Posted on 08. Mar, 2014 by wisdom.
An article appearing in Neurology, explores the effects of a migraine on the brain’s structure on a long term basis. The study suggests that migraine may permanently alter brain structure which is counter to previously held beliefs that migraine has no long term consequence for the brain. For example, see the post titled Are Migraine Related Changes Related to Impaired Cognition? where a study concluded that women with migraine have no long term effects of cognition over time. See also the post Do Migraines Lead to Cognitive Decline?
In the current study, researchers explored 6 population based studies and 13 clinic based studies to determine if people who have migraine had an increased risk of brain lesions, brain volume changes, or other abnormalities as measured from an MRI of the brain. The researchers found that migraine with aura increased the risk of white matter brain lesions by 68% while migraine without aura increased the risk by 34% when compared to those who do not suffer migraines. The researchers found that brain volume changes were more common in people with migraine than in those without migraine. Further the researchers determined that infarct-like abnormalities increased by 44% for those with migraine with aura when compared to those with migraine but without aura.
So the bottom line is that those who suffer from migraine with aura may be at the most risk. The reference for this study is: Asma Bashir, Richard B. Lipton, Sait Ashina and Messoud Ashina, “Migraine and structural changes in the brain A systematic review and meta-analysis,” Neurology, 2013.
The result that women with migraines were more likely to have scattered areas of white mater changes on MRI scans was also found in the CAMERA-1 study as referenced to above in the blog post.
Posted on 01. Mar, 2014 by wisdom.
As discussed before on this website, having a wisdom tooth extracted can in rare instances lead to death. This is expanded on over at the wisdom teeth death page http://www.teethremoval.com/death.html. At the time of writing this, at least 67 deaths have been listed on this page attributable to wisdom teeth removal.
In a recent case a 74 year old man has passed away in Japan after having a mandibular wisdom tooth extracted. A case report of this is described in Wataru Kawashima, Katsuhiko Hatake, Yoshifumi Morimura, Risa Kudo, Mari Nakanishi, Shigehiro Tamaki, Shogo Kasuda, Katsuya Yuui, and Akiko Ishitani, “Asphyxial death related to postextraction hematoma in an elderly man,” Foresnic Science International, vol. 288, e47-e49, 2013. In the article the authors describe how after having wisdom teeth extracted it is possible to develop bleeding. In some cases massive bleeding and hematoma formation can occur. It has been suggested that such bleeding is due to damage to the arterial branches during tooth extraction. I have described some such cases over on the complications page at http://www.teethremoval.com/complications.html.
In the case report the 74 year old man called his daughter 10 hours after having the wisdom tooth extracted due to shortness of breath (dyspnea). She found him unconscious and he was immediately transferred to a hospital. He was in a coma for 7 days before dieing. His cause of death was asphyxia resulting from airway obstruction that was caused by both deviation of the epiglottis and compression of the trachea due to cervical subcutaneous bleeding that resulted from postextraction bleeding.
The authors state that the fracture of the lingual side of the alveolar bone could result in massive bleeding. Since the mandibular bone and lingual side of the mandibular molar site are heavily vascularized regions it is likely that arterial damage occurred and led to massive bleeding. The authors also believed that hypertension which was caused by postextraction pain and a bleeding tendency due to liver cirrhosis contributed to the continuous bleeding. The authors also believe the bleeding flowed into the submandibular space and caused a hematoma formation.
The authors state
“In elderly patients, fracture of the alveolar bone…occurs more frequently during tooth extraction because of the firm adhesion between the roots of the teeth and the alveolar bone. Elderly patients, particularly with abnormal hemostatic mechanisms, may experience a fatal course, even with minimally invasive surgery, such as tooth extraction.”
A recent study shows that stem cells found in mouth tissue can help relieve inflammatory disease. The stem cells studied are gingival mesenchymal stem cells (GMSC) which are found in gum tissue in the mouth. Similarly to other types of stems cells, GMCS develop into cells that effect the immune system.
The study found two differet types of GMSC: those that arise from the mesoderm layer of cells during embryonic development (M-GMSC) and those that come from cranial neural crest cells (N-GMSC). The two types of stem cells vary substantially in their benefits. N-GMSC was found to be easier to change into other cells include neural and cartilage-producing cells. N-GMSC was found to have more of a healing effect on inflammatory disease. When the researchers transplanted N-GMSC into mice with dextrate sulfate sodium-induced colitis, which is an inflamed condition of the colon, it was found that the the inflammation was significantly reduced
The bottom line from this study is that stem cells found in gum tissue may have important applications to aid in disease and with health. The stem cells in the gum tissue may able to help in improving skin wound healing and helping to reduce scar formation. Of course any type of inflammation control is important in a variety of health conditions.
X. Xu, C. Chen, K. Akiyama, Y. Chai, A. D. Le, Z. Wang, S. Shi. Gingivae Contain Neural-crest- and Mesoderm-derived Mesenchymal Stem Cells. Journal of Dental Research, 2013
Posted on 15. Feb, 2014 by wisdom.
Bisphenol A (BPA) is a chemical compound that is used to make up resins and plastics. For example, bisphenol A is used in bottles, inside drink cans, and inside food tins. Research has shown that bisphenol A has been found in human blood and urine hence indicting that it has been ingested. Other research has shown that bisphenol A has adverse effects on the development and reproduction of lab animals. Bisphenol A has already been banned from being used in the manufacturing process of baby bottles in Europe.
A recent study set out to determine if teeth of rats when treated with low daily doses of bisphenol A are damaged. The researchers showed that the teeth of rats treated with low daily doses of bisphenol A are in fact damaged and that the characteristics present are similar to what has been found in a new pathology of tooth enamel in a small percentage of children between 6 and 8.
Specifically the researchers showed that the teeth showed numerous characteristics that are common with a tooth enamel pathology known as Molar Incisor Hypomineralisation which selectively affects permanent incisors and first molars. Children who have this pathology present with teeth that are susceptible to cavities and are hypersensitive to pain.
The researchers compared the white marks that appeared on the incisors of rats treated with bisphenol A to the characteristics of human teeth suffering from Molar Incisor Hypomineralisation. Macroscopic observation of marks on both series of teeth showed that they were both fragile and had brittle enamel. Microscope observation of the enamel of teeth in both series showed a significant reduction of the Ca/P and the Ca/C ratios. This reduction leads to mineral depletion which makes teeth more susceptible to cavities.
The researchers believe that teeth could be used as early markers of exposure to bisphenol A and could be beneficial in prevent more serious pathologies from occurring.
Source: Katia Jedeon, Muriel De la Dure-Molla, Steven J. Brookes, Sophia Loiodice, Clémence Marciano, Jennifer Kirkham, Marie-Chantal Canivenc-Lavier, Sofiane Boudalia, Raymond Bergès, Hidemitsu Harada, Ariane Berdal, Sylvie Babajko. Enamel Defects Reflect Perinatal Exposure to Bisphenol A. The American Journal of Pathology, 2013;
Posted on 13. Feb, 2014 by wisdom.
Some time recently (within the past 6 months) the ADA (American Dental Association) has updated their about me page over at http://www.ada.org/aboutada.aspx. A new video appears and under it the text reads
“This American Dental Association video tells our story and highlights how the ADA has always been a patient-centered, science-based and ethically-driven association. It captures the ADA’s spirit and what the ADA strives to be.”
Viewing the video the words patient centered, science-based, and ethically-driven are repeated. The video also throws around the terms continuous learning, research and development, patents, and up to date. In one segment a dentist presumably says do no harm, always do good, treat people with fairness and honesty, and respect the doctor patient relationship.
Unfortunately I disagree with the ADA’s assertion that they have always been patient-centered, science-based, and ethically-driven. As stated before on this website, see for example this blog post http://blog.teethremoval.com/the-war-on-healthcare-patients-who-hate-doctors I was never made clear that wisdom teeth were no longer commonly removed in other countries prior to having my healthy wisdom teeth extracted in June of 2006. Guidelines from SIGN and NICE existed in 1999 and 2000 respectively see http://www.teethremoval.com/controversy.html.
If the ADA was always a patient-centered, science-based and ethically-driven association why wasn’t this information made clear at the time. We are talking six years after the guidelines came to light. I am willing to give some leeway here as being up to date with all the new information coming out can be very challenging, but six years is just too long. This information was not found on the ADA’s website or other U.S. based physician/dental organizations.
Furthermore why at the time was information on complications related to wisdom teeth extraction so lacking. Look if constant pain very much so beyond numbness is a complication of removing wisdom teeth, why was this never disclosed? Isn’t this relevant to the discussion?
Let’s highlight a legal case of a complication from wisdom teeth extraction as displayed at http://www.teethremoval.com/dental_malpractice.html
“An attorney, won a total of $503,923.59 for a woman that had her lingual nerve bilateraly severed and a dental burr (drill bit) left in her mouth ….. She suffered from depression, pain, and anxiety and was unable to eat, sleep or open her mouth for weeks after the surgery and could not speak correctly for months… When she gets tired she has a hard time enunciating words…. The broken burr remains in her mouth.”
For one, it baffles me that a possibility that the dental burr can break off during surgery and be permanently left in the mouth does not have to be disclosed. Furthermore, it baffles me that the possibility that a thermal burn can occur during wisdom teeth extraction is not disclosed. Why is this information not disclosed and really even acknowledged? I only came to be aware of it by pouring over hundreds and hundreds of documents.
In the past the ADA has argued for a $250,000 cap on non-economic damages nationally in the U.S. How is this patient centered and ethically driven? The ADA does not seem to really disclose this information on their website. A $250,000 pain and suffering damage award for young injured patients can be unfair, unjust, and downright ridiculous in some instances.
Look I acknowledge that the ADA is taking steps to become patient-centered, science-based and ethically-driven but stating they have always been is in my opinion on weak footing.