6 DENTAL TRIBUNE Pakistan Edition January 2015 Head and neck cancer: Antacids could increase survival rate INTERNATIONAL NEWS Society’s poorest have eight fewer teeth DT International Report N DT International Report A NN ARBOR, Mich., USA: Antacids are usually prescribed to manage acid reflux, a common side effect of chemotherapy or radiation treatment in head and neck cancer patients. However, this medication might also aid in halting cancer progression, according to new research. A study conducted at the University of Michigan has found that patients who took antacids had better overall survival compared with patients who did not receive such medicine. The study included 596 patients with previously untreated head and neck squamous cell carcinoma, of whom two-thirds took antacid medication while the remainder served as controls. "Patients taking antacid medications had significantly better overall survival," the researchers said. Participants who took proton pump inhibitors had a 45 percent decreased risk of death compared with the controls, and patients who took histamine receptor-2 blockers had a 33 percent decreased risk of death. Although these findings indicate that routine use of antacid medications may have a significant therapeutic benefit in patients with head and neck cancer, the mechanisms underlying the effect are not well understood yet. Therefore, additional studies are planned to investigate whether antacids can be used to halt cancer progression and to reduce the risk of developing head and neck cancer. Proton pump inhibitors, such as Prilosec, Nexium and Prevacid, and histamine-2 blockers, such as Tagamet, Zantac or Pepcid, are regarded as relatively safe and typically have few adverse side effects. The study, titled "Proton Pump Inhibitors and Histamine 2 Blockers Are Associated with Improved Overall Survival in Patients with Head and Neck Squamous Carcinoma," was published in the December issue of the Cancer Prevention Research journal. Dentists develop saliva test for lung cancer DT International Report L OS ANGELES, USA: Dental researchers have developed a novel technology that can detect mutations characteristic of lung cancer in saliva. In a series of tests, the researchers were able to demonstrate that detecting such mutations in saliva using the new method was as effective as testing with plasma. Thus, they believe it could be a noninvasive, cost-effective and rapid alternative to conventional test approaches. The new technology, called electric field-induced release and EWCASTLE, UK: The poorest people in society have eight fewer teeth by their seventies than the richest, one of the largest studies of its type ever undertaken has found. The research, a collaboration between Newcastle University, the Newcastle upon Tyne Hospitals NHS Foundation Trust, University College London (UCL) and the National Centre for Social Research, showed that oral health is substantially worse among the poorest 20 per cent of society compared with the most wealthy. For those over 65 years old, the least well off averaged eight fewer teeth than the richest—a quarter of a full set of teeth. More than 6,000 people aged 21 and over from all income groups and regions of the UK, excluding Scotland, were involved in the study, which was funded by the Economic and Social Research Council and used data from the recent UK Adult Dental Health Survey. Those with lower income, higher deprivation and lower educational attainment, and in a lower occupational class generally had the worst clinical outcomes, including increased tooth decay, periodontal disease, and diastemas, as well as fewer teeth overall. Despite these social differences, oral health is improving and the oral health of young British adults overall is much better than it used to be. However, previously published research by the same team showed that, while the youth had much healthier mouths than did their predecessors, when asked how good or bad their own oral health was and how it affected them, the social divisions between rich and poor were evident, and even more pronounced than in older people. The poorest young people were very aware of their poor health and much more likely than the wealthiest to rate their oral health as poor or say that it affected their day-to-day life. Mix of reasons for poor oral health Prof. Jimmy Steele, CBE, Head of the School of Dental Sciences at Newcastle University and lead author, said: “It’s probably not a big surprise that poorer people have worse dental health than the richest, but the surprise is just how big the differences can be and how it affects people. Eight teeth less on average is a huge amount and will have had a big impact for these people. From our data it is hard to say which specific factors are driving each of the differences we are seeing here, but there is probably a real mix of reasons and it Continued to page 11 Saliva test in dental setting could help diagnose deadly diseases DT International Report L OS ANGELES, USA: Salivary fluid has become an emerging medium for the detection of oral and systemic diseases, as well as for health surveillance in recent years. Now, a study conducted at the University of California, Los Angeles (UCLA), has shown that a simple saliva test conducted in the dental practice could be capable of diagnosing serious illnesses such as diabetes and cancer at an early stage. The UCLA School of Dentistry has been researching biomarkers in saliva for over a decade. In the present study, the researchers analyzed 165 million genetic sequences and discovered that saliva contains various RNAs that are biomarkers for diseases and can thus be used to detect and monitor diseases. According to the researchers, the study is the most comprehensive analysis ever conducted on RNA molecules in saliva. It found that saliva contains many of the same diseaserevealing molecules that are contained in blood. Overall, they were able to identify more than 400 circular RNAs in human saliva, including 327 forms that were previously unknown. By comparing microRNA levels in saliva to those in blood and other body fluids, they also found that these levels were very similar, indicating that a saliva sample could serve as a good measure of microRNA in the body. Dr. David Wong, a senior author of the study and associate dean of research at the school, suggested that dentists might be able to take saliva samples to analyze for a variety of diseases, including Type 2 diabetes and gastric cancer, in the future. The findings could also lead to a new category of self-diagnostic devices, he said. The study will be published in the January 2015 special print issue of the ClinicalChemistry journal, titled Molecular Diagnostics: A Revolution in Progress. Cont 10 DENTAL TRIBUNE Pakistan Edition January 2015 lecture on different of stresses experienced by individuals of all ages, and their effects on dental health. He also linked the 9/11 chain of events to the stress and anxiety prevalent in our population, and how it gradually damages our oral musculature. Dr Kashif Ikram enlightened guests on the benefits of regularly using the 'Miswak', and linked deterioration of oral health with the development of various diseases. Dr Noor ul Wahab presented inspirational patient cases before and after orthognathic surgery, highlighting the role played by maxilla-facial surgeons in correcting facial aesthetics. Dr Irfan Qamaruddin comprehensively discussed orthodontic forces, encouraging all dentists to consider the three-dimensional effects of every force applied, because it has an equal and opposite reaction which may or may not be favorable, if not carefully evaluated during treatment planning. Dr Najeeb Saad spoke about the importance of case selection and the correct choice of ceramics for restoration. Dr Feroz Ali Kalhoro presented an interesting lecture on the common dilemma of broken endodontic files experience by all dentists - students or experts. Dr Nadeem Hafeez Khokhar shared his vast knowledge on the subject Continued to page 11 New study: Pure fruit juice Nature of our job could increase risk of developing does not promote caries in infant teeth mouth cancer DT International Report R UGBY, UK: Exposure to smoke, regular consumption of processed foods, time in the sun and the consumption of alcohol as part of one’s job could increase the risk of developing mouth cancer, according to the British Dental Health Foundation. A new survey conducted by the charity found that one in four people regularly ate processed foods at work, while one in five said sun exposure and second-hand smoke were regular occurrences. A further three in ten said they regularly drank alcohol as part of their job. The problem appears to be compounded by habits after work, with alcohol, smoking and sexual practices all forming part of a relaxing routine. Only one in four regularly exercised, which has been linked to lowering the risk of cancer. Tobacco use, drinking alcohol to excess, the human papillomavirus, often transmitted via oral sex, and poor diet are all risk factors for mouth cancer. Chief Executive of the British Dental Health Foundation Dr Nigel Carter, OBE, hopes for a change in attitude to help reduce growing rates. Carter said, “Working can be quite stressful at times, and it’s entirely understandable that people want to come home and relax. The problem with Continued to page 11 DT International Report B ALTIMORE, USA: It is widely believed that unrestricted consumption of acidic beverages, such as juices and soft drinks, can cause dental caries, one of the most common chronic diseases in children. However, a new study conducted by dental researchers at the University of Maryland, Baltimore, has suggested that consumption of 100 percent fruit juice is not associated with early childhood caries in preschool-age children. Using data from the 1999–2004 National Health and Nutrition Examination Survey for 2,290 children aged 2–5, the researchers found no link between intake of 100 percent fruit juice and early childhood caries. They thus recommended that limiting consumption to 4–6 oz per day among children aged 1–5 should be taught as part of general health education. "Our findings are consistent with those of other studies. Dental practitioners should educate their patients and communities about the low risk of developing caries associated with consumption of 100 percent fruit juice," the researchers concluded. The study, titled "Early Childhood Caries and Intake of 100 Percent Fruit Juice: Data from NHANES, 1999–2004," was published in the December issue of the Journal of the American Dental Association. January 2015 Pakistan Edition DENTAL TRIBUNE 11 PDA Symposium .... DTMA to host the largest Dental Show... Continued from page 10 Continued from page 2 largest dental show ever held in Pakistan. The exhibition is organized in Hall no 4 & 5 launching innovative products for the benefit of the entire dental community, the DTMA members are committed to offer huge discounts, introduce new technology and provide all solutions are made available under one roof. Talking to Dental News Mr Ghauri said that DTMA is promoting the event for the past several months and is confident that the largest dental show will attract the highest number of dental and allied professionals. Since DTMA decided the dates for the show well in time, it has provided enough time to all traders and manufacturers to plan things well in advance, hence all exhibitors will have plenty of stock to match the needs of customers visiting the expo. The highlight of the conference will be of dental adhesives, and Dr Murtuza Kazmi presented his lecture on the prosthodontic rehabilitation of edentulous patients. Sumptuous lunch was served, after which the scientific lecture session resumed. Dr Saifullah Khan gave a comprehensive guide on the correct management of oncology patients for dental rehabilitation, the use of bisphosphonates and their effect on oral tissues. Dr Abu Bakr Sheikh used excellent radiographs to explain the correct path to fail-proof root canal procedures. Dr Farhan Raza presented his lecture on the outcome of dental implant surgery and prosthetics at a university based hospital, while Dr Hina Ahmed elucidated the difference between manual and rotary instrumentation techniques in root canal preparation. Dr Faisal Qayyum's presentation on the implant-aesthetic zone was highly informative; and Dr Zahid Iqbal gave a descriptive lecture on the importance and application of endodontic MTA monoblocks. Towards the end of the lecture session, Prof Dr Saqib Rashid presented his vote of thanks and declared the ceremony officially closed. Guest speakers were awarded shields and participants received certificates with 5 credit hours each, courtesy IADSR. A pre-symposium workshop on Rotary Endodontics facilitated by Dr Saqib Rashid and Dr Arshad Hasan was held on the 29th of November, whereas a post-symposium workshop on Dental Implants facilitated by Dr Munis Mukhtar and Dr Irfan Qureshi was held on the 1st of December offering students a chance to practically apply their knowledge and skills on the subject. Students, trainees, academic experts and private practitioners flocked to Pakistan Dental Association's Symposium, and commended the efforts of the team in organizing an outstanding event. The PDA has promised similar events on a larger scale to equip young minds with the latest in dental research and technology in the future. Dr. Sonny Prince Akpabio.... Continued from front page Sonny Akpabio graduated from University College London, University of London in 1956. He was awarded the Gibbs Traveling Scholarship, in 1964, to undertake a three-month epidemiological study in Kenya, Tanzania, Uganda, Nigeria and Ghana. In 1970 he gained an MDS (London) degree. In 1982 he was appointed WHO Consultant and Member of the WHO Expert Panel on Oral Health. In 1991, Sonny Akpabio, with others, formed the Commonwealth Dental Association and was elected its Founder President. In 1996 he was awarded the OBE by Her Majesty - The Queen for services to medicine and dentistry internationally. In 1999, he was awarded the Roll of Distinction of the British Dental Association for outstanding services to UK Dentistry. Also in the same year, he was appointed as Honorary Senior Research Fellow in Oral Health at the University of London. Previously, he had served as the Executive Secretary of CDA (1994-2003) following his term as Founder President (1991-1994). surprise gifts and daily lucky draws managed by DTMA's media partner Dental News. The entry to the trade stalls at the expo will be absolutely free with new facilities to learn more in less. The chairman of the organizing committee also said that buyers will be offered lunch coupons. Product presentations will be held throughout the day with certificate of attendance to all those who attend. The highlight of this year's event will be the holding of hands on workshops by DTMA members at highly subsidized rates enabling the community to learn more for less, he added. On behalf of DTMA members he extended warm welcome to the entire dental and allied industry to attend this expo and play their role in making it a success as DTMA has left no stone unturned in making this event a mega success, he concluded. Dentists develop saliva.... Continued from page 6 measurement (EFIRM), was developed at the University of California, Los Angeles. According to the researchers, it allows for rapid testing of a patient's saliva for epidermal growth factor receptor gene mutation, an indicator of lung cancer. In contrast to conventional methods of detection that are mainly based on tissue biopsy, which is invasive, expensive, and time consuming, EFIRM relies on a multiplexible electrochemical sensor that can detect these gene mutations directly in bodily fluids. The total detection time is less than 10 minutes and only requires a small saliva sample, the researchers said. In clinical application, for example, EFIRM detected epidermal growth factor receptor gene mutations in the saliva and plasma of 22 patients with non-small cell lung carcinoma. In blinded tests on saliva samples from 40 patients with non-small cell lung carcinoma, the researchers achieved nearly identical results as with bronchoscopybased detection. The findings may have important implications for further development of effective and noninvasive methods for early detection of lung cancer. Early detection significantly improves survival rates in this patient group. The new method could be combined with tissue DNA testing or used as a complement to biopsy in cases in which the size of the tumor is insufficient for DNA extraction. The study, titled "Noninvasive SalivaBased EGFR Gene Mutation Detection in Patients with Lung Cancer," was published in the November issue of the American Journal of Respiratory and Critical Care Medicine. Society’s poorest.... Inequalities in oral health require urgent action Dr John Wildman, Professor of Health Economics at Newcastle University Business School, the principal investigator on the Economic and Social Research Council study, said: “Inequalities in oral health have not received the attention that they deserve. Our study is an attempt to redress this balance. Oral health contributes hugely to everyday wellbeing and addressing these inequalities may result in considerable improvements in quality of life for large numbers of individuals.” Prof. Richard Watt, Head of the Research Department of Epidemiology and Public Health at UCL, commented on the important policy implications of this research: “Inequalities in oral health require urgent action by organisations such as Public Health England—in particular more needs to be done to tackle the underlying causes of oral diseases such as sugary diets.” Continued from page 6 is not just about, for example, the availability of treatment.” “Although the younger generation have much better oral health than their parents ever did, the differences between rich and poor are very considerable and young people are particularly aware when they do not have a healthy mouth. The risk is that as health gets better overall the differences just get greater and poorer people lose out.” Dr Georgios Tsakos, senior lecturer at the Research Department of Epidemiology and Public Health at UCL, added: “In terms of the younger adults, we showed that it is not only being poor that affects their perceptions about their oral health and quality of life, but educational attainment can also make a major difference. This has profound implications for policy, as intervening in earlier life could have a significant long-term effect on oral health.” Nature of our job could increase risk.... Continued from page 10 this is that many of the ways to relax actually increase the chances of developing mouth cancer. “The problem is made worse by people not taking regular exercise and foregoing a healthy, balanced lifestyle. The idea of a takeaway after a long day at work may sound great, but fast food is one that can cause all sorts of problems, including mouth cancer.”