In the field of dental care, changes are constant as fresh ideas shape the industry. A recent collaboration agreement between Finland’s Koite Health Ltd and Trading Co., Ltd. from Thailand is set to revolutionize dental care standards by introducing innovative light-activated technology to the country.

Founded in 2017, Innodent has been at the forefront of delivering cutting-edge dental solutions to Thailand's healthcare sector. Driven by a commitment to leverage the latest advancements in high-tech solutions, the company aims to provide the most innovative technologies to the dental industry. This strategic vision led to a partnership with Koite Health, and the introduction of Lumoral, a Finnish med-tech innovation, to the dental market in Thailand.

– The introduction of Lumoral to Innodent's product portfolio was the result of a personal recommendation from Dr. Hildebrand, a renowned maxillofacial surgeon from Berlin. Dr. Hildebrand's successful clinical experiences with Lumoral convinced the team at Innodent to explore this revolutionary technology further, explains Thomas Constantin, CEO and owner of Innodent Trading Co., Ltd.

Lumoral: an innovative personal healthcare device

So, what exactly is Lumoral, and how does it work? Mr. Constantin reminds that the close link between oral bacteria and overall health and well-being is an important factor that sparked interest in the Finnish oral health-enhancing innovation in the first place.

– Oral bacteria can cause dental caries and bad breath but there can also be more severe secondary effects such as cardiovascular diseases, dementia, psoriasis and many more. Overall health starts with a healthy mouth. It is therefore important to regularly clean the mouth thoroughly.

Lumoral is an innovative personal healthcare device designed to remove 99.9% of harmful oral bacteria while preserving the healthy mouth flora. Traditional oral hygiene methods can only remove approximately 60% of bacteria, leaving behind a significant risk of oral health issues, Thomas explains.

Lumoral's advanced technology utilizes color molecules in its Lumorinse mouth rinse, which adhere to harmful oral bacteria attached to teeth surfaces and gum tissue in the mouth. Subsequently, the light emitted by the mouthpiece reacts with the green sensitizer, effectively breaking down the cell membrane of bacteria and destroying them both from inside and outside. This method ensures the eradication of harmful bacteria without the risk of resistance development.

Long-term benefits for implant patients

The addition of Lumoral to Innodent's product portfolio aligns with the company’s focus on dental implantology, with a specialization in ceramic implants. While the industry predominantly utilizes titanium implants, scientific evidence suggests a significant risk of peri-implantitis, an inflammation of the tissues surrounding these metal implants, over time.

– Lumoral presents a solution to mitigate this risk, offering long-term benefits for implant patients, Constantin says.

Furthermore, Lumoral's versatility extends beyond implant care, offering benefits for individuals with various oral health concerns, including chronic bad breath, gum disease, and orthodontic patients wearing braces or clear aligners.

– This accessibility makes Lumoral an invaluable addition to Innodent's offerings, catering to a diverse range of dental needs in Thailand.

– The great advantage of Lumoral however, is that everyone benefits from removing harmful oral bacteria. Whether you are wearing braces or clear aligners, suffer from chronic bad breath, gum disease or simply want to have a perfectly clean and healthy mouth, Lumoral is your solution.

Promising prospects for both companies

The collaboration between Koite Health and Innodent holds promising prospects for both companies and dental patients in Thailand. Mr. Constantin says that for Innodent, this partnership marks a significant expansion into the business-to-consumer (B2C) market, enabling the company to reach individual consumers through online channels like their dedicated webshop.

– This shift opens new avenues for marketing and sales, enhancing accessibility to innovative dental solutions for patients across the country. Ultimately, the collaboration aims to raise awareness about oral health and its crucial role in overall well-being among the Thai population.

– By introducing Lumoral's advanced technology to the market, Koite Health and Innodent are paving the way for a new era of dental care in Thailand, one that prioritizes prevention, innovation, and improved patient outcomes.

World Oral Health Day is celebrated annually on March 20th. This year's theme - A Happy Mouth… A Happy Body  - emphasizes the connection between a healthy mouth and overall health.

Dental and oral bacteria are linked to many chronic diseases in the body. Thorough brushing and regular dental visits can also prevent strokes (1).

According to statistics from the World Stroke Organization (WSO), over 13 million people suffer from strokes each year, and one in four people will have a stroke in their lifetime. Surprisingly, up to 90% of these cases could be prevented by making lifestyle changes such as adopting a healthier diet, increasing regular exercise, quitting smoking, and even improving regular oral hygiene.

Medical Licentiate Olli Patrakka examined the significance of oral bacteria, especially viridans group streptococci, in the development of strokes in his recent doctoral dissertation in forensic medicine at the University of Tampere. Although these bacteria are normal mouth microbes, they can cause serious illnesses such as heart valve inflammation when they enter the bloodstream. For example, they can enter the bloodstream through inflamed gums while brushing teeth.

- These bacteria attach to the tooth's surface in the mouth and initiate the process, leading to the formation of dental plaque. We hypothesize that a similar phenomenon occurs when bacteria that enter the bloodstream during, for example, dental procedures or dental infections travel into the walls of the arteries. This may accelerate the development of both strokes and atherosclerosis, explains Patrakka.

Poor oral hygiene is a risk factor for strokes

According to Patrakka, dental bacteria can be found in the blood clots of stroke patients in about four out of five cases. A similar result has yet to be reported.

Blood clots from stroke patients treated in Tampere were collected for the study during acute care. In addition, samples from patients suffering from symptomatic carotid artery stenosis were used as tissues for endarterectomy.

Epidemiological studies have shown that poor oral hygiene is an independent risk factor for strokes.

- The results of my study suggest that the connection could be explicitly explained through the inflammatory reaction caused by dental bacteria in atherosclerotic plaques.

The findings of the dissertation are significant as they open up new opportunities to develop the treatment of stroke patients.

Patrakka estimates that the development of a vaccine may also be possible.

So, what practical implications can findings like these have on treating stroke patients and healthcare practices?

Although further research is needed to determine causality, the study supports the view that oral health must be taken care of, especially in those at risk of strokes.

According to Patrakka, the inflammation caused by streptococcal bacteria in the mouth should always be considered in stroke prevention as part of regular dental care. Additionally, it is essential to investigate the potential benefits of timely antimicrobial treatment or bacterial vaccines in the future.

Periodontitis is the root cause of many ailments

Studies show dental plaque bacteria are responsible for about 95 per cent of oral diseases. One of the most common oral diseases is periodontitis, a severe gum disease caused by dental plaque. Early signs of this disease include red gums, gum bleeding, and bad breath.

In patients with periodontitis, the fibres that attach the tooth to the gum are destroyed, forming a periodontal pocket between the gum and the tooth. This pocket may expand around the entire tooth. If the infection is not treated promptly and oral hygiene is not improved, it can progress to destroy more extensively the supporting tissues of the teeth and, ultimately, the jawbone.

Thorough oral hygiene is crucial for the prevention and treatment of oral infections. According to the Finnish Institute for Health and Welfare (THL), more and more people in Finland brush their teeth at least twice a day, but there are still deficiencies in self-care. While about 80% of women brush their teeth at least twice a day, the corresponding figure for men is 53%.

Deficiencies in oral hygiene are directly reflected in the statistics of oral infectious diseases. For example, gum diseases are worryingly common in the age group of 30-44, both in women (43%) and men (57%).

Thorough mechanical brushing of teeth and cleaning of the interdental spaces are crucial because even asymptomatic oral inflammations can affect the body's overall health.

- According to statistics, individuals with healthy mouths live longer. Every missing tooth reduces life expectancy. This is talked about far too little, says Tommi Pätilä, a heart and transplant surgeon at HUS New Children's Hospital in Helsinki, Finland.

Pätilä is also one of the developers of the antibacterial Lumoral method. Lumoral is a medical device designed to improve oral hygiene and oral health. The antibacterial oral care method is especially suitable for patients with difficult-to-treat gum diseases such as periodontitis who do not get adequate results from traditional oral hygiene methods such as brushing teeth and cleaning interdental spaces.

The importance of interdisciplinary collaboration

According to Pätilä, collaboration between doctors and dentists is essential and needs to be increased in Finland. Many doctors in Finland already check the oral health status of their patients at their clinics and guide them to further treatment as needed. Diabetes is an excellent example of a disease where the importance of hidden inflammations is generally understood. However, more collaboration is required to expedite many diagnoses and even prevent general diseases.

- The recent medical dissertation at the University of Tampere is significant as it addresses oral health as part of overall body health, says Pätilä.

Olli Patrakka's interest in oral bacteria arose as part of his duties as a pathologist. Has the interest of young doctors in the impact of dental infections on general health increased?

- It hasn't increased, but it should. In the basic medical training I received about five years ago, there was also no discussion of the impact of dental infections on general health. Of course, the topic is still relatively new, but hopefully, awareness and scientific evidence will gradually increase over the years.

Patrakka emphasizes that a general practitioner should know when a dental problem requires a referral to a dentist. This would expedite the treatment of oral infections and potentially support the achievement of balance in the treatment of many general diseases.

- My research contributes to the evidence that the impact of oral health on general health is significant. The blood vessels of the tooth pulp are directly connected to the systemic circulation. Thus bacteria and their metabolites can circulate directly into our bodies if the teeth are not in good condition.

Olli Patrakka. Image: Hanna-Sofia Luoto

References:

Sen S, Giamberardino LD, Moss K, Morelli T, Rosamond WD, Gottesman RF, Beck J, Offenbacher S. Periodontal Disease, Regular Dental Care Use, and Incident Ischemic Stroke. Stroke. 2018 Feb;49(2):355-362. doi: 10.1161/STROKEAHA.117.018990. Epub 2018 Jan 15. PMID: 29335336; PMCID: PMC5780242.

https://trepo.tuni.fi/bitstream/handle/10024/154588/978-952-03-3315-7.pdf?sequence=2&isAllowed=y

Pakarinen S, Saarela RKT, Välimaa H, Heikkinen AM, Kankuri E, Noponen M, Alapulli H, Tervahartiala T, Räisänen IT, Sorsa T, et al. Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP)—Three-Month Interim Results. Dentistry Journal. 2022; 10(11):206. https://doi.org/10.3390/dj10110206

Nikinmaa S, Alapulli H, Auvinen P, Vaara M, Rantala J, et al. (2020) Dual-light photodynamic therapy administered daily provides a sustained antibacterial effect on biofilm and prevents Streptococcus mutans adaptation. PLOS ONE 15(5): e0232775. https://doi.org/10.1371/journal.pone.0232775

Nikinmaa S, Moilanen N, Sorsa T, Rantala J, Alapulli H, Kotiranta A, Auvinen P, Kankuri E, Meurman JH, Pätilä T. Indocyanine Green-Assisted and LED-Light-Activated Antibacterial Photodynamic Therapy Reduces Dental Plaque. Dentistry Journal. 2021; 9(5):52. https://doi.org/10.3390/dj9050052

Annimari Korte (35) is renowned for her sports track achievements and extensive sports career. However, many may need to realize that she is also a passionate advocate for oral health within and beyond the athletic arena. While a recent ADHD diagnosis may have come as a surprise in her life, for Korte, it brought a sense of relief.

Annimari is one of the fastest Finnish 100-meter hurdle runners ever and has represented Finland in several major competitions. Although she has decided to end her competitive career after this season, her goals remain high.

"The European Championships in early June are one of my main goals. I already reached the qualifying time last summer, so I don't need to chase any more limits, but I need to be in top shape by May," she says.

Annimari must meet the qualifying time to qualify for the Olympics or be ranked high enough by the end of June.

"It would be great to end my career at another Olympics. For most individual athletes in the world, competing in the Olympics is their biggest dream. It was a dream come true for me, too."

Elite Sports Challenge Oral Health

Success as a top athlete has not been a given for Korte. Illness forced her to even give up competitive sports from 2012 to 2017. It could be due to these setbacks that supporting overall health and oral well-being has always played an important role in her life.

Annimari points out that elite sports are one of the significant risk factors for oral diseases. According to one study, cavities are found in up to 70 per cent of elite athletes, tooth erosion in nearly 40 per cent, and severe gum disease in up to 15 per cent of dedicated athletes. (1)

"Athletes, in addition to their bodies, often put their teeth under strain because rigorous training requires sufficient energy intake. This can be reflected in the frequency of meals and acid attacks formed in the mouth," says Annimari.

Heavy breathing during intense training reduces saliva production in the mouth, causing dryness in the athlete's mouth. Saliva naturally provides good protection for teeth. When this is no longer the case, bacteria in the mouth can form cavities.

Annimari uses the Finnish researchers' developed light-activated Lumoral treatment as part of her regular oral hygiene routine.

"It's great that a device has been invented to help maintain oral health. Many don't realize how much oral health affects overall health and sports performance - including athletic performance," she says.

Annimari admits that training and top-level competition are much more challenging as one ages. Few over 30 can compete or train without any injuries, and dealing with them requires more effort than when younger. That's why taking care of health and healthy habits has been essential to her.

"Recovery is slower, and you can't train as much. It takes more time to recover from competitions and travel. So, you must try to eliminate all the extra stresses from training and focus only on the essential things. Experience, of course, brings the advantage of knowing what kind of training works for you and being able to train accordingly."

Oral Health and Overall Health Go Hand in Hand

Studies show that a long-standing infection in the mouth can cause low-grade inflammation in the body. Low-grade inflammation, in turn, has harmful effects on overall health. The inflammation can be present in the body without one being aware.

Annimari has noticed that her gum problems have eased since starting Lumoral use. This has been particularly important to her as a competitive athlete, as gum inflammation can maintain a mild inflammatory state in the body, adversely affecting overall health and thus also the progress of training.

Visible improvements in oral health have motivated Annimari to use Lumoral regularly for about a year and a half now.

"After starting to use Lumoral, I noticed that my gums no longer bleed when cleaning between my teeth. This has been a significant improvement compared to the initial situation. I've been using Lumoral since the beginning of last year, and I haven't even had a cold since. Last spring, I was able to train so well and healthily that I ran 12.83, which was my best time in three years!"

Annimari's oral hygiene routine includes daily mechanical brushing, cleaning between her teeth, and regular Lumoral treatment. (2, 3, 4)

If there's ever been a lapse in my Lumoral usage, I've observed my gums beginning to ache, signaling a potential recurrence of gum inflammation. Recognizing this, I promptly resume Lumoral treatment, and remarkably, after just one session, my gum condition improves."

Life Beyond the Racetracks

Annimari is ending her competitive career after this season. What thoughts does the decision to end her racing career evoke in her?

"For someone like me, it's probably unusually easy to end a top athlete career, as I've done it once for several years. Many people experience a crisis when their sports career ends, but I'm looking forward to enjoying normal life more and starting proper training with my dogs," says Annimari.

Sport has always been Annimari's passion and way of life, but now she looks forward to new adventures and opportunities. As early as next autumn, she plans to compete in sled dog racing with her Siberian husky, Cairo.

Last September, the sprint hurdler received confirmation of ADHD, a condition she had suspected for a long time. Getting the diagnosis was a relief to her because it explained many things in her life.

"I had considered the possibility of an ADHD diagnosis three years ago, but it slipped my mind afterwards. Even last winter, I mentioned it aloud once. These are typical symptoms of ADHD; thoughts and plans often fade into oblivion or are easily forgotten."

"The diagnosis was a big relief and explained many events, problems, and accidents in life."

Korte's openness about her ADHD diagnosis and its impact on her life is essential in fighting stigma and supporting others in similar situations. She now wants to encourage everyone concerned about their health to seek help if necessary.

"While ADHD certainly has its drawbacks, it can also be a significant advantage as an athlete. ADHD includes hyperfocus, where something interesting makes everything else forgotten, and everything can be focused on that one thing. For me, this has been hurdle running."

"ADHD doesn't prevent success, but it certainly helps when you find your own thing. I would encourage young people with ADHD to try out many different hobbies, where they can find their interests and utilize this hyperfocus."

Sources:

Merle CL, Wuestenfeld JC, Fenkse F, Wolfarth B, Haak R, Schmalz G, Ziebolz D. The Significance of Oral Inflammation in Elite Sports: A Narrative Review. Sports Med Int Open. 2022 Dec 25;6(2):E69-E79. doi: 10.1055/a-1964-8538. PMID: 36643596; PMCID: PMC9839431.

Pakarinen S, Saarela RKT, Välimaa H, Heikkinen AM, Kankuri E, Noponen M, Alapulli H, Tervahartiala T, Räisänen IT, Sorsa T, et al. Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP)—Three-Month Interim Results. Dentistry Journal. 2022; 10(11):206. https://doi.org/10.3390/dj10110206

Nikinmaa S, Alapulli H, Auvinen P, Vaara M, Rantala J, et al. (2020) Dual-light photodynamic therapy administered daily provides a sustained antibacterial effect on biofilm and prevents Streptococcus mutans adaptation. PLOS ONE 15(5): e0232775. https://doi.org/10.1371/journal.pone.0232775

Nikinmaa S, Moilanen N, Sorsa T, Rantala J, Alapulli H, Kotiranta A, Auvinen P, Kankuri E, Meurman JH, Pätilä T. Indocyanine Green-Assisted and LED-Light-Activated Antibacterial Photodynamic Therapy Reduces Dental Plaque. Dentistry Journal. 2021; 9(5):52. https://doi.org/10.3390/dj9050052

FAQs related to the article's topic: 

What preventive measures can endurance athletes take, in addition to the above measures, to protect their oral health during training and competitions?

Endurance athletes can protect their oral health by maintaining a balanced diet rich in vitamins and minerals, avoiding snacking on sugary foods, and using fluoride mouthwash to strengthen tooth enamel. During endurance training, it is good to take a sip of plain water after consuming energy.

Are there long-term studies or surveys showing that better oral health affects the performance of endurance athletes?

There has been much research and many studies on the subject, and new research results are constantly being published. Here are a few highlights:

• Vougiouklakis G et al. Dental data of the Athens 2004 Olympic and Paralympic Games.
• Ashley P. (2015, January 27). Oral health of elite athletes and association with performance: a systematic review. Retrieved from British Journal Of Sports Medicine.
• Gallagher J, Ashley P, Petrie A, Needleman I. Oral health and performance impacts in elite and professional athletes. Community Dent Oral Epidemiol.
• Frese C, Frese F, Kuhlman S, Reljic D, Saure D, Staehle H, Wolff D. (2014, May 9). Effect of endurance training on dental erosion, caries, and saliva.
• Oral health and sports performance in elite athletes (Perio talks podcast, also available on Spotify).

How do the acidity and sugar content of different sports drink and gel brands compare, and which ones are safer for teeth?

The acidity and sugar content of sports drinks and gels vary greatly between different brands; choosing products with a neutral pH level can help minimize tooth erosion. Citric acid is often added to energy gels as an additional ingredient to enhance flavor. However, it should be avoided as it increases the risk of erosion. For more detailed insights, it's best to consult a dentist or nutritionist.