HIV/AIDS; McGill University publishes research in HIV/AIDS
5 January 2009
AIDS Weekly
"Objective measures of dental diseases reflect only their clinical end-point. There is a need to use multidimensional measures of diseases that consider their psychosocial aspects and functional impact," researchers in Montreal, Canada report.
"The aim of this study is to compare the oral health-related quality of life (OHRQOL) between a group of HIV-infected women and a similar group of at-risk HIV-uninfected women, and to investigate the role of potential confounding clinical oral health and behavioral factors. Our sample included HIV-infected women (87%) and women at risk for HIV infection (13%) followed up for 5.5 years. OHRQOL was measured using the short version of the Oral Health Impact Profile (OHIP-14), which is a validated and reliable instrument. HIV-infected women averaged 10% poorer OHRQOL than HIV-uninfected women; this difference was not apparent after adjusting for the number of study visits attended and significant behavioral and clinical oral health factors. The OHRQOL was inversely related to dental and periodontal diseases and to smoking and freebase cocaine use; these relationships were not confounded by HIV status," wrote S. Li and colleagues, McGill University.
The researchers concluded: "The study identified specific clinical and behavioral factors where dental professionals can intervene to possibly improve the OHRQOL of HIV-infected or at-risk HIV-uninfected women."
Li and colleagues published their study in Community Dentistry and Oral Epidemiology (Oral health-related quality of life among HIV-infected and at-risk women. Community Dentistry and Oral Epidemiology, 2008;36(6):542-548).
For additional information, contact P.J. Allison, McGill University, Faculty Dental, 3640 University St., Montreal, PQ H3A 2B2, Canada.
Publisher contact information for the journal Community Dentistry and Oral Epidemiology is: Blackwell Publishing, 9600 Garsington Rd., Oxford OX4 2DQ, Oxon, England.
Friday, January 30, 2009
New study on pregnancy and periodontal disease
Health Reporter
BY SHERYL UBELACKER
29 January 2009
The Canadian Press
There's an old saying that mothers "lose a tooth for every baby." While the tooth-loss bit may be merely folklore, it's true that pregnancy can affect a woman's oral health, including exacerbating existing gum disease.
But contrary to another long-held suspicion, a major new study has found that treating pregnant women for periodontal disease does not lower their risk of premature birth or other fetal complications.
"Numerous studies have shown an association between periodontal disease in pregnant women and adverse pregnancy outcomes, which include premature deliveries, obstetric complications like pre-eclampsia and fetal growth restriction," said Dr. Steven Offenbacher, a professor of periodontal medicine at the University of North Carolina and principal investigator of the study.
"And in particular, mothers who showed disease progression during pregnancy - and about one in four mothers get quite a bit worse during pregnancy - are seen to be at the highest risk," he said Thursday from Chapel Hill, N.C.
Gum, or periodontal, disease is caused by a bacterial infection that attacks the teeth-supporting tissues below the gum line. Left untreated, it can lead to the loss of teeth and underlying bone. Standard treatment involves scaling and root planing to remove bacteria-induced deposits (calculus and plaque) from the surfaces of teeth.
The study of 1,800 pregnant women with periodontal disease, the largest of its type ever conducted, assigned half of participants to have treatment before 23 weeks' gestation, while the remainder had no treatment.
"We found that mothers who had a scaling and root planing to treat their periodontal disease did not have reduced risk of pre-term delivery," Offenbacher said. "This would suggest that scaling and root planing, although it may improve the periodontal health of the mothers, has no effect on pregnancy outcome. Dead stop."
The study, conducted at the University or North Carolina and three other U.S. academic centres, also found that treatment in many of the mothers-to-be did not arrest progression of their gum disease.
"In the untreated mothers, 40 per cent got significantly worse," Offenbacher said. "And in the treated group, 30 per cent of them got significantly worse. I think at this point we don't really know the best way to treat periodontal disease in pregnant women, because we're still having a lot of disease progression."
However, that doesn't mean that pregnant women with gum disease should put off having their teeth and gums checked, and having treatment as needed, said co-author Dr. Amy Murtha, director of obstetrics research at Duke University Medical Center in Durham, N.C.
"Our study emphasizes that treating periodontal disease during pregnancy is safe, but that standard periodontal care is not enough," Murtha, who presented the findings Thursday at the annual meeting of the Society for Maternal-Fetal Medicine in San Diego, said in a release.
It's possible, the researchers suggest, that pregnant women may need more aggressive treatment for gum disease, beyond the standard care provided in the study, to bring down the rate of premature delivery.
Murtha said much remains unknown about the link between gum disease and the increased risk for pre-term birth and low-weight babies. "Periodontal disease and poor pregnancy outcomes travel together, but we don't know why."
Offenbacher said changes in hormone levels and a somewhat lowered immune response may allow oral bacteria to flourish and exaggerate the body's inflammatory response. But he said more studies are needed to fully explain the connection.
Commenting on the U.S. study, Dr. Benoit Soucy of the Canadian Dental Association said the findings are not surprising because the association between pregnancy and gum disease is "a very, very complex issue."
"The reason they're not surprising to us is that there is no mechanism that has been identified to link periodontal disease to premature birth or small birth weight," Soucy, the association's director of clinical scientific affairs, said from Ottawa. "There could be there is an underlying process that is masked by other factors, and that is very likely because periodontal disease is extremely common. According to the best numbers that we have ... there would be as much as 70 per cent of the population that is affected by periodontal disease at one time or another."
Any woman who is considering getting pregnant should have a dental exam and regular monitoring during pregnancy because of the bumped-up risk for either developing gum problems or making existing disease even worse, he said. "There is no good general health if your mouth is not healthy. It is very important no matter what to keep your mouth in good health."
BY SHERYL UBELACKER
29 January 2009
The Canadian Press
There's an old saying that mothers "lose a tooth for every baby." While the tooth-loss bit may be merely folklore, it's true that pregnancy can affect a woman's oral health, including exacerbating existing gum disease.
But contrary to another long-held suspicion, a major new study has found that treating pregnant women for periodontal disease does not lower their risk of premature birth or other fetal complications.
"Numerous studies have shown an association between periodontal disease in pregnant women and adverse pregnancy outcomes, which include premature deliveries, obstetric complications like pre-eclampsia and fetal growth restriction," said Dr. Steven Offenbacher, a professor of periodontal medicine at the University of North Carolina and principal investigator of the study.
"And in particular, mothers who showed disease progression during pregnancy - and about one in four mothers get quite a bit worse during pregnancy - are seen to be at the highest risk," he said Thursday from Chapel Hill, N.C.
Gum, or periodontal, disease is caused by a bacterial infection that attacks the teeth-supporting tissues below the gum line. Left untreated, it can lead to the loss of teeth and underlying bone. Standard treatment involves scaling and root planing to remove bacteria-induced deposits (calculus and plaque) from the surfaces of teeth.
The study of 1,800 pregnant women with periodontal disease, the largest of its type ever conducted, assigned half of participants to have treatment before 23 weeks' gestation, while the remainder had no treatment.
"We found that mothers who had a scaling and root planing to treat their periodontal disease did not have reduced risk of pre-term delivery," Offenbacher said. "This would suggest that scaling and root planing, although it may improve the periodontal health of the mothers, has no effect on pregnancy outcome. Dead stop."
The study, conducted at the University or North Carolina and three other U.S. academic centres, also found that treatment in many of the mothers-to-be did not arrest progression of their gum disease.
"In the untreated mothers, 40 per cent got significantly worse," Offenbacher said. "And in the treated group, 30 per cent of them got significantly worse. I think at this point we don't really know the best way to treat periodontal disease in pregnant women, because we're still having a lot of disease progression."
However, that doesn't mean that pregnant women with gum disease should put off having their teeth and gums checked, and having treatment as needed, said co-author Dr. Amy Murtha, director of obstetrics research at Duke University Medical Center in Durham, N.C.
"Our study emphasizes that treating periodontal disease during pregnancy is safe, but that standard periodontal care is not enough," Murtha, who presented the findings Thursday at the annual meeting of the Society for Maternal-Fetal Medicine in San Diego, said in a release.
It's possible, the researchers suggest, that pregnant women may need more aggressive treatment for gum disease, beyond the standard care provided in the study, to bring down the rate of premature delivery.
Murtha said much remains unknown about the link between gum disease and the increased risk for pre-term birth and low-weight babies. "Periodontal disease and poor pregnancy outcomes travel together, but we don't know why."
Offenbacher said changes in hormone levels and a somewhat lowered immune response may allow oral bacteria to flourish and exaggerate the body's inflammatory response. But he said more studies are needed to fully explain the connection.
Commenting on the U.S. study, Dr. Benoit Soucy of the Canadian Dental Association said the findings are not surprising because the association between pregnancy and gum disease is "a very, very complex issue."
"The reason they're not surprising to us is that there is no mechanism that has been identified to link periodontal disease to premature birth or small birth weight," Soucy, the association's director of clinical scientific affairs, said from Ottawa. "There could be there is an underlying process that is masked by other factors, and that is very likely because periodontal disease is extremely common. According to the best numbers that we have ... there would be as much as 70 per cent of the population that is affected by periodontal disease at one time or another."
Any woman who is considering getting pregnant should have a dental exam and regular monitoring during pregnancy because of the bumped-up risk for either developing gum problems or making existing disease even worse, he said. "There is no good general health if your mouth is not healthy. It is very important no matter what to keep your mouth in good health."
The oral health status of patients on oral bisphosphonates for osteoporosis
Osteoporosis; Scientists at University of Adelaide publish new data on osteoporosis
22 January 2009
Women's Health Weekly
According to recent research from Adelaide, Australia, "The oral health status of patients on bisphosphonates is the key to the patient's ongoing health and well-being. If they are orally healthy, invasive bone procedures, particularly extractions can be avoided, then the risk of osteonecrosis of the jaws (ONJ) is low."
"The records of 49 consecutive patients on oral bisphosphonates, referred to the Oral and Maxillofacial Surgery Unit (OMSU) for an oral health check and probable extractions, were retrospectively reviewed. The DMFT, periodontal and pathologic state were calculated from the OPG radiographs. An age and gender matched control group, from patients referred to the OMSU but who were not on oral bisphosphonates, were similarly assessed. Community data were also obtained. The DMFT score for the oral bisphosphonate group was 29: Decayed 3, Missing 10, Filled 16. The control group DMFT score was 24: Decayed 5, Missing 11, Filled 8. Both groups had advanced periodontal disease (over 95 per cent) and were medically compromised (over 90 per cent). The DMFT for general community data for age matched government pensioners was 19.1: Decayed 0.8, Missing 10.4, Filled 7.9. With severe periodontal disease 23 per cent. Thus, the oral health of the oral bisphosphonate group was similar to the control group and both had more decayed teeth and periodontal disease than community values. This study confirms that one cannot assume that a patient on an oral bisphosphonate for osteoporosis has a healthy mouth," wrote R. Kunchur and colleagues, University of Adelaide.
The researchers concluded: "It supports the view that all patients on bisphosphonates need to be seen by a dentist either before or soon after commencement of bisphosphonate therapy."
Kunchur and colleagues published their study in Australian Dental Journal (. Australian Dental Journal, 2008;53(4):354-357).
For additional information, contact R. Kunchur, University of Adelaide, Faculty Health Science, Oral & Maxillofacial Surgery Unit, Adelaide, SA 5005, Australia.
Publisher contact information for the Australian Dental Journal is: Blackwell Publishing, 9600 Garsington Rd., Oxford OX4 2DQ, Oxon, England.
22 January 2009
Women's Health Weekly
According to recent research from Adelaide, Australia, "The oral health status of patients on bisphosphonates is the key to the patient's ongoing health and well-being. If they are orally healthy, invasive bone procedures, particularly extractions can be avoided, then the risk of osteonecrosis of the jaws (ONJ) is low."
"The records of 49 consecutive patients on oral bisphosphonates, referred to the Oral and Maxillofacial Surgery Unit (OMSU) for an oral health check and probable extractions, were retrospectively reviewed. The DMFT, periodontal and pathologic state were calculated from the OPG radiographs. An age and gender matched control group, from patients referred to the OMSU but who were not on oral bisphosphonates, were similarly assessed. Community data were also obtained. The DMFT score for the oral bisphosphonate group was 29: Decayed 3, Missing 10, Filled 16. The control group DMFT score was 24: Decayed 5, Missing 11, Filled 8. Both groups had advanced periodontal disease (over 95 per cent) and were medically compromised (over 90 per cent). The DMFT for general community data for age matched government pensioners was 19.1: Decayed 0.8, Missing 10.4, Filled 7.9. With severe periodontal disease 23 per cent. Thus, the oral health of the oral bisphosphonate group was similar to the control group and both had more decayed teeth and periodontal disease than community values. This study confirms that one cannot assume that a patient on an oral bisphosphonate for osteoporosis has a healthy mouth," wrote R. Kunchur and colleagues, University of Adelaide.
The researchers concluded: "It supports the view that all patients on bisphosphonates need to be seen by a dentist either before or soon after commencement of bisphosphonate therapy."
Kunchur and colleagues published their study in Australian Dental Journal (. Australian Dental Journal, 2008;53(4):354-357).
For additional information, contact R. Kunchur, University of Adelaide, Faculty Health Science, Oral & Maxillofacial Surgery Unit, Adelaide, SA 5005, Australia.
Publisher contact information for the Australian Dental Journal is: Blackwell Publishing, 9600 Garsington Rd., Oxford OX4 2DQ, Oxon, England.
Canadian tooth fairy takes message of dental hygiene to Kenyan kids
Canadian tooth fairy takes message of dental hygiene to Kenyan kids
Michelle Magnan
26 January 2009
Victoria Times Colonist
A former dental hygienist who reinvented herself as "Toothena the Tooth Fairy" for a children's book she wrote has spread her wings to Kenya to hand out 4,000 toothbrushes to kids in need.
It was the maiden voyage for the charity CoraMarie Clark of Calgary founded in late 2007, called The Tooth Fairy Children's Foundation. The foundation recently received its official charitable status.
"My goal is to get toothbrushes into the hands of all children. And if they end up getting a cavity, I want somebody there to help them have it taken care of," says Clark.
"In developing countries, 90 per cent of decay goes untreated. (Learning that) just ripped my heart out and I thought, 'I need to do something to try to make a difference.' "
The 52-year-old has an MBA from the University of Calgary and is a dental consultant for practices across North America. But dressed in her light-pink gown, wand and tiara, Clark glows as Toothena, the real-life version of the animated heroine in her self-published children's book, Emily's Magical Journey with Toothena the Tooth Fairy (2007, $22.95).
Clark donned her costume every time she spoke at a school or orphanage in Kenya and, months after her October trip, still gets teary speaking about the kids she met along the way.
Many times, the kids receiving the toothbrushes had never owned their own toothbrush and were used to sharing.
"At an orphanage for boys, there was a peanut butter jar with the oldest, most awful-looking toothbrushes I've ever seen. It made my stomach turn," she says.
"It was just amazing to give them (each) a new toothbrush."
For more information, visit thetoothfairyspeaks. com.
TOOTHENA'S TIPS FOR PARENTS
Caring for your child's teeth from a young age sets the stage for a lifetime of good oral health, Cora Marie Clark, otherwise known as Toothena, says. Here are her tips to ensure you and your kids have healthy, pearly whites:
- Set a good example by brushing and flossing your own teeth. Make toothbrushing a fun, bonding experience with your kids.
- Your child's teeth need to be brushed at least twice a day and flossed at least once a day, especially right before bedtime.
- Begin cleaning your child's teeth as soon as the first one appears. start with a cloth or piece of gauze and move on to a toothbrush as your child gets older.
- Don't share toothbrushes. If you have periodontal disease, it can be passed on to the child.
- Begin flossing your child's teeth when he is three or four years old. Flossing is important because no matter how meticulously you brush, when the teeth are touching each other, toothbrush bristles can't clean effectively between them.
- Plan to floss your kids' teeth until they are about eight years old. Children usually don't have the manual dexterity to floss on their own until that age.
- Your baby's first visit to the dentist should be for an assessment within six months of the eruption of the first tooth or by the time the infant reaches the first birthday. The goal is to have your child see your dentist before there are any problems with his/her teeth.
- Your child's first dental exam should happen by age two or three. This visit will allow the dentist to ensure your home care is working and to detect and prevent any problems right away.
- Help your child feel comfortable about a visit to the dentist. Read books, such as the Berenstein Bears go to the Dentist or Emily's Magical Journey With Toothena the Tooth Fairy. Consider bringing him along to your own checkup and cleaning, to familiarize him with how much fun a visit to the dentist can be.
Michelle Magnan
26 January 2009
Victoria Times Colonist
A former dental hygienist who reinvented herself as "Toothena the Tooth Fairy" for a children's book she wrote has spread her wings to Kenya to hand out 4,000 toothbrushes to kids in need.
It was the maiden voyage for the charity CoraMarie Clark of Calgary founded in late 2007, called The Tooth Fairy Children's Foundation. The foundation recently received its official charitable status.
"My goal is to get toothbrushes into the hands of all children. And if they end up getting a cavity, I want somebody there to help them have it taken care of," says Clark.
"In developing countries, 90 per cent of decay goes untreated. (Learning that) just ripped my heart out and I thought, 'I need to do something to try to make a difference.' "
The 52-year-old has an MBA from the University of Calgary and is a dental consultant for practices across North America. But dressed in her light-pink gown, wand and tiara, Clark glows as Toothena, the real-life version of the animated heroine in her self-published children's book, Emily's Magical Journey with Toothena the Tooth Fairy (2007, $22.95).
Clark donned her costume every time she spoke at a school or orphanage in Kenya and, months after her October trip, still gets teary speaking about the kids she met along the way.
Many times, the kids receiving the toothbrushes had never owned their own toothbrush and were used to sharing.
"At an orphanage for boys, there was a peanut butter jar with the oldest, most awful-looking toothbrushes I've ever seen. It made my stomach turn," she says.
"It was just amazing to give them (each) a new toothbrush."
For more information, visit thetoothfairyspeaks. com.
TOOTHENA'S TIPS FOR PARENTS
Caring for your child's teeth from a young age sets the stage for a lifetime of good oral health, Cora Marie Clark, otherwise known as Toothena, says. Here are her tips to ensure you and your kids have healthy, pearly whites:
- Set a good example by brushing and flossing your own teeth. Make toothbrushing a fun, bonding experience with your kids.
- Your child's teeth need to be brushed at least twice a day and flossed at least once a day, especially right before bedtime.
- Begin cleaning your child's teeth as soon as the first one appears. start with a cloth or piece of gauze and move on to a toothbrush as your child gets older.
- Don't share toothbrushes. If you have periodontal disease, it can be passed on to the child.
- Begin flossing your child's teeth when he is three or four years old. Flossing is important because no matter how meticulously you brush, when the teeth are touching each other, toothbrush bristles can't clean effectively between them.
- Plan to floss your kids' teeth until they are about eight years old. Children usually don't have the manual dexterity to floss on their own until that age.
- Your baby's first visit to the dentist should be for an assessment within six months of the eruption of the first tooth or by the time the infant reaches the first birthday. The goal is to have your child see your dentist before there are any problems with his/her teeth.
- Your child's first dental exam should happen by age two or three. This visit will allow the dentist to ensure your home care is working and to detect and prevent any problems right away.
- Help your child feel comfortable about a visit to the dentist. Read books, such as the Berenstein Bears go to the Dentist or Emily's Magical Journey With Toothena the Tooth Fairy. Consider bringing him along to your own checkup and cleaning, to familiarize him with how much fun a visit to the dentist can be.
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