Impressions

Jagged1 Protein Transforms Gum Stem Cells into Bone Cells

A recent study found that small RNA molecule activity changes occur when stem cells in the gums are treated with a specific protein, known as Jagged1. This change in activity helps the cell develop into bone cells, a highly effective treatment for gum disease. Researchers at the Center of Excellence for Dental Stem Cell Biology, Chulalongkorn University, Bangkok, Thailand employed NanoString analysis to identify 26 miRNAs that were differentially expressed (9 upregulated and 17 downregulated) in Jagged-treated PDLSCs compared to untreated controls, investigating the microRNA expression profile in human periodontal ligament stem cells (PDLSCs) treated with the Notch ligand Jagged1, which is known to promote osteogenic differentiation.

They found that the RNA molecules play a role in important cell processes, like how they grow, interact and move. Specifically, researchers discussed the potential roles of these miRNAs in modulating osteogenic differentiation of PDLSCs by regulating diverse signaling pathways like TGF-β, Wnt, and Hippo. However, they noted that the study was done in a lab setting and additional research is required to fully understand how Jagged1, RNA molecules and bone cell formation work together.

Overall, this study provides insights into the miRNA expression changes induced by Jagged1 in PDLSCs and their potential regulatory roles in osteogenic differentiation and stem cell properties, highlighting their promise for regenerative applications in periodontal diseases.

The research was published in BDJ Open.

New Report: Investing in Oral Health Key to Reducing Health Care Costs

A new white paper published by The American Dental Association (ADA) highlights that improvement of oral health can increase economic opportunities, enhance overall well-being and ultimately reduce health care costs. ADA, Colgate-Palmolive Company and Henry Schein collaborated to publish the document.

The report highlights that in the U.S., people with heart disease saved up to $675 per year on health care by taking advantage of regular preventive dental care. For those with diabetes, the savings ranged from $900 to $2,840. For patients with multiple chronic conditions that number was even higher. Also, better oral health decreased medical costs associated with pregnancy by a range of $1,500 to $2,400 per pregnancy.

Oral health is critical not just for enabling basic functions like eating and speaking, but also for overall health and well-being. Poor oral health is associated with many other serious health conditions like diabetes, stroke, dementia, heart disease and adverse pregnancy outcomes. As such, prioritizing oral health can provide significant economic benefits by reducing health care costs associated with treating these linked conditions.

The report confirms that prioritized oral health interventions promises significant returns in reducing health care costs, boosting workforce productivity and earnings, and promoting greater equity in both health and economic outcomes globally.

Strong Correlation Between PTSD and Daytime Teeth Grinding

A recent study found a significant association between PTSD and awake bruxism, a condition that causes clenching or grinding of the teeth during the day. Specifically, researchers at the University of São Paulo in Brazil found that patients with PTSD exhibited higher rates of bruxism and associated orofacial pain, emphasizing the need for collaboration between mental health and dental health professionals to improve treatment and diagnosis. Also, suggesting that bruxism could be a physical symptom of psychological distress.

Researchers clinically examined 76 patients diagnosed with PTSD at the university’s Institute of Psychiatry, along with control participants without PTSD. Despite having similar levels of oral hygiene as controls, the PTSD patients exhibited significantly lower pain thresholds and reported higher levels of pain during the oral examinations. This suggested a potential connection between their psychiatric condition and orofacial pain symptoms.

The PTSD patients also self-reported higher rates of awake bruxism compared to general population estimates of 8-30% prevalence. The researchers suggest that this bruxism could be a physical manifestation of the psychiatric distress experienced by those with PTSD, which is characterized by symptoms like flashbacks, negative emotional states, troubled sleep and dissociation. Researchers recommend that dentists use psychiatric screening tools during routine exams to identify potential underlying conditions like PTSD that may contribute to oral issues like bruxism. Conversely, practitioners treating PTSD patients should inquire about orofacial problems and recommend dental referrals when appropriate.

By taking this collaborative approach, the authors assert that both the psychiatric and oral health aspects can be properly diagnosed and treated in a comprehensive manner, ultimately improving the quality of life for individuals struggling with the debilitating effects of PTSD. The study highlights bruxism as a potential red flag for deeper psychological trauma that requires careful clinical attention.

This study was published in the journal Clinical Oral Investigations.

Study Finds Resin-Based Sealants Marginally More Effective Than Fluoride Varnish for At-Risk Kids

A new study found that resin-based fissure sealants (FS) deliver statistically but marginally higher clinical effectiveness than fluoride varnish (FV) in preventing caries in permanent molars of at-risk kids over a three-year span. This suggests that while FS may be slightly more effective, the difference may not be clinically significant when factoring in costs and practical application in a pediatric dental practice.

The study compared the 36-month effectiveness of FS vs. FV for preventing caries on permanent first molars in 409 high caries-risk children aged 6-10 years old. In the intention-to-treat analysis of the 369 children (90%) who completed follow-up, FS demonstrated a statistically significantly higher adjusted predicted probability of success (94.1%) compared to FV (89.6%). After adjusting for factors like baseline caries status, the FV group had 54% lower odds of success versus FS.

The findings were consistent in sensitivity analyses using the per-protocol set and adjusting for clinic county. However, the number needed to treat with FS to prevent one additional unsuccessful outcome versus FV was a relatively high 25. This, combined with the < 10% absolute difference in success rates, led the authors to conclude the statistical difference may not represent a clinically significant advantage for FS. Strengths of the study include the practice-based design enhancing real-world generalizability, high 36-month retention rate, and the split-mouth design controlling for patient-level confounders. Limitations were the moderate inter-rater reliability on caries assessments and some protocol deviations like 35% of the FS group also receiving FV, which could increase costs.

While supporting current guidelines recommending FS over FV in this population, the authors acknowledge the findings question whether the modestly higher effectiveness of FS justifies preferential selection over FV when considering costs and clinical significance. They suggest this first long-term pragmatic trial provides important evidence to reevaluate recommendations as sealants and fluorides continue evolving.

The research was published in Journal of Dental Research.

Study Finds Poor Oral Health Strongly Correlated with Higher Frailty Levels in Older Adults

A recent study found a significant negative correlation between oral health and frailty among older adults, an indicator that poorer oral health is associated with higher levels of frailty. The study examined the relationship between subjective oral health and frailty levels among 321 community-dwelling older adults aged 65 and above. It utilized the Geriatric Oral Health Assessment Index (GOHAI) to measure self-reported oral health and the Edmonton Frail Scale (EFS) to assess frailty. Overall, the study highlights the importance of integrating oral health into frailty screening and geriatric care to promote healthy aging.

The results revealed over half (52.6%) of the participants had poor oral health, and 56.1% exhibited varying degrees of frailty. More importantly, a significant negative correlation (r=-0.539) was found between GOHAI and EFS scores, indicating that as oral health declined, frailty levels increased. Through multivariate analysis, education emerged as the factor with the highest impact on both oral health and frailty measures. Higher education levels were associated with better oral health and lower frailty. Other factors like chronic disease, tooth brushing frequency, age and sex also significantly influenced frailty, but not oral health.

The strong inverse relationship between subjective oral health and frailty aligns with prior research highlighting oral health as a potential precipitating factor for frailty. Poor oral hygiene, tooth loss, chewing difficulties and compromised nutrition can contribute to the cycle of declining health and increased vulnerability. The findings emphasize the importance of maintaining good oral hygiene practices and regularly getting oral health care, particularly for less educated older adults who may face barriers to oral care. Integrating oral health into frailty screening and multi-disciplinary geriatric care could help identify and manage these interconnected issues.

The research was published in Public Health Nursing.