Prevora Blog

Hello everyone,

Recently the Partners in Prevention held its first guest speaker event which featured Dr Sally Mauriello an associate professor and coordinator of the Dental Hygiene Program at the School of Dentistry at the University of North Carolina. Dr Mauriello is one the lead researchers of the link between root caries and systemic health. She presented the finding of her research during presentations to the upper year hygiene classes at both George Brown College and the Canadian Academy of Dental Hygiene, as well as a contingent of the Partners in Prevention in Oakville. All three of these presentations were very well received by the audience and elicited many insightful questions and discussion.

Dr Mauriello’s findings have been summarized in three abstracts that have published over the past ten years a brief summary of these finding is below.

• In 1996, Mauriello reported that older adults with ≥ 2 new root caries lesions were four times more likely to die during the 3 to 5 year follow period, than those with fewer than 2 root lesions.[1] A subsequent study in 1999 by the Mauriello research team extended and confirmed these findings.[2]
• A 2006, Mauriello reported that amongst Americans aged 52-74 the incidence of heart attack over a 6 year period was 4.7% amongst the root caries group versus 2.4% for those without root decay.[3] In a regression analysis, root caries was significantly associated with a heart attack in this population, adjusting for periodontal pocketing, race, age, sex and the usual risk factors such as smoking, income, diabetes, hypertension and LDL

In her recent visit to Toronto, Dr. Mauriello provided some unpublished data from the Atherosclerosis Risk in the Community Study (ARIC), a large prospective study of risk factors for cardiovascular disease funded by the National Institutes of Health in the late 1980s and 1990s. ARIC tracked over 15,000 middle-aged Americans for cardiovascular disease over 10 years. Scientific articles from ARIC are still being published but the root caries connection has yet to be described. Dr. Mauriello reported that in ARIC, root caries out-weighed cholesterol as a risk factor for heart disease.

This link between root caries and overall health is still being investigated and is not completely understood at this point. However there is beginning to be more and more evidence of this link in the published literature. One of the most interesting articles has come from a Japanese research group which detected significant quantities of Streptococcus mutans in surgically removed heart valves and atheromatous plaque of patients with cardiovascular problems (Chart 1). This may indicate a pronounced or prolonged Bacteremia effect from recurrent root caries. The results of this study indicate that S. mutans is a possible causative agent of cardiovascular disease[4].

Chart 1

Source: Nakano K. et al, 2006. Detection of Cariogenic Streptococcus mutans in Extirpated Heart Valve and Atheromatous Plaque Specimens. J Clin Micro, 44: 3313 – 3317.

You can read more about both Dr Mauriello and the Japanese studies by following the links to the articles below.

Dr Sally Mauriello’s Research

Detection of Cariogenic Streptococcus mutans in Extirpated Heart Valve and Atheromatous Plaque Specimens

I hope that this post has given you a little more insight into the relationship between root caries and overall health and that it makes you look forward to the next Partners in Prevention guest lecture event.

Until the next time, take care
Tyler

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1 Mauriello S et al. 1996. Risk modeling for root caries and mortality in older adults. IADR Abstract 896.
2 Mauriello S et al. 1999. Root caries incidence as a risk predictor for mortality. IADR Abstract 3582.
3 Mauriello S et al. 2006. Root caries prevalence and incident myocardial infarction. IADR Abstract 1471.
4 Nakano K. et al, 2006. Detection of Cariogenic Streptococcus mutans in Extirpated Heart Valve and Atheromatous Plaque Specimens. J Clin Micro, 44: 3313 – 3317

At the recent meeting of the International Association of Dental Research (IADR) in Toronto, one of CHX Technologies Regulatory and Clinical Affairs officers, Holly Byrd, attended one of the many sessions and was kind enough to provide us with a post about this session.

An important symposium was held on July 3rd: “How do Medicine and Dentistry Collaborate on Oral/Systemic Health?” (Sponsored by Johnson & Johnson Oral Healthcare). The presentation included Dr. Bill Costerton of the University of Southern California, talking about the role biofilms play in oral and systemic health.

Dr. Costerton, known as the “father of biofilms” after coining the term in the late 1970’s, describes biofilms as a group of bacteria that colonize a surface. Once believed to be responsible for over 65% of infections, the National Institutes of Health now estimates biofilms to be associated with 80% of infections. Biofilms are mobile cultures that have been found in such areas of the body as the inner ears, lungs, implanted medical devices and tooth surfaces (in the form of plaque). Biofilms are 1000x more resistant to antibiotics than monocultures. Dr. Costerton believes that the explanation for the high resistance to antibiotics is due to a sticky slime that is secreted by the bacteria, which acts as a protective barrier for the biofilm. This slime makes up the majority of the biofilm composition and is responsible for allowing passing monocultures to attach to existing colonizations. When a biofilm has grown to capacity, it has the ability to shed bacterial members to other parts of the body, including the bloodstream. These bacterial members can colonize in a new area of the body and create a large biofilm, similar to the one they originated from, creating an infection. This may explain the high burden of Streptococcus mutans on diseased heart tissue as reported by Nakano et al.

K. Nakano et al, “Detection of Cariogenic Streptococcus mutans in Extirpated Heart Valve and Atheromatous Plaque Specimens”, Journal of Clinical Microbiology, v.44, 2006, pp. 3313-3317.

Dr. Costerton gave a very informative and thought provoking presentation on the link between medicine and dentistry with respect to oral and systemic health. See the link below for an article about Dr. Costerton.

http://blogs.uscannenberg.org/annenbergfiles/2007/11/usc_professor_offers_fresh_loo.html

Holly
CHX Technologies
Regulatory & Clinical Affairs

We would like to hear your thoughts about this presention and how these two displicines of the health care system collaborate so feel free to add your comments to this post.