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                                     DENTAL  Updated Weekly! 2005

Oral health is the gateway to overall health!

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December 2005

More vitamin D may mean healthier gums

People with higher blood levels of vitamin D may be less likely todevelop gum disease. Using data from a national U.S. health survey, researchers found that teenagers and adults with the highest blood levels of vitamin D were 20 percent less likely than those with the lowest levels to show signs of gingivitis -

The current study, published in the American Journal of Clinical Nutrition, is based on data from 6,700 Americans who took part in a
federal health study between 1988 and 1994. When the researchers broke participants into five groups based on their blood levels of vitamin D, they found that as vitamin levels rose, the risk of gingivitis inched downward. The group with the highest vitamin D levels was 20 percent less likely to have signs of gingivitis than the group with the lowest levels-even with factors such as age and income taken into account.

Vitamin D is probably best known for its role in calcium absorption and bone health. But recent research has suggested that it also
helps maintain a healthy immune system and may fight inflammation. It's this anti-inflammatory benefit that may explain the vitamin's
link to healthier gums, Dietrich and his colleagues speculate. Gingivitis arises when bacteria build up between the teeth and gums,
leading to inflammation and bleeding.

It is possible that vitamin D does not directly affect gum disease risk, but is instead a marker of general health habits, according to
the researchers. Vitamin D levels depend in large part on sun exposure, and people with higher levels may, for instance, spend
more time exercising outdoors. These same people may be especially careful about brushing and flossing, the researchers point out.


SOURCE: American Journal of Clinical Nutrition, September 2005.

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New Clue to Tooth Decay Could Lead to Dental Advances

A study comparing antimicrobial peptides (AMPs), a group of small proteins that occur naturally in human saliva and act like antibiotics against oral bacteria, could lead to new ways to screen children for risk of tooth decay and protect them against this common, chronic problem. The study, "Salivary Antimicrobial Peptide Expression and Dental Caries Experience in Children," published in the September 2005 issue of the journal Antimicrobial Agents and Chemotherapy, involved oral examinations performed on 149 middle school children. Researchers at the University of Washington in Seattle set out to determine a possible correlation between dental caries prevalence in children and salivary concentrations of three types of antimicrobial peptides. Results found that children with no tooth decay had higher levels of one particular type of AMP (alpha defensin) than children with tooth decay. The National Institute of Dental and Craniofacial Research, part of the National Institutes of Health, funded the study

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Pacifers reduce risk of crib deaths, study finds
Research shows SIDS cut by 90 percent when 'dummy' used


-Baby pacifiers can reduce the risk of sudden infant death syndrome, the leading cause of death in babies under a year old, according to new research published on Friday. Scientists in the United States found babies who used a pacifier, also known as a “dummy,” while they slept had a 90 percent reduced risk of crib death compared to other babies. Our results also provide some evidence that use of a dummy may reduce the impact of other risk factors for SIDS, especially those related to adverse sleep conditions.
Most cot deaths occur between two to four months of age and are more prevalent in boys than girls. The cause is unknown but lying the baby down on its stomach, parental smoking and old mattresses which may harbor toxic bacteria, have been cited as possible culprits. A campaign to encourage parents to put infants to sleep on their backs has led to a dramatic fall in cot deaths. Scientists from Kaiser Permanente and the National Institutes of Health questioned the mothers or carers of 185 infants who died of SIDS and 312 other infants of a similar age and race. The American Academy of Paediatrics, which issued revised guidelines in October, recommends that babies are put to sleep on their back onlyand said pacifiers could be used to help prevent SIDS.
Reuters
Updated: 7:05 p.m. ET Dec. 8, 2005

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November 2005

Drug Awareness..Drug Caused Periodontitis:

 

Coreg/Carvedilol. Lexicomp Drug listed dental health effects on dental  treatment has this statement: Key adverse event(s): related to dental treatment: Postural hypotension and periodontitis.

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Oral sex linked to mouth cancer: Swedish study

Certain cases of mouth cancer appear to be caused by a virus that can be contracted during oral sex.

People who contract a high-risk variety of the human papilloma virus, HPV, during oral sex are more likely to fall ill with mouth cancer, according to a study conducted at the Malmo University Faculty of Odontology in southern Sweden.
"You should avoid having oral sex," dentist and researcher Kerstin Rosenquist, who headed the study, told Swedish news agency TT. HPV is a wart virus that causes many cervical cancers, including endometrial cancer (in the uterus).Comparing 132 patients with mouth cancer with a control group of 320 healthy people, Rosenquist found that 36 percent of the cancer patients were carriers of HPV while only one percent of the control group had the virus.
The main factors that contribute to mouth cancer, most commonly contracted by middle aged and older men, are smoking and drinking alcohol. "But in recent years the illness has been on the rise among young individuals and we don't know why. But one could speculate that this virus (HPV) is one of the factors," Rosenquist said.

Her findings confirm other international studies in recent years. 1
1/18/05

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The Effect of Menopause, Hormone  Replacement Therapy (HRT), Alendronate (ALN), and Calcium Supplements on Saliva.
Purpose:  In menopausal women many physiological changes take place, most of which are due to decreased estrogen production.  It is known estrogen influences oral health in a number of ways and saliva undergoesvariations depending upon the levels of this hormone.

The most significant oral discomfort in women in the menopausal period was oral dryness, and this symptom was relieved after HRT with ALN and calcium  supplements.  The oral status of the non-menopausal women was better than the  women in menopause.  The salivary flow rate was decreased in the menopausal period  and increased after HRT, ALN, and calcium supplementation.  The saliva pHvalues were not affected by menopause and HRT with ALN and calcium supplementation.  The level of Na+ was increased with menopause and did not change with HRT  supplemented with ALN and calcium, whereas the K+ level decreased in the menopausal period and remained constant after HRT with ALN and calcium.  The Cl¯level was not affected by menopause and the HRT supplemented with ALN and calcium.  The Ca++ level was not different in the two groups of women and did not change after  HRT supplemented with ALN and calcium. 

Citation:   Yalcin F, Gurgan S, Gurgan T.  The Effect of Menopause, Hormone Replacement Therapy (HRT), Alendronate (ALN), and Calcium Supplements on Saliva.  J Contemp Dent Pract 2005 May;(6)2:010-017.

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Stress-Smokers under stress have deeper pockets than non-anxious smokers Bacterial biofilm triggers periodontal infection, and stress can aggravate the situation. Past studies have demonstrated that people with psychiatric disorders have more periodontal  disease. High stress levels combined with  smoking may lead to more periodontal infection. High-stress levels combined with smoking may lead to more periodontal infection.
Anxiety, Gingival Inflammation and    Periodontal Disease Johannsen, A., Asberg, M., Söder, P., Söder, B.: Anxiety, Gingival Inflammation and    Periodontal Disease in Non-Smokers and Smokers - An Epidemiological Study. J Clin Perio 32: 488-491, 2005. Cited Dental Hygienetown, PerioReports

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Grapefruit Cure For Gingivitis

Eating grapefruit could help fight gum disease. That's the conclusion of research published in the new edition of the British Dental
Journal (BDJ). Researchers found that eating two grapefruits a day significantly increased the vitamin C levels of those suffering from
gum disease. Because vitamin C promotes the healing of wounds and boasts antioxidant properties, it contributes to the therapy and
prevention of the condition. The effect was observed for smokers and non-smokers alike.

The two-week study examined the effect of consuming grapefruit on a mixed group of smoking and non-smoking subjects. At the start of the study, virtually all of those taking part exhibited plasma vitamin C levels well below the normal range, with the smokers' levels 29 per cent lower than the non-smokers'. A proportion of the group was then selected to consume two grapefruits per day after a main meal for the duration of the research.

Grapefruit raised the ascorbic acid plasma levels of all those who had consumed it. In non-smokers the mean level increased from 0.56
milligrammes (mg dl¹) to 0.87 mg dl¹. In smokers the mean level almost doubled, from 0.39 mg dl¹ to 0.74 mg dl¹. While smokers'
levels enjoyed a greater increase, the fact that they started from a lower baseline meant that their levels were still below those of the
non-smokers. The levels of the remainder of the group, who did not consume any grapefruit, were unchanged.

The researchers also observed a significant reduction of the sulcus bleeding index, that is bleeding from the gums, after grapefruitconsumption. They concluded that this effect was also likely to have been caused by the improved vitamin C supply.

The research was carried out by the Friedrich Schiller University inGermany.

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Use of NSAID May Slow Healing in Fractures

In the Journal of the American Academy of Orthopaedic Surgeons, two researchers from the University of North Carolina School of Medicine (UNC)reviewed several studies that examined the use of NSAIDs as analgesics for patients recovering from fractures.

One of the studies - as reported in the Journal of Bone Joint Surgery (2000) - compared the recovery of nearly 100 patients who had fractured a femur (the long bone that runs from the hip to the knee). The fractures of 32 subjects healed improperly and were classified as "nonunion," while fractures repaired correctly in a control group of 67 subjects.

The researchers found a significant association between the use of NSAIDs and the nonunion of fractures. More than 60 percent of the nonunion groupreported regular NSAID use compared to only 13 percent in the control group. Among the subjects who used NSAIDs, the average healing time was a full two months longer than among those who used no NSAIDs at all.

Based on this and other similar studies, the UNC researchers concluded that during the healing of fractures, NSAIDs should be avoided. They also noted that COX-2 inhibitors not only have an adverse effect on bone healing, but may also impair the healing of ligaments. IDF 10.05

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October 2005

Teeth In An Hour

Swedish dental implant maker Nobel Biocare has received FDA approval for Teeth-in-an-Hour, a quick, minimally invasive procedure for replacing several to all of a patient's teeth. Dentists take a computerized tomography scan of a patient's mouth and analyze the jawbone using software developed by Nobel. Nobel's Swiss factory uses these plans to make a stencil-like mouthpiece, predrilled with tiny holes to guide the dentist through the implant surgery - that takes about an hour. Currently there are 75 dentists in the US performing  Teeth-in-an-Hour. Nobel estimates it will train 400 more this year at dental conferences and universities. One consideration: a whole mouth can cost as much as $60,000. To view a live surgery demonstration.

 Teeth in an Hour by Nobel Biocare
Source: Forbes Magazine, 9/05

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Gums Need Extra Care After Menopause

Women with gum disease are at an increased risk for tooth loss following menopause according to a study in the Journal of Periodontology.  Researchers at the University of Buffalo found that each millimeter of clinical attachment loss was associated with 2.5 fold increase in tooth loss risk within a decade; each millimeter of alveolar bone loss increased risk three-fold.

AGD Impact October 2005 pg 10

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September 2005

Smokers Less Likely to Visit Dentist Than Nonsmokers


Smokers are significantly less likely to seek dental care than nonsmokers, according to data from a nationally representative sample of 15,250 American adults. The finding holds true regardless of age, gender, race, ethnicity, socioeconomic status, location and insurance coverage.

Because smokers face increased risk of gum disease, tooth loss and oral cancers, “they’re the very population that should be seeking more dental care,” says Susan K. Drilea, lead author of the study, which was sponsored by the National Institutes of Health and the Centers for Disease Control.

The study, reported in the latest American Journal of Health Behavior, analyzed data gathered during a government health care survey in 2000. “We found that 33 percent of current smokers reported having at least one dental visit that year compared to 45 percent of nonsmokers,” says Drilea.

The finding highlights an “opportunity for intervention,” according to the report. “Efforts to decrease the rates of serious oral diseases may be enhanced by targeting educational campaigns to smokers, emphasizing the need for regular dental visits.”

Dental professionals could play a key role in delivering these messages, says the report. Many practices have already adopted the “Ask, Advise, Refer” approach recommended by the American Dental Hygienists’ Association to help their patients quit smoking.

Drilea says support from other health advocates could augment the efforts of dental professionals. “Tobacco awareness campaigns are beginning to incorporate more recognition that oral health is affected by the use of tobacco. Lung cancer has traditionally been the focus of attention, but increasingly they are acknowledging that every system in the body is affected.”

Further research might improve such educational efforts by asking smokers why they don’t visit the dentist more often. “Determining whether this is a matter of personal choice, a lack of awareness, a financial issue, or whether there are obstacles as part of the dental visit itself” could be helpful, says Drilea.


Dan Peterson, a Nebraska dentist who places special emphasis on working with patients who smoke, offers insight into what such research might find. Smokers, he says, fear that their dentist will “condemn them for smoking and try to get them to quit, when most of my patients don’t want to quit.”

Peterson offers this advice to colleagues interested in promoting oral health among patients who smoke: “Don’t judge them, come across as caring and concerned. Be direct with the effects of smoking to their oral health and provide them with options of care. For our patients who insist on smoking, we provide a special program of more regular dental care. We educate, educate, educate and care.

By Laura Kennedy, Contributing Writer
Health Behavior News Service

INTERVIEWS
Contact Susan Drilea at [email protected]
American Journal of Health Behavior: Visit www.ajhb.org or e-mail [email protected]

Drilea SK, et al. Dental visits among smoking and nonsmoking U.S. adults in 2000. American Journal of Health Behavior 29(5), 2005

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Periodontal disease develops much earlier than dentists and other health professionals thought

 

Periodontal disease -- a progressive, eventually painful and disruptive condition in which bacteria attack gums and the hidden roots of teeth -- develops much earlier than dentists and other health professionals thought, a major new study concludes.

Clinicians found a significant proportion of young adult patients examined had well-established periodontal disease despite no signs or symptoms. Affected pregnant women faced more than twice the risk of preterm birth and other pregnancy complications as unaffected women, the research also revealed.

Data from the unique set of clinical studies, conducted at the universities of North Carolina at Chapel Hill and Kentucky were released Tuesday (Sept. 20) at a news conference during the annual meeting of the American Association of Oral and Maxillofacial Surgeons in Boston.

"Part of the reason was that research at UNC and elsewhere showed that the inflammation in the mouth that periodontal infections cause promoted inflammation in other parts of the body, which contributed in significant ways to coronary artery disease, stroke, kidney disease and obstetric complications," White said.

"That a quarter of patients in their 20s had periodontal problems with no symptoms was a surprise to us since most people assumed that you don't get periodontal problems until you are 35 or 40," White said.

In the evaluation of data from 1,020 higher-risk obstetrics patients enrolled in a National Institutes of Health-sponsored clinical trial, 18 percent delivered preterm, he said. Wisdom teeth were a major contributor to the young women's periodontal disease, and the severity of their disease clearly corresponded with the risk of preterm delivery. It also corresponded with indicators of systemic inflammation, such as elevated C-reactive protein, a substance produced by the liver in response to inflammation anywhere in the body.

Women with the worst periodontal disease around their 3rd molars had more than twice the risk of preterm birth, researchers found. The danger to pregnant women was comparable to the risks of smoking during pregnancy, the surgeon added. Since untreated periodontal disease in effect "seeds" the bloodstream with disease-causing bacteria, it's important that dentists, obstetricians and other physicians assess wisdom teeth when examining young adults, he said.

"Although most people eventually will develop pathology with wisdom teeth, periodontal disease, pericoronitis or tooth decay, it is too early to recommend strongly that everyone has their wisdom teeth removed," White said. "It is a good idea to have your 3rd molars evaluated before age 25. But since a quarter of people will never have problems with them, a lot depends on how risk-averse one is as to whether their third molars with no detected pathology should be extracted as a precaution."

http://www.unc.edu/

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Snap-on Smiles in National Media

Snap-on Smiles, recently featured in USA Today, Life Magazine, and IN STYLE magazine, are removable custom molds that slide onto teeth. "Think of the snap-on smile as the white-enameled cousin to the press-on nail," writes Olivia Barker of USA Today. Best of all, patients can emulate A-lister's smiles matching the look of Julia Roberts, Halle Berry, and more. The resin appliance, which fits snugly over existing teeth, reportedly costs between $1,000 and $3,000. The product's inventor is Marc Liechtung, a Manhattan dentist, who features Snap-on Smiles on his website for New York Center for Cosmetic Dentistry.

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Toothpaste goes gourmet with funky food flavors

Bitter chocolate, black licorice, pumpkin, caramel, and curry are spicing up the toothpaste market. Breath Palette (TM) offers 32 flavors. Essential fragrances are used to augment the taste of the pastes. Neiman Marcus will offer a holiday set for Christmas, with a $200 price tag. The Sweet Tooth Kit costs around $22, and includes vanilla, bitter chocolate, caramel, espresso, and pumpkin pudding toothpastes. These toothpastes are a big hit in Japan where women use the toothpaste as a diet dessert. They don't actually eat it, but feel they've had a treat after brushing with a sinfully rich caramel or chocolate.

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Alert!

Burkholderia cepacia pneumonia associated with contaminated alcohol-free mouthwash

The Centers for Disease Control and Prevention (CDC) has been notified by several states of clusters of pneumonia and other infections caused by Burkholderia cepacia.  These cases had exposure to alcohol-free mouthwash manufactured by Carrington Labs (Irving, TX) for Medline Industries (Mundelein, IL).  Cultures performed by a hospital laboratory where the first cases were detected indicate that multiple lots of Medline alcohol-free mouthwash are intrinsically contaminated with B. cepacia.

The FDA has posted  a voluntary recall of the product involved.  See http://www.fda.gov/oc/po/firmrecalls/medline08_05.html
 

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Invisalign Express is here! Provides a lower-cost option for minor crowding and spacing, and as a pre-cursor to restorative or cosmetic treatment such as veneers.

Invisalign Express is a simple, dual arch orthodontic treatment consisting of a series of up to ten clear removable aligners at an affordable price.  Invisalign Express allows  patients to have more affordable, reliable and  the high quality of Invisalign treatment.  It is available for patients with minor crowding and spacing.

Invisalign Express was specifically designed to provide affordable, predictable treatment for simple cases without compromising on quality or treatment outcome.

Ask us about Invisalign Express.

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August 2005

Exposure to cigarette smoke raises the risk among teens of metabolic syndrome, a disorder associated with excess belly fat that increases the chances of heart disease, stroke and diabetes, according to a study.

Researchers said it is the first study to establish such a link in teenagers.

For the study, metabolic syndrome was defined as having at least three of five characteristics: a big waist, high blood pressure, high levels of blood fats called triglycerides, low levels of good cholesterol, and evidence of insulin resistance, in which the body
cannot efficiently use insulin.

In the study, published Monday in the American Heart Association online journal Circulation, researchers found that 6 percent of 12-to 19-year-olds had metabolic syndrome and that the prevalence increased with exposure to tobacco smoke.

The study found that 1 percent of those unexposed to smoke developed the syndrome, 5 percent of those exposed to secondhand smoke had the disorder and 9 percent of active smokers had it.

Looking at teens who were overweight or at risk for being overweight, the effect of smoke was even more marked, with 6 percent of those not exposed to smoke developing syndrome, 20 percent of those exposed to secondhand smoke getting it and 24 percent of smokers suffering from the disorder.

“What this shows is that the percentages of kids who are at risk is vastly higher if they’re overweight and they’re exposed to secondhand smoke, down to very low levels,” Weitzman said.


Weitzman said it is not clear what it is about smoking that appears to make teenagers more susceptible to metabolic syndrome.

However, in adults smoking has been linked to insulin resistance, a risk factor for metabolic syndrome. Doctors also point out that smoking can lower levels of good cholesterol and raise blood pressure, two more markers for the disorder.

The researchers looked at 2,273 adolescents, using information from a Centers for Disease Control and Prevention survey. The youngsters reported their own use of tobacco. Also, the study looked at measurements of cotinine, a product of nicotine after it enters the body. Two-thirds of teens who did not smoke had cotinine levels that
indicated secondhand smoke exposure.

“It’s sobering,” said Dr. Michael Lim, assistant professor of internal medicine in the division of cardiology at Saint Louis University School of Medicine. “What it points out is a very high- risk group of people — young adults 12 to 19 — who are exposed to tobacco products and sedentary.”

The number of overweight teens in the United States has tripled in the past two decades.

Dr. Michael Weitzman, executive director of the American Academy of Pediatrics Center for Child Health Research in Rochester, N.Y
 

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August 6 is National Fresh Breath Day.
Here are the recommendations for solving the problem:
* Clean your tongue as part of oral health regimen.
* Chew gum to stimulate salivation, especially one sweetened with xylitol.
* Choose cinnamon flavored gum to help decrease oral bacteria.
* Avoid "ketone breath" from eating low-carb diets by adding a few healthy carbohydrates.
* Remove food from between teeth and under gums with floss and water irrigator.
* Don't panic:  a number of people who think they have halitosis do not.

 

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The US Surgeon General's website now includes a new "Clinician's Packet on Treating Tobacco Use and Dependence," a how-to kit on implementing Public Health Service clinical practice guidelines on tobacco cessation. The kit includes expanded definitions of the "Five A's" health professionals should keep in mind when confronted with a patient's tobacco use:
1. ASK. Identify and document tobacco use status for every patient at each visit.
2. ADVISE. In a clear, strong, and personalized manner, urge each tobacco user to quit.
3. ASSESS. Does the tobacco user appear willing to make an attempt to quit at this time?
4. ASSIST. For patients willing to make the attempt to quit, use counseling and pharmacotherapy to help them succeed.
5. ARRANGE. Schedule follow-up contact, in person or by telephone, preferably within the first week after the quit date
.

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New Mucositis Drug for Cancer Patients

Cancer patients may find relief from painful sores in the mouth or throat due to chemotherapy or radiation treatments from a new drug recently approved by the US Food and Drug Administration. Palifermin (brand name Kepivance) is an intravenous drug that is designed to help prevent or shorten the duration of mucositis in cancer patients. A study of palifermin showed that 98% of patients who didn't take the drug developed mucositis and the condition lasted for an
average of nine days, while only 63% of patients taking the drug developed mucositis and the conditions lasted for an average of three days.

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July 2005

Dry Mouth News Updates

Acupuncture in the treatment of xerostomia

 Seven xerostomia patients who were treated using acupuncture and the subsequent results of that treatment are discussed. Actual outcomes exceeded the author's expectations with all patients reporting an increase in salivary flow and the ability to eat and speakand improved sleep. Members of the dental team should consider referral for acupuncture as a viable adjunct when treating xerostomia.
http://www.agd.org/library/2005/june/dart_158.pdf

Acupuncture in the treatment of xerostomia: Clinical reportWarren M. Morganstein, DDS, MPH

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Boxing and Oral Health — Perhaps not Mutually Exclusive?

News Releases CDA  June 13, 2005 Your dentist will certainly never recommend it, but according to a study published in the latest edition of the Journal of the Canadian Dental Association (JCDA), participation in sports — even contact sports including boxing and wrestling — may have protective health effects.

The article, entitled "Tobacco Use among Young North American Aboriginal Athletes", found that youths at high-risk for smoking, are less likely to use tobacco when they are involved in organized sports.

Among Aboriginal youth, average reported smoking rates vary from 30- 77%, (higher than the non-Aboriginal Canadian youth average of 21.7%), putting them at increased risk for negative health effects — including oral diseases. Through a mouthguard clinic established at the July 2002 North American Indigenous Games, a group of dental
researchers was able to learn that participation in sports impacts other health choices.

We found that athletes presenting at the clinic were much less likely to use tobacco products than their peers — and even averaged below the rates of non-aboriginal youths who are less at risk.  These findings suggest that participation in organized sportsmay be an important protective factor against tobacco use.

Of 156 Aboriginal athletes participating in the study, only 22 (14.1%) reported current smoking. And of the few who did smoke, consumption levels were low and most were interested in quitting.

The full text of the above mentioned article is available from the eJCDA Web site:

Tobacco Use among Young North American Aboriginal Athletes[ http://www.cda-adc.ca/jcda/vol-71/issue-6/403.html ]

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Can brushing help you lose weight?

If you are trying to maintain a healthy weight you may want to try brushing. A study published in the Journal of the Japan Society for the Study of Obesity found that people who brush their teeth after every meal tend to remain slimmer than those who don't brush as often. Japanese researchers discovered this effect when they compared the lifestyle habits of nearly 14,000 people whose average age was the mid-forties. They concluded that tooth brushing is a good health habit that could play a role in preventing obesity. I have long suggested brushing your teeth at least twice a day, accompanied by daily flossing, to help prevent the buildup of small amounts of food that attract and nourish bacteria. So if gingivitis, cavities, or bad breath weren't enough of a reason to brush and floss, consider becoming a slimmer you.

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New Tooth Tattoos

Robert "Box" Hildman, a certified dental technician and owner of Crowns by Box in Waterloo, IA, has created a new way to tattoo teeth. He paints small pieces of artwork on back molars using a dental scaler and small paintbrushes with one or two bristles. One junior high student had a basketball painted on her tooth.   Contact: [email protected]

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FDA MedWatch Zometa and Aredia(R) associated with Osteonecrosis

Novartis and FDA have notified dental health care professionals of revisions to the prescribing information to
describe the occurrence of osteonecrosis of the jaw (ONJ) observed in cancer patients received treatment with
intravenous bisphosphonates, Aredia (pamidronate disodium) and Zometa (zoledronic acid). The prescribing information recommends that cancer patients receive a dental examination prior to initiating therapy with intravenous bisphosphonates (Aredia and Zomega), and to avoid invasive dental procedures while receiving bisphosphonate treatment. For patients who develop ONJ while on bisphosphonate therapy, dental surgery may exacerbate the condition.
 http://newsletters.smartpractice.com/GoNow/a27669a131305a340363469a6

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Cancer patients receiving intravenous bisphosphonate drugs should not be treated with invasive dental procedures. Novartis Pharmaceuticals Corp. stated that osteonecrosis of the jaw (ONJ) has been observed in cancer patients who are receiving Aredia or Zometa-bisphosphonates used to treat complications of advanced cancer known as "hypercalcemia of malignancy," bone metastases from solid tumors and other conditions ADA Updates 6/05

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Possible Alzheimer's signpost Gum inflammation may be linked to increased risk of the brain
disorder
. By Kevin W. McCullough, Times Staff Writer

Missing teeth and gum disease at an early age may be linked to an increased risk of Alzheimer's disease, researchers have found, bolstering the increasingly strong connection between early exposure to chronic inflammation and the degenerative brain disorder.

The study, among the findings presented last week at the first Alzheimer's Assn. International Conference on Prevention of Dementia, examined lifestyle factors of more than 100 pairs of identical twins. All of the pairs included one twin who had developed dementia and one who hadn't. Because identical twins are genetically indistinguishable, the study involved only risk factors that could be modified to helpprotect against dementia.

Twins who had severe periodontal disease before they were 35 years old had a fivefold increase in risk of developing Alzheimer's disease, the researchers found. Periodontal disease may be a marker for chronic exposure to
disease that provokes an inflammatory response. Chronic inflammation can damage tissue, including the brain, which may contribute to the development of the disease.

I would think of the periodontal disease as a signpost, not a cause. Periodontal disease is also linked to general health,
and even the inflammatory link to Alzheimer's may involve several factors. This finding reinforces a long-standing appreciation . that indicated inflammation in the brain was an essential part of the disease process,.
 

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June 2005

Raisins may fight cavities and gum disease - study
Wed Jun 8, 2005
(Reuters) - They may be sweet and sticky but raisins contain compounds that suppress bacteria responsible for cavities and gum disease, U.S. researchers said on Wednesday.

While the researchers have not shown that people who eat raisins have healthier mouths, they identified five compounds known as phytochemicals in raisins that can be beneficial for teeth and gums.

Raisins are perceived as sweet and sticky and any food that contains sugar and is sticky is assumed to cause cavities.

But our study suggests the contrary. Phytochemicals in raisins may benefit oral health by fighting bacteria that cause cavities and gum disease.

Foods that are sticky do not necessarily cause tooth decay; it is mainly the added sugar (sucrose) that contributes to the problem."

Wu's team found five compounds in Thompson seedless raisins that might help make teeth and gums healthier -- oleanolic acid, oleanolic aldehyde, betulin, betulinic acid and 5-(hydroxymethyl)-2-furfural.

All are phytochemicals -- antioxidants found in plants, Wu told a meeting of the American Society for Microbiology in Atlanta.

Oleanolic acid slowed growth of a bacteria that causes cavities and another that causes periodontal disease. The acid also stopped bacteria from sticking to surfaces, which prevents them from forming plaque.

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Is the Chair Position Important?

Dental anxiety in the general population is more prevalent in females than in males.  The presence of dental anxiety was studied in a group of 189 females and 176 males using the following scales: the Dental
Anxiety Scale, the Self- Rating Depression Scale  and the Quality of Life Index .  The results obtained showed significant differences only in relation to dental anxiety regarding the use of instruments (such as needles and handpieces) and the tilted-back position of the chair No significant gender differences emerged between the two groups in relation to dental anxiety regarding dentist-patient relations , depression , and the quality of life .  The results may explain why women avoid dental care and indicate new designs to make the chair position more comfortable would be useful.


Read complete article at http://www.thejcdp.com/issue021/index.htm Citation:  Settineri S, Tatì F, Fanara G.  Gender Differences in
Dental Anxiety: Is the Chair Position Important?  J Contemp Dent Pract 2005 February;(6)1:115-122.

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New Prescription For Gingivitis

The Food and Drug Administration (FDA) has approved a new prescription treatment for gingivitis, reports PharmacyOneSource. The Decapinol Oral Rinse treats gingivitis by reducing the number of
bacteria that attach to tooth surfaces and cause dental plaque.
Decapinol is approved for use in patients 12 years of age or older when routine oral hygiene is not adequate to prevent gingivitis. Decapinol is not recommended for use by pregnant women.

This new dental rinse helps treat gingivitis when tooth brushing and flossing are not enough,' said Dr. Daniel Schultz, Director of FDA's Center for Devices and Radiological Health. `This product can lead to a substantial reduction in gingivitis.'

Clinical studies were conducted in adults with mild to severe gingivitis. In these studies, Decapinol was compared either to `no treatment' or to an antimicrobial rinse. The studies showed that Decapinol decreases gingivitis up to 60 per cent - compared to no treatment and when used as instructed with recommended brushing and flossing.

Decapinol Oral Rinse is being regulated as a medical device and not as a drug because its primary mode of action is to create a physical barrier, rather than to act chemically.

Decapinol contains a substance called a surfactant that acts as a physical barrier, making it harder for bacteria to stick to tooth surfaces. FDA has also approved a number of other anti-gingivitis oral rinses, but since these products act chemically to kill bacteria that live in the mouth, they are regulated as antimicrobial drugs rather than as devices.

cited smile-on.com 26April'05

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Using Skin Cells to Treat Gum Disease

A simple treatment involving skin cell injections could be used to treat periodontal disease, reports the Society for Chemistry & Industry. The treatment uses fibroblast cells extracted from the skin's dermal layer. Fibroblasts control collagen and elastin levels, proteins that are found in skin, bones, and other connective tissue.

Researchers extracted fibroblast cells from the skin's dermal layer, multiplied these cells in-vitro, and then injected them into the site to be treated. In phase I and II clinical trials, the method  consistently succeeded in regenerating gum tissue. Anecdotal evidence suggests that bone is also being regenerated, and a phase III trial is planned to start soon in London.


Source: Adapted from a Society for Chemistry & Industry press release,
May 2, 2005, available from www.chemind.org/.

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Treatment of periodontal disease improves metabolic control of diabetes

Diabetes is a complex disease with both vascular and metabolic components. A back and forth connection exists between diabetic control and oral infections. When periodontal infection is established, metabolic control of diabetes is worsened. When diabetesis exacerbated, periodontal infection progresses. During the 3-month study, subjects in the control group received no periodontal treatment. Test group subjects received oral hygiene
instructions and scaling and root planing with local anesthesia.

Baseline, post-treatment and three-month data included clinical
indices and blood tests. Only a few in the test and control groups had moderately deep pockets. The others had gingivitis. Following treatment statistically significant differences were observed between the groups. The differences were not large, but did show evidence of
improved glycemic control following non-surgical therapy.

Clinical Implications: Oral hygiene instructions and non-surgical treatment of periodontal disease in type 2 diabetics can result in better metabolic control of the diabetes.

Kiram, M., Arpak, N., Ünsal, E., Erdogan, M.: The Effect of Improved Periodontal Health on Metabolic Control Type 2 Diabetes Mellitus. J
Clin Perio 32: 266-272, 2005. Cited: Perio Reports 2005 April

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May 2005

Huntridge Teen Clinic, which provides free or low-cost health care,


Teenagers who have never had dental care are a regular phenomenon for  Las Vegas   They are teens who don't have health insurance. When
pain finally brings them to Lincicome's dental chair, many of them  need extractions or root canals.

Lincicome is the lead dental professional at the nonprofit Huntridge  Teen Clinic, which has been providing free or low-cost health care to
adolescents for almost 12 years. The clinic, 2100 S. Maryland Parkway, was recently "adopted" by the  Leadership Las Vegas class of 2005 for a major renovation and  expansion. The project will double the clinic's dental program from  two to four patient chairs.

Steve Williams, clinic director, estimates the value of the work at  $75,000. Leadership Las Vegas is an annual program of the Las Vegas
Chamber of Commerce, intended to mentor potential community leaders. It is a tradition for each Leadership Las Vegas class to take on a
community project. This class has recruited people to donate labor,  supplies or funds to pay for the expansion. Now, the clinic is open 8:30 a.m. to 5 p.m. on Mondays through  Fridays, offering medical and dental services. Patients must be  between 12 and 18 years old at their first visit.

Back in 1993, Courtney was director of clinics and nursing at the  Clark County Health District. She suggested providing medical
services to needy adolescents, when a committee at Christ Church  Episcopal, 2100 S. Maryland Parkway, came looking for a
social-service cause. The church founded the Huntridge Teen Clinic. It is now the clinic's landlord. The charge is $10 per visit.

For fillings, root canals and extractions, she routes her teen  patients to the current 35 dentists and oral surgeons who volunteer
for the program. Some donate their hours at the Huntridge Teen  Clinic, others have Huntridge patients come to their private offices.

In the first half of this fiscal year, the dental clinic saw 234  patients. The count is lower than for medical patients because most
dental procedures are more complex and time-consuming than the typical teen's medical needs. We're running 20 percent ahead of last year,"
 

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Periodontitis and Renal Disease

Periodontitis, a chronic bacterial infection of the oral cavity, is a novel risk factor for atherosclerotic cardiovascular disease (CVD). Given the numerous shared risk factors for CVD and chronic kidney disease (CKD), we hypothesized that periodontitis also is associated with renal insufficiency in the Dental Atherosclerosis Risk in Communities study.
Methods: We conducted a cross-sectional study of 5,537 middle-aged black and white men and women. Periodontitis was determined by using an independent clinically derived definition and categorized as healthy/gingivitis,
initial, and severe. Renal insufficiency is defined as glomerular filtration rate (GFR) less than 60 mL/min/1.73 m2.  Results: A total of 2,276 individuals had initial periodontitis, and 947 individuals had severe periodontal disease. One hundred ten individuals (2%) had a GFR less than 60 mL/min/1.73 m2. Compared with healthy/gingivitis, initial and
severe periodontal disease were associated with a GFR less than 60 mL/min/1.73 m2 (odds ratio, 2.00; 95% confidence interval, 1.23 to 3.24) forinitial periodontal disease and an odds ratio of 2.14 for severe disease
(95% confidence interval, 1.19 to 3.85) after adjustment for important risk factors for CVD and CKD. S
Conclusion: This is the first study to show an association of periodontal disease with prevalent renal insufficiency. A prospective study is necessary to determine the exact nature of the observed relationship.

April 2005 • Volume 45 • Number 4 Pathogenesis and Treatment of Kidney Disease and Hypertension Periodontal disease is associated with renal insufficiency in the Atherosclerosis Risk In Communities (ARIC) study Abhijit V. Kshirsagar, MD, MPH Kevin L. Moss John R. Elter, DMD, PhD James D. Beck, PhD Steve Offenbacher, DDS, PhD Ronald J. Falk, MD

* Division of Nephrology and Hypertension, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC* Division of Dental Ecology, School of Dentistry, University of North
Carolina at Chapel Hill, Chapel Hill, NC, USA * The Atherosclerosis Risk in Communities study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute
contracts no. N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. In addition, this study is supported by National Institute for Dental and Craniofacial Research grant no. DE13019 and by the General Clinical Research Center grant no. RR00046. Dr. Kshirsagar’s efforts were supported by a grant from Renal Research Institute. * ⁎Address reprint requests to Abhijit V. Kshirsagar, MD, MPH, Division of Nephrology and Hypertension, CB 7155 348 MacNider Hall, Chapel
Hill, NC 27599-7155. * Email address: [email protected] (Abhijit V. Kshirsagar)

 

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April 2005

April is Free Toothbrush Exchange at Dr. Peterson's Office.

Did you know that you should replace your toothbrush every three months because the bristles just simply worn out, they lose their effectiveness, they become breeding grounds for  germs, fungus and bacteria  and can damage gum tissue. Any child from age 12 and under can bring in their worn toothbrush to our office and Dr. Dan Peterson will replace it for free with one brand new toothbrush and free tube of toothpaste

 

Mercury Fillings in Moms Don't Lead to Small Babies
Risk of low birth weight infants debunked in new study

  In good news for expectant moms with cavities, a new study suggests pregnant women aren't threatening their newborn's birth weight by getting mercury-based silver amalgam fillings.

This latest research revealed no connection between use of the fillings and low birth weight.You cannot prove absolute safety, but mercury seems to have quite a bit of data on it now indicating that it shouldn't be of concern.

The use of silver amalgam fillings has dipped over the past couple of decades. They made up 68 percent of all fillings in the United States in 1990, but dropped to 30 percent in 2003.Resin-based fillings known as "white" fillings have become more popular, and some dentists have abandoned silver fillings because of concerns about the safety of mercury.

While silver amalgam fillings are commonly known just as "silver," they're actually made of several metals, including silver, tin, mercury and copper. The fillings "are a very good filling material. They're very long-lasting and have good properties as far as dental material.

Concerns about mercury exposure have grown in recent years, especially regarding its presence in foods such as fish. However, the U.S. government has declared that there is "scant evidence that the health of the vast majority of people with amalgam (fillings) is compromised."

In the new study, Hujoel and his colleagues studied a dental insurance company's records of 1,117 Washington state women who gave birth to low-weight infants and 4,468 women who gave birth to infants of normal weight.

The findings appear in the April 15 issue of the American Journal of Epidemiology.

The researchers found no connection between getting amalgam fillings during pregnancy -- nearly 5 percent of the women did so -- and giving birth to a underweight baby. Even women who had as many as 11 fillings during pregnancy weren't more likely to give birth to a low-weight child.

The study is another paper in a growing body of evidence that amalgam is safe and effective way to repair teeth that have been damaged by decay or trauma.

Learn more about amalgam fillings from the U.S. Centers for Disease Control and Prevention.

By Randy Dotinga HealthDay Reporter

SOURCES: Philippe P. Hujoel, Ph.D., D.D.S., professor, dental public health sciences, University of Washington, Seattle; Dr. Rod Mackert, D.M.D., Ph.D., spokesman, American Dental Association, and professor, dentistry, Medical College of Georgia, Augusta; April 15, 2005, American Journal of Epidemiology

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Open Wide: Saliva Could Predict Cancer Risk
Researchers Isolate 'Biomarkers' In Bodily Fluids


Breast cancer screening and the early detection of other tumors could some day become as simple as spitting into a cup, according to recent studies.

Researchers at the University of California-Los Angeles said they found in an early study that genetic biomarkers in saliva can predict oral squamous cell carcinoma -- a type of oral cancer --- in about nine out of 10 cases. A recent study published in Clinical Cancer Research found similar predictive powers for head and neck cancers.
The UCLA team collected saliva and blood samples from breast cancer patients and matched them with samples from patients without breast cancer.

Using new techniques, they compared the samples and found that both serum and saliva had unique genetic profiles.
Researchers said more study is needed on a larger sample of cancer patients to refine how the fluids can be used to predict cancer risks. They also said more study is needed to review precancers and other cancers that are more difficult to detect, such as ovarian and pancreatic cancers.

The biggest hurdle stems from the fact that salivary nucleic acids, or protein markers, might be influenced by eating, drinking, smoking, diet or oral hygiene. The goal is to provide the optimized and standardized protocol to assure consistent results.

 

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Scientists to Study Berries, Oral Cancer

University of Kentucky and Ohio State researchers are conducting a test to see if a common fruit is useful in slowing or preventing oral cancer. Scientists believe the black raspberry carries two acids that can inhibit tumor growth.  The researchers will put the theory to the test this summer in a trial at Ohio State by using a gel made from freeze-dried black raspberries.

Obviously we'd like to see these lesions completely disappear, but I think everyone would be happy just to see the whole process slowing down. Ninety-nine percent or more of these lesions will advance to cancer. Oral cancer, which causes up to 8,000 deaths nationally each year, is generally associated with alcohol and tobacco use.

The idea for a raspberry-based medication was conceived by doctors at Ohio State's Comprehensive Cancer Center in Columbus. The raspberry gel was then developed by Mumper, the associate director at UK's Center for Pharmaceutical Science & Technology.

Natural foods advocates have touted the healthful benefits of raspberries for years. The trial at Ohio State is apparently is one of the first efforts by mainstream medicine to develop a medication from the fruit. The pulp of black raspberries contains two substances -- anthocyanin and ellagic acid -- that are thought to have anti-oxidant and anti-inflammatory properties, as well as the ability to slow tumor growth.

Stoner found that when the powder was fed to test animals, it appeared to inhibit the development of esophageal and colon cancer as well as oral cancers.

In the trial, doctors will give the gel to 20 patients who have precancerous oral lesions and to 10 healthy patients as a control. The patients will apply the gel four times per day for six weeks.
 

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Study backs amalgam
Top scientists find no link to neurological functions

A new study, conducted by leading scientists from highly regarded research and academic institutions, finds no link between amalgam exposure and neurological function. Our findings do not support the hypothesis that exposure to amalgam produces adverse, clinically evident neurological effects.

These effects tested, as part of the overall neurological evaluation, include abnormal tremors, coordination, station or gait, strength, sensation and muscle stretch reflexes.

An oral health examination has been part of the standard AFHS medical examination since 1992 because "peripheral neuropathy" is considered to be an important adverse neurological effect of high levels of exposure to elemental mercury. "Peripheral neuropathy" refers to an abnormality in sensation, such as vibration sensation at the ankle, pinprick sensation at the great toe and/or absence of ankle reflexes.

But as with other neurological effects, the study found no connection of amalgam to any level of peripheral neuropathy. They were unable to detect any associations between amalgam exposure and clinical signs of either neuropathy or a diminished sensation of the big toe among adult males — these are standard measures for diagnosing clinical neuropathy.

This study represents another important piece to the research puzzle because of the unique military population tested. The results should be taken in the context of the larger group of clinical studies that have not found direct evidence linking amalgam exposure to impaired neurological function or peripheral neuropathy.

The bottom line is there was no association between abnormal neurological signs and amalgam exposure. So these findings do not support the hypothesis that amalgam exposure produces clinically evident neurological effects."

The NIDCR-led research was conducted because "concerns regarding the safety of silver-mercury amalgam fillings continue to be raised in the absence of any direct evidence of harm," the study reads. "The widespread population exposure to amalgam mandated that a thorough investigation be conducted of its potential effects on the nervous system."

Amalgam is a safe dental restorative material. This study, like the recently published report by the independent, nonprofit Life Science Research Office, which extensively reviewed the literature and concluded that amalgam is safe to use in people, adds to the definitive scientific evidence attesting to amalgam's demonstrated track record of safety.

The LSRO report's executive summary can be downloaded at no cost by visiting "www.lsro.org", click on "Review of Dental Amalgams." To obtain the full text, call the LSRO bookstore at 1-301-634-7030. By Mark Berthold Rsearch by by Albert Kingman, Ph.D., Chief, Biostatistics Core, at the National Institute of Dental and Craniofacial Research, part of the federal National Institutes of Health. "Amalgam Exposure and Neurological Function," appears in the March issue of NeuroToxicology. It followed 1,663 subjects of the ongoing Air Force Health Study of Vietnam era veterans.

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April Events

National Facial Protection Month: Sponsored by the American Association of Oral and Maxillofacial Surgeons, the American Academy of Pediatric Dentistry, and the American Association of Orthodontists. This 4th annual event highlights the importance of avoiding sports injuries by wearing protective equipment. Many sports injuries can be prevented by wearing mouth guards, face shields and eye protection. www.aaoms.org
National Youth Sports Safety Month: www.nyssf.org
Be a hero when sports injuries hit the mouth by distributing the EMT ToothSaver™ to schools and sports leagues. The pH-balanced cell culture fluid in the EMT ToothSaver protects and nourishes a knocked-out tooth for up to 24 hours before replantation.
National Child Abuse Prevention Month: Dental professionals can watch for signs of potential child abuse. For more information, call 1-800-394-3366 or visit www.nccanch.acf.hhs.gov
April 13 - Kick Butts Day Campaign for Tobacco-Free Kids: www.kickbuttsday.org
April 11-17 - Oral, Head and Neck Cancer Awareness Week: routinely screen for oral cancer.

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Oral Bacteria May Predict Pregnancy Outcomes
Researchers from New York University found that certain bacteria from the mouth may be related to preterm delivery and low birthweight according to a study in the Journal of Periodontology. Previously it was reported that periodontal disease may be a factor in the occurrence of preterm low birthweight babies. Now it is believed that bacteria commonly found in dental plaque biofilms may also be related. Researchers evaluated bacterial levels in the saliva of 297 women in their third trimester of pregnancy. They found that a high salivary level of the bacteria called Actinomyces naeslundii Genospecies2 (A. naeslundii gsp2) is associated with low birthweight and preterm delivery, while higher levels of the bacteria Lactobacillus casei (L. casei) during pregnancy positively affected the birthweight. To view an abstract or learn more visit www.perio.org

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Oral Health Problems Aloe vera: Natural, home remedy treats canker and cold sores

 New reports prove that the aloe vera plant, which has been used to heal skin for more than 2,000 years, can also treat many oral health problems including canker sores, cold sores, herpes simplex viruses, lichen planus and gingivitis. There is good evidence to support using aloe vera for oral health problems because it is alsoan  inexpensive alternative.

Aloe vera accelerates healing and reduces pain associated with canker sores, which are blisters on the lips or mouth. Aloe vera does not have a bad taste or sting when applied. Patients can drank 2.0 ounces of aloe vera juice daily and apply topical aloe vera lip balm. The oral lesions may clear up in four weeks and complete success can be achieved. Thus Aloe vera can be taken both as the aloe vera juice and aloe vera gel. Those interested in using aloe vera for oral health problems are encouraged to speak with a dentist for proper treatment techniques.

Treatment and use of aloe vera plants
  • Aloe vera plants are available at most plant stores and nurseries.
  • Place near a window.
  • Water when the soil is dry.
  • Do not over water.
  • To get the gel out of the plant, use scissors to snip off an inch of the leaf.
  • Squeeze the leaf that was snipped off. The gel will squeeze out.

    January/February issue of General Dentistry, Richard L. Wynn, PhD, the Academy of General Dentistry's (AGD)

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    March 2005

    Cranberries May Help Oral Health cited Dimensions of DH March 2005

    In a study funded by the Cranberry Institute found that cranberry juice may prevent Streptococcus mutans from adhering to the teeth. According to a Medical News Today report, Koo performed an in vitro study where
    cranberry juice was ingested twice per day. The results showed the juice reduced bacteria adhesion by 67% to 85%. The National Center for Complementary and Alternative Medicine is funding additionalresearch,

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    Warning:

    Patients who have been receiving IV bisphosphonates should avoid having teeth pulled at all costs

    Over a three-year period, the jaws of dozens of patients who had undergone oral surgery at his hospital had failed to heal properly. Part of the jawbone had died and become exposed."We never saw this before in the jaw" except in patients who had received radiation therapy to that part of the face.

    Further investigation revealed one common thread: All of the patients had been treated with at least one of a class of drugs called bisphosphonates. Most were cancer patients who had received the intravenous bisphosphonates Zometa or Aredia or both for excessive calcium in their blood or bone tumors.But about 10% were osteoporosis patients who had taken an oral bisphosphonate, mainly Fosamax.

    Ruggiero co-wrote a report on 63 patients with osteonecrosis - or bone death - of the jaw in the Journal of Oral and Maxillofacial Surgery. Six had taken Fosamax, and a seventh had taken Actonel, another oral bisphosphonate for osteoporosis. The problem doesn't appear to be as severe with oral bisphosphonates as it is with the IV drugs. Patients who have been receiving IV bisphosphonates should avoid having teeth pulled "at all costs," Based on his cases, a Food and Drug Administration (news - web sites) Web site suggests that osteonecrosis of the jaw (ONJ) is a risk of all bisphosphonates, not just the IV drugs.

    Bisphosphonates remain in bone indefinitely. Ruggiero speculates that their long-term use could upset the delicate balance between cells that put calcium in bone and cells that take calcium away. The FDA (news - web sites) review concluded that all bisphosphonate labels should mention osteonecrosis.

    Rugierro says he has now seen a total of 12 or 13 cases of ONJ in patients treated with an oral bisphosphonate. Robert Marx, chairman of the division of oral and maxillofacial surgery at Florida's University of Miami, says he's aware of at least 40 or 50 cases of ONJ nationwide in patients who had taken Fosamax.That's a infinitely small fraction of the approximately 3 million women in the USA who are taking the drug, although most experts agree that only 1% to 10% of adverse events linked to drugs are reported

    3/05 USA Today

    Expert Panel Recommendation for the Prevention, Diagnosis and Treatment of Osteonecrosis of the Jaw.

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    Las Vegas casino workers can now take a break to receive a complete dental hygiene appointment as reported in the Review-Journal. Casino Direct operates three mobile dental vans outfitted with state of the art equipment offering complete dental care. The vans travel to casino parking lots providing dental care to workers. The Casino Direct accepts most of the area's insurance plans. .

    Dimensions of DH February 2005

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    Forget the Breath Mints, Eat Yogurt Instead

     - New study findings suggest that yogurt may be another weapon in the battle against bad breath.

    "Yogurt intake may improve oral hygiene, namely tongue-coating bacteria and halitosis," study author Dr. Kenichi Hojo of Tsurumi University in Yokohama, Japan told Reuters Health.

    He and his colleagues found that study participants who consumed 90 grams of yogurt twice a day for six weeks tended to have lower levels of hydrogen sulfide and other volatile sulfide compounds that contribute to bad breath.

    Other studies have found that yogurt plays a role in the prevention and management of bowel disease and other gastrointestinal conditions. Furthermore, another study showed that people who eat yogurt regularly may have a lower risk of cavities.

    The participants then consumed sugar-free yogurt fermented with streptococci and lactobacilli twice daily -- between breakfast and lunch and between lunch and dinner -- for six weeks. Afterwards, the investigators analyzed samples collected from the study participants' saliva and tongue.

    They found that most (80 percent) of the study participants identified as having halitosis had lower levels of volatile sulfide compounds after eating yogurt every day compared with the earlier two-week period when they did not eat any yogurt.


    These study participants also had significantly less plaque and gingivitis as a result of their eating yogurt,

    These findings suggest that yogurt intake may reduce the components leading to halitosis and harmful bacteria.

    Charnicia E. Huggins  (Reuters Health)

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    Type 2 Diabetes and Gum Disease Increases Risk of Death by Three Times

    A recent study suggest people with type 2 diabetes should be be certain they are taking excellent car of their teeth and gums.  According to a study published in the journal Diabetes Care on the effects of periodontal disease on mortality, people with severe periodontal disease had more than THREE TIMES the risk of dying of cardiac or renal disease. Johns Hopkins Medical Letter Vol. 17, Issue 2 pg 1 April 2005

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    "Bleachorexis" overwhitening their teeth

    ABC news reports that more people are using tooth bleaching – from over the counter products – to dentist prescribed take home kits– to in-office light activated whitening – to pursue a perfectly white smile. As with many cosmetic trends, some “whitening junkies” are aiming for an unnaturally white shade by overusing the products. Excessive use of bleaching products can damage tooth structure and gums. Some overly enthusiastic patients experience tooth sensitivity, blisters and discoloration on teeth and gums.
    Practice Smart® Newsletter    March 2005

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    Brushing with Bugs
     
    It sounds like a gross-out stunt from "Fear Factor." But putting these bugs in your mouth might just end tooth decay.

    SCRIPT: audio
    In a couple weeks, an innovative approach to cavity prevention will be tried for the first time. Volunteers will allow an engineered strain of Streptococcus mutans to be rubbed onto their teeth. J.D. Hillman, a bioengineer at Oregenics Inc., says these bugs use a natural antibiotic to permanently evict their lactic acid-producing relatives that normally live in your mouth. Then they take up residence. Lactic acid is what eats away at your teeth to cause decay, and Hillman says his bacterial hit men don't produce it. It may mean no more cavities, but you'll still have to brush your teeth to prevent gum disease and bad breath. With the National Academy of Engineering, Randy Atkins, WTOP Radio.
     
    bulletBackground on the special S. mutans
    bulletHow do cavities form?
    bulletChemistry of sugar, lactic acid, and tooth decay

    Resource: http://www.nae.edu/nae/pubundcom.nsf/weblinks/CGOZ-5SZQNG?OpenDocument

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    Musical Toothbrush Tiny microchip plays tunes while children brush
    A musical toothbrush intended to keep kids brushing for the recommended two minutes will hit stores in September, transmitting the '60s pop hit "Do You Believe in Magic?" through their jawbones directly to their inner ears. Toy maker Hasbro Inc. said Friday the battery-operated Tooth Tunes contains a tiny microchip that stores the song. Someone standing nearby would hear only a hum. The song plays for two minutes, the amount of time dentists recommend
    people spend brushing their teeth. Hasbro said the toothbrush will sell for under $10
     Copyright 2005 The Associated Press.
    http://www.msnbc.msn.com/id/7031709/

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     COMPUTERIZED TOOTH DEVELOPED FOR CHRONIC DRY MOUTH SUFFERERS

     Think of it as a pacemaker to moisten your mouth. Israeli dentists have invented a computerized tooth they say could alleviate the suffering of millions of people worldwide who have lost the ability to salivate because of autoimmune diseases and diabetes, or as a side-effect of cancer treatments.
    The Saliwell Crown, an experimental device by dentists at Assuta Medical Centre  in Tel Aviv, is shaped like a regular filling and screws to fit into a normal dental implant where it releases an electrical current to stimulate nerves in the mouth into secreting saliva. It's made of durable plastic stuffed with two miniature watch batteries, a wetness sensor, four electrodes, a microcomputer that calculates how much electrical charge to deliver and a diode communicating with a hand-held remote control unit. As many as 80 million people worldwide suffer chronic dry mouth. Once saliva production stops, patients find it hard to swallow and taste food and their speech becomes garbled. Using their remote-controlled tooth,patients dial the intensity of saliva up or down at will, or they can pre-program the crown. The high-tech tooth is to be tested on patients at hospitals in Berlin, Madrid and Naples as part of a clinical trial
    this springand it could become available commercially the following year.
    CanWest News Service

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    A less painful way to repair cavities?
    Japanese researchers develop synthetic paste for teeth

    Researchers in Japan have developed a new synthetic tooth enamel that can repair early tooth decay without the need for drillings and fillings.

    The crystalline white paste can reconstruct enamel without removing the decayed area. It repairs small cavities and helps prevent new ones.

    "We have shown that our synthetic material can reconstruct enamel without prior excavation,” Kazue Yamagishi, of the FAP Dental Institute in Tokyo, said in a report in the science journal Nature. The scientists tested the new paste on early decay in a lower premolar tooth. After examining the tooth with an electron microscope they found the paste integrated with the tooth’s natural enamel.


    But the researchers warned the paste should not come into contact with the gums because it could cause inflammation due to its high concentration of hydrogen peroxide.
     

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    February 2005

    Creighton Researcher Says Milk is the most reliable source of calcium

    A new study published today in Nutrition Today1 finds naturally calcium-rich milk is the most reliable source of this bone-building nutrient, superior to calcium-fortified soy and rice beverages and many orange juice brands. The study reveals that much of the calcium settles to the bottom of fortified soy and rice beverage containers, even after vigorous shaking. Researchers say that simply adding calcium to beverages does not make them nutritional substitutes for milk.  In addition to calcium, milk provides protein, phosphorus, vitamins A and D, and many other nutrients. 

    The calcium that you'll find added to many soy beverages will have settled to the bottom of the container. Hand shaking wasn't enough; we found that really vigorous shaking, such as with a hardware store paint shaker, would have been needed to suspend the calcium in these beverages so you can put them in the glass and drink them." 

    This study shows that the nutrition label for milk is accurate for calcium in that the amount listed on the label is same as what is actually in a glass of milk.  With 85 percent of shoppers looking at the Nutrition Facts Label when choosing which foods to buy, and almost eight out of ten Americans not meeting their calcium requirements/
    In this study, milk scored higher than all four soy or rice beverages, and eight of 10 orange juice products.  Scores comparing calcium liquid suspension for two of the orange juice products were nearly the same as milk.  Due to the inconsistent quality of calcium-fortification in soy/ rice beverages and orange juice brands, the researchers concluded milk is the most reliable calcium source.

    Recently, the 2005 Dietary Guidelines for Americans recommended 3 servings a day of calcium-rich milk and dairy foods, such as cheese and yogurt. For more information on the nutritional benefits of dairy foods, visit www.nationaldairycouncil.orOmaha, Neb., February 14, 2005

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    Periodontitis as risk factor for acute myocardial infarction. A case control study of Spanish adults

    A study was conducted of 149 Spanish patients aged between 40 and 75 years. Males, older patients, smokers, and
    those with hypertension, diabetes or hypercholesterolemia, showed an increased risk of acute myocardial infarction.  The association between periodontitis and acute myocardial infarction was high There is evidence of an association between periodontitis and acute myocardial infarction after adjusting for well-known risk factors for acute myocardial infarction.

    Journal of Periodontal Research  Volume 40 Issue 1 Page 36  -February 2005 A. Cueto, F. Mesa, M. Bravo, R. Ocaña-Riola

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    Impact of modified acidic soft drinks on enamel erosion

    From each of 144 bovine incisors one enamel sample was prepared. Labial surfaces of the samples were ground flat, polished and covered with adhesive tape, leaving an exposed area. The samples were distributed among four  groups for treatment with A: Coca-Cola, B: Sprite; C: Sprite light, D: orange juice. Either 1.0 mmol l1 calcium (Ca) or a combination (comb.) of 0.5 mmol l1 calcium plus 0.5 mmol l1 phosphate plus 0.031 mmol l1 fluoride was added to
    the beverages. Samples of each group were subdivided into three subgroups (-original; -Ca and -comb.) for treatment with original and modified drinks. Surface loss of the specimens was determined using profilometry after test procedure.In all subgroups, loss of enamel was observed. The enamel loss recorded for the samples rinsed with original Sprite and original orange juice was significantly higher compared with all
    other solutions 
    Modification of the test soft drinks with low concentrations of calcium or a combination of calcium, phosphate and fluoride may exert a significant protective potential with respect to dental erosion.
    Impact of modified acidic soft drinks on enamel erosion
    T Attin, K Weiss, K Becker, W Buchalla, A Wiegand

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    Dental Erosion Due to Wine Consumption
    Louis Mandel

    JADA 2005; 136:71-75.

     Dental erosions can result from numerous causes,  dietary factors are the most common. Because of wine'sacidity, it may have a deleterious effect on teeth.

    Wine could be a cause of dental erosion. Early recognition negates progressive dental damage with its need for extensive dental restoration. Furthermore, wine-incited dental erosions individuals consume large volumes of wine with its significant alcohol content, medical referral for a liver assessment is indicated

    Louis Mandel
    JADA 2005; 136:71-75

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    Use of water 'softening and conditioning systems' significantly increases the risk of periodontitis:

    Results: Subjects that answered the question 'yes' to soft water use had a significantly higher risk of periodontitis.

    Conclusions: Thus, use of water 'softening and conditioning systems' significantly increased the risk for periodontitis.

    Journal of Periodontal ResearchVolume 39 Issue 6 Page 367  - December 2004
     

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    Losing Teeth Latest Meth Use Side Effect


     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," .

    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
    .When the saliva isn't flowing, the bacteria build up a lot faster,"

    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. They're rotting teeth, missing teeth, rotting way into the gums,". Lotshaw has been drug-free for more than five months, but there's nodenying what is to blame for his empty mouth.

    By MATT SEDENSKY Associated Press Writer Originally published February 5, 2005, 2:03 PM EST

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    Clean teeth campaigners to host smoochathon

     Stockholm - Sweden's state-run pharmacy chain said on Monday it would host an attempt to break the world record for the longest kiss as part of a campaign to improve dental hygiene.

    US couple Louisa Almedovar and Rich Langley have held the record for the longest smooch - 30 hours, 59 minutes and 27seconds - since December 5, 2001.

    The Swedish kissathon will take place on Valentine's Day, February 14, and will be broadcast live on the website of Apotheket. The selected couple will undergo rigorous training ahead of D-day, including following a healthy diet, brushing their teeth under medical surveillance and learning to use different types of dental floss.

    Apoteket points out that a peck on the cheek demands the use of 12 facial muscles while a French kiss sets 34 different facial muscles in action.

    During an open-mouthed kiss, two individuals on average exchange 40,000 parasites, 250 different types of bacteria, along withvarying amounts of salt, fat, protein and other organic substances.
    Since a kissing couple also burns about four calories per minute, the Swedish pair should burn at least 7 436 calories if they want to break the world record.

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    January 2005

    Instant Tea May Have Too Much Fluoride

     Instant tea may be a source of harmful levels of fluoride
    that can lead to bone pain, researchers discovered, after looking into the case of a woman who drank one to two gallons of super-strength tea every day.

    But it does make the point "all things in moderation.
    He said the study tested 10 brands of instant tea at regular-strength levels in fluoride-free water; they didn't test brewed or bottled tea. Fluoride levels ranged from 1.0 to 6.5 parts per million. The maximum level allowed in drinking water by the Environmental Protection Agencyis 4 ppm.

    Fluoride is absorbed naturally into tea plants from soil and rain water and varies from "year to year, harvest to harvest. Swallowing high levels of fluoride boosts bone density, but also makes it more brittle. It can lead to skeletal fluorosis, which causes bone pain, calcified ligaments, bone spurs, fused vertebrae and difficulty in moving joints. It's a rare condition in the United States,

    It was this rare condition  Now she drinks lemonade. Although her fluoride levels are back to normal, her bone density remains high but her pain has eased.

    Aside from pointing to the need to drink tea in moderation.
    Fluoride is added to most major cities' drinking water to help prevent tooth decay. A British analysis in 2000 of numerous fluoride studies found no increased risk of bone fractures among the elderly from adding fluoride to drinking water.

     By CHERYL WITTENAUER
    Associated Press Writer
    Originally published January 25, 2005, 9:53 PM EST

    The American Journal of Medicine: http://www.ajmselect.com/

    Washington University School of Medicine: http://medicine.wustl.edu/

    Tea Association of the United States:
    http://www.teausa.com/general/icedtea.cfm
     

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    Nail embedded in man's skull for 6 days

    A dentist found the source of the toothache Patrick Lawler was complaining about on the roof of his mouth -- a four-inch (10-centimeter) nail the construction worker had unknowingly embedded in his skull six days earlier.

    A nail gun backfired on Lawler, 23, on January 6 while working in Breckenridge. The tool sent a nail into a piece of wood nearby, but Lawler didn't realize a second nail had shot through his mouth.

    Following the accident, Lawler had what he thought was a minor toothache and blurry vision. On Wednesday, after painkillers and ice didn't ease the pain, he went to a dental office where his wife, Katerina, works.

    He was taken to a suburban Denver hospital, where he underwent a four-hour surgery. The nail had plunged 1 1/2 inches (4 centimeters) into his brain, barely missing his right eye.

    This is the second one we've seen in this hospital where the person was injured by the nail gun and didn't actually realize the nail had been imbedded in their skull. But it's a pretty rare injury.

    Despite his lack of medical insurance and hospital bills between $80,000 and $100,000.

    "The doctors said, 'If you're going to have a nail in the brain, that's the way you want it to be,"' she said. "He's the luckiest guy, ever."

    Monday, January 17, 2005 Posted: 7:48 AM EST (1248 GMT) CNN Littleton Colorda.AP
     

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    New Dietary Guidelines

    The guidelines contain 41 key recommendations, 23 of them for the general public and 18 for certain populations such as children or older adults. Here are the main messages:
    bulletTo maintain a healthy body weight, balance calories taken in with calories expended.
    bulletTo reduce the risk of chronic disease in adulthood, engage in a moderate-intensity physical activity at least 30 minutes a day for most of days of the week. More vigorous exercise for longer periods of time is better.
    bulletTo prevent gradual weight gain in adulthood, engage in about 60 minutes of moderate-to-vigorous activity on most days of the week while keeping calories constant.
    bulletTo maintain weight loss in adulthood, do 60 to 90 minutes of daily moderate-intensity physical activity while keeping calories constant.
    bulletLimit intake of saturated and trans fats, cholesterol, added sugars, salt and alcohol.
    bulletFor a 2,000-calorie diet, eat two cups of fruit and two-and-a-half cups of vegetables each day.
    bulletEat three or more ounce-equivalents of whole-grain products each day, with the rest of the recommended grains coming from enriched or whole-grain products. In general, at least half the grains should come from whole grains.
    bulletConsume three cups a day of fat-free or low-fat milk or equivalent milk products.
    bulletConsume less than 10 percent of total calories from saturated fatty acids and less than 300 milligrams a day of cholesterol. Keep trans fatty acid consumption as low as possible.
    bulletKeep total fat intake between 20 percent and 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts and vegetable oils.
    bulletEat lean, low-fat or fat-free meat, poultry, dry beans, and milk or milk products.
    bulletConsume less than 2,300 milligrams -- about one teaspoon of salt -- of sodium per day.
    bulletIncrease potassium intake with fruits and vegetables.
    bulletLimit alcoholic beverages to one drink a day if you are a woman, up to two drinks a day for men. Some individuals, including pregnant women, should not drink alcohol at all.

    More information

    The U.S. government has more on the Dietary Guidelines for Americans 2005.

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    Judge: Listerine No Replacement For Floss, Despite Claim By Ads

    POSTED: 12:52 pm EST January 7, 2005
    UPDATED: 2:26 pm EST January 7, 2005

    NEW YORK -- An advertising campaign that says the mouthwash Listerine is as
    effective as floss at fighting tooth and gum decay is false and misleading
    and poses a public health risk because it can undermine the message of
    dental professionals, a judge has ruled.


    U.S. District Judge Denny Chin said in a decision signed Thursday and made
    public Friday that he will order Pfizer, the maker of Listerine, to stop the
    advertising campaign.


    "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."

    The judge ruled 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.

    Pfizer in print ads had featured a Listerine bottle balanced equally on a
    scale opposite a floss container with the words: "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 mouthrinse be used instead of floss.

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    ASSESSMENT OF THE ALVEOLAR BONE SURROUNDING THE MANDIBULAR ANTERIOR
    TEETH OF INDIVIDUALS WEARING A TONGUE STUD

    .It is imperative to be aware of the increasing occurrence of oral piercing and its health implications such as infection, fractured teeth, damaged gingival tissue, increased salivary flow, and negative affects on speech, mastication, swallowing, and alveolar bone abnormalities surrounding the mandibular anterior teeth associated with the wearing of a tongue stud.
    The findings from this study indicated that individuals wearing a tongue stud for any length of time are at risk for development of alveolar bone abnormalities surrounding the mandibular anterior teeth.

    *Susan L. Dougherty, RDH, MS
    Weber State University presented ADHA Annual Session 2004 1.06.05

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    Jesus in an x-ray?

    Click here to find out more: Jesus Appears in a Dental X-ray

    http://www.firstcoastnews.com/news/usworld/news-article.aspx?storyid=28783

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    Fluoride Release From Varnishes
    The authors conducted a study to evaluate fluoride released from fluoride varnishes that had been applied with two
    different protocols. The authors painted exfoliated primary molar teeth either in a single application (five samples) or three times within a single week (five samples) with fluoride varnish(Duraphat). The samples were immersed in buffered calcium phosphate solution (pH 6) to simulate the oral environment; the amount of fluoride released was measured during a span of six months.

    The total release of fluoride was significantly higher in the three-application regimen  than in the single application.  Applying fluoride-release varnish three times in a single week produced greater and longer release of fluoride than did one application.

    Fluoride Release From Varnishes in Two In Vitro Protocols Jorge L. Castillo[1], Peter Milgrom[2] JADA 2004; 135:1696-1699.

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    Check out the latest dental news for 2004 at:  Dental News 2004
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