Tag: dental hygiene

Categories : DentistryTags :

Beyond the Smile: South Africa Must Prioritise Oral Health as a Public Health Imperative

On By ModernMedia
Photo by Hush Naidoo Jade Photography on Unsplash

South Africa’s burden of oral diseases is not only inextricably linked to non-communicable diseases but also presents an urgent public health challenge, with rising concern over its impact on mental health.

Oral diseases are a major health concern for many countries and negatively impacts people throughout their lives. Oral diseases lead to pain and discomfort, social isolation and loss of self-confidence, and they are often linked to other serious health issues. And yet, there is no reason to suffer: most oral health conditions are preventable and can be treated in their early stages.

Globally, every year on March 20, World Oral Health Day is commemorated with the aim to empower people with the knowledge, tools, and confidence to secure good oral health.

This year, the Day’s focus shifts to the mind-mouth connection, with the tagline from the FDI World Dental Federation: “A Happy Mouth Is… A Happy Mind”. This campaign aims to raise awareness of how poor oral health can negatively impact quality of life, highlighting the importance of a healthy mouth for mental well-being.

Macelle Erasmus, Head of Expert at Haleon South Africa – a leader in consumer health and self-care, says, “Oral health is not just about bright smiles and good-looking teeth – it is a critical component of overall well-being. In South Africa, the high prevalence of oral diseases, particularly among children and vulnerable communities, reinforces the urgent need for improved oral health education and preventive care.”

Haleon’s leading oral health brands Aquafresh and Sensodyne, are committed to improving oral health education and access across the country.

Over the course of just three months, we have conducted more than 39,000 gum health screenings across 16 clinics. In 2025, our expansion aims to reach 100,000 underserved communities as part of Haleon’s oral health care outreach programs.

According to the South African Dental Association (SADA), 41% of children aged 1-9 years and close to 28% of people aged 5 years and over experienced untreated tooth decay in milk and permanent teeth respectively, while nearly 25% of people aged 15 years and over experienced severe periodontal disease in 2019. The country also saw 1,933 new cases of lip and oral cavity cancer in 2020.

The World Health Organisation’s Global Strategy and Action Plan on Oral Health 2023–2030, explains that oral health encompasses a range of diseases and conditions. The most prevalent public health issues include dental caries, severe periodontal (gum) disease, complete tooth loss (edentulism), oral cancer, oro-dental trauma, noma and congenital malformations such as cleft lip and palate, most of which are preventable.

The main oral diseases and conditions are estimated to affect close to 3.5 billion people worldwide. These conditions combined have an estimated global prevalence of 45%, which is higher than the prevalence of any other NCD.

However, oral diseases and conditions share risk factors common to the leading NCDs, including all forms of tobacco use, harmful alcohol use, high intake of free sugars and lack of exclusive breastfeeding.

The Department of Health’s National Oral Health Policy and Strategy 2024-2034 acknowledges that oral health is poorly integrated in other health programmes, “though it is an integral part of general health.” It further recognises that: “Its role in management and care of communicable diseases, genetic disorders, trauma, injury, and violence is often overlooked.”

This integration is particularly important as more than three million patients are treated in the country’s public primary healthcare facilities annually, at a cost of R650 million. Addressing oral health holistically – within the broader healthcare system – can significantly reduce this burden.

Categories : Dentistry Diet and NutritionTags :

Do Starchy Carbs Cause Cavities?

On By ModernMedia
Photo by Caroline Lm on Unsplash

It’s common knowledge that sugar causes cavities, but new research provides evidence that – depending on your genetic makeup – starches could also be a contributing factor.

The study, published in Microorganisms, explores the response of the oral microbiome to starch, finding that the number of copies of a particular gene, AMY1, in combination with starch, alters the complex composition of bacteria that play a role in oral health.

“Most people have been warned that if you eat a bunch of sugar, make sure you brush your teeth,” said Angela Poole, senior author and assistant professor of molecular nutrition in the College of Agriculture and Life Sciences and the College of Human Ecology. “The takeaway finding here is that depending on your AMY1 copy number, you may want to be just as vigilant about brushing your teeth after eating those digestible starches.”

Researchers, including first author Dorothy Superdock, PhD ’23, collected saliva samples from 31 subjects with a range of AMY1 copy numbers – copies of the AMY1 gene in the DNA – and added starch to the cultured samples, or biofilms, to see how the bacterial makeup changed. They found that, in general, the diversity of bacteria decreased when starch was added. For those samples with high numbers of AMY1, the starch significantly reduced the proportions of two bacteria, Atopobium and Veillonella, while Streptococcus appeared to increase.

All three bacteria are associated with tooth decay or gum disease, Poole said.

“Some increased and some decreased, so it’s not so straightforward as saying, ‘The whole thing is good or bad,’” Poole said. “It’s an interaction, but it looks like the AMY1 copy number, as well as which species are present in people’s mouths when they eat starch, is affecting the risk for developing these diseases.”

AMY1 codes for the salivary amylase enzyme, which helps break down starch in the mouth. Previous studies have associated AMY1 with cavities and periodontal disease. Poole, in prior studies, found that a high AMY1 copy number is associated with higher levels of the species Porphyromonas endodontalis, which is strongly associated with periodontitis and gum disease.

But how the salivary amylase enzyme interacts with its main substrate, starch, to alter the oral microbiome and increase disease risk was unclear.

“That’s what we wanted to know in this experiment,” Poole said. “What’s going on in the mouth if someone eats starch, and is the answer different if their copy number is high or if it’s low? What we found was that there are other bacteria involved in these processes and that the changes depended on AMY1.”

The researchers also found evidence that the oral microbiome has co-evolved in response to increasing copies of AMY1, which is found in higher numbers in populations where there’s a long history of agriculture and starch consumption. In the pool of 31 samples, taken locally in Ithaca, the AMY1 number ranged from two to 20 copies.

“The populations that historically had greater access to starch tend to have more copies,” Poole said, “which makes sense from a practical standpoint, because it would have given you a survival advantage when food is scarce, to be able to break down those starches more efficiently.”

In saliva samples with a high AMY1 copy number, the researchers saw increased populations of bacteria, like Streptococcus, that feed off the starch’s sugars.

“If someone has a high copy number, they break down starch efficiently, and bacteria that like those sugars are going to grow more in that person’s mouth,” Poole said. “So you can have species behave differently based on the different substrates. It’s pretty incredible – how we adapt and these microbes turn around and adapt, too.”

Source: Cornell University

Categories : Dentistry Respiratory DiseasesTags :

Can Toothbrushing Reduce Rates of Hospital-acquired Pneumonia?

On By ModernMedia
Photo by Towfiqu barbhuiya: https://www.pexels.com/photo/a-toothbrush-with-toothpaste-on-a-white-surface-12065623/

A new study by investigators from Brigham and Women’s Hospital examined whether daily toothbrushing among hospitalised patients is associated with lower rates of hospital-acquired pneumonia and other outcomes. Their analysis of 15 randomised clinical trials found that hospital-acquired pneumonia rates were lower among patients who received daily toothbrushing compared to those who did not. The results were especially compelling among patients on mechanical ventilation. Their results are published in JAMA Internal Medicine.

“The signal that we see here towards lower mortality is striking – it suggests that regular toothbrushing in the hospital may save lives,” said corresponding author Michael Klompas, MD, MPH, hospital epidemiologist and an infectious disease physician in the Department of Medicine at BWH and Professor of Population Medicine at Harvard Pilgrim Health Care Institute.

“It’s rare in the world of hospital preventative medicine to find something like this that is both effective and cheap. Instead of a new device or drug, our study indicates that something as simple as brushing teeth can make a big difference.”

Hospital-acquired pneumonia occurs when bacteria in the mouth enter a patient’s airways and infect their lungs.

Patients experiencing frailty or patients with a weakened immune system are particularly susceptible to developing hospital-acquired pneumonia during their hospital stay.

However, adopting a daily toothbrushing regimen can decrease the amount of bacteria in the mouth, potentially lowering the risk of hospital-acquired pneumonia from occurring.

The team conducted a systematic review and meta-analysis to determine the association between daily toothbrushing and hospital-acquired pneumonia.

Using a variety of databases, the researchers collected and analysed randomised clinical trials from around the world that compared the effect of regular oral care with toothbrushing versus oral care without toothbrushing on the occurrence of hospital-acquired pneumonia and other outcomes.

The team’s analysis found that daily toothbrushing was associated with a significantly lower risk for hospital-acquired pneumonia and ICU mortality.

In addition, the investigators identified that toothbrushing for patients in the ICU was associated with fewer days of mechanical ventilation and a shorter length of stay in the ICU.

Most of the studies in the team’s review explored the role of a teeth-cleaning regimen in adults in the ICU.

Only two of the 15 studies included in the authors’ analysis evaluated the impact of toothbrushing in non-ventilated patients.

The researchers are hopeful that the protective effect of toothbrushing will extend to non-ICU patients but additional studies focusing on this population are needed to clarify if in fact this is the case.

“The findings from our study emphasise the importance of implementing an oral health routine that includes toothbrushing for hospitalised patients. Our hope is that our study will help catalyse policies and programs to assure that hospitalised patients regularly brush their teeth. If a patient cannot perform the task themselves, we recommend a member of the patient’s care team assist,” said Klompas.

Source: Brigham and Women’s Hospital

Categories : DentistryTags :

Vaping Device Use Tied to Increased Risk of Developing Cavities

On By ModernMedia
Photo by Chiara summer on Unsplash

Research published in The Journal of the American Dental Association found patients who said they used vaping devices were more likely to have a higher risk of developing cavities. The findings of this study on the association between vaping and risk of caries serve as an alert that this once seemingly harmless habit may be very detrimental, says Karina Irusa, assistant professor of comprehensive care at Tuftst University and lead author on the paper.

Over the last few years, public awareness has increased about the dangers of vaping to systemic health, particularly after the use of vaping devices was tied to lung disease. Some dental research has shown ties between e-cigarette use and increased markers for gum disease, and, separately, damage to the tooth’s enamel, its outer shell. But relatively little emphasis has been placed on the intersection between e-cigarette use and oral health, even by dentists, says Irusa.

Irusa says that the finding may be just a hint of the damage vaping causes to the mouth. “The extent of the effects on dental health, specifically on dental decay, are still relatively unknown,” she says. “At this point, I’m just trying to raise awareness,” among both dentists and patients.

This study, Irusa says, is the first known specifically to investigate the association of vaping and e-cigarettes with the increased risk for getting cavities. She and her colleagues analysed data from more than 13 000 patients older than 16 who were treated at Tufts dental clinics from 2019–2022.

Irusa found a significant difference in dental caries risk levels between the e-cigarette/vaping group and the control group. Some 79% of the vaping patients were categorised as having high-caries risk, compared to just about 60% of the control group. The vaping patients were not asked whether they used devices that contained nicotine or THC, although nicotine is more common.

“It’s important to understand this is preliminary data,” Irusa says. “This is not 100% conclusive, but people do need to be aware of what we’re seeing.” Further studies need to be done, and Irusa wants to take a closer look at how vaping affects the microbiology of saliva.

One reason why e-cigarette use could contribute to a high risk of cavities is the sugary content and viscosity of vaping liquid, which, when aerosolised and then inhaled through the mouth, sticks to the teeth. (A 2018 study published in the journal PLOS One likened the properties of sweet-flavoured e-cigarettes to gummy candies and acidic drinks.) Vaping aerosols have been shown to change the oral microbiome making it more hospitable to decay-causing bacteria. It’s also been observed that vaping seems to encourage decay in areas where it usually doesn’t occur – such as the bottom edges of front teeth. “It takes an aesthetic toll,” Irusa says.

The Tufts researchers recommend that dentists should routinely ask about e-cigarette use as part of a patient’s medical history, including paediatric dentists who see adolescents. According to the FDA/CDC, 7.6% of middle- and high-school students said they used e-cigarettes in 2021.

The researchers also suggest patients who use e-cigarettes should be considered for a “more rigorous caries management protocol,” which could include prescription-strength fluoride toothpaste and fluoride rinse, in-office fluoride applications, and checkups more often than twice a year.

“It takes a lot of investment of time and money to manage dental caries, depending on how bad it gets,” Irusa says. “Once you’ve started the habit, even if you get fillings, as long as you continue, you’re still at risk of secondary caries. It’s a vicious cycle that will not stop.”

Source: Tufts University

Categories : Diseases, Syndromes and ConditionsTags :

Basic Toothbrush Still Tops for Gingivitis Prevention

On By ModernMedia
Photo by Diana Polekhina on Unsplash

In a review of evidence for dental hygiene techniques, only a few were able to provide additional protection against gingivitis and periodontitis beyond brushing one’s teeth with a basic toothbrush.

The paper was published in the Journal of the International Academy of Periodontology and examines the effectiveness of various oral hygiene devices.

At the moment, all other oral hygiene interventions are only supported by insufficient evidence, said principal investigator Frank Scannapieco, DMD, PhD, professor of oral biology in the UB School of Dental Medicine. The findings, he said, will help identify best practices for preventing gum disease.

“Patients can be confident that the oral care tools and practices supported by research, as described in the paper, will prevent the initiation and progression of periodontal disease, if they are performed regularly and properly,” said Prof Scannapieco.

The list of proven techniques includes: basic toothbrush; interdental brush; water pick; chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC) and essential oil (Listerine) mouth rinses.
Tooth brushing is the cornerstone of daily oral hygiene and is a reliable way to control dental plaque, said Scannapieco. Interdental brushes and water picks also performed better than other interdental oral hygiene devices at reducing gingivitis, and both should be used in combination with daily tooth brushing to prevent gum disease.

Mouth rinses based on CHX, CPC, and essential oils (such as Listerine) were proven to be effective at significantly reducing plaque and gingivitis.

While not effective at fighting gingivitis, toothpicks were useful for monitoring gum health, said Prof Scannapieco. By gently prodding the gums with a toothpick and monitoring for bleeding, patients could detect signs of gum disease.

While triclosan toothpastes and mouth rinses significantly reduced plaque and gingivitis, the compound is linked to cancer development and reproductive defects, and has been removed from most toothpastes in the US.
Unfortunately for those who invested in one, electric-powered toothbrushes are no more effective at reducing plaque and gingivitis than a basic toothbrush,  the researchers found. And little evidence has been published in support of dental floss – the mainstay of interdental cleaning – to reduce plaque and gingivitis. However, Prof Scannapieco said that flossing is still necessary:
“While there are few studies available that specifically examined toothbrushes or floss alone, both are still essential. Floss is especially useful to remove interdental plaque for people who have tight space between their teeth. Floss also likely reduces the risk for cavities that from between the teeth.”
Evidence was lacking for mouthwashes based on tea tree oil, green tea, anti-inflammatory agents, hydrogen peroxide, sodium benzoate, stannous fluoride, hexetidine or delmopinol reduced gingivitis.

Though promising as a preventive strategy against gum disease, the effectiveness of probiotics was unproven. There was also little evidence for dietary supplements improving gum health. The investigators also found insufficient evidence that professional plaque removal (known as scaling, the process of removing plaque with a scraper) prevents gum disease.

Source: University at Buffalo