Friday, February 27, 2009

Top 5 Most Annoying Dental Patient Behaviors

Dentists Dish On What Drives Them Crazy While They Work...

30,000+ Dentists Converge in Chicago February 27-March 1

CHICAGO, Feb. 24 /PRNewswire-USNewswire/ -- The following is being issued by the Chicago Dental Society:

Who: The Chicago Dental Society (CDS) recently polled more than 300 members to find out some wacky, unusual, and just plain distracting behaviors they've encountered while patients are in their chair.

As we countdown to CDS's annual Midwinter Meeting, one of the largest displays of dental products in North America, here are the most annoying patient behaviors, according to those surveyed. Give your dentist a break and avoid these activities if possible.

5) Public displays of affection. Your breath may be minty fresh after a cleaning, but don't test it on your significant other until after you leave the dental office.

4) Playing games on your handheld. A few dentists reported getting knocked upside the head during an exam while their patients tried to continue playing their games at arms-length. Really, Tetris can wait.

3) Reading a book or magazine while the dentist is trying to perform an exam. You'll have to relinquish that People magazine or John Grisham novel so your dentist can get a look at your teeth.

2) Grooming. The light in the dental chair might be just right for touching up makeup or - heaven help us - plucking your eyebrows, but dentists really would prefer you save those activities for the bathroom.

And the most annoying thing patients do while in the dentists' chair?

Answering cell phone!

Why: Data was collected for the Chicago Dental Society's 144th annual Midwinter Meeting, which begins at McCormick Place in Chicago on February 26, 2009. The exhibit floor opens on February 27.

Thursday, February 26, 2009

The Truth About Whitening

I get many inquiries from patients regarding in office whitening techniques such as so called laser whitening and Zoom. Studies show that the light or laser has absolutely no beneficial effect upon the results of teeth whitening. In other words the chemical applied to the teeth does the work, not the light.

The active ingredient in virtually all teeth whitening products is either hydrogen peroxide or carbamide peroxide, which releases hydrogen peroxide in the mouth. There is no science behind the light.

I have tried several in office whitening systems, and the results have been inferior to the take home systems.

Dentists who offer in office whitening often charge hundreds of dollars more than we charge for the take home whitening because the patient is taking up valuable chair and staff time. The teeth look whiter when the patient leaves the office because the treatment dehydrates the teeth, but they revert back to the original shade after a few hours. Many offices still give the patient a take home bleaching tray to "touch up" or finish the job.

So, if you are willing to pay more in the pursuit of instant gratification for a result that at best is equivalent to or at worst is inferior to take home whitening, then go for it.

Tuesday, February 24, 2009

Periodontitis And Myocardial Infarction: A Shared Genetic Predisposition

http://www.sciencedaily.com/releases/2009/02/090213115011.htm

ScienceDaily (Feb. 24, 2009) — A mutual epidemiological relationship between aggressive periodontitis and myocardial infarction has already been shown in the past. Scientists at the universities of Kiel, Dresden, Amsterdam and Bonn have now presented the first evidence of a shared genetic variant on chromosome 9, which maps to a genetic region that codes for the "antisense RNA" Anril, as reported in the latest edition of the specialist journal PLoS Genetics.

The first author, Dr Arne Schaefer from the Institute for Clinical Molecular Biology at Kiel University, sees clear similarities in the genetic predisposition: "We have examined the aggressive form of periodontitis, the most extreme form of periodontitis which is characterized by a very early age of onset. The genetic variation associated with this clinical picture is identical to that of patients who suffer from cardiovascular disease and have already had a myocardial infarction."

Because it has to be assumed that there is a causal connection between periodontitis and myocardial infarction, periodontitis should be taken seriously by dentists and diagnosed and treated at an early stage. "Aggressive periodontitis has shown itself to be associated not only with the same risk factors such as smoking, but it shares, at least in parts, the same genetic predisposition with an illness that is the leading cause of death worldwide.," warned Schaefer. Knowledge of the risk of heart attacks could also induce patients with periodontitis to keep the risk factors in check and take preventive measures.

Besides Arne Schaefer, Gesa Richter, who is doing a doctorate on the subject, is also part of Professor Stefan Schreiber's working group from the Institute for Clinical Molecular Biology at Schleswig Holstein University Hospital (UK S-H), Kiel Campus. As cardiologist, Dr Nour Eddine El Mokhtari from the Kiel Heart Centre is an important partner in the group. Dental expertise came from Dr Birte Größner-Schreiber from the Hospital for Conservative Dentistry and Periodontology at the UK S-H, Dr Barbara Noack, Technische Universität Dresden, as well as Professor Søren Jepsen from Bonn University and Professor Bruno Loos, Free University Amsterdam.

Wednesday, February 18, 2009

Mountain Dew Mouth

Dentists have known for a long time how chronic consumption of soft drinks, Mountain Dew in particular, can ravage tooth enamel. I have seen the devastating effects in my own practice. Now PepsiCo, the manufacturer of Mountain Dew, has agreed to support a dentist’s efforts in rehabilitating kids suffering from “Mountain Dew Mouth” in rural Appalachia. The story was featured on the ABC TV series 20/20. Click the link below or copy and paste it to your browser to watch a video of the 20/20 report.

http://www.abcnews.go.com/Health/story?id=6899312&page=1

Tuesday, February 3, 2009

Your Mouth and Heart Disease

ScienceDaily (Dec. 7, 2008) — Individuals 
reporting a history of periodontal disease 
were more likely to have increased levels of 
inflammation, a risk factor for heart 
disease, compared to those who reported no 
history of periodontal disease, according to 
an American Journal of Cardiology report 
available online. 
 
Led by investigators from Columbia University 
Medical Center and NewYork-Presbyterian 
Hospital, the findings suggest persons with 
increased levels of inflammatory markers 
associated with a higher risk of 
cardiovascular disease might be identified by 
asking about oral health history. This group 
might not be detected by traditional 
cardiovascular risk screening. 
 
Inflammation has been associated with 
cardiovascular disease and has been suggested 
to be a potential link between periodontal 
disease and cardiovascular disease. To 
examine whether oral health history and 
inflammatory markers associated with 
cardiovascular disease were linked, the 
investigators followed participants in the 
National Heart, Lung and Blood Institute 
(NHLBI) Family Intervention Trial for Heart 
Health (F.I.T. Heart), an ongoing national 
trial led by principal investigator Lori 
Mosca, M.D., M.P.H., Ph.D., professor of 
medicine at Columbia University College of 
Physicians and Surgeons and director of 
preventive cardiology at NewYork-Presbyterian 
Hospital/Columbia University Medical Center. 
 
The NHLBI Family Intervention Trial for Heart 
Health aims to study family members of 
patients hospitalized with heart disease 
because they may be at increased risk 
themselves due to shared genetic and/or 
lifestyle factors. Dr. Mosca and her research 
team recruited family members or co-habitants 
of patients hospitalized for such cardiac 
events as a heart attack or narrowed arteries 
that required bypass surgery or an 
angioplasty procedure. Previous research has 
shown that family members of cardiovascular 
disease patients may be at increased risk for 
the disease due to the genes and lifestyle 
habits they share. 
 
In this study, 421 individuals who were blood 
related to and/or living with a person 
recently hospitalized due to cardiovascular 
disease were screened for traditional 
cardiovascular risk factors (such as elevated 
blood pressure and abnormal cholesterol 
levels), inflammatory markers associated with 
disease risk (high-sensitivity c-reactive 
protein (hsCRP) and lipoprotein-associated 
phospholipase A2 (Lp-PLA2)). They were also 
asked standardized questions about their oral 
health status, including whether they had 
ever been diagnosed with periodontal (gum) 
disease, whether they had ever been treated 
for periodontal disease, whether they used 
partial or complete removable dentures, and 
the date of their last teeth cleaning. The 
oral health history was then correlated with 
standard markers of inflammation. 
 
Results found that among participants who did 
not have traditional cardiovascular disease 
risk factors (such as high blood pressure, 
high cholesterol, and overweight/obese 
status), almost one in four were found to 
have a personal history of periodontal 
disease and higher levels of Lp-PLA2, an 
inflammatory marker which has been found 
present in inflamed rupture prone plaque in 
heart arteries/valves. 
 
It is important to note that it is not 
possible to determine from this study that 
poor oral health causes cardiovascular 
disease risk or that any therapy based on 
oral health status would be effective in 
preventing cardiovascular disease. However, 
Dr. Mosca says, "Our finding is novel because 
it suggests the dentist and oral health exam 
may be the latest weapon in identifying 
persons at risk of cardiovascular disease, 
our nation's number one killer." 
 
"Many people don't realize how oral health is 
often a predictor of one's overall health," 
says co-author John T. Grbic, DMD, MS, MMSc, 
professor of clinical dental medicine at the 
Columbia University College of Dental 
Medicine. "Symptoms for many life-threatening 
illnesses, such as diabetes and heart 
disease, first appear in the mouth. For this 
reason, it's vitally important for people to 
have routine dental check-ups and have an 
ongoing dialogue with their dentist about 
their oral health. Patients may also benefit 
from seeing dentists affiliated with an 
academic medical center, where they are 
tapped into deep referral networks to 
appropriate clinicians." 
 
 

The Mouth - Body Connection

ScienceDaily (Sep. 11, 2008) — Heart disease is the leading cause of death worldwide. However, many people with cardiovascular disease have none of the common risk factors such as smoking, obesity and high cholesterol. Now, researchers have discovered a new link between gum disease and heart disease that may help find ways to save lives, scientists heard September 9, 2008 at the Society for General Microbiology's Autumn meeting being held at Trinity College, Dublin.

In recent years chronic infections have been associated with a disease that causes "furring" of the arteries, called atherosclerosis, which is the main cause of heart attacks. Gum disease is one of the most common infections of humans and there are now over 50 studies linking gum disease with heart disease and stroke.

"A number of theories have been put forward to explain the link between oral infection and heart disease," said Professor Greg Seymour from the University of Otago Dunedin, New Zealand. "One of these is that certain proteins from bacteria initiate atherosclerosis and help it progress. We wanted to see if this is the case, so we looked at the role of heat shock proteins."

Heat shock proteins are produced by bacteria as well as animals and plants. They are produced after cells are exposed to different kinds of stress conditions, such as inflammation, toxins, starvation and oxygen and water deprivation. Because of this, heat shock proteins are also referred to as stress proteins. They can work as chaperone molecules, stabilising other proteins, helping to fold them and transport them across cell membranes. Some also bind to foreign antigens and present them to immune cells.

Because heat shock proteins are produced by humans as well as bacteria, the immune system may not be able to differentiate between those from the body and those from invading pathogens. This can lead the immune system to launch an attack on its own proteins. "When this happens, white blood cells can build up in the tissues of the arteries, causing atherosclerosis," said Professor Seymour.

"We found white blood cells called T cells in the lesions of arteries in patients affected by atherosclerosis. These T cells were able to bind to host heat shock proteins as well as those from bacteria that cause gum disease. This suggests that the similarity between the proteins could be the link between oral infection and atherosclerosis," said Professor Seymour.

This molecular mimicry means that when the immune system reacts to oral infection, it also attacks host proteins, causing arterial disease. These findings could fundamentally change health policy, highlighting the importance of adult oral health to overall health and wellbeing: control of gum disease should be essential in reducing the risk of heart disease.

"This is a significant step towards a more complete understanding of heart disease and improving treatment and preventive therapies," said Professor Seymour. "An understanding of all the possible risk factors could help lower the risk of developing heart disease and lead to a significant change in disea
se burden."