Friday, May 04, 2012

The Morning Drill: May 4, 2012

Augusta Pediatric Dentistry assistant Molly Turner, left, and hygienist Diana DeRocher apply dental sealants to the teeth of Blin Rollins, 8 of Augusta, Maine. Photo: MSNBC

Good Friday morning! It is almost the weekend.

On to today's dentistry and health headlines:

Decay dilemma: Do kids need dental sealants?

But what Rollins didn’t know is that her child’s mouth is part of an ongoing debate over whether enough kids get the liquid plastic coverings that protect what Shenkin calls “the most decayed tooth in the mouth.”

Only about 20 percent of children at poverty level and only 40 percent of kids from higher-income homes actually receive recommended sealants, according to studies by the Centers for Disease Control and Prevention.

That confounds Shenkin, a pediatric dentist and spokesman for the American Dental Association. He says decades of research demonstrate that coating the biting surfaces of 6-year molars with a resin-based sealant can reduce cavities by up to nearly 80 percent immediately -- and up to 60 percent for four years or more.

“It’s imperative that as soon as those adult teeth erupt, that they be sealed,” he said.

In practice, however, less than 40 percent of dentists actually follow the recommendations of the ADA, according to a 2011 study by researchers at Temple University. The study tracked whether dentists were willing to seal teeth with the beginnings of decay, but no actual cavities.

“The lack of dentists doing sealants is a very silent and probably the most significant issue to care we face among children,” said Shenkin. “Parents should be asking for sealants and not taking no for an answer.”

But one of the profession’s most well-regarded dentists has been publicly cautious about sealants, saying there can be a high failure rate -- 50 percent within five years -- and arguing that they shouldn’t be placed if there’s any evidence of decay.

Gordon J. Christensen, who publishes Clinicians Report, widely regarded as the “Consumer Reports of dental products,” says that sealants done properly are “an excellent technique” for combatting decay. But, he adds, the success of the sealant depends largely on the skill of the person who applies it.

 “They have to seek out a practitioner who knows what they’re doing,” he said.

“If they see failure immediately, that opens the window for decay.”

Christensen is concerned about so-called “non-cavitated caries lesions,” early signs of tooth decay that have not yet resulted in cavities. He worries that sealants trap plaque on the tooth, creating an environment that fuels future decay.

CDC researchers say studies have shown that decay does not progress once sealants are added, but Christensen maintains that he’s not convinced.

Dentist charged with possession of crystal meth with intent to sell

A Silver Spring dentist has been busted for allegedly possessing methamphetamines and charged with intending to distribute the drugs.

Dr. Siar Karmand was arrested early Thursday morning at his home in the gated Beekman Place community in Northwest D.C.

D.C. Police claim to have found $11,000 worth of crystal meth and seven ounces of GHB in Karmand's home.

"There's a common denominator to drug use," says Ward 3 D.C. Councilmember Jim Graham. "It applies across the board. It doesn't have any particular group, class or income that it favors over another. It's just that we have stereotypes about all this. And this cuts through the stereotypes."

Karmand maintained an office at a medical building on Georgia Avenue in Silver Spring. At the dentist office next door to his, the staff told us this was a sad day for dentistry. They told us they rarely saw Karmand. They say he kept odd hours.

Aspen Dental Donates More Than $16,000 to Oral Cancer Foundation

Aspen Dental, one of the largest networks of dental care providers in the U.S., is donating $16,255 to the Oral Cancer Foundation in recognition of Oral Cancer Awareness Month. As a commitment to early oral cancer detection, 340 Aspen Dental practices in 22 states donated $5 from every Vizilite Plus screening conducted during the month of April. A total of 3,251 screenings were conducted throughout the month.

"The Oral Cancer Foundation is steadfast in its commitment to saving lives through prevention, research and advocacy, and we're proud to support their efforts through this donation," said Maureen Howes, RDH, MS, director of hygiene services at Aspen Dental Management, Inc.

According to the Oral Cancer Foundation, close to 37,000 Americans will be diagnosed with oral or pharyngeal cancer this year, which is responsible for approximately 8,000 deaths annually. Common risk factors for oral cancer include use of tobacco products (smoked and smokeless), excessive alcohol consumption, and HPV infection.

Coffee Stains Teeth More Indelibly Than Tobacco

Coffee stains return on bleached teeth, whereas cigarette stains may not. In addition, coffee stains cannot be removed by brushing alone, researchers report in an article published in the May issue of the Journal of the American Dental Association.

Soaking cows' teeth in coffee and exposing them to cigarette smoke darkened them about the same amount, but tooth brushing only lightened the smoke-stained teeth, not the coffee-stained teeth, note Juliana Zavala Bazzi, DDS, MDS, from Pontifical Catholic University of ParanĂ¡, Curitiba, ParanĂ¡, Brazil, and colleagues.

"We didn't expect that cigarette staining would be so easily removed either by tooth bleaching or toothbrushing," corresponding author Evelise M. Souza, DDS, MDS, PhD, a professor of restorative dentistry at the Pontifical Catholic University, told Medscape Medical News in an email.

Although bleaching is well established as a method of whitening teeth, there is not much research to show the susceptibility of bleached teeth to being stained once again, they note.

Enjoy your morning!

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