregular bend, this is known as a tooth dilaceration. This leads to a curved section of your or your child’s tooth, including the crown, root, or root tip. It can occur in any tooth type but is much more likely to occur in primary teeth, also known as baby teeth.

It's crucial to receive an accurate diagnosis by a dental professional, as tooth dilaceration can alter other dental care recommendations that you or your child receives. Even if not treating the dilacerated tooth directly, its presence may alter their approach to your other teeth.

Diagnosis and Causes

Because x-rays take two-dimensional images of your mouth, it can be difficult to capture the image and diagnose your dilacerated tooth fully. For this reason, cone-beam computer tomography (CBCT) is often used by your dental professional to help provide a clearer image of your condition, leading to more accurate diagnosis and treatment.

According to the International Journal of Clinical Pediatric Dentistry, the exact prevalence and range of causes are not fully understood. The typically understood causes are injury to your or your child's baby teeth, developmental issues, and various medical conditions.

The causes of dilaceration may include:

Developmental problems due to genetics or disease

Medical conditions, including cysts and tumors

Traumatic injury to your baby tooth or teeth

Baby tooth or teeth that did not properly grow out

Presence of an extra tooth or teeth

Prevention and Treatment

Because other health problems and trauma cause tooth dilaceration, it is sometimes impossible to prevent. Your best bet not to develop this condition is to avoid injury to your or your child's mouth and stay ahead of other oral health issues through proper dental care.

Regular visits to your dental professional can help catch this condition early to prevent associated issues from occurring. If your dilaceration is minor, you may likely require no treatment.

According to the International Journal of Clinical Pediatric Dentistry, treatment varies based on numerous factors. If you do require treatment, options will vary depending on:

Its severity and the underlying cause

The position and direction of the affected tooth

The amount of space around the affected tooth

The amount of root formation

Recommendation of your dental professional

If you do require treatment, the options typically require surgical intervention. Depending on your individual needs, your dental professional may recommend traction (putting pressure on your tooth) to guide your or your child's tooth or extraction of the tooth.

It’s vital to intervene with your dental professional as early as possible to prevent complications, so you’ve made the right choice to inform yourself about this condition. You’ve done a great job by acquiring an understanding of the causes and treatments for tooth dilaceration.

(06/18/2022)
by Colgate

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Nature vs. Nurture: Dental Problems Parents Pass Down To Children

Parents, in particular, want to know: does DNA predetermine dental health? It’s the classic nature vs. nurture question that dentists get asked often, but the answer doesn’t simply boil down to one or the other. The scary truth is that many dental problems are indeed “inherited”–but not from genetics alone! Harmful habits that run in the family can also play a huge role in the health of your child’s smile. Find out which oral issues you could be passing down, and what you can do about them.

DNA-Driven Dental Issues

Even before birth, the stage has already been set for certain aspects of your child’s oral health. Ultimately, your child’s genes dictate the likelihood for common issues such as:

Jaw-related Disorders: The size and position of one’s jaws, as well as overall facial structure, are hereditary traits that can cause a number of bite complications (or “malocclusions”). Overbites or underbites caused by uneven jaws can lead to chewing and speech difficulties, and result in chronic pain and/or Temporomandibular Jaw Disorder (“TMJ”) if left untreated.

Tooth Misalignments: Spacing problems, either due to missing or overcrowded teeth, are oral issues that have been hardwired in a person even before the emergence of teeth. Cases where people lack some (“Anodontia”) or all (“Hypodontia”) permanent teeth can threaten gum and jaw health, as can instances of “supernumerary” teeth, in which extra teeth erupt.

Weak Tooth Enamel: Though rare, it is possible for tooth enamel to be defective, or develop abnormally. Dentin, which makes up the protective enamel covering of teeth, may not be produced or mineralize at normal levels, leaving teeth vulnerable to decay, sensitivity and damage.

Predisposition To Oral Cancer: Genetic mutations and the presence of oncogenes, a type of gene that transforms healthy cells into cancerous ones, can increase the risk for cancer by interfering with the body’s ability to metabolize certain carcinogens.

From serious conditions such as a cleft palate, to occasional aggravations like canker sores, many other oral issues may be linked to genetics. Keeping track and sharing the family’s health history with your child’s dentist can help detect and treat inherited conditions as early as possible.

Behavioral Risks

DNA may deal your child some unavoidable complications, but when it comes to tooth decay and gum disease, learned habits and tendencies shoulder much more of the blame, including:

“Oversharing”: Harmful oral bacteria from a loved one can easily colonize and overtake your little one’s mouth from something as simple as sharing food, utensils, or kissing. The inadvertent swapping of saliva can put your child at increased risk for cavities and gingivitis.

Diet Choices: Satisfying that sweet tooth with sugary, refined treats, or turning to soda and juice for refreshment can create an unhealthy addiction that’s as dangerous to the mouth as it is to the waist. Sugar and acid can eat away at the tooth enamel, causing cavities and tooth sensitivity. Exposure to certain chemicals and ingredients can also cause discoloration.

Bad Hygiene: Last, but certainly not least, lacking a good dental routine can wreak havoc on teeth and gums. Failing to follow through on brushing and flossing twice a day (or as recommended by the dentist) can create a haven for cavities and periodontitis, not to mention halitosis.

Leading by example is an easy, effective way to teach your child the importance of oral health while benefitting the whole family.

Stay One Step Ahead

Every parent wants the best for his or her child–including a healthy smile. With so many potential problems that can be passed down, protecting your child’s oral health is not easy, but you don’t have to do it alone. Seek the help of your child’s dentist for optimal professional and at-home dental care. Treating existing issues early on and teaching your child to make dental-friendly decisions can provide lifelong benefits to his or her health.

(06/17/2022)
by Dr. Meghan Toland, DMD

More Information: https://authenticdentaldesigns.com/blog/nature-vs-nurture-dental-problems-parents-pass-down-to-children

Patrick Brambert, D.D.S., invited to screen his short film at L.A. film festival

Illinois man wears many hats: filmmaker, soldier, actor, dentist

(Second photo) Patrick Brambert, D.D.S, right, wrote, directed and acts in the cooking show spoof “Kitchen Spaces,” a 10-minute short film that was accepted in the Dances with Films film festival in Los Angeles. Photo courtesy of Dr. Brambert.

When Chicagoland was sweltering in mid-June with sky-high heat indexes, Patrick Brambert, D.D.S., was escaping from the area to make his first-ever trip to Los Angeles.

Dr. Brambert wasn’t there to savor the cool breeze-kissed beaches. As writer, director and star, he was invited there to screen his 10-minute film, "Kitchen Spaces," at the Dances with Films film festival, held at the iconic TCL Chinese Theatre on the Hollywood Walk of Fame.

A cooking-show spoof, Dr. Brambert described the short film as a cross between “The Office” and “Between Two Ferns,” two shows that use awkwardness as a springboard for laughs.

"I like cringey humor a little too much,” Dr. Brambert said.His trip to a film festival was just one of the many feathers in his cap. Besides being a filmmaker, Dr. Brambert is a Second City-trained improv comic, Army National Guard soldier and associate dentist at Dental Essence in Addison, Illinois.

Add all of that to a home life with his wife and two children under the age of 3, and you’ve found someone with more energy than many of his peers.

“I don’t think I’ll ever leave dentistry behind,” said the 30-year-old. “But I like variety in my week.”Dr. Brambert was in Oklahoma last year for Army National Guard basic training when he wrote the script for “Kitchen Spaces” in between — and during — long runs while living in constant fear of drill sergeants.

He said he has wanted to serve in the military about as long as he has wanted to be dentist, actor and filmmaker, with cherished memories of elaborately staged battle campaigns with his G.I. Joes as a child.

Besides inhabiting the personas of G.I. Joe characters Cobra Commander and Snake Eyes during playtime, Dr. Brambert loved visiting his pediatric dentist. That dentist, who inspired him to go to dental school at the University of Iowa College of Dentistry and Dental Clinics, was so beloved that Dr. Brambert insisted on keeping him as his dentist all the way until Dr. Brambert was 21 and half-a-foot longer than the length of the operatory chair.

Before his dental school graduation in 2017, Dr. Brambert completed an externship at a special-needs clinic in Iowa as well as an additional externship on a Native American reservation in Cass Lake, Minnesota. Once he graduated, he practiced for several years in the western Chicago suburbs. On the side, he completed the improv program at The Second City theater where he performed with the Yellow Belly Improv Group before landing an associateship at Dental Essence, owned by Paul N. Greico, D.D.S.

“He’s a really caring person,” said Dr. Greico. “He has a great rapport with his patients, and he’s highly qualified. He’s committed to dentistry and enjoys what he’s doing in dentistry. He’s just really a good guy, and a great family man.”When he is not on diaper duty at home or National Guard duty, Dr. Brambert trains with acting coach Max Arciniega. Mr. Arciniega is best known for his role as Domingo Gallardo "Krazy-8" Molina in the critically acclaimed series "Better Call Saul" and "Breaking Bad.”

The dentist acts when the opportunity presents itself. For example, Dr. Brambert played a jail guard in the television show "Chicago P.D." last season.As expected, Dr. Brambert has several goals in life, befitting someone who seems up for everything. One goal is to become more confident with implant placing, and second is becoming a fellow in the Academy of General Dentistry.But that’s not it. Of course not.

He is also hoping to hear from connections made in Los Angeles about turning “Kitchen Spaces” into a half-hour series on network TV.

It is entirely possible, especially since he has more energy than most.

(06/21/2022)
by David Burger

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WHO emphasizes importance of fluoride in toothpastes

The World Health Organization's decision to add fluoride toothpaste to its list of essential medicines is shining a light on the benefits of toothpastes that have earned the ADA Seal of Acceptance.

WHO updated its Model List of Essential Medicines to include fluoride toothpaste, silver diamine fluoride and glass ionomer cement in fall 2021. In an editorial published in April by the British Dental Journal, Habib Benzian, D.D.S., Ph.D., research professor and co-director of the WHO Collaborating Center for Quality Improvement and Evidence-Based Dentistry at the New York University College of Dentistry, described how WHO's decision could lead countries to take steps to ensure fluoride toothpaste is available and regulated.

"Why do these changes matter for oral health? One may think that fluoride toothpaste is a ubiquitous commodity, yet for many it is unavailable, unaffordable or of dubious quality," Dr. Benzian said.

The ADA Seal, which celebrated its 90th anniversary in 2021, evaluates the safety and efficacy of dental products. More than 400 products currently have the Seal, including 57 fluoride toothpastes.

"The quality of fluoride toothpaste is instrumental for efficacy, as mentioned by WHO," said Carlos González-Cabezas, D.D.S., Ph.D., professor in the department of cariology, restorative sciences and endodontics at the University of Michigan School of Dentistry and member of the ADA Council on Scientific Affairs' Seal Subcommittee. "In the U.S., we are fortunate to have it regulated by the Food and Drug Administration. Additionally, we have the ADA Seal program that confirms the quality of the product and gives consumers reassurance that they are using a product of high quality."

A study published in 2021 by the British Dental Journal showed increasing use of nonfluoridated toothpaste, "which should be cause for public health concern," Dr. Benzian said.

Nonfluoridated toothpastes are available in the U.S., but all toothpastes that earn the ADA Seal must contain fluoride. The American Dental Association has long supported the use of fluoride as safe and effective in preventing tooth decay in both children and adults.

"The recent WHO decision to include fluoride toothpaste in the Model List of Essential Medicines is great news for the dental community and for dental health worldwide," Dr. González-Cabezas said. "In the U.S., the ADA has been a strong supporter of fluoride toothpaste for many decades as it is one of the best evidence-based caries prevention strategies available to the general public. In fact, many would argue this is the most important reason for the decline in caries prevalence in most developed countries, including the U.S., in the last 50 years."

(06/19/2022)
by Mary Beth Versaci
Views: 428

Study quantifies the effect of early free sugar intake on dental caries

Free sugar consumption was measured in children enrolled in the Barwon Infant Study at age 18-months and 4-years. The exposure, free sugar intake was quantified as continuous and binary variables indicating less than 5% of total energy intake (TEI) at 18-months and 4-years of age.

The prevalence of dental caries was obtained from dental records. Multiple logistic regression estimated the effect of the exposure variables on the presence of dental caries at 4-6 years of age, adjusting for potential confounders.

Of the original birth cohort, dietary data (N=863) and dental caries data (N=368) were available. 70.4% and 36.7% participants consumed less than 5% TEI from free sugars at 18-months and 4-years, respectively.

Dental caries affected 46.7% of children. In fully adjusted models, free sugar at 18-months (OR 1.74; 95% CI 1.06, 2.86 per 5% of TEI) and at 4-years of age (OR 1.43; 95% CI 0.90, 2.28, per 5% of TEI) increased dental caries risk at 4-6 years. The estimated effect of consuming less than 5% free sugars of TEI at 18-months and 4-years of age on dental caries prevalence at 4-6 years was an OR 0.71, 95% CI 0.42, 1.19 and OR: 0.61; 95% CI 0.38, 0.97 respectively.

The estimated effect of lowering free sugars to less than 5% of TEI at both timepoints compared to exceeding 5% TEI at one or both timepoints, on dental caries risk at 4-6 years was an OR 0.55; 95% CI 0.33, 0.93.

The authors concluded that between 18-months and 4-years, free sugar consumption increased markedly with two thirds of children exceeding 5% of TEI at 4-years of age.

Early free sugar intake increases the risk of dental caries at 4-6-years of age.

(06/23/2022)
by News Medical Life Sciences

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How Regular Dental Visits Can Help Reduce Health Care Costs for People With Diabetes and Heart Disease

he benefits of getting your teeth cleaned go beyond dental care. Regular cleanings also appear to help prevent more significant and costly health challenges for those with diabetes and coronary artery disease, according to new research from the Mayo Clinic.

The study, published in Compendium of Continuing Education in Dentistry, researched how preventative oral care impacts the costs associated with care related to diabetes and coronary artery disease. The findings showed that regular dental cleanings and exams translate into significant savings in overall health care costs.

"Besides better oral outcome, regular preventive dental visits are associated with better health outcomes among patients with diabetes and chronic artery disease, resulting in significant savings in health care costs," lead investigator Bijan Borah, PhD, a health services researcher at Mayo Clinic told Health.

Interestingly, cost is one of the primary reasons people avoid going to the dentist, as many health insurance plans do not include dental coverage.

Here's a closer look at the ramifications of the study for your health and your finances.

Because previous research has associated periodontal disease—an infection in the gums, or the tissues that hold your teeth together—with other medical conditions like heart disease, diabetes and obesity, the Mayo Clinic research team set out to evaluate how regular, preventive dental care might impact overall health care costs.

The question is particularly relevant as past research suggests that the bacteria behind gum disease can travel throughout the body, triggering systemic inflammation. In addition, poor oral health has been linked to numerous health conditions. Beyond diabetes and heart disease, a relationship has been established between poor oral health and pneumonia, Alzheimer's disease and even cancer.

The irony of this connection is that cost is quite often a barrier to dental care and most insurance plans, including Medicare, do not include dental care. As a result, many people avoid regular teeth cleanings and exams. But a healthier mouth has been linked to less hospitalizations, and consequently, reduced expenditures.

To examine the question of health care costs, Mayo researchers recruited 11,734 people who had either diabetes or coronary artery disease, or both conditions. Participants were enrolled in a health care plan in Arkansas that included dental care coverage. The participants were enrolled in the plan for at least a year between 2014 and 2018.

The team compared the total health care costs — specifically, claims for inpatient and outpatient care and prescription medication costs — of those who had gone to at least one preventive dental visit to those who did not receive any preventive dental care.

(06/22/2022)
by Julia Ries

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