The mouths of people who suffer from migraines harbor significantly more microbes that can modify nitrates than the mouths of people who do not get migraine headaches, according to the University of California (UC) San Diego School of Medicine. Many of the 38 million Americans who have migraines report an association between consuming nitrates and their severe headaches.
“There is this idea out there that certain foods trigger migraines—chocolate, wine, and especially foods containing nitrates,” said Antonio Gonzalez, a programmer analyst at the Center for Microbiome Innovation at UC San Diego and senior author of the study. “We thought that perhaps there are connections between what people are eating, their microbiomes, and their experiences with migraines.”
Found in processed meats, green leafy vegetables, and certain medicines, nitrates can be reduced to nitrites by bacteria in the mouth. When circulating in the blood, these nitrites then can be converted to nitric oxide under certain conditions. Nitric oxide can improve blood flow and reduce blood pressure, though 4 out of 5 cardiac patients who take nitrate-containing drugs for chest pain or congestive heart failure report severe headaches as a side effect.
Gonzalez and colleague Embriette Hyde, PhD, used publicly available data from the school’s crowdfunded American Gut Project to sequence bacteria found in 172 oral samples and 1,996 fecal samples from healthy participants. These subjects had previously filled out surveys indicating whether they suffered from migraines.
The bacterial gene sequencing revealed that bacterial species were present in different abundances between people who get migraines, known as migraineurs, and those who don’t, or non-migraineurs. In terms of bacterial community composition, the team did not find huge differences in either fecal or oral samples from migraineurs compared to non-migraineurs.
The researchers then used the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) bioinformatics tool to analyze which genes were likely to be present in the different sets of samples given the bacterial species present. In fecal samples, they found a slight but statistically significant increase in the abundance of genes that encode nitrate, nitrite, and nitric oxide-related enzymes in migraineurs. In oral samples, these genes were significantly more abundant in migraineurs.
“We know for a fact that nitrate-reducing bacteria are found in the oral cavity,” said Hyde, project manager for the American Gut Project and assistant project scientist. “We definitely think this pathway is advantageous to cardiovascular health. We now also have a potential connection to migraines, though it remains to be seen whether these bacteria are a cause or result of migraines or are indirectly linked in some other way.”
Of course, bacteria play a significant role in oral hygiene too. Yet it is too soon to conclude that the organisms that may be influencing migraines are the same as those, for instance, causing periodontitis. The connections between the oral microbiome and migraines require much more exploration. In other words, better brushing and flossing won’t necessarily make those migraines go away.
“We still don’t know if and how the oral microbiome affects migraines. This study is very preliminary, and while the findings are exciting, we need to confirm them in a larger, targeted cohort of migraineurs to not only identify specific bacteria that might be playing a role but also to confirm that the bacteria are producing active nitrate and nitrite reductases that have a measurable effect on migraines,” said Hyde.
“If we do eventually identify these bacteria, we do need to be careful, because we know that oral nitrate-reducing bacteria can have a positive effect on blood pressure, so someone suffering from or at risk for hypertension or cardiovascular disease might not want to target nitrate-reducing bacteria to alleviate their migraines. I suspect that targeted treatment for migraines focusing on the oral microbiome will be highly personalized,” Hyde said.
Gonzalez and Hyde said the next steps will be to look at more defined groups of patients, separated into the handful of different types of migraines. Researchers then can determine if their oral microbes really do express those nitrate-reducing genes, measure their levels of circulating nitric oxide, and see how they correlate with migraine status.
“Perhaps doctors and dentists won’t be working in isolation, but will play an active, collaborative role in their patients’ health,” Hyde said.
The New Dentist Conference will take place once again at the ADA Annual Session this week. For dentists who graduated in the last 10 years, this program is designed to address the pressing issues of those who are new to the profession. Topics such as managing student loan debt, how to maintain a balance between work and home life, and ways to stay current with the future of healthcare will be covered in this program, which will be held today through Saturday, October 22.
Attendees of the New Dentist Conference can earn up to 6 hours of CE credit each day, and then can unwind at the New Dentist Reception.Register here: ada.org/en/meeting/attendee-information/new-dentist-conference.
Kick off the ADA Annual Session this afternoon with great food, local craft beer, entertainment, and colleagues from across the country. Attendees are welcome to bring friends and family to this year's Mountain Mixer, where, the ADA says, they’ll be bringing Denver to you.
Taking place on the exhibit floor from 4:30 to 6:00 pm, ADA participants are encouraged to experience Denver's diverse culture through a variety of activities all in one place. Take a “tour” of the city through complimentary craft beer tasting and appetizers, and catch up with colleagues and exhibitors while you wrap up day one of the ADA meeting.
Note:Additional beverages will be available for purchase. This event is open to all registered attendees. An ADA 2016 badge is required for entry.
At the 2016 ADA meeting, Michael Cataldo, CEO of Convergent Dental, announced the brand new partnership between Convergent and Patterson Dental.
Known for Solea, a hard-, soft-, and osseous tissue laser that can cut with a single setting, this new announcement brings even more attention to Convergent Dental. As they continue to work on more software updates, they look forward to this partnership.
Cataldo said, "Patterson shares the same commitment to their customers as Convergent does; that is, putting the customer first. We are excited for this partnership because of their track record of experience and success."
Cataldo also noted that working with Patterson may serve as a reassurance to dentists who may have had unfavorable experiences in the past with hard-tissue lasers. "The days of disappointment with hard-tissue lasers are over," he said.
For more information, visit convergentdental.com or stop by booth No. 1814 at the ADA meeting.
A new immunotherapy drug known as nivolumab greatly improves survival for patients with relapsed head and neck cancer, as more than twice as many patients taking it were alive after one year compared to those treated with chemotherapy. There are no other treatment options that improve the survival of patients with cisplatin-resistant relapsed or metastatic head and neck cancers, who typically live fewer than 6 months.
In fact, nivolumab was the first treatment to extend survival in a phase III clinical trial for patients with head and neck cancer in whom chemotherapy had failed, and it did so with fewer side effects than existing therapeutic notions. The trial was led by Kevin Harrington, PhD, of the Institute of Cancer Research (ICR), London, and the Royal Marsden National Health Service (NHS) Foundation Trust, with more than 20 research organizations from around the world.
Of the 361 patients in the trial, 240 with relapsed or metastatic head and neck cancer received nivolumab, while 121 received one of 3 different chemotherapies. In the United Kingdom, the chemotherapy patients received docetaxel, which is the only treatment approved for advanced head and neck cancer by the National Institute for Health and Care Excellence (NICE).
After one year of the study, 36% of patients treated with nivolumab were still alive, compared to 17% of the chemotherapy patients. The medial survival for patients on nivolumab was 7.5 months, compared to 5.1 months for chemotherapy.
Survival benefits were more pronounced in patients whose tumors had tested positive for human papillomavirus (HPV), with an average survival of 9.1 months compared to 4.4 months for those with chemotherapy. HPV negative patients survived an average of 7.5 months with nivolumab and 5.8 with chemotherapy.
Also, only 13% of patients taking nivolumab experienced serious side effects, compared to 35% of those with chemotherapy. Patients who received chemotherapy reported feeling physically, socially, and emotionally worse off, while those who received nivolumab remained stable during the course of treatment.
“Nivolumab could be a real game changer for patients with advanced head and neck cancer. This trial found that it can greatly extend life among a group of patients who have no existing treatment options without worsening quality of life,” said Harrington.
“Once it has relapsed or spread, head and neck cancer is extremely difficult to treat,” said Harrington. “So it’s great news that these results indicate we now have a new treatment than can significantly extend life, and I’m keen to see it enter the clinic as soon as possible.”
“Nivolumab is one of a new wave of immunotherapies that are beginning to have an impact across cancer treatment. This phase III clinical trial expands the repertoire of nivolumab even further, showing that it is the first treatment to have significant benefits in relapsed head and neck cancer,” said Paul Workman, PhD, ICR chief executive. “We hope regulators can work with the manufacturer to avoid delays in getting this drug to patients who have no effective treatment options left to them.”
Nivolumab still needs to be approved by the European Medicines Agency and NICE before it is available for head and neck cancer patients served by the NHS. The study, “Nivolumab for Recurrent Squamous-Cell Carcinoma of the Head and Neck,” was published in The New England Journal of Medicine.
Today on the show floor at the ADA annual meeting, Henry Schein Dental will launch #ScheinChats, a social media thought-leadership series that will feature interviews with customers, supplier partners, industry leaders, and more.
The first broadcast will occur at 1:00 (Mountain) this afternoon at the Henry Schein booth (No. 1016). It will feature James P. Breslawski, president of Henry Schein, who will sit down with the ADA's chief economist and vice president Dr. Marko Vujicic to discuss trends in dentistry and the future of the profession.For those who aren't able to attend in person, Henry Schein will be streaming this discussion live on its Facebook page. To watch, visit facebook.com/henryscheindental. Also, stay tuned to dentistrytoday.com for more on Henry Schein and other news from the ADA meeting.
Dentists and dental team members provided nearly $1.8 million in free oral healthcare services and education to more than 2,000 patients at CDA Cares, which took place at the San Joaquin County Fairgrounds in Stockton, Calif, on October 15 and October 16. These 14,718 procedures included fillings and cleanings, as well as 2,365 extractions. Volunteer technicians in the lab also provided 250 complete and partial dentures and repairs.
“Our CDA Cares program provides a significant impact throughout the state. At this clinic alone we were able to provide care and relieve pain and infection for more than 2,060 people,” said California Dental Association (CDA) president Ken Wallis, DDS. “Despite recent efforts to improve the Denti-Cal program, it remains chronically underfunded and people have trouble accessing care. The number of people we see at these events speaks to that need.”
“Seeing someone come to CDA Cares with pain or infection and leave smiling and in better health is heartwarming,” said Jean Creasey, DDS, chair of the CDA Foundation, which organized the event and promotes oral health awareness among the public and policymakers alike. “And to work with so many volunteers with the same goal of getting patients out of pain and in better health is incredibly rewarding.”
More than 2,500 volunteers donated their time and services to the event, including 850 health professionals such as dentists, dental hygienists, dental assistants, nurses, and laboratory technicians, in addition to community volunteers who assisted with registration, translation, data entry, and patient escort. The next CDA Cares event will be April 22 and April 23, 2017, in San Mateo, Calif.
The University of North Carolina (UNC) at Chapel Hill has selected Scott De Rossi, DMD, most recently the chair of the oral health and diagnostic sciences department at Augusta University’s Dental College of Georgia, as the new dean of its School of Dentistry.
“Scott De Rossi is a leader in oral medicine and brings significant clinical and research expertise,” said executive vice chancellor and provost James W. Dean Jr, PhD, MS. “Chancellor [Carol L.] Folt and I are confident that his concern for faculty and student diversity and globalization will help our School of Dentistry achieve its vision to be a world leader in improving oral health through excellence in education, patient care, research, public service, and engagement.”
De Rossi holds joint faculty appointments at Augusta University as professor of oral medicine in the department of diagnostic sciences at the Dental College of Georgia and professor of otolaryngology, head and neck surgery, and dermatology at the Medical College of Georgia. Also, he is an adjunct professor of oral medicine at the University of Pennsylvania’s School of Dental Medicine.
“I am honored to be chosen to lead Carolina’s School of Dentistry. The school has a rich history of distinctive strengths that position it to greatly influence academic dentistry and shape the next generation of oral health professionals,” said De Rossi. “I look forward to working with students, faculty, staff, and alumni in promoting the health of the people of North Carolina, the nation, and the world through excellence in education, patient care, research, and service.”
De Rossi’s appointment takes effect on January 15, 2017. A diplomate with the American Board of Oral Medicine, he is active with the ADA, the American Association for Dental Research, the American Dental Education Association, and the American Academy of Oral Medicine, where he serves as a trustee and as treasurer of the executive committee.
Also, De Rossi earned his DMD from the University of Pennsylvania School of Dental Medicine, graduating with the highest honors, and a certificate in oral medicine from the Hospital of the University of Pennsylvania. Also, he holds a BS from Providence College and expects to receive a master’s degree in business administration from Augusta University’s Hull College of Business in December.
The UNC Chapel Hill School of Dentistry is one of the only dental schools in the United States that offers training in dental assisting and dental hygiene as well as a DDS degree and all dental specialties recognized by the ADA. It also provides education tracks in other postdoctoral certificate programs and a pair of PhD programs. Its clinics see more than 115,000 patient visits and its students provide more than $4 million in in-kind dental care annually.