The International Dental Medicine Fair, commonly known as Dentex, once again brought the dental industry to the forefront from June 6-8, 2024. Organized by Zagreb Fair and the Croatian Chamber of Dental Medicine, the biennial event presented cutting-edge innovations, including Lumoral, to its visitors from Croatia and abroad.

One of the highlights of this year's event was Lumoral – a cutting-edge antibacterial therapy device developed by Finnish scientists designed to significantly improve oral hygiene when used as an adjunct therapy to regular brushing and flossing. The themes of the Dentex fair covered key areas of dentistry and dental technology.

Lumoral attracts attention

Lumoral has garnered attention for its innovative approach to maintaining oral hygiene. The device employs a dual-light photodynamic therapy that targets and eliminates harmful bacteria in the mouth, promoting healthier gums and teeth. Its user-friendly design and proven effectiveness make it an attractive option for both dental professionals and patients seeking to improve their oral health.

Lumoral's participation in Dentex reflects Croatian distribution partner Med-Faktor’s commitment to advancing dental care through innovation. Attendees at the event had the chance to experience firsthand how the Lumoral device can be integrated into their practice to enhance patient outcomes.

"The Dentex fair was a resounding success for our team. We had a spacious 50-square-meter area to showcase our products, with Lumoral drawing the most interest among visitors," said Med-Faktor Key Account Manager Marko Sever Cuglin.

With over 250 exhibitors presenting similar products like 3D printers, intraoral scanners, and implants, Lumoral stood out as a unique innovation.

"Our 'Wheel of Fortune' prize game, featuring a Lumoral starter set as the main prize, was a hit. It served as an excellent opportunity to introduce Lumoral to doctors, who were curious about its purpose, usage, and the time frame for seeing positive results in patients' oral health."

Sever Cuglin noted that dental professionals were impressed by Lumoral’s capabilities, recognizing its potential to improve treatment outcomes and serve as a preventive measure. "We gathered about 100 contacts interested in Lumoral, whom we plan to follow up with. Orthodontists were particularly excited about how Lumoral can help with braces maintenance, and periodontologists saw its potential to enhance standard dental treatments significantly."

Lumoral as a preoperative treatment

Experts in antimicrobial photodynamic therapy highlighted Lumoral’s utility as a preoperative treatment, emphasizing its effectiveness in eliminating harmful bacteria before implant placements or other surgical procedures.

"Overall, the response from the dental community was overwhelmingly positive. We look forward to continuing our engagements and expanding Lumoral's reach in dental practices," Sever Cuglin added.

***

Med-Faktor d.o.o. (www.medfaktor.hr), is a Croatia-based importing company established in 2010 by parent company Naturaldent Dental Group. The company is currently an exclusive distributor of products such as Medentis ICX implants, Belgian SMI sutures, NEXA3D printers and various other products for the countries of Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, Macedonia, Kosovo and Albania.

Tartar is mineralised plaque that forms on the surface of the teeth, usually as a result of poor oral hygiene. Plaque is made up of bacteria, food debris and saliva proteins. If plaque is not regularly removed by brushing and cleaning between teeth, it can harden and become tartar. Tartar is rough and can cause gum irritation, lead to gingivitis and contribute to the development of other oral health problems, such as periodontitis.

How common is tartar buildup?

Tartar is a very common oral health problem. Almost all adults have tartar buildup at some point in their lives, and the incidence increases with age. Here are some important facts to help you understand how common tartar is:

Adults: Most adults will get tartar at some point. The risk increases with age as plaque builds up over time, and possibly oral hygiene can also deteriorate, for example as fine motor skills in the hands deteriorate.

Adolescents and children: Although tartar is more common in adults, it can also occur in adolescents and children, especially if oral hygiene is poor.

Risk groups: Certain groups of people are more prone to developing tartar. These include smokers, diabetics, people with dry mouth, and people with certain types of eating habits (e.g. high consumption of sugary and starchy foods).

Tooth location: Plaque is usually more likely to form on the mandibular incisors and maxillary molars, as the salivary glands are located close to these teeth and saliva can contribute to plaque mineralisation.

How can I prevent the formation of tartar?

Regular and careful oral hygiene is the best way to prevent tartar. Tartar cannot be completely prevented, but the amount and effects can be significantly reduced through good daily oral hygiene and professional cleanings.

Regular brushing: brush your teeth twice a day for at least two minutes at a time with a fluoride toothpaste. Use a soft toothbrush and brush thoroughly on all tooth surfaces, including the gum line.

Use a floss, brush or other interdental cleaning tool daily to remove plaque between teeth where the toothbrush cannot reach.

Healthy diet: avoid sugary and starchy foods and drinks that contribute to plaque formation. Eat healthy foods, such as fruit and vegetables, that promote saliva production and help keep your mouth clean.

Regular dental visits: go to your dentist regularly for check-ups and cleanings. A dental hygienist can remove tartar that you cannot remove yourself at home.

Complementary treatment: regular use of the Lumoral antibacterial treatment reduces the amount of bacteria in your mouth and helps prevent plaque and tartar build-up.

Why do you need to remove tartar?

‘When the tooth surface is rough due to tartar, it is easy for new bacteria to accumulate on the surfaces of the teeth. These bacteria, together with tartar, irritate the gums and cause gingivitis. You cannot remove tartar yourself at home, but dentists and dental hygienists give patients an anti-infective treatment to remove tartar and reduce the amount of bacteria in the gum pocket.’ Viivi Soikkeli, dental hygienist at Hampaasi Dental Clinic in Helsinki, Finland, explains.

Lumoral antibacterial treatment is used as a complement to mechanical tooth cleaning.

‘Lumoral treatment is based on the fact that it effectively reduces the amount of plaque in the mouth, while also reducing the build-up of plaque and tartar,’ says Soikkeli.

Studies have shown that regular antibacterial treatment as an adjunct to conventional non-surgical standard treatment reduces gum inflammation and improves oral hygiene and the healing of deep pockets in chronic periodontitis compared to conventional treatment.

Antibacterial treatment has also been shown to prevent and help reduce inflammation in the tissues surrounding implants. It is suitable for everyone, but light-activated antibacterial treatment is considered most effective for patients who need to improve their oral hygiene.

Unlike conventional antibacterial mouthwashes, which affect the whole mouth and also remove the good bacteria that we need, Lumoral treatment targets only plaque, reducing bacterial and tartar build-up.

‘I recommend Lumoral especially to customers who have a lot of tartar,’ says Soikkeli.

Dental and oral bacteria have been linked to numerous chronic diseases throughout the body. Recent research indicates that thorough brushing and regular dental visits can also play a role in preventing strokes (1).

According to statistics from the World Stroke Organization (WSO), over 13 million people globally suffer from strokes each year, with one in four individuals experiencing a stroke in their lifetime. Surprisingly, up to 90% of these cases could be prevented through lifestyle changes such as adopting a healthier diet, increasing regular exercise, quitting smoking, and even improving oral hygiene practices (2).

In his recent doctoral dissertation in forensic medicine at the University of Tampere, Medical Licentiate Olli Patrakka examined the significance of oral bacteria, particularly viridans group streptococci, in stroke development. While these bacteria are normal mouth microbes, they can lead to serious illnesses like heart valve inflammation when entering the bloodstream, such as through inflamed gums during teeth brushing. (3).

Olli Patrakka suggests that these bacteria, attaching to tooth surfaces and initiating plaque formation, may similarly contribute to stroke and atherosclerosis development when entering arterial walls via the bloodstream during dental procedures or infections.

Poor oral hygiene is a risk factor for strokes

According to Patrakka, dental bacteria are present in the blood clots of stroke patients in about four out of five cases, with similar results yet to be reported. Blood clots were collected from stroke patients undergoing acute care in Tampere, Finland, for the study, along with samples from patients with symptomatic carotid artery stenosis used as endarterectomy tissues. (3).

Epidemiological studies have identified poor oral hygiene as an independent risk factor for strokes. Patrakka suggests that the inflammatory reaction induced by dental bacteria in atherosclerotic plaques could explicitly explain this connection.

The dissertation's findings are significant as they present new opportunities for stroke patient treatment development, Patrakka says. He also believes that the development of a vaccine may also be now feasible.

Patrakka stresses that while further research is necessary to establish causality, the study supports the importance of oral health, particularly in individuals at risk of srokes. He emphasizes that considering the inflammation caused by streptococcal bacteria in the mouth is crucial in stroke prevention as part of routine dental care. Moreover, investigating the potential benefits of timely antimicrobial treatment or bacterial vaccines in the future is essential.

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. (4)

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. (4)

Thorough oral hygiene is crucial for the prevention and treatment of oral infections. According to the Oral Health Foundation one-in-four (26%) British adults regularly brush their teeth only once a day raising concerns about the number of people willing to skip twice-daily brushing. (5)

The charity is especially worried by the number of people who regularly fail to brush their teeth last thing at night, when the health of the mouth is most likely to deteriorate.  Insights from the research show that one-in-four (25%) do not brush their teeth in the evening before they go to bed. (5).

Deficiencies in oral hygiene are directly reflected in the statistics of oral infectious diseases. More than 45% of adults in the UK are currently being affected by gum disease. Meanwhile, 10% are living with the most severe form, which can lead to tooth loss. (6)

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 even live longer, research shows (7).

– 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. (8, 9, 10).

The effectiveness of the novel oral health enhancing device relies on antimicrobial photodynamic therapy (aPDT), also referred to as photoantimicrobial chemotherapy. While this technology is already prevalent in dental clinics, the advent of a home-use device allows for more frequent application of this antibacterial treatment. (11)

aPDT technology itself utilizes light energy and a photosensitizer to generate an antimicrobial effect that eliminates problem-causing plaque bacteria from the mouth. Due to its targeted approach aPDT does not lead to bacterial resistance. (11)

The importance of interdisciplinary collaboration

According to Pätilä, the recent medical dissertation at the University of Tampere holds significance as it integrates oral health into overall body health. Enhancing collaboration between doctors and dentists is crucial and needs improvement across various European countries. While many medical doctors already evaluate their patients' oral health at clinics and refer them for additional treatment when needed, closer collaboration is essential.

Diabetes serves as a prime example of a disease where the importance of underlying inflammations is widely acknowledged. However, heightened collaboration is necessary to accelerate diagnoses and even prevent several common diseases.

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

– It hasn't increased significantly, but it should. In my basic medical training about five years ago, there was minimal discussion of the impact of dental infections on overall health. While the topic is relatively new, it's crucial that awareness and scientific evidence grow over time.

Patrakka underscores the importance of general practitioners recognizing when a dental issue necessitates a referral to a dentist. This could streamline the treatment of oral infections and potentially aid in achieving a balance in treating various general diseases.

– My research contributes to the growing evidence that oral health significantly influences overall health. The blood vessels of the tooth pulp directly connect to the systemic circulation. Therefore, if teeth are in poor condition, bacteria and their byproducts can circulate directly into our bodies.

References:

1. Shahi S, Farhoudi M, Dizaj SM, Sharifi S, Sadigh-Eteghad S, Goh KW, Ming LC, Dhaliwal JS, Salatin S. The Link between Stroke Risk and Orodental Status-A Comprehensive Review. J Clin Med. 2022 Oct 2;11(19):5854. doi: 10.3390/jcm11195854. PMID: 36233721; PMCID: PMC9572898.
2. 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.
3. https://trepo.tuni.fi/bitstream/handle/10024/154588/978-952-03-3315-7.pdf?sequence=2&isAllowed=y
4. Saini R, Saini S, Sharma S. Biofilm: A dental microbial infection. J Nat Sci Biol Med. 2011 Jan;2(1):71-5. doi: 10.4103/0976-9668.82317. PMID: 22470238; PMCID: PMC3312703.
5. Mehrotra N, Singh S. Periodontitis. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541126/
6. Oral health: What is gum disease? | British Dental Journal, Published 10 March 2017, Issue Date10 March 2017, DOI: https://doi.org/10.1038/sj.bdj.2017.196
7. Friedman PK, Lamster IB. Tooth loss as a predictor of shortened longevity: exploring the hypothesis. Periodontol 2000. 2016 Oct;72(1):142-52. doi: 10.1111/prd.12128. PMID: 27501497.
8. 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
9. 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
10. 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
11. Jao Y, Ding SJ, Chen CC. Antimicrobial photodynamic therapy for the treatment of oral infections: A systematic review. J Dent Sci. 2023 Oct;18(4):1453-1466. doi: 10.1016/j.jds.2023.07.002. Epub 2023 Jul 11. PMID: 37799910; PMCID: PMC10548011.