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Hid­den tooth in­fec­tions may increase risk of heart dis­ease



According to a study carried out at the University of Helsinki, an infection of the root tip of a tooth increases the risk of coronary artery disease, even if the infection is symptomless.

Hidden dental root tip infections are very common: as many as one in four Finns suffers from at least one. Such infections are usually detected by chance from X-rays. John Liljestrand, researcher said,

“Acute coronary syndrome is 2.7 times more common among patients with untreated teeth in need of root canal treatment than among patients without this issue,”

The study was carried out at the Department of Oral and Maxillofacial Diseases of the University of Helsinki, in cooperation with the Heart and Lung Centre at Helsinki University Hospital. Its results were published in the latest issue of the Journal of Dental Research.

Dental root tip infection, or apical periodontitis, is a bodily defence reaction against microbial infection in the dental pulp. Caries is the most common cause of dental root tip infection.

Today, information is increasingly available about the connection between oral infections and many common chronic diseases. For example, periodontitis, an inflammatory disease affecting the tissues that surround the teeth, causes low-grade inflammation and is regarded as an independent risk factor for coronary artery disease and diabetes. Dental root tip infections have been studied relatively little in this context, even though they appear to be connected with low-grade inflammation as well.

The study consisted of 508 Finnish patients with a mean age of 62 years who were experiencing heart symptoms at the time of the study. Their coronary arteries were examined by means of angiography, and 36 per cent of them were found to be suffering from stable coronary artery disease, 33 per cent were undergoing acute coronary syndrome, and 31 did not suffer from coronary artery disease to a significant degree. Their teeth were examined using panoramic tomography of the teeth and jaws, and as many as 58 per cent were found to be suffering from one or more inflammatory lesions. The researchers also discovered that dental root tip infections were connected with a high level of serum antibodies related to common bacteria causing such infections. This shows that oral infections affect other parts of the body as well. The statistical analyses took account of age, gender, smoking, type 2 diabetes, body mass index, periodontitis and the number of teeth as confounding factors.

Cardiovascular diseases cause more than 30 per cent of deaths globally. They can be prevented by a healthy diet, weight control, exercise and not be smoking. With regard to the health of the heart, measures should be taken to prevent or treat oral infections, as they are very common and often asymptomatic. Root canal treatment of an infected tooth may reduce the risk of heart disease, but more research is needed.

Source: J. M. Liljestrand, P. Mäntylä, S. Paju, K. Buhlin, K. A. E. Kopra, G. R. Persson, M. Hernandez, M. S. Nieminen, J. Sinisalo, L. Tjäderhane, P. J. Pussinen. Association of Endodontic Lesions with Coronary Artery Disease. J Dent Res 2016.

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Can These Proteins Cure Cavities?



Researchers at the University of Washington have designed a convenient and natural product that uses proteins to rebuild tooth enamel and treat dental cavities.

The research finding was first published in ACS Biomaterials Science and Engineering.

“Remineralization guided by peptides is a healthy alternative to current dental health care,” said lead author Mehmet Sarikaya, professor of materials science and engineering and adjunct professor in the Department of Chemical Engineering and Department of Oral Health Sciences.

The new biogenic dental products can — in theory — rebuild teeth and cure cavities without today’s costly and uncomfortable treatments.

“Peptide-enabled formulations will be simple and would be implemented in over-the-counter or clinical products,” Sarikaya said.

Cavities are more than just a nuisance. According to the World Health Organization, dental cavities affect nearly every age group and they are accompanied by serious health concerns. Additionally, direct and indirect costs of treating dental cavities and related diseases have been a huge economic burden for individuals and health care systems.

“Bacteria metabolize sugar and other fermentable carbohydrates in oral environments and acid, as a by-product, will demineralize the dental enamel,” said co-author Sami Dogan, associate professor in the Department of Restorative Dentistry at the UW School of Dentistry.

Although tooth decay is relatively harmless in its earliest stages, once the cavity progresses through the tooth’s enamel, serious health concerns arise. If left untreated, tooth decay can lead to tooth loss. This can present adverse consequences on the remaining teeth and supporting tissues and on the patient’s general health, including life-threatening conditions.

Good oral hygiene is the best prevention, and over the past half-century, brushing and flossing have reduced significantly the impact of cavities for many Americans. Still, some socio-economic groups suffer disproportionately from this disease, the researchers said. And, according to recent reports from the Centers for Disease Control and Prevention, the prevalence of dental cavities in Americans is again on the rise, suggesting a regression in the progress of combating this disease.

Taking inspiration from the body’s own natural tooth-forming proteins, the UW team has come up with a way to repair the tooth enamel. The researchers accomplished this by capturing the essence of amelogenin — a protein crucial to forming the hard crown enamel — to design amelogenin-derived peptides that biomineralize and are the key active ingredient in the new technology. The bioinspired repair process restores the mineral structure found in native tooth enamel.

“These peptides are proven to bind onto tooth surfaces and recruit calcium and phosphate ions,” said Deniz Yucesoy, a co-author and a doctoral student at the UW.

The peptide-enabled technology allows the deposition of 10 to 50 micrometers of new enamel on the teeth after each use. Once fully developed, the technology can be used in both private and public health settings, in biomimetic toothpaste, gels, solutions and composites as a safe alternative to existing dental procedures and treatments. The technology enables people to rebuild and strengthen tooth enamel on a daily basis as part of a preventive dental care routine. It is expected to be safe for use by adults and children.

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5 Unbelievable Ancient Dental Treatments



1. Ancient Italian Fillings

In March 2017 the American Journal of Physical Anthropology released a paper called “The dawn of dentistry in the late upper Paleolithic”.

The paper showed newly uncovered evidence for a dental practice in Tuscany, Italy, over 13,000 years ago. Two upper central incisors showed evidence of a cavity preparation by stone tools with traces of a crude filling material. The filling material was made of bitumen with plant fibres & hairs embedded into it!


2. Ancient Indian Bow Drills

The city of Mehrgarh contains a 9000 year old tomb where 11 drilled molars were discovered in 2001. In 2006 a research paper in Nature proposed that Mehrgarh was a centre of proto-dentistry in practice, in the ancient Indus Valley Civilisation. Bow Drills, also used for starting fires & woodwork, were used as dental drills.

Interestingly, the teeth were different ages, with the oldest being about 9000 years old & the most recent about 7500 years old. Perhaps this was a longstanding ancient dental practice?


3. Ancient Egyptian Toothpaste

“One drachma of rock salt – a measure equal to one hundredth of an ounce – two drachmas of mint, one drachma of dried iris flower and 20 grains of pepper, all of them crushed and mixed together.”

This is a 1700 year old recipe for a “powder for white and perfect teeth”, according to an Ancient Egyptian scribe. Interestingly, iris flower has been used by many civilisations as herbal medicine. The French symbol of the fleur-de-lis is thought to be a stylised Iris after King Louis supposedly had a dream, telling him to use the flower as the national flower of France.


4. Ancient Middle Eastern Toothbrush

A “miswak” is a teeth cleaning twig made from Salvadora persica tree twigs. Across Ancient Mesopotamia, Northern Africa & India, chewing twigs from trees which have natural antibacterial agents are still commonly used in many areas.

In 1986 the World Health Organisation recommended the use of chewing sticks but since 2000 studies showed that further evidence is needed before patients can be given this advice.


5. Ancient Etruscan Bridges

In Pre-Roman times Northern Italy was dominated by the Etruscans, where beautiful ox bone and gold wire bridges were created over 2500 years ago.

Intriguingly the bridges were a status symbol of the time, with women having a tooth extracted in order for an expensive bridge to be put in!


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8 Most Frustrating Moments Every Dentists Understands



1. Your equipment stops working.

It could be your chair, light, drill or light cure. It doesn’t matter – in this moment, nothing is more frustrating.

2. Your patient tells you they’re brushing twice a day & floss all the time.

But it’s obvious they’re lying to you…

3. Your patient just keeps closing their mouth!

Longest appointment ever.

4. Or their mouth opening is fine… their mouth is just tiny 😒


5. You put loads of effort into carving morphology into a restoration, only for it to fail within a week 🌚

6. Your patient keeps falling asleep.

Is the chair that comfy?

7. Your patient desperately needs treatment but they avoid it.


8. You’ve been treating your patient for absolutely ages and they don’t show up to a crucial appointment.


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