Dr. Ackerman

Marvin Ackerman, MD – I found out the hard way that an apparent sinusitis could actually be due to pain originating from a tooth.

It’s amazing how widespread the pain may appear to be, even spreading to the temporomandibular joint, the jaw, and nearby teeth, besides the maxillary sinus on that side.

There are clues pointing to dental origin such as localized reaction to cold, or eating on that side of the mouth. Causes include infection of the tooth or gums, splitting of a tooth, etc. The latter might be extremely difficult for your dentist or otolaryngologist to determine when the split occurs vertically through the tooth, because it does not always show up on an x-ray. The truth might only become apparent when you manage to crack the tooth in half while eating. I also discovered that the dental profession is far from lax as to researching new ways to improve therapy and techniques. Unfortunately, the price tag for benefiting from such new procedures as implants, tooth whitening, root canal, crowns and the like might appear to be prohibitive. However, the time spent and amount of work, time and cost of learning techniques and purchasing equipment and materials, necessity for hiring trained personnel, etc. involved in utilizing these new techniques fully justifies the price in most instances.

New dental techniques are not always designed to improve your appearance. For example, an infected mouth can be the source of bacteria traveling to other organs. This is especially true for heart disease, stroke, and diabetes. We have long been aware that infected teeth might be responsible for the infection in subacute bacterial endocarditis. With antibiotics rapidly loosing their effectiveness as bacteria learn how to cope with them, greater effort has been turning toward preparing vaccines instead. An article published by DeCarlo et al in the January 2003 issue of Infection and Immunity entitled “Feasibility of an HA2 Domain-Based Periodontitis Vaccine” may be the first step in creating a vaccine for gum disease. Of course, the work was only done on rat models with periodontitis, but that’s how most new concepts begin.

This is one time where a company, in this case Agenta Biotechnologies of Birmingham, Alabama, sponsored the research. The trouble-making bacterium involved is usually Porphyromonas gingivalis. The vaccine does not directly attack the bacterium itself. Action, instead, is directed at an area on enzymes called gingipains. These enzymes are believed to switch on or off the ability of the bacterium to attach to cells. The vaccine helps the immune system to form antibodies against the gingipains area. Results included definite activation of antibodies against the enzymes, some protection against gum disease, and less bone loss in the jaw after infection.

Don’t think that gum disease is for other people, not you, because the majority of adults will develop gum disease eventually. Furthermore, there is reason to believe that gum disease may also be involved in other diseases. The development of a vaccine to prevent this scourge may well prove to be a major weapon, which DeCarlo believes “could be relevant to everybody.”

For those of you who find going to the dentist nothing short of a horrific voyage into fear and excruciating pain, a vaccine capable of performing in this manner, may well be a form of partial salvation. That is, unless you also cannot bring yourself to the point of permitting someone to insert a needle into your body.



Bit on a pit,
Cracked a tooth,
Screamed out loud,
Words uncouth.

Hit the pedal,
To get there fast,
Had no idea,
How long I’d last.

Drove like crazy,
In and out,
Took 15 minutes,
Or thereabout.

Parked the car,
Ran up the stair,
Finally reached,
The dental lair.

On the door,
There was a note,
“I’ve gone fishing,
On my boat.”






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About Marvin Ackerman, MD

Dr. Ackerman provides helpful insights and answers to the important medical issues that affect you. He is also recognized as a prolific lecturer, researcher and inventor, and an author of numerous medical articles for journals, magazines, and the Internet. More about Dr. Ackerman.

Cartoons and Poems following each article are created and copyrighted by Dr. Ackerman and cannot be copied or reproduced without his permission. Copyright © 2009 by Marvin Ackerman, M.D.

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Christina Lorenzen, author, and editor of Ages and Stages of Child Development Section, she specializes in parenting and health issues. In addition to this column, Christine is also a columnist for Connecting Home magazine.
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