Study identifies ‘new risks’ for mouth and throat cancers

Poor oral health and irregular dental checks can increase the risk of oral cancer, a new study has found.

The International Agency for Research on Cancer report also found excessive use of mouthwash – more than three times a day – can also increase risk.

Smoking, heavy drinking and “low socio-economic status” are established risk indicators of mouth and throat cancers.

The study covered 1,962 cancer patients and a further 1,993 control subjects across nine countries in Europe.

The study was led by the Leibniz Institute for Prevention Research and Epidemiology in Bremen, Germany, (Bips) and backed by researchers from Glasgow University Dental School.

‘Really important’

Prof Wolfgang Ahrens, deputy director of Bips, described the study findings as “really important”.

“Up until now, it was not really known if these dental risk factors were independent of the well known risks for mouth and throat cancers – smoking, alcohol and low socio-economic status,” he said.

Prof Ahrens said the report findings were highly “nuanced” and there was an interconnectedness of many of the risk factors.

The definition of poor oral health included people who had complete or part dentures and people with persistently bleeding gums.

Dr David Conway, clinical senior lecturer at Glasgow University Dental School, said: “People should not assume that if they wear dentures and have none of their own teeth left, they have no need to see a dentist.

“On the contrary, even if you have got dentures, you should make sure you go for regular check-ups.”

People with poor dental care were defined as those who hardly ever or never brushed their teeth or visited the dentist.

Dr Conway said the frequency of dental visits should be determined by a dentist’s risk assessment and if people fell into the low-risk category it could be once a year or even every two years.

“It is not a case of one size fits all,” he added.

“Visits could be six-monthly, but certainly not five-yearly.”

Mouthwash ‘risk’

The research team said the possible role of mouthwash as a risk factor would require further research.

They were unable to analyse the types of mouthwash used many years ago by participants in the study.

Dr Conway added: “I would not advise routine use of mouthwash, full stop.

“There are occasions and conditions for which a dentist could prescribe a mouthwash – it could be that a patient has a low salivary flow because of a particular condition or medicine they are taking.

“But for me, all that’s necessary, in general, is good regular brushing with a fluoride toothpaste and flossing combined with regular check-ups by a dentist.”

The findings of the study have been published in Oral Oncology.

http://www.bbc.com/news/uk-scotland-glasgow-west-26875793

 

 

 

Treatment outcomes for preventive oral health services delivered to young children by non-dental primary care providers

 

The International and American Associations for Dental Research (IADR/AADR) have published a paper titled “Preventive Services by Medical and Dental Providers and Treatment Outcomes.” Nearly all state Medicaid programs reimburse non-dental primary care providers (nDPCPs) for providing preventive oral health services to young children; yet, little is known about how treatment outcomes compare to children visiting dentists. This study compared the association between the provider of preventive services (nDPCP, dentist or both) to Medicaid-enrolled children before their third birthday and subsequent dental caries-related treatment (CRT) and CRT payment. The complete study by researchers A.M. Kranz, R.G. Rozier, J.S. Preisser, S.C. Stearns, M. Weinberger and J.Y. Lee is published in the OnlineFirst portion of the IADR/AADR Journal of Dental Research (JDR).

The researchers conducted a retrospective study of young children enrolled in North Carolina Medicaid during 2000 to 2006. The annual number of CRT and CRT payments per child between the ages of three to five years of age were estimated with a zero-inflated negative binomial regression and a hurdle model, respectively. Models were adjusted for relevant child- and county-level characteristics and used propensity score weighting to address observed confounding.

The researchers examined 41,453 children with more than one preventive oral health visit from an nDPCP, dentist or both before their third birthday. Unadjusted annual mean CRT and payments were lowest among children who had only nDPCP visits (CRT = 0.87, payment = $172) and higher among children with only dentist visits (CRT = 1.48, payment = $234), and both nDPCP and dentist visits (CRT = 1.52, payment = $273). Adjusted results indicated that children who had dentist visits (with or without nDPCP visits) had significantly more CRT and higher CRT payments per year during the ages of three and four than children who had only nDPCP visits. However, these differences attenuated each year after age three.

Due to children’s increased opportunity to receive multiple visits in medical offices during well-child visits, preventive oral health services provided by nDPCPs may lead to a greater reduction in CRT than dentist visits alone. This study supports guidelines and reimbursement policies that allow preventive dental visits based on individual needs.

“On behalf of the Journal of Dental Research, I thank the authors for conducting this retrospective study of young children enrolled in North Carolina Medicaid,” said AADR President Timothy DeRouen. “This paper emphasizes the needs-based approaches to clinical care and demonstrates a good opportunity for dentists and physicians to collaborate on oral health for the benefit of children.”

 

http://www.medicalnewstoday.com/releases/277745.php