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The penny-per-ounce tax that the city of Berkeley in California imposed on sugar-sweetened beverages (SSBs) has reduced SSB consumption and increased water consumption, according to the School of Public Health at the University of Berkeley, and the Department of Epidemiology and Biostatistics, University of California, San Francisco.

After Berkeley became the first jurisdiction in the United States to implement a tax on SSBs in March of 2015, the researchers examined changes in pre-tax and post-tax beverage consumption in low-income neighborhoods in Berkeley compared to Oakland and San Francisco.

A questionnaire was used to determine the frequency of beverage consumption about 8 months after the tax was passed and 4 months after it was enacted. After it was implemented, SSB consumption in Berkeley decreased by 21%, compared to a 4% increase in the other cities. Also, Berkeley showed a 63% increase in water consumption, compared to a 19% increase in the other cities.

“An SSB tax is one of the few public health interventions expected to reduce health disparities, save more money than it costs, and generate substantial revenues for public health programs,” said the authors of the study. “If impacts in Berkeley persist, and evidence from other cities passing SSB taxes corroborate our findings, widespread adoption of SSB excise taxes could have considerable fiscal and public health benefits.”

The study, “Impact of the Berkeley Excise Tax on Sugar-Sweetened Beverage Consumption,” was published in the American Journal of Public Health.

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Breaches of infection prevention practices at a practice located in Morris County, NJ, have led to 15 cases of Enterococcus faecalis endocarditis, including one death, according to the New Jersey Department of Health.

The department’s investigation revealed that the outbreak occurred among patients receiving intravenous sedation for invasive oral surgical procedures from December 2012 through August 2014.

Local news media including nj.com identified John Vecchione, DDS, as the practicing dentist. His practice, North Jersey Oral, Maxillofacial & Reconstructive Surgery, has offices in Budd Lake and Parsippany.

The state’s Board of Dentistry has allowed Vecchione to continue to treat patients, but it also has ordered him to improve his infection prevention protocols. Vecchione has agreed to comply with those orders, and the board will continue its investigation.

According to the Department of Health, a healthcare provider reported a pair of cases of bacterial endocarditis caused by E faecalis in October 2014, followed by an additional case reported in November 2014.

Investigation revealed that these patients all had oral surgery at Vecchione’s Budd Lake office. The department called the odds of 3 cases of endocarditis associated with extractions at the same practice with the same enterococcal species “highly unlikely.”

Multiple local and state health agencies visited and inspected the Budd Lake location in November 2014 and determined that its infection prevention practices deviated from the guidelines promulgated by the Centers for Disease Control and Prevention and endorsed by the ADA.

Violations included:

  • Improper storage and handling of medication;
  • Failure to adequately monitor the cleaning, disinfection, and sterilization process;
  • Failure to maintain the sterility of products and instruments, to maintain aseptic technique during procedures, and to ensure a safe environment for care;
  • Failure to use appropriate personal protective equipment and other protective devices;
  • Failure to develop written policies and procedures.

The Department of Health returned to the office in January 2015 and noted changes that Vecchione had made based on its recommendations. However, investigators still found deficiencies in storing and handling medication, monitoring the sterilization process, maintaining sterility, using personal protective equipment, and policies and training.

Using Vecchione’s 2013 and 2014 records and the New Jersey Hospital Discharge Data Collection System, investigators associated 12 additional cases of E faecalis endocarditis with the oral surgery practice. The death was due to complications of endocarditis and the resulting cardiac surgery.

The Department of Health reports that 12 of the 15 total patients had cardiac surgery as a consequence of their infection, including 8 valve replacements and 4 valve debridement/repair procedures.

Also, 8 of these patients had a history of murmur, and 3 had conditions that might place them at increased risk for endocarditis. One of these 3 had aortic stenosis, one had a previously undiagnosed bicuspid aortic valve, and one had previously undiagnosed partial anomalous pulmonary venous return.

While these 3 particular patients were at higher risk of endocarditis, none of them or the other 12 had a high-risk condition that would have required antimicrobial prophylaxis before dental procedures. None of the patients had identifying underlying illnesses placing them at increased risk of enterococcal infections either.

The Department of Health noted that the practice’s incidence rate of enterococcal endocarditis among its patients in 2013 and 2014 was more than 248 times greater than the national incidence rate. It will continue its surveillance efforts to detect additional cases associated with the outbreak and ensure compliance with its recommendations.

Also, the department believes these patients were infected during the administration of intravenous sedation, not the surgical procedure itself. Patients who had invasive procedures with local anesthesia or who only had noninvasive procedures or consultations do not appear to be at risk.

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Henry Schein has launched its 2016 Healthy Lifestyles, Healthy Communities (HLHC) program, expanding access to healthcare, prevention, and wellness for underserved communities by providing free medical and dental screenings at community events around the country.

Created 10 years ago in partnership with the National Association of Community Health Centers (NACHC) HLHC expects to serve about 8,700 children and their caregivers with free medical and oral health services at 14 health fairs this summer and fall. Each event is held in conjunction with a local community health center.

The company supports each HLHC event with a $5,000 in-kind donation and a $5,000 cash grant from the Henry Schein Cares Foundation. Since HLHC’s inception, Henry Schein and the foundation have provided supplies and financial assistance combined in support of nearly 95 health fairs.

According to the NACHC, community health centers play a key role in the nation’s healthcare system by providing continuous primary and preventive care, reducing the risk of new healthcare problems and saving the healthcare system $24 billion per year. HLHC is annually cosponsored by state and local community health organizations and supported by Henry Schein’s supplier partners.

At each HLHC event, local physicians, nurses, dentists, and community volunteers screen for a range of health issues such as hypertension, asthma, diabetes, obesity, and poor oral health and associated risk factors that commonly affect children. Each participant also receives educational materials and assistance in finding a local community health center where they can access care regularly.

“Community health centers play a vital role throughout the country, providing excellent care to people who would otherwise go without,” said Stanley M. Bergman, chairman of the board and chief executive officer of Henry Schein.

“Community health centers, which promote high-quality, affordable healthcare, closely align with Henry Schein’s commitment to wellness, treatment, and disease prevention,” Bergman said. “We are pleased to join our supplier partners, Team Schein Member volunteers, and local community health center organization partners to ‘help health happen’ for thousands of children and their caregivers through our Healthy Lifestyles, Healthy Communities program.”

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Researchers at Tokyo Medical and Dental University have injected a gelatin-based gel carrying the peptide OP3-4 and recombinant human bone morphogenetic protein 2 (BMP-2) into the jawbones of mice to trigger local augmentation of bone around the injection site, promising potential nonsurgical treatment for alveolar bone loss.

BMP-2 has been used before to stimulate osteogenesis in humans, but high levels can cause inflammation and tumor development. OP3-4, meanwhile, has been shown to inhibit bone decay and stimulate the differentiation of cells that form bone.

By injecting these agents, the researchers avoided the need for surgical implantation, swelling, and other complications. They saw a region of increased bone mass around the BMP-2 and OP3-4 injection site that was larger than that seen in mice injected with BMP-2 alone or with other controls.

Additionally, the mass had significantly higher bone mineral content and density. Microscopic examination revealed the deposition of calcified tissue, or mineralization, throughout the newly formed bone of the mice treated with BMP-2 and OP3-4.

“Mineralization of the outer region evidently took place before that of the inner region,” said lead author Tomoki Uehara. “We speculate that the size of the new bone is determined before calcification starts and that OP3-4 plays an important role in making a regeneration site at the early stage of bone formation.”

“OP3-4 further enhanced the number of bone-forming cells induced by BMP-2 treatment and greatly increased the expression of genetic markers of bone formation,” said corresponding author Kazuhiro Aoki, DDS, PhD.

The study, “Delivery of RANKL-Binding Peptide OP3-4 Promotes BMP-2-Induced Maxillary Bone Regeneration,” was published by the Journal of Dental Research.

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Persistent orofacial pain, which is defined as pain in the face that lasts more than 3 months, affects about 7% of the population in the United Kingdom. Yet these patients often need to see different medical and dental practitioners during an average timeframe of 6 months at a cost of £642 (about $846) before they get effective treatment.

More rapid care, then, could relieve their suffering sooner and save the National Health Service millions, according to Newcastle University. This alleviation would begin by screening patients with a well-established chronic pain scale to ensure those most severely affected immediately receive specialist care.

The university interviewed 198 patients who also completed the graded chronic pain scale (GCPS) questionnaire to measure what treatment that they had received in the previous 6 months. Patients who ranked “high” on the GCPS were considered to have significant pain-related disability and needed more care.

These high-ranking patients should be referred to a specialist in a central hub for care, according the researchers. Patients who have low levels of disability based on their questionnaire results would be seen and treated by a range of healthcare professionals in regional clinics.

“It is likely that this hub-and-spoke model would be more efficient and effective for patients but can only work if there is investment and enough experts are recruited,” said Justin Durham, PhD, senior lecturer and National Institute for Health Research clinician scientist at Newcastle University.

“Ultimately, it is likely this model would provide faster, more effective treatment for patients but at a lower cost,” Durham said.

The study, “Healthcare Cost and Impact of Persistent Orofacial Pain,” was published in the Journal of Dental Research.

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Dentists who need assistance with food, water, clothing, and shelter in the wake of the recent flooding in Louisiana can seek immediate aid from the ADA Foundation’s Emergency Disaster Grant Program. The program can quickly provide up to $2,000 in aid to those dentists in declared disaster areas.

Dentists may apply by submitting an application form directly to the ADA Foundation. The application is available at adafoundation.org. Dentists do not have to be members of the ADA to receive aid. Also, the Louisiana Dental Foundation is offering disaster grants and a list of disaster preparedness and recovery resources for all dentists.

The ADA has additional information on disaster recovery and emergency planning at ADA.org. The ADA Foundation and accepts contributions for its Emergency Disaster Grant Program. To donate, call (312) 440-2547 or visit adafoundation.org/en/how-to-help. Donors can contribute to the Louisiana Dental Association Foundation as well.  

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The growing threat of antimicrobial resistance (AMR) could reduce or even eliminate the effectiveness of many common medications, putting people’s health and lives at risk. In response, global health experts have banded together to urge the United Nations to set global targets for reduced antibiotic consumption.

According to their recommendations, countries should consume no more than the current median global level of antibiotics, which is 8.54 defined daily doses per capita per year. This amount would reduce global antibiotic use by more than 17.5%, they say. Each country would have to determine its own strategy for reaching that goal.

In lower-income and middle-income countries that lack public health infrastructure, improving public health and sanitation could reduce antibiotic use. But wealthier nations, which often exceed the 8.54 dose target, will require public educational campaigns directed at physicians and patients alike to discourage the inappropriate use of antibiotics.

The experts note that the general public often doesn’t know when antibiotics should be used. In a recent European Commission survey, 57% of respondents incorrectly answered if antibiotics can kill viruses. In a recent US survey, 40% said antibiotics were the best treatment for a runny nose or sore throat.

“We need to measure progress and have some idea of what progress will look like,” said Ramanan Laxminarayan, PhD, MPH, lead author and director of the Center for Disease Dynamics, Economics & Policy in Washington, DC. He also noted that targets are the only way public officials will be able to tell if their efforts are working.

The United Nations will discuss strategies for preserving global access to effective antimicrobials during its September 21 General Assembly meeting. Laxminarayan believes this meeting is important because AMR isn’t an imminent threat like Zika or Ebola, so people don’t have a sense of how it could affect them personally.

“Getting people to respond to a problem that is creeping up slowly,” he said, “is difficult.”

The researchers estimate that $5 billion would be needed annually to develop new vaccines that would reduce the need for antibiotics, diagnostic tools that can determine the nature of an infection more quickly, and novel alternatives to antibiotics. New antibiotics are needed but aren’t a long-term solution, they said, because resistance to them will develop quickly.

To supervise these efforts, the authors call for the creation of a high-level coordinating mechanism that would bring together the World Health Organization, the UN Food and Agricultural Organization, the World Organization for Animal Health, and other UN agencies and stakeholders to coordinate support for the development, implementation, and monitoring of national AMR plans.

“Having goals is one thing, but having the architecture is absolutely critical,” said Laxminarayan.

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Surindar “Sindi” Bhaskar, DDS, who served as a major general in the United States Army Dental Corps before retiring, died on August 4, 2016 at the age of 93 in his home in Monterey, Calif. He was an oral pathologist, an educator, a periodontist, an author, and the first Asian-born general in the United States military.

Bhaskar was born in the state of Punjab in Northern India in 1923. He completed dental school at the University of Punjab by the age of 19 years and then practiced general dentistry in Bombay. At the age of 21, he came to the United States to attend the Northwestern University School of Dentistry, where he received his DDS in 1946.

Next, Bhaskar completed his master of science and doctor of philosophy degrees as well as specialty training in oral pathology and oral medicine at the University of Illinois and the University of Chicago. He entered the U.S. Army Dental Corps in 1955, serving in numerous positions and rising to the rank of major general before being promoted to chief of the corps and assistant surgeon general for dental services.

Additionally, Bhaskar was a professor at Georgetown University School of Medicine and Dentistry and wrote more than 200 scientific papers and 4 textbooks. After retiring from the military, he entered a residency to obtain a certificate in periodontics at the UCLA School of Dentistry, VAMC Wadsworth, which he completed in 1980.

Later, he practiced periodontics with the Monterey Peninsula Dental Group. An internationally renowned lecturer on oral pathology and periodontics, he delivered more than 10,000 hours of education before retiring in 2005. He was awarded the Legion of Merit and the Meritorious Service Medal for his work as well.

Bhaskar is survived by his wife, Norma; his sons, William, Philip, and Thomas; his brothers, Kedar, Som, and Prem; and his grandchildren, Elizabeth, Brian, and Emma. He was laid to rest at Arlington National Cemetery with full military honors.

Memorial donations may be sent to the S. N. Bhaskar Scholarship Endowment at the University of the Pacific Dugoni School of Dentistry, Development Office, 155 Fifth St., San Francisco, Calif. 94103.

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