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Survey: More pregnant women in U.S. visiting a dentist


May 16, 2016
By Michelle Manchir

The number of pregnant women in the U.S. going to the dentist has increased 5.5 percent over the last year, according to survey data released in May from Delta Dental Plans Association.

In 2015, 57.5 percent of mothers in the United States reported they visited the dentist during their pregnancy, Delta Dental Plans Association said. The 2016 survey results show that number has increased to 63 percent.

“This is positive news and we’re glad expectant mothers are increasingly visiting the dentist. Oral health issues have a heightened risk of occurring during pregnancy, so being aware and on top of these is crucial,” said Dr. Bill Kohn, Delta Dental Plans Association’s vice president of dental science and policy, in a news release.

Most women who reported seeing a dentist during pregnancy — 37 percent — said it was a routine checkup, while 13 percent said they wanted to address a particular oral health issue and six percent said they wanted to discuss what to expect when it came to oral health while pregnant.

The survey was conducted between Dec. 16, 2015, and Jan. 14, 2016, among a nationally representative group of 1,307 parents of children ages 6-12.

Dental professionals can use ADA’s consumer website, MouthHealthy.org, to help inform patients about what’s safe and healthy for them during pregnancy.

For more information, visit MouthHealthy.org/pregnancy.

In 2015, The Journal of the American Dental Association published research that showed it’s safe for pregnant women to undergo dental treatment with local anesthetics.

The researchers compared the pregnancy outcomes between a group of women exposed to dental treatment with anesthetics and a control group that did not have treatment. The study showed that exposure to dental care and local anesthetics during pregnancy is not associated with increased risk for major medical problems in newborns.

Gum diseases could open the body to a swarm of infections

Mouth microbes may be connected to a variety of illnesses, more and more studies are showing.

Dental care has been disconnected from general health care for many years now, but the more you start to think about it, the stranger it seems. After all, you don’t really separate any other branch of medicine so… why teeth? It all started in the 19th century, following conflicts between surgeons and dentists in England. The conflict was carried on in the United States, after medicine became linked to employer insurance and Medicare. The fissure between medicine and dentistry widened, until it was irreparable. Medicine was split into dental care and all the rest… and has remained so to this day. But is it really fair to exclude dental care from the rest of health care?

When Salomon Amar, a periodontal specialist at Boston University, began exploring links between oral bacteria and heart disease in animal studies in the late 1990s, reactions were unfriendly. Skepticism, in all its forms, was the general response – why would a dentist become involved in heart disease studies? But Amar was’t alone. Wenche Borgnakke, a dental researcher at the University of Michigan in Ann Arbor, has been making the same case for years, pointing to several published studies. Especially, a study published last year in the journal Medicine highlights that patients on dialysis who received periodontal treatment had an almost 30 percent lower risk of pneumonia and hospitalization from infections. Furthermore, a recent study found that gum problems is associated with a 10% higher mortality.

The scale seems to be tipping the other way, as more and more physicians are noticing connections between oral hygiene and general health. Says Jean Wactawski-Wende, a cancer epidemiologist at the State University of New York at Buffalo:

“The more I work on oral health and cancer, the more I think, ‘Oh my gosh, I’ve got to keep my teeth clean.’ ”

Plaque seems to one of the main culprits, and that makes a lot of sense – after all, it’s a thick layer of bacteria inside your mouth.

“If you do not brush your teeth, it will sit there and accumulate. As that plaque gets thicker and thicker, there is less and less oxygen in the deepest layers,” Borgnakke says. Safely sheltered, the innermost plaque starts to favor anaerobic bacteria, which, when they escape into the blood, can survive in the oxygen-starved nooks and crannies deep inside the body.
While many questions still remain, and the relationship between gum health and overall health remains an open question, there is growing evidence that you gums can open the body to a swarm of infections. The science is not yet clear on it, but in the mean time, it’s better to be safe and sorry. Clean your gums, you may be helping your entire body.

by Mihai Andrei
April 8, 2016

Source: G. Hajishengallis/Nat. Rev. Immuno. 2015

4 Tips for Avoiding Bad Breath When You’re On the Go

Moms, busy professionals, students and many other people are so busy throughout the day that they sometimes forget to take care of their mouths.

You’re so busy throughout the day that you might sometimes forget to take care of your mouth. While this is understandable, the fact that you’re busy shouldn’t mean that you neglect your oral health. When you forget or pass on brushing and flossing, you open to door to bacteria that can lead to bad breath, tooth decay and gum disease. In order to stay healthy, take care of your mouth even when you may not have the time to do so.

People who lead busy lives should remember the following things to help them keep their mouths clean.

1. Carry travel-sized oral health products

Travel-sized oral health products can really come in handy. Many are small enough to easily keep in your car, purse or backpack so that you have them when you need them. If nothing else, try to keep some floss and a small bottle of alcohol-free mouthwash handy. That way, if you have a meal where you get something lodged in your teeth or feel that your breath may have taken a turn for the worse, you can try to take care of it while still out and about. In addition to those two things, you can also carry a travel toothbrush and a small tube of toothpaste. Travel toothbrushes are compact and often have a small case or cover that allows you to carry and use them without any mess.

2. Drink lots of water

Drinking lots of water will help you wash away any food particles and bacteria that collect in your mouth. This will help keep your breath fresh, and because most water in the U.S. is fluoridated, you’ll even be strengthening your teeth. According to the Centers for Disease Control and Prevention, fluoride added into water helps remineralize teeth and prevent cavities. For this reason, it has been added to water supplies for over 70 years. By drinking lots of water and carrying a refillable water bottle, you’ll be able to help keep your teeth healthy.

3. Stay away from certain foods and drinks

Sugary foods and drinks should be avoided. When sugary foods are eaten, bacteria in the mouth interact with the sugar and leave behind an acid that can attack your teeth. This leads to cavities and tooth decay. Starchy foods high in refined carbohydrates, such as fried foods or snacks like potato chips, are no friend to your teeth and can lead to the same result as sugary foods. If you do end up eating these foods, you should make sure to clean your mouth after doing so.

4. Use sugar-free mints, lozenges or gum

Chewing gum or sucking on a mint can help clean your teeth. Gum and mints increase the amount of saliva in your mouth, which will wash away any leftover food or plaque that has collected on your teeth. While any gum or mint will increase the amount of saliva, sugar-fee gum or mints are much better and will help your oral health much more. Try to use products that contain xylitol instead of sugar as this natural alternative to sugar actually fights off the bacteria that cause bad breath and tooth decay.

Worlds first caffeinated toothpaste jolts you awake and prevents cavities


If you find that you simply cannot start your day without a caffeine fix, but can’t stand the aftertaste of coffee, this toothpaste is just the thing for you. Invented by American entrepreneur Dan Meropol, Power Energy Toothpaste is the world’s first caffeinated toothpaste, designed to give people that much needed morning boost as well as keep their teeth squeaky clean.

Meropol, a Brown University graduate, said he was disturbed to learn that only fifty percent of Americans floss daily, and fifty percent brush only once a day. So he was trying to come up with ways to inspire people to take better care of their teeth, when his friend Ian suggested a caffeinated toothpaste.

At first, Meropol figured that a caffeinated toothpaste must already exist, but he was shocked to learn that no one had ever thought of it before. So he decided to run with the idea and started formulating a special blend of his own. He eventually came up with Power Toothpaste, which provides an instant hit of caffeine that’s absorbed through the gums and mouth.

This is supposedly faster than the traditional coffee-through-the-stomach method, taking effect even before you’ve finished brushing. But this also means that the ‘high’ won’t last very long. “I was sleepy again less than an hour after brushing with Power Toothpaste,” wrote Motherboard contributor Rachel Pick, who tried the product first hand.

That’s because the caffeine fix is instant, and it isn’t being absorbed over time like with a cup of coffee. “Power Toothpaste is only meant as a quick jolt to take you out of your morning fog, and in that regard, it works well,” Pick wrote. Which is exactly what Meropol is aiming for – he just wants people to improve their dental care habits, and if a temporary caffeine high will do the trick, so be it. “Too many people aren’t taking care of their teeth, even when they know they should,” he said.

Pick also noted that Power Toothpaste doesn’t contain fluoride, so it technically classifies a cosmetic product rather than a drug. Dentists are apparently okay with this, but they do recommend following it up with a mouthwash that does contain fluoride.

Meropol first shared the toothpaste with his family and friends, and is now ready to bring it to the masses. He started an Indiegogo campaign on January 19, and he’s already raised over $15,000, completing 35 percent of his goal in just three days. Looks like a lot of people are interested in getting a rush while they brush.

Devices Reduce Blood Pressure in Sleep Apnea


January 5, 2016 — Both continuous positive airway pressure (CPAP) and mandibular advancement devices (MADs) reduce blood pressure in patients with obstructive sleep apnea, according to a new study in the Journal of the American Medical Association.

The meta-analysis found no significant difference between the blood pressure outcomes associated with the two therapies, but CPAP had a considerably higher probability of reducing systolic blood pressure, concluded lead study author Daniel Bratton, PhD, and colleagues (JAMA, December 1, 2015, Vol. 314:21, pp. 2280-2293).

Obstructive sleep apnea occurs in about 2% to 4% of the population in Western countries according to a 2002 study in the American Journal of Respiratory and Critical Care Medicine (May 2002, Vol. 165:9, pp. 1217-1239); however, the study authors noted that the prevalence of the condition is on the rise because of increasing obesity in these populations. The condition is associated with oxygen loss and wakefulness from sleep, which can lead to increases in blood pressure and the risk of cardiovascular disease, according to a 2010 study in Nature Reviews Cardiology(December 2010, Vol. 7:12, pp. 677-685).

CPAP versus MADs

Continuous positive airway pressure devices have been shown to be an effective treatment for improving symptoms of obstructive sleep apnea, such as daytime sleepiness. The authors of the current study cited multiple studies that show the device also lowers blood pressure. For patients who are unable to tolerate CPAP, an alternative treatment often used is the mandibular advancement device, which works by protruding the mandible and tongue to keep the airway open during sleep.

In this study, the researchers from the University of Zurich in Switzerland compared CPAP and MAD to see what changes the devices had in the blood pressure of patients with obstructive sleep apnea. The meta-analysis included 51 studies from the databases of Medline, Embase, and the Cochrane Library to the end of August 2015 and included 4,888 patients with obstructive sleep apnea.

The researchers found that both CPAP and MADs were associated with similar reductions in systolic and diastolic blood pressure compared with an inactive treatment.

Survey: Many pregnant women don’t visit the dentist

Theresa Pablos
DrBicuspid.com assistant editor

More than 75% of pregnant women experience an oral health problem, according to a new Cigna survey of pregnant women and new mothers. The survey also found that almost half of the surveyed women did not visit the dentist during pregnancy despite having dental problems.

The researchers cited cost as one of the main reasons why pregnant women do not visit the dentist, and they found that women without insurance were twice as likely as those with insurance to not visit the dentist during pregnancy. However, healthcare professionals may be able to increase the amount of women who prioritize oral health by simply talking to women about the importance of visiting the dentist.

“The dental professional community should continue to advise and emphasize to expectant mothers the importance of practicing good oral hygiene habits at home before and during pregnancy and the need for regular dental checkups,” stated Miles Hall, DDS, Cigna’s chief clinical dental director, in an email interview with DrBicuspid.com.

Pregnant women aren’t told the importance of oral health

It is important for pregnant women to visit the dentist because all infections, including ones in the oral cavity, may impact the health of their baby. In addition, according to the Cigna study, hormonal changes throughout pregnancy can increase the risk for periodontal disease.

“The dental professional community should continue to advise and emphasize to expectant mothers the importance of practicing good oral hygiene habits.”
— Miles Hall, DDS, Cigna’s chief clinical dental director

The American College of Obstetricians and Gynecologists recommends that all women, including pregnant women, should be counseled about the importance of oral health.

To see if pregnant women and new mothers knew about the importance of oral health during pregnancy and if they followed through with visiting a dentist, Cigna conducted a survey through M/A/R/C Research. The online survey went out to pregnant women and also women who had babies within the past 12 months.

All the women included in the survey were between the ages of 21 and 45. A total of 801 women were surveyed:

  • 200 pregnant women with dental insurance
  • 200 pregnant women without dental insurance
  • 201 new mothers with dental insurance
  • 200 new mothers without dental insurance.

The survey found that although 76% of pregnant women reported having an oral health problem, including bleeding gums, toothache, and increased tooth sensitivity, only 57% actually visited a dentist during their pregnancy. To help remedy this, the survey authors recommended that healthcare providers, including dentists and hygienists, explain how pregnancy can affect the oral cavity.

[caption id="attachment_113" align="aligncenter" width="600"]oral health survey Data courtesy of the 2015 Cigna survey “Health Smiles For Mom And Baby.”[/caption]

“Explain the connection between oral health and overall wellness before, during, and after pregnancy,” the survey authors wrote. “For pregnant women, any infection, including tooth decay and gum disease, has the added possibility of affecting the baby’s health.”

The study also found that pregnant women who did not have dental insurance were twice as likely to not visit the dentists as those with dental insurance, and 33% of the women skipped a dental visit during pregnancy because of the cost.

“It is important to acknowledge the frequent reasons for avoiding the dentist and offer insight into overcoming potential barriers — such as providing details about what services are covered under a preventive visit and upfront communications about treatment costs for restorative services,” Dr. Hall said. “Help patients determine whether their dental plan has a special program with extra covered services for pregnant women, like additional exams or cleanings.”

The Greenwich Dental Group now offers E4D same day dentistry!

same day crowns

Using E4D Same-day Dentistry technology, Dr. Altman was able to do two same-day crowns. The patient did not have to come back for a second appointment, get a second injection or wear temporary crowns for 2 weeks.

What is E4D Same-day Dentistry technology?

E4D is a new CAD/CAM technology that takes images of your teeth and allows us to design your crown, filling or veneer while you wait.

Does that mean you won’t have to have a temporary?

That’s right. No temporary. You’ll go home with your permanent ceramic restoration the same-day.

How does it work?

Your dentist determines that your dental condition is right for a digital restoration; we take a series of digital images of your teeth while you watch the process chairside. In the past, we’d have to take impressions and send them out to a laboratory, and they’d make your restoration while you had a temporary in place. With this new technology, you’re in and out on the same-day with your permanent restoration seated in place.

How will you know if I can have this same day treatment?

We will perform a thorough examination before recommending any dental treatment. If you’re experiencing any dental problems or want to learn if E4D is right for you, let’s schedule you for an appointment.

Drinking Alcohol May Worsen Periodontal Disease


The more alcohol people drink, the worse their periodontal condition may be, according to a new study in the Journal of Periodontology. The findings show that men and women who consume at least four alcoholic drinks per week have worse periodontal status than those who drink less than that amount monthly, or who do not drink alcohol at all.

The Brazilian researchers wanted to find out how alcohol usage affected the severity of periodontitis. After dividing patients into groups based on their alcohol consumption, they found that those who were alcohol-dependent had more plaque and higher clinical attachment levels than patients who drank less frequently.

“A higher severity of periodontitis has been reported among alcohol users with incremental odds for occurrence of the disease proportional to the frequency of alcohol consumption, as well as a higher need for periodontal treatment,” the authors wrote (J Periodontol, June 11, 2015). “Therefore, it is important to highlight that in the present study, alcohol-dependent users presented a higher plaque index and a higher severity of periodontitis.”

Link between alcohol and periodontitis

While many studies have linked alcohol consumption to other diseases, few have looked at its effects on periodontal disease. Since excessive alcohol intake can contribute to faster biofilm formation and alcohol users are more likely to have poor oral hygiene, the researchers wanted to see if alcohol consumption was associated with periodontitis.

“Alcohol-dependent users presented a higher plaque index and a higher severity of periodontitis.”

Alcohol-consumption questionnaires were given to men and women on the waiting list for medical and dental treatment from three health centers in Brazil. The patients were divided into four categories based on how much alcohol they consumed. Patients who consumed alcohol at least four times per week were categorized as alcohol-dependent, while those who did not use alcohol or used it less than monthly were deemed as nonusers or occasional alcohol users.

In the end, the researchers looked at 88 patients ages 35 to 55. The sample was divided into four groups of 22 people each based on their periodontal status and alcohol consumption levels:

  • ADP: alcohol-dependent with periodontitis
  • ADNP: alcohol-dependent without periodontitis
  • NAP: nonusers or occasional alcohol users with periodontitis
  • NANP: nonusers or occasional alcohol users without periodontitis

Despite the four groups having homogenous smoking status, educational levels, and body mass index, the alcohol-dependent groups tended to have worse periodontal status than the nonusers or occasional alcohol users.

“In the present study, the ADP group presented worse periodontal status and higher frequency of some periodontal pathogens,” the authors wrote. “The microbial analysis revealed significant differences in bacterial counts among the four groups, demonstrating higher counts associated with periodontitis and alcohol dependence.”


Periodontal condition by alcohol consumption and periodontal status
Plaque index 1.5 1.2 1.3 0.9
Site percentage PD 4-6 mm 15.3% 6.5% 0.31% 0.22%
Site percentage PD ≥ 7 mm 3.7% 2.3% N/A N/A
Site percentage CAL ≥ 4mm 16.4% 7.2% 5.4% 2.9%

PD = probing depth; CAL = clinical attachment level. Data from “Alcohol Consumption and Periodontitis: Quantification of Periodontal Pathogens and Cytokines,” Journal of Periodontology, June 11, 2015.


“Individuals without periodontitis showed significantly lower bacterial levels when compared to those with periodontitis, although with no significant difference in relation to alcohol consumption was observed,” the authors noted.

Alcohol users without periodontitis also had more plaque than their nondrinking counterparts. Alcohol’s drying effect on the mouth may contribute to plaque formation, triggering an inflammatory response in the gums, the researchers explained.

Encourage patients to be honest

While the study did present some significant findings, it consisted of a relatively small sample size, and the authors called for other researchers to look at larger samples and different populations. They also note that finding alcohol-dependent patients may be difficult.

“Although the topic of alcohol use and its effect on periodontal health requires further research, this report offers valuable insight on why our patients should care for their gums and teeth, especially if they enjoy the occasional drink,” stated Joan Otomo-Corgel, DDS, MPH, president of the American Academy of Periodontology, in a press release. “For patients who are diagnosed with periodontal disease, it’s imperative that they are encouraged to be completely honest about their drinking habits. This information can guide in determining appropriate treatment and next steps.”


Study: Half of oral cancer deaths due to cigarettes


June 15, 2015 — Almost half of the deaths caused by cancers of the oral cavity and pharynx in U.S. adults 35 and older in 2011 were attributable to cigarette smoking, according to a multi-institution research letter published in JAMA Internal Medicine

Overall, almost 346,000 people died of one of 11 cancers in 2011 in the U.S. (see list below), including about 150,000 women and more than 197,000 men. Of these deaths, 48.5% were attributable to cigarette smoking.
“Cigarette smoking continues to cause numerous deaths from multiple cancers despite a half century of decreasing prevalence,” the authors noted (JAMA Intern Med, June 15, 2015).
There were more than 8,500 deaths in the U.S. from cancers of the oral cavity and pharynx in 2011. Researchers attributed 47% of these deaths to cigarette smoking. In comparison, more than 80% of deaths from lung, bronchial, and tracheal cancers and more than 76% of deaths from cancer of the larynx were attributed to smoking in the research letter (see chart below). Source: JAMA Intern Med (June 15, 2015).


By gender, these deaths from oral and pharynx cancers broke down to more than 6,000 men and slightly more than 2,500 women. Just under half of these deaths (2,955) in men were attributed to smoking. In women, 43% (1,077) of deaths from cancers of the oral cavity and pharynx were attributed to smoking.

The authors noted that the 2014 U.S. surgeon general’s report provided an estimation of the annual number of smoke-attributable deaths from 2005 to 2009 from cancer overall and from lung cancer, but not from the 11 other cancers found to be caused by smoking.

“Updated estimates are needed because smoking patterns and the magnitude of the association between smoking and cancer death have changed in the past decade,” they noted.
The researchers, from the American Cancer Society, Harvard Medical School, the National Cancer Institute, and the Fred Hutchison Cancer Research Center, reported that while smoking prevalence dropped more than 5% (23.2% to 18.1%) from 2000 to 2012, the “risk of cancer death” among smokers increased over the same period.

The researchers noted one limitation of their study was the cohort populations, which were “less racially diverse” and “more educated” than the U.S. population in general. Also, exposure to secondhand smoke was not included in their analysis. Exposure to secondhand smoke is estimated to cause an additional 5% of lung cancer deaths, according to the 2014 U.S. surgeon general’s report.

The cancers in the study included colorectal; esophageal; kidney and renal pelvis; larynx; liver and intrahepatic bile duct; lung, bronchial, and tracheal; myeloid leukemia; pancreal; stomach; urinary bladder; and uterine cervix; and cancers of the oral cavity and pharynx.

“Continued progress in reducing cancer mortality, as well as deaths from many other serious diseases, will require more comprehensive tobacco control, including targeted cessation support,” the authors concluded.


American Oral Health Could Use a Brush-up


New data on tooth decay and cavities among American adults reveal the sad state of our pearly whites. More than 25% of American adults ages 20 to 64 have untreated tooth decay, and 91% have one tooth — or more — that has been treated for tooth decay or needs to be.

Read more at Time.com

or read the full study here.