Laura Dorr is the former executive editor of DPR's Modern Dental Network and a regular contributing author.

Laura Dorr

Articles

Losing a tooth is a right of passage of sorts, and some parents are ensuring that it is a memorable one for their loose-toothed children. We gathered up the nine most creative, bizarre and downright insane ways that folks have pulled loose baby teeth, and boy, are they impressive.

The 9 craziest ways people have pulled teeth

	Losing a tooth is a right of passage of sorts, and some parents are ensuring that it is a memorable one for their loose-toothed children.

We gathered up the nine most creative, bizarre and downright insane ways that folks have pulled loose baby teeth, and boy, are they impressive. (Beware: many of these will make dental professionals cringe!)

	Click through the following pages to see the outrageous tooth-pulling adventures.

	Anton Androshuchk’s pet parrot is far more industrious than other birds. An aspiring dentist, the parrot has diligently pulled five of Anton’s 

 for him. Hopefully the hard-working bird will stop his teeth-pulling business before the boy’s adult chompers come in.

When tooth extractions go bad: The 9 worst at-home dentistry mistakes

 (like just waiting for a loose tooth to fall out, or seeing a dentist) aren’t nearly entertaining enough, one dad decided to make sport out of removing his daughter’s loose tooth. And what better way to remove a tooth than a bow and arrow! Though the stunt was ultimately effective, watching the girl in the video spiral through a slew of conflicting emotions makes us think that perhaps the whole thing was a bit more fun for dad than for daughter.

Related reading: The 7 weirdest dental stories of 2014

	When you’ve got a cool sports car, it only makes sense to get the most out of it. Robert Abercrombie of Florida decided that nothing could be cooler than revving up that engine and using his Camaro to pull his son’s tooth. Nothing quite like using 

 to potentially tear out a chunk of your kid’s jaw.

More strange reading: The top 5 weirdest dental crime stories

	When you’re a gold medal-winning Olympian, you want to keep your skills honed even in retirement. Retired athlete Bryan Clay, who won the decathlon in the 2008 Summer Games, used his javelin expertise for his daughter’s 

.  An award-winning tooth-pulling performance!

Weird news: Man charged with using pliers to remove women's teeth during sex

	One brave young lad took control of his own tooth removal – remote control that is. Young Easton had his tooth tied to a remote control monster truck with dental floss, and then 

. Props to him: He put the pedal to the metal and yanked the tooth right out.

Trending article: Office manager arrested after posing as dentist, performing root canals

	Fore! A dad in Tennessee took to the links to pull out his son’s tooth – 

. Little Noah Smith was concerned that pulling out his tooth would be painful, so he and father Phil Smith decided that the best way was the expeditious way. And logically, the only clear choice was a golf ball.

More weird news: Rugby players get teeth replaced with bottle openers

	Once again, a dad thought the tying-a-tooth-to-a-doorknob trick was far too passé. Malcolm Sawn of Dublin, Ireland bought a quadcopter and 

Dental surprise: Missouri baby born with two teeth

	It’s important for aspiring athletes to practice, practice, practice – but maybe they should take a break before they pull a tooth. Unnecessary, thought one boy! This dedicated youngster used his tooth extraction as an 

. Hopefully he brings that sort of dedication and drive to the ice.

Related reading: Teams - and teeth - get knocked out of the NHL playoffs

	It’s a no-brainer that smoking is bad for your health, and the health of those subjected to your secondhand smoke. Now, researchers say that secondhand smoke can have even more detrimental effects than previously believed – on the dental health of children.

, researchers in Japan investigated the effects of 

, as well as the effects of secondhand smoke on infants and small children, to see if exposure to smoke could increase risk for caries in deciduous teeth. 

Related reading: New study shows smokers are at higher risk of losing teeth

	Parents of the more than 76,000 children who participated in the study were asked to fill out questionnaires detailing the amount of secondhand smoke exposure their children experienced from pregnancy to four months old. The children attended health checkups at birth, four, nine and 18 months and at three years of age. Dental caries was assessed at 18 months and three years. For the purpose of the study, dental caries was defined as at least one filled, decayed or missing tooth.

	During the study, 12,729 incidents of dental caries were recorded. Researchers noted that four-month-old babies that had been exposed to tobacco smoke were two times as likely to have caries than children in a non-smoking home.  The effect of maternal smoking during pregnancy was not statistically significant, and did not show a remarkable difference.

Trending research: Study finds children of stressed mothers are more likely to develop cavities

	“Differences in behavior patterns were also apparent between those exposed to and not exposed to smoking, such as lack of tooth brushing and irregular consumption of sweets,” the study stated. As such, the study could not definitively determine causality of the increased rate of dental caries in children constantly exposed to smoke versus those who were not, as other factors could come into play.

, “exposure to secondhand smoke at four months of age, which is experienced by half of all children of that age in Kobe City, Japan, is associated with an increased risk of caries in deciduous teeth. Although these findings cannot establish causality, they support extending public health and clinical interventions to reduce secondhand smoke.”

	This study coincides with other recent news regarding children and secondhand smoke. As of October 1, 2015, smoking in vehicles with anyone under the age of 18 is illegal in England and Wales. The British Dental Health Foundation believes this ban will have a profound effect on children’s dental health, as it will limit secondhand smoke exposure in enclosed vehicles.

Trending article: The importance of oral cancer screening in the dental practice

	“Research has shown that a single cigarette smoked in a car with closed windows produces 11 times higher levels of secondhand smoke than in an average bar where smoking is permitted,” said 

. “This is extremely dangerous to anyone within that car, especially children whose dental health is still developing.”

	Smoking has been banned in workplaces and enclosed spaces in Britain since 2007. Under the new ban, both the driver and the person smoking in the car could be issued a £50 fine for the violation.

Secondhand smoke and incidence of dental caries in deciduous teeth among children in Japan: Population based retrospective cohort study

," was published in the medical journal 

It’s a no brainer that smoking is bad for your health, and the health of those subjected to your secondhand smoke. Now, researchers say that secondhand smoke can have even more detrimental effects than previously believed – on the dental health of children.

Study finds secondhand smoke exposure linked to increased dental decay in children

	The Trojan horse ploy worked for the Greeks, and now it’s working for researchers, too. A team from the University at Buffalo School of Dental Medicine is employing the age-old strategy to combat a common oral fungus – and it appears they will win the battle. 

, also known as candidiasis, occurs when the fungus Candida albicans builds up in the lining of a person’s mouth. The fungus causes white lesions on the tongue and cheeks, and can sometimes spread to the tonsils, gums or back of the throat.

More emerging research: Study finds nanodiamonds might prevent tooth loss after root canals

	Although it is a normally harmless fungus that exists in many people’s mouths, oral thrush can be problematic for patients with compromised immune systems, such as people with 

, or those using antibiotics or undergoing chemotherapy. People who wear dentures or orthodontic appliances are also at increased risk, as the fungus is adept at binding to plastic surfaces.

	“Many people who wear dentures, use inhalers, or have been treated with antibiotics develop oral fungal infections, and this infection is very resistant to treatment with most available drugs,” said study leader 

University at Buffalo Department of Oral Biology

	Medications for oral thrush do exist, but the medicine is generally very bitter, so many patients do not follow the prescribed treatment in its entirety. This is problematic, as it allows the fungus to reoccur since it was never completely eradicated. The University at Buffalo researchers will evaluate the efficacy of using sugars and proteins that exist naturally in saliva with the hopes of developing an effective – and better-tasting – treatment for the fungus.

More emerging research: Will humans soon be able to regrow teeth? New research gets one step closer to making it happen.

, Edgerton found that glucosamine could make fungi more receptive to outside compounds. When combined with histatin, an antifungal protein found in saliva, researchers found that the glucosamine made it easier for the antifungal protein to enter the fungus. By additionally binding the protein to 

, a polyamine compound found in ribosomes, the researchers will create a bio-peptide to further enable entry, essentially disguising the fungus-fighting protein inside a “Trojan horse.”

	The team will study the effectiveness of the bio-peptide in mice, and will also evaluate a glucosamine mouthwash to see if it further primes the fungus to allow entry by the bio-peptide. According to a University at Buffalo 

, “Edgerton hopes to find optimal dosage and treatment procedure to fight the infection in humans.”

The Trojan horse ploy worked for the Greeks, and now it’s working for researchers, too. A team from the University at Buffalo School of Dental Medicine is employing the age-old strategy to combat a common oral fungus – and it appears they will win the battle.

Researchers developing ‘Trojan horse' to combat oral fungus

	Knock out an adult tooth and you’re out of luck: Humans only get two sets of teeth that have to last for an entire lifetime. Not true for one type of fish, that can constantly regrow teeth to replace missing ones – a fish that researchers hope holds the secret to tooth regeneration in humans.

, which can go through hundreds of teeth during their adult lives. Examining embryonic fish, researchers attempted to identify structures that trigger new tooth growth, and determine how long those structures remain active.

	Lake Malawi cichlids, native to their namesake 

 in Tanzania, are small fish that live among the piles of rocks on the rocky shores of the lake and eat predominantly algae. In this type of cichlid, taste buds and teeth both grow from the same epithelial tissue, and, since fish have no tongues, taste buds grow interspersed among the teeth. The epithelial tissue in the developing jaws of the cichlids differentiates later in development, with some tissue becoming teeth with dentine and enamel, and some growing into softer taste buds. 

	There are two types of Lake Malawi cichlids that have adapted in different ways to the environment, with one developing more teeth and taste buds. By crossing the two species, researchers were able to examine genetic differences and differing numbers of teeth and taste buds in second-generation hybrids, effectively mapping the genome that controls the development of the different structures.

Related reading: Everything we need to know about teeth, we learned from Shark Week

	“Using a combination of genome mapping, synexpression analysis and small-molecule manipulation, we identify factors that couple tooth and taste bud density … and those that differentiate the identity of each organ,” 

	After identifying the genes that controlled the “correlation between tooth and taste bud densities,” researchers then exposed embryotic cichlids to chemicals that influenced the development of teeth and taste buds to manipulate the progression of one over the other. They were able to boost the growth of taste buds over teeth, but only at an early developmental stage when the fish were still developing jaws.

	“There appear to be developmental switches that will shift the fate of the common epithelial cells to either dental or sensory structures,” said 

	The study indicated that with the right stimulation, human epithelial tissue might also be manipulated into regenerating new teeth. However, researchers would still have to determine the development of blood vessels and nerves in teeth before the teeth would be completely viable, but the research team believes it is a step in the right direction. They will next examine how far into adulthood the plasticity extends in terms of differentiation in development.

Related research: New study finds beaver teeth could provide insight on human tooth decay

	“It was not previously thought that development would be so plastic for structures that are so different in adult fish,” Streelman said. “Ultimately, this suggests that the epithelium in a human’s mouth might be more plastic than we had previously thought. “

	The study also examined dental differentiation in mice, which also indicated that the ability to grow new teeth might extend further into development than previously believed.

More emerging research: Can daily doses of a sugar subsitute reduce the risk of caries?

	“The exciting aspect of this research … is being able to identify genes and genetic pathways that naturally direct continuous tooth and taste bud development in fish, and study those in mammals,” 

, a professor from King’s College. “The more we understand the basic biology of natural processes, the more we can utilize this for developing the next generation of clinical therapeutics.” 

Coevolutionary patterning of teeth and taste buds

Proceedings of the National Academy of Sciences

Knock an adult tooth out, and you’re out of luck: Humans only get two sets of teeth that have to last for an entire lifetime. Not true for one type of fish, that can constantly regrow teeth to replace missing ones – a fish that researchers hope holds the secret to tooth regeneration in humans.

Will humans soon be able to regrow teeth? New research gets one step closer to making it happen.

	Anyone who’s had a fixed orthodontic appliance knows how frustrating oral hygiene can become. Fixed appliances often make the perfect breeding ground for bacteria and plaque, which can accumulate under the appliance. In an attempt to abort development of plaque-causing bacteria, researchers recently examined if daily doses of xylitol could make a difference.

 has discovered that many plaque bacteria are unable to ferment 

, a caloric sugar substitute used as a sweetener, into cariogenic end products. Due to this, xylitol inhibits bacterial growth. With this in mind, researchers hoped to discover if certain delivery methods of xylitol would be more effective in reducing plaque, and evaluate the long-term effects of xylitol on plaque.

 examined 41 young adults and adolescents who were undergoing orthodontic treatment. The study participants all had a full fixed appliance and no active dental decay. Divided into three groups, the first group of patients was given xylitol chewing gum and was instructed to chew six pieces of the gym per day for three months, for no less than five minutes.

	The second received xylitol chewable mints, of which they had to consume 12 per day for three months.  The third group acted as a control, and was not given any xylitol. All three groups were put on a six-month-long topical fluoride and cleaning schedule, and received oral hygiene instructions. Clinical examinations were performed at the start of the study, and at three, six and 12 months to evaluate caries, plaque and gingival scores and labial decalcification.

Trending research: Dental caries susceptibility linked to ... your hair?

	After the last evaluation, researchers did not see a pronounced difference in plaque scores or other indicators between the groups taking xylitol and the control group. Ultimately, it was determined that xylitol does not have a bacterial benefit to patients with fixed orthodontic appliances. Conversely, the study did find that xylitol did not increase the risk of dental caries, and had no negative effects on orthodontic appliances.

	Although xylitol did not make a difference in caries development rates, the study found that the oral hygiene instructions and the topical fluoride applications did reduce plaque and bacterial counts across the board, proving the importance of oral hygiene education and proper oral hygiene routines.

 in Saudi Arabia funded the research. Entitled "

Long-term clinical and bacterial effects of xylitol on patiente with fixed orthdontic appliances

," the study will be published in the December issue of the journal 

Anyone who’s had a fixed orthodontic appliance knows how frustrating oral hygiene can become. Fixed appliances often make the perfect breeding ground for bacteria and plaque, which can accumulate under the appliance. In an attempt to abort development of bacteria, researchers recently examined if daily doses of xylitol could make a difference.

Can xylitol reduce the risk of caries in patients with orthodontic appliances?

	With the debate about Planned Parenthood raging, Louisiana attorneys set out to put together a list of health care providers that could provide equivalent family-planning care should Planned Parenthood be defunded. However, the list included some unconventional options – options that left many people skeptical and scratching their heads.

	In response to the contentious videos reportedly depicting Planned Parenthood employees selling fetal parts in August, Louisiana 

 moved to cut off $730,000 in Medicaid reimbursements received by the two Planned Parenthood clinics in the state. Planned Parenthood requested an

 to block Jindal’s movement. According to a 

, the clinics in Louisiana do not provide abortions, but offer STD and cancer screenings, contraceptives and pap smears to low-income women on Medicaid.

Trending article: The top 10 things you need to know about ICD-10

	Attorneys representing the Louisiana Department of Health and Hospitals, looking to get a ruling on the legality of ending Planned Parenthood’s Medicaid contracts, presented a federal court judge with a list of over 2,000 family-planning providers in the state that could accommodate patients previously utilizing the clinics’ services. However, the judge found that the list included hundreds of specialists not usually associated with family planning, such as dentists, ophthalmologists, cosmetic surgeons and ear, nose and throat doctors.

	Dentists providing family-planning services? The 

. “It strikes me as extremely odd that you have a dermatologist, an audiologist, a dentist who are billing for family-planning services,” said Judge John deGravelles. “You’re telling me they can provide family planning and related services?”

	Attorneys for Planned Parenthood were also skeptical. "The list the defendent [Louisiana Department of Health and Hospitals] provided appears to be a list of all enrolled Medicaid providers," 

, attorney for Planned Parenthood. "There are numerous examples of ... providers that would not provide the care that Planned Parenthood provides, including dentists, radiologists, nursing homes, places that are not going to do breast cancer screenings or give out birth control."

	But the state did not withdraw the list without a fight. A Louisiana attorney stood by the list, saying that dentists could indeed provide family-planning services. According to 

, Judge DeGravelles asked the attorney “We have dentists on there, sir. There are dentists listed ... You’re telling me that they can provide family planning and related services?”

	“They have,” said the attorney. “That what I’m telling you, Judge."

	The attorney acknowledged that the dentists had been included on the list because "what they did was pull a code run and they matched the codes that are typically billed ... codes that were typically family-planning codes," implying that these dental practices on the list had at one time billed an 

 that fell within a loose collection of codes the state associated with family planning.

	Under the judge's scrutiny, the state ultimately submitted a new list of health care providers that could legitimately offer the services. 

	The Louisiana Department of Health and Hospitals 

 that “ dentists should not have been included in” the list. The revised list consisted of just 29 providers, down from the initial list of over 2,000. 

	"There are huge needs in the state for [Planned Parenthood] services," said Flaxman. "If the patients could find other providers to provide the care the defendent will be paying for those services under its obligations anyway under Medicaid."

With the debate about Planned Parenthood raging, Louisiana attorneys set out to put together a list of health care providers that could provide equivalent family-planning care should Planned Parenthood be defunded. However, the list included some unconventional options – options that left many people skeptical and scratching their heads.

Should dentists provide family-planning services?

When you've been in the dental industry for awhile, it can be hard to look at it with fresh eyes. This makes it important to listen to the new voices entering the industry and hear about their experiences, the challenges they face and perhaps, most importantly, the things the industry needs to address.

	In an effort to do just that, Dental Products Report sat down with 

, a 2012 graduate of Case Western Reserve University School of Dental Medicine, to talk about her experience entering the dental world as a young, female dentist. Dr. Sanders owns 

, in rural Frenchtown, Montana, a one-dentist clinic with 

. The general practice offers comprehensive care, and primarily sees patients for routine matters such as cleanings, fillings or crowns.

Related reading: Dental Products Report's Top 25 Women in Dentistry for 2015

As a newer dentist, what challenges have you (or your fellow classmates) faced?

	One big challenge is trying to find a good place to practice. It seems that some of the older dentists are putting off retirement longer than they had planned, or trying to sell their practices but then changing their minds and going back into practice. It makes it confusing and challenging for new dentists interested in buying practices. There’s also a lot of doom-and-gloom attitude out there about how dentistry used to be so much better pre-recession in 2008. As a new dentist who started dental school in 2008, I find that mentality frustrating. There seems to be a lot of looking back but not a lot of looking forward in the industry.

	From a patient standpoint, I think the biggest challenge is managing patient attitudes. It's hard to have patients come in who have had negative dental experiences and say they hate the dentist. It's very challenging to try and give these people the most positive experience possible and try to change their opinions.

Trending article: Why patient education is crucial to case acceptance

What do you wish someone had told you about the industry before you started? Have their been any surprises?

	I think going into it, you view it as “I’m going to be a dentist,” and you don’t think about how you also need to be a businessperson. One thing I’ve been surprised by is how many things you can do with a dental degree; there are a lot of different options and career paths you can take these days. It’s not just the stereotypical idea of dentistry where you automatically end up in an office by yourself doing fillings. I’m interested to see in 15 years how many of the people I graduated with are still doing the usual private-practice dentistry.

Continue to page two to read more from Dr. Sanders...

Do you feel you face any particular challenges being a female dentist?

	Some people automatically assume I am not the dentist, or that I don’t know what I am talking about because I am younger and female. On the other hand, some people assume I will be gentler because I am female.

Tending article: The latest hourly and annual salary numbers for dentists, dental hygienists and dental assistants

As a female, what do you think you notice differently about the dental industry?

	Advertising is really geared towards middle-aged males. When I go to a dental meeting, everyone assumes I am a hygienist. I think there are strict gender role expectations. This is something I feel needs to change. In medicine, there are starting to be many more male nurses; I think medicine is ahead of dentistry in evening out these gender gaps.

What would you tell other women about becoming a dentist?

	I would encourage anyone who’s thinking about going into dentistry, as it offers a certain flexibility and lifestyle that is very appealing. I think this is particularly trye for women who want a more flexible schedule, and more of a work-life balance. I think it’s worth the time and effort to become a dentist.

Trending article: The evolution of dentistry: What dentists say the biggest changes have been

What do you think needs to change in the dental industry?

	We need to be less separated from our other medical colleagues. The old perception that the mouth is not part of the body is starting to go away, so we’ll need to work more closely with all of our patients’ caregivers to provide the best possible care.

	You can read more about Dr. Sanders’ experiences, as well as those of many other female dental professionals, in the September “Top 25 Women in Dentistry” issue of Dental Products Report. 

When you’ve been in the dental industry for a while, it can be hard to look at it with fresh eyes. This makes it important to listen to the new voices entering the industry and hear about their experiences, the challenges they face and perhaps, most importantly, the things the industry needs to address.

6 things the dental industry needs to address now

	Everyone knows smoking is bad for your lungs, but new research has confirmed that smoking is also a bad idea if you want to keep your teeth.

 in Germany examined a group of over 23,000 subjects to explore the relationship between cigarette smoking, smoking cessation and rates of tooth loss.

 is a predominant cause. Since smoking can mask symptoms of periodontitis such as gum bleeding, a smoker’s gums may appear healthier than they really are. As such, dentists may miss key clues that could indicate severe gum disease. 

According to the American Academy of Periodontology

, smokers have an increased prevalence and severity of periodontal disease, and make up 86 to 90 percent of refractory periodontics cases.

Trending research: New study finds blueberries could reduce antibiotic use for treating gum disease

	“Most teeth are lost as a result of either caries (tooth decay) or chronic periodontitis (gum disease),” 

said lead author Professor Thomas Dietrich

. “We know that smoking is a strong risk factor for periodontitis, so that may go a long way towards explaining the higher rate of tooth loss in smokers.”

	Ultimately, the study concluded that smokers are at higher risk of losing teeth than those who say no to cigarettes. Researchers also reported that male smokers are up to 3.6 times more likely to lose their teeth than their non-smoking counterparts. Women who smoke were 2.5 times more likely to lose teeth.

	Young smokers and pack-a-day folks should be even more concerned: The association was stronger in young people and heavy smokers.

Related reading: Only 10% of smokers receive advice form dental professionals to quit

	“The association between smoking and the incidence of tooth loss was stronger in men than women and stronger in younger versus older individuals," 

. "Heavy smoking (15 or more cigarettes per day) was associated with three times higher risk of tooth loss in men and more than twice the risk of tooth loss in women.”

	Luckily, researchers stated in the study, if smokers quit the habit, their risk of tooth loss is reduced to that of non-smokers: “Smoking cessation was consistently associated with a reduction in tooth loss risk,” the study concluded, “with the risk of tooth loss approaching that of never smokers after approximately 10 to 20 years of cessation.”

Smoking, smoking cessation, and risk of tooth loss

A recent study in Germany examined a group of over 23,000 subjects to explore the relationship between cigarette smoking, smoking cessation and rates of tooth loss.

New study shows smokers are at higher risk of losing teeth

When dental problems necessitating surgery arise, the logical response is to treat the condition. However, recent research has found that numbing children up for dental procedures may be causing damage to the very teeth the dentist is trying to treat.

 examining local anesthetic and tooth cell growth discovered that prolonged exposure to high concentrations of local anesthetic had increasingly detrimental effects on tooth development. The use of local anesthetic is more prevalent in dental treatment than any other clinical area, the 

, making this discovery especially pertinent to dentistry. This is especially critical in a time when more and more children undergo dental procedures.

Related reading: Did dental anesthesia cause one man's bizarre amnesia?

	While dosage limits of local anesthetics have been researched and established, no prior work had been done on the potential side effects of anesthetics on dental tissue. The only 

, conducted on dogs, reported that local anesthetics could accumulate in tooth crypt buds or the mandibular canal, but effects of this accumulation were not examined.

 study, researchers used human tooth pulp cells and pig teeth to study how local anesthetics affected the cells. Pulp cells are crucial to tooth development and dentin repair, and the effects of the anesthetic on these cells was evaluated by measuring cell proliferation, differentiation and apoptosis.

	Local anesthetic was found to stunt tooth cell growth by interfering with mitochondria in the tooth and inducing 

, a mechanism of cell degradation and destruction that balances sources of energy in critical times in development.

, “our findings that local anesthetics can induce autophagy in tooth pulp cells have clinical implications, due to their potential impacts on tooth development as well as root formation and apical foramen closure.”

Other emerging research: New study finds blueberries could reduce antibiotic use in treating gum disease

	Anesthetics commonly used in dental clinics in the UK, China and Switzerland, including two articaine-based drugs, a mepivacaine-based drug and a Lidocaine-based drug, were used in the study. Researchers did not compare the similarities and differences between the different types of anesthetic, but focused on the common effects.

, the study emphasized that despite the discovery of the potentially harmful effects, further research is necessary before any review of clinical guidelines, and that necessary dental treatment should not be avoided due to these findings. Dr. Bing Hu concluded, “Future in vivo validation of our findings will be plausible to further enhance our knowledge about the clinical impacts of these local anesthetic drugs.”

Local anesthetics induce autophagy in young permanent tooth pulp cells

" was published on September 7, 2015, in 