Children Health

Baby Teeth Showed Autism Associated with Lead and Other Heavy Metals

According to the Centers for Disease Control and Prevention, as many as 1 in 68 children in the United Sates have autism spectrum disorder (ASD).

Researchers have shown that autism may be caused by a complex reaction between environmental factors and genetics. Separating these causative factors has been particularly challenging. A new study by Manish Arora, Ph.D., a dentist and environmental scientist at the Icahn School of Medicine at Mount Sinai in New York, has shown a way to isolate genetics from environmental factors, using baby teeth of ASD children. This was published in the journal Nature Communications.

Previous studies that have investigated the relationship between toxic metals, essential nutrients, and the risk of having ASD; but these studies showed only metal concentrations in the blood stream after ASD has developed. Information as to the level of toxic metal before ASD was diagnosed was left to guesswork. This study reasoned that if pre-ASD toxic levels can be determined, then environmental exposure toxic metals may be statistically separated from genetic factors.

The method used in this new study, however, manages to bypass many of these limitations. By looking at naturally shed baby teeth, the researchers explain, they have access to information that goes as far back as a baby’s prenatal life. And by studying twins, Dr. Arora and colleagues were able to separate genetic influences from environmental ones.

To determine how much metal the babies’ bodies contained before and after birth, the researchers used lasers to analyze the growth rings on the dentine (root structure) of the baby teeth. Much like looking at the age of a tree by examining the rings on its trunk, scientists can determine the amount of lead in dentine layers during different stages of development of the tooth bud. By this means, the scientists were able to ascertain the level of exposure to lead at different stages of fetal development prior to birth.

Laser technology allowed the scientists to accurately extract specific layers of dentine, which is the substance that lies beneath the tooth enamel.

Cindy Lawler, Ph.D., head of the National Institute of Environmental Health Sciences (NIEHS) Genes, Environment, and Health Branch, explains the importance of using this scientific method for studying autism:

“We think autism begins very early, most likely in the womb, and research suggests that our environment can increase a child’s risk. But by the time children are diagnosed at age 3 or 4, it’s hard to go back and know what the moms were exposed to. With baby teeth, we can actually do that.”

To isolate genetic factors causing ASD, the scientists recruited 32 pairs of twins. The scientists were able to compare the twin that developed ASD to the twin that has not. The study showed that the difference between the ASD twin and the normal twin was only the level of lead in the blood stream. Hence the conclusion is that heavy metals, or the body’s ability to process them, may affect ASD and that children with ASD had much higher levels of lead throughout their development.

Finally, manganese and zinc were found to correlate with ASD as well. Children with ASD seemed to have less manganese and less zinc than children without, both pre- and postnatally.

Overall, the study suggests that either prenatal exposure to heavy metals, or the body’s ability to process them, may influence the chances of developing autism.

Dr. Arora called the method “a window into our fetal life.” More extensive studies based on using baby teeth to look through this window are recommended by Dr. Arora.

Dr. Arora‘s study represents one of the numerous ways dental science impacts medical research. Dentists are working side by side with physicians and scientists to generate solutions to health problems.


Bad Bite & Bad Posture Related? Can a Better Bite Give You Better Athletic Performance?

Dental occlusion or “your bite” could be defined as contact between the top and bottom teeth when closing the mouth. Correction of the bite through orthodontic and other treatments leads to better dental health. It’s been known in the field of occlusion that malocclusion (bad bite) may be associated with neck, back and other postural problems.

Lately, two new studies appear to further confirm this clinical hypothesis.

Two new studies, carried out in collaboration between the Department of Physiology at the University of Barcelona (Spain) and the University of Innsbruck (Austria), indicate a connection between bad bite and poor posture.

“When there is a malocclusion, it is classified according to scientifically established criteria. What is relevant in the study is that malocclusions have also been associated with different motor and physiological alterations,” explains Sonia Julià-Sánchez to Sinc, the main author of the studies and a researcher at the Catalan University.

Both studies, whose results have been published in Motor Control and Neuroscience Letters, provide conclusive data which show that postural control is improved -both in static and dynamic equilibrium- when different malocclusions are corrected by positioning the jaw in a neutral position.

It has been known that athletic performance can be enhanced through bite guards as well as other means of bite correction. These studies further emphasize the role occlusion plays in the prevention of injuries such as sprains, strains and fractures caused by unexpected instability as fatigue increases and motor control capacity decreases.

“Therefore, it would be helpful for both the general population and athletes to consider correcting dental occlusions to improve postural control and thus prevent possible falls and instability due to a lack of motor system response,” adds Julià-Sánchez.

“Postural control is the result of a complex system that includes different sensory and motor elements arising from visual, somatosensory and vestibular information,” explains the expert.

Dr. Julià-Sánchez explains neurophysiological aspects of the phenomenon. There is a reciprocal influence between the trigeminal nerve and the vestibular nucleus ‑which are responsible for the masticatory function and balance control, respectively‑ as well as between the muscles of mastication and of the neck.

This influence would explain why dental malocclusions negatively affect postural control. Up until now, however, there was no conclusive research.

“The main problem stems from the fact that the majority of these studies had statically assessed balance under conditions of total stability, which in practice has little actual application in the control of posture while in action,” points out Julià-Sánchez.

The first study took into account the type of dental occlusion as well as whether there had been previous orthodontic treatment. The results showed that alterations in alignment of the teeth were related to poorer control of static balance.

The second study assessed the type of dental occlusion, control of posture and physical fatigue in order to analyze a possible relationship among these factors. The analysis demonstrated that balance improved when malocclusions were corrected, and that the latter had a greater impact on postural control when subjects were fatigued than when they were rested.

The take home lesson from these studies is that, no matter what age or occupation, malocclusion should be corrected. This could at the least prevent falls and accidents.

So see your dentist regularly and ask about your “bite.”


Diabetes Leads to Gum Disease; Gum Disease leads to Diabetes

Poorly controlled diabetic patients are at risk for numerous oral complications such as periodontal disease, salivary gland dysfunction, infection, neuropathy, and poor healing.

Diabetes mellitus (diabetes) is a common chronic disease of abnormal carbohydrate, fat, and protein metabolism that affects an estimated 20 million people in the United States, of whom about one third are undiagnosed. There are two major forms recognized, type-1 and type-2. Both are characterized by inappropriately high blood sugar levels (hyperglycemia). In type-1 diabetes the patient cannot produce the hormone insulin, while in type-2 diabetes the patient produces insulin, but it is not used properly. An estimated 90% of diabetic patients suffer from type-2 disease.

The causes of diabetes are multiple and both genetic and environmental factors contribute to its development. The genetic predisposition for type-2 diabetes is very strong and numerous environmental factors such as diet, lack of exercise, and being overweight are known to also increase one’s risk for diabetes. Diabetes is a dangerous disease which affects the entire body and diabetic patients are at increased risk for heart disease, hypertension, stroke, kidney failure, blindness, neuropathy, and infection when compared to nondiabetic patients. Diabetic patients also have impaired healing when compared to healthy individuals. This is in part due to the dysfunction of certain white blood cells that fight infection.

The most common test used to diagnose diabetes is the fasting blood glucose. This test measures the glucose levels at a specific moment in time (normal is 80-110 mg/dl). In managing diabetes, the goal is to normalize blood glucose levels. It is generally accepted that by maintaining normalized blood glucose levels, one may delay or even prevent some of the complications associated with diabetes. Measures to manage diabetes include behavioral modification (proper diet, exercise) and drug therapies (oral hypoglycemic, insulin replacement).

The choice of therapy prescribed takes into consideration the type and severity of the disease present and patient compliance. The physician may request the patient keep a log of their daily blood glucose measurements, to better assess therapeutic success. Another commonly obtained test is the hemoglobin A1c (HbA1c), which is a surrogate marker used to assess blood glucose levels over an extended period (2-3 months). This test provides the physician with a good picture of the patient’s glucose levels over time.

Oral changes are evident in poorly managed diabetics. These patients are at risk for numerous oral complications such as periodontal disease, salivary gland dysfunction, infection, neuropathy, and poor healing. None of these complications are unique to diabetes. However, their presence may serve as an early clue to the possible presence of diabetes, prompting your dentist to perform or request further testing.

Periodontal disease is a commonly observed dental problem for patients with diabetes. It is similar to the periodontal disease encountered among nondiabetic patients. However, as a consequence of the impaired immunity and healing associated with diabetes, it may be more severe and progress more rapidly. The potential for these changes points to the need for periodic professional evaluation and treatment.

In conclusion, we can summarize the above by citing the American Dental Association, which states that those with diabetes are more at risk for getting periodontal disease; and those with periodontal disease are more likely to contract diabetes.

Good hygiene and regular visits to the dentist will lower our risk for gum disease as well as diabetes and other diseases. Keeping your blood sugar level within the normal range by proper diet and exercise will keep your body healthy and lower the risk of gum disease.

(This column is partly based on statements of the American Academy of Oral Medicine.)


Gum Disease Can Raise Your Blood Sugar Level

According to the American Diabetic Association, roughly 10% of the U.S. population have diabetes and about 30% (84 million) have prediabetes. 1.5 million Americans are diagnosed with diabetes. It is the 7th leading cause of death in the U.S.

Now for the good news.

It has been known for a long time that people with diabetes, especially uncontrolled diabetes, have more gum disease than those without diabetes. According to the American Dental Association, scientists are finding that gum disease may raise blood sugar levels in people with and without diabetes. Conversely, the good news is that in people with type 2 diabetes, treatment of severe gum disease can lead to a drop in blood sugar levels. The benefit is about the same as you might find if you add another drug to your usual diabetes medicine.

For the 84 million Americans who have prediabetes, there is also good news. The American Dental Association has reported a study in Denmark that showed periodontitis accelerates the progression of prediabetes into diabetes. Hence treating and controlling periodontitis is a way to lower the risk onset of diabetes for these 84 million American who are pre-diabetic.

How would one know whether or not one is already pre-diabetic? When you see your physician on a regular basis for routine blood tests, screening for diabetes will reveal your status. One of the clues to whether you have additional risk factors for diabetes is a family history of diabetes. And incidentally one of the risk factors for gum disease is family history of gum disease and loss of teeth.

How does gum disease make blood sugar levels go up? Scientists think that some of the germs in infected gums lead into the bloodstream after normal activities such as chewing or tooth brushing. This starts a reaction from your body’s defense system, which in turn produces some powerful molecules (biochemicals, such as cytokines) that have harmful effects all over your body. One of the things these molecules do is to raise blood sugar levels.

Since fully 40% of the population has issues with diabetes or prediabetes, and half of the population have periodontitis, it is essential that everyone visit the physician and the dentist regularly. It will save your life and your teeth.

Healthy teeth mean a healthy life. A healthy life means healthy teeth.


Gum Treatment Reduces Pain of Rheumatoid Arthritis

“After gum treatment my arthritis pain is at least 65% better.”

Mary, age 63, has been suffering from rheumatoid arthritis (RA) for five years. Her suffering has been particularly from pain and swelling in the joints of the wrists, hands and toes. Because of the severity of the symptoms, her rheumatologist insisted that she see the dentist for treatment of noticeable oral infections. Her rheumatologist told her that removing sources of infection from the oral cavity may very well lessen the severity of her condition.

Having been a reader of my columns for many years, she chose to come to this office for treatment. After uneventful non-surgical gum treatment, she was thrilled that pain had subsided by so much. Mary also said that she felt more energetic and definitely more enthusiastic about life. Even her complexion cleared up.

Although we cannot predict the exact effect of gum treatment in every case involving rheumatoid arthritis, Mary’s experience is not uncommon in my practice. We have seen many cases just like Mary’s. In fact this association between rheumatoid arthritis and gum treatment has been reported in various medical and dental journals for at least the past ten years. But what is the science behind this improvement?

A recent study published by the American Rheumatism Association compared the dental health of 44 patients with rheumatoid arthritis (RA) with 44 healthy patients. With 95% confidence level, the study concluded that RA patients are more at risk for gum disease (periodontitis). Thus, being more susceptible to gum disease. It came as no surprise, since a previous study also showed that patients with rheumatoid arthritis may have a higher risk for gum disease (periodontitis) In an article published in January, 2008, in the Journal of Rheumatoid Arthritis, called”Association of periodontal disease and tooth loss with rheumatoid arthritis in the US population,” it was concluded that “RA (rheumatoid arthritis) may be associated with tooth loss and periodontitis.” This study involved 4461 patients.

What is interesting is that a third study published in June, 2009, in an issue of the Journal of Periodontology titled, “Periodontal Therapy Reduces the Severity of Active Rheumatoid Arthritis in Patients Treated With or Without Tumor Necrosis Factor Inhibitors,” showed that non-surgical treatment of gum disease “had a beneficial effect on signs and symptoms of RA.” The latter study was a collaborative project between the Division of Rheumatology, University Hospital Case Medical Center, Cleveland, Ohio, and the Department of Periodontology, School of Dentistry of Case Western Reserve University. This study involved forty rheumatoid arthritis patients who also had been diagnosed for moderate or severe gum disease. Twenty received non-surgical gum treatment and the other twenty received no gum treatment. Six weeks of objective observation by rheumatologists and blood tests were done.

The story that these three studies tells is that RA patients tend to get gum periodontitis which, if treated, may likely reduce symptoms of RA.

How are these two disorders related? According to the summary of the literature, as reported in this article, rheumatoid arthritis and periodontitis (gum disease) share some common characteristics. Rheumatoid arthritis is an inflammatory disease wherein the autoimmune system attacks the hard and soft tissue of the joints. Periodontitis is a bacterially incited inflammatory disease wherein the autoimmune system attacks and hard (bony) and soft (gum) tissue around the teeth. Bacteria that cause gum disease have been found in the joints of patients with rheumatoid arthritis. Patients with rheumatoid arthritis have been shown to have more antibodies against bacteria that cause gum disease than those patients without rheumatoid arthritis. Artificially induced rheumatoid arthritis has been associated with development of gum disease in some laboratory experiments.

Hence it appears that studies reported in both medical and dental journals acknowledge the association between rheumatoid arthritis and periodontitis. Although there is no scientific basis to definitively conclude that there is a “causal” relationship as yet, there is no downside risk in having one’s gum disease treated, no matter whether you have rheumatoid arthritis or not. Furthermore there is no dispute that removing infection from the gums and the mouth will not only save teeth, but also certainly improve one’s general health. In conclusion, for the rheumatoid arthritis patient who has gum disease and everybody else, only good can come out of seeing the dentist. So see your dentist regularly.

You can’t lose.


Jowl Lines May Be Caused by Grinding Your Teeth (Bruxism)

There is a muscle that attaches the corners of our mouth to the border of the lower jaw. It is called the “depressor anguli oris.” It is also called the “triangularis”. Triangularis is a muscle of facial expression. Specifically it allows us to frown. It stands to reason if we frown a lot, we are likely to over-develop this muscle.

The consequence is “jowl lines” that go at an angle from the corners of the mouth to the bottom of the lower jaw.

The bad news is that you don’t have to frown a lot to get jowl lines. You can get jowl lines just from unconsciously clenching and grinding your teeth. You would be doing something a lot of people do unconsciously during sleep, and even during the awake hours. This unconscious habit is called bruxism. According to the American Sleep Disorders Association, the prevalence of bruxism varies from 5 to 20 percent.

The wide range is due to reporting something you are not, by definition, aware of. Your dentist can with some confidence diagnose you as having bruxism if you have obvious signs of excessive wear on your teeth that cannot be attributed to what you eat and chew. If you are told you have bruxism, don’t fight it. Excessive wear of your teeth is forensic evidence you are unconsciously doing it during the daytime, or you are doing it while you are in certain stages of sleep.

So what do you do with habit? It needs to be changed. How? Your dentist can make you a specially designed and calibrated oral appliance that gives you an ideal bite. This ideal bite will lessen the tendency to clench and grind. But to change the habit, you will need to wear this appliance 24 hours per day for at least 6 months and often as long as two years. While you wear the appliance, you must remember to use it as a “biofeedback appliance” that will train your muscles not to clench and grind.

Every time you bite into it, you will be able to tell you are doing so. After a period of time, the muscles will learn not to clench or grind. This is just like training your muscles to golf or play tennis. It takes practice.

The bite appliances are not obtrusive nor obviously visible, especially if your dentist makes it to fit over your lower teeth. The benefits would be that you won’t wear your teeth down and you won’t get “frown” or “jowl” lines in your face.

Seeing the dentist can give you good dental health, as well as save you from facelifts, botox injections or dermal fillers. Don’t forget your regular checkups.


Maintaining Good Health by Taking Care of Your Toothbrush

Most dentists agree you should change your toothbrush at least every two to three months.

According to a recent report, “20 Things You Should Throw Away For Better Health”, by TIME (1/30, Jones) a toothbrush is one of these things. The American Dental Association (ADA) spokesman, Ruchi Sohota, was quoted to say, “Toothbrush bristles start to fray after two months and should be replaced by three months”.

After daily wear, a toothbrush can get worn and become less effective in cleaning teeth and gums. Bacteria, germs, and fungus can flourish in between the bristles. Putting a wet toothbrush in an enclosed case can cause mold to grow on it. Let your toothbrush dry before putting it a case.

It is very important to change your toothbrush after you have had a cold, flu, mouth Infections, cold sores, and sore throat. This will help you from re-infecting yourself and others. Even if you are not sick, bacteria and fungus can still grow on your toothbrush.

Always rinse, shake any excess moisture, and air dry your toothbrush after you brush your teeth. Also try to keep your toothbrush away from any flushing commode because of germs that may travel with any aerosols.

Taking care of your tooth brush can help you have a healthier 2015!

Obesity and Gum Disease

There is a connection between obesity and gum disease, says a study conducted at the Case Western University School of Dental Medicine and published in the British Dental Journal recently.

This study showed that increased body mass, waist circumference and percentage body fat may be associated with increased risk to gum disease. However, there is, yet, not enough concrete evidence to establish a cause and effect connection.

Nevertheless, this study showed that changes caused by obesity or gum disease create changes in body chemistry which leads to inflammation. The more the inflammatory burden in the body, the more likelihood for diseases of an inflammatory nature, such as diabetes, heart disease and pulmonary disorders to develop.

On the other hand, the more we can reduce inflammation in the body, the healthier we are, the longer and healthier our lives. This column has previously discussed the statistical connection between gum disease (periodontitis) and variety of systemic diseases, such as Alzheimer’s, cardiovascular disorders, pancreatic cancer, ulcers and pulmonary diseases, all of which involved abnormality in the level of chronic inflammation. Therefore, resolving gum disease just may reduce the risk of developing the above conditions. And perhaps keeping the gum healthy will also lessen the risk of obesity.

The new “thought” of the researchers is that perhaps effectively treating obesity may also reduce the risk of periodontal disease as well as other inflammatory disease of the body.

It is entirely possible that eliminating obesity may also make the treatment of periodontal disease more effective and long lasting.

See your dentist regularly. Keep your teeth and your health all the same time!


Getting Teeth Cleaned Reduced “Bad” Cholesterol by 30%

A study of 273 aboriginal Australians showed that treatment of gum disease with “deep cleaning” was so able to reduce the thickness of the carotid artery that this change can be equated to having reduced “bad cholesterol” by 30%.

This study was conducted by the University of Sydney and published in Hypertension online June 23, 2014. The author, Michael Skilton, BSc, PhD, said that,” The study shows that the non-surgical periodontal therapy significantly reduced the progression of thickening of the carotid artery over a one-year period”. He further explained, “The effect is comparable to a 30 percent [decrease] in low-density lipoprotein cholesterol [levels]—commonly referred to as ‘bad’ cholesterol—which is associated with a decreased risk of heart disease”.

Dr. Skilton led a team of researchers from The University of Sydney and other Australian and U.S. institutions. They enrolled 273 aboriginal Australians who had periodontitis in a parallel-group, open-label, randomized clinical trial. Participants in the intervention group received full-mouth periodontal scaling during a single visit. Those in the control group received no treatment.

Follow-up data were available for 169 participants at three months and 168 participants at 12 months.

After 12 months, participants in the intervention group had experienced a significant decrease in intima-media thickness—an indicator of arterial structure—but those in the control group did not, the authors reported. In contrast, there were no significant differences between the groups in pulse wave velocity, an indicator of arterial function.

“Future studies may tell us whether a more intensive approach to periodontal therapy, including regular periodontal maintenance schedules, can produce more marked improvements in vascular structure,” Dr. Skilton said.

So don’t wait when you have gum disease.

See your dentist and save your life.

Children Health

Saliva Can Predict Diabetes

Certain proteins (biomarkers) in the saliva of children have been identified to be possible predictors of Type II diabetes in a study published online in Public Library of Science June, 2014.

Based on this study, it is anticipated that salivary testing can in the future displace other more invasive methods, such as blood tests. It is speculated that in the future, saliva collected during a dental visit can be used to help diagnose medical conditions in conjunction with your physician.

The present study was conducted by researchers from the Forsyth Institute in Cambridge, Mass. They evaluated metabolic differences in 774 11-year-old children who were underweight, of normal healthy weight, overweight or obese.

In this study four salivary biomarkers, including insulin and C-reactive protein, changed with increasing obesity. Other biomarkers can be identified in future studies that can be used to diagnose or prognosticate (predict) risk of disease, regardless of body weight.

The advantage of salivary testing is that it is non-invasive and can be easily used to screen large numbers of people, especially children. This sort of non-invasive testing is important in developing disease prevention programs focused on children.

Called Salivary Diagnostics, this kind of testing “could provide a more acceptable alternative, which could create a new paradigm for research in preventive health,” said Dr. Max Goodson, author and senior member of the staff at Department of Applied Oral Sciences at The Forsyth Institute.

More and more your dentist will be corroborating with your physician. Working together to bring you better dental health as well as system health. Seeing your dentist regularly has become even more important than ever.

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