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

How To Become a Dental Hygienist

How To Become a Dental Assistant

Fluoride and Water

Keeping kids' teeth healthy requires more than just daily brushing. During a routine well-child exam, you may be surprised to find the doctor examining your child's teeth and asking you about your water supply. That's because fluoride, a substance that's found naturally in water, plays an important role in healthy tooth development and cavity prevention.

What Is Fluoride?

Fluoride exists naturally in water sources and is derived from fluorine, the thirteenth most common element in the Earth's crust. It is well known that fluoride helps prevent and even reverse the early stages of tooth decay.

Tooth decay occurs when plaque — that sticky film of bacteria that accumulates on your teeth — breaks down sugars in food. The bacteria produce damaging acids that dissolve the hard enamel surfaces of teeth. If the damage is not stopped or treated, the bacteria can penetrate through the enamel causing tooth decay (also called cavities or caries). Cavities weaken teeth and can lead to pain, tooth loss, or even widespread infection in the most severe cases.

Fluoride combats tooth decay in two ways. It is incorporated into the structure of developing teeth when it is ingested and also works when it comes in contact with the surface of the teeth. Fluoride prevents the acid produced by the bacteria in plaque from dissolving, or demineralizing, tooth enamel, the hard and shiny substance that protects the teeth. Fluoride also allows teeth damaged by acid to repair, or remineralize, themselves. Fluoride cannot repair cavities, but it can reverse low levels of tooth decay and thus prevent new cavities from forming.

Despite the good news about dental health, tooth decay remains one of the most common diseases of childhood. According to the Centers for Disease Control and Prevention (CDC), more than one quarter of 2- to 5-year-olds and half of kids 12 to 15 years old have one or more cavities, and tooth decay has affected two thirds of 16- to 19-year-olds.

Fluoride and the Water Supply

For over 60 years, water fluoridation has proved to be a safe and cost-effective way to reduce dental caries. Today, water fluoridation is estimated to reduce tooth decay by 20-40%. As of 2002, the CDC statistics show that almost 60% of the U.S. population receives fluoridated water through the taps in their homes. Some communities have naturally occurring fluoride in their water; others add it at water-processing plants.

Your child's doctor or dentist may know whether local water supplies contain optimal levels of fluoride, between 0.7 and 1.2 ppm (parts fluoride per million parts of water). If your water comes from a public system, you could also call your local water authority or public health department, or check online at the Environmental Protection Agency's (EPA) database of local water safety reports. If you use well water or water from a private source, fluoride levels should be checked by a laboratory or public health department.

Some parents purchase bottled water for their children to drink instead of tap water. Most bottled waters lack fluoride, but fluoridated bottled water is now available. If fluoride is added, the manufacturer is required to list the amount. If fluoride concentration is greater than 0.6 ppm up to 1.0 ppm, you might see the health claim "Drinking fluoridated water may reduce the risk of tooth decay" on the label.

The Controversy Over Fluoride

Opponents of water fluoridation have questioned its safety and effectiveness; however, there has been little evidence to support these claims.

Scientific research continues to support the benefits of fluoride when it comes to prevention of tooth decay and its safety at current recommended levels of 0.7 to 1.2 ppm. Dramatic reductions in tooth decay in the past 30 years is attributed to fluoridation of the water supply, and parents and health professionals should continue to ensure that kids receive enough fluoride to prevent cavities.

The American Dental Association (ADA), the United States Public Health Service (USPHS), the American Academy of Pediatric (AAP), and the World Health Organization (WHO), among many other national and international organizations, endorse community water fluoridation. The CDC recognized fluoridation of water as one of the 10 greatest public health achievements of the 20th century.

Kids' Fluoride Needs

So how much fluoride do kids need? In general, kids under the age of 6 months do not need fluoride supplements. Your child's 6-month checkup offers a great chance to discuss fluoride supplementation with a health professional. If you live in a nonfluoridated area, your doctor or dentist may prescribe fluoride drops, tablets, or vitamins after your baby is 6 months old.

The AAP recommends that these fluoride supplements be given daily to kids between the ages of 6 months and 16 years. The dosage depends on how much fluoride naturally occurs in the water and the child's age. Only kids living in nonfluoridated areas or those who drink only nonfluoridated bottled water should receive supplements.

What about toothpastes, mouth rinses, and other products that contain fluoride? Here are a few tips:

• Kids under 2 years old should not use fluoride toothpaste unless instructed by a dentist or health professional.
• Kids younger than 6 may swallow too much toothpaste while brushing, so should be supervised when brushing and taught to spit, not swallow, toothpaste.
• Kids over age 2 should use a fluoride-containing toothpaste that carries the ADA's seal of acceptance.
• Kids should use only a pea-sized amount of toothpaste.
• Kids under age 6 should never use fluoride-containing mouth rinses. However, older kids at high risk for tooth decay may benefit from using them. Your dentist can talk with you about risk factors such as a family history of dental disease, recent periodontal surgery or disease, or a physical impediment to brushing regularly and thoroughly.

Your family dentist or pediatric dentist (one who specializes in the care of children's teeth) is a great resource for information about dental care and fluoride needs. A dentist can help you understand more about how fluoride affects the teeth, and once all of your child's primary teeth have come in, may recommend regular topical fluoride during routine dental visits.

Overexposure to Fluoride

If some fluoride is good, why isn't more fluoride better? As with most medications, including vitamins and mineral supplements, too much can be harmful. Most kids get the right amount of fluoride through a combination of fluoridated toothpaste and fluoridated water or supplements.

Too much fluoride before 8 years of age, a time when teeth are developing, can cause enamel fluorosis, a discoloration or mottling of the permanent teeth For most, the changes are subtle. In one study, 94% of identified fluorosis cases were very mild to mild. Most cases are due to inappropriate use of fluoride-containing dental products, including toothpaste and mouth rinses. Sometimes kids take daily fluoride supplements but may be getting adequate fluoride from other sources, which also puts them at risk.

Recently, the National Research Council found naturally occurring fluoride levels exceeded the optimal levels used in community fluoridation programs (0.7 to 1.2 ppm), putting kids under 8 years old at risk for severe enamel fluorosis. The CDC recommends that in communities where fluoride levels are greater than 2 ppm, parents should provide kids with water from other sources.

The ADA also recognizes that infants need less fluoride than older kids and adults. Some infants may be getting too much fluoride in the water used to reconstitute infant formula. If you're concerned that your infant may be getting too much fluoride, talk with your doctor or dentist, who may recommend ready-to-feed formula or formula reconstituted with fluoride-free or low-fluoride water.

Very rarely, fluoride toxicity can occur when large amounts of fluoride are ingested during a short period of time. Kids under age 6 account for more than 80% of reports of suspected overingestion. Although outcomes are generally not serious, fluoride toxicity sends several hundred children to emergency rooms each year.

Symptoms of fluoride toxicity may include nausea, diarrhea, vomiting, abdominal pain, increased salivation, or increased thirst. Symptoms begin 30 minutes after ingestion and can last up to 24 hours. If you suspect your child may have eaten a substantial amount of a fluoridated product or supplement, call the poison control center or 911.

Be sure to keep toothpaste, supplements, mouth rinses, and other fluoride-containing products out of children's reach or in a locked cabinet. You should also supervise your young child's toothbrushing sessions to prevent swallowing of toothpaste or other fluoridated products.

If you have any questions about your water's fluoride content, the fluoridated products your child uses, or whether your child is receiving too much or too little fluoride, talk to your doctor or dentist.

To listen to the article visit http://kidshealth.org/parent/general/teeth/fluoride.html#

How Does Fluoride Work?

There's fluoride in your toothpaste and even in your water. But how does it work to keep teeth healthy? Let's find out.

Fluoride is a natural element found in the earth's crust as well as in water and air. It's also considered a nutrient because our bodies need fluoride to grow and develop properly. Decades ago, scientists discovered that kids who naturally had more fluoride in their drinking water had fewer cavities. In the mid-1940s, communities started to put more fluoride in their water supplies to protect people against tooth decay.

Fluoride helps because, when teeth are growing, it mixes with tooth enamel — that hard coating on your teeth. That prevents tooth decay, or cavities. But fluoride can help even after your teeth are formed. It works with saliva to protect tooth enamel from plaque and sugars. By using fluoride toothpaste, for instance, everyone can enjoy some cavity protection. Fewer cavities means healthier teeth when you're an adult — and less chance of having to wear false teeth (dentures) when you're old!

So how do you get your fluoride? Ask your dentist the next time you have an appointment. In addition to fluoride toothpaste, he or she might recommend a mouthwash that has fluoride in it. And if your drinking water doesn't have fluoride in it, your dentist might suggest supplements — which are like vitamins containing fluoride.

Just how effective is fluoridated water? Thanks to it, dentists say half of kids between 5 and 17 have never had a cavity in their permanent teeth. We hope you're one of them!

To listen to the article visit http://kidshealth.org/kid/talk/qa/fluoride.html

Preventing Decay with Fluoride

What is fluoride?

Fluoride is a mineral that is naturally present in varying amounts in almost all foods and water supplies. Fluoride is also used in many consumer dental products such as toothpaste and fluoride mouth rinses.

How does fluoride reduce tooth decay?

Fluoride acts in two ways: topically and systemically. Topical fluorides strengthen teeth that have already erupted into the mouth. As the fluoride washes over the tooth surface, it is incorporated into the outer surface of the tooth, making it more resistant to decay. Additionally, topical fluoride is used to protect and desensitize root surfaces by providing additional mineralization to the naturally occurring “softer” root surface.

Systemic fluorides are those that are ingested through food and water and are used by the body as teeth are formed. Systemic fluorides, if ingested regularly during tooth formation, will be deposited throughout the developing layer of enamel, creating a stronger, more decay resistant outer layer. Systemic fluorides also protect teeth topically, as the fluoride is present in saliva, which continually bathes the teeth, promoting remineralization or repair of tooth surfaces that have been damaged by acids early in the decay process. Additionally, fluoride becomes incorporated into the dental plaque layer and can contribute further to the remineralization process.

How can I get fluoride?

Topical fluoride comes from use of fluoride containing toothpastes, mouth rinses, and gels, which are placed directly onto the teeth. Children are routinely provided with topical fluoride applications at their dental checkup visits, as this is one of the most effective ways of providing the benefits of topical fluoride to newly erupted teeth. Additionally, depending on the level of decay activity or root surface sensitivity you or your child are experiencing, your CDA member dentist may prescribe a product with more available fluoride than can be found in over-the-counter products.

Systemic fluoride is available through community water supplies that either have naturally occurring levels of fluoride that are optimal or have had fluoride added to reach optimal levels. In communities without fluoridated water supplies, systemic fluoride is available through bottled water purchased specifically for its fluoride content or through fluoride tablets or vitamins prescribed by your CDA dentist or your child’s pediatrician. Remember, in order for fluoride to exert systemic benefits, it must be ingested. So, if you do not live in a community with fluoridated water, consult your dentist or physician about the need for another method of fluoride supplementation.

Who benefits from fluoride?

Everyone can benefit from fluoride’s ability to help prevent tooth decay. Unfortunately, only 30 percent of California’s water supply is fluoridated, which means that large portions of California’s population are without the systemic benefits that fluoride provides. If your community is considering fluoridating its water supply, it is in your best interests to support these efforts, not only for yourself and your children, but for all those members of your community that do not have access to dental care and other means of fluoride supplementation and the cavity protection it provides.

If some fluoride is good, is more fluoride better?

The benefits of fluoride have been well known for over 50 years and are supported by numerous health and professional organizations, including the California Dental Association, the American Dental Association, The American Medical Association, the United States Centers for Disease Control and Prevention, the US Public Health Service and the World Health Organization. However, as with nearly all substances we ingest, there are levels that are safe, levels that are optimal, and levels that can cause negative effects. When fluoride is ingested above optimal levels, a condition called dental fluorosis can result. While dental fluorosis is not harmful, it may cause discoloration, or white spots, on your child’s teeth.

Parents should be aware of the sources of systemic fluoride their child receives. If your community water supply is fluoridated, then that will supply the optimal amount of systemic fluoride and tablets or vitamins should not be ingested. Additionally, young children (those who cannot spit after brushing their teeth) should only use a pea-sized amount of fluoride toothpaste to ensure that unmeasured amounts of fluoride are not ingested.

What to remember?

Fluoride alone will not prevent tooth decay; it is only one of the tools necessary for maintaining strong teeth and positive oral health. Remember to brush your teeth at least twice a day with a fluoridated toothpaste, floss daily, eat a balanced diet, and limit the frequency of snacking, especially sweet and sticky foods. Just as important, visit your CDA dentist regularly and follow his or her recommendations for your family’s optimal oral health.

http://www.cda.org/popup/Fluoride