Dental Tribune United Kingdom Edition

Dental Tribune United Kingdom Edition | 9/20142 Figures by the National Health Service indicate that at least one in 15 adults in the UK currently suffers from the most severe form of periodontal disease. Worldwide, the situation looks even more devastating withtheconditiontobefoundinroughly11 per cent of the earth’s population. An inter- national review published by researchers from Barts and The London School of Med- icine and Dentistry and dental institutions inAustraliaandUSintheJournalforDental Research has recently provided the first in- sights into the global dynamics of the dis- ease and where it is most prevelant. According to the paper, prevalence as well as incidence of severe periodontitis was reportedly highest in East Sub-Saharan Africa and most parts of South America. Several countries including Australia, In- donesia or Greece, among others, also ranked below the global average. Regions with low occurrence were North America, followed by developed countries in the Asia Pacific region, as well as Oceania and Western Europe. While no statistically relevant difference could be found between genders, the re- searchers said the condition seemed to in- crease with age throughout all surveyed countries. Hence, people at age 38 and be- yond are most at risk for developing severe periodontitis. Overall, the study found that more than 700millionnewcasesofsevereperiodonti- tis worldwide add to the already large bur- den every year, which makes the condition rank among the six most prevalent dis- eases worldwide. If untreated, it can lead not only to physical pain and psychological discomfort, but also to functional limita- tion, as well as physical and psychological disabilities, according to the author, Direc- tor of Research at Barts Health NHS Trust Prof. Wagner Marcenes, who headed the study. “The number of severe periodontitis cases has increased dramatically between 1990 and 2010. Since we did not include othertypesofperiodontitissuchasitsmild and moderate forms, we are facing an even more serious problem in the population’s oral health,”he commented on the results. He said that the data are currently being evaluated further to find out what might cause this high prevalence including socio- economic indicators and other risk factors. One of the largest assessment ever con- ducted on the disease, the review was look- ing at epidemiological data from more than 70 studies involving 300,000 pa- tients from 37 countries. While it provides insight into the realities of the disease, ac- cording to the researchers, the results will havetobetreatedwithcautionowingtothe problem on how to actually measure peri- odontal disease. A new standard intro- duced by the American Academy of Peri- odontology and the US Centres for Disease Control and Prevention in 2007, for exam- ple, made it difficult to compare any data collected prior. In the report, the researchers indicated any site with Community Periodontal In- dex of Treatment Needs = 4, clinical attach- ment of larger than 6mm and pocket depth of 5 as periodontitis. UK NEWS Barts study on severe periodontitis reveals looming crisis By DentalTribune International The General Dental Council (GDC) has re- ported that it is suspending the registration of a dentist from Northern Ireland, after a publichearingheldbythedisciplinarypanel in London found him guilty of over 100 charges of malpractice. According to the council, he will be banned from practising dentistryforfiveyearsunlessheexerciseshis right of appeal against being struck off the register within 28 days. The suspension is a rare case of a member ofthedentalprofessionintheUKfacingsuch a high number of malpractice charges. In ad- ditiontoallegationsofhavingmisdiagnosed oral lesions and other conditions that led to the development of oral cancer, the council said that he had failed to carry out biopsies when necessary and misinformed patients about their condition. Other charges against him involved poor patient management and record keeping. The council said that he had mistreated 27 of the patients he saw while working as con- sultantattheRoyalVictoriaHospital’sSchool of Dentistry in Belfast between 2006 and 2010. He was removed from the post when patients he had treated presented with symptoms of oral cancer. UntilAugust,hehadworkedasadentaled- ucator at Queen’s University Belfast, but lost in an unfair dismissal case. GDCsuspendsdentistinrarecaseofmalpractice By DentalTribune International Scientists at the University of Sheffield have identified a significant rise in the num- ber of people diagnosed with a serious heart infection alongside a large fall in the pre- scription of antibiotic prophylaxis to dental patients owing to respective guidelines in- troduced several years ago. The researchers suggest that their results will provide the in- formationtheguidelinecommitteesneedto re-evaluatethebenefitsofadministeringan- tibiotics as a preventative measure. The pioneering study is the largest and most comprehensive to be conducted with regard to the National Institute for Health andCareExcellence(NICE)guidelines,which recommend that dentists no longer give an- tibiotics before invasive treatments to pa- tients considered at risk of the life-threaten- ing heart infection infective endocarditis, whichin40percentofcasesiscausedbybac- teria from the mouth. The team of international researchers, led byProf.MartinThornhillattheUniversityof Sheffield’s School of Clinical Dentistry, dis- covered that since the NICE guidelines were introducedinMarch2008,therehasbeenan increase in cases of infective endocarditis abovetheexpectedtrend.ByMarch2013,this accounted for an extra 35 cases per month. They also identified that the prescription of prophylactic antibiotics fell by 89 per cent from 10,900 prescriptions a month before the 2008 guidelines to 1,235 prescriptions a month by March 2013. Thornhill,ProfessorofOralMedicine,said: “Infective Endocarditis is a rare but serious infectionoftheheartlining.Wehopethatour datawillprovidetheinformationthatguide- linecommitteesneedtore-evaluatetheben- efits,ornot,ofgivingantibioticprophylaxis.” Thornhill stressed that health care profes- sionals and patients should wait for the guideline committees to evaluate the evi- dence and give their advice before changing their current practice. He added: “In the meantime, healthcare professionals and patients should focus on maintaining high standards of oral hygiene. Thiswillreducethenumberofbacteriainthe mouth which have the potential to cause In- fective Endocarditis and reduce the need for invasivedentalprocedurestobeperformed.” Barbara Harpham, National Director of Heart Research UK, said: “The findings play an important part in the ongoing explo- ration of the link between dental and heart health. Projects such as this one are vital to the ongoing collation of evidence to support ourunderstandingofhoworalhealthcanim- pact upon the heart and other conditions within the body. We are committed to fur- thering medical research in the UK and wel- come these new findings.” The data was analysed by an international group of experts from the University of Sheffield, Oxford University Hospitals NHS Trust, Taunton and Somerset NHS Founda- tion Trust, and the University of Surrey in the UK, as well as from Mayo Clinic and the Carolinas HealthCare System’s Carolinas MedicalCenterintheUS.Thestudywaspub- lished in The Lancet journal online on 18 No- vember under the title “Incidence of infec- tiveendocarditisinEngland,2000–13:Asec- ular trend, interrupted time-series analysis” andpresentedlastweektomorethan19,000 international attendees at the American Heart Association annual meeting in Chicago. The research was funded by a grant from national heart charity Heart Research UK, health care provider Simplyhealth and the National Institute of Dental and Craniofacial Research. Rise in endocarditis despite antibiotics guidelines for dentists By DentalTribune International Periodontitis is most severe in South America and East Sub-Saharan Africa,according to the report. (DTI/Photo eteimaging)

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