Effects of emotional stress on oral health – Center of Modern Dentistry


In addition to the heart and psychological health, emotional stress can cause effects on oral health of any individual. The anxiety caused by the disease can significantly affect teeth. Emotional stress affects the immune system; This is responsible for combating the bacteria that cause periodontal disease making the chances of gum infections are higher. Several studies have confirmed that emotional stress causes oral infections, inflammation in the gums, bone loss and common bleeding gums that many perceive. A specific study conducted at the University of Michigan confirmed that those with emotional stress linked to financial problems, were those with higher indicators periodontal diseases. Emotional stress caused by family, work, and especially money lead to severe periodontal disease. However, those who were dealing with this stress in a healthy way, they had both disease risk. Aside from periodontal diseases, emotional stress can also cause mouth ulcers, which are indicators of the weakness of the body by stress. Due to emotional stress, many people tend to increase the intake of foods such as sugars that increase risk and damage dental health. It has even been shown that the buccal mucosa is highly influenced by psychological stress. So much so that this is characterized as the second leading cause of damage to the teeth and oral cavity. In addition, in recent years it has found a close relationship between the incidence of caries and emotional stress. Other of the many effects of emotional stress are:

Bruxism (teeth grinding) Tooth wear Fatigue in the muscles of the jaw Herpes labialis Gingivitis Effects of emotional stress on oral health

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BIKER Register – Publications

Publications Here you can find scientific publications BiKeR project in reverse chronological order: Long-term safety of etanercept and adalimumab Compared to methotrexate in patients with juvenile idiopathic arthritis (JIA). Klotsche J, Niewerth M, Haas JP, Huppertz HI, zinc O, Horneff G, Minden K. Ann Rheum Dis. 2015 April 29 pii: annrheumdis-2014-206747. doi: 10. 1136 / annrheumdis-annrheumdis-2014-206747 Incidence of herpes zoster infections in juvenile idiopathic arthritis patients. Nimmrich S, Horneff G. Rheumatol Int. 2015 Mar; 35 (3): 465-70. doi: 10.

1007 / s00296-014-3197-6. Epub 2015 January 13 [Current news from the BIKER register]. Horneff G, K Minden, Földvári I, Onken N, wind sound D, Hospach A, G Ganser, Klotsche J, Becker I; BIKER Register Study Group. Z Rheumatol. 2014 Dec; 73 (10): 897-906. doi: 10. 1007 / s00393-014-1397-9. German. Safety and efficacy of etanercept in children with juvenile idiopathic arthritis below the age of 2 years. Wind noise D, Müller T, Becker I, Horneff G. Rheumatol Int. 2015 April; 35 (4): 613-8.

doi: 10. 1007 / s00296-014-3125-9. Epub 2014 Sep 11th Predictors of response to methotrexate in juvenile idiopathic arthritis. Albarouni M, Becker I, Horneff G. Pediatr Rheumatol Online J. 2014 Aug 13; 12: 35th doi: 10. 1186 / 1546-0096-12-35. eCollection, 2014. Safety and efficacy of etanercept in children with the JIA categories extended oligoarthritis, enthesitis-related arthritis and psoriasis arthritis. Wind noise D, Müller T, Becker I, Horneff G. Clin Rheumatol. 2015 Jan; 34 (1): 61-9.

doi: 10. 1007 / s10067-014-2744-6. Epub 2014 Jul 18th Efficacy and safety of adalimumab as the first and second biologic agent in juvenile idiopathic arthritis: the German Biologics JIA registry. Schmeling H, K Minden, Földvári I, Ganser G, T Hospach, Horneff G. Arthritis Rheumatol. 2014 SEP and 66 (9): 2580-9. doi: 10. 1002 / art. 38741. Definition of improvement in juvenile idiopathic arthritis using the juvenile arthritis disease activity score. Horneff G, Becker I. Rheumatology (Oxford).

2014 July; 53 (7): 1229-34. doi: 10. 1093 / rheumatology / ket470. Epub 2014 Mar. 4 Predictors of response to etanercept in polyarticular-course juvenile idiopathic arthritis. Geikowski T, Becker I, Horneff G; German BIKER Registry Collaborative Study Group. Rheumatology (Oxford). 2014 July; 53 (7): 1245-9. doi: 10. 1093 / rheumatology / ket490. Epub 2014 Mar. 4


Improvement in health-related quality of life for children with juvenile idiopathic arthritis after start of treatment with etanercept. Klotsche J, K Minden, Thon A, G Ganser, Urban A, Horneff G. Arthritis Care Res (Hoboken). 2014 February; 66 (2): 253-62. doi: 10. 1002 / acr. 22112 Efficacy and safety of oral and parenteral methotrexate therapy in children with juvenile idiopathic arthritis: an observational study with patients from the German Methotrexate Registry. Small A, Kaul I, I Földvári, Ganser G, Urban A, Horneff G. Arthritis Care Res (Hoboken). 2012 SEP and 64 (9): 1349-56. doi: 10. 1002 / acr.

21697 Development of inflammatory bowel disease in patients with juvenile idiopathic arthritis Treated with etanercept. van Dijken TD, Vastert SJ, Gerloni VM, Pontikaki I, Linnemann K, Girschick H, W Armbrust, Minden K, Prince FH, FT coccus, Nieuwenhuis EE, Horneff G, WulffraatNM. J Rheumatol. 2011 July; 38 (7): 1441-6. Epub 2011 April. 1 Summary National JIA register in the Netherlands, Germany, Finland, Denmark and Italy were searched for JIA patients who were sick also to inflammatory bowel disease (IBD). It was investigated whether treatment with etanercept lead in JIA patients to higher incidence rates of IBD. 13 cases of IBD in JIA patients were found in 1999 by 2008. The IBD coincidence with JIA patients with etanercept treatment was 362 per 100,000 patient years, 43 times higher than in the general pediatric population. Report on malignancies in the German juvenile idiopathic arthritis registry.

Horneff G, Földvári I, Minden K, D Moebius, Hospach T. Rheumatology (Oxford). 2011 Jan; 50 (1): 230-6. Summary Reports of malignancies in children who were exposed to TNF inhibitors, raise questions with regard to increased risk for malignant lymphomas. In German JIA registers found between 2001 and 2009 Classificação de 5 the total 1260 patients who had a malignancy. All 5 patients were exposed to a variety of cytotoxic agents (inter alia MTX, LEF, AZA, CSA) before they were treated with TNF-α blockers. Malignancies have been observed for a period of treatment with etanercept from 3 weeks to> 6 years. While in some of the patients the treatment time with TNF blockers was too short to determine a recognizable reference, the long preliminary treatment could be causative for other patients studied. JIA patients treated with biologics, or cytotoxic agents should be accompanied observed thoroughly malignancies – in the longer term, in adult life. Complete control of disease activity and remission induced by treatment with etanercept in juvenile idiopathic arthritis. Papsdorf V, Horneff G. Rheumatology (Oxford).

2011 Jan; 50 (1): 214-21. Erratum in: Rheumatology (Oxford). 2011 April; 50 (4): 814 Malignancy and tumor necrosis factor inhibitors in juvenile idiopathic arthritis. Horneff G. Z Rheumatol. 2010 Aug; 69 (6): 516-26. Review. German. Updated statement by the German Society for Pediatric and Adolescent Rheumatology (GKJR) on the FDA’s report Regarding malignancies in anti-TNF-treated patients from Aug. 4, of 2009. Horneff G, T Hospach, Dannecker G, Föll D, Haas JP, Girschick HJ, Huppertz HI, Keitzer R, Laws HJ, Michels H, K Minden, Trauzeddel R. Z Rheumatol.

2010 Aug; 69 (6): 561-7. German. Safety and efficacy of once weekly etanercept 0. 8 mg / kg in a multicentre trial in 12 week active polyarticular course juvenile idiopathic arthritis. Horneff G, Ebert A, S Fitter, Minden K, Földvári I Kümmerle-Deschner J, Thon A, Girschick HJ, Weller F, Huppertz HI. Rheumatology (Oxford). 2009 August; 48 (8): 916-9. Epub 2009 May 29th Improvement of functional ability in children with juvenile idiopathic arthritis by treatment with etanercept. Halbig M, Horneff G. Rheumatol Int. 2009 Dec; 30 (2): 229-38 Safety and efficacy of combination of etanercept and methotrexate Compared to treatment with etanercept only in patients with juvenile idiopathic arthritis (JIA): preliminary data from the German JIA registry.

Horneff G, De Bock F, Földvári I Girschick HJ, Michels H, D Moebius, Schmeling H; German and Austrian Paediatric Rheumatology Collaborative Study Group. Ann Rheum Dis. 2009 April; 68 (4): 519-25. Epub 2008 April 15 Safety and efficacy of etanercept in children with juvenile idiopathic arthritis below the age of 4 years. Tzaribachev N, Kuemmerle-Deschner J, M Eichner, Horneff G. Rheumatol Int. 2008 August; 28 (10): 1031-4. Epub 2008 Mar 28 Safety and efficacy of once-weekly application of etanercept in children with juvenile idiopathic arthritis. Kuemmerle-Deschner JB, Horneff G. Rheumatol Int. 2007 Dec; 28 (2): 153-6.

Epub 2007 Jul 20th Etanercept and uveitis in patients with juvenile idiopathic arthritis. Schmeling H, Horneff G. Rheumatology (Oxford). 2005 August; 44 (8): 1008-11. Epub 2005 April 26 The German registry etanercept for treatment of juvenile idiopathic arthritis. Horneff G, H Schmeling, Biedermann T, Földvári I, Ganser G, Girschick HJ, Hospach T, Huppertz HI, Keitzer R, Sexton RM, Michels H, D Moebius, Rogalski B, Thon A; Paediatric Rheumatology Collaborative Group. Ann Rheum Dis. 2004 Dec; 63 (12): 1638-44. Epub 2004 28 Apr Review.

Shingles – Herpes Zoster

Shingles – Herpes Zoster Erysipelas – erysipelas . . . Acute, rarely chronic relapsing (recurring) running, caused by streptococcal infection of the skin, mucosal selterner.  Synonym: Rose, erysipelas, Streptodermia cutanea lymphatica Cause: pathogens are beta-hemolytic group A streptococci, probably all subtypes. Incubation period (time between infection and outbreak): 1 to 3 days, gelengentlich hours Contagiousness (infectiousness): low Infection: lubricants and droplet infection, as a source come infected persons into consideration, but the infection requires local or general immune deficiency. The pathogen penetrates usually a skin lesion or a Gewebedefektw, ie at locations where continuity separations skin made. This may be a little scratch, an insect bite, Geschwürzbildung by venous disorders or lymphedema, scars etc .

. often found esp. In erysipelas of the lower limbs an athlete’s foot infection or deep cracks to strong cornea.  Frequency: as a result of the extended use of antibiotics significantly declined; even the early observed peak age in infants and the age group of 30- to 50-year-old patient is blurring, accurate figures on the current status was not available to me Symptoms: From anscheinendem Welfare emerge on fatigue, steeply rising fever, tenderness and pain in the affected area. There is often chills, localized skin swelling with initially sharply demarcated erythema and clearly warming to burning heat. The beginning of flaming redness proceeds with increasing time in a darkly red to bluish acting areal redness where the demarcation is blurred and has tongue-like extensions; later ‘pallor of the Centre. It often also cause swelling of the regional lymph nodes. Rare are vesicular progressions of acute erysipelas. In face, the redness is often shaped butterfly. pictured right (to zoom Double). 52-year-old patient, high fever, strong beinträchtigtes general health and pain in the left groin as an expression of regional lymph node inflammation, pinhead erosion of the left dorsum of unknown origin, 2 days after initiation of treatment with 1 , 2 million units a depot penicillin significant easing of tension feeling and fever freedom patient was concerned, despite better general condition due to the gloomy red discoloration. Diagnosis: The diagnosis can be made usually from the clinical picture.

The direct detection of pathogens would require skin samples from the edge of redness, making it uncommon. As an indirect proof of the steeply rising Antistreptolysin titer used. In addition, you will find non-specific parameters such as elevated white blood cell count, erythrocyte sedimentation rate increased significantly; alpha- and betaGlobuline are increased, gamma-globulins decreased, esp. when repeating (recurrent) erysipelas are alpha-1 and beta1 globulin and transferrin increased. Clinic: The clinical course may be best to the typical skin manifestations are dargestell and described sufficiently in symptoms. Complications: swelling of the epiglottis (glottis) at the transition to the oral mucosa, cellulitis or gangrene as local complications in immunocompromised weak people. The recurrent (relapsing) wound Rose leads at intervals repeatedly fever, pain and swelling. This affects which are mainly those with chronic skin damage (leg ulcers, stasis dermatitis cracked at Kramp wires or similar chronic lesions, athlete’s foot well. The Erysipelrezidiv leads more often than on initial presentation to a blockage of the lymph vessels and thus runs the risk of Elephatiasis.  Prognosis: The prognosis is generally good. Perilous erysipelas is occasionally in elderly or save weak people. In addition, the prognosis is always determined by the simultaneous existence of a serious underlying disease.  Therapy: drug of choice is still penicillin.

It is important that the penicillin treatment with sufficient Dosiserung least to obtain more than 10 days. Only with a penicillin allergy or signs of a non-response (ie a resistance) should be soft to macrolide antibiotics or cephalosporins. When recurrent erysipelas can help prevent complications of the heart valves or to avoid chronic lymphedema, a month-long treatment with benzathine penicillin (as Pendysin ®) are introduced (depot injection 1x monthly). In general, the treatment can be performed on an outpatient basis. Complicated courses should the clinic.  Prophylaxis: No known! The disease hinterläß no lasting immunity. Chronic skin defects should be treated professionally. For rapid detection of sequelae of streptococcal infection by allergic and hyperergic reactions, antibody or toxin effects (acute rheumatiches fever, acute glomerulonephritis) should be a follow-up three to four weeks after a streptococcal infection! Infection Protection: No beonderen measures; no insulation ill patients. Disqualification in children’s institutions, in healthcare facilities (surgical and obstetrical departments) and are in the food industry to recovery are recommended for people with streptococcal skin disorders. Differential diagnosis (differentiation from other diseases): erythema chronicum migrans – usually lighter than the erysipelas, barely general symptoms continue erysipelas – localized, burning-itching, almost always precedes injury in meat and fish processing (butcher, shop assistant (especially after tick bite. ) , cooks), mostly on the hands, very rare today, Erythrasma intertrigonosum – seat in the bar, no complaints; .

. . Also all skin diseases that are associated with planar redness (allergies, contact dermatitis, eczema of all kinds) – usually this lack fever, pain and severe impairment of the general condition. Created: 09. 08. 2009 / update: no / author: F. Wiegleb (fwiegleb@gmx. de)