New research from the University of Pittsburgh’s Swanson School of Engineering introduces a revolutionary treatment for these infections. The group, led by Tagbo Niepa, PhD, is utilizing electrochemical therapy (ECT) to enhance the ability of antibiotics to eradicate the microbes.

“We live in a crisis with antibiotics: most of them are failing. Because of the drug- resistance that most microbes develop, antimicrobials stop working, especially with recurring infections,” says Dr. Niepa, author on the paper and assistant professor of chemical and petroleum engineering at the Swanson School, with secondary appointments in civil and environmental engineering and bioengineering.

With this technique, the current doesn’t discriminate as it damages the microbe cell membrane.

“It’s more likely that antibiotics will be more effective if the cells are simultaneously challenged by the permeabilizing effects of the currents. This would allow even drug-resistant cells to become susceptible to treatment and be eradicated.”

The novel method passes a weak electrical current through the metal-based implant, damaging the attached microbe’s cell membrane but not harming the surrounding healthy tissue. This damage increases permeability, making the microbe more susceptible to antibiotics. Since most antibiotics specifically work on cells that are going to replicate, they do not work on dormant microbes, which is how infections can recur. The ECT causes electrochemical stress in all the cells to sensitize them, making them more susceptible to antibiotics.

The researchers hope this technology will change how infections are treated. Researchers focused their research on Candida albicans (C. albicans), one of the most common and harmful fungal infections associated with dental implants. But while dental implants are one exciting application for this new technology, Niepa says it has other potential applications, such as in wound dressings.

The retrospective cohort study enrolled 161,286 participants of the Korean National Health Insurance System aged 40 to 79 with no history of atrial fibrillation or heart failure. Participants underwent a routine medical examination between 2003 and 2004. Information was collected on height, weight, laboratory tests, illnesses, lifestyle, oral health, and oral hygiene behaviours.

During a median follow-up of 10.5 years, 4,911 (3.0%) participants developed atrial fibrillation and 7,971 (4.9%) developed heart failure.

Tooth brushing three or more times a day was associated with a 10% lower risk of atrial fibrillation and a 12% lower risk of heart failure during 10.5-year follow up. The findings were independent of a number of factors including age, sex, socioeconomic status, regular exercise, alcohol consumption, body mass index, and comorbidities such as hypertension.

While the study did not investigate mechanisms, one possibility is that frequent tooth brushing reduces bacteria in the subgingival biofilm (bacteria living in the pocket between the teeth and gums), thereby preventing translocation to the bloodstream.

Senior author Dr. Tae-Jin Song of Ewha Womans University, Seoul, Korea noted that the analysis was limited to one country and as an observational study does not prove causation. But he added: “We studied a large group over a long period, which adds strength to our findings.”

An accompanying editorial states: “It is certainly too early to recommend tooth brushing for the prevention of atrial fibrillation and congestive heart failure.” It adds: “While the role of inflammation in the occurrence of cardiovascular disease is becoming more and more evident, intervention studies are needed to define strategies of public health importance.”

The paper’s other authors include Shara Bailey, a professor in NYU’s Department of Anthropology, Bin Hu, an associate research scientist at NYU’s College of Dentistry, and Timothy Bromage, a professor at NYU’s College of Dentistry.

The research focused on cementum, the dental tissue that covers the tooth’s root. It begins to form annual layers — similar to a tree’s “rings” — from the time the tooth surfaces in the mouth.

“The discovery that intimate details of a person’s life are recorded in this little-studied tissue, promises to bring cementum straight into the center of many current debates concerning the evolution of human life history,” says Bromage.

The Scientific Reports study tested the hypothesis that physiologically impactful events — such as reproduction and menopause in females and incarceration and systemic illnesses in both males and females — leave permanent changes in the microstructure of cementum and that such changes can be accurately timed.

The cementum’s microstructure, visible only through microscopic examination, can reveal the underlying organization of the fibers and particles that make up the material of this part of the tooth.

In their work, the scientists examined nearly 50 human teeth, aged 25 to 69, drawn from a skeletal collection with known medical history and lifestyle data, such as age, illnesses, and movement (e.g., from urban to rural environments). Much of this information was obtained from the subjects’ next of kin. They then used a series of imaging techniques that illuminated cementum bands, or rings, and linked each of these bands to different life stages, revealing connections between tooth formation and other occurrences.

“A tooth is not a static and dead portion of the skeleton,” observes Cerrito. “It continuously adjusts and responds to physiological processes.

“Just like tree rings, we can look at ‘tooth rings’: continuously growing layers of tissue on the dental root surface. These rings are a faithful archive of an individual’s physiological experiences and stressors from pregnancies and illnesses to incarcerations and menopause that all leave a distinctive permanent mark.”

The U-M researchers compared the pain and satisfaction of those who used opioids to those who didn’t.

“I feel like the most important finding is that patient satisfaction with pain management was no different between the opioid group and non-opioid group, and it didn’t make a difference whether it was surgical or routine extraction,” said study co-author Romesh Nalliah, clinical professor and associate dean for patient services at the U-M School of Dentistry.

Surprisingly, patients in the opioid group actually reported worse pain than the non-opioid group for both types of extractions, Nalliah said.

The researchers also found that roughly half of the opioids prescribed remained unused in both surgical and nonsurgical extractions. This could put patients or their loved ones at risk of future misuse of opioids if leftover pills are not disposed of properly.

The findings are scheduled to appear March 13 in JAMA Network Open.

“The real-world data from this study reinforces the previously published randomized-controlled trials showing opioids are no better than acetaminophen and nonsteroidal anti-inflammatory drugs for pain after dental extraction,” said study co-author Chad Brummett, director of the Division of Pain Research and of Clinical Research in the Department of Anesthesiology at Michigan Medicine, U-M’s academic medical center.

Brummett co-directs the Michigan Opioid Prescribing Engagement Network, or Michigan OPEN, which has developed, tested and shared guidelines for the use of opioids in patients with acute pain from surgery and medical procedures.

“These data support the Michigan OPEN prescribing recommendations calling for no opioids for the majority of patients after dental extractions, including wisdom teeth extraction,” he said.

Severe cases of glossitis can be painful and affect the way a person talks or eats.

There are different types of glossitis, including:

• Acute glossitis. This often develops suddenly and can have severe symptoms.
• Chronic glossitis. Chronic inflammation of the tongue is often the result of an underlying condition.
• Atrophic glossitis also called Hunter’s glossitis. Here, the many of the tongue’s small bumps (papillae) shrink, which changes the surface of the tongue, making it appear glossy.
• Median rhomboid glossitis. A Candida yeast infection often causes this type of glossitis.

Symptoms

The symptoms of glossitis vary from person to person. They may also differ according to the underlying cause of the condition.

Common symptoms of glossitis include:

• a swollen tongue
• pain in the tongue
• burning or itching in the tongue
• change in the texture of the surface of the tongue due to the change in the size and shape of papillae
• different color of the tongue’s surface
• loss of ability to speak or eat properly
• difficulty swallowing

Causes

There is a variety of possible causes of glossitis, including:

Allergic reaction

When glossitis occurs due to an allergic reaction, a person is most likely to develop acute glossitis and have sudden tongue swelling and pain. An allergy to a particular food, drug, or specific irritant can cause this type of reaction.

Injury to the mouth

Injuries to the mouth, such as small cuts from braces or burns from hot food, might cause the tongue to inflame and swell.

When dental braces cause glossitis, a person is more at risk for chronic glossitis due to the risk of repeated injury to the mouth and tongue.

Diseases

Certain diseases can cause glossitis, especially those where nutritional deficiencies occur, such as celiac disease, protein-calorie malnutrition, and pernicious anemia.

Diseases that attack the immune system, such as Sjögren’s Syndrome, can cause changes in the mouth that lead to glossitis.

Infections

Bacterial, viral, and fungal infections can all cause glossitis. However, oral herpes, which is a viral infection, and fungal yeast infections are among the most likely infections to cause glossitis.

Nutritional deficiencies

Iron deficiencies occur when a person does not have enough iron in their blood. This can trigger glossitis since low levels of iron lead to low levels of myoglobin, a substance in the blood that plays a significant role in the health of all the muscles in the body, including the tongue.

Dental decay and cavities are very common. As one article notes, up to 91% of adults ages 20–64 have cavities. Also, around 27% of people in the same age group have untreated tooth decay. Treating tooth decay early is important to prevent complications such as tooth infections.

Anyone who experiences a tooth infection should see a dentist right away to prevent the infection from spreading.

One of the first things a dentist will likely recommend is an antibiotic to kill the infection. Some antibiotics work better than others for tooth infections, and there may also be some over-the-counter (OTC) pain medications to help with the symptoms.

When to use antibiotics for a tooth infection

Dentists will typically only recommend antibiotics in dentistry for tooth infections. However, not all infected teeth require antibiotics.

In some cases, a dentist may simply be able to drain the infected area, remove the infected tooth, or perform a root canal to fix the issue.

They tend to avoid recommending antibiotics unless they are absolutely necessary, such as when the infection is severe or spreading, or if a person has a weakened immune system.

How long do they take to work?

How long each antibiotic takes to work varies depending on many factors, such as the severity of the infection and how effectively the drug eliminates the infectious bacteria.

It is important for people to complete a full round of antibiotics, taking all of the prescribed medication exactly how the dentist says to take it. Although a person may begin to notice their symptoms go away after a couple of doses, completing the full round of antibiotics helps prevent the infection from coming back or getting stronger.

As the International Dental Journal study notes, the majority of acute infections resolve in 3–7 days.

Side effects

Although antibiotics can help clear up an infection to prepare a person for dental work, these drugs do have some possible side effects.

The side effects can vary with each type of drug. It is important to discuss any possible side effects from taking a drug with a doctor before moving forward with that particular treatment.

The soft palate does not contain any bone but is a fleshy area that ends in the uvula. The uvula is the fleshy projection that hangs down from the soft palate and is visible when a person opens their mouth. The function of the uvula is to block the nasal cavity when a person is eating or drinking.

The soft palate comprises muscle and tissue, which make it mobile and flexible. When a person is swallowing or sucking, the soft palate completely separates the mouth from the throat, which helps keep food out of the respiratory tract. The soft palate is also known as the muscular palate or the velum.

In this article, we look at the benefits and side effects of fluoride and fluoride treatment, as well as treatment recommendations.

What is fluoride treatment?

Fluoride treatments are typically professional treatments containing a high concentration of fluoride that a dentist or hygienist will apply to a person’s teeth to improve health and reduce the risk of cavities. These in-office treatments may take the form of a solution, gel, foam, or varnish.

There are also some high-concentration fluoride treatments that people can use at home but only under the specific direction of a dentist.

The fluoride dentists use in these treatments is similar to the fluoride in toothpaste. However, the treatment contains much higher doses and may offer more rapid benefits.

Benefits of fluoride and fluoride treatments

Fluoride has several benefits for the teeth:

1. It helps the body better use minerals, such as calcium and phosphate. The teeth reabsorb these minerals to repair weak tooth enamel.
2. It joins into the tooth structure when teeth are developing to strengthen the enamel of the teeth, making them less vulnerable to bacteria and cavities for life.
3. It slows or even reverses the development of cavities by harming bacteria that cause cavities.

When taken together, these benefits may help to:

• reduce the risk of cavities
• slow the growth of cavities
• delay the need for expensive dental work
• prolong the life of baby teeth
• reduce the amount of time and money a person has to spend at the dentist

By preventing cavities and slowing the growth of bacteria, fluoride treatment may also:

• prevent gum disease
• reduce tooth pain
• prevent the premature loss of teeth

Fluoride treatments can improve oral health, which, according to the World Health Organization (WHO), is a major predictor of overall health. Poor oral health can cause a range of other health conditions, including cardiovascular disease.

Gingivitis often resolves with good oral hygiene, such as longer and more frequent brushing, and flossing. In addition, an antiseptic mouthwash may help.

In mild cases of gingivitis, patients may not even know they have it, because symptoms are mild. However, the condition should be taken seriously and addressed immediately.

Types

There are two main categories of gingival diseases:

Dental plaque-induced gingival disease: This can be caused by plaque, systemic factors, medications, or malnutrition.

Non-plaque induced gingival lesions: This can be caused by a specific bacterium, virus, or fungus. It might also be caused by genetic factors, systemic conditions (including allergic reactions and certain illnesses), wounds, or reactions to foreign bodies, such as dentures. Sometimes, there is no specific cause.

Causes

The most common cause of gingivitis is the accumulation of bacterial plaque between and around the teeth. The plaque triggers an immune response, which, in turn, can eventually lead to the destruction of gingival, or gum, tissue. It may also, eventually, lead to further complications, including the loss of teeth.

Dental plaque is a biofilm that accumulates naturally on the teeth. It is usually formed by colonizing bacteria that are trying to stick to the smooth surface of a tooth.

These bacteria might help protect the mouth from the colonization of harmful microorganisms, but dental plaque can also cause tooth decay, and periodontal problems such as gingivitis and chronic periodontitis, a gum infection.

When plaque is not removed adequately, it can harden into calculus, or tartar, at the base of the teeth, near the gums. This has a yellow color. Calculus can only be removed professionally.

Plaque and tartar eventually irritate the gums, causing gum inflammation around the base of the teeth. This means that the gums might easily bleed.

Other causes and risk factors

Changes in hormones: This may occur during puberty, menopause, the menstrual cycle, and pregnancy. The gingiva might become more sensitive, raising the risk of inflammation.

Some diseases: Cancer, diabetes, and HIV are linked to a higher risk of gingivitis.

Drugs: Oral health may be affected by some medications, especially if saliva flow is reduced. Dilantin, an anticonvulsant, and some anti-angina medications can cause abnormal growth of gum tissue.

Smoking: Regular smokers more commonly develop gingivitis, compared with non-smokers.

Age: The risk of gingivitis increases with age.

Poor diet: A vitamin-C deficiency, for example, is linked to gum disease.

Family history: Those whose parent or parents have had gingivitis have a higher risk of developing it too. This is thought to be due to the type of bacteria we acquire during our early life.