(Reuters Health) - Asthmatic children who are exposed to cigarette smoke are more likely to make repeat trips to the hospital for breathing problems. But researchers say asking parents about kids' smoke exposure may not yield the most reliable information.

In a recent study, saliva revealed exposure to tobacco smoke in roughly 80% of children brought to the hospital for asthma or breathing problems. But only about a third of parents said their children came in contact with smoke.

What's more, finding evidence of nicotine, a chemical in tobacco, in children's saliva was a better predictor of whether they would need to come back to the hospital, compared to the information parents gave to doctors.

"We think saliva is a good and potentially useful test for assessing an important trigger for asthma," Dr. Robert Kahn, the study's senior author, told Reuters Health.

Previous research has found that being exposed to tobacco can lead to airway problems and poor asthma control among children, Kahn and his colleagues write in the journal Pediatrics.

By figuring out which children are being exposed to tobacco, doctors may be able to step in and identify and possibly eliminate the exposure, said Kahn, a pediatrician at Cincinnati Children's Hospital Medical Center in Ohio.

For example, if a parent is still smoking cigarettes and exposing the child to smoke, doctors can offer the parent smoking cessation tools while the child is hospitalized.

For the new study, the researchers assessed data from 619 children admitted to Cincinnati Children's Hospital Medical Center for asthma or other breathing problems between August 2010 and October 2011. The children were between one and 16 years old.

During the children's first couple of days in the hospital, researchers asked their parents if the children had any exposure to tobacco - either at home, in the car or in another place the children slept. Nurses also collected blood and saliva samples from the children.

About 35% of parents reported their children having some tobacco exposure.

However, about 56% of the children's blood samples and about 80% of their saliva samples tested positive for cotinine, a component of nicotine that's a marker for tobacco exposure.

The difference in the results of the saliva and blood tests and the parents' reports doesn't necessarily mean the parents lied about their children's exposure to smoke.

It could also be that the researchers and doctors didn't ask enough or the right questions or that the parents didn't know their children were being exposed to smoke.

"Sometimes a parent's response to a simple question may not reflect the nuances of life," Dr. James Kreindler said.

He was not involved with the new study but is an attending pulmonologist at The Children's Hospital of Philadelphia in Pennsylvania.

One in six children in the study had to be readmitted to the hospital within a year.

Parents' reports of smoke exposure weren't tied to the likelihood of children returning to the hospital. But Kahn and his colleagues did find that children were more likely to be readmitted if their saliva or blood tested positive for cotinine.

The researchers write that saliva is an attractive testing option, because it's not hard or invasive to get a sample. It also appeared to be a more sensitive test than blood.

But Kreindler cautioned that the new results don't mean children should get tested for cotinine in the hospital.

"The test they are using to determine cotinine levels is a very sophisticated test - not one that would be available to every community hospital," he said. And the treatment for asthma wouldn't necessarily change based on whether a child was exposed to tobacco, he noted.

Kreindler said a cost analysis would also be needed to look at the expense of testing.

According to Kahn, a cost analysis would most likely follow a trial of whether smoking cessation after positive saliva tests decreased hospital readmissions among children.

"The take-home message should always be that exposure to secondhand smoke for both adults and children is a significant health risk factor - particularly for children with asthma and respiratory disorders," Kreindler said. "They should not be exposed to secondhand smoke under any circumstance."

SOURCE: bit.ly/uFc4g2 Pediatrics, online January 20, 2014.

Four University of Washington School of Dentistry faculty members have received a patent for a new way of using titanium-based materials to fight oral bacteria.

The patent culminates several years of work in which the group studied a novel class of substances called titanates and peroxotitanates, which can inhibit bacterial growth when bound to metal ions. These titanates could be incorporated into a gel or a solution that would be applied by a dentist after a procedure such as a root canal or a filling. The application could reduce the chances of infection or tooth decay at that site.

Titanates could also be used in bandages, skin gels, mouthwashes and toothpaste to limit bacterial growth, said Dr. Whasun Oh Chung, research associate professor of oral health science, who works on this new antibacterial agent. The others are Dr. Daniel Chan and Dr. John Wataha, both professors of restorative dentistry; and Dr. Bruce Rutherford, lecturer in oral biology.

The group’s work grew out of nearly a decade of research performed by Wataha and Dr. David Hobbs of South Carolina’s Savannah River National Laboratory. Hobbs is also listed on the patent as an inventor. Their studies formed the basis for a four-year, $1.5 million federal grant by the National Institute of Dental and Craniofacial Research to the UW School of Dentistry to evaluate titanates’ antibacterial properties.

Chan, the School of Dentistry’s associate dean for clinical services, was co-principal investigator on the grant with Dr. James Bryers of the UW Department of Biomedical Engineering.  Whasun Oh Chung and another School of Dentistry faculty member, Dr. Albert K.H. Chung, were co-investigators.  Dr. Charles Spiekerman of the School of Dentistry’s Department of Oral Health Sciences is the group’s biostatistician, while Wataha is  a consultant. Hobbs helped secure the grant.

Metals have long been known to have antibacterial properties, said Whasun Oh Chung, but, when used in concentrations high enough to be effective, they also carry a risk of toxic side effects. What makes the work with titanates promising, she said, is that the therapeutic benefits are achieved with less risk of toxicity.

“It is very new and novel,” said Chung. “Nothing has delivered materials at such a non-toxic level. We’re working with something we know is effective. Metals have been around a long time, and the bacteria haven’t become resistant to them.”

That is also an important consideration at a time when growing bacterial resistance to antibiotics places greater urgency on the need to find antimicrobial alternatives, she noted.

“The use of metal ions to control bacterial infections remains of interest as drug-resistant bacteria are becoming increasingly common and dangerous to human health,” Chung said.

Aside from their uses in the mouth or other topical applications, titanates could even be used in narrowly targeted treatments for internal organs, she said.

Titanates could also be used in dental or medical materials and devices, she said, including suture material, catheters, shunts, and dental fillings. They could even show up in toothpastes and mouthwashes some day, she said.

“[Titanate-metal complexes have] proven to be effective against endodontic, cariogenic  and periodontic bacteria,” Chung said. “The idea is to make it easy for people to use every day.” At the same time, Wataha cautioned that the practical or clinical benefits have yet to be conclusively demonstrated for the new patent-related application.

The researchers are now conducting human trials and expect to finish this spring, Chung said. However, she declined to predict when titanates might be approved for general use.

Source: University of Washington

Alexandria, Va., USA - The International Association for Dental Research (IADR), with Unilever, has announced the creation of the "IADR Unilever Social Entrepreneur Approach to Change Oral Health Behavior Research Award." This is an IADR award with funding provided exclusively by Unilever.

The purpose of the IADR Unilever Social Entrepreneur Approach to Change Oral Health Behavior Research Award (IADR Unilever SEA Change Research Award) is to stimulate scientific research in social entrepreneur approaches to affect real behavioral change at the individual or community level that improve oral health, with a particular emphasis on interventions targeted to disadvantaged and vulnerable populations. One IADR Unilever SEA Change Research Award will be granted up to $75,000.

In geographies such as Asia, Latin America, Africa and Europe, Unilever has a significant presence of oral care brands, including Signal and Close Up.

“IADR is excited to partner with Unilever on this new research award,” said IADR President Helen Whelton. “Given the global burden of oral diseases and the worldwide oral health inequalities, new, innovative research approaches are sorely needed and IADR is very grateful for Unilever’s generous support in an area that is often overlooked by traditional funding agencies.”

“Unilever is committed to improving oral health of populations and articulates five levers of encouraging behavioral change: make it understood, make it easy, make it desirable, make it rewarding and make it a habit,” said Alexis Roberts-McIntosh, VP Global Oral Care Category R&D for Unilever. “We are delighted to be partnering with IADR to stimulate behavioral research to improve oral health.”

The IADR Unilever SEA Change Research Award will be provided in the form of an unrestricted research grant.

Examples of research areas of interest could include, but are not be limited to:

• Demonstrating the effectiveness of social entrepreneurial approaches to improving individual health decisions.

• Expanding on current behavioral change models.

• Demonstrating the effectiveness of positive, relevant oral health messaging incorporated into a complex social milieu.

• Understanding the underlying social determinants of health, including oral health.

IADR will be accepting proposals for this new award until March 3, 2014. Please visit www.iadr.org/SEA for more information about the IADR Unilever Social Entrepreneur Approach to Change Oral Health Behavior Research Award.

A team at the U.S. Army Institute of Surgical Research in San Antonio, Texas, is working on a chewing gum that kills cavity-causing bacteria, according to the New York Daily News.

Combat gum is still in clinical trials, but Col. Robert Hale, the commander of the US Army Dental and Trauma Research Detachment, estimates it could be available with a prescription in the next 3 to 5 years.

To read the full article, click here.

Bordeaux, France – ACTEON Group has announced it is merging the imaging units of SOPRO Dental and De Götzen to create one ACTEON Imaging business unit. This merger consolidates the companies imaging units, which will improve customer relations, create synergies in marketing and logistics, and increase growth and efficiencies in both manufacturing and R&D.

It has been announced that SOPRO CEO Pierre Montillot will take over as general manager of De Götzen and lead the new ACTEON Imaging management committee.

“This merger is a turning point for our company,” said Gilles Pierson, President and CEO of ACTEON Group.” The new imaging unit will focus on bringing new and exciting products to the market and realize our goal to become the leading dental imaging company in the world.”

With the recent releases of X-Mind Unity and Sopix Inside the two companies have developed cutting edge products that have changed dentistry and improved the patient experience. This merger will ensure that there will be many new and innovative products to come from ACTEON.

DETROIT – A new study reveals an alarming increase in oropharyngeal cancers among young adults. While the exact cause for this phenomenon is unknown, the human papillomavirus (HPV) may be to blame.

According to researchers from Henry Ford Hospital in Detroit there was an overall 60% increase from 1973 and 2009 in cancers of the base of tongue, tonsils, soft palate and pharynx in people younger than age 45.

Among Caucasians, there was a 113% increase, while among African-Americans the rate of these cancers declined by 52% during that period of time.

But compared to Caucasians and other races, the 5-year survival rate remains worse for African-Americans.

The study is published online ahead of print in Otolaryngology-Head and Neck Surgery, the official journal of American Academy of Otolaryngology-Head and Neck Surgery.

"The growing incidence in oropharyngeal cancer has been largely attributed to the sexual revolution of the 1960s and 1970s, which led to an increased transmission of high-risk HPV," says study lead author Farzan Siddiqui, MD, PhD, director of the Head & Neck Radiation Therapy Program in the Department of Radiation Oncology at Henry Ford Hospital.

"We were interested in looking at people born during that time period and incidence of oropharyngeal cancer. Not only were we surprised to find a substantial increase in young adults with cancer of the tonsils and base of tongue, but also a wide deviation among Caucasians and African Americans with this cancer."

The American Cancer Society estimates about 36,000 people in the US will get oral cavity and oropharyngeal cancers in 2013; an estimated 6,850 people will die of these cancers. Oropharyngeal cancers are more than twice as common in men as in women, and about equally common in African Americans and Caucasians.

Recent medical research has shown that HPV exposure and infection increases the risk of oropharyngeal squamous cell cancer independently of tobacco and alcohol use, two other important risk factors for the disease, according to the National Cancer Institute.

The incidence of oropharyngeal cancer has been growing in recent years due to increasing rates of HPV infection. This has been largely attributed to changes in sexual practices. Studies have shown, however, patients with HPV related head and neck cancer do have a better prognosis and survival.

For the Henry Ford study, Dr. Siddiqui and his colleagues used the SEER (Surveillance Epidemiology and End Results) database to gather information about adults younger than age 45 who had been diagnosed with invasive squamous cell oropharyngeal cancer between1973 and 2009.

Since SEER does not record HPV information, the researchers used tumor grade as a surrogate indicator of HPV infection.

Among the study group of more than 1,600 patients, 90% were ages 36-44 and the majority (73%) was Caucasian.

During the 36-year period, the majority of patients (50%-65%) underwent surgical resection for their tumors. Patients who had both surgery and radiation therapy had the highest five-year survival rate.

"These patients have a favorable prognosis and are likely to live longer while dealing with treatment related side-effects that may impact their quality of life," notes Dr. Siddiqui.

The 5-year survival for the study group was 54%. There was no difference in survival based on gender. African-Americans, however, had significantly poor survival compared to other races.

"The predominance of oropharyngeal cancer in this age group suggests either non-sexual modes of HPV transfer at a younger age or a shortened latency period between infection and development of cancer," says Dr. Siddiqui.

Source: EurekaAlert!

A new 7-minute video from Crosstex provides a tutorial on face mask selection and use. In “MaskEnomics” viewers will learn:

• The differences between various mask protection levels (ASTM Level 3, 2, or 1)

• How to select the best mask for the procedure you are performing

• The Advantages of Secure Fit^® Technology

• How to best safeguard youself from harmful pathogens

To view the tutorial, click here.

The Hinman Dental Society has pledged $500,000 to establish the University of North Carolina School of Dentistry's 16th professorship: the Dr. Thomas P. Hinman Distinguished Professorship in Restorative Dentistry. This new professorship, specifically for the support of the Department of Operative Dentistry, will be eligible for appointment in fiscal year 2014-15.

“We are very appreciative of the support the Hinman Dental Society has shown our school, historically and today,” Dr. Jane Weintraub, dean of the UNC School of Dentistry, said. “The establishment of this new professorship will allow us to recognize, reward and augment our already top-tier restorative dentistry faculty by providing additional funding to retain or recruit deserving educators to advance our school’s missions.”

The endowed professorship adds to the long-standing support that the school has received from the Hinman Dental Society. The society earlier established the Thomas P. Hinman Continuing Education Scholarship Fund and the Thomas P. Hinman Distinguished Lecture. The Hinman Lecture, hosted annually by the Department of Operative Dentistry, has been in existence nine years and has included notable speakers such as Drs. Frank Spear, John Kois, Gordon Christensen and others. In sum, the Hinman Dental Society has contributed more than $600,000 to the school.

“As a non-profit organization, the Hinman Dental Society is committed to supporting dental education through scholarships, gifts and endowments, such as this $500,000 gift to endow a professorship in restorative dentistry at UNC,” said Dr. Paul G. Isler, Hinman Dental Society chairman of the trustees. “We are honored to be in a position to support one of the most prestigious dental schools in the country. If Dr. Hinman were alive today, he would be very pleased that we continue to dedicate our organization to furthering education for both practicing and emerging dentists.”

The Thomas P. Hinman Dental Society, founded in 1911 by its namesake, is a not-for-profit organization comprising more than 800 member dentists. Committed to the advancement of its membership, the society provides educational and professional development opportunities while promoting high practice standards through advocacy and outreach. The first Thomas P. Hinman Dental Meeting was held the year of the society's founding and was considered the first clinic strictly for serious-minded educational purposes. Now an annual occurrence, it is known for its attention to detail and hospitality. For more than 100 years, the Hinman Dental Society has maintained its reputation for delivering quality continuing education by the industry's foremost experts, not only for dentists, but also for the whole dental team.

Dr. Thomas P. Hinman graduated from Southern Dental College in Atlanta with his D.D.S. in 1891 and one year later joined the faculty of his alma mater, becoming professor of oral surgery. Hinman held many high offices in numerous professional organizations, including an appointment by President Woodrow Wilson as the U.S. delegate and honorary chairman of Section VII of the Fourth International Congress of Dentists in London.

Source: UNC School of Dentistry

Anesthesia Progress –The demand for outpatient dental procedures is increasing and, along with it, the requirement for sedatives that meet the needs of both patient and the dentist. For many outpatient oral surgical procedures, an intravenous sedative and local anesthetic are used, but there are many drug combinations and techniques. A new drug being evaluated, fospropofol, shows promise as a safe and effective intravenous sedative.

The current issue of the journal Anesthesia Progress reports on a comparison of two drugs, midazolam, a widely used sedation medication, and fospropofol for intravenous moderate sedation. Midazolam relieves anxiety, and provides sedation and amnesia; however, it can be slow to take effect, does not always adequately relieve discomfort from the procedure, and may require a longer physical recovery time. Fospropofol has also been shown to relieve anxiety, to take effect more quickly and to allow patients to recover physically in less time.

Sixty patients scheduled for oral surgery participated in a single-center clinical trial and were randomly selected to receive either midazolam or fospropofol. Both of these intravenous sedation drugs were paired with fentanyl and local anesthesia. Each drug was evaluated for the onset and maintenance of sedation, safety, cardiovascular stability, time to patient recovery, adverse effects, and patient and surgeon satisfaction.

There were no significant differences in sedation maintenance, safety, or patient and surgeon satisfaction. The fospropofol group had a shorter mean physical recovery time than the midazolam group, although there was no significant difference in cognitive recovery times. Among significant adverse effects, more patients receiving midazolam experienced an increased heart rate, whereas more patients receiving fospropofol reported perineal discomfort. The patients receiving fospropofol also had a higher rate of local anesthetic injection recall. Although fospropofol appears to be a safe alternative to midazolam when administered by anesthesia-trained dentists, such side effects may preclude its completely replacing midazolam.

Full text of “A Comparison of Fospropofol to Midazolam for Moderate Sedation During Outpatient Dental Procedures,” Anesthesia Progress, Vol. 60, No. 4, 2013, is available at https://anesthesiaprogress.org/doi/full/10.2344/0003-3006-60.4.162.

The ADA Council on Scientific Affairs has named Dr. Noor Obaisi as its first John W. Stanford New Investigator Award recipient, according to ADA News.

Dr. Obaisi, who completed an orthodontic residency program at the University of Illinois at Chicago College of Dentistry in May 2013, works in private practice in Chicago.

To read the full article, click here.