The Morning Drill: November 8, 2011

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

Equity firm to acquire American Dental Partners

American Dental Partners Inc. said Monday that it agreed to be acquired for about $317 million by a group led by the private equity firm JLL Partners Inc.

The company, based in Wakefield, Mass., has affiliations with 27 dental group practices with 282 dental facilities located in 21 states.

Under terms of the deal, its shareholders would get $19 per share in cash for each of its outstanding shares. That represents an 83 percent premium over the stock's closing price of $10.38 on Friday.

Its shares rose $8.20, or 79 percent, to $18.58 in afternoon trading Monday after rising to a 52-week high of $18.71 earlier in the session.

American Dental said a special committee of its board members negotiated the deal and recommended it to the full board, but it still needs shareholder approval.

The buyers would also assume $81 million in outstanding debt, boosting the value of the transaction to about $398 million.

Under terms of the deal, American Dental can seek acquisition proposals from other parties for 40 calendar days from the date of the merger agreement, and New York-based JLL Partners has the right to match a superior proposal.

American Dental Partners, Inc. Takeover under Investor Investigation

American Dental Partners, certain of its officers and directors, and/or others breached their fiduciary duties owed American Dental Partners, Inc. (NASDAQ:ADPI) investors in connection with the proposed acquisition.

On Monday, Nov. 7, 2011, American Dental Partners, Inc. (Nasdaq:ADPI) announced that it has entered into an agreement to be acquired by funds affiliated with JLL Partners, Inc., that provides for holders of the Company's outstanding common shares to receive $19.00 per share in cash. The transaction is valued at approximately $398 million, including $81 million in currently outstanding debt.

American Dental Partners, Inc said the price represents a premium of 83% to the closing price of the common shares as of November 4, 2011.

However, the investigation concerns whether the American Dental PartnersBoard of Directors undertook an adequate sales process and in particular breached their fiduciary duties to NASDAQ:ADPI shareholders by failing to adequately shop the Company before entering into this transaction. Furthermore the investigation concerns on whether the funds affiliated with JLL Partners, Inc would underpay for NASDAQ:ADPI shares, thus unlawfully harming American Dental Partners stockholders.

American Dental Partners’ performance for the past two years has been improving. Its annual Revenue rose from $274.34millio in 09 to $285.64million in 2010 and its Net Income increased from $7.73million in 2009 to $10.34million for 2010.

Premature Children Have Smaller Teeth, Research Suggests

The size of teeth in premature children is smaller than that of children who were full-term according to a study by the Faculty of Odontology at Malmö University in Sweden.

Our knowledge about premature children, and their physical and mental development as they grow up, is constantly growing. In recent years several studies of children's dental health have been published by researchers at the Faculty of Odontology in Malmö. Liselotte Paulsson-Björnsson, a specialist in orthodontics, has studied 80 children born before week 33 of pregnancy.

"We have examined how their teeth are developing and, among other things, we've looked at their bites. We've also checked their need for orthodontic adjustments and found that it is greater than in the control group, children born at full term," she says.

The children participating in the various studies were born in the mid 1990s and were examined when they developed their first permanent teeth at the age of eight to ten. The first permanent teeth are the front teeth in the upper and lower jaw and the so-called six-year molars, the first big molars.

The results show that the teeth of premature children were up to ten percent smaller compared with the control group. The earlier the children were born the smaller their teeth were.

"When we examined the children we also saw that their teeth were farther apart," says Liselotte Paulsson-Björnsson, who stresses that having small teeth as such is not a serious problem, but it can be aesthetically problematic to have large gaps between your teeth.

"But these problems can be addressed. We can move teeth if the gaps between them are too large, and there is also good material to extend teeth if they're too small."

Disturbances in the teeth's mineralization phase can also lead to spots on the front teeth, but this is also a problem that can be dealt with using cosmetic dental treatments.

Web-Based Intervention Appears Ineffective for Preventing Weight Gain in Adolescents

A web-based computer-tailored intervention aiming to increase physical activity, decrease sedentary behavior, and promote healthy eating among adolescents was not associated with positive long-term outcome measures, but may have positive short-term effects on eating behaviors, according to a report published Online First by Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

"The high prevalence of overweight and obesity among adolescents is a major public health concern because of its association with various chronic diseases," the authors write as background information in the article. "Computer tailoring has been recognized as a promising health communication technique to promote energy balance-related behaviors."

To evaluate short- and long-term effectiveness of a web-based computer-tailored intervention on preventing excessive weight gain in adolescents, Nicole P. M. Ezendam, Ph.D., then of Erasmus University Medical Center, Rotterdam, the Netherlands, now of Tilburg University, Tilburg, the Netherlands, and colleagues developed the online school-based, FATaintPHAT intervention. The intervention included 20 schools in the Netherlands, and a total of 883 students ranging from 12 to 13 years of age. The main objectives of the intervention were to improve dietary behaviors (including reducing consumption of sugar-sweetened beverages, and increasing intake of fruits, vegetables and whole grains), reduce sedentary behavior and increase physical activity. Students not meeting behavioral guidelines at the start of the study were considered "at risk."

The FATaintPHAT intervention included eight modules that addressed issues of weight management and energy balance-behaviors. Each module contained information about the behavior-health link, an assessment of behavior, individually tailored feedback on the behavior and an option to formulate an implementation intention to prompt specific goal setting and action planning.

The complete analysis showed no intervention effects on BMI (body mass index), waist circumference, or percentage of students being overweight or obese in the total sample. At the four-month follow-up, students in the intervention group were less likely to report drinking more than 400 milliliters (13.52 ounces) of sugar-sweetened beverages per day compared with students in the control group in the total sample, but not in the at-risk group. Average self-reported snack consumption was lower in the intervention group than the control group at the four-month follow-up; however, the difference was not statistically significant at the two-year follow-up.

Enjoy your morning!