WOMEN'S HEALTH
Lung Cancer Affects Women Differently Than Men
Current studies vary about the impact of smoking on men and women and which gender has a greater susceptibility to lung cancer. However, a recently published article in the Journal of the American Medical Association documents differences between men and women in responding to cancer treatment, and cites higher levels of genetic damage in women's lungs. Some differences could be attributed to estrogen, either naturally occurring or from supplements. Women are more likely to develop adenocarcinoma. Survival rates for women in treatment were longer than for men. Since the 1960s, smoking rates for American men have decreased nearly 50 percent, while only 25 percent for women.
SOURCE: Patel JD, Bach PB, Kris MG. Lung cancer in U.S. women. A contemporary epidemic. JAMA 2004; 291:1763-1768.
Study Confirms Mother Wit About Monthly Hormone Shifts Impacting Periodontal Health
The abstract below of a preliminary study of 18 women provides important clues that every woman already knows about the impact of hormones on periodontal health. Several women reported an increase in gingival inflammation and gingival discomfort associated with menses. For the entire article, go to perio.org. Studies such as this should prompt attention to the study of women's health in the dental school curriculum.
SOURCE:Macheti E, Mahler D, Sanduri H, Peled M. The effect of menstrual cycle on periodontal health. J Periodontol 2004; 75:408-412.
Background: Fluctuation in estrogen/progesterone levels has been shown to affect the periodontium. The effects of pregnancy, prepuberty, and oral contraceptives on gingival health has been studied extensively, with gingival scores reported to be higher, in most instances, than in controls. Fluctuation in steroid sex hormone is also noticeable through women's menstrual cycles. Many women report an increase in gingival inflammation and discomfort associated with their menstrual cycle, most commonly around the menses period. However, this well-known phenomenon has never been studied. The purpose of this longitudinal, prospective study was to compare the periodontal status of premenopausal women at different times during their menstrual cycle.
Methods: Eighteen premenopausal women, enrolled in our maintenance program, were recruited. Clinical examination was performed before the recall visit at three different time points in their menstrual cycle: ovulation (OV), premenstruation (PM), and menstruation (M). Plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were examined around the Ramfjord index teeth. Analysis of variance, with Scheffe modification, was used to determine differences between the menstrual time points.
Results: Several women in this study reported appreciable oral symptoms just before or during menses. Mean PI (0.85 ± 0.06) was almost identical at all time points. Despite this, GI was significantly higher (P = 0.0245) in OV (0.54 ± 0.07) and in PM (0.5 ± 0.08) than in M (0.38 ± 0.07). Mean patient's PD (2.22 ± 0.08 mm) and CAL (2.92 ± 0.15 mm) were not significantly different between examinations.
Conclusions: We observed changes in gingival scores during the menstrual cycles of periodontally healthy women. These changes need to be addressed when analyzing data from epidemiological and treatment studies in premenopausal women.
ORAL HEALTH MATTERS
Survey of Esthetics Courses in Dental Schools Documents Deficiencies
The following excerpt from an abstract documents the need for esthetic dentistry in the dental school curriculum.
SOURCE:Gordan VV, Abu-Hanna A, Mjör IA. Esthetic dentistry in North American dental schools. J Can Dental Assoc April 2004; 70(4).
Objectives: Esthetic dentistry is among the most dynamic areas of contemporary clinical dentistry. Teaching programs in dental schools have a strong effect on the practice of dentistry, not only for recent graduates but also for established clinicians, especially with respect to new techniques and concepts. The purpose of the study was to assess the frequency and extent of the teaching of esthetic dentistry in North American dental schools.
Materials and Methods: A 19-question survey was mailed to 64 North American dental schools about the teaching of esthetic dentistry in the school, including how the subject was taught (through regular curricular courses or through multidisciplinary approaches or electives). The questionnaire also detailed course content and length, as well as integrated approaches among different disciplines in the teaching of esthetic dentistry, and assessed the techniques and commercial materials used.
Results: Fifty-two (81 percent) of the 64 dental schools completed and returned the questionnaire. Twenty-five of these schools (48 percent; designated group A) reported having a course exclusively for the teaching of esthetic dentistry, taught mainly in the operative dentistry department. Twenty-seven schools (52 percent; designated group B) reported that esthetic dentistry was addressed in multiple courses; i.e., no specific course was available, with four schools developing a separate course for esthetic dentistry. Many schools in this group provided only clinical instruction. Most frequently reported course duration was four to six months, with wide variation.
Course content offered in group A schools included extrinsic and intrinsic discoloration, bleaching, diastemas, malformation and malpositioning (the latter including rotation, intrusion, and labio-linguoversion), and replacement of amalgam and gold restorations. Only seven (28 percent) of the group A schools reported the support of an in-house laboratory. The esthetic procedures taught were similar for reporting schools. The use of direct posterior composite restorations, all-ceramic crowns, and nonvital bleaching was more common among group B schools. Ceramic inlays, onlays, and indirect posterior composite restorations were not taught by four (16 percent) of the schools in group A and seven (26 percent) of the schools in group B.
Conclusions: The teaching of esthetic dentistry in North American dental schools is highly variable and shared among different disciplines. Dental schools should work together to establish the parameters for teaching this subject and should formulate the necessary standards for education and research in this new field.
Profile on Fluoride From CDC/ATSDR
The CDC/ATSDR (Centers for Disease Control and Agency for Toxic Substances and Disease Registry) Toxicological Profile for Fluorides, Hydrogen Fluoride, and Fluorine has been published. For details, go to http://www. atsdr.cdc.gov/toxprofiles/tp11.html. The ATSDR periodically issues these profiles to characterize the toxicologic and adverse health effects for certain hazardous substances. The last report on fluorides was issued in 1993.
FDA Approves Use of Oral Fluid Samples for HIV Testing With Results in 20 Minutes
The FDA approved the use of oral fluid samples with a rapid HIV diagnostic test that provides screening results in 20 minutes. The new test is 99 percent accurate. Until now, rapid tests required blood samples, and screening results for HIV — often confirmed with ELISA and Western Blot blood tests — usually took several days.
WHO Global Oral Report
With chronic diseases and injuries as leading health problems in most of the world, rapidly changing disease patterns are linked to modifiable factors such as diet, use of tobacco, and high alcohol intake. Oral diseases qualify as major public health problems due to their high prevalence in all regions of the world, with the greatest burden on the disadvantaged and socially marginalized populations. More than 75 percent of the world's population has no access to a dentist. The impact of oral disease on quality of life, including pain and suffering, impaired function, and perception of esthetics on self-esteem, has not been fully measured. The World Health Organization (WHO) Oral Health Programme describes the global oral health picture, key strategies, and technical approaches for better oral health in the 21st century. For more details, go to www.who.int/oral_health/media/en/orh_report_en.pdf.
KUDOS!
- to the Oral Health Foundation of Boston for donating $584,500 for free dental screenings for the elderly. Through a volunteer program for dentists, the Foundation provides treatment to students in public schools, low-income residents, and the uninsured. It also established a preventive dental clinic at a Boys and Girls club facility in Massachusetts.
- to Dr. Kate Hakala, who continues to find and place volunteers for Smiles for Success so that women who want to go from welfare to work have a chance to smile at prospective employers! Contact Kate at www.sfs.org to volunteer.
— UPCOMING CONFERENCES —
AAWD (American Association of Women Dentists) — July 8-11, 2004; Anaheim Marriott; Anaheim, Calif.; www.aawd.org; (800) 920-2293
AGD (Academy of General Dentistry) — July 8-11, 2004; Anaheim Convention Center; Anaheim, Calif.; www.agd.org; (888) 243-3368
NDA (National Dental Association) — July 30-Aug. 4, 2004; Century Plaza; Los Angeles, Calif.; www.ndaonline.org; (202) 588-1697
ADA (American Dental Association) — Sept. 30-Oct. 3, 2004; Orange County Convention Center; Orlando, Fla.; www.ada.org; (312) 440-2500
AOS (American Orthodontic Society) — Oct. 21-24, 2004; Westin Riverwalk; San Antonio, Texas; www.orthodontics.com; (813) 264-6677
GNYDM (Greater New York Dental Meeting) — Nov. 26-Dec. 1, 2004; Jacob K. Javitz Center; New York, N.Y.; www.gnydm.com; (212) 398-6922
