Dental X-rays Can Spot Osteoporosis

A computer program that analyzes routine dental X-rays could offer a simple, cheap way to detect the bone-thinning disease osteoporosis, new research suggests.

British researchers found that a software program they developed was able to spot signs of declining bone density in dental X-rays of the lower jaw — a potential sign of osteoporosis.

The findings, they report, suggest that routine dental X-rays could provide an inexpensive way to provide wide screening of older adults for osteoporosis. Those with signs of bone thinning in the jaw could be referred for more expensive osteoporosis testing.

Gum Disease Linked to Pancreatic Cancer

According to research reported at the American Association for Cancer Research’s Frontiers in Cancer Prevention Research Meeting in Boston, gum disease may increase the risk of developing pancreatic cancer.

To research further, Dr. Dominique S. Michaud of Harvard School of Public Health and colleagues analyzed 16 years of health data on nearly 52,000 male doctors in the Health Professionals Follow-up Study. This ongoing study, initiated in 1986, is looking at lifestyle factors related to cancer and other chronic diseases.

A total of 216 men developed pancreatic cancer during follow-up. After factoring out smoking, diabetes, obesity, physical activity, diet and other potentially confounding factors, men with a history of gum disease had a 63-percent higher risk of developing pancreatic cancer relative to men without periodontal disease.

Dr. Scott Lippman of The University of Texas M. D. Anderson Cancer Center in Houston said, "this study is the first clearly establishing the increased risk of pancreatic cancer with periodontal disease.” Michaud’s team also found that men with gum disease and recent tooth loss had a 2.7-fold increased risk of developing pancreatic cancer compared with those who reported neither gum disease nor tooth loss.

Gum disease results in chronic inflammation over many years, they explain, and people with gum disease harbor high levels of harmful bacteria in the mouth and gut and tend to have higher amounts of cancer-causing nitrosamines. Pancreatic cancer, the fourth leading cause of death from cancer death in the United States, is one of the most deadly cancers, largely because it is often not detected until it has spread beyond the pancreas. Only about five percent of pancreatic cancer patients survive the first five years after being diagnosed.

Infective Endocarditis: NEW AHA GUIDELINES

New guidelines for prevention of infective endocarditis were released by the American Heart Association April 19, 2007. The AHA and ADA now recommend that fewer dental patients with heart disease receive antibiotic prophylaxis before dental procedures to prevent the heart infection called infective endocarditis (IE). The guidelines were developed by a group appointed by the AHA that included experts in infectious disease and cardiology and members representing the ADA. The guidelines were endorsed by the Infectious Diseases Society of America and the Pediatric Infectious Diseases Society.

After reviewing relevant scientific literature from 1950–2006, the group concluded that bacteremia resulting from daily activities is much more likely to cause IE than bacteremia associated with a dental procedure. In addition, only an extremely small number of IE cases might be prevented by antibiotic prophylaxis, even if prophylaxis is 100% effective. Based on these conclusions, antibiotic prophylaxis is now recommended before dental procedures only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from IE, such as patients with artificial heart valves, a history of endocarditis, certain serious congenital heart conditions and heart transplant patients who develop a problem with a heart valve.

Electric Handpieces Can Overheat

The FDA last month advised dentists that serious patient injuries, including third-degree burns, have been associated with poorly maintained electric dental handpieces. Some burns have been severe enough to require plastic surgery. The burns occur when handpieces that haven't been properly maintained overheat during dental procedures. Neither the patient nor the dentist may be aware that the handpiece is overheating because the patient is anesthetized and the handpiece housing insulates the dentist from the heat. Earlier this year in the ADA Professional Product Review report on electric handpieces, the FDA urged dentists to strictly adhere to the manufacturer's instructions for use, maintenance and lubrication.

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ADA Seal of Acceptance Awarded

The ADA Council on Scientific Affairs (CSA) has awarded the Seal of Acceptance to Wrigley Orbit Sugar Free Gum, Wrigley Extra Sugar Free Gum and Wrigley Eclipse Sugar Free Gum, the first chewing gum products available to receive the Seal. CSA awarded the three Wrigley products the Seal after reviewing laboratory and clinical studies showing "that the physical action of chewing sugar-free gum for 20 minutes after eating stimulates saliva flow, which helps prevent cavities by reducing plaque acids and strengthening teeth." The Wm. Wrigley Jr. Co. will announce more details at a September 25 press conference in Chicago so it's possible some of your patients will see press coverage and have questions about sugar-free gum. Wrigley also will include information about the products in an upcoming mailer to ADA members.

Antibiotics Before Dental Treatment

Any time there is bleeding in the mouth, oral bacteria can enter the bloodstream and travel to the heart. This presents a risk for some patients who have cardiac abnormalities or endocarditis, a serious inflammation of the heart valves or tissues.

Precautions
The American Heart Association and the American Dental Association publish guidelines for dentists to help them protect patients at risk of developing bacterial endocarditis. The AHA guidelines are listed in the “Dental Guidelines” section of the DRC site. The guidelines recommend the use of antibiotics before dental treatment, based on patient's medical conditions and on the dental treatment they receive.
Premedication -- taking antibiotics before dental treatment -- may be necessary for dental procedures such as professional tooth cleaning; extractions; incision and drainage of infected oral tissue; some types of injections; and some oral surgeries.

Below is a list of conditions that require antibiotic prophylaxis:
· heart surgery within the last 6 months
· vascular surgery (replaced artery) within the past 6 months
· pacemaker
· history of rheumatic fever
· history of heart murmur (mitral valve prolapse)
· previous bacterial endocarditis
· systemic pulmonary shunt
· congenital heart defect
· acquired valvular dysfunction
· diagnosed with other heart ailments

Consult with the patient’s physician or cardiologist to determine which antibiotics you should prescribe. Have the patient fill the prescription before their next visit and make sure they understand the dosage and frequency.

Periodontal infections and poor dental hygiene at home may spread heart-threatening bacteria. Encourage your patients to brush and floss regularly, maintain a healthy diet and schedule regular dental appointments to have their teeth cleaned and examined.
If your patient has heart disease or has a special heart condition, taking good care of their teeth and gums is a must -- not just for a healthy smile, but also for a healthy body.