The presence of certain proteins in pre-malignant oral lesions may predict oral cancer development, a new study reveals.
The findings, which help eliminate the guesswork in some cases, ‘are fundamental, according to lead author of the study, oral and maxillofacial pathologist Dr Kalu Ogbureke.
Dr Ogbureke, from the Medical College of Georgia School of Dentistry, explained: ‘Several years ago we discovered that three SIBLINGs – osteopontin, bone sialoprotein and dentin sialophosphoprotein – were expressed at significantly high levels in oral cancers. Following that discovery, we began to research the potential role of SIBLINGs in oral lesions before they become invasive cancers.’
SIBLINGs (Small Integrin-Binding Ligand N-linked Glycoproteins) are a family of five proteins that help mineralise bone but can also spread cancer and have been found in cancers including breast, lung, colon and prostate.
The study, published online this week in the journal Cancer, examined 60 archived surgical biopsies of pre-cancerous lesions sent to MCG for diagnosis and the patients’ subsequent health information.
Of the biopsies, 87% were positive for at least one SIBLING protein – which the researchers discovered can be good or bad, depending on the protein.
As an example, they found that the protein – dentin sialophosphoprotein – increases oral cancer risk fourfold, whereas bone sialoprotein significantly decreases the risk.
Dr Ogbureke said: ‘The proteins could be used as biomarkers to predict [the potential of a lesion to become cancerous]. That is very significant, because we would then be in a position to modify treatment for the individual patient’s need in the near future.’
Pre-cancerous oral lesions, which can develop in the cheek, tongue, gums and floor and roof of the mouth, are risk factors for oral squamous cell carcinoma, which accounts for more than 95% of all oral and pharyngeal cancers.
Treatment so far has been hindered because of clinicians’ inability to predict which lesions will become cancerous.
‘When we treat these lesions now, there’s an implied risk of under- or over-treating patients,’ Dr. Ogbureke said. ‘For example, should the entire lesion be surgically removed before we know its potential to become cancer, or should we wait and see if it becomes cancer before intervening?’
Further complicating the matter is that the severity of dysplasia, or abnormal cell growth, in a lesion can be totally unrelated to cancer risk. Some mild dysplasias can turn cancerous quickly while certain severe dysplasias can remain harmless indefinitely.
Dr Ogbureke said: ‘If we’re able to recognise these lesions early and biopsy them to determine their SIBLING profile, then oral cancer could be preventable and treatable very early.’
He now plans to design a multi-centre study that incorporates oral cancer risk factors, such as smoking and alcohol consumption, to further investigate their relationship with SIBLING protein expression.
^1266969600^2572^’Fundamental’ findings in oral canc…^The presence of certain proteins in pre-malignant oral lesions may predict oral cancer development, a new study reveals.The findings, which …^http://dev.dentistry.co.uk/sites/all/themes/dentistry/images/news_images/siblingprote.png
Hurry for tickets to the World Aesthetic Congress 2010 ^
The UK’s leading annual aesthetic dentistry event is to be held on 11-12 June at the Queen Elizabeth II Conference Centre, London.
This, the ninth consecutive World Aesthetic Congress (WAC), is a unique opportunity for dentists and team members to learn from the world’s leading experts in the rewarding field of aesthetic dentistry.
To view the programme of lectures and alternative sessions visit www.independentseminars.com/wac.
Attending WAC is essential whether you’re new to aesthetic dentistry or experienced with a desire to remain at the forefront of this rewarding area.
Last year, more than 500 dentists, hygienists, technicians, team members and exhibitors benefited from the educational, networking and social opportunities that this prestigious annual event offers.
Plus, this year is set to be bigger and better than ever before, offering an unrivalled series of lectures and hands-on sessions that will earn you up to 14 verifiable CPD hours.
WAC 2010 hosts the world’s finest and most respected speakers including Corky Willhite, David Winkler, Linda Greenwall, John Cranham, Pedro Pena, Chris Orr, Komal Suri, Sia Mirfendereski and James Russell.
Over two days 34 renowned experts come together to present the key lectures on a range of aesthetic related topics of both a clinical and business nature. Delegates also have the option of attending the one-day dentist and team programme and one-day hygienist and therapist programme.
Also, don’t forget to consider the vast number of alternative sessions that you can attend in place of the key lectures.
After viewing the full programme on www.independentseminars.com/wac book your place by calling 0800 371 652. As places on the limited attendance sessions are booked on a first come, first served basis we advise you to book early to avoid disappointment.
Dentist standard delegate rate (Fri+Sat) £567+vat
*Subscriber dentist 10% discount (Fri+Sat) £510+vat
DCP (Fri) £225+vat
DCP (Sat) £225+vat
DCP (Fri+Sat) £300+vat
Special team price 1 dentist + 2 team members (Fri+Sat) £987+vat
*10% discount for subscribers to Private Dentistry, Aesthetic Dentistry Today, Implant Dentistry Today or Endodontic Practice.
^1267056000^2574^Hurry for tickets to the World Aest…^The UK’s leading annual aesthetic dentistry event is to be held on 11-12 June at the Queen Elizabeth II Conference Centre, London. Thi…^http://dev.dentistry.co.uk/sites/all/themes/dentistry/images/news_images/WAC2010.png
Gum treatment may boost diabetics’ health^^1274227200^2782^Gum treatment may boost diabetics^^http://dev.dentistry.co.uk/sites/all/themes/dentistry/images/news_images/blood-sugar-insulin.jpg
Help for dentists in face of PRSI cuts^^1267142400^2575^Help for dentists in face of PRSI c…^^http://dev.dentistry.co.uk/sites/all/themes/dentistry/images/news_images/SOE-Irish.jpg
New dental group seeks spokes for its hub^
A new dental practice group in Shropshire is set to become the largest in the region.
The practice took on a firm of business consultants to help develop its brand concept and grow the business through acquisition.
Velvet Group engaged the services of The Business Company after the firm worked on its behalf to facilitate and negotiate the acquisition of its ground-breaking hub practice, The Dental Spa, last year.
Following their appointment The Business Company worked with the Shrewsbury based practice to re-engineer its offering and prepare it for expansion.
The firm is currently in the process of identifying further suitable practices for acquisition in Shropshire, mid Wales, and Hereford and Worcester that will ultimately form 10 autonomous spokes for the hub.
Mark Harris, managing director of The Business Company explains why the ‘hub and spoke’ model makes Velvet Group different.
He said: ‘Unlike other national dental practice models each practice within Velvet Group will retain its own identity whilst having the opportunity to increase its reputation and profitability through standardised clinical protocols, technical excellence and high levels of customer service set and overseen by The Dental Spa hub.
‘Individual practices will each take specialist referrals but will be able to refer more complex cases to the Referral Clinic at the hub.’
The Dental Spa is one of only a handful of practices in England to meet the standards of a small hospital and gain registration with the Care Quality Commission.
Last year, Dr Thomas Norlin was appointed as clinical director.
Dr Norlin, who qualified as a dentist in Stockholm in 1998, is widest known for his part in developing and patenting SB12, an internationally marketed product which neutralises bad breath and keeps it fresh for up to 12 hours.
After completing his training as an implantologist in Sweden in 1981 Dr Norlin built up his own practice in Gothenburg which became a Centre of Excellence for Implantology focusing on the aesthetics of the procedure, including restorative prosthodontics and surgery, as well as general dentistry.
A full member of the British Academy of Cosmetic Dentistry, Dr Norlin carries out surgical grafting procedures at The Dental Spa, including block grafts, sinus lifting and apicectomies, as well as implantology.
Dental practices interested in joining Velvet Group should contact Ellen Morley at The Business Company on 01743 762244 or email [email protected].
^1267142400^2576^New dental group seeks spokes for i…^A new dental practice group in Shropshire is set to become the largest in the region.The practice took on a firm of business consultants to …^http://dev.dentistry.co.uk/sites/all/themes/dentistry/images/news_images/Mark-Harris.png
Dental association in fundraising initiative^^1267401600^2577^Dental association in fundraising i…^^http://dev.dentistry.co.uk/sites/all/themes/dentistry/images/news_images/Benevolent-fund.jpg
‘Beer’ pressure means people drinking more^
Peer pressure to drink to excess could be all in our minds, according to a survey published for the Department of Health today.
A YouGov poll of more than 2,000 English adults suggests over one in five (22%) people who have ended up drinking more than planned put it down to peer pressure, while 39% of drinkers feel the need to make up an excuse or lie to justify refusing a drink.
However, the survey for the Department of Health’s ‘Alcohol Effects’ campaign shows this is unnecessary as it appears peer pressure hardly exists.
The poll found:
• only 1% of English adults who drink, think less of people who refuse a drink or choose to drink less than them;
• just 4% expect their friends to keep up with them when drinking
• only 2% admit to piling on the pressure for friends to drink more when they don’t want to.
The NHS recommends women do not regularly drink more than 2-3 units a day (about 2 small glasses of wine), and men do not regularly drink more than 3-4 units a day (about two pints of beer).
Public Health Minister Gillian Merron said: ‘Many of us enjoy a drink — drinking sensibly isn’t a problem, but too many are regularly drinking more than the NHS advises. This means you’re at higher risk of getting cancer or having a stroke or heart attack.
‘This survey should encourage us all that it is ok to be honest with our friends about when we’ve had enough.
‘Protecting our long-term health should be a good enough reason for anyone.’
Health and Wellbeing expert Liz Tucker said: “There is sometimes a certain amount of cajoling that goes on between friends on a night out to have an extra tipple, but people need to realise this is usually all in good jest, as this research backs up.
‘In reality, nobody really minds when a friend calls it a night if they feel they’ve had enough, or when our partner doesn’t fancy sharing a bottle at home – and we should all feel confident enough to say so.’
• Drs Graham Cope and Anwen Cope will be looking at the complex issue of alcohol and drug abuse effects upon oral health in March’s issue of Preventive Dentistry magazine.
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Dentists ‘sickest of all health professionals’^
Dentists are the sickest of all health professionals, according to the head of an NHS service aimed at helping clinicians struggling with physical or mental illnesses.
Clare Gerada, medical director of the NHS Practitioner Health Programme (PHP) – the scheme set up a year ago to encourage doctors and dentists with addictions or mental health problems to come forward for treatment – said she believed the project had reached only the ‘tip of the iceberg’ of ill dentists.
The free, confidential service for practitioners living or working in the London area was launched by the National Clinical Assessment Service amid concerns that some doctors and dentists were either struggling to access appropriate care or were suffering in silence rather than seeking proper medical help because of fears they would be stigmatised.
A report on the first year of the scheme’s operation, published last month, showed that 184 doctors or dentists had been offered an initial assessment, with 62% presenting with mental health problems, 36% addictions and 2% physical health problems. The patients were mainly doctors but also included 15 dentists and two nurses.
After 12 months, 88% of those who had reported an illicit drug addiction were abstinent and
46% who had not been working were back at work – a much higher success rate than
comparable schemes for the general population.
Dr Gerada said: ‘Lives had been transformed’ in the first year of the programme – but warned that more needed to be done to help dentists in particular.
She added: ‘Dentists on the whole are at the far end of complexity and sickness. They come to us very, very unwell, for example with severe alcohol addiction, or they might have had a fit, or with severe depression.
‘They are a much sicker group [than other health professionals]. They work in a much more isolated manner, sometimes in small teams, and they’re the boss. They don’t go to doctors and many can’t identify their GP. They might also have financial problems, or back problems, which they don’t want to disclose.’
Dr Gerada said while she believed the scheme had got through to a significant proportion of doctors with health problems in the M25 area, for dentists those that were presenting were the ‘tip of the iceberg’.
The report found that interest in the scheme among dentists had dropped off over the year. In the first quarter, dentists represented 17% of all initial assessments. This fell to 8% across the whole year.
‘Additional awareness raising among dentists was initiated as a result of this drop in attendance rates’, the report said.
Dr Gerada, who has approached the General Dental Council to try to seek more referrals, said she wanted to create ‘a whole network across whole of the country of experienced doctors who can manage sick health professionals’.
Plans are underway to launch similar schemes in Avon and Newcastle, but it is not thought that every area of the country will need one because patients are said to be willing to travel some distance for specialist help.
Liam Donaldson, the chief medical officer, who came up with the idea for the service, said: ‘In any workforce, a small minority will have health problems, but the degree of denial in the medical profession is a problem not only for doctors and dentists but also potentially for patients.’
Sir Liam said the PHP had been a ‘remarkable success’ in uncovering problems that would not otherwise have been addressed. Interventions had in many cases been ‘highly effective’, he said, adding: ‘This problem was largely buried under the surface before and it was getting worse – with patients potentially being harmed. From the number of patients accessing the programme during its first year of operation, it is clear that there is a need for this highly specialised service.’
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Join pensions day of action, BDA urges dentists^
The British Dental Association (BDA) is urging dentists in England and Wales to join a public sector-wide day of action against government proposals to downgrade their pensions on 30 November.
The BDA is one of a number of professional representative bodies in the health sector whose members are not taking strike action, but is encouraging members to demonstrate opposition to the Government plans by participating in the day of action.
The BDA is asking members to participate in a number of ways:
• Members in general practice are urged to display a poster explaining to patients their unhappiness at the proposals. The poster can be downloaded from the BDA website
• Members in hospital or primary care salaried services should check with their workplace representatives for details of events to mark the day
• All members can tweet their opposition to the pensions changes using the hash tag #30nov.
• All members can supplement the campaigning work done by the BDA on their behalf by signing a Government e-petition and contacting their MP.
The poster, link to the e-petition and suggestions of useful points to make to MPs are available on the BDA website’s pensions campaign page at www.bda.org/protectNHSpensions. The site also features information about the proposals and their potential consequences for dentists.
Dr Susie Sanderson, chair of the BDA’s executive board, said: ‘Like other public sector workers, dentists’ pensions are under threat. The BDA and other unions have fought the Government hard on these proposals and some concessions have been won.
‘Nonetheless, the proposals on the table still represent a significant attack on the pensions that hardworking NHS staff contribute to during the course of their careers.
‘The BDA has not, at this stage, balloted on potential strike action on this issue. It is important that decision is not misinterpreted as a lack of concern about the proposed changes and we are therefore urging dentists to join with colleagues across the public sector and show their support for the day of action on 30 November. We need to send a clear message to government that what they are proposing is unacceptable.’
^1321833600^4629^Join pensions day of action, BDA ur…^The British Dental Association (BDA) is urging dentists in England and Wales to join a public sector-wide day of action against government p…^
Impressing clinicians^
With its low incidence of microleakage and incredible internal cavity, the new bulk-fill, flowable composite base SDR (Smart Dentine Replacement) from Dentsply has impressed clinicians using it.
Dr Roel Bester, from Treetops Dental Surgery in Norwich, said: ‘I have been using SDR and really enjoy working with it. I am now using it in all my posterior composite fillings as a base. It really fills very well, the flow is excellent and by leaving it a few seconds, I can actually see how it settles in the prepared cavity. I have not had one patient complain of post-operative sensitivity. SDR is definitely a material I would recommend to other dentists. Thanks SDR!’
SDR is now being used by over 2,000 dentists across the country, and is enjoyed by thousands more throughout the world. Contact Dentsply today to receive a free sample.
0800 072 3313
www.dentsply.co.uk
^1321833600^4630^Impressing clinicians^With its low incidence of microleakage and incredible internal cavity, the new bulk-fill, flowable composite base SDR (Smart Dentine Replace…^
Genes found to influence tooth growth^^1267401600^2582^Genes found to influence tooth grow…^^http://dev.dentistry.co.uk/sites/all/themes/dentistry/images/news_images/baby-teeth.jpg
Smoking cessation may increase diabetes risk^
Cigarette smoking is a well-known risk factor for type 2 diabetes, but new research suggests that quitting the habit may actually raise diabetes risk in the short term.
The researchers from Johns Hopkins University suspect that the elevated diabetes risk is related to the extra pounds people typically put on after giving up cigarettes and caution that no one should use the study’s results as an excuse to keep smoking.
Study leader Hsin-Chieh ‘Jessica’ Yeh, an assistant professor of general internal medicine and epidemiology at the Johns Hopkins School of Medicine, said: ‘The message is don’t even start to smoke. If you smoke, give it up. That’s the right thing to do. But people have to also watch their weight.’
In the study, researchers found that people who quit smoking have a 70% increased risk of developing type 2 diabetes in the first six years without cigarettes as compared to people who never smoked.
The risks were highest in the first three years after quitting and returned to normal after 10 years.
Among those who continued smoking over that period, the risk was lower, but the chance of developing diabetes was still 30% higher compared with those who never smoked.
The study enrolled 10,892 middle-aged adults, from 1987 to 1989, who did not yet have diabetes. The patients were followed for up to 17 years, and data about diabetes status, glucose levels, weight and more were collected at regular intervals.
Type 2 diabetes is a common disease that interferes with the body’s ability to properly use sugar and to regulate and properly use insulin, a substance produced by the pancreas that normally lowers blood sugar during and after eating.
In type 2 diabetes, also known as adult-onset diabetes, the pancreas makes plenty of insulin to help the body when food is eaten, but the body cannot use it normally. The result is excess levels of blood sugar, which, over time, can lead to blindness, kidney failure, nerve damage and heart disease. Overweight people and those with a family history of the disease have an increased risk for developing it, as do smokers, though the causal relationship is unclear.
According to the study, those who smoked the most and those who gained the most weight had the highest likelihood for developing diabetes after they quit.
On average, over the first three years of the study, quitters gained about 8.4 pounds and saw their waist circumferences grow by approximately 1.25 inches.
Yeh and her team said that they want physicians to keep these findings in mind when they are consulting with patients who are giving up cigarettes, especially the heaviest smokers.
They recommend considering counter measures such as lifestyle counselling, aggressive weight management and the use of nicotine-replacement therapy, which seems to blunt the weight gain related to quitting.
^1267401600^2583^Smoking cessation may increase diab…^Cigarette smoking is a well-known risk factor for type 2 diabetes, but new research suggests that quitting the habit may actually raise diab…^
Golden smile for outstanding dental nursing student^
A dental nurse from Plymouth has been voted ‘top of the class’ by a national exam board for her results and achievements while she was training.
Rebecca Smith-Wightman, 25, was presented with the National Examining Board for Dental Nurses Gold Award at a special event at the University of Plymouth.
The Gold Award, provided by the Kamlesh Kumari Mehan Memorial Trust, recognises the most outstanding student out of a total of 3,020 candidates. The board praised Rebecca for being ‘knowledgeable, committed, and dedicated to dental nursing and the dental profession’ and someone ‘willing to share her knowledge and experience with colleagues’.
Rebecca said: ‘It was a brilliant feeling to be recognised for all the hard work I had done over the previous 18 months. I had no idea I was going to receive the award on the night, and it was great that my family and friends could be there to see it.’
The Gold Award was given to Rebecca by Professor Richard Stephenson, dean of the Faculty of Health and Pro Vice-Chancellor at the University of Plymouth, at the presentation ceremony for those students receiving their National Certificate in Dental Nursing.
Rebecca also received a cheque for £200, a commemorative gold badge and certificate, and The Peninsula Achievement Award, sponsored by Peninsula Dental School, for her commitment to learning and gaining a distinction in her National Examination.
Rebecca, who works at Mount Wise Dental Practice, in Plymouth, Devon, added: ‘I wanted to give my best and so I hit the books and worked as hard as I could. There was no secret other than hard work – although we did hold some study groups and it was great to be able to bounce ideas off my fellow students.’
^1267401600^2584^Golden smile for outstanding dental…^A dental nurse from Plymouth has been voted ‘top of the class’ by a national exam board for her results and achievements while s…^http://dev.dentistry.co.uk/sites/all/themes/dentistry/images/news_images/Rebecca-Smith-Wightman.png
Poor dental health flags up meths users^
Severe dental problems in otherwise healthy young people could be a sign of methamphetamine addiction, a new study suggests.
Researchers collected medical, oral health and substance use data from 300 methamphetamine-dependent adults and compared it with data from non-meth users from the U.S. National Health and Nutrition Examination Survey.
About 40% of meth users have serious dental problems, including more missing teeth than those who don’t use the drug, according to the researchers, from the University of California, Los Angeles.
They also found that meth users who smoke or inhale the drug have lower rates of dental disease, compared to those who inject the drug and are more likely to have a severe addiction.
The finding that dental disease is a distinct marker of methamphetamine abuse means that dentists can play an important role in the early detection of drug abuse and in the collaborative care of meth users, the researchers said.
Meth Mouth Can Signal Addiction to Dentists
When otherwise healthy young people show up at the dentist with severe oral health problems, it should signal to the dentist that the patient may be addicted to methamphetamine. Patients who exhibit symptoms of meth mouth are more likely to be injection drug users, according to a new study.
The link between meth abuse and increase dental disease is no longer a myth, it has been documented by scientific research.
A new study, The Relationship Between Methamphetamine Use and Increased Dental Disease, published in The Journal of the American Dental Association is the first to directly link severe dental problems with methamphetamine abuse.
Early Detection Needed
Key findings of the research include:
- 40% of methamphetamine abusers have severe oral health problems.
- People who smoke or snort meth have fewer dental problems.
- Those who inject meth have more severe dental health problems.
The researchers write that dentists can help with early detection and intervention of meth abuse by detecting severe problems in otherwise healthy patients.
The study was funded by the National Institute on Drug Abuse.
Source: Shetty, V., et al. The Relationship Between Methamphetamine Use and Increased Dental Disease. The Journal of the American Dental Association March 2010.
^1267747200^2596^Poor dental health flags up meths u…^Severe dental problems in otherwise healthy young people could be a sign of methamphetamine addiction, a new study suggests.Researchers coll…^
Scientists uncover genes that influence tooth development ^
Genes that influence tooth development in the first year of life have been identified by scientists.
The research team has also uncovered a link between the delayed appearance of milk teeth and the need for future corrective work.
The research, which involved teams from Imperial College London, the University of Bristol and the University of Oulu in Finland, has identified several genes which affect tooth development in the first year of life.
They found that babies who carried specific genetic variants tended to have fewer teeth by their first birthday than other children.
By the time they turned 30 those carrying one of the genes were 35% more likely than their peers to need treatment by an orthodontist.
The study scanned the genetic code of 6,000 people from Finland and Britain whose health had been followed from birth.
Previous studies have shown that tooth development is also linked to that of the skull, jaws, ears, fingers, toes and heart.
