Prevora Blog

At the recent International Association of Dental Research (IADR) meeting held in Toronto, Dr. Tina Papas (Tufts University School of Dental Medicine, Boston) presented the results of a nine month study on the changes in oral health status in patients taking psychiatric medications compared to patients who were taking medications known to cause xerostomia (dry mouth). It is well known that many psychiatric drugs such as those used to treat anxiety, depression and those with an effect on the autonomic nervous system all have a xerogenic (drying) effect. Medications that cause dry mouth have been shown to contribute to a higher caries rate.

In her abstract Dr. Papas was able to demonstrate in a population of 653 patients that psychiatric drugs led to a significantly higher increase in periodontal attachment loss and recession and a significantly higher increment of caries than even drugs known to cause xerostomia. This is despite having acceptable oral hygiene habits and receiving regular dental visits.

This reinforces data by Rindal published in 2005 (Community Dentistry and Oral Epidemiology, 33:74-80) demonstrating that for patients taking antidepressants the restoration rate is an amazing 60% higher than for those taking no medication at all.

Clearly, understanding a patient’s medical history and specifically the use of psychiatric drugs could be critical in identifying this risk factor for caries and assist in the development of preventive treatment strategies.

See the link below for the abstract of Dr Papas’ presention

IADR Session 1513 Changes in Oral Health Status in Volunteers on Psychiatric Medications

Take Care,
Tyler

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At the recent meeting of the International Association of Dental Research (IADR) in Toronto, one of CHX Technologies Regulatory and Clinical Affairs officers, Holly Byrd, attended one of the many sessions and was kind enough to provide us with a post about this session.

An important symposium was held on July 3rd: “How do Medicine and Dentistry Collaborate on Oral/Systemic Health?” (Sponsored by Johnson & Johnson Oral Healthcare). The presentation included Dr. Bill Costerton of the University of Southern California, talking about the role biofilms play in oral and systemic health.

Dr. Costerton, known as the “father of biofilms” after coining the term in the late 1970’s, describes biofilms as a group of bacteria that colonize a surface. Once believed to be responsible for over 65% of infections, the National Institutes of Health now estimates biofilms to be associated with 80% of infections. Biofilms are mobile cultures that have been found in such areas of the body as the inner ears, lungs, implanted medical devices and tooth surfaces (in the form of plaque). Biofilms are 1000x more resistant to antibiotics than monocultures. Dr. Costerton believes that the explanation for the high resistance to antibiotics is due to a sticky slime that is secreted by the bacteria, which acts as a protective barrier for the biofilm. This slime makes up the majority of the biofilm composition and is responsible for allowing passing monocultures to attach to existing colonizations. When a biofilm has grown to capacity, it has the ability to shed bacterial members to other parts of the body, including the bloodstream. These bacterial members can colonize in a new area of the body and create a large biofilm, similar to the one they originated from, creating an infection. This may explain the high burden of Streptococcus mutans on diseased heart tissue as reported by Nakano et al.

K. Nakano et al, “Detection of Cariogenic Streptococcus mutans in Extirpated Heart Valve and Atheromatous Plaque Specimens”, Journal of Clinical Microbiology, v.44, 2006, pp. 3313-3317.

Dr. Costerton gave a very informative and thought provoking presentation on the link between medicine and dentistry with respect to oral and systemic health. See the link below for an article about Dr. Costerton.

http://blogs.uscannenberg.org/annenbergfiles/2007/11/usc_professor_offers_fresh_loo.html

Holly
CHX Technologies
Regulatory & Clinical Affairs

We would like to hear your thoughts about this presention and how these two displicines of the health care system collaborate so feel free to add your comments to this post.

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Hello,

A few days ago, a colleague of mine passed along a study about the association between maternal periodontal disease , systemic inflammation and an elevated risk for preeclampsia that was published in the April edition of the American Journal of Obstetrics & Gynecology.

First and foremost I had to look up what preeclampsia was. At which time I discovered that preeclampsia is a serious complication involving the development of hypertension (high blood pressure) during pregnancy and can lead to premature delivery. For the purpose of this study the condition was categorized as 2 episodes of blood pressure greater than 140/90 mmHg and at least 1+ proteinuria on a catherized urine specimen.

In the study the presence of periodontal disease was defined as 1 or more tooth sites with greater than or equal to 4 mm pocket depth or 1 or more tooth pockets greater than 3 mm that bled on probing. During this study they also measure the level of C-reactive protein a known non-specific marker of inflammation in order to determine the level of systemic inflammation.

This study showed that expecting women with an increased level of C-reactive protein and periodontal disease were at an increased of developing preeclampsia

If you would like more information about this article you can follow the link below to the Reuters article from May 7th, or the article from the journal.

Reuters Article

Ruma M, Boggess K, Moss K, et al. Maternal periodontal disease, systemic inflammation, and risk for preeclampsia. Am J of Obstet Gynecol. 2008;198:389.el389.e5

Take care,
Tyler

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Hi everybody,

I recently came across a very interesting scientific paper in the April 1 issue of Circulation that defined a link between chronic periodontitis and edentulism and the risk of coronary heart disease (CHD). The topic of this paper is not new, and a lot of people know about the link between perio and CHD; however the research behind this link has never really been consistent or definitive. This is what makes this paper so interesting; finally there is some definitive proof of the relationship between these two diseases.

If you would like more information about this topic you can follow the link below which will lead you to the article in Circulation.

Age-Dependent Associations Between Chronic Periodontitis/Edentulism and Risk of Coronary Heart Disease

Take care,

Tyler

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Hello Everybody,

I was recently asked by one of our Partners in Prevention about the possibility of an allergic reaction to Prevora in a patient who has recently had surgery and is also allergic to “many” things.

The response that they received was as follows: there have been no know allergic reactions to Prevora and its ingredients during the clinical trials which have taken place over many years and involved thousands of patients. There have been only 2 or 3 cases of asthmatics having difficulties during the treatment and approximately 2% of patients having a mild topical irritation of the oral mucosa. Prevora’s safety profile has been rigorously reviewed by both Health Canada (DIN # 02046245) and the Irish Medical Board prior to receiving approval as a prescription drug.

Patients with known sensitivities to chlorhexidine, Sumatra benzoin, ethyl alcohol or polymethylmethacrylate should be consulted prior to treatment. Chlorhexidine the active ingredient in Prevora, is a very well know antimicrobial which has been used in dentistry throughout the World for over 50 years.

If you have any other questions about Prevora’s safety profile or contraindications feel free to leave a comment and I will be happy to reply

Regards,
TYLER

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