The Evolution of the Toothbrush

By Irma Wallace, Infographic Journal

🐴 Can you imagine brushing your teeth with horse hair?! Take a look at just how far the toothbrush has come. The Oral Surgery DC team

Attention to dental hygiene dates all the way back to 3500 BCE with the Chew Stick in Egypt and Babylonia. Centuries later, we have seen tremendous advances in the dental hygiene industry. Check out this Evolution of the Toothbrush by Fortis to understand the incredible transformation of the dental hygiene industry from 3500 BCE until today.

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Why Sharks Don’t Get Cavities

By Megan Garber, The Atlantic 

Should sharks be our role models for oral hygiene? Learn about the two species with “toothpaste-teeth”! The Oral Surgery DC team

Sharks live lives that are, to human sensibilities, mostly unenviable. The creatures are constantly moving. They are hunted by predators far higher than they are on the food chain. They are often made to dine on manmade trash. They are totally oblivious to the subtler plot points of Orange Is the New Black.

But sharks, as a group, do have one evolutionary leg (fin?) up on us humans — one that has nothing to do with the terrifying sharpness of their enormous teeth and everything to do with the evolutionary resilience of those teeth. Sharks, it turns out, can’t get cavities.

In part, that puts sharks in company with most non-human animals. While creatures who don’t have access to Colgate have dental problems just like we do — among them tartar buildup that can cause gum disease — cavities are a largely human affliction, the result (for the most part) of our affinity for sugar.

What makes sharks unique, however, is that their teeth seem to be coated in fluoride. Yes: coated in fluoride. According to research published last year in the Journal of Structural Biology, at least two species of sharks, makos and tiger sharks, feature teeth whose outer coatings “contained one hundred percent fluoride.” Which is a nice cuspid coup. It’d be, for us, essentially like walking around with a perma-coating of toothpaste on our teeth.

While the Structural Biology research focused only on the two species, the makos and tiger sharks were chosen precisely because they feed in such different ways: makos rip the flesh off their prey, messily, while tiger sharks use their teeth to neatly slice through their meals. Since both species feature toothpaste-teeth, there’s reason to believe that those teeth are a feature enjoyed by other shark species, as well. And the choppers don’t just protect sharks against tooth decay: since teeth coated with fluoroapatites are less water-soluble than hydroxyapatites— the stuff that coats most mammals’ teeth, including our own — sharks’ teeth are also particularly suited to their underwater environment.

So take a moment to appreciate the elegantly Darwinian design of shark teeth. Then push your thoughts of those teeth aside to where they belong: your nightmares.

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Chocolate: A Superfood for Your Teeth

By Ask the Dentist 

🍫 Who says chocolate isn’t good for you? The antibacterial effects of chocolate can help protect against tooth decay. Sounds too good to be true? The Oral Surgery DC Team. 

A dentist recommending chocolate? Yes, that’s right, you read correctly.

Recent studies emerging from Japan, England, and the U.S. support the fact that chocolate is effective at fighting cavities, plaque, and tooth decay in the mouth.

Dark chocolate (I can’t speak for sugary milk chocolate) doesn’t deserve its bad rap as a cavity-causing treat. It may actually help prevent cavities!

And here’s where the gauntlet gets thrown down. Compounds in chocolate may be more effective at fighting decay than fluoride. Researchers are predicting that one day, the compound found in chocolate called CBH will be used in mouthwashes and toothpaste.

Tooth decay occurs when bacteria in the mouth turn sugar into acids, which eat away at the tooth’s surface and cause cavities. Compounds in the cocoa bean husk have an anti-bacterial effect and also fight against plaque. This makes chocolate less harmful than many other sweet foods your dentist might warn you against because the antibacterial agents in cocoa beans offset its high sugar levels.

This research has even revealed that the cocoa extract is more effective than fluoride in fighting cavities. To many, this is shocking news, but for me that’s not saying much. I’m not a big fan of ingesting fluoride, and I think it has long been over-hyped (more on that in future posts).

The compound CBH, a white crystalline powder whose chemical makeup is similar to caffeine, helps harden tooth enamel, making users less susceptible to tooth decay. This specific compound has been proven effective in the animal model, but it will it will take another two to four years before the product is approved for human use and available for sale (in the form of mouthwashes and toothpastes).

In the mean time, however, one can “administer” this compound via the ingestion of chocolate. Eating 3-4 oz of chocolate a day is a great way to take advantage of this wonder compound and lower your chance of getting cavities. What an easy and fun recommendation a doctor can make; it’s been called the food of the gods, a supposed aphrodisiac, and the drink that Casanova favored.

Now, before you reach for that Snickers bar, listen to this:

For the best therapeutic effect (yes, I’m still talking about chocolate), it’s best to chew on cacao nibs. Most will find this option unpalatable.

The second best choice, is dark chocolate with less than 6-8 grams of sugar per serving – organic if possible. Be aware that chocolate is a calorie-rich food, so modify your calorie intake accordingly.
Raw chocolate is even a better choice, as it it less processed, and more of the antioxidants are left intact.

Do all of this for your teeth, but enjoy the other benefits of mood elevation and better blood flow as well!

With the recent findings, it’s now more true than ever, that chocolate is a superfood. Chocolate has over 300 chemical compounds in it, making it one of the most complex foods we know of, and I predict that many new compounds in chocolate beneficial to us will surface over time and cement its nutritional five star rating.

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The Secret To Better Teeth Found In Beer Breweries

By Jason Tetro, Popular Science

🍻 Are beer hops the secret to superior oral health? The Oral Surgery DC team. 

On St. Patrick’s Day, millions of people worldwide will raise their beer glasses and offer a cheer to the patron saint of Ireland in hopes of better fortunes in the future. While the majority of toasts will involve personal happiness, friendship and wealth, there is another blessing that could come from buying the sudsy symbol: better teeth and overall health.

Though there may be a bounty of beer recipes worldwide, they all have a very common ingredient list comprised of water, malt, yeast and hops. The latter, biologically known as the flowers of the Humulus genus of plants, which also includes cannabis, has been traditionally known for giving the beer a unique taste. However, hops have served a second purpose, determined back in the 18th Century when England began to export to the colonies.

Because of the length of time needed to travel, beer had the propensity to spoil to a variety of bacteria. Yet, those that had a higher proportion of hops in the recipe appeared to survive without any significant product loss. This led to the requirement of hops not to offer a fulfilling flavor, but to stay fresh. Eventually, hops became a critical component in any beer recipe; a tradition that continues until today.

Although the beer bacterial burden was solved, microbiologists, curious individuals that they are, wanted to know why that was the case. The answer wasn’t known until 1937 when the antiseptic properties of hops were finally seen. When exposed to a hop extract, bacteria simply couldn’t survive. The finding not only gave more reason to drink hoppy beer, but also opened the door to a natural means of infection prevention.

Over the next 80 years, researchers identified specific chemicals in hop extracts and tested them to determine if there were any useful antimicrobials. Back in 1949 one of the components of the extract, lupulone, was tested as an antibiotic; it failed. Over a half-century later, however, the same extract proved to be an effective killer of tuberculosis. Another component, xanthohumol, was tested to determine its ability to kill viruses; this time it was quite effective. The same compound was also shown to have an anti-malarial activity.

But perhaps the most positive results have come from the world of odontology. For centuries, dentists have been trying to find natural means to prevent gum disease, which is an inflammatory process sparked by bacteria. When the antimicrobial activity of hops were found, dentists decided that it was at least worth a try. What they have found reveals that not only are they good for the mouth, they can potentially help to prevent problems in the future.

Through a series of experimental papers published over the last five years, we can understand exactly how hops help. In 2008, a team from Osaka University unveiled a group of chemicals known as polyphenols, which are known to help prevent oral cancer. Based on their experiments, these compounds stopped inflammation and kept gums pink instead of red. In the same year, a team from Nippon Dental University revealed the molecules also halted the development of dental plaque. By 2013, xanthohumol also proved to keep teeth happy and healthy by ensuring that bacteria could not stick to the teeth and gums.

Considering the benefit of the hop flower, there was every reason to believe there was more to the Humulus story. The focus was on the leaves of the hop flower, known as bracts. In the brewing process, bracts tend to be discarded as they do not impart much to the quality of the beer. But in 2007, a team from Tokyo Medical and Dental University demonstrated that bract extract could not only prevent but also removeplaque from teeth. Considering the extracts were safe, there was every indication to believe that incorporating bracts into beer might be an option for better teeth.

This week, a Japanese team of investigators gave some of the most compelling evidence to prove this theory. Although their work was chemical, not medicinal or dental in nature, their results have all but confirmed that bracts are all that and more. Moreover, they have shown the beer brewery may be the best place to find the future of healthy teeth.

Looking closer at the paper, the tack was routine for any physical chemistry experiment. Bract extracts were taken back to the lab and racked for assessment of their beneficial knack. The results left the researchers jacked as there was no lack of known orally-beneficial compounds, stacking up to twenty in all. The pack also included others yet to crack the market but showed health potential based on evidence not quacks.

Thanks to this study, there is little doubt of the potential benefit of bracts. This may lead to a new range of natural oral products providing not only a greener alternative to modern day toothpaste, but also a more effective means to prevent gum disease.There is another perhaps less obvious benefit. Focusing on the leaves will also ensure no competition between beer and dental industries. While the flowers will still go to the breweries to keep our glasses full, the leaves will head to health manufacturers who will help to keep our teeth healthy. All said, that is surely a blessing even St. Patrick would approve.

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When It Comes to Oral Health, We Can Learn Something from the Beavers

By Staff writer, Youth Health

🌱 ‘Leave it to beavers’ right? The Oral Surgery Team

When it comes to understanding tooth decay, a group of researchers is saying, “Leave it to beavers.”

Researchers from Northwestern University have discovered something remarkable about the oral health of beavers, the semi-aquatic rodents that are known for their building skills and strong set of teeth.

These furry creatures certainly don’t enjoy the same conveniences humans have as far as taking care of their oral health is concerned. But unlike us, they don’t develop tooth decay.

The answer, it turns out, is the presence of iron in the enamel.

The enamel is one of the tissues that make up the teeth of humans and many animals including beavers. They are also the most visible parts-see the whites in your teeth?-and are made to be resistant to acids. Acid build-up happens based on the food a person eats. When there’s too much acid, it “dissolves” the enamel, making the teeth more sensitive and at risk of developing cavities.

The main composition of enamel is hydroxylapatite, which looks like nanowires. Surrounding it are magnesium and iron, both amorphous minerals. When the enamel tries to protect the teeth from acid deterioration, it’s not the nanowires that respond but these minerals. As the researchers put it, we do share a similar enamel structure but not composition with the beavers and perhaps other animals, and the difference in composition may help determine the degree of acid resistance of enamels.

In their study, the researchers looked into enamel of three animals including rabbits and beavers and analyzed the enamel’s amorphous structure using tomography.

They then exposed the enamel to acid while taking before-and-after images, then noticed that the nanowires remained but the surrounding minerals dissolved. Subsequently the team analyzed how these minerals help in increasing the enamel’s resistance and hardness and discovered that the incisors of beavers are pigmented and rich in iron, making it a much better enamel than one that’s treated with fluoride.

With this knowledge, the research may be helpful in gaining a better understanding of oral health, especially how tooth decay develops.

The entire research is available in Frontiers in Psychology journal.

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How Chewing Gum Can Help Your Oral Health

By Jason Tetro, Huffpost 

The question has plagued dental professionals for years. Is chewing gum good or bad for your teeth? The rubbery substance has been used for millennia dating back to the Ancient Egyptians and Mayans. Originally gum was used to keep the mouth busy during times or work, ennui or angst but in the latter part of the 19th Century, specially formulated sticks were developed to help keep teeth white and improve breath.

Jump a hundred years later and the benefits of chewing were put under scrutiny. During the 1970s and ’80s, a number of studies revealed the lack of any dental benefit. There was no significant plaque reduction unless combined with normal oral health procedures, such as brushing and flossing. In contrast, the addition of sugars and other acid-promoting ingredients made gum an enemy rather than a friend of oral health.

As formulations modified, research revealed some benefit with alternative ingredient lists. The use of sugarless gum was shown to help if only to dilute out the levels of sugar and low pH in the mouth. The addition of sugar-substitutes xylitol and sorbitolhelped to reduce the formation of caries. In the case of xylitol, a lower incidence of other secondary problems including ear infections was also seen.

 Though research provided some indication of the impact of gum on health, few investigated the effects of chewing on the most populous resident of the mouth, sinuses and respiratory tract: microbes. There was a good reason for this lack of study; until a few years ago, no one really knew the nature of the oral microbiome other than those species known to be associated with dental cavities. As a result, the first studies focused on whether gum could reduce the levels of pathogens without any specific perspective on the rest of the over 250 different types contained in the average human mouth.

But last week, an international team of researchers provided the first comprehensive look at the impact of gum on oral health. Their initial goal was to identify the dynamics of chewing gum on the microbes. Yet, the results provided them — and us — with a potential path to even greater oral health with the help of a few moments of chewing pleasure.

The methods were relatively simple. The group asked five volunteers to chew one of two different sugarless gums containing sorbitol and other non-cavity causing ingredients. At varying time points between 30 seconds and 10 minutes, the volunteers spit the well masticated ball into a sterile solution. Then the researchers used a variety of methods ranging from culture to genetic techniques to identify the bacteria in the gum. To make the results even more robust, they looked at pieces under the electron microscope to visualize how the bacteria adhered to the matrix.

When all the data had been analyzed, the group was treated to a surprise. While they expected to see bacteria in the gum — and they did to the tune of 100 million per piece — they were taken aback when they found the highest concentrations in gum spit out after the first few minutes. As the time went on, the concentration decreased in a linear fashion.

This reduction in extraction efficiency over time might have been due to a higher level of saliva in the mouth or the lack of stickiness, allowing the bacteria to return to the mouth. Either way, the data suggested the best amount of time to chew in terms of oral health was anywhere from 30 seconds to two minutes. Any time after that, a loss of 10 per cent of the population per minute would occur.

The group then looked at the nature of the microbes in the gum. Again, there was a surprise waiting for them in the data. When they looked at the origin of the bacteria, not all isolates were part of the tooth or the salivary microbiome. In the case of one gum, less than half of the bacteria could be traced. The results suggested the majority of bacteria were transient rather than colonized.

This result was particularly intriguing as the gum could potentially remove any pathogenic invaders who might be on the lookout for a home. The team suggested this radical removal might actually assist the maintenance of health. While the oral cavity has the ability to fight off infections through immune function, enzymes and antimicrobial peptides, physical removal via gum chewing might offer significant help in the process.

The last step of visualization involved what the researchers suggested was akin to looking for a needle in a haystack. Despite the over 100-million bacteria isolated from a stick of gum, the researchers had difficulties finding a bacterium using the electron microscope. When they did, it was alone, not in clumps, and took up only a small surface area.

This latter result suggests a large potential for increased bacterial removal. By incorporating ingredients to make the gum stickier to pathogens, a means of oral health improvement could be developed. This could be beneficial to help individuals who are particularly susceptible to infections as well as those who might be travelling. They can maintain their microbiome by getting rid of the newly introduced strains.

Overall, this particular study reinforces the beliefs of those over a century and a half ago who believed chewing gum could be good for health. Although the road has been bumpy and formulations have changed to reflect the necessities of a healthy lifestyle, the influence of gum on oral health appears to be positive. Whether the goal is fresher breath or removal of pathogens, it seems a few minutes of gum chewing might be an excellent way to keep a healthy mouth.

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