Oral and Whole Body Health

This topic contains 15 replies, has 3 voices, and was last updated by  Harrison 7 years, 7 months ago.

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  • #2968 Score: 0

    Harrison
    Keymaster
      2 pts

      Some of you may have seen this comprehensive document published by Scientific American, I received the paper copy from one of my interviewees (thanks Nic!). I was surprised — and delighted — to find it online! Here it is:

      http://www.dentalcare.com/media/en-AU/products/owbh.pdf

      This is the motherlode – the 13 articles discuss the criticality of managing bacterial diseases in the mouth. Many discuss bacterial biofilm infections; most discuss the link between dental disease and systemic health conditions.

      June 17th – Please note: I just learned that the above link is dead, since Proctor and Gamble unpublished this amazingly helpful article! Why would they remove this from US sites? More later. I’ll share the articles later.

    • #3432 Score: 0

      periocdent
      Member

        There are a lot of perio/systemic disease ‘links’ but links per se do not always mean cause/effect. A link is an association/correlation but for each link, a lot of research needs to be done to confirm/deny these links. For example, let’s ask the question: “Does the treatment for periodontal disease help curb/prevent preterm birth/low birthweight babies?” This is a question that researchers have spent a lot of grant money studying and, in fact, the NIH (National Institutes of Health) spent about 20 million studying this question.

        There are now enough high quality research studies and results have been analyzed. Pooled results from these high-quality research trials do not support the the hypothesis (question) above. For those women who were treated for periodontal disease during pregnancy there was not a reduction of preterm birth or low birthweight babies. Some of the early publications about perio/systemic links may have prematurely jumped to conclusions about some of these links and time will tell which ones are real and which ones are not.

      • #3433 Score: 0

        Harrison
        Keymaster
          2 pts

          Good points all around. But there are some serious design flaws in these studies. For example, a study which “disproved” the link between oral disease and preterm birth:

          Dental Treatments Don’t Stop Preterm Births – Oral Health: Common Problems, Dental Hygiene, Tooth Decay and Cavity Prevention on MedicineNet.com

          This “study” has nothing to do with the diagnosis and treatment of oral biofilms, right? This is just plaque removal and deep cleaning; which ironically actually contribute to bacteremia in some patients.

          The topic I posted yesterday is one of hundreds of studies that spell out the oral-cardiovascular link in spades. It is NIH-sponsored research, if that matters to anyone:

          http://www.biofilmcommunity.org/f11/oral-health-cardiovascular-disease-95/

          It appears that even this study was constrained by culturing techniques. But even then, the results were compelling. Again, this and other studies are handicapped as they do not include designs to account for biofilm infections — which are non-planktonic. Happy to be wrong here; either way, I see it as a progress – and validation of the obvious.

          At the turn of the last century (1900), dentists were taught this: bad gums = bad heart. Are we going backwards? Why is it so hard to admit what has been known for centuries, maybe longer?

          In the meantime, can’t we all agree it is smart to keep bacterial biofilm off our teeth?! 😉

        • #3434 Score: 0

          Harrison
          Keymaster
            2 pts

            Arch Gynecol Obstet. 2010 Dec 1. [Epub ahead of print]
            Periodontal disease and perinatal outcomes.
            Matevosyan NR.

            Open Medical Institute, Salzburg, Austria

            PURPOSE: To elucidate plausible associations between periodontal disease (PD) and pregnancy events through meta-analysis of original research published between 1998 and 2010.

            METHODS: One hundred and twenty-five randomized, case-control, matched-cohort studies on pregnancy and postpartum specifics in women with PD are identified through PubMed, LILACS, and Cochrane Register. Meta-study is performed on a sample of 992 births allocated from studies of level I-II-1 evidence. An oral inflammation score (OIS) is composed from parameteric and observational components of maternal PD. Pearson arrival process is modeled for exchangeable correlations.

            RESULTS: Women with preeclampsia and preterm birth have poor periodontal parameters in both, treatment and placebo groups (OR 1.94-2.9). In puerperae with severe periodontitis birth weight is negatively correlated with maternal probing depth (r = -0.368), and C-reactive protein (r = -0.416). Higher rates of tobacco use (RR 3.02), bacterial vaginosis (RR 2.7), clinical attachment level (OR 2.76), and fetal tyrosine kinase (OR 1.6) contribute in increased rates of preeclamsia (RR 1.68), and prematurity (RR 2.75). After adding confounders into the model OIS remains significantly associated with preterm birth (OR 2.3).

            CONCLUSIONS: Maternal PD has strong associations with preeclampsia and prematurity.

          • #3435 Score: 0

            Harrison
            Keymaster
              2 pts

              Infect Immun. 2010 Apr;78(4):1789-96. Epub 2010 Feb 1.
              Transmission of diverse oral bacteria to murine placenta: evidence for the oral microbiome as a potential source of intrauterine infection.
              Fardini Y, Chung P, Dumm R, Joshi N, Han YW.

              Department of Periodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio 44106-4905, USA.

              Microbial infection of the intrauterine environment is a major cause of preterm birth. The current paradigm indicates that intrauterine infections predominantly originate from the vaginal tract, with the organisms ascending into the sterile uterus. With the improvements in technology, an increasing number of bacterial species have been identified in intrauterine infections that do not belong to the vaginal microflora.

              We have demonstrated previously that intrauterine infections can originate from the oral cavity following hematogenous transmission. In this study, we begin to systemically examine what proportion of the oral microbiome can translocate to the placenta. Pooled saliva and pooled subgingival plaque samples were injected into pregnant mice through tail veins to mimic bacteremia, which occurs frequently during periodontal infections. The microbial species colonizing the murine placenta were detected using 16S rRNA gene-based PCR and clone analysis.

              A diverse group of bacterial species were identified, many of which have been associated with adverse pregnancy outcomes in humans although their sources of infection were not determined. Interestingly, the majority of these species were oral commensal organisms. This may be due to a dose effect but may also indicate a unique role of commensal species in intrauterine infection.

              In addition, a number of species were selectively “enriched” during the translocation, with a higher prevalence in the placenta than in the pooled saliva or subgingival plaque samples. These observations indicate that the placental translocation was species specific. This study provides the first insight into the diversity of oral bacteria associated with intrauterine infection.

            • #3436 Score: 0

              Harrison
              Keymaster
                2 pts

                J Clin Periodontol. 2005 Jan;32(1):45-52.
                Periodontitis, a marker of risk in pregnancy for preterm birth.
                Dörtbudak O, Eberhardt R, Ulm M, Persson GR.

                Department of Periodontology and Fixed Prosthodontics, University of Bern, Switzerland.

                BACKGROUND: Why chronic periodontitis may induce an inflammatory response with premature pregnancy termination is unclear.

                AIMS: (1) To assess if periodontitis predicts premature gestation; (2) to study amniotic fluid cytokines and periodontitis variables in early-stage pregnancy.

                MATERIAL AND METHODS: A periodontal examination and collection of amniotic fluid was performed (weeks 15-20) of pregnancy in 36 women at risk for pregnancy complications. Amniotic fluid (bacteria), vaginal smears and intra-oral plaque samples were studied. Cytokine levels in amniotic fluid were studied in relation to other study variables.

                RESULTS: Periodontitis was diagnosed in 20% of normal and in 83% of preterm birth cases (p<0.01). Bacteria were never found in the amniotic fluids studied. Sub-gingival plaque samples including bacteria in the orange and red complexes were found in 18% of full-term 100% of preterm cases (p<0.001) and total colony-forming units (CFUs) were higher in preterm birth (p<0.01). Amniotic levels of interleukin (IL)-6 and prostaglandin-E2 (PGE2) were higher in preterm cases (p<0.001). Amniotic IL-6 (r=0.56, p<0.01) and PGE2 (r=0.50, p<0.01) cytokine levels were correlated with CFU from sub-gingival plaque samples (r2=0.44). The odds ratio of preterm delivery and having periodontitis was 20.0 (95% confidence interval (CI): 2.0-201.7, p<0.01). The odds of >60 CFU in sub-gingival plaque and preterm birth was 32.5:1 (95% CI: 3.0-335.1, p<01).

                CONCLUSIONS: Pregnant women with findings of elevated amniotic fluid levels of PGE2, IL-6 and IL-8 in the 15-20 weeks of pregnancy and with periodontitis are at high risk for premature birth. The implication of this is that periodontitis can induce a primary host response in the chorioamnion leading to preterm birth.

              • #3437 Score: 0

                Harrison
                Keymaster
                  2 pts

                  This article is interesting, as it confirms what other labs (with molecular diagnostics) are finding: that (not only bacteria) can be more virulent or pathogenic than others. This issue has been researched, documented and published myriad times in the past five or six years.
                  ____________________________________________________

                  Virulence. 2010 Jul-Aug;1(4):254-9.
                  Examination of maternal gingival crevicular fluid for the presence of selected periodontopathogens implicated in the pre-term delivery of low birthweight infants.
                  Africa CW, Kayitenkore J, Bayingana C.

                  Faculty of Science, Department of Medical Biosciences, University of the Western Cape, Belville, South Africa.

                  BACKGROUND: Reports show that more than 20 million infants world-wide are born prematurely with 95% of all pre-term births occurring in developing countries. Oral colonization of gram-negative anaerobes has been implicated as a risk factor for preterm delivery of low birth weight infants.

                  MATERIALS AND METHODS: This study comprised 200 women admitted to the department of obstetrics and gynecology of the teaching hospital of Butare in Rwanda. Gingival crevicular fluid was collected from each quadrant of the mother’s mouth (using paper points) within 24 hours of delivery. A dichotomous score of presence or absence of gingival inflammation was recorded for each patient along with demographic data such as age, marital status etc. Samples were examined by PCR for the presence of Aggregatibacter actinomycetemcomitans and selected members of the red and orange complexes described by Socransky et al., (1998), and their presence associated with age, gingival inflammation and pregnancy outcomes.

                  RESULTS: Association of bacterial species with the risk of periodontal disease and thus the risk of preterm delivery was only observed when they occurred in pairs or groups of three or more. Aa appeared to be a necessary co-factor for significant associations of bacterial groups with the variables recorded.
                  _______________________________________

                  And another:

                  Minerva Stomatol. 2010 Oct;59(10):543-50.
                  Effect of periodontal treatment on the incidence of preterm delivery: a systematic review.
                  Pimentel Lopes De Oliveira GJ, Amaral Fontanari L, Chaves De Souza JA, Ribeiro Costa M, Cirelli JA.

                  UNESP, Division of Periodontology, São Paulo State University, Department of Diagnosis and Surgery, School of Dentistry at Araraquara, Araraquara, SP, Brazil

                  Preterm birth is a major problem in public health in developed and developing countries and the search for risk factors of this event is important. The aim of this study was to review the effect of periodontal treatment on the incidence of preterm delivery. A wide research was executed considering an evaluation period between November of 1998 and October of 2009 at MEDLINE/PUBMED databases.

                  The selection strategy consisted of the search for the following key-words: “periodontal therapy” or “periodontal disease” and “pregnancy outcome” or “preterm birth”. The search was limited for articles written in English. The randomized clinical trials that evaluated the effect of the non-surgical periodontal treatment on the incidence of Preterm Low Birth Weight (PLBW) were selected.

                  In a total of 7 papers selected, the incidence of PLBW was lower in groups of women who were submitted to periodontal treatment. Reductions of Preterm Birth (PTB) ranged from 0.8% to 28.01%, while reduction of Low Birth Weight (LBW) ranged from 0.44% to 33%. In studies that analyzed these two variables together, . The majority of the studies concluded that non-surgical periodontal treatment in pregnant women reduces incidence of preterm babies with low weight.

                • #3438 Score: 0

                  periocdent
                  Member

                    Good points all around. But there are some serious design flaws in these studies. For example, a study which “disproved” the link between oral disease and preterm birth:

                    Dental Treatments Don’t Stop Preterm Births – Oral Health: Common Problems, Dental Hygiene, Tooth Decay and Cavity Prevention on MedicineNet.com

                    This “study” has nothing to do with the diagnosis and treatment of oral biofilms, right? This is just plaque removal and deep cleaning; which ironically actually contribute to bacteremia in some patients.

                    Hi again from Lynne, No, plaque is another term for biofilm so this was not a flaw in the study design. Patients received meticulous debridement (what some call deep scaling and root planing) so biofilm was disrupted.

                    The topic I posted yesterday is one of hundreds of studies that spell out the oral-cardiovascular link in spades. It is NIH-sponsored research, if that matters to anyone:

                    http://www.biofilmcommunity.org/f11/oral-health-cardiovascular-disease-95/

                    It appears that even this study was constrained by culturing techniques. But even then, the results were compelling. Again, this and other studies are handicapped as they do not include designs to account for biofilm infections — which are non-planktonic. Happy to be wrong here; either way, I see it as a progress – and validation of the obvious.

                    At the turn of the last century (1900), dentists were taught this: bad gums = bad heart. Are we going backwards? Why is it so hard to admit what has been known for centuries, maybe longer?

                    In the meantime, can’t we all agree it is smart to keep bacterial biofilm off our teeth?! 😉

                    Absolutely correct here! Yes, it’s important to disrupt biofilm on our teeth daily. For each of my patients, I customize care so that biofilm removal can be as complete as possible! Some patients will floss and use a high-end powered toothbrush and then some patients will use a WaterPik and interdental brushes instead of floss. Tongue cleansing is important, too, because biofilm grows on the tongue AND TONSILS!

                  • #3439 Score: 0

                    periocdent
                    Member

                      The article you gave me to look at talked about one of the ten studies . . . Offenbacher 2009 but there are nine others. In addition, the federal government spent 20 million or so studying this question. Pharmaceutical companies like to promote these links because it helps them to sell toothpaste/other medical/dental products. There is a lot of research bias and when you’re looking at research outcomes, it’s sometimes best to talk to an epidemiologist/biostatistician.

                      Hi there, Let me explain to you how ‘associations’ (correlations) work in the research world. Let’s say for example, a researcher wants to determine if there is an association between preterm birth and the treatment of periodontal disease. There are many variables (factors) that contribute to preterm birth like infection (fever, too) placenta tears, bleeding disorders, stretching of the uterus, low socioeconomic status, nonwhite race, maternal age, smoking, substance abuse, low prepregnancy weight, previous history of preterm delivery, other uterine factors like trauma, uterine anomalies and sometimes it’s a combination of various factors. So, researchers who are interested in testing the hypothesis (question) that pertains to preterm birth and periodontal disease will design a study and treat women with periodontal disease. They they will determine if there was a reduction in preterm birth. Study design is complex and you have to have experimental and control groups and these studies are typical large and very expensive to conduct. Also, it takes time to complete them and you NEVER conclude anything based on ONE study because there are always study errors. Instead, in the case of preterm birth specifically, researchers looked at studies that were conducted over the past two decades. Researchers look at all the studies, throw out the bad ones (meaning that they were fraught with error) and they analyze the good ones in what is called a meta-analysis. In the case of preterm birth/low birthweight babies and periodontal disease, enough research was done over the past two decades to properly analyze the data.

                      Just because there’s a reported ‘link’ (which is also referred to as an association or correlation) does’t mean that it’s true. It takes a LONG TIME to study these links to determine if they really do exist.

                      The link you sent me does talk about one of the studies but there are many. A good way to search for studies that have been done on a given subject is to go to pub med and search for them but we now look at what are called meta-analyses and systematic reviews . . . . these are reports that look at ALL the good research studies to date on a given topic. In the case of preterm birth, there are about 10 clinical trials that researchers have analyzed in a meta-analysis.

                      Here’s a more reliable source for you to look at: Looking at the Periodontal-Systemic Disease Connection

                      Hope this helps a little bit. Lynne

                    • #3441 Score: 0

                      Harrison
                      Keymaster
                        2 pts

                        No, this doesn’t help –it ignores the progress that’s been made and the points I made above in the various topics and studies.

                        The fact that that $20,000,000 of our tax payer money was spent to arrive at conflicting conclusions does not help me feel any better either. In the meantime, I hope future studies involve the inclusion of these things which are helping patients get better:

                        – Water Pik
                        – Sonicare and other ultrasonic cleaners
                        – natural products like xylitol, essential oils
                        – new antibacterial technologies, approved in Canada and used in thousands of patients
                        – PCR and even more advanced technologies
                        – visual microscopy
                        – others that I don’t even know about

                        Please tell us a bit more about your research as it relates to bacterial oral biofilms. Is the research you are referencing “correct?” What is it about the oral-systemic connection that you cannot believe? Forget the flawed studies, tell us what you learned about oral biofilms — that’s what this forum is for — helping people move beyond the paradigm of chronic bacterial illness.

                      • #3440 Score: 0

                        Harrison
                        Keymaster
                          2 pts
                        • #3448 Score: 0

                          Harrison
                          Keymaster
                            2 pts

                            Neuro Endocrinol Lett. 2011 Feb 15;32(1).
                            Pregnancy and periodontal tissues.
                            [No authors listed]

                            Periodontitis is today considered to be a serious disease of periodontal tissues, one caused in most cases by bacterial infection which stimulates proteolysis and osteolysis of the tissues. Typical for the disease is formation of periodontal pockets and a chronic destructive inflammation which impacts on the whole organism.

                            Periodontopathic bacteria colonized in a subgingival biofilm cannot be removed by common oral hygiene. Overproduction of bacteria and other pro-inflammatory mediators can increase the total pro-inflammatory state of the organism in pregnant women. Increased levels of some pro-inflammatory cytokines (PGE2) and cells in fetoplacental space can lead to premature rupture of membranes and subsequent delivery of immature babies.

                            An increasing number of studies in this field provide evidence that good professional care and personal oral hygiene can bring benefits through a decreased prevalence of preterm low birth weight infants (PLBWI) in women suffering periodontitis, although definitive conclusions have not yet been reached. Future mothers with periodontitis can run not only an increased risk of PLWBI but often also suffer pre-eclampsia – a state called acute atherosis – which can be ethiopathogenetically associated with high concentrations of various pro-inflammatory mediators. An increased production of female hormones during pregnancy contributes to the development of gingivitis and periodontitis because vascular permeability and possible tissue edema are both increased.

                            PMID: 21407157 [PubMed – as supplied by publisher]

                          • #3457 Score: 0

                            shirdent
                            Member

                              Here’s the thing, until we can decide on a way to diagnose periodontal disease all these studies will give questionable results. How was PD determined? Bone loss? That can come from a number of problems, only one of which is perio related.

                              Pathogens? they must live in a caustic biofilm in order to be damaging.

                              Xrays? You’re kidding, right?

                              Bleeding on probing? how are the probers calibrated? What pressure was used on the probe?
                              Was the patient already pregnant? that causes tissue changes that mimic perio

                              Is it ok for a pregnant woman to have an infected open wound anywhere? NO!

                              Does it cause preterm birth? who cares? Clean it up!

                              Was Semmelweis wrong, he sure was for a long time. Now look! You can’t go anywhere without seeing hand sanitizers everywhere! It’s hard being so far forward!:rolleyes:

                              The science of biofilm shows us that the body reacts to the presence of the film by increasing inflammatory cascades and the chemistry that comes with fighting infection. That’s not good for anyone. It’s also hard to study, as the effects take a long time to show.

                              Shirley Gutkowski

                              Arch Gynecol Obstet. 2010 Dec 1. [Epub ahead of print]
                              Periodontal disease and perinatal outcomes.
                              Matevosyan NR.

                              Open Medical Institute, Salzburg, Austria

                              PURPOSE: To elucidate plausible associations between periodontal disease (PD) and pregnancy events through meta-analysis of original research published between 1998 and 2010.

                              METHODS: One hundred and twenty-five randomized, case-control, matched-cohort studies on pregnancy and postpartum specifics in women with PD are identified through PubMed, LILACS, and Cochrane Register. Meta-study is performed on a sample of 992 births allocated from studies of level I-II-1 evidence. An oral inflammation score (OIS) is composed from parameteric and observational components of maternal PD. Pearson arrival process is modeled for exchangeable correlations.

                              RESULTS: Women with preeclampsia and preterm birth have poor periodontal parameters in both, treatment and placebo groups (OR 1.94-2.9). In puerperae with severe periodontitis birth weight is negatively correlated with maternal probing depth (r = -0.368), and C-reactive protein (r = -0.416). Higher rates of tobacco use (RR 3.02), bacterial vaginosis (RR 2.7), clinical attachment level (OR 2.76), and fetal tyrosine kinase (OR 1.6) contribute in increased rates of preeclamsia (RR 1.68), and prematurity (RR 2.75). After adding confounders into the model OIS remains significantly associated with preterm birth (OR 2.3).

                              CONCLUSIONS: Maternal PD has strong associations with preeclampsia and prematurity.

                            • #3458 Score: 0

                              Harrison
                              Keymaster
                                2 pts

                                Shirley, well said. However, I find it interesting that so much research and practical knowledge has been muted. Perhaps people are finally starting to get it — see the article below.

                                As you know, many other kinds of microbes other than strep mutans can and do end up in heart tissue. I would like to know what happens when they get there, but people I interviewed for the film unequivocally mentioned their pathogenic role in disease and their documented role as colonizers in the biofilm formation process.
                                _____________

                                How Cavity-Causing Microbes Invade The Heart

                                28 Jun 2011

                                Scientists have discovered the tool that bacteria, normally found in our mouths, use to invade heart tissue, causing a dangerous and sometimes lethal infection of the heart known as endocarditis. The work raises the possibility of creating a screening tool – perhaps a swab of the cheek, or a spit test – to gauge a dental patient’s vulnerability to the condition.

                                The identification of the protein that allows Streptococcus mutans to gain a foothold in heart tissue is reported in the June issue of Infection and Immunity by microbiologists at the University of Rochester Medical Center.

                                S. mutans is a bacterium best known for causing cavities. The bacteria reside in dental plaque – an architecturally sophisticated goo composed of an elaborate molecular matrix created by S. mutans that allows the bacteria to inhabit and thrive in our oral cavity. There, they churn out acid that erodes our teeth.

                                Normally, S. mutans confines its mischief to the mouth, but sometimes, particularly after a dental procedure or even after a vigorous bout of flossing, the bacteria enter the bloodstream. There, the immune system usually destroys them, but occasionally – within just a few seconds – they travel to the heart and colonize its tissue, especially heart valves. The bacteria can cause endocarditis – inflammation of heart valves – which can be deadly. Infection by S. mutans is a leading cause of the condition.

                                “When I first learned that S. mutans sometimes can live in the heart, I asked myself: Why in the world are these bacteria, which normally live in the mouth, in the heart? I was intrigued. And I began investigating how they get there and survive there,” said Jacqueline Abranches, Ph.D., a microbiologist and the corresponding author of the study.

                                Abranches and her team at the University’s Center for Oral Biology discovered that a collagen-binding protein known as CNM gives S. mutans its ability to invade heart tissue. In laboratory experiments, scientists found that strains with CNM are able to invade heart cells, and strains without CNM are not.

                                When the team knocked out the gene for CNM in strains where it’s normally present, the bacteria were unable to invade heart tissue. Without CNM, the bacteria simply couldn’t gain a foothold; their ability to adhere was about one-tenth of what it was with CNM.

                                The team also studied the response of wax worms to the various strains of S. mutans. They found that strains without CNM were rarely lethal to the worms, while strains with the protein were lethal 90 percent of the time. Then, when Abranches’ team knocked out CNM in those strains, they were no longer lethal – those worms thrived.

                                The work may someday enable doctors to prevent S. mutans from invading heart tissue. Even sooner, though, since some strains of S. mutans have CNM and others do not, the research may enable doctors to gauge a patient’s vulnerability to a heart infection caused by the bacteria.

                                Abranches has identified five specific strains of S. mutans that carry the CNM protein, out of more than three dozen strains examined. CNM is not found in the most common type of S. mutans found in people, type C, but is present in rarer types of S. mutans, including types E and F.

                                “It may be that CNM can serve as a biomarker of the most virulent strains of S. mutans,” said Abranches, a research assistant professor in the Department of Microbiology and Immunology. “When patients with cardiac problems go to the dentist, perhaps those patients will be screened to see if they carry the protein. If they do, the dentist might treat them more aggressively with preventive antibiotics, for example.”

                                Until more research is done and a screening or preventive tool is in place, Abranches says the usual advice for good oral health still stands for everyone.

                                “No matter what types of bacteria a person has in his or her mouth, they should do the same things to maintain good oral health. They should brush and floss their teeth regularly – the smaller the number of S. mutans in your mouth, the healthier you’ll be. Use a fluoride rinse before you go to bed at night. And eat a healthy diet, keeping sugar to a minimum,” added Abranches.

                                Abranches presented the work at a recent conference on the “oral microbiome” hosted by the University’s Center for Oral Biology. The center is part of the Medical Center’s Eastman Institute for Oral Health, a world leader in research and post-doctoral education in general and pediatric dentistry, orthodontics, periodontics, prosthodontics, and oral surgery.

                                Additional authors of the study include laboratory technician James Miller; former technician Alaina Martinez; Patricia Simpson-Haidaris, Ph.D., associate professor of Medicine; Robert Burne, Ph.D., of the University of Florida; and Abranches’ husband, Jose Lemos, Ph.D., of the Center for Oral Biology, who is also assistant professor in the Department of Microbiology and Immunology. The work was funded by the American Heart Association.

                                Source:
                                Tom Rickey
                                University of Rochester Medical Center
                                Article URL: How Cavity-Causing Microbes Invade The Heart

                              • #3505 Score: 0

                                Harrison
                                Keymaster
                                  2 pts

                                  What is amniotic fluid ‘sludge’?

                                  R. ROMERO, J. P. KUSANOVIC, J. ESPINOZA, F. GOTSCH, C. L. NHAN-CHANG, O. EREZ,C. J. KIM, N. KHALEK, P. MITTAL, L. F. GONCALVES, C. SCHAUDINN, S. S. HASSAN and J. W. COSTERTON

                                  The presence of free-floating hyperechogenic material within the amniotic fluid in close proximity to the uterine cervix (Figures 1 (cover) and ​and22 and Videoclips S1 and S2) has been described previously in women with an episode of preterm labor1, in women with a history of preterm delivery or threatened preterm labor2, and in asymptomatic women at risk for spontaneous preterm delivery in the mid-trimester of pregnancy3.

                                  We have proposed the term amniotic fluid ‘sludge’ to refer to this sonographic finding and provided evidence that ‘sludge’ is an independent risk factor for impending preterm delivery, histological chorioamnionitis and microbial invasion of the amniotic cavity in patients with spontaneous preterm labor and intact membranes1.

                                  Moreover, amniotic fluid ‘sludge’ has been identified in asymptomatic women at risk for spontaneous preterm delivery in the mid-trimester of pregnancy and is also an independent risk factor for preterm prelabor rupture of membranes (PROM) and spontaneous preterm delivery3. To determine the nature of amniotic fluid ‘sludge’, the material collected under sonographic guidance was examined under the microscope and microbiological studies were performed.

                                  _______________________

                                  Excerpt on the bugs found (dental professionals and moms, take note!):

                                  The amniotic fluid culture was positive for Mycoplasma hominis, Streptococcus mutans and Aspergillus flavus.

                                  Note that this test was a culture. More on this diagnostic later.

                                  Full article and pictures here: What is amniotic fluid

                                • #2969 Score: 0

                                  Harrison
                                  Keymaster
                                    2 pts

                                    March 23, 2012, 1:30 p.m. EDT

                                    Treatment for Gum Disease Can Lower Medical Costs for People With Diabetes
                                    United Concordia Dental offers innovative program in response to study findings
                                    HARRISBURG, Pa., March 23, 2012 /PRNewswire via COMTEX/ — Medical costs are lower for people with diabetes who receive treatment for gum disease, according to a study presented today to the American Association for Dental Research by Dr. Marjorie Jeffcoat of the University of Pennsylvania. The study was done in collaboration with United Concordia Dental and Highmark Inc.

                                    “The study showed that periodontal treatment and ongoing maintenance is associated with a for people with diabetes – in the amount of $1,800 per year,” said James Bramson, D.D.S., chief dental officer for United Concordia. “The findings also showed that hospitalizations decreased by 33 percent and physician visits by 13 percent across the entire study population of diabetics when gum disease is treated and managed afterward.” Findings related to pharmacy costs in the study population will be released in the near future.

                                    – a number that has more than doubled since 1999, according to the Centers for Disease Control and Prevention.

                                    “It is really a landmark study because of its size and three-year duration. These numbers clearly demonstrate the importance of the study’s findings for people with diabetes, as well as the can have on the rising medical costs associated with diabetes,” said. Dr. Bramson.

                                    F.G. Merkel, United Concordia president and chief operating officer, said the dental insurer and its parent company, Highmark Inc., funded the study by Professor and Dean Emeritus Marjorie Jeffcoat, D.M.D., of the University of Pennsylvania, School of Dental Medicine, because of United Concordia’s increasing concern with the importance of oral health on overall health and to underscore both companies’ commitment to wellness.

                                    “The study points to the ability to lower medical costs among patients with diabetes through appropriate dental care,” said Merkel. “Because of what we now know, United Concordia is introducing a group product that provides additional coverage for treatment of periodontal disease for members with diabetes. We believe that when their employees with diabetes receive appropriate periodontal care.”

                                    As a result of the study’s findings, United Concordia will offer UCWellness, a disease-specific program that provides following periodontal treatment, certain surgical procedures that treat gum disease and removal of plaque and tartar in patients with gum disease. An important component of UCWellness is targeted education geared toward covered members with diabetes.

                                    “What makes UCWellness different than others on the market is the enhanced surgical benefit we are offering,” said Merkel. “United Concordia is the first to offer this type and level of coverage to people with diabetes.”

                                    “A considerable amount of literature exists pointing to an ,” said Dr. Jeffcoat. “The number of individuals’ data in this study makes it the largest of its kind and is clinically significant in my opinion.”

                                    The information being released related to diabetes is the first in a series of findings which will demonstrate that appropriate dental treatment and maintenance can actually help lower medical costs for individuals with certain medical conditions.

                                    “We hope these additional findings will show medically related cost savings as well. What’s clear now is that appropriate dental treatment and maintenance for diabetics can predict lower medical costs,” said Dr. Bramson.

                                    The University of Pennsylvania study analyzed data over a three-year period from nearly 1.7 million individuals with United Concordia dental and Highmark medical coverage. It focused on determining if dental cleanings and/or treatment of gum disease would decrease the cost of medical care in patients who have diabetes. The study will also analyze other chronic diseases and conditions, such as .

                                    Dr. Jeffcoat presented the diabetes findings today to more than 2,500 attendees at the American Association for Dental Research annual meeting in Tampa, Florida. United Concordia expects to release the finding for the other diseases and conditions when the analysis is complete and will use the information to help employers drive down group benefit costs.

                                    To learn more about the UCWellness program and the connection between diabetes and oral health, visit UCCI Home Page .

                                    About United ConcordiaUnited Concordia is a leading national dental carrier and delivers high-quality, cost-effective dental programs. Headquartered in Harrisburg, Pa., the company has more than 8 million members, a network of more than 76,000 dentists at over 163,000 access points nationwide and is licensed in all 50 states, D.C. and Puerto Rico. United Concordia has a companywide dedication and commitment to superior customer service, which is evident in the design, implementation, administration and servicing of its dental benefits programs.

                                    SOURCE: United Concordia Dental


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