Category: General Dentistry

The U.S. Centers for Disease Control and Prevention have issued a warning following confirmation of a recent outbreak of a nontuberculous mycobacteria infection. This appears to have been caused by contaminated water lines in some dental clinics. Now, medical professionals are urging parents to look out for symptoms in their children and themselves. Fortunately, treatment is available for those who have caught the infection.

The U.S. Centers for Disease Control and Prevention (CDC) have issued a warning that some American children have caught a serious infection from contaminated water lines in some dental clinics [1].

The infection, caused by a bacteria type called Nontuberculous Mycobacteria (NTM) is rare. But small clusters of cases in recent years have taken place, with the CDC now becoming aware of another recent cluster [1].

The harmful bacteria lodge in the narrow water lines of dental equipment. This equipment is used for everything – from routine cavity fillings to more complex procedures like root canal treatments.

What is Nontuberculous Mycobacteria?

NTM is a type of bacteria. It is found in water, marshland and soil. However, it shouldn’t be confused with mycobacteria tuberculous – which causes Tuberculosis.

While children are predominantly at risk, adults can also be affected. Infections typically occur after either wisdom teeth extractions or root canal treatments [1].

One of the most notorious past outbreaks of NTM came in California in 2016 [1]. 71 patients were treated for NTM infection [1].

NTM is not the only infection or disease linked to dental water lines. For example, Legionella Disease is another type of bacteria that has contaminated water supplies in dental clinics in the past [3].

The new outbreak

This most recent outbreak was in March 2022, which the CDC was alerted to [2]. An investigation into this new outbreak is being carried out by the CDC [2].

Initial visits to the dental clinic under investigation found that the tested water line resulted in microbial counts far higher than the level recommended by the CDC [2].

Symptoms and treatment of an NTM infection

The symptoms of an NTM infection usually involve swelling in the jaw or neck. Moreover, an abscess, pain, weight loss, night sweats and general fever are other symptoms to look out for [4]. Symptoms do not always appear immediately. Instead, they can slowly appear.

If left alone, hearing loss, permanent tooth loss and facial nerve palsy are potential consequences [1]. This underlines the importance of getting help if you believe you have an NTM infection.

NTM infections usually get worse over time [1]. Treatment usually requires surgical removal of the diseased tissue. This can result in loss of the jawbone, and potentially even teeth [1]. Antibiotics are commonly prescribed as part of a multi-drug regimen [1].

In every case in the past that has involved NTM infection following dental treatment, a surgical procedure has been required to resolve the issue [1]. Therefore, this shows the possible damage of an NTM infection.

The CDC’s comments

Dr. Michele Neuburger is a dental officer within the CDC’s Division of Oral Health. She commented on this development. She says that “NTM infections following dental procedures are very serious” [1].

Neuburger continued by warning that “these infections can be resistant to antibiotic treatment”, before calling them “difficult to treat” [1].

Continuing, Neuburger says that “if dental water lines are not maintained properly and regularly treated with germicides, these bacteria, along with other microorganisms in the water, will attach to the interior surfaces of the water-line tubing and form a biofilm, which serves as a reservoir where microorganisms can grow and increase in numbers” [1].

Neuburger continued to explain by saying that “pieces of biofilm can break off into the water system and then be released into the patient’s mouth” [1].

Furthermore, Neuburger has urged parents to contact their dentist immediately if they suspect themselves or a child of theirs has developed an NTM infection [1].

The CDC have made some recommendations to dental clinics. These include the regular use of chemical germicides in the water lines – which can help in lessening the threat of bacteria.

It is important for dental clincis to follow these guidelines. Moreover, this involves maintaining equipment and following safety procedures for water to ensure that it is safe for use.

These infections are rare, but do happen. Remaining vigilant both before and after dental treatment is important. Our oral health is crucial, and should always be a priority for us all.

Thinking points…

1) While this is concerning, do not let this put you off attending the dentist. Please remember that NTM infections are very rare. Visiting the dentist is very important for both yourself and your children. Regular check-ups can help to ensure your oral health is strong, and identify any potential problems. Remember to book an appointment when needed!

2) If this news makes you anxious, you’ll be pleased to hear that at our Calgary dental clinic Savanna Dental, safety is of the utmost importance to us. We follow the designated guidelines to ensure our water supply is safe for patients. Furthermore, our dental staff are always happy to talk you through treatments, and reassure you about the water supply. We would love to see you soon – see our website for more information!

What we offer at Savanna Dental

Savanna Dental is a Calgary dental clinic that provide its patients with a range of treatment options and advice aimed at improving oral health.

It is crucial to brush your teeth at least twice a day and to floss regularly. Moreover, eating healthily and trying to avoid sugary foods and drink is important.

We advise our patients to attend our Calgary-based dental clinic twice a year for a regular dental check-up. When problems are detected, we have many treatments available. For instance, these include cavity fillings and root canals.

Here at Savanna Dental, we also have some cosmetic treatments available! These include dental implants, tooth whitening and Invisalign™! Many people find that these treatments have a positive impact on their appearance, confidence and self-esteem.

In addition, all of our services at our Calgary dental clinic Savanna Dental are in line with the Alberta Dental Fee Guide.

We would love you to visit our Savanna Dental clinic in Calgary! You can find out more about us by visiting our website https://savannadentalclinic.ca.

References

[1] Reinberg, S. (2022). CDC warns of rare bacterial infections from dentists’ water lines. Available: https://medicalxpress.com/news/2022-11-cdc-rare-bacterial-infections-dentists.html. Last accessed: 12th November 2022.

[2] CDC Health Alert Network. (2022). Outbreaks of Nontuberculous Mycobacteria Infections Highlight Importance of Maintaining and Monitoring Dental Waterlines. Available: https://emergency.cdc.gov/han/2022/han00478.asp. Last accessed: 12th November 2022.

[3] Atlas, R. M., Williams, J. F., & Huntington, M. K. (1995). Legionella contamination of dental-unit waters. Applied and Environmental Microbiology. 61 (4): p1208-1213. DOI: https://doi.org/10.1128/aem.61.4.1208-1213.1995.

[4] Asthma + Lung UK. (2022). Non-tuberculous mycobacterial infection (NTM). Available: Last accessed: 12th November 2022.

A new topical gel has been created by a research team, which appears to be capable of treating gum disease in a more effective way than current treatments. The gel is capable of blocking the receptor for something called Succinate – which is known to be associated with Gum Disease. This can suppress inflammation in the mouth. Such findings are exciting, and could in the future result in better treatment outcomes for gum disease.

Recent research has led to the creation of a new topical gel which looks like it can treat Gum Disease in an effective way. The gel can suppress inflammation in the mouth by targeting the receptor of a molecule called Succinate [1].

Given how many people suffer from gum disease, this is an exciting finding. Gum disease can be challenging to treat.

In the long-term, the aim is that the gel could be used at home by a person in an effort to prevent or treat gum disease [1].

Background

Gum disease is one of the most common oral health conditions, and affects a huge number of people around the world. Symptoms include inflammation, redness around the gums and pain.

Gum disease typically involves an imbalance of unhealthy and healthy bacteria within the mouth. In the worst cases, gum disease can result in bone destruction, chewing issues and loss of teeth.

Studies suggest that gum disease affects up to half of adults aged 30 and above [2]. This shows the sheer scale of the impact of gum disease. Therefore, finding an effective treatment would have a very positive impact.

The Succinate Connection

This research considered the impact of Succinate. Succinate is a molecule that is produced during metabolism. Past research has showed that those with high levels of succinate typically have higher levels of inflammation [3].

Moreover, high levels of succinate is also associated with speeding up the process of bone loss, which is something that is a consequence of advanced gum disease [3]. Succinate is naturally produced by the human body.

The Research

The research was done by New York University’s (NYU) College of Dentistry. Their findings were then published in the journal Cell Reports [1].

To begin with, the researchers wanted to confirm the link between succinate and gum disease. They examined dental plaque samples from humans and mice [1].

Then, the researchers used metabolomic analysis to determine the levels of succinate in those with gum disease, and those without [1]. As they had expected, those with gum disease had higher levels of succinate than those without [1].

While doing this analysis, the researchers noticed that the succinate receptor was active in the gums of both humans and mice. Therefore, the researchers hoped to look further into this. To do this, they genetically altered some mice in a way that their succinate receptor would be inactivated [1].

In the mice with an inactivated receptor, the researchers measured the levels of inflammation in the gum tissue and blood of mice with and without gum disease. As a result, they found that mice with an inactivated receptor had lower levels of inflammation in their gum tissue and blood [1].

The investigation into the succinate receptor uncovered other findings too. Mice with gum disease had a greater imbalance of bacteria than the mice with inactivated receptors did [1]. Moreover, they also showed less bone loss – which further cemented their conclusions over succinate [1].

To ensure their findings were accurate, the researchers administered extra levels of succinate to both sets of mice [1]. For the mice with regular receptors, their gum disease worsened. However, for the mice with an inactivated succinate receptor, their mouths were mainly protected against inflammation, increases in unhealthy bacteria and bone loss [1].

This clearly showed that when the succinate receptors were inactivated, that better oral health followed. Therefore, elevated levels of succinate and the activation of the succinate receptor are key factors in gum disease [1].

Based on this knowledge, the researchers developed a gel formulation that is aimed towards treating gum disease [1]. The gel is a small compound that is capable of targeting the succinate receptor – with the aim of stopping it from activating [1].

Subsequently, lab studies were carried out on human gum cells, which found that application of the gel resulted in reduced inflammation and other processes that are associated with gum disease [1].

Then, the gel was applied to the gums of mice with gum disease. A group of mice with gum disease were not given the gel. Over a 4 week period, it was found that inflammation was significantly reduced, while bone loss was cut in half in the mice that received the gel compared to those that didn’t [1].

Therefore, the findings clearly showed that this gel was able to successfully lower inflammation and bone loss – two key consequences of gum disease [1].

Implications for the future

The authors were delighted with the results. Author and Associate Research Scientist at NYU’s College of Dentistry. Yuqi Guo, commented on the findings. He said that “no current treatment for gum disease simultaneously reduces inflammation, limits disruption to the oral microbiome, and prevents bone loss. There is an urgent public health need for more targeted and effective treatments for this common disease” [4].

Now that the results are clear, the researchers are hoping to use the gel on other animal models, which will enable the researchers to have an idea on the appropriate dosage and timing for application of the gel [4]. Toxicity will also need to be checked [4].

The long-term goal of the team is to develop a gel and oral strip that regular people can use at home in an effort to treat gum disease [4]. Moreover, they are also aiming to develop a slow-release formulation that dentists could use to fill pockets in the gums of those with gum disease [4].

Given how many people suffer from gum disease, if this treatment did eventually get used, it would be highly popular. It could result in the oral health of many people around the world being improved.

Thinking points…

1) This article mentions gum disease, which is a condition that affects so many of us. It is important to look after our gums – they are a critical part of oral health. Therefore, if you think you may need attention to your gums, why not discuss your options with your dentist? Treatment options typically include root planing, scaling or a gum graft. We recommend seeing a dentist soon!

2) Preventing gum disease is possible. Like all other oral health conditions, strong oral hygiene can help in many cases. This includes brushing and flossing regularly, eating healthily, and attending dental appointments on a regular basis. At these appointments, a dentist will be able to take a look at your gums and your overall oral health, and judge whether or not treatment is needed. Consider booking an appointment right away!

What we offer at Savanna Dental

Savanna Dental is a Calgary dental clinic that offers many services, including regular check-ups, cavity fillings and root canals.

We are also pleased to offer some cosmetic services. Here at our Calgary dental clinic, we offer treatments like tooth whitening, Invisalign™ and dental implants.

It is important for oral problems to be addressed early. Any issues can be identified at check-ups. If further treatment is needed after a check-up, our patients receive a clear treatment plan that is suited to their needs. Early detection helps to prevent the problem getting worse.

The best way of avoiding extra treatment is to have strong oral hygiene. This includes brushing our teeth at least twice a day, flossing regularly, and getting a dental check-up at least twice a year. Avoiding sugary foods and drink and not smoking also helps.

Our Calgary-based dental clinic Savanna Dental follows the Alberta Dental Fee Guide. This means our prices are competitive, transparent and affordable.

We would love you to visit us here at Savanna Dental soon! You can see more about us by visiting our website https://savannadentalclinic.ca.

References

[1] Guo, Y., Xu, F., Thomas, S. C., Zhang, Y., Paul, B., Sakilam, S., Chae, S., Li, P., Almeter, C., Kamer, A. R., Arora, P., Graves, D. T., Saxena, D., & Li, X. (2022). Targeting the succinate receptor effectively inhibits periodontitis. Cell Reports. 40 (12): 111389. DOI: https://doi.org/10.1016/j.celrep.2022.111389.

[2] Centers for Disease Control and Prevention. (2022). Periodontal Disease. Available: https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html. Last accessed: 24th September 2022.

[3] Guo, Y., Xie, C., Li, X., Yang, J., Yu, T., Zhang, R., Zhang, T., Saxena, D., Snyder, M., Wu, Y., & Li, X. (2017). Succinate and its G-protein-coupled receptor stimulates osteoclastogenesis. Nature Communications. 8 (15621). DOI: https://doi.org/10.1038/ncomms15621.

[4] New York University. (2022). Gel treats gum disease by fighting inflammation. Available: https://medicalxpress.com/news/2022-09-gel-gum-disease-inflammation.html. Last accessed: 24th September 2022.

Recent research has found that “positive stress” can make good changes in tooth stem cells – which can make them more resistant to injury and disease. This boosts the potential of tooth regeneration too, and could help with more extensive research into tooth regeneration in the future. These findings come after a range of areas to do with cells and teeth were examined.

Stress is often seen as something negative. However, recent research has found that “positive stress” is capable of making good changes in tooth stem cells – which can make them more resistant to injury and disease [1].

In the past, when there have been issues with our natural teeth, it is common to turn to dentures or implants. But such research suggests that regenerating our natural teeth could be a possibility.

What happens when teeth get damaged?

The main research looks at the steps taken when teeth become damaged. When a tooth gets damaged, either through injury, trauma or decay, the tissue inside the tooth can become exposed to harmful bacteria. Moreover, it becomes vulnerable to infection.

If the tissue inside the tooth becomes fully infected, there are only a few current treatments. This includes a root canal treatment or extraction. At third option can be to remove the pulp in the tooth and fill the canal with artificial materials like rubber or cement.

This third option does however pose problems – as these artificial materials dry over time. Unfortunately, this means that extraction becomes likely – which is something all dentists try to avoid.

Therefore, scientists have looked for a long time at finding ways where a teeth is able to regenerate itself, and not need any manual work from dentists to do so.

The Research

The research was completed by a team from the Hong Kong University of Dentistry. Their work has been published in the Journal of Dental Research [1].

The authors acknowledged that the usual approach towards dental pulp regeneration – which involves stem cell-based therapeutics – has its limitations [1]. This is because a tooth’s root canal is surrounded by tissue with a limited blood supply, making it a harsh environment for any cells to be viable in. Moreover, with the low oxygen levels making it almost impossible for any cell transplant to thrive in.

The team instead used a technique where they modified the cells genetically, yet altered them to include a responsive state for low oxygen conditions – causing “stress” [1]. Therefore, this could theoretically help the cells to survive in the environment described above.

The research involved the root canal of a human tooth fragment being implanted into mice. The root canal was altered using the technique above. The researchers observed the mice, after 28 days they witnessed that tissue formation had occurred [1].

This research was able to show that such a technique appears to work. By adapting some elements in tooth stem cells, the stress was able to boost the regeneration of the tooth [1].

The researchers concluded that this positive stress could result in tooth stem cells becoming more resistant to disease and injury [1]. This would clearly have an excellent impact on teeth.

What this means

Overall, this research has been able to show that positive stress can have a positive impact on tooth stem cells, and can help to improve survival of teeth, and also play a potential role in tissue regeneration.

Dr. Dissanayaka is Assistant Professor in Oral Biosciences at Hong Kong University of Dentistry. He commented “former research has revealed that our cells possess (a) number of adaptive mechanisms for stress” [2].

But by pre-conditioning the cells genetically, this “significantly enhanced the dental hard tissue formation within the regenerated pulp tissue” – Dissanayaka says [2]. Continuing, he says that “tooth stem cells have an inherent capacity to survive under stress” [2].

Looking ahead, the authors aim to identify drugs that could be used in clinical tissue regeneration. This, along with the research carried out above, will help the team to form new strategies to improve the potential of tooth stem cells.

Thinking points…

1) The idea of tooth regeneration is certainly exciting. However, as always, the focus should be on prevention rather than treatment. The best way of preventing dental issues is to have strong oral hygiene, including brushing your teeth regularly, flossing, and eating healthily. Another hugely important aspect of strong oral health is to have regular dental check-ups. We should have a check-up at least twice a year, why not book an appointment now?

2) It is important to remember that unlike many parts of the body, a tooth won’t automatically recover if it becomes damaged. Despite the regenerative topics outlined above, it isn’t something we will see overnight. It can be tempting to avoid visiting the dentist if you are in pain, as you may think it isn’t necessary. But if you leave problems untreated, they will only get worse. Therefore, if you do need treatment, do ensure that you book in an appointment!

What we offer at Savanna Dental

Savanna Dental is a Calgary dental clinic that offers many services, including regular check-ups, cavity fillings and root canals.

We are also pleased to offer some cosmetic services. Here at our Calgary dental clinic, we offer treatments like tooth whitening, Invisalign™ and dental implants.

It is important for oral problems to be addressed early. Any issues can be identified at check-ups. If further treatment is needed after a check-up, our patients receive a clear treatment plan that is suited to their needs. Early detection helps to prevent the problem getting worse.

The best way of avoiding extra treatment is to have strong oral hygiene. This includes brushing our teeth at least twice a day, flossing regularly, and getting a dental check-up at least twice a year. Avoiding sugary foods and drink and not smoking also helps.

Our Calgary-based dental clinic Savanna Dental follows the Alberta Dental Fee Guide. This means our prices are competitive, transparent and affordable.

We would love you to visit us here at Savanna Dental soon! You can see more about us by visiting our website https://savannadentalclinic.ca.

References

[1] Han, Y., Koohi-Moghadam, K., Chen, Q., Zhang, L., Chopra, H., Zhang, J., & Dissanayaka, W. L. (2022). HIF-1α Stabilization Boosts Pulp Regeneration by Modulating Cell Metabolism. Journal of Dental Research. 101 (10). DOI: https://doi.org/10.1177%2F00220345221091528.

[2] University of Hong Kong. (2022). Dentistry study shows how ‘positive stress’ can boost tooth tissue regeneration. Available: https://medicalxpress.com/news/2022-09-dentistry-positive-stress-boost-tooth.html. Last accessed: 10th September 2022.