Otzi the Iceman needed to see a dentist

Ötzi the Iceman Needed a Dentist

Tia Ghose, LiveScience Staff Writer   |   April 11, 2013 11:41am ET

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Otzi the iceman, an astonishingly preserved Neolithic mummy found in the Alps in 1991, shows evidence of severe gum disease and cavities (shown in red). Credit: UZH View full size image

Ötzi the Iceman could have used a dentist. The amazingly preserved Neolithic mummy found in the Italian Alps had tooth decay, gum disease and dental trauma, new research suggests.
The new findings, published Tuesday (April 9) in the European Journal of Oral Sciences, suggest that the Iceman mummy's grain-heavy diet took a toll on his dental health.
"It's surprising how bad condition he is in," said study co-author Frank Ruhli, a paleopathologist at the University of Zurich in Switzerland. "We have the whole range of disease pathologies you can imagine." [Album: What Otzi the Iceman Looked Like]

Ötzi is probably the most-studied Neolithic man in history. More than 5,000 years ago, the ancient iceman was hit by an arrow and bled to death on a glacier in the Alps between modern-day Austria and Italy. The glacier preserved his body until it was discovered by hikers in 1991.
Since his discovery in the Ötzal Alps by the hikers, scientists have reconstructed Ötzi's face, analyzed his clothing, scrutinized his body and sequenced his genome.
These extensive studies revealed that Ötzi was a middle-age, well-to-do agriculturalist who lived not far from where he died. He also suffered from heart disease and joint pain, and probably had Lyme disease.
But somehow, scientists had never analyzed his teeth before. So Ruhli and his colleagues used a CT scanner to analyze the condition of Ötzi's teeth. They found that the ancient farmer had several cavities, likely caused by his carbohydrate-rich diet.
Ötzi also showed severe wear of his tooth enamel and severe gum disease. Hard minerals in milled grains abraded the surface of his teeth and gums, exposing the bone below and making the roots loose. Similar wear-and-tear is found in the teeth of Egyptian mummies who ate milled grains, Ruhli said.
"This is like a sandpaper acting on your teeth," Ruhli told LiveScience. "In another five to 10 years, he certainly would have lost some of his teeth."
As a result of his poor dental health, Ötzi would have felt pain when eating hot or tough foods, Ruhli said.
Ötzi also showed evidence of trauma to his front right incisor from being struck, either in a fight or an accident.
Ötzi's dental problems show the results of switching from a strict hunter-gatherer diet to an agricultural one, Ruhli said.
"Hunter-gatherers were depending on meat and berries, whereas [Ötzi] had processed food," Ruhli said. "The processing added a bigger variety of food but also impacted the quality of the teeth."

Science from ancient plaque...Huffington Post

Ancient Dental Plaque From 1,000-Year-Old Human Skeletons Sheds New Light On Disease

LiveScience  | by  Tanya Lewis

Posted: 02/25/2014 9:17 am EST Updated: 02/25/2014 9:59 am EST

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Microbial PompeiiDaily DiscoveryAnthropologyTooth DecayGum DiseaseAncient Dental PlaqueFossilized Dental PlaqueDental HealthDental Plaque SkeletonsCalculusScience News

A "microbial Pompeii" has been found on the teeth of 1,000-year-old human skeletons. Just as volcanic ash entombed the citizens of the ancient Roman city, dental plaque preserved bacteria and food particles on the skeletons' teeth.

Researchers analyzed dental plaque from skeletons in a medieval cemetery in Germany, and found that the mouths of these aged humans were home to many of the same bacterial invaders that cause gum disease in the mouths of modern humans.

"One thing that is clear about the population we studied is that they didn't brush their teeth very often, if at all," said study leader Christina Warinner, an anthropologist at the University of Zurich in Switzerland and the University of Oklahoma in Norman.

The discovery of these bacteria also revealed clues to the dental hygiene and diets of these centuries-old humans, according to the study detailed today (Feb. 24) in the journal Nature Genetics. [5 Surprising Ways to Banish Bad Breath]

Plaque is a dentist's worst enemy, but it turns out to be a great time capsule for preserving the bacteria (or "microbiome") and bits of food on the teeth of humans long after they die. The sticky bacteria on teeth trapped particles of food and other debris, and over time, the calcium phosphate in saliva — the same mineral found in bones and teeth — caused the plaque to calcify into tartar.

"We knew that calculus preserved microscopic particles of food and other debris but the level of preservation of biomolecules is remarkable — a microbiome entombed and preserved in a mineral matrix, a microbial Pompeii," another study researcher, Matthew Collins from the University of York, in England, said in a statement.

With their new study, Warinner and her colleagues are the first to sequence the DNA in ancient dental tartar, using a rapid method known as "shotgun sequencing." The team reconstructed the genome of a major bacterial pathogen and recovered some of the first evidence of food molecules from ancient dental plaque.

The DNA in food found in the plaque matched pigs, sheep, bread wheat and vegetables such as cabbage. The researchers also found starch granules that matched cereals and the pea/bean family.

"Amazingly, it's much the same thing you would find at a German restaurant today," Warinner said.

The skeletons had many years' or decades' worth of plaque built up on their teeth, and many of them showed signs of gum disease and tooth decay. While a few individuals had surprisingly healthy teeth, most of the older adults had lost most or all of their teeth due to wearing, decay or dental disease.

The microbe species found in the ancient plaque were remarkably similar to ones found in modern mouths, the researchers said. Gum disease is most often caused by the species Porphyromonas gingivalis, Tannerella forsythia,Treponema denticola and Filifactor alocis, and these microbes were all present on the teeth of the skeletons with dental disease.

Gum diseases are usually caused by infections or inflammation of the gums and surrounding bone. About 47 percent of adults ages 30 or older in the United States have some form of gum disease, according to the Centers for Disease Control and Prevention.

Non-human primates and other wild animals rarely get dental diseases, Warinner said, which raises the question, "What is it about humans that allows these pathogens to grow?"Scientists speculate that modern human diets and lifestyles may be to blame, but Warinner's team plans to analyze more ancient populations from other time periods to find out.

Follow Tanya Lewis on Twitter and Google+. Follow us @livescience, Facebook &Google+. Original article on Live Science.

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Oral Health is more than a Cosmetic Concern

   The following is a link to a very good article:
As a primary care doctor, much of my focus is on preventive care. While most patients anticipate my promoting the benefits of a healthy heart, balanced diet and regular exercise, many are surprised when I emphasize the importance of oral health.
Study after study has linked oral health to overall health. Dental problems may affect conditions such as diabetes, heart disease, poor nutrition, systemic infection and even preterm labor.
Studies also have shown correlations between poor dental health and poor school performance for children. Untreated dental disease can have lasting, damaging effects on children’s development by disrupting sleep, and making it harder to learn and communicate.
We also know that prevention is effective, and that untreated dental problems ultimately lead to a lifetime of unhealthy adult teeth and expensive dental treatment. Yet, I have seen firsthand many patients, in particular low-income adults and children, who struggle to get the dental care they need.
When the Washington State Board of Health recently released recommendations aimed at improving the oral health of all Washington residents, it was the first time the state formally recognized that dental diseases impact general health.
The board recommendations urge us all – health care professionals, government, social service agencies and citizens – to support efforts that improve oral health and advocate for collaboration. Doctors, nurses and pharmacists are urged to incorporate oral health into their practices and dentists to partner with social service agencies to help young mothers, seniors, diabetics, and low-income children and adults get the dental care they need.
The Tacoma-Pierce County Health Department has long been a proponent of similar strategies. Its oral health program is based on the guiding principles that it is in everyone’s interest to look after the whole body – including the mouth.
The Health Department has raised doctors’ awareness that they play an important role in the oral health of our children by emphasizing the integration of oral care into well-child checks.
Pierce County’s poorest children also are able to get the dental care they need through ABCD (Access to Baby and Child Dentistry), a nationally recognized program that ensures children age 6 and under see a dentist. ABCD establishes a referral network of doctors, dentists, social service agencies and early childhood development programs to identify and reach out to low-income children and their parents.
In the past, some of my patients with painful mouth problems had to go to the emergency room for care. Some even stood outside a clinic at 6 a.m., hoping an opening might appear that day.
I look forward to the day when patients are no longer turned away due to lack of available services. Even better, we can prevent cavities from happening in the first place.
Community water fluoridation is lauded by the Centers for Disease Control as one of the top 10 public health achievements of the last century. Yet in Pierce County, just 44 percent of county residents have access to fluoridated water, well below the state’s 65 percent and the national average of 74 percent.
Individuals also need to do their part by taking care of their teeth. Brush twice a day and floss daily. Get a regular dental check-up. Every cavity you prevent saves you money and protects you from the risks of infection.
It’s time we rethink oral health as a necessity for healthy living, not a cosmetic luxury. We can do better. We can all be healthier.
Dr. Stephen Cook is a family physician at Paladina Health and member of the Tacoma-Pierce County Board of Health.

Read more here: http://www.thenewstribune.com/2014/02/18/3053406/oral-health-is-much-more-than.html#storylink=cpy

 

Oral Hygiene for the Physically or Mentally Impaired Part II

  How to proceed
   You have had the patient's teeth cleaned and examined at the dental office. You will now disorganize the bacteria at the gumline once a day.
   The teeth are a four sided object and you want to clean all four sides.  The tooth brush will get two sides..the cheek and tongue side. The end tuft brush will clean the other two sides. You will moisten the brush as needed with the mouthwash.  Finish by having the patient rinse with the remaining mouthwash.
  1. Put on your gloves
  2. Have ready the toothbrush, end tuft brush and a cup of mouthwash.
  3. Place the patient in comfortable position for them and you ie laying on bed with head on pillow or in chair with a head rest.
  4. Picture the mouth having four rows you need to brush 1. Upper cheek and lip side
                                                                                              2. Upper tongue side
                                                                                              3. Lower cheek and lip side
                                                                                              4. Lower tongue side
      Do it methodically....know where you are going and where you have been. I go upper outside, upper inside, lower outside and lower inside. Just so you know where you are going and where you have been.
    5. The end tuft brush is to disturb the bacteria between the teeth.  Like with the tooth brush do this methodically. Stick the end tuft brush between the teeth and wiggle. Do this from the cheek side and the tongue side. For example...starting between the upper right last two teeth I stick the end tuft brush at a 45* angle and wiggle the end tuft brush.  I work my way around to the other side and come back around on the tongue side. I will repeat this procedure on the bottom arch.
   6. Have patient swish with the rest of the mouthwash.
Note: The tooth is a four sided object..when you brush the teeth you have cleaned 50%.... the end tuft brush(or floss, tooth pick etc) is the other 50%

Oral Hygiene for the Physically or Mentally Impaired...How to get ready to brush someone's elses teeth. Part I

   I'm going to start with some facts you need to know:
1. Bacteria(plaque, tartar, biofilm) form on the teeth constantly and becomes more tenacious and harder with age.
2. Most of the bacteria are harmless but in the mix is the bacteria that causes decay and gum disease.
3. The bad bacteria must work in the absence of oxygen..they are anaerobic.
4. It takes the anaerobic bacteria about 24 hours to get organized..they then begin to eat the sugar that comes into the mouth and poop acid.  The acid eats away at the gums and dissolves the tooth structure.
5. The gums fit the tooth like a turtleneck collar....if you disorganize the bacteria at the gumline you can prevent gum disease and decay along the gumline(the most susceptible place for decay in people with poor oral hygiene).
6. Tooth paste does not clean teeth..it's a mouth wash. It makes your mouth taste better and puts some fluoride on teeth. It also makes you salivate when it's in the mouth.
7.  The average person finds the mouth scarey...they describe it as dirty or repulsive. They can be, but not if you clean them every day.
8.  Fresh plaque or bacteria are are very easy to remove...like talcum powder on a washboard..you can't shake it off but you can just touch it and it comes off. Bacteria in the mouth just needs to be touched.
   What you want to accomplish:
1.  Once a day you want to disturb or aerate the organized bacteria all around the base of the teeth.
2.  Apply fluoride to teeth to prevent decay.
   How to start:
1. Start with a clean slate.  Take the patient to the dentist and have the hygienist clean their teeth, have the dentist do an exam.  Have the hygienist or dentist show you potential problem areas.  Don't worry....you are like a blind man at this point but your eyes will slowly start focusing.  It will take practice.
2. Tools to get: Toothbrush, end tuft brush, fluoride mouthwash and latex gloves for yourself.                                       a. A very soft tooth brush, preferably with spaces between the bristles. The best one out there is the Lactona S-19. I have found them on Drugstore.com and even on Ebay.  They are a tooth brush made in Holland.  The bristles are soft and the bristle ends have been rounded to prevent abrasion.  You can't hurt any one with this brush.
                          b. An end tuft brush.  This is a tooth brush with the back bristles missing.
                          c. Mouthwash for dry mouth like Biotene or Act for dry mouth. They don't use alcohol as a base...very mild.  You don't want the patient salivating and wanting to spit.

Professionalism and Honesty in the Dental Office

       As a hygienist it is not my place to diagnosis.  Over the years I have worked for many wonderful dentists.  They all have a different styles...some very conservative to very aggressive. There is that gray area...but if they treat their friends and family the same way I don't question their treatment.   I do not want to sit there knowing the dentist is not being forthright with the insurance company(easy to do) and eventually the patient.  The patients are the innocent ones that expect us to be professionals and honest with them.  When I sit there knowing that dishonesty is in progress.... I feel like the driver in the get away car!  That's the time to find another job!

Polishing-When and why

  It has been brought to my attention by a couple of hygienists that they polish before they start the cleaning!  Any patient with plaque will be polished before the gross scaling starts because it's gross to push plaque around and you need visibility. I finish the cleaning with a polish also for all the reasons we polish at the end of the cleaning.