We wish to everyone informed of the latest news relating to Dental Hygiene.  This page will be dedicated to keeping you informed of the latest news of random sorts.  There will be statements of new products, product recall, legislative issues, and a multitude of information.

January 12, 2007

Teeth grown from stem cells
By Megan Rauscher in New York

January 07, 2007 07:44am

USING stem cells harvested from the extracted wisdom teeth of young adults, researchers have successfully generated tooth root and supporting tooth ligaments to support a crown restoration, in experiments using miniature pigs.

The restored tooth mirrored the original tooth in function and strength, the research team reports in the December issue of the open access medical journal PLoS ONE. The technique holds promise for use in humans, the investigators say.

Stem cells are the master cells of the body that give rise to all the blood and tissue in the body.

Dr. Songtao Shi said: "In this study, we use stem cell technology to generate 'a bio-root and periodontal tissue' along with dental clinical porcelain crown technique to restore tooth function in swine (mini-pig)."

Dr Shi, from the University of Southern California School of Dentistry, Los Angeles, added. "This is a hybridized approach (stem cell and clinical technologies) leading to reconstruction of functional tooth in an animal model similar to human."

The researchers hope to test their technique in humans within the next several years. If successful, it could be especially attractive to dental patients who are not good candidates for dental implants or would prefer living tissue derived from their own teeth.

"Implant patients must have sufficient bone in the jaw to support the implant. For those who don't, this therapy would be a great alternative," Dr Shi said.

Sherri Bush, RDH
Cleveland, TN
Owner of
Dental Hygiene News
                                                                                  

October 20, 2006

SBDE JURISPRUDENCE REQUIREMENTS ARE CHANGING NOVEMBER 1, 2006!

Effective November 1, 2006, the State Board of Dental Examiners (SBDE) jurisprudence examination process will be changing to a new, on-line assessment.  This new assessment can be accomplished from any PC with an internet connection and will be hosted by E-Strategy Solutions.  This methodology will offer a “24/7” on-line interactive educational experience as opposed to a ‘test’.  Applicants will pay the nominal $55 fee by credit card. 

After November 1, 2006 the new assessment can be used to satisfy the jurisprudence requirement for ANY of the following:new license applications for dentists and dental hygienists board order mandated completion of the jurisprudence exam three year requirement for license renewal.  Note:  licensees may also choose to complete this requirement by any existing approved format through 2007.  Effective January 1, 2008, the on-line assessment will be required for every dental and dental hygiene licensee every three years.

To access this new program, after November 1, 2006, candidates will log on to www.estrategysolutions.com and choose our program – Texas State Board of Dental Examiners Jurisprudence.  Once accessed, there will be general information and instructions – when the candidate is ready to begin, question 1 appears.  For example:

The sky is:       A.  blue            B.  red             C. green          D. orange

If the candidate selects answer D, they will be linked to whatever rule or statue spells out that the sky is blue.  Once reviewed, they will be sent back to the question and allowed to answer again.  If they answer A, they will move forward to question 2;  if they answer C, they will be taken back to the citation again.  Candidates will learn as they go, unlike the current method, which only calculates the number of correct and incorrect responses.

Candidates may take extended time to complete the assessment – it does not have to be completed in one sitting.  Also, if the completion certificate is misplaced, duplicates will be available through their website.  Finally, if candidates provide an email address when they register, it will be added to a database that we use to provide periodic “SBDE news of interest”.

The SBDE is very excited to announce this change – we look forward to adopting this process of a unique and enjoyable experience that will offer licensees easy access to the most current statutes and rules. 

Feel free to visit www.estrategysolutions.com after November 1, 2006 and see for yourself!

8/3/06

  NATIONAL TOBACCO CONTROL NEWS   
  Hawaii Governor Signs Smokefree Air Bill; Lets Cigarette Tax Increase Become Law
On July 10, Hawaii Gov. Linda Lingle signed legislation into law that will prohibit smoking in almost all public places and workplaces, including restaurants and bars.  The new law will go into effect November 16, the day of the Great American Smokeout.  Hawaii joins 14 other states as well as the District of Columbia and Puerto Rico who have all passed strong smokefree air laws.  The laws in 11 states have taken full effect currently.  Also, on July 12, a bill that will increase the cigarette tax in Hawaii to $2.60 per pack in $0.20 increments over the next six years became law without the governor's signature.  The first increase will take effect on September 30.  Hawaii joins three other states New Jersey, Texas and Vermont that have passed increases in their cigarette taxes in 2006 so far. Louisiana Significantly Strengthens Statewide Smoking Restrictions
On June 30, Louisiana Gov. Kathleen Blanco signed a bill into law significantly strengthening Louisiana's statewide smoking restrictions.  Effective January 1, 2007, smoking will be prohibited in most public places and workplaces, including all restaurants with or without attached bars.  Smoking will still be allowed in stand-alone bars and casinos, including establishments with video-poker machines.  Perhaps most important, Louisiana's partial preemption of local smokefree air ordinances was repealed and replaced by a specific non-preemption clause meaning local communities are now free to close loopholes in the state law by local ordinance. New Jersey Enacts Cigarette Tax Increase
On July 8, New Jersey passed a small increase in its cigarette tax in conjunction with passage of the state budget for FY2007, which then went into effect July 15.  The tax increased by $0.175, bringing New Jersey's cigarette tax to $2.575 per pack, and giving New Jersey the new highest cigarette tax in the country.  Tobacco control advocates in New Jersey were a bit disappointed because they had been pushing for a $0.60 increase. (Parts excerpted from: Fraidy Reiss, New Jersey Cigarette Tax Increase Falls Short for Cancer Society, Press of Atlantic City, July 11, 2006.) American Legacy Foundation Ads Not a Violation of the MSA
On July 17, the Delaware Supreme Court ruled that advertisements produced by the American Legacy Foundation as part of its Truth® advertising campaign did not “vilify” the tobacco industry, and were, therefore, not a violation of the Master Settlement Agreement (MSA).  Lorillard, the third largest tobacco company in the U.S., originally filed the lawsuit, which sought to strip funding from the American Legacy Foundation because it claimed certain ads constituted personal attacks against the tobacco industry.  The Supreme Court decision upheld a previous ruling from a Delaware Chancery Court judge.  The American Lung Association and several other public health groups filed an amicus brief supporting the American Legacy Foundation during the original chancery court trial.  The American Legacy Foundation is funded through payments by tobacco companies as part of the MSA.  The Truth® advertising campaign has been credited with contributing significantly to the reduction in youth smoking rates since 1997.  It is unclear whether Lorillard will appeal the case to a higher court. (Parts excerpted from: Delaware Supreme Court Upholds Anti-Smoking Ads Decision, Dow Jones News Service, July 17, 2006.) Smokefree Air Laws Take Effect in Two States in July
During July, new smokefree air laws took effect in two states.  On July 1, a new smokefree air law took effect in Colorado that prohibits smoking in most public places and workplaces, including all restaurants and bars.  Non-public workplaces with three or fewer employees and gaming areas of casinos are exempt.  Also, on July 21, much stronger smoking restrictions took effect in Arkansas prohibiting smoking in most public places and workplaces, including almost all restaurants.  Restaurants and bars that do not allow persons under 21 to enter at any time, and non-public workplaces with three or fewer employees are exempt.  To view your state's restrictions on smoking, go to: http://slati.lungusa.org, click on a state and then the “Clean Indoor Air” link. Tobacco Tax Increases Take Effect in Several States in July
During July, tobacco tax increases in several states went into effect.  On July 1, cigarette taxes increased in Alaska ($0.20 to $1.80 per pack), North Carolina ($0.05 to $0.35 per pack) and Vermont ($0.60 to $1.79 per pack).  Vermont's increase was passed in May 2006 while the increases in Alaska and Vermont were scheduled increases passed in previous years.  The cigarette tax also increased in New Jersey on July 15 (see article above).  The new state cigarette tax average as of August 1 is $0.937 per pack up from $0.917 per pack at the beginning of 2006.  For a list of state cigarette excise tax rates as of August 1, 2006, go to: click here , then click on the “State Cigarette Excise Taxes” link.             Marriott Hotels Go Smokefree
On July 19, Marriott International Inc., the largest hotel chain in the United States, announced that it will make all of its 2,300 hotels and corporate apartments in the United States and Canada smokefree.  The new policy will cover nearly 400,000 hotel rooms.  Hotel brands covered by the new policy include Marriott, JW Marriott, Renaissance, Courtyard, Residence Inn, Fairfield Inn and the Ritz-Carlton.  Marriott officials said they made the decision to go smokefree for both financial and public health reasons.  Only 10 percent of the rooms are designated smoking currently, and only 5 percent of customers request smoking rooms.  The new policy will take effect in October and violators of the new policy will be charged $200 to $300 for clean-up costs.  Marriott follows the Westin Hotels & Resorts chain, which made all of its 77 properties in the U.S., Canada and the Caribbean smokefree in January. (Parts excerpted from: Michael S. Rosenwald, Marriott Hotels Ban Smoking in Rooms, Washington Post, July 20, 2006, p. A01.) Florida Supreme Court Tosses out Large Punitive Damages Award
On July 6, the Florida Supreme Court issued its long awaited decision in an appeal of a large class-action lawsuit on behalf of Florida smokers.  The original $145 billion in punitive damages awarded by the jury was thrown out and the class-action that covered between 300,000 and 700,000 Florida smokers was decertified.  However, the court upheld key findings in the original trial court case such as that cigarette smoking causes cancer, heart disease and other ailments, and that tobacco companies marketed “defective and unreasonably dangerous” products.  This could potentially make it easier for individual lawsuits to succeed because the need to prove these facts during trial has been eliminated.  The court gave plaintiffs in the case one year to file individual claims. (Parts excerpted from: Big Win for Tobacco in $145 Billion Florida Case, Reuters, July 6, 2006.) Senate Tobacco Sales Targeted
On July 24, U.S. Sen. Frank Lautenberg from New Jersey penned a letter asking the U.S. Senate's Food Service Management Agency to prohibit the sale of tobacco products in the U.S. Senate.  Currently, tobacco products are sold at various Senate sundry shops at a discount because no state excise or sales taxes are applied.  The District of Columbia and Maryland both have cigarette taxes of $1.00 per pack making cigarettes sold inside the U.S. Senate substantially less expensive.  The Senator also noted in his letter that a 21-year-old intern in his office bought a pack of cigarettes at a Senate shop without showing identification but was asked for ID when she went out of the Senate complex to another store.  Stores are supposed to ask for ID for cigarette purchases if the customer does not appear to be at least 27 years old. (Parts excerpted from: Lautenberg Targets Senate Tobacco Sales, Associated Press, July 24, 2006.) Massachusetts Enacts Fire-Safe Cigarette Law
On July 8, Massachusetts Gov. Mitt Romney signed a bill into law that will require all cigarettes sold in Massachusetts to self extinguish when they are not being smoked, effective January 1, 2008.  Massachusetts becomes the sixth state to enact this type of law joining California, Illinois, New Hampshire, New York and Vermont.  Cigarette-ignited fires are the nation's leading cause of home fire deaths, killing between 700 and 900 people each year, according to the National Fire Protection Association.  Also, a 2005 study by the Harvard School of Public Health found that self-extinguishing cigarettes sold in New York, while not perfect, were much more likely to go out than keep burning and had no adverse effect on cigarette sales in New York.  A number of states are considering or have considered similar bills in the past several years. (Parts excerpted from: New Law Requires Fire-Safe Cigarettes in Massachusetts, CBS4 Boston, July 10, 2006.) Recent Action on Smokefree Air Bills/OrdinancesKentucky
On July 11, Kentucky Gov. Ernie Fletcher signed an executive order that makes all state government buildings under the control of the executive branch smokefree, effective August 1.  The portions of the state Capitol and Capitol Annex controlled by the legislature are excluded.  The executive order was signed the day before a law passed during the 2006 legislative session is set to take effect that allows the state executive branch, local governments and universities to prohibit smoking in state and local government buildings.  This is a big victory for Kentucky, which is one of the top tobacco-producing states in the country. (Parts excerpted from: Smoking Ban Imposed in Kentucky State Buildings, Associated Press, July 11, 2006.)Frankfort, KY
On July 25, the Frankfort, KY city commission passed, on a 3 to 2 vote, an ordinance that will prohibit smoking in almost all public places, including restaurants and bars.  Frankfort is the capital city of Kentucky, and joins the cities of Lexington, Georgetown and Morehead, as well as Letcher County with comprehensive smokefree air ordinances in Kentucky. (Parts excerpted from: Emily Yahr, Frankfort Passes Smoking Ban in Public Places, Lexington Herald-Leader, July 25, 2006.)North Carolina
On July 10, North Carolina Gov. Mike Easley signed into law a bill that prohibits smoking in all buildings occupied by the North Carolina General Assembly.  The bill had previously passed the legislature on a near unanimous vote.  The law took immediate effect.  Again, this is a big victory for North Carolina, the largest tobacco-producing state in the country.    
 
Nevada
On July 26, a lawyer for the Nevada Resort Association filed briefs with the Nevada Supreme Court seeking to remove an initiative currently on the November 2006 ballot to prohibit smoking in many public places and workplaces, including all restaurants, because he claims backers of the initiative misled petition signers by saying hotel/motel rooms would not be included in the initiative, when they actually will be.  However, it was an earlier decision by Carson City District Judge Bill Maddox that included hotel/motel rooms in the initiative based on its wording not its supporters.  The appeal is scheduled to be heard August 23 with a decision no later than September 28 because of a short timetable due to the upcoming election. (Parts excerpted from: Gambling Group Wants Anti-Smoking Petition off Nevada Ballot, Associated Press, July 26, 2006.)Pennsylvania
During July, the Pennsylvania Restaurant Association reversed its long-held position on a statewide smokefree air law saying it now will support a comprehensive law that covers all establishments for the health of the hospitality industry's employees.  The release of the recent Surgeon General's report was cited as an important factor in their decision.  Previously, on June 6, the House Health & Human Services Committee had agreed to table comprehensive smokefree air legislation on a 14 to 14 tie vote.  The earliest the bill could be reconsidered in the House is September, and a similar bill in the state Senate is likely to be considered in the fall as well.  According to media reports, the decision by the restaurant association could increase the chances of passage. (Parts excerpted from: Tom Knapp, Restaurant Owners Divided on Smoking Ban, Lancaster Intelligencer Journal, July 6, 2006.)St. Paul, MN
On July 8, the Minnesota Licensed Beverage Association abandoned its effort to put a repeal of St Paul's comprehensive smokefree air ordinance on the November 2006 ballot.  The decision came a day after a Ramsey County District judge upheld the city's right to regulate indoor smoking.  Opponents had challenged the ordinance, saying the merger of the city and county health departments in 1996 somehow prevented the city from putting restrictions on indoor smoking.  A poll sponsored by the Ramsey County Medical Society and the Minnesota Partnership for Action Against Tobacco released in early July found that 72 percent of 500 registered voters in St. Paul favored the smokefree air ordinance in city restaurants and bars. (Parts excerpted from: Liquor Group Drops Effort to Repeal St. Paul's Smoking Ban, Associated Press, July 10, 2006.)St. Louis County, MO
On July 24, St. Louis County Council Chairman Kurt Odenwald introduced two pieces of legislation, the first would prohibit smoking in most public places and workplaces throughout St. Louis County, and the second would refer the smokefree air legislation to the ballot in November.  The first piece of legislation would not go into effect unless voters approve it first via the second piece of legislation.  The legislation that would refer the proposal to the November ballot would have to be voted on by September 5. (Parts excerpted from: Clay Barbour, Smoking Ban Gets New Life in St. Louis County, St. Louis Post-Dispatch, July 24, 2006.)New York
On July 20, the New York State Department of Health released a report on the third anniversary of the implementation of New York's smokefree air law showing that there has been an estimated 50 percent decrease in exposure to secondhand smoke among the general public and an estimated 78 percent decrease in exposure among hospitality workers in New York.  Both results were achieved by measuring cotinine, a by-product of nicotine in the blood.  The report also found that support for the law statewide stood at 80 percent, and that the law has had no adverse economic impact on the hospitality industry over the three years since the law went into effect. To see where your state restricts or prohibits smoking, click here, then click on the “State Laws Restricting Smoking” link. Recent Action on Cigarette Tax IncreasesArizona
On June 28, supporters of an initiative to increase the cigarette tax by $0.80 per pack filed more than 206,000 signatures with the Arizona secretary of state to put the initiative on the November 2006 ballot.  The increase would bring Arizona's cigarette tax to $1.98 per pack.  The new revenue would be used for various early childhood education programs across the state. (Parts excerpted from: Howard Fischer, Initiative for Cigarette Tax Likely to be on the Ballot, Capitol Media Service, June 29, 2006.) Indiana
On July 23, in an interview with a newspaper, Indiana Gov. Mitch Daniels indicated he was prepared to again push for a cigarette tax increase when the Indiana legislature convenes in January for its 2007 legislative session.  He did not specify an amount, but said that the increase would be solely to benefit public health by reducing smoking rates in Indiana.  Top legislators, like last year, appeared skeptical unless the additional revenue is tied to health-related programs.  Indiana's current cigarette tax rate is $0.555 per pack. (Parts excerpted from: Mike Smith, Daniels Tries Cigarette Tax Hike Again, Associated Press, July 24, 2006.) Cuyahoga County, OH
On July 5, Cuyahoga County commissioners unanimously passed a resolution putting a $0.30 increase in the county cigarette tax before voters in November.  The revenue generated would go to a grant program to support arts and culture in the county.  Cuyahoga County includes the city of Cleveland, and has an estimated total population of about 1.3 million people. (Parts excerpted from: Carolyn Jack, Cuyahoga to Vote on Smokers Tax to Aid Arts, Cleveland Plain Dealer, July 6, 2006.) For more information on tobacco taxes in your state, go to: http://slati.lungusa.org, click on a state and then the “Tobacco Excise Tax” link. U.S. Smokeless Tobacco Company Testing New Spit-Free Product
In July, U.S. Smokeless Tobacco (UST) announced it will start test marketing a new “spit-free” smokeless tobacco product called Skoal Dry in two cities, Louisville, KY and Austin, TX.  UST joins Reynolds American, which is currently test marketing a similar product called Camel Snus in Portland, OR and Austin, TX, and Philip Morris, which is also currently test marketing a “spit-free” smokeless product called Taboka in Indianapolis, IN.  Unlike traditional chewing tobacco or snuff, these products are designed as “spit-free,” intended to attract smokers who find spit-tobacco unappealing or socially unacceptable.  The danger is that these products will be marketed in such a way as to encourage youth to start using tobacco, and discourage current users from quitting.  Also, smokeless tobacco, including the “spit-free” variety, is a known cause of cancer and other adverse health conditions. (Parts excerpted from: Gregory A. Hall, “Spitless” Tobacco to be Tested Locally, Louisville Courier-Journal, July 11, 2006.) Tobacco Use Could Kill 1 Billion People This Century
On July 10, two new reference guides, the Cancer Atlas and Tobacco Atlas, released at the International Union Against Cancer Conference in Washington, D.C., predicted that tobacco use could kill 1 billion people this century if current trends remain the same, which is 10 times the number of deaths in the 20th century.  According to the atlases, tobacco use currently accounts for one in five cancer deaths or 1.4 million deaths worldwide each year.  When deaths from tobacco-related cardiovascular and pulmonary diseases are included, the yearly death toll rises to nearly 5 million. Also, an estimated 1.25 billion men and women currently smoke cigarettes and more than half of them will die from the habit.  However, millions of lives can be saved by implementing proven policies to reduce tobacco use such as increasing cigarette taxes and implementing strong smokefree air laws. (Parts excerpted from: 1 Billion Tobacco Deaths This Century?, CBS/AP, July 10, 2006.) New CDC Study Shows Youth Smoking Rates Increase Slightly
The July 7th edition of the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR) contained an article showing that smoking rates in grades 9 through 12 increased slightly between 2003 and 2005.  Specifically, the rate increased to 23.0 percent in 2005 from 21.9 percent in 2003.  Current smoking is defined as having smoked a cigarette on one or more of the 30 days preceding the survey.  Although the increase is not statistically significant, the 2005 Youth Risk Behavior Survey (YRBS), a survey completed every two years by the CDC, where the data for the article was drawn from, produced similar results to other surveys over the past several years that showed the decline in youth smoking rates stalling, and is certainly a worrisome trend.  Previously, smoking rates had been declining steadily in these surveys from a high of 36.4 percent in 1997.  For a copy of the MMWR article, click here . Study Shows Cigarette Users Who Smoke “Light” Cigarettes Find it Harder to Quit
A new study published recently in the American Journal of Public Health found that smokers who use so-called “light” cigarettes are 50 percent less likely to attempt to quit smoking than users of regular cigarettes.  The study analyzed the results of a survey of more than 12,000 current and former smokers conducted in the U.S. in 2000, and a third had said they had used “light” cigarettes to try to reduce the health risks from smoking.  The results of the study are particularly disturbing because it indicates a perception among the general public that the health risks from smoking can be reduced by switching to “light” cigarettes when the risk is the same as regular cigarettes. (Parts excerpted from: Jennifer Warner, Light-Cigarette Smokers 50% Less Likely to Quit Smoking, June 29, 2006.) 

8/3/06

FDA Warns Against Internal Use of High-Strength Hydrogen Peroxide
Yael Waknine Medscape 2006. © 2006 Medscape


July 28, 2006 — The US Food and Drug Administration (FDA) has issued a health advisory to warn consumers against the purchase and ingestion of high-strength hydrogen peroxide products for medicinal purposes due to the risk for serious harm or death.

Consumers are advised to immediately discontinue use of these products, which include currently marketed items such as "35 Percent Food Grade Hydrogen Peroxide," and consult their healthcare provider, according to an alert sent yesterday from MedWatch, the FDA's safety information and adverse event reporting program.

The high-strength hydrogen peroxide products are more than 10 times more concentrated than topical products used for disinfecting minor cuts. Ingestion of these highly corrosive products can cause gastrointestinal irritation or ulceration, and intravenous administration can result in blood vessel inflammation at the injection site, gas embolisms, and potentially life-threatening allergic reactions.

The FDA is currently working to stop companies from making illegal claims regarding their high-strength hydrogen peroxide products, because their ingestion is of no known clinical value and they have not been approved by the agency for any medical indications; moreover, their use can cause significant harm and lead to "tragic results."

To this end, warning letters have been issued to 2 firms selling 35% hydrogen peroxide products on the Internet for the treatment of AIDS, cancers, emphysema, and other serious and life-threatening diseases. The letters, dated 7/19/06, are available for viewing online at http://www.accessdata.fda.gov/scripts/wlcfm/recentfiles.cfm.

Similar warnings previously issued to consumers include one from April 1989 that warned against the use of industrial-strength hydrogen peroxide illegally promoted for the treatment of AIDS and cancer; the alert followed a related death in Texas and several injuries requiring hospitalization.

Adverse events related to internal use of high-strength hydrogen peroxide should be reported to the FDA's MedWatch reporting program by phone at 1-800-FDA-1088, by fax at 1-800-FDA-0178, online at http://www.fda.gov/medwatch, or by mail to 5600 Fishers Lane, Rockville, MD 20852-9787.

Reviewed by Gary D. Vogin, MD

3/15/06

Bisphosphonates Can Cause Problems in Jaw


By Rachael Myers Lowe, cancerpage.com 

(March 15, 2005) - Cancer patients given drugs called bisphosphonates to control hypercalcemia – too much calcium in the blood – or the growth of bone metastases can develop bone death in the jaw the FDA warns.  

Makers of several bisphosphonates have added advisories to their drugs, warning doctors and patients of the increased risk of osteonecrosis of the jaw (ONJ), particularly in patients undergoing a dental procedure while taking an intravenous bisphosphonate such as Aredia or Zometa and other cancer treatments. 

These drugs are often given to cancer patients with metastases to the bone as standard therapy.  

Cancer that has spread to the bone upsets the delicate balance of healthy bone growth and regeneration so that often, bone is destroyed faster than it can be replaced.  Bisphosphonates slow down unnaturally speeded up bone destruction - called bone resorption.  

Although researchers don’t know why,  a small number patients taking bisphosphonates develop osteonecrosis of the jaw, a condition in which the bone tissue in the jaw fails to heal after a minor trauma such as a tooth extraction causing the bone to be exposed.  Symptoms include jaw pain or inflammation, gums that don’t heal, loosening teeth, or a feeling of numbness or heaviness in the jaw.  

The condition sometimes can be treated with antibiotics and mouth rinses. Because surgery can make the condition worse, it’s avoided although sometimes it’s necessary to remove dead tissue.  

A background sheet from the FDA’s Oncologic Drugs Advisory Committee points out that the research suggests the risk is highest for people given bisphosphonates intravenously. Some patients take oral bisphosphonates, such as Fosamax, for osteoporosis.  The FDA acknowledges that there have been reports of ONJ in oral bisphosphonate users but writes: “There have been fewer reports [ …] and risk-benefit considerations are different for patients with malignant as opposed to benign disease.”  

The new drug warning labels recommend patients delay invasive dental procedures such as tooth extraction.

1/14/06

AHA Changes Guidelines for CPR

By Mary Fran Hazinski, RN, MSN; Vinay M. Nadkarni, MD; Robert W. Hickey, MD; Robert O'Connor, MD; Lance B. Becker, MD; Arno Zaritsky, MD
The

emergency cardiovascular care (ECC) scientists involved in the 2005 evidence evaluation process and the revision of the 2005 AHA Guidelines for CPR and ECC began and ended the process aware of the limitations of the resuscitation scientific evidence, optimistic about emerging data that documents the benefits of high-quality cardiopulmonary resuscitation (CPR), and determined to make recommendations that would increase survival from cardiac arrest and life-threatening emergencies. This editorial summarizes the factors that contributed to the tipping point, the point at which information and discussion either triggered support for major changes in the guidelines or reaffirmed existing recommendations.

The scientists critically reviewed the sequence and priorities of the steps of CPR to identify those factors with the greatest potential impact on survival. They then developed recommendations to support those interventions that should be performed frequently and well. There was unanimous support for increased emphasis on ensuring that rescuers deliver high-quality CPR: rescuers need to provide an adequate number and depth of compressions, allow complete chest recoil after each compression, and minimize interruptions in chest compressions.

The 2005 AHA Guidelines for CPR and ECC are based on the most comprehensive review of resuscitation literature ever published. The evidence evaluation process incorporated the input of 281 international resuscitation experts who evaluated research, topics, and hypotheses over a 36-month period before the 2005 Consensus Conference. The process included structured evidence evaluation, analysis, and documentation of the literature. It also included rigorous disclosure and management of potential conflicts of interest, a process summarized in two editorials.

This special supplement to Circulation is freely available at: http://www.circulationaha.org

Heart Association Offers New CPR Guidelines:

New, simpler guidelines, in a radical departure from past advice, say, "push hard, push fast" next time you give CPR to someone having cardiac arrest. Putting the emphasis on chest compressions instead of mouth-to-mouth resuscitation, the American Heart Association now urges people to give 30 compressions - instead of 15 - for every two rescue breaths.

"Basically, the more times someone pushes on the chest, the better off the patient is," said Dr. Michael Sayre, an Ohio State University emergency medicine professor who helped develop the guidelines. "We have made things simpler," he said. "Push hard on the person's chest and push fast." The streamlined guidelines should make it easier for people to learn CPR. Earlier rules were different for adults and for children and called on untrained rescuers to stop pushing the chest periodically to check for signs of circulation.

Now, the advice is the same for all ages - 30 compressions - and you don't have to stop to check for improvement. What's important is to keep the blood flowing. Studies have shown that blood circulation increases with each chest compression and it must be built back up after an interruption. "When you're doing 30 of those compressions, you're giving more circulation throughout the body and the brain," said Jennifer Khonsari of Texas CPR Training. She said the new advice makes sense.

Sudden cardiac arrest - when the heart suddenly stops beating - can occur after a heart attack or as a result of electrocution or near drowning. It's most often caused by an abnormal heart rhythm. The person experiencing it collapses, is unresponsive to gentle shaking and stops normal breathing. More than 300,000 Americans die from it each year. About 75 percent to 80 percent of all cardiac arrests outside a hospital happen at home, and effective CPR can double a victim's chance of survival. "The most common reason many people die from cardiac arrest is no one nearby knows CPR," Sayre said. "For the bystander that witnesses a collapse, the main danger is inaction."

More than 9 out of 10 cardiac arrest victims die before they get to the hospital, the heart association estimates. "The bottom line is we think more people need to learn CPR," said Mary Fran Hazinski, a clinical nurse specialist at Vanderbilt University Medical Center who also worked on the guidelines. "We have more and more evidence that good CPR works. We're doing our best to increase the number of bystanders that learn CPR."

Currently, about 9 million Americans a year are trained in CPR, the heart association says, but it has a goal of more than doubling that number in the next five years to 20 million. The new guidelines call for 911 operators to be trained to provide easy-to-follow CPR instructions by phone. The Heart Association also offers new guidance to professionals, calling for cooling down cardiac arrest patients to about 90 degrees Fahrenheit for 12 to 24 hours. Two significant studies have shown that practice can improve survival and brain function for those who are comatose after initial resuscitation.

There are a variety of methods - both internal and external - for cooling a person down, but the guidelines don't recommend a specific approach. The new guidelines also advise just one shock from a defibrillator before beginning chest compressions instead of giving up to three shocks first. Studies show that the first shock works more than 85 percent of the time.

Defibrillators have been popping up in public places like airports and businesses, but the heart association says that more public places need to install the devices. Survival rates have been as high as 49 percent to 74 percent for lay rescuer programs when defibrillators are placed in casinos, airports or used by police. The new guidelines provide an opportunity for those who have taken CPR in the past to take a refresher course, said Dr. Ahamed Idris, professor of surgery and medicine at the University of Texas Southwestern Medical Center.

"I think it's a good idea for people to take CPR lessons at least every couple of years," said Idris, also involved in creating the guidelines. He led a study presented at the American Heart Association meeting earlier this month that showed CPR could be effectively taught in little more than 20 minutes. The study found that just five minutes of training on defibrillator use and 20 minutes of instruction in CPR was as effective as the standard four-hour course.

Source: American Heart Association http://www.americanheart.org

Technical Report for The National Board Dental Hygiene Examination The Joint Commission on National Dental Examinations sponsors testing programs for dentists and dental hygienists. This technical report concerns the National Board Dental Hygiene Examination (hereafter referred to as the dental hygiene examination).

Validity is the most important consideration in any testing program. Validity refers to the degree to which logic and evidence support the use of test scores for making pass/fail decisions affecting candidates for dental hygiene licensure. The Joint Commission also needs to assure its constituency, state boards, that the Joint Commission is doing its best to provide the highest quality testing program possible given the resources they have.

National testing standards provide useful guidance to testing organizations that can help improve validation. It is important to follow these standards and give some evidence that a testing program such as this one follows these standards. This technical report provides a complete and comprehensive summary of information about the current year's validation. Both direct evidence, presented in this technical report, and references to other documents and sources of information contribute to this body of validity evidence. Additionally, this report provides background information that allows each reader the opportunity to understand the history and processes that have led this examination program to its current status.

Download the Executive Summary of the 2004 Technical Report for the National Board Dental Hygiene Examination
 (1page) | PDF file/21k
Download the 2004 Technical Report for the National Board Dental Hygiene Examination (66 pages) | PDF file/181k

MARILYN LINTON EXPLAINS HOW CHANGES THROUGHOUT A WOMAN'S LIFE CAN CAUSE FLUCTUATIONS IN HER ORAL HEALTH
By MARILYN LINTON, TORONTO SUN
From:http://torontosun.com/Lifestyle/2005/07/03/pf-1115151.htmlWHEN IT COMES to teeth, putting your best face forward for most women means the whitest of whites. The bleaching of our chompers has become a nationwide obsession. But one Toronto dentist believes that women are shortchanging themselves by not learning more about the impact of gender on oral health. "There is certainly nothing wrong with bleaching. We are a society that puts a high value on appearance," says Dr. Susan Sutherland who even has 90-year-old patients demanding bleaching. "But I want women to make sure that they don't ignore the basics."

Sutherland, chief of Dentistry at Sunnybrook and Women's College Health Sciences Centre, is working with the Ontario Dental Association to get out the word that during certain ages and stages, women may have special oral health needs and that our shifting hormones strongly influence oral health. "For instance, starting with the onset of menstruation, some women experience monthly changes to the gums," she explains. Research has shown that the sex hormone increase can change the way gums respond to oral germs with the result that gums may become red, swollen, and occasionally bleed. Canker sores may also develop, and with some women canker and cold sores recur with every period.

Women who note gum changes, particularly increased bleeding, during menstruation may be wise to reschedule any oral surgery until after their periods, Sutherland advises. Women taking oral contraceptives may also have "an exaggerated response of their gums" -- sensitivity and inflammation. Some research has shown that women on birth control pills may have more trouble healing after having a tooth pulled. Scheduling extraction during the non-estrogen pill phase of the pill cycle may not be a bad idea.

Pregnancy is when women should pay particular attention to their oral health. "That old expression, 'For every child, expect to lose a tooth,' is an absolute myth," Sutherland stresses. "But there are definate changes in the gums and up to three-quarters of pregnant women will experience gingivitis. It often occurs around the second month and peaks around the eighth. It's due to hormonal and vascular changes which tend to exaggerate the inflammatory response to bacterial plaque."

Often times, women will avoid dental checkups for fear that any intervention might be harmful. But in fact, tooth decay can put both a mom and her growing baby at risk for infection, say some studies. A few other studies have suggested that women who have gum disease are at higher risk for delivering preterm low birth weight babies than women who do not have periodontal disease. "The message is don't neglect your teeth during pregnancy. In fact, try to increase your oral hygiene," Sutherland advises.

In addition to predictable gum changes, a few women may develop what's called a "pregnancy oral tumour. It's an awful term," says Sutherland, "bcause it's not a tumour, per se, but rather an overgrowth of oral vascular tissue." The area is enlarged, red and extra sensitive to bleeding. Between one and eight percent of pregnant women are affected. "There's a debate around whether pregnant women should have dental care during pregnancy or put it on hold. I think in the first trimester most dentists prefer not to do much intervention. But by the second trimester most women can have routine dental care, generally speaking."

Menopause also brings its own oral challenges, she adds: "The appearance of the oral tissue changes and may be pale and thin, similar to the changes that menopausal women find with their thinning skin." Older women can also complain about "burning mouth" and altered taste perceptions due to oral dryness that comes about with loss of estrogen. "In some women on hormone replacement therapy, these symptoms are ameliorated," she says, "But that's only anecdotal evidence."

DENTISTS NOT ALWAYS INFORMED

In fact, there's a lot that dentists don't know about the impact of gender on oral health. The tradition, in the past, of excluding women from various forms of medical and drug research has also compromised dental knowledge. Clinical studies in many areas of dentistry in the past have tended to focus on young healthy males. Currently, Sutherland is doing a review of research studies of the past to see whether or not women were included and, if they were, to see if the results were analyzed by sex or gender. It's a first!

Many oral treatments offered to women are the same as those offered to men. Yet women respond to medications differently; they have co-existing conditions and hormonal influences. For instance, in autoimmune diseases, which affect more women than men, dry mouth is common and can lead to devastating dental problems. Some types of mouth ulcers are more prevalent in women, and TMJ or temporomandibular joint pain is also more common in women. Eating disorders, particularly bulimia, where sufferers chronically force themselves to vomit after eating, have disastrous effects on teeth and enamel.

There is no lack of potential areas to explore, says Sutherland. "Hormonal fluctuations across the lifespan are associated with oral health and disease in women. We need to know more about how being female affects how some of the major oral diseases progress -- and whether or not the therapies we do differ in women and men."

Facial Profile Appears to Predict Sleep Apnea

By Megan Rauscher, Reuters

NEW YORK (June 30) - People with a steep jaw line and a crowded or narrowed air passage at the back of the throat are at increased risk of obstructive sleep apnea (OSA), regardless of their weight or ethnic background, a study shows.

People with OSA suffer frequent, short periods during sleep when they stop breathing. The condition is linked to high blood pressure and other heart conditions.

"OSA is prevalent worldwide but is under-recognized and therefore under-treated," Dr. Frank Ryan from the University of British Columbia in Vancouver told Reuters Health. "The common denominator in the vast majority of patients with OSA is a narrowed or constricted airway at the back of the throat."

Major factors leading to this airway narrowing include obesity, variations in facial bony structure or a combination of both, the researcher explained. Craniofacial abnormalities may be a more important factor in some ethnic groups, he said.

To see whether the craniofacial profile is predictive of OSA, Ryan and colleagues studied 239 consecutive patients who were referred to sleep clinics in Hong Kong and Vancouver for suspected sleep disordered breathing.

"Our study showed that, in a mixed sample of patients of both sexes that included whites and Asians, a crowded or narrowed air passage at the back of the tongue and soft palate and a steep jaw line were the best predictors of OSA, regardless of the patients' ethnic group or their degree of obesity," Ryan told Reuters Health.

Because these abnormalities of the craniofacial profile are easily identified on routine clinical examination, they are a potentially useful tip-off to the possibility of OSA, he added.

SOURCE: Thorax June 2005.


06/30/05 10:00 ET

Copyright 2005 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in content, or for any actions taken in reliance thereon. All active hyperlinks have been inserted by AOL.

NEW YORK (June 30) - People with a steep jaw line and a crowded or narrowed air passage at the back of the throat are at increased risk of obstructive sleep apnea (OSA), regardless of their weight or ethnic background, a study shows.

People with OSA suffer frequent, short periods during sleep when they stop breathing. The condition is linked to high blood pressure and other heart conditions.

"OSA is prevalent worldwide but is under-recognized and therefore under-treated," Dr. Frank Ryan from the University of British Columbia in Vancouver told Reuters Health. "The common denominator in the vast majority of patients with OSA is a narrowed or constricted airway at the back of the throat."

Major factors leading to this airway narrowing include obesity, variations in facial bony structure or a combination of both, the researcher explained. Craniofacial abnormalities may be a more important factor in some ethnic groups, he said.

To see whether the craniofacial profile is predictive of OSA, Ryan and colleagues studied 239 consecutive patients who were referred to sleep clinics in Hong Kong and Vancouver for suspected sleep disordered breathing.

"Our study showed that, in a mixed sample of patients of both sexes that included whites and Asians, a crowded or narrowed air passage at the back of the tongue and soft palate and a steep jaw line were the best predictors of OSA, regardless of the patients' ethnic group or their degree of obesity," Ryan told Reuters Health.

Because these abnormalities of the craniofacial profile are easily identified on routine clinical examination, they are a potentially useful tip-off to the possibility of OSA, he added.

SOURCE: Thorax June 2005.


06/30/05 10:00 ET

Copyright 2005 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in content, or for any actions taken in reliance thereon. All active hyperlinks have been inserted by AOL.

Type of Lip Piercing Can Cause Receding Gums

Thu Mar 10, 3:29 PM ET   Health - Reuters
 

By Alison McCook

NEW YORK (Reuters Health) - A form of lip piercing in which people place a stud in the middle of the bottom lip where it meets the chin may put people at risk of receding gums, according to new research reported Thursday.


Investigators at Ohio State University in Columbus found that people with this type of piercing were significantly more likely than people without to develop receding gums in the front bottom teeth, where the stud of the piercing rubs against the gums.


"What you have is basically mechanical trauma hitting the gums," study author Dr. Dimitris N. Tatakis told Reuters Health. "Inevitably, they're going to have problems."


Tatakis explained that when gums recede, they creep down the teeth, exposing the root. This makes teeth ultra-sensitive to cold, and more susceptible to cavities, he said.


Moreover, if people have an uneven gum line, it's harder for them to brush and clean their teeth, putting them at risk of plaque buildup, which can cause long-term problems like gingivitis, Tatakis added.


He emphasized that the problem only occurs with lip piercings that include a stud on the inside of the lip that hits the gum line, and only affects the part of the gums that touches that stud.


As part of a study Tatakis and his colleagues presented Thursday during the 83rd General Session of the International Association for Dental Research in Baltimore, they measured gum recession in 58 people. Twenty-nine had this type of lip piercing.


They found that 40 percent of people with this type of lip piercings had receding gums in their bottom front teeth, compared with only 7 percent of people without any lip piercings.


And the longer people had the piercings, the more likely they were to develop gum recession, Tatakis said in an interview. He said he found recession in 80 percent of people who had the piercings for more than 36 months.


Tatakis noted that good brushing and oral hygiene is always helpful, but there's no way people can prevent recession if they wear an object that constantly rubs up against their gum line.


"I don't think there's anything they can do, barring removing it," he said.

Copyright © 2005 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.
Copyright © 2005 Yahoo! Inc. All rights reserved.

Additive May End Up in Toothpaste, Gum                                                           March 10, 2005 8:52 PM ESTBALTIMORE - An additive that provides the minerals used by teeth to rebuild themselves could find its way into products ranging from toothpaste to chewing gum, University of Maryland researchers say.

Calcium and phosphorous ions found in saliva are used by teeth during the natural repair process. The additive, named Novamin, provides more of the ions, which can decrease with age, the researchers said.

So far, the Novamin, has been added to several products used by dentists and a toothpaste sold as a demonstration product by the company marketing the additive, Alachua, Fla.-based NovaMIn Technology Inc., said Randy Scott, the company's president and chief executive officer.

One of the dental products treats sensitive teeth. Unlike products that deaden nerves to make teeth less sensitive, the product fills in tiny holes that cause the sensitivity, Scott said.

Other products include a less abrasive paste for teeth cleaning and a root conditioner. The company is working with several large national brands and consumer products containing Novamin should be on store shelves early next year, Scott said.

"Ultimately, we hope to see it in toothpaste as a common ingredient. It also could be incorporated in chewing gum, dental floss, mouth wash, you think of a dental care product and it could incorporate Novamin," Scott said.

The additive, one of a number of advances on display this week at the annual convention of the International Association for Dental Research, is a spinoff of research into bone regeneration, said Dr. Gary Hack, one of the developers of Novamin.

The work is similar to that of Japanese researchers, who announced earlier this year that they had developed a synthetic tooth enamel that can repair early tooth decay without the need for drilling and fillings. The substance developed by the Japanese researchers has yet to be made into a product.

Kevin Smith, CEO of Omnii Pharmaceuticals, which is marketing the sensitivity product, said it is cheaper and easier to demonstrate to the FDA that a new product works on sensitive teeth than that it helps prevent cavities.

Smith said his company is hoping to market more products containing additives such as Novamin. To do that, he is hoping to convince the FDA that it should allow approval of products for a new category of treatment - remineralizing teeth to repair a lesion before it becomes a cavity.

Researchers at the conference in Baltimore also presented the results of studies of how stem cells guide tooth formation.

Pamela Yelick of the Harvard School of Dental Medicine said researchers have succeeded in transplanting tooth buds in animals and growing full teeth. Now, they are experimenting with cells cultured from tooth buds that have been placed on synthetic substrates and coaxed into developing into tooth cells.

However, growing new teeth in humans, she said, "is years away, unfortunately."Copyright 2005 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed

Hasbro Launching Musical Toothbrush                                                                  February 25, 2005 6:52 PM ESTPROVIDENCE, R.I. - Toymaker Hasbro Inc. plans to turn jawbones into headphones in an effort to tune out tooth decay.

The company announced Friday it's launching "Tooth Tunes," a toothbrush that transmits music through the jawbone to the ear when its bristles touch teeth.

"You can clearly hear the words and the music," said Brian Goldner, president of Hasbro's U.S. Toys unit. "You can hum right along if you like."

For someone standing near a person brushing, the noise would be a muted hum, Goldner said.

The battery-operated toothbrush contains a tiny microchip that stores the song. When the user presses a button and starts brushing, the sound vibrations pass through the tooth, to the jawbone and directly into the inner ear. The song plays for two minutes, the amount of time dentists recommend people spend brushing their teeth.

Hasbro executives say the music quality is akin to the sound from personal headphones.

The Pawtucket-based company will offer the product, priced under $10, beginning in September. It initially will be carried in CVS stores nationwide, before being distributed more broadly, Goldner said. CVS, also based in Rhode Island, is the nation's largest drugstore operator.

Hasbro will market the product to all age groups, but sees great potential in its interest to children, who sometimes need an extra incentive to brush their teeth.

Goldner said the company was negotiating with various recording companies and artists, such as young pop performer Hilary Duff, on music rights. Disney has granted rights to a new rendition of the 1960s song "Do You Believe in Magic?" Goldner said. The toothbrush initially will carry one song.

Cleveland dentist Matthew Messina, a consumer adviser for the American Dental Association, doesn't see any drawbacks.

"Assuming it does what they say it does, it's an interesting little gimmick to keep kids brushing a little longer," he said. "The important thing is that the kids still have to move the toothbrush along the surfaces of the teeth."

Hasbro debuted the technology in a lollipop called "Sound Bites" in 1999. The line was discontinued, but executives sought to take the technology to a bigger audience.

Currently, the toothbrushes would need to be completely replaced when the bristles on the head wear out. The company is researching replaceable brush heads, Goldner said.

Hasbro, the nation's second largest toy maker behind Mattel Inc., reported weak sales in its U.S. toys unit in the fourth quarter of 2004. Goldner would not give any sales projections for Tooth Tunes.

Shares of Hasbro rose 43 cents, or 2 percent, to close at $20.93 in Friday trading on the New York Stock Exchange.Copyright 2005 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.


Meth Addiction Leading to Rotting Teeth                                                              February 05, 2005 7:01 PM ESTMARYVILLE, Mo. - The growing use of highly addictive methamphetamine throughout the country is creating a prominent scar on an increasing number of users - rotting, brittle teeth that seem to crumble from their mouths.

Methamphetamine can be made with a horrid mix of substances, including over-the-counter cold medicine, fertilizer, battery acid and hydrogen peroxide. Together, the chemicals reduce a user's saliva, which neutralizes acids and physically clears food from the teeth, said Dr. Eric Curtis, an Arizona-based spokesman for the Academy of General Dentistry.

"When the saliva isn't flowing, the bacteria build up a lot faster," said Dr. Darrell Morton, an Atlanta dentist.

Jeffery Lotshaw flossed regularly. He brushed faithfully, sometimes four or five times in a day.

All that care makes his condition seem incomprehensible - at the age of just 33, Lotshaw's grin is toothless. His teeth all broke apart, tarnished with yellow and black.

"Before I started doing meth, I didn't have a cavity in my head," said Lotshaw, imprisoned on drug charges at Missouri's Maryville Treatment Center.

Meth users also may neglect their teeth, or moisten their dry mouths with high-sugar drinks, and anxiety caused by the drug prompts them to grind their teeth, which speeds decay.

The problem is particularly noticeable among inmates, whose oral problems have some prison systems struggling to provide dental care.

"They're rotting teeth, missing teeth, rotting way into the gums," said Kathy Bachmeier, the head of medical services for North Dakota's prisons. "It's ugly."

There are no statistics on "meth mouth" - as the condition has come to be known - because addicts are sometimes reluctant to admit their drug use and because it is difficult to distinguish between damage done by bad dental hygiene and that caused by narcotics. But there are signs it is on the rise around the country.

The head of the company in charge of dental care for Missouri inmates says he is seeing teeth rotted by meth use nearly every day. In North Dakota, the number of days a dentist was serving inmates jumped from 50 in 2000 to 78 in 2004. And the tab for inmates' dental care in Minnesota rose from $1.2 million five years ago to about $2 million last year.

"There are more and more urgent care needs, which pushes back routine care like cleanings," said Nanette Schroeder, director of health services for Minnesota's Corrections Department. "They're seeing just worse mouths, generally. This is really an emerging problem."

Missouri pays a company $7.50 per day per prisoner for health care, regardless of what's needed, so no major cost increase has been incurred.

"My dentists always opt for the best treatment we could offer our patients, as we would in private practice," said Dr. Ernest Jackson, whose Jefferson City-based company is in charge of dental care for Missouri prisons.

But that philosophy isn't necessarily at play everywhere.

Schroeder said there's a constant juggling act between constitutional obligations to inmates, costs and the risk of lawsuits.

"Do we always think that it's fair to provide some services to our offender population that people on the outside might not get? Of course not," Schroeder said. "On the other hand, we have to balance that with the risk."

Bryan Rogers, another inmate at the Maryville facility, which is exclusively for convicts with drug problems, said he noticed other users' teeth were rotting but made sure he brushed regularly.

"I was always thinking that's not going to happen to me because I keep brushing," he said.

Rogers, 30, has had three teeth pulled since arriving at the prison in August, and he's awaiting a dental plate. Lotshaw's last 11 teeth have been removed since arriving, also in August, and he's waiting for dentures.

Lotshaw has been drug-free for more than five months, but there's no denying what is to blame for his empty mouth.

"It reminds me a lot of my addiction," he said.Copyright 2005 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

States May Cut Medicaid Dental Programs                                                                 February 04, 2005 3:20 AM ESTDENTISTS' PLEA: Dentists say reducing Medicaid dental benefits would hurt the needy and cost states more in the long run because patients may seek more costly emergency treatment.

STATES' PROBLEM: Lawmakers are looking to make cuts while wrestling with stagnant revenue and soaring health care costs.

PROGRAMS PULLED: The number of states with comprehensive dental benefits for adults under Medicaid dropped to seven in 2004, down from 14 in 2000, according to the American Dental Association.Copyright 2005 Associated Press. All rights reserved. This material may not be published, broadcast January 30, 2005Inventor of Wacky Fake Teeth Says to FlossJanuary 30, 2005 7:32 PM ESTPOTLATCH, Idaho - Rich Bailey, inventor of the wacky and lucrative Billy-Bob novelty teeth, hopes to use his notoriety for a nonprofit campaign to encourage flossing throughout the country.

The motto for the Potlatch dentist's Floss Across America campaign will be "No Smile Left Behind."

"We want to revolutionize the American mind-set on flossing," says Bailey, 33. "And I believe it's most important to start with the children."

Bailey, who received international attention over his large, plastic, decayed Billy-Bob Teeth costume prop, crafted a spin-off with two buck teeth that can be flossed using small rope for the program. He will use that to pitch for healthy teeth cleaning habits to elementary schools in Lewiston, Moscow, Potlatch and the Post Falls area.

"Flossing needs to be a fun, yet unavoidable, part of a child's daily routine. I can't think of a better environment than a classroom."

He's still associated with Billy-Bob Teeth, but is no longer involved in production and sales.

"I want to give back because I've been accused of earning a living off other people's afflictions," he said

Bailey created a nonprofit company called Smilemakers International, and has bought a variety of flossing devices to distribute to children.

Bailey said Floss Across America could eventually become self-supporting, with manufacturers donating devices to schools to further the cause.

"I feel passionate about this, and that's why it's easy for me to do it," says Bailey, who has a dental practice in Potlatch.

Bailey will begin his first pilot sessions on Valentine's Day in the two Moscow schools. He's scheduled for appearances in Lewiston and Post Falls schools Feb. 18.

---

Information from: Lewiston Morning Tribune, http://www.lmtribune.comCopyright 2004 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. 

Judge: Listerine No Replacement for Floss                                                                   January 07, 2005 8:59 PM ESTNEW YORK - Mouthwash is no substitute for dental floss, a federal judge ruled, calling a Listerine ad campaign false and misleading and a public health risk.

Judge Denny Chin said in a written ruling made public Friday that he expected to order Pfizer Inc. as early as Monday to stop claiming that its product, Listerine, is as effective as floss at reducing plaque and gingivitis between teeth.

The ruling came after McNeil-PPC Inc., a subsidiary of Johnson & Johnson, filed a lawsuit saying that false claims in the advertising campaign that began last June posed an unfair threat against its sales of dental floss.

"Dentists and hygienists have been telling their patients for decades to floss daily," Chin wrote. "They have been doing so for good reason. The benefits of flossing are real - they are not a `myth.' Pfizer's implicit message that Listerine can replace floss is false and misleading."

Pfizer in print ads had featured a Listerine bottle balanced on a scale opposite a floss container. The ad said: "Listerine antiseptic is clinically proven to be as effective as floss at reducing plaque and gingivitis between the teeth."

The campaign also featured a television commercial titled the "Big Bang." In it, the commercial announces that Listerine is as effective as floss and that clinical tests prove it, though it does add that there is no replacement for flossing.

The judge said "substantial evidence" demonstrates that flossing is important in reducing tooth decay and gum disease and that it cannot be replaced by rinsing with a mouthwash.

The judge also noted that the authors of articles on which Pfizer based its advertising campaign had emphasized that dental professionals should continue to recommend daily flossing and cautioned that they were not suggesting that mouth rinse be used instead of floss.

Chin said Pfizer based its findings on two flawed studies of people with mild to moderate gingivitis who did not use floss properly. The studies, he added, proved only that Listerine is "as effective as improperly used floss."

Gingivitis, which affects some two-thirds of the U.S. population, causes inflamed, swollen and sometimes bleeding gums. It can precede periodontitis, a less common inflammation that develops in deeper tissues and sometimes leads to tooth loss.

The judge noted that 87 percent of consumers floss either infrequently or not at all, despite frequent warnings from dentists and dental hygienists to do so.

The judge said Pfizer had received complaints about its advertising, including one from a dental professional who said he was "aghast" to hear of the company's claims and another who said the claims "can set back years of progress by the ethical dental profession in convincing patients that flossing is essential for their oral health."

Chin wrote that flossing provides benefits that Listerine does not, including the ability to remove plaque below the gumline and to dislodge pieces of food trapped between teeth.

The judge said he found it "highly troubling" that Pfizer took the position in the lawsuit that floss can be replaced by Listerine even though it had told dental professionals for two years that it was not suggesting that was the case.

Messages left with Pfizer were not immediately returned. Danielle Devine, a Johnson & Johnson spokeswoman, said the company was pleased with the ruling.

Pfizer shares closed up 1 cent to $26.30 on the New York Stock Exchange Friday. Johnson & Johnson shares fell 23 cents to $62.61.Copyright 2004 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. 

New study confirms diuretics good choice for high blood pressure                               January 5, 2004 TRENTON, N.J. (AP) - The benefits of diuretics for elderly people with high blood pressure apparently outweigh the risks. A new long-term study found diuretics prescribed for the elderly do increase the risk of diabetes. But the rate of death from heart attack or stroke was almost 15 percent lower. The study is expected to answer nagging questions for doctors with elderly patients, especially those with high blood pressure and diabetes. Even people who developed diabetes while taking diuretics during the study got some benefit. Their cardiovascular death rate was 32 percent lower than for a group not on diuretics. Diuretics, which are a first-line treatment, are medicine's oldest blood pressure drug. They cost just pennies a day compared to some of the newer prescription drugs. The new study is in the January issue of the American Journal of Cardiology. AP Links SOUND: Doctor John Kostis (KAH'-stis), study leader and director of the Cardiovascular Institute at U-M-D-N-J-Robert Wood Johnson Medical School, in A-P interview Kostis says the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure, or J-N-C Seven, lists diuretics as a first-line treatment for hypertension. (UMDNJ is University of Medicine and Dentistry of New Jersey) CUT *374 (01/03/05)>> :06 "J-N-C Seven " Doctor John Kostis (KAH'-stis), study leader and director of the Cardiovascular Institute at U-M-D-N-J-Robert Wood Johnson Medical School, in A-P interview Kostis says the study shows the benefits of using diuretics to lower high blood pressure outweigh the risks. (UMDNJ is University of Medicine and Dentistry of New Jersey) CUT *375 (01/03/05)>> :11 "to placebo" Doctor John Kostis (KAH'-stis), study leader and director of the Cardiovascular Institute at U-M-D-N-J-Robert Wood Johnson Medical School, in A-P interview Kostis says the use of diuretics to lower high blood pressure can reduce the long-term risk of death from heart attacks and strokes. (UMDNJ is University of Medicine and Dentistry of New Jersey) CUT *376 (01/03/05)>> :11 "one medication" On the Net: http://www.nhlbi.nih.gov 01/03/05 20:25 EST Copyright 2005 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press. All active hyperlinks have been inserted by AOL.  

January 5, 2005                                                                                                        DENTSPLY International Acquires a Unique Compound for Protection of Tooth StructureYORK, Pa.--(BUSINESS WIRE)----_DENTSPLY International Inc._ (http://finance.aol.com/pfweb/quote/detail?sym=XRAY&exchange=NASDAQ) (NASDAQ:XRAY) today announced that it has acquired rights to a unique compound called SATIF from the SANOFI-AVENTIS Group (EURONEXT: SAN / NYSE: SNY) for an undisclosed amount. Mr. Gary Kunkle, DENTSPLY's Vice Chairman and Chief Executive Officer stated, "SATIF is another excellent example of the progress our Office of Advanced Technology has made in their efforts to locate and acquire new technologies with potential applications in dentistry. SATIF is a unique Titanium-Fluoride derivative, which has demonstrated in studies the ability to protect the tooth surface, which could be of particular value in preventive and aesthetic dentistry. We believe that the potential applications from this technology could be seen as a significant innovation in oral healthcare, similar to the discovery of the benefits of Fluorides." DENTSPLY designs, develops, manufactures and markets a broad range of products for the dental market. The Company believes that it is the world's leading manufacturer and distributor of dental prosthetics, precious metal dental alloys, dental ceramics, endodontic instruments and materials, prophylaxis paste, dental sealants, ultrasonic scalers, and crown and bridge materials; the leading United States manufacturer and distributor of dental x-ray equipment, dental handpieces, intraoral cameras, dental x-ray film holders, film mounts and bone substitute/grafting materials; and a leading worldwide manufacturer or distributor of dental injectible anesthetics, impression materials, orthodontic appliances, dental cutting instruments and dental implants. The Company distributes its dental products in over 120 countries under some of the most well-established brand names in the industry. DENTSPLY is committed to the development of innovative, high quality, cost-effective new products for the dental market. This press release contains forward-looking statements regarding possible future events. Actual events or results may differ materially from the descriptions set forth herein as a result of certain risk factors. These risk factors include without limitation; the ability to develop commercially acceptable products which incorporate the technology, the continued strength of dental markets, the timing, success and market reception for new products, and changes in the general economic environment that could affect the dental business. DENTSPLY International Inc. Bret W. Wise, 717-849-4718 01/04/2005 09:05 ET © Business Wire 2003  

December 29, 2004                                                                                                             FDA Approves New Drug for Severe PainBy LAURA MECKLER, APWASHINGTON (Dec. 28) - The government approved a drug Tuesday that offers a new way of fighting severe pain - an option for patients who no longer benefit from morphine and other traditional pain medications. It's the first in a new class of drugs that selectively blocks the nerve channels responsible for transmitting pain signals. It will be marketed as Prialt and should be available by the end of January. "When you've taken all the kinds of pain medication that there is and you still have pain, that is a very frightening situation," said Dr. Lars Ekman, president of research and development for the drug's Ireland-based manufacturer, Elan. "When you have that kind of pain, there is nowhere to go." The drug is part of a new class known as N-type calcium channel blockers. It is known chemically as ziconotide. Morphine is the standard treatment for severe pain from cancer, AIDS, amputations and other significant illnesses, but its effects eventually wear off and the dosage must be increased. At some point, many patients switch from taking medication by mouth or by injection to a microinfusion pump implanted under the skin that delivers drugs directly into the fluid surrounding the spinal cord. Ekman said about 35,000 to 50,000 Americans have these pumps now. The Food and Drug Administration approved Prialt for patients who are already using these pumps but not getting effective relief from them or who cannot tolerate the available treatments. This is the first new drug in 20 years to treat pain using such a pump. Prialt has been studied in patients with cancer, AIDS and other chronic pain, such as back pain. More than 1,200 patients took part in three clinical trials. There are side effects, and the FDA was including a "black box" warning - the government's strongest warning short of a ban. Side effects may include dizziness, drowsiness and altered mental status, with patients confused at times. Despite the side effects, the drug was approved because there are no other options for these patients and the benefits outweighed the risks, said Dr. Robert Meyer, director of the FDA's Office of Drug Evaluation II. "Because this is such an important patient population where they have such pain and they have so few options we felt this drug does offer some real gains," he said. Patients with a history of psychoses should not receive it, and all others should be monitored for signs of cognitive impairment, he said. The idea for the drug came from a snail called the Conus magus that lives in the South Pacific, which paralyzes its victims with venom after capturing them, the company said. Researchers set out learning how to develop a drug based on this venom and eventually copied the amino acid sequence. Elan would not say how much it plans to charge for the drug. 12-28-04 18:48 EST Copyright 2004 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press. All active hyperlinks have been inserted by AOL.  

November 16, 2004                                                                                                           DENTAL PLAQUE ASSOCIATED WITH RESPIRATORY INFECTION IN ELDERLY Dental plaques (DPs) may often house respiratory pathogens responsible for hospital-acquired pneumonia (HAP), according to a new study by researchers at the University of Buffalo, Buffalo, NY. Of 49 critically ill nursing home residents who required intensive care treatment, researchers found that 28 subjects (57%) had aerobic pathogens in their DPs, including Staphylococcus aureus and enteric Gram-negative bacilli, pathogens commonly found in elderly patients with severe pneumonia, and 14 patients (29%) developed HAP. Institutionalized elders comprise a population that frequently has DPs due to lack of oral hygiene, a decline of daily activities, and, possibly, prior treatment with antibiotics. Further research is needed to determine if daily oral hygiene would reduce the incidence of HAP in this population. The study appears in the November issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians. GERD SYMPTOMS OFTEN MISLEADING FOR ASTHMATICS One third of adults with asthma have gastroesophageal reflux disease (GERD), but many do not experience the typical symptoms of heartburn and/or regurgitation, a new study shows. Researchers from Tampere University Hospital in Finland looked at 90 asthmatic patients and identified 32 patients (36%) with GERD, of which 8 patients (25%) did not experience classic reflux symptoms. The study further showed that asthmatics who experience GERD symptoms may not actually have the condition, as only 24 patients (51%) of the 47 who presented with classic reflux symptoms were found to have abnormal acidic reflux. The study appears in the November issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians. EMERGENCY CARE WORKERS MOTIVATE ASTHMA PATIENTS TO BECOME EDUCATED Emergency department (ED) professionals can help reduce asthma-related morbidity by motivating asthma patients to attend an asthma education program, according to a study from the Laval University Cardiology and Pneumology Institute, Laval Hospital, Sainte-Foy, Quebec, Canada. Researchers implemented automatic asthma education center (AEC) referrals for asthma patients presenting to the ED for asthma at nine acute care centers. In the first four months of the program, 1,104 asthma patients were referred to an AEC, compared to 110 patients in the same period a year earlier. Of those referred, 488 patients (68.9%) made appointments at an AEC, and 72.8% of those patients attended their sessions. Training sessions on asthma were also attended by ED physicians, nurses, and respiratory therapists, which raised their scores on an asthma evaluation questionnaire from 16 to 70% after the session. The study indicates that such asthma-education referral programs are well accepted by ED staff. The study appears in the November issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.  

November 16, 2004                                                                                                      NYSCOF More Tooth Decay in Poor Children; Fluoridation No HelpNEW YORK, Nov. 8 /PRNewswire/ -- "Caries experience may be associated with income," reports the U.S. Centers for Disease Control (CDC). Low income, not fluoridation deficiency, predicts more cavities is revealed in newly-released statistics posted 10/25/04 on the CDC's website(1), reports the New York State Coalition Opposed to Fluoridation (NYSCOF). Those states reporting third-graders cavity rates and children living below the federal poverty level indicate that poor children have more cavities -- even when water is fluoridated. And, the states with the highest rates of fluoridation don't have the lowest cavity rates. For example, CDC statistics show that: Despite a 60% fluoridation rate, Arkansas has the highest rate of third-graders suffering with tooth decay (72%) and the most poor children(45%) Oklahoma third-graders endure the second worst cavity rate (69%) even though 3/4 of the state is fluoridated. But 41% are poor, the second poorest state on the CDC's list. Similarly, 89% fluoridated South Dakota reveals the third worst decay rate (68%) where 41% are poor. At the low end: Massachusetts, Maine and Vermont third-graders have the least decay -- 49%, 45% and 44%, respectively, and the smallest amount of poor children (26%, 32% and 31%), Fluoridation rates: 63%, 75%, and 54%, respectively. "Increasingly, studies and statistics find that the purported cavity reducing benefit of fluoride have not been demonstrated, while the documented health risks of fluoride have dramatically risen," says lawyer Paul Beeber, NYSCOF President. Water engineers dispense fluoride chemicals into 2/3 of Americans via their water supply attempting to prevent tooth decay. However, in the United Kingdom, where only 10% drink fluoridated water, tooth decay rates are equal too or better than those of the U.S.(2) and have declined over the last ten years. (3) In contrast, U.S. cavity rates increased(4) along with fluoride overdose symptoms, prompting some researchers to suggest that water fluoridation be stopped(5a,b). In both the U.S. and U.K., lack of money and dental care predicts higher rates of tooth decay -- regardless of fluoridation status(6a,b). By neglecting the poor, organized dentistry helped create an oral health epidemic.(7) Promoting fluoridation may deflect government regulators from forcing dentists to treat poor children.(8). References: (1) http://www2.cdc.gov/nohss/IndicatorV.asp?Indicator=2&OrderBy=2 (2) http://www.cdc.gov/nccdphp/aag/aag-oh.htm (3) http://www.statistics.gov.uk/cci/nugget.asp?id=973 (4) Wall Street Journal http://www.sfgate.com/ cgi-bin/article.cgi?file=/news/archive/2002/03/08/financial1058EST0079.DTL (5a) http://ehp.niehs.nih.gov/members/2004/7077/7077.pdf (5b) http://www.orgsites.com/ny/nyscof/-pgg8.php3 (6a) http://www.orgsites.com/ny/nyscof2/-pgg6.php3 (6b) http://www.dundee.ac.uk/dhsru/cdh/supp151/#2 (7) http://www.surgeongeneral.gov/news/pressreleases/pr-oral-52000.htm (8) http://www.oregondental.org/oda/section.cfm?wSectionID=1277(Page 6) Contact: Paul Beeber, 516-433-8882, nyscof@aol.com http://www.orgsites.com/ny/nyscof SOURCE NYS Coalition Opposed to Fluoridation, Inc. CO: NYS Coalition Opposed to Fluoridation, Inc. ST: New York SU: CHI Web site: http://www.orgsites.com/ny/nyscof http://www.prnewswire.com 11/08/2004 10:35 EST  Jill Rethman, RDH, BAEditorial Director, Dimensions of Dental Hygienewww.dimensionsofdentalhygiene.com2004 OSU Dental Hygiene Distinguished Alumni Awardwww.jillrethman.com 

RESEARCHERS ARE STUDYING PHOTODYNAMIC THERAPY AS AN OPTION TO TREAT PERIODONTAL DISEASES CHICAGO (November 11, 2004) – As the scientific community is seeking alternatives to antibiotic treatment, periodontal researchers found that photodynamic therapy (PDT) is advantageous for suppressing anaerobic bacteria that lead to periodontal diseases according to a recent study in the Journal of Periodontology.“Although this study is still in its early phase, with the recent number of reports about bacterial strains becoming resistant to frequent doses of antibiotics, PDT could be an alternative to conventional periodontal therapeutic methods,” said Michael P. Rethman, D.D.S., M.S., and president of the American Academy of Periodontology. “Antibiotics may be used as an adjunctive therapy for periodontal diseases, so there is a pronounced interest in the development of alternative antimicrobial concepts.PDT involves two stages. In the first stage, a light-sensitive drug is applied. The second stage involves shining a light or laser directly on the area treated with the drug. When the light is combined with the drug, phototoxic reactions are induced which destroy bacterial cells. PDT was first approved by the Food and Drug Administration in 1999 to treat pre-cancerous skin lesions of the face or scalp.In this study, researchers investigated anaerobic bacterial strains (bacteria that can only survive and grow in the absence of molecular oxygen) and facultative anaerobic bacteria (bacteria that can survive without oxygen).“The photosensitizers we investigated were able to completely suppress the anaerobic key pathogens leading to periodontal diseases; however, facultative anaerobic bacteria tested responded to a lesser extent to PDT,” said Dr. Bernd W. Sigusch, Friedrich Schiller University of Jena, Conservative Dentistry; Germany.To specifically address the periodontal pockets in the body, the test tube results are presently being verified in several animal and human experiments.A referral to a periodontist in your area is available by calling 800-FLOSS-EM or visiting the AAP's Web site at www.perio.org.The American Academy of Periodontology is an 8,000-member association of dental professionals specializing in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of nine dental specialties recognized by the American Dental Association. EDITOR'S NOTE: A copy of the study “Killing Periodontopathogenic Bacteria by Photodynamic Therapy” is available to the media by contacting the AAP Public Affairs Department at 312/573-3243. The public and/or non-AAP members can view a study abstract online, and the full-text of the study may be accessed online for $20.00 at www.perio.org. 

November 11, 2004                                                                                          HHS SECRETARY TOMMY G. THOMPSON ANNOUNCES NEW INITIATIVES TO HELPAMERICANS QUIT SMOKING HHS Secretary Tommy G. Thompson announced today a series of initiativesdesigned to help Americans quit smoking. The initiatives include theopening of a national quitline number (1-800-QUITNOW) that puts users intouch with programs that can help them give up tobacco. In addition, a newHHS Web site (www.smokefree.gov <http://www.smokefree.gov/>) offers online advice and downloadable information to make cessation easier.The Secretary also announced plans to make all HHS campuses tobacco-free, and to make all HHS employees who use tobacco eligible for participation in cessation programs. He made the announcements after a meeting with members of the CEO Roundtable on Cancer and the tobacco control community."What starts as a single puff can become a death sentence for millions of Americans," said Secretary Thompson. "Americans want to quit smoking, and they should quit smoking. These initiatives will help Americans kick thehabit and save their own lives."The toll-free number (1-800-784-8669) is a single access point to theNational Network of Tobacco Cessation Quitlines. Callers are automaticallyrouted to a state-run quitline, if one exists in their area. If there is no state-run quitline, the call goes to the National Cancer Institute (NCI)quitline. As part of the network, HHS' Centers for Disease Control and Prevention (CDC) provided funding to 49 states and the District of Columbia to either enhance their existing quitline or to create one.Quitlines offer advice, support and referrals to local cessation services.Scientific evidence shows quitlines are effective tools that help smokersquit. Cigarette smoking is the nation's leading preventable cause of death and disease, causing about 440,000 premature deaths each year."I ask all doctors and nurses to encourage every tobacco user they see to call this number as a supplement to any medication they recommend,"Secretary Thompson said.The establishment of the national quitline fulfills a pledge that theSecretary made in February 2004.The new Web site includes the NCI's direct quitline number and aninteractive map with toll-free state quitline numbers. The site also offers instant messaging text chat with an NCI specialist in tobacco cessation,during specified hours of operation. Always available is information such as a step-by-step guide to managing the process of quitting.HHS also has worked with WebMD to train physicians to better help smokers to give up tobacco. Secretary Thompson encouraged all physicians to take the free training, for which Continuing Medical Education (CME) credit is available.Secretary Thompson said that beginning Nov. 18 -- the date of the GreatAmerican Smokeout -- HHS employees who use tobacco will get greater access to cessation programs. If the employee's health insurance does not cover cessation services, a new HHS program will provide medication as well as support in making lifestyle changes.The department also will make all HHS properties tobacco-free. This means no smoking or tobacco use anywhere on HHS properties (as legally allowed). The program, to begin Jan. 1, 2005, will make HHS the first federal department to be so stringent in banning tobacco use. November 10, 2004'Normal' Blood Pressure May Still Be Too HighBy GINA KOLATA Published: November 10, 2004 New study of heart disease patients finds that "normal" blood pressure may not be low enough. By reducing their pressure well below the levels suggested by national guidelines, patients had fewer heart attacks, strokes, cardiac arrests, hospitalizations for chest pain, procedures to open blocked coronary arteries, and deaths. In addition, lower blood pressure appeared to slow or stop the growth of the fatty deposits called plaque in the coronary arteries, compared with patients taking a placebo, whose plaque growth continued over the two-year study. The international study, led by Dr. Steven Nissen of the Cleveland Clinic, is being published today in The Journal of the American Medical Association. It found that for every 16 heart disease patients with normal blood pressure given drugs to lower it, 1 adverse event could be prevented. Although the study was modest in size, with 1,991 patients, all with normal blood pressure, experts said its surprising result reopened this longstanding question: How low should blood pressure go? The question takes on special urgency because millions of Americans have heart disease severe enough to cause the adverse symptoms. The patients in the study were at high risk for adverse events, Dr. Nissen said, but their blood pressure was considered so well controlled that researchers had not previously asked what would occur if it went lower. Their starting pressure, he said, "was 10 millimeters lower than anyone has studied." Blood pressure is measured in millimeters of mercury. National guidelines for most people say systolic pressure, when the heart contracts, should be lower than 140 millimeters. Diastolic pressure, when the heart relaxes between beats, should be lower than 90. When the new study began, its participants averaged 129 over 78. "If you walked in a doctor's office and your blood pressure was 129 over 78, your doctor would say you have normal blood pressure," Dr. Nissen said. The research was sponsored by Pfizer, which makes a drug in the study, amlodipine, or Norvasc. But the investigators say they, not the company, controlled the data and wrote the paper. While Pfizer saw the manuscript before it was submitted for publication, they wrote, "the final decision on content was exclusively retained by the authors." The investigators and other experts said more research was needed before changing the national guidelines. Still, they said, the new study should advance the discussion. "It's a brick in the wall that is being built in terms of ever lower targets for blood pressure," said Dr. Jeffrey Cutler, a blood pressure researcher at the National Heart, Lung and Blood Institute. The findings do not apply to healthy people, for whom the side effects of blood pressure drugs may outweigh any benefits of taking them. Amlodipine, for example, can cause swollen ankles, and enalapril a dry cough. "You really can't generalize to people without pre-existing disease," said Dr. Paul K. Whelton, senior vice president for health sciences at Tulane University. The study began with a question, said one investigator, Dr. Peter Libby of the Harvard Medical School: "Is average blood pressure optimal for our species?" Most studies have focused on reducing high blood pressure to average levels. Such reductions seem to reduce the risk of heart attacks and strokes. In the new study, patients with average blood pressures were randomly assigned to take one of two types of drugs to lower their pressure further - Pfizer's drug amlodipine, from a class known as calcium channel blockers, or enalapril, a generic drug in the class ACE inhibitors - or to take a placebo. The two drugs had similar effects on blood pressure, reducing systolic pressure an average of 5 points and diastolic by an average of 3. The number of cardiac events like heart attacks, strokes or hospitalizations for chest pains was reduced 31 percent for patients taking amlodipine and 15 percent for those taking enalapril. Amlodipine also stops plaque growth in coronary arteries. Among the placebo group, 23 percent, or 151 patients, had such an event during the two-year study. But for those taking amlodipine, the figure was 16.6 percent, or 110. For those on enalapril, it was 20.2 percent, or 136. Some experts not connected with the study said that they were not sure that amlodipine was better, that study was too small to be definitive. "To me, that suggests that the major benefit is blood pressure lowering, no matter how you get there," said Dr. Carl J. Pepine, chief of the cardiovascular medicine division at the University of Florida. Dr. Thomas P. Giles, a professor of medicine at Louisiana State University School of Medicine who is the president of the American Society of Hypertension, said the figures were encouraging for heart disease patients. The study "shows you can stop progress of atherosclerosis and have some regression and you can accomplish that with a reduction of a blood pressure level that some people have considered normal," he said. The findings also are consistent with studies of populations that indicate that the risk of heart attacks increases continuously as systolic pressure climbs above 115, Dr. Giles and other researchers said. Virtually all experts not employed by the government have been paid consultants for drug companies. "We have taken it as the natural human condition that blood pressures are as high as they are," said Dr. Henry R. Black, an associate vice president for research at the Rush University Medical Center and an author of the blood pressure guidelines. "We have arbitrarily defined 'normal blood pressure.' " But that, Dr. Black said, does not mean that normal is optimal. Dr. Libby, for one, was astonished by the findings. "It was an eye-opener," he said. It means, he added, that "we have to rethink blood pressure levels for those with heart disease." _Copyright 2004_ (http://www.nytimes.com/ref/membercenter/help/copyright.html) _The New York Times Company_ (http://www.nytco.com/) | 

November 9, 2004                                                                                           New Oral Hygiene Instruction Set to Prevent Oral Disease in Children  Rostrevor, South Australia (PRWEB) November 8, 2004 -- Dr. Garth D Pettit is a second-time retired dentist. Instead of the golf courses he chose to follow his passion to be a full time oral healthcare educator to help children to prevent oral disease. He passionately believes he knows how to prevent oral disease in children. The 'secret' weapon he believes he has in his armoury to prevent oral disease in children is his new oral hygiene instruction 'Treat Your Mouth'. 'Brush Your Teeth', he claims in his recently launched web blog site 'Prevent Oral Disease in Children', is flawed and even contributes to oral disease in children. He believes 'The Colgate-Palmolive and American Dental Association October 1, 2004 Launch of 'Save The World from Cavities' Campaign to Prevent Tooth Decay in Children' will also fail in it's objective if it too has been based on the oral hygiene instruction 'Brush Your Teeth'.From 1997 to 2002 Dr Pettit was responsible for the annual screening (recording decayed, missing and filled teeth) at several remote community schools. Rampant tooth decay was the norm for most children in all schools. One school was regularly different. In this school there was a dramatic reduction in the incidence of children's oral disease but only in the children in two particular classrooms. The two teachers of these classrooms provided their students with a wholesome breakfast each morning. Following breakfast each student was given a tooth brush on which the teachers placed some tooth paste. The teachers then instructed the children to 'brush your teeth and rinse and rinse your brush under the tap'. Then the first lesson of the day began. Dr Pettit recalled that Aboriginal people take instructions literally. The children interpreted the instruction 'brush your teeth and rinse and rinse your brush under the tap' as meaning two, not three, instructions; first 'brush your teeth', next 'and rinse and rinse your brush under the tap'. Children did not 'brush your teeth', then 'and rinse (your mouth)', then 'and rinse your brush under the tap'. By not rinsing their mouths they left a coating of toothpaste ingredients on every surface in their mouths. The ingredients in the toothpaste were doing as intended; killing bacteria, preventing decay, preventing gum disease and bad breath. Had they rinsed their mouths with water, the dramatic reduction in their oral diseases would not have occurred. Dr Pettit concluded the oral hygiene instruction 'Brush Your Teeth' was flawed and could be a cause of oral disease and there was need for a new oral hygiene instruction for children to prevent oral disease. He created the following oral hygiene instruction and named it 'Treat Your Mouth": . Firstly, treat surfaces of teeth, then gums, then tongue, to clean away plaque and debris. Then thoroughly rinse the mouth with water. Then spit out the debris. . Secondly, treat all surfaces a second time to apply the paste. Then swish the foam thoroughly around the mouth. Then spit out excess foam. NOTE: no rinsing with water.. Finally, rinse the bristles under the tap.Dr Pettit believes the terms 'tooth brush' and 'tooth paste', should be banished along with "Brush Your Teeth". Throughout the extensive array of MouthWise oral healthcare education resources developed by Dr Pettit for children, their parents and their teachers, Dr Pettit' main educational theme is to instruct children to "Treat Your Mouth" with a mouth treater and mouth paste to prevent oral disease. Dr Pettit believes the current children's oral disease crisis in countries across the world will not be resolved so long as children continue to be instructed to 'Brush Your Teeth' to prevent oral disease. The oral hygiene instruction 'Brush Your Teeth' is flawed and probably contributes to the incidence of oral diseases in children. The new children's oral hygiene instruction is based on the result of 5 years of observations that revealed dramatic reductions in the incidence of children's oral disease. The ideal oral hygiene instruction to give children is 'Treat Your Mouth' with mouth paste and a mouth treater to prevent oral disease.Details on product availability:MouthWise Oral Health Resources:. The oral health website where all MouthWise Oral Health resources can be viewed and purchases made at www.oralhealthhelpsite.com . The MouthWise oral health information website 4 Your Smile 2 Shine at www.oralhealthcare.info . The kids oral health website All About A Smile where children can learn the oral health song '4 Your Smile 2 Shine', the song lyrics of which are the oral hygiene instruction 'Treat Your Mouth', at www.allaboutasmile.com . Book previews of the ten MouthWise oral healthcare books for children at www.oralhealthhelpsite.com/site/708332/page/394498 . Track information of the MouthWise Oral Health C.D. at www.oralhealthhelpsite.com/site/708332/product/ISBN-1-920712-12-7 . 'The MouthWise Oral HealthCare School-on-the-Web' for children's parents, teachers and anyone teaching children oral health or oral healthcare. Great also for older children in the 5 to 11 years old bracket to teach themselves. www.oralhealthhelpsite.com/site/708332/page/260688 and 'Lesson Guidelines' for 'The MouthWise Oral HealthCare School-on-the-Web' at www.oralhealthhelpsite.com/site/708332/page/292398About 4 Your Smile 2 Shine Pty. Ltd.:4 Your Smile 2 Shine is a 4 year old, sole owner company run by a retired dentist. The company's focus is on the production and distribution of oral healthcare education products. Oral healthcare education products that children can use on their own or that parents and teachers can use as teaching resources. The company's mission is to banish easily preventable oral disease in children.  Contact Information:Garth Pettit4 Your Smile 2 Shine Pty LtdTel: 618 8165 2144Fax: 618 8165 2155http://www.oralhealthcare.infohttp://www.oralhealthhelpsite.com http://www.allaboutasmile.com http://www.prevent-oral-disease-in-children.blogspot.com  

November 5, 2004                                                                                              Acid-Suppressive Therapy May Increase Risk of Community-Acquired PneumoniaCME News Author: Laurie Barclay, MDCME Author: Charles Vega, MD, FAAFP Disclosures To earn CME credit, read the news brief along with the CME information thatfollows and answer the post test questions.Release Date: October 26, 2004; Valid for credit through October 26, 2005 Credits Available Physicians - up to 0.25 AMA PRA category 1 credit(s)  October 26, 2004 Gastric acid-suppressive therapy increases the risk ofcommunity-acquired pneumonia, according to the results of a case-controlanalysis study published in the Oct. 27 issue of JAMA."Reduction of gastric acid secretion by acid-suppressive therapy allowspathogen colonization from the upper gastrointestinal tract," write RobertJ.F. Laheij, PhD, from University Medical Center St. Radboud in Nijmegen,the Netherlands, and colleagues. "The bacteria and viruses in thecontaminated stomach have been identified as species from the oral cavity."Using the Integrated Primary Care Information database between Jan. 1, 1995, and Dec. 31, 2002, the investigators identified acid-suppressive drug users with at least one year of valid database history, and they comparedincidence rates for pneumonia for unexposed and exposed individuals.A case-control analysis was conducted nested in a cohort of incident usersof acid-suppressive drugs to reduce confounding by indication. Cases wereall individuals with incident pneumonia during or after stopping use ofacid-suppressive drugs. For each case, up to 10 controls were matched forpractice, year of birth, sex, and index date. Using conditional logisticregression, the investigators compared the risk of community-acquiredpneumonia in users of proton pump inhibitors (PPIs) and of H2-receptorantagonists (H2RAs).The primary outcome was community-acquired pneumonia, defined as certain(proven by radiography or sputum culture) or probable (clinical symptomsconsistent with pneumonia).Of 364,683 individuals, 5,551 developed first occurrences of pneumoniaduring follow-up. Pneumonia incidence rates were 0.6 per 100 person-years in non-acid-suppressive drug users and 2.45 per 100 person-years inacid-suppressive drug users.Compared with persons who stopped using PPIs, the adjusted relative risk(RR) for pneumonia among persons currently using PPIs was 1.89 (95%confidence interval [CI], 1.36 to 2.62), with a significant positivedose-response relationship. Risk of pneumonia was increased 1.63-fold (95%CI, 1.07 to 2.48) for current users of H2RAs compared with those who stopped use, but the variation in dose was restricted. November 5, 2004 Hello all.  I thought you’d be interested to know that Helena’s interview can now be heard on United Airlines flights! The November/December schedule began Monday. Even if you’re not flying this holiday season, you can access the interview via ADHA’s News Coverage page (accessed from the Press Room page), or by clicking this link: http://www.adha.org/media/ultripp.htm.  You can also link to it through United’s site: http://www.united.com/page/article/0,6722,1070,00.html,  click on the link under “Audio” and in the scroll down menu on that page, select: Sky Radio Business & Lifestyles. The full November/December schedule will appear.  In addition, you can access the interview directly from Sky Radio, the service that provides the audio feeds to United, by clicking here:  http://www.skyradionet.com/united.cfm.  I’ll include a notice in the next ADHA listserv.We will be receiving copies of the printed guides from United Hemispheres and the Entertainment Guide. The interview turned out great and Helena highlighted several key messages for ADHA. Let me know if you have any questions. Pam AntonManager of Public RelationsAmerican Dental Hygienists' Association444 N. Michigan Ave., Suite 3400Chicago, IL  60611PH: 312-440-8943FX: 312-467-1702Visit ADHA's Press Room: http://www.adha.org/media/ November 2, 2004                                                                                           NEW YORK CENTER FOR HEALTH WORKFORCE STUDIES JUST RELEASED  The Professional Practice Environment of Dental Hygienists in the Fifty States and the District of Columbia, 2001 To better understand the changing role of dental hygienists in the oral health care system and the impact of these changes on access to oral health care, the National Center for Health Workforce Analysis in the Health Resources and Services Administration 's Bureau of Health Professions commissioned the Center to conduct a study to develop a professional practice index for the dental hygiene profession, summarizing the legal practice environment for the profession in each of the 50 States and the District of Columbia as of 2001. The study considered the extent to which the professional practice environment was related to numbers of practitioners, selected characteristics of practitioners, oral health outcomes, and utilization of oral health services and assessed the impact of dental hygienists on access to care for underserved populations. The full report can be found on HRSA'swebsite: http://bhpr.hrsa.gov/healthworkforce/reports/hygienists/dh1.htm#execsum.October 28, 2004

 ADHA Institute Launches Online Auction to Benefit Programs                                                                                                                                             On November 1st, the ADHA Institute for Oral Health will officially launch its annual online auction, just in time for your holiday shopping. All proceeds will directly benefit the foundation and its programs, such as scholarships, research and community service grants, and educational fellowships. Some initial items include: a Tiffany's Sterling Silver Heart Tag Charm Bracelet, a 1980 United States Olympic Hockey Team Signed and Framed Jersey, and a Red Leather Coach Lexington Briefcase.  Two auction cycles will be held: November 1-7 and November 8-15.  (Auction items will be available for preview and preliminary bidding on October 30th and November 6th.)

 Visit the foundation’s website at www.adha.org/institute to view items and place your bid.October 27, 2004On-line Certification to Dental Professionals for Hidden Braces System Lingualcare, the makers of Hidden Braces(TM) for teens and adults, announced today that the Lingualcare Certification Course for Hidden Braces is now available on-line. Orthodontists, dentists and staff members will learn the clinical procedures and treatment techniques for successfully incorporating Hidden Braces into their practices and receive CE credit. http://www.hiddenbraces.com   October 27, 2004Toothbrush RecallGillette and FDA notified healthcare professionals and consumers of a recallof Oral-B CrossAction Power and PowerMAX toothbrushes and refills. Instanceshave occurred where the brush head became loose in the mouth during theassisted brushing of teeth of persons with special needs, such as cerebralpalsy or autism. During brushing, the loose brush head was