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___________________Dental Check up time! _____
.Do you have Oral Cancer?
Gum Disease?
Decay between the teeth?
Are you creating inflammation that circulates in your blood and causes damage to liver kidney heart tissues?
Well, we hope not, but the only way to tell is to come see us and get the real truth!
Call about our latest special! 913 498 8899
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What is the greatest challenge we face today regarding oral cancer?
![Sol Silverman, DDS]()
Sol Silverman, DDS, University of California, San Francisco School of Dentistry. Image courtesy of the University of California, San Francisco.
Dr. Silverman: Professional and public education. The No. 1 thing for professionals is to perform examinations and pursue any deviations from normal signs and/or symptoms and to take part in their patients' lives. If they have a patient who smokes, they should try to get them to stop smoking or tell them not to start. On the other hand, it's public education. You have to let people know there are such things as precancerous and cancerous lesions, and to seek professional examination. In some cases these can be prevented or treated. Certainly there are risk factors: alcohol and smoking. You should certainly eat a balanced diet with fruits and vegetables; all these things count. People can lead a perfect life but some are still going to develop a cancer -- although the risk can be reduced. So both public and professional education are very important things that we can do today.
What do dental practitioners need to know to help ensure early detection of oral cancer?
There are about 36,000 new cases of head and neck cancer diagnosed every year in the U.S., including 22,000 in the oral cavity. The odds of screening programs finding a cancer are pretty low.
So we teach the general principle that with every patient the dentist should do an oral examination using the light at chairside and palpating, feeling anything that looks abnormal. If any changes have been there for more than two to three weeks and a diagnosis has not been established, then the dental office should either take another step to establish a diagnosis or refer the patient for further evaluation.
The most important thing we can do now and for the next few years for oral cancer control is early detection. There's no question that, No. 1, early detection and appropriate treatment will increase the five-year survival rate. Some of the basic research that's still years away is to find very specific markers that, when we take a specimen, we can use some type of reaction and determine with a high degree of accuracy that this change is going to become malignant. In that way, not only can we practice prevention to a little higher standard, but we can then also develop targeted therapies that would help in the treatment.
more dentists are checking for signs of oral cancer in more patients, not just older, white patients who smoke and drink
Early detection should start in people when they're teenagers because we do have an increasing number of patients who are under 40 with no risks of alcohol or smoking who will have precancerous or early cancerous lesions. So we don't like to limit it. What is the greatest number? It's still people beyond middle age who have risk factors such as smoking and drinking, and they're male rather than female. But if you're going to prevent it, a good oral exam takes less than a minute, and if there is some abnormality, then it's worthwhile to either pursue what that abnormality represents or properly refer the patient. There's more emphasis on oral exams now, and more dental offices are doing it.
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We are not JUST another dental office...just like you are not JUST another mouth attached to a body!
You will benefit from Dr. Nelson's experience and integrity...As my patients say: " you can't be successful in dentistry for over twenty-five years without integrity and skill! "
Healthy teeth and gums improve your overall health.
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We offer the latest teeth whitening (bleaching) techniques and cosmetic treatments. Click or Visit Here to learn more about the Wow of Power whitening: http://www.zoomnow.com/
You can get the best treatment possible because our office is an up to date facility with the most technologically advanced techniques and equipment available. Great equipment...Great Skills...Great Staff...this equals great dental care for you!
We won't compromise our quality of care ...which means you get the health and smile that you deserve.
For people that choose to be healthy, you can be on your way to a lifetime of trouble-free teeth and gums, because we want to treat the CAUSE of any problems you may have, rather than just treat the symptoms
This means you get real value for your health dollar!. .
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While our practice is known for cosmetic and reconstructive dentistry, we are very much a General Practice.
Patients of all ages see us for everything from regular check-ups and routine care to complex restorative care.
Dr. Nelson will give the same meticulous attention to your family's routine dental care as he does cosmetic treatment.
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Another reason to visit our office:
We have gone Green...
By conserving water, using digital imaging, and recycling the many recyclables that pass through our green dental office, we intend to make a difference.
What we do as a green dentist is utilize water saving techniques, recycle, and use other techniques within the office to be environmentally friendly:
Eco-friendly cleaning solutions to protect our water ways
On-site, energy-efficient laundry facility to reduce waste
Bio-hazard disposal policies and amalgam separators to ensure toxic chemicals (such as mercury) don’t polluteour environment
Comprehensive Patient Protection Program to ensure mercury vapors don’t pollute the air or our patients’ lungs
Paperless records to reduce paper consumption and waste
Switching to digital radiography uses less energy and environmentally negative chemicals than previous methods. Green dentistry has really taken off in this area because digital radiography is also more effective than previous x-ray methods.
Saving water
It is important for dentists and staff to wash their hands. We use automatic shutoffs to limit how much water is used. However, so much water is wasted every single day in many different establishments. Water is wasted by letting it run when doing something instead of turning it off. You would be amazed how many individuals will wash their hands and leave it running while they dry their hands.
Another way in which green dentistry is making an impact is through recycling. We use paper cups for various reasons. Those paper cups can be recycled. Employees drink beverages throughout the day in both cans and plastic bottles, so a recycling program helps the environment.
Dr Nelson is a member of the Environmental Excellence Business Network (EEBN). This is a network of environmental professionals and business people who all share a common goal: making sustainable business decisions that protect our natural resources AND make good business sense.
Vision: A community of businesses focused on environmental excellence through environmental, social and economic sustainability.
Mission: To lead Kansas City area businesses toward environmental excellence through environmental, social and economic sustainability.
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Holistic dentistry? Ask us!
The key issue to having a healthy mouth is nutrition.
Holistic dentistry can become the first line of defense for preventive medicine by looking at changes in nutrition
. When was the last time you went to the dentist and were told you had gum disease or even a milder form, gingivitis, and ' periodontal bacteria that may impact the risk of heart disease, diabetes, and cancer?
Have you ever spoken with a holistic dental hygienist?
Did you ever have a periodontal diagnosis and systemic diagnosis at the same time
? Did you know a dental hygienist sometimes spends four times as much quality time with you than your personal physician?
But what do you talk about? Nutrition?
Or is the conversation not related to remineralizing your teeth with specific nutrition? With your mouth open, you can't talk, but how many dental hygienists talk to you about nutrition or natural solutions to getting rid of gum disease?
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Medicare's refusal to cover extensive dental treatment that is often needed to treat patients with diseases such as oral cancer and Sjögren's syndrome is unreasonable and arbitrary, according to a lawsuit pending in U.S. federal court.
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Lawsuit targets Medicare denial of dental care
By Donna Domino, Associate Editor
Medicare policy, which excludes coverage of "routine" dental care, does cover dental services when they are "incident to and an integral part of" eligible medical care. Dental procedures that are covered include extractions in preparation of radiation treatment of neoplastic disease, reconstruction of ridges that are performed simultaneously with the surgical removal of oral tumors, and the wiring of teeth if done in connection with jaw fractures.
"We have argued that this is a misinterpretation of the Medicare statute," said CMA attorney Sally Hart, who filed the suit. "We think that beneficiaries who require extensive dental services because of damage from Sjögren's syndrome, as well as cancer radiation treatment and other conditions that destroy the production of saliva, should not fall within the exclusion."
Why coverage denied
Each of the plaintiffs in the CMA lawsuit suffered a serious medical condition, resulting in impairment of salivary gland function, with resulting damage to the mouth and teeth that threatened their overall health, according to the complaint.
But in each case, they were denied coverage, for reasons ranging from "Medicare does not cover most dental services" to "when an excluded dental service is the primary procedure involved, coverage is excluded regardless of the complexity of the procedure."
“If you have a leg amputated because you have diabetes, they'll certainly pay for a prosthetic limb.”
— James Sciubba, DMD, PhD
In one case, even though the Medicare Appeals Council agreed that the beneficiary's need for dental services was provoked by a medical condition, "the fact that there was a relationship between a medical condition and the dental services does not, by itself, qualify the dental services for Medicare coverage. ... In order to be covered by that exception, the dental services would have to be furnished along with another covered procedure performed by the dentist on the same occasion."
One of the plaintiffs, Ron Fournier, developed squamous cell cancer in his tonsils that metastasized to his neck nodes. His chemotherapy and radiation treatments resulted in muscositis, altered salivary gland function, and dental infections. He has extensive caries, and his teeth have broken off at gum level, leaving him unable to eat solid food, according to the complaint.
His oral surgeon prescribed the extraction of all 21 of Fournier's teeth, but the Centers for Medicare and Medicaid Services (CMS) and the Medicare Appeals Council denied coverage because extractions are covered only in three scenarios: for patients undergoing transplants, to prepare the jaw for radiation treatment for cancer, or in emergency treatment of injuries to the jawbone or surrounding tissues.
Exorbitant costs
"Medicare has dodged this bullet for a long time, and it must be addressed," said James Sciubba, DMD, PhD, an oral pathologist in Baltimore who is vice president of Support for People with Oral and Head and Neck Cancer, another advocacy group.
CMS consistently denies this type of coverage because of the exorbitant costs associated with often extensive dental treatments, Dr. Sciubba toldDrBicuspid.com. Medically related dental treatments can cost more than the surgery and radiation treatment for the underlying medical conditions, he added.
For example, if a patient has part of the maxilla or mandible removed, and it has to be reconstructed with a metal bar or vascularized bone graft. Implants may then be placed into the grafted bone, followed by prosthetic reconstruction, which can often cost many thousands of dollars, Dr. Sciubba said -- more, in fact, than the cancer surgery and radiation therapy.
"That's part of the problem, and the Medicare folks certainly understand that," he said.
It is easier to get Medicare reimbursement for dental treatment related to oral cancer cases than other conditions, according to Dr. Sciubba.
Medically related dental care to completion is usually not performed at the same time of surgical resection of the tumor and bony reconstruction and by the same provider for the underlying medical condition, the lawsuit noted. This makes the Medicare requirement a "Catch-22" situation.
"If you have a leg amputated because you have diabetes, they'll certainly pay for a prosthetic limb, and this is precisely the same thing," he said.
FDA warns of benzocaine complications in teething gels
The U.S. Food and Drug Administration announced April 7 that it continues to receive reports of methemoglobinemia, a rare but serious blood disorder that is associated with pain relievers containing benzocaine, including teething gels.
The agency says that methemoglobinemia has been reported with all strengths of benzocaine gels and liquids, including concentrations as low as 7.5 percent. The cases involving low concentration products were mainly in children ages 2 or younger who were treated with the benzocaine gel form for teething.
The FDA is advising health care professionals to refer to the American Academy of Pediatrics guidelines for teething, which recommend giving a child a chilled—not frozen—teething ring or gently rubbing or massaging his gums with a finger instead of using benzocaine to relieve the symptoms.
Methemoglobinemia is a serious blood disorder that reduces the amount of oxygen in the blood stream and in severe cases can lead to death.
Benzocaine gels and liquids are sold under the brand names Anbesol, Hurricaine, Orajel, Baby Orajel, Orabase as well as store brands. In addition to gels and liquids, it is also sold in lozenges and spray solutions to treat a variety of conditions, such as teething, canker sores, and irritation of the mouth and gums.
Symptoms of methemoglobinemia include pale, gray or blue-colored skin, lips, and nail beds; shortness of breath; fatigue; confusion; headache; lightheadedness; and rapid heart rate.
For consumers who use benzocaine, the FDA advises that health care professionals advise them to use the smallest amount possible to relieve pain and not to apply the product more frequently than four times daily. Before recommending benzocaine products, health care professionals should discuss the signs and symptoms of methemoglobinemia with patients and tell them to look for signs and symptoms when using benzocaine products, and to seek medical attention immediately if they suspect methemoglobinemia.
The FDA will “continue to evaluate this safety issue and will take appropriate regulatory actions as warranted,” said the agency in its online safety alert.
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How can OsteoNecrosis of the Jaw be prevented?
The Ontario Dental Association recommends that everyone maintain good oral hygiene and that you see your dentist every 6 months.
It is important to stop smoking and to limit your consumption of alcohol. If possible, before starting high dose intravenous bisphosphonate
therapy in cancer patients, a detailed dental examination should be completed with X-rays of the jaw bones.
Any necessary dental surgery should be completed before starting high dose intravenous bisphosphonate therapy. The recommendations for osteoporosis patients on low dose bisphosphonates are much the same as for all .Maintain good oral hygiene and visit your dentist every 6 months. If oral surgery is needed, it is ideal to have this surgery completed before starting low dose oral or intravenous yearly bisphosphonate therapy if possible.
Some individuals on bisphosphonate therapy may be advised by their dentist to stop treatment 3 months before dental surgery and to
restart therapy after the surgical site has completely healed. As bisphosphonates are extremely important in preventing fractures, this
should be discussed with your family physician or specialist first before stopping your treatment.
Routine dental work such as dental cleaning, fillings or root canals do not require temporary stopping of your bisphosphonate treatment.
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Radiation is everywhere
Radiation is around us every day.
It comes from your microwave oven; chest x-rays; and the dentist's office.
The concern comes in the amount of that radiation and the time you're exposed to it.
There is a threat of serious illness from exposure to high levels of radiation like the workers at the stricken Japanese nuclear plant are likely to be facing. The longer a person is exposed, the sicker they may become.
Radiation can damage or destroy cells in the body. Mild exposure can lead to nausea and headache, but very severe doses can result in death.
Those who survive exposure to higher levels of radiation are at a higher risk of cancer later in life.
There are three major factors in protecting against radiation.
- TIME: Reducing your time of exposure.
- DISTANCE: Get as far away from the source of radiation as possible. That's why the Japanese have set up evacuation areas and exclusion zones around the crippled nuclear plant.
- SHIELDING: You've probably been given a lead-lined apron during dental X-rays; even the walls of an ordinary home can provide a barrier against dangerous radiation.
Every year, just walking around the planet, each of us is exposed to about 3.5 millisieverts of radiation, the equivalent of about 67 chest X-rays, or the same as 134 cross-country plane trips.
In order to get radiation sickness, you must be exposed to 1,000 millisieverts at once, and for most people, a fatal dose is about five times that level.
So to put that in perspective, the radiation levels at the scene of the fire at the nuclear plant in Japan have reached about 400 millisieverts, meaning someone would have to be right there at the fire for two-and-a-half hours to get sick.
So what about the level of radiation that is expected to reach the West Coast of the U.S.?
"If any radiation were to make it here, it would be merely background levels and nothing for people on the West Coast or people in the United States to be concerned about," said Jere Jenkins, director of radiation laboratories at Purdue University.
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Low Risk of Jaw Problems With Oral Osteoporosis Drugs
Study Shows Lower Risk of Jaw Osteonecrosis With Oral Bisphosphonates Than With IV Drugs
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-- Osteoporosis drugs and serious jaw problems have been linked in past studies, but new research presented at the International Association for Dental Research in San Diego finds a low risk with oral osteoporosis drugs, known as bisphosphonates.
Echoing the findings of previous studies, the researchers did find a higher increase in risk for intravenous bisphosphonates, taken by a minority of those with osteoporosis.
"The risk of intravenous bisphosphonates [and jaw problems] is increased by sixfold compared to oral bisphosphonates," says researcher Peter Tawil, DDS, a resident in postdoctoral periodontics at the University of Pennsylvania School of Dental Health.
Osteoporosis Drugs and Jaw Osteonecrosis
Reports of bisphosphonates and a link with the jaw problem known as osteonecrosis of the jaw began to appear in about 2003, Tawil tells WebMD. Osteonecrosis of the jaw is rare but serious and involves death of the bone due to lack of blood flow.
Early case reports, says Tawil, mainly involved patients on intravenous bisphosphonates.
Oral Osteoporosis Drugs vs. IV Drugs
Jeffcoat and Tawil report on four studies in all. .
They examined patients every three months to look for evidence of osteonecrosis of the jaw and compared them with 516 matched patients not on bisphosphonates.
No cases were found in either group.
Next, the researchers evaluated a data base of more than 55 million people enrolled in 700 health plans from 2000 to 2006. They focused in on those who took bisphosphonates.
"Some of them took IV bisphosphonates; others took the oral," Tawil says. Of those on the drugs, 213,364 were on oral and 2,321 were on IV.
Next, they compared these to a group of 423,845 patients who did not take any bisphosphonates.
The risk of the jaw problem while on oral bisphosphonates, Tawil says, was similar to those not on the drugs. In non-users, he says, the risk was about 0.9, or less than one in 1,000.
"The benefit outweighs the risk in treating osteoporosis with oral drugs," Jeffcoat says.
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
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FDA issues warning to Invisalign maker
A San Jose company that makes a device used to realign teeth has been warned it could face federal fines or other penalties because it hasn't disclosed enough information about patients who suffered serious side effects after using the product.
Align Technology, which touts its Invisalign system to reposition teeth, disclosed Tuesday that it received the warning letter from the Food and Drug Administration .
FDA officials in San Francisco who sent the letter could not be reached for comment. But their warning accused the company of failing to comply with federal reporting requirements covering medical devices that contribute to serious injury or death.
"swollen, irritated and sore lips,"
the company had received complaints similar incidents that "required hospitalization."
"injuries of swelling that could be life-threatening" after using the device, the FDA also said. In May of this year, it added, a patient reported "a burning tongue sensation, sore throat, ulcerations in the mouth and swollen lymph nodes."
In addition to being subject to unspecified fines if it fails to provide the information the FDA has demanded, the agency's letter said Align could face a federal injunction or have its assets seized.
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Toothbrushing May Stave Off Heart Woes
Study finds link between lack of oral hygiene and cardiovascular disease
By Amanda Gardner
Here's another reason to brush your teeth regularly: People who don't perform this essential of oral hygiene seem to have a greater risk of heart disease compared to their more diligent peers.
Periodontal disease has been associated with a 19 percent increase in the risk of heart disease. That number leaps to 44 percent in people under the age of 65, according to the study.
The most likely culprit is the inflammation associated with gum disease, which can go system-wide and contribute to plaque build-up in the arteries.
The rarely/never brushers also had higher levels of C reactive protein, a marker of inflammation.
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Jeff Segal, MD, JD, FACS
A lot has been said and written about defensive medicine. Some pundits have stated, “If I’m a patient, I want you to practice defensive medicine.”
This is where the misunderstanding begins. There is universal agreement that doctors should do what is reasonable to keep patients safe. Period. Doctors agree. As do patients and attorneys.
But, defensive medicine is different. Defensive medicine has a different purpose. It includes tests, referrals, and procedures focused primarily on keeping doctors out of the courtroom.
Some will argue “Wait a minute. Shouldn’t a doctor do everything possible to prevent a problem?” Here’s where an analogy helps.
Tens of thousands die in auto accidents every year. This is a national tragedy. The easy solution is to ban driving and go back to horse and buggy days. Of course that would be ridiculous. Our GDP would revert to that of a Fourth World country.
How about mandating that every driver wear a helmet and flameproof clothing? It works for NASCAR and Indy drivers. They can ram a car into a wall at 180 MPH and often walk away with few or no serious injuries.
Now, mandate that the helmet and flameproof clothing must be replaced weekly and you have to pay for it.
That’s analogous to defensive medicine. Most of the time wearing the helmet and flameproof clothing will do nothing; just add cost. On rare occasion, it will indeed keep you safe. And, on occasion, the extra equipment could cause harm (eg: perhaps the helmet will keep you from hearing a oncoming ambulance). Is it worth adding an additional $5,000 per year, for example, to make driving safer? How about $10,000 per year? And what if some of the new tools create new harms?
Defensive medicine imposes a friction cost on our healthcare system. The simple solution, which has bipartisan support, is to provide safe harbor immunity for doctors who follow doctor-developed guidelines.
We would add to that. Allow qualified immunity for doctors who consciously deviate from such guidelines when it makes good clinical sense for the patient. Just document why the deviation occurred. This would give physicians the latitude to do the right thing for patients 100% of the time, and not be penalized for doing so. There would be no such thing as cookbook medicine.
If we could get these ideas over the finish line (couldn’t resist one more racecar analogy) we could greatly improve healthcare for everyone.
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High-fructose diet increases men's blood pressure; gout drug protective American Heart Association meeting report
A high-fructose diet raises blood pressure in men, while a drug used to
treat gout seems to protect against the blood pressure increase,
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Heart disease is exacerbated by inflammation which can be caused by bacteria from 'unhealthy'gums.
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Changes in your gums or spit can signal that all's not well
What your mouth is trying to tell you
If the eyes are the windows to your soul, then your mouth is the gateway to your overall health. Changes in color or texture can signal that alls not well with your anatomy.
Open wide once a week and check for these conditions.
Tongue
Look for: pale color
Might mean: You have iron- deficiency anemia, which affects one in five women. Without enough iron — which helps produce energy and maintain the immune system — your body cant make hemoglobin, the pigment in red blood cells that gives your licker its ruby color.
Saliva
Look for: thick, stringy saliva
Might mean: You have xerostomia (dry mouth). The likely culprit? Prescription and OTC medications (including allergy, pain, and cold meds) that change the amount of water flowing in and out of cells. Left untreated, dry mouth can lead to tooth decay, gum disease, and oral yeast infections. Rx Talk to your doc about your meds and dry mouth, then rewet your whistle.
Drink more water, chew sugarless gum, and brush with childrens toothpaste, which typically has fewer drying ingredients, Still parched? Spritz an OTC mouth moisturizer like Salivart ($10, drugstore.com), or have your dentist prescribe saliva stimulators like Salagen or Evoxac.
Gums
Look for: bright red color, puffiness, or small abscesses
Might mean: Gum disease — about 23 percent of women aged 30 to 54 have it. Look for blood or pus coming out of your gums, especially while brushing,
These could signal a bacterial infection. Gum disease can also be a sign of something more serious, such as diabetes. If youre pregnant, it makes you seven times more likely to deliver your baby too early, according to the American Academy of Periodontology. It appears that gum disease increases the levels of biological fluids that induce labor.
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Why Almost Everything You Hear About Medicine Is Wrong
by Sharon BegleyJanuary 24, 2011
Illustration by Jacob Thomas
If you follow the news about health research, you risk whiplash. First garlic lowers bad cholesterol, then—after more study—it doesn’t. Hormone replacement reduces the risk of heart disease in postmenopausal women, until a huge study finds that it doesn’t (and that it raises the risk of breast cancer to boot). Eating a big breakfast cuts your total daily calories, or not—as a study released last week finds. Yet even if biomedical research can be a fickle guide, we rely on it.
But what if wrong answers aren’t the exception but the rule? More and more scholars who scrutinize health research are now making that claim. It isn’t just an individual study here and there that’s flawed, they charge. Instead, the very framework of medical investigation may be off-kilter, leading time and again to findings that are at best unproved and at worst dangerously wrong. The result is a system that leads patients and physicians astray—spurring often costly regimens that won’t help and may even harm you.
Breakthroughs and Breakdown
It’s a disturbing view, with huge im-plications for doctors, policymakers, and health-conscious consumers. And one of its foremost advocates, Dr. John P.A. Ioannidis, has just ascended to a new, prominent platform after years of crusading against the baseless health and medical claims. As the new chief of Stanford University’s Prevention Research Center, Ioannidis is cementing his role as one of medicine’s top mythbusters. “People are being hurt and even dying” because of false medical claims, he says: not quackery, but errors in medical research.
This is Ioannidis’s moment. As medical costs hamper the economy and impede deficit-reduction efforts, policymakers and businesses are desperate to cut them without sacrificing sick people. One no-brainer solution is to use and pay for only treatments that work. But if Ioannidis is right, most biomedical studies are wrong.
In just the last two months, two pillars of preventive medicine fell. A major study concluded there’s no good evidence that statins (drugs like Lipitor and Crestor) help people with no history of heart disease. The study, by the Cochrane Collaboration, a global consortium of biomedical experts, was based on an evaluation of 14 individual trials with 34,272 patients. Cost of statins: more than $20 billion per year, of which half may be unnecessary. (Pfizer, which makes Lipitor, responds in part that “managing cardiovascular disease risk factors is complicated”). In November a panel of the Institute of Medicine concluded that having a blood test for vitamin D is pointless: almost everyone has enough D for bone health (20 nanograms per milliliter) without taking supplements or calcium pills. Cost of vitamin D: $425 million per year.
Ioannidis, 45, didn’t set out to slay medical myths. A child prodigy (he was calculating decimals at age 3 and wrote a book of poetry at 8), he graduated first in his class from the University of Athens Medical School, did a residency at Harvard, oversaw AIDS clinical trials at the National Institutes of Health in the mid-1990s, and chaired the department of epidemiology at Greece’s University of Ioannina School of Medicine. But at NIH Ioannidis had an epiphany. “Positive” drug trials, which find that a treatment is effective, and “negative” trials, in which a drug fails, take the same amount of time to conduct. “But negative trials took an extra two to four years to be published,” he noticed. “Negative results sit in a file drawer, or the trial keeps going in hopes the results turn positive.” With billions of dollars on the line, companies are loath to declare a new drug ineffective. As a result of the lag in publishing negative studies, patients receive a treatment that is actually ineffective. That made Ioannidis wonder, how many biomedical studies are wrong?
His answer, in a 2005 paper: “the majority.” From clinical trials of new drugs to cutting-edge genetics, biomedical research is riddled with incorrect findings, he argued. Ioannidis deployed an abstruse mathematical argument to prove this, which some critics have questioned. “I do agree that many claims are far more tenuous than is generally appreciated, but to ‘prove’ that most are false, in all areas of medicine, one needs a different statistical model and more empirical evidence than Ioannidis uses,” says biostatistician Steven Goodman of Johns Hopkins, who worries that the most-research-is-wrong claim “could promote an unhealthy skepticism about medical research, which is being used to fuel anti-science fervor.”
Even a cursory glance at medical journals shows that once heralded studies keep falling by the wayside. Two 1993 studies concluded that vitamin E prevents cardiovascular disease; that claim was overturned by more rigorous experiments, in 1996 and 2000. A 1996 study concluding that estrogen therapy reduces older women’s risk of Alzheimer’s was overturned in 2004. Numerous studies concluding that popular antidepressants work by altering brain chemistry have now been contradicted (the drugs help with mild and moderate depression, when they work at all, through a placebo effect), as has research claiming that early cancer detection (through, say, PSA tests) invariably saves lives. The list goes on.
Despite the explosive nature of his charges, Ioannidis has collaborated with some 1,500 other scientists, and Stanford, epitome of the establishment, hired him in August to run the preventive-medicine center. “The core of medicine is getting evidence that guides decision making for patients and doctors,” says Ralph Horwitz, chairman of the department of medicine at Stanford. “John has been the foremost innovative thinker about biomedical evidence, so he was a natural for us.”
Ioannidis’s first targets were shoddy statistics used in early genome studies. Scientists would test one or a few genes at a time for links to virtually every disease they could think of. That just about ensured they would get “hits” by chance alone. When he began marching through the genetics literature, it was like Sherman laying waste to Georgia: most of these candidate genes could not be verified. The claim that variants of the vitamin D–receptor gene explain three quarters of the risk of osteoporosis? Wrong, he and colleagues proved in 2006: the variants have no effect on osteoporosis. That scores of genes identified by the National Human Genome Research Institute can be used to predict cardiovascular disease? No (2009). That six gene variants raise the risk of Parkinson’s disease? No (2010). Yet claims that gene X raises the risk of disease Y contaminate the scientific literature, affecting personal health decisions and sustaining the personal genome-testing industry.
Statistical flukes also plague epidemiology, in which researchers look for links between health and the environment, including how people behave and what they eat. A study might ask whether coffee raises the risk of joint pain, or headaches, or gallbladder disease, or hundreds of other ills. “When you do thousands of tests, statistics says you’ll have some false winners,” says Ioannidis. Drug companies make a mint on such dicey statistics. By testing an approved drug for other uses, they get hits by chance, “and doctors use that as the basis to prescribe the drug for this new use. I think that’s wrong.” Even when a claim is disproved, it hangs around like a deadbeat renter you can’t evict. Years after the claim that vitamin E prevents heart disease had been overturned, half the scientific papers mentioning it cast it as true, Ioannidis found in 2007.
The situation isn’t hopeless. Geneticists have mostly mended their ways, tightening statistical criteria, but other fields still need to clean house, Ioannidis says. Surgical practices, for instance, have not been tested to nearly the extent that medications have. “I wouldn’t be surprised if a large proportion of surgical practice is based on thin air, and [claims for effectiveness] would evaporate if we studied them closely,” Ioannidis says. That would also save billions of dollars. George Lundberg, former editor of The Journal of the American Medical Association, estimates that strictly applying criteria like Ioannidis pushes would save $700 billion to $1 trillion a year in U.S. health-care spending.
Of course, not all conventional health wisdom is wrong. Smoking kills, being morbidly obese or severely underweight makes you more likely to die before your time, processed meat raises the risk of some cancers, and controlling blood pressure reduces the risk of stroke. The upshot for consumers: medical wisdom that has stood the test of time—and large, randomized, controlled trials—is more likely to be right than the latest news flash about a single food or drug.
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Research says older people need more sun
Spending more time in the sunshine could help older people to reduce their risk of developing heart disease and diabetes.
Researchers have shown vitamin D deficiency is significantly associated with metabolic syndrome, a combination of medical and metabolic disorders that increase the risk of developing cardiovascular disease and diabetes.
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GlaxoSmithKline pulls zinc-based denture creams from market
Faced with dozens of lawsuits filed by consumers claiming they were harmed by Super PoliGrip and other denture adhesives that contain zinc, GlaxoSmithKline (GSK) announced that it will stop manufacturing these products and replace them with zinc-free alternatives.
The company warned consumers about the potential health risks associated with long-term excessive use of zinc-containing denture adhesives, including Super PoliGrip Original, Super PoliGrip Ultra Fresh, and Super PoliGrip Extra Care.
Adverse neurological effects
In 2008, the peer-reviewed journal Neurology reported on four patients suffering from neuropathy and other neurological symptoms typical of zinc poisoning and copper depletion (August 2008, Vol. 71:9, pp. 639-643). The article specifically linked excess zinc in Super PoliGrip to "profound neurologic disease" in the patients reviewed.
"Neurological symptoms may include numbness, tingling, or weakness in the arms and legs, and difficulties with walking and balance."
The acceptable daily zinc intake is 8 mg for women and 11 mg for men, and more than 40 mg constitutes zinc poisoning, according to the U.S. National Academy of Sciences.
A 2.4-oz (68-gram) tube of Super PoliGrip contains 38 mg of zinc per gram of product, and GSK recommends that a single tube should last approximately six weeks.
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Stillbirth linked directly to mother's oral bacteria
by Kate Melville
A Case Western Reserve University researcher has established a direct link between a mother's oral bacteria and the death of her fetus. Researcher Yiping Han's revelations about Fusobacterium nucleatum and its likely role in pre-term labor and stillbirths appear in the February issue of Obstetrics & Gynecology.
The mother in question carried the baby fullterm, but during the 35-year-old's pregnancy she reported excessive gum bleeding, a symptom of pregnancy-associated gingivitis. Around 75 percent of pregnant women experience gum bleeding due to the hormonal changes during pregnancy.
The bleeding associated with the gingivitis allowed the bacteria - normally contained to the mouth because of the body's defense system - to enter the blood and work its way to the placenta. Even though the amniotic fluid was not available for testing, Han suspects that the bacteria entered the immune-free amniotic fluid and eventually were ingested by the baby.
Han explained that normally a mother's immune system takes care of the bacteria in the blood before it reaches the placenta. But in this case, the mother also experienced an upper respiratory infection just a few days before the stillbirth. "The timing is important here because it fits the time frame of hematogenous [through the blood] spreading," Han said.
Postmortem microbial studies of the baby found the presence of F. nucleatum in the lungs and stomach. The baby had died from a septic infection and inflammation caused by bacteria. After questioning the mother about her health during the pregnancy, Han arranged for her to visit a periodontist, who collected plaque samples from her teeth.
Using DNA cloning technologies, Han found a match in the bacterium in the mother's mouth with the bacterium in the baby's infected lungs and stomach. "The testing strongly suggested the bacteria were delivered through the blood," Han said.
Happily, with preventative periodontal treatment and oral health care, the mother has now given birth to a healthy baby. Han suggests women who are considering a pregnancy seek dental care to take care of any oral health problems before conceiving.
What about the fathers periodontal bacteria? The baby sitter, the day care later, Grandma and Grandpa? Friends, neighbors, family? Insist that everyone around the baby is healthy.
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Tips for Doggie Dental Care by Cesar Milan
1. If your dog hasn't received a dental exam, take him to the vet first! He may require a cleaning, and then you can maintain his clean teeth at home.
2. Create a regular dental care routine at home. For example, you can brush your dog's teeth with special canine toothpaste.
3. Don't use human toothpaste or mouthwash. They can make your dog sick.
4. Start early! Grown dogs can learn to become comfortable with brushing, but make things easier for yourself by working with your dog as a puppy.
5. Take your dog to the vet if you see signs of dental problems:
- Bad breathe
- Change in eating or chewing habits
- Pawing at the face or mouth
- Depression
- Excessive drooling
- Misaligned or missing teeth
- Discolored, broken, missing or crooked teeth
- Red, swollen, painful or bleeding gums
- Yellowish-brown tartar crust along the gum line
- Bumps or growths within the mouth
6. Aggressive chewing on hard objects can cause broken teeth. Make sure you are providing safe objects for your dog to gnaw on.
7. During your dog's annual check-ups, make sure your veterinarian takes a good look at his or her teeth to keep an eye out for any issue you may miss.
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Sour candy not sweet on teeth
Study helps guide patients to consume candies in a "healthy" fashion -- particularly those patients with dry mouth.
Both original-flavor and sour candies are tough on tooth enamel, but the sour variety has much greater erosive potential, according to a new study in the Journal of the American Dental Association.
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Researchers looked at four brands of sour candies that had original-flavor counterparts: Jolly Ranchers, Life Savers, Mike and Ikes, and Twizzlers.
The researchers dissolved the candies in artificial saliva or water, and compared the pHs and titratable acidities of the original-flavor candies with those of the sour candies.
The team noted that sour candies had lower pHs and higher titratable acidities in artificial saliva than the original-flavor candies. In water, only sour Twizzlers had a pH lower than that of the original-flavor candy; all sour candies had titratable acidities higher than those of the original-flavor candies.
"Compared with water, the artificial saliva solvent was associated with higher pHs and lower titratable acidities for original-flavor candies but not for sour candies," the authors noted (JADA, July 2009, Vol. 140:7, pp. 906-913).
For the artificial saliva solvent, enamel lesion depths were significantly greater after exposure to sour candies than after exposure to original-flavor candies for Jolly Ranchers, Life Savers, and Mike and Ike, but the difference was not statistically significant for Twizzlers, according to the researchers.
Dental caries and erosion likely result from an interplay of behaviors and food and beverage composition.
Erectile Dysfunction Might Be Associated With Chronic Periodontal Disease
We can’t divide our body into absolutely different systems and functions. All of them depend one on another. A deeper study into the subject can discover ways to find or prevent one disease by other disease symptoms. The same can be said about erectile dysfunction and chronic periodontal disease.
Researchers organized a study to develop knowledge about the connection between erectile dysfunction and chronic periodontal disease.
In the analyzed number of persons; only 2.1% without erectile dysfunction had proved to have advanced periodontal disease.
9.8% of the analyzed people had mild erectile dysfunction and the same advanced periodontal disease.
The last obtained number was 15.8%, and it was representing the percent of persons with moderate or severe erectile dysfunction and advanced periodontal disease.
When talking about advanced periodontal disease we mean a recession of periodontal bone of 6 mm or more.
The idea of studying this subject is based on some previous findings of DNA of periodontal pathogenic bacteria in athermanous plaques and the epidemiological association between periodontal disease and coronary heart morbidity. Many world wide researches has proved that erectile dysfunction is an early sign of coronary heart disease.
There are reasons to think that extra-oral inflammation induced by periodontal bacteria might be associated with atherosclerosis and dysfunction of vessels.
Both conditions have strong connections with other diseases like coronary heart disease and diabetes mellitus.
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Sjögren’s syndrome is a chronic autoimmune disease in which people’s white blood cells attack their moisture-producing glands. Today, as many as four million Americans are living with this disease.
Although the hallmark symptoms are dry eyes and dry mouth, Sjögren’s may also cause dysfunction of other organs such as the kidneys, gastrointestinal system, blood vessels, lungs, liver, pancreas, and the central nervous system. Patients may also experience extreme fatigue and joint pain and have a higher risk of developing lymphoma.
With upwards of 4,000,000 Americans suffering from Sjögren’s syndrome, it is one of the most prevalent autoimmune disorders. Nine out of 10 patients are women.
Since symptoms of Sjögren’s syndrome mimic other conditions and diseases, Sjögren’s can often be overlooked or misdiagnosed. On average, it takes nearly seven years to receive a diagnosis of Sjögren’s syndrome. Patients need to remember to be pro-active in talking with their physicians and dentists about their symptoms and potential treatment options.
All patients should receive regular dental care in order to prevent cavities and tooth loss that may occur as a complication of the disorder. Patients with dry eyes should see an ophthalmologist (eye doctor) regularly for signs of damage to the cornea.
Since the disease was first identified in 1933 by Dr. Henrik Sjögren, it has been proven to affect virtually every racial and ethnic group.
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