Flossing May Add Years to Your Life 

Cleaning between the teeth affects more than oral health and may even affect the risk of cardiovascular disease, dementia, kidney disease and more.

Flossing is an essential component of oral hygiene, offering benefits that extend beyond clean teeth. Dr. Mia L. Geisinger, who is a professor at the University of Alabama School of Dentistry, Birmingham, Alabama, said flossing can improve both quality of life and life expectancy.

“Oral health is integral to overall well-being,” said Dr. Geisinger. “In fact, individuals who floss daily live on average nearly six and a half years longer than those who do not floss every day.” Brushing removes only 40% to 60% of plaque, but cleaning between teeth helps eliminate more. When plaque builds up, the risk of tooth decay and periodontal disease can increase. Periodontal disease, also known as gum disease, is characterized by local and systemic inflammation of the tissues that support teeth.

“People who regularly floss demonstrate lower levels of gingival (gum) bleeding and inflammation,” said Dr. Geisinger. Diseases linked to oral health issues include diabetes, cardiovascular disease, kidney disease, cancer and some forms of dementia. Understanding factors that can initiate or worsen cardiovascular health can help with prevention. Cardiovascular disease can develop from many different factors. A lack of flossing may be a contributor to heart disease development or progression. “Flossing regularly is associated with a reduced risk of stroke, major cardiovascular events and irregular heart rhythms,” said Dr. Geisinger.

Gum tissue that is often irritated by poor oral hygiene can increase the chances of bacteria spreading through blood vessels. The body responds by releasing chemical messengers to fight these bacteria, which can lead to inflammation throughout the body. “Gum disease can lead to higher levels of inflammatory markers and compound damage within tissues throughout the body,” said Dr. Geisinger. “This includes the arteries and the heart.”

Poor flossing habits are not a direct cause of dementia. However, poor oral health, particularly periodontal disease, can increase the chance of developing dementias. As dementia develops, the protective layer around the brain, called the blood-brain barrier, becomes permeable. This could increase the chance of bacteria, bacterial byproducts and inflammatory markers entering the brain. “Specific bacteria found in advanced periodontal disease, for example Porphyromonas gingivalis, have been associated with worsening cognitive function and dementias,” said Dr. Geisinger.

The earliest forms of gum disease can present without any symptoms. Dr. Geisinger says it is important to schedule a comprehensive periodontal examination every year to diagnose gum disease at the earliest stages. 

Diagnosing Skin Cancer with a Skin Patch

Melanoma testing could one day be done at home with a skin patch and test strip with two lines, similar to COVID-19 home tests, according to University of Michigan (U-M) researchers. The new silicone patch has star-shaped microneedles and it is called the ExoPatch. This approach could provide a rapid at-home melanoma testing, helping patients catch the most aggressive form of skin cancer early without a biopsy or blood draw.

“The star-shaped needles make puncture easier and less painful, but they are so small that they only go through the top-most layer of the skin, the epidermis, and do not draw blood,” said Sunitha Nagrath, who is a professor of Chemical Engineering at U-M, Ann Arbor, Michigan. The ExoPatch microneedles are coated with a gel that picks up exosomes, which are tiny packages released by cells. Once thought to be trash ejected from cells for cleanup, exosomes actually contain DNA and RNA fragments that cells use to communicate with each other. Cancer cell exosomes can help tumors spread by preparing tissues to accept tumor cells before arrival, and detecting them can catch cancer earlier than past methods.

The gel that coats the ExoPatch contains a protein called Annexin V. It attracts and sticks exosomes to the microneedles’ surface. Once removed from the skin, placing the patch in an acid dissolves the gel, which releases the exosomes into a solution. After dipping a test strip into the solution, two lines form if the sample contains melanoma exosomes, and one line forms for a negative test. It is the same way an at-home COVID-19 test strip works.

“A fair-skinned person with moles must go to the doctor about every six months to send off a biopsy to see if they’re malignant or benign. With this test, they could instead test at home, get the results right away, and follow up with a dermatologist for a positive result,” said Nagrath.

A pilot study in humans followed by a series of clinical trials will be the next steps to move the technology toward use. Beyond melanoma, the ExoPatch gel coating could be modified to detect exosomes released by other cancers, including lung, breast, colon, prostate and brain cancer. “This is the first patch designed to capture disease-specific exosomes from fluid under the skin. The potential applications are huge,” said Nagrath.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.  He can be reached at medicalminutes@gmail.com