• New Evidence-Based Clinical Recommendations on Fluoride • Upcoming NIOSH Health and Safety Practices Survey of Healthcare Workers • Dental Therapeutics Q&A • FDA, CDC and EPA Updates

New Evidence-Based Clinical Recommendations on Fluoride Intake

Two multi-disciplinary expert panels have issued reports containing clinical recommendations on children’s fluoride intake from infant formula and prescription fluoride supplements.

The first report on prescription fluoride supplements was published in the December Journal of the American Dental Association (JADA). The second report on fluoride intake from infant formula, appears in the January issue of JADA. Both reports are available on the ADA Center for Evidence-Based Dentistry website. The expert panels were convened by and the clinical recommendations were reviewed and approved by the ADA’s Council on Scientific Affairs.

Evidence-based clinical recommendations are intended to provide dentists and other health professionals with a review of the latest scientific evidence on particular topics and are not considered a standard of care.

“It is important for parents and caregivers to talk with their child’s physician and dentist so they can make informed decisions regarding their child’s health care,” says Edmond Hewlett, D.D.S., an ADA consumer advisor spokesperson and professor at the University of California Los Angeles (UCLA) School of Dentistry. “The American Dental Association continues to strongly advocate for the use of fluoride as a proven method to prevent tooth decay. These new evidence-based clinical recommendations are a resource that dentists can consider along with their own clinical judgment and patient preference when diagnosing and treating patients.”

HEALTH AND SAFETY

Upcoming NIOSH Health and Safety Practices Survey of Healthcare Workers

On January 31, 2011, the National Institute for Occupational Safety and Health (NIOSH) which is part of the Centers for Disease Control and Prevention (CDC) will be launching the online Health and Safety Practices Survey of Healthcare Workers with the assistance of their contractor, Westat.

A random sample of members of the American Dental Association (ADA) will be invited to participate in the survey. If you are selected, the ADA encourages you to participate in the survey as we are very interested in any data which can lead to your improved health and safety.

The survey, which is anonymous and voluntary, asks about health and safety practices and types of exposure controls used by healthcare workers who handle or come in contact with hazardous chemical agents. The chemical agents under study include aerosolized medications, antineoplastic agents, chemical sterilants, high level disinfectants, surgical smoke, and anesthetic gases. Information regarding other health and safety hazards is also being collected. The survey will take about 30 minutes to complete. Your participation is critical to the success of the survey.

NIOSH will prepare a report presenting aggregate data from all respondents from the ADA which will be made available to all of our members.

PROFESSIONAL PRODUCT REVIEW

Dental Therapeutics Question & Answer

The ADA Professional Product Review, which mails with JADA and can be found online, has expanded to include a new dental therapeutics column due to overwhelming reader demand. Dr. B. Ellen Byrne, professor of endodontics and PhD in pharmacology and toxicology, answered reader questions about patient care following her article in the October 2010 issue. Here’s a sneak peak at what you’ll find in the January 2011 issue.

Question from David L Garber, DDS:
I have a patient who takes lamotrigine (Lamictal) and zonisamide (Zonegran) for his epileptic seizures. He had a seizure following some restorative dental work where septocaine was given (infiltrations). Could this have triggered or influenced his seizures? Is it contraindicated in his case?

Answer from Dr. Byrne:
There are no contraindications with the use of local anesthetics, including articaine (Septocaine®) in patients with seizure disorders taking anti-seizure medications. Assuming the articaine dose was not excessive, the seizure was most likely coincidental.

Local anesthetics readily cross the blood-brain barrier. Their pharmacological action on the central nervous system (CNS) is depression. At low, therapeutic blood levels there are no CNS effects of any clinical significance. At high levels, adverse actions may be observed and this would include generalized tonic-clonic convulsions. Many may ask why a CNS depressant drug would cause varying degrees of CNS stimulation. It is thought that local anesthetics produce clinical signs and symptoms (including convulsions) through selective blockage of inhibitory pathways in the cerebral cortex. Inhibition of an inhibition causes excitation and thus a seizure at high doses.

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