[drsnehamaheshwari]

 Frequent consumption of sugary foods and drinks exposes teeth to acids and prevents the mouth’s pH level from stabilizing. Now, U.S. researchers have found that certain combinations of foods and beverages affect dental plaque acidity. In particular, they observed that the consumption of milk reduced plaque pH drop after eating a sugary breakfast cereal.

In the study, 20 adults were given four combinations of foods. The first group ate 20 g of a dry sugary cereal only. The second, third and fourth groups consumed the same amount of this cereal followed by 50 mL of whole milk, 50 mL of 100 percent apple juice and 50 mL of tap water, respectively.

In order to examine the combinations’ effectiveness in reducing dental plaque acidity after a sugary meal, the researchers measured the plaque pH in the participants’ mouths. While relatively low values were observed in the groups that had consumed the dry cereal (5.83), or juice (5.83) or water (6.02) after the cereal serving, a significantly higher plaque pH (6.48) was found in the group that had consumed the milk after the cereal.

The researchers concluded that drinking milk after a sugary cereal challenge significantly reduced plaque pH drop due to the sugary challenge. "When discussing the cariogenicity of foods and beverages with patients, dentists and other health care professionals should emphasize that the order of ingesting sugary and nonsugary foods is important and may affect their oral health," they recommended.

The study, titled "The Effects of Beverages on Plaque Acidogenicity After a Sugary Challenge," was conducted at the University of Illinois at Chicago. It was published in the July issue of the Journal of the American Dental Association.

        

[drsnehamaheshwari]

 The Maharashtra state government has decided to take control of vacant medical college seats after two rounds of admissions. The move comes in the wake of malpractices by private medical colleges last year.

The state has asked private medical and dental colleges to surrender their unfilled seats after the second round; admissions to these seats will then be done on the basis of merit scores in NEET, the central entrance test.

        

[drsnehamaheshwari]

 Coating toothbrush bristles with chlorhexidine appears to reduce concentrations of some harmful oral bacteria more than coating them with silver nanoparticles.

A study presented at the International Association for Dental Research’s 2013 annual meeting found that chlorhexidine-coated toothbrushes (Butler GUM) reduced concentrations of Streptococcus mutans by 99.8% 16 hours after the toothbrushes were immersed for three minutes in a microbe-containing suspension. The silver nanoparticle-coated toothbrushes (Mouth Watchers) reduced the bugs’ concentration by 93% at 16 hours. Neither had a statistically significant effect on levels of Candida albicans.

"Mouth Watchers’ patent-pending, innovative antibacterial bristles naturally eliminate 99.9% of bacteria to help your teeth, gums, and body stay healthier," the Mouth Watchers website claims.

As lead investigator Lt. Col. Jeremy Hamal, DDS, explains, the Mouth Watchers brushes are relatively new to the market, and the only available research on them is from Korea, where these brushes are manufactured. Moreover, their effectiveness in toothbrush disinfection has proved controversial in prior studies, he noted.

"So I decided to compare them to a control and also to the chlorhexidine brush, which has not been the subject of any independent study to date," said Dr. Hamal, who is an AEGD-2 senior resident at the Dunn Dental Clinic, Joint Base San Antonio – Lackland, TX. "The GUM brush manufacturers have made no overt claims of percent reduction in microbes."

 

Comparing bristles to bristles

The study was funded by the Wilford Hall Clinical Research Division. Dr. Hamal and his group used 80 each of the silver-nanoparticle and chlorhexidine toothbrushes, along with 80 toothbrushes that did not have coated bristles. They immersed half of each type of toothbrush for three minutes in a solution of Streptococcus mutans and the other half in a Candida albicans solution.

They immediately immersed one-quarter of each type of toothbrush in sterile saline and mixed them vigorously for 15 minutes to remove all of the organisms. At eight hours after initial immersion they repeated this (mixing to remove microorganisms) with another 20 of each type of toothbrush. They repeated this, each time with another set of 20 of each type of toothbrush, at eight and 16 hours post-initial immersion. They then diluted and placed on agar plates the resulting saline solutions. After incubating the plates, the investigators counted the resulting colony-forming units.

Reduction in colony-forming units at 3 time periods postimmersion

Microorganism/brush type          8 hours 16 hours               24 hours

S. mutans/control            88.6%    96.3%    95.4%

S. mutans/chlorhexidine              98.8%* 99.8%* 99.3%*

S. mutans/silver nanoparticles   90.6%    93.0%    96.3%

*p < 0.05 compared to control and silver-nanoparticle toothbrushes

The chlorhexidine-coated brushes brushed off more of the S. mutans at all three time periods compared to the other two types of toothbrushes. However, not even the chlorhexidine-coated toothbrushes ever reached the 99.9%-reduction level, which is "a benchmark for disinfection," according to Dr. Hamal.

With the C. albicans groups, the chlorhexidine-coated toothbrushes’ level of disinfection peaked at 97.5% at 24 hours, while the nanoparticle-coated toothbrushes reached 99.5% disinfection at this time period. However, Dr. Hamal’s team reported that none of the levels of disinfection were statistically significantly greater at any time period and between any of the types of brushes.

DrBicuspid.com queried Dr. Hamal about the potential for antibiotic resistance with the use of broad-based antimicrobial agents: "Antibiotic resistance is certainly a long-term problem in the management of infectious diseases; however, it is not my area of expertise, and I cannot comment on that," he responded.

        

[drsnehamaheshwari]

 Successful sedation in dentistry does not end when the patient departs the practice. Children, in particular, are sensitive to sedation, and as childhood caries rates remain high, the need for sedation will also persist.

Researchers from the department of pediatric dentistry at Louisiana State University Health Sciences Center (LSUHSC) School of Dentistry noticed the dearth of data about children’s response to sedation after they have left the practice where the dental procedure took place. In a study published in Anesthesia Progress, the researchers compared the adverse events experienced by children administered meperidine and hydroxyzine versus midazolam eight hours and 24 hours after sedation (Summer 2013, Vol. 60:2, pp. 54-59).

Their results could help set expectations and inspire advice for parents as they prepare to take their children home.

"Sleeping in the car during the ride back home was observed in half of the sedated children in this study," wrote Priyanshi Ritwik, an associate professor in the department of pediatric dentistry, and colleagues. "This has the risk of airway obstruction."

The researchers also observed different reactions to the sedatives they compared. "Vomiting was seen in children sedated with meperidine and hydroxyzine but not in the children sedated with midazolam," they noted. "Prolonged sleep at home was significantly higher in the children sedated with meperidine and hydroxyzine." And most adverse effects were likely to occur in the first eight hours, although some took up to 24 hours to manifest.

 

The drive home

Sedatives often last longer than the duration of the dental appointment. Consequently, the trip home from the dental practice can be a hazardous one, involving vomiting or worse.

"It is critical to know the effects of these medications beyond the time spent by the child in the dental office, so that parents can be appropriately cautioned about the expected effects and how to distinguish them from any potential emergencies that may lead to airway obstruction," the researchers explained.

During a three-month period, the researchers called the parents of children undergoing sedation at LSUHSC who were willing to participate in a survey eight hours and 24 hours after the procedure. The children included in the study were generally healthy and sedated due to acute situational anxiety.

The eight-hour questionnaire asked predominantly "yes" or "no" questions about complaints of pain, vomiting, snoring, or sleeping in the car on the way home, sleeping at home arousability, irritability, the ability to eat and drink, the need for medications at home, and the need for additional medical care after the appointment. The questions at the 24-hour mark were similar.

The parents of 46 children participated in the study; 40 were sedated with a combination of meperidine and hydroxyzine while the remaining six were sedated with midazolam. In the former group, 16 children reported pain after eight hours and seven of them said it persisted at the 24-hour mark. Only two children in this group had a fever. One child in the midazolam group reported pain in the first eight hours and one child had a fever. There was no statistical difference in the proportion of patients experiencing pain (p = 0.647) or fever (p = 0.349) based on which sedative they were given.

Three children given meperidine and hydroxyzine vomited within eight hours of sedation; none from the midazolam group did. Half of the children from both groups slept in the car after departure. Of those who slept in the car, 13 from the meperidine-hydroxyzine group and one child from the midazolam group had a ride of less than 30 minutes to get home. Five children from the former group and one from the latter had a ride of more than 30 minutes.

"All children in the meperidine and hydroxyzine group exhibited prolonged sleep at home in the eight- to 24-hour period," the researchers noted. "Five children (13%) were difficult to wake up in this time period." In the other group, 67% of the children exhibited prolonged sleep and one of them was difficult to rouse.

The researchers noted that sleeping during the car ride home has the potential for airway obstruction because the children may tilt their head down to their chest. "It is, therefore, important to ask parents to bring another responsible adult to accompany their child in the car when planning sedations for pediatric patients," they concluded.

        

[drsnehamaheshwari]

 Smokers and single men are more likely to acquire cancer-causing oral human papillomavirus (HPV), according to new results from the HPV Infection in Men (HIM) study (Lancet, July 2, 2013).

Researchers from Moffitt Cancer Center, the National Cancer Institute, Mexico, and Brazil also reported that newly acquired oral HPV infections in healthy men are rare and when present usually resolve within one year.

HPV-related oropharyngeal cancer is rare, but rates have been increasing rapidly, especially among men, the study authors noted. To determine the pattern of HPV acquisition and persistence in the oral region, they evaluated HPV infection status in oral mouthwash samples collected as part of the HIM study, which was originally designed to evaluate the natural history of genital HPV infections in healthy men.

"Some types of HPV, such as HPV16, are known to cause cancer at multiple places in the body, including the oral cavity," said lead author Christine Pierce Campbell, PhD, MPH, in a news release. "We know that HPV infection is associated with oropharyngeal cancer, but we don’t know how the virus progresses from initial infection to cancer in the oral cavity."

During the first 12 months, nearly 4.5% of men in the study acquired an oral HPV infection. Less than 1% of men in the study had an HPV16 infection, the most commonly acquired type, and less than 2% had a cancer-causing type of oral HPV.

These findings are consistent with previous studies showing a low prevalence of oral HPV cancers, the researchers noted. However, the study suggests that the acquisition of cancer-causing oral HPV was greater among smokers and unmarried men.

Additional HPV natural history studies are needed to better inform the development of infection-related prevention efforts, the study authors concluded.

        

[drsnehamaheshwari]

 White blood cells play a role in activating cancer cells and facilitating their spread to secondary tumors, according to a new study in the Journal of Clinical Investigation (July 1, 2013).

Researchers from McGill University and the University of Calgary used both cultured cells and mouse models of cancer to show there is a relationship between infection and metastasis.

Web-like neutrophil extracellular traps (NETs) are produced by white blood cells in response to an infection and normally trap and kill invading pathogens, such as bacteria, the researchers noted. However, they found that in the case of animals with cancer, NETs also trapped circulating cancer cells. Instead of killing the cancer cells, the webs activated the cancer cells and made the animals more likely to develop secondary tumors.

The researchers went one step further and demonstrated that the neutrophil web can be broken down by certain medication. Furthermore, in mice with cancer, markedly less tumor growth and metastasis occurred after the medication was administered. This finding was true for a number of different cancer types, suggesting that neutrophil webs may be a common pathway involved in the spread of cancer.

 

        

[drsnehamaheshwari]

Appliance Therapy Group (ATG) and Space Maintainers Laboratories have rebranded under the name SML.

The new brand encompasses Space Maintainers Laboratories, ATG, Success Essentials, SMILE Foundation, Second Opinion, Orthopix, and the professional support group known as ATPA.

As part of the rebrand, SML has developed a more easily navigable website to help customers better understand each of the brand’s products and services.

Space Maintainers Laboratories was founded in 1957 by lab technician Bill Veis. Comprised of five companies and offices in the U.S., Canada, Australia, Taiwan, and Malaysia, SML services more than 150,000 dentists and orthodontists worldwide in the field of appliance therapy.

 

        

[drsnehamaheshwari]

King’s researchers are one step closer to developing a method to replace missing teeth with bioengineered teeth generated from a person’s own gum cells.

Current implant methods to replace missing teeth mean that there is no natural root structure in the gum. As a consequence of the friction from eating and other jaw movement, loss of jaw bone can occur around the implant. Bioengineered teeth, or bioteeth, would mean a whole new tooth, complete with a root structure, grows from cells transplanted into a person’s gum.

The new research is being led by Professor Paul Sharpe, an expert in craniofacial development and stem cell biology at King’s College London’s Dental Institute. His team have been building on the bioteeth research done so far, which has focused on generating immature teeth that could then be transplanted into an adult jaw to develop into fully functional teeth. However, the cells used to form the immature teeth were sourced from embryos – thereby meaning the method cannot be widely used. The challenge in developing bioteeth that grow from a human jaw is finding adult sources of both human gum cells and human cells that are able to produce teeth.

Professor Sharpe and his team are half-way there. They took human gum tissue from patients at the Dental Institute at King’s College London, grew more of it in the lab, and then combined it with tooth-forming cells from mice. By transplanting this combination of cells into mice the researchers were able to grow hybrid human/mouse teeth containing dentine and enamel, as well as viable roots.

The next challenge in the development of bioteeth is to find a source of adult human tooth-forming cells that can be combined with human gum cells. If successful, it will revolutionise tooth replacement methods.

 

        

[drsnehamaheshwari]

Imagine that you have a toothache and you rush to your nearest dentist to get the problem fixed. When you get there, the dentist doesn’t wash his hands or wear gloves or a mask, nor does he disinfect his tools before inspecting your pearly whites.

 

Be careful, there’s a chance he might be one of the nearly 3,000 illegal dentists operating in the city, says the Dental College of Lima.

 

According to Dean David Vera Trujillo, the high volume of unlicensed dentists is a growing concern for the dental community. He told El Comercio that 10 percent (about 300) of the new dental clinics that open each year are bogus.

 

The majority of the illegal clinics can be found on the outskirts of the city, in the districts of Huaycan, San Juan de Lurigancho, Carabayllo, Comas, San Martin de Porres and Villa Maria del Triunfo.

 

Last week, El Comercio went down to Avenida Nicolas Ayllon in ATE district and counted more than six dental clinics per block. The daily even found a dentist willing to remove a tooth for only S/.15 ($5.50). The procedure normally costs closer to S/. 40 in a fully licensed clinic, according to experts contacted by El Comercio.

 

Extreme low cost is one of the signs of an illegal clinic.

 

“Lack of sanitary dental practices increases the chance of a dentist transmitting Hepatitis B by 15 percent and HIV by 2 percent,” Amparo Moscoso, of the Metropolitan Health System, told El Comercio. “These diseases are dangerous and can be spread through the blood, used toothbrushes, or contaminated instruments.”

 

The Dental College of Lima also estimates that 20 percent of “legally” licensed dental clinics end up being run by individuals without the proper training. Among them are technicians and dental students without legal certification for the job.

According to El Comercio, operating as a dentist without a license is punishable by up to 4 years in prison. However, the Dental College would like to see the punishment increase.

 

        

[drsnehamaheshwari]

Medical students whose admissions had been recommended for cancellation by the Pravesh Niyantran Samiti have got further relief with the Bombay high court saying on Tuesday, that their first year results could be declared. In January, the Samiti, set up to regulate medical college

 

 

admissions, had ‘disapproved’ around 250 admissions in private medical and dental colleges on grounds that they violated procedure.

After some students had approached the court, it had, in an order passed on April 5, allowed them to write their first year exams, but had said that results would be on hold pending a further order.

 

While hearing the matter on Tuesday, the court said that results could be declared but would be subject to further order. Those who passed could be permitted to enter second year. The court said it will next hear the case on August 5.

 

In a rare first this year, the Samiti had recommended cancelling admissions after the second round in 17 colleges where merit had been allegedly violated, following hundreds of complaints from students.

On Tuesday,Maharashtra also sought the liberty to take a decision on the admission procedure for this academic year in private colleges, which the court has allowed.

 

        

[drsnehamaheshwari]

The Delhi High Court on Wednesday said the formula adopted by AIIMS for allocation of seats to various categories in the Master of Dental Surgery (MDS) course, which commenced from July this year, is "not just and fair" as no seat was reserved for OBC category.

 

The court, however, declined to interfere with this year’s course and asked the Centre and AIIMS to allocate seats as per the provisions in the Central Educational Institutions (Reservation in Admission) Act in future.

 

"The formula adopted by respondent 1 (AIIMS) is not in conformity with the legislative mandate since sometimes the reserved category candidates are getting more than their due shares and sometimes they are not getting the share which ought to have come to them….," Justice V K Jain said.

 

The court order came while disposing of a plea filed by one Anusar Gupta, first rank holder in OBC category in post- graduate MDS course, who was refused admission on OBC seat in the institute for this year’s course.

 

"There is no legal sanctity behind the formula adopted by AIIMS for allocation of seats amongst various categories in the MDS course. Considering the meagre number of seats available in various specialities, the legislative mandate cannot be achieved in case the formula adopted by respondent No1 is allowed to continue.

Whether the legislative mandate can be achieved by treating all the seats in MDS, irrespective of the speciality, as one branch of study and providing reservation accordingly in terms of Section 3 of the Act, is for the respondent No 1 to examine. But the formula applied by it is neither legal nor just and fair," the court also said.

 

 

        

[drsnehamaheshwari]

Patient fear of the needle is a regular obstacle for dental professionals. Now St. Renatus, a Colorado start-up, is navigating the U.S. Food and Drug Administration (FDA) approval process to bring an anesthetic in the form of a nasal mist to the market.

The nasal spray, called Kovacaine Mist, is designed to anesthetize the maxillary arch. While the absence of a needle is an important aspect of the technology, it could provide other advantages to a dental practice as well, according to the company.

"A dental assistant can apply this topical drug, allowing for the dentist or dental professional to work more on actual procedures and billable treatments," Jill Shoemaker, vice president of investor relations at St. Renatus, explained.

In addition, because nasal mist anesthetic does not circulate in the bloodstream for as long as injected anesthetics, it is less harmful to the kidneys, liver, and lungs, according to an article in Innovation News. And since its effect would wear off more quickly, it could mean less drooling after a completed procedure. Also, a pediatric formulation could make treating children with an anesthetic much less stressful for everyone involved.

 

Inspired by a bloody nose

Founded to commercialize the new needle-free dental anesthetic, St. Renatus entered phase III clinical trials in July of 2012 after it secured up to $3.5 million from an angel investment group in January 2012.

Mark Kollar, DDS, was inspired to create the product after a basketball smashed into his nose during a pickup game of hoops, according to the Innovation News article. He noticed that the nasal spray drug that he received, commonly used by used by ear, nose, and throat physicians when they operate on the nose, numbed his upper teeth as well. The novel drug was successfully patented in 2002; it took only seven years to complete phase I and II safety studies.

After Dr. Kollar partnered with St. Renatus, the company hired Steve Merrick as its first full-time CEO, luring him away from his position as vice president of global marketing for Septodont’s pain control division in the fall of 2009.

There is no shortage of optimism that the product, if approved, could be successful — and a valuable tool for dentists.

"Market research has revealed more than 70% of patients are willing to switch to a dentist that offers the needle-free mist if their current provider doesn’t offer the nasal mist anesthetic," Shoemaker said. "Research has also revealed more people who are needle-phobic would visit the dentist."

 

Positive patient feedback

The results of the company’s successful phase II clinical trials were published last month in the Journal of Dental Research (May 20, 2013). Researchers from the department of periodontics and endodontics at the University at Buffalo and other schools compared the effects of Kovacaine Mist (3% tetracaine hydrochloride and 0.05% oxymetazoline hydrochloride) plus a sham infiltration injection to a buffered saline nasal spray plus an active-control intraoral injection (lidocaine hydrochloride 2% and epinephrine injection 1:100,000 in a dental cartridge).

Forty-five adult participants needing restorations participated in the single-center, randomized, double-blind, active-control, parallel-group study. Of the 45 patients, 30 were selected at random to receive the nasal spray, and the remaining 15 received the lidocaine injection.

After the patients received the experimental spray, the researchers monitored vital signs and used a probe to test sensitivity in four sites at regular intervals until one hour after full sensation had returned.

"The occlusal, distal, and mesial surfaces were most often involved for both groups, accounting for 77% of the spray cases and 93% of the lidocaine cases," the researchers noted.

The results were quite positive. During the intent-to-treat analysis, the researchers determined that 83% of nasal spray group required no rescue anesthesia; for one of the five that required it, the rescue anesthetic proved ineffective as well.

"Also, 90% of test individuals had anesthesia success from maxillary premolar to premolar," the researchers noted. The side effects, which included stuffiness, runny nose, numbness of the roof of the mouth, and sneezing, were minor, and the 11 patients who experienced them recovered without assistance.

"The St. Renatus team is very pleased to have the successful phase II data," Shoemaker stated. "They are also very encouraged by the positive patient feedback for the needle-free mist to provide proper anesthesia with significantly less anxiety."

While phase III clinical trials are already underway, some of the testing that is included was revealed in the phase II study. A wide age range of patients will be asked about preferences and facial numbness. In addition, a separate study in children is nearing completion, the researchers noted. "Children have better circulation and a smaller area for delivery of a larger volume of drug, which could be an advantage," they wrote.

So far, phase III appears to be progressing as well as phase II did.

"St. Renatus has seen similar success in the first part of their adult phase III trials," Shoemaker noted. "They anticipate being done with all FDA trials by the end of summer 2013."

 

        

[drsnehamaheshwari]

U.S. officials recently lowered the recommended dosage of fluoride in water from 1.2 to 0.7 parts per million — a limit that previously had been several times higher.

But detecting fluoride at such miniscule levels can be tricky, according to Texas A&M University chemist François Gabbaï, PhD.

So he and his research team have focused on building a solution — organometallic molecules that emit fluorescence when they are mixed with water containing fluoride. The new tool could be used to monitor water supplies and ensure safety standards.

"The sensors have to physically make contact with fluoride, but we had a fundamental challenge: Water serves as a very efficient buffer and keeps the sensor away from the fluoride anion," said Gabbaï, a professor in the department of chemistry. "So we make organometallic compounds that have a high affinity for small anions. These compounds are Lewis acids — molecules that are lacking in electrons — that capture fluoride and brighten when they find it."

Gabbaï recently earned a $440,000 National Science Foundation grant to further develop the technology.

 

        

[drsnehamaheshwari]

Biofilms on the surface of oral squamous cell carcinomas (OSCC) play a key role in the development of postoperative infections in patients with OSCC, according to a new study in Clinical Oral Investigations (June 22, 2013).

But antibiotics such as azithromycin, telithromycin, levofloxacin, and moxifloxacin used in a prophylactic regime can dramatically reduce the risk of infection in these patients.

Researchers from Martin Luther University Halle-Wittenberg swabbed the mouths of 90 patients, then cultured the swabs on media for aerobes and anaerobes. They found that the predominant pathogens of the normal healthy oral mucosa were aerobes, while the ratio between aerobes and anaerobes was 2:1 in risk patients and inverted in the OSCC group.

Altogether, they cultured 1,006 isolates. The most frequent strains were viridans streptococci (47), 30 Staphylococcus species (30), Enterococcus faecalis (14), Neisseria species (36), Escherichia coli (14), other aerobes (23), Peptostreptococcus species (66), Fusobacterium species (39), and Prevotella species (34). The resistance rates in the OSCC group were penicillin (40%), ampicillin (57%), doxycycline (23%), clindamycin (47%), and amoxicillin/clavulanic acid (20%).

"Gram-negative anaerobes play a decisive role in the development of postoperative infections in patients with OSCC," the study authors concluded. "This tumor special type of colonization does not agree with the normal flora of the oral cavity."

 

        

[drsnehamaheshwari]

The California Dental Association (CDA) has issued a warning about the significant risks associated with oral piercings, including the possibility of cracked, broken, scratched, or sensitive teeth and damaged fillings.

The CDA said that it recognizes that in today’s society many people use body piercing as a type of self-expression. However, people should be aware of the potential drawbacks, according to CDA President Lindsey Robinson, DDS. Oral piercings can interfere with speech, chewing, or swallowing and injure periodontal tissue. In addition, because the mouth is full of bacteria, a pierced area is difficult to keep clean, and infections occur more readily after an oral piercing, Dr. Robinson added.

Although not common, serious infections can occur, such as hepatitis or endocarditis (inflammation of the tissue surrounding the heart). Common symptoms after oral piercing include pain, swelling, and an increased flow of saliva. For some, blood poisoning, metal allergies, or blood clots can occur. Additionally, piercers have no standardized training and may have limited knowledge of anatomy and physiology.

If there’s a blood vessel or nerve in the path of a piercing, severe and difficult-to-control bleeding or nerve damage can result, Dr. Robinson warned.

Metal jewelry is often the culprit in cracked or broken teeth, and although plastic jewelry reduces this risk, it cannot eliminate it entirely. For lip piercings, the back side of the jewelry attaches inside the mouth and can be a source of irritation to the opposing tissue. As the metal or plastic rests on the gum tissue, it can wear away the tissue as it moves back and forth — a result that requires reconstructive surgery to repair and, in some instances, results in lost teeth.

It happens more commonly than people realize, Dr. Robinson said. Checking the tissues in contact with metal or plastic to ensure the jewelry isn’t causing damage or infection is important.

The CDA recommended consulting a dentist before making the decision to pierce.

 

        

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