Friday, June 7, 2013

How dirty is your toothbrush?

How dirty is your toothbrush? Answer: Not as much as you think
You might not need to throw away that toothbrush after a sore throat, a new study shows
It’s common wisdom as old as your grandmother – after a child has had strep throat, flu or some other similar infection, it’s important to throw away that contaminated old toothbrush and get a new one.
But a new study being presented on Saturday challenges this assumption. A team of experts couldn’t find any strep germs on toothbrushes used by children with strep throat. But they did find potentially nasty germs on two brand-new toothbrushes right out the package.
“I was just dumbfounded,” says Dr. Lauren Shepard of the University of Texas Medical Branch (UTBM) in Galveston, who will present her findings on Saturday at a meeting of the Pediatric Academic Societies.
Tests of toothbrushes from more than 40 children showed just one contaminated with group A Streptococcus – the bacteria that causes strep throat. And that one came from a child who did not have strep throat. Not a single toothbrush from 16 kids with strep throat produced the bacteria.
“They grew the normal stuff but they did not grow strep. That really surprised us,” Shepard said in a telephone interview.
Shepard says she had been curious about the toothbrush issue for a while. She wanted to see if throwing away a toothbrush after an illness might have an effect on children.
“When I was doing my research I realized there were no other studies about throwing away your toothbrush after you have had strep. I thought, ‘how is this possible that no one has ever looked at this?’ I have been told this all my life,” Shepard says.
So Shepard’s team set up a series of studies – first making sure that it is possible to even culture bacteria off toothbrushes – it is – and then trying to simulate a real-life test.
“What we ended up doing was devising a way to collect real kids’ toothbrushes,” Shepard said. They set up shop in an urgent care clinic, offering free toothbrushes to kids who took part in the study.
“We bought these toothbrushes that had a little light in them. Of course the kids liked that,” Shepard said. The light is set to blink for a minute or so, to ensure children brush thoroughly.  “The toothbrushes came two to a pack, so we took one and the kids got to keep one. Everybody did it because they wanted the toothbrush.”
The children brushed for one minute, without toothpaste, and then the toothbrushes were stored in a sterile bag for testing.
They were unable to grow Streptococcus A bacteria off any of the toothbrushes from infected children. A single child who wasn’t sick had Strep A on her toothbrush, Shepard says. It's possible the child was a so-called strep carrier -- someone who carries the bacteria without showing any ill-effects, she said.
"This study supports that it is probably unnecessary to throw away your toothbrush after a diagnosis of strep throat," said Dr. Judith Rowen, a strep specialist and pediatrician at UTMB who worked on the study.
“Maybe the strep is just growing down on the tonsils,” Shepard adds. “It might be it doesn’t actually grow on the teeth as much.”
Strep can live outside the body for days, Shepard says. And, she says, toothbrushes don't really dry out overnight, so it it not unrealistic to think someone could be re-infected by a contaminated toothbrush.
An even bigger surprise – they tested two brand-new, unused toothbrushes as a control. But they found bacteria on them.  
“When we took them straight out of the package using our own sterile techniques … both of them grew something,” Shepard says. One grew staphylococcus – a fairly common bacteria – and another grew some type of bacillus, perhaps E. coli or some other very common germ.
“Even the microbiologists thought that was pretty gross,” Shepard says. “They were like, ‘Oh, I can’t believe they grew stuff’.”
It might be worth rinsing even a brand-new toothbrush, Shepard says. “It’s not like a true health hazard but you should be aware when you take it out it’s not sterile,” she said.
The American Dental Association agrees there's little evidence that any germs on a toothbrush could hurt you. But the organization recommends that people not share toothbrushes or store them in closed containers that might encourage the growth of bacteria. They should be thoroughly rinsed, and replaced every three to four months --mostly because they become frayed and less effective.
"While there is evidence of bacterial growth on toothbrushes, there is no clinical evidence that soaking a toothbrush in an antibacterial mouthrinse or using a commercially available toothbrush sanitizer has any positive or negative effect on oral or systemic health," the group says. "Some toothbrush cleaning methods, including use of a dishwasher or microwave oven, could damage the brush."
As for tossing the toothbrush after an illness? Don’t bother, the researchers advise.

Friday, April 26, 2013

Regular scaling can reduce atrial fibrillation risk

Study: Regular scaling can reduce atrial fibrillation risk
April 9, 2013 -- Is there a relationship between periodontal health and cardiac dysrhythmia? Yes, according to a study in the International Journal of Cardiology (March 1, 2013).
In fact, the study authors propose a way to lower the risk of developing atrial fibrillation (AF), the most common type of sustained cardiac dysrhythmia: by undergoing dental scaling at least once a year.
"Oral infections due to poor oral hygiene may also predispose patients to new-onset AF by adding to the inflammatory burden of the individuals," the researchers from Taiwan wrote.
Atrial fibrillation affected approximately 2.7 million Americans in 2010, according to the U.S. Centers for Disease Control and Prevention (CDC). AF's disorganized cardiac electrical impulses and incomplete atrial emptying place patients at significantly increased risk for clots, strokes, and heart failure, the CDC noted.
For this study, the researchers used data from Taiwan's National Health Insurance Research Database (NHIRD) for the year 2000 to identify 28,909 subjects age 60 or older who had no history of cardiac dysrhythmias. The NHIRD is a cohort database of medical claims data for 1 million Taiwanese citizens that is representative of the 26 million citizens enrolled in Taiwan's mandatory National Health Insurance (NHI) universal coverage program, according to the study authors. Although each individual's identity is encrypted to protect confidentiality, the code remains consistent throughout the dataset, which allowed the study authors to follow insurance claims by the same subject.
"The present study suggests that the risk of AF can be reduced through dental scaling," the study authors concluded. "Given the high prevalence of periodontal diseases in the population, improvement of oral hygiene through dental scaling may be a simple and effective way to decrease the inflammatory burden and prevent AF."
"Poor oral hygiene is the major cause of periodontal disease, which has been found to be a potential risk factor for coronary heart disease, ischemic stroke, and peripheral vascular disease," the current study authors wrote. "Systemic inflammation could represent the underlying mechanism that links oral health and cardiovascular disease."

Tuesday, June 12, 2012

Tongue Cleaning Reduces Bad Breath

    Everyone has bad breath sometimes, and some people have chronic bad breath all the time, 25 to 50 percent, depending on the population. Morning bad breath is due to overnight dryness when salvia flow is at it lowest, enhancing the growth of oral bacteria. Bacteria biofilm accumulates on and around the teeth, and is also part of tongue coating, especially on the dorusm of the tongue. Eating and drinking in the morning tends to eliminate overnight bad breath, but sometimes it is a chronic problem.
    Ninety percent of bad breath can be attributed to oral causes including caries, periodontal disease, poor oral hygiene, and tongue coating. The gold standard measures of measuring bad breath is organolepic testing or smelling the person's breath. It is also measured by the level of unpleasant smelling volitale sulfur compounds (VSC) in the mouth and air.
     Researchers at three universities in The Netherlands reviewed research to determine if tongue cleaning with a scraper or toothbrush in addition to regular oral hygiene would reduce oral malodor. Of the 405 studies and abstract their search produced, 22 full text articles were read and 17 of these were excluded as they didn't established criteria they were looking for in the studies The five studies that did fit all criteria were evaluated and compared, showing that tongue scraping or brushing does reduce oral malodor. The studies did not evaluate chronic bad breath.

Thursday, April 19, 2012

Heartburn Medications May Increase Bacterial Infections, Diarrhea

Popular medications used to treat heartburn, stomach ulcers, and gastroesophageal reflux disease (GERD) may be associated with an increased risk of bacterial infections and diarrhea, according to a safety announcement released Feb. 8, 2012, by the FDA.

According to the FDA, taking proton pump inhibitors (PPI), a drug class commonly used to treat heartburn and stomach acid, may increase a patient's chance of developing Clostridium difficile- associated diarrhea (CDAD- a chronic diarrhea that may cause severe intestinal problems and in several cases, death. The FDA based its safety announcements on almost two dozen studies that found people taking PPIs were approximately 2.75 times more likely to suffer from CDAD than those not taking the medications. The FDA warning applies to both prescription and over the counter PPIs including Dexilant, Nexium, Prilosec, Prilosec OTC, Prevacid, and more. For an entire listing of brand and generic PPIs included in the warning, visit

PPIs are a class of drugs used to reduce gastric acid production and are considered one of the most popular and effective class of drugs worldwide. There medications are used to treat peptic ulcers, dyspepsia (upset stomach/indigestion), GERD, and more. Common side effects of PPI use include headache, abdominal pain, fatigue, nausea, dizziness, and diarrhea. According to the FDA, patients taking PPIs who experience persistent diarrhea should speak to with their health care provider as this may be a sign of CDAD.

Tuesday, March 20, 2012

Total Health Facts

Dental Office: The Front Line of Health
  • Each year nearly 20 million Americans who see their dentist do Not see a physician.
  • The average physician visit lasts between 10 and 20 minutes, giving patients much less time with health care providers than dentists.
  • Patients should visit the dentist twice a year, at least, but often see a physician once a year or less
Periodontal Disease
  • Approximately 78% of the adult U.S. population has peridontal disease.
  • Less than 3% of those with periodontal disease receive treatment.
  • Health care costs are 21% higher for patients with severe periodontal disease than those with no periodontal disease.
  • Periodontal disease is linked to the following health conditions:  
           Birth of premature low-birth-weight babies causes 20,000 infant deaths each year
           Pancreatic cancer causes 38,000 deaths each year.
           Coronary artery disease contributes to 445,000 deaths each year.
           Diabetes contributes to 230,000 deaths each year.
Oral Cancer
  • 36,000 new cases of oral cancer are diagnosed each year.
  • Only half the people diagnosed with oral cancer are alive in 5 years.
  • One person dies every hour from oral cancer.
  • When discovered in early stages, the oral cancer survival rate leaps to 80%-90%.
  • When surveyed, only 15% of patients who went to the dentist reported receiving an oral cancer exam.
  • More than 20 million people in the United States are infected HPV and there are approximately 6 million new cases each year.
  • Studies suggest that 15%-25% of oropharyngeal cancer cases are associated with HPV16.
Sleep Disorders
  • 50-70 million Americans suffer from chronic sleep disorders.
  • Reducing sleep from 7 hours to 5 doubles the risk of cardiovascular death.
  • An estimated 18 million Americans have obstructive sleep apnea.
  • 80%-90% of sleep apnea suffers remain undiagnosed and untreated.
  • Moderate sleep apnea increases the risk of death by 17%. Severe sleep apnea increases the risk of death by up to 46%.
Heart Disease
  • Heart disease is the leading cause of death for both men and women.
  • Forgetting to brush twice a day raises your risk of heart disease by 70%.
  • Men and women with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without.
  • Periodontal disease can exacerbate existing heart conditions.
  • Diabetes contributes to approximately 230,000 deaths each year.
  • 95% of Americans with diabetes have periodontal disease.
  • Periodontal disease makes it more difficult for diabetics to control their blood sugars, which can lead to health complications.
  • Not only are diabetics more likely to have periodontal disease, but periodontal patients are also more likely to develop diabetes.

Thursday, March 1, 2012

How alcohol affects teeth and the oral cavity

There are many serious consequences to imbibing to excess. Alcoholic beverages can affect the mouth and teeth in many different ways. In recent times, some of the healthful benefits of moderate alcohol consumption have been noted. Certainly, in excess alcohol has been to be detrimental to health. The detrimental effects of alcohol on the mouth can range from gum disease to oral cancer.
Drinking can lead to gum disease
Researchers at the University at Buffalo School of Dental Medicine found a direct correlation between the amount of alcohol consumed and the severity of the risk for gum disease. With five drinks per week, the risk was 10 percent, and that rose to 40 percent for people who consumed 20 drinks per week. Gum disease can lead to more severe periodontal disease, which can very easily lead to tooth loss.
Periodontal disease and poor oral health have been shown to have a direct effect on systemic health. Periodontal pathogens have been implicated in a long list of systemic diseases, from heart disease to pancreatic cancer. While the effect of alcohol on tooth enamel isn't directly dangerous, many cocktails are mixed with sugary fruit juices or soft drinks, which have been proven to cause tooth erosion. When one drinks a sugary beverage, the sugars from the drink and the bacteria in the mouth combine to create acids. These acids then attack the tooth enamel, causing decay to resulting in cavities. Heavy drinking can also lead to frequent vomiting and the vomit is extremely acidic.
The most significant way in which drinking affects the mouth is increasing the risk of oral cancer. Evidence suggests that this is because alcohol breaks down into a substance called acetaldehyde, which can bind to proteins in the mouth. This can trigger an inflammatory response from the body. In the most severe cases, cancerous cells can develop. While oral cancer most often appears on the lips or the tongue, it can also occur on both the floor and the roof of the mouth or on the gums. This risk is significantly impacted when alcohol consumption is combined with tobacco use.
According to the Oral Cancer Foundation, the synergy between alcohol and tobacco results in a 15 times greater risk for the development of oral cancer. Even on its own, alcohol abuse is the second largest risk factor. It's thought because alcohol dehydrates the cell walls in the mouth, carcinogens can permeate the tissue more easily, resulting in development of cancer. Oral cancer is the fasting growing disease in 18-34 year old population. Sometimes, this is the very segment of the population that drinks alcohol in excess. Oral cancer is the major cause of preventable deaths in the United States.
Habits can affect dental cavities
Heavy drinkers may experience dry mouth at night and neglect both personal and professional oral health care. They may also consume higher levels of refined carbohydrates to satisfy their "munchies." All of these might increase their risk of developing cavities. Sometimes enlargement of the parotid salivary glands (glands which secrete saliva into the mouth) may be a sign of a chronic alcohol use problem. Drinking alcohol can have both direct and indirect effects on one's oral health, which also directly affects one's systemic health. Consuming alcohol is always best in moderation.

Tuesday, November 29, 2011

Common Causes of Sensitive Teeth

  1.  Using mouthwash 3,4 or 5 times per day will cause tooth sensitivity, as some mouthwashes are   acidic. A neutral pH fluoride rinse may be a solution.
  2. Acidic foods such as citrus fruits, juices, and tomatoes can erode protective enamel and cause sensitivity. Rinse with water or drink some milk to help neutralize afterwards.
  3. Gum recession exposing tooth roots which do not have enamel can transmit temperature changes to the tooth nerves more easily. Toothpaste for sensitivity, fluoride rinses or laser treatment may help.
  4. Cracked or broken teeth caused by chewing ice or hard candy or other hard foods can lead to irritation of the nerve tissue inside the tooth. A cracked tooth can allow bacterial entrance into the tooth causing additional pain.
  5. Teeth clenching or grinding can wear away enamel or cause cracked teeth leaving teeth more sensitive. A night guard or bite splint can protect teeth and prevent wear and associated sensitivity.