Dental CSI – it may sound funny, but it’s a very real science! Teeth are not only for eating, speaking and looking beautiful, but can be used in crime scene investigations with bite marks and extracted DNA. Dental ID, similar to fingerprint ID, is the most common form of dental forensics, a definitive meansof identification of unknown human remains in forensic investigations.It is routinely acceptable as evidence in court. Because of the resistant nature of dental tissues to environmental assaults, such as incineration, immersion, trauma, mutilation and decomposition, teeth represent an excellent source of DNA material as scientific identification!
Dental DNA can be used in anthropology as well! Earlier this month, doctors from the Massachusetts General Hospital threaded a scope up the neck and into the skull of a disembodied, 4,000-year-old mummified skull, in an effort to extract a molar. The tooth DNA was collected from the pulp of a well-preserved tooth and used to solve an “ancient art mystery,” which could identify his or her gender and age from material lying deep within the pulp of the tooth.
My experience with forensic dentistry was sad and shockingly personal – I had to send dental x-ray records to police department officials for identification of a friend killed in a plane crash.
Even criminals are aware of dental identification. Just this past summer, reality show star Ryan Jenkins had been suspected of killing his ex-wife Fiore; the perpetrator removed her teeth and fingers to destroy her forensic ID. What he didn’t realize was that the breast implants in Fiore’s chest carried a serial number that was later used to identify the body, and subsequently issue a warrant for Jenkins’ arrest. He committed suicide.
Dental identifications have always played a key role in natural and manmade disaster situations, in particular the mass casualties normally associated with aviation disasters. In the attacks on the World Trade Canter on September 11, 2001, only an estimated half of the 2,749 victims were identified – through a mixture of DNA, jewelry, and dental records. The deceased individual’s teeth are photographed and charted with impression materials that can be compared to the dentist’s patient chart, to make a positive identification.
Forensic dentistry has also been used to identify several infamous figures from the Nazi era, including Adolf Hitler, Martin Bormann, Eva Braun, and Joseph Mengele. The assassin responsible for the murder of John F. Kennedy, Lee Harvey Oswald, was also confirmed through dental records. Even the remains of Czar Nicholas II and his family, who were shot during the 1917 Russian Revolution, were initially identified through dental identification.
Forensic evidence in dentistry is a widely-applicable science in the identification of those individuals who cannot be identified visually or by other means or used as evidence utilized in law enforcement, but in scientific discovery as well! Teeth speak the truth!
In a story that spread across the news (and the web) in a matter of hours, a revolutionary surgical procedure took place in Florida that essentially used a female patient’s own eye tooth (canine) as a base to hold a prosthetic lens inside her eye, which was blinded nine years ago due to Stevens-Johnson Syndrome. Blind for nine years, Sharron “Kay” Thornton recently regained her vision through a first-in-the-U.S. surgical procedure at Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine. The surgical procedure — modified osteo-odonto-keratoprosthesis (MOOKP) — implanted her canine eyetooth in her eye, as a tissue base to hold a prosthetic lens in place.
The disease, which claimed Sharron Thorton’s vision for so many years is an idiopathic condition (read: spontaneous and of unknown-origin) which causes the epidermis to separate from the dermis in what is often a life-threatening battle. The condition destroys the cells on the surface of the eye causing severe scarring of the cornea. Because the eye is such a sensitive part of the body – which rejects foreign material, including plastics and other man-made objects – a piece of hard natural tissue was needed for the implantation of the prosthetic lens. Because the body would normally reject an artificial base, the eye tooth was chosen as a hard, durable tissue which was composed of natural minerals that the body would not reject.
Corneal specialist Dr. Victor Perez said of the procedure, which was developed in Italy, “MOOKP has proven effective as a solution to end-stage corneal disease where severe corneal scarring blocks vision and corneal transplants are no longer an option but the eye’s internal structures and optic nerve remain healthy. For certain patients whose bodies reject a transplanted or artificial cornea, this procedure ‘of last resort’ implants the patient’s tooth in the eye to anchor a prosthetic lens and restore vision,” he explained.
Before the eye-opening procedure, the eyetooth was actually implanted in the patient’s stomach for several months, in order to expose the tooth to other bodily tissues (blood, plasma etc), preparing the tooth for implantation within the eye. Had the tooth not been cocooned by the body before implantation, the chances of bodily rejection would have been rather high. Medical technologies like these (and revolutionary medical procedures) have helped improve our life so much – dental or other bodily implants have been used routinely with great success, but the bottom line is that prevention still is the best answer for our health and quality of life. When tragedy strikes – as it did with Kay Thorton – a combination of science and fortune just might save the day.
The economy has not yet recovered, and although we are out of the darkest corners of the recession, uncertainty still looms! Where should we put our money, where should we invest – what about investing in your smile? Believe it or not, taking care of problems you may have thought of as cosmetic (like a missing tooth) can actually prevent facial sagging and other signs of aging, while improving your quality of life.
It shouldn’t be news to hear that polls done over the last few decades have proven that a person’s smile is one of the biggest factors that make a first impression. A survey done by the American Academy of Cosmetic Dentistry found that 74% of American adults believe an unattractive smile can harm a person’s chances of career success. Does your smile show your true colors? If it doesn’t, speak with your dental professional about what options you might be eligible for in terms of cosmetic dentistry.
As we get older, our teeth shift around (and our smiles often degrade). This is primarily due to improper care of the oral cavity, including poor brushing and flossing habits (as well as not visiting your dental hygienist twice annually) or habits of drinking and smoking or clenching , grinding teeth at sleep. What you may not realize is that many of the most common aging symptoms – wrinkled skin, a slacked jaw, sagging lips – are partially caused by an unhealthy facial muscular system that did not provide proper support to the facial structure! As we clench and grind, our teeth shift and our bite falls out of alignment, contributing to many of the problems listed above. Thankfully, cosmetic dentistry can help prevent or repair some of these problems and restore our facial muscular system to its proper health and harmony, freshening up our appearance and providing a healthier oral system.
A bright and beautiful smile can take five to ten years off of your appearance, boosting your self esteem and empowering you to have a go-get-it attitude: a good thing in today’s economic environment! Speak with your dental professional today about your smile to find out what treatment options are available to you. Remember, prevention is always the best medicine. It’s always cheaper and easier to take care of problems before they exist!
Did you know that dental diseases like periodontitis and even cavities are the most common diseases – apart from the common cold? It may surprise you, but enough people neglect their oral hygiene enough to make this an extremely common ailment, even though it’s an easily-preventable situation! These numbers are so high because most people who have some form of gum or tooth disease have no knowledge of it – and with 75% of the population having some form of periodontal disease, you must take careful attention when cleaning your mouth.
Dental decay is not much of an issue in modern society (thanks to fluoridated water and toothpaste), but a proper hygiene routine is still necessary to prevent gum disease and/or cavities. Brushing and flossing is essential, as this both cleans the smooth surfaces of the teeth, and also helps break up food particles and plaque in between the teeth and gum line. Gum disease starts in between the teeth, and some toothbrushes can’t reach critical areas necessary to be cleaned to prevent bacteria from growing.
Although gingivitis – the bacterial infection that invades your gums – is reversible, periodontitis is gum and bone disease, and is not irreversible! Because periodontal disease is so serious, and can only be managed under the strict supervision of a dental professional, it is important to understand just how periodontal disease can affect you. This disease has been linked to heart disease, stroke, diabetes and other degenerative diseases that can be life threatening! I’ve blogged about periodontitis before, and I can’t stress enough how important and serious it can be to have regular cleanings and check-ups from a dental professional twice yearly. Periodontal disease can disfigure even the most beautiful of smiles. Your gums can be so swollen, receded and bloody that your teeth will look longer, will become loose and eventually will need removal. If you detect gum disease early, you will need a management program that includes regular treatment with your dentist and/or hygienist and solid home care to manage the disease.
Root planing and scaling is the common form of soft tissue management treatment, when a hygienist or dentist uses a precise tool to detoxify the tooth surfaces below the gum line and in between each tooth, and then rinses with antiseptic. With advanced technology, laser energy can also be utilized to remove diseased tissues and eliminate bacteria to allow healing to take place. Your dental professional will discuss the best treatment plan for you – a routine cleaning is not enough by itself to treat periodontal disease! You may need to visit your dental hygienist more often, up to four times per year in order to properly manage the disease. On a daily basis, a solid home care program (which should be designed by you and your dentist) will help you maintain your oral health. Besides brushing and flossing after every meal, other tools like prescription tooth brushes (like Rotadent) and water irrigators (like Hydrofloss) could be helpful for your hygiene routine. Antiseptic rinses like Tooth and Gum Tonic Herbal Rinse, a healthy diet and/or supplements and antioxidants like vitamin C and B can also help to fight and manage gum disease. Healthy gum supports a healthy smile, which supports a healthy body!
Let me start by saying that – for some of you – this post may seem a bit silly. However, I get questions in my office about enamel, the white coating of our teeth that the outer layer is made of. Some people confuse the definition “enamel.” Is this enamel the same as that enamel? What is enamel, and how can you keep the different types straight?
Tooth enamel is the hardest and most highly mineralized material in a mammal’s body. 92- 96% of enamel consists of minerals (hydroxyapatite, a phosphate and calcium salt) with the remaining part being water and organic material. Enamel makes up the shiny hard outer layer of a tooth for protecting dentin and pulp, while at the same time carrying out the function of chewing and grinding our food. When you brush your teeth in the morning and at night (and after every meal – hint hint!), you are in fact brushing enamel. The normal color of enamel varies from light yellow to grayish white. At the edges of teeth where there is no dentin underlying the enamel, the color sometimes has a slightly blue tone. Since enamel is semitranslucent, the color of dentin and any restorative dental material underneath the enamel strongly affects the appearance of a tooth.
One day I was asked “why can’t we use bathtub enamel to fix tooth decay, since it is a cavity on the enamel?” Well, in an effort to permeate some inquiring minds, here are a few other types of enamel – which should never be confused with tooth enamel! Vitreous enamel is the colorful result of fusing powdered glass to a decorative object (usually metal, glass or ceramic tile) by firing, usually between 750 and 850 degrees Celsius. The powder melts and hardens to a smooth, durable vitreous coating used in aesthetic applications, such as decorative work. This technique of applying enamel to add color or texture was originally mastered by the ancient Egyptians! Enamel paint is a type of liquid paint that gives a brilliant glossy shine when cured, and is especially useful in attention-grabbing mediums (such as street signs, door painting and road markers). The term “enamel paint” can also mean an object that is covered in an oil-base paint, but recently has come to include latex-and-water based paints.
Yes, it’s true that there are several different uses of the word “enamel,” but don’t confuse the brilliant white enamel of your teeth with enamel paint or decorative enamel!
People ask me all the time whether they should have laser bleaching to whiten their smile. “It all depends on whether you are in a hurry to get your teeth whitened, and whether or not you are a candidate for tooth whitening in the first place” – my typical response! The benefits of laser bleaching over an over-the-counter home solution include instant results, a painless experience and a completely guided procedure. If your teeth can benefit from teeth whitening, at-home tray bleaching techniques will work for most people unless their teeth are sensitive, eroding, severely worn or if they have gum recession. If you do have severely discolored teeth, a combination of laser bleaching and home bleaching would be the best approach to obtaining and maintaining a bright and dazzling smile.
Laser bleaching utilizes laser light energy to accelerate the chemical reaction of a bleaching agent, typically a hydrogen peroxide base product. Hydrogen peroxide is very unstable in response to light and heat (which is why over-the-counter 3% hydrogen peroxide solution is stored in opaque dark brown bottles). Because of this, light energy can excite peroxide molecules, breaking the covalent bonds of the bleaching agent. The agent then reacts to and breaks the long, discolored molecule chains into shorter-chained molecules, lightening the tooth color. The bleaching agent used with laser bleaching is a high-strength solution when compared to home bleaching agents or over-the-counter kits. Your mouth will be protected with an isolator to protect the oral tissues , and placement of the bleaching agent is done in a very controlled manner by a highly trained dental professional. Once a 10-to-15 minute bleaching cycle is complete, the teeth will be cleaned and evaluated to discern whether additional applications of bleaching agent will follow. Normal bleaching procedures involve three applications of the bleaching gel, with an “instant average” of six shades of whiteness typically resulting. Laser bleaching is instantly gratifying. In my office, you can watch a movie through virtual i-glasses while the procedure takes place, and before your movie is finished your teeth will have been transformed into a younger, prettier and whiter smile!
Many different types of lasers (or light) are used for eliciting fast chemical reactions in teeth whitening. Some people will experience more sensitivity when infrared energy (heat) is utilized, which appears in most dental offices, but a few alternatives like Argon or KTP lasers (which emit blue and green light) exist. These lasers have the correct level of energy required to excite the bleaching gel, but they leave the teeth cool and comfortable. Most sensitivity is transient, and should subside within a day (Ibuprofen will be helpful if there is any available). After a smile has been bleached with a laser, one must be very careful to maintain his or her newly brightened smile lest the brilliant white color fade and dull over time. Alcohol, soft drinks and smoking are all bad habits which can stain teeth and regress any laser bleaching process. A healthy diet will also be beneficial for your physical and oral health. If you take care of your mouth, your reward will be apparent with a happy and healthy smile.
Summer break is a busy time for oral surgeons, who are often busy extracting the wisdom teeth of college bound or high school students. This wisdom teeth removal surgery could be the biggest medical and dental procedure for a young person. As long as as you are under the care of a capable and well-experienced oral surgeon, the procedure should run smoothly, but proper home care after having the wisdom teeth removed is very important to assure a healthy and speedy recovery.
Anesthetics or sedatives used during oral surgical procedures will often take a couple hours to wear away – the first 72 hours are crucial for normative recovery. Pain medication like anti-inflammatory Ibuprofen or narcotic Tylenol #3 with codeine often is prescribed depending on the severity of the procedure in addition to a 3-times-daily antibiotic, such as amoxycillin.
Regarding eating and drinking after oral surgery, avoid soft drinks for a week and avoid alcohol for 3 to 5 days .No smoking forever is the best, however if you really are dying for a draft,wait as long as possible, at least for 24 hours for being kind to your body. The first day at home should consist of using a cold compression (ice bag on 15 minute off 15 minutes for few hours), which can eliminate swelling. Stay away from straws and any mouth-opening activities to prevent loosing blood clots which lay a foundation for regenerate tissues as part of the natural healing process. Using a straw can cause the painful condition known as “dry socket.” Both preventing infection and timely healing are pivotal for post-surgery patients; follow the instructions from your surgeon on medication, diets, hygiene and habit. You’ll fully recover in no time.
Other than chipmunk cheeks for a couple days, the other common complication related with wisdom teeth extraction is the discomfort associated with dry socket. What causes dry socket and the prevention of dry socket are still being researched, but as a general rule the surgeon’s technique should be gentle and precise, so as to not traumatize the bone during the procedure. If the tooth is impacted or laying side ways, instead of forcing it out with forceps (which can create excessive compression on the bone), the surgeon should use a rotary tool with a saline cooling system to create access to the impacted molar. The molar will be dissected into smaller pieces and removed, without traumatizing the bone. On the patient’s part, there should be no rinsing, spitting, smoking or sucking of any kind for the first 24 hours after oral surgery. This will prevent disruption of the blood clot from a physical force in the mouth. Better oxygen saturation and circulation of the blood from not smoking is also important for healing. A good diet rich in antioxidants and vitamin c, lean proteins are good for tissue regeneration, for overcoming the negative influence on our body from consuming antibiotics. Eat yogurt or take acidophalus to restore the friendly flora in our body to prevent a yeast infection.
If your are healthy, forget all the above mentioned, you will be just fine after surviving the oral surgery!
We all know that brushing and flossing is not the only key to preventing dental disease (tooth decay and gum disease) – you probably also know that a healthy smile and fresh breath can actually reduce risk of a heart attack and stroke. What may surprise you, however, is this: researchers at West Virginia University have discovered that a clean mouth may also help preserve memory!
Thanks to a grant awarded by the National Institutes of Health, West Virginia University has found an obscure link between periodontitis (gum disease) and memory loss. A test sample (of over 270 seniors) was chosen to be part of the university study, during which School of Dentistry researchers checked the oral and cognitive health of patients every day over a period of roughly two years. Initial conclusions showed that 23% of the group who suffered from mild to moderate memory loss also had relatively poor oral hygiene habits.
Dr. Crout of the WVU School of Dentistry explains that although the specific genetic link between periodontitis and memory loss has not yet been defined, the team hopes to have more details soon. “If you have a gum infection, you’ll have an increased level of inflammatory byproducts,” Crout explained. “We’re looking for markers in the blood that show inflammation to see if there is a link to memory problems. We’d like to go full circle and do an intervention — to clean up some of the problems in the mouth and then see if the inflammatory markers go down.”
We’re not quite sure about whether bacteria or the body’s inflammatory response is the contributing factor of observed memory loss; it may be a combination of both, or a result of other environmental and physiological factors. What we do know, however, is that the rate of Alzheimer’s cases is skyrocketing. Imagine the benefits of knowing that keeping the mouth free of infection could cut down cases of dementia – it could be revolutionary!
Keep brushing and flossing to keep the mind sharp – or maybe we need a sharp mind to keep brushing and flossing? As a clinician, when I see a patient who can’t keep their oral hygiene in reasonable condition, I become concerned. The risk of heart attack and stroke are heightened in patients who suffer from poor oral hygiene. Knowing that memory loss is somewhat associated with inflammatory factors in the mouth, we should all improve our oral health in order to keep our mind sharp!
It’s no shocking headline – bad breath is the #1 complaint (and reason of visit) in dental offices across America! 85% of people who suffer from bad breath actually have a medical condition known as halitosis, which is usually caused as a result of bacteria in the mouth. The recent 4th of July holiday is a joyous occasion for BBQers across the country, but it could be a nightmare if you suffer from halitosis! If you think you have chronic bad breath, and nothing seems to be helping, read on for a bit of assistance.
Halitosis: it's hard to hide!
Apart from being severely embarrassing, bad breath can actually impact your personal and professional relationships. No employer wants a smelly employee (especially one that interacts with customers on a regular basis, like salespeople), and no partner or date wants a stinky kisser. Bad breath can even instill psychosis into patients with halitophobia, or a fear of bad breath. We know halitosis can seriously impact lives, and not in a positive way – so what can we do about it?
Certain foods with strong aromas – like onions, garlic, sea foods and refined carbohydrates (pastas, dairy products and cheese) – can cause bad breath, but bad habits like drinking and smoking can as well. Dental conditions like dental caries, periodontal disease and dry mouth can create halitosis. Physical conditions like indigestion, GERD (GastroEsopageal Reflux Disease), Asthma and Diabetes can also lead to haliatosis. Treatment for halitosis on the physical end is getting to the root of the problem: eliminating the food debris and bacterial factors in the oral cavity (managing the physical illness). Regarding diet and habits, my professional recommendation would be (of course) to stop smoking and drinking! Control the intake of foods / herbs that can cause smelly breath. Consume greens like celery and parsley, drink plenty water and (at the very least) brush and floss your teeth after every meal. If you eat a lot of garlic or fish, even after brushing and flossing a bad smell can linger in the mouth for a long period of time. Over-the-counter mouth washes and breath fresheners can only temporarily mask over halitosis – they will often times not rid the mouth of foul odors.
Bad breath is a social embarrassment, and is also a sign of having poor hygiene or health problems. We must all be aware of the condition our body is in. Maintaining the self is infinitely beneficial, and health professionals are always ready to provide advice to assist you in reaching our goal: healthy and happy living.
Antibiotics help us fight infections, however certain antibiotic medication could dim your smile! When taking antibiotic medications, it is important to realize that these types of medications not only eliminate harmful bacteria, but also affect the body by disturbing the balance of our gastrointestinal system. Sometimes the chemical components of antibiotic meds can leave deposits in the hard tissues of the oral cavity, like in the tooth and bone, affecting the color of the teeth.
Staining from the antibiotic tetracycline.
It has been well established that commonly prescribed antibiotics like tetracyline, if taken during the second half of the pregnancy can affect the future teeth of the fetus. Children younger than eight years old with prescription tetracycline (for treating ear infections) can have seriously discolored teeth as well from chemical deposits on the inner layer of the tooth structure (dentin), causing grayish brown bands that are not so easy to correct. Discoloration is usually a consequence of the chemicals affecting the developing stage of the teeth. If any discoloration is noticed in a child with primary teeth, promptly speak with your doctor or dental professional! Review the child’s history to determine whether the discoloration could possibly be associated with any medications, diet or even drinking water. Discoloration of erupted permanent teeth has also been proven to result from antibiotic use, as discussed in an earlier edition of the Journal of the American Dental Association. Although this is fairly rare, discoloration can happen to nearly anyone taking tetracycline, erythromycin, minocycline, or rinses containing chlorhexidineantiseptic solution. Keep your dental professional informed as to your antibiotic regiment.
In Kentucky, a 25-year-old woman whose teeth were gray-streaked from use of antibiotics was highlighted in a study completed by Frederick M. Parkins, D.D.S., of the University of Louisville School of Dentistry. The patient took two years of tetracycline therapy for teenage acne. She had been taking minocycline (brand name Minocin), a synthetic form of tetracycline and now has very discolored teeth (see above picture). Thankfully, only about 3-6% of adult antibiotic users will experience tooth-staining. Discoloration can develop as early as one month after the antibiotic regiment begins, but the staining could take years to appear!
Prevention is always the best solution – avoid teeth staining medications. If staining does occur, speak with your dental professional about options to whiten affected teeth. Procedures such as in-office or take-home whitening and bleaching will be the first conservative treatment option available to you before porcelain veneers or bonding procedures, which work well at masking over discolored areas of teeth.
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. The tooth DNA was collected from the pulp 
