Dr. Rick Newhart Updates

ANNOUNCEMENTS:

A Mid-Ohio Valley Dental Mission of Mercy is set for July 31 and August 1, 2009 . Dental volunteers are needed to help to serve the less fortunate in dental need at WVUP. Volunteers may choose from participating in triage, anesthesia, extractions or restorative dentistry. All materials will be provided for this event. All we need is you! Please contact Dr. Newhart ’s office or use a copy of the enclosed form to help register for this event.

 There will be a West Virginia Dental Association Meeting this weekend, at the Charleston Marriott. Please call the West Virginia Dental Association for further information 304.344.5246.

 The Blennerhassett Dental Society meeting is scheduled for January 28, 2009 at the Parkersburg Country Club. A representative from Pre-Paid Legal Services will be talking about the new federal guidelines regarding patient confidentiality and records protection. They offer a free in-office training for offices interested in complying with the federal guidelines. Please call Dr. Whitaker’s office to register for this meeting 304.424.4900.

DEATH AND ORAL HYGIENE?

Dr. Bassim (The Journal of American Geriatrics Society September 2008) performed a study in which enhanced oral hygiene reduced mortality for nursing home residents. Pneumonia, in the elderly, is often triggered by aspirating saliva or food. Several studies have shown that poor oral care is associated with pneumonia. Bassim studied the impact of improved oral hygiene in two wards in a Florida nursing home vs. two other wards, which did not receive any special oral hygiene care. Bassim found that the risk of dying from pneumonia was three times higher in those patients who did not receive enhanced oral care. Bassim includes that improved oral hygiene and good oral care may significantly reduce the risk of a patient dying from pneumonia.

UNSEEN HERPETIC VIRUS RISK

Miller and Danaher report on viral asymptomatic shedding in individuals which occurs then there is no visible herpetic lesion. Miller and Danaher evaluated existing epidemiologic data from 22 reports of herpus virus shedding in more than 3,500 individuals. They found HSV-1with no lesions in the saliva of 97 of 180 patients. They found that at least 70% of the population sheds HSV-1 asymptomatically at least once a month. The herpes virus was even detected in the saliva of seronegative individuals. The authors stress, that even without clinical lesions, dental personal may at risk. All efforts should be taken to minimize splashes and splatters of fluids. Miller CS, Danaher RT. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105(1): 43-50.

TO FREEZE IS BETTER!

Kosaraju and Vandewalle compared the use of a topical refrigerant and a topical anesthetic gel as pre-anesthetic in 16 participants. In this split-mouth design, patients received either a topical anesthetic gel with 20% benzocaine or a 5 second application of a refrigerant called Pain Ease prior to paletal injections. Participants later reported their discomfort on a visual analogue scale. Kosaraju found that the use of a refrigerant was more effective than compared to the use of a topical anesthetic. The advantage of the refrigerant is that it works quickly (within 5 seconds) and it does not dissipate into saliva and affect other parts of the mouth. Dr. Newhart feels that this was a good study and there may be a refrigerant in your patient’s futures.

JADA Vol. 140; 68: Jan 2009

DEAD BONE AND FOSAMAX

Sedghizadeh studied oral bisphosphonate use and the prevelance of osteonecrosis of the jaw in this USC study.  The authors used the USC dental computers to find 208 patients with a history of alendronate use. They further found that nine of those patients had active osteonecrosis, which was being treated in the USC dental clinic. The percentage of complications was about 4%. Further studies have found a strong correlation between intravenous bisphosphonate use and osteonecrosis of the jaw. This is the first large institutional study regarding oral bisphosphonate use. The authors state that even short-term use of an oral bisphosphonate can lead to osteonecrosis in a certain subset of patients after certain dental procedures. In this study, the only patients that developed osteonecrosis of the jaws had either denture trauma or tooth extraction. The shortest duration of Fosamax use was only one year in two females. She developed osteonecrosis of the jaw. The authors found no osteonecrosis of the jaw in any patients that had no received Fosamax. Dr. Newhart feels that all patients who are taking oral bisphosphonates should be informed of the potential risks for complications and sign a consent form if oral surgery is necessary.

JADA Vol. 140; 61: Jan 2009