Category: Dentistry

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Omega-3 and Low-dose Aspirin Similar to Antibiotics’ Effect Against Severe Periodontitis

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Study shows that combining the two compounds with conventional treatment may be a promising alternative, reducing the need for antibiotics.

Photo by Caroline Lm on Unsplash

By Fernanda Bassette  |  Agência FAPESP – A combination of omega-3 and low-dose acetylsalicylic acid (ASA) produced results comparable to antibiotics in treating severe periodontitis. This conclusion is based on a study conducted by researchers affiliated with Albert Einstein Israelite Hospital, Guarulhos University (UNG), the University of Taubaté (UNITAU), and the Ribeirão Preto School of Dentistry at USP (FORP-USP) in Brazil, as well as Harvard University in the United States. The findings were published in May in the Journal of Periodontology and suggest a promising therapeutic alternative for some patients by reducing the need for antibiotics. These findings are particularly relevant in the context of growing global concern about bacterial resistance.

Supported by FAPESP (projects 20/05874-2 and 20/05875-9), the study followed 109 patients with advanced periodontitis over the course of one year. Advanced periodontitis is a chronic inflammatory disease caused by the accumulation of bacteria beneath the gums, affecting the tissues that support the teeth. If left untreated, it can lead to tooth mobility, bone loss, and even tooth loss. 

“Patients with severe disease have very deep pockets, which act as reservoirs for bacteria associated with the disease. It’s a very challenging condition to treat,” says dental surgeon Nídia Cristina Castro dos Santos, the first author of the study and a professor and researcher at Einstein. 

For the study, participants were randomly assigned to one of four groups. All underwent subgingival instrumentation – popularly known as scaling – which is considered the standard treatment for periodontitis. However, they received different complementary therapies.

The control group received placebos of the antibiotics, omega-3, and ASA in capsules identical to those used for the active treatments. A second group received a combination of the antibiotics metronidazole and amoxicillin, considered the therapy with the strongest scientific evidence for severe cases of the disease, administered three times a day for 14 days. The third group took three grams per day of omega-3, in addition to a daily dose of aspirin for six months. The fourth group received a combination of the two strategies simultaneously: antibiotics for two weeks and the omega-3 and ASA protocol for six months. Participants were reevaluated after three, six, and twelve months.

By the end of the follow-up period, about 58% of patients who were treated with antibiotics had met the researchers’ established clinical goal of having no more than four remaining deep periodontal pockets. Among those who received omega-3 and ASA, the percentage was virtually the same: 57.7%. In contrast, in the group that received only scaling and a placebo, the rate was 23.1%. Combining the two strategies, antibiotics and supplementation, didn’t provide any additional benefits.

“The use of antibiotics isn’t considered the gold standard of treatment. Although metronidazole and amoxicillin yield good results in the most severe cases, their use should be evaluated on a case-by-case basis due to risks related to bacterial resistance and possible adverse effects,” says Castro dos Santos. 

These results reinforce a line of research that has been underway for some time. In a previous study also supported by FAPESP and published in the journal Scientific Reports, the researchers observed that omega-3 supplementation reduced inflammation and bone loss caused by periodontal disease in rats, especially when combined with physical exercise. Although the study was conducted in an animal model, it already indicated the nutrient’s potential in inflammatory processes related to oral health (read more at agencia.fapesp.br/54990). 

According to Castro, omega-3 differs from traditional anti-inflammatory drugs in that it contributes to the production of molecules involved in the natural resolution of inflammation and tissue repair, rather than blocking certain inflammatory pathways. Low-dose ASA, on the other hand, was used because it enhances the formation of these mediators. The researchers hypothesised that this strategy would help the body better control the chronic inflammatory process characteristic of periodontitis.

“We imagined that the combination of antibiotics and omega-3 would be most effective in controlling periodontitis in these patients. We also believed that the results for the group that used omega-3 with ASA would be slightly lower than those for the antibiotic group. The result was surprising because the two therapies performed very similarly, paving the way for it to become a treatment option for these patients,” says Castro.

Another finding that caught the researchers’ attention was the persistence of the observed benefits. Even six months after supplementation ended, patients continued to show results similar to those recorded at the end of treatment. According to Castro, this suggests that modulating the inflammatory response may produce lasting effects, although the mechanisms involved are still being investigated.

For dental surgeon Magda Feres, the lead author of the study and a full professor at the Harvard School of Dental Medicine and the Graduate Program in Dentistry at UNG, the results suggest that modulating the inflammatory response may represent a viable alternative for selected patients. “The combination of omega-3 and low-dose aspirin achieved clinical benefits comparable to those of the metronidazole and amoxicillin protocol, opening up a real alternative for those who can’t take antibiotics, especially patients with allergies or intolerance to these medications,” she says.

The researcher adds that the results are especially significant in light of growing concerns about antibiotic resistance, which is considered one of the main threats to global public health. “Demonstrating that it’s possible to treat severe periodontitis by modulating the body’s own response is new and relevant information that helps preserve antibiotics for when they are truly indispensable,” says Feres.

However, the authors emphasise that the results do not imply an immediate change in clinical practice. The study was conducted on patients without significant systemic or oral diseases. Further research is needed to confirm the findings in different populations and to identify which groups can truly benefit from each approach.

According to Feres, some of the answers may come from microbiological analyses currently underway. These analyses are investigating how these therapies influence the composition of bacteria in periodontal pockets. Preliminary data suggest a reduction in disease-associated species and an increase in microorganisms related to gum health. “It’s an important step forward, but not the end of the story. Therefore, the message is one of cautious optimism: we have a promising, scientifically plausible alternative to antibiotics in select cases. Routine replacement will require more evidence,” she concludes.

The article “Immunomodulators, associated or not with systemic antibiotics, to treat periodontitis: A 1-year multicenter, placebo-controlled, double-blind, randomized clinical trial” can be read at aap.onlinelibrary.wiley.com/doi/10.1002/jper.70081.

Source: FAPESP

Categories : Dentistry PaediatricsTags :

Brush-on Treatment Could Halt Cavities and Prevent Fillings

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Photo by Hush Naidoo Jade Photography on Unsplash

Every year, untreated tooth decay sends thousands of young children to emergency departments for dental problems doctors can’t treat. Many eventually undergo surgery under general anaesthesia, while others endure pain and infection.

A simple, inexpensive liquid called silver diamine fluoride, or SDF, could spare many of those children. Applied to a cavity with a tiny sponge-tipped applicator in about a few second’s time per tooth, SDF arrests decay without drilling, shots or sedation.

Dentists have used SDF successfully for decades in many countries, and off label in the United States since 2014, when it was approved as a medical device to treat tooth sensitivity. However, it has lacked the large US population clinical trials for efficacy and safety that are needed for FDA approval as a drug to treat cavities.

Now, a University of Michigan-led clinical trial has produced that evidence.

Published in JAMA Pediatrics, the Phase III trial enrolled 830 children under age 6 who were recruited through dental offices, pediatric medical practices, Head Start and Early Head Start programs in Michigan, New York and Iowa.

Researchers found that 38% SDF arrested tooth decay in more than half of children’s affected baby teeth when treated at 6-month intervals. Unlike conventional treatment, which removes part of the tooth before placing a filling, SDF is simply painted onto the cavity.

“This is a very effective and safe treatment – even in children as young as 1,” said Margherita Fontana, professor of dentistry at the University of Michigan School of Dentistry and the study’s lead investigator.

Tooth decay is the most common chronic disease of childhood, affecting more than 40% of US children. Left untreated, cavities can cause severe pain, infection, difficulty eating and sleeping, missed school and repeated medical visits.

SDF may be especially valuable for very young children, older adults, people with developmental or physical disabilities, patients with severe dental anxiety, and others who cannot easily tolerate or access conventional dental treatment, Fontana said.

Its primary drawback is cosmetic, she said. The silver permanently darkens the decayed portion of the tooth.

“If we want more children and families to benefit from this treatment, we need rigorous evidence showing both that it works and that it’s safe. From a public health perspective, if we want broader implementation across the United States, including in medical settings, we need carefully collected data in U.S. populations, and we now have that,” Fontana said.

The study began in 2018 and progressed even with the challenges of the COVID-19 pandemic.

“In medicine, clinicians want high-quality evidence before changing practice,” Fontana said. “It is important to have data they can refer to because young children often see paediatricians years before they ever visit a dentist, broader acceptance could allow many more cavities to be treated while a referral to a dental home is successful, and before they become painful, infected or require surgery.”

The product used in this trial, Advantage Arrest 38% SDF, was provided by Elevate Oral Care.

Amr Moursi, professor of paediatric dentistry at New York University College of Dentistry, said the study provides important data for broadening use of SDF.

“Our results support FDA approval of SDF for managing arrest of tooth decay in young children. Removing SDF from off-label status would be an important innovation which could lead to increased utilisation by providers, enhanced payments by insurers and more consistent product quality,” said Moursi, a co-principal investigator on the study.

For some children, reapplying SDF every few months may be all that’s needed until the baby tooth naturally falls out. For adults, it may serve as a long-term treatment or as a bridge until restorative procedure is affordable or practical.

“For almost anyone, this can arrest the decay and stop the infection and the pain it causes,” Fontana said. “This could benefit many people.”

Source: University of Michigan

Categories : Dentistry Implants and ProsthesesTags :

Why Antibiotics Fail Against a Common Dental Implant Disease

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By Alexmit art – Own work, CC BY-SA 4.0, Link

Dental implants have given tens of millions of people something dentures never could: a full set of fixed and fully functioning teeth. Unfortunately, 10% to 20% of implant patients eventually experience an aggressive jawbone infection called peri-implantitis. 

Antibiotics usually fail to stop the infection for reasons that researchers have never understood – until now.

A new study in PNAS Nexus by researchers with the Rutgers School of Dental Medicine found that bacteria corrode implants, causing them to shed microscopic titanium particles into the surrounding tissue. Those particles hijack the immune cells sent to clear the infection and lock them into a state of inflammation that destroys the jawbone they are supposed to protect.

Working with human tissue samples, cultured human immune cells and a genetically engineered mouse model, the team pinpointed a specific calcium channel in the body’s bacteria-eating macrophages that the titanium particles activate. Switching that channel off in mice prevented the disease. The result is the first credible drug target for a condition that affects up to one in five implant recipients and costs the global health system more than a billion dollars a year.

“For the first time, we show why all the antibiotic treatments that work around teeth do not work around implants,” said Georgios Kotsakis, the study’s senior author and the assistant dean for clinical research at the dental school. “Now that we know the cause, we can start developing therapeutics.”

Peri-implantitis has long been a puzzle because it initially looks like its counterpart in natural teeth, which is called periodontitis and begins with the same oral bacteria. In patients with natural teeth, antibiotics and routine cleaning resolve the infection. In patients with implants, the same drugs against the same bacteria succeed less than half the time, while the bone underneath continues to disappear.

Most research over the past 20 years has focused on the bacteria. Members of Kotsakis’ lab took a different approach and began looking at the implants. Bacteria living on the implant surface produce acidic biofilms that slowly corrode the titanium, releasing billions of particles smaller than a red blood cell. The same shedding can occur during routine cleaning, especially with instruments that dentists typically use on natural teeth.

Inside the gum, those particles get coated with a bacterial toxin called lipopolysaccharide. To the immune system, they suddenly look like enormous, indigestible bacteria – but macrophages cannot digest metal. The cells become trapped in a hyperinflammatory state, pumping out signalling molecules including interleukin-1 beta, an inflammatory protein also implicated in rheumatoid arthritis and Alzheimer’s disease. 

That inflammation eats away at bone. Worse, the immune cells lose their ability to deal with the original infection. In the lab, macrophages exposed to titanium particles took up less than half as many bacteria as unexposed cells. 

“These particles are little magnets that attract the bacterial toxin, and they hijack the immune system, preventing it from clearing bacteria,” said Kotsakis. “You have a perfect storm that defies antibiotics.”

Team members traced the cascade to a calcium channel (a specialised, pore-forming protein structure within cell membranes) called TRPC1. In mice engineered without it, the immune cells handled the same titanium-plus-bacteria challenge normally: abscesses were dramatically smaller, inflammatory cytokines dropped, and bacterial clearance was restored. 

Funded by the National Institutes of Health, members of Kotsakis’ group are testing drug candidates that target the same pathway in human cells.

For people who already have implants, the most useful finding may be a quieter one. The strongest known protective factor is regular professional cleaning, but the kind of cleaning matters. Until roughly a decade ago, many dentists scraped implants with the metal scalers used on teeth, a method the Rutgers lab and others have shown can itself corrode the implant and accelerate the disease. Nonabrasive techniques are now standard. 

By Andrew Smith

Source: Rutgers University

Categories : DentistryTags :

Beyond Straight Teeth: Why Orthodontic Health Matters More than You Think

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Angelo Maura, General Manager Africa and Middle East at Align Technology

Photo by Tima Miroshnichenko on Pexels

Orthodontic treatment goes beyond getting a better smile; it can also support important oral functions such as chewing and speaking, as well as help patients maintain good oral health over a lifetime. Angelo Maura, General Manager for Africa and Middle East at Align Technology, discusses World Orthodontic Health Day 2026 (WOHD 2026), what “Beyond Straight Teeth” means, and how digital innovation is reshaping orthodontic care for South African patients and practitioners.

Q1: What does “Beyond Straight Teeth” mean to orthodontics?

“Beyond Straight Teeth” strongly reflects how we have always approached orthodontic care. For nearly 30 years, our focus has been on improving the journey to a healthy, confident smile, but that journey has never been limited to aesthetics.

Orthodontic treatment plays an important role in oral function, including how patients chew and speak. It can also support long-term oral health by helping create tooth positions that are easier to clean and maintain. For general dentists and orthodontists, the theme is a reminder that case assessment and treatment goals extend beyond alignment to include function, hygiene access and long-term stability.

Q2: Oral health is said to have an impact on overall health. What are the health benefits of orthodontics?

Misaligned teeth and bite issues can be associated with uneven wear and may make oral hygiene more difficult, which can contribute to plaque build-up and gingival inflammation. In some people, bite problems may also be linked to jaw discomfort. Depending on the individual case, misalignment can also affect everyday functions such as eating and speaking.

At Align Technology, we design solutions that help clinicians address a wide range of malocclusions through modern, evidence-based orthodontic care. The Invisalign® System is designed to treat a wide range of malocclusions, and starting the conversation early can help patients understand their options and plan the right care with their doctor.

Q3: Orthodontic treatment is often associated with teens and young adults. How does it benefit patients at different life stages?

Our aim at Align Technology is to ensure patients of all ages have access to treatment that fits into their daily lives while supporting overall oral health.

For children, early orthodontic assessment can help identify developing issues such as crowding and spacing. Invisalign First™ aligners are designed for growing patients and are removable, which can support oral hygiene when used as directed and supervised appropriately.

For teens, adherence and day-to-day practicality are important. Removable aligners can help many teens maintain normal activities and oral hygiene routines, while clinicians can use digital planning and monitoring to support progress throughout treatment.

For adults, treatment often needs to fit around work and family commitments, and many patients benefit from an interdisciplinary approach. Clear aligner therapy can be an option that balances aesthetics with planned tooth movement, particularly when coordinated with periodontal maintenance and restorative goals where needed.

To date, approximately 22.8 million patients worldwide have been treated with the Invisalign® System, including more than 6.5 million teens and kids.*

*Data on file at Align Technology, as of December 31, 2025.

Q4: How is Align Technology equipping clinicians to raise the standard of care beyond straightening teeth?

We support clinicians through comprehensive education programmes and tools. There are currently approximately 299,500 Invisalign-trained doctors globally. In South Africa, this includes bringing international specialists to work directly with local clinicians through in-market education sessions and academic engagements, ensuring global best practice is shared in a way that is locally relevant.

Q5: Digital technology and AI are changing healthcare. How is the Align™ Digital Platform reshaping what happens in dentistry?

The Align™ Digital Platform connects diagnosis, treatment planning, manufacturing, and monitoring into a single workflow.

One key development is ClinCheck® Live Plan, which automates the generation of an initial doctor-ready ClinCheck® treatment plan within about 15 minutes after an eligible case is submitted with Flex Rx, so the doctor can review and approve the plan faster.

The Align™ Oral Health Suite offers a comprehensive set of digital tools that assist clinicians in evaluating, monitoring, and managing patients’ oral health. By integrating advanced assessment capabilities and patient education resources, the suite supports effective communication and engagement, helping doctors deliver personalised care and promote long-term oral wellness.

These technologies are designed to support clinical expertise, with the doctors central to every treatment decision.

Q6: WOHD 2026 calls for global unity in prioritising orthodontic health. What does this commitment look like in South Africa?

South Africa is an important market for us. There is strong engagement from clinicians, and patient awareness continues to grow. We are also seeing increased adoption of digital dentistry.

At the same time, practitioners are at different stages of their digital journey. A high-volume practice in Johannesburg will have different needs from a smaller practice beginning with aligner therapy.

Our approach is to support clinicians at every stage and grow with them.

Our focus is on expanding access to innovation, strengthening engagement with the dental community, and ensuring clinicians have the tools and support needed to deliver strong patient outcomes.

Ultimately, a healthy smile contributes to overall health.

Categories : DentistryTags :

Zinc-based Compound Could be a New Cavity Fighter

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Scientists at NYU are developing a zinc-based treatment for tooth decay that combats bacteria, blocks pain, and avoids staining teeth – all without drilling

Photo by Caroline Lm on Unsplash

Tooth decay is the most common health condition worldwide. While it is preventable and treatable, billions of people are living with cavities and the pain that accompanies them.

Given the massive scale of the problem, there’s a growing movement in dentistry to treat cavities without drilling and filling them. One such approach is applying a clear liquid called silver diamine fluoride to the surface of teeth. Silver diamine fluoride is already FDA-approved to treat tooth sensitivity, and recent NYU research shows that the compound’s antimicrobial properties also make it effective at preventing cavities and stopping small cavities from progressing into larger ones. Because it’s inexpensive and easy to administer, it can be given in schools, in rural areas lacking dentists, or to patients who may have difficulty with dental care, including those with disabilities. 

But treatment with silver diamine fluoride comes with one notable drawback: when the silver in it interacts with tooth decay, it turns the treated surface black. While this is not a significant issue for molars at the back of the mouth or baby teeth that fall out, it’s not a great option for teeth seen in a smile.

“Once your teeth are treated with silver diamine fluoride, that stain is permanent, which is a barrier for many people wanting to use the product,” explains Marc Walters, professor of chemistry at NYU. 

Walters has long studied silver and other elements used in medicine to carry drugs and imaging contrast agents. Several years ago, he was approached by researchers at NYU College of Dentistry seeking to better understand how silver stains teeth in order to avoid that outcome.

From silver to zinc

Walters had an idea. What if another mineral could be used that was also colourless and antimicrobial but didn’t turn teeth black? This question led him to zinc, an important nutrient found in foods like oysters and beef, as well as in over-the-counter products intended to shorten the duration of colds. Zinc is also used in dentistry, including in toothpaste and mouthwash to fight bacteria and bad breath, as well as in some denture adhesives and cementing agents to affix crowns or temporary fillings.

Walters began studying a zinc phosphate compound to see how it interacts with cavities, and crucially, to determine whether it can permeate deep into teeth. In order to address pain and hypersensitivity, the compound would need to reach the tooth’s dentin, the porous material sandwiched between the hard enamel outer layer and the nerves within. Dentin contains an abundance of microscopic, hollow channels – in fact, 40 000 of these tubules are packed into each square millimetre of dentin. 

“We had to develop a solution to give dentists that will be taken up in these very small openings and go deep enough in the tubules so that the material will be retained,” Walters explains.

Walters applied phosphate followed by zinc to slices of a human tooth. Under the microscope, he saw deposits of the compound deep inside the dentin tubules. But while the zinc phosphate successfully permeated the teeth, he knew that a simpler approach that didn’t require applying two treatments would be easier for dentists. “Two steps is one too many,” says Walters.

Drawing inspiration from silver diamine fluoride, Walters developed another zinc-based molecule called zinc tetramine difluoride, which forms a colourless zinc oxide deep inside dentin tubules. The agent starts out as a liquid that is sensitive to concentration and pH. When painted onto a tooth and absorbed, the conditions within dentin tubules prompt a chemical change that quickly turns it into a solid, blocking the tubules and slowly releasing the antimicrobial zinc into the tooth.

His team is continuing to develop several related compounds for the treatment of cavities and has applied for patents of these zinc-based materials in several countries.

Fast and slow

Having both fact-acting and long-lasting properties would offer an ideal combination for fighting cavities and tooth sensitivity, given that many current treatments for sensitive teeth require multiple applications and can take days or weeks to work. 

“In one of our studies, two minutes after treatment with our agent, we can see using the electron microscope that the zinc forms long cylinders of mineral that occupy the tubules,” says Walters. “Blocking the dentin tubules cuts off access to the nerves that are much deeper in dentin. It’s like putting a cork in place that shuts off the lower portion of the tubule from the outside environment – and this happens within a minute or two.”

Walters shows an image of a tubule under the microscope that was filled with the zinc compound.

In additional tests, Walters found that zinc oxide persisted in tooth samples for at least one to two months. The goal is to develop a product that lasts for months or even years inside of teeth, stopping hypersensitivity and fighting bacteria on an ongoing basis. 

“Not only do you have the analgesic result of having tubules blocked, but you also have a very low solubility agent that can slowly release the zinc into the tubule to prevent the growth of Streptococcus mutans and other bacteria,” Walters adds.

The journey from lab to shelves

With a promising zinc nanocrystal agent in hand, Walters sought out other experts at NYU and beyond. His work caught the attention of Southern Dental Industries (SDI), an Australian company that makes restorative dental materials, including silver diamine fluoride. The company purchased the license for the zinc technology and NYU is working with them to develop it.

Closer to home, Walters began collaborating with Deepak Saxena, professor of molecular pathobiology and director of research innovation and entrepreneurship at NYU College of Dentistry.

Saxena and Walters are collaborating on a new NIH grant to further develop the zinc-based treatment.

As a result of bringing together this diverse expertise Saxena and Walters received a award from NYU, and last month, secured a grant from the NIH. 

The NIH grant will fund feasibility studies for Walters’s team to further develop the formulation and confirm its ability to block tubules in a range of dentin samples. It will also fund research through Periomics Care in which Saxena’s team will study the agent’s antimicrobial properties. Specifically, they will look to see if the zinc creates a “zone of inhibition” – preventing the growth of decay-causing bacteria in the vicinity of it or even killing bacteria that comes in contact with it.  

“The mouth is full of bacteria. A compound needs to have good antimicrobial activity, which can occur from ionic imbalance, the properties of the zinc, or by the fluoride,” Saxena says. “If a compound does not stain, has good antimicrobial activity, plus it blocks the tubules, then it should be successful in stopping tooth decay and be aesthetically accepted.” 

Saxena and Walters are already planning for the next phase of their research, which will include additional studies on the compound’s formulation, effectiveness, toxicity, and shelf life. Ultimately, if these studies go well, the researchers and SDI will approach the FDA for permission to do a clinic trial.

One factor working in their favour: because zinc phosphate has long been used as a dental adhesive, it’s known to be safe and the FDA has already approved it in other forms. These existing products may pave the way for faster research and development of a cavity treatment compared to untested elements, which can take many years to develop.

The future of dentistry

A new non-invasive treatment for cavities could be a game-changer in oral health. “We know that there’s a need – and a market – for a product that stops tooth decay that is effective, cheap, easy to use, and non-staining, given the rise in global numbers of untreated cavities,” Saxena says. 

Dentists could use it to treat cavities without needing to scrape or drill out the cavity in preparation. Squirmy kids would need less time in the dentist’s chair. Older adults who get cavities near the roots of their teeth as their gums recede could have a new option for stopping sensitivity and decay in difficult-to-treat areas. If safe and effective, perhaps small quantities could even be available on drugstore shelves and sold directly to consumers.

For Walters and Saxena, their goal is a future with less tooth decay and pain – and if their studies of zinc confirm its potential, silver-stained teeth may be a thing of the past.

Source: New York University

Categories : DentistryTags :

Tooth Pain Nerves Serve Another Purpose: Tooth Protectors

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Types of teeth. Credit: Scientific Animation CC4.0

Until now the sensory neurons inside the tooth were primarily thought to send pain signals to the brain, but a new study shows those neurons are multitaskers that also trigger a jaw-opening reflex that almost instantaneously prevents damage and further injury to teeth.

The reflex that pops open the lower jaw was a widely known craniofacial reflex, but until this study the cellular origins of this phenomenon were not known.

University of Michigan researchers in sensory neuroscience, dentistry and mechanical engineering found the origin using special live imaging, behaviour-tracking tools and mice molars to uncover the neurons’ additional role of monitoring the inner tooth and outer enamel.

The discovery and understanding of this additional role shows how important healthy, active nerves are for preserving teeth.

“We suspected there was a more fundamental role for tooth nerves,” said Joshua Emrick, senior author of the study and assistant professor at the U-M School of Dentistry. “When we consider regenerating a tooth pulp, we need to bring back the nerves.”

Emrick’s research team looked at how nerve cells reacted to stimulation of the molar teeth of mice in real time. Their experiments revealed a newly defined, protective role for intradental High-Threshhold Mechanoreceptors, highly specialized sensory neurons that respond to tooth damage. These HTMRs detect dangerous threats and send the message rapidly to the brain for instantaneous action.

“Our study challenges the prior assumption that nerves inside the tooth primarily function to elicit pain and force us straight to the dentist for help,” Emrick said. “If you’ve ever accidentally bitten down on your fork, you’ve probably experienced a startling jolt, but also stopped short of fracturing your teeth. You may thank these intradental HTMRs for that.”

The reflex is really about self-preservation.

“We think protection of the teeth through this jaw-opening reflex is highly conserved among mammals that haven’t developed the ability to replace teeth – like humans or in the molar teeth of mice,” Emrick said. “Our work reports an ability to use these neurons to also elicit pain which will open up possibilities for developing new methods for relieving toothache at the dentist’s office.”

To break it down further, the study, published in Cell Reports, showed that when enamel or dentin is damaged, the neurons fire a response. Follow-up experiments determined what happened after the HTMRs were activated. As previously known, the group identified that they trigger acute pain, but more surprisingly they also witnessed a rapid jaw-opening reflex within 5 to 15 milliseconds of the activation.

While the authors focused their work on understanding how the HTMRs function within the tooth, this important subclass of sensory neurons may protect other oral and body structures from damage.
Elizabeth Ronan, postdoctoral fellow at the School of Dentistry and lead author of the work, said the findings are the start of a deeper understanding.

“While we typically think of sensation as giving rise to our perceived external experience of the world, sensory neurons are equally essential in protecting and maintaining our tissues throughout life,” she said. “Much remains to be discovered regarding how sensory neurons function within individual tissues, especially internal ones such as the teeth.”

Source: University of Michigan

Categories : Dentistry Implants and ProsthesesTags :

Study Finds that Titanium Particles are Common Around Dental Implants

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Photo by Tima Miroshnichenko on Pexels

Titanium micro-particles in the oral mucosa around dental implants are common. This is shown in a new study from the University of Gothenburg, which also identified 14 genes that may be affected by these particles.

According to the researchers, there is no reason for concern, but more knowledge is needed.

“Titanium is a well-studied material that has been used for decades. It is biocompatible and safe, but our findings show that we need to better understand what happens to the micro-particles over time. Do they remain in the tissue or spread elsewhere in the body?” says Tord Berglundh, senior professor of periodontology at Sahlgrenska Academy, University of Gothenburg.

Found at all implants

Previous research has shown that titanium particles may occur in inflamed tissues around dental implants. The new study, published in Communications Medicine, showed that titanium micro-particles were consistently found at all examined implants—even those without signs of inflammation.

The researchers analysed tissue samples from 21 patients with multiple adjacent implants. Samples were taken both at healthy implants and at implants affected by peri-implantitis, an inflammatory disease in the tissue around the implant. Each patient thus served as their own control. The density of particles varied between patients, but not between sites with and without peri-implantitis within the same patient. The analyses were conducted in collaboration with Uppsala University, where researchers used an advanced method called µ-PIXE to map the distribution of titanium particles in the tissue samples.

Affected genes

Peri-implantitis is a microbial biofilm-associated inflammatory disease around dental implants, with features similar to those of periodontitis around teeth. The inflammatory process is complex and the resulting destruction of supporting bone in peri-implantitis may lead to loss of the implant. 

“We observed that tissue samples with higher concentrations of titanium particles had an altered gene expression, especially genes related to inflammation and wound healing. We identified 14 such genes, but it is unclear whether the particles influence the local immune response or if the difference in gene expression reflects inter-individual variability in inflammatory conditions,” says Carlotta Dionigi, specialist in periodontology and researcher at the Department of Periodontology, Sahlgrenska Academy, University of Gothenburg.

The researchers suspect that titanium particles are released during the surgical installation procedure, when the screw-shaped implant is inserted into the prepared canal in the alveolar bone. In this context, the observation on differences in micro-particle densities between various implant systems deserves attention, since the surface structure of the implant may influence the deposition of micro-particles. This is now an important topic for continued research.

Source: University of Gothenburg

Categories : DentistryTags :

Beyond the Smile: South Africa Must Prioritise Oral Health as a Public Health Imperative

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Photo by Hush Naidoo Jade Photography on Unsplash

South Africa’s burden of oral diseases is not only inextricably linked to non-communicable diseases but also presents an urgent public health challenge, with rising concern over its impact on mental health.

Oral diseases are a major health concern for many countries and negatively impacts people throughout their lives. Oral diseases lead to pain and discomfort, social isolation and loss of self-confidence, and they are often linked to other serious health issues. And yet, there is no reason to suffer: most oral health conditions are preventable and can be treated in their early stages.

Globally, every year on March 20, World Oral Health Day is commemorated with the aim to empower people with the knowledge, tools, and confidence to secure good oral health.

This year, the Day’s focus shifts to the mind-mouth connection, with the tagline from the FDI World Dental Federation: “A Happy Mouth Is… A Happy Mind”. This campaign aims to raise awareness of how poor oral health can negatively impact quality of life, highlighting the importance of a healthy mouth for mental well-being.

Macelle Erasmus, Head of Expert at Haleon South Africa – a leader in consumer health and self-care, says, “Oral health is not just about bright smiles and good-looking teeth – it is a critical component of overall well-being. In South Africa, the high prevalence of oral diseases, particularly among children and vulnerable communities, reinforces the urgent need for improved oral health education and preventive care.”

Haleon’s leading oral health brands Aquafresh and Sensodyne, are committed to improving oral health education and access across the country.

Over the course of just three months, we have conducted more than 39,000 gum health screenings across 16 clinics. In 2025, our expansion aims to reach 100,000 underserved communities as part of Haleon’s oral health care outreach programs.

According to the South African Dental Association (SADA), 41% of children aged 1-9 years and close to 28% of people aged 5 years and over experienced untreated tooth decay in milk and permanent teeth respectively, while nearly 25% of people aged 15 years and over experienced severe periodontal disease in 2019. The country also saw 1,933 new cases of lip and oral cavity cancer in 2020.

The World Health Organisation’s Global Strategy and Action Plan on Oral Health 2023–2030, explains that oral health encompasses a range of diseases and conditions. The most prevalent public health issues include dental caries, severe periodontal (gum) disease, complete tooth loss (edentulism), oral cancer, oro-dental trauma, noma and congenital malformations such as cleft lip and palate, most of which are preventable.

The main oral diseases and conditions are estimated to affect close to 3.5 billion people worldwide. These conditions combined have an estimated global prevalence of 45%, which is higher than the prevalence of any other NCD.

However, oral diseases and conditions share risk factors common to the leading NCDs, including all forms of tobacco use, harmful alcohol use, high intake of free sugars and lack of exclusive breastfeeding.

The Department of Health’s National Oral Health Policy and Strategy 2024-2034 acknowledges that oral health is poorly integrated in other health programmes, “though it is an integral part of general health.” It further recognises that: “Its role in management and care of communicable diseases, genetic disorders, trauma, injury, and violence is often overlooked.”

This integration is particularly important as more than three million patients are treated in the country’s public primary healthcare facilities annually, at a cost of R650 million. Addressing oral health holistically – within the broader healthcare system – can significantly reduce this burden.

Categories : Dentistry Diet and NutritionTags :

Do Starchy Carbs Cause Cavities?

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Photo by Caroline Lm on Unsplash

It’s common knowledge that sugar causes cavities, but new research provides evidence that – depending on your genetic makeup – starches could also be a contributing factor.

The study, published in Microorganisms, explores the response of the oral microbiome to starch, finding that the number of copies of a particular gene, AMY1, in combination with starch, alters the complex composition of bacteria that play a role in oral health.

“Most people have been warned that if you eat a bunch of sugar, make sure you brush your teeth,” said Angela Poole, senior author and assistant professor of molecular nutrition in the College of Agriculture and Life Sciences and the College of Human Ecology. “The takeaway finding here is that depending on your AMY1 copy number, you may want to be just as vigilant about brushing your teeth after eating those digestible starches.”

Researchers, including first author Dorothy Superdock, PhD ’23, collected saliva samples from 31 subjects with a range of AMY1 copy numbers – copies of the AMY1 gene in the DNA – and added starch to the cultured samples, or biofilms, to see how the bacterial makeup changed. They found that, in general, the diversity of bacteria decreased when starch was added. For those samples with high numbers of AMY1, the starch significantly reduced the proportions of two bacteria, Atopobium and Veillonella, while Streptococcus appeared to increase.

All three bacteria are associated with tooth decay or gum disease, Poole said.

“Some increased and some decreased, so it’s not so straightforward as saying, ‘The whole thing is good or bad,’” Poole said. “It’s an interaction, but it looks like the AMY1 copy number, as well as which species are present in people’s mouths when they eat starch, is affecting the risk for developing these diseases.”

AMY1 codes for the salivary amylase enzyme, which helps break down starch in the mouth. Previous studies have associated AMY1 with cavities and periodontal disease. Poole, in prior studies, found that a high AMY1 copy number is associated with higher levels of the species Porphyromonas endodontalis, which is strongly associated with periodontitis and gum disease.

But how the salivary amylase enzyme interacts with its main substrate, starch, to alter the oral microbiome and increase disease risk was unclear.

“That’s what we wanted to know in this experiment,” Poole said. “What’s going on in the mouth if someone eats starch, and is the answer different if their copy number is high or if it’s low? What we found was that there are other bacteria involved in these processes and that the changes depended on AMY1.”

The researchers also found evidence that the oral microbiome has co-evolved in response to increasing copies of AMY1, which is found in higher numbers in populations where there’s a long history of agriculture and starch consumption. In the pool of 31 samples, taken locally in Ithaca, the AMY1 number ranged from two to 20 copies.

“The populations that historically had greater access to starch tend to have more copies,” Poole said, “which makes sense from a practical standpoint, because it would have given you a survival advantage when food is scarce, to be able to break down those starches more efficiently.”

In saliva samples with a high AMY1 copy number, the researchers saw increased populations of bacteria, like Streptococcus, that feed off the starch’s sugars.

“If someone has a high copy number, they break down starch efficiently, and bacteria that like those sugars are going to grow more in that person’s mouth,” Poole said. “So you can have species behave differently based on the different substrates. It’s pretty incredible – how we adapt and these microbes turn around and adapt, too.”

Source: Cornell University

Categories : Cardiovascular Disease DentistryTags :

Regular Flossing may Lower Risk of Ischaemic Stroke and Atrial Fibrillation

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Photo by Caroline Lm on Unsplash

Flossing your teeth at least once a week may be linked to a lower risk of stroke caused by blood clotting and atrial fibrillation, according to a preliminary study to be presented at the American Stroke Association’s International Stroke Conference 2025. The meeting is in Los Angeles, Feb. 5-7, 2025, and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

“A recent global health report revealed that oral diseases – such as untreated tooth decay and gum disease – affected 3.5 billion people in 2022, making them the most widespread health conditions,” said study lead author Souvik Sen, MD, MS, MPH, chair of the Department of Neurology, Prisma Health Richland Hospital and the University of South Carolina School of Medicine in Columbia, South Carolina. “We aimed to determine which oral hygiene behaviour – dental flossing, brushing or regular dentist visits – has the greatest impact on stroke prevention.”

The Atherosclerosis Risk in Communities (ARIC) study, one of the first large-scale investigations of this kind in the US, assessed the home use of dental floss through a structured questionnaire of more than 6000 people. Among those who reported flossing, 4092 had not experienced a stroke, and 4050 had not been diagnosed with atrial fibrillation (AFib).

Participants were asked about their status regarding high blood pressure, diabetes, high cholesterol, smoking, body mass index, education, regular brushing and dentist visits. During the 25 years of follow-up, 434 participants were identified as having strokes, of which 147 were larger artery brain clots, 97 were heart-driven clots and 95 were hardening of the smaller arteries. Additionally, 1291 participants were noted to have experienced AFib.

The analysis found:

  • Flossing was associated with a 22% lower risk of ischaemic stroke, 44% lower risk of cardioembolic stroke (blood clots traveling from the heart) and 12% lower risk of AFib.
  • The associated lower risk was independent of regular brushing and routine dental visits or other oral hygiene behaviours.
  • Increasing the frequency of flossing had a greater chance of stroke risk reduction.
  • Flossing was also associated with a lower chance of cavities and periodontal disease.

Researchers were surprised by the reduction of irregular heartbeats, or AFib. AFib is the most common form of irregular heartbeat. It can lead to stroke, heart failure or other cardiovascular complications.

“Oral health behaviours are linked to inflammation and artery hardening. Flossing may reduce stroke risk by lowering oral infections and inflammation and encouraging other healthy habits,” Sen said. “Many people have expressed that dental care is costly. Flossing is a healthy habit that is easy to adopt, affordable and accessible everywhere.”

Study limitations include that data were based on answers to a questionnaire, and the 25-year follow-up appears to have focused on stroke and heart outcomes only. There was no follow-up concerning flossing or other oral behaviours over the years, Sen said.

Source: American Heart Association