Introduction August 1, 2014
As you read this, I will be at the University of Buffalo (UB) teaching students from Italy about evidence-based care and XP technology.1 A group of dentists and dental hygienists come to UB annually to enhance their knowledge.
In this issue, among other things, we discuss prevention. In a recent CNN story, five things were highlighted that kill more people in the United States than anything else. They are heart disease, cancer, lung disease such as emphysema and chronic bronchitis, stroke, and unintentional injuries such as those on roads or caused by medication overdoses. These five conditions cause almost two-thirds of all deaths in the country, approximately 900,000 each year. This was on the heels of a Centers for Disease Control and Prevention (CDC) report that stated that data informs us that we could prevent at least a third of those deaths.2 Read the section on prevention in this newsletter.
We know that deaths and disease caused by smoking are preventable. So how do we help people to quit? A recent study evaluated the efficacy and safety of combining varenicline and nicotine replacement therapy (NRT) in the form of a nicotine patch vs. varenicline alone in smoking cessation.3 The researchers did find that varenicline in combination with NRT was more effective than varenicline alone at achieving tobacco abstinence at 12 weeks (end of treatment) and at six months. Further studies are needed to assess long-term efficacy and safety.
Also, related to tobacco use, people living in communities with comprehensive smoke-free laws or regulations are 22 percent less likely to be hospitalized for chronic obstructive pulmonary disease, according to a new study.4 The study concluded that tough smoke-free public policies may possibly provide protection against chronic obstructive pulmonary disease (COPD) hospitalizations, mainly after one year, with the possibility of saving lives and decreasing health care costs. We need to continue to examine behavioral approaches and pharmacotherapy to assist smokers to quit.
Another resource available from the Institute of Medicine (IOM) is the result of a workshop that focused on identifying and exploring issues, attitudes, and approaches to increasing patient engagement in healthcare decisions. The IOM calls for shared decision making and better communication about the evidence in support of testing and treatment options, the best value from the health care consumers receive, and the use of data to drive decision making. Much like evidence-based care, they placed the patient as a leader for each of three portions: value, science, and decision making.
A drug currently used to treat intestinal worms could protect people from periodontitis. An animal study showed that the drug Oxantel inhibits the growth of biofilm by interfering with an enzyme that bacteria require for biofilm formation. In addition, since Oxantel is known to inhibit fumarate reductase in some bacteria, the researchers tested its ability to inhibit fumarate reductase activity in Porphyromonas gingivalis, one of the major bacterial components of periodontitis biofilms. The tests were successful.
And last, but not least, the National Institute of Dental and Craniofacial Research (NIDCR) released its 2014-2019 Strategic Plan.7 The 2014-2019 NIDCR Strategic Plan is constructed on four strategic goals: support the best science to improve dental, oral, and craniofacial health; enable precise and personalized oral health care through research; apply rigorous, multidisciplinary research approaches to overcome disparities and inequalities in dental, oral, and craniofacial health; and ensure that a strong research workforce is dedicated to improving dental, oral, and craniofacial health.7
Enjoy the newsletter!
Maria Perno Goldie RDH, BA, MS
- Center for Disease Control and Prevention, Morbidity and Mortality Weekly Report. Potentially Preventable Deaths from the Five Leading Causes of Death — United States, 2008–2010. Weekly / Vol. 63 / No. 17, May 2, 2014. http://www.cdc.gov/mmwr/pdf/wk/mm6317.pdf.
- Koegelenberg CN, Noor F, Bateman ED, et al. Efficacy of Varenicline Combined With Nicotine Replacement Therapy vs Varenicline Alone for Smoking Cessation: A Randomized Clinical Trial. JAMA.2014;312(2):155-161.
- Ellen J. Hahn, Mary Kay Rayens, Sarah Adkins, Nick Simpson, Susan Frazier, and David M. Mannino. Fewer Hospitalizations for Chronic Obstructive Pulmonary Disease in Communities With Smoke-Free Public Policies. American Journal of Public Health: June 2014, Vol. 104, No. 6, pp. 1059-1065.
- Institute of Medicine. Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement: Workshop Proceedings. Washington, DC: The National Academies Press, 2013.
- Dashper S, O'Brien-Simpson N, Liu SW, Paolini R, Mitchell H, Walsh K, D'Cruze T, Hoffmann B, Catmull D, Zhu Y, and Reynolds E. Oxantel disrupts polymicrobial biofilm development of periodontal pathogens. Antimicrobial Agents and Chemotherapy, 2013.