Tuesday, April 23, 2013

The Evolution of Oral Cancer

Cancer is one of the more unfortunately diverse and broad issues the medical field has found itself dealing with. The intriguing characteristic about cancer is its ability to infect all parts of the human body. For this reason, I thought it would be of interest to myself, and hopefully the rest of the class, a closer look at oral cancer, and its evolution throughout time.

The origins of oral cancer, as we learned during lecture, are driven by both one’s genes and the environment. About 75% of oral cancers are linked to modifiable behaviors that include the excessive use of tobacco and alcohol consumption, poor hygiene, poor nutrition, ill-fitting dentures/ rough surfaces on the teeth, and chronic infections by bacteria (like HPV). When detected early, oral cancer can be prevented. According to the Oral Cancer Foundation however, “death rate associated with this cancer is particularly high not because it is hard to discover or diagnose, but due to the cancer being routinely discovered late in its development”. Other concerning facts about oral cancer (oral and pharynx) include: 42,000 individuals will be diagnosed this year alone. Thus, about 1 person every hour is killed by this sub-type of cancer, because of the 57% survival rate. This survival rate is not limited to only the United States. The prevalence of oral cancer can be cross-culturally examined as in The Open Nutraceuticals Journal . This article explores the molecular biology of oral cancers—and the reason behind higher genetic risk factors found among South Asian individuals.

Therapy of oral cancer is not always effective. If detected early, “stage I and II and be cured by surgery or radiation therapy but later stages, like III and IV are treated with radiotherapy or chemotherapy with 20% and 12% survival rates respectively”, according to Advances inthe biology or oral cancer. These methods of treatment of adaptive therapy result in a cultural lifestyle trade-off of the quality of life versus the quantity of life. For example through low dose chemotherapy, there is less strong selection pressures made thus sensitive cells are not killed, whereas responsive chemo cells are maintained. This way, resistant cells are unable to grow in new spots. In other words, one can either survive cancer (living with cancer) or completely get rid of cancer (with a lower fitness and life quality) and risk a relapse of the cancer.

In short, the existence of oral cancer was almost if not completely nonexistent during the age of our ancestors. The increase use of processed foods, agriculture, and uses of technology has exposed more viral infections and bacteria to the human oral cavity than ever before. It is inevitable that cancer treatment will become more progressive throughout the future years, and only time will tell just how effective it will be. 

Until next time, 

Monday, April 1, 2013

A Refreshing Blast to the Past, the Dental Way

Hello all!

Today's discussion is one I hope you all enjoy, because I know I am going to. As we talk about the way our teeth and environment have evolved together and independently of one another, I feel it is inevitable to discuss how the treatment of human dentition has evolved as well. From the usage of plants to toothbrushes to toothpaste to minty gum and breath-mints to floss and tongue cleaners, the condition and well-being of our teeth have been directly impacted as well. 

The process in which organisms started taking care of their teeth is an astonishing one. We know animals like elephants and monkeys utilize bamboo shoots and other plants for maintenence, but what about humans? Oral Wellness claims all cultures have used plant-based dental care at some point--"our ancestors picked their teeth as far back as 1.8 million years ago, the earliest records we have found of humans caring for their oral health comes out of ancient Asia and Africa. For example, the Chinese recorded the benefits of using clove for oral health thousands of years ago. The people of India have been using stems from the neem tree as a toothpick for thousands of years as well. Tribes in Africa have been chewing on sticks from specific trees known to support oral health for as far back as they know".

Toothbrush History, Chewstick
Above: Chew Stick. 

Toothbrush History, Toothbrushes, Oldage Toothbrushes

But, according to the Library of Congress, China invented a bristle brush in 1498, and the Americas experienced the first modern day toothbrush in 1938. SO, toothbrushes are a relatively recent invention. 

Yet toothpaste, didn't follow too far behind cultures using toothbrushes. 

Below, is the History of Toothpaste:

Back in the Days of Buddha.... 

The activity of keeping the mouth clean dates all the way back to the religious figure Buddha. It has been recorded that he would use a "tooth stick" from the God Sakka as part of his personal hygiene regimen. 

In 23 - 79 AD the practice of oral hygiene included:

  • Drinking goats milk for sweet breath
  • Ashes from burnt mice heads, rabbits heads, wolves heads, ox heels and goats feet were thought to benefit the gums. 
  • Picking the bones out of wolves excrement and wearing them was considered to be a form of protection against toothaches.
  • Washing your teeth with the blood from a tortoise three times a year was a sure bet against toothaches as well.
  • Mouthwashes were known to consist of pure white wine, or old urine kept especially for this purpose.

The 18th Century

The earliest record of an actual toothpaste was in 1780 and included scrubbing the teeth with a formula containing burnt bread. 

Other toothpastes around this time called for:
  • 1 1/2 oz. dragons blood 
  • 1 1/2 oz. cinnamon
  • 1 oz. burnt alum

The 19th Century
  • In the 19th century, charcoal became very popular for teeth cleaning purposes.
  • Most toothpastes at this time were in the form of a powder.
  • The purpose of the tooth powder was not only to clean the teeth, but to give fresh breath.
  • Strawberries were considered to be a "natural" solution for preventing tartar and giving fresh breath.
  • In 1855, the Farmers Almanac included this recipe for an appropriate toothpaste:
    1 oz. myrrh (fine powder)
    2 spoonfuls of your best honey
    A pinch of green sage
  • Another toothpaste included:
    2 oz. cuttlefish bone
    1 oz. cream of tartar
    2 drachms drop lake
    15 drops clover oil

The 20th Century
  • Liquid cleansers (mouth rinses) and pastes became more popular, often containing chlorophyll to give a fresh green color.
  • Bleeding gums became a concern as well as aching teeth.
  • In 1915 leaves from certain trees in South East Asia (Eucalyptus) were beginning to be used in mouthwash formulas.

  • sodium monofluorophosphate
  • color
  • flavoring
  • fluoride
  • foaming agents
  • detergents
  • humectants (prevent the paste from hardening)
  • Herbal toothpastes have gained popularity for people looking for a "natural" toothpaste or for those who don't want fluoride in their dental cleansers. Some herbal toothpastes contain:
    peppermint oil
    plant extract (strawberry extract)
    special oils and cleansing agents
^Similar ingredients to earlier toothpastes*

The ancient Egyptian recipe for toothpaste

The world's oldest-known formula for toothpaste, has been discovered on a piece of dusty papyrus in the basement of a Viennese museum.In faded black ink made of soot and gum Arabic mixed with water, an ancient Egyptian scribe has carefully described what he calls a "powder for white and perfect teeth".
When mixed with saliva in the mouth, it forms a "clean tooth paste".
According to the document, written in the fourth century AD, the ingredients needed for the perfect smile are one drachma of rock salt - a measure equal to one hundredth of an ounce - two drachmas of mint, one drachma of dried iris flower and 20 grains of pepper, all of them crushed and mixed together.
The result is a pungent paste which one Austrian dentist who tried it said made his gums bleed but was a "big improvement" on some toothpaste formulas used as recently as a century ago.

There is great debate as to how toothpastes should be (as with most things) as natural as possible. General rule of thumb: if you wouldn't swallow your toothpaste, you probably shouldn't be brushing with it, as chemicals ingested through the oral cavity are more likely to enter the blood stream than chemicals obtained through other means. I'd like to sound like a hypocrite and say I'm a faithful Colgate customer, however after my research I am more concerned. Read the chemicals listed on your toothpaste (you can do it, you have a free 2- 2 1/2 minutes every time you brush your teeth). Teeth-whitening brands often contain baking soda, and even hydrogen peroxide! Hydrogen peroxide? Definitely should NOT be ingested in any way. Be cautious, and hopefully in another post I can provide alternative suggestions on better more natural toothpastes to use. 

Dental Floss:
Dental floss is another relatively new oral health care tool introduced as early as 1815 by a New Orleans dentist who used a silk thread between teeth. 

In the early 1880s, J&J took the idea and mass-marketed it across the United States. It wasn't until the 1940s that nylon replaced silk. Waxed floss and dental tape followed about a decade later. 

After this fun blog post, I'd like to dive back into dental pathology. If you have any requests, please let me know! I have a great interest in pediatric dentistry, but will be more than willing to cover other subfields as well. 

Until next time,
See you soon Baboon


Brace :) Yourself!--Not Another Blog

Hey all!

Sorry for posting yet another website, but I feel if you have the time you should check them out as they provide interesting and relevant information to everyone's dentition needs!

Incisors and Molars provides a well-balanced, holistic source of information for all your questions and concerns! From finding a dentist to the history of toothbrushes...hint hint (upcoming blog).

So, enjoy!

Stay in Tune with Your Teeth!

Hey you all!

Here's a GREAT LINK to stay up-to-date with what's happening in the field of dentistry...around the WORLD!

Dental News

Sunday, March 31, 2013

Wednesday, March 27, 2013

Shuga’ Shuga’—the Not so Sweet Side of Man’s Greatest Gluttony

It’s inevitable. The last slice of cake, the last vine of juicy grapes, or that “one” cookie we all know ends up being “one” entire BOX. What is this urge (and persistent desire) of satisfying our sweet tooth, that is assuming we truly DO have a sweet tooth? As young children, we are taught throughout the world the importance of limiting our consumption of such an addicting substance. Have humans learned to reduce their sugar/sweet intake? Absolutely, positively, definitely, NO. Sugar consumption has been at an increase globally--most notably the US (surprise, surprise). 


Yet , as with everything in the life of humans, there is a biological factor that contributes to this ravenous urge: evolution. The evolution of craving sugary foods is a desire that encompasses multiple biological reasons, with multiple biological consequence as a result. One such result is the effect of it on teeth. Sugar is perceived as teeth’s worst nightmare. Is it possible that sugar may provide some degree of benefits to the teeth? Or to the body that may potentially outweigh the harm done to teeth? Are there ways to prevent the negative impacts of sugar on teeth? Sugar is a universal commodity found in foods of all cultures, and since we still are growing teeth, there must be something “healthy” or not too deathly in it, right? Turns out, the truth may or may not be so complicated.  

It is important to keep in mind the different forms of sugar around us. There is fructose (fruit sugar), high fructose corn syrup (the processed manufactured sugar), and sucrose (sugar, sugar--white/brown). The USDA's food pyramid suggests consuming "fats, oils, and sweets sparingly". This is the best way to avoid high fructose corn syrup, but what about fruit sugar? The USDA cannot advise against fruit...can they? Apart from preaching "everything in moderation", fruit sugar is not as bad as many people often perceive. But first, let us take a look at WHY and how sugar does what it does to human's teeth, and how its effects may or may not have changed throughout generations. 

It is no question that excessive sugar (of any form) inevitably leads to tooth decay. Tooth decay is visible in the form of cavities. The culprit of sugar, is that the bacteria lining the teeth feast on its structure--simple sugars. Annahad O'Conner sheds light on this bacteria; when the bacteria feasts on sugar, it creates acid that ruins the enamel. More interestingly enough, a case is made for bacteria as it takes "20 seconds to convert it to acid, which then lasts for about 30 minutes. That means that a can o soda is less harmful to your teeth when consumed in a few minutes instead of over several hours with repeated sips" Emphasis is placed on the negative impact acid formation by teeth bacteria have on an individual depending on his or her sugar-eating patterns. 

[Dental Bite: From the reasons explained above, it is advised to eat candy at one siting not throughout the day, as with other sugary drinks. Toddlers using sippy cups, should thus only drink sippy cups containing water and not sugary fruit juices that are consumed throughout the day leader to tooth decay!] 

On a more nitty-gritty, scientific level, it is important to remember that our teeth are made up of calcium-phosphate--according to Dr. Chemical, phosphates erode when exposed to acids. Sucrose (sugar) and the glycoproteins within the mouth become attracted to one another and stick to the teeth like "glue". HINT: This is called plaque that dentists love to clean. Dr. Chemical goes on to explain how the components of sucrose includes fructose which is used by the body for energy by converting it into lactic acid. It is this lactic acid that is referred to as the "acidic" component of sugar thus lower the pH levels within your mouth resulting in enamel loss.  [Take a fresh breath of air: 

Still not scared? Well, here's the awful tooth: Lactic acid is "10 times more acidic than vinegar which itself is acidic enough to be used as a household cleaning agent!

But, have no fear and take a breath of fresh air: "many toothpastes now contain sodium bicarbonate – this raises the pH and neutralizes the acid, thus protecting your teeth". 

I feel it is essential for readers to understand how humans have evolved to consume sugar more readily and how although it appears counter-intuitive that natural selection has not chosen against the side effects of sugar, it is not entirely Mother Nature's fault. Sugar had historically been a rare substance for our ancestors to obtain--when it was ingested, it was readily stored and then used. New York Times states "humans evolved to crave sugar" and that apart from honey, there was rarely any food sweeter than carrots.

If only they tried a Twinkie or two. 

Natural Selection has indirectly favored this genetic predisposition of craving sugar as a means of survival and reproductive success. What limits modern day humans is the excessive consumption of refined sugar spread throughout the day instead of at one sitting.  

From a dentition standpoint, it thus makes sense why our early Hominid ancestors lacked any cavities or tooth decay. When agriculture was discovered, the lactic-acid causing bacteria Streptococcus was found in more mouths across the world--found from eating all sots of foods from carbohydrates to milk sugar (lactose) and sucrose. And, because brushing one's teeth was a relatively novel idea at the time, the decay of teeth began. 
I would also like to clarify the misconception of fruit sugar. Theoretically, too much fruit sugar is not beneficial to one's teeth, but compared to the sugar contained in a can of Coke or other processed sugary commodities, it barely does any harm. As I am an advocate of most things natural, I still like to strongly advise in brushing your teeth after eating anything: healthy, natural, or not. 

So the next time you pick up that Twinkie (if you can find one) or a Ho-Ho, cookie, ice-cream, lollipop, etc., don't think twice about eating it. Because as we now know, they longer teeth are exposed to acidic environments caused by sugar and bad bacteria, the quicker our teeth become no more!

Look forward to our next discussion: The history of tooth-brushing and toothpaste along with its effectiveness throughout time. 

Until next time,
Bye-Bye Buttefly!




Monday, March 11, 2013

Third Set of Molars-- Obsolete(ly) Teeth-Numbing Wisdom

Third Set of Molars--Teeth-Numbing Wisdom

I have been anxious and excited to write this post, because every since I have began to find research concerning this topic, it is all I have been thinking about! (Nerdy? Well, of course). The ingenuity of the existence of wisdom teeth is quite remarkable. I mean, what evolutionary benefit does it provide other than every person growing them wanting to scrape at it with a sharp object? If that is anything like the feeling babies go through when teeth, well by golly, we've underestimated their strength. So to what purpose does this persistent pain and agony the majority of the human race undergoes serve? Why do some require it to be removed while others are able to retain them. And heck, why are they called wisdom teeth? I have been growing mine in for a couple years now, and according to my mom, I am far from epitomizing any characteristics of a wise oracle.

Wisdom teeth often start growing in as a third set of molars in the teenage years (16-25). However, mutations in growing wisdom teeth are possible, resulting in:

Hypodontia--failure to develop third molar teeth, and as a result possessing less than the normal 32 teeth. This condition occurs between 9-30% of the population.


Supernumerary Teeth--when an individual possess more than 32 teeth. This condition is present across cultures and is usually caused by environmental triggers.

This later growth of teeth was noticed by scholars in the 17th century, where they were referred to as "teeth of wisdom" and later changed to "wisdom teeth" in the 1800s. Although those with wisdom teeth may not be all that wise, eruption reiterates the transition period an individual goes from a child to an adult.

As you can see from the image above, wisdom teeth are one of humans' more larger ones heavily rooted into the gums. But, if they are so heavily rooted in the gums, why do many have them extracted? The answer lies in their purpose. To derive a purpose out of something so specific in the human body, it is inevitable and necessary to approach this question from an evolutionary perspective. There must have been a purpose that wisdom teeth served to our ancestors. And there is.

Rachele Cooper explores this history, and discovered a fairly straight-forward answer. "Anthropologists believe wisdom teeth, or the third set of molars, were the evolutionary answer to our ancestor’s early diet of coarse, rough food – like leaves, roots, nuts and meats – which required more chewing power and resulted in excessive wear of the teeth." As highlighted in a previous post, the evolution of teeth size and shape have greatly impacted the efforts of dentition today. Wisdom teeth are no exception. Our teeth all do not grow in at once, instead we are subject to the process of teething much of our child to young adult lives. But, natural selection does not force this adaptation in vein. The timeline of the growth of our teeth appear in an organized manner. Cooper elaborates on this with your two front teeth first emerging, followed by first, second, and eventually third molars. Thus, with time human's ability to eat more tougher foods requiring rigorous use of the teeth are capable.

Most interesting, is that our generation of humans are witnessing a natural selection decision being made in the process. Should we keep our wisdom teeth? Lately, it appears that the decision has been made, and we are losing them. On average,  35% of humans are found not growing wisdom teeth at all. This is a surprisingly large statistic considering how at one point wisdom teeth played a vital role in the survival of our species. Nonetheless, the use of modern technology and innovation has led to the creation of softer, cooked foods, utensils, and the ability to go on liquid diets. These man-made factors serve to facilitate the acceptance of allowing wisdom teeth obsolete with biological factors.

Across specific cultures, wisdom teeth variation can be observed. The way in each society utilizes their jaws heavily determines the formation of teeth. For example, Eskimo women were found in a 1970 study to possess a larger jaw (thus more prevalent wisdom teeth) than East Asia women. Causation? Their culture. Eskimo women traditionally have chewed leather in order to soften--this custom correlates with eating raw meats and "tougher" foods, thus retaining larger jaws. East Asian cultures on the other hand, are found to have less existent wisdom teeth likely to their cooked diets.

Biologically, as mentioned in earlier posts, evolution has gone to great lengths to shift the image of the human body. Larger brains have decreased the jaw structure and its ability to hold large numbers of teeth. Sad to say, similarly as the appendix, wisdom teeth are developing into a vestigial element in the human anatomy. Because our third set of molars are located so far back in the oral cavity, there is little question as to why our wisdom teeth might be the first to go. Dr. Louis K. Rafetto estimates that roughly 75-80% of individuals are unable to keep their wisdom teeth!! This means, that they likely are growing in at a wrong and harmful angle, or have bad bacteria trapped underneath growing tissue that carries high potential for more dangerous diseases. Dr. Raymond P. White Jr. confirms this estimate in that about 60-70% of patients eventually find difficulty with their wisdom teeth. Even 80% of those who are able to retain their wisdom teeth at a young age find themselves having them removed about 7 years later! This is due to the growing number of oral complications associated wisdom teeth from severe pain to cysts to tumors.

So do I have to get my wisdom teeth removed? Intimidating question, but the odds in today's day and age is...probably, yes. My reccomendation? Do it while you're young and have insurance, because oral surgeons are sure not hurtin' when it comes to this evolutionary decision.

Perhaps the reason wisdom teeth are still around is due to wisdom teeth growth's weak ties to natural selection. We mentioned before how teeth grow in on a timeline...natural selection has less control over growth occurring during the life of humans as opposed to when they are born. It is a slow process, one that likely will continue to take hundreds, if not thousands of years to complete, but I hypothesize that wisdom teeth will be lost. And until they are, they will have to be taken out.

So, save your wisdom teeth. Not only may you retain wisdom, but who knows? They might be worth even more one day.

Until next time,
Take Care Polar Bear!