European Stars and Stripes (Newspaper) - November 19, 1991, Darmstadt, Hesse                                Tic Bur health anti tartar toothpaste does it bite Back by Denise Gellene the los Angeles times concerned about gum disease Gerald Dageford decided to try an anti tartar toothpaste. Within Days his Gums bled and his Teeth ached. When he stopped using the toothpaste his painful symptoms disappeared. Dentists say Dageforde a problem Isnit unusual. His dentist sees one patient a week with similar ailments. A we used to see More cases Quot said Torrance Calif., dentist Alan Jones. Quot but we be taken most of our patients off the  though the toothpastes have been around for six years dentists Are just now starting to link them to otherwise unexplained ulcers and toothaches that patients experience. Supporting these clinical observations is research at the University of California los Angeles that shows that one person in 20 develops Adverse reactions. What a More the . Food and drug administration has questioned the claims of anti tartar toothpaste makers these developments Are threatening to take a bite from the nation s $1 billion toothpaste business. The anti tartar toothpastes Are important to Procter amp Gamble co., Colgate palmolive co. And other toothpaste 1makers. When introduced in 1985 As a weapon against gum disease anti tartar toothpastes were an overnight Success. Snapped up by aging baby Boomers worried about their Teeth the anti tartar formulas account for nearly one third of All toothpaste sales. Until the products came along toothpaste sales stagnated because of a Steep drop in cavities among the nation s children. Quot cavities have gone the Way of polio Quot said Cornelia Stanek an analyst with Kline amp co., a Fairfield n.j., consumer products research company Quot the big growth area of the 1990s is gum  _ indeed gum disease is the common cold of dentistry the government run National Institute of dental research ays that about 80 percent of adults have it. Infected with bacteria Gums bleed and separate from Teeth severe gum disease May cause Teeth to fall out. The nation s leading toothpaste makers Procter amp Gamble and Colgate palmolive say they have received few complaints about the toothpastes although some Consumers have noted a Quot hot Mouth Quot sensation. Procter amp Gamble is critical of the Urcla study. It says that it has received just one Telephone complaint about its tartar control Crest for every 2 million tubes sold. Nonetheless Colgate palmolive recently changed the formula of anti tartar Colgate significantly reducing the amount of the suspected irritant a a tartar fighting Salt called pyrophosphate. Colgate says that it made the change mostly to improve taste. The anti tartar toothpastes Appeal to such people As Dageford who bought tartar control Crest after a bout with gum disease. Like Dageford some people end up with new gum problems. Quot patients complain my Mouth is killing me. Could it be the tartar control often it is Quot said Peter Jacobsen an associate professor of Oral Medicine at University of the Pacific at Stockton Calif. The question for some people at least is whether the discomfort is Worth it. As disease fighters experts say anti tartar toothpastes fall Short. They prevent buildup of Yellowish tartar above the Gums where its mostly a cosmetic problem. But the toothpastes done to Block tartar accumulation below the Gums where it can Lead to health problems. The toothpastes can to Brush away old tartar either. Even with these shortcomings the toothpastes Are useful some dentists say. With tartar under control Quot Teeth cleanings Are easier for the hygienist and More comfortable for the patient Quot said Kenneth Berrell of the american dental association s Council on dental therapeutics. Berrell said however that it is the official position of the Council that the toothpastes Quot do not inhibit the disease  the Fra is reviewing the accuracy of anti tartar claims but said that the process will take at least a year at the same time it is examining Colgate a claim that its toothpaste also fights plaque the Sticky bacteria Laden film responsible for gum disease. Procter amp Gamble dropped its plaque claim two years ago. The manufacturers Are confident their claims will be approved by the Fra. The Fra will also take a look at reports of Adverse reactions a spokeswoman for the Agency said. The number of people affected by the toothpastes is a matter of scientific dispute. In testimony before the Council on dental therapeutics several years ago manufacturers said the anti tartars caused reactions in one person out of every 100, said Jacobsen a former Council chairman. The manufacturers would not disclose their reaction rates. Regular toothpaste produces reactions in one person out of every 200. Independent research suggests that the reaction rate is higher. A 1987 Field study at clinical research associates in Provo Utah found that one person in 20 experienced a wide Range of Side effects including Mouth ulcers and an unusual sensitivity to hot and cold beverages. A few people reported Quot a strange reaction a a feeling that their Teeth were on Edge like they just sucked a Lemon Quot said Rella Christiansen clinical research director. When people stopped using the toothpastes Christiansen said the symptoms cleared up. In a study published last october in the medical journal Oral surgery Oral Medicine Oral pathology a team of Urcla dentists disclosed similar findings. One researcher likened the inflammations to Quot a sunburn in your  the Urcla study tested toothpastes with less pyrophosphate than Crest. Cincinnati based Procter amp Gamble said Urcla tested the toothpaste on dental students who have Quot an above Normal sensitivity Quot to Oral problems. In addition the company complained that the dental students brushed their Teeth for two minutes at a time a four times longer than most people. Quot we think this greatly magnifies the results Quot said spokeswoman Terri Glover. Urcla s research team acknowledged that its study partly funded by Colgate did not Mirror real life. Even so the researchers believe that their findings Are valid. People in the test who used a regular toothpaste had significantly fewer reactions. Said Gerald Kowitz Urcla associate dentistry professor who led the research team. Quot i am sure that people Are visiting dentists for problems that could be solved simply by switching toothpastes Quot tracking the bacteria that cause tooth loss by Wendy Melillo the Washington Post with the identification of bacteria in the Mouth that May cause gum disease researchers Are moving closer to solving the problem of tooth loss in adults according to a study published last week in the new England journal of Medicine Spiro Hetes a kind of bacteria were found in people with ulcerative gingivitis a a severe form of gum ulcers known As Trench Mouth a and in those with period otitis an inflammation of the Gums Bones and ligaments surrounding Teeth the culprit bacteria were isolated from plaque a a White Sticky substance that attaches to Teeth samples were Analysed from 36 people with gum disease and 24 healthy adults. Results showed that the Spiro Chete bacteria which May be related to the microorganisms that cause syphilis were present in the Mouths of patients with gum disease but not in the study s control group of healthy adults. Quot we have no direct evidence that these bacteria Are the Only cause of periodontal disease Quot said George r. Riviere a professor in the department of paediatric dentistry at Oregon health sciences University and an author of the study. But if researchers determine that this family of bacteria plays a key role in the development of periodontal disease patients could be monitored for Levels of this and other bacteria in the Mouth and preventive measures could be taken before a a ethical signs of the disease appear. Quot we could begin treatment much earlier Quot Riviere said. While advances in dental treatment and fluoridation of water supplies have resulted in fewer cavities periodontal disease is still the primary cause of tooth loss. Three out of four adults suffer from some form of gum disease in their lifetimes according to the american dental association in Chicago. The risk of developing the problem increases with age about 64 percent of adults Over age 65 have gum disease said Philip Weintraub. A spokesman for the dental association. Dentists have known for some time that bacteria play a crucial role in the development of gum disease. The spiral shaped Spiro Chete is the latest bacterium to be linked to this common affliction. Quot there Are Over 300 types of bacteria in the Mouth and about 10 have been proven to cause disease Quot said Michael Newman an adjunct professor of period ontology at the University of California at los Angeles. Most bacteria in the Mouth Are Good microorganisms that help to keep the More virulent bacteria under control making it More difficult for plaque to form in periodontal disease gum tissue becomes detached from the base of a tooth and forms a pocket bacteria accumulate in the pocket and eat away at the structural Bones supporting Teeth the Way termites Mable away at foundations of houses traditional therapies for treating gum disease involve scraping bacteria Laden plaque from the pockets that have formed below the gum line Quot the purpose is to keep the Teeth very clean and keep the bad bacteria at very Low or at totally non detectable Levels Quot said Kenneth Kornman a professor of periodontics at the University of Texas health science Center in san Antonio. More advanced cases of gum disease usually require surgery. Incisions Are made in the gum and it is pulled away from the tooth after the area is cleaned the gum is stitched Back into place. One surgical Case can Cost Between $2,500 and $3,000 and take three to six months to Complete. For most people treatment of gum disease usually begins after they show signs of a problem a red swollen Gums that often bleed when brushed with earlier intervention people could retain the structures that support Teeth much longer Riviere said knowing which bacteria Are responsible for destroying Gums allows researchers to develop bettor therapies aimed at prevention so far dentists can test Tor three bacteria linked to gum disease and an experimental test to detect Spiro Chete bacteria is also available the tests allow dentists to better assess a person s risk of developing gum disease said Kornman at this Point monitoring bacteria Levels May be beneficial Only for people who already show some signs of gum disease in patients with healthy Mouths Quot the chances of finding the bacteria Are so Low that it does not. Justify the Cost of testing Quot said Kornman for All the advances in ways to treat gum disease dentists emphasize the need for More preventive maintenance of Teeth outside the dentist s office essential is the use of dental floss to clean Between Teeth which is where gum disease usually begins Page 14 b the stars and stripes tuesday. November 19, 1991 what s this painless dentistry by Gerri Kobren the Baltimore Sun the room t of is Odd almost of pts except Toi the dental Chan and a White Tom wheeled Case the sice of a Small Ladia Toi. With a Phoneil thin Cable looped at one end _ no sign anywhere of that big mechanism Vou expect to see in every dentist s Olliee the Mastodon like Hulk that holds the spigot and howl the Tia Lull of Shaip instruments the Dull that Laek hammers in oui Mouth. Lairy a Ilecki iodine in the Chan looking Moie Laid Back than any dental patient has a Light to tie he does t mind going to the dentist he says it s the alter Ell acts of the aesthetic he finds most Hoth isome i ust Don t like to be unable to feel my  he explains that s Why he s come to the a Altimie Ollice Oldi Maik Seward whose new dental laser collets the Pion use of no pain dentistry that Means no Needle no numbness no Ambau assent when you Mouth won t work right for a few Houis Afton quid and in some cases no Moie expense Toi the patient than conventional drilling this particular laser Sells for $50,000 according to reports from around the country some dentists Are charging Moie when they use it but Seward says he is making it up in volume instead Quot patients Tell their friends about it Quot he says Quot they be become  no newcomer to Medicine the laser is already in widespread use in such specialities As ophthalmology gynaecology dermatology and plastic surgery More recently the device has entered orthopaedics As Well different types have different strengths and weaknesses making them More or less appropriate for various uses. Overall however their effects Are dazzling they can be aimed and applied with such precision that they vaporize tissue a few cell layers at a time they sterilize what they touch and cauterize As they Cut so there s no bleeding Little or no swelling and faster Healing. In dental surgery the advantages Are similar they permit removal of infected or abnormal soft tissue in the Mouth a diseased Gums for instance or even tutors a without a Scalpel. Seward uses his laser to Zap away tooth decay As Well. He wears special glasses As he works so does his assistant Theresa Guidici patients Are protected in wraparound Green goggles since the invisible beam can damage the eyes another kind of laser Energy produces a red glow at the end of the wire to show turn where tie s aiming the Power beam Quot i am constantly interviewing patients to get a Leel Tor what they Are experiencing Quot he  and what they say they feel is a Little heat but no pain he recoils Why that is the Case is unclear one theory Fields that the Energy moving at Many pulses ii in end demolishes tissue so quickly that the nervous system does t have time to recognize pain but Seward also suggests that the laser might tie sealing off the structures that communicate Between the outer layers of the tooth and the pulp which contains the Neive Seward a laser developed spelt if Lily Lor dentistry derives its Power from a substance called nil Naglor neodymium yttrium aluminium Garnet developed specifically for dentistry by a Michigan dentist and his ophthalmologist brother it received marketing approval from the food and drug administration in May 1990, and has since been sold to nearly 400 dentists nationwide but it is not the Only kind of laser used in dentistry or Robert m pick a Chicago periodontist and associate clinical professor at tie Northwestern University dental school has been working with lasers since 198? his preference is the Carbon dioxide Tojie the primary use is for soft tissue pick said listing such procedures As treatment of canker sores and lesions under dentures removal of malignancies and infected gum tissue and reshaping of Gums it s a wonderful wonderful surgical tool1 he said the stars and stripes b Page 15