Recent research has raised the possibility that cavities and infections of the inner ear that commonly affect young children may be related. The possibility of such a connection arose in studies of chewing gum containing xylitol. Derived from the bark of birch trees, xylitol is a sweetener that has antibacterial powers and has been shown to prevent tooth decay. A Finnish study also found that xylitol may prevent cases of the ear infection otitis media in children.
Whether children who have cavities in their teeth are also more likely to have ear infections is uncertain, so Natalie A. Nechvatal and colleagues at Case Western Reserve University in Cleveland, Ohio, compared the rate of cavities and ear infections in a group of 97 children aged 2 to 5.
The investigators found that children with dental cavities tended to have more ear infections than children without cavities, but the difference was not statistically significant and could have been due to chance.
There were some noticeable age-related differences, however. In children without cavities, the percentage who had ear infections was fairly consistent across age groups, ranging from 39% in 2- and 3-year olds to 38% in 4-year-olds.
Among children with cavities, however, the proportion of children with ear infections was much higher among the youngest kids, although the difference was not statistically significant. In those with cavities, the rates of ear infections were 71% and 60% in 2- and 3-year-olds, respectively, but the rate was only 41% in 4-year-olds.
Nechvatal reported the findings earlier this month at a meeting of the International Association for Dental Research in San Diego, California.
The study is preliminary, but the researchers recommend that larger trials be conducted to verify the possible link between cavities and ear infections.
Nechvatal and her colleagues also suggest that parents should try not to put young children to bed with a bottle, since this practice was linked to an increased risk of cavities. If a child is reluctant to go to sleep without a bottle, parents may be able to reduce the risk of cavities by filling the bottle with water rather than milk or sweet drinks, they advise.
Dental
X-Rays Found to Be Screen for Stroke Risk
Besides searching for teeth-destroying cavities, dental X-rays have a
potential new major use -- showing whether a person is in imminent danger
of a heart attack or stroke, researchers said on Wednesday.
By comparing the health outcomes of men whose teeth were examined at the Veterans Affairs Greater Los Angeles Healthcare System over a 15-year period, Cohen's team found that panoramic X-rays can be used to spot carotid artery calcification -- a condition that contributes to stroke and heart attack.
"For the men with calcifications, the risk of a serious heart-related problem is two times as high as it is for those without calcifications," the researcher said. Carotid artery calcifications (CAC) are calcium deposits that line the walls of the arteries supplying blood to the brain.
The study, presented at a meeting of the American Academy of Neurology (news - web sites) in Denver, looked only at men over the age of 55 so results don't reflect the general population, but there is no reason to think that younger people or women would not have the same risks, Cohen said.
"In my mind, carotid artery calcification is a marker for atherosclerosis," the researcher said, referring to the deposits of cholesterol-rich plaques that can build up in arteries and eventually clog them.
RECORDS COMPARED
Previously, evidence of calcifications on dental X-rays was seen as an indication that patients needed to be evaluated for blockage of their carotid arteries, but these examinations rarely yielded evidence of blockage, Cohen said.
"What remained unclear was whether CAC was a separate risk factor for heart problems and stroke or whether it was simply a characteristic of patients with numerous risk factors for either condition," Cohen said.
To find out, the investigators compared medical records of 46 men with calcifications to the records of 46 men without the calcium deposits. The groups were matched in terms of age and preexisting risk factors like obesity and prior heart attack.
They found that 20 heart or stroke-related conditions occurred in 12 patients with CAC, compared with six events in five of the patients without CAC.
In the group with CAC, six patients had heart attacks and three had strokes, compared with one heart attack and one stroke in the group without calcifications.
In addition, patients with CAC suffered a cardiac event or stroke 2.9 years after their X-ray was taken, compared with 3.9 years later for patients without CAC.
Cohen said the findings warrant a recommendation that dentists, when they see CAC on an X-ray, refer their patients to a cardiologist who can evaluate and treat them before they develop full-blown heart disease.
"Instead of just looking at teeth, the patient would be put on notice that they are at risk for heart problems in the near future," he said.
The American Dental Association said some dentists are already screening for the calcium deposits based on the earlier studies. Dentists are also trained to look for conditions other than tooth decay and are often the first to spot oral cancer or gum conditions associated with diabetes.
Gold teeth can worsen gum disease, dentists warn
Brightening up your smile with a gold tooth can lead to a serious case of gum disease if the decorative crown isn't fitted properly, a new report shows.
Drs. Catherine M. Flaitz and Francesca Agostini of the University of Texas at Houston Health Science Center Dental Branch report on the case of a 16-year-old girl who adorned her pearly whites with a decorative gold crown that was improperly fitted to one of her front teeth.
Writing in the March issue of the journal Pediatric Dentistry, the doctors report that the girl came to their office about 3 months after having the gold crown placed on the tooth by another dentist. The girl's gums were swelling and bleeding, and the dentists recommended that she have the crown removed, but she would not consent to treatment, according to the report.
About 4 weeks later, the girl returned and was diagnosed with necrotizing ulcerative gingivitis, a very severe form of gum disease involving tissue death, ulceration, bleeding and severe pain. After anesthetizing the affected area, the gold crown was removed and medication was applied. The girl was instructed to use a medicated mouthwash for 7 days. The following week, the girl's gum health had significantly improved, the report indicates.
"Since many of these crowns are prefabricated and are not always inserted by a dentist, a number of oral health problems may develop," Flaitz and Agostini write. Periodontal disease, dental decay, fractures of the teeth and contact allergies are potential complications, they note.
The good news is that those who can't live without added sparkle to their grin may opt for "healthier artistic options," the authors point out.
One choice is a 24-karat yellow or white gold charm or ornament that is bonded to the front of one or more of the front teeth. "This oral jewelry is the latest fashion trend from Europe and is placed by the dentist, who can instruct the patient on proper maintenance and potential complications," Flaitz and Agostini report.
Another option is the tooth tattoo--a temporary decorative applique. The tattoo adheres to a clean tooth surface for a short period, and is designed for younger people.
"When it comes to tooth art, healthier alternatives exist, which may prevent irreversible and disfiguring oral complications in the future," the team advises.
SOURCE: Pediatric Dentistry 2002;24:47-49.