Hygiene Tribune U.S. No. 1, 2016
Coronary heart disease patients with no teeth have nearly double risk of death / Mouthguard has athletes smiling / Industry News
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[1] =>
HYGIENE TRIBUNE
The World’s Dental Hygiene Newspaper · U.S. Edition
January 2016 — Vol. 9, No. 1
www.dental-tribune.com
Coronary heart disease patients with no
teeth have nearly double risk of death
Researchers connect levels of tooth loss (due primarily to poor dental hygiene
that leads to periodontal disease) with increasing rates of death and stroke
C
oronary heart disease patients
with no teeth have nearly double the risk of death as those
with all of their teeth, according to research recently published in the
European Journal of Preventive Cardiology.1 The study with more than 15,000
patients from 39 countries found that
levels of tooth loss were linearly associated with increasing death rates.
“The relationship between dental
health, particularly periodontal disease,
and cardiovascular disease has received
increasing attention over the past 20
years,” said lead author Dr. Ola Vedin,
cardiologist at Uppsala University Hospital and Uppsala Clinical Research Center in Uppsala, Sweden. “However it has
been insufficiently investigated among
patients with established coronary heart
disease who are at especially high risk of
adverse events and death and in need of
intensive prevention measures.”
Analysis included 15,456 patients
from 39 countries on five continents
This was the first study to prospectively
assess the relationship between tooth
loss and outcomes in patients with coronary heart disease (CHD). The results
are from a substudy of the STABILITY
trial2, which evaluated the effects of the
Lp-PLA2 inhibitor darapladib versus placebo in patients with CHD.
The analysis included 15,456 patients
from 39 countries on five continents
from the STABILITY trial.2 At the beginning of the study, patients completed
a questionnaire about lifestyle factors
(smoking, physical activity, etc), psychosocial factors and number of teeth in five
categories (26-32 [considered all teeth remaining], 20-25, 15-19, 1-14 and none).
Patients were followed for an average
of 3.7 years. Associations between tooth
loss and outcomes were calculated after
adjusting for cardiovascular risk factors
and socioeconomic status. The primary outcome was major cardiovascular
events (a composite of cardiovascular
death, myocardial infarction and stroke).
Patients with a high level of tooth loss
were older, smokers, female, less active
and more likely to have diabetes, higher
blood pressure, higher body mass index
and lower education.
During follow up there were 1,543 major cardiovascular events, 705 cardiovascular deaths, 1,120 deaths from any cause
and 301 strokes.
After adjusting for cardiovascular risk
factors and socioeconomic status, every
increase in category of tooth loss was
associated with a 6 percent increased
risk of major cardiovascular events, 17
percent increased risk of cardiovascular
death, 16 percent increased risk of allcause death and 14 percent increased risk
of stroke.
746 patients had a myocardial
infarction during the study
Compared with those with all of their
teeth, after adjusting for risk factors and
socioeconomic status, the group with no
teeth had a 27 percent increased risk of
major cardiovascular events, 85 percent
increased risk of cardiovascular death, 81
percent increased risk of all-cause death
and 67 percent increased risk of stroke.
“The risk increase was linear, with the
highest risk in those with no remaining
teeth,” said Vedin. “For example, the risks
of cardiovascular death and all-cause
death were almost double to those with
all teeth remaining. Heart disease and
gum disease share many risk factors
such as smoking and diabetes, but we adjusted for these in our analysis and found
a seemingly independent relationship
between the two conditions.
“Many patients in the study had lost
teeth so we are not talking about a few
individuals here,” continued Vedin.
“Around 16 percent of patients had no
teeth and roughly 40 percent were missing half of their teeth.”
During the study period, 746 patients
had a myocardial infarction. There was
a numerically increased risk of myocardial infarction for every increase in tooth
loss, but this was not significant after
adjustment for risk factors and socioeconomic status. Vedin said, “We found
no association between number of teeth
and risk of myocardial infarction. This
was puzzling (because) we had robust associations with other cardiovascular outcomes, including stroke.”
Tooth loss could identify patients
who need more prevention efforts
Gum disease is one of the most common
causes of tooth loss. The inflammation
from gum disease is thought to trigger
the atherosclerotic process and may explain the associations observed in the
study. Poor dental hygiene is one of the
strongest risk factors for gum disease.
“This was an observational study so
we cannot conclude that gum disease
directly causes adverse events in heart
Cumulative incidence rates by tooth loss level: (a) Major adverse cardiovascular events (MACEs)
(cardiovascular death (CV dth), myocardial infarction (MI), or stroke); (b) cardiovascular death; (c)
stroke; and (d) all-cause death from 0 to 1,400 days from randomization, stratified by tooth loss
level (26–32, 20–25, 15–19, <15, or no teeth). Chart/Provided by European Journal of Preventive Cardiology
patients,” Vedin said. “But tooth loss
could be an easy and inexpensive way to
identify patients at higher risk who need
more intense prevention efforts. While
we can’t yet advise patients to look after
their teeth to lower their cardiovascular
risk, the positive effects of brushing and
flossing are well established. The potential for additional positive effects on cardiovascular health would be a bonus.”
About the European Journal
of Preventive Cardiology
The European Journal of Preventive
Cardiology describes itself as being the
world’s leading preventive cardiology
journal, playing a pivotal role in reducing the global burden of cardiovascular
disease.
About the European Society
of Cardiology
The European Society of Cardiology represents more than 90,000 cardiology
professionals across Europe and world-
wide. Its mission is to reduce the burden
of cardiovascular disease in Europe.
ÿ References
1.
2.
Vedin O, Hagström E, Budaj A, Denchev S,
Harrington RA, Koenig W, Soffer J, Sritara
P, Stebbins A, Stewart RHA, Swart HP, Viigimaa M, Vinereanu D, Wallentin L, White
HD, Held C on behalf of the STABILITY Investigators. Tooth loss is independently
associated with poor outcomes in stable
coronary heart disease. European Journal
of Preventive Cardiology. 2015; DOI:
10.1177/2047487315621978
The Stabilization of Atherosclerotic Plaque
by Initiation of Darapladib Therapy (STABILITY) study evaluated the efficacy of darapladib, an oral inhibitor of lipoproteinassociated phospholipase A2, compared to
placebo. Patients were eligible to participate if they had coronary heart disease,
defined as prior myocardial infarction, prior coronary revascularisation, or multivessel coronary heart disease without revascularisation.
(Sources: European Society of
Cardiology and European Journal
of Preventive Cardiology)
[2] =>
B2
INDUSTRY NEWS
The PF2 mouthguard is a do-ityourself guard that provides a
custom fit without any need to
take impressions of the teeth.
Hygiene Tribune U.S. Edition | January 2016
HYGIENE TRIBUNE
Photo/Provided by Keystone Industries
Publisher & Chairman
Torsten Oemus t.oemus@dental-tribune.com
President & Chief Executive Officer
Eric Seid e.seid@dental-tribune.com
Mouthguard has athletes smiling
Keystone Industries, the U.S.-based
company that manufacturers some of
the world’s top mouthguard products,
has launched the latest product in its
Pro-Form Mouthguard line — the PF2
mouthguard.
Unlike laminated mouthguard products that require a dentist to custom fit
to the patient, the PF2 mouthguard is a
do-it-yourself guard that provides an
accurate custom fit without any need
Ad
to take impressions of the teeth.
With the elimination of dentist appointments and impressions, the price
of this guard is significantly lower
than custom-fit mouthguards while
still providing high-impact protection,
according to the company. The PF2’s
unique design also enables it to be refit by the user multiple times.
“Being a leader in this field means we
need to set the bar high for new prod-
ucts and innovation,” said Michael
Prozzillo, vice president of sales for
Keystone. “The PF2 will change the way
athletes buy mouthguards, but also
how the dentist sells them.”
The suggested retail of the PF2
mouthguard is $38. It is available in
either black or white. The company reports that there will be bulk purchas” See MOUTHGUARD, page B3
Group Editor
Kristine Colker k.colker@dental-tribune.com
Editor in Chief Dental Tribune
Dr. David L. Hoexter feedback@dental-tribune.com
Editor in Chief Hygiene Tribune
Patricia Walsh, RDH feedback@dental-tribune.com
Managing Editor
Robert Selleck r.selleck@dental-tribune.com
Managing Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Managing Editor
Sierra Rendon s.rendon@dental-tribune.com
Product/Account Manager
Humberto Estrada h.estrada@dental-tribune.com
Product/Account Manager
Will Kenyon w.kenyon@dental-tribune.com
Product/Account Manager
Maria Kaiser m.kaiser@dental-tribune.com
Business Development Manager
Travis Gittens t.gittens@dental-tribune.com
EDUCATION Director
Christiane Ferret c.ferret@dtstudyclub.com
Accounting Coordinator
Nirmala Singh n.singh@dental-tribune.com
Tribune America, LLC
116 West 23rd Street, Suite 500
New York, NY 10011
Phone (212) 244-7181
Published by Tribune America
© 2016 Tribune America, LLC
All rights reserved.
Tribune America strives to maintain the utmost accuracy in its news and clinical reports. If you find a
factual error or content that requires clarification,
please contact Managing Editor Robert Selleck at
r.selleck@dental-tribune.com.
Tribune America cannot assume responsibility for
the validity of product claims or for typographical
errors. The publisher also does not assume responsibility for product names or statements made by
advertisers. Opinions expressed by authors are their
own and may not reflect those of Tribune America.
Editorial Board
Dr. Joel Berg
Dr. L. Stephen Buchanan
Dr. Arnaldo Castellucci
Dr. Gorden Christensen
Dr. Rella Christensen
Dr. William Dickerson
Hugh Doherty
Dr. James Doundoulakis
Dr. David Garber
Dr. Fay Goldstep
Dr. Howard Glazer
Dr. Harold Heymann
Dr. Karl Leinfelder
Dr. Roger Levin
Dr. Carl E. Misch
Dr. Dan Nathanson
Dr. Chester Redhead
Dr. Irwin Smigel
Dr. Jon Suzuki
Dr. Dennis Tartakow
Dr. Dan Ward
Tell us what you think!
Do you have general comments or criticism
you would like to share? Is there a particular
topic you would like to see articles about in
Hygiene Tribune? Let us know by emailing
feedback@dental-tribune.com. We look
forward to hearing from you!
If you would like to make any change to your
subscription (name, address or to opt out)
please send us an email at c.maragh@dentaltribune.com and be sure to include which
publication you are referring to. Also, please
note that subscription changes can take up to
six weeks to process.
[3] =>
INDUSTRY NEWS
Dental Tribune U.S. Edition | January 2016
B3
Keystone Industries unveils redesigned website
Worldwide dental manufacturer adds content and enhances ecommerce capabilities
Keystone Industries, one of the leaders in manufacturing
dental products for both domestic and international markets, recently unveiled its completely redesigned website,
www.keystoneindustries.com.
Changes include improved display on all screen sizes
across multiple viewing platforms; an updated user experience for search and navigation; an option for live-chat with
customer service; and a new way to place orders that the
company describes as being easier and more efficient.
“We have been extremely excited to get this website
launched for the start of 2016, because we know how much
our customers value easy access to information and ordering,” said Derek Keene, vice president of marketing and
product development. “As an international manufacturer,
we want to stay ahead of the technological curve to serve our
wide customer base.”
Along with the new look to Keystone’s website comes an
experience that should better serve customers from all over
◊ MOUTHGUARD, page B2
ing available in the near future, which
will include a display piece and literature on the product suited for dental
offices.
Multiple color options will also be
available soon, similar to the Pro-Form
line of color options, according to the
company.
the world. According to the company, placing orders is now
more efficient than ever, with both Keystone and the customer’s preferred dealer able to process the order. Getting
product information is readily available, with tutorial videos
housed in a “Learning Center” and all SDS forms available in
a newly designed SDS database.
“Everything from the look and feel of our product pages to
our order forms has changed, and undeniably for the better,”
Keene said. “This innovative platform for the dental industry will certainly boost the connection between manufacturer, dealer, end user and the product itself.”
Keystone’s website will undergo more updates in the coming months, including multiple language translations, more
product tutorial videos and more.
The newly launched website is up and fully operating at
www.keystoneindustries.com.
Custom fit in less than a minute
“You just won’t be able to get ahold of
another mouthguard that can be custom fit in under a minute and provide
the same beneficial features,” said Derek
Keene, Keystone’s vice president of marketing and product development. “We’re
excited to watch PF2 take off and provide significant value to our customers
and athletes across the country.”
(Source: Keystone Industries)
On Keystone’s new website, both Keystone and the
customer’s preferred dealer can now process orders.
Screen capture/Provided by Keystone Industries
To keep up to date on the PF2 and Keystone, go to www.keystoneindustries.
com. You also can follow the company
on all the major social media platforms.
About Keystone Industries
Keystone Industries, a privately held
company founded in 1908, has maintained a reputation for producing innovative, high-tech dental products
in both the operatory and laboratory
realms. The company is committed
to providing customers with the finest quality materials while developing
products that surpass customer expectations. As this commitment has been
met, the company has moved forward
with expansion around the globe.
(Source: Keystone Industries)
Ad
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