SCIENCE NEWS AND RESOURCES
Look for Future Opportunities for Having Your Patients Make Appointments Online
On Oct. 27, 2003, the New York Times reported that the Internet may bring all kinds of automated transactions between businesses and individuals. With new system integrations in your office linking your digital photos, radiographs, computerized billing, and insurance processing, you could also create methods for greater assistance with patient scheduling. For example, you could input your calendar with stated time, preferences, and availability. Then, patients could input this into their calendars and availability to automatically set up an appointment. Microsoft, Oracle, and Hewlett Packard are looking at these types of systems.
Spanish Help for Your Hispanic Patients
Elsevier/Mosby has released a new publication, "Spanish Terminology for the Dental Team," which can be ordered at www.us.elsevierhealth.com/product.jsp?isbn=0323025366.
New CDC Infection-Control Guidelines for Dentistry
In follow-up to the release of the Guidelines for Infection Control in Dental Health-Care Settings, 2003, (Dec. 19, 2003, MMWR: 52 (RR-17)), these new guidelines for dental infection control replace previously published guidelines in 1993 and 1986. Part I is a review of the available dental science of infection control, with Part II containing guidance for routine use of personal protective equipment, such as gloves, masks, and protective eyewear. This section incorporates broader CDC recommendations, such as those for hepatitis B immunization or hand hygiene. Recommendations in Part II are categorized based on the strength of the scientific evidence, ranging from strongly recommended and supported by well-designed experimental, clinical, or epidemiologic studies to those that are suggested for use based on theoretical considerations. Go to www.cdc.gov/mmwr. For easier-to-understand material, look for an upcoming companion workbook and six Web-based training modules being developed by the Organization for Safety & Asepsis Procedures (OSAP) at www.osap.org.
Health-Care Providers To Assist in Efforts To Vaccinate Children Against Hepatitis A
A rash of food-borne outbreaks has prompted public health officials to recommend intensified efforts to provide vaccination for all children against hepatitis A. In October, contaminated green onions from Mexico were implicated in a hepatitis A outbreak, killing three and sickening more than 600 in Pennsylvania. Similar outbreaks were reported in Georgia, North Carolina, and Tennessee and traced to scallions. Hepatitis A is spread by fecal-oral contamination from infected people. Dental health workers are encouraged to ask whether or not children have been vaccinated against hepatitis A.
Call for Abstracts for 2004 National Conference on Health Care and Domestic Violence
The Family Violence Prevention Fund National Conference on Health Care and Domestic Violence invites you to submit abstracts for the Oct. 22-23, 2004, conference in Boston, Mass. Visit http://endabuse.org/ health/conference for a complete description of the conference and to submit an abstract online. The deadline for submission of abstracts is Feb. 26, 2004. The goal of the Third National Conference on Health Care and Domestic Violence is to advance the field of health care's response to domestic violence. The conference will broaden the discussion on health impacts, co-occurring issues, and responses related to victims, children, perpetrators, and communities affected by domestic violence. The conference will also highlight innovative research, practices, and programs, and will describe the wide array of partnerships between health-management systems, providers, governments, legal systems, and social service agencies to enhance patient safety and health status. Contact Mari Spira at (415) 252-8900, Ext. 20, or [email protected] with questions.
Ephedra Removed From Market
Now more than ever, be sure to ask your patients about their use of herbal supplements when taking their health history. Most herbal supplements are not required to submit safety studies unless there is proof of unreasonable health risk to the public. Now, an herbal dietary supplement, ephedra, has been removed from the market by the Food and Drug Administration (FDA). The supplement contains two alkaloids, ephedrine and pseudoephedrine. These can ease breathing and congestion, but may also cause serious heart conditions or stroke. With the report of more than 100 deaths and 1,000 serious injuries from consumption of the herbal supplement, the FDA concluded that ephedra posed an "unreasonable health risk." The American Medical Association and the American Heart Association support the removal of the herb from the market. Other herbal supplements with "possible health hazards" include chaparral, comfrey, willow bark, and wormwood.
American Academy of Periodontics — News on Periostat
This statement was revised by the Committee on Research, Science and Therapy and approved by the Board of Trustees of the American Academy of Periodontology in January 2000. This statement on Periostat replaces the one approved in June 1998.
SOURCE: http://www.perio.org/resources-products/periostat.htm
Periostat® is a systemically delivered collagenase inhibitor consisting of a 20 mg capsule of doxycycline hyclate for oral administration. This is the first FDA-approved systemic drug for host modulation as an adjunct to scaling and root planing in the treatment of periodontitis. Periostat, administered BID, reduced the elevated collagenase activity in the gingival fluid of patients with adult periodontitis.
A randomized, multicenter, double blind study was performed to compare the efficacy of scaling and root planing (SRP) plus placebo to scaling and root planing plus Periostat administered BID. That study revealed statistically significant pocket-depth reduction with adjunctive use of Periostat at three, six, and nine months post initial therapy (for initial depth >7 mm, 1.20 vs. 1.68 mm, at depths 4 to 6 mm, 0.69 vs. 0.95 mm) and gain of clinical attachment (for initial depths >7 mm, 1.17 mm vs. 1.35 mm, at depths 4 to 6 mm, 0.86 vs. 1.03 mm). Mean changes in pocket depth and attachment level across large numbers of patients and tooth sites were small and may not reflect the magnitude of change that may occur in an individual patient or tooth site. For example, when SRP plus Periostat was compared with SRP plus placebo, more sites initially demonstrating 5 to 8 mm probing depth exhibited >2 mm reduction in probing depth (41 percent vs. 30 percent, 886 vs. 640 sites).
In a three-month follow-up study, where patients received no additional therapy, pocket-depth reductions and clinical attachment level gains observed following nine months adjunctive Periostat were maintained. The Academy is not aware of any data regarding treatment outcomes for periods longer than 12 months.
At present, the Academy is not aware of any available data concerning the need for surgical or nonsurgical treatment of sites after using Periostat. Furthermore, there are no studies to the Academy's knowledge that address the use of Periostat in the treatment of specific types of periodontal defects or diseases other than adult periodontitis.
When considering using Periostat or other adjuncts to SRP, clinicians must consider the expected results in view of the severity of the defects being treated. Furthermore, it should be noted that adjunctive procedures to enhance conventional therapies are not a substitute for meticulous home care, professional root planing, and appropriate treatment designed to minimize bacterial load and facilitate proper home care. In this regard, each practitioner must determine the usefulness of Periostat in light of the available data and needs of the individual patient.
References
- Caton J, Blieden T, Adams D, et al. Subantimicrobial doxycycline therapy for periodontitis. J Dent Res 1997; 76:177 (Abstract # 1307).
- Caton J, Ciancio S, Crout R, Hefti A, Polson A. Adjunctive use of subantimicrobial doxycycline therapy for periodontitis. J Dent Res 1998; 77:1001 (Abstract # 2957).
INFECTIOUS DISEASE UPDATE
Mad Cow Disease
Eight of the last 10 global disease outbreaks have been attributed to animals. Mindful of these concerns, the Department of Agriculture released new regulations on Dec. 30, 2003, to respond to concerns about the first reported U.S. case of bovine spongiform encephalopathy, or "mad cow" disease, in a cow. The disease is believed to be associated with prions and related diseases, including Creutzfeldt-Jakob disease in humans. These new regulations ban the sale of neuronal tissue of any mature cow for human consumption, since the disease is thought to be spread by this tissue. They also provide for animal tracking systems and better methods to prevent contamination of meat with spinal cord tissue during packaging. Great Britain has reported 143 people with Creutzfeldt-Jakob disease, which is a low number partly because 4.5 million cows were destroyed and effective quarantine occurred in the last several years. To date, the United States has not reported any human cases related to mad cow disease derived from prions, or proteins from infected cows.
Oral Sex Increases Risk of Recurrent Vaginal Yeast Infections Among Women
The December 2003 issue of The Journal of Women's Health reports that women who have recurrent yeast infections may be infected by oral sex, not by re-infection by their male partners. Among the study participants, relative risk of developing multiple episodes of itching and burning from yeast was higher in women who receive oral sex.
Based on the study of 148 women with Candida vulvovaginitis and 78 partners followed for a year, recurrent yeast occurred in 40 percent of the women (n=33). Receiving oral sex had an association with increased risk of recurrent yeast infections. Women who had recently received oral sex or masturbated with partner saliva were three times as likely to develop recurrent yeast infection than women who did not engage in this practice.
While reinfection by male partners is common with many sexually transmitted diseases, Dr. Barbara Reed and her colleagues determined that women's risk was unrelated to whether or not male partners were infected with yeast. While women and men do sometimes re-infect each other with the same strain of yeast, the presence of yeast was unrelated to symptoms.
The authors surmised that oral sex may increase a woman's risk of developing symptoms if she is carrying Candida and her immune system interacts with her partner's saliva, resulting in a symptomatic yeast infection. The authors recommend reducing or eliminating oral sex temporarily to see if symptoms improve. Oral sex, however, may not be a risk factor for all women for recurrent yeast infections.
Potential SARS Case in China
On Dec. 26, 2003, the Chinese Ministry of Health (MOH) reported a single case of suspected severe acute respiratory syndrome (SARS) in a 32-year-old man in the southern Chinese province of Guangdong. Two notices describing the Chinese MOH report are available on the Web site of the World Health Organization (WHO) Regional Office for the Western Pacific (http://who.org). Clinical findings were consistent with a diagnosis of SARS, while laboratory testing results for SARS coronavirus were inconclusive. The patient had no known contact with high-risk groups, such as health workers or animal handlers. WHO is advising that SARS outbreaks may be likely this winter.
UPCOMING CONFERENCES
CDS (Chicago Dental Society) 2004 Midwinter Meeting — Feb. 19-22, 2004; McCormick Place Convention Center; Chicago, Ill.; www.cds.org; [email protected]; (312) 836-7300
ALD (Academy of Laser Dentistry) SOURCE 2004: Lasers in Dentistry — March 3-6, 2004; Renaissance Esmeralda Resort; Indian Wells ~ Palm Springs, Calif.; www.laserdentistry.org; [email protected]; (877) 527-3776
RDH Under One Roof Conference (sponsored by RDH Magazine/PennWell) — March 4-6, 2004; Hilton Costa Mesa; Costa Mesa, Calif.; www.rdhmag.com; [email protected]; (888) 299-8016
CDA (California Dental Association) Spring 2004 Scientific Session — April 16-18, 2004; Anaheim Hilton; Anaheim, Calif.; www.cda.org; (916) 443-3382
Greater Long Island Dental Meeting First Annual Women's Day Conference — April 20, 2004; Long Island Marriott Hotel; Uniondale, N.Y.; www.glidm.org; (631) 244-0722
Adhesive Dentistry Bermuda Style Symposium — April 22-25, 2004; Southampton Princess Resort; Hamilton, Bermuda; www.clinicianschoice.com; (800) 265-3444, Ext. 223
KUDOS!
- ... to Rear Admiral Carol Turner, who was installed as new chief of the Navy Dental Corps on Nov. 7, 2003. Go to the Navy Dental Corps Web site for a nice bio — https://bumed.med.navy.mil/med06/. Congratulations!
- ... to Dr. Joy Jordan, who was installed as president of the National Dental Association on Dec. 8, 2003. This is the second female president of the National Dental Association in the last five years! Other organizations will have to move quickly to copy this feat!
- ... to Dr. Eva Dahl, of Onalaska, Wis., an endodontist and past president of AAWD, who was recently honored by the Wisconsin Dental Association for her work on dental access to underserved children and dental education.
- ... to Dr. Dushanka Kleinman, who is the new assistant director for roadmap coordination to the National Institutes of Health (NIH) Director Elias Zerhouni, MD. Dr. Kleinman, the National Institute of Dental and Craniofacial Research (NIDCR) deputy director, will work closely with the NIH Roadmap Implementation Coordination Committee and across the various NIH Institutes and Centers to better coordinate and integrate science and policy across NIH. This should assist in integrating oral health with systemic health issues too! Dr. Kleinman will continue her role as chief dental officer, USPHS, during this detail. Amazing!
- ... to Dr. Michèle Aerden, who is the first woman president of the FDI. Congratulations to both Dr. Aerden and the FDI!
- ... to the Maine Health Access Foundation for giving $50,000 to Maine Dartmouth Family Practice Residency for training in preventive and emergency dental care for family physicians.
