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30 Haziran 2011 Perşembe
23 Mart 2011 Çarşamba
Get Headaches? Smart Ways to Deal
Headache Triggers
By Winnie Yu Scherer
Sometimes you know exactly what's causing that pounding in your skull. Other times, you're blindsided. Headaches—whether debilitating migraines or less-painful-but-still-annoying tension headaches—are often set off or made worse by a key trigger, says Brian Grosberg, MD, director of the Inpatient Headache Program at Montefiore Headache Center in New York City.
Here, the seven most common pain provokers, and how to head off the hurt. (See your doctor if these DIY fixes don't do the trick; for those plagued by headaches, prescription meds may help.)
Invasive Dentistry May Raise Short-Term Heart, Stroke Risk
MONDAY, Oct. 18 (HealthDay News) — Invasive dental procedures designed to treat gum inflammation may raise the risk for heart attack and stroke, researchers say.
But the increase appears to be slight and short-term, the study team noted.
“I don’t want to downplay this entirely, because we saw a genuine rise in cardiovascular risk in the period just after dental work was done among patients undergoing invasive treatment,” said study co-author Liam Smeeth, a professor of clinical epidemiology at the London School of Hygiene and Tropical Medicine in England. “But the overall risk is quite small and endures for only a very brief period.”
Smeeth and his colleagues published their findings in the Oct. 19 issue of the Annals of Internal Medicine.
Previous research has linked common and chronic low-grade dental infections to inflammatory processes that elevate the risk for strokes and heart attacks, the authors pointed out.
But whether treatment for those infections raises a similar risk had not been explored, said the authors who set out to study the potential link between the two.
The team analyzed U.S. Medicaid records for nearly 1,200 patients who had undergone invasive dental treatments and had also experienced a stroke or a heart attack between 2002 and 2006.
The patients’ median age was 67, and invasive dental procedures were characterized as those with the potential to cause an inflammatory response, such as periodontal therapy and tooth extractions.
Nearly three-quarters of the patients had undergone a single dental procedure, nearly all of them (89 percent) tooth extractions. About one-quarter had had two to four dental treatments, with 57 days, on average, between each procedure.
About 4 percent of the patients died during hospitalization.
Even after taking into consideration a history of diabetes, high blood pressure and/or coronary heart disease, the team observed a significant but slight increase in heart-related events during the month following a dental treatment, primarily because of an apparent short-term rise in heart attack risk. Stroke risk appeared to rise less significantly than heart attack risk.
However, no patient suffered a cardiovascular event on the day of treatment, and the apparent increased risk for heart problems dissipated within six months, the researchers noted.
Such “transient” cardiovascular concerns are generally minimal, do not outweigh the long-term cardiovascular benefits of invasive dental treatment, and should not deter patients from getting the dental care they need, the authors concluded.
In an editorial in the same journal, Dr. Howard Weitz of the Jefferson Heart Institute and Dr. Geno Merli of the Jefferson Vascular Center, both in Philadelphia, noted that it is too early to say that routine dental care should be altered in any way based on the current findings.
For one thing, they said the jury is still out on how clear a connection actually exists between periodontal disease and cardiovascular illness in the first place. And they theorized that much of the observed treatment-related risk might actually stem from a common pre-procedure practice, namely that patients who routinely take aspirin to lower their heart risk stop taking the medication before undergoing dental surgery.
With millions of Americans on an ongoing aspirin regimen, Weitz and Merli said this angle requires further exploration.
Anthony Iacopino a prosthodontist and dean of the University of Manitoba’s school of dentistry in Canada, said he was not surprised that dental treatment may entail some cardiovascular risk. But he agreed that the benefits of treatment far exceed the risks.
“Periodontal disease is an infection, and bacteria gets into the bloodstream as a result,” he noted. “This happens at a low level at rest, and even more so when a person eats and chews, and perhaps even more so when he or she has dental treatment.
“But there is a very big difference between a temporarily high level of bacterial exposure during one or two treatment sessions and years and years of walking around with untreated periodontal disease,” stressed Iacopino. “Clearly, whatever exposure a patient goes through during dental treatment, it’s worth it in the long run.”
More information
For more on periodontal disease, visit the American Academy of Periodontology.
SOURCE: Liam Smeeth, Ph.D., M.D., professor of clinical epidemiology, department of epidemiology and population health, London School of Hygiene and Tropical Medicine, London; Anthony Iacopino, D.M.D., Ph.D., prosthodontist, and dean, University of Manitoba, school of dentistry, and director, International Center of Oral-Systemic Health, Manitoba, Canada; Oct. 19, 2010, Annals of Internal Medicine
TUESDAY, Jan. 4 (HealthDay News) — Elderly people who lose their teeth may be at increased risk for dementia, researchers have found.
The new study included more than 4,000 Japanese participants, 65 and older, who underwent a dental examination and a psychiatric assessment. Compared with participants who still had many of their natural teeth, those with fewer or no teeth were much more likely to have experienced some memory loss or have early-stage Alzheimer’s disease.
The findings were published online Dec. 31 in Behavioral and Brain Functions.
Participants with symptoms of memory loss tended to report that they had visited the dentist rarely, if at all. Dr. Nozomi Okamoto, the study’s principal investigator, said that this may be one explanation for the study’s findings but suggested that there may be other links between tooth loss and memory problems.
“Infections in the gums that can lead to tooth loss may release inflammatory substances, which in turn will enhance the brain inflammation that cause neuronal death and hasten memory loss,” she said in a news release from the journal’s publisher. “The loss of sensory receptors around the teeth is linked to some of the dying neurons.”
This may lead to a vicious cycle, Okamoto explained. The loss of these brain connections can cause more teeth to fall out, further contributing to cognitive decline.
More information
The U.S. National Institute of Neurological Disorders and Stroke has more about dementia.
– Robert Preidt
U.S. Officials Recommend Reduced Fluoride Levels in Water
FRIDAY, Jan. 7 (HealthDay News) — U.S. government officials said Friday that the amount of fluoride in the nation’s drinking water should now be set at the lowest recommended level.
Although fluoride is a significant help in preventing cavities and tooth decay, too much of it can cause unattractive spotting on children’s teeth. About two out of five teens have white spots and streaks on their teeth due to too much fluoride, according to a recent government study.
To prevent this problem, the U.S. Department of Health and Human Services and the U.S. Environmental Protection Agency are recommending that the fluoride level in drinking water be set at 0.7 milligrams per liter of water, replacing the current recommended range of 0.7 to 1.2 milligrams.
“One of water fluoridation’s biggest advantages is that it benefits all residents of a community — at home, work, school, or play,” HHS Assistant Secretary for Health Dr. Howard K. Koh said in a statement. “Today’s announcement is part of our ongoing support of appropriate fluoridation for community water systems, and its effectiveness in preventing tooth decay throughout one’s lifetime.”
One reason for the new recommendation is that over the years the sources of fluoride have increased from water to include toothpastes, mouth wash, fluoride supplements and fluoride applied by dentists, EPA and HHS officials noted.
According to the agencies, this new recommendation allows the maximum prevention of tooth decay through fluoridation, while reducing the possibility of children getting too much fluoride.
Overexposure to fluoride results in a condition known as fluorosis, which can damage children’s developing teeth.
In the United States fluorosis is usually mild, seen as barely visible lacy white markings or spots on the enamel. The severe form of fluorosis, which causes staining and pitting of the tooth surface, is rare here, but is more common in places like China where the water has naturally occurring levels of fluoride.
A spokesman for the American Dental Association, Dr. Matthew Messina, said these government agencies are doing their job in recommending what community water supplies are supposed to do.
“They have just refined from a range and provided a more exact direction,” Messina said. “We are excited that they continue to advocate the safety and effectiveness of fluoride and its value as a public health measure in preventing dental decay.”
Messina noted that fluoride occurs naturally in water and different places have different levels of fluoride. Some towns may not have to add any fluoride and others only a little to reach the recommended level, he said.
“Fluoride is one of the best returns on investment as far as the small amount of money spent on fluoridating water relative to the tremendous reduction in the cost of having cavities,” Messina said.
Dr. Leo Dorado, an assistant professor of oral surgery at the University of Miami, said that each locality needs to tailor adding fluoride to water to achieve the right level.
Dorado is concerned that too much fluoride can cause fluorosis in young children. “I don’t think the standard has been enforced state by state,” he said. “It’s not just an easy fix. It is something that has to be regulated according to government standards, but state by state,” he said.
More information
For more information on fluoride, visit the American Dental Association.
SOURCES: Matthew Messina, D.D.S., spokesman, American Dental Association; Leo Dorado, D.D.S., assistant professor of oral surgery, University of Miami; U.S. Department of Health and Human Services, news release, Jan. 7, 2011
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