Oral Health Research: From dental caries dental implants

Oral disorders cover a wide range of ailments ranging from tooth decay to birth defects and cancer through gum disease and chronic pain. Often a poor state of health leading to poor oral health, it is likely that the reverse is also true. People with chronic diseases like diabetes and AIDS are more susceptible to infections Gingival persistent, and there is increasing evidence that a range of gum infection is accompanied by an increased risk of heart disease or of preterm labor and low birth weight.

There is no need to go too far in the past to return to a time when older people often lose the most if not all of their adult teeth due to dental caries and advanced chronic infections gums (periodontitis). In fact, an epidemic of dental caries which continued until the 1970s explains that millions of seniors in Canada today have lost all their teeth. The edentula (medical term referring to the widespread loss of teeth) meets the criteria for chronic disability of the World Health Organization, as it has profound effects on how to talk and eat a person, and therefore on its quality of life, nutritional status and health in general.

Recent research has shown that traditional dentures do not allow people to eat well, and things get worse with age. The bone and the lining under the ever-thinning dentures, and eating becomes more difficult and painful. To find a solution for the millions of Canadians without teeth, the Canadian Institutes of Health Research (CIHR) fund new clinical trials in partnership with manufacturers to determine whether the insertion of small metallic implants in the lower jaw would allow people without teeth to speak and eat more easily. Early results suggest that these implants would actually people who have lost all their teeth during the epidemic of dental caries to change their diet and improve their nutritional status and health.

One of the most important differences between now and then is fluoride. Most experts agree that fluoridation of water is a public health measures are most effective ever been taken. Over the past 30 years, tooth decay among children has significantly decreased in the industrialized world - visible benefit better prevention programs, including fluoridation of water by municipalities. Despite the controversy that it had raised at the beginning, retrospective studies comparing municipalities with and without water fluorinated have shown conclusively that fluoridation programs have significantly reduced the rate of dental caries. (In trace amounts, fluoride prevents bacteria in plaque release acids that cause cavities, and it may remineralize enamel that has been softened by the acid.) Fluoride is also a common ingredient in many toothpastes and mouthwashes.

With fluoride, the daily dental hygiene and regular access to professional care, tooth decay is now considered a preventable disease. Nevertheless, almost everyone has dental caries, and about 60% of people have a localized infection (gingivitis), in most cases limited to redness of gum tissue. In a significant minority of people, however, gingivitis can lead to periodontal disease and possibly tooth loss.

Unravel the mysteries of oral health
Although they are few, the Canadian scientists in the field of oral health are regarded as leading international infectious diseases of the mouth, biology and mineralized tissues, biomaterials, of Neuroscience and Pain . This varied expertise lies in the fact that many of the basic tissues (mucous membranes, bones, joints) and biological processes in the oral cavity - including cell communication, inflammation, and repair the immune response to infection - look to other parts of the body, like the skin, lungs, digestive tract and members. The mouth becomes a valuable research model for understanding the biological activity in other organs less accessible.

Approximately 500 species of bacteria colonizing the oral cavity, and usually a single millimeter of human saliva contains more than 100 million bacteria. Although scientific knowledge about the organisms that cause cavities, they are less well how some groups of bacteria causing periodontal disease, especially the attacks and parades taking place microscopic parasites cells and host cells. Since these microbes are endemic in the mouth, why does periodontitis Does that certain people? And what are the broader consequences of periodontal infection on the heart and the fetus? Bacteria communicate them to other organ systems, or they release toxins that circulate in the blood. These questions about oral microbiology are almost endless, but the answers to many of them would help to expand into other mysteries of the body.

How to form the teeth, bone and connective tissue is another important research question. How the body regulates Does precursor cells to form calcified tissues? This issue has far-reaching, since the mineralization (or demineralisation) tissue plays a role in dental caries, the healing of fractures, arthritis, hardening of the arteries, osteoporosis and kidney stones . And these are just some of the most commuens. The prospect terribly attractive to regenerate gum tissue and tooth enamel in the laboratory, or better still, in the mouth, is not so crazy that we would be inclined to believe at first sight. Indeed, a group in Boston has managed to grow a tooth from cells in culture!

However painful that may be the toothache, other types of oral pain caused intense suffering even more and are much more difficult to treat. By necessity, some researchers in the field of oral health have specialized in biology and signal processing of pain. Facial neuralgia, also known as tic douloureux of the face, is primarily seen as a bout of unilateral intense pain radiating dazzling plays until the middle of the face, upper lip, the upper lip and chin. Eating and talking can cause great pain. The causes are uncertain, and the trigeminal nerve, one of the largest face, shows no apparent damage. One way or another, this nerve becomes hypersensitive, any stimulus received by the exciter. As amputees who complain of phantom limb pain, some people have a toothache ghosts "which derives from the vacuum left by the teeth extracted.

The temporo-mandibular dysfunction include a set of conditions that cause pain in the jaw and muscles. Sometimes, the pain resulting from arthritis, but many cases are of unknown etiology. The burning mouth syndrome "is another condition disconcerting that one has the impression of having the tongue and mucous membranes of the mouth singed. There is much to learn about all these syndromes, especially since they seem to coexist with other painful conditions like fibromyalgia syndrome pain myofasciale and irritable colon. For now, their causes remain unknown, and no medication is truly effective.

In recent decades, the surgical reconstruction of Cleft Lip and cleft palate has advanced to the point of making these birth defects almost invisible. Unfortunately, it can not be said of cancer of the throat and mouth, the sixth for prevalence among men. Most often associated with smoking (including the consumption of chewing tobacco or snuff) and excess alcohol, oral cancer is extremely disfiguring, because the treatment is to remove the tumor and a area surrounding healthy tissue. In general, people who must undergo a radical can not afford to have reconstructive facial surgery after the fact, so they must continue to live with one half of play or face. In this context, social policy rather than medical technology limits the processing and data should once again be collected to evaluate measures to effectively address this problem.

Deciding on the research program in oral health
In Canada, 60 to 80% of dental caries and virtually all cases of periodontal disease are the lot of disadvantaged and remote populations, including Aboriginal people, the elderly and people with physical or intellectual disability. Although there is still much to learn about the basic science of tooth decay and gum infections, there is certainly a solid knowledge base that must be implemented by progressive social policy.

An essential part of the research in oral health of IMHA is the accumulation of socio-economic data on which to base public health strategies that meet the needs of oral health of vulnerable populations. At present, only about 40% of Canadians have access to clean water fluorinated. People with low income or fixed and without insurance often can not afford basic care, let alone expensive treatments restaurateur.

Members of First Nations, for against, must be patient and wait for federal preclearance of directors removed before they can receive dental care and orthodontics. In the heart of Canadian cities, children with dental caries are so advanced that they must be treated under general anesthesia can be counted by hundreds. Many more suffer chronic pain dental waiting to be treated in pediatric hospitals. In short, people who could benefit most from advances in medicine have difficulty accessing dental care or can not afford them.

To tackle these problems, and various other IMHA organized the first planning workshop for research in oral health in June 2002. It was attended by various stakeholders who have begun to lay the foundations for a research strategy that will include oral health in both the priorities and training programs for this research.