This is a monthly column detailing health information gathered from various sources that may be helpful to the general public. You may have already heard about some of the items mentioned, but surely some will be new to you. This page is the idea of and sponsored by www.cognitivedoctor.com .
Last year we declared July Preventive Dentistry Month in our office. We celebrated by offering new patients who had a check up, cleaning and full series of radiographs, a complimentary Oral B electric tooth brush as a gift. This year we are again extending this special offer. If you haven’t had a cleaning and a check up this year, please take advantage of our celebration!
A recent study published in the American Cancer Society Online Journal in April 2012 has found a correlation between the dental bite-wing radiographs and the liklihood of a person developing a benign brain tumor termed meningioma. The study was based on questioning those diagnosed with meningioma about their prior history of dental x-rays.
Lead author of the study, Elizabeth Claus, MD, PhD, of Yale University School of Medicine, was quoted as saying “Don’t panic – don’t stop seeing the dentist – but do look at the (ADA) guidelines and discuss them with your dentist to see if you can reduce the number of x-rays you’re getting.” A copy of the ADA Guidelines can be found posted on the web or by reading a summary of them on this website.
On a lighter note, as an avid coffee drinker I have been pleasantly surprised to read the numerous studies that seem to indicate that coffee drinking may actually be good for you! It seems to help prevent Alzheimers, diabetes and now colon cancer? The New York Times wellness blog reports ” recently a team of researchers at the National Cancer Institute followed half a million Americans over 15 years. The researchers looked in detail at their diets, habits and health, and found that people who drank four or more cups of coffee a day — regular or decaf — had a 15 percent lower risk of colon cancer compared with coffee abstainers.” Colon problems run in my family, so this is especially good news for the Spindels, who all love their java. Now if only they will find that excessive salt consumption is good for you!
Our office has declared July Preventive Dentistry Month! To celebrate we will be giving out electric toothbrushes to patients having a checkup, cleaning and full set of radiographs, throughout the month of July. Most patients do a better job when brushing with a good electric toothbrush. If you are not using one, why not schedule your checkup with us this July, and make the switch to an electric toothbrush.
Here is some news that seems counter intuitive! People may get happier as they get older! According to an article in New York Times , June 1,2010, a Gallup poll has found people get happier as they get older. The study was based on a telephone survey carried out in 2008 thatcovered more than 340,000 people nationwide, ages 18 to 85. The Times article was of the opinion that the results, published online May 17 in the Proceedings of the National Academy of Sciences, were good news for older people. ” On the global measure, people start out at age 18 feeling pretty good about themselves, and then, apparently, life begins to throw curve balls. They feel worse and worse until they hit 50. At that point, there is a sharp reversal, and people keep getting happier as they age. By the time they are 85, they are even more satisfied with themselves than they were at 18. “
According to a Reuters News article posted Sunday March 21,2010, democrats have lined up enough votes to pass a newly proposed health care bill. According to the Reuters article the bill would bill “would extend health coverage to 32 million uninsured, covering 95 percent of all Americans, and halt industry practices such as refusing insurance to people with pre-existing medical conditions.
It also would require most Americans to have insurance, give subsidies to help some pay for coverage and create state-based exchanges where the uninsured can compare and shop for plans.”
The Reuter’s article stated that “If the House approves the package of changes to the Senate bill, the Senate would take it up next week.” and that “Senate Democratic leader Harry Reid…told House Democrats he had commitments from “a good majority” of the 100-member Senate to pass the changes.”
We all know that television has gotten really bad, but did you know that it is bad for our health?The New York Times has just reported a new study whose findings were reported in the online edition of the American Heart Association that showed that television watching was bad for the people in the study and each hour of television watching led to an increased mortality rate! According to the Times article “Those who watched television four hours or more per day were 80 percent more likely to die of cardiovascular disease than those who watched two hours or less, and 46 percent more likely to die of any cause.”
Now how about a study about the health effects of reading the New York Times?
A study featured on the cover of the current issue of The American Dental Association Journal seems to indicate that some dental fillings can perform better when repaired than when replaced. The study performed at University of Florida College of Dentistry followed 88 fillings that had been classified as defective. Students treated these restorations in five possible ways: Repair (resurfacing), Resealing, Refinishing (polishing), filling replacement and no treatment.
All treatment was by dental students and after seven years the results are in! The first two groups (Repair and Resealing) had zero failures while the last two groups (filling replacement and no treatment) had almost identical failure rates (21 and 23 % respectively).
My conclusion differs slightly from the authors. The study dedinately supports the conclusion that resurfacing an other wise perfectly good filling makes sense as compared with its entire replacement. This certainly makes sense if a restoration that is well done in other respects, only has surface deterioration. How ever, I believe if a restoration is evidencing significant decay away from the margin, it should be replaced in its entirety, especially if the decay is at the gingival margin of a class II filling. It is not possible to ‘seal’ this margin without replacing an entire filling.
The relatively high rate of failure of the filling replacement group, may support an additional unmentioned conclusion, ie: that having a replacement filling done by a dental student in training has a relatively high rate of failure and is comparable with doing nothing! It would be a more interesting and possibly more valid study if the fillings were done by skillful and licensed dentists.
More good reasons to go regularly to the dentist! An article in Reuters (Friday, November 13,2009) reported on a study published in the Journal fo Neurology,Neurosurgery and Psychiatry, that found those with the highest the levels of the gum disease-causing pathogen Porphyromonas gingivalis were three times more likely to have trouble recalling a three-word sequence after a period of time.
The Reuters article also reported “Research has already established an association between poor oral health and heart disease, stroke and diabetes, as well as Alzheimer’s disease.”
The authors of the study, conducted at Columbia College of Physicians and Surgeons in New York, concluded “Although results presented here are preliminary and inconclusive, a growing body of evidence supports exploration of a possible association between poor oral health and incident dementia.”
The researchers believe that gum disease could also influence brain function through several mechanisms including causing inflammation throughout the body, a risk factor for loss of mental function.
Finally some good news about our health system. An article published by the New York Times (09/21,2009), points out that if you exclude mortality related to a prior history of smoking, our longevity patterns compare favorably with other developed countries. The article quotes Samuel H. Preston, a prominent demographer at the University of Pennsylvania, as saying ” The U.S. actually does a pretty good job of identifying and treating the major diseases,” says Dr. Preston. According to the Times article, after examining the data, he found that ” no evidence that America’s health care system is to blame for the longevity gap between it and other industrialized countries. In fact, he concludes, the American system in many ways provides superior treatment even when uninsured Americans are included in the analysis.”
He points out that although An American’s life expectancy at birth, about 78 years, is lower than in most other affluent countries, ” if deaths due to smoking were excluded, the United States would rise to the top half of the longevity rankings for developed countries.”
He also found that if you reach eighty years old in the USA your life expectancy tends to be longer than in most other developed countries. Apparently our healthcare system is doing something right, especially when caring for our elderly population!
A Recent article in the New York Times had some interesting insites about possible beneficial effects of taking aspirin. Practically all of us have heard of taking baby aspirin to help prevent strokes and heat attacks, but new evidence may indicate that taking aspirin may both protect against and even help fight certain cancers. A new study, published in The Journal of the American Medical Association, found that patients who had colorectal cancer and took aspirin survived longer. The article quoted a number of prominent physicians and researchers on the effects of aspirin.
According to the times article, there are also a number of indicators that inflammation, at least for some kinds of cancer, may increase the risk of a person developing a malignancy. Aspirin is a potent antiimflammatory medicine. “Aspirin is a drug that been with us a little over 100 years, and we continue to learn impressive and important things about its potential benefits,” said Dr. Otis Brawley, medical director of the American Cancer Society It seems like — and we’re still talking in theory in some instances here — there is a relationship between inflammation and cancer in certain tumors,” Dr. Brawley said.
The article pointed out that there are well known risks to taking aspirin including increased chance of developing GI bleeding or developing bleeding in the brain. The article pointed out that clearly there is a need for futher study on the subject to determine exactly how beneficial aspirin use is
Having Pain in your mouth and your dentist can’t find the reason? Think it might just be all in your head, you might just be right! In the June addition of the Journal of the American Dental Association there is an article entitled “Neuroplasticity and Sensitization“. It seems that ganglion, in between the source of pain and the brain, can become sensitized to the pain and can cause us to feel it even after the original stimulus has been removed. This can especially be true for chronically painful but uncorrected dental conditions. I guess if you do have a dental condition that needs treatment you have another good reason to call your dentist today!
Bad News for conspiracy theory fans, but good news for everyone else. The New York Times reported on thursday that the WHO believes that the Swine Flu Virus has occurred naturally and was not created in a laboratory somewhere. On Thursday they quoted Dr. Keiji Fukuda, the World Health Organization’s deputy director general as saying” the evidence suggests that this is a naturally occurring virus, not a laboratory-derived virus.” This was a rebuttal to a theory proposed by Adrian J. Gibbs, a retired plant virologist from the AustralianNational University. He theorized that the virus may have been grown in eggs at a vaccine laboratory because when he analyzed the virus DNA it had more of the amino acid lysine and more mutations than typical strains of swine flu. According to the Times scientists at the CDC are also skeptical about his theory.
Maybe participating in Facebook is so studid after all? A new study has shown that maintaining a network of friends as we age is good for our health. According to an New York Times Article “A 10-year Australian study found that older people with a large circle of friends were 22 percent less likely to die during the study period than those with fewer friends”. The Times article also sited a Harvard study that found ” strong social ties could promote brain health as we age. ” I guess I won’t delete my Facebook profile anytime soon.
More news on the importance of Vitamin D to our health. A study just presented at the 2009 IADR meetings in Toronto, found an association between appropriate intrauterine vitamin D levels and health cavity free teeth in infants. The study reported that “reported that mothers of children who developed cavities at an early age had significantly lower vitamin D levels during pregnancy than those whose children were cavity-free”. This News comes from Reuters News and can be found on the web at:http://www.canada.com/Health/Prenatal+vitamin+linked+kids+dental+health/1320490/story.html
One might guess if this finding may imply that drinking milk fortified with vitamin D may indeed strengthen our children’s developing teeth. A study is needed to prove if this supposition is true.
I guess our mothers were right, we should drink our milk! According to the New York Times“Vitamin D Pills May Prevent Fractures in Older Adults “. The times sited an article in the March 23 issue of the Archives of Intenal Medicine, in which researchers reviewed randomized trials including more than 65,000 subjects and found a strong dose-dependent effect for vitamin D in lowering the risk for nonvertebral fractures in the elderly.
This is cute, the FDA has embrassed “Tweeter”. You can find out about product recall through their Tweer feed. http://twitter.com/fdarecalls
According to a New York Times Op- Ed article by Michael Alderman “The New York City Department of Health and Mental Hygiene…. has embarked on a campaign to persuade the makers of processed food to reduce its salt content by more than 40 percent over the next 10 years” This measure is supposed to help us reduce our blood pressure and decrease the incidence of strokes and heart attacks.
There is no actual scientific evidence that widespread salt reduction in our diet will be actually good for us. This inititive amounts to a wide spread clinical trial that will undoubtedly yield some unintended results. I agree with Dr Aldermans conclusion that “to help people lower their risk of heart attack and stroke, health officials should concentrate on promoting the benefits of weight control (which reduces salt intake) and physical exercise.”
Good news for Java addicts! According to an article in the New York Times a twenty one year study done by Swedish researchers has found that”subjects who had reported drinking three to five cups of coffee daily were 65 percent less likely to have developed dementia compared with those who drank two cups or less”
New York City is experimenting with computerization of health records. According to the New York Times, the city is paying about a thousand physicians to enter patient notes into computers rather than paper charts. The New York Times article reports that “Experts say it is the most ambitious government effort nationwide to harness electronic data for public-health goals like monitoring disease frequency, cancerscreening and substance abuse“.
Sounds like a good idea to me. Having a database of health records could be used to improve our health care and as long as it is not misused for other purposes it is a good idea.
Google has developed a new tool to help public health experts track flu epidemics called “Google Flu Trends”. Apparently users queries on flu symptoms can be used as an early warning system for flu outbreaks. According to the New York Times “Tests of the new Web Tool from Google.org, the company’s philanthropic unit, suggest that it may be able to detect regional outbreaks of the flu a week to 10 days before they are reported by the Centers for Disease Control and Prevention” .
If you’re a dental patient who hates how long local anesthesia takes to wear off, Novalar may have some good news for you! Starting sometime in 2009 they plan on marketing a product called OraVerse to dentists. Administered by injection, OraVerse is a vasodialtor (Phentolamine Mesylate) to be used after a patient receives a local anaesthetic. The company claims that when used “patients can return to normal sensation in about half the normal time’ . Company representatives plan on offering this product to dentists for about $12/dosage.
It’s that time of the year to get your flu vaccine! According to New York City Department health Information brochure from September,”Every adult who wants to be immunized should receive and annual influenza vaccine. In July 2008 the CDC has recommended that all children aged 6 months through 18 years be vaccinated. The City Health Bulletin indicates that all health care workers should be vaccinated every year! Aside from children less that 6 months of age, almost every one is recommended to have the vaccine.
An antibody has been discovered which seems to be present in higher concentrations in people with healthy mouths without periodontal disease. The antibody is directed at a protein called HtpG. This protein is a by product of Porphyromonas gingivalis bacterium. This finding has some potential clinical significance since it has been long been apparent that some patients respond to conventional periodontal therapy better than others.
Finding markers which may identify patients at greater risk for periodontal disease or who are immunocompromised in some way, may modify our treatment protocols.
The Associated Press carried an article detailling an ‘attack’ by two congressman ( Burton and Watson) about the ADA’s failure to recommend the need for amalgam separators to be installed in dental offices to protect waste water from mercury conamination. I think it is naive to expect the American Dental Association to support this move. If the congressmen are truly interested they should sponsor legislation requiring amalgam separtors in dental offices. Currently it is required in New York City and our office has recently installed an amalgam separator to comply with our local ordinances.
I was saddened to read an article in the New York Times that reported that the New York Statelegislature had passed a measure allowing the New York State Dental Society decide to remove a local chapter from the dental society and that the State dental society had voted to oust the current New York Chapter and replace it with another one. This move disturbs me greatly.
Although I am not competent to comment on the nature of the dispute between these two component organizations of the American Dental Association, I can say that over all of my years of dental practice in New York City, I have always been able to rely on the New York County Dental Society. I have depended upon them for my medical insurance, as a source of fine continuing education, for help with obtaining affordable malpractice insurance and as a reliable a source of advice and counsel on many important matters.
They have always taken my calls and offered immediate and useful help with any question I have been able to pose to them. Additionally, every year they have been a cosponsor of the Greater New York Dental Convention. This convention makes it easy for New York Area dentists to easily update their knowledge on all the new developments in dentistry and choose from a large menu of excellent continuing education courses.
I can honestly say that I would not be the dentist I am today without the help and input of the New York County Dental Society. I have been assured by the current director of the New York County Dental Society that it will continue on and I sincerely hope that this will be the case.
It has been my observation that sometimes doctors recommend certain modes of treatment because they have invested heavily in it. Dentists can purchase dental lasers, air abrasion systems and cerec cad cam technology. All of these technologies are “cool”, but not every one needs them, nor do they necessarily provide the best results in every instance. Dentists who have purchased these items often may feel a financial pressure to use these technologies on their patients so that their investment “pays for itself”(often the sales persons words) The New York Times (Sunday, June 29,2008) wrote an interesting news article about Cardiologists investing in CT scanners which can scan hearts and search for plaques in coronary arteries. The article points out that some cardiologists feel that these scans are being overused and actually the tests carry their own risks (increased cancer risk) . The tests can save lives, but there are other tests that could be used as well. The choice of which test to use, should not be influenced by a Drs investment in the technology.
Ben Bernanke opened a daylong bipartisan symposium convened by the Senate Finance Committee. During his remarks he stated that health spending would “rise relentlessly” unless lawmakers overhauled the health care system, and he recommended an eclectic approach. According to the New York Times ” leaders of both parties predict will be a major push for health care legislation next year” and this symposium would lay the ground work for the major push by congress for this new health care legislation . -Get ready for what maybe a bumpy ride.
According to the Wall Street Journal (Thursday, May 29,2008) Consumer Reports is starting an online service to Rate Hospitals. It’s data service will cover around 3000 facilities. Although the site doesn’t have any proven methods yet to rate hospital outcomes,John Santa, the director of the ratings center is said to be on the look out for outcome measures that could be added to the site. As of today(Thursday May 29,2008), I did not find the site online, but this is potentially a very positive development for health care.
Novalar Pharmaceuticals has recently won approval from the FDA to market a drug which, when administered by the dentist, will cut the time it takes dental local anesthesia to wear off by over 50 percent. The drug is called OraVerse and will cost dentists approximately $12.50 per injection(source New York Times,Monday May 12, 2008). It works by dialating the blood vessels adjacent to an injection site , thus causing the local anaesthetic to be carried away more quickly by the body’s vascular system. I not sure this product is needed, but for patients who hate the numbness that comes with dental local anesthetic administration it may desirable.
It seems like a new ‘killer’ virus has turned up in China. The virus has been dubbed foot an mouth disease, since sufferers can have ulcers in the mouth and blisters on hands, feet and buttocks. The virus seems most deadly to small children under 6 years old. According to the New York Times, most sufferers recover in about a week, but so far there have been 22 reported fatalities. Also the Times article repoted” the World Health Organization warned that the disease, which thrives in warm weather and passes easily among children, could spread in the coming summer months”
Both Google are working on systems for online medical records. Placing our medical record online in a centralized and accessible place can improve our health care but also could , without the proper precautions could lead to potential abuse of our privacy. The New York Times cited an article recently written in the New England Journal of Medicine and pointed out that Google and Microsoft are currently “not bound by the privacy restrictions of the Health Insurance Portability and Accountability Act, or Hipaa, the main law that regulates personal data handling and patient privacy. Hipaa, enacted in 1996, did not anticipate Web-based health records systems like the ones Microsoft and Google now offer“.
The lack of current regulation about online health records does not negate the potential value of making health record available to those who may help us (doctors and researchers), but clearly more regulations and safeguards for our privacy are necessary
A new lollipop has come on the market that claims to be able to ‘fight tooth decay’. This sounds too good to be true. The lollipop was developed based on research by a professor at the UCLA Medical and Dental School, Dr. Wenyuan Shi . The candy is called Dr John’s herbel lollipop and thecompanies web site claims”One Dr. John’s Herbal Lollipop, two times per day for 10 days, disables tooth decay bacteria for 12-27 weeks. Therefore, use the lollipop dosing 20-Pack between two and four times per year, depending upon the patient’s decay history and oral hygiene condition, to maintain effectiveness” According to an article found in ScienceDaily,Feb 5,2006 “The orange-flavored, sugar-free lollipop they devised is infused with a natural ingredient found in licorice that kills the primary bacterium causing tooth decay, Streptococcus mutans.”
February is National Children’s Dental Health Month. It has been observed every February for more than 55 years. The American Dental Association (ADA) sponsors it to raise awareness among families and policymakers about the importance to children of good practices of oral health. If you are already one of our patients check out our gift certificate page!
According to the New York Times “Polling has found that health care is a top concern of Democratic voters, and that they rank covering the uninsured as more important than reducing health costs or improving quality.” Hillary Clinton has emphasized the need for universal coverage as an important issue for the country. Barak Obama also maintains that this continues to be an important issue.
According to Bloomberg News (Jan 16,2008)“A rebellion by U.K. dentists against the latest government contract has led more than 7 million Britons to avoid state-subsidized dental care in the past two years.” Furthermore the article states “Since the government changed its contract with 21,000 NHS dentists in April 2006, one in 10 dentists stopped offering state-funded services, saying the contract required them to increase their workloads while limiting their earnings”. Evidently, people in the U.K. are having more difficulty getting appointments at their public health service dentists and some are frustrated. The article went on to point out thatthere is even a trend of Brits seeking their dental care in other countries.
An article in the New York Times’ Style section(Thursday, January 10, 2008) reported on a trend for dentists to bring out their own branded cosmetic dentistry products. They mentioned three Manhttan Dentists who have developed their own whitening products. The article points out that “…without adequate comapative studies it is hard to say a dentist made whitener is more effective than,say the 51 whitening toothpastes and 14 whitening toothpastes and 14 whitening kits sold by the Duane Reade chain.” Although I do think that some of the gels that are offered through dental offices are somewhat better than over the counter products, it is not clear that all dentist developed products are worthwhile!
Scientists at University of Pittsburgh may have developed a non invasive dye that may help detect early alzheimer’s disease. Patients with alzheimer’s disease have build ups in their brains of amyloid protein. PIB is a new dye that can be used in conjunction with PET scans to find deposits of amyloid in the brains of live human beings. Currently this dye is being used to test the efficacy of anti alzheimers drugs, but eventually it may be of use in the early detection and treatment of alzheimers disease.
New research shows that the flu is best transmitted in relatively cold dry weather(temperature about 41 degrees F).A New York Times article (December 5,2007) quotes Dr Peter Palese-Chairman of the Department of Microbiology at Mount Sinai Medical School and a Dr who did flu research with guinea pigs” Flu viruses are more stable in cold air, and low humidity also helps the virus particles remain in the air. That is because the viruses float in the air in little respiratory droplets. When the air is humid, those droplets pick up water, grow larger and fall to the ground.” The conclusion was we are most likely to get the Flu out side on the way to work and not inside where it is warm. Also the Flu virus doesn’t do well in warm humid environments. There is no Flu in the tropics.
According to the Times article Dr. Palese does not suggest staying in a greenhouse all winter to avoid the flu. The best strategy, he says, is a flu shot.
According to article in the New York Times (November 29,2007), Americans,who are being X-rayed at a higher rate than ever,maybe getting exposed to a greater cancer risk. F’urther more, an article published in the New England Journal of Medicine, maintains that the greater use of Cat Scans may in part be responsible and over time it may lead to an increase in radiation enduced cancers. Eric Hall, a co-author of the report was quoted as saying “we are very concerned about the built-up public health risk over a long period of time”
Starting next year British Doctors making the rounds in hospitals will no longer be tied by ties. Doctors ties have been found to harbour infectious bacteria and ties are not regularly laundered so they may help spread nosocomial infections. “British hospitals are banning neckties, long sleeves and jewelry for doctors and their traditional white coats in an effort to stop the spread of deadly hospital-borne infections, according to new rules Associated Press . It is hoped that this may help limit the spread of MRSA.
Walking fast may be good for you. Studies of older adults are reporting that those who walk faster live longer. The New York Times reports( 11/20/07)that ” Researchers who followed the health of nearly 500 older people for almost a decade found that those who walked more quickly were less likely to die over the course of the study.”
Also It has been reported that elderly who improve the speed of their walking , improve the odds of living longer. This study was published in the Journal of Geriatrics Society
The three main Democratic presidential candidates have all proposed offering private health insurance to uninsured americans. According to the New York Times (October 20, 2007)They all have proposed the same thing; that we “adapt the health care program that covers Congress and offer it to the 47 million Americans currently without insurance.”
Hillary Rodham Clinton has stated that “The American people should have access to the same array of health care choices and benefits as the senators and representatives they elect.”
The times article quotes health policy experts as saying that “there is nothing about it that would help address what they see as an underlying reason for the growing numbers of uninsured: the nation’s runaway medical costs. And without major changes, they say, the model would be sharply limited in achieving the goal of universal coverage for all Americans.”
An article published recently by Reuters reports that” A survey of 5,200 patients showed that some six percent of patients have begun doing a spot of home dentistry, a quarter had chosen to pay a private dentist and that 10 percent of patients had no dentist at all because they could not find one on the National Health Service (NHS).”
The article went on to say this trend may be an indication of British patients inabiltiy to find a good public health dentist nearby who will see them.
More News over the trend to rate healthcare quality: Presidential Candidate John McCain has unvailed his healthcare initiative and it includes” new incentives for both patients and doctors to emphasize prevention and wellness, while moving toward compensating medical providers based on the quality of their work.” (NYTimes Octover 11,2007) His plan includes a proposal to somehow link payments to doctors in part on their performance.
osteonecrosis of the jaw. The brand name of some of these popularly prescribed drugs are: Actonel ,Boniva, Fosamax, Fosamaz Plus D, Skelid and Didonel.
Clearly if you are taking this class of medications you should discuss it with your dentist.