Dental Tribune Nordic Edition No. 3, 2016

Malocclusion affects posture and balance By DTI BARCELONA, Spain/INNSBRUCK, Austria: In recent years, there has been increasing medical interest in cor- recting teeth that are not perfectly aligned in order to resolve diaste- mas and crowding and to prevent problems such as jaw pain. Two studies, carried out by Spanish and Austrian researchers, have now provided evidence that dental occlusion is associated with the control of posture and balance. The studies, a collaboration between the Department of Cell Biology, Physiology and Immunol- ogy at the University of Barcelona and the Department of Sport Sci- ence at the University of Inns- bruck, found a relationship be- tween malocclusion and postural control. Both studies provide con- clusive data that shows that pos- tural control is improved—both in static and dynamic equilibrium— when various malocclusions are corrected by positioning the jaw in a neutral position. The first study took into ac- count the type of dental occlusion and whether there had been previ- ous orthodontic treatment. The results showed that alterations in alignment of the teeth were re- lated to poorer control of static balance. The second study assessed the type of dental occlusion, control of posture and physical fatigue in order to analyse a possible re- lationship between these factors. It demonstrated that balance im- proved when malocclusions were corrected, and that the latter had a greater impact on postural control when subjects were fatigued than when they were rested. “When the subjects were tired, their balance was worse under both stable and unstable condi- tions. Under static conditions, the factor that had the greatest im- pact on imbalance was fatigue. In contrast, a significant relationship between exhaustion and dental occlusion was observed under con- ditions of maximum instability,” said lead author Dr Sonia Julià- Sánchez, a researcher at the De- partment of Cell Biology, Physi- ology and Immunology at the University of Barcelona’s Faculty of Biology. “When there is a malocclusion, it is classified according to scientif- ically established criteria. What is relevant in the study is that mal- occlusions have also been associ- ated with different motor and physiological alterations,” Julià- Sánchez explained. This relation- ship is not as obvious in everyday static conditions, although there may be conditions associated with pathologies, such as obesity, that worsen the body’s instability, thus decreasing postural control and in- creasing the risk of falls. In athletes, this relationship can play a crucial role in how well they ultimately perform, as well as in the prevention of injuries such as sprains, strains and fractures caused by unexpected instability asfatigueincreasesandmotorcon- trol capacity decreases. “Therefore, it would be helpful for both the general population and athletes to consider correcting dental occlu- sions to improve postural control and thus prevent possible falls and instability due to a lack of motor system response,” added Julià- Sánchez. “Postural control is the result of a complex system that includes different sensory and motor ele- ments arising from visual, somato- sensory and vestibular informa- tion,” explained the expert. In recent years, there has been increasing scientific interest in the relationship between the stomato- gnathic system—the set of organs and tissues that allow us to eat, talk, chew, swallow and smile—and pos- tural control. The link may have a neurophysiological explanation. There is a reciprocal influence be- tween the trigeminal nerve and the vestibular nucleus, which are re- sponsible for masticatory function and balance control, respectively, as well as between the muscles of mastication and of the neck. This in- fluence would explain why dental malocclusions negatively affect pos- tural control. Up until now, however, there was no conclusive research. “The main problem stems from the fact that the majority of these stud- ies had statically assessed balance under conditions of total stability, which in practice has little actual application in the control of pos- ture while in action,” Julià-Sánchez pointed out. The first study, titled “Dental occlusion influences the standing balance on an unstable platform”, was published in the October 2015 issue of the Motor Control journal. The second study, titled “The in- fluence of dental occlusion on the body balance in unstable platform increases after high intensity exer- cise”, was published in Volume 617 of Neuroscience Letters. 04 Dental Tribune Nordic Edition | 3/2016 WORLD NEWS Impact of an oral health-optimised diet By DTI FREIBURG, Germany: Based on the results of a pilot study in Germany, people suffering from gingivitis and periodontal disease should perhaps consider changing their eating patterns in order to improve their oral health. In the study, par- ticipants who followed a diet low in carbohydrates and rich in omega-3 fatty acids, vitamins C and D, anti- oxidants and fibre for four weeks showed significantly lower inflam- mation values than did partici- pants in the group who did not change their diet. Aiming to test the hypothesis that diet helps reduce inflamma- tion—a connection that diet-based studies have already proved in part—lead author Dr Johan Wölber from the University of Freiburg and his colleagues investigated the im- pactofanoralhealth-optimiseddiet on periodontal health in a group of patients with a history of gingivitis. Of the 15 participants who were otherwise accustomed to a diet rich in carbohydrates, ten were asked to follow a list of restricted and rec- ommended foods and meals, while five continued with their typical eatingpatterns.Peoplewhosmoked, were taking antibiotics, or had carbohydrate- or insulin-related diseases, such as diabetes, were excluded from the study. Apart from not using interdental clean- ers, participants were advised not to change their oral health routines throughout the study period. Dietary instructions in the experimental group included re- stricting the amount of fructose, disaccharides, sweetened bever- ages and meals, flour-containing foods, rice and potatoes as far as possible. Fruits and vegetables (polysaccharides) were excluded from this as long as the total amount of carbohydrates was considered. The dietary protocol further included the daily intake of omega-3 fatty acids (such as fish oil capsules, a portion of sea-fish, two spoons of flaxseed oil), a re- striction in the amount of trans- fatty acids as far as possible (such as fried meals, crisps, donuts, croissants, etc.) and a reduction in omega-6 fatty acids as far as pos- sible (such as safflower oil, grape- seed oil, sunflower oil, margarine, sesame oil and maize oil). In addition, each participant had to ensure the daily intake of antioxidants (a handful of ber- ries, a cup of green tea or coffee, etc.), a source of vitamin C (such as two kiwis, one orange or one bell pepper) and a source of vitamin D (15 minutes of unprotected expo- sure to the sun, nutritional sup- plementation, 300 g of avocado, etc.). In order to ensure all partici- pants followed these recommen- dations, they were asked to docu- ment their daily intake in a food diary. After four weeks, participants in the low-carb group showed significantly reduced gingival and periodontal inflammation com- pared with the control group. According to the researchers, re- ducing carbohydrates in particu- lar led to a significant improve- ment in the gingival index, bleeding on probing and the perio- dontal inflamed surface area. Al- though the study had its limi- tations—mainly the small study group, the loose dietary instruc- tions and the difficulty in ensur- ing the participants’ compliance with the nutritional protocol, among other factors—the pre- sented dietary pattern signifi- cantly reduced periodontal in- flammation in the study group, the researchers concluded. In total, the results support the assumption that modern Western eating habits, including consump- tion of refined carbohydrates and a high omega-6 to omega-3 fatty acid ratio, promote inflammatory processes, they wrote. Thestudy,titled“Anoralhealth optimized diet can reduce gingi- val and periodontal inflammation in humans—A randomized con- trolled pilot study”, was published online on 26 July in the BMC Oral Health journal. The findings of a small sample size study in Germany have shown that an oral health-optimised diet could significantly reduce gingival and periodontal inflammation in a clinically important range without any changes in oral hygiene performance. The impact of oral health on general health is a topic of current prominence. The latest research has found a connection between malocclusion and posture and balance problems. © Oleksandra Naumenko/Shutterstock.com © Aisylu Ahmadieva/Shutterstock.com

Dental Tribune Nordic Edition No. 3, 2016

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