Wednesday, January 02, 2013

The Morning Drill: January 2, 2013

Happy New Year!

On to today's dentistry and health headlines:

Wary dentist fixes lion's tooth troubles at Werribee zoo

Well, when the patient is a 161kg lion, oral surgeon Dr David Clarke has no desire to be nearby, waving a drill, when the anaesthetic wears off - and never has the timing of that been more important.

Get it wrong and "I'd be running for the door - the first one out, for sure".

But he says in 20 years of dentistry on wild animals, none has woken early, and Werribee zoo's Johari, 9, proved no exception during a 20-minute operation to fill a tooth.

Court defeat could open door to Medicaid doctor pay cuts

An appeals court ruling allowing California to cut Medicaid payments could provide other states more freedom to pursue similar reductions, observers said. A panel of the 9th U.S. Circuit Court of Appeals ruled Dec. 13 that California may slash pay by 10% to doctors, pharmacists and others who serve low-income patients under Medi-Cal, the state’s Medicaid program.

The three-judge panel said the federal Dept. of Health and Human Services has the authority to determine whether states are justified in cutting Medicaid rates, and that California need not have considered physicians’ costs of providing all the medical services in question before receiving approval from the government for the rate reductions. If the decision stands, it would impede efforts by health professionals throughout the nation to resist unjust Medicaid cuts, said Francisco Silva, vice president and general counsel for the California Medical Assn. The medical society, a co-plaintiff in the case, will ask the full appeals court to rehear the case.

Long-term study supports periodontitis/diabetes link

The scientific evidence linking type 2
diabetes with a significantly greater risk of periodontitis continues to
mount, according to long-term data published in Diabetes Research and Clinical Practice (December 2012, Vol. 98:3, pp. 494-500).

Type 2 diabetes mellitus (T2DM) exhibited an even stronger association with risk of periodontitis among those who consumed few fruits and vegetables, noted the study authors, from the Harvard School of Public Health, Brigham and Women's Hospital, Dana-Farber Cancer Institute, and University of Puerto Rico School of Dentistry.

In one of the largest prospective investigations evaluating the association between periodontitis and T2DM, they analyzed data from the Health Professionals Follow-up Study (HPFS), an ongoing closed cohort that comprises 51,529 U.S. male health professionals, ages 40-75 (at baseline), who responded to a mailed questionnaire in 1986 to evaluate associations between diet, heart disease, and cancer.

The initial questionnaire collected data regarding diet, lifestyle behaviors, anthropometric measures, medication use, and medical and dental histories. Follow-up questionnaires have been mailed biennially since 1988, and more than 90% of the baseline population has responded to these additional questionnaires, the researchers noted.

"Given the high prevalence of periodontitis, the public health impact of an association between diabetes and periodontitis would be substantial among those affected by diabetes," they wrote.

Enjoy your morning!

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