The Morning Drill: November 15, 2011

Good Morning!

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

Pomegranate Juice Lowers Cardiovascular Risk Factors

Patients on hemodialysis consuming a moderate amount of pomegranate juice for a year saw a continuous, cumulative, beneficial effect on their lipid profile, their blood pressure, and the number of antihypertensive medications they required, Batya Kristal, MD, MHA, from the Nephrology Department at the Western Galilee Hospital in Nahariya, Israel, reported here at Kidney Week 2011: American Society of Nephrology 44th Annual Meeting.

In addition to water, sugars, and pectin, pomegranates contain the antioxidants ascorbic acid and polyphenolic flavonoids.

Dr. Kristal speculated that the consumption of pomegranate juice might lower the risk for cardiovascular disease in patients on hemodialysis, and recommended that it be added to diets that improve cardiometabolic risks, including low-salt diets, Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean diet.

One safety concern is that pomegranate juice contains a high level of potassium, so potassium overload is a risk, especially in patients with chronic kidney disease and dietary potassium restrictions. Dr. Kristal recommended that such patients be monitored by a dietician and a nephrologist. In addition, pomegranate juice intake can interfere with the metabolism of certain drugs, raising their levels in the blood. However, no adverse effects were detected in the group taking pomegranate juice.

Delta Dental donates $2 million to Marquette Dental School

Delta Dental of Wisconsin has donated $2 million toward the planned expansion of the Marquette University School of Dentistry.

The gift is the first in a planned campaign to raise $8 million to expand the dental school. The Building for the Future campaign will match $8 million committed by the state in its 2011-2013 biennial budget, according to Marquette University.

The $16-million, 40,000-square-foot expansion will add clinical, lab and classroom space and enable the school to accept 20 additional students a year, increasing its class size to 100 students and the school's enrollment to 400.

More than 80% of the school's graduates practice in the state, the school said.

Delta Dental of Wisconsin, based in Stevens Point, has donated or pledged more than $7 million to the Marquette University School of Dentistry since 1998.

CT Colonography Improves Participation in Cancer Screening

Participation in colorectal cancer screening is significantly improved with computed tomographic (CT) colonography compared with traditional colonoscopy and has a similar diagnostic yield for advanced neoplasia, according to a study published online November 15 in The Lancet Oncology.

Members of the general population were invited for colorectal cancer screening by colonoscopy or noncathartic CT colonography. Of the 5924 participants invited for colonoscopy, 1276 (22%) underwent the procedure compared with 982 (34%) of the 2920 CT colonography invitees (relative risk [RR], 1.56; 95% confidence interval [CI], 1.46 - 1.68; P < .0001).

The diagnostic yield for advanced neoplasia was 8.7 per 100 participants for the colonoscopy group and 6.1 per 100 participants for the CT colonography group (RR, 1.46; 95% CI, 1.06 - 2.03; P = .02). For lesions 10 mm or greater, the diagnostic yield for advanced neoplasia was similar for both techniques 1.5 per 100 invitees for colonoscopy and 2.0 per 100 invitees for CT colonography — indicating that both procedures can be used successfully for population-based screening, according to the researchers.

"The decision about the preferred method for colorectal cancer screening in population-based screening can be guided by the results of our trial, which showed more participants with noncathartic CT colonography, a higher yield for colonoscopy, but a similar diagnostic yield for both methods in the detection of advanced neoplasia per 100 invitees, " write Esther M. Stoop, MD, from the Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, the Netherlands, and colleagues.

"The implication that CT colonography would lead to greater participation in colorectal screening over colonoscopy is a crucial finding, since this modality could operate in parallel with existing colonoscopic screening," writes Dr. Pickhardt.

Trip to dentist can reduce risk of heart attack: research

A new study of 100,000 people found those who had their teeth scraped and cleaned by a dentist had a 24 per cent lower risk of a heart attack and a 13 per cent lower risk of a stroke in the seven years following the appointment.

The findings were presented at the American Heart Association Scientific meeting.

Dr Emily Chen, cardiology fellow at the Veterans General Hospital in Taipei, Taiwan, said: “Protection from heart disease and stroke was more pronounced in participants who got tooth scaling at least once a year.”

The study included more than 51,000 adults who had received at least one full or partial tooth scaling and a similar number of people matched with gender and health conditions who had no tooth scaling.

Professional tooth scaling appears to reduce inflammation-causing bacterial growth that can lead to heart disease or stroke, she said.

In a separate study, researchers found dental health was linked to heart attacks, congestive heart failure and stroke in different ways.

Dr Anders Holmlund, Centre for Research and Development of the County Council of Gävleborg, Sweden, found people with fewer than 21 teeth had a 69 per cent increased risk of heart attack compared to those with the most teeth.

Also those with few teeth were two and half times more likely to have heart failure than those with the most teeth and gum bleeding was linked to a doubling in the risk of a stroke.

Dr Nigel Carter, Chief Executive of the British Dental Health Foundation, said: “Professional tooth scaling will remove the tartar, essentially a build-up of hardened plaque, from our mouths. If this is not taken away then the gums will become inflamed, causing gingivitis and eventually gum disease. This is when your general health, not just your oral health could be effected.

“Gum disease has been linked to many diseases and illnesses within the body, an increased likelihood of suffering a heart attack being one of them.

“This is thought to be as a result of the bacteria from the mouth getting into their bloodstream.

“Other systemic links that have been associated with gum disease include strokes, diabetes, preterm births and dementia.”

Enjoy your morning!