The Morning Drill: August 22, 2011

A collection of dentistry and health related links/comments for your day.

Still a 20-month wait for dentist

PATIENTS wanting to register with an NHS dentist can still face a wait of 20 months, it was revealed as he government unveiled its new five-year dental health plan.

The Department of Health’s oral strategy for the Isle of Man aims to improve the island’s dental health, which is worse than the North West region of England, which is, the worst in the UK.

The new document replaces the old policy which was in place for 10 years.

Commenting on the shortage of NHS dentists, health strategy and performance director Norman McGregor Edwards said 4,500 patients had been placed with dentists in the past two years, which he said had effectively halved the waiting list.

The wait to become registered to a dentist is up to 20 months, but he added patients wanting a dentist in a specific area of the island faced a longer wait.

He stressed emergency dental care was available within a maximum of 72 hours (usually much less) for those who were not registered with a dentist.

The document follows a two-week consultation last autumn which elicited 26 responses from the public as well as politicians, dentists and other professional bodies.

Moderate Exercise for 15 Minutes Daily Improves Survival

The minimal amount of physical activity to reduce mortality risk is 15 minutes a day of moderate-intensity exercise, according to the results of a prospective cohort study reported online August 16 in The Lancet.

"Exercising at very light levels reduced deaths from any cause by 14 percent," said senior author Xifeng Wu, MD, PhD, professor and chair of the University of Texas MD Anderson Cancer Center Department of Epidemiology, in a news release. "The benefits of exercise appear to be significant even without reaching the recommended 150 minutes per week based on results of previous research."

The study cohort consisted of 416,175 persons in Taiwan (199,265 men and 216,910 women) who were evaluated between 1996 and 2008 in a standard medical screening program. Average duration of follow-up was 8.05 ± 4.21 years. Participants were categorized according to the amount of weekly exercise self-reported on a questionnaire as inactive, low, medium, high, or very high activity. For each group, life expectancy and hazard ratios (HRs) were calculated for mortality risk, with use of the inactive group as the standard.

The average amount of exercise in the low-volume activity group was 92 minutes per week (95% confidence interval [CI], 71 - 112) or 15 ± 18 minutes per day. Risk for all-cause mortality was 14% lower (HR, 0.86; 95% CI, 0.81 - 0.91), and life expectancy was 3 years longer in the low-volume activity group vs the inactive group.

Beyond the minimal amount of 15 minutes of daily exercise, each additional 15 minutes was associated with a further reduction in all-cause mortality risk by 4% (95% CI, 2.5 - 7.0) and in all-cancer mortality risk by 1% (95% CI, 0.3 - 4.5). These benefits of exercise were seen in all age groups, in both sexes, and in persons at risk for cardiovascular disease. Compared with individuals in the low-volume group, inactive persons had a 17% increased risk for mortality (HR, 1.17; 95% CI, 1.10 - 1.24).

"15 min a day or 90 min a week of moderate-intensity exercise might be of benefit, even for individuals at risk of cardiovascular disease," the study authors write.

New infection-control rules take effect in California

Dental professionals in California, take note: New infection control regulations developed by the Dental Board of California took effect August 20, and without making some significant changes in certain aspects of your everyday routine, you could be in violation of the state's minimum standards for infection control.

The regulations have not been updated since 2005, according to Leslie Canham, CDA, RDA, an infection control compliance expert in California.

The Dental Board of California does not contact dental licensees to inform them of the new regulations, Canham noted; instead, dentists are expected to check the dental board website to stay informed of any changes. In addition, a copy of the regulations must be conspicuously posted in each dental office, and a written protocol outlining proper instrument processing, operatory cleanliness, and injury management must be made available to all workers.

The board made several changes and additions to the regulations, Canham said, some more significant than others. For example, utility gloves that are chemical- and puncture-resistant must now be worn by anyone working with germicides or hazardous chemicals and when processing contaminated instruments.

"Many people don't like to wear the heavy-duty utility gloves because they are bulky and don't fit well, but anyone cleaning a treatment room has to wear them now," she said.

In addition, instrument pouches, packages, and wraps must be labeled with the date of sterilization and sterilizer used (if an office has more than one sterilizer).

"Some offices already do this, but the majority don't," Canham said.

Other changes in the regulations include the following:

• Instruments, items, and devices processed by high-level disinfection (cold sterile) must be packaged or wrapped and dated upon completion of the disinfection process.
• Hand washing with soap and water must be performed at the start and end of each workday. Alcohol-based hand rubs may still be used in between glove changes as long as hands are not   visibly soiled or contaminated.
• Protective eyewear and face shields must be cleaned and disinfected after each patient treatment.

The board also changed some language in the regulations to help clarify who the rules apply to. "Dental workers" is now "Dental Healthcare Personnel," which broadens the scope of who might be exposed to infectious materials while working in a dental office, Canham noted.

"This is a better definition because it applies not only to a dentist's employees, but contracted workers as well," she said.

Feds oppose ban on food stamps for sodas in NYC

A plan by New York City to combat obesity by restricting the purchase of sugary drinks with foods stamps would be too large and complex, federal officials said Friday.

The U.S. Department of Agriculture rejected a waiver request that would have allowed the city to implement the plan, which would have barred food stamp recipients from using their benefits to buy sodas, teas, sports drinks and other sugar-sweetened drinks.

The ban would have applied to any sweetened beverage that contains more than 10 calories per 8 ounces.

Mayor Michael Bloomberg and Gov. David Paterson announced in October that they would seek a waiver from the USDA to start up a temporary program that would be evaluated before becoming permanent.

In a statement released Friday, Bloomberg said his administration was disappointed by the USDA's decision.

"We think our innovative pilot would have done more to protect people from the crippling effects of preventable illnesses like diabetes and obesity than anything being proposed anywhere else in this country — and at little or no cost to taxpayers," he said.

While sharing the goal of reducing obesity, an official with the nation's food stamp program said in a letter Friday addressed to the state Office of Temporary and Disability Assistance that the USDA had concerns about the plan's "potential viability and effectiveness."

Jessica Shahin, associate administrator of the program, wrote that the proposal lacked clear product eligibility guidelines, didn't take into account the burden that might be placed on city food retailers and failed to put forward a credible design for evaluating the effect on obesity and health.

The food stamp program was launched in the 1960s and serves more than 40 million Americans each month.

Enjoy your morning!