March 2005

Ideal Tooth Brush...
Wednesday, March 30, 2005 | gp

BRUSH BASICS

Replace your toothbrush at least every three months; more often if the bristles become frayed or splayed.

Replace your toothbrush when you first get sick and when you feel better. Otherwise, you can keep re-infecting yourself.

Use a toothbrush that fits comfortably in your mouth so that you can reach all of your back teeth.

Never store your toothbrush in a closed container or dark place.

Allow your toothbrush to dry upright.

Do not store your toothbrush in the bathroom, which often has the highest concentration of bacteria in the house.

Soaking your toothbrush in a mouthwash or other disinfecting solution once a week will kill many, but not all, bacteria.

Never share your toothbrush, and don’t let toothbrushes touch each other.


Brushing your teeth is one of the basic tenets of personal hygiene, taught and reinforced before you’re out of diapers.

But tooth brushing is as much about the health of your gums as the aesthetics of your teeth. Gum disease has been linked to everything from heart disease to a lackluster social life, but one of your main defenses against it — the toothbrush — can pose a health risk all by itself. Yet few people give much thought to its care and cleaning.

“I really believe we need to be better about taking care of our toothbrush,” said Maria Perno Goldie, past president of the American Dental Hygienists’ Association. “Periodontal disease can be transmitted toothbrush to toothbrush, tooth decay can be transmitted … not to mention colds and other illnesses. Plus, if you have periodontal disease or a cold, you can keep re-infecting yourself.”

But what kind of toothbrush should you be using in the first place?

Experts agree that a soft-bristled brush with end rounding bristles is the safest, most effective brush for most people because it’s gentle on teeth and gums. Individuals should choose a brush that is small enough to fit far enough into their mouth so that it easily reaches their back teeth, according to Dr. Bruce Barton, a dentist in Hood River, Ore., and president of the Academy of General Dentistry.

“Hard bristles don’t get teeth any cleaner, and can actually damage gum tissue and wear away teeth over time,” Barton said.

There is no clear recommendation on whether to use a manual or power toothbrush, and most dentists leave that to a patient’s personal preference and pocketbook.

Power toothbrushes are becoming more popular. Barton said people with limited dexterity might prefer them, as well as those who tend to brush too hard, since most have a built-in function that shuts the brush down when too much pressure is applied.

“The best power brushes have oscillating and rotating motion,” Goldie said. “A power brush is better because it has three dimensional movement — it cups the tooth and goes in and out.”

Whether you’re using a power or manual brush, the recommended brushing time is about two minutes. To help kids get used to this, Hasbro is coming out with a toothbrush in late 2005 that will play a two-minute song while kids brush.

Once you have the right toothbrush, caring for it properly can make a big difference in your overall health.

Many people simply change toothbrushes when they go to the dentist and get a new one for free. But experts agree you should change your toothbrush at least every three months, more often if you’re sick.

Others recommend more frequent swaps, and go so far as recommending a daily toothbrush change if you have major surgery scheduled in the next two weeks.

“The act of brushing produces bacterium, which puts bacteria in bloodstream,” said Dr. R. Tom Glass, D.D.S. and professor of forensic sciences, pathology and dental medicine at Oklahoma State University in Tulsa. “The area of surgery gets high blood flow, so it will be the main target of anything in bloodstream.”

Where and how you store your toothbrush is also important. The bathroom, although intuitive, is not the best place, and often has the highest bacteria levels of any room in the house.

“When we brought the outhouse in-house, we changed its location, not its function,” Glass said.

Toothbrushes are best stored outside the bathroom, preferably near a source of natural light. There are also several different toothbrush sanitizers on the market using either ultra-violet light or steam to disinfect the brush.

Toothbrushes should be left upright to dry and should never be put into a dark or airtight container, which are perfect breeding grounds for bacteria, Burton said.

Soaking your toothbrush in mouthwash once a week will kill most bacteria, and washing your hands before picking up the brush also cuts down on germs, Burton said.

Travel toothbrushes present a special challenge, since they need to be kept clean and dry while traveling and shielded from the unknown germs lurking in your hotel room.

One suggestion is to bring your toothbrush from home and toss it at the end of the trip. Never, ever put your toothbrush on the counter in a hotel room.

“Someone was in that room last night, and it wasn’t you,” Glass said.
For people who scoff at unwrapping a fresh brush more than once or twice a year, Glass suggests they put it in perspective, compared to those $4 golf balls they leave in water traps each weekend, or the $5 double mocha latte they line up for each day.

Tips on tooth whitening...
Wednesday, March 30, 2005 | gp

First of all, try your best at home to whiten your teeth. There are several products that are designed for home use. Most of them contain carbamide peroxide as the whitening agent. Some can be purchased over the counter but check with your dentist. Not every product has been approved by the American Dental Association. When it comes to the health of your teeth, it is best to stick with the tried and the true.

Usually, the tooth-whitening gel is best to cure the problem. It is spread in a molded mouth tray. If you have received your kit through your dentist, the mouth tray will be custom-made for your teeth. You wear the mouth tray for the prescribed amount of time, and over the course of several weeks, your teeth are gradually lightened. This is the very effective method of whitening your teeth at home.


But in case your teeth doesn’t get whiten at home and they are still stained or yellowish. Then you need to consult a dentist.

Dentists can perform a "super bleach" in their office. During this procedure, the dentist covers the gums with either a protective gel or a rubber dam. Then, the bleaching agent is applied to the teeth. Next, the teeth are exposed to a special light that enhances the bleaching agent. After 30 to 60 minutes, the teeth become lighter than they were before. If necessary, this treatment can be repeated several times until ideal tooth color is achieved.

Some side-effects: In this tooth whitening procedure, some people experience minor side-effects. Some can experience tooth sensitivity following treatment. This is temporary and goes away when treatment is finished. Another problem that can result is irritation of the gums. This happens if the bleaching agent is allowed to come in contact with the soft tissues. This is more of a problem in the do-it-yourself kits than in the ones that are properly prescribed by a dentist.

Not all the teeth respond the best to bleaching. Brownish teeth do not respond as well, and gray-hued teeth may not bleach well at all. Also, restored or bonded teeth do not bleach and stand out noticeably against your other bleached teeth. For these teeth, other options such as veneers and bonding should be investigated. They, too, can be made whiter and more attractive.

Most people can benefit from having their teeth whitened. But remember, only use products that carry the Dental Association's seal of approval. Consult your dentist for the one that is right for you.

Gingivitis- Signs and symptoms
Tuesday, March 29, 2005 | gp

Gingivitis is the inflammation and infection of the gum tissue surrounding the teeth. It is a very common condition and can affect people of any age group.

Causes: The causes may include poor eating habits, poor tooth alignment, heavy plaque deposits, blood disorders, drug reactions and vitamin deficiencies and most important poor dental hygiene.


Signs of gingivitis:

---swollen and tender gums

---blood on toothbrush while brushing

---pus around teeth

---bad breath

---gum redness

---visible tartar deposits

---bad taste in mouth

---gums bleed easily

---gum ulcers

Gingivitis can cause damage in other areas of the body if allowed to remain untreated. The bacteria from the gums can enter the bloodstream and cause infections elsewhere. Gum disease has been linked to heart disease, stroke and pneumonia. It may also cause the delivery of premature infants to gingivitis-infected mothers. Those with diabetes may have problems controlling blood sugar levels if they also suffer from gingivitis.

Treatment: As it’s harmful for the body so it needed to be cured timely. If you see any signs of gingivitis, go to the dentist. The dentist will first remove the plaque and tartar from the teeth. Newer and more advanced dental instruments make it possible to clean much deeper below the gum line and remove more plaque and tartar deposits. The dentist will also take steps to eliminate any areas where bacteria may breed, such as broken bridgework or fillings, etc. The dentist will give instructions concerning proper dental care. Various gels, mouth rinses and toothpastes to prevent plaque build-up may be prescribed. It’s quite easy to solve the problem of simple gingivitis.

However, advanced gingivitis is a more serious matter. Advanced gingivitis occurs when gingivitis spreads to the bony tissues which support the teeth. The gingivitis has then progressed into periodontitis, a serious condition. After reaching this stage, the teeth become loose and pus may come from the gums or tooth sockets. The infection may become so serious that teeth literally fall out or must be removed. In severe cases, surgery may be necessary. Oral treatments such as antibiotic applications and medications are available for those who do not wish to have surgical procedures.

Natural treatments: There are several alternative treatments that can help to prevent gingivitis. It is believed that an adequate amount of calcium will help reduce the risk of gingivitis by strengthening the bones of the jaw, thus making them more resistant to infection. Cranberry juice is believed to reduce plaque accumulation by inhibiting bacteria in the mouth from sticking together. Adding foods containing calcium and drinking cranberry juice may have a positive effect on the gums of those prone to gingivitis. It is also recommended that foods containing sugar be limited since sugar stimulates the production of acid which may help to erode teeth and gums.

Energy and Sports Drinks Attack Enamel
Saturday, March 26, 2005 | gp

- A study of the effects some of these beverages had on enamel, appearing in the January/February 2005 issue of General Dentistry, the Academy of General Dentistry's (AGD) clinical, peer-reviewed journal, found that over time, exposing dental enamel to bottled lemonades, energy drinks and sports drinks can do more harm to tooth enamel than soft drinks.

"This study revealed that the enamel damage caused by non-cola and sports beverages was three to 11 times greater than cola-based drinks, with energy drinks and bottled lemonades causing the most harm to dental enamel," says J. Anthony von Fraunhofer, FRSC, FADM, lead author, Professor of Biomaterials Science at the University of Maryland Dental School. "A previous study in the July/August issue of General Dentistry demonstrated that non-cola and canned iced teas can more aggressively harm dental enamel than cola."

Most soft drinks contain one or more food additives. These acids cause the tooth enamel to breakdown. Phosphoric and citric acid are the most common but malic and tartaric acids are sometimes present.

Drinking the beverages does not automatically mean a mouth full of cavities. There are ways to minimize the harmful effects, says Dr. von Fraunhofer.

"The major problem with any of these drinks is not chugging it down, it's sipping continuously over a long period," says Dr. von Fraunhofer. "Sitting and sipping on these drinks throughout the day can do terrible things to your teeth."

The study continuously exposed enamel from cavity-free molars and premolars to a variety of popular sports beverages, including energy drinks, fitness water and sports drinks, as well as non-cola beverages such as lemonade and ice tea for a period of 14 days (336 hours). The exposure time was comparable to approximately 13 years of normal beverage consumption.

The study findings revealed there was significant enamel damage associated with all beverages tested. Results, listed from greatest to least damage to dental enamel, include the following: lemonade, energy drinks, sports drinks, fitness water, ice tea and cola. Most cola-based drinks may contain one or more acids, commonly phosphoric and citric acids; however, sports beverages contain other additives and organic acids that can advance dental erosion. These organic acids are potentially very erosive to dental enamel because of their ability to breakdown calcium, which is needed to strengthen teeth and prevent gum disease.

AGD spokesperson and President-Plect Bruce DeGinder, DDS, MAGD, agrees that it is healthier to drink a soft drink all at once rather than sipping for a long period of time.

Link Between Pregnancy and Tooth Loss
Saturday, March 26, 2005 | gp

NYU Dental Researcher Finds Link Between Pregnancy and Tooth Loss
Monday, Mar 07, 2005

The old wives tale, “for every child the mother loses a tooth,” has some validity, according to New York University College of Dentistry’s Dr. Stefanie Russell.

Russell’s paper, entitled “Exploring Pathways between Parity and Dental Health in U.S. Women,” is being presented at the 83rd General Session of the International Association for Dental Research (IDAR) in Baltimore, MD, March 8th and 10th. This is the first U.S. study conducted that shows a link between number of pregnancies and oral health problems.

To schedule an interview with Dr. Russell during or after the IADR conference, please contact Ami Finkelthal, 212.998.9294 or af73@nyu.edu.

Dr. Russell’s study looked at 2,635 white and black non-Hispanic women aged 18-64 who reported at least one pregnancy. The data were selected from the Third National Health and Nutrition Examination Survey (NHANES III), a nationally representative study of the U.S. population.

Dr. Russell found that childbirth is related to dental disease in American women. Although further study is needed to determine the specific reasons for the link, Dr. Russell offers these hypotheses:

While it has been shown that pregnancy raises the risk of gingivitis (gum disease), the gingivitis usually goes away after the birth of the child. But if a woman has repeated pregnancies and more frequent outbreaks of gingivitis, she may develop periodontal disease, which if left untreated can eventually cause tooth loss.
Many dentists are reluctant to treat pregnant women, and women who have to care for more children may have less time to visit the dentist.
Mothers with several children may be more likely to eat the “junk food” that their kids are eating.
Dr. Russell’s findings suggest that women with several children need to be especially vigilant about their oral health. “We, as a society, need to be more aware of the challenges that women with several children may face in getting access to dental care,” Dr. Russell says. “That means offering these women the resources and support they need, which can be as simple as making sure a working mother gets time off from work to see the dentist.”

Source:New York University College of Dentistry

The end for false teeth?
Saturday, March 26, 2005 | gp

THE skilled art of making false teeth may be lost in a tidal wave of patients clamouring for teeth-whitening and other cosmetic procedures.

Experts have warned, at a meeting in Cardiff, that people who lose their teeth face a future crisis at the dentist.

The British Society for the Study of Prosthetic Dentistry is concerned dental schools are no longer teaching their students key technical skills, such as denture making.

No longer regarded as fashionable, amid high demand from patients for a "Hollywood smile", the society claims teaching resources at dental schools are now concentrated on areas that attract research funding - such as preventative dentistry and orthodontics - at the expense of the making of dentures (prosthodontics).

But, the society warned, while tooth loss is a taboo subject and the UK's 11 million denture wearers are a large and invisible population, their needs should not be underestimated.

It is not just the elderly who require dentures - almost a million people aged 16 to 44 have false teeth and the NHS provided dentures for 12,408 children and young people aged six to 24, in England and Wales in 2003.

Dr Brian Schottlander, from Davis Schottlander and Davis, who's Enigma and Natura range of teeth and dentures won the 2004 Queen's Award for Excellence, said, "Our dental health may have improved dramatically in recent years, but millions of people in the UK still suffer tooth loss.

"Providing high quality dentures will continue to be of key importance.

"People have increasingly high expectations when it comes to their health and politicians underestimate the critical importance of dentures to those who need to wear them."

By 2021 it is expected that one in five people will be over 65 and, as people are living longer, they will need to wear dentures for longer.

The society said many of the baby boomers, who are now approaching old age, will need false teeth in years to come, even though they have better dental health than their parents.

But it is feared in years to come there will be fewer dentists trained in making sets of replacement teeth.

Although new techniques for dental implants, which allow replacement teeth to be permanently fixed on titanium screws in the jawbone, will provide some people with an alternative to dentures, not everyone will be suitable for them, the society's members said.

The Welsh School of Dentistry has recently changed its teaching of prosthetic dentistry to reflect the changes in the dental health of the population and the corresponding changes in dental practice.

Peter Jacobsen, who is responsible for teaching prosthodontics, said, "People are now living longer and keeping their natural teeth longer too.

"There are far fewer people losing all their teeth and having to wear complete dentures.

"There has also been an increase in the use of fixed tooth replacements by means of implants and bridges. This means there is a changing emphasis in restorative dentistry and this has been met at Cardiff by combining the two subjects of fixed and removable prosthodontics to provide integrated teaching.

"Dental students learn the clinical and laboratory techniques involved in providing complete and partial dentures in combination with learning about fixed prosthodontic appliances in the context of the management of patients having one or many missing teeth."

Some Dental Remedies
Saturday, March 26, 2005 | gp

Two substances have been handed down for generations as folk. medicines: baking soda and common table salt. Claims for the properties of these familiar chemicals range from the ridiculous to the sublime: They've probably been "known" to cure almost anything, at one time or another.

In your oral health medicine cabinet, these two can be used for hygienic purposes as well as dental first aid. The first use, hygiene, simply has both soda and salt doubling as a dentifrice.

As a youngster, you probably experimented at one time or another by mixing baking soda and vinegar. Remember the reaction? The solution bubbled and boiled and fizzed: Something was happening. Apparently vinegar and soda are not overly compatible. Why is that? Well ... vinegar is acidic, and soda is alkaline. Acid and alkali are at separate ends of a scale ... they truly "don't get along".

Part of the disease process of odontosis takes place when the germs ingest sugar and begin excreting acid. It is this acid that begins the insult to tooth enamel which will become, eventually, a cavity.

If you use soda as a dentifrice, you will no doubt create that "soda—vinegar" reaction ... except on a scale so small as to escape observation. In this, there aren't any research figures we can supply ... no weighty documentation is available. It is, instead, plain common sense. Soda and acid are not compatible. Soda won't hurt your teeth and gums ... it won't hurt you if you swallow a teaspoonful (makes you burp) ... but it isn't going to do acid a whole lot of good when it comes in contact with it. Conversely, acid will hurt you in the teeth and gums. . . "it'll rot yer teeth. "

Salt is sodium chloride, which is a significant element in the physical makeup of the human body. The "saline solution" used in many medical applications is generally about point nine percent (0.9%) salt in water. It is used, for example, as a base solution for injections: It balances the osmotic action of the body fluids so the injection does not disturb the normal balance of water inside the body's cells at the area of the injection.

Saline solution (salt water) in any concentration where the salt can be tasted will be a hypertonic solution: It will draw water from the cells of tissue bathed in it. A hypertonic condition in the mouth will instantly and automatically cause the salivary glands to go into overtime production. This is something to remember if you are frequently in places where water is not available for "normal" toothbrushing. A dry mixture of soda and salt is not inconvenient to take along on a camping trip, for example. Using this "dentifrice" without water is easy: The mouth's water fountains will provide more than enough.

This capacity of salt—to act as a hypertonic and draw water (fluids) from tissues—should be kept in mind for another reason: When teeth "act up" and pain sets in; there is often (perhaps usually) a buildup of fluids in the area of the affected tooth. Wouldn't it make sense to use a "medicine" which helped reduce this fluid pressure? Hand me the salt, please ... I'm getting a toothache....

Role of Dental Hygienist picking up...
Friday, March 25, 2005 | gp

There are three major roles in the Dental Office today, the dentist, the dental hygienist, and the dental assistant. Each role is equally important to helping the patient receive good oral care. The dental hygienist has become one of the 30 fastest growing occupations, and with the growing population and increase in the elderly, the need for dental hygienists has become much greater. In a typical dentists office the dental hygienist would have many responsibilities, such as teaching clients how important it is to maintain good oral hygiene and instructing them on the principles of preventive oral care. They would also help demonstrate to the patient how to brush and floss their teeth correctly, how to select the correct type of toothbrush for their teeth and analyze patients’ diets and counsel them on how to eat right to maintain good dental and gum health. And although dental hygienists duties may vary from state to state due to their laws, they typically include examining the teeth and gums for any disease or abnormalities, taking medical and dental histories, and charting the condition of the client’s teeth. Hygienists also clean, polish, inspect for cavities and loose fillings, look for cracks in teeth.

DentistryRegister.com...Dental Industry Supplier Directory
Thursday, March 24, 2005 | gp

DentistryRegister.com is an online dentistry supplier directory of 1,500 worldwide vendors for dental labs, dental infection control equipment and dental practice. Site includes free magazines, jobs, news, links, forums and event calendar. Buyers can browse and search suppliers arranged categorically across 1,000 dental products. Suppliers can list and monitor their impressions online.

Process Register, Inc. announces launch of www.dentistryregister.com, a comprehensive online reference database of suppliers of products and services for the dental industries. The elegant user interface has been meticulously designed to allow prospective buyers to efficiently search and browse over 1,000 vendors of 1,000 dental products. The geographical search and diversity of the vendor listings is a testament to our commitment to an international audience. While the buyer's guide is the primary focus, we also provide carefully laid out, useful process industries content such as magazines, jobs, news, events, links and forums.

While companies may have a mere presence on the internet via web sites, DentistryRegister has achieved prominence among a huge audience who prefer to consult a single comprehensive reference database for their buying needs. Vendors can list their company in 3 easy online steps and can self manage and monitor hits in their online listing by signing in at any time later. DentistryRegister harnesses brilliant technology to provide innovative services such as customized store fronts and zoned ad-banners. This enables small and medium sized business targeting the dental industries to have a powerful marketing presence on the internet, helping them to defend and advance their market position against large companies.

The vendors and buyers linked by DentistryRegister.com participate in a wide product range including dental laboratory equipment, denture materials, inlays, crowns, bridges, orthodontic elements, prophylaxis oral hygiene, autoclaves, dental infection control, dental chairs and much more.

Karnataka Common Entrance on May 1
Thursday, March 24, 2005 | gp

The Association of Medical, Dental and Engineering colleges (Comed-K) has decided not to await the Supreme Court decision and go ahead with its entrance test for admission to professional courses.


Non-Karnataka students too can write the Comed-K test on May 1, two days before the state CET.

Even as the state government is yet to finalise its strategy for admissions for 2005, Comed-K at its meet held on Wednesday has decided to go ahead with its admission process. "We've already identified 12 centres across the state to hold the exam. We're not going ahead with an all-India entrance test. But we'll not bar any student, from Karnataka or outside the state, to take the exam.",said Comed-K secretary S. Kumar .

The Comed-K notification will be out on March 28 that will give details of the number of colleges and the seats that will accept the Comed-K scores. In 2004, 20,000 students took this entrance test.

Last year, 16 medical colleges, 22 dental colleges and 34 engineering colleges accepted the Comed-K scores. This year, as the state CET is restricting itself only to Karnataka students, sources in the Comed-K offices stated, "More engineering colleges have sent in letters to join Comed-K. With so many seats in engineering colleges going vacant, they've lost trust in the state CET. The government will not be in a position to fill up the huge number of engineering seats only with Karnataka students."

Comed-K has argued for 100 per cent seats before the Supreme Court. Last year, Comed-K gave away 50 per cent of its seats to the government. The All-India Private Colleges Management Association too had argued for an all-India test for admitting students under the management quota.

Mom's Dental Health Could Affect Baby's Birth
Thursday, March 24, 2005 | gp

March 23, 2005 -- Pregnant women have extra incentive to brush,Pregnant women have extra incentive to brush, floss, and take good care of their teeth. Those simple steps could help their babies get a better start in life.

Bacteria in the mouth of the mother-to-be could influence the baby's birth weight and delivery date, says a new study. That's important because babies born prematurely and/or at a low birth weight are more vulnerable to health problems, disability, and even death.

The preterm and low birth weight problem was put in sharp, startling detail earlier this year in a CDC report. The CDC found that infant deaths rose in 2002 for the first times since 1958,CDC found that infant deaths rose in 2002 for the first times since 1958, partly due to more babies being born too small and too soon.

"Birth weight is one of the most important predictors of an infant's survival chances," the CDC reported. The 2002 death rate for preterm infants was 15 times higher than that of full-term babies, according to the CDC.

Rates Rising

Today, most U.S. babies are not born prematurely (before 37 weeks of pregnancy) or at a low birth weight. Medical advances have made it possible to keep tiny babies alive that would almost certainly not have survived in past generations.

But the problem hasn't gone away. Preterm low birth weight is still the second leading cause of infant death in general.

The numbers have increased in America over the last few decades. The preterm delivery rate rose from 10.2% to 11.6% of all live births from 1987-1998. Low birth weight increased for all races from 6.8% to 7.6% from 1980-2000.

Those numbers come from the latest study on oral health, preterm delivery, and low birth weight. The researchers included Ananda Dasanayake of New York University's College of Dentistry.

How to Find a Kid-Friendly Dentist
Thursday, March 24, 2005 | gp

Although more parents know about the importance of age-one dental visits, many parents may still wonder about what kind of dentist can provide care for their child.


Chicago, Ill. - infoZine - An article in the February issue of AGD Impact, the newsmagazine of the Academy of General Dentistry (AGD), provides suggestions on what to look for in a dentist and what to expect when dental offices treat children.

According to AGD spokesperson Cindy Bauer, DDS, MAGD, many general dentists treat children.

"Parents should seek out a dental office that provides a fun environment for children, so that they are excited about coming to the dentist's office."

For that reason, many dentists have made an effort to incorporate child-friendly design into their office environment. They provide entertainment-such as books, video games, television and movie access-for their patients.

To prepare the child for the visit, parents should ask the dentist about the procedures of the first appointment so there are no surprises. Plan a course of action for either reaction the child may exhibit-cooperative or non-cooperative. Very young children may be fussy and not sit still. Talk to the child about what to expect, and build excitement as well as understanding about the upcoming visit. Bring with to the appointment any records of the child's complete medical history.

Parents that feel their child is anxious about a dental visit, should ask their dentist if they will schedule a pre-visit. Many dentists use pre-visits to alleviate any fear or anxiety by acclimating them to the office environment. The dentist will walk the child around the office, show them the tools, allow them to sit in the chair and even demonstrate on a family member to help them become comfortable.

Most importantly, parents should make sure their child regularly visits a dentist, reminds Dr. Bauer. "This will help them have better oral health for the rest of their lives."

How to keep your child from being anxious about the dentist
Talk to the dentist about the best way to communicate about dental visits.
Ask the dentist to take your child on a tour of the office and explain the equipment.
Ask if the dentist will allow a relative to accompany the child in the treatment room.
Avoid caffeine or sugary foods before a dental appointment.

Are COXIBs Safe?
Tuesday, March 22, 2005 | gp

For decades many of us have been consuming painkiller pills for day-to-day painful conditions be it headache or arthritis without thinking twice. But the kind of attention these painkillers have generated in last couple of months is quite unprecedented. Ever since Rofecoxib, a newer painkiller molecule was withdrawn from the market since it increased the risk of heart attacks and strokes, other medications of the same class (COXIBs) have been put under scanner. The common man is the most confused about the safety of the painkillers as a whole.

Barely around 6 years have passed since the COXIBs, mainly rofecoxib, valdecoxib and celecoxib, were first approved for use in painful conditions. But all the three now seem to tumble down one after the other on a scale of their cardiovascular safety. Researchers hold a view that COXIBs including etoricoxib must be carefully administered to patients with generalised atherosclerosis and ischaemic heart disease. Under these circumstances focus is now shifting back to conventional and more established painkillers like non-steroidal anti-inflammatory drugs (ibuprofen, diclofenac & naproxen) and paracetamol.

Unlike the COXIBs and other NSAIDs, ibuprofen, a commonly prescribed NSAID, is in use for the last 40 years, and has never been labeled with any of the heart related adverse events. Infact, one of the studies published in Arch Intern Med concludes that there does not seem to be an increased risk of myocardial infarction (heart attack) among patients simultaneously consuming aspirin and ibuprofen compared with aspirin alone.

Patients suffering from acute myocardial infarction (heart attack) routinely receive painkillers like morphine and nonsteroidal anti-inflammatory drugs (NSAIDs) alone or in combination. According to a study published in J Pharmacol Exp Ther both ibuprofen (an NSAID) and morphine are even cardioprotective as they help reduce the infarct (dead heart muscle) size.

According to Dr. Balakrishnan, Consultant Rheumatologist, PD Hinduja National Hospital & Medical Research Centre, Mumbai, “Over the past few months intense debate is raging all over the world regarding the coronary artery disease problems encountered with COXIBS. Rofecoxib has been withdrawn from the market due to this and few other COXIBS are also under scrutiny. Due to this I avoid the COXIBS where possible. I have been using and will continue to use the NSAIDS like IBUPROFEN, DICLOFENAC and INDOMETHACIN.”

Elaborating on the safety of Ibuprofen, Dr.S.L.Yadav Associate Professor, Dept. of Physical Medicine & Rehabilitation, All India Institute of Medical Sciences (AIIMS), New Delhi said, ” I understand that pain is an after effect of some or other disease process and until we treat the basic disease, we probably are reducing the symptoms not the disease as such. In such instance, until we club other treatment modalities together such as physiotherapy, manipulations, and electrotherapy etc., the pain killers are of really not a big substitution to treat these painful entities. In such situation even USE OF PARACETAMOL, IBUPROFEN ARE BETTER OPTIONS AS ON TODAY if we want to treat pain vis-à-vis to curb the side effects, whereas COX-2 inhibitor’s efficacy and safety is yet to be established.”

Ibuprofen belongs to a group of medicines known as non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs provide relief by changing the body’s response to pain, swelling and high temperature. Ibuprofen is an effective and well-tolerated analgesic for general use. It can provide relief from headaches, migraine, backache, dental pain, muscular pain, period pain, cold and flu symptoms and feverishness.

Plant extract can heal oral diseases
Tuesday, March 22, 2005 | gp

Aloe vera plant known for healing skin, can also solve many oral health problems including canker sores, cold sores, herpes simplex viruses, lichen planus and gingivitis, according to researchers from the Academy of General Dentistry.

An article, written by Richard L. Wynn, PhD, in the AGD journal mentions a study done on a patient with lichen planus, a disease affecting the skin and oral mucus membranes. The patient drank 2.0 ounces of aloe vera juice daily and applied aloe vera lip balm topically.The oral lesions, reportedly healed in a span of four weeks .Aloe vera is a succulent plant which accelerates healing and reduces pain associated with canker sores, which are blisters on the lips or mouth. Already known to be good for skin and hair, it finds its way to most of the skin cremes and shampoos.

"Aloe vera can be taken both as the aloe vera juice and aloe vera gel. These are the two modes of delivery recognized by the FDA," says Dr. Wynn.

"There is good evidence to support using aloe vera for oral health problems.I believe a number of patients will be interested in this inexpensive alternative." says AGD spokesperson Kenton A. Ross.(ANI)

Study Says Saliva Test Can Spot Gum and Heart Disease
Sunday, March 20, 2005 | gp

Source: University Of Michigan

A self-contained saliva test kit developed by a University of Michigan School of Dentistry professor in collaboration with government agencies and the private sector is now undergoing limited preliminary testing at two U-M sites.

“For years, oral health care professionals have talked about a close connection between a person's saliva and his or her bloodstream,” said William Giannobile, a professor of dentistry and associate professor of biomedical engineering who developed the test kit. “There are a significant number of potential applications for this device because of its ease of use and its portability.”

The hand-held, battery-powered rapid-test kit is being used to test saliva samples from several dozen patients to determine if they have periodontal or cardiovascular disease biomarkers. Once marketed, the kit will allow dentists to test patients in their offices and learn, in 15 minutes or less, if their patients have those diseases. One day the kit may also be used by federal, state or local government agencies as well as corporations to detect biological toxins.

Giannobile, who is also the director of the Michigan Center for Oral Health Research (MCOHR), said that the kit has been used to analyze saliva samples from nearly 30 individuals who have participated in a pilot study that began in December 2004 at the School of Dentistry. Before the end of this year, saliva samples will be collected from another 100 individuals at MCOHR clinics in northeast Ann Arbor.

“The tests we are now conducting using this kit may determine just how much of a link there is between a person's saliva and their blood, and how it may be affecting their overall health,” Giannobile said. The preliminary testing now underway will help determine which biological markers indicate the presence of periodontal disease and osteoporosis as well as detect the presence of C-reactive protein, a cardiovascular disease marker.

It may be several years before the kit is available for widespread use, however. “After the last of the patients are tested in December, we will analyze the results and conduct follow-up examinations of all 130 patients for a year to see if there is a correlation between their oral health and the test results,” Giannobile said.

Collaborating with Giannobile are Dr. Charles Hasselbrink and Dr. Mark Burns, both with the U-M School of Chemical Engineering. Funding for the test studies is being provided by the National Institutes of Health.

Manufactured by Sandia National Laboratories, The Microchem LabTM is designed to eliminate the need for dentists to send a patient's saliva sample to a laboratory. Sandia has major research and developmental interests in national security, energy, and environmental technologies.



This story has been adapted from a news release issued by University Of Michigan.

Lumiracoxib in the Treatment of Acute Postoperative Dental Pain:
Friday, March 18, 2005 | gp

Objectives: Overview of three dose-response studies demonstrating the efficacy of lumiracoxib, a novel COX-2 selective inhibitor, for chronic pain associated with osteoarthritis (OA), or rheumatoid arthritis (RA) and acute pain following dental extraction.


Results: Throughout the OA study, all lumiracoxib doses provided superior reductions in Pl versus placebo and at Week 4, all lumiracoxib doses provided efficacy similar to each other and to diclofenac. In the RA study, lumiracoxib 100 mg bid, 200 mg bid and 400 mg od were significantly better than placebo in Pl at Weeks 1 and 2 (all p < 0.05) but demonstrated borderline significance at Week 4 (lumiracoxib 400 mg od, p = 0.06). In pain following dental surgery, PID scores for both lumiracoxib doses were superior to placebo from 1.5 h onwards and always comparable, or superior, to ibuprofen. Lumiracoxib 400 mg had the fastest onset of analgesia, measured as median time to confirmed first perceptible pain relief using the two-stopwatch method (37.4 min, superiority versus placebo, p < 0.001). Lumiracoxib was well tolerated in all studies.

Conclusions: These studies provide initial evidence that lumiracoxib is an effective, well-tolerated agent for the treatment of chronic and acute pain.

Introduction

Traditional nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit both the constitutively expressed cyclooxygenase-1 (COX-1) isoform of COX, which generates prostaglandins cytoprotective to the gastrointestinal (GI) tract1-2, and the inducible COX-2 isoform responsible for the synthesis of prostaglandins that mediate pain and inflammation3,4. Inhibition of the COX-1 isoform by traditional NSAIDs is believed to explain the high incidence of GI-related adverse events (AEs) associated with this class of drugs. In contrast, COX-2 selective inhibitors are associated with significantly fewer GI AEs than traditional NSAIDs5,6.

Lumiracoxib (Prexige*) is a novel COX-2 selective inhibitor, which is being developed for the treatment of osteoarthritis (OA), rheumatoid arthritis (RA) and acute pain. Selectivity of lumiracoxib for COX-2 over COX-1 has been demonstrated in vitro and in vivo1 and is maintained ex vivo at doses of 800 mg8. Lumiracoxib demonstrates good oral bioavailability (74%), is rapidly absorbed (median time to maximal plasma concentration of 2 h-3 h) and is rapidly cleared from plasma resulting in a short plasma half-life (3h-6h)8-10.

Lumiracoxib is structurally distinct from other COX2 selective inhibitors in that it lacks a sulfur-containing moiety but possesses a carboxylic acid group, which confers mildly acidic properties (pKa 4.7]11. This acidity may be the reason for its distinct pharmacokinetic and pharmacodynamic profile, as weak acids have been shown to be readily sequestered into acidic environments such as inflamed joints12. For example, in animal models, lumiracoxib is characterized by preferential distribution into inflamed tissue, an effect seen with acidic NSAIDs13 but not with other COX-2 selective inhibitors14,15. Furthermore, in patients with RA, lumiracoxib demonstrates rapid absorption and sustained high concentrations in synovial fluid compared with plasma16.

This pharmacologic profile suggests that further evaluation of lumiracoxib in acute and chronic pain states is warranted. This overview describes three key dose-response Phase II studies of the efficacy and tolerability of lumiracoxib in the management of OA, RA and pain following dental surgery.

Lumiracoxib in pain following dental surgery

This single-center, randomized, double-blind, placeboand active- controlled, parallel-group, 12-h study was performed to evaluate the analgesic efficacy and tolerability of single oral doses of lumiracoxib, compared with placebo and ibuprofen using the acute postoperative dental pain model. Healthy males and females aged ≥ 17 years who experienced moderate-to-severe pain within 5 h of surgical extraction of two or more impacted third molar (at least one mandibular) teeth were eligible for inclusion.

Extractions were performed using a standard surgical technique with short-acting local anesthesia and nitrous oxide. Females of childbearing potential were eligible only if they were not pregnant and were using an acceptable form of contraception. Patients were excluded from the study if they had received any analgesic medication or methylphenidate hydrochloride within 48 h prior to surgery. The use of heparin or coumarin-type anticoagulants, tricyclic antidepressants, tranquillizers, muscle relaxants, lithium or narcotics was not permitted from 2 weeks prior to surgery until completion of the study. Additional exclusion criteria included known hypersensitivity to traditional NSAIDs, aspirin or paracetamol, a history or signs of any severe or uncontrolled medical condition likely to affect the safety and/or efficacy of the trial medications, a history of GI disease or bleeding, or an active peptic ulcer.

Demographic and medical background information and concomitant medications were recorded at screening (Visit 1, within 14 days prior to randomization). At Visit 2, following third molar extraction, eligible patients with moderate-to-severe pain were randomized to receive a single oral dose of lumiracoxib 100mg, lumiracoxib 400 mg, ibuprofen 400 mg or placebo.

Outcome measures

The primary efficacy outcome in this study was the time-specific pain intensity difference (PID [calculated as pain intensity at baseline minus pain intensity at each timepoint]) score based on a categorical scale. PID (categorical) was used to determine if the primary objective of the study was met, i.e. was single-dose lumiracoxib 100 mg and 400 mg effective at each post-dose timepoint when compared with placebo, and comparable to single-dose ibuprofen 400 mg.

Lumiracoxib in pain following dental surgery

In total, 202 patients were randomized to receive a single oral dose of lumiracoxib 100 mg (n = 51), lumiracoxib 400 mg (n = 50), ibuprofen 400 mg (n = 51) or placebo (n = 50). There were no notable differences in demographic or baseline characteristics between the four treatment groups. Randomized patients were of mean age 22.0 4.9 years (range 17years57 years), predominantly female (61.9%) and Caucasian (67.3%). A total of 57 (28.2%) patients completed the study (Table 5). The majority of discontinuations resulted from patients taking rescue medication. Only one patient, in the ibuprofen 400 mg group, withdrew due to an AE (postoperative bleeding at the suture site).

Efficacy assessments

PID (categorical) scores for lumiracoxib 400 mg, lumiracoxib 100 mg and ibuprofen 400 mg were significantly superior to placebo (p < 0.05) (Figure 3). This was seen at all timepoints from 1 h through 12 h post dose for lumiracoxib 400mg and ibuprofen 400mg, and from 1.5h to 9h (inclusive) for lumiracoxib 100 mg. Mean PID scores for lumiracoxib 400 mg were comparable with ibuprofen 400 mg up to 4 h post dose but superior to ibuprofen from 5 h onwards. Mean PID scores for lumiracoxib 100 mg were similar to ibuprofen 400 mg throughout the post-dose study period. The results for PID (VAS) were generally similar and consistent with those for PID (categorical).

Lumiracoxib 400 mg demonstrated the fastest time to onset of analgesia (median 37.4 min) followed by ibuprofen 400mg (median 41.5min), lumiracoxib 100 mg (median 52.4min) and placebo (median ≥ 12 h) (Table 6). The times to onset of analgesia were significantly faster for all active treatments compared with placebo (all p ≤ 0.001) and there was no significant difference between either of the two lumiracoxib doses and ibuprofen.

Discussion

This paper describes the findings from three doseresponse Phase II trials conducted to evaluate the efficacy of lumiracoxib in relieving chronic pain associated with OA and RA and for the relief of acute pain following dental surgery. In these studies, lumiracoxib demonstrated similar efficacy to traditional NSAIDs across three disparate indications coupled with better tolerability than diclofenac in OA and RA. Specifically, lumiracoxib was shown to provide effective relief from pain and stiffness and improve functional status in OA. A similar trend was seen in RA, although comparison of lumiracoxib with placebo reached only borderline significance at study endpoint, Week 4, despite significant differences having been seen earlier in the study at Week 1 and Week 2. Single-dose lumiracoxib was also shown to provide effective rapid analgesia in patients with acute pain following dental surgery.


In patients with acute pain following dental surgery, single doses of lumiracoxib 100 mg and 400 mg provided a statistically superior PID compared to placebo at most post-dose timepoints and a significantly faster time to onset of analgesia when compared with placebo. Notably, for both PID and time to onset of analgesia, each dose of lumiracoxib was comparable or superior to ibuprofen, an agent considered particu\larly effective in the management of pain following dental surgery and, as such, widely regarded a first choice regimen25,26.

All three studies were of short duration with relatively few patients and were not designed to detect clinically meaningful differences in most safety endpoints. Therefore, firm conclusions regarding safety and tolerability could not be drawn. However, all studied doses of lumiracoxib were well tolerated and there was no apparent dose-relationship between lumiracoxib and the incidence of any AE. In the OA and RA studies presented here, lumiracoxib was better tolerated by patients compared with diclofenac, complementing earlier observations with naproxen in healthy subjects27. In particular, the incidence of GI-related AEs was markedly lower in patients treated with lumiracoxib than in those who received diclofenac, supporting the superiority of COX-2 selective inhibitors on reducing GI symptomatology compared with traditional nonselective NSAIDs. As might be expected, the majority of AEs in the study of pain following dental surgery were related to the postoperative status of the patient.

A recent systematic review of population-based epidemiological studies estimated a slight, but nonsignificant increase in liver injury with NSAID use28. In the OA and RA studies reported here, occasional, transient increases in liver function parameters were observed with lumiracoxib and diclofenac. These were not associated with any clinical symptoms. Larger, longer-term studies will provide more robust information regarding the hepatic safety and tolerability of lumiracoxib.

Conclusions

These studies provide initial evidence that lumiracoxib is an effective and well-tolerated alternative to traditional NSAIDs for the treatment of both chronic and acute pain and inflammation. Additional studies of longer duration with larger patient populations evaluating different total daily dosages of lumiracoxib, particularly once-daily dosing regimens, are warranted. Such trials will be needed to confirm both the efficacy data from these trials, as well as to obtain additional information regarding the safety of lumiracoxib. As such, these studies provide a strong platform from which the full efficacy and tolerability profile of lumiracoxib can be evaluated.

Orientation workshop for dental surgeons
Thursday, March 17, 2005 | gp

Source: The Sangai Express

Imphal, March 16: The training and orientation workshop for dental surgeons and health workers of Manipur, Nagaland and Mizoram was held at the Jubilee Hall, RIMS on March 14.

Health Minister Laishram Nandakumar inaugurated the workshop as chief guest.

Project Director of National Oral Health Care Programme, AIIMS, New Delhi Dr Hari Prakash, Regional Workshop Co-ordinator, Dr AC Bhuyan, Additional Director of Manipur Health Services Dr Motilal, Head of Dental Department, RIMS Dr T Nabachandra and Dr N Sukumar of Manipur Health Services were among those present at the workshop.

Speaking on the occasion, Director of RIMS Prof L Fimate said such workshops would help to keep the people abreast with the latest health care sciences.

Oral health concerns the general health and it plays a major role in improving the quality of life, he pointed out.

He further observed that in developing countries incidence of dental diseases has come down through oral health care education, modification of diet, use of fluoride and the like.

However, in India, gum diseases and oral cancers have been increasing.

Thirty percent of the children suffer from mal-aligned teeth and jaws, he noted while informing that cancer as a result of use of tobacco, betel nut, etc is very high.

He also pointed out that 30 to 40 percent of cancer cases is caused due to lack of knowledge of dental diseases.

According to the WHO guidelines, the dental surgeon and patient ration should be 1:75000.

However, in India it is 1:120,000, he said, adding that people in the urban area are mostly neglected in the dental health care system.

There's no substitute for flossing, Says Judge
Thursday, March 17, 2005 | gp

March 16 /PRNewswire/ -- Millions of Americans don't take time to floss, but after reviewing substantial medical evidence, in a recent case against Listerine, Federal Judge Denny Chin of United States District Court in Manhattan ruled in favor of McNeil-PPC, Inc., makers of new Johnson & Johnson REACH® EASY SLIDE® PRO(TM) floss -- reinforcing what dental experts have been saying for years: There's simply NO SUBSTITUTE for flossing.


Dental experts overwhelmingly agree that daily flossing is a critical, preventive step in reducing tooth decay and gum disease. Flossing removes plaque between teeth and below the gum line -- dislodging the pieces of food trapped between teeth which otherwise cannot be brushed or rinsed away. Plaque build up causes gum disease (gingivitis) which affects some two- thirds(1) of the U.S. population, while advanced-stage gum disease (periodontal disease) is the leading cause of tooth loss in American adults and affects between ten and fifteen percent of the U.S. population.

To make flossing more effective and beneficial, Johnson & Johnson REACH® introduces new EASY SLIDE® PRO(TM) floss, preferred two to one vs. Glide by consumers. Johnson & Johnson REACH® EASY SLIDE® PRO(TM), available in stores in April, is a superior sliding(2) floss that delivers thorough plaque cleaning with patented PLAQUE GRABBERS(TM). Johnson & Johnson REACH® EASY SLIDE® PRO(TM) floss has a long lasting, intense flavor thanks to freshening Mint Crystals. (Suggested Retail Price: $3.79).

According to celebrity Dentist Dr. Marc Lowenberg whose smile makeovers command upwards of $20,000, "In a country obsessed with whitening and creating the perfect smile, we have lost sight of the most important oral care habits. Make no excuses. Flossing is a critical step in creating the foundation for a healthy and beautiful smile."

Dr. Lowenberg offers the following advice for good oral hygiene: Brush twice a day with a fluoride toothpaste; clean between teeth daily with Johnson & Johnson REACH® EASY SLIDE® PRO(TM) floss to remove plaque and food particles from between the teeth and under the gum line; eat a balanced diet; limit between-meal snacks; and visit your dentist regularly for professional cleanings and oral exams.

ABOUT THE LEADERS IN INTERDENTAL CLEANING

In 1896, Johnson & Johnson first introduced dental floss to American consumers. Today, Johnson & Johnson REACH® Dental Floss (manufactured by McNeil-PPC, Inc.) is THE leader in interdental cleaning and the number one selling dental floss worldwide.

The Company has been recognized for driving innovation and growth within the interdental cleaning category for over 100 years. In 2003, the company introduced the REACH® ACCESS(TM) Daily Flosser to eliminate all flossing hassles for those consumers who do not like to floss, or simply cannot do so. The REACH® ACCESS(TM) Daily Flosser Makes Flossing As Easy As Brushing(TM).

McNeil-PPC, Inc., continues to offer a range of floss products to meet every consumer need, including: Waxed and Unwaxed Floss, CLEAN BURST(TM) Dental Floss, which provides superior cleaning(3) and high impact flavor, DENTOTAPE®, Gentle Gum Care, Whitening Floss, clinically proven to whiten between teeth, STIMUDENT® Interdental Cleaners, WILD FLOSSERS® (for kids), and the REACH® ACCESS(TM) Daily Flosser, which Makes Flossing As Easy As Brushing(TM).

Committed to providing flossing solutions to consumers, the Company's latest innovation, Johnson & Johnson REACH® EASY SLIDE® PRO(TM) floss launches, in April 2005, at mass, drug and food retailers nationwide.

ABOUT THE FLOSS CASE

On Friday, January 7, 2005, U.S. District Judge Denny Chin ruled that Listerine mouthwash is not a replacement for dental floss -- despite confusing claims featured in advertising for Listerine mouthwash claiming that Listerine mouthwash was clinically proven to be as effective as floss in fighting plaque and gingivitis. The ruling was a result of a suit filed by McNeil-PPC, Inc., makers of Johnson & Johnson REACH® Dental Floss, as part of their ongoing commitment to the endorsement of proper consumer education about the benefits of flossing as a foundation for good oral health.

In his written ruling, Judge Chin included this statement "Dentists and hygienists have been telling their patients for decades to floss daily," he wrote. "They have been doing so for good reason. The benefits of flossing are real."


1. ''Judge: Listerine No Replacement for Floss,'' by Larry
Neumeister, Associated Press, January 7, 2005.
2. When compared to standard waxed dental floss in laboratory
testing.
3. When compared to standard floss in clinical testing.

Source: McNeil-PPC, Inc.

More kids causes more dental problems for mother
Wednesday, March 16, 2005 | gp

NEW YORK (Reuters Health) - For women, a bigger brood brings a bigger risk of dental problems, new research reports.

The study found that U.S. women who had more children were more likely to have periodontal disease, more missing teeth and more untreated cavities.
In an interview, study author Dr. Stefanie Russell of New York University in New York explained that these findings persisted even when she factored in the influence of mothers' social class, income, education and age.

Russell suggested that pregnancy may have a biological effect on oral health, making women prone to dental difficulties. "It's possible that women who have multiple pregnancies could have lasting effects" regarding their oral health, she told Reuters Health.

Women with many children are also often forced to lead "different lives" from other women, she added. A big and busy household is stressful, and may leave mothers with less time to take care of themselves by visiting the dentist, Russell suggested. Women who are busier may also have less energy to put into eating well or quitting smoking, the researcher said.

An alternative explanation for why having children may take a toll on women's oral health is that dentists are often "very conservative" when treating pregnant women, Russell said. Many dentists worry about what X-rays and anesthesia could do to unborn children, she said, and may consequently ask women to postpone treatment for dental problems until after childbirth.

However, as every parent knows, newborns are very time-consuming, and new mothers may simply feel they can't squeeze in a dentist appointment to deal with an earlier problem, Russell noted.

All of these factors likely contribute to mothers' poor oral health, she added. "I think it's multiple causes."

To investigate how a bigger brood influences oral health, Russell reviewed data collected from 2,635 women between the ages of 18 and 64 who had been pregnant at least once.

Common Dental Diseases....
Wednesday, March 16, 2005 | gp

DECAY

Common symptoms of tooth decay include pain in tooth or ear, a broken tooth, and sometimes bad breath. Broken, cracked, or damaged teeth should be seen by a dental professional immediately to prevent the damaging effects of decay. People from all ages can suffer decay. Proper oral hygiene and regular dental visits can help to prevent decay.



CAVITIES

A build up of plaque on teeth is what causes cavities. Large amounts of bacteria that are not removed by brushing, flossing, or properly caring for teeth and gums turn into plaque, which is the most common cause of tooth cavities.

GUM DISEASE

Gum disease occurs in three stages: gingivitis, periodontitis, and advanced periodontitis.

Gingivitis is an inflammation of the gums and the initial stage of gum disease. At this level, gum disease is easy to treat. Gingivitis is caused by a build up of plaque around the gum line. During this early stage, damage can be reversed since bone and tissue that hold the teeth in place have not yet been damaged.

Periodontitis occurs when untreated inflammation and gingivitis spread to the roots of the teeth. During this second stage of disease, the plaque penetrates into the gum tissue and begins to affect the underlying healthy bone. Gums tend to recede from teeth, and gum pockets form in which more plaque, food, and bacteria collect.

Advanced periodontitis, or pyorrhea, is diagnosed when major gum recession and severe bone loss have already occurred. At this stage of gum disease, teeth are often too loose to be saved and often have to be removed from the mouth.

Symptoms of tooth problems:

Prolonged bleeding from gums

Tooth damage (including cracks, breaks, and broken fillings)

Bad breath

Inflamed gums

Sore teeth or gums

Most of the tooth problems are curable, so you need to go to the doctor immediately to prevent further loss to the tooth. Even if you don’t have any problem, you must consult a dentist twice a year.

PREVENTION

Preventing tooth loss, tooth decay, and gum disease is as simple as caring for your mouth on a daily basis. Regular care keeps your mouth germ and bacteria free, promoting healthy teeth and gums.

1. Brushing your teeth is one of the easiest ways to help prevent gum and dental diseases. Use a soft toothbrush and a gentle, circular, massaging motion at least three times daily. An effective brushing should last 2-3 minutes. The average person brushes as little as 30 seconds at a time. Time yourself until you're certain you're brushing long enough to adequately clean your teeth and gums.

In order to prevent serious build up, teeth need to be brushed at least once every 24-36 hours, though brushing after every meal is encouraged.

2. Gum Massage: gently massage the gums in a circular motion. This will help to loosen debris and avoid the formation of gum pockets and infection.

3. Flossing: This helps to clean out debris and plaque from areas your toothbrush cannot reach. Trapped food, bacteria, and plaque all lead to gum disease and tooth loss. Flossing should be done with A.D.A. approved floss, twice daily and before bedtime. Begin with your back teeth and move forward. Follow flossing with a thorough rinsing to further remove debris.

4. Tongue Scraping: This can be done with a commercial scraper or gentle toothbrush. Tongue scraping helps to prevent bacteria build up and will also ensure a fresh, clean smelling mouth.

Le Forte Dental to scale up operations
Wednesday, March 16, 2005 | gp

CHENNAI: Encouraged by a good response, Le Forte Dental Paradigm Ltd, a venture by a group of surgeons from different specialities in Chennai, is planning to increase its presence and expand operations through corporate tie-ups and special schemes.

"We will be opening two clinics in Pondicherry and Chidambaram in the next couple of days and we are targeting 30 dental clinics across the State by the end of 2005," Director - Resources and Resolutions, Le Forte, Mr S K Mukilan, said.

"We see a paradigm shift among the dental surgeons to accept a new perspective. This shift will definitely make the country a world leader in dentistry in the future," Mr Mukilan said adding, "dental treatments are very expensive in the West and in the n ext one year, health tourism in India will be promoted in a big way."

Le Forte, a public limited company, is in the process of obtaining ISO certification for its clinics.

"We are also in discussion with a few corporates, who offer reimbursement for medical treatments to their employees, to provide an economical package for their employees," he said adding, "our demographical spread is the major advantage and the employees can get the treatment in any one of our clinics."

Le Forte is planning to come up with a card scheme. "People, who buy this card for Rs 10,000, will be given free treatment, except replacements and alignment treatments, for the next three years," said Mr Mukilan. - PTI

Dental health begins when kids are toothless
Tuesday, March 15, 2005 | gp

LITTLE ROCK — Many parents may be surprised that good oral health begins when their children do not have any teeth. In fact, teaching children the importance of taking care of their teeth and gums should begin at birth. There are many preventative measures parents can take that lead to optimum oral hygiene and better overall health for their children.

James Koonce, DDS, chief of dentistry at Arkansas Children’s Hospital advises parents to start caring for their child’s teeth and gums at an early age. "It is very important to begin promoting good oral health even when children have no teeth. There have been many studies which prove that medical problems can be the result of poor oral hygiene," says Koonce. "The same blood supply that flows through the mouth flows through the rest of the body. Bacteria building up inside the mouth, whether it’s from gum disease or an abscess, will enter a child’s bloodstream. This can be hazardous to children who already have medical conditions as well as to healthy children."

Dr. Koonce recommends that parents begin wiping their child’s gums with a damp cloth after each feeding even when they have no teeth. Starting to use a damp cloth inside the mouth at birth allows the child to get used to cleaning his or her teeth and gums after eating. After children have a bottle or are breast fed, the milk, formula or other beverage pools inside the mouth and causes the level of bacteria to rise. Once a child’s teeth start to come in, this pooling can cause tooth decay and unhealthy gums if not brushed away, "says Koonce.

He also stresses the importance of not letting children fall asleep with a bottle or while breastfeeding. This can cause a condition known as" baby bottle tooth decay. "When children fall asleep while feeding, the liquid sits in their mouth on their gums and teeth causing decay.

If a child is put to bed with a bottle to help the child fall asleep, the bottle should be removed as soon as the child falls asleep and the gums and teeth should be wiped clean with a clean damp cloth. Prolonged nursing while asleep from either the bottle or breast, will allow the sugar and carbohydrates in milk to damage the teeth. Care should be exercised when putting children to bed with a bottle with or allowing the child to nurse at will while asleep.

He also warns against the prolonged use of sippy cups. When a child uses a sippy cup filled with juice, milk or sugarladen beverages throughout the day, they may be at a higher risk for tooth decay and poorly aligned front teeth.

" When children drink out of a sippy cup all day, it is essentially the same as falling asleep with a bottle. Children should use sippy cups at meal time and be introduced to a regular cup as soon as possible. They should also be encouraged to hold the sippy cup with their hands instead of carrying it around by their teeth. This will help teeth grow in straight and not protrude forward. "

And Dr. Koonce offers some preventative practices that parents can teach their children to instill healthy dental habits.

Children should brush their teeth after meals and before bed. Parents should teach their children how to brush and help them until they are old enough to sufficiently clean their teeth.

When baby teeth grow in, parents should floss between teeth. This usually occurs around age two. Parents should floss their children’s teeth until they can floss effectively on their own (usually around age eight).

Children should have routine dental visits and should be seen by the dentist no later than their second birthday. Preferably they should have their first visit by their first birthday. This also helps them get used to visiting the dentist office and makes it a positive experience from an early age.

Children should receive topical fluoride treatments at their dentist visits. If your local water supply does not contain fluoride, contact the dentist for supplements. At home, children should brush with American Dental Association (ADA) approved fluoridated toothpaste (after age two to prevent swallowing).

Parents should teach their children good dietary habits. Children should not drink soda and sweetened drinks on a regular basis. They should be fed healthy snacks like fruits and vegetables and should stay away from snacks with high sugar and carbohydrate content.

" Taking care of a child’s teeth and promoting good oral health is a cumulative effort. It is proven that children with good oral health have a better chance at good overall health. From birth on they need to have adequate home care, see a dentist regularly and have exposure to fluoride. These steps all work together to prevent cavities and promote great dental habits that children will practice into adulthood. "

Combating Bacterial Biofilm
Tuesday, March 15, 2005 | gp

BALTIMORE, March 14 / -- The critical and underappreciated role of antibacterial mouthrinse in preventing gum disease was explored here today in a symposium at the International Association of Dental Research Conference.

In a presentation on "Myth versus Reality" in treating gum disease, John Gunsolley, DDS, Professor and Chair of Endodontics and Periodontics at the University of Maryland's Baltimore College of Dental Surgery, explained how free-floating bacteria in the mouth can bond together forming a "biofilm" of plaque, which unchecked can adhere to all tooth surfaces and spread from above the gum to below the gum line. This process can lead to the initiation and progression of gingivitis.

"Patients often mistakenly think that bacteria in the mouth just cause bad breath," noted Gunsolley. "In reality, the greater worry with bacteria is that once allowed to entrench themselves below the gum line, they become more difficult to kill. Regular use of an antibacterial mouthrinse, in addition to brushing and flossing, kills bacteria while they are more vulnerable above the gum line."

While regular brushing removes the bacterial biofilm from easily accessed tooth surfaces, it's often left behind on the harder-to-reach surfaces between teeth, according to Rebecca Wilder, RDH, Associate Professor and Director of Graduate Dental Hygiene Education at The University of North Carolina Chapel Hill School of Dentistry.

According to Wilder, "The reality is, most people only brush their teeth for about 46 seconds, while the recommended brushing time is two minutes, and only 2 to 10 percent floss regularly and effectively." The adjunctive use of antibacterial mouthrinses has been found to be an effective at-home treatment for plaque control.

Surveying the currently available antibacterial mouthrinse products, Stuart Fischman, DMD, Professor Emeritus of Oral Diagnostic Sciences at the State University of New York at Buffalo School of Dental Medicine, noted that to date, only two products have received the American Dental Association's Seal of Acceptance as adjunctive agents -- Listerine® Antiseptic Mouthrinse and Peridex®, a prescription oral rinse for short-term use only. He also highlighted factors that should be considered in recommending or selecting an antibacterial mouthrinse.

"Because these are products that patients should use on a regular, sustained basis, aesthetic concerns are important as well as the mouthrinse's effectiveness," asserted Fischman. "For example, ingredients such as cetylpyridinium chloride (CPC) and chlorhexidine, both may cause significant brown staining on teeth and the tongue versus an essential oil antibacterial mouthrinse such as Listerine®, which is safe for long-term daily use." cautioned Fischman. "In addition, because of possible interactions with sodium lauryl sulfate, a commonly used ingredient in toothpaste, neither CPC nor chlorhexidine mouthrinses should be used immediately following brushing or else their effectiveness might be compromised. Chlorhexidine mouthrinse may also promote the formation of calculus or tartar above the gum line in patients using the product. This is not an issue with, for example, an essential oil formula."

In conclusion, symposium moderator Sebastian Ciancio, DDS, Distinguished Service Professor and Chair of the Department of Periodontics and Endodontics at the University at Buffalo, State University of New York, recommended to the audience that dental professionals evaluate the evidence supporting the efficacy of the products they recommend and weigh potential side effects. He also suggested methods for promoting patient compliance, such as keep routines uncomplicated, highlighting product instructions and providing recommendations in writing. He stressed, "The better the patient's compliance, the better his/her oral health."

This program, Biofilm Control: Science vs Perception, was jointly sponsored by the University at Buffalo School of Dental Medicine Continuing Dental Education (UB/CDE) and Health Learning Systems (HLS). This activity was made possible through an unrestricted educational grant from Pfizer Inc.

Source: University of Buffalo

New PG Course to be Introduced, DCI President
Monday, March 14, 2005 | gp

March 13: Anil Kohli, the president of Dental Council of India (DCI), has said that a post graduate course in dentistry will be introduced from the next academic session. He also unveiled plans of the Council aimed at improving the quality of education in dental colleges.

Talking to the mediapersons here today Dr Kohli said, ‘‘The course would be equivalent to a post graduate degree in dentistry and would be internationally recognised.’’ He said that DCI recently discussed the matter with the Union Health Ministry.

Dr Kohli, who recently took over the reins of DCI, said that his priorities would be to bring transparency in the functioning of DCI and to bring accountability in the system of its working.

The DCI president said that though there were over 190 dental colleges in the country and over 18,000 dental surgeons pass out every year from these colleges, most of them lack proper facilities.

He said that DCI was keeping an eye on the infrastructure of dental colleges in the country.

Dr Kohli said that DCI recently inspected around 15 dental colleges across the country. He said that infrastructure was grossly lacking at these colleges.

The DCI president further said that those colleges had been given a month’s time to comply with the DCI norms of infrastructure at dental colleges.

Dr Kohli said that DCI would include representations from Indian Dental Association (IDA) and Army’s dentistry wing from now onwards .

The Indian Dental Association president Dr Bhagwant Singh and Additional Director General of Dental Services of the Indian Army Major General Dr Paramjit Singh were also present at the function.

Upgraded Dental Chair Launched
Monday, March 14, 2005 | gp

New dental chair model launched

Express News Service

The chairman of the Desh Bhagat Group of Institutes, Zora Singh Mann, on Sunday unveiled the new and upgraded model of an electrically operated dental chair. The chair has been manufactured by Tulja Dental.

The upgraded model has an operating light with imported glass reflectors and a time operated water control for a spittoon and tumbler. Moreover, the electrically operated dental chair has a combination foot switch (press type) and a cordless remote control. An overhanger delivery system is also available. The chair has been priced at Rs 16,000.

Dental Tourism catching up in India
Sunday, March 13, 2005 | gp

Millions of people every year fly from USA, and Europe to tourist places in India for a grand holiday and DENTAL TREATMENT.

Yes, its true. The cost of dental treatment is the western countries is approximately 7-10 times more than that in India.
With these high costs people have started to club their tours with dental treatments into one, ending up by having a grand holiday almost FREE.

Dental treatment in India is inexpensive as compared to the western countries. We have state to the art equipments and well trained experienced doctors to match the best of international standards.

Here's a brief comparison of the cost of treatment in India and USA

Dental Treatment Description Cost in USA ($)and cost in India in $
Dental Implants 2,000.00 600.00
Porcelain-Metal Crown/Bridge 600.00 70.00
Root canal Treatment 500.00 50.00
Tooth colored composite fillings 150.00 15.00

Many clinics now offer dental treatment and tourism as a package.The concept is widely getting accepted and dental clinics in Kerala and other tourist attractions like Jaipur, Goa, Cochin are cashing on this market.

Dental Clinic in Kochi ( Cochin ) , Kerala couples dental treatment and ayurvedic massage as a tourist package. Even Honeymoon couples from North India visit the dentist after a night at the treehouse in the hill station or mountain hideways or after safaris in the tiger resrve jungle. Small hotels , resorts, guesthouse,boutique hotels by the beach all are part of this tourism package combined with dental treatment in Kerala.

OPG unneccassary, says study
Saturday, March 12, 2005 | gp

- New research suggests one type of x-ray routinely done during dental checkups may not be necessary.

The study suggests panoramic dental x-rays may only be necessary when small x-rays don't give dentists the information they need.

Researchers analyzed 1,000 panoramic dental x-rays and found that about 90 percent of the problems the x-rays showed would have been picked up on regular small x-rays.

They also say that panoramic x-rays aren't useful in evaluating gum disease or cavities.

Research on Robocasting to fabricate Crowns
Saturday, March 12, 2005 | gp

Breakthrough research in the field of chemical engineering conducted on Oklahoma State University’s campus is only taking place in three or four locations nationwide.

Jim Smay, chemical engineering associate professor, is conducting research that includes robocasting, a type of free form fabrication using ceramics, polymers and metals to create various items.

The process involves putting paste in a syringe and placing it in a robot. The paste is 50 percent oil and 50 percent paste. Because the paste is in such small amounts, it is put under an oil bath so it doesn’t dry out.

Current research is focused on building dental crowns, Smay said. He is being sought out because of his research, which he began as a graduate student. At a conference in Canada, he ran into a group of dentists who had seen his work and were interested in how they could use it. Collaboration involves the New York University School of Dentistry.

The robocasting process will “centralize crown manufacture,” Smay said. This technology would eliminate the need for skilled technicians at dentist offices.


The field is moving toward automation.

“Our research focuses on developing a process whereby the crowns can be printed directly from a digital model using computer-aided design and subsequently reducing the time required to process each crown,” said Sarosh Nadkarni, chemical engineering graduate student.

The advantages of this new technology are that it will allow for faster production of each dental crown and make them more affordable, Nadkarni said.

It is a work in progress, Smay said. It is a continual development process. Smay said he expects to see realistic crowns by summer.

He has already filed a patent with NYU’s dental school. Once the patent is made, the goal will be to publish it in a journal, and then possibly a company will use the information in the years ahead.

Nadkarni is one of three graduate students conducting research under Smay’s supervision. Each have a specific project they are working on involving extrusion-based robotic deposition.

“The current research plan is directed towards refining the printing process to print the dental crown components,” Nadkarni said.

Russ Rhinehart, department head of the School of Chemical Engineering, said to him, the importance of research is the “technical transfer, the development of knowledge and understanding for the field.”

“Professors’ jobs involve giving technology away so other people can make money on it,” Rhinehart said.

Smay received the Victor K. Lamer Award presented by the American Chemical Society for the development work on the printing process discovered during his graduate work. He wrote a doctoral thesis that was reviewed nationwide over a two-year period.

He also received the CAREER award from the National Science Foundation, which recognizes the most promising new professors, Rhinehart said.

There is a monetary award of $75,000 a year for a five-year period. The money is used to hire graduate students and buy equipment.

“Lots of people apply early in their career and never get it,” Rhinehart said.

Forensic Dentistry Key in Identifying Victims of Tsunamis
Saturday, March 12, 2005 | gp

BALTIMORE, March 11 /PRNewswire/ -- Disaster victim identification (DVI)is an intensive and demanding task involving experts from various disciplines.DVI interventions can be brought to a successful conclusion only if properly planned, involving well-trained key experts and selection of the appropriate forensic diagnostic tools.
Today, during the 83rd General Session of the International Association for Dental Research, convening at the Baltimore Convention Center, a symposium, entitled "Current Concepts in Diagnostic Forensic Odontology," will feature presentations, by experts from Canada and Belgium, on "Forensic identification of victims of mass casualty incidents," "The dentist as a member of the disaster victim identification team -- The Interpol DVI interdisciplinary philosophy," and "Facial reconstruction based on 3-D
craniofacial reconstruction and in vivo soft-tissue depth registration."
As a key member of the identification team, the forensic odontologist takes an active part in all phases of the identification process. Modern disaster scenarios may include more destruction, fragmentation, and mingling of the human bodies than ever before. This means that identification of the victims has become much more difficult. Forensic odontologists are responding to these new challenges with approaches to identification that embrace modern
scientific methods. Since teeth and dental structures may survive post mortem, personal identification by means of dental data is still one of the most reliable methods of human identification.
Nevertheless, some disasters, including massive fires, may destroy most of the dentition, leaving little dental information for comparison with dental records. Therefore, other diagnostic approaches have been developed. Traces of saliva and fragments of teeth and bone may be a valuable source of DNA
evidence, offering new probes to solve unanswered questions and clarify unusual cases. Craniofacial reconstruction is another tool, offering important potential for victim identification. Conventional techniques for craniofacial reconstruction are usually based on manual modeling and standard soft-tissue depth tables. More recent developments in computer-aided 3-D imaging and ultrasound applications for soft-tissue depth registrations may offer new diagnostic tools for craniofacial reconstruction.

The symposium will conclude with a discussion of the state of the art and
identifying the challenges facing forensic diagnostic research.

This is a summary of a symposium entitled "Current Concepts in Diagnostic
Forensic Odontology," to be presented at 10:45 a.m. on Friday, March 11, 2005,
in Room 339 of the Baltimore Convention Center, during the 83rd General
Session of the International Association for Dental Research.


SOURCE International and American Associations for Dental

IDA To Start CDE Accridition Programme
Saturday, March 12, 2005 | gp

THE newly-appointed national president of the Indian Dental Association (IDA) Dr Bhagwant Singh has said that to encourage the dental surgeons for updating their knowledge, the IDA will soon start holding Continuing Dental Education Accredition Programme, so that every dental surgeon attends CDE programmes to update his or her knowledge. The IDA president has also unveiled his areas of priorities.

Talking to mediapersons here today, Dr Bhagwant Singh said the IDA would be giving points to every dental surgeon on attending one continuing dental education (CDE) programme. He said the Dental Council of India (CDI) would give weightage to these points and every dental surgeon who carries specific points would be eligible to read his or her research papers at CDE programmes.



He said the CDE accredition programme had been planned as some of the dental surgeons, who had completed their courses a long ago, had been practising on the basis of that knowledge only and were not updating their knowledge. He said there had been a lot of developments in the field of dentistry and thus was the need of updating the knowledge of the dental surgeons.

Elaborating his plans, Dr Bhagwant Singh said the IDA had planned to go to 50 lakh schoolchildren for free examination of their teeth and for oral diseases.

He said each of the state and local IDA units had been given specific targets to examine schoolchildren, specially from rural areas, for the oral and dental diseases.

He said that after his taking over as the IDA president, the website of the association had been launched. He said that this year, they were also planning to undertake a nationwide survey whether the dental surgeons were affected with hepatitis and other diseases. He said this had been planned as the dental surgeons were more prone to various diseases.

He said the IDA would also make the dental surgeons aware about the sterilisation of the equipment.

The Ludhiana and Punjab branches of the IDA had organised the function, Abhinandan, to honour and felicitate Dr Bhagwant Singh on his becoming the national president of the IDA.

Medical and Dental tourism set to take off ..
Saturday, March 12, 2005 | gp

With world class healthcare professionals, nursing care and treatment cost almost one-sixth of that in the developed countries, India is witnessing 30 per cent growth in medical tourism per year. According to a CII-McKinsey study, medical tourism can contribute Rs 5,000-10,000 crore additional revenue for up-market tertiary hospitals by 2012.

India is the most touted healthcare destination for countries like South-East Asia, Middle East, Africa, Mauritius, Tanzania, Bangladesh and Yemen with 12 per cent patient inflow from developing countries. And the most sought-after super-specialties are cardiology, neuro-surgery, orthopaedics and eye surgery.

The government has woken up to realise the potential of medical tourism, with tourism minister Renuka Chowdhury recently promising that she would put policies in place to help hospitals promote medical tourism by seamless integration of healthcare delivery with tourism and travel related facilities in the country.

The concept of medical tourism is gaining significance for India with both Indian and foreign insurance companies looking at India as a prospective healthcare destination, with corporate hospitals which can compete globally.

Realising the potential, hospitals have now started tying up with facilitating agencies like tour operators and have taken to marketing and advertising their sevices in the form of treatment packages for foreign patients to give a fillip to the health tourism sector.

Experts feel that Indian healthcare institutions should tie-up with multinational insurance companies to offer healthcare services to patients from abroad in order to improve medical tourism. They advocate accreditation of healthcare institutions by a foreign agency, marketing and advertising of healthcare institutes, the facilities and treatment packages they offer to the patient from abroad, as some of the components that need to be given a serious thought, if medical tourism has to really take off in a big way.

A provision for room-sharing facilities and special wards for patients from abroad, proper visa facilities and preferential treatment at immigration are other subjects which need to be addressed. The healthcare institutions are tying up with tour operators to tap the potential of medical tourism. “Other ways of exploring this sector is through seminars and exhibitions, which helps feature the healthcare industry and the medical sector globally,” points out Anupam Verma, director, administration, Hinduja Hospital.

Experts pinpoint that the other big advantage about the need to improve medical tourism is that it is non-seasonal. National Health Policy also encourages the supply of services to patients of foreign origin on payment.

According to Dr Keval Jain, consultant internal medicine, Sir HN Hospital, “Medical tourism can be improved, if we have a good infrastructure in place to deliver quality healthcare to the foreign tourists. Now, big and large hospitals in small towns and cities have a good set-up to offer treatments to foreign patients..”

To which Dr Atul Marwah, head, nuclear medicine, Bombay Hospital, adds, “Medical tourism can be promoted by marketing the medical expertise and facilities to the American and European countries. Some accreditation programmes need to be devised by the Medical Council of India (MCI) to ensure that General Medical Council, UK could accreditate the healthcare institutions in the country.”

Packages of treatments offered by Indian healthcare institutions should be advertised in the foreign country after being certified by an accreditation agency, suggests Dr Marwah.

According to Dr Gustad B Daver, director, professional services, Hinduja Hospital, “A good set-up in a hospital like pre-operative evaluation, an extensive lab set-up and operation theatre facilities, good post operative, intensive care and radiological facilities will be of major help to boost health tourism. A provision for room sharing facilities and special wards is also a prerequisite for an ideal set up.”

Opines Dr B K Goyal, dean, Bombay Hospital and Medical Research Centre, “Medical tourism can improve, if our healthcare institutions have a set up, which is on par with the West. Our doctors have the expertise, which needs to be marketed through a proper system set up in the healthcare institution, that of a special department to look after the requirements of patients from abroad.”

“Having a system to give proper accommodation and pick up facility from the airport for the relatives of the patient are some of the value addition to the treatment packages offered to the foreign patients,” Dr Goyal adds.

Medical tourism can be improved by creating awareness among the global community about the facilities rendered by Indian healthcare institutions. “The cost, quality and infrastructure of the Indian healthcare institution need to be advertised. Besides this, a proper civic infrastructure need to be in place like airports and good roads. There should be proper visa facilities and preferential treatment at immigration,” opines Verma.

Experts cite that medical insurance, alternate wellness concepts and BPO in diagnostics are other upcoming businesses which will give a boost to medical tourism in the coming years.

In the Capital, corporate hospitals like Apollo hospitals, Escorts Heart and Research Institute, Rockland hospitalare aligning themselves to capitalise on this trend.

The Apollo Hospital Enterprises, which treated an estimated 60,000 patients between 2001 and 2004 is the front runner in this field. Apollo’s business began to grow in the 1990s, with the liberalisation of the Indian economy. Apollo now has 37 hospitals, with about 7,000 beds. The company is in partnership in hospitals in Kuwait, Sri Lanka and Nigeria.

According to Anjali Kapoor Bissel, head, international marketing, Apollo Hospitals, there’s a team of eight people looking after medical tourism in Delhi and at the moment they are focussing on attracting patients from East Africa, Gulf (Oman and Yemen) and South Asia (Nepal, Bangladesh and Nepal).

She also informs that Apollo Hospitals has entered into a tie-up with Sita, to launch a jointly developed project, Sita Care, which will market hospitals packages abroad. There are several other small travel companies, which guide the tourists to avail health services (viz. dental check-up, whole body check-up etc). Majority of the patients contact the hospital directly via their web site and they usually get a package deal that includes flights, transfers, hotels, treatment and often a post-operative vacation.

According to a CII-McKinsey study, medical tourism can contribute Rs 5,000-10,000 crore additional revenue for up-market tertiary hospitals by 2012.

Apollo is steadily making progress in the field of medical tourism and developing methodologies to attract foreign patients, says Anne Marie Moncure, MD, Indraprastha Apollo. According to Moncure, every 5th doctor in the world is an Indian and their expertise is already acknowledged world over therefore, patients from abroad don’t hesitate to come to India and have treatment here.

It is about setting the expectations and nurturing the outcomes, she adds. For follow-ups of the medical tourists, Apollo has set the telemedicine centres, where through video-conferencing patients get in touch with their patients, informs Anjali. Last year in November, the group opened a telemedicine centre at the Om Hospital in Nepal.

Incidentally, Apollo is opening its first international Apollo health and lifestyle Ltd (AHLL) clinic at Doha on the January 26, 2005. The move is another initiative in developing medic al tourism because these international clinics will be telemedicine and information centres in international markets. According to Ratan Jalan, CEO, AHLL, these clinics will highlight the standards Apollo hospitals’ abroad. Apollo is looking to branch in South-east Asia, West Asia, Africa, UK and USA through this model, informs Mr Jalan Along with follow-ups these clinics will take care of initial investigations and day-to-day health services that patients may have to undergo, adds Mr Jalan.

Talking about challenges, Anjali says, the biggest challenge that they face is of connectivity with no direct flights from many places. Talks are going in with the ministry of aviation in this regard. Another challenge is that of competition from Singapore and Thailand. However, the cost in India is one fifth of Singapore and half of Thailand, elaborates Anjali and adds that we have brand India and we should cash in on that. Earlier, westerns were wary of coming here but now that perception has changed and India is perceived as a safe destination, adds Anjali.

The cardiac success rate here is more than 98.6 per cent. “We are planning to work with insurance providers and healthcare providers abroad in the UK and the US”, she adds. Patient break-up at Apollo from various countries is as follows: US and other countries-10.5 per cent, Maldives-46 per cent, Nepal-16.6 per cent, Oman-10.1 per cent, Sri Lanka-22 per cent, Bangladesh-27 per cent.

Disagreeing Dr Marwah on the importantance of accreditation in medical tourism, Moncure says, “Unlike the popular belief, accreditation is not at all important to attract the foreign patients. The patients are concerned about facilities and outcomes at hospitals. They would want to know the number of cases done, success of outcome and incidence of infections at the hospital. It is about setting the expectations and nurturing the outcomes.”

Regenerate Your Lost Tooth By Gene Therapy
Friday, March 11, 2005 | gp

We may not be very far away from a time when dentists offer to help people with damaged or missing teeth grow new ones, according to new research presented on Wednesday.

A series of presentations at a dental meeting demonstrate that techniques using stem cells and gene therapy to regenerate teeth are producing promising results, suggesting this technique may not be far off.

"I think it's looking like quite an exciting technology for the near future," said Dr. Tony Smith, editor of the Journal of Dental Research, who was not involved in any of the newest studies.

Smith explained that the presentations describe techniques that enable dentists to coax existing teeth into repairing and regenerating themselves, and techniques where dentists can "start from scratch."

Clearly, techniques that involve adding new tissue to already-existing teeth are "probably a bit closer on the horizon," perhaps within a "handful of years," Smith predicted. Techniques that grow teeth from scratch will likely take at least another 10 years to perfect, he added.

In some instances, researchers are trying to reprogram cells in the mouth to behave like tooth-growing cells, convincing them they have to produce new teeth, Smith explained.

Other techniques being explored involve using stem cells, which have the potential to become any type of cell or tissue. In one study being presented at the meeting, researchers successfully extracted stem cells from the pulp of adult teeth, Smith said. The next step is to examine whether it's possible to use these teeth to regenerate new dental tissue, he said.

Other research being unveiled describes tests of different approaches to select stem cells from pulp, and all shows "different degrees of success," Smith said.

These techniques may one day help people whose teeth have decayed from very bad cavities, who have lost teeth in an accident, or whose teeth have worn down from acid or hard brushing, among other conditions, he predicted.

Problems in RGUHS' Net exam
Wednesday, March 9, 2005 | gp

BANGALORE: *A medical college in Kolar gets question paper 45 minutes late.


*Of the five questions in BDS exam, two repeated verbatim. Worse, students are forced to repeat answers for both questions, if they want full marks.

*BDS Physiology and Anatomy papers are a recycle of Sept. 2004 exams.

Online transmission of question papers may have kept touts at bay, but Rajiv Gandhi University of Health Sciences has learnt the hard way that going hi-tech isn't all that easy.

The ongoing MBBS and BDS exams, where question papers were transmitted online for the first time in the country, has drawn angry responses from students and colleges. Colleges said the printers failed at many centres and computers took long to download question papers.

And the question papers weren't error-proof. For instance, third-year BDS General Surgery paper asked students twice to write short essays on the same topic — Cystic Hygroma. Similarly, second-year BDS General Pharmacology paper had 50% questions from another subject altogether — Dental Anatomy and Oral Histology.

Amid confusion, the university battled another problem: Confidentiality of the exam system prevented the authorities from checking the question paper before it was disbursed via the Net to 75 exam centres in the state. "We admit the mistakes. Due to confidentiality, it's not possible to check and recheck the question papers. Now, we've drawn up strategies to ensure such mistakes don't recur," RGUHS registrar (evaluation) Visveswara Reddy said.

BDS students faced with the Siamese twins of a question have been promised marks for both questions. "For the errors on our part, students will get marks. Initial hiccups will be there. We'll learn," RGUHS vice-chancellor R. Chandrasekhara said.

But Karnataka Private Dental Colleges' Association president L.K. Raju has come down heavily on the varsity's negligence. "The university should have first experimented it for internal exam rather than going in for public exams. A trial-and-error method would've helped the varsity to implement the scheme better. They haven't done their homework."

S N Medical and Dental College Takes Shape
Wednesday, March 9, 2005 | gp

MUSCAT — Sree Narayana Institute of Medical Sciences, a private medical college coming up near Paravur in Ernakulam district in Kerala, is set to open its hospital by the end of this year.

This was announced by a delegation of officials of the Gurudeva Charitable Trust, under which this institute has been established, who are in town to apprise trustees of the project that is fast nearing completion. The main objective of the trust is to establish and run educational and research institutions in the field of nursing, medical and paramedical subjects.

Speaking to the Times of Oman, Dr K. R. Rajappan, director and senior plastic surgeon at Specialists’ Hospital, Ernakulam, and president of the trust, said: “We have already upgraded the small clinic existing on the premises to a super-specialty one. The 300-bed hospital, which will be inaugurated by the end of this year, will incorporate the most modern facilities. We hope to start the college by next year and begin admitting students soon after.”

Initially, the medical college will admit a batch of 100 students through an admission test and other formalities laid down by the university, the government and the Indian Medical Council. The trust has already started on a recruitment drive of best faculty for the college.

A sprawling 44-acre campus will house the Sree Narayana Medical College and there are also plans for establishing a nursing institute and a dental college in the near future. Development of the area where the institute is located and establishing primary medical health centres are also top on their list of priorities.

The project is being funded by a total of 60 trustees from all over the world, most of whom are from the Gulf.

“We are immensely happy with the response generated for our educational institution. We aim to be the best medical college and hospital. Above all that, we will concentrate on helping the poor and needy. Our aim is to earn money, make profits and pass it on to the poor,” says Dr Rajappan who was recently given an award by Lion’s International for his work in charity.

“At a time when most medical facilities are beyond the reach of the poor, it becomes imperative for us to reach out and help. Our efforts will be in identifying and assessing cases which require financial help,” he added. There are also plans to have clinics and diagnostic centres in the Gulf, which will be linked to the parent hospital SNIMS.

“We are all for a medical package system wherein diagnoses can be done at these centres and we will look after the complete treatment of the patient at SNIMS.”

Dr Rajappan agrees that ‘healthcare has become a big business and we can use the extra money for the welfare of the poor’.

“Quality medical care is a necessity. We have the support of the trustees and of qualified and experienced doctors. We hope to be able to reach out and provide service in every way we can,” he concluded

Elderly for that 'perfect' smile
Tuesday, March 8, 2005 | gp

NEW DELHI: It's not just the aspiring Miss Indias who are opting for an all-new and improved smile. With both time and money to spare, more and more grandmas and grandpas are warming up to the idea of a redesigned smile.


"They all want youthful, younger smiles and they are at a stage in their lives when they have the money and the time for meticulous restoration work on their teeth," says Dr Mahesh Verma, principal and head of department of prosthodontics at Maulana Azad Dental College and Hospital.

So stained, deformed teeth are out and so are dentures, considered an essential accessory for the elderly a few years back. Implants which are essentially titanium screws fixed into your jaw bone are in. "In the last year itself, I would say that the number of people going in for implants has gone up by as much as 50%. Nobody wants to be in a situation where they sneeze and their dentures fall into the next person’s plate," says Dr Ashish Kakkar, senior consultant, department of dental surgery at the Indraprastha Apollo Hospital.

So what if you could buy yourself a car with the kind of money you spend on these implants? Both permanent as well as removable dentures can be fixed on these implants. A complete new set of teeth which are removable, can set you back by about Rs 60,000-Rs 70,000 while the permanent ones cost a whopping Rs 2-Rs 2.5 lakh.

Also, with better awareness and improved techniques, more and more people are coming forward to get their teeth preserved these days. So the ones who do not need implants opt for bleaching, and even increasing the height of the teeth.

"Attrition over the years causes the height of the teeth to decrease, we increase that, helping them chew their food better. We also make them whiter and do away with any gum disease that they may have," said Dr Verma.

Not only does it help them smile better, it also helps them live a healthier life.

"Oral health has off late been linked to a whole lot of other diseases as well. While earlier, no one may have bothered to go in for so many sittings and spend so much on their teeth, people are now waking up to the idea," said Ram Pal Singh, a south Delhi businessman who just got himself a whole new set of teeth.

And besides increasing their confidence and their health, this trend has also meant better communication for the elderly. "Whatever problems they may have had earlier due to missing teeth are also solved thus," said Dr Verma.

For that perfect smile
Tuesday, March 8, 2005 | gp

Oral care becomes easy when you realise the importance of dental hygiene



Nothing seems to highlight the travesty of neglect more than the state of preventable diseases in the oral cavity viz. dental caries and gum disease. It is probably among the top ten healthcare issues that India faces and wears horseblinds about. It is the cause of pain, family stress, financial burden and lost man hours that this country sleep walks through.
The mouth is the mirror of disease - thus spake William Osler - the world's first physician.
Here are some facts and figures to wake you up:
The prevalence of gum disease in India has been in the range of 90-99 per cent.
The prevalence of dental caries (cavities) in India is 80 per cent in children and 60 per cent in adults.
Most toothpastes available today are clinically proven to be effective for 12 hours. Brushing once a day only protects your mouth for half the day!
Imagine this scenario - if 50 million Indians at a given point in time spend just Rs. 200 on dental care of any sort, crores would have been spent on preventable disease. Even the zeros are hard to figure out.
Night brushing - singularly, the easiest most feasible and cheapest option (unless one doesn't sleep at all!).
The WHO and almost all other research globally clearly point us in this direction of brushing twice a day and especially brushing at night, if we are to maintain our oral equilibrium for a lifetime. What's amazing is that the one arena we need to be careful about is the most neglected. Try this - of all the functions of the human body, eating well, speaking smiling are perhaps done through the day till we pass over, maintaining oral integrity viz. teeth and gums in good shape should be paramount on our minds, specially at bedtime. This activity is very much in our control, it takes but a few minutes every night and it can actually become an integral part of our routine with minimal effort on our part. As a direct result of proper brushing at night, we can expect a healthy mouth and a great smile, which affects our self-esteem immeasurably. Yet, despite indisputable evidence, we do not pick up that toothbrush and toothpaste at night to keep our mouths in order, until the last ball is bowled.

Why night brushing?
Night is the time the mouth is especially susceptible to attack. Some of the reasons are cited below:
There are food particles present in the mouth, from a day of eating and snacking.
The rate of saliva flow during sleep is much reduced and hence it does not wash away these food particles.
There are plenty of bacteria present in the mouth, which produce acid, which has 6-8 hours of uninterrupted time to breakdown the tooth structure.
Brushing at night would eliminate these disease-causing bacteria, which would otherwise multiply, brew, ferment and form acids and tartar that in turn lead to dissolution of tooth structure (cavity formation), gum disease, bad breath and the like that are everybody's nightmare.

How does it work?
The physical cleaning action of the toothbrush and the toothpaste go a long way in physically removing food debris and plaque. Along with this, fluoride in the toothpaste replenishes the fluoride reservoirs that maintain the oral homeopathic balance. Fluoride has been unequivocally proven to be the singular anti-cavity agent which protects against oral insults from dietary habits and sugar challenges. Add triclosan to the formulation and you have an excellent gum disease preventing agent.

Who can promote night brushing?
Anyone who is in a position to advise and influence others can advocate night brushing. Your dentist definitely would. As a parent, this is one of the most important lessons you can teach your child about oral care (and of course you should remember that children learn from following your example). As a teacher, you could encourage your school to participate in oral health education sessions held by various NGOs throughout the country or you could counsel the children in your class to brush every night. Corporates such as oral care manufacturers can take this cause up and use some of their advertising time to promote night brushing.

So there...
Pick up that brush with a fluoride, triclosan combination, keep your sugar challenges to maximally five times a day, rinse after every meal and you will perhaps be seeing your friendly dentist for a chat and chai and very little else.

Keep Your Gums Healthy
Sunday, March 6, 2005 | gp

The best way to prevent gingivitis (gum disease) is to practice good dental hygiene. It's never too early to start in life, because

In addition to brushing at least twice daily and flossing at least once each day, the Mayo Clinic suggests these tips to keep your family's gums healthy:

Choose the right toothbrush. Select a toothbrush with soft, end-rounded or polished bristles -- stiff or hard bristles are more likely to injure your gums. Some dentists recommend electric toothbrushes with rotating or vibrating bristles because they may be more effective at removing plaque and maintaining healthy gum tissue.
Brush as if your teeth depended on it. To clean outer surfaces of your teeth and gums, use short, back-and-forth, and then up-and-down strokes. Use vertical strokes to clean inner surfaces. To clean the junction between your teeth and gums, hold your brush at a 45-degree angle to your teeth.
Floss. If you're like most people, this is the part that's usually ignored. A good alternative for non-flossers is an antiseptic mouthwash, but it will work best when combined with brushing and flossing.
See your dentist. Be sure to go for regular checkups and cleanings.

83rd General Session & Exhibition of the IADR
Thursday, March 3, 2005 | gp

From March 9-12, 2005, thousands of dental research scientists, students, and educators from around the world will convene in Baltimore, Maryland, as the International Association for Dental Research holds its 83rd General Session & Exhibition at the Baltimore Convention Center. This is also the 34th Annual Meeting of the American Association for Dental Research and the 29th Annual Meeting of the Canadian Association for Dental Research.

Cooking Blamed for Modern Dental Problems
Wednesday, March 2, 2005 | gp

The human jaw and teeth have diminished in size from the time of our early pre-human, ape-like ancestors. Their protruding jaw may not be beautiful to us, but their teeth were better spaced and more orderly than ours. We have tinier teeth, but they are still packed tightly into small jaws, often crookedly. Unlike other mammals, our third molars, nicknamed "wisdom teeth," sometimes do not have room to erupt at all.

George Washington University anthropologist Peter Lucas says the modern mouth is in disarray.

"The norm is a mess! It's basically twisted, not in the right position, such that orthodontists are commonly needed in order to straighten it out," he said. "There isn't enough space. And thirdly, it's diseased. If the dentition is disordered such that the mouth can't clear particles properly, then it's got more of a chance to get gum and periodontal disease that typifies modern humans."

Mr. Lucas blames the situation on the invention of cooking and other methods to process food, like cutting and chopping. This may make meals much more palatable and easier to chew than the raw, hard fare our primate cousins like chimpanzees and gorillas eat in the wild. But the anthropologist told a recent science convention in Washington that it has taken its toll on the human jaw.

"Food preparation techniques that generally reduce the particle size that we take into our mouth have acted very rapidly to reduce front tooth size and the jaw size of humans," he said. "There has also been reduction due to cooking in our back tooth size due to reduction generally in the toughness of foods. But they are of synchronization. Front teeth, jaw size [are] reducing very much faster than the back teeth, so that leads to crowding in the mouth."

Nevertheless, we are not likely to give up cooking and adopt gorilla diets to try to reverse the situation. For one thing, that would be too hard on our teeth. Mr. Lucas says a raw potato is almost twice as stressful on our molars than a cooked one.

A George Washington University anthropology colleague not involved in this study, Bernard Wood, agrees that we have developed to eat soft foods. He also notes, however, that at least we survived, whereas our more hardy-toothed, jut-jawed ancestors became extinct. Dentists worldwide should be delighted at this turn of evolution.

"The things that allow us to thrive with our small teeth are the things that are leading our teeth to be disorganized and deranged and so on," said Mr. Wood. "We obviously have evolved in fits and starts towards having very small teeth. Unless now we have the ability to cook food or prepare it in some way, we would be completely finished. We have such a lousy, small dentition that we just couldn't cope."

Another scientist interested in teeth, Peter Ungar of the University of Arkansas, is studying fossil dental evidence to understand the evolution of the human diet. To get at this, he is examining the wear patterns of ancient teeth.

"Tooth shape tells you what an animal has evolved to consume, but tooth wear tells you what an animal actually ate," he said.

Mr. Ungar described for the science convention two new techniques to analyze shape and wear patterns on teeth to help infer diets. One method uses laser beam scanning to generate three-dimensional computer maps.

Enlarged, they look like the surface of the Earth.

"The cusps become mountains," said Mr. Ungar. "The fissures become valleys."

The other technique uses a microscope to determine surface abrasions of old teeth. The type of abrasion is a clue to what was eaten.

Animals that eat leaves and things of that nature, tough foods, tend to have scratches on the surfaces of their teeth," Mr. Ungar said. "As the teeth shear and slide past one another, the abrasives in between them get dragged along, forming scratches. Those primates that eat hard, brittle foods tend to have a lot of pits on their teeth because as the teeth come together in crushing and grinding, that forms pits."

Combining laser dental topography with microscopic abrasion patterns, Mr. Ungar hopes to differentiate among the diets of our various primate and early human predecessors.