Dental Health in The Wall Street Journal

AN INDEPENDENT SUPPLEMENT FROM MEDIA PLANET IN THE WALL STREET JOURNAL
MARCH 2009
DENTAL HEALTH
YOUR GUIDE TO ORAL HEALTH
Foreword
O
ral
cancer
has
reached epidemic
levels with an annual growth rate of 11
percent. As is true for
most cancers, early detection improves the survival rate. But equally
important for such cancer
is that detecting smaller
tumors early frequently
results in treatment with
little physical or functional impact. Unfortunately, the treatment
of advanced oral cavity
cancers may require disfiguring surgery and aggressive
chemotherapy
combined with radiation
that may impair speaking
and swallowing.
The most common
symptoms of oral cavity
cancer include a painful,
non-healing ulcer, loose
teeth, and a firm lump in
the neck. Pre-cancerous
lesions may precede the
development of an ulcerated lesion all of which
can easily be diagnosed
by a physician or dentist carefully examining the mouth. Although
early detection is possible, many patients at
present have advantaged
stages of the disease.
They had minimal oral
cavity symptoms until
the tumor spread to the
lymph nodes in the neck.
Treatment of these cancers may involve several
physician specialties including a head and neck
BY ROBERT H. MILLER, MD, MBA
surgeon, a medical oncologist, a reconstructive
surgeon, and a radiation
therapist. In addition,
speech/language pathologists, dieticians, and
other health professionals are part of the rehabilitative team.
Smoking, including the
use of any tobacco products in the mouth, is a
well known cause of oral
cavity cancer. The carcinogens in smoke affect
the entire upper aerodigestive tract (mouth,
throat, larynx, lungs, and
esophagus) which is why
patients who develop one
aerodigestive cancer are
at increased risk of developing a second cancer
in this region. Alcohol is
also associated with oral
cavity cancer. In addition, excessive sun exposure increases the chance
of developing cancer of
the lips. Lichen planus,
an unusual condition
of unknown etiology, is
characterized by sometimes painful white, lacey lines in the mouth and
may increase the risk of
developing oral cancer.
More recently, the human
papilloma virus (HPV)
transmitted during oral
sex has been associated
with oral cavity cancer.
Certain HPV types are
associated with cervical
cancer in women, and
it appears the same virus can cause oral cavity
cancers in infected men.
Habits in other countries
have also been associated with the development
of oral cancer. Maté, a
South American beverage made from a type of
holly tree, and betel nuts,
chewed as a stimulant in
areas of Asia, are known
carcinogens.
Elimination of known
carcinogens, all involving lifestyle changes,
will reduce the chance
of developing oral cavity
cancer. Although some
have suggested certain
vitamins might be used
for prevention, the results of these studies
have not shown clear effectiveness. Clinical trials of other preventive
measures are underway.
Poor dental hygiene
is associated with a higher risk of developing oral
cavity cancer, so routine
visits to the dentist are important not only for dental
cleaning, but also for regular oral examinations during which early lesions can
be detected. Recent studies
have suggested an additional benefit of improved
oral hygiene to reduce the
risk of cardiovascular disease including stroke.
Dr. Miller is the Executive
Director of the American
Board of Otolaryngology
and Visiting Professor of
Otolaryngology at Baylor
College of Medicine.
J^[h[^Wl[X[[del[h*c_bb_edL;BiYef[ehWbYWdY[h[nWci$
>Wl[oek^WZoekhi5
6cVaVgb^c\cjbWZgd[dgVaXVcXZgk^Xi^bhYdcÉiÒii]ZjhjVaegdÒaZd[daYZgbVaZjhZghd[idWVXXdVcYVaXd]da#
I]^hYZVYanVcYY^hÒ\jg^c\Y^hZVhZ^hcdlVhhdX^ViZYl^i]i]ZhZmjVaanigVchb^iiZY]jbVceVe^aadbVk^gjh=EK#
6hVgZhjai!]ZVai]ZmeZgihgZXdbbZcYi]ViVaaVYjaih\ZiVcdgVaXVcXZgZmVbViaZVhidcXZVnZVg#
I]ZK:AhXdeZhnhiZb^hi]ZdcanYZk^XZ^cjhZidYVnXaZVgZYWni]Z;96id]ZaeYZiZXidgVaXVcXZgVcYegZ"XVcXZg
i]Vib^\]icdiWZk^h^WaZidi]ZcV`ZYZnZ#>[ndjgYZci^hiYdZhcÉid[[ZgK:AhXdeZZmVbh!\didlll#kZahXdeZ#Xdb
idÒcYdcZl]dYdZh#I]ZnÉgZ[Vhi!eV^caZhhVcYV[[dgYVWaZ#6cYndjÉaaadkZi]ZeZVXZd[b^cYi]Znegdk^YZ#
1
AN INDEPENDENT SUPPLEMENT FROM MEDIA PLANET IN THE WALL STREET JOURNAL
A lifetime of smiles: engaging children early in good oral hygiene E
CONTENT
..................................
1 . . . . . . . . . . Foreword
. . . . . . . . . . . by
. . . Dr.
. . . .Miller
......
oral
2 . . . . . . . . . . . . . . .Pediatric
. . . . . . . . . . . . . . .care
....
Oral health linked to
2 . . . . . . . . . . . . . . . . . . . overall
. . . . . . . . health
.......
Emerging dental
3 . . . . . . . . . . . . . . . . . . . . . .technology
............
3 . . . . . . . . . . . . . . . .Dental
. . . . . . . stem
. . . . . . cells
.....
Oral cancer diagnosis
3 . . . . . . . . . . . . . . . . . .and
. . . . treatments
............
products
4 . . . . . .Dental
. . . . . . . . . . . . . . . . . .showcase
..........
4 . . . . . . . . . . . . . . . . . .Ask
. . . .the
. . . .experts
........
4 . . . . . . . . . . . . . .Cosmetic
. . . . . . . . . . dentistry
..........
DENTAL HEALTH
A TITLE FROM MEDIAPLANET
Publisher:
Anthony Chiaravallo
+1 646 922 1404
[email protected]
Editor:
Marlene Piturro, PhD
Contributors:
Kirk Van Hyning
Robert Miller, MD, MBA
Designer:
Daniel McKernan
[email protected]
Print: Wall Street Journal
Mediaplanet is the leading worldwide
publisher in providing high quality and
in-depth analysis on topical industry
and market issues, in print, online and
broadcast.
For more information about supplements in the daily press, please contact
Kayvan Salmanpour
+1 646 922 1400
[email protected]
www.mediaplanet.com
BY MARLENE PITURRO
D
espite pare n t ’ s b e s t
effor ts, the i n c i den ce of too t h c av i ties is r ising. Whi l e c an d y
an d soda ar e comm o n c ul pr its, per ceived he al t hy
snacks such as fr u i t j u i c e
an d milk can also b e t he
sour ce of cavitie s . P ro tecting childr en f ro m c av ities is an import a n t g o a l
for parents. Fifty p e r c e n t
of children betw e e n t h e
ages of five and n i n e w i l l
have a cavity or f i l l i n g ,
accor din g to the U.S. De par tment of H eal t h an d
H uman Ser vices, s o re placing bad or al hy g i e n e
habits with good o n e s i s
essential to rever s i n g t h e
tr end. “C hildr en’ s f o rm ative year s ar e an i m p o rtant time to teach h e a l t h y
habits and to s e t t h e
foun dation for g o o d o ral
health,” said Dr. Kan e t a
Loft, a boar d cer t i f i e d p e diatr ic den tist and A m e ri can Academy of Pe d i at ri c
Dentistry member.
Getting kids i n v o l v e d
in or al car e and ke e p i n g
them engaged i s c hal lenging. A r ecent s urv e y
of parents with children,
ages six to 12, conducted
b y St rat e g y On e an d H arri s I n t e rac t i v e s ho w e d t hat
f i f t y p e rc e n t o f p are n t s
are unsatisfied with their
child’s oral care habits.
T he s urv e y re v e al e d ki d s
u s i n g c r e a t i v e e xc u s e s
to avoid proper oral care
ranging from “The cat hid
my toothbrush” to “My
t o o t hb rus h f l e w aw ay ”.
The most popular excuses were:
* ‘I forgot’- 73%
* ‘I’m too tired’ -46%
* ‘It takes too much time’ -22%
* ‘It’s boring’ -16%
* ‘I lost my toothbrush’ -12%
P ro p e r o ral hy g i e n e i n volves brushing, flossing
a n d a d d i t i o n a l t o o l s . D r.
Lo t t re c o m m e n d s i n t ro d u c i n g a f l u o r i d e r i n s e l i ke
LISTERINE SMART RINSE
™ t o o f f e r e x t ra p ro t e c t i o n
ag ai n c av i t i e s f o r c hi l d re n
ag e s s i x an d o l d e r. Ri n s i n g
al s o he l p s c hi l d re n w i t h
braces to clean in places
w he re b rus hi n g an d f l o s s ing don’t reach.
A special thanks to...
THE AMERICAN ACADEMY OF
COSMETIC DENTISTRY (AACD) is
the world’s largest non-profit
membership organization dedicated to advancing excellence
in cosmetic dentistry, with over
7000 members in more than 60
countries worldwide. Cosmetic
dentistry is comprehensive oral
healthcare that combines art and
science to optimally improve
dental health, esthetics, and function. To learn more about cosmetic dentistry, call 800.543.9220 or
visit our website.
ZILA, INC. is a fully integrated
oral diagnostic company dedicated to the prevention, detection
and treatment of oral cancer and
periodontal disease. Zila designs,
manufactures and markets ViziLite® Plus with TBlue®, the Rotadent® Professional Rotary Toothbrush, the Pro-Select Platinum®
Ultrasonic Scaler and a portfolio
of oral pharmaceutical products.
THE ORAL CANCER FOUNDATION
is a national public service, nonprofit entity designed to reduce
suffering and save lives through
prevention, education, research,
advocacy, and support activities.
At the forefront of our agenda
is the firm establishment in the
minds of the American public for
the need to undergo an annual
oral cancer screening, combined
with an outreach to the dental and
medical communities to provide
this service as a matter of routine
practice. 949-646-8000
JOHNSON & JOHNSON Healthcare
Products Division of McNEIL-PPC,
Inc. is a leader in the consumer oral
health and whitening market with
LISTERINE® Antiseptic Mouthwash,
LISTERINE® TOTAL CARE Anticavity
Mouthwash, LISTERINEÒ WHITENINGÒ VIBRANT WHITE™ Pre-Brush
Rinse, LISTERINE WHITENING Pen,
LISTERINE® WHITENING® Quick Dissolving Strips, LISTERINE® WHITENING® Pre-Brush Rinse, LISTERINE®
SMART RINSE™, LISTERINE® AGENT
COOL BLUE®, REACH® toothbrushes,
REACH® floss, and REMBRANDT®
tooth whitening products.
LED MEDICAL DIAGNOSTICS, INC.
is a Vancouver-based company
which has developed the VELscope System in partnership
with the British Columbia Cancer
Agency (BCCA). The technology
has received over 50 million dollars in NIH and other government
grants, as well as public and private equity financing to assist in
its development. It is a technology platform based on the direct
visualization of human tissue
fluorescence and the changes in
fluorescence that occur when abnormal tissue is present.
www.aacd.com
www.zila.com
oralcancerfoundation.org
www.jnj.com
www.velscope.com
Further connections found linking oral health to overall health
BY MARLENE PITURRO
O
pening your mouth and
saying “aaah” may lead
to more than a dental cleaning, tooth filling or
whiter smile. Alert dentists
detect many links between
your oral health and general
health because the mouth is
one of the first places disease
manifests. Conversely, mouth
infections such as periodontitis can cause problems
throughout the body, so controlling them is critical.
Scientifically establishing
links between oral health and
serious medical conditions is
difficult but necessary. Such
links would incentivize insurers to add dental benefits
because proper dental care
would bring cost savings for
other health problems. But
proving such connections involves sorting out complex
issues. For example, research
shows that patients with
periodontal disease are at increased risk for heart attack,
stroke, diabetes, premature
birth, HIV/AIDs and other
conditions. However, lifestyle
factors such as smoking, alcohol consumption, poor
eating habits, obesity, lack of
exercise and socioeconomic
status are linked to both oral
and systemic diseases.
Research from the Mayo
Clinic, World Health Organization, and the National
Institute of Dental and Craniofacial Research, has documented links between oral
health and the following
conditions:
CARDIOVASCULAR DISEASE including arterial plaque and
stroke-this top killer of both men
and women globally has a complicated relationship with oral
health. Some studies report a
moderate link between periodontal disease while others don’t,
and some researchers identify
the two as having common causal factors such as smoking and
obesity. Most evidence points to
a 1.5-2 fold greater risk of a fatal heart attack for patients with
periodontal disease
PREMATURE BIRTH AND LOW
BIRTH WEIGHT are strongly linked
to periodontal disease. Pregnant
women with this disease are three
to eight times as likely to have low
birth weight babies and other perinatal complications than those with
healthy mouths. Additionally, the
metabolic and hormonal changes associated with pregnancy can be mitigated with proper oral hygiene.
DIABETES has a two-way relationship with oral health since it increases the risk of gum disease, cavities, tooth loss, and oral infections.
Periodontal disease is often called
the sixth complication of diabetes
because of its high prevalence and
its tendency to make glycemic control more difficult
RESPIRATORY DISEASE - dental
plaque acts as a reservoir of potential respiratory problems in highrisk patients such as diabetics, alcoholics and hospital patients with
compromised immune systems
and swallowing reflexes. Better
oral hygiene has been shown to
improve respiratory outcomes in
these patients.
HIV/AIDS – oral problems including
mouth ulcers, dry mouth, and mucosal lesions are common. Fungal,
viral or bacterial infections attack
the gums and are often one of the
first signs of AIDS. Managing oral
infections in these immuno-suppressed patients is critical.
OSTEOPOROSIS - the mouth can be
the first site of systemic bone density loss because the bone supporting the jaw becomes susceptible
to infectious destruction. Routine
dental exams and dental x-rays
help this track bone loss.
CANCER - chemotherapy and radiation often bring on oral complications such as oral Mucositis,
radiation-induced dental cavities,
and even jawbone necrosis, making oral hygiene critical for cancer
patients because of their compromised immune systems
The links between oral disease and serious medical conditions is a strong motivation
to practice good oral hygiene
and have regular dental checkups to detect such problems
before they become debilitating and even life threatening.
RINSE TWICE A DAY AND
CALL ME IN THE MORNING.
Taking care of your mouth may be important to your overall health. Rinsing
with LISTERINE® Antiseptic may help. It kills germs that cause gingivitis.
If left untreated, gingivitis could progress to advanced gum disease, which
emerging science suggests is associated with many other health problems.
DO IT FOR YOUR MOUTH. DO IT FOR LIFE.
www.listerine.com
Use as directed to help prevent or reduce plaque and gingivitis.
AN INDEPENDENT SUPPLEMENT FROM MEDIA PLANET IN THE WALL STREET JOURNAL
Emerging technology: new impressions Bone and organ creation
from dental stem cells
BY KIRK VAN HYNING
T
hree-D digital scanners
let dental patients avoid
the uncomfortable excessive salivation and gagging caused by using gooey
material to make a mold of
their mouths. Ziemak Aesthetic Dental Lab in Olympia,
Washington uses 3-D oral
scanning and found that all
of the 275 crowns it has inserted have fit, a record surpassing conventional molds.
Also eliminated are bacteria getting into imperfect
molds; abrasions from the
stone poured into a mold;
and tears and holes that
typically reduce the lifespan
of a crown or bridge to five
years. According to Ziemek
lab manager Jamie Stover,
a good fit can last up to 20
years.
Dentists in Ontario,
Canada’s Thornhill Smile
Center are getting similarly good results using the
Cadent iTero ™ Digital Impression System., finding
that digital scanning helps
create crowns and bridges more easily and with
more long lasting results
than conventional molds.
The system uses resin and
intraoral lasers to create a
3D image of the mouth, and
is fast, comfortable and
accurate.
www.thornhillsmilecentre.com
www.ziemekdentallab.net
BY KIRK VAN HYNING
H
arvesting stem cells
from teeth can unlock family dental histories and may
someday be used to grow
healthy bone and tissue,
effectively reversing oral
damage and allowing the
generation of healthy organs. Dr. John Lupori of
Steamboat Springs Oral
has partnered with New
York-based StemSave to
extract and store cells
found in pulp tissue at
the base of teeth. Accord-
Diagnosing and treating oral cancer
n
e
s
-
BY MARLENE PITURRO
etecting stealthy oral cancers in their early stages
falls to the front-line medical professionals – dentists, hygienists and physicians – in the
fight against this killer that grew
at an 11 percent rate in 2007.
Making their jobs more difficult
is contending with a new risk factor, oral/pharyngeal cancers developed through exposure to the
sexually-transmitted human papilloma virus. The traditional risk
factors of tobacco and alcohol use
remain.
Many patients don’t realize
that their regular dental or physical check-up may include an oral
cancer screening in which the
health professional checks about
10 places inside and around the
mouth, looking for lumps or irregular tissue changes. The American
Cancer Society and the American
Dental Association recommend
such periodic visual exams.
Yet visual screening alone may
not reliably spot pre-malignant
cells and yields only a 59 percent
five-year survival rate. Early detection, in comparison, boosts the
survival rate odds to 80 percent.
New non-invasive screening tests
and medical devices such as rinses, dyes, and hand-held optical
lights are being used in conjunction with visual examination to
detect abnormalities in their early
stages. Most of these new tests
D
add $35-$65 to the patient’s annual dental check-up bill.
A recent study published in
the Journal of the American Dental Association (July 2008) by
researchers at the University of
North Carolina’s School of Dentistry shows that such adjunctive techniques may facilitate the
early detection or oral premalignant and malignant lesions. The
scientists evaluated the effectiveness of these new technologies:
toluidine blue (TB), ViziLite Plus
with TBlue (Zila Pharmaceuticals),
Microlux DL (AdDent), Orascoptic
DK (a Kerr Company), and VELscope (LED Dental). They concluded that there was evidence
that toluidine blue is effective as
a diagnostic adjunct for use with
high-risk populations and suspicious mucosal lesions. They also
noted that pharmaceutical grade
toluidine blue is commercially
available only as part of ViziLite Plus. In an online survey of
234 dentists using the VELscope
system, 75% said their patients
agreed to oral cancer screening,
even though most insurers don’t
cover such tests. Ninety-four percent of survey respondents were
satisfied with VELScope’s ability
to detect cancerous and precancerous tissue that would otherwise
have been missed. While such
research is encouraging, medical professionals need more and
larger studies on these screening
adjuncts. ing to StemSave CEO Art
Greco, scientists hope to
one day re-create the bone
using 3-D printers. The
applications range from
new teeth to replacement
organs, made
possible
since stem cells are undifferentiated, meaning they
are not classified as tissue
or organs but can become
either. Organs grown from
one’s cells are not rejected and would last one’s
lifetime. Dr. Bob Pensak,
who elected to save his
daughter’s cells when she
had her wisdom teeth re-
ORAL MUCOSITIS: CANCER TREATMENT’S DEBILITATING SIDE EFFECT
TREATING CANCERS
arbara Murphy, MD, a medical
oncologist and Director of Head
and Neck Research at VanderbiltIngram Cancer Center, sees a growing
prevalence of oral cavity and oral/pharyngeal cancers, particularly in nonsmokers and non-drinkers, i.e., those
infected through HPV. Unlike previous
generations of oral cancer patients, diagnosed in their 60’s and 70’s, these
patients are being diagnosed at a different life stage – in their 40’s and 50’s.
“With these younger patients we have
to strike a careful balance to optimize
treatment. There’s much more expectation to return to full functionality,
particularly if this is a 45-year parent
of three children who is a breadwinner,” says Dr. Murphy. For example,
HPV-related cancers are usually treated non-surgically with chemotherapy
and radiation while anterior tongue
cancers are treated surgically. “We
have to be careful with the sequelae
of chemotherapy and radiation such
as acute mucositis leading to pain,
swelling, dry mouth and difficulty
swallowing. We want highly effective
cancer treatment but not have patients
so debilitated that they can’t return to
work” she adds.
Dr. Murphy is a member of the
Eastern Cooperative Oncology Group/
NCI gathering data on ameliorating
the pain and discomfort of mucositis
using calcium/phosphorous mouth
rinses. Much work remains to be
done on detecting and treating oral
and head and neck cancers early so
that disabling and disfiguring late
stage treatment can be avoided.
B
C
hemotherapy and radiation have
saved millions of patients’ lives but
often produce uncomfortable and even
debilitating side effects. Oral mucositis,
inflammation and ulceration of oral
mucosa, affects over 40 percent of all
patients undergoing chemotherapy and
ionizing radiation, 70 percent of bone
marrow transplantation patients, and
nearly 100 percent of head and neck
cancers. It appears seven to ten days
after treatment and should be checked
for at least twice daily.
Oral mucositis can limit patients’
ability to eat or swallow as well as cause
severe pain that can require the use of
pain medication including morphine. In
severe cases, oral mucositis can cause
the interruption and premature termination of treatment regimens for cancer
patients, according to Spencer Redding,
DDS, MD. “Therefore, the oral complications of cancer therapy have the potential to adversely affect treatment outcomes, cancer prognosis and quality of
life for millions of patients,” he adds.
Treatment agents such as Caphosol, an advanced electrolyte solution
used as a rinse by patients undergoing cancer therapy, have been shown
to be effective in a UK double-blind
prospective randomized clinical trial
of 95 patients undergoing bone marrow transplant following radiation
or chemotherapy. More than twice as
many patients in the Caphosol treatment group avoided oral mucositis and
the duration of symptoms was halved.
These patients also used 72% less
morphine for pain and nearly 75%
required no morphine.
DENTAL HEALTH
moved, calls the potential
“miraculous”.
A crucial link between
saliva and blood has aided
this development. In May
2008, the American Academy for Pediatric Dentistry
(AAPD) found that anything traceable in blood
can also be traced in saliva. This allows for a reliable and fast way to diagnose diseases – dental and
otherwise – and implement
treatment. David Wong,
DMD, DMSCc, of the
School of Dentistry and
Dental Research Institute,
UCLA theorizes that infant
stem cell samples could be
used to create dental pulp
tissue and a full tooth in
the near future.
25 MILLION WOMEN INFECTED
WITH THE HUMAN PAPILLOMA
VIRUS (HPV)
T
he skyrocketing incidence of
oral cancers, now the world’s
sixth largest killing cancer, has
been linked to oral sex with HPVinfected women. Of the 25 million
women infected with HPV, three
million carry the sexually transmitted virus that causes cervical
cancer in women and oral cancer
in both women and men. HPV can
also cause genital warts, penile
and anal cancers. The National
Cancer Institute has studied HPVrelated oral cancers from 1973 to
2004, concluding that such cancers are about as common as those
caused by tobacco and alcohol use.
Gardasil, a vaccine given in three
doses and costing $360, is currently given only to girls and women,
although Merck, the vaccine’s
manufacturer, has asked governmental approval to offer the vaccine to boys in hopes of reducing
both cervical and oral cancers.
ORAL CANCER FAST FACTS
* 35,000 new cases annually in U.S.
* 7,500 deaths
* Incidence of oral cancer is 3X greater
than cervical cancer w/ 2X more deaths
* 5 year survival rate 59%, with early
detection 80%
* Sixth most common cancer worldwide
* 75% of patients use tobacco and/or alcohol
* Average oral cancer screening test $35-$65
Source(s):
Academy of General Dentistry, 2008
American Cancer Society, 2008
Can anything relieve oral mucositis and dryness
caused by radiation and chemotherapy?
Caphosol Can
®
(supersaturated calcium
phosphate rinse)
Oral mucositis (damage to the lining of the mouth) and xerostomia (dry
mouth) are common with:
! Radiation for cancers of the head and neck1,2
! Certain types of chemotherapy1,2
Caphosol treats these problems.
If you are experiencing oral discomfort as a result of cancer therapy
speak with your doctor before the problem becomes serious.
Caphosol is indicated for dryness of the mouth or throat regardless of the
cause and regardless of whether the conditions are temporary or permanent.
Caphosol is also indicated as an addition to standard oral care in treating the
oral mucositis that may be caused by radiation or high dose chemotherapy.
Safety Information
—Reported side effects have been rare and generally mild
—If Caphosol is swallowed accidentally, no adverse effects are expected
—There are no known interactions with other medicines3
—Patients should avoid eating or drinking for at least 15 minutes after use.
Caphosol contains sodium (71 mg per 30mL dose). Patients restricted
to a low-sodium diet should consult their physician before use3
For additional Caphosol product information,
visit www.caphosol.com or call 1-800-833-3533.
Please see full Prescribing Information below.
References: 1. Stack KM, Papas AS. Xerostomia: etiology and clinical management.
Nutr Clin Care. 2001;4:15-21. 2. Pico J-L, Avila-Garavito A, Naccache P. Mucositis: its
occurrence, consequences, and treatment in the oncology setting. Oncologist. 1998;446-451.
3. Caphosol (supersaturated calcium phosphate rinse) prescribing information. October, 2008.
Caphosol®
supersaturated calcium phosphate rinse
Prescribing information
Ingredients: Dibasic Sodium Phosphate 0.032,
Monobasic Sodium Phosphate 0.009, Calcium
Chloride 0.052, Sodium Chloride 0.569, Purified
Water qs ad (%w/w)
Pharmaceutical form: Aqueous solution. Caphosol
is a preparation comprising two separately
packaged aqueous solutions, a phosphate solution
(Caphosol A) and a calcium solution (Caphosol B)
which, when both ampule solutions are combined
in equal volumes, form a solution supersaturated
with respect to both calcium and phosphate ions.
Actions: Caphosol is an electrolyte solution
resembling human saliva, designed in part to
replace the normal ionic and pH balance in the oral
cavity. It is intended as a mouth rinse to moisten,
lubricate and clean the oral cavity including the
mucosa of the mouth, tongue and throat. Caphosol
facilitates chewing and speaking; loosens tough
mucus and prevents mucous membranes from
sticking together.
Indications: Caphosol is indicated for dryness of
the mouth or throat (hyposalivation, xerostomia),
regardless of the cause and regardless of whether
the conditions are temporary or permanent.
Caphosol is also indicated as an adjunct to standard
oral care in treating the mucositis that may be
caused by radiation or high dose chemotherapy.
Relief of dryness of the oral mucosa in these
conditions is associated with an amelioration of pain.
Special precautions for use: Avoid eating or
drinking at least 15 minutes after use. Do not use
if the seal of the ampule is broken or the ampule
shows sign of leakage or damage. Contains sodium
(71mg per 30mL dose). Patients restricted to a low
sodium diet should consult their physician before
use. Store at room temperature, do not refrigerate.
KEEP OUT OF REACH OF CHILDREN.
Caution: Federal law restricts this device to sale
by or on the order of a physician or dentist.
Interaction with other medicinal products and
other forms of interaction: There are no known
interactions with medicinal or other products.
How Supplied:
Item Code
30 Dose1 Box
0-8489-8000-1
120 Dose1 Box
0-8489-8000-4
1
One Dose = 2 ampules, each 15mL, mixed together.
Directions for use: (1) Mix 1 blue (Caphosol A)
and 1 clear ampule (Caphosol B) in a clean glass.
(2) Swish the mouth thoroughly for 1 min with 1/2
of the solution and spit out. (3) Repeat with the
remaining 1/2 of the solution and spit out. Use
immediately after mixing the ampules.
s&ORuse during high dose chemotherapy or
radiation treatment: 4 doses per day from the
onset of the cancer treatment. Up to 10 doses
per day if pain from mucositis is experienced.
Use for the duration of the treatment or as
instructed by physician.
s2ELIEFOFDRYMOUTHTIMESPERDAYORAS
instructed by physician.
If Caphosol is swallowed accidentally, no adverse
effects are anticipated.
Manufactured by Holopack GmbH, Germany for:
EUSA Pharma (USA), Inc. USA
Princeton, NJ 08540
[email protected], www.caphosol.com,
1-800-833-3533
Caphosol® is a registered trademark of EUSA
Pharma (USA), Inc., USA
NHRIC Labeler Code 8596
US patents no. 5993785, 6387352, patents pending
Date of revision: October 2008
Caphosol is a registered trademark of EUSA Pharma (USA), Inc.
© 2009 EUSA Pharma (USA), Inc. All rights reserved. C-0343-09 02/09
ONE PERSON DIES EVERY HOUR IN THE US FROM ORAL CANCER
The typical risk factors for oral cancer may be commonly known, however,
a new risk factor called HPV, is now changing the face of oral cancer. HPV
has long been known to cause cervical cancer in women and recent studies
show that it may play a role in more than 25% of oral cancer cases.
When oral cancer is found early, treatment can be successful 82% of the time.
Unfortunately, when compared to the survival rate of other cancers, the
survival rate of oral cancer has not improved greatly over the last 30 years.
Because early detection is a key to survival, it is important to see your dentist
regularly. An annual screening exam called ViziLite Plus with TBlue, used in
conjunction with a routine head and neck examination performed by your
dentist, can help to find abnormalities that could lead to cancer. That’s the
kind of screening that could help save lives.
To learn more about oral cancer and to find
a ViziLite Plus provider near you, please visit:
http://www.vizilite.com/cancer_ad.asp
or contact:
Zila Pharmaceuticals, Inc.
866-ZILAPRO (866-945-2776)
©2008 Zila Pharmaceuticals, Inc.
ZILA-243-2008
3
AN INDEPENDENT SUPPLEMENT FROM MEDIA PLANET IN THE WALL STREET JOURNAL
DENTAL HEALTH
Product Showcase
SONICBRITE
CYBERSONIC
LUSTER
THE TOOTHBRUSH
SOLUTION
Since 1992
SONICBRITE CLEANS AND DISINFECTS
DENTURES, RETAINERS AND DENTAL
APPLIANCES
Greet everyday with confidence and a
beautiful smile
o Look years younger with a brighter,
whiter smile!
o Breaks off hardened plaque build-up
that trap Stains, odors and bacteria
o Clinically proven to remove tobacco,
tea and Coffee stains that effervescent
tablets can’t
o Kills more than 99.99% of bacteria
before they travel throughout your
body when you swallow
o Works in only 15 minutes – very private
o Only $39.95 – comes with a 30 day
money back guarantee
Use the promotional code AMRCO9
for your SonicBrite purchase and SonicBrite will make a donation of $5 to
the American Red Cross.
(877)-460-1518
www.sonicbrite.com
A TREMENDOUS VALUE!
The Original sonic oral care system
that includes:
Flosser, tongue cleaning, bleach &
charger stand
o FREE Replacement Brush Heads*
o FREE Lifetime Warranty
o
* brush replacement program S&H fee of $5.85 applies
$39.95
plus S&H
RID YOUR TOOTHBRUSH OF
DANGEROUS BACTERIA
The Most Powerful Toothbrush Sanitizer!
Researchers have found over 100,000,000
microorganisms on one single toothbrush.
The Toothbrush Solution’s (trademark)
innovative bio-cleansing formula destroys even the most hazardous bacteria
on your toothbrush every day, effectively
eliminating 99.99% of germs. Its patented
germ-trapping container design guarantees that your toothbrush will never again
be infected by unhealthy germs.
Clinically Proven
FDA Approved By The Dental
Infection Control Department
o Remains effective for 30 days
o Helps prevent cross contamination
o Works with regular and electric
toothbrushes
o Comes with convenient attached
toothbrush holder
o Kills microorganisms that cause
colds, the flu’s and other infections
o
o
(LIST PRICE $79.95)
WSJ readers save 50% coupon code “WSJ39”
For more information call (800) 770-7525
www.cybersonicclassic.com
REVOLUTIONARY WHITENING SYSTEM
This revolutionary tooth whitening system
consists of three components that work synergistically to revitalize your smile:
Step 1: Rinse with the Accelerator Mouth Rinse,
which will enhance the efficacy of the professional strength whitening gel
Step 2: Brush on the Super Whitening Gel, the
same whitening agent used by dentists during
professional treatments
Step 3: Apply the Activating Whitening Light,
which will stimulate the photo-activator in the
gel in just 2 minutes
o
o
o
o
Dentist-developed
At-home tooth whitening system
Easy-to-use, three-step process
Guaranteed to whiten teeth up to 6 shades
in less than 1 hour
o Clinically proven not to cause tooth sensitivity.
o The only over-the-counter whitening product
to be FDA-cleared
o Availability: CVS, Rite Aid and Walgreens nationwide
Price: $39.99
For more information call (800) 823-5272.
www.toothbrushsolution.net
www.lusteroralcare.com
Ask the experts
Q: What is one overlooked issue in oral hygiene and how would you fix it?
“
Dr. Jason Kasarsky, DDS
Dr. Jason S. Kasarsky graduated from
New York University College of Dentistry
and attended North Shore University
Hospital, a Cornell University teaching
hospital. Since 1975, he has incorporated
the latest developments in dentistry into
his practice so that the care offered to
patients is of the highest quality.
www.jkdds.com
With the average American living to 78 years
and our wellness mentality to live longer and
better, we need our teeth to last. That requires
periodontal care at home and a long lasting partnership with your dentist. Dental work done at
age 35 or 40 may have to be replaced at age 6075; it’s like driving on bald tires.
Moderate to severe periodontal disease, affecting 35 percent of adults, can lead to tooth loss,
and other serious problems, so preventing it is
important. Rinsing for 45-60 seconds before bed
time with an inexpensive, simple home remedy
is conservative periodontal therapy that produces
fabulous results. Swish several times and then spit
out a rinse that is an inch of liquid consisting of a
third each Listerine, hydrogen peroxide and water.
This is in addition to regular brushing and flossing. Teeth scaling and root planning every three
months, plus tongue scraping, laser periodontal
therapy, and antibiotics in infected gum pockets
are other methods your dentist can use to mitigate
the effects of moderate periodontal disease, which
can start impacting oral health between ages 3550. So rinse your way to a healthy old age.”
Cosmetic dentistry: the perfect smile
BY MARLENE PITURRO
A
fter greeting every new
patient in his private
office rather than first
encountering them in the dental chair, Jan Linhart, DDS, a
dentist specializing in cosmetic
and restorative dentistry, puts
them at ease and begins work
on achieving the perfect smile.
Backed by an inter-disciplinary team of oral health care
professionals including an implant specialist, a periodontist,
an orthodontist, a root canal
4
specialist, three hygienists and
three general dentists, Dr. Linhart uses a variety of techniques
including gum sculpting with a
laser to create a more favorable
gum line, immediate implants to
replace lost teeth, and porcelain
veneers to create more beautiful
smiles.
“Porcelain veneers are a
particularly useful procedure
in cosmetic dentistry,” says Dr.
Linhart, adding that “we complete this smile makeover process in two visits.” Starting with
taking pictures of the patient’s
“
Dr. Jan Linhart
Dr. Jan Linhart has been practicing
the art and science of dentistry since
1980 and provides cutting edge, quality
dental care. Dr. Linhart received his
Dental Education from New York
University College of Dentistry in 1979
and completed his residency in General
Dentistry at Mountainside Hospital in
Montclair, New Jersey.
www.drlinhart.com
www.drlinhart.com
teeth, Dr. Linhart then discusses what type of look the patient
wants, natural versus dynamic,
for example. He makes a wax
model of what the patient’s new
smile will look like and applies
a temporary veneer so they can
try the new look. On the second
visit he applies the permanent
veneer in which the veneer is
bonded to the tooth enamel.
The procedure is popular with
patients ranging in age from
17 to 80 years, and costs
approximately $1800
to $2200 per tooth.
Thanks to cutting
edge technologies and
his team’s expertise, Dr.
Linhart produces natural-look-
In the last few years we’ve seen an
association being made between oral
health and general health. While there’s
never been conclusive concrete evidence we
now see a relationship between periodontal disease and heart disease, stroke and low
birth weight babies. Evidence shows that
bacteria in dental plaque and in the heart
are the same, indicating that unhealthy and
untreated gums can lead to heart disease
and also diabetes. Swallowing plaque and
tarter in the bacteria causes inflammation
elsewhere in the body.
People should take care of the health
of their gums. If there’s any bleeding they
should see their dental hygienist. One concern of patients with heart murmur or other
cardiac conditions is the use of prophylactic
antibiotic before periodontal treatment. The
American Heart Association has changed
this recommendation quite a few times and
there is no agreement that pre-treatment antibiotics improve outcomes. Common sense
argues that people with bleeding gums are
swallowing bacteria anyway, but check with
your dentist before periodontal treatment if
cardiac issues are of concern.”
ing teeth with durable dental
materials that can last approximately 12 to 15 years.
To learn more about cosmetic
dentistry or find a local provider
visit the American Academy of
Cosmetic Dentistry’s web site.
www.aacd.com
Other popular cosmetic dentistry treatments include:
* Composite bonding for
chipped, broken, discolored or
decayed teeth
* Teeth Whitening through
bleaching stained teeth
* Dental implants-artificial
tooth root replacements for lost
teeth
* Full mouth reconstruction to
improve not only teeth’s appearance but necessary
treatment to correct
underlying
functional problems with bite,
muscles, teeth and bone
structure