Dentist New York,NY-Dr Lawrence Spindel Health News You Can Use

 

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 Health News You Can Use

By Dr Lawrence Spindel

 

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 sponsered by www.cognitivedoctor.com   .

 

June 2008

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.

 May 2008

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"

April 2008

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

March 2008

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 the companies 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 2008

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

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.

January 2008

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 that there 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!

 December 2007

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.

 

November 2007 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 October 2007 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.                       Dentist New York                                               "Everything looks nicer when you win. The girls are prettier. The cigars taste better. The trees are greener"-Billy Martin,Former New York Yankee Manager Sunday, November 25, 2007

 

 

October 2007

 

 

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.

August 2007

It has long been reported that anger and hostility may be bad for your health.  Now a new 10 year study of Vietnam Veterans  has showed and increse in blood levels of  C3(marker for inflammation) in veterans who display increased hostiltiy and anger.  C3 is a marker that correlates to increased risk for cardiovascular disease when found in increased levels in the blood stream. (source: New York Times 8/14/2007)

 June 2007

More of the toxic chinese toothpaste has turned up in the U.S..  It is estimated that roughly 900,000 tubes has turned up in hospitals,prisons and juvenile detention centers. 

The Food and Drug Administration recommends that consumer discard all Chinese-made toothpaste, regardless of the brand. (source: New York Times)

 

The federal goverment may have begun rating the healthcare delivered by our hospitals!  For the first time in nearly two decades it has released a list of hospitals where heart patients are most likely to die.  The report was released by the Department of Health and Human Servisce after a year long study and is part of a push by federal health-care officials to beging demanding accountability form hospitals for the quality of the care they provide. 

In the past , it has been found that the worst scoring hospitals were those that treated the poorest and sickest patients.  This new report is based on a study of 5,000 hospitals, has identified 55 where patients ded far less often than the national average.  Among those hospitals is New York-Presbyterian Hospital.

A list of the hospitals can be found at www.hospitalcompare.hhsgov  

 (source New York Times)

 

 

The Food and Drug Administration has been testing tooth paste and found that some Tooth paste imported from china had toxic ethyline glycol as an ingredient. 

The New York Times reports "Agency officials said they found toothpaste containing a small amount of diethylene glycol, a sweet, syrupy poison, at a Dollar Plus retail store in Miami, sold under the brand name ShiR Fresh Mint Fluoride Paste. The F.D.A. also identified nine other brands of Chinese toothpaste that contain diethylene glycol, some with concentrations of 3 percent to 4 percent."

Consumers are advised to discard any toothpaste that they have that has been manufactrued in china!

 

 

Gum Disease, Bone Loss and Cancer of the tongue

People with gum disease and bone loss apparently are at a higher risk for developing cancer of the tongue even after adjusting for smoking status and other confounding factors.  This was the finding of a multi year study published in the May issue of The Archives of Otolaryngology.  Researchers calculated that for every millimeter of bone loss, the risk of tongue cancer increases more than five times.  The study stated that chronic infections can possibly play a role in cancer, either as a result of the micro-organisms present or as a result of inflammation which can stimulate tumor formation.(The New York Times ,Tuesday May 22, 2007-Science section)

 

 

What if medical care came with a 90-day warranty? The New York Times reports that a hospital group (Geisinger Health System)in central Pennsylvania is trying a quality control experiment; Charging a flat fee that includes 90 days of follow-up treatment.  This may incentivize the hospitals and doctors to provide better treatment and follow-up and may result in better outcomes! 

 

May 2007

The American Heart Association has just issued new guidlines for premedication of patients with heart problems.  The new guidelines reduce the number of disorders which require antibiotic premedications.  Patients with prolapsed mitral valves and heart murmers no longer require antibiotic premedication.

According to the Ada website: 

The new guidelines are aimed at patients who would have the greatest danger of a bad outcome if they developed a heart infection.

Preventive antibiotics prior to a dental procedure are advised for patients with:

1.       artificial heart valves

2.       a history of infective endocarditis

3.       certain specific, serious congenital (present from birth) heart conditions, including

o        unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits

o        a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure

o        any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device

4.       a cardiac transplant that develops a problem in a heart valve.

The new recommendations apply to many dental procedures, including teeth cleaning and extractions. Patients with congenital heart disease can have complicated circumstances. They should check with their cardiologist if there is any question at all as to the category that best fits their needs."

 May 2007

It has been reported in numerous articles that patients being treated with bisphonates are at a risk of experiencing osteonecrosis of the jaw bones. The risk is greatest for patients treated with IV doses of bisphosphonates. According to the latest ADA guidelines on the ADA's website patients taking oral bisphosphonates are only at a very small risk of developing 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.

 

 

April 2007

Treating Gum Disease May Ease Other Ailments- An article published the science section of the New York Times Tuesday March 27,2007 reported on a study published in the March issue of the New England Journal of Medicine that showed an improvment of blood flow edfficiency after treatment of patients periodontal disease.  Specifically the study measure blood vessel elasticity (one measure of blood flow efficiency)  "The study's lead author Dr. Maurizio S. Tonetti,explained in an interview that gum disease,along with other chronic inflammation,might contribute to atherosclerosis or hardening of the arteries. ...It's (periodontal disease) one of many things that can contribute.  But investing in oral health, both in terms of prevention and treatment, may not only be good for your smile and chewing, but for your overall health as well."-quote excerpted from the New York Times article.

 

 

 

 

 

 

 

 

 

Dentist New York