Archives for May 2018

In the midst of all the things you need to think about, worrying about seeing your dentist may not be very high on the list. But your dental health has a big impact on your overall health which in turn has a major influence on the health of your baby, so it’s important that you maintain a good dental health routine throughout your pregnancy, and beyond.

You should also disregard old wives tales about calcium leaching from your teeth to the baby, the loss of a tooth for every baby you have, and fluorides treatments being bad for your baby. None of these are true and your dentist should be an active part of your healthcare team in the lead-up, during and after your pregnancy.

Make seeing your dentist a priority

Hormonal fluctuations during pregnancy can exacerbate problems with your teeth and gums, and so you should maintain regular check-ups and cleanings. Your dentist is well-versed in which medications you can safely take while pregnant, and which procedures can be safely done at different stages of pregnancy.

Dealing with food cravings and morning sickness

Unusual food cravings are a fact of life for many women during pregnancy. For instance, you might routinely wake up at midnight desperate for chocolate-covered pickles in ice cream, with a side order of chips and jalapeno peppers. If your cravings take a turn towards the sweet end of things, try to limit the sugary snacks and instead, choose healthier options such as fresh fruit with natural or Greek yoghurt.

If you suffer from morning sickness, you need to know that vomit is highly acidic and can cause irreversible damage to your teeth. Tempting though it is to brush your teeth straight after a bout of morning sickness, it’s best to wait an hour or so as brushing too soon can strip away the enamel, which is the softened protective coating of your teeth, leaving them more vulnerable to decay and sensitivity. While you’re waiting, try rinsing your mouth with water to remove the acids, chew sugar-free gum or try eating an acid-neutralising food such as milk or hard cheese.

Brushing and flossing

Maintaining your usual oral health routine is even more important when you’re pregnant since hormonal changes mean that you have an increased susceptibility to gum inflammations and infections. Some women develop “pregnancy gingivitis”, where gums swell and become more sensitive and bleed during brushing and flossing. Should this happen to you, your dentist is able to keep a close eye on your gums and help you manage the condition. Generally this condition will resolve itself after you have your baby.

Source: Australian Dental Association Website, Your Dental Health.

“Children’s teeth and jaws change each year just as much as their feet grow so it’s important that they see a dentist to have their mouthguard checked. An ill-fitting mouthguard could actually do more harm than good” stated Professor David Manton, Chair of the ADA’s Oral Health Committee.

The ADA recommends wearing a custom-made mouthguard that is properly fitted by a dentist, to ensure maximum protection against dental and facial injuries. The ADA does not recommend over-the-counter or ‘boil and bite’ mouthguards as they offer little or no protection to your teeth and mouth.

Sports Medicine Australia also recommend the use of custom fitted mouthguards, and have worked with the ADA to develop a “No Mouthguard, No Play” policy which sporting clubs and schools can adopt.

“The basic requirement of any mouthguard is for it to remain in place at the time of impact so fit, retention and resilience are crucial to protection being achieved” added Professor Manton. “Some parents may believe that it is too costly to get a professionally made mouthguard, but this is a false economy. The cost of repairing missing or broken teeth can be a lot more expensive”.

“Every year people are treated for dental injuries that could have been avoided by wearing a professionally made mouthguard,” added Professor Manton. “Wearing a custom-fitted mouthguard helps to absorb and spread the impact of a blow to the face, which may otherwise result in injury to the mouth or jaws”.

Visit the ADA’s website https://www.ada.org.au/Your-Dental-Health/Teens-12-17/Mouthguards to access information on why protecting your mouth with a custom-fitted mouthguard is so important, as well as first aid advice for treating an injury to a tooth.

Source: Australian Dental Association News

ADA and the Australian Health Policy Collaboration (AHPC) have released a report showing three in four children consume too much sugar while one in three five- to six-year-olds had decay in their baby teeth.

Dr Sachs said the latter figure was an unacceptably high rate that put “children at risk of poor oral health in their development and adult years”.

The report – Australia’s Oral Health Tracker – showed one third of the 67,000 people hospitalised for oral health problems were children under nine years old.

“Poor oral health in childhood is a predictor of disease in adulthood,” Dr Sachs said.

“Australia needs to recognise that oral health care is part of good health care, and that access to dental care is a significant contributor to good oral and physical health.”

Gum disease and tooth decay are two diseases tied to poor oral health.

TLC Dental Winthrop’s Ian McCarrey said parents had an important role to play.

“Children lack the dexterity and often the enthusiasm and patience to tooth brush effectively under the age of ten,” he said.

“Ideally parents should brush for them when they are young or supervise them when they are older once a day to ensure that it is being done properly.”

He said the elderly could use similar assistance.

Dr McCarrey said good dental hygiene was a combination of measures including brushing, flossing, avoiding sugary drinks, as well as regular visits to the dentist for an examination and clean.

March 26th, 2018, 04:30PM, Written by Bryce Luff,  Melville Times

Powerful campaigning has pressured politicians and regulators to change the legislation and make cannabis more accessible for medical research. On 31 August 2016, the TGA announced their final decision to down-schedule cannabis and tetrahydrocannabinols (THC) to Schedule 8 from 1 November 2016, which will allow medial research and therapeutic use to go ahead unfettered by legal restrictions.

CANNABIS vs MARIJUANA
Cannabis is a genus of flowering plants that includes a number of species, most frequently Cannabis sativa and Cannabis indica. There is no plant named ‘marijuana’ so, from a botanical point of view, ‘cannabis’ is the correct term of use. ‘Marijuana’ is used to describe the dried flowers and leaves of the cannabis plant. Hemp is that name given to the male cannabis plant that produces low levels of THC is used for production of fibre and oil.

Cannabis has an extensive history as a medicinal agent across many cultures and civilisations. Early Chinese accounts dating back to the Emperor Shen-Nung (c2700BC) cite cannabis as an important herbal remedy. Sir Joseph Banks, the botanist on Captain Cook’s 1770 voyage to Australia, is credited with bringing the first recorded cannabis seeds to Australia.

SO WHAT IS MEDICINAL CANNABIS?
There is no agreed definition of ‘medicinal cannabis’ nor a specific product. The term actually relates to a range of cannabis derivatives which fall into three categories:

• Crude plant products (e.g. marijuana, hashish and cannabis oil)
• Natural cannabinoids (e.g. THC and cannabidiol) and
• Synthetic cannabinoids (e.g. dronabinol or nabilone).

Due to the historical prohibition of cannabis, research into cannabinoid pharmacology has only occurred fairly recently. The first human cannabinoid receptor, CB1, was only discovered in 1988 and the endogenous agonist for CB1 and CB2 receptors called anandamide, an omega-6 fatty acid neurotransmitter, was discovered in 1922. The name anandamide is taken from the Sanskrit word Ananda, which means “joy, bliss, delight.”

The fact that we have endogenous cannabinoids and several cannabinoid receptors throughout our central nervous system suggests cannabinoids play an important role in human physiology, otherwise they would have evolved away centuries ago.

WHAT EVIDENCE SUPPORTS THERAPEUTICS BENEFIT?
Overall, regulatory authorities have taken the view that cannabis is not a panacea but definitely carries therapeutic potential. Research evidence supporting medicinal cannabis is so far thin on the ground but many clinical trials are underway.

The therapeutic uses fall into five main areas: muscle spasticity in multiple sclerosis, chemotherapy-induced nausea and vomiting, loss of appetite in palliative care, chronic pain and epilepsy. THC is largely responsible for the psychiatric effects of cannabis, both good and bad, but it is also claimed to provide the analgesic relief and muscle relaxing properties of cannabis. Cannabadiol is thought to convey the anticonvulsant effects, and has shown impressive results in some rare forms of intractable epilepsy. It is given as a 98 per cent CBD product in oil called ‘Epidiolex’ that a child takes orally. Another anticonvulsant cannabis derivative called cannabidivarin is currently the subject of clinical trials in New South Wales.

Nabiximols is a whole-plant botanical extract of cannabis, administered as a mouth spray, containing THC and CBD in approximately equal proportions. The trade name for nabiximols is ‘Sativex’ and has been registered for use in Australia for several years. Nabilone and dronabinol are synthetic cannabinoids that have been marketed since the 1990’s in Australia and overseas as oral tablets but have never been clinically successful.

You may have noticed by now that there has been no mention of smoke-able cannabis for medicinal use. Due to the well-known adverse effects of smoking, only non-smokeable cannabis products will be supported by the TGA for medicinal purposes. What form these take may range from tablets, oils, edibles and maybe vaporisable products.

SO HOW WILL PRESCRIBING AND DISPENSING WORK?
This is the hard part. Currently, there is no infrastructure to support prescribing or dispensing of cannabis outside of clinical trials and the TGA’s Special Access Scheme. No one even knows what a cannabis prescription would look like! However, in the future regulatory authorities have made it clear they will only allow authorised medical specialists to initiate medicinal cannabis treatment and specially trained and authorised general practitioners to continue prescribing it. Only authorised pharmacists will be permitted to dispense it, although it is not known yet how the cannabis will be accessed, but it looks like only Australian-grown cannabis products will be permitted. Many details around manufacture, shelf-life, and storage, record-keeping and reporting are yet to be ironed out.

INDICATIONS POTENTIALLY OF MOST INTEREST

• Multiple sclerosis
• Chemotherapy-induced nausea and vomiting
• Cancer pain
• Palliative care
• AIDs nausea and vomiting
• Refractory epilepsy
• Neuropathic pain
• Inflammatory bowel disease
• Psych conditions, e.g. PTSD
• Rheumatological conditions
• Glaucoma
• Tourette syndrome

Source: Australian Dental Association News Bulletin

But despite the clear oral health benefits, ‘antifluoride’ groups serving as a noisy minority have been successful in having fluoride removed from water supplies in some areas of Queensland and are also targeting Western Australia, spruiking unfounded claims that fluoride causes a range of health issues and lowers IQ. These groups have targeted local councils after the state governments handed over the responsibility to them for what is clearly a national issue, an error of judgement that the Australian Dental Association has repeatedly criticised.

The National Health and Medical Research Council (NHMRC) has now released the findings of a study conducted by  a research group engaged from the University of Sydney, which yet again reinforces the positive impacts of fluoride water supplies, and the resulting decline in decay for children’s permanent and baby teeth. Further, it comprehensively debunks the myths surrounding links between fluoride and health issues or lower IQ.

ADA President, Dr Rick Olive said, “it’s unacceptable that local councils are giving into the pressure of a small number of fanatics and are completely ignoring evidence and the recommendations from organisations like the ADA, the World Health Organisation, and the Australian Medical Association on this vitally important issue.”

The government of Western Australia, Department of Health has also released the findings of an independent study, Dental Health Outcomes of Children Residing in Fluoridated and Non Fluoridated Areas of Western Australia, which reaffirms many of the findings of the NHMRC.

The ADA recommends fluoride be added to water supplies across the nation without the exception as a critically-important step in protecting the oral health of all Australians.

Source: Australian Dental Association News Bulletin

A confusing nutrition landscape and popularisation of fad diets goes some way to explaining the under-consumption of foods from the five food groups. However, the survey also revealed that on average, 35 per cent of Australians’ total daily energy intake came from discretionary (junk) foods. This suggests that Australians are reaching for discretionary foods when they should be reaching for foods from the five food groups.

HOW HAVE AUSTRALIANS’ DIETS CHANGED?
A CSIRO study comparing Australian diets from 1995-1996 to 2011-2012, based on national nutrition survey data showed that Australians’ had improved. In 2011-2012, Australians were eating more fruit, a greater diversity of vegetables, less refined sugar, more yoghurt and there was an increased preference for brown and wholegrain cereals. However, it also showed that Australians were still not eating in a manner consistent with the ADGs. In addition, the vegetables and legumes and the dairy food groups continue to be the most under-consumed of the five food groups. The key learnings from the comparison in Australian diets from 199 to 2011 were that Australians need to reduce their consumption of energy-dense and nutrient poor discretionary foods and eat more whole fruit, vegetables, legumes and dairy foods such as milk, cheese and yoghurt.

DENTISTS PROVIDING NUTRITION ADVICE
A recent survey by Dairy Australia exploring the opinions and attitudes of 100 dentists found that 92 per cent provide nutritional advice to patients, with a round 45 per cent of consultations involving a nutrition component. The most common piece of dietary advice dentists provide to patients is to reduce consumption of sugar sweetened beverages and foods high in sugar. In addition, 1 in 5 dentists recognise the importance of recommending milk, cheese and yoghurt as part of their patient’s daily lives.

While there have been some small improvements in Australian diets over time, dentists can play a crucial role in encouraging their patients to reduce discretionary foods and eat a wider variety of foods from the five food groups. Dentists an us the Foods that Do Good Nutrition Calculator to generate tailored fact sheets for every age and gender to show their patients how many recommended serves of each of the five food groups they need for optimal health.

Source: Australian Dental Association News Bulletin

“This new definition is an important milestone for the oral health profession,” said Dr Patrick Hescot, FDI President. “True to our vision 2020 advocacy strategy and our ambition to lead the wold to optimal oral health, the new definition will allow us to develop standardised assessment and measurement tools for consistent data collection on a global level.”

The changes to the definition were discussed at length at the AWDC with significant contribution from the ADA delegation.

As defined by FD, oral health:

Is multi-faceted and includes, but is not limited to, the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and free form pain or discomfort, and disease of the craniofacial complex.

Further attributes related to the definition state that oral health:

• Is a fundamental component of health and physical and mental wellbeing, which exists along a continuum influenced by the values and attitudes of individuals and communities,
• Reflects the physiological, social and psychological attributes that are essential to the quality of life,
• Is influenced by the individual’s changing experience, perceptions, expectations and ability to adapt to circumstances.

The new oral health definition is the result of a wider consultation which included patients, oral health professionals, NDAs, the public health community, academia, government, and industry and third-party payers.

“With this new definition, we want to raise awareness of the different dimensions of oral health and emphasise that oral health does not occur in isolation, but is embedded in the wider framework of overall health” said Professor David Williams, Co-Chair of FDI’s Vison 2020 Think Tank.

“We are proposing a contemporary definition of oral health, which resonates with that used by many NDAs and the World Health Organisation” said Professor Michael Glick, Co-Chair of FDS’s Vision 2020 Think Tank. “It is therefore not a revolution, but an evolution.”

FDI plans to widely disseminate this oral health definition and advocate for its operationalisation to establish a standard measurement instrument that can be applied across countries. A measurement toolbox will be ready in 2017 to allow for assessment of individual and population needs that can inform and drive oral health policies.

Source: Australian Dental Association News Bulletin