The Morning Drill: July 7, 2011

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

Actually, it is afternoon here in Indianapolis but it is morning in California, so I will leave the title as is.

NSAID Use Associated With Risk of Atrial Fibrillation or Flutter

Nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors are associated with an increased risk of atrial fibrillation or flutter, according to the results of a new population-based, case-control study [1]. The study adds evidence that these arrhythmic risks should be added to the overall CV risks when considering prescribing NSAIDs, say researchers.

"It's important to know that the absolute risk of atrial fibrillation associated with these drugs is still low," lead investigator Morten Schmidt (Aarhus University Hospital, Denmark) told heartwire . "The use of NSAIDs is associated with an increased risk, but overall the absolute risk is still small. Like any other drug, for physicians that prescribe NSAIDs it continues to be a question of balancing the benefits and risks."

The study, published July 4, 2011 in the British Medical Journal, examined the risk of atrial fibrillation or flutter associated with NSAID use. It included 32 602 patients diagnosed with atrial fibrillation or flutter in Northern Denmark between 1999–2008 and 325 918 age- and gender-matched controls selected from the source population. Schmidt, a junior research fellow in the department of clinical epidemiology, said that a previous study had suggested that traditional NSAIDs were associated with an increased risk of atrial fibrillation in long-term users, and that one meta-analysis had indicated that COX-2 inhibitors, in particular rofecoxib (Vioxx, Merck & Co), also could be associated with cardiac arrhythmias, but no data specifically on atrial fibrillation were available before now.

FDA Clears First Antiviral Surgical Mask

The US Food and Drug Administration (FDA) has granted market clearance to the first treated surgical facemask that promises to inactivate virtually all strains of the influenza virus in 5 minutes.

The BioMask has an inner layer treated with copper and zinc ions, which in vitro tests found to be effective against most influenza viruses. The multilayered mask is made by Filligent, a Hong Kong–based company that also makes antimicrobial wipes and shoe inserts.

Traditional surgical masks were designed to maintain sterile care settings and also offer some protection for healthcare workers. The new mask's treated filter is designed to block and inactivate viruses, including newly emerging pathogens such as H1N1 influenza.

The single-use mask enters the market as infection control specialists are debating the efficacy of traditional surgical masks vs N95 respirators, which protect users from aerosol particles. During the initial outbreak of H1N1 influenza in 2009, some health departments recommended N95 respirators, whereas others argued that surgical masks were sufficient.

The manufacturer reports that the FDA granted market clearance under a new medical device classification "OUK" for "anti-microbial/anti-viral surgical facemasks." The classification was created "by the FDA to accommodate Filligent's innovations in infection control and respiratory protection." The mask features plastic coating on the outer layer and a second inner layer treated with metal ions, "which form ionic bonds with negatively-charged side-groups on influenza viruses."

Gum Disease Can Increase the Time It Takes to Become Pregnant

Professor Roger Hart told the annual meeting of the European Society of Human Reproduction and Embryology that the negative effect of gum disease on conception was of the same order of magnitude as the effect of obesity.

Periodontal (gum) disease is a chronic, infectious and inflammatory disease of the gums and supporting tissues. It is caused by the normal bacteria that exist in everyone's mouths, which, if unchecked, can create inflammation around the tooth; the gum starts to pull away from the tooth, creating spaces (periodontal pockets) that become infected. The inflammation sets off a cascade of tissue-destructive events that can pass into the circulation. As a result, periodontal disease has been associated with heart disease, type 2 diabetes, respiratory and kidney disease, and problems in pregnancy such as miscarriage and premature birth. Around 10% of the population is believed to have severe periodontal disease. Regular brushing and flossing of teeth is the best way of preventing it.

Prof Hart, who is Professor of Reproductive Medicine at the University of Western Australia (Perth, Australia) and Medical Director of Fertility Specialists of Western Australia, said: "Until now, there have been no published studies that investigate whether gum disease can affect a woman's chance of conceiving, so this is the first report to suggest that gum disease might be one of several factors that could be modified to improve the chances of a pregnancy."

The researchers followed a group 3737 pregnant women, who were taking part in a Western Australian study called the SMILE study, and they analysed information on pregnancy planning and pregnancy outcomes for 3416 of them.

They found that women with gum disease took an average of just over seven months to become pregnant -- two months longer than the average of five months that it took women without gum disease to conceive.

In addition, non-Caucasian women with gum disease were more likely to take over a year to become pregnant compared to those without gum disease: their increased risk of later conception was 13.9% compared to 6.2% for women without gum disease. Caucasian women with gum disease also tended to take longer to conceive than those who were disease-free but the difference was not statistically significant (8.6% of Caucasian women with gum disease took over one year to conceive and 6.2% of women with gum disease).

Information on time to conception was available for 1,956 women, and of, these, 146 women took longer than 12 months to conceive -- an indicator of impaired fertility. They were more likely to be older, non-Caucasian, to smoke and to have a body mass index over 25 kg/m2. Out of the 3416 women, 1014 (26%) had periodontal disease.

Realistic Robotic Patient to Revolutionize Dental Schools

Showa Hanako 2 is a dentistry robot that will revolutionize the way students practice dentistry. The life like robotic patient sits in the regular dentist’s chair and gives the users almost the same stress that they would get while working on a human patient.

Showa Hanako 2 can sneeze, blink, roll its eyes, open and close its mouth, cough, and even gag if you stick your fingers too far back into its throat. It is even known to say “ouch that hurts!” The face of this pretty robot girl can give students of dentistry a good feel of what to expect with a real human patient.

The robot was the joint invention of researchers at the Universities of Showa, Waseda and Kogakuin. This is the second dental training robot to be made by the group. The first one was more like a plastic doll.

Showa Hanako 2 was produced by Tmsuk, a Japanese robotics company, and the realistic mouth lining came from a company that also manufactures sex dolls, Orient Industry. The robot will be sold to Japanese dental groups later this year by Yoshida Dental Manufacturing. The price for the dentistry robot is not yet known.

Enjoy your morning!