Vital Record » Dentistry http://news.tamhsc.edu Your source for health news from the Texas A&M Health Science Center Tue, 01 Sep 2015 18:55:34 +0000 en-US hourly 1 Investigating the color sustainability of endodontic materials http://news.tamhsc.edu/?post=investigating-the-color-sustainability-of-endodontic-materials http://news.tamhsc.edu/?post=investigating-the-color-sustainability-of-endodontic-materials#comments Wed, 26 Aug 2015 14:42:40 +0000 http://news.tamhsc.edu/?post_type=post&p=24196 In today’s world of modern dentistry, endodontic treatments such as vital pulp therapies and root canals can breathe new life into a tooth that otherwise might be lost. There’s just one problem: Certain materials used in these procedures can cause discoloration of the teeth, most often to an undesirable shade of gray or even blue]]>
Esther Oluwo, a third-year dental student

Esther Oluwo, a third-year dental student whose research won top honors from the Student National Dental Association

In today’s world of modern dentistry, endodontic treatments such as vital pulp therapies and root canals can breathe new life into a tooth that otherwise might be lost. There’s just one problem: Certain materials used in these procedures can cause discoloration of the teeth, most often to an undesirable shade of gray or even blue. Since these materials are packed inside the tooth, the darkened hue shines through the enamel. The only way to get rid of it is to bleach the tooth or cover it with a crown, but that only works in permanent teeth.

It’s an issue that Esther Oluwo, a third-year student at Texas A&M University Baylor College of Dentistry, understands well. She spent most of summer 2014 testing the color sustainability of several products used in these procedures. The findings were telling; they recently earned her first place in the 2015 Student National Dental Association scientific poster competition during the July annual session of the group’s professional counterpart — the National Dental Association.

Oluwo, a participant in the Predoctoral Research Training Fellowship program at TAMBCD, spent the course of several weeks meticulously examining pellet-size portions of some of the most commonly-used root and pulp treatment materials on the market today: Biodentine, White ProRoot MTA, and bioceramics MTA Plus and NeoMTA Plus. She then exposed those samples to substances commonly found in the mouth, like saliva and blood, as well as compounds used in clinical procedures, such as sodium hypochlorite — bleach — used to irrigate a tooth after removing damaged pulp tissue, and formocresol, which is commonly used in primary teeth pulpotomies.

“We wanted to find out what was causing the teeth to change color and out of all the materials, which one changes color the least,” explains Oluwo.

Findings revealed significant darkening in the presence of formocresol, which gives dentists an immediate takeaway to avoid this substance in combination with the tested endodontic materials. Other materials showed varying discoloration in combination with substances like saliva and saline.

“This is clinically relevant because now clinicians can make more informed decisions when treating patients,” Oluwo says. “The dentist can look at the materials and compare to determine which one they would like to use to treat their patients.”

Next steps, Oluwo suggests, could include looking at how much of the culprit materials it takes to cause discoloration.

Her research builds upon multiple projects at the college evaluating color stability of current and emerging endodontic materials. It’s a hot topic, as response to the research has been strong: Oluwo won first place in the TAMBCD Research Scholars Day dental student poster competition this spring and will present at the Hinman Student Research Symposium in the fall.

Lynne Opperman, Ph.D., B.Sc., professor and director of the Office of Technology Development, served as faculty mentor for the project and says research opportunities like Oluwo’s offer an added benefit for students.

“It’s a really good experience for students to understand product development when as clinicians they get a sheet saying, ‘I’ve got this great, fabulous new material,’ and determine whether great experiments were done, or not so great experiments,” Opperman says. “It allows them to understand the process and critically assess the work done on those materials.”

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Is your dentist finding more than just cavities? http://news.tamhsc.edu/?post=is-your-dentist-finding-more-than-just-cavities http://news.tamhsc.edu/?post=is-your-dentist-finding-more-than-just-cavities#comments Thu, 20 Aug 2015 13:00:47 +0000 http://news.tamhsc.edu/?post_type=post&p=24098 A quick glance in the mouth and your dentist can spot a plethora of bad habits, like opening bobby pins with your teeth or chewing ice. But did you know they can also see more serious health issues that may be lurking elsewhere in the body]]>

A glass full of dental tools.A quick glance in the mouth and your dentist can spot a plethora of bad habits, like opening bobby pins with your teeth or chewing ice. But did you know they can also see more serious health issues that may be lurking elsewhere in the body? William Wathen, D.M.D., associate professor at the Texas A&M University Baylor College of Dentistry, gives an inside perspective of what your dentist sees during a regular checkup.

Cardiovascular/Cerebrovascular Disease

To understand how oral health is linked to cardiovascular disease and cerebrovascular disease we must look first at how plaque affects the gums in the mouth.

Plaque is a sticky deposit on the teeth where bacteria proliferate. When plaque is not removed by regular brushing or flossing, the bacterial byproducts begin to irritate at the gums, producing an ulcer in the gums. This hole in the gum allows the germs to enter the blood stream.

“This irritation triggers an inflammatory response, which sends powerful chemicals that rush to repair the damage done by the plaque,” Wathen said. “However, these chemicals may damage tissues they are not meant to, like artery linings, which can be a factor in heart attack or stroke.”

Dementia

The same type of inflammatory response that happens in the mouth when gums are irritated has also been linked to dementia, Wathen noted.

When inflamed gums are left untreated, it can turn into periodontal disease, a serious form of gum disease that can cause tooth loss. Worth noting, patients with tooth loss seem to be at a higher risk for developing dementia.

“The more teeth patients have lost means that they have been battling chronic inflammatory disease for quite some time, which can affect other organs in the body,” Wathen said. “In the brain, chronic inflammation can damage nerve cells and cause a buildup of proteins both of which are linked to dementia.”

It’s important to note that gum disease does not cause dementia, but it is a contributing factor.

Diabetes

Bad breath, or halitosis, is the most common symptom of hidden issues found elsewhere in the body, but did you know that the same can be said for fruity breath? Fruity breath is a common symptom of ketoacidosis, a condition particularly associated with Type 1 diabetes.

Type 1 diabetes occurs when the metabolic process – controlled by the pancreas – is not working correctly. When the body doesn’t have enough insulin, it instead uses fatty acids for energy, which produces acidic ketones (byproducts of fat metabolism). When ketones build up in the blood, they make it more acidic. In extreme cases, ketoacidosis can lead to diabetic coma or even death.

Eating Disorders

The two most common eating disorders – anorexia nervosa and bulimia nervosa -both leave distinct markers on the teeth.

Anorexia nervosa, along with vitamin deficiency in general, can cause lesions on the mouth and tongue and also cause the corners of the mouth to crack.

Bulimia nervosa, and in particular purging bulimia  – or self-induced vomiting – can cause the stomach acid to erode the enamel on the backs of the teeth. As the enamel weakens, the tops of the teeth can also become worn down, especially if patients also grind their teeth or eat a course diet.

Oral Cancer

Each year, there are 30,000 new cases of oral cancer diagnosed in the United States. While oral cancer is curable if found early, the signs can be hard to spot on your own. Luckily, dentists are trained to look for these telling signs making regular check-ups all the more important.

The most common symptoms are a red or white lump or a sore that does not go away after two weeks. Other symptoms include: thickening in the oral soft tissues, soreness or a feeling that something is caught in the throat, difficulty chewing or swallowing, difficulty moving the jaw or tongue, hoarseness, numbness in the mouth or swelling in the jaw.

“For most people, the dangerous triad is smoking, heavy alcohol use and poor oral hygiene, but anything that causes irritation in the mouth can lead to an increased risk for oral cancer,” Wathen said.

Pregnancy

While a pregnancy test is your best bet in determining whether or not you are pregnant, your dentist may notice subtle changes that occur in the mouth that often point to pregnancy.

“In pregnancy, there are some natural hormonal fluctuations that take place and cause the gums to be more fragile,” Wathen said.

Common oral issues expecting mothers tend to see are pregnancy gingivitis (swollen red, bleeding gums) and tumors (swollen gums).  Pregnancy gingivitis can occur due to the gums becoming more susceptible to inflammation and infection. To help prevent this, Wathen said that expecting mothers should be extra vigilant in brushing and flossing, particularly if they notice any irritation. Pregnancy tumors can also arise and are nothing more than an isolated swollen gum, and while they can be uncomfortable, they will usually resolve after the baby is born.

Sinus Infections

There are two oral issues that sinus infections can cause: bad breath and toothaches.

“Sinus drainage can cause bad breath, as it can be hard to keep the sinuses cleaned out. To resolve the issue, patients will generally need to go to an ear, nose and throat specialist to have their sinuses flushed out,” Wathen said.

Toothaches caused by sinus infections aren’t actually toothaches at all. The nerves of the back, upper teeth are very close to the sinus cavity. When there is inflammation caused by a sinus infection, it can push on the nerves of the teeth, which can cause some minor discomfort.

“If the pain is coming from the tooth, the nerves are inflamed and swollen and it throbs and hurts,” Wathen said. “When that’s not the case, we can typically tell the pain is coming from somewhere else.”

It is important to note that oral issues do not create these systemic issues, but they can add to an existing issue or a symptom of a bigger problem that is going on elsewhere in the body.

“Your mouth is the gateway to the rest of your body,” Wathen said. “Oral health is much more than preventing cavities and gum disease, it is an important part of your overall health.”

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Teen e-cig users more likely to smoke http://news.tamhsc.edu/?post=adolescents-most-at-risk-with-e-cigarettes-yet-teen-usage-soars http://news.tamhsc.edu/?post=adolescents-most-at-risk-with-e-cigarettes-yet-teen-usage-soars#comments Wed, 19 Aug 2015 18:42:02 +0000 https://news.tamhsc.edu/?post_type=post&p=20931 Teenagers are among the fastest growing groups of electronic cigarette consumers in the U.S. They may also be the most vulnerable to the devices’ physical and psychological side effects, according to experts from Texas A&M University Baylor College of Dentistry’s Tobacco Treatment Services]]>

As e-cigarette usage among high school students continues to climb, a recent study from The Journal of the American Medical Association reveals an unsettling trend: that adolescent e-cigarette users are more likely than their non-vaping peers to initiate use of combustible tobacco products such as cigarettes, cigars and hookahs. The reason may lie in a common denominator between e-cigarettes and their combustible counterparts: nicotine.

While the study hints that more research is needed to determine if this association is merely casual, it’s important to note that while e-cigarettes don’t contain tobacco, the battery-powered devices do deliver nicotine in aerosol form.

“Nicotine’s addictive properties are a risk for any age group, but with adolescents, the stakes are even higher,” says Dr. K. Vendrell Rankin, director of Texas A&M University Baylor College of Dentistry’s Tobacco Treatment Services.

05experts-ecigarette-2For teens, mental health as well as key emotional and cognitive systems are at stake.

“Major cognitive functions and attention performance are still in the process of developing during adolescence,” says Rankin, also a professor and associate chair in public health sciences at TAMBCD. “Nicotine increases the risk of developing psychiatric disorders and lasting cognitive impairment and is associated with disturbances in working memory and attention. Reliance on nicotine to manage negative emotions and situations impairs the development of coping skills.”

In addition to affecting the emotional and cognitive development of teens, nicotine is highly addictive. In fact, the younger a person is when they begin using nicotine, the more likely they are to become addicted and the stronger the addiction may become. According to the American Lung Association, of adults who smoke, 68 percent began smoking at age 18 or younger.

In other words, the younger users are when they try or start using nicotine, the more nicotine receptors they will have and the more they may struggle with nicotine cravings throughout  their lives.

“Everybody has a certain amount of nicotine receptors in the brain,” Rankin says. “When you start smoking, vaping or supplying nicotine to them, they multiply. If you stop smoking or vaping, the receptors don’t go away.”

Nicotine use very quickly escalates into addiction, even when dealing with tobacco-free, odorless “vaping” associated with e-cigarettes. That’s because nicotine in any form triggers the release of neurotransmitters such as adrenaline and dopamine, which dramatically impacts a number of body systems. Dopamine floods the brain, and nicotine cravings increase.

This includes spit, or smokeless tobacco, which in the past was promoted as a replacement to smoking. The result: The creation of a large group that began using spit tobacco as a smoking replacement but eventually became dual users.

“We are seeing the same phenomena with the e-cigarette,” says Rankin. To better understand the similar association between e-cigarettes and combustible tobacco product use among teens, Rankin says further research could be replicated on a national level, as the study published in The Journal of the American Medical Association focused on Los Angeles high school students.

E-cigarette companies currently advertise their products to a broad audience that includes 24 million youths, and proposed U.S. Food and Drug Administration regulations would not limit e-cigarette marketing. Bold marketing tactics, celebrity endorsements, endless flavor choices and a plethora of online videos instructing users on how to mix their own e-cigarette liquid, or “e-juice,” have only added fuel to the fire. There currently are no federal laws in place to restrict minors from purchasing e-cigarettes.

There is a glimmer of hope on the horizon. In April, the FDA released the details of a proposal to extend its tobacco authority to e-cigarettes, including minimum age and identification restrictions intended to prevent sales to minors. A final ruling is slated for summer 2015.

In the meantime, many Texas cities have set their own regulations and ordinances banning the sale of e-cigarettes to minors. Any e-cigarette regulation in Texas will have to occur city by city, Rankin says, since the state doesn’t have comprehensive smoke-free laws.

“I don’t think e-cigarettes are going to drop off,” Rankin says. “It’s the newest — or most popular — kid on the block right now.”

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Back to school: How to encourage healthy dental habits away from home http://news.tamhsc.edu/?post=back-to-school-how-to-encourage-healthy-dental-habits-away-from-home http://news.tamhsc.edu/?post=back-to-school-how-to-encourage-healthy-dental-habits-away-from-home#comments Wed, 29 Jul 2015 13:00:08 +0000 http://news.tamhsc.edu/?post_type=post&p=23529 School is just around the corner, which means backpacks and packed lunches await your children. Whether it’s their first year at school or they’re already climbing the ranks, you want to ensure they are making healthy choices when it comes to lunch. However, one aspect you may not have considered when it comes to lunch options is dental health]]>
young girl brushing her teeth in front of a bathroom mirror

Participate in your child’s morning and nightly teeth cleaning rituals, and teach them the tools to keep those pearly whites healthy and happy.

School is just around the corner, which means backpacks and packed lunches await your children. Whether it’s their first year at school or they’re already climbing the ranks, you want to ensure they are making healthy choices when it comes to lunch. However, one aspect you may not have considered when it comes to lunch options is dental health.

All ages are at risk of developing cavities, especially if they don’t practice healthy dental habits, but “dental cavities are a prevalent disease in our childhood population,” said Kathleen Pace, D.D.S., assistant professor at Texas A&M University Baylor College of Dentistry.

Pace offers the following tips for parents to promote healthy dental habits in children:

1. Eat healthy foods at home

A healthy diet won’t just improve your child’s growth and physical health; it will also improve their dental health. Most natural foods contain lower amounts of sugars and aren’t as damaging to the teeth.

One of the easiest things you can do to ensure your child will make healthy, tooth-conscious decisions at school is to eat healthy foods at home. Aim to serve your child a balanced diet, including fruits, vegetables, whole grains, dairy products and protein.

“Parents need to serve these foods at home so their children will imitate those eating habits when they are elsewhere,” Pace said.

2. Pack fruits and dairy

Natural is usually better when it comes to foods in general, and the same goes for snacks. Instead of popular snacks that may lead to unhealthy teeth or dental habits, try going the au naturel route. Packing fruit will satisfy your child’s sweet cravings and help them gain all the proper nutrients they need to grow healthy.

Milk doesn’t just help their bones grow stronger, it can also help their teeth stay healthier as well. One of the best snacks you can pack in your child’s lunch is a dairy product. Try throwing in a string cheese or a carton of milk to their lunchbox.

“Cheese or other dairies are a great way to end meals,” Pace remarked. “They can help protect tooth enamel, which is key to preventing decay.”

3. Avoid sticky and sugary foods

“In general, any food that is sticky, crunchy or has sugar can promote cavities,” Pace warned. Sticky foods like candy or gummies are not only loaded with sugar, but they can also be difficult to dislodge later. Anything that sticks to the teeth can potentially damage them or cause decay.

“Frequent sugar consumption is one of the worst things for your teeth that can cause tooth decay. Unfortunately, sugar is in almost everything,” Pace said. Avoid packing food with extra sugar like cookies, sugary beverages or candy in children’s daily lunches. Sugary, prepackaged snacks may be convenient short term, but they may also help a cavity thrive later on.

Check all the sugar content on any prepackaged foods or snacks, and opt for more natural or low-sugar foods instead. Switch out your kid’s sugar-bomb applesauce for the no sugar added variety. If you’re having trouble thinking of appropriate snacks, fruits with peels can satisfy your little one’s sweet tooth without promoting cavities.

4. Be active in their dental care

Participate in your child’s morning and nightly teeth cleaning rituals, and teach them the tools to keep those pearly whites healthy and happy. You can also take it a step further by acting as a dental advocate yourself to promote healthy habits in your children.

“Children love to imitate, so let them watch you brush your teeth and floss. Or even better, do it with them,” Pace suggested. “Really try to have your kids brush their teeth after breakfast.”

Healthy habits start at home, so try to make your child’s formative years fun and memorable. While brushing teeth, sing a favorite song or play a catchy tune on your phone to make it enjoyable, and always serve them healthy foods at home. These are habits they’ll take with them throughout their lifetime.

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Meeting the demand for patient-centered care with $5.4 million in grant funding http://news.tamhsc.edu/?post=meeting-the-demand-for-patient-centered-care-with-5-4-million-in-grant-funding http://news.tamhsc.edu/?post=meeting-the-demand-for-patient-centered-care-with-5-4-million-in-grant-funding#comments Tue, 21 Jul 2015 17:47:42 +0000 http://news.tamhsc.edu/?post_type=post&p=23946 More than 5 million Texans live in dentally underserved areas, according to 2014 numbers from the Health Resources and Services Administration. Of those individuals, more than 1.5 million did not receive dental services the same year. What makes those figures even more staggering is that the needs of these vulnerable, underserved populations are not limited to dental care. Where oral health is lacking, there also may be unmet medical or psychosocial needs. ]]>
Fourth-year dental student Ethan Yang treats a patient at North Dallas Shared Ministries in June 2014.

Fourth-year dental student Ethan Yang treats a patient at North Dallas Shared Ministries in June 2014.

More than 5 million Texans live in dentally underserved areas, according to 2014 numbers from the Health Resources and Services Administration. Of those individuals, more than 1.5 million did not receive dental services the same year. What makes those figures even more staggering is that the needs of these vulnerable, underserved populations are not limited to dental care. Where oral health is lacking, there also may be unmet medical or psychosocial needs.

As part of a focus on patient-centered care, the creation of “health homes,” focusing on the total needs of these patients and their families, has come to the fore. Texas A&M University Baylor College of Dentistry is responding to this trend by expanding its predoctoral and postdoctoral training with $5.4 million in funding from the Health Resources and Services Administration of the U.S. Department of Health and Human Services.

Through collaboration among TAMBCD, Texas A&M Health Science Center, Dallas-area health care institutions and community partners, TAMBCD will amp up its interprofessional training to help integrate dentistry into the broader health care delivery system.

The funding is composed of two awards, each lasting five years: $3.7 million for TAMBCD’s postdoctoral training and $1.7 million for the predoctoral component. Of the 38 awards given nationwide, the dental school is one of only five institutions to receive predoctoral and postdoctoral funding.

Predoctoral: expansions to the interprofessional experience

In 2013, volunteer dentists at North Dallas Shared Ministries, a nonprofit that provides social and health services to low-income residents within 20 metroplex zip codes, saw a total of 479 patients. In June 2014, TAMBCD initiated a partnership with the organization, making it the third site in its community-based clinical training program. In the six months to follow, that same clinic saw 1,719 dental patients, thanks to the influx of TAMBCD students providing care.

“We know that the need is huge,” says Judy Rorrie, executive director of North Dallas Shared Ministries, which will be impacted in a big way by the HRSA funding.

The $1.7 million, which is an extension of a previous HRSA grant, will increase interprofessional experiences at the community-training site. Through collaboration with UT Southwestern Medical School, dental students will work closely with nutritionists, family medicine residents, medical students, physician assistant students and social workers. Whereas in the past dental students may have taken a patient’s blood pressure and heart rate during appointments, they’ll now measure body mass index and assist with diabetes and cholesterol screenings.

“Students won’t, strictly speaking, just be doing dentistry when they are out there,” says Daniel Jones, D.D.S., Ph.D., chair of public health sciences at TAMBCD and principal investigator for the predoctoral grant. “The ultimate goal at North Dallas Shared Ministries encompasses the patient-centered medical home: One-stop shopping, where you can see the dentist, the social worker and case managers to connect people with the right resources.”

In order to make a difference with underserved populations, that’s the way it needs to be done, says Paul Hoffmann, administrative director of community clinics at TAMBCD and co-investigator for both grants.

“We are really going to try to impact the social determinants of health,” says Hoffmann. “If a patient comes in for oral health needs, we are going to do a comprehensive assessment. What other needs does the patient have? Are there economic issues; are there behavioral health issues? It’s about looking at more than just a patient’s chief complaint.”

Postdoctoral: a revamped public health graduate program 

For 14 years, TAMBCD has offered a graduate program in dental public health. There’s just one caveat: In addition to a dental degree, a master’s in public health has been a prerequisite. Until now.

As part of collaboration with the Texas A&M Health Science Center School of Public Health, TAMBCD will now offer a master’s degree in public health, as part of the newly redesigned residency program in dental public health. The new program has one important distinction: an interprofessional emphasis, which negates the need for an existing public health degree to enroll. The new program also will be made available to a select number of pediatric dentistry residents who want to combine the M.P.H. degree with their residencies.

Existing pediatric dentistry residents who opt not to pursue a master’s in public health will benefit from the changes, too. The grant will gradually expand their clinical rotations to all of the college’s community-based training centers, beginning with North Dallas Shared Ministries.

Andreea Voinea-Griffin, D.D.S., M.S.H.A., who is co-principal investigator and research assistant professor in public health sciences at the dental school, says the changes will affect didactic as well as clinical components of the curriculum, with an emphasis on emerging health care technologies such as teledentistry.

“We are training practitioners for the future, bridging the gap between medicine and dentistry, instead of the way dentistry is done today,” says Griffin.

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Heart medications: What you may not know about side effects in the mouth http://news.tamhsc.edu/?post=heart-medications-what-you-may-not-know-about-side-effects-in-the-mouth http://news.tamhsc.edu/?post=heart-medications-what-you-may-not-know-about-side-effects-in-the-mouth#comments Wed, 15 Jul 2015 13:00:09 +0000 https://news.tamhsc.edu/?post_type=post&p=19484 For individuals living with cardiovascular disease or high blood pressure and cholesterol, consistent use of heart medications can be a literal life saver, but they can also cause uncomfortable side effects in the mouth. ]]>
3 medicine bottles and loose pills

Heart medications can cause adverse reactions in the mouth.

For individuals living with cardiovascular disease or high blood pressure and cholesterol, consistent use of heart medication can be a literal life saver. Perhaps a not-so-well-known fact is that these types of drugs don’t just impact the cardiovascular system.

While the mouth and gums are not intended targets, Terry Rees, D.D.S., M.S.D., a periodontist who is professor and director of the Stomatology Center at Texas A&M University Baylor College of Dentistry, routinely diagnoses and treats burdensome oral conditions that occur as a side effect of heart medication. Some of the usual villains are gum overgrowth, altered taste sensation and burning mouth.

That’s bad news for the 49 percent of Americans living with at least one risk factor for heart disease – according to the Centers for Disease Control and Prevention – including millions who are already on heart medication.

The good news is that there are ways to combat the onset of painful and irritating symptoms in the mouth.

“Classic heart medications like the calcium channel blockers used to treat hypertension and heart disease can lead to drug-induced gum overgrowth,” Rees says, “but meticulous dental hygiene and periodontal health will help prevent it.”

A patient who experiences the condition can try changing medications if the cardiologist approves.

“Otherwise the option is to remove the excess gum tissue to allow the patient to be more effective when they brush and floss. This helps prevent recurrence of the overgrowth,” says Rees, who adds that antibacterial products and a water irrigator may help fight infection.

Some blood pressure medications are a culprit in what patients report as dry mouth, altered taste sensation or ‘burning mouth,’ according to Rees.

“Patients typically describe altered taste sensation as a metallic or salty taste or an abnormal response to sweets,” Rees says. “Usually it is older females who mention burning mouth to me; most often on the tongue or roof of the mouth, but sometimes all over.

“If medications are causing the problem, we may be able to offer the patient some relief by collaborating with their physician.” Rees adds that many patients experience no severe side effects from heart medications other than a slight reduction in salivary flow.

“However, for some people over 50 who are taking medications to stay alive, you can’t just take them off the meds to see if that’s what is causing the problem,” notes Rees. “Therefore, you treat the symptoms to make the patient feel better, but the problem does not go away entirely.”

Rees advises many patients that lifestyle modifications can enhance both oral health and heart health.

“There is some evidence to suggest that periodontal (gum) disease may be a low-level risk factor for heart disease,” says Rees. “However, a cause-and-effect relationship has not been firmly established because some risk factors for heart disease — smoking, excessive use of alcohol or illicit drugs, high cholesterol levels, obesity and diabetes — are also risk factors for periodontal disease.

“Both heart disease and periodontal disease are inflammatory processes, and you should treat both. Gum health is important to overall health.”

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You Asked: What is the difference (or lack thereof) between oral and genital herpes? http://news.tamhsc.edu/?post=what-do-you-mean-i-might-have-herpes-the-difference-or-lack-thereof-between-hsv-1-and-hsv-2 http://news.tamhsc.edu/?post=what-do-you-mean-i-might-have-herpes-the-difference-or-lack-thereof-between-hsv-1-and-hsv-2#comments Tue, 07 Jul 2015 16:50:22 +0000 http://news.tamhsc.edu/?post_type=post&p=23851 For a long time, the medical world made the distinction between oral herpes (HSV-1) and genital herpes (HSV-2), because it was thought that HSV-2 led to types of genital and oral cancers. Now we know that the human papilloma virus is the leading culprit for causing cancers specifically focused around the genitals and mouth, not herpes. However, HSV-1 and HSV-2 aren’t mutually exclusive; there is about a 20 percent crossover between the two types]]>
Woman walking

Oral herpes (HSV-1) and genital herpes (HSV-2) aren’t mutually exclusive; there is about a 20 percent crossover between the two types. The U.S. National Library of Medicine estimates that most people will contract oral herpes by the time they are age 20.

A woman stands on a porch, practicing yoga as the sun sets behind her figure. The entire scene exudes tranquility as she turns to the camera and firmly declares, “I have genital herpes,” with a smile on her face.

Most of us have seen these commercials, and have experienced the bizarre and uncomfortable response that is natural when someone brings such a taboo and private matter to light. However uncomfortable it may be, though, it’s important to be informed about Sexually Transmitted Infections (STIs) and the ways you can contract them, including genital herpes. According to the Centers for Disease Control and Prevention (CDC), one of every six people, ages 14 to 49, have genital herpes.

Perhaps the most shocking thing about the herpes simplex virus (HSV) is that it isn’t necessarily transferred from genitals to genitals during intercourse. HSV has two common strains: HSV-1 (widely known as oral herpes, cold sores or fever blisters) and HSV-2 (the traditional cause of genital herpes).

“For a long time, the medical world made the distinction between HSV-1 and HSV-2, because it was thought that HSV-2 led to types of genital and oral cancers. Now we know that the human papilloma virus is the leading culprit for causing cancers specifically focused around the genitals and mouth, not herpes” explained John Wright, D.D.S., regents professor and department chair of diagnostic sciences at the Texas A&M University Baylor College of Dentistry. “However, HSV-1 and HSV-2 aren’t mutually exclusive; there is about a 20 percent crossover between the two types.”

The U.S. National Library of Medicine estimates that most people will contract oral herpes by the time they are age 20. HSV affects the nervous system, and outbreaks can be brought on by many factors including:

  • Hormone changes, including menstruation
  • Stress
  • Exposure to the sun
  • Fever

This 20 percent crossover means that traditional, oral herpes can be present in the genital region, and conversely, HSV-2 herpes can infect the mouth. According to Wright, both strains will exhibit identical symptoms in the mouth:

  • Itching of lips or skin around the mouth
  • Pain on the lips or in the mouth
  • Tingling near the lips and mouth
  • Lip blisters or sores (ulcers) typically where the lip meets the skin
  • Blisters or rash on the gums, lips, mouth or throat
  • Swollen lymph nodes

“The main difference between the two types of HSV is a slight difference in DNA,” Wright said.

Similarly, HSV-1 will present itself like HSV-2 if it becomes present in the genital region:

  • Blister(s) around the genitals, rectum or mouth
  • Sores that take weeks to heal
  • Swollen lymph nodes

“With both types, the first outbreak that occurs will be the most severe, and may even display flu-like symptoms. Recurrences happen more frequently during the first year of infection, with 50 percent of those infected experiencing four outbreaks within a year. However, each subsequent recurrence will display more mild symptoms and may even be asymptomatic, which increases the chance of unknowingly spreading the virus to a partner (viral shedding),” said John K. Midturi, D.O., assistant professor of internal medicine at the Texas A&M Health Science Center College of Medicine in Temple.

Although outbreaks can be asymptomatic, viral shedding increases when they reoccur. While antivirals can treat outbreaks and reduce the chance of spreading it to others, they do not cure the virus.

“Once a person is infected with a strain of HSV, it is permanent,” Wright explained. “Antivirals can manage the symptoms and limit its ability to spread, but they do not cure the patient of the virus.”

Both strains of HSV are highly communicable and can infect other parts of the body, specifically if the virus gets into open wounds, but the marked increase of HSV-1 and HSV-2 being found in the oral and genital regions is attributed to increased occurrences of oral sex. For example, if a person is having a recurrence of HSV-1 in their mouth, and is engaging in oral sex, they put their partner at a higher risk of contracting HSV-1 in the genital region.

While most outbreaks are mild, and many people are unaware that they even have the virus, some people can have severe reactions to it. People who are immuno-compromised may experience outbreaks in less traditional locations, such as the esophagus or liver, and may even develop pneumonia precipitated by the virus. Even in those with uncompromised immune systems, the membranes surrounding the brain or spinal cord can become infected and inflamed, causing herpetic meningitis.

“The best method of prevention is treating outbreaks when they occur, to reduce viral shedding, and using condoms or completely abstaining from sexual activities, especially during outbreaks,” Midturi advised.

Condoms don’t cover all the areas that genital herpes can occur, but they can limit exposure. To reduce the spread of HSV, always wash your hands after touching infected areas or fluids and avoid sharing utensils and other objects that enter your mouth during recurrences.

Always inform your partner if you have genital herpes, so you can make responsible decisions, and try to treat any outbreaks that occur. If you suspect you might have genital herpes, visit your health provider for examination or testing. For more information about genital herpes, visit the CDC site.

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Does gum cure bad breath? http://news.tamhsc.edu/?post=does-gum-cure-bad-breath http://news.tamhsc.edu/?post=does-gum-cure-bad-breath#comments Tue, 07 Jul 2015 14:00:43 +0000 http://news.tamhsc.edu/?post_type=post&p=23658 Whether it is your morning coffee or garlic bread at lunch, one way or another, you might find yourself seeking a quick fix for bad breath more often than not. Your inclination may be to reach for gum, but Cherri L. Kading, assistant professor and clinic coordinator at Texas A&M Caruth School of Dental Hygiene, explains that may not always be the best option]]>

Woman smiling playfully holding a piece of gum between her teeth.Whether it is your morning coffee or garlic bread at lunch, one way or another, you might find yourself seeking a quick fix for bad breath more often than not. Your inclination may be to reach for gum, but Cherri L. Kading, assistant professor and clinic coordinator at Texas A&M University Baylor College of Dentistry Caruth School of Dental Hygiene, explains that may not always be the best option.

“Gum alone doesn’t cure bad breath, but chewing gum does help,” Kading says. The mechanical act of chewing helps to pull out debris that may be stuck in teeth. It also helps to produce saliva that clears debris and acts as a buffering agent.

Kading suggests chewing gum with Xylitol listed as one of the first three ingredients. Xylitol is a healthy alternative to sugar and the optimal gum ingredient for reducing the pathogenic bacteria that contributes to risk of dental cavities, or tooth decay. While it has a sweet taste, unlike sugar, Xylitol does not convert to acids that cause tooth decay. In fact, this sugar substitute has been found to reduce the levels of decay-causing bacteria in saliva. Many stores, especially natural grocery stores, sell gum and mints that are 100 percent Xylitol.

However, to really get to the root of bad breath, good, old-fashion dental hygiene is key. If you do not clean your teeth often enough, trapped food will begin to rot and quickly lead to bad breath. Brushing after every meal, and flossing regularly are good ways to get rid of leftover food stuck in between teeth. Kading also recommends tongue scrapers as another good way to get rid of odor-causing bacteria.

If you are looking for a better way to alleviate bad breath in a pinch, consider mouthwash as an alternative to chewing gum.

“Mouthwashes that have essential oils, including thymol, methyl salicylate, eucalyptol, and menthol, in combination with alcohol tend to work best. The essential oils and alcohol work together to eliminate bacteria that causes bad breath,” Kading said.

Whether you choose chewing gum with Xylitol, brushing after every meal, gargling mouthwash or even a combination of the three, your mouth will thank you – and so will the people you talk with throughout the day – as all of those techniques will help in varying degrees to alleviate the odor-causing bacteria that stick around in your mouth.

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Enrichment program opens doors to international collaboration http://news.tamhsc.edu/?post=enrichment-program-opens-doors-to-international-collaboration http://news.tamhsc.edu/?post=enrichment-program-opens-doors-to-international-collaboration#comments Wed, 01 Jul 2015 13:33:24 +0000 http://news.tamhsc.edu/?post_type=post&p=23814 Meet Hessa. There’s not a whole lot this young girl doesn’t do: She’s just as likely to cough or sneeze during appointments as she is to close her mouth in fatigue, hyperventilate, or simply complain of a hurting tooth. Her behaviors help second-year dental students feel more comfortable with practical skills and chairside manner before they begin seeing patients in clinic. There’s one more thing: Hessa is a robot]]>
A student from Princess Nourah bint Abdulrahman University (PNU) College of Dentistry in Riyadh, Saudi Arabia, completes a lab activity during the monthlong enrichment program at TAMBCD in Dallas.

A student from Princess Nourah bint Abdulrahman University (PNU) College of Dentistry in Riyadh, Saudi Arabia, completes a lab activity during the monthlong enrichment program at TAMBCD in Dallas.

Meet Hessa. There’s not a whole lot this young girl doesn’t do: She’s just as likely to cough or sneeze during appointments as she is to close her mouth in fatigue, hyperventilate, or simply complain of a hurting tooth. Her behaviors help second-year dental students feel more comfortable with practical skills and chairside manner before they begin seeing patients in clinic. There’s one more thing: Hessa is a robot.

Hessa, a dental simulator, can be found at the Princess Nourah bint Abdulrahman University (PNU) College of Dentistry in Riyadh, Saudi Arabia, which opened in 2012 and is one of 15 colleges within PNU, an all-female university with more than 50,000 students. At the PNU dental school, Hessa is right at home in bright, state-of-the art clinics and labs replete with state-of-the-art technology, including Moog dental training simulation systems.

Since PNU is a new school, it is still building its patient pool, something that takes time. An established patient base and diverse array of cases is one of the factors that sparked PNU leaders’ interest in pursuing an international partnership with Texas A&M University Baylor College of Dentistry. This way, PNU dental students can be exposed to as many oral conditions and treatment modalities as possible while their own program is in its infancy.

It should come as no surprise that observation in TAMBCD clinics has been a highlight during the four-week International Dental Student Summer Enrichment Program, which started June 1 in Dallas.

“I remember the first day in the oral diagnosis clinic. I was amazed by the amount of different cases I saw, such as pleomorphic adenoma (salivary gland tumors), Stafne bone defect (asymptomatic lingual bone depression of the lower jaw), gunshot cases and bone graft surgery,” says Mehdiya Haider, a fourth-year dental student at PNU and one of 15 participants in the enrichment program. “Every day during rotations I learned something new; all the doctors had their own techniques, and they loved sharing them with us,” she adds. It’s a deviation from Haider’s typical patient base; she, like her classmates, treats mostly fellow PNU students.

Participants’ experiences are not limited to the clinic. They have received lecture and hands-on instruction ranging from ethics to onlay casting, crown and bridge preparation, and mouthguard fabrication. The program represents two years of planning between TAMBCD and PNU, with preparations already in the works for next year, says Dr. Loulou Moore, associate professor in restorative sciences and director of the summer enrichment program. There may be potential to develop a faculty exchange program with visiting professorships.

Hoda Abdellatif, B.D.S., M.P.H., Ph.D., Vice Dean of Students Affairs at PNU as well as an adjunct professor at TAMBCD, helped facilitate planning for the program starting in 2013, shortly after joining the PNU College of Dentistry.

“Such a program will expose the PNU students to learn from the differences in clinical care, dental education and culture at the TAMBCD institution, and it will also create a student network between PNU and TAMBCD dental students,” says Abdellatif. “This is hopefully the starting point for further collaboration between the two institutions.”

The exchange program also offers the chance for dental students to see how disease patterns vary in different areas of the world, says Ebtissam Al-Madi, Ph.D., who is dean of PNU College of Dentistry.

“It impacts dentistry first of all by breaking some barriers, especially with our faculty or students who might think that dentistry is performed differently in the U.S.,” Al-Madi says. “It shows them that dentistry is dentistry wherever you are in the world. It gives them a little addition in terms of seeing the patterns of disease in the States compared with Saudi Arabia,” she added, explaining that the program at TAMBCD may reveal more to PNU students about geriatric dentistry concerns, as the majority of their patient base consists of young, college-age adults. It mirrors the nation’s demographics a whole, as 48.6 percent of the population in Saudi Arabia is 25 years old or younger, according to the PNU dental school website. Al-Madi observes an interesting trend among this population in Saudi Arabia: high rates of dental decay among young adults from high and low socioeconomic groups because of lack of awareness of good oral hygiene coupled with a shift toward diets containing more sugar than in generations past.

Faculty and students agree that the importance of partnerships like the one between TAMBCD and PNU is highlighted as our world becomes increasingly connected.

“This program is an open channel for exchanging knowledge, and it’s good to collaborate,” says participant Tolean Jundieh, who is beginning her third year in PNU’s five-year curriculum. “We are one world now; and there is globalization in all levels, even in dentistry.”

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