Focal infection revisited—the swinging of the pendulum.
A historical review, focusing not only on disease, but also on the relationship between the medical and dental professions.
Sleep and airway assessment: A review for dentists.
Introduction: Dentists can be the first professionals to recognize a patient’s potential sleep problem since they typically have more frequent contact with their patients than do physicians. It is important that dentists have a reasonable understanding of sleep disorders and how to assess their patients if they suspect such a problem so that a timely referral can be made or treatment can be provided as appropriate.
Objective: To review the key literature relevant to sleep-disordered breathing (SDB) characteristics and diagnosis, including history, examination, and investigation with an emphasis on radiographic airway analyses.
Conclusion: The authors present a concise explanation of SDB conditions and an outline for thorough patient examination and evaluation, including radiographic airway analyses. Limited two-dimensional and three-dimensional norms exist for adult patients with no SDB and even less so for children. Much more research is needed, particularly in the pediatric population.
Prenatal mercury exposure, neurodevelopment and apolipoprotein E genetic polymorphism.
The aim of the present study was to evaluate the association between prenatal exposure to mercury (Hg) and neurodevelopment of the child, taking into account genetic polymorphism of apolipoprotein E (Apoe) and other relevant confounders. Six hundred and one mother-child pairs were recruited from the central Slovenia region and 243 from Rijeka, on the Croatian coast of the northern Adriatic. The total Hg in cord blood, Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) assessment at 18 months of age and Apoe genotyping was performed on 361 children; 237 of them were from Slovenia and 124 from Croatia. The results showed negative association between low-to-moderate Hg exposure in children with normal neurodevelopmental outcome and cognitive and fine motor scores at 18 months of age as assessed by Bayley III. The Hg-related decrease in cognitive score was observed only in children carrying at least one Apoe ε4 allele, while the decrease in fine motor scores was independent of the Apoe genotype. Adjusting for selenium (Se) and lead (Pb) levels, a positive association between Se and the language score and a negative association between Pb and the motor score was observed, but not in the subgroup of children carrying the ε4 allele.
Global mercury supply, trade and demand.
A response by the world’s nations to the abundant evidence of the negative effects of mercury pollution on human health and the environment, the Minamata Convention on Mercury entered into force on 16 August 2017. The Convention includes provisions to control the supply, trade and use of mercury. This report provides an overview of the current state of these activities in order to assist governments and otherstakeholders as the Convention moves into the implementation phase. The most important findings and observations are summarized here.
A cross-sectional study of the relationship between infant Thimerosal-containing hepatitis B vaccine exposure and attention-deficit/hyperactivity disorder.
Attention-deficit/hyperactivity disorder (ADHD) is characterized by a marked pattern of inattention and/or hyperactivity-impulsivity that is inconsistent with developmental level and interferes with normal functioning in at least two settings. This study evaluated the hypothesis that infant Thimerosal-containing hepatitis B vaccine (T-HepB) exposure would increase the risk of an ADHD diagnosis. This cross-sectional study examined 4393 persons between 13 and 19 years of age from the combined 1999-2004 National Health and Nutritional Examination Survey (NHANES) by analyzing demographic, immunization, socioeconomic, and health-related variables using the SAS system. Three doses of T-HepB exposure in comparison to no exposure significantly increased the risk of an ADHD diagnosis using logistic regression (adjusted odds ratio=1.980), linear regression (adjusted beta-coefficient=0.04747), Spearman’s rank (Rho=0.04807), and 2×2 contingency table (rate ratio=1.8353) statistical modeling even when considering other covariates such as gender, race, and socioeconomic status. Current health status outcomes selected on an a priori basis to not be biologically plausibly linked to T-HepB exposure showed no relationship with T-HepB. The observed study results are biologically plausible and supported by numerous previous epidemiological studies, but because the NHANES data is collected on a cross-sectional basis, it is not possible to ascribe a direct cause-effect relationship between exposure to T-HepB and an ADHD diagnosis. During the decade from 1991 to 2001 that infants were routinely exposed to T-HepB in the United States (US), an estimated 1.3-2.5 million children were diagnosed with ADHD with excess lifetime costs estimated at US $350-$660 billion as a consequence of T-HepB. Although Thimerosal use in the HepB in the US has been discontinued, Thimerosal remains in the HepB in developing countries. Routine vaccination is an important public health tool to prevent infectious diseases, but every effort should be made to eliminate Thimerosal exposure.
Chemical forms of mercury in human hair reveal sources of exposure.
Humans are contaminated by mercury in different forms from different sources. In practice, contamination by methylmercury from fish consumption is assessed by measuring hair mercury concentration, whereas exposure to elemental and inorganic mercury from other sources is tested by analysis of blood or urine. Here, we show that diverse sources of hair mercury at concentrations as low as 0.5 ppm can be individually identified by specific coordination to C, N, and S ligands with high energy-resolution X-ray absorption spectroscopy. Methylmercury from seafood, ethylmercury used as a bactericide, inorganic mercury from dental amalgams, and exogenously derived atmospheric mercury bind in distinctive intermolecular configurations to hair proteins, as supported by molecular modeling. A mercury spike located by X-ray nanofluorescence on one hair strand could even be dated to removal of a single dental amalgam. Chemical forms of other known or putative toxic metals in human tissues could be identified by this approach with potential broader applications to forensic, energy, and materials science.
Per-and polyfluoroalkyl substances (PFASs).
Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are used in various consumer and industrial products, including food contact materials (FCMs) (Figure 1). Thousands of different PFASs have been synthesized in the past decades [1]. Their common properties include high water and oil repellency as well as thermal and chemical stability.
Health complaints attributed to dental amalgam: a retrospective survey exploring perceived health changes related to amalgam removal.
BACKGROUND:
Many patients have complex health complaints they attribute to dental amalgam. There is some evidence of symptom relief after removal of amalgam.
OBJECTIVE:
The aims of this study were to assess the total symptom load in patients with all their amalgam fillings removed, and to investigate the self-reported improvement of health with regard to precautions taken under amalgam removal and time since removal.
METHODS:
The survey was distributed to all members (n=999) of the Norwegian Dental patients association in 2011. The study participants returned the questionnaires anonymously by means of a pre-stamped envelope. The questionnaire asked for sociodemographic data, subjectively perceived health status, complaints persisting after amalgam removal and self-reported changes in symptoms after amalgam removal.
RESULTS:
A total of 324 participants were included in the study. The majority of the participants reported improved health after amalgam removal, even though the mean degree of severity of complaints was still high. Exhaustion and musculoskeletal complaints were most severe, and reflects the fact that 38% of the participants reported poor to very poor current health. With regard to amalgam removal, associations between improved health, number of precautions applied, and time since removal were found.
CONCLUSION:
Most of the participants in this study reported improvement of health after amalgam removal even though they still suffered a high complaint load. Since absolute symptom load is a robust predictor for general health outcome and socioeconomic burden for society, a possible intervention, which enables patients to further improve their health status is desirable.
Effect of Chlorhexidine with Fluoride Mouthrinse on Plaque Accumulation, Plaque pH-A Double Blind Parallel Randomized Clinical Trial.
INTRODUCTION:
Mouthwashes are important means used in chemical control of dental plaque. There is strong evidence suggestive of better effectiveness, when fluoride is added to chlorhexidine mouthwash.
AIM:
To assess the anti-plaque efficacy of Chlorhexidine combined with Fluoride mouthwash and to measure its impact on plaque accumulation and on plaque pH.
MATERIALS AND METHODS:
Initially 100 subjects were screened. A double blind, parallel randomized clinical trial was conducted on 30 subjects after applying inclusion and exclusion criteria. Other independent variables were matched before randomly allocating them in three groups: Group A-Chlorhexidine as positive control, Group B-Chlorhexidine + Fluoride as test group and Group C- Distilled water as negative control. Oral prophylaxis of participants was done before onset of the study. Plaque pH was assessed before and immediately after rinsing at 0, 5 and 10 minutes interval and after 7 days with digital pH electrode (pHepR pH meter, Hanna Instruments R10285) and accumulation of plaque was recorded by Turesky et al., modification of Quigley Hein Plaque Index (1970). ANOVA test was used for statistical analysis.
RESULTS:
Although there was a statistically significant reduction in mean plaque scores from baseline to seven days in both Groups A and B, Group B showed better anti-plaque efficacy . Almost equal drop in plaque pH was seen for both the groups at 5 and 10 minutes.
CONCLUSION:
Better anti-plaque efficacy was observed in Group B (Chlorhexidine and Fluoride combination) with minimum variation of plaque pH.
What is the risk? Dental amalgam, mercury exposure, and human health risks throughout the life span. InEpigenetics, the Environment, and Children’s Health across Lifespans
All dental amalgam fillings contain approximately 50% elemental mercury by weight. Concerns about health risks due to continual emissions of mercury vapor from this tooth restorative material have been addressed by dentists, scientists, and government authorities worldwide and have resulted in a range of recommended practices and regulations.