Oral Disease More Likely In Children With Special Needs

At the beginning of 2010, as many as 17 percent of children in the United States were reported as having special health care needs. Behavioral issues, developmental disorders, cognitive disorders, genetic disorders and systemic diseases may increase a child's risk of developing oral disease, according to an article published in the May/June 2010 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD). For a child with special health care needs, special diets, frequent use of medicine and lack of proper oral hygiene can make it challenging to maintain good oral health.

"By the time these children are 12 months old, they should have a 'dental home' that will allow a dentist to administer preventive care and educate parents about good oral health habits tailored to fit their child's needs," says Maria Regina P. Estrella, DMD, MS, lead author of the article.

For example, some parents may not know that special diets for children with below-average weight or unique food allergies can unintentionally promote tooth decay. Underweight children may be directed to consume drinks containing high amounts of carbohydrates, which can cause demineralization of teeth. Medications can also be a source of concern. Because children often find it difficult to swallow pills, many of their medicines may utilize flavored, sugary syrups. When parents or guardians give these syrups to a child, especially at bedtime, the sugars can pool around the child's teeth and gums, promoting decay.

"Children should continue with the diet and medications as directed by their physician, but a dentist may recommend more frequent applications of fluoridated toothpaste and mouthrinse and rinsing with water to decrease the risk of decay," says Vincent Mayher, DMD, MAGD, spokesperson for the AGD.

Additionally, adults will need to help children who lack the dexterity to brush their own teeth. When brushing a child's teeth, it may be helpful for caregivers to approach their child from behind the head, which will provide caregivers with good visibility and allow them to control the movement of both the child's head and the toothbrush. This approach is especially helpful with wheelchair-bound children.

Taking children with special health care needs to the dentist is as important as caring for their other medical needs. A dentist who understands a child's medical history and special needs can provide preventive and routine oral care, reducing the likelihood that the child will develop otherwise preventable oral diseases.

Source:
Lauren Henderson

Academy of General Dentistry

http://www.medicalnewstoday.com/articles/192506.php

Study Shows A Possible Link Between Preschoolers' Cavities And Excess Body Fat

Preschool children with tooth decay may be more likely to be overweight or obese than the general population and, regardless of weight, are more likely to consume too many calories, a new study indicates. The results will be presented Saturday at The Endocrine Society's 92nd Annual Meeting in San Diego.

"Poor eating habits may play a role in both tooth decay and obesity in preschoolers," the study's lead author, Kathleen Bethin, MD, PhD, said.

"Dental decay is the most common chronic disease of childhood, and obesity in youth is a growing problem. To prevent these problems, the dentist's office may be an important place to educate families about nutrition," said Bethin, a pediatrician at Women and Children's Hospital of Buffalo and an associate professor of pediatrics at the University of Buffalo in New York.

With funding from the New York State Department of Health, the doctors at the Women and Children's Hospital of Buffalo and University of Buffalo studied the relationship between poor dental health and overweight in 65 children who were 2 to 5 years old. All children needed dental work due to decay and had their dental procedure and blood work performed while they were under anesthesia.

Each child's height and weight were measured before the procedure to calculate the body mass index, or BMI. For most people, BMI reliably indicates the amount of body fat. Also, the child's guardian completed a questionnaire about the child's recent average daily food consumption.

Almost 28 percent of the children were overweight or obese compared with an estimated 21.2 percent in the general U.S. population. Those 18 children, who's BMI was high for their age (at the 85th percentile or above), already had much higher total cholesterol levels than their healthy-weight counterparts, Bethin reported.

Of the 65 children, 47 were a healthy weight, having a BMI in the fifth to 84th percentile for their age.

However, the questionnaire showed that both the normal-weight and overweight children consumed more calories a day than recommended for their age (1,440 and 1,570 calories respectively). Seventy-one percent of children consumed more than 1,200 calories per day although the daily recommended caloric intake ranges from 1,000 to 1,400 calories depending on age and gender of the child.

"Further analysis is needed to explore whether consumption of juice and sweets accounts for the excessive calorie intake and links high BMI and dental decay," Bethin said.

Source:

Endocrine Society

http://www.medicalnewstoday.com/articles/192606.php

Gel That Regenerates Tooth Tissue Could Replace Fillings

After testing their idea on cell cultures and laboratory mice, scientists in France suggest that a new biomaterial shown to regenerate bone could be used as a gel inserted in tooth cavities to encourage tooth regeneration, thus avoiding the need to drill and fill the teeth.

The study was the work of co-author Dr Nadia Benkirane-Jessel, a scientist at the Institut National de la Sante et de la Recherche Medicale (INSERM) Faculty of Medicine in Strasbourg, France, and you can read about it in a paper published online in the American Chemical Society journal ACS Nano on 27 May.

Benkirane-Jessel told the press that the purpose of the gel would be to control cavities after they develop, it was not like toothpaste, so people would still need to keep brushing and flossing to prevent the cavities in the first place, reported Discovery News.

Dentists save millions of teeth every year by drilling and filling and doing root canal therapy, and there is a high rate of success in such procedures, but the researchers hypothesized that a better approach might be to remove decayed or diseased dental pulp and replace it with healthy tissue that revitalizes teeth.

For the patient this could be an attractive alternative because it would mean no more drilling: just a quick dab of gel on the infected tooth and it would heal from within, said Berkirane-Jessel. However, the researchers also said the method would probably only work for a small number of cases: most cavities would still have to be drilled and filled.

The researchers decided to try a version of a peptide called MSH (melanocyte-stimulating hormone), that had already been shown to regenerate bone. The version they used is called PGA-a-MSH, a chemical combination of poly-l-glutamic acid (PGL) and alpha-MSH.

They tested the biomaterial on cultures of human dental pulp fibroblasts, the cells that produce the collagen and other extra-cellular materials that form the structure of new tissue, and found it had "potential effects in promoting human pulp fibroblast adhesion and cell proliferation".

They concluded that:

"Our results indicated clearly that, by using PGA-a-MSH, we increase not only the viability of cells but also the proliferation."

When they did a nanoscale examination of the new tissue using atomic force microscopy they found an increase in the thickness and roughness of its structure that was consistent with an "increase of the proliferation of the cells growing on the surface of these architectures".

"We report here the first use of nanostructured and functionalized multilayered films containing a-MSH as a new active biomaterial for endodontic regeneration," they added.

Benkirane-Jessel also said they tested the new film on mouse tooth cavities, and that within a month the cavities had disappeared, reported Discovery News.

"Nanostructured Assemblies for Dental Application."

Florence Fioretti, Carlos Mendoza-Palomares, Marie Helms, Denise Al Alam, Ludovic Richert, Youri Arntz, Simon Rinckenbach, Fabien Garnier, Youssef Hakel, Sophie C. Gangloff, Nadia Benkirane-Jessel

http://www.medicalnewstoday.com/articles/193341.php

he Next Big Treatment Era In Dentistry

Scientists are reporting an advance toward the next big treatment revolution in dentistry - the era in which root canal therapy brings diseased teeth back to life, rather than leaving a "non-vital" or dead tooth in the mouth. In a report in the monthly journal ACS Nano, they describe a first-of-its-kind, nano-sized dental film that shows early promise for achieving this long-sought goal.

Nadia Benkirane-Jessel and colleagues note that root canal procedures help prevent tooth loss in millions of people each year. During the procedure, a dentist removes the painful, inflamed pulp, the soft tissue inside the diseased or injured tooth that contains nerves and blood vessels. Regenerative endodontics, the development and delivery of tissues to replace diseased or damaged dental pulp, has the potential to provide a revolutionary alternative to pulp removal.

The scientists are reporting development of a multilayered, nano-sized film - only 1/50,000th the thickness of a human hair - containing a substance that could help regenerate dental pulp. Previous studies show that the substance, called alpha melanocyte stimulating hormone, or alpha-MSH, has anti-inflammatory properties. The scientists showed in laboratory tests alpha-MSH combined with a widely-used polymer produced a material that fights inflammation in dental pulp fibroblasts. Fibroblasts are the main type of cell found in dental pulp. Nano-films containing alpha-MSH also increased the number of these cells. This could help revitalize damaged teeth and reduce the need for a root canal procedure, the scientists suggest.

Article: "Nanostructured Assemblies for Dental Application"

Source: American Chemical Society

http://www.medicalnewstoday.com/articles/193685.php

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