Preparing Your Practice for Disasters, Flu Pandemics, and Bioterrorism BEFORE ...
Do You Have a Business Contingency Plan?
With President Bush unveiling the Federal government’s plan to address a potential avian flu pandemic, make sure that you are prepared with contingency plans for your business in case of illness or health. As if hurricanes and terrorism concerns weren’t enough, be sure that your practice includes business continuity plans for a possible pandemic. Martin Meltzer, senior health economist for the Centers for Disease Control and Prevention (CDC), states that starting the planning process is most important.
In the United States, the CDC estimates that even a “medium-level” pandemic could produce 89,000 to 207,000 deaths in the first six months alone, with between 314,000 and 734,000 hospitalizations. They estimate a minimum of 18 million to 42 million outpatient visits to hospitals. The U.S. economic impact would be between $71.3 billion and $116.5 billion. Remember that in a pandemic, the fewer people who are physically together, the better. Meltzer and the CDC have developed a software application, Flu Aid 2.0., which provides users with a range of estimates based on historical data collected from the last three pandemic flu cycles for deaths, hospitalizations, and outpatient physician visits.
Recently, the United Nation’s Kofi Annan announced the seven-point plan for avian flu: improving bird monitoring, focusing on research in human animal contact, minimizing pandemic impact, facilitating speedy vaccine discovery, communicating effectively, and coordinating efforts with political leaders. The software program includes these elements. Work now to develop your office plan. For details, go to the Small Business Administration Web site: http://www.sba.gov/disaster_recov/prepared/getready.html. A wonderful resource for disaster planning is by the Institute for Business and Home Safety, “Open for Business: A Disaster Planning Toolkit,” found at http://www.ibhs.org/docs/openforbusiness.pdf.
Information Backup Is Key
Having an information database backup for your computerized records is key. Be sure to have a system in place to back up your data, whether on a secure Web site for a fee or with your own tape or disk system. Designate someone to take the tapes or disks with them, and you should take at least one set.
If you don’t have computerized dental records and a plan to back them up, consider getting them. Before disaster strikes, Surgeon General Richard Carmona, MD, has called for the need for an interconnected health-care system as a tool to monitor disease outbreaks nationally and internationally and to mitigate disasters. He has now joined the chorus of lawmakers and health-care officials calling for IT as a way to monitor the spread of disease or to gather information for public health officials in the event of a bioterrorist attack or disasters. The ADA is one of the many national health-care organizations currently working on an integrated health record system. Noting that barriers to health-care IT adoption include buying hardware and software, Carmona said, “There is no greater tool on the horizon that we should be chasing right now.” Know where and how you will take your data in case of a disaster or event.
During... New Resource for Providing Dental Care During Disasters
The Organization for Safety and Aseptic Procedures has a new online resource guide for providing care during disasters. Go to www.osap.org. Women dentists may want to inform their dental colleagues about this new resource for disaster planning for dental practice.
AFTER ..
The Small Business Administration offers low-cost loans and recovery packages to businesses impacted by disaster. Go to http://www.sba.gov/disaster_recov/index.html. The ADA can be contacted about assistance to dentists impacted by events. Go to http://www.ada.org/ada/prod/adaf/.
Digital Mammography Better for Some Women in Detecting Breast Cancer
Since film mammography has limitations for detecting breast cancer among young women and women with dense breasts, a recent study analyzed images from 42,760 women in the United States and Canada to determine whether digital imaging was superior to film mammography. Digital mammograms produce images on a computer screen, and were found to be superior in detecting cancer compared to standard X-rays for such groups. The study hypothesis was to determine if digital technique was more accurate in detecting cancer and not giving too many false alarms. Digital mammograms proved 15 percent more accurate than standard film among women under 50 (p=.002). Among women with dense breasts and those in pre- or perimenopause, digital mammograms were 11 percent and 15 percent better, respectively (p=.003 or p=.002).
SOURCE: Pisano E, et al. Diagnostic performance of digital vs. film mammography for breast cancer screening. New Engl J of Med Sept. 16, 2005 (10.1056/NEJMoa052911)http://content.nejm.org/cgi/content/abstract/NEJMoa052911.
Caesarean Births May Contribute to Increased Decay for Babies
Dr. Yihong Li reported on a four-year study of a cohort of 156 women, whose babies were delivered either vaginally or by Caesarean. Among babies born vaginally, it was almost 29 months before Streptococcus mutans appeared in saliva. Among babies born by Caesarean, the bacteria appeared in 11.7 months (p=0.038). A history of sexually transmitted disease (p=.01), caries score and bacteria level (p=.02), and family income (p=.03) were associated with bacteria acquisition. Since babies’ mouths are sterile at birth, the mouth becomes colonized with bacteria, which are beneficial in developing immunities and protecting against harmful bacteria. C-section infants had a 100 percent correlation of their bacteria to that obtained from their mother. The author suggested that babies born vaginally may come into contact with more beneficial bacteria during birth than those born by the nearly sterile Caesarean procedure. Larger additional studies are needed to determine the long-term impact of Caesarean, which is increasing among U.S. women. For the abstract, go to http://jdr.iadrjournals.org/cgi/content/abstract/84/9/806.
SOURCE: Li Y, Caulfield PW, et al. Mode of delivery and other maternal factors influence the acquisition of Streptococcus mutans in infants. J Dent Res Sept. 2005; 84(9):806-811.
New Plantibody Approved in Europe Prevents Bacteria From Adhering to Teeth
A new plantibody, or plant-produced antibody, has been approved in the European Union as a medical device. The product, CaroRx, is the first of its type to prevent adhesion of Streptococcus mutans to tooth structure. Manufactured by Large Scale Biology Corp. and Planet Biotechnology, CaroRx provides genetically engineered coding for the desired immunity into plants which produce the plantibody.
Smokers Less Likely To Visit Dentist
An analysis of a national survey of 15,000 adults (study by NIH and CDC) found that 33 percent of smokers said they went to the dentist at least once a year, compared to 45 percent of nonsmokers. The author, Dr. Susan Drilea, noted that it could not be determined whether this result was due to personal choice, lack of awareness, financial issues, or the dental experience. Given the higher risk of oral diseases and other critical issues among smokers, this is a perplexing outcome. More than one in five people smoke in the United States.
SOURCE: Drilea S, et al. Dental visits among smoking and nonsmoking adults in 2000. Am J of Health Behavior Sept/Oct 2005; 29(5):462-471. http://www.ajhb.org/2005/5/SepOct0905Drilea.pdf
Does Bottled Water Contribute to More Decay Among Children?
Bottled water may be contributing to increases in tooth decay among children, according to new data from the CDC’s Community Preventive Services Task Force. Since many types of bottled water don’t contain enough fluoride, dentists and dental hygienists may want to caution parents that using bottled water may mean that their children won’t get enough fluoride from water. Data presented at the World Dental Congress in Montreal earlier this year suggests that use of community fluoridated water results in a median decrease of about one-third for tooth decay among children 4 to 17 years old, based on summary data. Only about one-fourth of the top bottled water manufacturers contain adequate amounts of fluoride to prevent tooth decay. Dentists can assess the sources of water for their pediatric patients to determine if additional fluoride is needed.
