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U.S. Dental Schools Teaching little on Sleep Disorders

Posted on 13. Aug, 2010 by wisdom.

American adults suffer from sleep disorders and the number is quite large, around 70 million. U.S. dental schools are not teaching their graduating soon to be dentists the importance of screening their patients for sleep disorders.

The main problem is for those 18 million Americans that suffer from Obstructive Sleep Apnea (OSA). It estimated that 80 % to 90 % of patients with OSA are not diagnosed and this can consequently raise the patients risk for many diseases and problems.

The researchers feel since dentists see patients on a regular basis, they can notice early warning signs of sleep disorders. This greatly makes sense and thus U.S. dental schools should increase the amount of time during the 4 years of study that students receive on sleep disorders.

Source: http://www.sciencedaily.com/releases/2010/06/100605112529.htm

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The Role of Dentists in Diabetes Screening

Posted on 15. Feb, 2010 by wisdom.

A study, led by Dr. Shiela Strauss, Associate Professor of Nursing and Co-Director of the Statistics and Data Management Core for New York University’s Colleges of Dentistry and Nursing, examined data from nearly 3,000 adults in the 2003-2004 National Health and Nutrition Examination Survey who had not been diagnosed with diabetes. The results appear in the Journal of Public Health Dentistry in the article titled “The dental office visit as a potential opportunity for diabetes screening: an analysis using NHANES 2003-2004 data.” The results indicate that the majority of people who have periodontal (gum) disease are also at high risk for diabetes. In addition, half of those at risk had seen a dentist in the previous year. This one can draw the conclusion that dentists should consider offering diabetes screenings in their offices.

Dr. Strauss and colleagues determined that 93% of those examined had periodontal disease, compared to 63% of those without the disease, were considered to be at high risk for diabetes and should be screened for diabetes. Diabetes screening is recommended for people at least 45 years of age with a body mass index (BMI) of 25 or greater, as well as for those under 45 years of age with a BMI of 25 or greater who also have at least one diabetes risk factor. Dr. Strauss’s study indicated that  a first-degree relative (a parent or sibling) with diabetes and high blood pressure were reported in a significantly greater number of those examined with periodontal disease than in those without periodontal disease.

Dr. Strauss said that dentists can screen patients for diabetes by evaluating them for risk factors such as belonging to a high-risk ethnic group (African-American, Latino, Native American, Asian-American, or Pacific Islander, being overweight,  a first-degree relative with diabetes, having high cholesterol, and/or having high blood pressure.

Dentists can use a glucometer which is a diagnostic instrument for measuring blood glucose. This could potentially be done in one of two ways, 1)  analyze finger-stick blood samples, or 2) use the glucometer to evaluate blood samples taken from pockets of inflammation in the gums. Both methods have been shown to be correlated and provide correct results as indicated in an earlier study by Dr. Strauss.

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Latest Dental News

Posted on 26. May, 2009 by wisdom.

There are some articles I found recently that I feel may be worth a read.

1) Unfortunate Error in Oral Surgeon’s Background

This article from the L.A. times discusses how Dr. Suzanne McCormick, president of the Dental Board of California,  wrongly removed 2 permanent molars instead of wisdom teeth from a patient several years ago, and settled out of court.

2) Some Facts your Dentist Does Not Want you to Know

This interesting article provides insights in how you should be managing your dental care. Two fascinating tidbits from this article are

“It is estimated that 15 to 18 percent of dentists are addicted to drugs or alcohol.”

“Dr. Jay Friedman, the nation’s leading authority on dental quality control, once told me the source of the conventional wisdom that you should brush your teeth twice a day…He told me it was based on a toothpaste commercial.”

3) Still Part of the Team

Austin Stone, who went into comatose on March 30 following the extraction of his wisdom teeth, helped his track team make it to state last year. Now he is currently rehabilitating and his track team is without him but can still feel his presence.

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Vasovagal Syncope at the Dentist

Posted on 20. Feb, 2009 by wisdom.

Vasovagal syncope is characterized by a loss of consciousness and muscle tone, which typically are preceded by non-specific symptoms that last anywhere from a few seconds to a minute. These symptoms result from alterations in the nervous system that can include dizziness, lightheadedness, paleness, palpitations, nausea, sweating, hyperventilation and changes in vision.

According to Dr. Kapusta, DDS, “Any patient who experiences a syncope reaction may have an underlying cause that can predispose him or her to a life-threatening situation.” It is considered the most common clinical problem that occurs among patients of all ages, affecting 3.5 percent of the general population. Emotional stress, anxiety, pain, fatigue and being in a hot and crowded environment can lead to vasovagal syncope.

“It is not uncommon for patients to experience some anxiety when visiting their general dentist,” says  Melvin Pierson, DDS. “Yet, there are ways to lessen the possibility of an anxiety-related incident.” Dr. Pierson encourages patients to discuss with their general dentist any fears they may have.

“Asking questions and requesting informational materials can help you get a better understanding of your dental service or treatment,” says Dr. Pierson. “General dentists are trained to answer questions and tell you what to expect to help you feel comfortable.”

Even so the dental materials and what your dentist tell you may not be the whole truth. Therefore I would encourage you to explore materials online and talk with other patients and people you know.

Adapted from materials provided by Academy of General Dentistry.

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Dentists Reviewing Literature

Posted on 15. Aug, 2008 by wisdom.

I think this is somewhat of joke; however, dentists are soon going to be getting their hands dirty reviewing dental literature. The American Dental Association (ADA) is starting to practice evidence based dentistry (EDA) as opposed to biased dentistry. They should have been doing this decades ago!

The recent ADA’s Evidence Reviewers workshop in late June of 2008 taught clinicians and researchers how to critically assess scientific literature and how and why critical summaries should be written.

“I was able to come away from the EBD reviewer workshop training with a dramatically new and refreshing perspective on evidence in dentistry,” said Dr. Joseph Hagenbruch of Harvard, Ill., a general dentist and incoming chair of the ADA Council on Dental Benefit Programs.

“More importantly, I was able to learn skills and techniques for use when reviewing dental literature for determination of document validity, reasonable applicability and even aspects of predictability.”

The participants were taught how to adopt an evidence-based approach to treatment planning as well as how to write concise one-page critical summaries of systematic reviews to help practitioners understand and use scientific findings.

“It was really exciting to be talking to the leaders in the field and learning from them the science of evaluating systematic reviews,” said Dr. Heather Hill, a general dentist and National Library of Medicine Fellow at Oregon Health and Science University. “They were focused on making the information succinct and relevant to clinicians.”

All of the reviewers received individual mentoring and feedback to further develop their skills in preparation of the critical summaries.

“It may sound naive or perhaps a bit cheesy, but the experience felt much like investigating a new frontier or planet that was overdue for exploration and our charge was to look under every stone, move every leaf of vegetation to make sure that nothing is missed and all the bases are touched in terms of examining evidence,” said Dr. Hagenbruch.

Getting involved in EBD research has been a satisfying experience for Dr. Hagenbruch, who over the years has often questioned some of the material he has heard during continuing education programs and in published studies he has read.

“At times I have experienced situations in which material being presented by the seminar speaker, in my opinion, was less than accurate or the individual was showing an obvious bias toward a product, piece of dental equipment or treatment technique,” he said. “On those occasions the thought always crossed my mind of how advantageous it would be to actually be able to serve within a group that sorted out the fact from the fiction, phony and fluff.

“The American Dental Association’s Evidence-Based Dentistry Program and its commitment, through membership involvement, to sort out and untangle things in an unbiased manner, seemed to me to be too favorable of an invitation to pass up,” he said.

Like Dr. Hagenbruch, Dr. Hill is enthusiastic about taking up the charge to get clinicians interested in EBD. She became involved in EBD because she enjoys dental research and having it ultimately make life easier for dentists and patients.

“Systematic reviews are the gold standard of EBD and I feel like I am just starting to understand their intricacies,” she said. “It is gratifying to be involved in this project from the beginning. I look forward to being able to use what we create.”

Go to the following link to learn more about the American Dental Association and Evidence Based Dentistry. The orginal article was written by Jennifer Garvin and is located here.

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