Postmenopausal women with periodontal disease are more likely to develop breast cancer than those with healthy gums, according to the American Association for Cancer Research.
A study by the University of Buffalo School of Public Health and Health Professions monitored 73,737 postmenopausal women enrolled in the Women’s Health Initiative Observational Study who did not have any previous breast cancer and found periodontal disease in 26.1% of them.
After a mean follow-up time of 6.7 years, 2,124 of these women were diagnosed with breast cancer. Among all of the women, the risk of breast cancer was 14% higher in those with periodontal disease.
Women with periodontal disease who had quit smoking within the past 20 years had a 36% higher risk of breast cancer, while women overall who were smoking at the time of the study had a 32% higher risk.
Those who had never smoked or who had quit more than 20 years ago had a 6% and 8% increased risk, respectively, if they had periodontal disease. The researchers said that previous exposure to smoking might affect the carcinogenic process since the highest risk was found in smokers who had quit within the past 20 years.
“We know that the bacteria in the mouths of current and former smokers who quit recently are different from those in the mouths of nonsmokers,” said Jo L. Freudenheim, PhD, of the University of Buffalo and lead author of the study.
The researchers noted several explanations for the link between periodontal disease and breast cancer. First, there may be systemic inflammation with periodontal disease that affects the breast tissues. Or, bacteria from the mouth can enter the circulatory system and affect the tissue. Further studies are needed to establish a causal link, though.
“If we can study periodontal disease and breast cancer in other populations, and if we can do more detailed study of the characteristics of the periodontal disease, it would help us understand if there is a relationship,” said Freudenheim. “There is still much to understand about the role, if any, of oral bacteria and breast cancer.”
The women in the study self-reported their periodontal disease status after being asked if a dentist had ever told them that they had it. Also, the subjects already were enrolled in a health study, so they were more likely than the general population to be conscious of health issues. The general population, then, would have higher rates of periodontal disease and other risk factors like smoking, diabetes, and obesity.
The study was published by Cancer Epidemiology, Biomarkers & Prevention. It was funded by the National Heart, Lung, and Blood Institute; the National Institutes of Health; and the US Department of Health and Human Services.
Tuesday, March 8, 2016
No, your baby's fever was not caused by teething
http://www.cnn.com/2016/02/19/health/baby-teething-no-fever/index.html?eref=rss_topstories
Wednesday, March 2, 2016
Friday, February 12, 2016
BAD BREATH? 6 Causes and 7 Solutions
Bad breath happens. If you’ve ever gotten that not-so-fresh feeling on a date, at a job interview or just talking with friends, you’re not alone. Studies show that 50 percent of adults have had bad breath, or halitosis, at some point in their lives.
Bacteria
Bad breath can happen anytime thanks to the hundreds of types of bad breath-causing bacteria that naturally lives in your mouth. Your mouth also acts like a natural hothouse that allows these bacteria to grow. When you eat, bacteria feed on the food left in your mouth and leaves a foul-smelling waste product behind.
Dry Mouth
Feeling parched? Your mouth might not be making enough saliva. Saliva is important because it works around the clock to wash out your mouth. If you don’t have enough, your mouth isn’t being cleaned as much as it should be. Dry mouth can be caused by certain medications, salivary gland problems or by simply breathing through your mouth.
Gum Disease
Bad breath that just won’t go away or a constant bad taste in your mouth can be a warning sign of advanced gum disease, which is caused by a sticky, cavity-causing bacteria called plaque.
Food
Garlic, onions, coffee… The list of breath-offending foods is long, and what you eat affects the air you exhale.
Smoking and Tobacco
Smoking stains your teeth, gives you bad breath and puts you at risk for a host of health problems. Tobacco reduces your ability to taste foods and irritates gum tissues. Tobacco users are more likely to suffer from gum disease. Since smoking also affects your sense of smell, smokers may not be aware of how their breath smells.
Medical Conditions
Mouth infections can cause bad breath. However, if your dentist has ruled out other causes and you brush and floss every day, your bad breath could be the result of another problem, such as a sinus condition, gastric reflux, diabetes, liver or kidney disease. In this case, see your healthcare provider.
Brush twice a day and clean between your teeth daily with floss to get rid of all that bacteria that’s causing your bad breath.
Take Care of Your Tongue
Don’t forget about your tongue when you’re taking care of your teeth. If you stick out your tongue and look way back, you’ll see a white or brown coating. That’s where most of bad breath bacteria can be found. Use a toothbrush or a tongue scraper to clear them out.
Mouthwash
Over-the-counter mouthwashes can help kill bacteria or neutralize and temporarily mask bad breath. It’s only a temporary solution, however. The longer you wait to brush and floss away food in your mouth, the more likely your breath will offend.
Clean Your Dentures
If you wear removable dentures, take them out at night, and clean them thoroughly before using them again the next morning.
Keep That Saliva Flowing
To get more saliva moving in your mouth, try eating healthy foods that require a lot of chewing, like carrots or apples. You can also try chewing sugar-free gum or sucking on sugar-free candies. Your dentist may also recommend artificial saliva.
Quit Smoking
Giving up this dangerous habit is good for your body in many ways. Not only will you have better breath, you’ll have a better quality of life.
Visit Your Dentist Regularly
If you’re concerned about what’s causing your bad breath, make an appointment to see your dentist. Regular checkups allow your dentist to detect any problems such as gum disease or dry mouth and stop them before they become more serious. If your dentist determines your mouth is healthy, you may be referred to your primary care doctor. Need a dentist? Find an ADA member near you.
What Causes Bad Breath?
There are a number of reasons you might have dragon breath. While many causes are harmless, bad breath can sometimes be a sign of something more serious.Bacteria
Bad breath can happen anytime thanks to the hundreds of types of bad breath-causing bacteria that naturally lives in your mouth. Your mouth also acts like a natural hothouse that allows these bacteria to grow. When you eat, bacteria feed on the food left in your mouth and leaves a foul-smelling waste product behind.
Dry Mouth
Feeling parched? Your mouth might not be making enough saliva. Saliva is important because it works around the clock to wash out your mouth. If you don’t have enough, your mouth isn’t being cleaned as much as it should be. Dry mouth can be caused by certain medications, salivary gland problems or by simply breathing through your mouth.
Gum Disease
Bad breath that just won’t go away or a constant bad taste in your mouth can be a warning sign of advanced gum disease, which is caused by a sticky, cavity-causing bacteria called plaque.
Food
Garlic, onions, coffee… The list of breath-offending foods is long, and what you eat affects the air you exhale.
Smoking and Tobacco
Smoking stains your teeth, gives you bad breath and puts you at risk for a host of health problems. Tobacco reduces your ability to taste foods and irritates gum tissues. Tobacco users are more likely to suffer from gum disease. Since smoking also affects your sense of smell, smokers may not be aware of how their breath smells.
Medical Conditions
Mouth infections can cause bad breath. However, if your dentist has ruled out other causes and you brush and floss every day, your bad breath could be the result of another problem, such as a sinus condition, gastric reflux, diabetes, liver or kidney disease. In this case, see your healthcare provider.
How Can I Keep Bad Breath Away?
Brush and FlossBrush twice a day and clean between your teeth daily with floss to get rid of all that bacteria that’s causing your bad breath.
Take Care of Your Tongue
Don’t forget about your tongue when you’re taking care of your teeth. If you stick out your tongue and look way back, you’ll see a white or brown coating. That’s where most of bad breath bacteria can be found. Use a toothbrush or a tongue scraper to clear them out.
Mouthwash
Over-the-counter mouthwashes can help kill bacteria or neutralize and temporarily mask bad breath. It’s only a temporary solution, however. The longer you wait to brush and floss away food in your mouth, the more likely your breath will offend.
Clean Your Dentures
If you wear removable dentures, take them out at night, and clean them thoroughly before using them again the next morning.
Keep That Saliva Flowing
To get more saliva moving in your mouth, try eating healthy foods that require a lot of chewing, like carrots or apples. You can also try chewing sugar-free gum or sucking on sugar-free candies. Your dentist may also recommend artificial saliva.
Quit Smoking
Giving up this dangerous habit is good for your body in many ways. Not only will you have better breath, you’ll have a better quality of life.
Visit Your Dentist Regularly
If you’re concerned about what’s causing your bad breath, make an appointment to see your dentist. Regular checkups allow your dentist to detect any problems such as gum disease or dry mouth and stop them before they become more serious. If your dentist determines your mouth is healthy, you may be referred to your primary care doctor. Need a dentist? Find an ADA member near you.
Friday, February 5, 2016
Wednesday, January 6, 2016
Breast Cancer Linked to Periodontal Disease
Normal (left) versus cancerous (right) mammography image.Wednesday, December 23, 2015
Monday, November 2, 2015
Decade of Research Supports Salivary Oral Cancer Test
More than 47,000 Americans will be diagnosed with oral or pharyngeal cancer this year, according to the National Cancer Institute. When caught early, survival rates can reach 80% to 90%. But oral cancer often isn’t diagnosed until it is too late, leading to more than 8,650 deaths annually. Researchers at PeriRx, LLC believe their SaliMark OSCC salivary test, which is now on the market, can dramatically improve those numbers and save thousands of lives.
“This is a molecular genetic test,” said Stephen M. Swanick, CEO and founder of PeriRx. “No matter what’s going on in that oral cavity, we will find that cancer if there is something there.”
PeriRx designed the test to be accurate, easy to use, and noninvasive. It begins in the dentist’s office with a thorough visual exam. If a clinician sees a lesion or some other abnormality, the patient may be referred to a specialist who then could order a biopsy to determine the presence of cancer. However, this decision for referral often is known to be difficult based on clinical assessment alone. Often, this surgery is painful and unnecessary.
“Many of these people are getting pieces of their tongue cut out. There are pieces of their lip cut out. Pieces of their face cut out. And 95% of them are benign,” said Swanick. “This test provides a benchmark, and it’s a lot less expensive than a biopsy.”
With SaliMark OSCC, if there is an abnormality or a history of smoking or other high-risk behaviors, the patient spits 2 cc of saliva. Dentists and hygienists alike can administer it. The clinician then uses the test kit’s bio bag, collection tube, and pre-paid Federal Express envelope to send the sample to the PeriRx lab. Results indicating low, medium, or high risk of cancer are available in 3 business days or fewer.
“If it’s low risk, the chances of cancer are very small. Dentists could follow that patient to make sure things are going in the right direction and the problem is resolving,” said Dr. Jack Martin, MD, chief medical officer at PeriRx. “The moderate and high risk is the same answer for the dentist. We suggest you get a cancer specialist to see these patients.”
These specialists would have the benefit of their own expertise and the quantitative results of the SaliMark OSCC test before deciding whether or not the patient would need a biopsy. The company believes the test gives specialists options in deciding how best to pursue treatment. Insurance companies also favor the 3-tiered results and their potential for eliminating unnecessary procedures.
“The insurance companies that we’ve talked to—Delta Dental, Aetna, United Healthcare—they don’t want a yes or no binary answer,” said Swanick. “It’s too simplistic, and there are too many variances of stages of cancer. We consulted the companies on that exact algorithm.”
PeriRx’s work with major insurance carriers was only one part of the SaliMark OSCC test’s development. The product on the shelves now is the result of more than a decade of work supported by the National Institute of Dental and Craniofacial Research and the National Institute of Health, with initial discovery and pre-validation work conducted by Dr. David T.W. Wong of the University of California at Los Angeles (UCLA). Unlike other salivary tests that look for a single biomarker to identify cancer potential, SaliMark OSCC identifies multiple biomarkers.
“Dr. Wong decided many years ago that a single biomarker is not powerful enough to get the kind of clinical information you need. You really require a combination of several biomarkers to get the kind of clinical performance to help do the best job in discriminating between people with and without the cancer you are looking for,” said Martin.
The National Cancer Institute (NCI) independently found that 3 protein and 7 message RNA markers were feasible in determining oral squamous cell carcinomas from healthy controls. PeriRx refined the panel to 3 RNAs, including 2 “housekeeping” genes that validate the quality of the sample. It uses the messenger RNAs because they are more robust and easier to stabilize and transport from a dentist’s office to a laboratory than the proteins.
“It’s not every single marker you could find. There could be thousands of markers that are abnormal in a disease. But it’s not useful to measure all of them. We measure the top several markers and add them together to improve the performance of the test compared to a single marker alone,” said Martin.
“Biomarkers have to stand up against the test of time of multiple clinical trials, when you have more and more patients. Single markers may lose their power. They lose their discriminatory nature,” said Swanick. “What we’re doing is a multimarker approach that gives us unbelievable discriminatory robustness and consistency.”
Prior to the recent PeriRx trial, this technology had already been tested in several different ethnic cohorts with researchers at UCLA, and independently validated in collaboration with the NCI, unlike competing technologies, according to the company. The NCI noted the need to validate its independent findings in a prospective blinded study in the intended use population.
PeriRx validated its biomarkers in this rigorous study recommended by the NCI with very highly statistically significant results. Other tests have not been studied according to the NCI’s rigorous recommendations, Martin said. Studies performed in a simple case control design introduce bias since the controls often can be healthier than the cancer patients, and markers could be present for reasons other than cancer, such as smoking habits, ethnic group, age, and gender.
And, PeriRx conducted studies with patients with suspicious oral lesions as the intended use population as recommended by the NCI since it designed SaliMark OSCC to further quantify the risk in patients identified by caregivers as being at some risk for oral cancer, not as a general screening tool for all patients.
“Some of the other tests are planning to advocate their use as general screening tools,” said Martin. “This is fraught with concerns for raising the suspicion of cancer in millions of people who are healthy.”
According to published data, SaliMark OSCC may reveal if patients have pre-cancer dysplasia in the absence of other abnormalities. PeriRx says it has completed a prospective study, commercial assay, and regulatory processes, enabling it to finally launch SaliMark OSCC last month. And in addition to its use in finding cancer early, there is interest among patients and providers for use as a surveillance tool for survivors.
“I’ve had mothers call me about their children and they say their children are dying, because cancer came back. And they can’t take any more radiation because the radiation is killing them,” said Swanick. “And they’re begging me, ‘Can we take your test? We’ve got to find out if the cancer is coming back.’”
PeriRx notes that patients with oral cancer face significant risks of relapses as well as the highest risk of developing new primary cancers elsewhere in the body of any cancer patients. So by identifying an oral cancer patient early, Swanick explains, you’re saving that patient from possibly 2 cancers.
“The oral-systemic connection is alive, and it’s real,” he says.
With so much at stake, PeriRx believes every dentist should be using SaliMark OSCC. The industry seems to agree, with Benco Dental, Henry Schein Dental, Patterson Dental, and Darby Dental all offering it. In fact, Swanick says that he can’t think of any other products carried by all of the major distributors.
“They all agreed. They all came together and said, ‘This is cancer.’ This is unanimous. This is not prejudicial. Everybody should be ordering this test,” he said.
Insurance companies are on board too. According to Swanick, major insurers told PeriRx that as long as the test costs less than $200, they would give it a CDT code. Dentists can bill patients for the cost of the exam and for the time that is involved. Patients then can submit that bill to their insurance carrier.
Once the benefits of the test are more fully realized, Swanick expects payers to reimburse at higher and higher levels. Indeed, insurance companies have cited the solid science behind the test and plan on adding it to patients’ policies as part of their annual physicals, he said.
“We were told many times by a lot of people, a lot of big pharma companies, that we should be charging a thousand dollars, 2 thousand dollars,” Swanick said. “And we say that’s great. But what that means is that 95% of the people who we want to have this test won’t use it.”
Looking ahead, PeriRx is applying the technology to detecting other diseases. The company is halfway done with a trial using salivary markers that are very discriminatory to detect small-cell lung cancer. Tests involving diabetes and Sjögren’s syndrome are underway as well.
“Sjögren’s disease is something of great interest to dentists. People get dry eyes and dry mouth, and associated with the dry mouth are increases of periodontal disease and cavities. The problem is millions of people go into their dentist and say they have a dry mouth because it’s very commonly associated with many drugs that people take. It’s a common side effect,” Martin said. “Better diagnostic tests are necessary.”
Meanwhile, PeriRx is launching SaliMark OSCC with more than 2,500 sales personnel. Oral cancer is the most costly cancer of all by a factor of 2 because of its typically late diagnosis. The test and the early diagnosis it supports, then, could save insurance companies millions of dollars, Martin says. Oral cancer also impacts productivity and income as patients who are diagnosed rarely go back to work. But most importantly, PeriRx says, the test will save lives.
“Oral cancer is the most aggressive cancer out there. It’s a vicious killer, and it is almost always diagnosed in stage IV, so this test is a lifesaver,” said Swanick. “We are going after this cancer, full-bore.”
Dentistry Today ~ Stephen M. Swanick (left), CEO and founder of PeriRx, LLC, and Dr. Jack Martin, MD, chief medical officer at PeriRx
“This is a molecular genetic test,” said Stephen M. Swanick, CEO and founder of PeriRx. “No matter what’s going on in that oral cavity, we will find that cancer if there is something there.”
PeriRx designed the test to be accurate, easy to use, and noninvasive. It begins in the dentist’s office with a thorough visual exam. If a clinician sees a lesion or some other abnormality, the patient may be referred to a specialist who then could order a biopsy to determine the presence of cancer. However, this decision for referral often is known to be difficult based on clinical assessment alone. Often, this surgery is painful and unnecessary.
“Many of these people are getting pieces of their tongue cut out. There are pieces of their lip cut out. Pieces of their face cut out. And 95% of them are benign,” said Swanick. “This test provides a benchmark, and it’s a lot less expensive than a biopsy.”
With SaliMark OSCC, if there is an abnormality or a history of smoking or other high-risk behaviors, the patient spits 2 cc of saliva. Dentists and hygienists alike can administer it. The clinician then uses the test kit’s bio bag, collection tube, and pre-paid Federal Express envelope to send the sample to the PeriRx lab. Results indicating low, medium, or high risk of cancer are available in 3 business days or fewer.
“If it’s low risk, the chances of cancer are very small. Dentists could follow that patient to make sure things are going in the right direction and the problem is resolving,” said Dr. Jack Martin, MD, chief medical officer at PeriRx. “The moderate and high risk is the same answer for the dentist. We suggest you get a cancer specialist to see these patients.”
These specialists would have the benefit of their own expertise and the quantitative results of the SaliMark OSCC test before deciding whether or not the patient would need a biopsy. The company believes the test gives specialists options in deciding how best to pursue treatment. Insurance companies also favor the 3-tiered results and their potential for eliminating unnecessary procedures.
“The insurance companies that we’ve talked to—Delta Dental, Aetna, United Healthcare—they don’t want a yes or no binary answer,” said Swanick. “It’s too simplistic, and there are too many variances of stages of cancer. We consulted the companies on that exact algorithm.”
PeriRx’s work with major insurance carriers was only one part of the SaliMark OSCC test’s development. The product on the shelves now is the result of more than a decade of work supported by the National Institute of Dental and Craniofacial Research and the National Institute of Health, with initial discovery and pre-validation work conducted by Dr. David T.W. Wong of the University of California at Los Angeles (UCLA). Unlike other salivary tests that look for a single biomarker to identify cancer potential, SaliMark OSCC identifies multiple biomarkers.
“Dr. Wong decided many years ago that a single biomarker is not powerful enough to get the kind of clinical information you need. You really require a combination of several biomarkers to get the kind of clinical performance to help do the best job in discriminating between people with and without the cancer you are looking for,” said Martin.
The National Cancer Institute (NCI) independently found that 3 protein and 7 message RNA markers were feasible in determining oral squamous cell carcinomas from healthy controls. PeriRx refined the panel to 3 RNAs, including 2 “housekeeping” genes that validate the quality of the sample. It uses the messenger RNAs because they are more robust and easier to stabilize and transport from a dentist’s office to a laboratory than the proteins.
“It’s not every single marker you could find. There could be thousands of markers that are abnormal in a disease. But it’s not useful to measure all of them. We measure the top several markers and add them together to improve the performance of the test compared to a single marker alone,” said Martin.
“Biomarkers have to stand up against the test of time of multiple clinical trials, when you have more and more patients. Single markers may lose their power. They lose their discriminatory nature,” said Swanick. “What we’re doing is a multimarker approach that gives us unbelievable discriminatory robustness and consistency.”
Prior to the recent PeriRx trial, this technology had already been tested in several different ethnic cohorts with researchers at UCLA, and independently validated in collaboration with the NCI, unlike competing technologies, according to the company. The NCI noted the need to validate its independent findings in a prospective blinded study in the intended use population.
PeriRx validated its biomarkers in this rigorous study recommended by the NCI with very highly statistically significant results. Other tests have not been studied according to the NCI’s rigorous recommendations, Martin said. Studies performed in a simple case control design introduce bias since the controls often can be healthier than the cancer patients, and markers could be present for reasons other than cancer, such as smoking habits, ethnic group, age, and gender.
And, PeriRx conducted studies with patients with suspicious oral lesions as the intended use population as recommended by the NCI since it designed SaliMark OSCC to further quantify the risk in patients identified by caregivers as being at some risk for oral cancer, not as a general screening tool for all patients.
“Some of the other tests are planning to advocate their use as general screening tools,” said Martin. “This is fraught with concerns for raising the suspicion of cancer in millions of people who are healthy.”
According to published data, SaliMark OSCC may reveal if patients have pre-cancer dysplasia in the absence of other abnormalities. PeriRx says it has completed a prospective study, commercial assay, and regulatory processes, enabling it to finally launch SaliMark OSCC last month. And in addition to its use in finding cancer early, there is interest among patients and providers for use as a surveillance tool for survivors.
“I’ve had mothers call me about their children and they say their children are dying, because cancer came back. And they can’t take any more radiation because the radiation is killing them,” said Swanick. “And they’re begging me, ‘Can we take your test? We’ve got to find out if the cancer is coming back.’”
PeriRx notes that patients with oral cancer face significant risks of relapses as well as the highest risk of developing new primary cancers elsewhere in the body of any cancer patients. So by identifying an oral cancer patient early, Swanick explains, you’re saving that patient from possibly 2 cancers.
“The oral-systemic connection is alive, and it’s real,” he says.
With so much at stake, PeriRx believes every dentist should be using SaliMark OSCC. The industry seems to agree, with Benco Dental, Henry Schein Dental, Patterson Dental, and Darby Dental all offering it. In fact, Swanick says that he can’t think of any other products carried by all of the major distributors.
“They all agreed. They all came together and said, ‘This is cancer.’ This is unanimous. This is not prejudicial. Everybody should be ordering this test,” he said.
Insurance companies are on board too. According to Swanick, major insurers told PeriRx that as long as the test costs less than $200, they would give it a CDT code. Dentists can bill patients for the cost of the exam and for the time that is involved. Patients then can submit that bill to their insurance carrier.
Once the benefits of the test are more fully realized, Swanick expects payers to reimburse at higher and higher levels. Indeed, insurance companies have cited the solid science behind the test and plan on adding it to patients’ policies as part of their annual physicals, he said.
“We were told many times by a lot of people, a lot of big pharma companies, that we should be charging a thousand dollars, 2 thousand dollars,” Swanick said. “And we say that’s great. But what that means is that 95% of the people who we want to have this test won’t use it.”
Looking ahead, PeriRx is applying the technology to detecting other diseases. The company is halfway done with a trial using salivary markers that are very discriminatory to detect small-cell lung cancer. Tests involving diabetes and Sjögren’s syndrome are underway as well.
“Sjögren’s disease is something of great interest to dentists. People get dry eyes and dry mouth, and associated with the dry mouth are increases of periodontal disease and cavities. The problem is millions of people go into their dentist and say they have a dry mouth because it’s very commonly associated with many drugs that people take. It’s a common side effect,” Martin said. “Better diagnostic tests are necessary.”
Meanwhile, PeriRx is launching SaliMark OSCC with more than 2,500 sales personnel. Oral cancer is the most costly cancer of all by a factor of 2 because of its typically late diagnosis. The test and the early diagnosis it supports, then, could save insurance companies millions of dollars, Martin says. Oral cancer also impacts productivity and income as patients who are diagnosed rarely go back to work. But most importantly, PeriRx says, the test will save lives.
“Oral cancer is the most aggressive cancer out there. It’s a vicious killer, and it is almost always diagnosed in stage IV, so this test is a lifesaver,” said Swanick. “We are going after this cancer, full-bore.”
Dentistry Today ~ Stephen M. Swanick (left), CEO and founder of PeriRx, LLC, and Dr. Jack Martin, MD, chief medical officer at PeriRx
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