Dental cavitations??

The information I have gleaned from this discussion group has been absolutely invaluable to me, my family (especially in dealing with my autistic neice), friends and clients and I feel privileged to have access to it. I am hoping you can help with something I have been seeing with my about 70% of my clients over the past 3 months... Read more

Study Links Osteoporosis Drugs to Jaw Trouble

(HealthDay News) -- The proportion of people taking widely prescribed oral osteoporosis drugs who develop a nasty jaw condition may be much higher than previously thought, a new study suggests.

Previous reports had indicated that the risk of developing osteonecrosis of the jaw (ONJ) from bisphosphonates in pill form were "negligible," although there was a noted risk in people taking the higher-dose intravenous form of the drug.

But Dr. Parish Sedghizadeh, an assistant professor of clinical dentistry at the University of Southern California School of Dentistry in Los Angeles, said his clinic is seeing one to four new cases a week, compared to one a year in the past. This led him to investigate the phenomenon and publish the findings in the Jan. 1 issue of the Journal of the American Dental Association.

"This is more frequent than everybody would like to think it is," said Sedghizadeh, lead author of the study.

ONJ is characterized by pain, soft-tissue swelling, infection, loose teeth and exposed bone.

Dr. James Liu, chairman of obstetrics and gynecology at MacDonald Women's Hospital at Case Medical Center, University Hospitals in Cleveland, said the finding "does not mean that women should stop taking the drug if they're on it. It does mean that there may be more frequent side effects than was previously known."

Bisphosphonates are medications used to reduce the risk of bone fracture and to increase bone mass in people with osteoporosis. They're also used to slow bone "turnover" in people who have cancer that has spread to their bones, and in people who have the blood cancer multiple myeloma.

Use of bisphosphonates has been associated with other problems in the past, including an increased risk of atrial fibrillation (a type of abnormal heart rhythm), unusual fractures of the thigh bone, and inflammatory eye disease.

After searching the USC School of Dentistry's electronic medical records database, the study authors found that nine of 208 patients taking Fosamax had active ONJ, a prevalence of about 4 percent. All were patients who had undergone some kind of dental procedure, such as having a tooth removed.

Fosamax (alendronate) is the most widely prescribed oral bisphosphonate and has been the 21st most prescribed drug in the United States since 2006, according to background information in the study.

The jaw complication has been seen in patients taking Fosamax for as little as one year. It seems to occur most frequently after routine tooth extraction, the study authors said.

Although no one is sure why bisphosphonates seem to have this effect only on jaw bones, Sedghizadeh speculated that the drugs may make it easier for bacteria to adhere to bone that is exposed after a tooth extraction.

Previously, experts had thought that ONJ in people taking intravenous bisphosphonates was related to their underlying condition (for example, cancer) than to the actual drug, Liu explained.

The USC School of Dentistry now screens every patient for bisphosphonate use.

"As a school now, we don't have complications any more, we only have referrals," Sedghizadeh said. "We put patients on anti-microbial, anti-fungal rinse one week pre-operatively or post-operatively. If they have been on bisphosphonates six months or a year or longer, then we have a prevention protocol which has been very, very effective."

According to a statement released by Merck & Co., which makes Fosamax, the new study "has material methodological flaws and scientific limitations, making it unreliable as a source for valid scientific conclusions regarding the prevalence of ONJ in patients taking alendronate."

No reports of ONJ have been noted in controlled trials involving more than 17,000 patients, the statement said.

More information
To learn more about ONJ, visit the American Dental Association.

Scientists Find Gene for Tooth Enamel

(HealthDay News) -- A gene that plays a role in immune function and the development of skin and the nervous system also controls the production of tooth enamel, Oregon State University researchers have found.

Their discovery about the gene Ctip2 (a transcription factor) could lead to new methods of repairing damaged enamel and preventing cavities, restoring teeth or even producing replacement teeth.

"It's not unusual for a gene to have multiple functions, but before this, we didn't know what regulated the production of tooth enamel," Chrissa Kioussi, an assistant professor in the college of pharmacy at Oregon State, said in a university news release. "This is the first transcription factor ever found to control the formation and maturation of ameloblasts, which are the cells that secrete enamel."

Kioussi and her colleagues studied baby mice in which the Ctip2 gene had been "knocked out" and its protein was missing. The mice had rudimentary teeth ready to erupt, but the teeth lacked the proper enamel coating and would never have been functional.

The findings appear in this week's Proceedings of the National Academy of Sciences.

Using this new information about Ctip2, it might be possible to use tooth stem cells to stimulate the growth of new teeth, Kioussi said. She noted that some researchers have successfully grown the inner portions of teeth in laboratory animal experiments, but the teeth had no hard coatings because the scientists didn't know which gene controlled enamel growth.

"A lot of work would still be needed to bring this to human applications, but it should work," Kioussi said. "It could be really cool -- a whole new approach to dental health."

Many people have problems with eroded tooth enamel, and most cavities start as a hole in tooth enamel that allows decay to begin.

More information
The American Academy of Family Physicians has more about oral health.

Health Tip: Prevent Bleeding Gums

(HealthDay News) -- Bleeding gums can occur because teeth haven't been properly brushed and flossed, or as a side effect of conditions including leukemia, scurvy or vitamin K deficiency.

The U.S. National Library of Medicine offers these suggestions to help keep gums healthy:

• Don't smoke or use other forms of tobacco.
• Take vitamin supplements, as recommended by your doctor.
• Don't take aspirin, unless your doctor advises otherwise.
• If medication is causing your gums to bleed, ask your doctor about possible alternatives.
• Massage your gums gently with an oral irrigation tool. Set the device on low.
• Make sure dentures fit properly, and talk to your dentist if they cause bleeding or soreness.
• If your gums do bleed, wet a gauze pad with ice water and hold it to the affected area.
  
  
  

Most Insured Adults Worry About Health Care Costs: Poll

(HealthDay News) -- More than three-quarters of adult Americans who have health insurance say they still worry about paying more for their medical care, and nearly 50 percent say they're "very" or "extremely" worried about the issue, a new Harris Interactive/HealthDay poll shows.

More than half (57 percent) of those polled said they feared losing their health insurance sometime in the future, which may explain another key finding in the poll -- sizeable numbers of Americans said they're skipping doctor visits or not getting prescriptions filled to save money.

Middle-aged Americans -- people too old to be blasé about their health but too young to be covered by Medicare -- seemed most worried about paying their health care bills. Among insured individuals aged 45 to 64, a full 84 percent said they were concerned that rising health care costs would exceed their ability to pay.

Only 8 percent of all insured Americans polled were "not at all worried" about getting health care coverage.

"Many are, in fact, not filling prescriptions, skipping a doctor's visit, not following up on something that was recommended by the doctor, taking a medication less or pill-splitting, doing without dental care," said Humphrey Taylor, chairman of The Harris Poll.

He added that with the economy in a tailspin and many Americans losing their employer-based health insurance, the problem may only get worse. "If the number of uninsured rises sharply, one would expect to see these numbers increase," Taylor said.

One consumer advocate wasn't surprised by the results of the poll, which included 2,078 adults surveyed between Feb. 25 and 27.

"Even for people who have insurance, increasingly, the costs have been shifted to them -- and those costs have risen," said Carol Pryor, policy director at The Access Project, a nonprofit group dedicated to making health care available to more Americans. More and more, she added, insured Americans are paying higher deductibles and co-pays, stretching their ability to get proper medical care.

Pryor agreed with Taylor that the situation is only likely to get worse, since "more people are becoming uninsured as a result of the economic meltdown."

Some other key findings from the poll:

78 percent of adults with health insurance worry about paying more for their medical care.
Nearly two-thirds (65 percent) of all insured adults say they're worried about how they can afford to pay for medical care and prescription drugs, with that number rising to 76 percent among people aged 45 to 54. Even among those aged 65 and over -- most of whom are eligible for Medicare -- 62 percent say they worry about paying for the care they need.
Over the past year, one in five insured adults skipped filling a prescription because of the cost. That number jumped to 30 percent for those without insurance.
Similarly, cost concerns led 24 percent of the insured and 51 percent of the uninsured to forgo seeing a doctor for a specific medical problem. Twenty-one percent of the insured and 33 percent of the uninsured didn't get a recommended follow-up test or treatment for the same reason.
Trying to cut down on medical expenses, 14 percent of the insured and 19 percent of the uninsured took a medication at a lower dose than that recommended by a doctor.
Dental care took the biggest hit: 51 percent of the uninsured and 30 percent of the insured skipped necessary dental care over the past year due to financial concerns.
Forgoing care to save costs over the short term may not save costs over the long term, the experts warned. "Some things do go away on their own over time," Pryor said. "But there are a lot of conditions that get worse if they aren't treated, and they then require more expensive care later. So it's definitely a gamble."

Taylor noted that the statistics on the percentage of Americans skipping needed care have remained about the same since 2007, when Harris first asked these types of questions. That may seem odd given the recent downturn in the economy, he added. But, he noted that even if a few million Americans lose their health insurance, that's still only 2 percent of the adult population -- not enough to show up in this type of survey.

The new poll results come on the heels of a report released Wednesday by the nonprofit advocacy group Families USA. It found that a third of Americans under the age of 65 -- nearly 87 million people -- went without health care coverage at some point over the past two years.

The most recent U.S. government statistics suggest that 16 percent of all adults (including those 65 and older) have no health insurance. And a Commonwealth Fund report published last June found that the number of "underinsured" -- people who have insurance that doesn't fully meet their health care needs -- rose by 60 percent between 2003 and 2007.

The issue gained momentum in the nation's capitol last Thursday, when President Barack Obama convened a long-anticipated White House summit on health care reform. The Associated Press reported that Obama made a point of bringing a wide range of views to the table -- voices representing the insurance industry, patient groups, physicians and even those advocating a single-payer system.

"Every voice has to be heard. Every idea must be considered," Obama said during the summit. "The status quo is the one option that is not on the table."

According to Pryor, one item that should be up for discussion in Washington is the plight of the underinsured.

"Covering the uninsured is only part of the problem," she said. "Unless reform includes adequate, comprehensive and affordable coverage, just having insurance will not be protection -- either from facing barriers to care or concern over one's financial stability. And after all, those two things are the function of insurance."

More information
There's more on the underinsured in America at The Commonwealth Fund.

Eating healthy on a shoestring budget

CNN's Sean Callebs has finished a long assignment: living on food stamps during all of February. See what he learned. full story

COUNTERTOP CORPULENCE - Eating On the Run Doubles Calorie Intake

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