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Monday, April 30, 2012

Not Again... Twice in One Month!

I don't know if every one's patients are as up on dental news as mine are but this month has been full of discussions about x-rays and heart disease.

Just as the waters seem to be settling on the new finding on x-rays the following study emerges and muddies the waters on gum disease.

A doctor I work for made this comparison:
"Studies show that drinking red wine reduces your chance of heart disease. But it is impossible to tell if it is the red wine or other factors in the life style of someone who drinks red wine (as compared to someone who drinks beer...) that is actually responsible for the lower risk." B.R.

Below is a summary of the AHA findings, followed by a statement released by The Canadian Dental Association.

No proof that gum disease causes heart disease or stroke
 April 18, 2012 
Statement Highlights: There is no convincing evidence that proves gum disease causes heart disease or stroke, or treating gum disease reduces the risk of those diseases. Gum and heart disease share common risk factors, including smoking, age and diabetes, which is possibly why the diseases often occur in the same person.
 EMBARGOED UNTIL 3 pm CT/4 pm ET, Wednesday, April 18 DALLAS, April 18, 2012 —
 Despite popular belief, gum disease hasn’t been proven to cause atherosclerotic heart disease or stroke, and treating gum disease hasn’t been proven to prevent heart disease or stroke, according to a new scientific statement published in Circulation, an American Heart Association journal.

 Keeping teeth and gums healthy is important for your overall health. However, an American Heart Association expert committee -- made up of cardiologists, dentists and infectious diseases specialists -- found no conclusive scientific evidence that gum disease, also known as periodontal disease, causes or increases the rates of cardiovascular diseases. Current data don’t indicate whether regular brushing and flossing or treatment of gum disease can cut the incidence of atherosclerosis, the narrowing of the arteries that can cause heart attacks and strokes. Observational studies have noted associations between gum disease and cardiovascular disease, but the 500 journal articles and studies reviewed by the committee didn’t confirm a causative link. “There’s a lot of confusion out there,” said Peter Lockhart, D.D.S., co-chair of the statement writing group and professor and chair of oral medicine at the Carolinas Medical Center in Charlotte, N.C. “The message sent out by some in healthcare professions that heart attack and stroke are directly linked to gum disease, can distort the facts, alarm patients and perhaps shift the focus on prevention away from well known risk factors for these diseases.” Gum disease and cardiovascular disease both produce markers of inflammation such as C-reactive protein, and share other common risk factors as well, including cigarette smoking, age and diabetes mellitus . These common factors may help explain why diseases of the blood vessels and mouth occur in tandem. Although several studies appeared to show a stronger relationship between these diseases, in those studies researchers didn’t account for the risk factors common to both diseases. “Much of the literature is conflicting,” Lockhart said, “but if there was a strong causative link, we would likely know that by now.” A large, long-term study would be needed to prove if dental disease causes heart disease and stroke, he said. Such a study isn’t likely to be done in the near future, and it’s most important to let patients know “what we know now, and what we don’t know,” Lockhart said.

 For more than a century, doctors have proposed that infected gums lead to systemic problems like heart disease, and we know that mouth bacteria frequently enter the blood stream during dental procedures and during naturally occurring events such as tooth brushing. “We already know that some people are less proactive about their cardiovascular health than others. Individuals who do not pay attention to the very powerful and well proven risk factors, like smoking, diabetes or high blood pressure, may not pay close attention to their oral health either” Lockhart said. Statements that imply a cause and effect relationship between periodontal disease and cardiovascular disease, or claim that dental treatment may prevent heart attack or stroke are “unwarranted,” at this time, the statement authors said. The American Dental Association Council on Scientific Affairs agrees with the conclusions of this report. The statement has been endorsed by the World Heart Federation.

 The statement’s writing group was co-chaired by Ann F. Bolger, M.D. Other co-authors are Panos N. Papapanou, D.D.S., Ph.D.; Olusegun Osinbowale, M.D.; Maurizo Trevisan, M.D.; Matthew E. Levison, M.D.; Kathryn A. Taubert, Ph.D.; Jane W. Newburger, M.D., M.P.H; Heather L. Gornik, M.D., M.H.S.; Michael H. Gewitz, M.D.; Walter R. Wilson, M.D.; Sidney C. Smith Jr., M.D.; and Larry M. Baddour, M.D. Author disclosures are on the manuscript.

 Learn more about how a healthy lifestyle and healthy eating are important steps toward good health. Take these free risk assessment quizzes and find your personal risk of heart attack, high blood pressure and diabetes. Visit the American Stroke Association site for comprehensive info on stroke. ### The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical companies and device manufacturers, is available at . NR12-1061 (Circ Statement/Lockhart) Additional resources, including multimedia, is available on the right column of this link: For Media inquiries: (214) 706-1173 Maggie Francis: (214) 706-1382; Bridgette McNeill: (214) 706-1135; Julie Del Barto (broadcast): (214) 706-1330; For Public Inquiries: (800) AHA-USA1 (242-8721) and

 The Canadian Dental Association reaffirmed on Friday their position after consulting with the Canadian Medical Association and CHA: 
 Association between Periodontal Disease and Systemic Disease The Canadian Dental Association recognizes the impact of systemic diseases, such as diabetes and immuno-compromised states on the periodontal tissues. A report on oral health (‘Oral Health in America: A Report of the Surgeon General’) released May 25, 2000 supports the possible association between periodontal disease and systemic disease. This report suggests that the signs and symptoms of life-threatening diseases may appear in the mouth long before they show up in other parts of the body. The Surgeon General’s report highlights a bi-directional interaction between oral and systemic health. Systemic conditions noted to occur with oral manifestations include diabetes, cutaneous diseases, hereditary disease, joint disease, immuno-compromised states and osteoporosis. Recent evidence presented in this report, primarily from epidemiological studies, now suggests that there may be an association between periodontitis and certain systemic disorders, notably cardiovascular disease (artherosclerosis, heart attacks and strokes) and complications of pregnancy (pre-term birth and low birthweight infants). While a number of interactions have been identified, other reviewers suggest no or limited relationship. Therefore, additional research is needed to evaluate disease pathogenesis, relationships to the oral cavity and possible therapeutic interventions. Dentists and dental specialists are constantly looking for signs and symptoms of these diseases, which can be detected during regular oral health and physical examinations. The Canadian Dental Association recognizes the Surgeon General’s report but recommends that further emphasis should be placed on research and educating dentists, physicians, students, residents, other healthcare professionals and most importantly, patients regarding the importance of these possible relationships. This report places oral health in the perspective of systemic health and suggests that the dental and medical professions need to develop even closer ties in the future. Approved CDA Board of Directors February 2005

Tuesday, April 24, 2012

Have you seen these?

I recently had a chance to use an instrument that I had never seen before- the O'Hehir curettes.
If you haven't had a chance to try these out I would highly recommend them!

O’Hehir New Millennium curettes from PDT have small scooped blades with 310-degree radius cutting edges. They have the toe of a curette without the interference of the remaining unused portion of a traditional blade. This unique design allows the clinician to reach areas missed by traditional curette blades. New Millenium curettes can be used with a push or pull motion and in vertical, horizontal, and diagonal directions.

To order these instruments CLICK HERE

Monday, April 16, 2012

Have you seen how much sugar is in RedBull?

This would be a great poster to take into schools:

CLICK HERE to see the original post

Looking for other ideas to take into the classroom- click here

Wednesday, April 11, 2012

X-rays in the News

The following is an article that has been receiving a lot of attention recently.

It my belief that this was a poorly written article on a poorly performed study.I do however take pride that I work in an office that has invested in digital radiography to provide our patients with the safest and best treatment possible.

Although I believe this is drawing a lot of negative attention to preventive care I am optimistic that it will force other dental practitioners to follow guidelines that have been established and upgrade equipment to provide better care.

Additional information is available:

ADA Press Release on dental xrays
Common Dosages of Ionizing Radiation in Everyday life
Estimate your personnel annual radiation dose
NEW YORK (Reuters Health) - A new study suggests people who had certain kinds of dental X-rays in the past may be at an increased risk for meningioma, the most commonly diagnosed brain tumor in the U.S.

The findings cannot prove that radiation from the imaging caused the tumors, and the results are based on people who were likely exposed to higher levels of radiation during dental X-rays than most are today.

"It's likely that the exposure association we're seeing here is past exposure, and past exposure levels were much higher," said Dr. Elizabeth Claus, the study's lead author and a professor at the Yale School of Medicine in New Haven, Connecticut.

Claus and her colleagues write in the journal Cancer that dental X-rays are the most common source of exposure to ionizing radiation -- which has been linked to meningiomas in the past -- but most research on the connection is based on people who were exposed to atomic bombs or received radiation therapy.

There have been some studies that looked at dental X-rays, but they were from years ago and included fewer people than the current study, Claus noted. Still, they were generally in agreement with the new findings.

[RELATED VIDEO: Promising miniature x-ray device may limit exposure]

For her study, Claus' team recruited 1,433 people diagnosed with intracranial meningioma -- a tumor that forms in the tissues lining the brain -- between May 2006 and April 2011. All of the participants were diagnosed when they were between 20 and 79 years old and they were all from Connecticut, Massachusetts, North Carolina or the Houston or San Francisco Bay areas.

For comparison, the researchers also followed 1,350 people who were similar in age, sex and state of residence as the study group, but who had not been diagnosed with a tumor.

The study looked at how often people had three different types of dental X-rays. They included a focused image of one area, a number of images of the full mouth and a single panoramic view of the entire mouth. These are known in dentistry parlance as bitewing, full-mouth and panorex films, respectively.

Each person was interviewed by someone trained to administer a questionnaire that asked about demographic details, family history of cancer, pregnancy and medical history. The interviewers also asked -- among other things -- about the person's history of dental work and the number of times they had the three types of dental x-rays taken throughout their life.

The researchers found that those diagnosed with meningiomas were more than twice as likely as the comparison group to report ever having had bitewing images taken.

And regardless of the age when the bitewings were taken, those who had them yearly or more frequently were at between 40 percent and 90 percent higher risk at all ages to be diagnosed with a brain tumor.

To put that in perspective, Dr. Paul Pharoah, a cancer researcher at the University of Cambridge said in a statement the results would mean an increase in lifetime risk of intracranial meningioma in the U.K. from 15 out of every 10,000 people to 22 in 10,000 people.

Panoramic X-rays taken at a young age, especially if done yearly or more often before age 10, also raised the risk of meningiomas by up to five times.

There was no association between full-mouth X-rays and the tumors, although the authors note they saw a trend similar to that seen for the bitewing X-rays.

The lack of association with full-mouth X-rays led one expert to question the connection.

"They found a small risk (from) a pair of bitewings, but not a full mouth series, which is multiple bitewings. That inconsistency is impossible to understand to me," said Dr. Alan Lurie, president of the American Academy of Oral and Maxillofacial Radiology.

Lurie also echoed Claus' caution that radiation levels from dental X-rays when some of the participants were younger was much greater than is used now.

He does warn, however, patients shouldn't assume it's fine for the dentist to take X-rays.

"They should ask why are (dentists) taking this image and what is the benefit to me," he said.

The American Dental Association put out a statement in response to the study noting that the interviews relied on participants' memories of how often they had different types of X-rays years earlier.

The statement added, "The ADA's long-standing position is that dentists should order dental X-rays for patients only when necessary for diagnosis and treatment. Since 1989, the ADA has published recommendations to help dentists ensure that radiation exposure is as low as reasonably achievable."

Dr. Sanjay Mallya, an assistant professor the UCLA School of Dentistry in Los Angeles, said that patients should be concerned whenever they are exposed to radiation, but "it's important to emphasize that this concern should not mean that we shouldn't get X-rays at all."

According to the researchers, "while dental X-rays are an important tool in well selected patients, efforts to moderate exposure to (ionizing radiation) to the head is likely to be of benefit to patients and health care providers alike."

SOURCE: Cancer, online April 10, 2012.

Tuesday, April 10, 2012

10 Tips for Teaching Kids to Care for their Teeth

brushteeth 10 Tips for Teaching Kids to Care for their Teeth

Proper dental hygiene is such an important part in maintaining healthy teeth and gums for a lifetime, and learning these good habits early on is crucial. When kids make brushing and flossing part of their daily routine it will become second nature by the time they reach adulthood. On the other hand, people who don’t learn proper dental care as children have a difficult time correcting bad habits later on. Since this is not something that comes naturally it needs to be taught, and some children aren’t going to be willing pupils. Here are 10 tips for teaching reluctant kids to care for their teeth.

(1)Lead by example – Kids love to emulate their parents, so leading by example is a must. Let your children watch you brush and floss and explain to them what you’re doing and why. They’ll love to feel like they’re able to something just like the grown-ups do.

(2)Start early – Children won’t be able to brush their teeth by themselves until the ages of 3 or 4, so you’ll have to do it for them until then. This will give them time to get used to the idea that this is a part of a normal daily routine and they’ll look forward to when they can do it on their own.

(3)Make it fun – Try to make brushing and flossing a fun activity and something to look forward to instead of just a chore. You can invent little games to play and be excited about it when they do a good job.

(4)Rewards – Be sure to reward kids when they achieve goals like brushing by themselves for the first time or not having to be reminded. Give them an extra bedtime story or let them stay up another 15 minutes to prove how grown-up they are.

(5)Plaque monsters – You can invent stories to help explain what happens if they don’t take care of their teeth. Tell them that after they eat food invisible plaque monsters are hiding in their teeth and they need to be brushed and flossed away.

Click Here to read the next 5 tips

Wednesday, April 4, 2012

103.5 FM- My Radio Show Debut

One of the Dr.'s that I work with has started co-hosting a radio show Wednesday evenings at 10:30pm. He asked me to sit in as his guest to discuss changes in dentistry.

Below is the link to listen to our show

CLICK HERE to listen to How Dental Cleanings Have Changed 

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