|
The Friends of the National Institute of Dental and Craniofacial Research (FNIDCR) online newsletter is a membership benefit. Permission is granted to repost this publication only with inclusion of the header. Past issues are posted on www.fnidcr.org/news.html Executive Director’s Report It has already been an exciting summer. To better serve our members, the Friends of NIDCR have moved our offices and will continue to advocate on behalf of oral health research. With the help of our patient advocate partners and the entire oral health professional community, the Friends are looking forward to advancing the cause. Already, federal budget experts are suggesting that an omnibus budget package is a likely resolution to the current stalemate in the appropriations process. We will track pending legislation and report on the NIH’s funding progress. I am happy to report that the Friends’ 2004 Patient Advocacy Day held in the spring was a great success. The keynote speaker at this year’s Legislative Briefing was NIDCR Director Lawrence Tabak. In addition, the Friends were honored to hear from Congressional Oral Health Caucus Co-Chairs U.S. Representatives John Linder and Mike Simpson. It was an extraordinary event and the Friends will continue to promote the NIDCR’s initiatives and programs to decision-makers. With your help, we will make oral health research a national priority.
Sincerely,
Alec Stone NIDCR Clinical Trials Need Volunteers ClinicalTrials.gov provides regularly updated information about federally and privately supported clinical research in human volunteers. ClinicalTrials.gov gives you information about a trial's purpose, who may participate, locations and phone numbers for more details. Before searching, you may want to learn more about clinical trials. For NIDCR trials, visit: clinicaltrials.gov/...ServSessionldzone_ct=c6j5hdnmq1 NIH Reauthorization Will Require Some Restructuring, Says Rep. Barton A restructuring for the National Institutes of Health may be in the offing as part of a legislative package to reauthorize the agency being prepared by House Energy & Commerce Committee, chaired by Rep. Joe Barton (R-Tex.). During a June 2 hearing called by the Energy & Commerce/Health Subcommittee, chaired by Michael Bilirakis (R-Fla.) to examine NIH's priority setting process, Barton asked NIH Director Elias Zerhouni whether the legislation, "working with stakeholders," should, "create a new structure," or, "give the director's office the authority to do the restructuring." Zerhouni responded that, "a process, with authority obviously, to look at certain structural elements and the need for change," is important and that it, "should be mandated in some fashion." Barton, in his introductory remarks, clarified that in this fifth hearing in a series on the structures and goals of NIH he was not so much concerned with NIH's peer review process as with the, "serendipitous," origins of the agency's 27 institutes and centers. Noting that the Energy & Commerce/Oversight Subcommittee, chaired by Rep. Jim Greenwood (R-Penn.), also is holding hearings on NIH, Barton said, "We're kind of on a dual track here. Oversight [is] looking at the way certain things are being done, while this subcommittee is looking at the general structure of NIH and how we can maybe reorganize, reprioritize, reform to make it better." Asked how he would create NIH from scratch, Zerhouni described a structure, "that evolves easily and flexibly according to its priorities." The rigidity of the current structure, "needs to be thought through," he said. A, "process by which that structure would be reviewed at regular intervals could ask the obvious question: Do we have structures that still fit the reality of today." "There is no such process that would allow a reasoned, learned evaluation of the appropriateness of structure relative to mission," he said. The other witnesses, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases; Andrew von Eschenbach, National Cancer Institute director; and National Institute on Drug Abuse Director Nora Volkow agreed with the need for some kind of adaptive change. Asked whether Congress should provide a reorganization or NIH should be give some sort of institutional authority to restructure, Fauci declared his opinion that legislating, "structural changes, as opposed to providing the kinds of flexibility that would allow the NIH to evolve," with scientific opportunity, would be "fraught with danger." "The difficulty with legislating something that's a structural change is that then it's there," he reasoned. "That would only create a different model that would be as inflexible as the concerns you have now," he said. But, countered Barton, "If we give the authority to do it, and we let the various stakeholders interact, it might not get done. We might create a process that has no end...where, obviously, if we do it in law almost by definition it's going to be imperfect, but at least something will be done." Fauci pointed out that the committee in its oversight capacity would, "have ample opportunity...if the flexibility that is evolving is something that you're concerned about [to] get us in front of you," and ask for an explanation. Volkow and von Eschenbach were more conceptual in their responses. "I come from the perspective that structure really should be driven by function," reasoned the NCI director. He said authority to require collaboration and interaction among institutes and centers, "is very important," and would allow, "flexibility without dismantling the structure that's there." When, "integration," was, "appropriate and necessary," the authority would be there; otherwise, the institutes and centers could stay, "mission focused." Volkow compared the structure of NIH to scientific disciplines that are recognizing the need to break down barriers in order to work together to solve evolving multidisciplinary problems. "Even though we're dealing with different diseases, we're starting to recognize that [much] of the basic knowledge pertains to multiple disease processes...How do you ensure an infrastructure that will allow [us] to optimize the information and resources," without being redundant, she posed. The key element, she said, is, "flexibility that will allow us to drive the organization as the new discoveries and the new emerging trends come around." Barton assured reforms are in order, however they are realized. With a nod to NIH's scientific acumen, he went on to say, "The dollars are too big and the consequences are too big and quite frankly the assets at the disposal of the NIH are significant, and if we can channel them in a more comprehensive, coordinated fashion, we're going to do great deeds in the years ahead." NIH Launches Expanded Health Information Web Site Valuable online resource provides links to wider range of health information — highlights popular health topics, cutting-edge science and interactive features The National Institutes of Health (NIH) announced the launch of an expanded health information Web site, available at health.nih.gov The expanded site now offers links to a wider range of NIH's valuable resources, features colorful images to highlight an intriguing range of useful features, and gives readers the chance to test their health knowledge. Visitors can still access the popular A to Z listing of health topics, browse topics by body location/systems, or use the main Search box. Favorite health databases, such as Clinical Trials, MEDLINEplus, and PubMed, remain one click away. "NIH is the nation's medical research agency, and has long been considered a highly trusted source of health information," said Dennis Rodrigues, NIH Web site manager. "As more than half of American adults use the Web to access health information, we are pleased to be able to expand our services and provide 'one-stop shopping' for valuable information from across the more than two dozen institutes and centers that comprise NIH." The Web site includes three colorful new feature sections. Healthy Lifestyles highlights links to popular topics such as seasonal health concerns, nutrition and weight loss. Research In Action links users to cutting-edge scientific information on topics such as stem cells and genetics, and provides readers with an opportunity to meet scientists ranging from high school students to Nobel Laureates. Now Online emphasizes interactive features and Web exhibits, such as the Portion Distortion quiz, the Household Products Database, and the Milk Matters campaign. The new "Take a Quiz" box challenges viewers to test their knowledge with a series of continually rotating true/false questions on hot topics such as diabetes, osteoporosis, cancer prevention, and heart disease. The newly expanded NIH health information Web site has information geared for the whole family, including kids, teens, parents, and seniors. Educators, clinicians, and researchers will continue to find the site a valuable resource of tools and guidelines. HHS Awards $849 Million to Improve Public Health Preparedness HHS Secretary Tommy G. Thompson announced Thursday an additional $849 million in awards to states, territories, and four major metropolitan areas to strengthen the ability of government and public health agencies to respond to bioterror attacks, infectious diseases and natural disasters. "This funding is a critical component to our national security," Secretary Thompson said. "Our state and local public health system is the first line of defense when it comes to detection, reporting and containing a terrorist attack, an infectious disease outbreak or any other public health emergency." This funding is in addition to $498 million released earlier this month by HHS' Health Resources Services Agency to strengthen hospitals and improve overall response capability. All totaled since Sept. 11, 2001, HHS has invested more than $3.7 billion in strengthening the nation's public health infrastructure. "We're better prepared to respond to public health emergencies than ever before," Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention (CDC) said. "We have more work to do, but these funds will go a long way to further ensure states and local governments are prepared to respond to public health emergencies." The CDC will distribute the federal funds to enhance the capabilities of public health departments in the states, territories and metro areas (New York City, Chicago, Los Angeles County and Washington, D.C.). The money will be used to improve the readiness of the public health sector and other major health care providers to respond to bioterrorism and other public health emergencies. Recipients will be able to use the funds in a number of ways to improve public health and emergency response. These include improving communication and coordination between hospitals and local and state health departments, and their laboratories, while bolstering epidemiology and disease surveillance in state and local areas by increasing the number of people trained in emergency response. For a complete listing of the FY 2004 awards from the Public Health Preparedness and Response Cooperative Agreement, please go to: www.hhs.gov/news/press/2004pres/20040617.html HHS Extends Use of Rapid Oral HIV Test to New Sites Nationwide HHS Secretary Tommy G. Thompson announced Friday that HHS has extended the availability of a recently approved rapid oral HIV test from the current 38,000 laboratories permitted to perform the test to more than 100,000 sites, including physician offices, HIV counseling centers and community health centers. In addition, Secretary Thompson announced HHS would fund a $4.8 million effort to add the rapid test to Department-funded programs to reduce HIV/AIDS among injection drug users. "These actions will expand even further the availability of a simple, rapid HIV test to communities where people are at high risk of HIV," Secretary Thompson said. "HIV testing has never been easier or more accessible than it is today. As we prepare to mark National HIV Testing Day on Sunday, I urge anyone who thinks they may be at risk for HIV to get tested and know your status." The OraQuick® ADVANCE Rapid HIV-1/2 Antibody Test, manufactured by OraSure Technologies, Inc., of Bethlehem, Pennsylvania, provides results in as little as 20 minutes. To perform the oral test, the person being tested for HIV-1/2 takes the device, which has an exposed absorbent pad at one end, and places the pad above the teeth and against the outer gum. The person then gently swabs completely around the outer gums, both upper and lower, one time around. The device is then inserted into a vial containing a solution. The test device will indicate with more than 99 percent accuracy if HIV-1/2 antibodies are present in the solution by displaying two reddish-purple lines in a small window on the device. HHS' Food and Drug Administration (FDA) approved OraQuick in November 2002 for use as a blood test in laboratories that perform moderate complexity testing, and in January 2003, HHS categorized the rapid blood test as a waived test under Clinical Laboratory Improvement Amendments. FDA approved the oral version of the test in March 2004. Secretary Thompson also announced that $4.8 million has been allocated to HHS' Substance Abuse and Mental Health Administration (SAMHSA) from the National Minority AIDS Initiative Secretariat fund to support new demonstrations for rapid HIV test technologies. This includes both testing kits and, critically, the training to support their proper use. SAMHSA will incorporate rapid HIV testing into its programs for reducing the spread of HIV/AIDS among injection drug users and their sex partners, who represent one-third of persons infected with HIV in the U.S. Each year, 8,000 HIV-infected people who come to public clinics for HIV testing do not return a week later to receive their test results. With the new rapid HIV test, individuals need only give a drop of blood or a swab of saliva, and the results are available on the spot in about 20 minutes. As with all screening tests for HIV, if the OraQuick gives a reactive test result, that result must be confirmed with an additional specific test. Oral Health Partnership Meeting
Summary of Discussion of Next Steps Speakers early in the meeting reported on their organizations' many successful efforts, as individual entities and through multilateral partnerships, to promote oral health. Building upon those remarks were expressions of a vision for broader collaboration via sustaining a national Oral Health Partnership. Characteristics of effective coalitions were presented by Dr. Fran Butterfoss, an expert on coalitions who has been retained by the U.S. Centers for Disease Control and Prevention to provide consultation to the Partnership for consideration of "next steps." Characteristics include:
Dr. Butterfoss concluded her presentation by noting that the Oral Health Partnership has many necessary attributes that should enable it to get off to a good start. Dr. Caswell Evans suggested that the Partnership agree to a structure that, at the very least, would ensure four functions:
U.S. Surgeon General Richard Carmona reiterated to the Partnership his commitment to make oral health synonymous with general health. He noted recent successes, but also pointed out areas of challenge where better outcomes can be achieved. He identified health literacy as a goal of his office, and sought the support of the Partnership to undertake actions that would provide assurance that the Surgeon General's Report on Oral Health would ultimately provide information that would be useful to real families. Suggested Models
Summary Joint Center Health Policy Institute Briefing: Improving Oral Health of African American Males This briefing was held on June 10, 2004, at the National Press Club in Washington, D.C. At this briefing, dental and medical professionals and health policymakers discussed the oral health needs of African American males and in particular, the findings of a new report released by the Joint Center. Visible Differences: Improving the Oral Health of African American Males highlights the health disparity and recommends several policy options for federal and state governments, dental schools and private companies. U.S. Surgeon General Richard H. Carmona gave the opening remarks. There was also a panel discussion with personal testimony and the perspectives of dental practitioners and state legislators. Speakers included Dr. Ronald E. Inge, associate executive director, Division of Dental Practice, American Dental Association; Dr. Amid Ismail, professor and director, Detroit Center for Research on Oral Health Disparities, University of Michigan; Shelly Gehshan, program director, National Conference of State Legislatures; and Eric Williams, Cleveland Cavaliers forward and founder, Believe In Me Foundation. Welcome remarks by Dr. Margaret Simms, Senior Vice President for Programs, Joint Center. She was introduced by moderator Dr. Chester Douglass, professor and chair, Oral Health Policy and Epidemiology, School of Dental Medicine, Harvard University. U.S. Surgeon General Richard H. Carmona called for greater public-private partnerships to meet the oral health needs of Americans, especially black men and boys. He was introduced by Dr. Caswell Evans, director, National Oral Health Initiative. Presentation of key findings from Visible Differences: Dr. Gail C. Christopher, director, Health Policy Institute, Joint Center. For the full story, visit: www.jointcenter.org/whatsnew/061404-news.htm National Maternal and Child Oral Health Resource Center The National Maternal and Child Oral Health Resource Center (OHRC) is pleased to announce the availability of two new resources. Promoting Awareness, Preventing Pain: Facts on Early Childhood Caries (ECC) (fact sheet) defines ECC, describes who is at risk, and presents information on both the financial and the human costs of ECC. The fact sheet also suggests ways in which health professionals can reduce a child’s risk for ECC. The latest issue of the Oral Health Resource Bulletin contains descriptions of recently released materials including Web-based oral health learning tools, state needs assessments, and final reports and action plans from Head Start oral health forums. Additional print copies of both resources are available at no charge from the HRSA Information Center, 2070 Chain Bridge Road, Suite 450, Vienna, VA 22182-2536, phone: (888) ASK-HRSA (275-4772), fax: (703) 821-2098, e-mail: ask@hrsa.gov. To obtain an electronic copy, go to the Materials page on the OHRC Web site at www.mchoralhealth.org/materials/index.lasso, and then click on Fact/Tip Sheets or Interchanges/Resource Bulletins under the section titled Resource Center Materials. Patient Advocacy Spotlight: AboutFace & cleftAdvocate Partnership Further enhancing family support services for cleft and craniofacial patients on a local, regional and national basis, Rickie Gill, Executive Director of AboutFace USA, has announced the organization's recent partnership with cleftAdvocate and its founder Debbie Oliver. "AboutFace USA and cleftAdvocate have been working together for quite some time," said Gill. "It made sense to combine our efforts and draw on the strengths of both networks to offer improved services to families." The two organizations recently collaborated to host a Pathfinder outreach workshop at Shriner's Hospital in Chicago and have announced a national family conference for Summer 2005 in Las Vegas. "We are very proud to be a program of AboutFace USA," remarked Oliver regarding the partnership. "Combining the two entities marks a milestone in the way we reach families and the types of services we can offer them." Oliver explained how recent technology has allowed the cleftAdvocate website and the Pathfinder program to flourish. "The Family-to-Family Connection (www.cleftadvocate.org/ftfc.html) is the cornerstone of the Pathfinder program. Combine that with the well-established AboutFace organization, their newsletter and their fabulous, informative booklets on birth anomalies and acquired facial differences and we can reach more families, faster and with more information than ever before," she said. Working with medical professionals and patient families, the Pathfinder program is open to everyone. A live teleconference overview and training is conducted on the second Monday of every month. If you are interested in hosting a live Pathfinder workshop, or for more information on the Pathfinder program, contact Program Director Debbie Oliver at (702) 769-9264, via e-mail at debbie@cleftadvocate.org, or visit the website at www.cleftadvocate.org. For more information on the 2005 family conference or for patient literature, contact Executive Director Rickie Gill at (888) 486-1209 or info@aboutfaceusa.org. CDHP’s Congressional Briefing on Oral Health Disparities Congressional staff and dental advocates packed a Capitol Hill meeting room on June 4, 2004, to hear a panel of experts discuss research-based findings on disparities in oral health and access to dental services. This event was co-sponsored by FNIDCR. For the full speakers’ presentations, visit: www.cdhp.org/Index.asp?PA=2&XX=115&XX=153&XX=147&XX=81 Dr. Caswell Evans to Join UIC Faculty By Mark Berthold Chicago — Dr. Caswell Evans, who directed and edited the landmark Surgeon General's report Oral Health in America, will join the University of Illinois at Chicago College of Dentistry in August. Dr. Evans was named associate dean for Prevention and Public Health Sciences and director of the Center for Prevention and Oral Public Health Sciences, the college announced Feb. 18. He also will have an adjunct faculty appointment in the UIC School of Public Health. "Oral health services are a vital part of the prevention agenda, and it's important for all health providers regardless of their discipline to understand that part of what they're doing is in the domain of the public's health," says Dr. Evans. "I think the collaboration between the College of Dentistry and School of Public Health will benefit both schools, and I'm looking forward to fostering that partnership." Currently the National Oral Health Initiative director for the U.S. Surgeon General, Dr. Evans was executive editor and project director of Oral Health in America, the first report by the Surgeon General on the state of oral health and oral health care delivery in the United States. The report reviewed the burden of oral diseases on the nation and the interdependence of oral and general health. It examined oral disease prevention and oral health maintenance, and explored the opportunities for enhancing oral health in the future, particularly among underserved populations. Dr. Evans later headed the Surgeon General's follow-up program, National Call to Action to Promote Oral Health, toward eliminating oral health disparities and improving quality of life. After earning his dental degree from Columbia University, interning at the University of Chicago and receiving a master's in public health from the University of Michigan, Dr. Evans directed public health programs for Los Angeles County and Seattle-King County, Wash. He held faculty positions at Columbia University, Boston University, the University of California at Los Angeles, Drew Medical School and Howard University. One of only 14 dentists elected to the Institute of Medicine of the National Academy of Sciences, Dr. Evans is a past president of the American Public Health Association, founder of its Faith Community Caucus and chair of the National Advisory Committee for the Robert Wood Johnson Foundation Pipeline grants program. "The UIC College of Dentistry is honored to have Dr. Evans join its faculty and senior leadership team and looks forward to his contributions to fulfilling the college's Vision 2010 in dental education, patient care and research founded on prevention and public health sciences," said Dr. Bruce Graham, dean of the UIC dental school. Support Key to Sustained National Investment in the Public Health Enterprise The Washington Fax, John T. Softcheck The need to engage the public as an active force in national public health efforts has taken on new immediacy as the operating environment has evolved from a state of near invisibility to a reactive, almost media-driven enterprise, American Public Health Association Executive Director Georges Benjamin exhorted attendees at the 3rd annual Partnership Conference in Public Health Law, held June 14-16 in Atlanta. Even after the World Trade Center attacks, Benjamin said he is still surprised by the large percentage of the public that continues to believe they have never been touched by a public health service. Yet, he emphasized, gaining congressional support for increased investments in public health will require the active support of the public that stands to benefit. Though he is cautious to avoid terms such as "doubling," recalling the reaction by some in Congress in the wake of the NIH budget doubling effort, Benjamin is nonetheless an ardent supporter of the plan proposed by Sen. Arlen Specter (R-Penn.) to increase the Centers for Disease Control and Protection budget by $15 billion over the next five years. The Bush Administration's budget request for FY 2005 would cut the agency's funding from all sources by approximately 1.6%, to $6.86 billion. "Legislators get it when we spend the time and explain what the impacts of these funding cuts are," Benjamin noted. "We have an obligation to finish what we've begun." Pointing to the relatively recent example of SARS, Benjamin added that the speed of science has grown exponentially, with causative agents identified, sequenced and diagnostic efforts begun in a matter of days or weeks instead of months and years. Where once public health officials dealt with a reasonably controlled information flow, they now must contend with near information overload, and the national scope of health efforts must now recognize the global nature of health challenges. Additionally, he pointed out, in the aftermath of Sept. 11, public health has been incorporated as one facet of a larger national security enterprise. But, while the new national focus on protection has spilled over to benefit public health, the resultant short-term, sizable research investments have resulted in what many meeting participants saw as a destructive funding cycle that reacts largely to the "crisis of the month." For public health infrastructure to grow, Benjamin argued the scientific community will have to persuade Congress to move away from funding whatever issue has the public's attention and toward a sustained investment to ensure the fruits of NIH basic research will result in new and better public health practices. Indiana State Senator Beverly Gard, who spoke on the intersection of science and public policy, agreed with Benjamin's assessment, emphasizing the importance of revisiting legislators with the growing body of scientific evidence demonstrating the long-term benefit that will mitigate the cost of an increased translational investment. Howard Markel, a physician/historian who has chronicled the efforts of the public health enterprise in the U.S. notes the "tragic refrain" of epidemics and public health crises is that the public forgets and gives up the fight, while diseases and threats do not. "We must remember that we do not 'conquer'" public health threats, Markel observed. "At best, we wrestle them to a draw." Sodas, Canned Teas Attack Tooth Enamel
Additives in Regular, Diet Drinks Damage Teeth in Laboratory Study Soft drinks, especially light-colored drinks, and canned iced tea appear to "aggressively" harm teeth, new research shows. The list includes many different sodas -- Coke, Pepsi, Mountain Dew, Dr. Pepper, Sprite, Canada Dry ginger ale -- and canned iced tea, specifically Arizona Iced Tea, all eroded tooth enamel in laboratory studies. In addition, both diet and regular versions had the same bad effect on tooth enamel, according to researcher J. Anthony von Fraunhofer, MSc, PhD, with the University of Maryland Baltimore Dental School. Non-cola drinks, such as ginger ale, Mountain Dew, and Sprite were particularly harmful to tooth enamel. Brewed black tea, root beer, coffee, and water had a minimal effect, he writes in his report. It appears in the new issue of General Dentistry. Other studies have pointed to soft drinks as being responsible for children's tooth decay and obesity problems. It is a huge problem, since it has been reported that the average person in the U.S. drinks about 16 ounces of soft drinks daily -- that's about 53 gallons a year, writes von Fraunhofer. While sugar in soft drinks is at least partially to blame for tooth decay, other factors are also at work, he writes. The acidity from certain drinks also plays a role. If mouth acidity increases -- and if it happens often enough -- the chemical reaction hurts teeth to a greater extent. Over time the result is tooth decay, he explains. In this pilot study, von Fraunhofer examines the effects that various carbonated soft drinks -- both regular and diet versions -- on tooth enamel. He exposed 20 healthy teeth (all extracted for orthodontic or periodontic reasons) to various soft drinks including canned iced tea for 14 days. The result: Soft drinks like Sprite, Mountain Dew, and Arizona Iced Tea were especially harmful to tooth enamel, reports von Fraunhofer. Tap water, root beer, brewed black tea, and black coffee all showed minimal enamel damage. Specifically:
Non-cola drinks contain flavor additives that are "far more aggressive" at eroding teeth, compared with regular cola soft drinks such as Coke and Pepsi, he writes. The best defense against tooth decay is drinking fewer soft drinks. Also, allowing more time between soft drinks, rinsing your mouth with water after drinking, or brushing your teeth will also help. Breaking News: You Still Need to Floss
By Jennifer Huget Newly publicized clinical research carrying the imprimatur of the American Dental Association (ADA) shows that rinsing twice daily with Listerine does "at least as good" a job of reducing gingivitis (swollen, irritated gums) and plaque (bacteria and the sticky stuff they feed on that cause gingivitis) as once-daily flossing. So is it time for slaves to dental hygiene to throw off their floss? Can two 30-second rinses with the tingly elixir really replace the nightly ritual of winding the twin digital tourniquets, spattering the mirror with bits of dinner and drawing blood between those two unruly molars? Of course not. If that were true, you'd have found out about it by now, via the tickertape parades in major cities, the mass dental floss bonfires and stadium-filling thanksgiving services. Still, the research is tantalizing, especially to the estimated 85 to 90 percent of Americans who, according to dentist and ADA spokesman Matt Messina, fail to floss regularly. The story begins with a study that was funded by Pfizer Consumer Healthcare, maker of Listerine, and published last year in the ADA's journal. The study showed that, among 600 people ages 18 to 65 who had mild to moderate gingivitis, Listerine Antiseptic mouth rinse (civilians call it mouthwash) used as directed (twice-daily, 30-second rinses) reduced plaque between the teeth by 20 percent and gingivitis by 11.1 percent after six months. Flossing, by contrast, reduced between-teeth plaque by only 3.4 percent and gingivitis by 4.3 percent in the same period. The study confirmed the findings of earlier research, also funded by Pfizer, published in 2002 in the American Journal of Dentistry. Both studies apply to all versions of Listerine mouth rinse except the natural citrus variety. Both Pfizer and the ADA emphasize that the results relate only to people with gingivitis, a mild form of gum disease that affects a majority of Americans over 30. Those with periodontitis, a more serious condition in which bacteria have affected the bony structure of the mouth, have no choice but to floss if they wish to be well. From these two studies, published in respected, peer-reviewed journals, a reasonable person might infer that it's time to pitch the floss. But of course that's not the message the ADA -- or, for that matter, Pfizer -- wants you glean. And with good reason. The ADA has for decades recommended twice-daily brushing and daily flossing, along with regular visits to the dentist. That stance is reinforced by yet another Pfizer-sponsored study, this one published in the April 2004 issue of the ADA journal, which demonstrates that brushing plus flossing plus two Listerine rinses a day deliver the biggest anti-gingivitis punch of all. Those in the study who merely brushed saw little change in the amount of plaque between their teeth or the degree of gingivitis they suffered at six months. Those who brushed and flossed reduced plaque by 8.9 percent and gingivitis by 7.7 percent during that time. Those who brushed, flossed and rinsed with Listerine saw a 52.4 percent reduction in plaque vs. the brushing-only group and a 22.3 percent reduction in gingivitis vs. the brushing-only group; the triple-treatment group's plaque reduction was 47.7 percent better and its gingivitis reduction 15.8 percent better than those of the brushing-and-flossing group. Naresh Sharma of Bio-Sci Research Canada Ltd., a research laboratory that conducted the first and most recent studies for Pfizer, speculates that brushing and flossing not only scrape away most of the plaque (thus reducing the ranks of bacteria to be reckoned with) but also help disrupt the surface of any remaining plaque, creating opportunities for the Listerine to get at more of the bacteria. In the new study, patients in the brushing-only group and in the brushing-and-flossing contingent both used mouth rinse that didn't contain Listerine's essential oils, just to make sure that it was the ingredients in Listerine, not the mechanical action of liquid swishing over teeth, that improved outcomes. In the mid-1980s, Listerine became one of the first mouth rinses to receive the ADA's "seal of acceptance" for its role in reducing plaque and gingivitis. Research supporting that distinction showed that Listerine's four active ingredients -- the essential oils thymol, eucalyptol, methyl salicylate and menthol -- were effective in reducing plaque and thus limiting its assault on the gums. Now any private-label and store-brand Listerine look-alike can make the same claims, provided it has Listerine's exact mix of active ingredients. (Alcohol, which accounts for up to 26.9 percent of Listerine's volume, is listed as an inactive ingredient. Last decade's scary stories linking Listerine's alcohol to oral cancer risk have been largely discounted.) The results of the 2002 and 2003 studies have been in dental professionals' hands for some time. You're just hearing about them now because of the vagaries of ADA protocol: Products such as Listerine that wish to publicize research-based claims must first have those claims reviewed by the ADA's Council on Scientific Affairs. Cliff Whall, a leading member of that council, explains that it was only in March that Pfizer won permission from the ADA to publicize Listerine's effectiveness relative to dental floss. The 2004 study hasn't yet been reviewed by the council, Whall says, so while your dentist may have read it and may be figuring out how to deliver the news to patients, you're not really supposed to know about it yet. "The ADA's position still is clear," Whall said. "Brush two times a day with a fluoride dentifrice, floss every day to remove plaque. But we also recognize that this company [Pfizer] has done two studies [not counting the 2004 one] that satisfy our criteria" for establishing that essential-oil-containing mouth rinse is as good as flossing at combating plaque and gingivitis. Which puts you in a funny position. On the one hand, the compelling data from the 2003 study might support your tendency to go floss-free. But now that we've told you about the newer study, which shows that Listerine is even more effective when added to a flossing regimen, you can't pretend not to know better. Dentist Messina, who practices near Cleveland, is in the same boat. "I'm afraid people will make too big a jump" and give up flossing altogether, he said. "I'm not willing to let go of something I know works really well [brushing and flossing] for something we believe may be a good adjunct [adding mouth rinse to the mix]." Messina concedes that while brushing, flossing and rinsing remains the best approach against gingivitis, "if we have only time to just brush and rinse, that's better than not doing anything." Is that permission to ditch the floss? At least once in a while? You didn't hear it from us. Access to Oral Health Care for Individuals Affected by Ectodermal Dysplasias The National Foundation for Ectodermal Dysplasias (NFED) will address the enormous problem of access to care and regional disparities for individuals affected by ectodermal dysplasia (ED) syndromes by sponsoring a meeting of dental professionals to be held at Saint Louis University Center for Advanced Dental Education in St. Louis, Missouri on October 8th and 9th. This meeting will address the major problems that individuals affected by ED face as they search for qualified professionals to treat their dental needs and as they investigate treatment options. With each passing day, the excitement surrounding our Access to Care Workshop mounts. The NFED is pleased that representatives from eighteen of our nation's dental schools, the NIDCR, the American Dental Association and four dental implant companies will be in attendance. Saint Louis University Center for Advanced Dental Education and Southern Illinois University School of Dental Medicine are joining the NFED in serving as co-hosts for the meeting. The event will begin with presentations by key individuals experienced with patient management. This portion of the proceedings is open to individuals wishing to earn continuing education credits. This planning meeting is critical to discuss possible collaborations and regional solutions. The participants will clearly identify the problems that individuals who are affected by ED syndromes face with access to dental care and identify solutions. The goal is to establish a network for individuals to access quality, cost effective dental health care and also to establish a research network to develop evidence based treatment options. Finding the solutions to these problems will require the collaborative efforts of business, academic institutions, and the private sector. For more information about the program, contact the National Foundation for Ectodermal Dysplasias at 618-566-2020 or info@nfed.org. Keep smiling! North American Craniofacial Family Conference The North American Craniofacial Family Conference, hosted by AboutFace USA and cleftAdvocate, is scheduled for early summer 2005 in Las Vegas. Featuring a wide variety of specially-designed workshops for parents, children, teens and adults, the educational portion of the program will focus on the particular interests and needs of each group. Topics will range from early intervention to genetics, from self-esteem to employment counseling, from social skills to insurance issues, and much more! A Pathfinder Outreach Workshop will also be offered in conjunction with the conference. The North American Craniofacial Family Conference is open to all individuals with congenital or acquired facial differences, their families, friends and medical professionals. If you are interested in attending, or you are interested in being a presenter, contact Debbie Oliver at (702) 769-9264 or debbie@cleftadvocate.org. Registration packets will be available in Fall 2004. If your organization or corporation is interested in being a sponsor, exhibitor or advertiser, please contact Rickie Gill at (888) 486-1209 or info@aboutfaceusa.org. News of Note
2005 Research!America Advocacy Awards: Request for Nominations The 2005 Research!America Advocacy Awards nomination are for individuals and organizations demonstrating leadership in medical and health research advocacy. The deadline for nominations is July 30, 2004, and the awards will be presented March 15, 2005, in Washington, DC. To download the PDF version of the nomination booklet, visit www.researchamerica.org/publications/advocacyawardsform.pdf. For more information, contact Janet Fedak at 703-739-2577, ext. 36, or jfedak@researchamerica.org. FNIDCR Moves Headquarters The Friends of NIDCR has a new address. Contact us at: Friends of NIDCR |