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ADA News ADA News Archive Featured Events Videos Podcasts Media Resources April 02, 2012 Opioids and pain management top ADA webinar

By Kelly Soderlund, ADA News staff Medications like Vicodin, Lorcet and Percocet can be helpful to those in pain but disparaging to those who become addicted.

It’s a constant seesaw for dentists, who need to be adept at pain management for their patients but also aware of those who are at high risk for substance abuse. The dentist must also be ready to intervene with drug users, counsel patients about side effects and addictive nature, and understand the proper storage and disposal of prescription drug medications.

Dr. Sammon A webinar hosted by the American Dental Association titled “Opioid Analgesia in Your Dental Practice: Assessing Risks and Effective Pain Management” is scheduled for May 17 to discuss these topics. The ADA received a sub-award from the American Academy of Addictive Psychiatry from the Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment, which received a three-year grant to create webinars and training on treating pain and opioid addiction.

Over the next three years, the ADA will receive a sub-award of $33,000 per year. The center is paying for the Prescriber’s Clinical Support System for the Appropriate Use of Opioids in the Treatment of Pain and Opioid-related Addiction, which is a collaborative effort among a handful of medical associations that will provide training and education on the topic.

Dr. John E. Lindroth and Patrick J. Sammon, Ph.D., who are both professors in the Department of Oral Health Practice at the University of Kentucky College of Dentistry, will be the instructors. Dr. Lindroth is the director of the college’s urgent care clinic and is a part-time faculty member in the Orofacial Pain Center. Dr. Sammon is a consultant for the Kentucky Dental Association’s Well Being Committee and an instructor for the Federal Law Enforcement and Counter Drug Task Force training programs.

Dr. Lindroth They will help participants understand how drug abuse can lead to addiction and drug-seeking behavior; recognize clinical problems associated with opiate painkillers and over-the-counter drugs; identify signs, symptoms and behavioral problems associated with the abuse of prescription drugs; and learn how prescription monitoring tracking programs prevent diversion of prescription drugs. Dentists will also hear how to spot drug-seekers; refer drug-abusing patients for assessment and/or treatment; understand pain processing mechanisms to apply evidence-based pain management strategies; and how to manage post-operative pain in the face of addiction.

This program advances the Office of National Drug Control Policy’s recommendations in “Epidemic: Responding to America’s Prescription Drug Crisis.”

To register, contact Alison Siwek, manager of dentist health and wellness at the ADA, at siweka@ada.org.

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Source: http://www.ada.org/news/6941.aspx

Washington—The U.S. Senate took testimony Feb. 29 on proposals to increase access to dental care, including a dental therapist’s appeal to Congress to “do whatever you can to make it easier to improve access to care through the exploration and utilization of new types of dental providers.”

Source: http://www.ada.org/news/6830.aspx

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Many congenital heart disease patients are seeing their risk of endocarditis increase. One reason stands out above others: poor dental hygiene.

Teens with congenital heart disease floss and brush less than other people and they visit the dentist less as well. Conversely, they take better care of their health in regards to alcohol consumption, smoking and drug usage.

Adults with single ventricle physiology also have be known to have worse dental hygiene routines when compared to their peers even though their health in other areas is superior.

Source: http://www.dentistrytoday.com/todays-dental-news/7130-dental-hygiene-essential-for-congenital-heart-disease-patients

While several other health care-associated infections rates are in decline, potentially fatal infections of Clostridium difficile, or C. difficile, not only persist but have climbed in the last decade, according to the Centers for Disease Control and Prevention, which recently issued a call to action on preventive measures.

Source: http://www.ada.org/news/6875.aspx

Conclusion: There are more compressive stresses concentrated at the apex of incisors with a high degree of inclination than in incisors that are more upright. This may be associated with the higher clinical incidence of apical root resorption found in inclined maxillary central incisors. PMID: 22360298 [PubMed - as supplied by publisher] (Source: The Angle Orthodontist)

Source: http://www.medworm.com/index.php?rid=5773341&cid=s_37502_11_f&fid=37502&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22360298%26dopt%3DAbstract

Thousands of children are receiving an excessive amount dental care in Texas because of Medicaid. Some of these children are receiving crowns on teeth that aren’t permanent.

There are even dentists that are hiring recruiters to bring in these types of patients, according to a report on wfaa.com. There are people who pass out information regarding this treatment to people utilizing food stamps. There are ipods, electric toothbrushes and other prizes being given to these types of patients if they see a particular dentist.

Source: http://www.dentistrytoday.com/todays-dental-news/7071-some-texas-dentists-will-do-anything-to-treat-medicaid-patients

Publication year: 2012 Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 141, Issue 3 Larry J. Oesterle, Justin M. Owens, Sheldon M. Newman, William Craig Shellhart Introduction Orthodontists depend on perceptions derived from education and clinical experience to judge the optimal forces in patient treatment. The purpose of this study was to survey practicing orthodontists to determine the interarch latex elastic forces they prescribe in different malocclusion scenarios. Methods Thirty orthodontists were presented with 4 clinical scenarios on study models, including Class II and Class III malocclusions in edgewise and light wires. These orthodontists described the size and location of the elastics they would use. The forces produced by the prescribed elastics were measured and compared with actual dry forces measured on a testing machine. Results The orthodontists’ force recommendations were a mean of 277 ± 89 g and a median of 256 g (range, 132-464 g) for a Class II malocclusion with edgewise wires; a mean of 183 ± 59 g and a median of 177 g (range, 59-284 g) for a Class II malocclusion with light wires; a mean of 290 ± 83 g and a median of 305 g (range, 151-562 g) for a Class III malocclusion with edgewise wires; and a mean of 216 ± 66 g and a median of 209 g (range, 119-344 g) for a Class III malocclusion with light wires. The force levels for light wires were statistically significantly lower than for edgewise wires. Conclusions There were considerable variations in the forces selected for all cases. “Expert” recommendations fell within 1 SD of the mean of the orthodontists’ recommendations except for the light-wire Class III scenario. Since latex elastic force decays significantly during a patient’s use, elastics should be selected with initially higher forces than desired.

Source: http://www.sciencedirect.com/science?_ob=GatewayURL&_origin=IRSSSEARCH&_method=citationSearch&_piikey=S0889540611010766&_version=1&md5=d2b6062ded88357f02a7a4ce2f9ef51a

Publication year: 2012 Source:American Journal of Orthodontics and Dentofacial Orthopedics, Volume 141, Issue 3 Catherine Kroczek, Katherine Kula, Kelton Stewart, James Baldwin, Tie Fu, Jie Chen Introduction The 3-dimensional load system (forces and moments) was quantified at the canine bracket during space closure with sliding mechanics with elastomeric chain on dry and wet stainless steel and beta-titanium 0.019 × 0.025-in archwires. Methods A custom-made maxillary dentoform simulating first premolar extractions was attached to an orthodontic force tester. The canine was attached to a load cell through an adaptor with silicone simulating the periodontal ligament. The orthodontic force tester simultaneously measured the entire load system produced at the canine bracket by an elastomeric chain. The effects of archwire material, time (activation and 1 hour), and lubrication were analyzed by using 3-way repeated measures analysis of variance (ANOVA, ? = 0.05). Results Stainless steel provided a greater (P = 0.001) load system than did beta-titanium. The force was greatest on the canine in the lingual axis. The greatest moment was about the y-axis. The moment-to-force ratio, the most critical ratio, was greater for beta-titanium than stainless steel; however, both were close to the ideal 10:1. Conclusions With a stainless steel archwire for retraction sliding mechanics, a canine will experience a greater load system in all 3 dimensions than with a beta-titanium wire. Both archwires produced a moment-to-force ratio adequate for translation.

Source: http://www.sciencedirect.com/science?_ob=GatewayURL&_origin=IRSSSEARCH&_method=citationSearch&_piikey=S0889540611010729&_version=1&md5=ea63429438faa2961fb5fb2957a42e6b

Maintaining solid oral hygiene could be a key to preventing bowel cancer.

A research team from the Dana-Farber Institute and the Broad Institute discovered a correlation between bacteria associated with gum disease and nine colorectal tumor samples. This indicates that there could be some kind of link.

Bowel cancer is one of the more common types of cancer. Only about half of the people who develop bowel cancer survive.

Source: http://www.dentistrytoday.com/todays-dental-news/6954-some-oral-bacteria-may-cause-bowel-cancer

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Stripping some mouth bacteria of their access key to other pathogenic oral bacteria could help prevent gum disease and tooth loss.

The study, published in the journal Microbiology suggests this bacterial access key could be a drug target for people who are at high risk of developing gum disease.

Oral bacteria called Treponema denticola frequently gang up in communities with other pathogenic oral bacteria to produce destructive dental plaque.

This plaque, made up of bacteria, saliva and food debris, is a major cause of bleeding gums and gum disease which can lead to periodontitis and loss of teeth.

It is this interaction between different oral pathogens that is thought to be crucial to the development of periodontal disease.

Researchers from the University of Bristol have discovered that a molecule on the surface of Treponema called CTLP acts as the key pass that grants the bacterium access to the community, by allowing it to latch onto other oral bacteria.

Once incorporated, CTLP in conjunction with other bacterial molecules can start to wreak havoc by inhibiting blood clotting (leading to continued bleeding of the gums) and causing tissue destruction.

Professor Howard Jenkinson, who led the study, said that periodontal disease and bleeding gums are common ailments, affecting many groups of people, including the elderly, pregnant women and diabetics.

‘Devising new means to control these infections requires deeper understanding of the microbes involved, their interactions, and how they are able to become incorporated into dental plaque,’ he said.

Source: http://www.dentistry.co.uk/news/news_detail.php?id=4853

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Smokers not only have more problems with their teeth than non-smokers, they also go to the dentist less often.

Those are the findings of a new US government survey, released by the Centers for Disease Control and Prevention.

The CDC looked at 2008 survey responses from more than 16,000 adults ages 18 through 64.

More than a third of smokers reported having three or more dental problems, ranging from stained teeth to jaw pain, toothaches or infected gums. That was more than twice as much as people who never smoked.

But 20% of the smokers said they had not been to a dentist in at least five years.

Only 10% of non-smokers and former smokers had stayed away that long, the study found.

Source: http://www.dentistry.co.uk/news/news_detail.php?id=4852

View the full PDF brochure for this upcoming Ontario Canada 12-Session Course

This session serves as an optional session for potential course participants giving them the opportunity to meet the course instructor, the clinical instructor, the host dentist and visit the course clinical facility. Course enrollment is based on “a first-come, first-served basis”. Potential enrollees have one week following the “Introductory Session” to enroll in the course. Enrollment is full tuition and 2 years membership payment. All course enrollments are contingent upon approval by the course instructor following the Introductory Session. This session will assist the participant in making an informed decision as to whether he/she will make the commitment to participate in the comprehensive 12-session hands-on program. This will also allow the instructor, the clinical instructor(s) and/or host dentist the opportunity to meet and interview potential course participants. The Friday morning session will consist of a lecture of current ideas and trends in orthodontics and will allow the participant to view documented case presentations with a Question and Answer (Q & A) period regarding the course curriculum and the Differential Straight -Arch® Technique (Tip-Edge® System). The Saturday clinical session will continue with a clinical demonstration of initial banding and bracketing of patients with the Tip-Edge® System by the course instructor and patients will be assigned.

YOUR INSTRUCTOR will be Roy Holexa, D.D.S. who began his orthodontic training in 1985 under the direction of the late Dr. Charles Yates, utilizing the Begg method of orthodontic treatment. Dr. Holexa is a member of the American Orthodontic Society and past president of the Academy of Gp Orthodontics.

Dr. Holexa teaches the hands-on courses in McHenry, Illinois and Toronto, Canada. Dr. Holexa graduated from Loyola University School of Dentistry in 1976, where he was a member of the teaching faculty. He also served as a clinical supervising dentist at Harper College dental programs in Palatine, Illinois and was instructor for Head and Neck Anatomy in the dental hygiene program. Dr. Holexa resides in Fountain Hills, Arizona where he is currently a Comprehensive Care Unit Clinical Director at the Arizona School of Dentistry and Oral Health in Mesa. He is an alumnus of the L.D. Pankey Institute for Advanced Dental Education, a member of the American Dental Association and component dental societies.

Stripping some mouth bacteria of their access key to gangs of other pathogenic oral bacteria could help prevent gum disease and tooth loss. The study, published in the journal Microbiology suggests that this bacterial access key could be a drug target for people who are at high risk of developing gum disease…

Source: http://www.medicalnewstoday.com/releases/241323.php

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Smokers not only have more problems with their teeth than non-smokers, they also go to the dentist less often.

Those are the findings of a new US government survey, released by the Centers for Disease Control and Prevention.

The CDC looked at 2008 survey responses from more than 16,000 adults ages 18 through 64.

More than a third of smokers reported having three or more dental problems, ranging from stained teeth to jaw pain, toothaches or infected gums. That was more than twice as much as people who never smoked.

But 20% of the smokers said they had not been to a dentist in at least five years.

Only 10% of non-smokers and former smokers had stayed away that long, the study found.

Source: http://www.dentistry.co.uk/news/news_detail.php?id=4852

Two glasses of wine or some types of beer on a daily basis can increase oral cancer risk, according to a recent study.

The information came to light after the United Kingdom unveiled an advertising campaign aimed at discouraging daily drinking. The campaign also hopes to raise awareness about the causes and symptoms of oral cancer.

Some of the advertising will also target drinking and some of the other health problems associated with excessive drinking, such as high blood pressure.

Source: http://www.dentistrytoday.com/todays-dental-news/6789-daily-drinking-may-increase-oral-cancer-risk

Sacramento, Calif.—Legislation approved by the state senate Jan. 26 would create a dentist-led Statewide Office of Oral Health within the state Department of Public Health charged with addressing the “significant human and financial costs” of unmet dental needs.

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Researchers have pinpointed a genetic variation that increases the risk of developing necrotic jawbone lesions. The condition stems from bisphosphonates. The study appeared in the online version of The Oncologist.

This research shows that a genetic screening test will be necessary to show who will be able to take these drugs in the future without awful side effects.

There are currently about 3 million women in the United States who take oral bisphosphonates. These bisphosphonates are taken to treat osteoporosis. Bisphosphonates are also taken intravenously by cancer patients.

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There are some dentists around the world who want more people to be vaccinated for human papilloma virus. In the United Kingdom, there’s a vaccination program for girls. Dentists and other people the medical profession, however, want boys to now be included in the program.

HPV is a huge risk factor for cervical cancer but it has also been linked to oral cancer. The amount of throat cancer cases has roughly doubled in the last 15 years and much of that has been because of HPV. Drinking and smoking are some of the other risk factors.

Things you can do from here: – Subscribe to Today’s Dental News using Google Reader – Get started using Google Reader to easily keep up with all your favorite sites

Many Americans are turning to the emergency room for dental care. A lack of dental insurance is the reason.

People without dental insurance are increasingly visiting the emergency room because they don’t have any other options. The issue is not a good one for many local medical services. Since many people don’t have the insurance coverage they once did, this is the result.

Dental care isn’t affordable for many people with low incomes or people who are unemployed. The risk of oral diseases, infections and pain is up dramatically because people don’t receive the regular treatment they had in the past.

Source: http://www.dentistrytoday.com/todays-dental-news/6733-more-patients-visit-emergency-room

Hyattsville, Md. – Seven percent of American children aged 17 and younger had unmet dental need in 2010 because their families could not afford dental care, the National Center for Health Statistics said in an analysis of data collected by U.S. Census Bureau interviewers and reported in the Vital and Health Statistics series.

Source: http://www.ada.org/news/6700.aspx

Conclusions: The prevalence of MdM2 impaction in this study was low but slightly higher than previous reports investigating whites. Although such impactions are rare, it is recommended to diagnose early for an optimal treatment time and reduction of complications. In addition, the effective molar uprighting appliance used in this study has displayed good treatment outcomes with natural improvement of the adjacent infrabony defects of the first molars. PMID: 22229822 [PubMed - as supplied by publisher] (Source: The Angle Orthodontist)

Source: http://www.medworm.com/index.php?rid=5579456&cid=s_37502_11_f&fid=37502&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22229822%26dopt%3DAbstract

Conclusions: Both bracket types presented adequate clinical performance at least for the time period studied and in terms of esthetic appearance and morphologic integrity. PMID: 22229823 [PubMed - as supplied by publisher] (Source: The Angle Orthodontist)

Source: http://www.medworm.com/index.php?rid=5579455&cid=s_37502_11_f&fid=37502&url=http%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fentrez%2Fquery.fcgi%3Ftmpl%3DNoSidebarfile%26db%3DPubMed%26cmd%3DRetrieve%26list_uids%3D22229823%26dopt%3DAbstract