12 5 Focus 20

A new app for children, a tool for elderly individuals, and saliva as disease evaluator

Dec. 3, 2014
There are many advancements that can help dental hygienists help their patients, and Maria Perno Goldie, RDH, addresses some of them here. She also talks about changes down the road regarding antibiotics, and more.
In this issue we discuss a variety of issues, from children to geriatrics and beyond. In international news, the father of an autistic child, who is an executive of a Saitama IT company, is in the process of creating an iPad app to help children become comfortable during their visits to the dentist.(1) The app, called "Hassurudenta," uses drawings and photographs to describe dental procedures such as fillings. The app is already being used on a trial basis at some university hospitals, and the plan is for it to be for sale next spring. The app benefits those who are not disabled as well, and can be widely used. Hassurudenta was highlighted at a meeting of the Japanese Society for Disability and Oral Health, held in Sendai Nov. 14 to 16. Inquiries about Hassurudenta should be directed to the company Microbrain via telephone at 048-687-9841. (Image courtesy of Microbrain)(1)

Regarding older and infirm individuals, Google is developing adaptive equipment for people with essential tremors and Parkinson’s disease. In September they bought a company called Lift Labs, initially funded by the National Institutes of Health, that has transformed the humble spoon.(2)

The scientists and engineers who started Lift Labs were motivated by friends and family members with conditions that affect their dexterity, and their focus is on improving overall quality of life and independence. The Liftware Stabilizer with a battery charger and soupspoon attachment costs $295, which the company says averages out to 27 cents per meal over the first year. After the first year, your return on investment is realized. For more information and videos, visit the website.(2)

In exciting news from University of California Los Angeles (UCLA), Dr. David Wong revealed that oral health professionals might be able to take saliva samples to evaluate for a variety of diseases, including Type 2 diabetes and gastric cancer. The discoveries could also lead to a new category of self-diagnostic devices. The study will be published in the January 2015 special print issue of the Clinical Chemistry journal, titled “Molecular Diagnostics: A Revolution in Progress.” Why is this important? Diabetes is undiagnosed in nearly 28% of Americans who have the disease, as reported by a new study.(3) We also know that with most diseases, early diagnosis and intervention is the next best thing to prevention.

In the area of tooth decay, the Centers for Disease Control and Prevention (CDC) presented data on "Innovations in the Prevention and Treatment of Early Childhood Caries" at an Oct. 23-24 dental conference. The data show a downward trend in early childhood caries in the United States.(4) The investigation is based on a review of 2011-2012 National Health and Nutrition Examination Survey (NHANES) longitudinal health data from the CDC, and a representative sample of the U.S. population. It was presented in advance of expected CDC publication of the full range of data next year covering 2011 through 2014, and should be regarded as a preliminary analysis.

Biopharmaceutical company Allovate has partnered with Restore Health for the exclusive rights to provide Allerdent, a new therapeutic toothpaste delivery system available by prescription for people with allergic rhinitis.(5) Restore Health is dedicated to bringing personalized specialty medicines to health-care providers throughout the U.S. Allerdent is designed for daily use as part of a normal toothbrushing regimen, and it permits users with allergic rhinitis to incorporate immunotherapeutic allergy treatment into their daily activities. Oral mucosal immunotherapy is an innovative technique of delivering allergenic extracts to the oropharyngeal mucosa using a compounded toothpaste vehicle. The study describes three cases where people with seasonal allergic rhinitis demonstrated improvement of symptoms and decreased skin reactivity after using oral mucosal immunotherapy in a preseasonal and coseasonal fashion.(6)

Last, but not least, research presented at the American Heart Association (AHA) meeting and published in the “Lancet” suggests that reducing the routine use of preventive antibiotics before dental procedures may have contributed to an increase in heart valve infections in England.(7) Researchers found that in the U.S., the highest risk patients still receive preventive antibiotics and no similar trend in heart valve infections has been seen in the U.S. In 2007, the AHA and others stated that preventive antibiotics should only be used for the highest risk patients. In the U.K., guidelines from the National Institute for Health and Clinical Excellence (NICE) recommended complete cessation of antibiotic prophylaxis for prevention of infective endocarditis in March 2008. Although the data do not establish a causal association, prescriptions of antibiotic prophylaxis have fallen substantially and the incidence of infective endocarditis has increased significantly in England since introduction of the 2008 NICE guidelines.(7) The U.K.’s National Institute for Health and Care Excellence reported that it would immediately review its guidance on the basis of the study, but until that was done the existing advice should be followed.

The question remains – what is the balance between antibiotic use and antibiotic resistance? The CDC identified antimicrobial resistance as one of five urgent health threats facing the U.S. this year. Antimicrobial resistance is a global health security threat that warrants collaboration from many stakeholders around the world. Read more about a workshop held on this topic.(8)

I would like to thank the contributors to this newsletter. Enjoy the holiday season!

References 1. http://mainichi.jp/english/english/features/news/20141109p2a00m0na007000c.html. 2. http://www.liftlabsdesign.com/. 3. Holt TA, Gunnarsson CL, Cload PA, Ross SD. Identification of undiagnosed diabetes and quality of diabetes care in the United States: cross-sectional study of 11.5 million primary care electronic records. CMAJO, November 4, 2014 vol. 2 no. 4 E248-E255. http://www.cmajopen.ca/content/2/4/E248.abstract?sid=819a94fc-2893-4d78-aefc-4d09d77b0a5b. 4. http://www.ada.org/en/press-room/news-releases/2014-archive/october/cdc-data-shows-early-childhood-caries-trending-down. 5. http://weill.cornell.edu/news/news/2014/10/reisacher-allerdent-immunotherapy.html. 6. Reisacher W, Rudner S, Kotik V. Oral Mucosal Immunotherapy Using a Toothpaste Delivery System for the Treatment of Allergic Rhinitis. International Journal of Pharmaceutical Compunding, Jul/Aug 2014 - Volume 18, Number 4, 287-290. 7. Dayer MJ, Jones S, Prendergast B, et al. Incidence of infective endocarditis in England, 2000—13: a secular trend, interrupted time-series analysis. The Lancet, Early Online Publication, 18 November 2014. doi:10.1016/S0140-6736(14)62007-9. 8. IOM Workshop Summary: The Richard & Hinda Rosenthal Symposium 2014: Antimicrobial Resistance: A Problem Without Borders. October 17, 2014. http://www.iom.edu/Reports/2014/The-Richard-and-Hinda-Rosenthal-Symposium-2014-Antimicrobial-Resistance-A-Problem-Without-Borders.aspx.