Health

New Study Further Confirms How Diabetes Leads to Gum Disease

A new study led by University of Pennsylvania researchers has found that the oral microbiome affected by diabetes causes a shift in the likelihood of disease.

The microbiome is the microorganisms that coexist with our own cells. We depend on a vast army of microbes to stay alive. Microbiome protects us against germs, breaks down food to release energy, and produces vitamins.” Hence, when microbiome is affected by diseases such as diabetes, it has been hypothesized that we are more likely to succumb to diseases. This study proves that microbiome affected by diabetes causes gum disease (periodontitis) and explains how this happens.

The research, published in the journal Cell Host & Microbe this week, not only showed that the oral microbiome of mice with diabetes shifted but also change was associated with increased inflammation and bone loss around the teeth.

“Up until now, there had been no concrete evidence that diabetes affects the oral microbiome,” said Dana Graves, senior author on the new study and vice dean of scholarship and research at Penn’s School of Dental Medicine. “But the studies that had been done were not rigorous.”

Just four years ago, the European Federation of Periodontology and the American Academy of Periodontology issued a report stating there is no compelling evidence that diabetes is directly linked to changes in the oral microbiome. But Graves and colleagues were skeptical and decided to pursue the question, using a mouse model that mimics Type 2 diabetes.

“My argument was that the appropriate studies just hadn’t been done, so I decided, we’ll do the appropriate study,” Graves said.

The researchers began by characterizing the oral microbiome of diabetic mice compared to healthy mice. They found that the diabetic mice had a similar oral microbiome to their healthy counterparts when they were sampled prior to developing high blood sugar levels, or hyperglycemia. But, once the diabetic mice were hyperglycemic, their microbiome became distinct from their normal littermates, with a less diverse community of bacteria.

The findings underscored an association between changes in the oral microbiome and periodontitis but didn’t prove that the microbial changes were responsible for the disease. To drill in on the connection, the researchers transferred microorganisms from the diabetic mice to normal germ-free mice, animals that have been raised without being exposed to any microbes.

These recipient mice also developed bone loss. A micro-CT scan revealed they had 42 percent less bone than mice that had received a microbial transfer from normal mice. Markers of inflammation also went up in the recipients of the diabetic oral microbiome.

 

“We were able to induce the rapid bone loss characteristic of the diabetic group into a normal group of animals simply by transferring the oral microbiome,” said Graves.

With the microbiome now implicated in causing the periodontitis, Graves and colleagues wanted to know how. Suspecting that inflammatory cytokines, and specifically IL-17, played a role, the researchers repeated the microbiome transfer experiments, this time injecting the diabetic donors with an anti-IL-17 antibody prior to the transfer. Mice that received microbiomes from the treated diabetic mice had much less severe bone loss compared to mice that received a microbiome transfer from untreated mice. The findings “demonstrate unequivocally” that diabetes-induced changes in the oral microbiome drive inflammatory changes that enhance bone loss in periodontitis, the authors wrote.

Though IL-17 treatment was effective at reducing bone loss in the mice, it is unlikely to be a reasonable therapeutic strategy in humans due to its key role in immune protection. But Graves noted that the study highlights the importance for people with diabetes of controlling blood sugar and practicing good oral hygiene.

“Diabetes is one of the systemic diseases that is most closely linked to periodontal disease, but the risk is substantially ameliorated by good glycemic control,” he said. “And good oral hygiene can take the risk even further down.”

In conclusion, if you have diabetes, not only should you brush, brush, floss and see your dentist regularly, but also strictly control sugar intake. Even if the sugar you ingest doesn’t cause decay right off, the “good germs” (microbiome) will change so that you get gum disease.

So cut down the sugar, folks!

Health

Oral Bacteria In Brain Clots

As published recently in the Journal of the American Heart Association, researchers from Tampere University in Finland analyzed blood clot samples from 74 subjects who received emergency treatment for ischemic stroke and found that 79% contained DNA from a common oral bacteria, called Streptococci mitis.

Simply put, oral bacteria likely grew in the brain clots.

Oral bacteria can stimulate endothelial cells, or cells that line the blood vessels, to secrete inflammatory signals from the immune system. This, in turn, contributes to the establishment of plaque in the blood vessels.

Inflammation caused by these oral bacteria can exacerbate atherosclerosis, a buildup of plaque on artery walls. When enough plaque builds up, strokes become more likely.

It appears logical that if oral pathogens (bacteria that cause inflammation) could be minimized, then the risk of strokes could be lowered. In fact, a study confirmed that regular dental care lowers the risk for this kind of medical emergency.

Another study published in this journal also determined that oral hygiene should be emphasized in the primary prevention of acute ischemic stroke. Periodontitis, gum disease leading to loss of bone around the teeth, involved uncontrolled inflammation of the gums caused by pathogens. This disease, which is the number one cause of adult tooth loss, were identified in this study as an independent risk for the occurrence of strokes.

How can you tell whether you have periodontitis? Here are some of the symptoms:

(1) Your gums bleed when you brush or floss your teeth.

(2) You notice your gums are receding and you can see bare roots.

(3) Dark holes (triangles) or spaces are seen between your front teeth.

(4) You notice bad breath or bad taste.

(5) Teeth are shifting or growing long, called getting “long in the tooth.”

(6) Your teeth are getting loose.

(7) Your bite is changing.

If you notice any of the above symptoms, see your dentist for rule out gum disease.

Save your teeth. Save your life.

Health

Sugar Eats Away Your Teeth and Your Brain

According to the American Dental Association, Americans consume sugar, particularly in the form of sugar-sweetened beverages (SSBs), at an alarming rate.

SSBs are a leading cause of dental cavities, obesity, and type II diabetes. SSBs are sports drinks, energy drinks, fruit drinks, flavored milk, and other beverages that contain added caloric sweeteners.

Sadly, new evidence indicates SSBs are also associated brain shrinkage. So, it can be said that SSBs can eat away your teeth as well as your brain.

In the United States, SSB consumption has reached epidemic proportions. The average American is now consuming a whopping 50 gallons per person per year! This is the second highest consumption rate in the world (after Mexico). This consumption is equivalent to approximately 1.5 cans of soda per person per day. SSBs are the leading source of added sugar in the American diet and is strongly associated with the high rate of dental caries in the U.S. Obesity is associated with diabetes. The United States is amid an obesity epidemic fueled in great part by SSBs. Americans are among the most overweight and obese population in the world. Today, over two-thirds (69%) of all Americans older than 20 years are overweight, and just over one-third (35%) are obese. It is no wonder that the Center for Disease Control (CDC) reported that in 2017 more than 100 million adults in the United States have diabetes or pre-diabetes. This is estimated to be over 30% of the entire U.S. population.

What is not well known is, according to the Framingham Heart Study, one or more sugary drinks per day resulted in lower total brain volume, lower hippocampus volume. Hippocampus is an important part of the brain for memory and is also where the process of Alzheimer’s disease starts. In other words, normal shrinking of the brain due to aging is accelerated by consuming sugary drinks.

This study reported that those people who consumed one or two sugary drinks per day experienced the equivalent of 1.6 years of accelerated brain aging per year. Those subjects in the Framingham study taking in more than two sugary drinks per day showed an astounding 11.0 years of brain aging.

The Framingham Heart Study is a long-term, ongoing cardiovascular cohort study on residents of the city of Framingham, Massachusetts.The study began in 1948 with 5,209 adult subjects from Framingham and is now on its third generation of participants.

So, the next time you are tempted to drink a soda or other sugary drink, remember it’s not just your teeth but your brain that is also at stake. Don’t let these beverages eat away your brain!

Teeth

10 Things Not To Put In Your Mouth

Everyone knows that certain things present high risk of harm when put into the mouth. Tobacco, raw meat, toys, gun barrels or your own foot are some well-known examples.
Other not-recommended items are:

1) A toothbrush with too much toothpaste – This may keep you from seeing what you are brushing. Studies show that people who dry brush their teeth first, then brush again with toothpaste, have less gum bleeding and tartar than those who brush only with toothpaste. The overwhelming taste of the toothpaste may also cause hastening of the teeth brushing routine.

2) Contact Lenses – Cleaning or moistening your contact lenses by putting them in your mouth is not a good idea, because bacteria in the mouth can cause conjunctivitis.

3) Pencils, pens or pipes – Chewing on these items can cause both the wearing down of the teeth and invisible cracks or fissures to form in the enamel of the teeth. Under certain circumstances, these cracks or fissures can make it more likely for your teeth to crack or chip. TNJ (jaw joint) problems can be aggravated by chewing on foreign objects.

4) Tongue studs and lip or cheek rings – Puncture of the tongue can lead to excessive bleeding or infection, such as hepatitis. It’s amazing how many people with tongue studs or lip rings tell their dentists they hate Novocain shots.

5) Hot food followed by cold – Hot coffee or drinks followed immediately by an icy drink or ice cream can lead to cracks in your teeth. Dental enamel is highly mineralized and hard, when it is exposed to extremes in temperatures, tiny cracks may form on your teeth.

6) Metal nails – Holding nails in your mouth may be convenient, but a slip or fall can cause nails to puncture the lip or mouth.

7) Small (onilateral) partial dentures – Partial dentures or removable bridges that are not attachable to both sides of the mouth are small enough to be swallowed during sleep and can cause choking.

8) Aspirin on the gum – Because aspirin is so acidic, leaving an aspirin on your gum to relieve pain can end up leaving you in more discomfort. Aspirin can denude the surface of the gum and leave it extremely raw and sore.

9) Super glue to glue back a loose crown – Gluing back a loose crown with super glue or any other commercial glue may seem like a good self-help idea. But the strong chemicals in these glues can cause terrific toothaches and result in the entire tooth being dissolved by the glue in a very short time.

10) Ice, seeds, jawbreakers, etc. – Chewing on hard items like these can fracture your teeth, especially if you already have large fillings in your teeth. Incidentally, restaurants and markets are generally fair about reimbursing you for the cost of restoring a tooth that broke from biting into a foreign object in your food. In either case, you must report it immediately to the restaurant or store manager. Then see your dentist as soon as possible. If it happened from food purchased at a market, you must show the manager the food item, the receipt, the foreign object and tooth fragments, if any. Then see your dentist for a brief report stating the cause and estimated cost for treatment.

Dental Health

Bite Guards Used to Treat Tourette Syndrome

Tourette syndrome is a neurological disorder characterized by vocal and motor tics, which can contribute to anxiety, depression, and low self-esteem. Researchers in Japan have developed a removable dental appliance (bite guard) that can reduce these tics in both children and adults with Tourette syndrome. The ability to ameliorate tics could positively impact the everyday lives of individuals with Tourette syndrome.

While there is no cure for Tourette syndrome, there are several available options to treat severe tics. These include behavioral (e.g. psychotherapy and cognitive behavioral therapy), pharmacological (e.g. medications that block dopamine in the brain), and more intrusive surgical interventions (e.g. deep brain stimulation, whereby motor areas of the brain receive electrical stimulation). However, the efficacy of these treatments can vary, and patients still frequently suffer from physical, mental, and social disabilities.

As an alternative treatment option, researchers at Osaka University have developed a custom-made oral splint. These are typically used for unconscious teeth clenching and grinding, and for temporomandibular disorders such as misalignment of the teeth or jaw. The oral splint is applied to the molars to increase the occlusal vertical dimension, which essentially means that the alignment of the nose, lips, and chin is altered. The study was recently published in Movement Disorders.

“Biting down on the device immediately improved both motor and vocal tics in 10 of the 14 children and 6 of the 8 adults that participated in the study,” says Jumpei Murakami, joint first author of the study. “What’s more, these effects were long-lasting. Long-term improvements in motor tics after more than 100 days were especially evident in patients who were younger when their tics first started.”

While it isn’t yet clear how the oral splint exerts these effects, the action of biting down could serve as a sensory trick. Sensory tricks are voluntary maneuvers that usually involve touching parts of the face and head and can alleviate involuntary movements. Sensory tricks have been well documented to temporarily improve dystonia, which is a movement disorder that is, like Tourette syndrome, characterized by uncontrollable tics.

“Considering previous findings on sensory tricks in patients with cervical dystonia, it seems possible that the oral splint modulates proprioceptive, or ‘touch’ signals,” explains Yoshihisa Tachibana, co-first author of the study. “These ‘touch’ signals might be modified by the muscles involved in jaw-closing before being relayed to the brain.”

Unlike Las Vegas, nothing happens in the mouth just stays in the mouth. Whatever happens to the mouth invariably spreads to the rest of the body, for good or bad. In this case, it’s potentially very good news, indeed. Dentists may be able to help patients with Tourette’s disorder.

Dental Health

Vitamins and Minerals for Dental Health

Certain vitamins and minerals are especially beneficial to your dental health. These nutritional building blocks may be essential for keeping your teeth and gums healthy while benefiting your entire body.

Calcium

Throughout the body, this mineral helps build bones and provide structural support. In your mouth, calcium helps harden your enamel and strengthen your jawbone. Milk, cheese, yogurt, broccoli and salmon are some known sources of calcium.

Vitamin D

Vitamin D helps the body absorb calcium while boosting bone mineral density, so it’s crucial to get an adequate amount of vitamin D to get the most out of your calcium intake. Your body naturally makes vitamin D when it’s exposed to sunlight, but the vitamin can also be found in fatty fish, canned tuna and portobello mushrooms. You can also look for foods and drinks that have been fortified with vitamin D, such as milk, orange juice and cereal.

Potassium

Like vitamin D, potassium improves bone mineral density. It also works with magnesium to prevent blood from becoming too acidic, which can leach calcium from your bones and teeth. Bananas are well known sources of potassium, but they’re not alone. Other fruits and vegetables with high levels of the mineral include lima beans, tomatoes, Swiss chard, potatoes, sweet potatoes, avocados and prunes.

Phosphorus

Phosphorus supports calcium in building strong bones and teeth. Phosphorus is found in a wide range of foods. Rich sources of the mineral include seafood, such as scallops, sardines, cod, shrimp, tuna and salmon. If you’re looking to get your phosphorus from plant-based foods, consider soybeans, lentils and pumpkin seeds. You can also find phosphorus in beef, pork and cheese.

Vitamin K

Think of this vitamin as a shield – it helps block substances that break down bone. It also helps your body produce osteocalcin, a protein that supports bone strength. A vitamin K deficiency can slow down your body’s healing process and make you more likely to bleed. Leafy greens, such as kale, collards and spinach, can help increase vitamin K in your diet. Other great sources include parsley, broccoli and Brussel sprouts.

Vitamin C

Vitamin C strengthens your gums and the soft tissue in your mouth. It can protect against gingivitis, the early stage of gum disease, and can prevent your teeth from loosening. You probably already know that citrus fruits are rich in vitamin C, but you can also find it in potatoes and leafy greens.

Vitamin A

This vitamin helps keep the gums healthy. It prevents dry mouth and helps your mouth heal quickly. Vitamin A is found in fish, egg yolks and liver as well as leafy green vegetables like spinach, kale and collard greens, or in orange-colored fruits and oranges, apricots, cantaloupe, pumpkin, carrots and sweet potatoes. These fruits and veggies contain high levels of beta-carotene, which your body converts into vitamin A. Please check with your physician and dentist as to whether any foods or supplements containing these vitamins and minerals are appropriate for you. Also ask for advice as to quantity, duration, frequency and dosage.

(Portions of the above information were excerpted from a Delta Dental publication.)

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