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Trouble with Titanium Dental Implants

corroded titanium dental implantWhen it comes to replacing teeth with dental implants, we opt for biocompatible ceramic instead of the usual titanium. Now new research offers even more support for this choice.

One of the biggest risks with implants is the potential for peri-implantitis. This condition is marked by inflammation and bone loss around a failing implant. It’s not something to be taken lightly. According to implant expert Dr. Stephen Jacobs, studies suggest that one-third of patients will be infected.

And according to a new study in the Journal of Periodontology, titanium may elevate the risk.

Researchers took plaque samples from 20 implants with peri-implantitis and 20 without, coming from 30 total patients. Then they looked for evidence of titanium. Why?

Increasing preclinical data suggest that peri-implantitis microbiota not only triggers an inflammatory immune response but also causes electrochemical alterations of the titanium surfaces, i.e., corrosion, that aggravate this inflammatory response.

That is, the bacteria causing the infection also corrode the titanium, and that makes the inflammation worse.

Thus, it was hypothesized that there is an association between dissolution of titanium from dental implants, which suggests corrosion, and peri-implantitis in humans.

And this is indeed what they found.

Greater levels of dissolved titanium were detected in submucosal plaque around implants with peri-implantitis compared with healthy implants, indicating an association between titanium dissolution and peri-implantitis.

Other studies have looked at other triggers for corrosion. According to research in the Dental Materials Journal, fluoride appears to have a significant impact on the dissolution of titanium.

Although titanium is well known for its superior corrosion resistance, it is not strongly resistant to corrosion caused by fluoride.

Hydrogen peroxide was also found to break down some titanium alloys. Peroxide is commonly used to bleach teeth and so appears in a good number of oral hygiene products and is often seen as an ingredient in natural DIY home care recipes.

Yet other research showed that ultrasonic scaling – deep cleaning – released titanium and thus increased inflammation. More, that inflammation triggered bone loss, which the study authors suggest ”is unlikely to be reversible.”

We’ll stick with ceramic.

For even more on corrosion, check out this excellent article by implant specialist Dr. Sammy Noumbissi.

Image via Dr. Noumbissi

A Look Back at…Nitric Oxide

Originally posted September 29, 2016

nitric oxide moleculeUnlike nitrous oxide, a.k.a. “laughing gas,” nitric oxide it is no laughing matter. Rather, it’s a signaling molecule that our body produces to help the trillions of cells in our body communicate with each other.

Nitric oxide is made by the body’s blood vessel’s lining. When this lining – the endothelium – senses healthy conditions, such as when you exercise, it releases more nitric oxide. Nitric oxide expands the blood vessels, increases blood flow, and decreases plaque and blood clotting.

A healthy release of nitric oxide has been reported to

  • Help memory and behavior.
  • Support the immune system’s fight against pathogenic bacteria and defend against tumors.
  • Regulate blood pressure.
  • Improve sleep quality.
  • Reduce inflammation.
  • Increase endurance and strength.
  • Aid digestion.

We get plenty of nitric oxide when we’re young, but production falls later in life. Production also drops off when the endothelium senses less than healthy factors such as high blood pressure, high cholesterol, smoking, and increased stress levels. Free radical damage, inactivity, and poor dietary choices likewise have a negative effect nitric oxide release.

Happily, there are ways to increase nitric oxide and reap its benefits.

  1. Exercise
    When you exercise your muscles require more oxygen, which is supplied by the blood. As your heart pounds, your arteries release nitic oxide into the blood. This opens and relaxes the vessel walls and allows more blood to pass through.

  2. Diet
    Vegetables such beets, beet juice, celery, and dark leafy greens such as kale chard, arugula, and spinach are high in dietary nitrates and nitrites, both of which stimulate the production of nitric oxide. In addition, eating food with color increases the flavonoids in your diet. Flavonoids protect nitric oxide from free radical damage. Generally, it’s best to avoid a diet either too high in fat or carbohydrate. Both can inhibit nitric oxide production.

  3. Nitric oxide supplements
    Traditionally, supplementing for nitric oxide meant taking supplements containing L-arginine. But current research indicates that, as you age, L-arginine is less likely to prove effective.

    Enter new research out of the University of Texas Health Science Center, which has led to a proprietary, beetroot-based, nitric oxide formula that generates authentic nitric oxide while supporting the enzyme that makes nitric oxide in the body.

    The scientist at the helm of this form of supplementation is Dr. Nathan Bryan who co-authored The Nitric Oxide (NO) Solution based on his research.

Whether you increase nitric oxide via exercise, diet, supplementation, or a combination of all three, tapping into this overlooked molecule’s power may well help you age with strength and vitality.

The Future of Dentistry Is Mercury-Free

no mercuryThis week marks the 7th anniversary of the Mercury Awareness Week, a joint campaign by Dr. Mercola and Consumers for Dental Choice, the organization leading the fight against the use of mercury amalgam in dentistry.

Our office has proudly been mercury-free – and mercury-SAFE! – for many years now. Through that time, we’ve seen more and more practices turn away from amalgam, too. Just a few decades ago, only 3% of American dentists were mercury-free. Today, more than half are.

More, we now have the Minamata Convention on Mercury, a global treaty that went into effect just last week. Among other measures to stop the use of mercury in consumer products and industry, it requires member countries to begin phasing out dental mercury – a provision fought for by Consumers for Dental Choice. And that’s just the latest milestone in the movement toward mercury-free dentistry.

  • 1800s: Mercury-based amalgam fillings are introduced.

  • 1830s: Dentists express concern about the health risks of filling teeth with mercury.

  • 1845: The first US professional association of dentists, the American Society of Dental Surgeons (ASDS), makes its members sign a pledge not to use amalgam. They considered its use malpractice.

  • 1850s: A group of pro-amalgam dentists abandons the ASDS and forms the organization today known as the American Dental Association, which continues to endorse mercury amalgam.

  • 1920s and 30s: German chemist Alfred Stock’s research on mercury toxicity revives interest in amalgam research.

  • 1970s: There is another surge in amalgam research, while Dr. Hal Huggins begins his very vocal campaign against dental amalgam. In 1985, he publishes the first edition of It’s All in Your Head: Diseases Caused by Silver-Mercury Fillings.

  • 1996: Consumers for Dental Choice is founded with the ultimate goal to “phase out the use of amalgam…worldwide.”

  • 1997: Sweden officially announces a ban on mercury amalgam, but it doesn’t pass EU administration until 2008. Norway bans amalgam in 2008, as well.

  • 2013: The Minamata Convention on Mercury treaty is signed.

  • 2016: A new EPA rule requires all dental offices that routinely handle amalgam to install separators to keep mercury out of the water supply. Although the rule is temporarily rolled back in early 2017, it is soon reinstated and takes effect come summer.

Learn more about the march toward mercury-free dentistry:
 

 
Yet for all the progress, we still have a long way to go. Find out how you can get involved in turning the promise of a mercury-free future into a reality.

Changing the Narrative of Food

Healthy eating starts with whole food, real food, including lots of fresh produce. When you picture how it’s grown, you may imagine wide open spaces, fields spanning acres and acres.

But it can just as well happen on a much smaller scale, in urban and suburban areas alike. Think front yard gardens, rooftop and courtyard gardens, or any underutilized space. Many communities have unused or struggling properties that can be repurposed for flourishing community gardens.

In this TED Talk, Pam Warhurst describes how she and a group of others made it happen in her community of Todmorden in northern England, launching an initiative they came to call “Incredible Edible”:

Such programs are cropping up all over the world, including here in Arlington, where we have things like the Community Garden of UT Arlington and the Harvesting Hope Community Garden.

Consider supporting one of these or another community garden project. Volunteer or donate or buy from harvests put up for sale. Or follow Warhurst’s lead and create your own concept for an edible neighborhood landscape and make it a reality.

Already doing so? Share your experiences in the comments!

More Reason to Kick the Sugar Habit (and More Tips on How to Do It)

dropped cupcakeEver notice that when you cave in to sugar cravings, you don’t end up feeling any better – and may, in fact, actually feel worse?

That feeling worse may not just be a short term effect. According to new research in Scientific Reports, depressive symptoms can be directly linked to the intake of sugary foods and drinks.

Food frequency questionnaires were reviewed from over 23,000 British subjects dating back to 1985 and compared with mood responses on validated questionnaires. Men who ate the most sugar were found to have a 23% higher chance of common mental disorder (CMD) after five years – a condition marked by insomnia, fatigue, irritability, forgetfulness, difficulty concentrating, and somatic (physical) complaints.

Both men and women who ate the most sugar were found more likely to experience recurrent depression, as well.

The researchers also tried to find a reverse causation between mood disorder and sugar intake – in other words, whether mood also caused more sugar consumption. The answer to that was “no.”

“Our research,” they wrote, “confirms an adverse effect of sugar intake from sweet food/beverage on long-term psychological health and suggests that lower intake of sugar may be associated with better psychological health.”

With a high prevalence of mood disorders, and sugar intake commonly two to three times the level recommended, our findings indicate that policies promoting the reduction of sugar intake could additionally support primary and secondary prevention of depression.

No, the study isn’t perfect. All data was self-reported and thus prone to bias. Sugar from alcohol wasn’t counted. But its results do jibe with the new understanding of the role chronic inflammation appears to play in depression.

Sugar is one of the main fuels for inflammation. Eating less of it is the first step in any anti-inflammatory diet: You quit adding fuel to the fire.

Here are 7 simple tips for cutting back on added sugars (and keep in mind, when we’re talking sugar, we’re talking about all kinds, including honey, agave nectar, and other “natural” alternatives):

  1. Try a squeeze of fresh lemon into your iced tea instead of a sweetener.

  2. If you eat oatmeal or other grains in the morning, top them with fresh sliced whole fruit instead of pouring sugar on them.

  3. Clean your cupboards to simply remove temptation.

  4. Include more healthy fats such as avocado or coconut and olive oils to help satiety.

  5. Create a schedule with healthy snacks throughout the day to avoid those “hangry” moments that might lead you to binge on a sugary snack.

  6. Consider making your own “pudding” with whole fat coconut milk rather than buying something at the store packed with artificial ingredients and extra sugars. Here’s one way to do it, for example.

  7. Substitute things like bananas and applesauce in your baking. Here’s a simple cookie recipe using bananas, oats, Sunbutter, and raisins (optional).

Previously

Image by mumblyjoe

Sleep Like Your Health Depends on It (Because It Does)

bedA recent article over at CNN offers a good reminder that running a sleep debt can have far greater effects than daytime sleepiness and general grouchiness.

It can mean more accidents due to weakened reflexes and an unfocused mind. It can mean weight gain. It can mean a higher risk of depression, anxiety, diabetes, heart disease – in general, a shorter, unhealthier life span.

Recent research has also supported the suspected link between Alzheimer’s and sleep loss. A study in Brain, for instance, found that when sleep is constantly interrupted – as in cases of obstructive sleep apnea (OSA) – more of the proteins suspected to cause Alzheimer’s build up in the brain. (Normal sleep helps clear them.)

What’s more, research in the Annals of the American Thoracic Society found that those who are genetically susceptible to Alzheimer’s appear to be at greater risk of the cognitive decline that OSA and other forms of sleep disordered breathing can contribute to.

Many don’t realize that dentists are in a unique position to help identify sleep breathing problems and even, in mild to moderate cases, offer solutions that can enhance both oral and systemic health. Many signs of OSA can show up in the mouth, from inflamed tonsils to scalloping along the tongue, from tooth wear from bruxing (grinding the teeth during sleep) to headaches and other TMJ symptoms. If exam findings suggest OSA, a sleep test may be recommended for diagnosis.

Dental options for treating apnea provide welcome alternatives to CPAP. Most often, dental treatment involves appliance therapy – comfortable devices that typically keep the airway open by gently pulling the lower jaw forward. On the whole, research suggests that oral appliance therapy (OAT) can be at least as effective as CPAP, yet much more comfortable and well-tolerated.

We may also recommend diet, activity, and other lifestyle changes to support improved sleep, as well as additional therapies such as acupuncture or chiropractic care. As ever, everything depends on the individual and the specific causes of their symptoms. After all, it’s causes we want to address.

While tending to symptoms can bring short term relief, only attention to causes can bring about good long-term results.

Many people don’t even realize the impacts a little lack of sleep can cause. We all know those who like to brag of only getting four to six hours of sleep a night, almost like it’s a competition. Yet according to a 2003 paper in Sleep, such folks are likely unaware of what they’re losing in the course of gaining those extra waking hours.

Since chronic restriction of sleep to 6 h or less per night produced cognitive performance deficits equivalent to up to 2 nights of total sleep deprivation, it appears that even relatively moderate sleep restriction can seriously impair waking neurobehavioral functions in healthy adults. Sleepiness ratings suggest that subjects were largely unaware of these increasing cognitive deficits, which may explain why the impact of chronic sleep restriction on waking cognitive functions is often assumed to be benign.

For the sake of your health, happiness, and those around you, it is worth a quick conversation with your dentist to identify warning signs or offer suggestions for improving your sleep. And if dental factors aren’t at the root of your running a sleep debt, here are some great tips from Harvard Medical School on getting a better night’s sleep.


Image by ellas quezada

When Technology Tackles Teeth

triple-headed toothbrushesA new toothbrush doesn’t guarantee better brushing habits or even that you’ll get a better cleaning. Technique matters. But what if you have movement challenges, say, that make it hard for you to brush effectively?

One technology developed for such folks is the triple-headed toothbrush. The idea is that the three heads together maintain contact with all surfaces of each tooth at the proper angle. So you also see it marketed for children who have trouble with proper brushing, as well.

Marketers insist that a triple-headed brush will get the job done faster, easier, and better than a standard brush. But recent research in the International Journal of Dental Hygiene suggests that may only be the case when caregivers are doing the brushing.

Evaluating 15 clinical trials including 18 relevant comparisons, the authors found that

Of the 14 comparisons with self-performed brushing by the participants, the majority showed no difference between triple-headed and single-headed toothbrushes, with a few favouring the triple-headed. In the comparisons in which a caregiver performed the brushing, three of the four showed that the triple-headed toothbrush performed significantly better on the reduction in plaque scores.

Less is known about the efficacy of some new toothbrush designs for the general public, most of which aim to make brushing so quick and effortless, it becomes a cinch to do it regularly.

As if two minutes each morning and night – the duration and frequency we recommend for toothbrushing – were such a terrible sacrifice to make for supporting your oral and overall health.

But we digress.

The latest entry in the speed-brushing category is Amabrush, which has raised over $2.3 million through its highly publicized Kickstarter campaign. The device fits in your mouth and automatically brushes all the surfaces of your teeth with tiny silicon bristles in just 10 seconds.

But speed doesn’t come cheap. Not only do you pay a bit over $90 for the unit and charger but $7 every three to six months for a replacement mouthpiece and roughly $3.50 a month for the special toothpaste the device requires.

BlizzidentIt seems a lot like an automated version of the Blizzident device that came onto the market a while back. The makers of that device claim it cleans all tooth surfaces in just six seconds as you bite on the bristled mouthpiece. They also say it flosses your teeth and cleans your tongue – all for an investment of a few hundred dollars every year.

Amabrush stops short of the flossing claim. And the company’s founder and CEO offers an important caveat:

“It’s really hard to compare it to regular toothbrushes, manual or electric, because a toothbrush is just a tool, and tools are only as good as the people using them,” he said. “If a person already uses his regular toothbrush in a professional way, then Amabrush will definitely be no better than a regular toothbrush.

And you still need to floss – the part of hygiene that most people are most irregular about. We’ve yet to see any gizmo addressing that.

Previously

Why You Need to Tend to Your Teeth: Meet the Bacteria in Your Mouth

S. mutansSome are good guys; others, not so much. Good oral health means maintaining a proper balance of good to bad – and not just bacteria, but fungi and other microbial critters that hang out in even the cleanest of mouths. (In fact, recent research has shown that the yeast Candida interacts with the bacterium S. mutans to create especially strong oral biofilms [plaque].)

Unfortunately, those bad guys don’t necessarily stay confined to the mouth. And that’s the beginning of the link between gum disease and other inflammatory health problems such as heart disease, diabetes, stroke, rheumatoid arthritis, Alzheimer’s, cancer, and more.

This excellent short video will help you visualize what’s happening in your mouth when the balance is upset and how bacteria get from there to other parts of your body:

Also

That Warrior Pose Could Be Good for Your Gums, Too!

Warrior 2 poseYoga is traditionally thought of as a way to strengthen muscles, increase flexibility, and reduce stress. Sure, it does all of that, but did you know that it’s linked to healthier teeth and gums, too?

One way is by improving blood flow. As a recent post at India’s Tribune noted,

The strength of our teeth is directly related to the strength of our bones. The organ responsible for stimulating the growth of bones is the pituitary gland. So any posture or asana like sirshasana [a headstand pose], which will stimulate more blood to this gland will increase the strength of bones and teeth.

Here are more poses that can help with circulation.

Then there’s yoga’s well-known ability to reduce stress. Chronic stress is one of the major risk factors for gum disease. It can also lead to bruxing – habitual clenching and grinding – which can cause gum recession and damage teeth.

But there’s another way in which stress can have a negative impact on your oral health. As a paper earlier this year in the International Journal of Dentistry Research noted, it can lead us to neglect our oral health.

People who are stressed are less likely to give their teeth and gums the proper oral care. Yoga is one of the most effective treatment[s] for stress. Yoga reduce[s] the stress, improve[s] the [oxidative] status of body, improve[s] the immune system, and reduces chronic gingival inflammation. Yoga also improve[s] the life style more towards the natural. All these effects help…in better maintenance of oral hygiene, and reduction in gingival inflammation and prevention of dental diseases.

Other benefits the authors note include maintaining a healthy balance of saliva, preventing autonomic dysregulation, and managing health overall.

Other research has shown yoga’s ability to reduce inflammation. For instance, a 2015 study in the Journal of Clinical and Diagnostic Research found that regular yoga practice lowers levels of two key markers of inflammation, tumor necrosis factor alpha (TNF-α) and Interleukin-6 (IL-6).

It also reduces the extent of increase of TNF-α and IL-6 to a physical challenge of moderate exercise and strenuous exercise. There is no significant gender difference in the TNF-α and IL-6 levels. Regular practice of yoga can protect the individual against inflammatory diseases by favourably altering pro-inflammatory cytokine levels.

Even yoga’s impact on posture can affect your oral-systemic health. As Yoganonymous notes,

Poor posture can affect just about every part of your body, including your mouth. When one’s posture is poor, it can cause the lower jaw to move forward. It can even affect the alignment of the teeth and result in a condition called TMJ disorder. TMJ disorder can result in dental problems, such as teeth grinding. It can also cause a person to have difficulty chewing and swallowing. Additionally, TMJ disorder can cause pain in the face and jaw.

Not to mention the head, neck, and shoulders. Yoga may help prevent TMJ problems from arising in the first place, but it can also be one way to find some relief from the pain (in addition to long-term dental solutions).

Partner yoga with practices like good home hygiene and mindful nutrition, and you only add to the whole-body approach to maintaining healthy teeth and gums.

Image by lululemon athletica

Scared of the Dentist? Go for a Brisk Walk!

anxietyPlenty of folks get anxious around dental visits. It’s why we offer sedation options to patients who need them – so fear doesn’t have to stand in the way of getting the care they want or need.

But sedation is hardly the only option.

A new study in the journal Depression and Anxiety found that 30 minutes of walking at a moderate pace right before a dental appointment can significantly reduce stress and anxiety before, during, and after the visit. As Dr Bicuspid reported,

“In the present study, [moderate-intensity exercise] not only led to a significantly stronger reduction of dental anxiety during the anxiogenic challenge (dental procedure), but also to a decreased fear prior to the stressful situation,” the authors wrote. “The additional effect of [moderate-intensity exercise] on anticipatory fear in [dental phobia] is an important clinical finding of the current trial because both aspects of the phobic reaction are important barriers to seek treatment.”

This study monitored patients who scored high on the Dental Anxiety Scale and hadn’t seen a dentist for at least three years. Half of them walked for 30 minutes at a low-intensity treadmill pace; half walked at moderate-intensity. After one week, they switched paces.

Pain intensity was measured using a tool called the visual analog scale (VAS). You can see just how much lower the scores were with moderate-intensity exercise:

You might be wondering how the heck you can fit in 30 minutes of moderate cardio right before your appointment (doctor visits are often squeezed into already jam-packed days). But the good news is that even if you can’t exercise right before your appointment, you may still benefit from incorporating exercise into your daily routine.

For we know that exercise can help reduce anxiety in all settings, not just the dentist’s chair. According to the Anxiety and Depression Association of America, the impacts of exercise can be long lasting.

Science has also provided some evidence that physically active people have lower rates of anxiety and depression than sedentary people. Exercise may improve mental health by helping the brain cope better with stress. In one study, researchers found that those who got regular vigorous exercise were 25 percent less likely to develop depression or an anxiety disorder over the next five years.

And there’s another benefit to exercise: It appears to support good gum health, too. One key study out of Case Western Reserve “found that individuals who exercised, had healthy eating habits and maintained a normal weight were 40 percent less likely to develop periodontitis, a gum infection that can result in loss of teeth.” A contemporary study had even more startling results.

People who never smoked and took regular exercise were about 54% less likely to have periodontitis than people who never smoked but did not engage in physical activity. Rather surprisingly, the prevalence of periodontitis in former smokers was 74% lower for physically active than inactive individuals.

Better oral health and less anxiety plus all the other health benefits of exercise, physical and mental alike? What are you waiting for?

Image by Practical Cures

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