To Prevent Rheumatoid Arthritis, Look Past the Joints to the Gums. In Case You Missed It- TGBSL#27

An explanation of TGBSL

To Prevent Rheumatoid Arthritis, Look Past the Joints to the Gums

The mouth may seem like a strange place to search for a culprit in a disease that primarily affects the joints. But a recent collaboration by a group of multidisciplinary researchers suggests that one type of oral bacteria may be an important trigger in about half of rheumatoid arthritis (RA) cases. Continues

Some Neanderthals were vegetarians who used natural forms of penicillin and aspirin as medicine

‘Apparently, Neandertals possessed a good knowledge of medicinal plants … the use of antibiotics would be very surprising, as this is more than 40,000 years before we developed penicillin’ Continues & here

Root canal treatments overhauled through new device to detect untreated bacteria

A new method of detecting bacteria during root canal treatments could eradicate the need for follow up appointments and prevent treatments from failing, according to a study published in the Journal of Dental Research. The SafeRoot device, created by a team of researchers at King’s College London, enables rapid bacterial detection inside the root canal, ensuring the procedure has been successful and reducing the need for tooth extraction or surgical intervention. Continues.

Tooth loss linked to an increased risk of dementia

In a study of 1566 community-dwelling Japanese elderly who were followed for 5 years, the risk of developing dementia was elevated in individuals with fewer remaining teeth. Continues

Can oestrogen therapy lead to healthier teeth and gums?

A new study finds links between estrogen therapy and reducing tooth and gum diseases in postmenopausal women. Estrogen therapy is known to help women manage a variety of menopause-related issues: improving bone density and heart health and reducing hot flashes, to name a few. As such, many women choose to take hormones to treat the numerous symptoms associated with menopause. Continues

Review confirms link between drug use and poor dental health

A new review published online in the scientific journal Addiction has found that dental patients with substance use disorders have more tooth decay and periodontal disease than the general population, but are less likely to receive dental care. With drug use increasing by approximately three million new users each year, this is a problem that won’t disappear anytime soon. Continues

Why Dentistry Is Separate From Medicine – and the possible consequences

Why Dentistry Is Separate From Medicine 

The divide sometimes has devastating consequences.

Doctors are doctors, and dentists are dentists, and never the twain shall meet. Whether you have health insurance is one thing, whether you have dental insurance is another. Your doctor doesn’t ask you if you’re flossing, and your dentist doesn’t ask you if you’re exercising. In America, we treat the mouth separately from the rest of the body, a bizarre situation that Mary Otto explores in her new book, Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America.

Specializing in one part of the body isn’t what’s weird—it would be one thing if dentists were like dermatologists or cardiologists. The weird thing is that oral care is divorced from medicine’s education system, physician networks, medical records, and payment systems, so that a dentist is not just a special kind of doctor, but another profession entirely.

But the body didn’t sign on for this arrangement, and teeth don’t know that they’re supposed to keep their problems confined to the mouth. This separation leads to real consequences: Dental insurance is often even harder to get than health insurance (which is not known for being a cakewalk), and dental problems left untreated worsen, and sometimes kill. Anchoring Otto’s book is the story of Deamonte Driver, a 12-year-old boy from Maryland who died from an untreated tooth infection that spread to his brain. His family did not have dental benefits, and he ended up being rushed to the hospital for emergency brain surgery, which wasn’t enough to save him.

A thought provoking read which continues here.

Pharmacists – another endangered species?

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The Minister for Community and Social Care (Alistair Burt) spoke in Parliament on 24 May 2016 a few days before he silver tongued the BDA conference with similar words after which I wrote, “Much of his speech we have heard before and it did little to convince me that (NHS) dentistry is anything other than an irregular irritation in the big picture of health. There will be no more funding in the foreseeable future, no matter what sort of contract is produced, be prepared to deliver it with a tighter belt.”

Hansard has the full transcript of May 24th here but I have selected the phrases (reminiscent of Bullshit Bingo) that chimed with me, thinking back to his speech in Manchester.

We want to empower primary care health professionals to take up opportunities to embrace new ways of working with other health professionals to transform the quality of care that they provide to patients and the public. In particular, we want to free up pharmacists to spend more time delivering clinical and public health services to patients and the public in a range of settings.

I have seen at first hand the fantastic work that pharmacists are doing from within community pharmacies, such as in healthy living pharmacies and other settings, and colleagues have also paid tribute to that work. Pharmacy-led services, such as the recently recommissioned community pharmacy seasonal influenza vaccination programme, can help to relieve pressure on GPs and A&E departments……

The fund is set to rise by an additional £20 million a year. By 2020-21, we will have invested £300 million in addition to the £31 million that NHS England is investing in funding, recruiting and employing clinical pharmacists to work alongside GPs to ease current pressures in general practice and improve patient safety.

The chief pharmaceutical officer, has commissioned an independent review of community pharmacy clinical services to make recommendations on future models for commissioning pharmacy-led clinical services. Clinical pharmacists will offer complementary skills to GPs, giving patients access to a multi-disciplinary skill set, and helping GPs manage the demands on their time and provide a better experience for patients. This is a great opportunity for pharmacists wanting to make better use of their clinical skills and develop them further.

Sweet words indeed, after Alister Burt, who seemed to me to be a pragmatic and likeable (unlike his boss Mr Hunt) moved to the back benches post Brexit vote, the words are transformed into reality.

Pharmacy plan ‘could lead to High Street closures’ BBC website (October 20th 2016)

The Department of Health said it wanted to reduce the £2.8bn a year pharmacy bill by more than £200m over the next two years.
…It has been suggested cuts on this scale could lead to up to 3,000 of the 11,700 pharmacies being closed.
Currently, the average pharmacy receives £220,000 a year from the NHS.
This accounts for between 80% and 90% of their income and includes a flat rate of £25,000, which nearly all pharmacies receive.
The changes being announced scrap that and put much more emphasis on performance-related funding, with ministers understood to see the current system as outdated and inefficient…

I repeat….There will be no more funding …. no matter what sort of contract is produced, be prepare to deliver it with a tighter belt.

If only he had worn a suit and tie….

jackboots-2The CQC Borg will decide….

…..in 2014 when the inspectors last came. He had explained his philosophy and modus operandi, talking of medicine as an art form, “being a human being so patients feel they know well me enough to trust, while maintaining boundaries – compassionate detachment, I call it.”

“On that occasion,” he will recollect later, “they seemed concerned with seeing whether I was running a healthy, happy, well-functioning practice. They looked at feedback forms, talked to patients and made intuitive judgment.” They gave him a glowing report.

This time round…read here.

Michele Golden, head of inspections for London at the Care Quality Commission, says:

“We know, from various inspections, that patients will say how happy they are, and it may be that their doctor is a very nice person, but that doesn’t mean they understand if the system is actually unsafe for them.”

It would seem that Nanny may not always know best…but she holds all the cards.

There has never been a serious complaint against him, and he is exceptional in not having been called for a disciplinary hearing in all his 40 years as a GP.

Although he could continue practising as a doctor, his surgery must close with immediate effect.

Childhood obesity – another let down.

Here is today’s piece from The Guardian about the the UK government’s “Childhood Obesity Strategy”.

The BBC joins in and says, it’s weak and watered down.

In April this year I stuck my head above the parapet and said I was not in favour of a sugar tax. I thought it was far too little and doubted the UK government’s commitment. Here’s the piece in Dentistry.

Because I dared swim against the perceived tide, I wanted to tax sugar, all sugar, where it comes into the food chain and not at the retailer, I have been contacted on several occasions by food industry lobbyists who wanted me to put my name to letters against the “sugar tax”. I was left in little doubt how strong and broad ranging these groups are. I declined any and all offers.

I committed much of my clinical career to prevention and the control of diseases, especially in the young, I take no pleasure in thinking, “I told you so”.

….Why be specific about drinks? Dentists have advocated a tax on confectionary for decades. We know that many confectionary sales are an impulse in response to advertising. Deal with that and get rid of sweets at checkouts and petrol stations.

Why not tax it in the supply chain with a levy on all sugar containing food ingredients? Tax sugar, high-fructose corn syrup, fruit juice concentrate and other added sugars at the point where they’re manufactured or imported, essentially taxing everything with added sugar, at a level appropriate to its sugar content.

Amongst the acolytes for a sugar tax is Jamie Oliver, whose recipe for “Scrumptious sticky toffee pudding” contains nearly 2lb of sugar. Shouldn’t the BBC be made to give public health warnings with every episode of The Great British Bake Off?…

…The belief that a tax will automatically lead to a reduction in obesity and related diseases is far too simplistic in my opinion. It will take other measures including the elimination of marketing and advertising of other junk foods. Above all it will take Government will to confront the food industry and to promote change in the hearts and minds of the country and with so many lobbyists and vested interests that’s not going to happen soon.

In the meantime dentists would be best advised to walk the talk, to limit their own intake, step up their patient education so it’s about general and dental health and vote for a government with a genuine commitment to health.”

Truth-O-MeterSleep well in your flaming pants Mr Cameron, Mr Osborne and Mrs May and as for Jeremy Hunt….

 

In case you missed….TGBSL #22

Effectiveness of SDF in arresting root caries in different fluoridated areas

Conclusion: Based on the 18-month result, the researchers concluded that the annual application of 38% SDF solution can arrest root caries in community-dwelling elders. Furthermore, background water fluoride level does not have a statistically significant influence on the effectiveness of SDF. This clinical trial is still ongoing and longer-term results will be reported later.

Full article click here

Research - monitor screen

Researchers investigate prevalence of gingivitis during 1st/2nd trimesters of pregnancy

Conclusion: Clinical examination of 600+ pregnant women showed moderate-to-severe gingivitis to be common, well-established and relatively stable in the late first and second trimester, and regular dental care prior to and during pregnancy may be critical to maintaining oral health.

Full article click here

For the background to TGBSL series take a look here

The Monday Morning Quote #367

Three this morning:

“I attribute my success to this – I never gave, nor took excuses…”
“… very little can be done under the spirit of fear.”
“… the first requirement in a hospitals is that it should do the sick no harm.”

Florence Nightingale

by Henry Hering, copied by Elliott & Fry, half-plate glass copy negative, 1858 (1950s)

are you listening Jeremy?

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…no I thought not.