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The New York Times and the Registered Dental Hygienist have reported new evidence supporting the effectiveness of fluoride varnish in preventing early childhood caries, based on the findings of a study published in the Journal of Dental Research¹.

The two-year study from the University of California-San Francisco (UCSF) was a randomized controlled trial that evaluated caries incidence in 376 caries-free children from low-income, primarily Hispanic or Chinese families in the San Francisco area. The children ranged in age from 6 months to 3½ years, and all were required to have at least four erupted maxillary incisors. Each child participating in the study received oral health counseling from their parents or caregivers, and 202 children remained in the study for the duration. The study found that children receiving no fluoride varnish were more than twice as likely to have dental caries as those who had annual varnish treatments, and nearly four times as likely to have cavities than children who received fluoride varnish at six-month intervals.

Fluoride varnish is a topical agent containing a high concentration of fluoride (5 percent sodium fluoride (NaF) or 22,600 ppm of fluoride) in a resin or synthetic base. Professionally applied fluoride varnishes were first developed in the 1960s, and have been in use for over 30 years.

Source: ADA.org

¹Fluoride Varnish Efficacy in Preventing Early Childhood Caries. Journal of Dental Research 85(2):172-176, 2006.

Fluoride varnishes, comonly known as Duraflor, may be useful in very young children as cavity preventative agents. Varnish is painted directly onto teeth without the need of a dry field, unlike pit & fissure sealant which requires thorough drying through the use of rubber dam, something kids may not want. Thus fluoride varnish can be a good alternative for sealant, especially for a very young child where the placement of a rubber dam in the mouth may be difficult. However, varnish only lasts hours in contrast to sealant which can last for months.

Currently FDA (Food and Drug Administration) approves the use of fluoride varnish as cavity liners and for the treatment of hypersensitive teeth, but not for caries prevention.

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This is to follow up with my previous posting regarding Tongue Piercing.

Here is a good article discussing body piercing complications: Complications of Body Piercing¹, published in American Family Physician (a journal from American Academy of Family Physicians).

Complications of Mouth Piercing

Airway compromise, altered eating habits, gingival trauma, hematoma formation, increased salivary flow, infection, injury to salivary glands, interference with radiographs, loss of taste, Ludwig’s angina, pain, permanent numbness, speech impediments, tooth fracture or chipping, uncontrolled drooling

Source: see below

¹ Complications of Body Piercing. Am Fam Physician. 2005 Nov 15;72(10):2029-34.

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Kids who drink bottled water risk tooth decay: American Dental Association

More and more Americans are guzzling bottled water every year – some 7.5 billion gallons were sucked back in 2005, according to preliminary figures from the Beverage Marketing Corp. – and that has some dentists worrying about tooth decay.

The American Dental Association says most bottled water doesn’t have enough fluoride in it to fight the bacteria-produced acids that erode teeth.

The issue is not whether bottled water is good or bad, the ADA says, but whether a child is getting adequate fluoride protection - either through drinking water or from other sources.

Source: cbc.ca

Bottled water, especially those that have no minerals, is definitively more inferior than the tap water, in terms of fluoride content.

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NEW ORLEANS — A federal jury handed Merck & Co. a major victory when it cleared the drug maker of any responsibility in the death of a 53-year-old Florida man who had a heart attack after taking its once popular painkiller Vioxx for less than a month.

This was the second court victory for Merck, and the first in a federal court. The company had argued in this case that plaintiff lawyers never proved any link between Vioxx and the heart attack Richard “Dickey” Irvin suffered in 2001. Merck’s lawyers contended Irvin’s age, gender and diet all put him at risk for heart attacks.

Source: canada.com

Well, it’s still not known definitively whether Vioxx can induce heart attack. Usually people who take Vioxx have other systemic illness and take other medications that may potentially interact with Vioxx, thereby confounding the conclusion regarding the safety of Vioxx.

This is a major problem associated with any NEW drug. There are potential risks involved when taking innovative pharmaceutical therapeutics. Phase III clinical trial is tested on healthy normal human being where a new drug may not have any major harmful side effect. When the drug is released and marketed for phase IV clinical trial, that’s where the problem starting to appear. Phase IV trial targets the public in general without selecting specific age/gender groups. When a new drug is particularly useful for geriatric patients who also take a multitude of various medications, drug-drug interaction and thus harmful side effects may take place. The more number of medications involved, the more complicated the potential drug-drug interaction, and the more difficult to delineate which drugs are the ones that cause the interaction. Thus, in order to know the exact etiology, it can takes tens of years to elucidate the underlying problem. Vioxx is a fairly new recent drug, so its pharmacokinetic profile is certainly less characterized than other older drugs, such as aspirin. Undountedly, there are always risks involved when taking a new invented drug. In order to provide a better quality of care, both doctors and particularly PATIENT THEMSELVES have to consider both risks and benefits of taking a new drug. Informed consent should be given to patients, but sometimes is still insufficient because people may not remember exactly the drug effects their doctors discussed with them during their visits. So whenever something wrong happens with the new drug, it’s not just doctor’s responsibility but also patients’.

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Pierce Your Tongue with a Toothbrush for Good Oral Hygiene?

Tongue piercing has long been a thing that dentists do not recommend patients to have.

First, if it’s a metal ring, tongue piercing frequently leads to tooth chipping due to accidental biting on the piercing. This means more fillings and restorative work (and possibly replacement of porcelain crown if procelain gets chipped off). Ultimately, this translates to more dental treatment and more expenses.

Second, the metal piercing will interfere the quality of x-ray film. When taking a panorex, patient is advised to remove necklace and earrings, because they can obscure the anatomical structures. Now, to ask the patient to remove the tongue ring may be something s/he doesn’t like. As soon as the ring is removed, the pierced hole may be closed in a few seconds, minutes, or hours, depending on individual cases. Once the hole is closed, patient will have to re-do the piercing if s/he insists having a tongue piercing still…

Third, tongue piercing is getting fancier and fancier, and the material used to make the metal ring may be questionable and possibly hazardous to health. When people get their tongue pierced, they seldom inquire into the exact constituents of the ring, and the tongue piercing service providers probably don’t have the material specification either. Well, if you don’t know what it is, then don’t put it inside your mouth—simple as that.

Now, how about a toothbrush piercing?? On the surface, one may think it’s a cool idea and toothbrush piercing will help clean the teeth. Well, on the second thought, this is probably not the case. First, the pierce is small. How effective will its cleansing ability be? Second, the pierce itself can actually become a breeding ground for bacteria and plaque build-up. So, it creates more problems at the end.

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