Prevora Blog

Hello everyone,

Recently the Partners in Prevention held its first guest speaker event which featured Dr Sally Mauriello an associate professor and coordinator of the Dental Hygiene Program at the School of Dentistry at the University of North Carolina. Dr Mauriello is one the lead researchers of the link between root caries and systemic health. She presented the finding of her research during presentations to the upper year hygiene classes at both George Brown College and the Canadian Academy of Dental Hygiene, as well as a contingent of the Partners in Prevention in Oakville. All three of these presentations were very well received by the audience and elicited many insightful questions and discussion.

Dr Mauriello’s findings have been summarized in three abstracts that have published over the past ten years a brief summary of these finding is below.

• In 1996, Mauriello reported that older adults with ≥ 2 new root caries lesions were four times more likely to die during the 3 to 5 year follow period, than those with fewer than 2 root lesions.[1] A subsequent study in 1999 by the Mauriello research team extended and confirmed these findings.[2]
• A 2006, Mauriello reported that amongst Americans aged 52-74 the incidence of heart attack over a 6 year period was 4.7% amongst the root caries group versus 2.4% for those without root decay.[3] In a regression analysis, root caries was significantly associated with a heart attack in this population, adjusting for periodontal pocketing, race, age, sex and the usual risk factors such as smoking, income, diabetes, hypertension and LDL

In her recent visit to Toronto, Dr. Mauriello provided some unpublished data from the Atherosclerosis Risk in the Community Study (ARIC), a large prospective study of risk factors for cardiovascular disease funded by the National Institutes of Health in the late 1980s and 1990s. ARIC tracked over 15,000 middle-aged Americans for cardiovascular disease over 10 years. Scientific articles from ARIC are still being published but the root caries connection has yet to be described. Dr. Mauriello reported that in ARIC, root caries out-weighed cholesterol as a risk factor for heart disease.

This link between root caries and overall health is still being investigated and is not completely understood at this point. However there is beginning to be more and more evidence of this link in the published literature. One of the most interesting articles has come from a Japanese research group which detected significant quantities of Streptococcus mutans in surgically removed heart valves and atheromatous plaque of patients with cardiovascular problems (Chart 1). This may indicate a pronounced or prolonged Bacteremia effect from recurrent root caries. The results of this study indicate that S. mutans is a possible causative agent of cardiovascular disease[4].

Chart 1

Source: Nakano K. et al, 2006. Detection of Cariogenic Streptococcus mutans in Extirpated Heart Valve and Atheromatous Plaque Specimens. J Clin Micro, 44: 3313 – 3317.

You can read more about both Dr Mauriello and the Japanese studies by following the links to the articles below.

Dr Sally Mauriello’s Research

Detection of Cariogenic Streptococcus mutans in Extirpated Heart Valve and Atheromatous Plaque Specimens

I hope that this post has given you a little more insight into the relationship between root caries and overall health and that it makes you look forward to the next Partners in Prevention guest lecture event.

Until the next time, take care
Tyler

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1 Mauriello S et al. 1996. Risk modeling for root caries and mortality in older adults. IADR Abstract 896.
2 Mauriello S et al. 1999. Root caries incidence as a risk predictor for mortality. IADR Abstract 3582.
3 Mauriello S et al. 2006. Root caries prevalence and incident myocardial infarction. IADR Abstract 1471.
4 Nakano K. et al, 2006. Detection of Cariogenic Streptococcus mutans in Extirpated Heart Valve and Atheromatous Plaque Specimens. J Clin Micro, 44: 3313 – 3317

I was recently in a dental clinic and one of the hygienists asked me: What is this “Partners in Prevention” thing that I keep hearing about?

I explained to her that Partners in Prevention is a growing network of dental professionals throughout Canada who are trained to provide more preventive services to older adult dental patients. I talked to her about how the program is a unique education, training and promotion program designed to expand those dental services most preferred by Boomer Plus patients (those age 40+).

This network responds to the most significant opportunity now in dental care — more prevention to an aging community.  The hygienist I was speaking to agreed that older patients tend to “disappear” from the normal recall pattern in her office — seniors just don’t visit the office as much as younger patients do. And with more and more seniors, her hygiene team was beginning to wonder about its bookings.

I asked this hygienist if she and her hygiene team had ever asked these older patients what they preferred in their dental care? She said, rather embarrassed, that she had never thought of doing so. I said that our company had asked many older Canadians this fundamental question in several surveys and found that overwhelmingly, these older patients wanted more prevention, far more than other dental services such as cosmetics, implants, crowns, etc.

So, with the aging of her patients, this hygienist understood the importance of shifting her efforts to new preventive services such as Prevora, the antibacterial tooth coating which is the only approved preventive treatment for root caries.

This conversation with the hygienist explains the rationale to Partners in Prevention. It is a network  of dental offices shifting their services to more preventive care, as this is what their aging community best responds to.

Our company’s ongoing market research has indicated that 8 out of 10 of older patients want to pursue preventive strategies and almost all of them are willing to pay for this, regardless of insurance. In a recent survey conducted by Ipsos – Reid, it was demonstrated that 2 out of 10 patients would look for a dental office that is a Partner in Prevention and 4 out of 10 will ask you about it and expect your clinic to be a part of this growing network.

What is the cost of joining the Partners in Prevention network?  There is no charge for the following services but every Partner is committed to recommending prevention of root caries with Prevora, when it is appropriate. And given that Prevora is the only proven and approved preventive treatment for this most common disease in aging Canada, that commitment only makes sense.

The Partners in Prevention program means you will be raising the profile of your clinic in your community. You will be improving the level of care you provide to your patients while developing a more efficient and productive hygiene department, gaining the required continuous education credits and at the same time increasing the value of your practice.. There are a wide range of services within the Partners in Prevention program that are offered at no charge to a partner practice some of which are listed below.

Partners in Prevention consists of education programs that include:
● Semi-annual Educational Seminar Series
● Guest Lecture Series
● Lunch and Learn Sessions
● Training Sessions
● Hygienist education courses

As well there are education resources consisting of:

A Partners in Prevention Monthly Newsletter, a Partners in Prevention website, a Prevention of root caries video and a Prevora video, Patient brochures, Prevora poster and a Prevora blog.

Along with this there will be extensive training on identifying the patients at risk, counseling patients on appropriate preventive therapy and the application of Prevora – the only approved treatment for the prevention of root caries.

Once your clinic is on board with the Partners in Prevention program it will be included in:

• On-page advertising in your local newspaper media
• Inserts listing the Partner in Prevention clinics in your local newspaper media

At the end of my chat with this hygientist, it was clear to her that becoming a Partner in Prevention was a way to set a new standard of care for their older patients. A standard of care that they want and are willing to pay for.

I hope that this helps out with your understanding of what the Partners in Prevention is all about and if you would like more information see the website www.partnersinprevention.ca 

Take care,
Tyler