What to research???

Since I will be entering dental school next year, it is no surprise that I would like to investigate some sort of dental-related disease. Since I did my chemistry CUE paper on dental caries, I thought I would investigate something different. So, I browsed through “Topics in Dental Biochemistry” by Martin Levine to get ideas.1 One disease that interested me was periodontitis. The text mentions different types including chronic and aggressive periodontitis, but if I were to select this disease, I would likely focus on chronic because it is significantly more prevalent.1 Chronic periodontitis typically originates as gingivitis, or inflammation of the gums. If the inflammation spreads to the periodontium (tissue below the gums that surrounds teeth), then the patient has developed periodontitis.1 Inflammation of the periodontium can lead to loss of tissue, resulting in loose teeth or even tooth loss.1 The original gum inflammation is caused by bacteria, and the resulting inflammatory response has been found to be destructive to the gingiva and periodontium.1 If I were to investigate this disease, I would look into the roles of bacteria in developing chronic periodontitis (specifically Eikenella corrodens), the effects of the immune system response, and mechanisms of current drugs to treat or prevent this disease.

A second oral disease that I am interested in investigating is enamel fluorosis. Enamel fluorosis is mottled (spotted) tooth enamel resulting from excessive fluoride intake. In many locations, fluoride has been added to public water supplies as a means of protection from dental caries, or cavities. At controlled amounts, fluoride protects the tooth enamel without causing fluorosis; however, in areas with high fluoride concentrations in water, there are higher instances of fluorosis.1 One reported reason is because fluoride hinders enzymes involved in enamel formation.1 If I were to research this disease, I would look further into the mechanisms explaining how fluoride can be both beneficial for prevent caries and also detrimental when ingested in higher doses.

Additionally, beyond my dental interests, I would consider investigating selective immunoglobulin A (IgA) deficiency because I have a familial connection to it. Selective IgA deficiency is the most common primary immunoglobulin deficiency, particularly among Caucasiaans.2 While the deficiency itself tends to be asymptomatic, there are common diseases that occur because of the lack of sufficient IgA, including autoimmune diseases, sinopulmonary infections, and gastrointenstinal infections.2 Primary IgA deficiency is a deficiency caused by underproduction of serum and mucosal IgA, which is caused by a defect in terminal lymphocyte differentiation.2 There are currently no treatments for IgA deficiency – only the resulting diseases are treated. If I were to choose to investigate this disease, I would look more into the cause of the deficiency and how it impacts the prevalence of other diseases.

Futhermore, I would be interested in investigating one of two dental diseases (chronic periodontitis and enamel fluorosis) or selective IgA deficiency. After researching the three diseases, I am leaning towards enamel fluorosis. This is not just because I am interested in the dental aspect, but also because of the environmental impact on the disease. I think that it would be interesting to investigate this to make a case for more controlled fluoride use in public water supplies.

References:

  1. Levine, M. Topics in dental biochemistry; Oklahoma: Springer Berlin Heidelberg, 2011.
  2. Latiff, A. H. A.; Ker, M. A. The clinical significance of immunoglobulin A deficiency. Ann. Clin. Biochem. 2007, 44, 131-139.

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