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Primary Teeth Health An Early Indicator of Adult Teeth

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A research team from Case Western Reserve University School of Dental Medicine found that health of primary teeth an early predictor of adult teeth.

Do children really need their baby teeth? Many believe that primary teeth aren’t all that important. After all, they typically fall out by age 12, and new, adult teeth take their place.

That line of thinking tends to leave experts in the dental community with a grimace.

In a practical and medical sense, the health of primary teeth is an early predictor of adult teeth. A research team headed by the Case Western Reserve University School of Dental Medicine sought to improve parents’ and caregivers’ perception of the importance of baby teeth.

The team’s findings were published in a recent article in Contemporary Clinical Trials.

Unlike other medical issues, tooth decay and cavities are preventable with adequate self-management strategies.

“Parents’ failure to recognize the importance of baby teeth is associated with adverse health habits and outcomes for their children, such as less tooth-brushing and a lower likelihood of having preventative dental visits and higher rates of tooth decay,” said Suchitra Nelson, assistant dean in the dental school’s Department of Community Dentistry, who leads the research.

Other researchers include Mary Beth Slusar and Jeffrey Albert, both also from the Case Western Reserve School of Dental Medicine, and Christine Riedy, from the Harvard University School of Dental Medicine.

Several ongoing, randomized clinical trials are testing oral health-behavior interventions to change outcomes. In addition, researchers are looking at the perceptions of chronic tooth decay and cavities between parents who did and did not believe baby teeth were important.

One approach used in self-managing chronic medical conditions is the Common Sense Model of Self-Regulation, a psychological framework describing the person’s perception of a chronic disease that drives coping and action planning.

In other words, changing parental perception is fundamentally important to view cavities and decay as a chronic disease, rather than an acute symptomatic disease, to improve dental outcomes.

Dental issues more disproportionately and adversely affect children in lower-income households. According to the article, about $450 million has been spent nationally on preventable dental conditions on Medicaid-enrolled children age 1 and 20 between 2010 and 2011.

The article notes that the Common Sense Model behavioral intervention can reach a wider audience—parents, providers and primary-care practices—to change perceptions about baby teeth and generally improve children’s oral health.

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Can These Proteins Cure Cavities?

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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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Is the Sweet Tooth Gene Connected With Having Less Body Fat?

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People with a gene variation of FGF21 have a predisposition to less body fat than others, new research conducted at the University of Copenhagen, among others, shows.

It comes as a bit of a surprise to the researchers, who last year discovered that precisely this genetic variation could be one of the reasons why some people have a particular craving for sweet things. People with this variation eat more sugar than others.

‘It sort of contradicts common intuition that people who eat more sugar should have less body fat. But it is important to remember that we are only studying this specific genetic variation and trying to find connections to the rest of the body. This is just a small piece of the puzzle describing the connection between diet and sugar intake and the risk of obesity and diabetes’, says one of the researchers behind the study, Associate Professor Niels Grarup from the Novo Nordisk Foundation Center for Basic Metabolic Research.

Higher Blood Pressure and More ‘Apple Shape’

But the effects associated with the genetic variation are not all positive, the new study shows. The genetic variation is connected with slightly increased blood pressure and more fat around the waist than the hips — that is, more ‘apple shape’.

The study is an international collaboration headed by researchers at the University of Exeter Medical School and has just been published in the scientific journal Cell Reports.

The researchers’ conclusions are based on large amounts of data. They have studied health information from more than 450,000 individuals who have allowed their data to be recorded in the UK Biobank. It includes blood samples, questionnaires on diet and genetic data, among other things.

‘Now that so many people are involved in the study, it gives our conclusions a certain robustness. Even though the difference in the amount of body fat or blood pressure level is only minor depending on whether or not the person has this genetic variation or not, we are very confident that the results are accurate. Around 20 per cent of the European population has this genetic predisposition’, says Niels Grarup.

Potential Drug Target

This new knowledge about people with a ‘genetic sweet tooth’ is mainly important in connection with the development of drugs and future research. Because researchers are currently trying to determine whether it is possible to target or replace FGF21 using drugs in order to treat for obesity and diabetes.

‘Due to its connection with sugar, FGF21 constitutes a potential target in the treatment of for example obesity and diabetes. This research helps us to understand the underlying mechanisms of the hormone and to predict its effects and side effects’, says Niels Grarup.

The study is funded by the European Research Council (ERC), the National Institute of Health (NIH) and the Novo Nordisk Foundation, among others.

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Losing Teeth During Middle Age Linked To An Increased Risk Of Cardiovascular Disease

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Losing two or more teeth in middle age is associated with increased cardiovascular disease risk, according to preliminary research presented at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions 2018, a premier global exchange of the latest advances in population-based cardiovascular science for researchers and clinicians.

Studies have shown that dental health problems, such as periodontal disease and tooth loss, are related to inflammation, diabetes, smoking and consuming less healthy diets, according to study author Lu Qi, M.D., Ph.D., professor of epidemiology at Tulane University in New Orleans.

“Previous research has also found that dental health issues are associated with elevated risk of cardiovascular disease,” Qi said.

“However, most of that research looked at cumulative tooth loss over a lifetime, which often includes teeth lost in childhood due to cavities, trauma and orthodontics. Tooth loss in middle age is more likely related to inflammation, but it hasn’t been clear how this later-in-life tooth loss might influence cardiovascular disease risk.”

In a collaborative research effort between Tulane University School of Public Health and Tropical Medicine and Harvard T.H. Chan School of Public Health, Qi and colleagues analyzed the impact of tooth loss in large studies of adults, aged 45 to 69 years, in which participants had reported on the numbers of natural teeth they had, then in a follow-up questionnaire, reported recent tooth loss. Adults in this analysis didn’t have cardiovascular disease when the studies began. The researchers prospectively studied the occurrence of tooth loss during an eight-year period and followed an incidence of cardiovascular disease among people with no tooth loss, one tooth lost and two or more teeth lost over 12-18 years.

They found:

  • Among the adults with 25 to 32 natural teeth at the study’s start, those who lost two or more teeth had a 23 percent increased risk of cardiovascular disease, compared to those with no tooth loss.
  • The increased risk occurred regardless of reported diet quality, physical activity, body weight and other cardiovascular risk factors, such as high blood pressure, high cholesterol and diabetes.
  • There wasn’t a notable increase in cardiovascular disease risk among those who reported losing one tooth during the study period.
  • Cardiovascular disease risk among all the participants (regardless of the number of natural teeth at the study’s start) increased 16 percent among those losing two or more teeth during the study period, compared to those who didn’t lose any teeth.
  • Adults with less than 17 natural teeth, versus 25 to 32, at the study’s start, were 25 percent more likely to have cardiovascular disease.

“In addition to other established associations between dental health and risk of disease, our findings suggest that middle-aged adults who have lost two or more teeth in recent past could be at increased risk for cardiovascular disease,” Qi said.

“That’s regardless of the number of natural teeth a person has as a middle-aged adult, or whether they have traditional risk factors for cardiovascular disease, such as poor diet or high blood pressure.”

Armed with the knowledge that tooth loss in middle age can signal elevated cardiovascular disease risk, adults can take steps to reduce the increased risk early on, he said.

A limitation of the study was that participants self-reported tooth loss, which could lead to misclassification in the study, according to Qi.

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