Sarah Handzel, BSN, RN

The root canal, known as a painful, costly procedure with multiple risks, just recieved an upgrade thanks to researchers from Oregon Health & Science University 

Each year, over 15 million root canals are performed by dentists around the country. In a new report published in 

, researchers from Oregon Health & Science University detail a 

 to complete this common treatment using prefabricated blood vessels created from endothelial cells. These cells make up the interior lining of blood vessels throughout the body. The hope is that this new procedure 

 in which synthetic biomaterials are used to replace infected dental tissues 

 could replace the current method of performing root canals.

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Principal investigator Luis Bertassoni, D.D.S., and colleagues were inspired by modern 3D printing techniques to try to create new blood vessels in a laboratory setting. A fiber mold made of sugar molecules was first placed across the root canal of already extracted human teeth. Then, the team injected a gel-like material containing dental pulp cells into the space. The sugar fiber was removed to create a long channel within the root canal. Finally, endothelial cells were inserted into the channel.

After a period of seven days, the research team noted artificial blood vessels forming within the tooth, along with dentin-producing cell proliferation.

“(Root canals eliminate) the tooth's blood and nerve supply, rendering it lifeless and void of any biological response or defense mechanism,” Bertassoni 

. “Without this functionality, adult teeth may be lost much sooner, which can result in much greater concerns, such as the need for dentures or dental implants.”

Bertassoni added that the result verifies that the construction of artificial blood vessels can be a highly effective strategy for fully regenerating the function of teeth.

“We believe that this finding may change the way that root canal treatments are done in the future,” he says.

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Articles

Root canals are one of the most dreaded procedures for patients. At Oregon Health & Science University, principal investigator Luis Bertassoni, D.D.S., and his team have discovered a new method that uses synthetic means to repair infected dental tissue. Inspired by the latest technology, this development has the potential to revolutionize dental care. Read more about the report and the benefits of the improved root canal procedure. 

Could Prefabricated Blood Vessels Change Root Canals Forever?

For children at greater risk for dental disease, early preventative care is imperative. 

A pilot program launched by the University of California, Los Angeles (UCLA) is expected to increase coverage for preventative dental care for up to 500,000 Los Angeles children who are enrolled California’s Medicaid program, Medi-Cal. The program is part of the Medi-Cal 2020 Dental Transformation Initiative, a bigger project that is expected to continue through December 2020.

Currently, 6.1 million children and teens are enrolled in Medi-Cal, but only about one-third of those children receive preventative dental care each year. UCLA’s new program intends to address the discrepancy by focusing on 

1. The expansion of preventative services in both dental clinics and community settings

2. The coordination of oral healthcare services among providers from dental, medical, and community clinics

3. The use of information technology (IT) to boost both the quality and continuity of care

The new program already features collaboration between several entities, including local dental and medical organizations, Medi-Cal and Denti-Cal, early childhood programs, and the UCLA Fielding School of Public Health. There are also plans for UCLA’s dental school to increase cooperation with Los Angeles County agencies, organizations, and community programs already focused on improving the health and lives of children and families living in the area.

James Crall, the program director and professor of public health and community dentistry at UCLA School of Dentistry, 

, “The Dental Transformative Initiative provides an incredible opportunity to expand UCLA’s recent work with local community partners to improve the oral health of children at greatest risk for dental disease throughout Los Angeles County.”

Crall continues, “Given that one-quarter of all California children enrolled in Medi-Cal live in Los Angeles County, we clearly need to engage more critical stakeholders to create the meaningful system changes that will truly transform oral health care for children on Medi-Cal.”

Dental care is an essential piece of everyone's health, but for children, having access to a dental provider is especially urgent. For the half-million Los Angeles children enrolled in Medi-Cal, that urgency is being recognized in the form of increased coverage for preventative care. Continue below to learn about UCLA's efforts to create a generation of healthy smiles. 

UCLA Heads Project to Increase Preventative Dental Care

Several new partnerships will lead to consolidated, more comprehensive and engaging conferences over the next three years.  

The American Dental Association (ADA) has announced a partnership with several other dental organizations to create more impactful dental meetings through 2020. Collaborative efforts include combining three dental conventions in 2019 and two in 2020 to better enhance the experience for attendees, guests and exhibitors.

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One of the joint meetings will be held in September 2019 and will feature collaboration between the ADA, FDI World Dental Federation (FDI), the California Dental Association (CDA) and the San Francisco Dental Society (SFDS). Also in 2019, the ADA will work with the World Dental Federation, CDA and SFDS to host the FDI World Dental Congress, which typically sees large numbers of attendees and guests. At this meeting, the ADA’s 160th anniversary will be celebrated.

Regarding the 2019 FDI World Dental Congress, FDI president Patrick Hescot says, “FDI is excited to combine organizational expertise to produce an engaging scientific program, as well as host what should be one of the largest exhibitions ever seen at FDI’s World Dental Congress.”

In 2020, the ADA plans to consolidate meetings with the Florida Dental Association (FDA). The organization is exploring other opportunities for collaboration with other professional dental groups for increased conference offerings in the same year.

“Because of the willingness to partner, a number of dental tradeshows will be combined,” Gary Roberts, President of the ADA, 

. “This approach makes great sense because it saves everyone time and money. Rather than wonder which meeting to attend or exhibit at, the choice is now easy.”

It is already the policy of the ADA to work with both state and local authorities as national meetings take place around the country. Another optional model, recently added to the ADA policy, is already showing positive results. 

The formation of a new partnership between the ADA, FDI World Dental Federation, California Dental Association (CDA) and more has materialized in an effort make dynamic dental conferences. In the future, attendees and vendors can expect engaging programs and experiences. Continue below to learn more about the collaborations.

More Impactful Dental Meetings Goal of New ADA Collaboration

In a recent study, participants who used marijuana regularly had higher rates of gingivitis and other gum disease.

Researchers at Columbia University have completed a study linking recreational cannabis use — including hashish and hash oil – to periodontal disease. The study, published in the 

, is one of the first of its kind to suggest a relationship between cannabis use in a variety of forms and gum disease. While other factors, such as tobacco use, are already known to cause periodontitis, cannabis use has not previously been identified as a risk factor for the disease.

The lead author of the study, Jaffer Shariff, D.D.S., noticed a relationship between frequent recreational cannabis use and periodontal disease during his residency training. To complete the 

, Shariff and his colleagues used data from the 2011-2012 National Health and Nutrition Examination Survey (NHANES), specifically self-reported data regarding cannabis use among study participants.

More than 1,900 participants were included in the study. Of those who participated, almost 27 percent were self-reported recreational cannabis users who used cannabis in one or more forms at least once over the course of a year. Measurements including probe depth and gum attachment loss were used to determine each patient’s degree of periodontal disease.

The study showed that frequent cannabis users had more gingival sites with pocket depths deep enough to indicate moderate to severe periodontal disease. Less frequent recreational cannabis users did not have such sites.

, “It is well known that frequent tobacco use can increase the risk of periodontal disease, but it was surprising to see that recreational cannabis users may also be at risk. The recent spate of new recreational and medical marijuana laws could spell the beginning of a growing oral public health problem."

Shariff continued, “Even controlling for other factors linked to gum disease, such as cigarette smoking, frequent recreational cannabis smokers are twice as likely as non-frequent users to have signs of periodontal disease. While more research is needed to determine if medical marijuana has a similar impact on oral health, our study findings suggest that dental care providers should ask their patients about cannabis habits."

Everyone knows about the damage tobacco can cause to one's oral health, but according to a new study from Columbia University, the risks can extend to another habit. For frequent recreational marijuana users, the risk of gum disease is apparently present, a surprising discovery for the researchers. Users of marijuana in other forms are vulnerable as well. Continue below to learn more about the relationship between frequent marijuana use and periodontal disease. 

New Study Suggests Link Between Gum Disease and Cannabis Use

In an effort to reach Latinos in the U.S., Colgate and the ADA are continuing their partnership for the Share More Time, Share More Smiles campaign.

In time for Oral Health Month, the American Dental Association (ADA) has announced its continued partnership with the Colgate-Palmolive Company in support of Colgate’s Share More Time, Share More Smiles awareness campaign. Through June 30, 2017, patients and families can share pictures and videos on social media platforms using #TimeToSmile. For each image or video posted, shared or liked using #TimeToSmile, Colgate will donate $1 to the ADA Foundations’s 

The awareness campaign is especially geared toward Hispanic families. Historically, Hispanic adults in the U.S. have higher rates of untreated dental caries compared to non-Hispanic patient populations. What’s more, Hispanic children miss millions of hours of school time due to untreated dental disease.

“Colgate is committed to improving children's oral health around the world. Share More Time, Share More Smiles gives us the opportunity to make this happen,” 

 Carla Kelly, general manager of U.S. Multicultural Marketing at Colgate-Palmolive. “As a platform that engages with the entire Hispanic family, we can give parents the tools to adopt healthier oral care habits and encourage more generations of healthy smiles.”

The Share More Time, Share More Smiles movement also provides oral health educational materials in bilingual formats. Patients and families can access bilingual children’s activity sheets and infographics at 

. Additionally, the ADA provides bilingual videos, articles, and downloadable family activities at 

“Healthy habits that start in childhood last a lifetime,” ADA President Gary Roberts 

. Leading by example — brushing for two minutes, twice a day with fluoride toothpaste and visiting a dentist regularly — teaches kids about the importance of dental health and creates fun family memories along the way."

This month, Colgate's Share More Smile More campaign is taking aim at the oral health of Hispanic communities within the U.S. Partnering again with the American Dental Association, Colgate has pledged to donate $1 to the Give Kids a Smile® program each time someone interacts with #TimetoSmile. Keep reading about the campaign and its goals below. 



For Oral Health Month, ADA Partners with Colgate to Create More Smiles

Researchers used lazers to to assess metal exposure in autistic subjects, finding that factors such as lead could be a direct cause.

 from the Centers for Disease Control and Prevention (CDC) estimates that as many as one in 68 children in the U.S. have some form of Autism Spectrum Disorder (ASD). As researchers explore environmental factors that could cause autism, a new 

 has been published that suggests exposure to heavy metals, including lead, may be a predetermining factor for the development of autism. Using lasers, researchers analyzed growth rings in naturally shed baby teeth to accurately extract specific layers of dentine.

The numbers are high, but a definitive cause of autism has not been identified, and researchers believe the condition develops as a result of interactions between a person’s genetic makeup and the environment.

While there have been studies published previously that link heavy metal exposure to autism, the new study is unique in that researchers were able to assess metal concentrations in the teeth. The study involved the teeth of 32 pairs of twins, in addition to the teeth of 12 individuals from twin pairs. In pairs of twins in which one twin is diagnosed with autism, the teeth of the affected child showed large differences in metal uptake levels, including much higher levels of lead in the dentine. The researchers noted the period after the twins’ birth showed the greatest difference between lead levels in children with ASD compared to children without the condition.

The research team also examined levels of zinc and manganese. It was shown that zinc levels were lower in children with ASD during the prenatal period, but that these levels increased beyond those in children without ASD in the period after birth. Children with ASD were found to have less manganese compared to children without ASD both prenatally and postnatally.

“We think autism begins very early, most likely in the womb, and research suggests that our environment can increase a child’s risk," Cindy Lawler, Ph.D., 

. "But by the time children are diagnosed at age three or four, it’s hard to go back and know what the moms were exposed to. With baby teeth, we can actually do that.”

While science has yet to find a definitive cause of Autism Spectrum Disorder, recent studies suggest a connection between heavy metals like lead. Using baby teeth, researchers were recently able to assess metal concentrations in 32 pairs of twins, the results of which suggest exposure to heavy metals may be a directly associated with the development of ASD. Read on to learn more about how the researchers reached their conclusions. 

Autism Study Analyzes Baby Teeth to Uncover Link to Heavy Metal Exposure

Dentists in Illinois are owed more than $200 million for services provided to state employees.

 in the Chicago Business Journal, the state of Illinois is on the hook for more than $200 million that’s owed to dentists across the state. The sum covers a variety of dental services provided to state employees in 2016 and 2017, many of which are covered by Delta Dental of Illinois. To make ends meet while waiting on payment, many dentists are cutting their own salaries and taking out additional loans just to keep their practices open.

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Overall, Illinois owes more than $13.02 billion to various businesses and organizations. As state vendors wait to receive payment, the state governor and members of the General Assembly are at an impasse regarding the state’s budget.

Many dentists are suffering while they wait for the state to reimburse them. Kent Splaingard, D.D.S., 

 the Journal, “We’ve gone all of ‘16 and the first part of ‘17 with no claims paid.”

He believes his practice can make it through the payment waiting period, but is still currently owed over $62,000 by Delta Dental of Illinois.

 more than $200,000 since the state stopped paying him for common dental procedures, like teeth cleanings and crowns. To keep his practice open, he’s taken out almost $60,000 in loans.

In response to the budget dilemma, Senator Scott Bennet has proposed legislation that would allow dentists who haven’t been paid for six months following submission of a claim to require state insurance-covered patients to pay upfront for any and all services. The Illinois State Dental Society, a lobbying group, is also advocating for a program that would allow dentists to sell unpaid bills to a participating financial institution. The institution would pay some of the bills immediately, and dentists would collect the remaining funds when the state finally pays its bills.

As dentists wait for solutions, their frustration with the state continues to grow. Splaingard 

, “For a young practitioner, three or four years out of school with a lot of debt, having to wait 16 or 18 months for payment may mean they have to borrow a lot more money to keep their practice going.” His sentiment is 

 by Patterson: “It's just irresponsible what (the state is) doing. It's forcing dentists to loan the state money."

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Dentists in Illinois are owed more than $200 million in back payments from Delta Dental of Illinois, according to a recent report in the Chicago Business Journal. The amount pertains to services performed on state employees between 2016 and 2017. The late payments are having a dire effect on dentists in the state.


Dentists Owed Over $200 Million in Illinois

The American Academy of Pediatrics has said that researchs shows fruit juice is too high in sugar to give to children under the age of one.

The American Academy of Pediatrics (AAP) has recently revised guidelines advising against giving fruit juice to children before one year of age. In the past, it was thought that fruit juice was a good source of vitamin C and extra water for healthy infants and toddlers. The new recommendation is based on substantial scientific evidence that suggests fruit juice does more harm than good in the first year of a child’s life.

It’s true that some fruit juices are naturally high in certain vitamins and minerals, but a wealth of scientific evidence has shown that such juices are also high in sugar and low in other important nutrients, like fiber. A 2016 

 showed fruit juices have as much as two teaspoons of sugar per each 100-milliliter serving. 

 study determined that fruit juice and soda are the “biggest culprits of dental erosion.” 

 has also indicated that fruit juice intake could be a contributing factor in childhood obesity.

Because of the overwhelming evidence against its consumption by young children, the AAP has 

 "fruit juice offers no nutritional benefits for infants younger than one year," and shouldn’t be given to young children "unless clinically indicated." AAP fellow Melvin Heyman, M.D., 

, “Parents may perceive fruit juice as healthy, but it is not a good substitute for fresh fruit and just packs in more sugar and calories. Small amounts in moderation are fine for older kids, but are absolutely unnecessary for children under one.”

The AAP further recommends that children between the ages of one and three should not consume more than four ounces of fruit juice daily. Juice should also not be given to toddlers in “sippy cups” which allow them to drink freely throughout the day. These types of bottles may cause teeth to be excessively exposed to fruit juice and lead to tooth decay.

The AAP says parents should encourage young children to eat whole fruits instead of drinking fruit juice. AAP fellow Steven Abrams, M.D., 

We know that excessive fruit juice can lead to excessive weight gain and tooth decay. Pediatricians have a lot of information to share with families on how to provide the proper balance of fresh fruit within their child's diet." Dentists are also in prime position to educate parents on the evidence against fruit juice consumption in very young children.

New American Academy of Pediatrics (AAP) guidelines warn against giving fruit juice to children under the age of one. Recent evidence suggests that fruit juice has little nutritional benefit, causes dental erosion and contributes to obesity. Children should get nutrients through whole fruit instead to eliminate exposure to the excess sugar and negative effects of fruit juice. 


New APP Guidelines: No Fruit Juice Before 1 Year

Asbestos was used in some casting rings, which are used to manufacture dental prostheses.

 published in the American Journal of Industrial Medicine details a 14-year study that identifies four dental laboratory technicians who developed mesothelioma, a cancer related to asbestos exposure, because of their work. The study was conducted in Italy, but it raises concerns about exposure to carcinogens in dental workplaces in the U.S. as well.

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While the popularity of asbestos as an ingredient in many building and manufacturing products reached its height almost 40 years ago, the material has been known to be used as a heat-resistant lining material in certain casting rings used to manufacture dental prostheses. For this study, the authors reviewed 5,344 patient records involving pleural mesothelioma and identified four cases that occurred between 2000 and 2014.

Three of the patients, all men, worked as dental laboratory technicians and were exposed to asbestos for 10, 34, and 4 years, respectively. The fourth case occurred in a female patient, who assisted her husband in manufacturing dental prostheses for a total of 30 years. It is hypothesized that the laboratory technicians were exposed to asbestos through the inhalation of microscopic fibers released from certain casting rings, leading to the development of mesothelioma in their lung tissue.

 after a person’s exposure to asbestos. Around 

 are diagnosed in the U.S. every year, more commonly in older adults than in younger people. On average, only 

 of patients survive five years after diagnosis. This is due, in part, to a lack of early screening tests for this specific type of cancer, and because it is uncommon — many doctors have little to no prior experience in diagnosing mesothelioma patients.

, “Dental technician is not one of the professions we typically associate with asbestos exposure or mesothelioma but this study is an important reminder that mesothelioma risk can sometimes be found in unexpected places.”

A 14-year study published in the American Journal of Industrial Medicine shows how dental lab technicians in the U.S. may be at risk for developing mesothelioma. The Italian study identified four patients who developed mesothelioma after working in dental laboratories. Researchers hypothesized that the technicians were exposed to asbestos contained in casting rings.

Grape seed extract may be on it's way to finding it's first official medical application in dentistry.

 from the University of Illinois at Chicago’s School of Dentistry, grape seed extract might be a new way to help make dentin stronger. By doing so, it could be possible to extend the life of resin fillings, since these fillings must firmly adhere to dentin over the long-term. Since more than 90 percent of adults younger than 64 years old have dental caries, grape seed extract could prove to be a solution for extending the life of fillings while helping to keep costs down for patients.

On average, resin fillings last from five to seven years in the typical patient’s mouth. One of the main reasons for this is the breakdown of the interface between the patient’s dentin and the resin material, which can occur as the result of weak dentin.

However, grape seed extract can potentially be used to make dentin stronger. Research has already shown that the extract can help damaged collagen repair itself. Since dentin is primarily composed of collagen, any damaged dentin could benefit from the application of grape seed extract.

Ana Bedran-Russo, associate professor of restorative dentistry, 

, “When fillings fail, decay forms around it and the seal is lost. We want to reinforce the interface, which will make the resin bond better to the dentin. The interface can be changed through the use of new natural materials. The stability of the interface is key for the durability of such adhesive joints, and hence, the life of the restoration and minimizing tooth loss.”

 from the crushed seeds of grape plants. While the extract does not currently have any official medical use, several independent studies have suggested its effectiveness in treating a variety of conditions, including inflammation and chronic venous insufficiency. It is also thought that grape seed extract has antioxidant and antimutagenic properties.

A new study from the University of Illinois at Chicago's School of Dentistry shows that grape seed extract could be beneficial in strengthening dentin, thus helping to prevent filling failure. Typically, resin fillings have a lifespan of five to seven years. Adding to that lifespan by strengthening dentin, thus promoting filling adherence, could save dental costs as populations age.