Journal Series on Caries Garners National Attention

The February and March 2003 two-part Journal of the California Dental Association series titled “Caries: Moving From Restoration Toward Prevention” has received significant interest from not only California dentists, but also from individuals and organizations interested in oral health from across the nation and around the world. The CDA Foundation purchased an additional 2,000 copies of the series and has already exhausted its supply.

The success of the Journals and the accompanying DVD containing six educational prevention videos (inserted into the February edition) began in April when two of the educational videos won national awards for Non-broadcast Film/Video & Television Programs from the Telly Awards media competition. The winners were “Cavity-Free Families” and “My Trip to the Dentist.” The Telly Award has become one of the most sought-after awards in the television, commercial, and video industry. Video, film, and program winners from the competition included A&E television, The History Channel, National Geographic Channel, Discovery Channel, and Walt Disney Studios. The awards, founded in 1980, showcase and give recognition to outstanding non-network and cable TV commercials, film and video productions, as well as non-network TV programming.

The Journal series was also highlighted at the 2nd Annual International Conference on Social Marketing. The conference, sponsored by Convenience Advertising International, brought public health officials from Australia, New Zealand, and Ireland together to discuss international strategies for public health promotion. Jon Roth, CAE, executive director of the CDA Foundation, gave the keystone lecture on the scientific articles contained in the Journal series as well as on the prevention videos and community-based strategies available through the research.

The Journal series also captured the interest of the National Head Start Association, which invited Roth and Healthy Smiles Manager Annie Gronewald, MPH, to the national convention to present to directors of Head Start programs from around the country. The conference highlighted the research contained in the Journal series and Gronewald’s local dental health program, a community-based training program that she developed from the research. The lecture resulted in more than 200 Head Start directors receiving the research and a free copy of the community-based curriculum for their Head Start programs.

The articles have also received national attention. Requests for the articles have come from many types of community programs, dental education institutions, and dental organizations such as the Hispanic Dental Association, Arizona State School of Dentistry, the University of Washington, and the University of Texas -- San Antonio.

Perhaps the most far-flung request from was public health officials in Cochabamba, Bolivia. Joseph Mercardante, DDS, of San Luis Obispo, Calif., recently traveled to Bolivia on a mission to help provide dental care for underserved people in Cochabamba. Mercardante brought the Spanish language prevention videos, playing them at the treatment clinic for the local residents. A Bolivian health official was so impressed with the educational messages that they are considering placing the videos on Bolivian public television.

To review the February and March editions of the Journal or to order the accompanying DVD, please visit www.cdafoundation.org.

ADA Session Health Screenings Broadened

The health screening program during the ADA Annual Session in San Francisco this October has been expanded to include mental health screening and cardiac C-reactive protein evaluation to check for heart disease risk.

The annual ADA Foundation health screenings will be available in Moscone Center North, Hall D, for four days, Thursday, Oct. 23, through Sunday, Oct. 26, from 9 a.m. to 4 p.m.

“While the ADA Foundation’s Health Screening Program has gathered the largest national database in the health of dental professionals during the past four decades, there is very little data regarding depression or other mental health conditions among dentists,” says Dr. Anthony Volpe, president of the Foundation Board of Directors. “By gathering this confidential information from volunteers, the profession can better respond to the overall health of the dentist.”

Participants will also receive 10 additional free screens, including hepatitis B and C, Legionella pneumophilia antibodies, cholesterol/HDL and LDL, blood pressure and weight, head and neck exam, latex hypersensitivity, carpal tunnel syndrome, electrocardiogram, urinary mercury, and periodontal screening and recording.

Leisure Activity Associated With Reduced Risk of Heart Disease

Physical activity during free time, but not strenuous physical activity at work, is associated with a decreased risk of coronary heart disease, according to an article in the May 26 issue of the Archives of Internal Medicine.

According to information in the article, cardiovascular diseases are the leading cause of disability and death in the United States and other developed countries, and half of all cases are caused by coronary heart disease. Physical activity has been widely acknowledged as beneficial for cardiovascular health, but the amount of physical activity needed for health benefits is debated; and the role of work place physical activity and strain has not been widely studied.

Wolfgang Koenig, MD, of the University of Ulm Medical Center, Ulm, Germany, and colleagues assessed leisure time physical activity and work-related physical strain among 312 patients aged 40 to 68 years old with coronary heart disease and 479 age- and sex-matched patients without heart disease. Patients were asked about physical activity during their leisure time and at work during the summer and winter.

The researchers found an inverse association between leisure time physical activity and risk of coronary heart disease. Compared with patients who reported no leisure activity in the summer, there was a 15 percent reduction in risk for coronary heart disease in the group reporting less than one hour per week of activity; a 40 percent reduction in risk for coronary heart disease for those reporting one to two hours per week; and a 61 percent reduction in risk for those reporting more than two hours per week. Similar results were obtained for winter activity.

The researchers also found a strong positive association between work-related physical strain and risk of coronary heart disease and an inverse association between leisure time physical activity and levels of several biomarkers in the blood (such as c-reactive protein) that are involved in the inflammatory response (which is thought to be involved in the buildup of plaques in the blood vessels).

“The present study provides additional evidence that leisure time physical activity, but not work-related physical strain, is associated with a decreased risk for coronary heart disease seen at even moderate levels,” the authors wrote. “It further suggests that leisure time physical activity is associated with a beneficial effect on the inflammatory response potentially involved in atherogenesis [hardening of the arteries]. These data therefore strongly support the recommendation of leisure time physical activity in the general population for the prevention of coronary heart disease.”

Researchers Find a Link Between Obesity and Periodontal Disease

Researchers from Case Western Reserve University have found a significant association between obesity and prevalence of periodontal disease, especially among individuals aged 18 to 34 years. Study findings were published in the May issue of the Journal of Periodontology.

The study looked at 13,665 people, and all participants underwent a periodontal examination. Body mass index and waist circumference were used to indicate obesity. The relationship between obesity and periodontal disease among individuals aged 18-34 years was 76 percent higher than normal-weight individuals in this age group. No significant association was found between body weight and periodontal disease in the middle and older age groups.

Several explanations for the association between obesity and periodontal disease in younger adults and not older adults are plausible. The younger people in the study may have different dietary patterns than older study participants. Research in dietary trends in adolescents ages 11 to 18 reveal a significant decrease in raw fruit and non-potato vegetables, which are sources of vitamin C. In addition, adolescents have decreased their calcium intake and increased their intake of soft drinks and noncitrus juices. This is important to oral health because low dietary intake of calcium and vitamin C have been associated with periodontal disease.

“Periodontists have known for a while that people who consume less than the recommended dietary allowance for calcium and vitamin C have slightly higher rates of periodontal disease. Young people are now drinking more soft drinks and noncitrus juices than milk and healthier beverages, decreasing their vitamin C and calcium intake” said Mohammad S. Al-Zahrani, DMD, Centers for Health Promotion Research, Case Western Reserve University. “Periodontitis has long been considered an ‘older person’s’ disease, as more than half of people aged 55 or older have it. We now know that widespread risk factors such as obesity may also compromise periodontal health in younger populations.”

“This is one more finding that shows healthy nutrition and adequate physical activity are necessary for overall health, and may also help to improve periodontal health by reducing the rate of progression of periodontal disease,” said Gordon Douglass, DDS, president of the American Academy of Periodontology.

Common Treatment for Acne May Cause the Appearance of Discolored Gums

A case report published in this month’s Journal of Periodontology reported that minocycline, a commonly prescribed antibiotic for the treatment of acne and rheumatoid arthritis, can cause the teeth and bone to discolor, which may make gum tissue appear blackish-blue in color. Patients who take this drug or health care professionals who prescribe it should be made aware of the possibility of oral discoloration.

Mayo Clinic researchers were presented with a 29-year-old white female patient referred to the Periodontics Department by her dermatologist for an evaluation of the dramatic blue appearance of the gum tissue and bone surrounding her teeth. A review of her medical history indicated that she had been taking 50 mg of minocycline four times a day for the previous 17 months.

“We informed the patient that in addition to the bone discoloration, her permanent teeth could also become discolored with continued use of minocycline. And, unlike the periodontal bone, teeth discoloration from minocycline does not always resolve after discontinuation of the therapy,” said Phillip J. Sheridan, DDS, Mayo Clinic, Periodontics, Department of Dental Specialties. “In this patient’s case, the dermatologist elected to change antibiotics to treat her acne.”

According to this case report, approximately 3 percent to 6 percent of long-term minocycline users will develop dental staining. This discoloration does not harm the teeth, bone or gum tissue, but is the reason behind the blackish-blue appearance of the gums. The periodontal bone can become discolored from minocycline therapy and show through the gum tissue, causing it to appear discolored as well.

Use of Internet for Health Information Not as Common as Thought

The Internet is used moderately for health information and has less substantial effects on actual health care utilization than thought, according to an article in the May 14 issue of the Journal of the American Medical Association.

The Internet has attracted considerable attention as a means to improve health and health care delivery, but it is not clear how prevalent Internet use for health care really is or what impact it has on health care utilization. Available estimates of use and impact vary widely. Previous estimates suggest that more than half and as much as 80 percent of adults with Internet access use the Internet for health care purposes. Without accurate estimates of use and effects, it is difficult to focus policy discussions or design appropriate policy activities.

Laurence Baker, PhD, of Stanford University School of Medicine, and colleagues assessed the extent of Internet use for health care among a representative sample of the U.S. population, examined the prevalence of e-mail use for health care, and examined the effects that Internet and e-mail use has on users’ knowledge about health care matters and their use of the health care system.

The study was based on a survey conducted in December 2001 and January 2002 among a sample drawn from a research panel of more than 60,000 U.S. households. Responses were analyzed from 4,764 individuals aged 21 or older who were self-reported Internet users.

The survey found that “approximately 40 percent of respondents with Internet access reported using the Internet to look for advice or information about health or health care in 2001. Six percent reported using e-mail to contact a physician or other health care professional. About one-third of those using the Internet for health reported that using the Internet affected a decision about health or their health care, but very few reported impacts on measurable health care utilization; 94 percent said that Internet use had no effect on the number of physician visits they had and 93 percent said it had no effect on the number of telephone contacts. Five percent or less reported use of the Internet to obtain prescriptions or purchase pharmaceutical products.”

The researchers add that with about half of the adult U.S. population using the Internet at all, these findings suggest that about 20 percent of the entire adult population in the U.S. used the Internet for health care purposes in 2001.

“We also found that Internet use for health is relatively infrequent. Seventy-eight percent of those who ever used the Internet for health care in 2001 reported using it every two to three months or less. Only 22 percent of those who ever used the Internet reported using it once a month or more. Again, our estimates are much lower than those reported in other studies. One recent report indicated that 59 percent of adults who search for health information online do so about once a week to once a month,” they wrote.

The authors concluded: “We found evidence of moderate rates of use of the Internet for health care among adult Internet users, moderate effects of the Internet on the knowledge of users, and very small effects on actual use of office visits, telephone calls to health care professionals, and pharmaceutical purchases. Nonetheless, the Internet clearly is an important tool with the potential to improve information dissemination and perhaps to improve health care delivery and outcomes. Continuing efforts to maximize the potential of this tool could have great value.”

Honors

Mahmoud Torabinejad, DMD, MSD, PhD, of Loma Linda, Calif., has been elected president of the American Association of Endodontists.

Upcoming Meetings

2003

July 17-20 Academy of General Dentistry Annual Meeting, Nashville, (888) AGD-DENT, www.agd.org.

Oct. 23-26, ADA Annual Session, San Francisco, (800) 232-1432.

Nov. 2-7 U.S. Dental Tennis Association Annual Meeting, Palm Desert, Calif., (800) 445-2524.

Nov. 8-9 International Conference on Evidence-Based Dentistry, Chicago, j.ryley@elsevier.com

Dec. 5-7 California Academy of General Dentistry Annual Meeting, San Diego, (877) 408-0738, www.cagd.org.

2004

March 3-6 Academy of Laser Dentistry 11th Annual Conference, Palm Springs, Calif., (954) 346-3776, www.laserdentistry.org.

April 15-18 CDA Spring Scientific Session, Anaheim, (916) 443-3382, Ext., 4470.

Sept. 8-11 International Federation of Endodontic Associations Sixth Endodontic World Congress, Brisbane, Queensland, Australia, www.ifea2004.im.com.au.

Sept. 10-12 CDA Fall Scientific Session, San Francisco, (916) 443-3382, Ext. 4470.

Sept. 30-Oct. 3 ADA Annual Session, Orlando, Fla., (312) 440-2500.

To have an event included on this list of nonprofit association meetings, please send the information to Upcoming Meetings, CDA Journal, P.O. Box 13749, Sacramento, CA 95853 or fax the information to (916) 443-2943.