Impressions

Meta-Analyses Find No Association Between Community Water Fluoridation and Children’s IQ

A study led by California State Dental Director Jayanth Kumar, DDS, MPH, found that fluoride exposure by community water fluoridation is not associated with lower IQ scores in children. The study was published in the journal Public Health in June 2023 and is the first meta-analyses on fluoridation and IQ that considers different concentrations of fluoride in the conclusion.

Previous meta-analyses have mainly focused on studies conducted in endemic fluorosis areas with relatively high fluoride concentrations, such as impoverished rural communities in China, India and Iran. These findings cannot be generalized to developed countries, according to Dr. Kumar et al.

For the study, the researchers assessed fluoride exposure in three ways: 1) an ecological measure based on place of residence and using fluoride concentration from 2) child and 3) maternal urine samples. Three meta-analyses of cross-sectional and cohort studies were conducted to synthesize the effects of fluoride using the random effects models.

The meta-analyses showed that fluoride exposure at the concentration used in community water fluoridation is not associated with lower IQ scores. However, the authors noted that the reported association observed at higher fluoride levels in endemic areas requires further investigation.

Music Reduced Dental Students’ Stress, Improved Their Performance

In a pilot study carried out at the University of Eastern Finland, the use of background music was found to reduce dental students’ stress and improve their performance during preclinical tooth preparation exercises. The results were published in the Journal of Dental Education.

Research on music in various environments has supported its positive effects on emotions and well-being. Evidence also suggests that background music can foster education and learning and has the potential to increase student satisfaction and productivity. However, data on whether background music has an influence on the anxiety levels of preclinical dental students during practice, or whether it alters their performance, is scarce to nonexistent.

The present prospective cross-sectional pilot study compared the performance of 36 young dental students on a cariology course during phantom head training exercises in a simulation laboratory without background music or listening to quiet, low-tempo background music. The objective was to determine if music has an impact on dental students’ anxiety, satisfaction and performance during the exercises. The students’ perceptions were surveyed and quantitative, computer-aided measurements were taken to analyze their performance.

The students’ overall satisfaction in the background music was high. Music was found to reduce stress while also increasing the motivation to learn and practice. Communication in the classroom was smooth despite the background music, and the students’ use of time and quality of cavity preparation were enhanced.

According to the researchers, this pilot study lends support to the use of background music in preclinical cariology training, as it appeared to have helpful effects on dental skills education and practice. This music intervention could also be extended to other stressful dental education environments.

Ability to Chew Properly May Improve Blood Sugar Levels in Patients with Type 2 Diabetes

Research published in the journal PLOS ONE demonstrates that patients with Type 2 diabetes (T2D) who have full chewing function have a blood glucose level that is significantly lower than patients whose ability to chew effectively is impaired.

The retrospective study, led by Mehmet Eskan, DDS, a clinical assistant professor at the University at Buffalo School of Dental Medicine, looked at data gathered from 94 patients with T2D who had been seen at an outpatient clinic in a hospital in Istanbul, Turkey. The patients were divided into two groups: the first group included patients who had good occlusal function. That group’s blood glucose level was 7.48. The second group couldn’t chew well, if at all, because they were lacking some or all of those teeth; their blood glucose level was almost 2% higher at 9.42.

Addressing oral health has recently become part of the approach to managing diabetes along with encouraging patients to maintain a healthy weight, eat a healthy diet and quit smoking. This study did not find any independent variables that could affect blood glucose levels among the subjects because there were no statistical differences among subjects regarding body mass index (BMI), sex, smoking status, medications or infection as indicated by white blood cell count (WBC) at the baseline.

The dramatic improvement in one patient’s case described in a 2020 study co-led by Dr. Eskan illustrates the potential benefit of improving occlusal function through dental implants and appropriate fixed restoration. A T2D patient whose chewing function was severely impaired by missing teeth presented initially with a blood glucose level of 9.1. The patient obtained nutrition by using a bottle and eating baby food. Four months after treatment with a full mouth implant-supported fixed restoration, the patient’s glucose level dropped to 7.8. After 18 months, it decreased to 6.2.

Dr. Eskan said research has shown that an increase of just 1% in blood glucose level is associated with a 40% increase in cardiovascular or ischemic heart disease mortality among people with diabetes. Other complications can include kidney disease, eye damage, neuropathy and slow healing of simple wounds like cuts and blisters.

Researchers Create Bone Graft Material from Eggshells

A research team at the University of Oslo has developed a method to convert eggshells into bone graft material. The study was published in the journal Smart Materials in Medicine.

Autologous and allogeneic bone grafts are considered the gold standard when it comes to reconstructing bones, largely due to their bioactive compounds and osteoblastic cells that can generate new bone effectively. However, limited supply, donor-site complications and risk of disease transmission have deterred its widespread use.

In contrast, xenograft materials represent a feasible alternative because they are safe to use and come in abundance. Nonetheless, xenograft materials do have their limitations. Most commercialized xenograft materials are prepared from mammalian tissue with heavy bio-cost, environmental pollution and potential ethical issues, especially in underdeveloped areas.

Therefore, a top priority of bone graft materials development is to obtain safe, modifiable and environmentally friendly synthetic biomaterials capable of replacing natural graft material, which was the motivation that spurred the discovery of the use of egg shells.

For the Oslo study, the research team developed a dissolution-precipitation method to convert eggshells into endotoxin-free and immunocompatible amorphous calcium phosphate (ACP) particles. “Eggshells is an ideal raw material to synthesize bone graft materials as it contains plenty of calcium and phosphorous components,” said Qianli Ma, PhD, first author of the study. “In addition, some trace elements associated with bone regeneration, such as magnesium and strontium, are also found in eggshell.”

Further, the team established a novel 3D spheroid model for studying the osteogenic activity of eggshell ACP in vitro. In the model, ACP materials were observed to interact with osteoblasts more realistically and were safe, cell-friendly and effective in promoting bone regeneration.

“This technique promises to create an unlimited supply of bioactive and sustainable bone graft materials while reducing the environmental pollution,” said senior and corresponding author Håvard Jostein Haugen, PhD. “The osteoblastic spheroids constructed in the study provided a more practical biomaterial research model, reflecting the three-dimensional interactions between cells and biomaterials.”

Compound Combats Multi-Drug-Resistant Bacteria in Less Than One Hour

An article published in a special issue of the journal Antibiotics highlights a compound with antibacterial activity that presented promising results within one hour in laboratory trials.

The study was led by Ilana Camargo, PhD, last author of the article, and conducted during the doctoral research of first author Gabriela Righetto at the University of São Paulo’s São Carlos Institute of Physics (IFSC-USP) in Brazil.

“The compound we discovered is a new peptide, Pln149-PEP20, with a molecular framework designed to enhance its antimicrobial activity and with low toxicity. The results can be considered promising insofar as the trials involved pathogenic bacteria associated with MDR infections worldwide,” said Adriano Andricopulo, PhD, a coauthor of the article.

For the study, Righetto synthesized 20 analogs of Plantaricin 149, a substance produced by the bacterium Lactobacillus plantarum to combat other bacteria, and found that Pln149-PEP20 had the best results and was also half the size of the original peptide.

“The main advances in our research consist of the development of this smaller, more active and less toxic molecule, and the characterization of its action and propensity to develop resistance. It has proven to be highly promising in vitro – active against MDR bacteria and extensively resistant bacteria,” said Dr. Camargo.

Further research can now be conducted to investigate the molecule’s action mechanism in more depth, to look for formulations, and possibly to develop an application. “In terms of the action mechanism, it’s also possible to use the cell morphology of the bacteria to identify cellular pathways affected by the peptide,” Dr. Righetto said. “As for optimization, the molecule can be functionalized by being linked to macrostructures, and the amino acid sequence can be modified.” Research is also needed on its cytotoxicity and on its selectivity.