Monday, June 18, 2012

The Morning Drill: June 18, 2012

Good Monday morning!

I have been away on vacation the past ten days or so and had a great time in Las Vegas, Nevada and the World Series of Poker.

Now, on to today's dentistry and health headlines:

Canadian firm to buy OraPharma for $312M

Valeant Pharmaceuticals International is acquiring OraPharma, makers of Arestin and other oral health products, from private equity firm Water Street Healthcare Partners for approximately $312 million.

The deal marks Valeant's first foray into the dental market. Valeant is a publicly traded pharmaceutical company that develops, manufactures, and markets a range of pharmaceutical products primarily for neurology, dermatology, and branded generics.

OraPharma was founded in 1996 and acquired by Johnson & Johnson in 2002, although the deal was not completed until February 2010, at which time the transaction was valued at $85 million.

Water Street acquired OraPharma from Johnson & Johnson in December 2010. At the time, Water Street officials said it planned to build OraPharma into a leading pharmaceutical products company focused exclusively on dental and oral health.

OraPharma's flagship product, Arestin, is the first locally administered, time-released antibiotic encapsulated in microspheres that effectively controls the germs that can cause periodontal disease, according to the company. OraPharma's other product development efforts include a compound for the treatment of oral mucositis, an agent for bone and tissue regeneration, and a next-generation periodontal therapeutic.

Gum Disease Joins Hot Flashes and PMS Associated With Women's Hormones

Women, keep those toothbrushes and dental floss handy. A comprehensive review of women's health studies by Charlene Krejci, associate clinical professor at the Case Western Reserve University School of Dental Medicine, has shown a link between women's health issues and gum disease.

Across the ages, hormonal changes take place during puberty, menstruation, pregnancy and menopause. Krejci found female hormones that fluctuate throughout women's lives can change conditions in the mouth that allow bacteria to grow, enter the blood, and exacerbate certain health issues like bone loss, fetal death and pre-term births.

Her overview of the literature was reported in the article, "Women's Health: Periodontitis and its Relation to Hormonal Changes, Adverse Pregnancy Outcomes and Osteoporosis" in the May issue of Oral Health and Preventive Dentistry.

The Case Western Reserve University periodontist reviewed 61 journal articles with nearly 100 studies for a collective answer on whether hormones have a relationship to gum disease and specific women's health issues like preterm labor, bone loss, and the side effect of hormonal replacement therapy.

"There's definitely a gender-specific connection between women's hormones, gum disease, and specific health issues impacting women," Krejci said.

Study: Graphic warning labels on cigarette packs work

Adding graphic warning labels on cigarette packaging can improve smokers' recall of the warning and health risks associated with smoking, according to researchers from the Perelman School of Medicine at the University of Pennsylvania.

Their findings are published online first in the American Journal of Preventive Medicine.

In past studies in Europe and Canada, graphic warning labels have proved to be effective in eliciting negative responses to smoking, increasing reported intention to quit smoking in smokers, and modifying beliefs about smoking dangers, the researchers noted. However, these previous research results have generally been conducted using large, population-based studies that could be confounded by concurrent tax increases or antismoking media campaigns that coincide with the introduction of new warning labels.

"An important first step in evaluating the true efficacy of the warning labels is to demonstrate if smokers can correctly recall its content or message," said lead author Andrew Strasser, PhD, an associate professor in the department of psychiatry. "Based on this new research, we now have a better understanding of two important questions about how U.S. smokers view graphic warning labels: Do smokers get the message and how do they get the message."

Antibiotic Limits in 2007 Endocarditis Guidance 'About Right'

There has been no increase in the incidence of infective endocarditis (IE) in patients with specific underlying cardiac conditions, despite what was considered a "sea change" in AHA recommendations in 2007, whereby antibiotic prophylaxis for this--previously given to all considered "at risk"--was restricted to just four very high-risk groups, new research published online today in Circulation shows [1].

The findings show that the updated recommendations are "about right," says lead author Dr Daniel C DeSimone (Mayo Clinic, Rochester, MN). "There remained a lingering concern from the medical community that the 2007 AHA dental-prophylaxis guidelines may be leaving patients at risk for viridans group streptococci (VGS)-IE. This study aims to reduce this fear, as we found no increase in incidence of VGS-IE in our population-based study," he told heartwire .

Writing in an accompanying editorial [2], dentist Dr Peter Lockhart (Carolinas Medical Center, Charlotte, NC) says, "DeSimone and colleagues have provided further data to reinforce the trend toward a greatly decreased number of patients recommended for antibiotic prophylaxis."

There remained a lingering concern from the medical community. . . . This study aims to reduce this fear, as we found no increase in incidence of IE.

And in fact, says DeSimone, the idea that those undergoing dental procedures are most at risk of developing IE is a fallacy. "Since 1955, patients have been told that dental procedures place them at a higher risk of developing IE, when brushing your teeth, flossing, and/or chewing food is more likely to cause IE," he observes.

Lockhart agrees, adding that there is a need "for a more definitive study to determine the extent to which oral hygiene, periodontal disease, and oral bacteria are associated with IE. These data would improve our understanding of the risk factors and refocus efforts on prevention of IE to improving oral hygiene." Such data would be "immediately transferable to everyday clinical practice, and it would inform future AHA and other international guidelines on preventive strategies for IE."

Enjoy your morning!

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