Tobacco smoke makes germs more resilient

UofL dental researcher explores microbiological mechanisms as World Health Organization urges for a day of abstinence from tobacco use

University of Louisville- logoThe mouth is one of the dirtiest parts of the body, home to millions of germs. But puffing cigarettes can increase the likelihood that certain bacteria like Porphyromonas gingivalis will not only set up camp but will build a fortified city in the mouth and fight against the immune system.

University of Louisville School of Dentistry researcher David A. Scott, Ph.D., explores how cigarettes lead to colonization of bacteria in the body. Scott and his research team have identified how tobacco smoke, composed of thousands of chemical components, is an environmental stressor and promotes bacteria colonization and immune invasion.

Scott says since this initial finding several years ago, a recent literature review published in Tobacco Induced Diseases revealed that cigarette smoke and its components also promote biofilm formation by several other pathogens including Staphylococcus aureus, Streptococcus mutans, Klebsiella pneumonia and Pseudomonas aeruginosa.

Biofilms are composed of numerous microbial communities often made up of complex, interacting and co-existing multispecies structures. Bacteria can form biofilms on most surfaces including teeth, heart valves and the respiratory tract.

“Once a pathogen establishes itself within a biofilm, it can be difficult to eradicate as biofilms provide a physical barrier against the host immune response, can be impermeable to antibiotics and act as a reservoir for persistent infection,” Scott said. “Furthermore, biofilms allow for the transfer of genetic material among the bacterial community and this can lead to antibiotic resistance and the propagation of other virulence factors that promote infection.”

One of the most prevalent biofilms is dental plaque, which can lead to gingivitis – a gum disease found in almost half the world’s population – and to more severe oral diseases, such as chronic periodontitis. Bacterial biofilms also can form on heart valves resulting in heart-related infections, and they also can cause a host of other problems.

“We are continuing research to understand the interactions of the elaborate communities within biofilms and how they relate to disease. Many studies have investigated biofilms using single species, but more relevant multispecies models are emerging. Novel treatments for biofilm-induced diseases also are being investigated, but we have a long way to go,” Scott said. 

Scott elaborates on this research in a short question and answer style blog published today on the BioMedCentral website.

Attention to Scott’s work comes as the World Health Organization observes World No Tobacco Day on May 31 to encourage a global 24-hour abstinence from all forms of tobacco consumption. The effort points to the annual 6 million worldwide deaths linked to the negative health effects of tobacco use.

In the United States, Kentucky ranks second for cigarette use among adults, according the Centers for Disease Control and Prevention (CDC). Only West Virginia has more smokers. Kentucky also brings up the rear among youth in grades 9-12 who use tobacco; according to 2011 CDC data, about 24-percent of high school students smoke cigarettes.

World Oral Health Day: Five things you should know about THE POWER OF A SMILE!

To mark World Oral Health Day 2016 on Sunday 20 March the British Dental Health Foundation want to make sure everybody understands the enormous power that lies behind a smile.

We want you to take a moment and think about how a simple smile can be one of the most powerful tools at our disposal… and we all have one.

So to help everyone understand the power of a smile we have put together some of our favourite facts about smiles:

  • Charles Darwin who was one of the first to really look at the power of a smile. He noted that smiling is truly universal, unlike other physical actions such as body language, or verbal communication, which differs from culture-to-culture, we all understand a smile and the feelings behind it.
  • Smiles are hugely infectious.  So even if we don't feel much happier straight away, by smiling the people around us are more likely to smile, and that can then improve our mood as well.
  • A smile can really have a big effect our relationships.  More than half of people make a smile one of the first things that people notice about others and one of the most attractive features people can have.
  • A smile can also benefit our professional life too. A smile is seen as friendly and trustworthy; interviewers are likely to find candidates far more appealing if they go for a job interview with smile on their face.
  • It really is easier to smile too. I am sure you would have heard that it takes less muscles to smile than frown, this really is true 43 to frown and only 17 to smile!

World Oral Health Day is an excellent opportunity to let you know about the power of smile and discuss how important vitally oral health can be to our confidence, happiness and health.

You may have heard recent press about the amount of children with oral health problems. New statistics revealed more than 33,000 children were admitted to hospital for tooth extractions under general anaesthetic in the last year alone.

We cannot let poor oral health stop our children from smiling!

It's important that we are all aware of the correct way to look after our oral health to make sure maintain our smiles.

Looking after our smile should be quite simple, if you make sure you follow our three key messages:

  • Brush your teeth last thing at night and on at least one other occasion with a fluoride toothpaste.
  • Cut down on how often you have sugary foods and drinks.
  • Visit your dentist regularly, as often as they recommend.

Try to share a smile, not just on World Oral Health Day but every day, and bring a bit of happiness to those around you.

World Oral Health Day is celebrated every year on 20 March. It is an international day to celebrate the benefits of a healthy mouth and to promote worldwide awareness of the issues around oral health and the importance of oral hygiene to looking after everyone old and young.

It is a day for us to have fun – this should be a day full of activities that make us laugh, sing and smile!

To find out more about World Oral Health Day visit www.worldoralhealthday.com

Meeting Review: 2016 Thomas P. Hinman Dental Meeting

 

ATLANTA, Ga., USA: During the 104th Thomas P. Hinman Dental Meeting, Atlanta was abuzz with excitement for the dental professionals who gathered from around the country at the Georgia World Congress Center and Omni Hotel at CNN Center. The theme was “Your Total Health Connection.” New this year was the Total Health Pavilion, featuring lectures on nutrition and health.

 

In addition to a comprehensive continuing education program featuring hundreds of opportunities ranging from hands-on workshops to all-day educational tracks, there was the exhibit hall, where nearly 400 companies presented some of the latest and most innovative products and services available in the dental industry.

The hall gave meeting attendees plenty of opportunity to shop and get product and equipment questions answered by exhibitors in an efficient setting.

 

Also on the show floor, table clinics were available to meeting attendees for additional continuing education credits.

The Hinman Dental Society uses proceeds from the meeting to award scholarships, and this year nearly $450,000 in scholarships and gifts were awarded to dental education schools and programs. Included in these gifts are 89 scholarships, dispersed to students at 39 different dental programs throughout the Southeast. The students selected for scholarships were named “Hinman Scholars” and were recognized during a luncheon.

“Hinman is proud to support student programs in the Southeast for the past 29 years,” said Dr. Jim Roos, general chairman of the 2016 Hinman Dental Meeting, in a press release announcing the awards. “In the last 16 years alone, the Hinman Dental Society has contributed nearly $8 million in scholarships and large gifts in support of dental education.”

“In addition to providing scholarships and endowments, Hinman invites students to attend the meeting to learn the latest in the profession, network with established dentists and prepare for a successful career in dentistry,” Roos said.

For 104 years, dental professionals have considered the Hinman meeting to be one of the premier sources of continuing education.

Among the many educational highlights: “Botox and Dermal Filler Training” and “Botulinum Toxin for Best Therapeutic and Esthetic Outcomes,” presented by Dr. Louis Malcmacher; “Geriatrics Mini-Residency,” presented by Dr. Gretchen Gibson, Dr. Randy Huffines and Dr. Linda Niessen; and “Pediatric Oral Healthcare Mini-Residency,” presented by Dr. Melinda Clark, Dr. Gregory Psaltis, Dr. David Rothman and Dr. J.C. Shirley.

Other highlights: “Lab Tech Day,” presented by Thomas Sing, Arian Deutsch, Jungo Endo and Mike Dominguez; and “S.I.L.V.E.R. (Strategies to Implement that Lead to a Valuable, Enjoyable Retirement),” presented by Dr. Wayne Kerr, Joseph Jordan and Wes Moss.

 

 

GKAS Institute ambassador success stories span the U.S.

By Michelle Manchir

Photo of Dr. Jonathan Zsambeky, Lori Pinion and Adilene at Give Kids A Smile event in North Carolina
Give kids a thumbs up: Dr. Jonathan Zsambeky, right, Lori Pinion, dental hygienist, and Adilene, center, smile following a treatment during the Give Kids A Smile event in Cabarrus County, N.C. on March 4.

When Tracy Ginder walks into dental offices across Cabarrus County in central North Carolina, she’s often greeted with a wave of hellos and familiar smiles.

That’s because Ms. Ginder, for the last 10 years, has coordinated the Give Kids A Smile event there. Under her watch, thousands of youngsters here have accessed dental care and education they may not have received otherwise.

This year, Ms. Ginder had some newly acquired expertise when it came to coordinating the event. That’s because she was one of 10 GKAS Ambassadors who in October participated in the ADA Foundation Give Kids A Smile Community Leadership Development Institute in St. Louis.

Ambassadors are chosen from state and local dental societies and community-based organizations to learn best practices for initiating, expanding and enhancing a Give Kids A Smile program, in part by attending and helping facilitate one of the country’s largest GKAS events in St. Louis. The ADA Foundation will post the application for the 2016 GKAS Institute April 4 on ADAFoundation.org. The application deadline is May 13.

Here are three of the 2015 ambassadors’ stories.

Tracy Ginder — Cabarrus County, North Carolina

This year, 12 dental offices across Cabarrus County, North Carolina participated in a March 4 Give Kids A Smile event, treating more than 200 underserved kids. Patients received education, cleanings, treatment and in most cases, an invitation to return for future cleanings and treatment when necessary.

Thanks to Ms. Ginder’s GKAS Institute experience, the Cabarrus County program expanded this year to include “Tiny Smiles” — inviting children ages 0 to 5 to see a dentist for the first time. She estimates 40 children in this age group saw dentists this year.

Ms. Ginder also organized a pilot program in which the Cabarrus Health Alliance donated books so children in some of the offices would receive a book on their way out the door — in addition to a goody bag that included toothpaste and a toothbrush.
 

Photo of Erica Pankey with Juan at Give Kids A Smile event in North Carolina
No waiting for a smile: Erica Pankey, above, a dental assistant with the Cabarrus Health Alliance, sits with Juan, 6, as he awaits treatment at the March 4 Give Kids A Smile event in North Carolina.

Ms. Ginder, a marketing coordinator at the Cabarrus County Health Alliance, said she took the reins of the GKAS program when the county’s dental task force was eliminated a few years ago. If she hadn’t stepped up, she worried the program would cease in the county.

“I couldn’t let that happen,” Ms. Ginder said. “As a parent I know what it’s like when your child needs something. I hear the relief in parents’ voices when they call us and make a dental appointment. It’s one more concern they can check off their list.”

Ms. Ginder said she gleaned new information and ideas – and made new friends and contacts – thanks to attending the Institute.

“If I had a problem, someone else there had a solution,” she said.

In Cabarrus County, the Cabarrus Health Alliance that employs Ms. Ginder set up a phone bank with bilingual operators so the county’s growing Spanish-speaking population could make appointments. A local nonprofit, Cabarrus Partnership for Children, pitched in for support – thanks in part to Ms. Ginder’s networking.

“We are fortunate in this county to have a lot of willing collaborators,” she said.

Dr. Tim Kinnard — Oklahoma City

Dr. Tim Kinnard attributes the Oklahoma City Indian Clinic’s record GKAS year to his participation in the GKAS Institute. The clinic, which serves Native American patients, provided more than 50 children with screenings, sealants, radiographs, fluoride treatments and restorations during its Feb. 5 event.

Meeting dentists and others at the Institute in October who had experience streamlining their GKAS programs helped Dr. Kinnard and his team make their event more efficient, he said.

“The Institute helped us find ideas on how to be efficient in evaluating a patient to provide for them a range of treatment – from getting their teeth cleaned to following up right away with any other needs,” he said.

Dr. Kinnard and his team also recruited volunteers from other parts of the clinic to pitch in during the GKAS event, including staff from maintenance and reception who volunteered to offer face painting.

“The positive effects of having a wealth of volunteers is something else that I gathered from the ambassador program,” Dr. Kinnard said.

Dr. Kinnard and his group treated many children who “might not be able to get this type of dental treatment and education anywhere else.”

The Indian Health Service has established that oral health disparities exist among American Indian and Alaskan Native preschool children, and that significant oral health disparities exist among Indian Health Service areas.

Dr. Kinnard said the clinic has always worked to make itself culturally relevant and comfortable place for its target patients so that they are motivated to return for follow-up care.

“A lot of these kids are at risk and there is misinformation about dentistry out there,” Dr. Kinnard said. “Getting kids coming in regularly is so important.”

Dr. Stephen Gasparovich — Biloxi, Mississippi

The days when the dental team at the 81st Dental Squadron at Keesler Air Force Base scrambled to fill 40 open appointment spots during its Give Kids A Smile Event are over.

That’s in part because Dr. Stephen Gasparovich, Lieutenant Colonel and a Support Flight Commander, attended the October Give Kids A Smile Institute.

“At the Institute, I learned skills to form partnerships with medical specialties and key civilian groups on the base,” he said, which helped get more patients scheduled for treatment.
 

Photo of Give Kids a Smile near Biloxi, Miss.
Tiny Smiles: a child of Biloxi, Miss. Give Kids A Smile event on Feb. 10 engages in dental hygiene education with a toy. 

During the event Feb. 10, the group doubled the number of participating children from last year, providing treatment that ranged from well-baby exams to extractions for 120 children. Also different this year was “100 percent staff participation” on the behalf of the dental squadron, Dr. Gasporavich said.

“The Institute helped me present a clear vision of GKAS event objectives to leadership.  That support allowed us to expand the event and increase the outreach to more children,” he said.

Many of the children treated at Keesler were also rescheduled for follow-up care in the dental clinic. Dr. Gasparovich’s team also implemented a Tiny Smiles component to the event this year – allocating a specific location for these young children separate from the older kids.

Dr. Gasparovich said he foresees the GKAS event at the air force base continuing to grow and build momentum.

“In the past, I took on most of the responsibilities myself.  Delegating the tasks allowed more individuals to participate in the planning process.  Hopefully this will translate into a broader perspective and understanding of the event by fellow committee members, and they will feel more comfortable with future GKAS leadership roles,” he said.

Household catastrophic health expenditure and impoverishment

Household catastrophic health expenditure and impoverishment due to payments for dental care in low and middle income countries.

At the 45th Annual Meeting & Exhibition of the American Association for Dental Research, researcher Eduardo Bernabé, King's College London Dental Institute, England, UK, will present a study titled "Household Catastrophic Health Expenditure and Impoverishment Due to Payments for Dental Care in Low and Middle Income Countries." The AADR Annual Meeting is being held in conjunction with the 40th Annual Meeting of the Canadian Association for Dental Research.

In this study, researchers explored whether dental care spending was associated with household catastrophic health expenditure and impoverishment in 40 low- and middle-income countries. Data from 174,257 respondents age 18 years and over (62,961 in 17 low income countries, 58,388 in 15 lower middle income countries and 52,908 in 8 upper middle income countries) who participated in the World Health Organization's World Health Surveys were analyzed.

Respondents were asked to provide information on total household expenditure over the last four weeks, and then details of item-by-item expenditure (including dental care) over the same period. Health expenditure was defined as catastrophic (CHE) if it was equal to or higher than 40 percent of the household capacity to pay. A household was considered impoverished when household expenditure was equal to or higher than subsistence spending but lower than subsistence spending net of health expenditure. The association between expenditure on dental care, CHE and impoverishment was assessed in multilevel logistic regression, with individuals nested within countries and adjusting for a number of individual and country-level factors.

The proportion of households with dental care spending in the last four weeks was 7.8%, whereas the proportions of households incurring CHE and becoming impoverished were 11.2 percent and 4.3 percent, respectively. The odds of CHE (1.88, 95 percent CI: 1.78-1.99) and impoverishment (1.65, 95percent CI: 1.52-1.80) were significantly greater among adults living in households that spent on dental care in the last four weeks, after adjustment for gender, age, marital status, education, household wealth and size, having children less than five years old and adults over 60 years old in the household, health insurance status and urban/rural status, gross domestic product, Gini coefficient and national out-of-pocket health expenditure. This study shows that payments for dental care can pose a considerable burden on households, to the extent of preventing expenditure on basic necessities and pushing families into poverty.

Recognizing Depression among Health Care Practitioners

Stress is a common occurrence in everyday lives. Whether it is running late for work because of unforeseen circumstances, trying to find time to practice healthy habits, or not being able to take a break from your hectic schedule, stressors are difficult to avoid. While some form of stress is healthy and even necessary to help us perform and react during times of crisis, prolonged and excessive stress can have damaging effects, leading to burnout or depression.

Those within the health care industry often joined their profession to find compassion and satisfaction from helping others. While that is frequently the case, it’s no surprise that at one time or another, health care professionals find themselves working under significant stress. While all health care practitioners can be at risk for burnout as a result of work, those who care for seriously ill patients face a higher risk for diminished personal wellbeing, burnout, moral distress and compassion fatigue. In addition, those caring for terminally ill patients often don’t recognize the personal emotional toll it takes, and these unexamined emotions could lead to professional loneliness, loss of professional sense of meaning, loss of clarity about the goals of medicine, cynicism, hopelessness, helplessness, frustration, anger about the health care system, loss of sense of patients as human beings, increased risk of burnout, and depression.

The problem is that depression doesn’t show up on an X-Ray or an MRI and can oftentimes be difficult to detect. So how do we know where healthy stress ends and overload begins? Every person experiences moments of sadness or struggle, however depression is more than just sadness. People with depression may experience a lack of interest and pleasure in daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack of energy, inability to concentrate, feelings of worthlessness or excessive guilt and recurrent thoughts of death or suicide. As health care professionals it is critical to recognize and be aware of these symptoms, both in our personal and professional settings. Failure to recognize these symptoms could not only adversely affect your patients’ lives, but your own as well.

Fortunately, there are ways to manage stress to prevent burnout through self-care strategies. Self-care strategies begin with the recognition that people have multiple personal dimensions to attend to in order to live a good or happy life. These dimensions include family, work, community and spirituality. Strategies for personal self-care include prioritizing close relationships such as those with family; maintaining a healthy lifestyle by ensuring adequate sleep, regular exercise, and time for vacations; fostering recreational activities and hobbies; practicing mindfulness and meditation; and pursuing spiritual development. Another strategy is that of positive psychology. Positive psychology focuses on utilizing traits such as kindness, optimism, generosity, gratitude and humor. Not only will utilizing these traits lead to a happier self, they also help to build personal resilience and buffer stress.

While self-care strategies serve as important tools, it may also be helpful to meet with your primary care provider who can determine whether you can benefit from a referral to mental health specialist.