Oral Health Watch

Published Online: Wednesday, September 21, 2011

Proper oral care is an important part of preventive medicine, and pharmacists must be fimiliar with current trends.

Gum Disease Associated with Infertility

In a study presented in July 2011 at the annual meeting of the European Society of Human Reproduction and Embryology in Stockholm, Sweden, researchers showed that gum disease in women is associated with a prolonged time to pregnancy.

The study enrolled 3737 pregnant women who were taking part in a Western Australian study called the SMILE study. Information from 3416 of these women regarding pregnancy planning and pregnancy outcomes was analyzed. The researchers found that women with gum disease took an average of 7 months to become pregnant, 2 months longer than women without gum disease.

The study further showed that non- Caucasian women with gum disease fared worse, taking over a year to become pregnant when compared with those without gum disease.

Other factors that increased time to pregnancy were also identified, including being older than 35 years, being overweight or obese, and smoking.

The authors emphasize that gum disease is a modifiable risk factor and encourage women who are trying to get pregnant to see their dentist regularly and have gum disease treated before trying to conceive. A proposed reason that gum disease may prolong the time to pregnancy involves the effects of inflammation, which is at a higher level in gum disease and is associated with infertility.

Sports and Energy Drinks Often Misused by Children and Adolescents

In a clinical report published by the American Academy of Pediatrics (AAP) in the June 2011 issue of the journal Pediatrics, experts warn that the growing consumption of sports and energy drinks by children and adolescents may have deleterious effects.

One of the main concerns experts have with sports and energy drinks is their harmful dental effects. Because sports and energy drinks have a low pH due to high quantities of citric acid, enamel demineralization and subsequent dental erosion is a major issue. This effect continues even after the pH has been neutralized. Additionally, many of these drinks have high sugar content, which also may be detrimental to oral health and serve as a major contributor to the epidemic of children being overweight and obese.

In a broad recommendation, the AAP states that all caloriecontaining beverages should be eliminated from a wellbalanced diet, with the exception of low-fat or fat-free milk. Further, the group recommends that schools have water available at no cost; restrict carbonated, fortified, or flavored waters; restrict sports drinks to use by athletes only during prolonged, vigorous sports activities; prohibit energy drink use, even for athletes; and prohibit the sale of caffeinated products in school.

The AAP also encourages health care practitioners to improve education of children and adolescents and their parents in the area of sports and energy drinks by highlighting the differences between the 2 beverages and promoting water rather than sports or energy drinks as the principal source of hydration.

Medicaid Should Increase Payments to Pediatric Dentists, Study Says

A new study published in the July 13, 2011, issue of JAMA demonstrates that increased Medicaid reimbursement for pediatric dentists may improve access to dental care and pediatric oral health.

The study examined data on Medicaid dental fees in 2000 and 2008 for 42 states and the District of Columbia. The data were merged with data from 33,657 children and adolescents in the National Health Interview Survey for the years 2000-2001 and 2008-2009. The effect that Medicaid prophylaxis fees had on children and adolescents seeing a dentist in the past 6 months was estimated, and the occurrence of dental visits in this population was compared with that in privately insured counterparts, the control group.

The study found that in 2008-2009, more children and adolescents covered by Medicaid had seen a dentist in the past 6 months than did uninsured children, but the number was fewer than children covered by private insurance. Increased state Medicaid dental payment fees between 2000 and 2008 were associated with increased use of dental care among children and adolescents. Sandra L. Decker, PhD, the author of the study, believes these results are telling, because poor oral health is associated with more costly health outcomes. Poor oral health has “the potential to affect children’s speech, social development, and quality of life,” Dr. Decker wrote. In a climate of sweeping health care reform, “More attention to the effects of provider payment policies on access to care, quality of care, and health outcomes may be warranted,” she said. PT

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