(This comes straight from the ADA!-7/10/18 Morning Huddle)

The Daily Mail (UK) (7/4, Blanchard) reports researchers at the University of Granada in Spain have found that men with “either gum disease or erectile dysfunction” have increased likelihood of developing the other. According to “the first study to be done on European men,” scientists “say both conditions are linked to the same protein made in the liver.” The Daily Mail says “the study suggests gum disease is a bigger factor in erectile dysfunction than either diabetes or heart disease. Oral health experts say the study suggests the benefits of taking care of your mouth extend beyond avoiding losing teeth, and the mouth affects other parts of the body. They say brushing your teeth twice a day and visiting the dentist regularly could help men to avoid gum disease and erectile dysfunction as well.”

NPR reported the age old noise of knuckle cracking does not  cause arthritis, and may actually be good for the joint. According to Dr. Kevin deWeber of Vancouver, Canada,  the arthritis urban myth is a misconception perpetuated by “by mothers who are sick of hearing their kids crack their knuckles.” Dr. Greg Kawchuk, professor of Rehabilitative Medicine at the University of Alberta performed a MRI study discerning the culprit behind the noise:gas bubbles which get collapsed upon the knuckle cracking.

So what about other joints? Many dental patients complain of jaw joint noises. The implication of Dr. Kawchuck’s study is that the noise is harmless and moving the jaw around to create the pop may actually help. This still has to be verified by dental research. Pain, on the other hand, is a complicating factor which would need to be investigated by your doctor. Popping the joint may be harmful in those cases. Stick with the knuckles!

Mailonline ran an article  with the title, “Mouthwash use “linked to oral cancer”: People who use products more than three times a day increase risk.” The research, done by a Scottish doctor at the University of Glasgow has been deemed inconclusive by the British Dental Association. The article did however, indicate  that there “may be a link between excessive mouthwash rinsing and people who use it to mask the smell of smoking and alcohol.” These alone are independent risk factor for cancer, and together exert a well established link for cancer.  As such, mouthwash may not be as significant as the alcohol and smoking with regard to cancer, and should probably not be discontinued if recommended for use.

From the Amereican Dental Association ( ADA):

Good Morning America Segment on Microbeads in Toothpaste

ABC’s Good Morning America (GMA) contacted the ADA for a segment that aired today on microbeads (polyethylene) in toothpaste. All of the varieties of Crest ProHealth® toothpaste which have earned the ADA Seal of Acceptance contain microbeads.

The ADA provided a press statement to the GMA producer indicating, “According to the American Dental Association, clinically relevant dental health studies do not indicate that the ADA Seal should be removed from toothpastes that contain polyethylene microbeads. Products with the ADA Seal have been independently evaluated for safety and effectiveness by the ADA Council on Scientific Affairs.”

Local news stations, including ABC 7 Chicago, have previously reported on microbeads from health and environmental angles. Procter & Gamble (P&G), the manufacturer of Crest ProHealth®, includes information for the public on their website and has indicated they plan to remove microbeads from toothpaste.

According to P&G, “While the ingredient in question is completely safe, approved for use in foods by the FDA and part of an enjoyable brushing experience for millions of consumers with no issues, we understand there is a growing preference for us to remove this ingredient. So we will. Crest will continue to provide consumers with effective and enjoyable products which are designed to their preferences.”

The following suggested talking points may help you discuss the issue with your patients should they ask you about microbeads in toothpaste:

• Microbeads have been in the news lately. You may have heard about it in connection with toothpaste.
• Microbeads are most often used as scrubbing beads in exfoliating skin care products.
• The FDA has approved microbeads as a food additive, and small quantities, which appear as colored specks, are in some of Crest’s toothpastes, including Crest Pro Health, which has the American Dental Association Seal of Acceptance.
• According to the ADA, clinically relevant dental health studies do not indicate that the ADA Seal should be removed from toothpastes that contain microbeads.
• Products with the ADA Seal have been independently evaluated for safety and effectiveness by the ADA Council on Scientific Affairs.
• While there is no clinical evidence that microbeads in toothpaste are harmful to your dental health, Crest is voluntarily withdrawing the ingredient from toothpaste in response to growing consumer preference.
• As your dentist, my goal is to help you achieve optimal dental oral health. Whenever you have questions about any dental care product, feel free to talk with me.
• Brushing two minutes twice a day with fluoride toothpaste and flossing daily are important ways to take care of your dental health.

Some concerns have been raised about the safety of triclosan, an ingredient in Colgate Total toothpaste. At present it is believed to be safe in the amounts used, though the EPA is looking into data concerning the endocrine effects, developmental and reproductive toxicity, chronic toxicity and carcinogenicity. There are also concerns about the possibility of Triclosan contributing to making bacteria resistant to other bacteria.

Triclosan has been shown to be effective in preventing gingivitis.  Colgate’s website refutes some of the research claims about carcinogenicity and endocrine effects, and offers the extensive research which supports the use of Triclosan in toothpaste. It remains to be seen then, whether further research will continue to  vindicate its use in toothpaste.

This information comes from the United States Environmental Prtoection Agency factsheet on Triclosan,  the the U.S. Food and Drug Adminstration Factsheet, and Colgates’s website.

Very few communities in New Jersey have water fluoridation.  As such, the benefits of fluoride for the prevention of tooth decay must be obtained through other means. For children, this is in the form of an ingestible source, typically a vitamin with fluoride added, or simple fluoride drops. To avoid excess fluoride consumption the following recommendations have been made. It breaks down into three columns of possible external sources of fluoride consumption, such as bottled water, or areas where fluoride occurs naturally in drinking water.

It should be noted iingestible fluoride is only of benefit when the teeth are being formed and the fluoride can become incorporated within the enamel .  After teeth have erupted, ingestible fluoride is of no use, and only topical applications of fluoride are of benefit, such as toothpaste and/or fluoride applications or rinses.