Bacteria and Fungus Can Team Up to Cause Cavities

An interesting article titled “Symbiotic relationship between Streptococcus mutans and Candida albicans synergizes the virulence of plaque-biofilms in vivo,” appears in the February 2014, edition of Infection and Immunity, written by Megan L. Falsetta and et al. The article describes how although Streptococcus mutans is often cited as the main bacteria in dental caries (cavities), particularly in early-childhood caries (ECCs), it may not act alone and may team up with Candida albicans. The infection with both can double the number of caries and increase their severity as it did for rats in the study. Candida albicans adheres mainly to the cheek and tongue, while Streptococcus mutans sticks to the surfaces of teeth by converting sugars to a sticky glue-like material called extracellular polysaccharide (EPS). The researchers found that the exoenzyme that S. mutans uses to react with sugar to produce EPS also enables Candida to produce a glue-like polymer in the presence of sugar, which makes it adhere to teeth and bind S. mutans. It lacks these abilities otherwise. When this occurs the fungus contributes the bulk of the plaque. The researchers note that the combination of the two organisms led to a enhanced product of the glue-like polymer which boosts the […]

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Few Children Under 1 See a Dentist

Unfortunately, new research has shown that few children under the age of 1 are seeing a dentist. This was touched on in an earlier blog post over at where it was mentioned that for children between ages 1 and 4 around 60% of them have seen a medical doctor (physician) during the year, but not a dentist. The new research appears in an article titled “Factors Associated With Dental Care Utilization in Early Childhood,” by Denise Darmawikarta and et al. which was published online in Pediatrics in May 2014. The study looked at 2505 children in Toronto, Canada, who were seen for primary health care between September 2011 and January 2013. The study was past of TARGet Kids (The Applied Research Group for Kids), a collaboration between doctors and researchers from St. Michael’s Hospital and the Hospital for Sick Children in Toronto. The aim of the program is to follow children from birth with the goal of preventing common problems in the early years and understanding how they impact health in later years. In the study, less than 1% of the healthy urban children looked at received dental care by the age of 12 months and less than 2% of the […]

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Fluoride in Water Does Not Lower Intelligence

An interesting article titled “Community Water Fluoridation and Intelligence: Prospective Study in New Zealand,” appears in the 2014 edition of the American Journal of Public Health by Jonathan M. Broadbent and et. al. The researchers set out to explore whether or not having fluoride in water that one drinks when they are young and age effects the developing brain negatively. The researchers followed nearly all aspects of the health and development of around 1,000 people born in Dunedin in southeast New Zealand in 1972-1973, up to age 38. The researchers compared IQs of those who grew up in Dunedin suburbs with and without fluoridated water. Furthermore, if one used fluoride toothpaste and tablets the researchers used this in their analysis. The researchers focused on fluoride expose during the first five years of life as this is a critical period of time in brain development. The researchers looked at average IQ scores between the ages of 7 and 13 years and at age 38, along with subtest scores for working memory, verbal comprehension, perceptual reasoning, and processing speed. A total of 992 child and 942 adults had data available. The researchers were sure to control for childhood factors which are known to be […]

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Differing Views in Medicine and Dentistry Applied to Wisdom Teeth

An interesting article appears in the 2014 version of the Journal of Oral and Maxillofacial Surgery titled “Asymptomatic Third Molars Under Nominalist and Essentialist Lenses,” written by V. Wallace McCarlie and Daniel L. Orr II, pp. 658-659.  The authors define two differente views: 1) essentialism and 2) nominalism and then try to apply them to the management of wisdom teeth. The authors state “Essentialism is the notion that underlying every properly defined disease is an unchanging reality causing illness. Conversely, nominalism is not concerned with underlying causes, but rather with signs and symptoms of illness.” In the article the authors mention a study which says that dentists detect rather than diagnose. The authors later say that detection implies nominalism and diagnosis implies essentialism. The authors give some downsides to both points of view. For example, they say essentialism is less focused on the patient and treatment. They say nominalism does not focus on causes which may be important for prevention. The authors state “An example of the importance of not focusing solely on symptoms (nominalism) is the case of asymptomatic impacted third molars. Life-threatening head and neck pathology, such as space infections, necrotizing fasciitis, osteomyelitis, and cysts or tumors, may […]

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Should the NICE Guidelines for Management of Wisdom Teeth (Third Molars) be Reevaulated?

An article titled “Changes in Demographics of Patients Undergoing Third Molar Surgery in a Hospital Setting Between 1994 and 2012 and the Influence of the National Institute for Health and Care Excellence Guidelines,” written by Vahe Petrosyan and Phillip Ameerally appears in the February 2014 issue of the Journal of Oral and Maxillofacial Surgery, pp. 254-258. The article discusses how National Institute for Health and Care Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN) were published around 2000 recommending against prophylactic removal of wisdom teeth. This led to a reduction in surgeries performed. In the article the authors question whether or not the NICE guidelines on wisdom teeth should be updated. They mentioned a 2009 study which said 27% of previously symptom free wisdom teeth can become symptomatic after 1 year, especially those that are distoangularly impacted. In the article the authors looked at data from Northampton General Hospital in England which services around 0.7% of the population over the time period from 1994 to 2012. A total of 10,447 patients older than 16 years were treated during the study period. The mean patient age increased from 29 years in 1994 to 36 years in 2012, with the median […]

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