can infections from dental work cause a heart attack ?
It has been recognized that oral infection, especially periodontitis, may affect the course and pathogenesis of a number of systemic diseases, such as cardiovascular disease, bacterial pneumonia, diabetes mellitus, and low birth weight.
The incidence of bacteremia (presence of bacteria in blood) following dental procedures such as tooth extraction, endodontic treatment, periodontal surgery, and root scaling has been well documented (4, 12, 25, 29, 33, 53, 75, 83, 100, 108). Bacteremia after dental extraction, third-molar surgery, dental scaling, endodontic treatment, and bilateral tonsillectomy has been studied by means of lysis-filtration of blood samples with subsequent aerobic and anaerobic incubation. Bacteremia was observed in 100% of the patients after dental extraction, in 70% after dental scaling, in 55% after third-molar surgery, in 20% after endodontic treatment, and in 55% after bilateral tonsillectomy.
There are several proposed mechanisms by which periodontal disease may trigger pathways leading to cardiovascular disease through direct and indirect effects of oral bacteria. First, evidence indicates that oral bacteria such as Streptococcus sanguis and Porphyromonas gingivalis induce platelet aggregation, which leads to thrombus formation. These organisms have a collagen-like molecule, the platelet aggregation-associated protein, on their surface. When S. sanguis is injected intravenously into rabbits, a heart attack-like series of events occur. Possibly, antibodies reactive to periodontal organisms localize in the heart and trigger complement activation, a series of events leading to sensitized T cells and heart disease.
» Asked by roseroselli
How do you sense the passing of time?
Did you make it to work on time this morning? Go ahead and thank the traffic gods, but also take a moment to thank your brain. The brain’s impressively accurate internal clock allows us to detect the passage of time, a skill essential for many critical daily functions. Without the ability to track elapsed time, our morning shower could continue indefinitely. Without that nagging feeling to remind us we’ve been driving too long, we might easily miss our exit.
But how does the brain generate this finely tuned mental clock? Neuroscientists believe that we have distinct neural systems for processing different types of time, for example, to maintain a circadian rhythm, to control the timing of fine body movements, and for conscious awareness of time passage. Until recently, most neuroscientists believed that this latter type of temporal processing – the kind that alerts you when you’ve lingered over breakfast for too long – is supported by a single brain system. However, emerging research indicates that the model of a single neural clock might be too simplistic. A new study, recently published in the Journal of Neuroscience by neuroscientists at the University of California, Irvine, reveals that the brain may in fact have a second method for sensing elapsed time. What’s more, the authors propose that this second internal clock not only works in parallel with our primary neural clock, but may even compete with it.
Past research suggested that a brain region called the striatum lies at the heart of our central inner clock, working with the brain’s surrounding cortex to integrate temporal information. For example, the striatum becomes active when people pay attention to how much time has passed, and individuals with Parkinson’s Disease, a neurodegenerative disorder that disrupts input to the striatum, have trouble telling time.
But conscious awareness of elapsed time demands that the brain not only measure time, but also keep a running memory of how much time has passed. Scientists have long known that a part of the brain called the hippocampus is critically important for remembering past experiences. They now believe that it might also play a role in remembering the passage of time. Studies recording electrical brain activity in animals have shown that neurons in the hippocampus signal particular moments in time. But the hippocampus isn’t always necessary for tracking time. Remarkably, people with damage to their hippocampus can accurately remember the passage of short time periods, but are impaired at remembering long time intervals. These findings hint that the hippocampus is important for signaling some – but not all – temporal information. If this is the case, what exactly is this time code used for, and why is it so exclusive?
In their new study, the researchers tried to unravel this mystery by training rats to discriminate between different time intervals. They then rewarded the rats with treats when they indicated, by choosing between different odors, that they could tell how much time had passed. Before some of the trials the scientists injected a chemical that temporarily inactivates the hippocampus. This allowed them to test whether a functional hippocampus is necessary to distinguish between different time intervals.
The rats with inactive hippocampi could tell the difference between vastly different time intervals (e.g., 3 versus 12 minutes) just as well as the control rats, but performed no better than chance at detecting differences between similar periods of time (e.g., 8 versus 12 minutes). This suggests that the hippocampus is important for distinguishing between similar time intervals, but isn’t needed when the intervals are very different. But oddly enough, this pattern only held up at long time periods; rats with nonfunctional hippocampi were not just normal at discriminating between similar time periods at short scales (e.g., 1 versus 1.5 minutes), but they in fact performed better.
So while the hippocampus does signal elapsed time, it has a very particular role in doing so. It specifically discriminates between similar time periods at long time scales – on the order of several minutes. When you can tell that you’ve been showering for 10 minutes, and not 15, you can thank your hippocampus. But when you sense the difference between 1 and 1.5 minutes, or 20 minutes and an hour, other brain regions have taken over as internal time-keeper.
While it may seem odd for the hippocampus to perform such a highly specialized function, this is perfectly consistent with what we know it does in other domains. The hippocampus is renowned for its ability to discriminate between overlapping objects or experiences – a process known as pattern separation. This study suggests it pattern separates many features of an experience, detecting subtle differences between objects, places and time periods.
The hippocampus might be oblivious to events that happen on a second-by-second scale, but we’re certainly able to track the rapid passage of these moments. Considering that the striatum is believed to track time on the order of seconds, the authors propose that the hippocampus and striatum might actually compete with one another, such that when the hippocampus is quieted, the striatum is freed to function even more effectively than usual. Although it’s not a good idea to intentionally damaging your hippocampus (you’ll develop a significantly graver problem), doing so could theoretically boost your ability to track the passage of short time periods.
But it’s unclear whether this inhibitory relationship is reciprocal or unidirectional. If the hippocampus and striatum indeed function as separate, antagonistic clocks, does the striatum suppress the hippocampus, just as the hippocampus appears to impair the striatum? Scientists know that damaging the striatum leads to a host of problems processing time. But could it also confer one particular time-telling superpower – that of distinguishing between similar long time intervals - by launching the hippocampus into high-gear? Only further research will tell.
So when you make it to work on time tomorrow, acknowledge not just one, but your multiple inner clocks, and rest easy you have a healthy hippocampus.