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For the Avoidance of Doubt

May 2018

Nearly a quarter of five-year-olds starting primary school in England have tooth decay, figures reveal

Some 23.3% of five-year-olds have tooth decay, of which most miss 3.4 teeth

Around 17,000 youngsters have been forced to have decayed teeth removed

This often requires hospital stays and children being put under anaesthetic

There is 'wide variation' between rates of decay in different English regions

Expert said it is a 'tragedy' that postcodes determine children's oral health  

http://www.dailymail.co.uk/health

/article-5732145/Nearly-quarter-five-year-olds-starting-primary-school-tooth-decay-figures-reveal.html

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Gingival Hyperplasia

  • A Google search for ”Gingival Hyperplasia”
  • Recovered 11,100,000 results in 0.49 secs

  • None of the patients 4 patients presented have hyperplasia associated with either their medical history or medication.
  • I can find no references which associate medical stainless steel or plastic to Gingival Hyperplasia
  • The Four patients in this trial were all seen between 13:30 and 14:30 on 21.12.17.

  • Also attached are three patients for whom I would like your opinion, assistance in Oral hygiene support and treatment planning. They all have Gingival hyperplasia associated with their Medical history.

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3.3.8

31.10.2000

10mm OJ

”Null hull, hadde bra.”

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30.8.2009

3.3.2008

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2002

2010

The “Five Circle test”

Acid Erosion

British Dental Journal

Jan 2010. Vol 28 10.1038/sj.bdj.2010.57

M.N.Lowey

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Espelid tidene 2002 112, 266-9

89-118L Soft drinks 1992-2000

17-24% Fruit juice 1990-1999

54%-61% Carbonated drinks1990-1999

3-7% increased erosion 1990-1999

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The 15 WORST sugary drinks in Britain: Orange juice with as much sugar as 13 Hobnobs and

Innocent smoothies have the same as three-and-a-half doughnuts

Single serving of white grape juice contains same sugar as four doughnuts

One Starbucks coffee has as much sugar as 10 bowls of Golden Grahams

Lucozade sport drink has same sugar as two Walls Magnum Ice Creams�

Experts warn health drinks are partly to blame for our ballooning waistlines

No fibre in juices means sugar is absorbed faster leading to liver overload

��Read more: http://www.dailymail.co.uk/health/article-

2013

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As a 19-year-old dies after downing a high-caffeine drink, the worrying truth about the energy drink craze that's putting young lives in danger

Jenni Weaver, 40, from Bridlington, East Yorkshire, pictured left, was baffled by her 15-year-old daughter Gina's mysterious symptoms last year. Gina's symptoms became so bad that she was hospitalised and doctors were baffled until they asked about her diet. She then told them she was drinking three cans a day, and it appears she is not alone as popularity for the drinks among teenagers soars. However their is growing concerns over the largely unregulated drinks that have been linked to the deaths of Joshua Merrick, top right and Chloe Leach, bottom right.

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Britons currently consume one billion litres of sports and energy drinks - but experts are now warning that ingredients in pick-me-ups such as Red Bull and Monster Energy can destroy your health.

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Man, 21, SNAPPED four of his front teeth biting into an apple after ‘guzzling six Monster Energy drinks a day’ – 7 months

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Colon cancer crisis in young people could be fuelled by booming drinks brands adored by teens

They believe an ingredient in Red Bull and other top brands such as Celsius and Monster may be linked to bacteria in the gut that speeds up tumor growth.

Researchers in Florida theorize that cancer cells use taurine - an amino acid thought to improve mental clarity - as their 'primary energy source.'

At the world's biggest cancer conference this week, the team announced a new human trial that will test their hypothesis, which so far is based on animal studies.

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2014

One in 8 three-year-olds has rotting teeth... and fruit juice is to blame: Parents warned organic drinks and smoothies can contain as much sugar as a glass of coke

In some English regions as many as a third of children have rotten teeth

Leicester has the most, with 34 per cent of three-year-olds suffering 

Experts urge families to restrict children to milk and water 

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17,930 black and white adults over the age of 45. They were were tracked for about six years. Dr Jean Welsh, assistant professor at Emory University.����

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Royal college of Surgeons

Surgeons support campaign for Coca-Cola to stop handing out free sugary drinks this Christmas

The Coca-Cola Christmas tour, which has been running since 1995, has been scaled back in response to concerns raised by 83 organisations, including the Faculty of Dental Surgery at the RCS. The organisations signed a letter calling on Coca-Cola to hand out sugar free drinks only as part of the tour. The Christmas tour, which began last week, will now visit 24 towns and cities as opposed to 38. As a result of considerable local opposition coordinated by the Sugar Smart campaign last year, Public Health England issued guidance to local authorities warning of the impact of such marketing promotions on diet-related issues such as tooth decay and obesity.

The views expressed in this email do not necessarily reflect those of the RCS. If you have any feedback regarding the content please email us.

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2014

One in 8 three-year-olds has rotting teeth... and fruit juice is to blame: Parents warned organic drinks and smoothies can contain as much sugar as a glass of coke

In some English regions as many as a third of children have rotten teeth

Leicester has the most, with 34 per cent of three-year-olds suffering 

Experts urge families to restrict children to milk and water 

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How fruit juices rot toddlers' teeth: 1,200 under-twos in hospital to have them pulled out

Experts believe parents are rotting children's teeth with sugary fruit juices

More than 1,200 toddlers had to have teeth removed in hospital last year

It is a ten per cent increase on 2010 which dentists blame on sugary diets

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The shock sugar in YOUR child's food: It looks unbelievable - but in 136 bags, this is the 22 stones or 140 kg of sugar children now eat by the age of ten. 

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��

Children aged four to six should only have up to 19g of added sugar a day, according to the NHS, while youngsters between six and 10 can have up to 24g. We all know fizzy soft drinks contain a lot of sugar, with some varieties containing as much as 35g of sugar in a single glass.��

Public Health England, children are eating three times more

sugar than they should be, which has led

to new guidance this month stating that under-11s should

only be eating two low-calorie snacks a day.

Even snacks that promote themselves as

healthy treats such as fruit yoghurts and cereals

can contain alarming levels of sugar, however. (2018)

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Revealed: How kids under the age of TEN are being hospitalised by vaping

  • Since January 2022 there have been 24 NHS hospital admissions for under-tens
  • Admissions for under 20s also rose six-fold to 66 over the same two-year period
  • READ MORE: Nicotine powder legally sold to kids as an 'alternative to vaping' 

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Mother's horror as asthmatic daughter, 12, is left in a COMA after vaping left her lungs 'very weak'

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Gingival hyperplasia

  • Stavanger Universitetssjukehus Microbiologi seksjon for bakteriedignistikk
  • Four patients attending on same day 21.12.17, 1 Hour.
  • Oral swabs delivered on 21.12.17 – grown on Blood agar and Chocolate Agar
  • Request ´Oral swap - Hyperplasia’
  • Report for each case from SUS reported along with clinical images.
  • Case 1 – Upper removable appliance present 3 years Full time (2 Biopsies)
  • Case 2 – Upper removable appliance 3 years full time and lower fixed ....... (2 Biopsies)
  • Case 3 – No appliances at all (1 biopsy)
  • Case 4 – Upper removable appliance present 3 years Full time (1 biopsy)

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Streptococcal growth of

Alphahaemolysis on blood Agar.

Betahaemolysis has a clear

surrounding zone.

Reports on the average life cycle

of oral Streptococci varies but

appears to be around 2.5 hours.

Cleaning 2x day would appear to be

Insufficient to remove the bacteria

Effectively during Orthodontic treatment

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Streptococcal growth

on Chocolate Agar.

I could find NO published research

on PubMed Associating ”Anaerobes

with Gingival Hyperplasia”

I did find 437 published research articles on PubMed Associating ”Anaerobes

with Periodontal disease”

Diversity of Oral bacteria reduced at two significant points in Human history:-

  1. Introdution of Farming,

8-6000 BC

  1. Industrial revolution

1760-1820 AD

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Strep Mutans

  • Is a facultative anaerobic gram positive coccus.
  • It is a significant contibutor to tooth decay along with Strep. Sobrinus
  • It was identified in 1886 James Killian Clarke, but not fully implicated in dental decay until the 1960’s
  • At least 25 other species of Strep. inhabit oral biofilms
  • It is acid resistant and increase adherence with extracellular dextran
  • It has specialist adhesion receptors

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5405

Noonans Syndrome URA 21.12.17

Some palatal hyperplasia

No obvious inflammation or hyperplasia

in lower arch sites

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Palatal URA biopsy

Lower biopsy NO APPLIANCES

Lingual 46 buccal 41,42

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4868

URA & Lower fixed

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5.9.14

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1.10.15

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Palatal URA

Lower biopsy Fixed, Buccal to 41,42

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4757

No appliances at all.

Sister of the above patient

21.12.17

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21.12.17

26.10.13

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12.3.14

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NO APPLIANCES

BIOPSY Palatal and

Buccal to 41,42

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  1. URA FULL TIME

for 3 years

due to reduce wear soon

21.12.17

BOTH UPPER AND LOWER JAW DISCLOSED AT THE SAME TIME

NOTE obviously rich colonies of bactiera on 46 and 47 not UPPER

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3 YEARS URA FULL TIME

N.B. NO ANAEROBES

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21.12.17

23.12.12

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25.4.16

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16.12.16

24.10.17

24.4.15

25.4.17

Rate of Change of Vertical Growth

2015 -2017

Potential growth for 7 years

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Conclusions

  • 5405 URA only
    • 1. Palatal. Rich growth of Strep Alpha
    • Sparse Growth of Anaerobes
    • 2. Buccal LOWER. lower 41,41 lingual 46. Moderately Rich growth Strep Alpha
    • Sparse growth of Anaerobes
  • 4868 URA & Lower fixed
    • 1. Palatal. Rich growth of Strep Alpha
    • Sparse Growth of Anaerobes
    • 2. Buccal LOWER. lower 41,41 lingual 46. Moderately Rich growth Strep Alpha
    • Moderately rich growth of Anaerobes

  • 4757 NO APPLIANCES
    • 1. Palatal and Lower buccal.
    • Rich growth of Strep Alpha
    • Sparse Growth of Anaerobes
  • 4438 URA only FULL TIME 3 years
    • 1. Palatal. Rich growth of Strep Alpha
    • NO Anaerobes present

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Conclusions

  • There was no ”mystery irritant ” discovered by SUS patholgy lab.
  • There were very sparse or even NO anaerobes found under the upper removable appliances
  • The only sample with moderately rich growth of Anearobes was associated with the fixed appliances
  • The cause of any inflammation/hyperplasia would therefore most likely be the presence of Strep alpha
  • Cleaning, diet as well as socioeconomic factors are well associated with both the presence of these bacteria and dental disease

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Conclusions

  • DURATION OF WEAR
    • The case with an UPPER REMOVABLE APPLIANCE, full time wear of 3 years, had less bacterial growth and NO ANAEROBES present when compared with the patient with

NO APPLIANCES WHATSOEVER

  • ANAEROBES
  • The Patient with the greatest number of ANAEROBES present
    • WAS IN THE LOWER ARCH associated with FIXED appliances

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  1. 30.9.17 - 3.1.18

Full time wear URA. Following diet advice. Cleaning 3 x day

Had been told required extractions. Will not need extractions.

No Hyperplasia

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