DENTAL TRIBUNE The World’s Dental Newspaper · South Asia Edition Published in India www.dental-tribune.in 02/20 Coronavirus outbreak Dental world reacts to coronavirus outbreak UN event Oral health the focus at UN event EFP and WHF EFP and WHF release consensus report on links between periodontal and cardiovascular health Candida auris Centers for Disease Control and Prevention release statement on spread of Candida auris ” Page 02 ” Page 03 ” Page 04 ” Page 05 Guest editorial by Dr. Bhavdeep Singh Ahuja: Salient features of budget 2020 for health care professionals in multiple topics of Practice Management, Medical Law, Ethics and Consent and Finance for Dentists and he is writing a series on all these topics journals simultaneously. He has been the Editor-in-Chief, L.E.D. E-Journal & PAGE 3 OLA-D E-Newsletter, the twin Publications of IDA Ludhiana Branch. Presently, he is into his 21st year of Clinical Private Practice in Ludhiana, Punjab. Past Dear readers, I am not going to do a minute post mortem of the budget, only those aspects (well, most of them) which we Dentists in particular and Doctors, in general, are going to feel an impact of in healthcare. 10 KEY FEATURES – HEALTH CARE Let me list out the top points affecting us – the health care professionals. 1. Mission Indradhanush has been now expanded to cover 12 diseases (it was 7 earlier), including five new vaccines. FIT India movement is a vital part of the fight against non- communicable diseases coming out of lifestyle issues. Focused safe water (Jal Jeevan Mission) and a comprehensive sanitation program Bharat Mission) have been launched to support the health vision reducing the disease burden on the poor. (Swachch 2. Presently, under PM Jan Arogya Yojana (PMJAY), there are more than 20,000 empanelled hospitals and more would be built in Tier-2 and Tier-3 cities for poorer people under this scheme. 3. Using machine learning and AI, in the Ayushman Bharat scheme, health authorities and the medical fraternity can now target disease with an appropriately designed Preventive regime. launched with a commitment by the Govt. to end Tuberculosis by 2025. 5. Jan Aushadhi Kendra Scheme will be expanded to all districts of India offering 2000 medicines and 300 surgicals by 2024. The 6. The health sector has been allocated about Rs. 69,000 crores that are inclusive of Rs. 6400 crores for Prime Minister Jan Arogya Yojana (PMJAY). and 7. A National Police a National University Forensic Science University will be made in the domain of policing science, forensic science, cyber-forensics etc. 8. To overcome the shortage of qualified medical general doctors – practitioners as specialists, a medical college will be attached to an existing district hospital in PPP mode. both, as well 9. The Govt. will encourage large hospitals with sufficient capacity to offer resident doctors, Diploma and Fellow of National Board courses under the National Board of Examinations which imparts PG medical qualifications. (DNB/FNB) 10. The imposition of Health Cess on specified medical equipment: Health Cess at the rate of 5% is proposed to be imposed on the import of medical devices and the proceeds shall be used for financing the health infrastructure services. This Health Cess shall be a duty of Customs and shall not apply to medical devices which are exempt from BCD (Basic Customs Duty). Further, inputs/ parts used in the manufacture of medical devices shall also be exempt from Health Cess. and 10 KEY FEATURES – TAXATION & INVESTMENT 4. “TB Harega Desh Jeetega” campaign has been 10 Let me features of summarize the taxation and Guest Editorial by Dr. Bhavdeep Singh Ahuja: Salient features of Budget 2020 relevant for Healthcare Professionals by Dental Tribune South Asia Dr. Bhavdeep Singh Ahuja graduated in 1998 from Punjabi University, Patiala. He has specialized in Implants from BioHorizons Inc. USA in 2004- 05 & in Advanced Course from LACE-ICOI, USA in 2006. Apart from Dentistry, he holds a Triple M.B.A. in Hospital Management, Finance/Human Resources (dual) & Marketing from three premier Institutes/ Universities of India viz. the IIMM Pune, IGNOU Delhi & Annamalai University, Chennai respectively. He also holds Post Graduate Diploma’s in Medical Law & Ethics (NLSIU - Premier LAW School of India), Clinical Research, Cyber Law, IPR‘s (Intellectual Property Rights), Disaster Management, Management, Financial amongst Bioinformatics many more from different Universities. He is a Certified Health Care Waste Manager from IGNOU & is qualified in Consumer Law as well. He is an academically oriented dentist & has more than 75 Original Scientific Publications to his credit in many International & National journals. He lectures all over India extensively on the investment which are going to affect us 1. Tax facilitation measures introduced — PAN linked to Aadhaar, reduction of direct tax litigation, faceless appeals and a charter for taxpayers (India will be the third country to have this). 2. Reduction in rate of Tax Deduction at Source (TDS): In order to reduce litigation, it is proposed to reduce rate for TDS in case of fees for technical services (other than professional services) to 2% from existing 10% in order to align the same with the rate of TDS on works contract. Debt-based Exchange Traded Fund (ETF) recently floated by the Govt. was a big success, so it will expand this by floating a new Debt-ETF consisting primarily of Govt. securities to act as an attractive investment for pension funds and long-term investors. The 3. 4. The New Tax Regime Tax Rates (NTR) has been introduced Existing New Taxable Tax Income Slab (Rs.) Rates 0-2.5 Lacs Exempt Exempt 2.5-5 Lacs 5% 5-7.5 Lacs 20% 7.5-10 Lacs 20% 10-12.5 Lacs 30% 12.5-15 Lacs 30% Above 15 Lacs 30% 5% 10% 15% 20% 25% 30% 5. The Dividend Distribution Tax (DDT) has been abolished for companies. Currently, companies are required to pay Dividend Distribution Tax (DDT) on the dividend paid to its shareholders at the rate of 15% plus applicable surcharge and cess in addition to the tax payable by the company on its profits. 6. Currently, a taxpayer is required to fill the complete details of the donee in the ITR form for availing deduction. In order to ease the process of claiming a deduction for the donation, the ITR would be pre-filled with the donee’s information in taxpayer’s return on the basis of information of donations the donee to have a hassle-free claim of deduction for the donations made by the taxpayer. furnished by 7. The interchangeability of PAN and Aadhaar was introduced in the last budget and now to further ease the process of allotment of PAN, the Govt. will launch a system under which PAN shall be instantly allotted online on the basis of Aadhaar without any requirement for filling up of detailed application form. the tax net, 8. TDS on E-commerce transactions: In order to widen and deepen it is proposed to provide that e-commerce operator shall deduct TDS on all payments or credits to e-commerce participants at the rate of 1% in PAN/Aadhaar cases and 5% in non-PAN/Aadhaar cases. In order to provide relief to small businessman, it is proposed to provide an exemption to an individual and HUF who receives less than Rs. 5 lakh and furnishes PAN/ Aadhaar. the to relevant 10. The (TCS) on 9. The alternate Janam Kundli as I fondly call it for all of us, the Form 26AS would be modified to include all the prescribed information the proposed changes in the budget. tax collection at source remittance under Liberalised Remittance Scheme of Reserve Bank of India exceeding Rs. 7 Lac in a year and on sale of overseas tour package has been notified to further widen the scope. So, dealers and companies offering the same to doctors under the garb of education will have to cough out a bigger amount.
2 News 02/20 Dental world reacts to coronavirus outbreak by Brendan Day, DTI the LEIPZIG, Germany: Over the past month, one topic has dominated international news cycle above all else—the Wuhan coronavirus outbreak. As of 10 February 2020, more than 40,620 cases of the virus have been confirmed and 910 deaths have from it. In response, many dental associations and organisations have released advice on what dental professionals can do to help limit the transmission of the virus. resulted This particular coronavirus was identified in December 2019 in Wuhan, one of the largest cities in China, where it is believed to have first been contracted at a live animal and seafood market. A ban on travel both to and from Wuhan was implemented on 23 January 2020, though a multitude of countries have evacuated their respective citizens from the area since its implementation. In addition, the World Health Organization declared it to be a Public Health Emergency of International Concern (PHEIC), owing to the severity of the outbreak. Spread through air droplets expelled when an infected individual coughs or sneezes, the coronavirus Wuhan In light of the Wuhan coronavirus outbreak, numerous dental associations and organisations have come out with advice and guidance for dental professionals seeking to limit its transmission. is considered to be highly infectious, and the number of confirmed cases has risen each day since its identification. “It’s very, very transmissible, and it almost certainly is going to be a pandemic,” Dr Anthony S. Fauci, director of the National Institute of Allergy Infectious Diseases in the US, told the New York Times. and Since the outbreak, numerous national health bodies have released guidance for dental and medical professionals relating to the Wuhan coronavirus. For (Image: Robert Wei/Shutterstock) example, Public Health England has set up a webpage that, among other guidance, recommends isolating and not physically examining any patients who are reasonably suspected of having contracted the virus, and the Australian Dental Association has strongly endorsed the use of thorough infection control and hygiene measures in dental practices. responsible Meanwhile, the organising team the International Dental Exhibition and Meeting has (IDEM) for that attendees the event and reassured exhibitors is still scheduled to take place in Singapore from 24 to 26 April 2020. “We continue to closely monitor developments pertaining to the Novel Coronavirus and will put in place precautionary measures at IDEM,” the IDEM organisers wrote in an email. “Should a pandemic situation arise, we may reassess our position on continuing to host IDEM, and keep you promptly informed of any updates,” they continued. in China FDI World Dental Federation (FDI), which is set to host its annual World Dental Congress in Shanghai this coming September, also released an update regarding its plans. “The safety and security of all those taking part in FDI’s World Dental Congress is always our primary concern,” FDI stated. “We continue to monitor developments in China and are in close contact with our local partners to assess the situation daily. Currently, the congress is scheduled to take place as planned as we anticipate the situation will be under control by this time,” it continued. The effects of the Wuhan coronavirus are also being felt by some of the dental industry’s biggest companies. As reported by Dental Tribune International, the clear aligner manufacturer Align announced in a recent conference call that it expects to sell between 20,000 and 25,000 fewer Invisalign cases in China in the first quarter of 2020, owing to the outbreak of the virus. Further costs associated with idling of manufacturing the capacities in Align’s Chinese plants are expected to be around US$3 million to $4 million. Ad Relax your patients and make them feel more comfortable during dental procedures Matrx Nitrous Oxide and Oxygen Conscious Sedation Systems There are many good reasons to use nitrous oxide sedation in your dental practice: • Safe - N2O/O2 has been used globally for over 100 years • Relieves patient anxiety and discomfort • Patients remain awake, yet more relaxed, making it an excellent patient management tool • Improves patient experience, resulting in return visits Matrx is made in the USA 210 Udyog Mandir 1 7-C Bhagoji Keer Road Mahim West, Mumbai 400016 India Phone: +91 22 61 46 47 48 Email: email@example.com www.lifecare.in
3 News 02/20 Oral health the focus at UN event conclusion of Prof. Stefan Listl from Radboud University in the Netherlands discussed the economic impact of oral diseases, noting that dental diseases are the third most expensive diseases to treat after diabetes and cardiovascular disease. The the event saw a panel of key oral health stakeholders, including corporate, research, professional and civil society organizations, discuss and challenges for partnerships and multisectoral collaboration. In his closing remarks, The Lancet Editor-in-Chief Dr. Richard Horton noted that the current poor state of oral health around the world is the collective failure the entire global health of community. He pledged the journal’s full support in fighting for better recognition of and priority for global oral health. opportunities Ad by Dental Tribune International co-sponsored by NEW YORK, U.S.: At the 2019 United Nations General Assembly, a side event, hosted by New York University (NYU) and The Lancet, called for oral health to be integrated into universal health coverage (UHC). Among the main issues raised were the influence of the sugar industry worldwide and the importance of public- private partnership. The event was the governments of Egypt, Japan and Thailand as well as the World Economic Forum and supported by the Henry Schein Cares Foundation. “Oral health largely ignored in conversations about global health and UHC, but The Lancet’s series on oral health and our recent event have been critical in creating visibility and urgency for oral health,” said Dr. Richard Niederman, chair of the Department of Epidemiology and Health Promotion at the NYU College of Dentistry and director of the WHO Collaborating is Center for Quality-improvement, Evidence-based Dentistry (QED WHO CC). In 2019, The Lancet published a series of papers on oral health. Dr. Habib Benzian, associate director of global health and policy for the NYU College of Dentistry’s QED WHO CC, co- authored a two-part article on UHC, focusing predominantly on the urgent need for reform and the role prevention will play. Speaking about the action needed to be taken in a 2019 interview with Dental Tribune International, Benzian said: “We are calling for full integration of basic oral health care in universal health coverage. We consider that this is the most promising entry point for change. This means that everyone, irrespective of socioeconomic status, should have access to quality oral health care, including preventive services, at a cost that does not lead to financial hardship. Many countries have shown that this is possible and realistic.” At the recent side event, the importance of innovative and At a side event to the 2019 United Nations General Assembly, universal oral health care was the focus of a conversation led by New York University and The Lancet. (Image: Drop of Light/Shutterstock) collaborative partnerships not only in the dental community but also across all sectors was raised. On hand to put forward ideas about how to create a plan of action, Benzian said, “No one organization or sector can enact these recommendations alone, underscoring the need for collaboration and the important roles the private sector, academia, and others can play. Change happens incrementally, but we have to start somewhere,” he explained. that governments, A number of co-authors of The Lancet’s oral health series were present at the event, and each had an opportunity to speak about their respective topics. Among them was Dr. Cristin Kearns from the University of California, San Francisco, who highlighted the influence of the sugar industry on science and policy processes, calling for reforms and strong conflict of interest policies to shield public health and dental research from harmful industry interference. PRINT EVENTS EDUCATION DIGITAL SERVICES Dental Tribune International The World's Dental Marketplace www.dental-tribune.com
4 News 02/20 EFP and WHF release consensus report on links between periodontal and cardiovascular health by Dental Tribune International BRUSSELS, now. The Belgium/ Switzerland: GENEVA, Though various associations between periodontal health and cardiovascular health have previously been explored, a comprehensive analysis of this relationship has been absent— until European Federation of Periodontology the World Heart (EFP) and Federation have published a consensus report asserting that there is strong evidence epidemiological independent demonstrating associations between severe periodontitis and cardiovascular disease. (WHF) The report is the result of the Perio and Cardio Workshop 2019, a meeting of more than 20 representatives from the EFP and WHF during which the latest research into links between the two chronic non-communicable diseases was discussed. Among that its key findings were patients with periodontal disease have a higher risk of suffering cardiovascular disease and that patients who already have both of these diseases are at a higher risk of suffering further cardiovascular complications. “This workshop was a great opportunity for both cardiology and periodontal communities to review the scientific evidence behind these associations in a rigorous and unbiased manner,” commented Dr Mariano Sanz, professor and chair of periodontics at the Complutense University of Madrid and lead author of the consensus report. periodontitis “Cardiovascular disease is the leading cause of death and disability worldwide. Now that we are aware of the association between and coronary heart disease, we need to emphasise risk factors such as smoking and poor diet,” added Dr Pablo Perel, senior science adviser at WHF and professor of clinical epidemiology at the London School of Hygiene and Tropical The European Federation of Periodontology and the World Heart Federation have teamed up to publish a consensus report that emphasises the link between periodontitis and cardiovascular health. Medicine’s Centre Chronic Conditions. for Global be informed “People with periodontitis should about cardiovascular risk. We need to move beyond disease silos and have a ‘person-centred’ approach, which is why we at WHF are Ad (Image: Svetlana8Art/Shutterstock) proud to have joined forces with the EFP on this important issue,” concluded Perel. last year by As reported Dental Tribune International, numerous studies have shown that non-traumatic tooth loss— the final outcome of periodontal disease—may lead to a higher risk of cardiovascular disease. This applies in particular to older people, who are more likely to possess a calcified carotid artery if they present with periodontitis. Ad NOW OFFERING SPECIAL 20% DISCOUNT Belmont leads the way with totally new generation of dental treatment centre. (*Exclusive of Taxes. Terms and Conditions apply.) Exclusive Distributor in India: LifeCare Devices Private Limited T: (022) 6146 4725, 6146 4727. E: firstname.lastname@example.org l Mumbai l Delhi l Bangalore l Kolkatta l Chennai l Pune l Ahmedabad l Madurai l Hyderabad l Chandigarh l Lucknow l Jaipur l Vijayawada
6 News 02/20 Countries across the world seek to reduce sugar consumption Countries such as Chile and England have adopted various measures to reduce sugar consumption. (Image: Evan Lorne/Shutterstock) by Dental Tribune International obesity LEIPZIG, Germany: The epidemic global shows few signs of abating, and numerous countries from different regions have introduced policies aimed at reducing its impact. One of these countries is Chile, whose adoption of a strict warning system for the labelling of food and beverages high in sugar, fat or salt cut purchases of these products by almost a quarter over an 18-month period, according to a recent study. in relation In 2016, Chile brought the law of food labelling and advertising into effect. It encompasses a range of policies that subject unhealthy foods and beverages to certain marketing restrictions, particularly to advertising aimed at children. Furthermore, the regulation bans the sale of such food and drink at schools and includes a mandatory front-of-packaging warning label system that clearly states, with the assistance of black stop signs, whether a product contains excessive amounts of sugar, sodium, saturated fats or energy. According to the led the study’s regulation’s findings, introduction to a 23.7% reduction in purchases of sugar- sweetened beverages (SSBs) in the country, while a 5% increase in sales of bottled water, diet soft drinks and fruit juices without added sugar was recorded. In New Zealand Dental Association (NZDA) to press for its country’s government to adopt similar policies. “The idea of a levy on sugary drinks is widely talked about, but what this study shows is that other measures can have an impact on sugary drink consumption too,” said NZDA sugary drinks spokesperson Dr Rob Beaglehole. “The success also of warning labels tells us that both a teaspoon icon showing the number of teaspoons of sugar in a drink, and warning labels which highlight the tooth decay, obesity, and diabetes risks that high-sugar drinks pose can lead to reduced sugary drink consumption and harm,” he added. “The Australian “The ADA Dental Association [ADA] endorses the use of a sugar-sweetened beverage tax,” Dr Michael Foley, chair of the ADA’s Oral Health Committee, told Dental Tribune International. supports any public health measures designed to reduce Australia‘s high sugar consumption. Strong public health measures, including cigarette tax, plain packaging and alcohol tax, have been shown to influence purchases, and evidence around the world suggests that a tax on sugar-sweetened beverages does too,” Foley concluded. addition, another study published in Public Health Nutrition found that Chilean children’s exposure to unhealthy food and drink advertisements decreased by 58% on average. “An effect this big at the national level in the first year is unheard of,” Dr Lindsey Smith Taillie, lead author of the study and a nutrition epidemiologist at the University of North Carolina at Chapel Hill, told the New York Times. “It is a very promising sign for a set of policies that mutually reinforce one another. This is the way we need the world to go to begin to really combat preventable diseases like obesity, hypertension and diabetes,” she added. unhealthy Though Chile’s approach has thus far proved to be extremely fruitful, it is not the only country by far attempting to reduce its populace’s intake of sugar and other ingredients. In England, the April 2018 introduction of the Soft Drinks Industry Levy—commonly known as the sugar tax—was primarily responsible for a 28.8% decrease in the sugar content per 100 ml of carbonated beverages. Similarly, the 2014 implementation of a tax on SSBs in Mexico led to a 6.3% reduction in SSB purchases and a 16.2% increase in bottled water purchases, according to a study in the Journal of Nutrition. The success of law’s introduction in Chile has led the the DT-SA Editor‘s comments: Why was this study carried out? • The Law of Food Labeling and Advertising, implemented by Chile in 2016, is a set of policies designed to prevent further increases in the prevalence of obesity. The law subjects the foods and beverages high in energy, sugar, sodium, and saturated fat content to marketing restrictions, sales ban in schools, and a front-of- package (FOP) warning-label system. • Several countries are seriously considering the implementation similar policies, particularly the FOP warning-label policy. of the U n d e r s t a n d i n g • how implementation of this policy can influence the beverage purchases can guide the development of future policies on obesity prevention. What did the researchers do and find? • The researchers used the national data on household food purchases from before and implementation, after policy and evaluated the changes in purchases of beverages high saturated fat, sodium, or calories (i.e., “high-in” The study compared the observed beverage purchases after policy implementation to the expected beverages). sugar, in purchases had the policy not been implemented. • • research The research found that the purchase volume of high-in beverages decreased by 22.8 mL per capita per day or 23.7% after the policy was implemented. The also found that although both - high as well as low-educated households similar absolute reductions in high-in beverage high- educated households showed larger relative reductions in high-in beverage purchases. purchases, had What do these research findings mean? • The observed decrease in the purchases of high-in beverages after the implementation of Chile’s labeling, marketing, and school food sales policies, is greater than purchase changes that have been observed following single, implementation of standalone policies in Latin America (eg. sugar-sweetened- beverage tax). • Future research to understand is required to what degree these changes are attributable to the reformulation of products and/or to changes in consumer behavior, as well as the impact of these regulations on dietary intake and health- related outcomes.
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