Dental Tribune United Kingdom Edition

A n article recently pub- lished in The Lancet de- scribes a case report of an 82-year-old woman in Italy who died of Legionnaires dis- ease due to contaminated den- tal equipment. The report describes how the elderly woman was admit- ted to the intensive care unit “G.B. Morgagni-Pierantoni” Hospital, Department of emer- gency Anaesthesia and Inten- sive Care Unit, Forlì, Italy with fever and respiratory distress. Although the elderly lady had no underlying disease, af- ter a chest radiography and a Legionella pneumophila uri- nary antigen test, the woman was promptly diagnosed with Legionnaires’ disease. Al- though she was immediate- ly given oral antibiotics the patient developed fulminant and irreversible septic shock and unfortunately died two days later. The case report prompted an investigation into to finding the source of L pneumophila, and after enquiring about the patient’s whereabouts dur- ing the incubation period, it was revealed that she had at- tended two dental appoint- ments. As a result, samples were taken from both the woman’s home and the dental surgery that she visited in order to inves- tigate possible L pneumophila contamination. According to the report, samples from her home tested negative for L pneumoph- ila, however, samples from the dental practice tested positive and showed genomic matching between L pneumphila in the dental unit waterline and in the women’s respiratory secretion. The authors have called for various control measures at den- tal surgeries to prevent similar incidents. The authors explain: “The case here shows that the disease can be acquired from a dental unit waterline during routine dental treatment. Aerosolized water from high-speed turbine instruments was most likely the source of the infection. Legionel- la contamination in dental unit waterlines must be minimised to prevent exposure of patients and staff to the bacterium. “We suggest several control measures: use of anti-stagnation and continuous-circulation wa- ter systems; use of sterile water instead of the main water supply in the dental unit waterline; ap- plication of discontinuous or con- tinuous disinfecting treatment; daily flushing of all outlets and before each dental treatment; use of filters upstream of the instru- ments; and annual monitoring of the waterline. Further useful procedures to prevent legionello- sis within dental surgeries can be obtained from [already available] dedicated guidelines.” DT Elderly woman dies due to contaminated dental equipment Legionnaires disease A recent study has sug- gested that oral blood samples taken from pockets of periodontal inflam- mation can be used to meas- ure a patient’s diabetic status. The NYU nursing-dental research team found that the technique, which works by using oral blood samples to measure hemoglobin A1c (which is widely used to test for diabetes), compares well to blood samples taken from the patients finger. Samples of oral and finger- stick blood were taken from 75 patients with periodontal disease; the NYU research- ers then compared the hemo- globin A1c levels from the oral and finger-stick blood. The results that produced a reading of 6.3 or greater in the oral sample corresponded to a finger stick reading of 6.5 in identifying the diabetes range. “In light of these findings, the dental visit could be a use- ful opportunity to conduct an initial diabetes screening - an important first step in identi- fying those patients who need further testing to determine their diabetes status,” said the study’s principal investiga- tor, Dr Shiela Strauss, associ- ate professor of nursing and co-director of the Statistics and Data Management Core for NYU’s Colleges of Nurs- ing and Dentistry, in an online report. Throughout the year-long study, dentists and dental hy- gienists were able to collect finger-stick blood samples and send them to a labora- tory for analysis thanks to a hemoglobin A1c testing kit that was designed specifically for the study. “There is an urgent need to increase opportunities for dia- betes screening and early dia- betes detection,” Dr Strauss added in the report. “The is- sue of undiagnosed diabetes is especially critical because early treatment and secondary prevention efforts may help to prevent or delay the long- term complications of dia- betes that are responsible for reduced quality of life and increased levels of mortality risk.” The study was funded by an NYU CTSI (Clinical and Translational Science Insti- tute) grant, which was award- ed to the research team last year. The findings were then published in the Journal of Periodontology. According to the report, the research is part of a series of NYU nursing-dental stud- ies examining the feasibility of screening for diabetes and other physical illnesses in the dental setting. DT Could oral blood be used to screen for diabetes? T he National Examining Board for Dental Nurs- es (NEBDN) is seeking to recruit new members to its Panel of Examiners in or- der to deliver the new NEBDN National Diploma in Dental Nursing examination. Featuring Objective Struc- tured Clinical Examinations (OSCEs), NEBDN has com- pletely revised the format of the qualification in order to provide a more modern ap- proach to the assessment of Dental Nurses. To become an Examiner with NEBDN you must: • Have previous experience of assessing OSCEs within dental training • Be registered with the Gen- eral Dental Council • Be currently practicing as a Dental Surgeon or Dental Care Professional • Have two years’ experience since qualification • Be well organised and able to maintain high quality standards • Be passionate about Dental Nurse Education and helping people reach their full poten- tial Becoming an Examiner will help you to: • Improve your personal de- velopment and professional status • Develop your skills and un- derstanding of Dental Nurse Education and training • Gain verifiable CPD through on-going support and training • Network with other profes- sionals with a commitment to improving Dental Nurse Edu- cation For further information please contact sarah@nebdn. org. Full training and support will be provided. Successful applicants will be invited to an assessment day in April / May 2012. DT NEBDN calls for examiners V isiting Specialist Services (VSS) has announced the launch this month of ‘VSS Mentor’, a new UK wide mentor- ingprogrammeinimplantdentist- ry for GDPs. This new programme provides clinicians undertaking implant training with support in their own practices from an ex- perienced mentor. Practitioners can choose from a range of levels of support to best suit their needs, from a single mentoring session to a full mentoring programme which supports dentists from their first implant placement through to becoming an independent im- plant surgeon. “There are several excellent courses in implant dentistry in the UK, and our aim is to provide additional support to help the practitioner gain experience and confidence in their own practice environment with the supervision and guidance of a clinician ex- perienced in the field,” said Fadi Barrak, Director of VSS and one of the VSS Mentors. “By providing support in this way we can help dentists to develop their implant service more quickly and effectively, and build their practice’s profile and goodwill, which is especially im- portant in the current economic climate.” To find out more please con- tact 0845 6585737. DT ‘VSS Mentor’ launched February 27-March 4, 20126 News United Kingdom Edition