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09/16/2011 03:41 AM

Neuromuscular Diseases, Conditions, & DENTIST!!

Bettyg
 
Posts: 32240
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Neuromuscular Diseases and Conditions

Bell's Palsy

Epilepsy

Multiple Sclerosis

Cerebral Palsy

Muscular Dystrophy

Parkinson's Disease

Huntington's Disease

Myasthenia Gravis

Spina Bifida

**********************

Bell's Palsy

Oral Effects

Bell's palsy is a temporary paralysis of certain facial muscles. It comes on very quickly, sometimes overnight. It usually affects only one side of the face. Bits of food are more likely to build up on the paralyzed side of your mouth.

Therefore, frequent and careful dental hygiene is important. If you wear dentures, clean them daily. You also may have less saliva flow and a loss or decrease in the sense of taste on the paralyzed side of your mouth.

At the Dentist

If you have Bell's palsy, visit a dental or medical specialist to see if the cause can be identified.

Causes can include herpes simplex virus, Lyme disease, herpes zoster and certain tumors in the ear.

If possible, reschedule elective dental treatment until the paralysis has disappeared. If your dental work can't be delayed, your dentist may use special dental tools (retractors) to help control the paralyzed parts of your mouth and tongue.

If your eyelids cannot close properly, you also should see an eye doctor. Sometimes the eye needs to be protected with lubricating eye drops, ointment or a patch.

You should wear protective eyewear during dental treatment to keep debris out of your eyes.

Make sure to always tell your dentist about all the medicines you take. This should include over-the-counter vitamins and herbal supplements.

Epilepsy

Oral Effects

If you are taking phenytoin (Dilantin) or other anti-seizure medicines for epilepsy, your gums may overgrow.

This effect occurs in nearly half of people taking phenytoin. Good oral hygiene can help prevent or limit the overgrowth.

Some people with severe overgrowth will need a type of gum surgery called gingivectomy.

Overgrown gum tissue that is not treated can cause changes in the bone supporting your teeth and may lead to tooth loss.

If you stop taking phenytoin, your gums should improve (recede) somewhat, but some people may still need gum surgery.

Children take phenytoin as a chewable tablet or a syrup.

Both forms are high in sugar, so parents should pay special attention to good oral hygiene.

People taking carbamazepine (Tegretol or Carbatrol) may have dry mouth, bleeding of the gums or both.

At the Dentist

Routine dental treatment for people with well controlled epilepsy is no different than for people without epilepsy. Routine use of sedation is not necessary.

You also don't need to increase your dose of anti-seizure medicine before a dental visit.

If you have seizures frequently, you may be referred to a hospital-based dental practice.

Your dentist should be familiar with your medical history.

Tell your dentist how often you have seizures and what usually triggers them.

Keep your dentist informed of your medical history, including the medicines you take. This includes over-the-counter vitamins and herbal supplements. Many drugs can interact with anti-seizure medicines and may affect the way they work.

Multiple Sclerosis

Oral Effects

Because multiple sclerosis affects muscle control, it may be more difficult for you to brush and floss your teeth.

You might need to consider toothbrushes that are adapted to make them easier to hold, as well as other adaptive dental care appliances.

Multiple sclerosis also may paralyze all or part of the face.

Associated nerve diseases can affect your face and mouth and may cause severe tooth, jaw, chin or lip pain or numbness.

Your dentist and neurologist may need to address these issues.

Problems with oral hygiene and swallowing can lead to tooth decay and periodontal (gum) disease.

It may become difficult or impossible to wear dentures as your multiple sclerosis gets worse.

Small partial dentures may be dislodged and swallowed. Larger dentures may fall out more often or just not fit well anymore.

At the Dentist

Try to keep your dental appointments to a comfortable length of time. The purpose is to avoid stress and fatigue.

It also may be difficult for you to sit in the dental chair throughout an appointment.

If you are paralyzed (paraplegic or quadriplegic), your dentist may use padding in the dental chair and change your body position frequently to avoid pressure sores and pain.

You may need help getting in and out of the dental chair.

If you are unable to transfer from your wheelchair to the dental chair your dentist may be able to treat you in your wheelchair.

It may be difficult for you to hold your mouth open for long periods of time and to control your tongue movements and swallowing. Your dentist has special devices that can help.

A rubber bite block, or mouth prop, can be placed between your teeth to keep your mouth open. This reduces the stress on your muscles.

A tongue retractor can be used to help keep your tongue in one place.

A thin piece of rubber ("rubber dam"Wink can be stretched over your teeth to prevent you from inhaling foreign substances during dental procedures.

Be aware that if your dentist needs to prescribe sedatives, they can worsen your muscle control.

Tell your dentist about all medicines you are taking, including those by injection. Some medicines used to treat multiple sclerosis affect blood cells.

If you are under active treatment, give your dentist copies of your most recent blood tests. Also, tell your dentist how to get in touch with your physician so they can coordinate dental and medical treatment if needed.

Make sure to always tell your dentist about all the medicines you take. This should include over-the-counter vitamins and herbal supplements.

Cerebral Palsy

Oral Effects

Cerebral palsy refers to a group of body movement (motor) disorders that result from brain injury and do not get worse over time.

Children with cerebral palsy have more defects in their tooth enamel, although the cause of this is not known.

The permanent teeth of children with cerebral palsy may come in late. They may be stained a greenish color.

People with cerebral palsy may experience:

Malocclusion (upper and lower teeth that do not come together properly)

Severe grinding of teeth (bruxism), which wears them down and requires repair

Damage to front teeth as a result of falls

Problems in controlling plaque and in chewing and swallowing food, which can increase the risk of tooth decay and periodontal (gum) disease

Problems with control of oral, facial or neck muscles, which can result in excess saliva flow or drooling

Underdeveloped tooth enamel

Some people who have cerebral palsy also have seizures and take anti-seizure medicines. These may cause gum overgrowth. Good oral hygiene can help prevent or limit the overgrowth.

Some people with severe overgrowth will need a type of gum surgery called gingivectomy.

Overgrown gum tissue that is not treated can cause changes in the bone supporting your teeth and may lead to tooth loss.

If you stop taking the medicine, your gums should recede somewhat, but some people may still need gum surgery.

At the Dentist

If you have cerebral palsy, you may need help getting into the dental chair. You also may need, or want, pillows or other stabilizers to keep you comfortable.

If you cannot get in and out of your wheelchair, your dentist may be able to treat you while you are in your wheelchair.

People with severe cerebral palsy may need to be treated in a hospital using sedation or general anesthesia.

Your dentist may have an assistant to help keep you relaxed and comfortable during dental procedures.

It may be difficult for you to hold your mouth open for long periods of time and to control your tongue movements. Your dentist has special devices that can help.

A rubber bite block, or mouth prop, is placed between your teeth to keep your mouth open. This reduces the stress on your muscles. A tongue retractor can be used to keep your tongue in one place.

A thin piece of rubber ("rubber dam"Wink can be stretched over your teeth to prevent you from inhaling foreign substances during dental procedures.

Always tell your dentist about all the medicines you take. This includes over-the-counter medicines, vitamins and herbal supplements.

Muscular Dystrophy

Oral Effects

Muscular dystrophy is a genetic disease that causes muscle weakness. Over time, the weakness gets worse, often becoming severe.

There are several types of muscular dystrophy.

They are caused by different genes and have somewhat different symptoms. Some types of muscular dystrophy affect the muscles in the face, head, neck and hands.

For example, people with myotonic dystrophy may have trouble chewing, moving their lips and turning their head. Other types usually do not involve facial muscles.

In some people with muscular dystrophy, the upper and lower teeth don't meet properly.

This can be caused by muscle weakness, and by the tongue pushing the teeth out toward the lips. Some people with muscular dystrophy also may have problems with their jaw joints (temporomandibular joints).

This can lead to difficulty with chewing, clicking of the joints, headaches or muscle tenderness.

Many people with muscular dystrophy have trouble brushing, flossing or rinsing. Power-assisted brushes and tools to help with flossing are available.

At the Dentist

Your treatment at the dentist will depend on the type of muscular dystrophy you have and how severe your condition is. Bring a complete list of all your medicines and the doses you take.

Tell your dentist how to contact your physician. They will work as a team to coordinate your dental and medical treatment.

Try to keep your dental appointments to a comfortable length of time, especially if stress worsens your condition. It also may be difficult for you to sit in the dental chair throughout an appointment.

If you are paralyzed (paraplegic or quadriplegic), your dentist may use padding in the treatment chair and change your body position frequently to avoid pressure sores and pain.

Your dentist may have someone help you get in and out of the chair and assist with dental procedures. Your dentist may be able to treat you in your wheelchair. If your condition is severe, it may be best for you to be treated in a hospital setting.

It may be difficult for you to hold your mouth open for long periods of time and to control your tongue movements and swallowing. Your dentist has special devices that can help.

A rubber bite block, or mouth prop, is placed between your teeth to keep your mouth open. This reduces the stress on your muscles.

A tongue retractor can be used to keep your tongue in one place.

A thin piece of rubber ("rubber dam"Wink can be stretched over your teeth to prevent you from inhaling foreign substances during dental procedures.

Be aware that if you need sedatives, they may worsen your muscle control.

Always tell your dentist about all the medicines you take. This includes over-the-counter medicines, vitamins and herbal supplements.

Parkinson's Disease

Oral Effects

Parkinson's disease mainly affects adults in middle to late life. It apparently is caused by continuing breakdown of nerve cells in the brain.

The result is a decrease in dopamine, a chemical that transmits messages between cells. People with Parkinson's disease have uncontrolled muscle movements (tremors) and stiffness.

Many people with Parkinson's disease are older adults, who may be less likely to seek dental treatment except in an emergency.

Older adults may have other barriers to dental care, including transportation problems and chronic diseases.

If you have dentures, they may become difficult or impossible to wear as your disease worsens.

Small partial dentures could be dislodged and swallowed. Larger dentures may fall out more often, break from sudden movements, or not fit properly anymore.

Some medicines taken by people with Parkinson's disease can cause dry mouth (xerostomia).

This can increase your risk of tooth decay, and fungal/yeast infections because there is less saliva in your mouth to wash away bacteria and bits of food.

If you have this condition, your dentist can prescribe a topical fluoride treatment or an artificial saliva solution to help protect your teeth from decay.

At the Dentist

Anxiety can aggravate symptoms of Parkinson's disease.

Therefore, it is important for people with this condition to be calm and reassured during a dental appointment. The environment at your dentist's office should be low-stress. It also helps to keep your appointments as short as possible.

The tremors caused by Parkinson's disease can make dental treatment challenging. If your disease is severe, you may need to have treatment using sedation or general anesthesia. This may be done in a hospital or in a properly equipped dental office by a dental anesthesiologist.

It may be difficult for you to hold your mouth open for long periods of time and to control your tongue movements and swallowing. Your dentist has special devices that can help.

A rubber bite block, or mouth prop, may be placed between your teeth to keep your mouth open. This reduces the stress on your muscles.

A tongue retractor can be used to keep your tongue in one place.

A thin piece of rubber ("rubber dam"Wink can be stretched over your teeth to prevent you from inhaling foreign substances during dental procedures.

Levodopa/carbidopa (Sinemet) is a common treatment for Parkinson's disease.

People taking this medicine should be careful when getting up from the dental chair. It can reduce blood pressure and lead to light-headedness or fainting if you move too quickly from a lying to a sitting or standing position.

Always tell your dentist about all the medicines you take. This includes over-the-counter medicines, vitamins and herbal supplements.

Huntington's Disease

Oral Effects

People with Huntington's disease have muscle movements that they can't control. This includes muscles in the face and tongue.

They can have trouble swallowing as well. It can be difficult for people with Huntington's disease to brush and floss their teeth.

Preventive dental treatment (regular dental visits) is very important for people with Huntington's disease and those at risk of it.

Dental care should be thorough and frequent. If you become unable to take care of your mouth and teeth, a family member or caregiver should help you.

A proper diet is also important in reducing the risk of decay.

Good oral hygiene is important in order to decrease infections and tooth loss.

Some people with Huntington's disease should not wear dentures. It can be difficult for people with Huntington's disease to adapt to dentures.

The sudden and violent facial movements associated with the disease can break dentures.

Patients with Huntington's disease must be careful to avoid accidentally swallowing, dislodging or ejecting dentures from the mouth.

At the Dentist

Dental treatment of patients with advanced Huntington's disease can be difficult, because they may not be able to open their mouths very wide or sit still for long periods.

Dental appointments should be kept to a comfortable length of time.

Your dentist can use mouth props and tongue retractors to ease some of the strain on your muscles.

You may need sedation or general anesthesia for dental treatment. You may need to go to a hospital for this.

Always tell your dentist about all the medicines you take. This includes over-the-counter medicines, vitamins and herbal supplements.

Myasthenia Gravis

Oral Effects

People with myasthenia gravis may have partial or no facial expression because they cannot move their facial muscles. Some people have difficulty chewing food.

Their muscles may be so tired that they cannot keep their mouths closed after eating. They may also have weakened tongue and palate muscles.

If you have myasthenia gravis, you may not be able to keep complete dentures in your mouth because your muscles may be too weak.

Ill-fitting dentures may make it more difficult to close your mouth. This may result in dry mouth, tongue fatigue, a tight upper lip, and difficulty with speaking, chewing or swallowing.

As much as you can, choose foods that promote dental health and reduce the risk of decay. If weakness prevents you from performing regular dental care, consider using a power-assisted brush or other aids. A family member or caregiver can help you with dental care.

Medicines used by people with myasthenia gravis may have oral effects. Tell your dentist about any medicines you are taking. This should include over-the-counter vitamins and herbal supplements.

At the Dentist

Your dental appointments should be early in the day and should be kept to a comfortable length of time.

You may find it most comfortable to receive dental care an hour or two after taking your medicines.

Your dentist and physician can work as a team and talk about adjusting your schedule so you can take your medicine before your dental appointment.

Some people have such poor muscle control that there is concern about maintaining proper breathing during dental procedures. Some of these people are treated in the hospital.

During your appointment, a dental assistant may observe you and monitor your vital signs.

These include blood pressure, pulse and breathing rate. Your dentist may use a mouth prop, or bite block, to reduce the strain on your jaw muscles.

He or she also may use a tongue retractor and rubber dam. Let your dentist know if you feel like you are tipped too far back in the dental chair.

Ask for rest periods during treatment if you think that would help you.

Be aware that if you require sedatives, they can worsen your muscular control.

If you have problems keeping your teeth clean, there are modified brushes and other appliances that can help. Your dentist or dental hygienist can tell you about them.

If you take medicines that weaken your immune system and your ability to fight off infection, be sure your dentist is aware.

Bring your updated medical records to each dental appointment so your dentist can see what medicines you are taking and their doses.

Tell your dentist how to contact your physician. They may work together to coordinate your medical and dental needs.

Spina Bifida

Oral Effects

People with spina bifida have no unusual dental problems. However, if your arms or chest are paralyzed, it may be difficult for you to brush and floss without help.

There are many adaptive dental aids and techniques to help you maintain good dental care. A family member or caregiver also can help you.

Some people with spina bifida may take medicines that cause oral side effects (for example, gum overgrowth).

At the Dentist

Try to limit your dental appointments to a comfortable length of time. It also may be difficult for you to sit in the dental chair throughout an appointment.

Your dentist may use padding in the treatment chair and change your body position frequently to avoid pressure sores and pain.

Your dentist probably will have someone help you get in and out of the chair and assist with dental procedures.

If you can't be moved, your dentist may be able to treat you in your wheelchair.

It may be difficult for you to hold your mouth open for long periods of time and to control your tongue movements and swallowing. Your dentist has special devices that can help.

A rubber bite block, or mouth prop, may be placed between your teeth to keep your mouth open. This can help to reduce the stress on your muscles.

A tongue retractor can be used to keep your tongue in one place.

A thin piece of rubber ("rubber dam"Wink can be stretched over your teeth to prevent you from inhaling foreign substances during dental procedures.

Infants with spina bifida are at a high risk of developing a latex allergy.

The dentist should ask about any allergies and avoid exposing infants to latex products.

If you have a surgically placed plastic tube or shunt, you may need to take antibiotics before dental treatment (such as draining an abscess or infection).

Discuss these shunts with your physician and dentist before treatment. Also bring a copy of any paperwork that may explain the type of shunt.

Make sure to always tell your dentist about all the medicines you take. This should include over-the-counter vitamins and herbal supplements.

Also, tell your dentist how to get in touch with your physician so they can coordinate dental and medical treatment if necessary.

Last updated October 6, 2010

© 2002-2011 Aetna, Inc. All rights reserved.

http://www.simplestepsdental.com/SS/ihtSSPrint/r.WSIHW000/ st.31848/t.32262/pr.3/c.354211.html

Post edited by: Bettyg, at: 09/16/2011 03:47 AM

Reply

10/31/2011 02:42 AM
Bettyg
 
Posts: 32240
VIP Member
I'm an Advocate

Healthy Bacteria Play Surprising Role in Gum Disease of gingivitis

Developing gum disease may require not only bad bacteria but also a benign background microbiota, researchers reported in Cell Host and Microbe.

When the gingivitis-associated Porphyromonas gingivalis was introduced at low levels into the mouths of normal mice, it triggered a substantial growth in the healthy bacteria already there, and the ensuing periodontal disease led to bone loss.

But no such thing happened when the gingivitis bacteria were introduced to mice with sterile mouths that harbored no normal bacteria.

It seems that a single species, even at low levels, can disrupt the stability of the bacterial ecosystem in the mouth, the researchers noted.

This may open up opportunities to fight periodontal disease by targeting the factor that gingivitis bacteria use to scramble signaling pathways of the protective leukocytes that keep the overall microbiota under control, they suggested.

-- C.P.

http://www.medpagetoday.com/LabNotes/LabNotes/29347? utm_content=&utm_medium=email&utm_campaign=DailyHeadlines& utm_source=

© 2011 Everyday Health, Inc. All rights reserved


03/10/2012 01:27 PM
Bettyg
 
Posts: 32240
VIP Member
I'm an Advocate

YEAST!! Wash Your Mouth out With Silver, to Treat Hard-To-Treat Mouth Infections?

Al

LymeNet Contributor

Member # 9420

posted 03-10-2012 12:08 AM

Wash Your Mouth out With Silver, to Treat Hard-To-Treat Mouth Infections?ScienceDaily (Mar. 8, 2012) —

Yeasts which cause hard-to-treat mouth infections are killed using silver nanoparticles in the laboratory, scientists have found.

These yeast infections, caused by Candida albicans and Candida glabrata target the young, old and immuno-compromised.

Professor Mariana Henriques, University of Minho, and her colleagues hope to test silver nanoparticles in mouthwash and dentures as a potential preventative measure against these infections.

Professor Henriques and her team, who recently published their research in the Society for Applied Microbiology's journal Letters in Applied Microbiology, looked at the use of different sizes of silver nanoparticles to determine their anti-fungal properties against Candida albicans and Candida glabrata.

These two yeasts cause infections including oral thrush and dental stomatitis, a painful infection affecting around seven out of ten denture wearers.

Infections like these are particularly difficult to treat because the microorganisms involved form biofilms.

The scientists used artificial biofilms in conditions which mimic those of saliva as closely as possible.

They then added different sizes and concentrations of silver nanoparticles and found that different sizes of nanoparticles were equally effective at killing the yeasts.

Due to the diversity of the sizes of nanoparticles demonstrating anti-fungal properties the researchers hope this will enable the nanoparticles to be used in many different applications.

Some researchers have expressed concerns around the safety of nanoparticle use but the authors stress this research is at an early stage and extensive safety trials will be carried out before any product reaches the market.

Professor Henriques comments:

With the emergence of Candida infections which are frequently resistant to the traditional antifungal therapies, there is an increasing need for alternative approaches.

So, silver nanoparticles appear to be a new potential strategy to combat these infections.

As the nanoparticles are relatively stable in liquid medium they could be developed into a mouthwash solution in the near future.

Moving forward Professor Henriques hopes to integrate silver nanoparticles into dentures which could prevent infections from taking hold.

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The above story is reprinted from materials provided by Wiley-Blackwell, via AlphaGalileo.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:

D. Al Groosh, G.B. Roudsari, D.R. Moles, D. Ready, J.H. Noar, J. Pratten. The prevalence of opportunistic pathogens associated with intraoral implants.

Letters in Applied Microbiology, 2011; 52 (5): 501 DOI: 10.1111/j.1472-765X.2011.03031.x

Need to cite this story in your essay, paper, or report? Use one of the following formats:

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Wiley-Blackwell (2012, March 8). Wash your mouth out with silver, to treat hard-to-treat mouth infections?. ScienceDaily. Retrieved March 10, 2012, from http://www.sciencedaily.com­ /releases/2012/03/120308062553.htm?utm_source=feedburner& utm_medium=email&utm_campaign=Feed%3A+sciencedaily% 2Fhealth_medicine+%28ScienceDaily%3A+Health+% 26+Medicine+News%29

, to Treat Hard-To-Treat Mouth Infections?

Marz

LymeNet Contributor

Member # 3446

posted 03-10-2012 12:39 AM

Thanks for posting. Very interesting.

Wondering if colloidal silver used just to rinse mouth would work in the meantime until the mouthwash is developed? [/b

------------

'Kete-tracker

LymeNet Contributor

Member # 17189

posted 03-10-2012 01:20 AM

[b]GOD... I was sucking down the colloidal silver solution per my LLND for aWhile there. (2 TBSP, 4 times a day) I HOPE there's no safety issue with "nanoparticle use"!

Interesting... They never say how strong this silver nano-particle solution IS that they're planning to have us swish around as a mouth wash.

It makes sense that it works, though, as external topical applications of silver products have been used quite extensively for Decades- i.e: to knock down bacterial & other infections of the skin- prior to the development of our "modern antibiotics", in the 1940s & '50s.

Re: "silver nanoparticles appear to be a new potential strategy"

It's almost as if they're 'discovering' silver solutions all over again!

**********

Carol in PA

Frequent Contributor (1K+ posts)

Member # 5338

posted 03-10-2012 02:14 AM

Yes, they've used Silvadene Cream since the 70's at least, to apply to burns to prevent infection.

Something else you may be interested in to kill Candida is Gentian Violet solution.

It's not expensive, and is available at drugstores.

I also found it at Amazon.com and most of the reviews were good.

However, Gentian Violet stains whatever it touches, so a silver solution would be alot less messy.

Editing to add, I've read some of the reviews for colloidal silver at iHerb and at Amazon, and people are using it for oral infections.

Also almost every other infection you could think of, including in a nebulizer for bronchitis/pneumonia.

-------

[chaps

LymeNet Contributor

Member # 25286

posted 03-10-2012 09:36 AM

"The candida yeast answer" has a protocol for candida. It's proprietor claims that it is extremely successful. Nanoparticle "biotic" silver is a main component of this program.

I've mentioned this program a few times here, but no one seems to know anything about it.

http://flash.lymenet.org/scripts/ultimatebb.cgi? ubb=get_topic;f=1;t=115639;p=0

© 1994-2011 The Lyme Disease Network of New Jersey, Inc.

All Rights Reserved.


03/10/2012 11:24 PM
Bettyg
 
Posts: 32240
VIP Member
I'm an Advocate

Acid Reflux From Chronic Heartburn May Damage Teeth

Study reveals extent of harm that GERD can cause in the mouth, but some preventive measures exist

Thursday, March 8, 2012

THURSDAY, March 8 (HealthDay News) --

If you have chronic heartburn, it's not only your esophagus that you should be worried about. New research reveals how the condition known as gastroesophageal reflux disease, or GERD, can severely damage your teeth thanks to an influx of acid into the mouth.

The study, which followed patients over six months, found that almost half of those with the condition suffered much worse tooth wear and erosion than healthy people. The disease can ultimately lead to thin, sharp and pitted teeth.

"We hope we can raise awareness that gastroesophageal reflux disease, a condition quite common in any population, is able to cause tooth damage.

Dental professionals are mostly aware of tooth erosion, but the public may not be," said study lead author Dr. Daranee Tantbirojn, an associate professor in the department of restorative dentistry at the University of Tennessee Health Science Center.

GERD, which is also known as acid reflux disease, causes chronic heartburn. The stomach contents, including acid, leak into the esophagus and often work their way back up into the mouth, causing burning pain.

Dentists know that chronic heartburn can damage teeth, Tantbirojn said.

The acid from the stomach is strong enough "to dissolve the tooth surface directly, or soften the tooth surface, which is later worn down layer by layer.

The damage from acid reflux looks like tooth wear -- the tooth is flattened, thin, sharp or has a crater or cupping."

In the new study, researchers used an optical scanner to measure chronic heartburn's effect on teeth of 12 patients with GERD and compared them to six healthy patients without the disease over six months.

The study appears to be the first to follow people for that long, Tantbirojn said.

It's normal to have tooth erosion due to chewing, and about half of those with the condition had about the same or slightly more erosion than healthy people, she said. "However, almost half of the GERD participants had tooth wear and erosion several times higher than the healthy participants."

Several patients with chronic heartburn said they were taking medications, but they still suffered from tooth erosion.

"Some patients told us that they still have acid reflux episodes despite the medication, or they might have skipped the medication every now and then," Tantbirojn said.

Dr. David Leader, an associate clinical professor at Tufts University School of Dental Medicine, who's familiar with the study findings, said the research is innovative and uses technology that more dentists will have on hand in the near future so they too can track the progress of tooth erosion.

"Even though a patient wouldn't notice all of a sudden that 'my teeth are different,' a dentist might be able to notice that using this technique in a six-month visit," Leader said.

Once the outer coating of the teeth (known as enamel) is gone, it's gone for good, he noted. "The only thing that you can do is wait for it to become bad enough that we have to put a crown, veneer or filling on the tooth," Leader added.

Tantbirojn discussed what helps prevent tooth damage in patients with heartburn.

"Generally speaking, saliva is good as the body's defense mechanism. Saliva has a so-called buffering capacity, meaning it can neutralize acid," she said. "Saliva also contains small amounts of calcium and phosphate ions that can reduce the damage of the tooth."

But there's a limit to what saliva can do, Tantbirojn said. "That's why we saw the erosion."

Here are some tips from Tantbirojn:

Don't brush immediately after an acid reflux episode, but a fluoride rinse is a good idea.

Dentists may prescribe a special toothpaste for acid reflux patients, and they also may recommend that patients take baking soda or antacids after acid reflux episodes to protect their teeth.

Leader said Xylitol chewing gum, which reduces acid in the mouth, is another good idea.

The study appears in the March issue of the Journal of the American Dental Association.

SOURCES:

Daranee Tantbirojn, D.D.S., M.S., Ph.D., associate professor, department of restorative dentistry, University of Tennessee Health Science Center, Memphis, Tenn.;

David M. Leader, D.M.D., associate clinical professor, Tufts University School of Dental Medicine, Boston; March 2012, Journal of the American Dental Association

http://www.nlm.nih.gov/medlineplus/news/ fullstory_122734.html

Copyright (c) 2012 HealthDay. All rights reserved.


04/25/2012 01:33 AM
Bettyg
 
Posts: 32240
VIP Member
I'm an Advocate

Infected Gums Not Likely Cause of Vascular Disease

Download Complimentary Source PDF By Crystal Phend, Senior Staff Writer, MedPage Today

Published: April 18, 2012

Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner

5 comment(s)

Action Points

Links between oral health and cardiovascular disease have been commonly promoted, and this review was aimed at assessing whether available data support an independent association between atherosclerotic vascular disease and periodontal disease.

The reviewers found that observational studies to date support an association between periodontal disease and atherosclerotic vascular disease independent of known confounders, but the studies do not support a causative relationship, and there is no evidence that periodontal interventions prevent vascular disease.

Healthy gums aren't proven to prevent atherosclerotic vascular disease, nor will treating periodontal disease clearly reduce risk of heart attack or stroke, according to a scientific statement from the American Heart Association (AHA).

The two conditions are linked through common risk factors without convincing evidence for a causal relationship, the statement cautioned in the May 22 issue of Circulation: Journal of the American Heart Association.

"Patients and providers are increasingly presented with claims that periodontal disease treatment strategies offer atherosclerotic vascular disease protection; these claims are often endorsed by professional and industrial stakeholders," Peter B. Lockhart, DDS, and colleagues wrote, warning that such assertions "are unwarranted."

The AHA scientific statement stemmed from a systematic review by a group of cardiologists, dentists, and infectious disease specialists and was endorsed by the American Dental Association and World Heart Federation.

"A link between oral health and cardiovascular disease has been proposed for more than a century," it noted.

Pockets of bacteria around the teeth in diseased gums are thought to contribute to systemic inflammation and thus to atherosclerotic disease.

Periodontal disease also lets oral bacteria enter the blood during chewing and tooth brushing, which may contribute to vascular disease more directly.

With the intense interest and active research, a strong causative link likely would have been found already if there were one, Lockhart argued in a press release.

"Although a contribution of periodontal disease to atherosclerotic vascular disease is biologically plausible, periodontal and cardiovascular diseases share multiple risk factors that are prevalent and powerful promoters of disease, including tobacco use, diabetes mellitus, and age," the scientific statement noted.

But lack of a causative relationship to vascular disease isn't free license to neglect oral health, Ronald Burakoff, MDM, MPH, chair of dental medicine at Long Island Jewish Medical Center in New Hyde Park, N.Y., warned in an email to reporters.

"Managing inflammatory issues, such as chronic gum disease, is part of a heart healthy lifestyle," agreed Suzanne Steinbaum, DO, a preventive cardiologist at Lenox Hill Hospital in New York City.

Lockhart's group reviewed 537 studies on the topic, most observational in design and thus unable to prove causality.

They found plenty of evidence for an association between periodontal disease and atherosclerotic vascular disease.

Of the 26 studies using clinical or radiographic measures of periodontal status, 18 linked worse gum disease to higher risk for atherosclerotic vascular disease-related outcomes in adjusted analyses. Another two studies showed the same in unadjusted analyses.

All eight studies that looked at clinically assessed periodontal disease in relation to myocardial infarction found a link.

The only study that looked at periodontal bacterial burden found a link to both atherosclerotic vascular disease and heart attack.

When looking at risk of stroke, 11 studies pointed to higher risk when gums were in bad shape, while three studies did not find a positive association.

Six showed higher stroke risk with more teeth lost to periodontal disease, but the same number failed to show a significant association.

Rather than looking at such hard endpoints, most studies looking at the impact of treating periodontal disease focus on surrogate measures like markers of inflammation or subclinical atherosclerosis.

Observational and clinical trial data have indicated improved endothelial dysfunction and associated markers of inflammation after mechanical debridement of the root surfaces, with or without systemic antibiotics.

That evidence "supports the theory that if cardiovascular toxicity from periodontal disease occurs, it is mediated at least in part through inflammation and endothelial dysfunction," Lockhart's group noted.

But studies haven't turned up consistent results on the impact of gum disease treatment on specific inflammatory markers or established a durable benefit.

"In addition, transient proinflammation and deranged endothelial functions are observed after intensive therapy for periodontal disease," the statement added.

The one clinical trial to look at periodontal treatment for secondary prevention of cardiac events found no benefit.

A large, long-term study would be necessary to prove that good oral hygiene and dental treatment cut down on cardiovascular risk, "given the possibility of periodontal disease recurrence after therapy and the extended time course of evolution of atherosclerotic vascular disease and its manifestations," the statement concluded.

Lockhart reported having no conflicts of interest to disclose.

From the American Heart Association:

Periodontal Disease and Atherosclerotic Vascular Disease: Does the Evidence Support an Independent Association?

Primary source: Circulation: Journal of the American Heart Association

Source reference:

Lockhart PB, et al "Periodontal disease and atherosclerotic vascular disease: Does the evidence support an independent association? A scientific statement from the American Heart Association" Circulation 2012; 125; DOI: 10.1161/CIR.0b013e31825719f3.

http://www.medpagetoday.com/Cardiology/Prevention/32243? utm_content=&utm_medium=email&utm_campaign=DailyHeadlines& utm_source=

© 2012 Everyday Health, Inc. All rights reserved.


05/07/2012 12:56 AM
Bettyg
 
Posts: 32240
VIP Member
I'm an Advocate

Latest Use for Botox: Teeth Grinding

By John Gever, Senior Editor, MedPage Today

Published: April 28, 2012

Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco.

1 comment(s)

Action Points

Note that these studies were published as abstracts and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

Two studies found that patients who ground their teeth so hard during sleep that they required medical attention achieved significant relief from botulinum toxin (Botox) injections.

Note that the only adverse events in the patients receiving Botox were cosmetic changes in their smiles, and no difficulties with chewing or swallowing were reported.

NEW ORLEANS -- Patients who ground their teeth so hard during sleep that they required medical attention achieved significant relief from botulinum toxin injections, researchers said here.

In a small randomized study, 13 patients with severe bruxism during sleep receiving onabotulinumtoxin A (Botox) in the masseter muscles of their jaws had significant reductions in self-reported pain and teeth grinding relative to 10 patients who had placebo injections, reported William Ondo, MD, of the University of Texas Health Science Center in Houston, and colleagues.

Physicians at Henry Ford Health System in Detroit, meanwhile, reported that four patients with severe bruxism obtained significant relief with open-label Botox.

Both studies were presented at the American Academy of Neurology's annual meeting.

Bruxism is common but usually mild.

In severe cases, it can cause pain in the jaw or generalized headache, as well as dental problems.

Eventually it can fracture teeth or wear them down. Hypertrophy of the masseter muscle can also occur, altering the facial appearance.

Treatment usually involves mechanical devices that protect the teeth but do nothing to stop the basic clenching/grinding impulse, so headache and jaw pain may continue.

Ondo and colleagues noted that drug treatments, such as benzodiazepines and dopaminergic agents, are sometimes effective but that there is no consensus on a standard of care.

The Houston study included polysomnography as well as patient self-reports to determine the effectiveness of Botox injections.

Patients with sleep apnea or who failed to demonstrate bruxism during baseline polysomnography were excluded.

Polysomnography showed that sleep architecture and breathing parameters were not altered with Botox relative to placebo, alleviating one concern with the treatment.

The only adverse events in the 13 patients receiving Botox were cosmetic changes in their smiles, the researchers said.

No difficulties with chewing or swallowing were reported.

Ondo and colleagues used nine different instruments to measure efficacy -- none of which, they indicated, had been validated for bruxism but were the best available.

Mean scores in the primary measures -- visual analog scales for bruxism and pain at week four -- both showed significant improvements with Botox relative to placebo:

Bruxism: 47.3 for placebo, 64.5 for Botox (P<0.05)

Pain: 44.2 for placebo, 65.0 for Botox (P<0.05)

For the other measures, nonsignificant trends favoring Botox were reported.

These included the Headache Impact Test, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the Self-Rated Anxiety Scale.

The study protocol allowed patients in both treatment arms to receive open-label injections of Botox when bruxism symptoms returned.

Mean time to receive this follow-up treatment differed greatly between treatment arms: 38 days in the placebo group versus 103 days in the Botox group.

But it just missed statistical significance (P=0.05) because of wide variation in the Botox group, in which the standard deviation was 78 days.

The Henry Ford group, led by Nawaf Murshed, MD, also reported favorable results in four patients, in whom the condition arose after anoxic brain injury.

The group's patients ranged in age from 23 to 63. Botox was injected into the masseter and/or the temoporalis muscles.

In two patients, one injection failed to resolve the symptoms, so additional injections were given at intervals of 3 weeks to 3 months.

Like the Houston group, Murshed and colleagues reported no significant adverse effects and that symptoms were clearly improved with the treatment.

Neither study had external funding and the authors declared they had no relevant financial interests.

Primary source: American Academy of Neurology

Source reference:

Ondo W, et al "Onabotulinum toxin-A injections for nocturnal bruxism: a parallel, double blind, placebo controlled polysomnographic study" AAN 2012; Abstract P05.006.

Additional source: American Academy of Neurology

Source reference:

Murshed N, et al "Successful treatment of severe bruxism with onabotulinumtoxinA in patients with post anoxic brain injury" AAN 2012; Abstract P01.237.

http://www.medpagetoday.com/MeetingCoverage/AANMeeting/ 32403?utm_content=&utm_medium=email& utm_campaign=DailyHeadlines&utm_source=

© 2012 Everyday Health, Inc. All rights reserved


05/08/2012 11:49 AM
Courious
 
Posts: 678
Member

FYI

Dentists always seemed to make my condition worse....

There are very few Biologic dentists.


05/08/2012 02:43 PM
Bettyg
 
Posts: 32240
VIP Member
I'm an Advocate

curious, did you check the biologic dentist link found in MDS/TREATMENT?

look in index, a-z .... dental!!

bettyg, iowa activist forever


05/08/2012 07:40 PM
Courious
 
Posts: 678
Member

Betty,

No. I hadn't.

But I will now.

Could you help me...

Where is the MDS/TREATMENT section?

Thanks.

Post edited by: Courious, at: 05/08/2012 07:46 PM


05/08/2012 10:07 PM
Bettyg
 
Posts: 32240
VIP Member
I'm an Advocate

curious, i sure can help you/others.

i'll make this a separate post as you are not the only one who is NOT aware of the other sections of our lyme board.

go to top right above where we post here ok.

click on FORUMS

it will then show you the breakdown of this:

Lyme Disease Support Forums

i copied/pasted what i saw there below and it reformatted itself!!

Forum

Topics

NO. OF Replies

Last Post

Doctor (LLMD) Requests..post HERE NOT support forum!!

LLMD info request will be answered via PM but can be asked here.

ANSWER THE LIST OF QUESTIONS IN BETTYG'S "WELCOME LETTER" posted in instructions; you will receive faster service for names providing ALL info needed 1st time Wink

IF you are from CALIFORNIA, bettyg has it broken down into sections, see the section names in POSTING INSTRUCTIONS. post betty's SECTION name where you live; NOT the name of your city; thank you!

you can ask for feedback on LLMDS HERE, BUT NO FULL NAMES, LASK NAMES OR CITY NAMES WHERE THEY PRACTICE MAY BE POSTED ON PUBLIC BOARD.

example, you can show Dr. C, kids llmd in Conn.

OR if they have a specialty, you can name it, Dr. R, psychologist, NY

OR the direction in the state where their office is; got it?

1275

2397

05/08/2012 06:20 PM

by dcgobeil

Introductions & Personal Stories

Lyme Disease Support Group members are welcome to introduce themselves.

Tell your story, share experiences, success stories and failures.

1204

7316

05/02/2010 10:20 PM

by Bettyg

General & Support

Lyme Disease Support Group questions and answers.

Ask the community for their help, provide help for to others.

Share your dilemmas, your feelings and experiences.

SUCCESS STORIES HERE!

This is the main forum section of the Lyme Disease Support Group.

14521

91469

05/08/2012 09:48 PM

by jbailey

Tips - All together now.

Share your unique tips and ideas.

Tips for the newly diagnosed, treatments, and day to day guidelines and advice.

205

1232

05/08/2012 07:52 PM

by nank59

Medicine & Treatments

The place to write and ask about Lyme treatments, medication, doctor suggestions, etc.

2028

9260

05/08/2012 08:11 PM

by shorelinelyme

Lounge - Off topic discussions

This is where group members can share and discuss their day to day, favorite jokes, fun & games and everything not directly related to Lyme.

241

1903

05/05/2012 07:41 AM

by mysticthecat

Lyme Facts

Discussions on SCIENTIFIC STUDIES and RESEARCH PROVEN TREATMENTS. [u]Lyme and CO-INFECTION FACTS only!

366

799

05/08/2012 02:57 AM

by Bettyg

Lyme Disease Activism

Lyme in the newspapers,

upcoming events: conferences, rallies, UNDER OUR SKIN film showings,

what you can do to help the cause.

CONGRESS/STATE LYME/VECTOR-BORNE BILLS,

MAY LYME AWARENESS ACTVISTIES.

Here is where we gather ideas, post media events, anything to help Lyme Disease get the recognition it deserves.

597

1856

05/08/2012 02:57 AM

by Bettyg

- Indicates there are new posts in this forum since your last visit

- No new posts since your last visit

I hope this helps you/others who NEVER leave the support group; there is so much MORE to this valuable forum.

please check out the LYME FACTS SECTION AND INDEXES for each of the forums since owner, roy, forced us to go down to 7 max STICKY PINS/SECTION of the forums

so know you know how to find our mds/treatment section to look for the biological dentist link and much other valuable info in the index.

i created the INDEX of HUNDREDS of subjects in this area due to the complications of our lyme/co-infection diseases from NOT being diagnosed promptly and treated long enough! uffda.

now, are'nt you'glad you asked me? lol

bettyg, iowa activist forever Kissing

Post edited by: Bettyg, at: 05/08/2012 10:13 PM

Post edited by: Bettyg, at: 05/08/2012 10:21 PM

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