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August 2016

Childrens Dental Care Delray CPP-ACP Varnish Inhibits More Demineralization

Varnishes with fluorides are standard tools in dental hygiene. But not all varnishes are created equal. According to a recent study, one varnish with casein phosphopeptide stabilized amorphous calcium phosphate (CPP-ACP) in addition to fluoride outperformed its peers in inhibiting enamel demineralization. The researchers examined Premier Dental’s Enamel Pro with amorphous calcium phosphate; 3M ESPE’s Clinpro White with functionalized tricalcium phosphate; GC America’s MI Varnish with CPP-ACP; Colgate’s Duraphat (first no added calcium control); VOCO’s Profluorid (second no added calcium control); and a placebo (no added calcium or fluoride control). Next, the researchers cut 36 human enamel slabs in half and covered each half with one of the 6 varnishes to create a window. These half-slabs were individually immersed in a polyacrylate demineralization buffer pH 4.8 for 4 days at 37°C with a change of solution each day. Transverse microradiography was used to determine mineral content. All of the varnishes with fluoride significantly inhibited enamel demineralization compared to the placebo varnish. Yet the researchers noted that MI Varnish, with fluoride and CPP-ACP, was superior to the others in protecting against enamel demineralization. The study, “Effect of Calcium Phosphate Addition to Fluoride Containing Dental Varnishes on Enamel Demineralization,” was published by the Australian Dental Journal. Related Articles Pediatricians Seek Collaboration After New Task Force Recommendation on Fluoride Varnish SDF Alternatives Examined for Treating Childhood Caries Study Examines Erroneous Diagnoses of Caries

Childrens Dental Care Delray Dr. Azhar Ilyas of the Baylor College of Dentistry is researching materials that accelerate implant healing to 5 weeks.

Dental implants typically take 2 to 4 months to heal. Yet research from the Texas A&M University Baylor College of Dentistry uses principles gleaned from electrical engineering to accelerate that process to 5 weeks. Also, the results could be extended to other bone implant systems. “In this study, we showed that the fabrication of nanoscale films as coatings for implantable devices healed large bone defects within a 5-week period,” said Dr. Azhar Ilyas, a postdoctoral research associate who works in the lab of assistant professor Dr. Venu Varanasi at the school. “The beauty of our work is that we can tune and tweak the material’s properties in such a way that the bone chemistry of the newly generated bone exactly matches the surrounding bone,” added Ilyas, who has a BS in electrical engineering, enabling him to use high-precision, nanoscale fabrication methods applied in semiconductors and solar cells. Since oral and maxillofacial bone has different biochemical properties, Ilyas said, he and his colleagues can modify the material properties accordingly. Changes on the bone’s surface and at the cellular level complement each other. “The surface chemistry promotes osteogenesis while nanostructured surface morphology enhances cellular response and improves osteointegration via mechanical bonding,” Ilyas said. The research is funded by a $228,000 National Institutes of Health R03 grant and supplementary grants. Ilyas also has received a merit-based travel award from the Texas A&M Health Science Center Postdoctoral Association to present his work at the 2016 American Association for Dental Research annual meeting in Los Angeles, March 16-19. Related Articles The Advantages of the Morse Taper Dental Implant Connection Study Identifies Peri-Implantitis Risk Factors Antibacterial Glass Inhibits Peri-Implant Disease

Childrens Dental Care Delray Professional Groups Defend Flossing’s Effectiveness

Dentists have been advising their patients to floss for decades. However, the Associated Press shook up this conventional wisdom yesterday with a report that said the evidence behind flossing’s effectiveness has not been reliable. While social media exploded with consumers expressing joy in believing that they don’t need to floss anymore, prominent dental associations countered with support for the practice. The ADA issued a statement reiterating its view that interdental cleaners such as floss are essential to oral health. The organization noted that cleaning between teeth removes plaque and debris from areas where brushes don’t reach, decreasing the risks of gum disease and tooth decay. The ADA also said that these tools require proper techniques to be effective, though, so dentists may need to teach their patients how to floss correctly. The American Academy of Periodontology (AAP) also issued a statement recommending daily flossing as part of regular oral hygiene. The AAP said that accumulated plaque bacteria beneath the gumline may cause an inflammatory response that could lead to gingivitis, periodontitis, tooth loss, and even other systemic illnesses like diabetes and heart disease. Furthermore, the AAP said that periodontal disease develops slowly and is caused by multiple factors, so studies examining flossing’s efficacy need to be conducted throughout a number of years and among a large population. The AAP concedes that current evidence doesn’t use a large sample size or examine gum health during a significant amount of time, and many existing studies don’t measure true markers of periodontal health such as inflammation or clinical attachment loss. In the absence of quality research, the AAP concludes, patients should continue to floss. The Canadian Dental Association (CDA) agrees that flossing is part of healthy gum and tooth maintenance and calls it an effective preventive measure for removing plaque. It also says that the weakness of the evidence supporting flossing’s value in preventing gum disease reflects the difficulty of conducting the necessary studies, not the value of flossing for maintaining good oral health. Admitting that flossing can be difficult, the CDA provides clear instructions for doing it properly. The ADA offers an online video tutorial as well. In fact, while 53% of readers in a 2015 poll said they brush before they floss and 47% said they brush after, the ADA says flossing is effective anytime as long as it’s done once a day and done correctly. For more information, tune in to the August 10 edition of the Wednesday Watch next week. Related Articles Survey Proves Your Patients Lie About Flossing (Gasp!) Flossing May Cause Peri-implant Disease Rethinking Oral Hygiene Instructions

Childrens Dental Care Delray Mack Watson

Discharged members of the armed services no longer get dental coverage through the Veterans Health Administration, due to budgetary constraints. The Arthur A. Dugoni School of Dentistry in San Francisco has stepped in to fill this gap with a reduced-fee program to ensure veterans have access to affordable care. “Our clinics serve people from all walks of life and many Bay Area communities, and we are excited to offer this program to men and women who have served their country and are looking to improve both their oral health and overall general health,” said Dr. Sig Abelson, associate dean for clinical affairs at the school. The program provides services at the Denti-Cal rate, which often is up to 30% or 40% off the typical rate of private dental practices. Payment plans are available for those who qualify. Dental students and residents provide care under faculty supervision at the school’s clinic, located at 155 Fifth Street, accessible by the BART/muni mass transit system. Procedures include checkups, cleanings, fillings, scaling and root planing, removable partial dentures, crowns, endodontic procedures, implants, and more. Patients with flexible schedules are welcome, as appointments often have extended times, and multiple visits may be required. Also, the school hosted a clinic that offered free oral health checkups to local veterans on November 17. Conducted by 8 students and 5 faculty and staff volunteers, the examinations included blood pressure checks, oral cancer screenings, dental health screenings, and oral health information. “Volunteering at this event made me realize that dental care benefits for our veterans are definitely lacking,” said Phillip Duong, a student in the school’s DDS class of 2016. “As a soon-to-be Pacific alumni, I’m so proud of my school for offering extended dental coverage to our veterans. These great men and women deserve it for all they have done for our country.” The 27 veterans who attended the free checkup also received an oral health gift bag, along with information about the school’s dental services and how to become a patient. To learn more about the school’s ongoing program, veterans should call (415) 929-6501. Related Articles Virtual Dental Homes Improve Care and Cut Costs Minorities Face Disparities in Oral Care $2.4 Million Grant to Boost Virginia Pediatric Care

Childrens Dental Care Delray Toothpaste Remineralizes Teeth to Prevent Decay

Researchers from Queen Mary University of London have developed a toothpaste that slowly releases calcium, phosphate, and fluoride ions during an 8- to 12-hour timeframe to form fluorapatite material, which rebuilds, strengthens, and protects tooth structure. The slow release of fluoride also is beneficial in preventing tooth decay. “Using remineralizing material makes teeth far more resistant to attack from acidic soft drinks like fruit juices and sodas,” said professor Robert Hill, chair of dental physical sciences and leader of the research team. “It is also much more effective than conventional toothpastes where the active ingredients, such as soluble fluoride, are washed away and become ineffective less than 2 hours after brushing.” The toothpaste includes a substance the researchers call BioMin, which is based on calcium phosphor-silicates, otherwise known as bioactive glass. When the glass encounters bacteria-metabolizing sugars or acidic beverages, it dissolves quickly to raise the pH level and release calcium, phosphate, and optionally fluoride ions to minimize the acid dissolution of the enamel apatite crystals. BioMin also helps with tooth sensitivity, which affects about 40% of all dental patients. It is caused by open tubules in the teeth that allow access to nerve receptors. Toothpastes with BioMin seal these tubules with acid-resistant fluorapatite, which acts as a barrier to the hot and cold that’s transmitted inside the tooth. “The technology behind BioMin is not exclusively designed for toothpastes,” said Hill. “It can also be incorporated in other professionally applied dental products such as cleaning and polishing pastes, varnishes, and remineralizing filling materials.” Along with Dr. David Gillam, Hill is one of the cofounders of BioMin Technologies, which plans on commercializing the material. So far it has developed BioMinF, which includes fluoride ions, and BioMinC, which includes chloride ions, both mimicking the natural biological mineralization process of enamel. Related Articles Bioactive Glass Leads to Longer-Lasting Fillings Antibacterial Glass Inhibits Peri-Implant Disease Silica Particles Could Fix Damaged Teeth

Childrens Dental Care Delray ADA Approves Code for Canary System

The ADA has approved the addition of a procedure and billing code for caries detection for its 2017 ADA Fee Guide. The code, “Non-ionizing diagnostic procedure capable of quantifying, monitoring, and recording changes in structure of enamel, dentin and cementum,” enables dentists to bill for exams that use the Canary System, effective January 1, 2017. Developed by Quantum Dental Technologies, the Canary System is a non-ionizing diagnostic caries detection device that can quantify, monitor, and record changes in the structure of enamel, dentin, and cementum. Its crystal structure diagnostics lets users detect, image, and measure tooth decay on all surfaces, around restoration margins, and beneath opaque sealants in addition to detecting cracks in teeth. However, the code might not cover other detection methods using visual examination, explorers and other tactile probes, fluorescence, or translumination with visible light (not near-infrared light) because of their inability to detect changes in all of the tissues or to record and quantify changes in those tissues. “This billing code establishes the importance of ongoing examination of caries with appropriate modalities so that dentists can provide a wide range of treatment options and monitor outcomes,” said Dr. Stephen Abrams, president of Quantum Dental Technologies. “It offers patients and dentists another option that does not involve ionizing radiation to detect caries.” Related Articles

Childrens Dental Care Delray This dental abutment is partially coated with antibacterial glass. Plaque has accumulated on the uncoated area.

Three glass coatings developed by the Nanomaterials and Nanotechnology Research Center (CINN) in Spain can be used to control peri-implant infection and subsequent disease. During a peri-implant disease induction model carried out in 5 dogs, the application of bioactive glass on implantable medical devices inhibited the formation of surface biofilms both in vitro and in vivo. One of the glasses, G3, showed an especially remarkable ability to prevent bacterial colonization and slow down disease progression, according to CINN. The glass coatings also could be used with other medical implants such as joint replacements, metal heart valves, and catheters, which all face the risk of bacterial colonization. In fact, bacterial colonization is the main cause of total knee arthroplasty failure and the third leading cause of total hip replacement failure, CINN says. The researchers envision uses beyond medicine as well. For example, the coatings could be used in air conditioning devices to prevent Legionella growth, which causes epidemic outbreaks and even death. CINN is a joint center of the Spanish Council of Scientific Research, the University of Oviedo, and the Principality of Asturias. Its researchers worked with the Institute of Advanced Oral Surgery of Madrid and the Center for Minimally Invasive Surgery Jesús Usón in developing the bioactive glass. PlosOne published their study. Related Articles Necessity of Antibiotics After Implants Questioned Biomarkers Tallied for Peri-Implant Disease Potential Flossing May Cause Peri-Implant Disease

Childrens Dental Care Delray AsapSCIENCE notes the physiological benefits of meditation

Mindfulness is the skill of learning to pay attention to one’s present experience without judgment. It boosts wellbeing by significantly reducing anxiety and stress while improving mood. Now, students at the University of Kentucky College of Dentistry (UKCD) are practicing mindfulness too. When the school launched a pilot program for first-year students in the fall of 2014, 75% of its participants used mindfulness techniques during the following semester. They described increased focus and attention in addition to less stress. Also, the students studied more effectively, regulated their emotions better, and saw a decrease in negative physiological reactions to stress. Specifically, students who had moderate to high levels of anxiety before starting the program showed a decrease in anxiety levels later. “Because I have personally utilized mindfulness and know the benefits, I will most definitely, as a future dentist, use and introduce this to my patients,” said UKCD student Bethany Burton.” After the pilot program, assistant dean of student affairs and adjunct faculty Christine Harper and Dr. Pam Stein VanArsdall, UKCD professor of oral health science, began instructor training in the Koru mindfulness method. Targeting college students and other emerging adults, Koru offers mind-body skills such as abdominal breathing and guided imagery, as well as insight meditation practice, that quickly reduce distress and build motivation to practice stress management. “Our students have a massive amount of information to absorb, as well as the difficult task of learning and perfecting their hand skills to perform a variety of oral surgeries and procedures. It’s very challenging, and we try to find ways to help students manage their anxiety and stress,” said VanArsdall. “Using an evidence-based practice, such as mindfulness, can help improve their quality of life while they are at UKCD,” VanArsdall said. “It’s truly a life skill they can use after graduation to help manage the stress and challenges of being a practicing dentist as well.” UKCD now offers its students an elective 4-week mindful meditation course. In groups of 10 to 12, students meet once a week for 75 minutes to discuss assigned reading and learn and practice mindfulness techniques. They also are asked to practice techniques for 10 minutes each day and keep a journal. During the course’s first session, students are asked why they are taking it. Common responses include the desire to relax between classes, the need to manage anxiety before tests, and a longing for help in balancing everything. TED talks on meditation also inspired some students to try the class, which is growing in popularity. “I’m very glad that I participated in the mindfulness course and have already recommended it to my classmates, especially if they are dealing with stress, poor sleeping habits, jumbling thoughts, or any other problem,” said UKCD student Austin Delpont. “To get the full benefit of mindfulness exercised, you have to buy in completely,” said UKCD student Troy Miller. “But if you fully immerse yourself in it, it will make a difference in your daily life.” Related Articles Trends Evolve in Dental School Admissions Emotional Intelligence Key to Student Success Behavioral Therapy Can Treat Dental Anxiety

Childrens Dental Care Delray Smoking Alters the Mouth’s Microbiome

The oral microbiome comprises approximately 600 bacterial species, and smoking drastically affects it, according to the New York University Langone Medical Center and its Laura and Isaac Perlmutter Cancer Center. According to the researchers, their work represents the most comprehensive study of the effects of smoking on bacteria in the mouth based on precise genetic testing. “Our study is the first to suggest that smoking has a profound effect on the oral microbiome,” said Jiyoung Ahn, PhD, the study’s senior investigator and epidemiologist. “Further experiments will be needed, however, to prove that these changes weaken the body’s defenses against cancer-causing chemicals in tobacco smoke, or trigger some other diseases in the mouth, lungs, or gut.” The study examined mouthwash samples from 1,204 American men and women whose health already was being monitored as part of ongoing risk studies funded by the National Institutes of Health and the American Cancer Society. Volunteers all were age 50 and older, with 112 smokers, 571 former smokers (17% of whom who had quit within the past 10 years), and 521 people who had never smoked. Using genetic tests to distinguish among the thousands of bacteria in each subject’s mouth, the researchers found that the oral microbiome of smokers differed significantly from those who had quit smoking or who had never smoked. They also found that the oral micobiome of smokers bounces back after they quit, with those who had not smoked for at least 10 years showing the same microbial balance as nonsmokers. More than 150 bacterial species showed significantly increased growth in the mouths of smokers, while 70 showed sharp decreases in growth. For example, smokers had relatively fewer species of Proteobacteria (at 4.6% of overall bacteria in the mouth) than nonsmokers (at 11.7%), with Proteobacteria involved in the breakdown of toxic chemicals introduced by smoking. Also, smokers had 10% more species of the tooth decay-promoting Streptococcus than nonsmokers. The study did not indicate how long it takes former smokers to rebalance their oral microbiomes after they quit, though further experiments are planned to determine the timeline for microbiome recovery. The researchers’ goal is to identify what happens biologically from smoking-related changes in the oral microbiome, and they plan to investigate how these changes influence cancer risk in the mouth and elsewhere in the body. The study, “Cigarette Smoking and the Oral Microbiome in a Large Study of American Adults,” was published by The ISME Journal. Related Articles Smokers More Likely to Lose Teeth Oral Bacteria Linked to Esophageal Cancer Bacteria Enlisted in Fight Against Cavities

Childrens Dental Care Delray Fusobacterium novum after being cultured in a thioglycollate medium.

Some bacteria known as fusobacteria that commonly are found in the mouth use a sugar-binding protein to stick to developing colorectal polyps and cancers, reports the Harvard T. H. Chan School of Public Health and Hebrew University-Hadassah School of Dental Medicine. Understanding this mechanism could help fight colorectal cancer, as it might help researchers develop ways to block fusobacteria from homing in on colorectal tumors, said Wendy Garrett, MD, PhD, the study’s co-senior author and associate professor of immunology and infectious diseases at the Chan School. “Alternatively, and perhaps more importantly, our findings suggest that drugs targeting the same or similar mechanisms of bacterial sugar-binding proteins could potentially prevent these bacteria from exacerbating colorectal cancer,” Garrett said. Colorectal cancer is the third leading cause of cancer-related deaths in the United States, and microbes have emerged as key factors that influence its development and progression. The researchers used human samples as well as mouse models to confirm their new findings. The study, “Fap2 Mediates Fusobacterium Nucleatum Colorectal Adenocarcinoma Enrichment by Binding to Tumor-Expressed Gal-GalNAc,” was published by Cell Host & Microbe. Related Articles Gum Disease Linked to Cancer Increase Among Nonsmokers Periodontal Disease Increases Lung Cancer Risks Statistics Alone Don’t Reveal Oral Cancer’s Terrible Toll

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