Athletes, compete in oral health!
By Claudia Salwiczek, DTI (Guest commentary)
Two weeks ago, the 21st Winter Olympics ended with the passing on of the Olympic torch from Vancouver to Sochi in Russia. All the excitement and records aside, what remains are images of many athletes failing at their respective disciplines. Never before have the Games pushed the physical limits of what the human body can accomplish. Sadly, one athlete from Georgia lost his life after leaving the track at high speed during the men’s luge competition.
One major issue overshadowed by these tragedies is oral health. It seems that athletes and officials alike are not paying much attention to this problem, maybe because a healthy mouth and teeth are not considered relevant to top performance. This assumption is certainly wrong. Pain resulting from tooth decay, root-canal infection or gum disease can trouble athletes to such an extent that they are not able to compete. In addition, UV radiation accumulated over a long time in sports like the biathlon or crosscountry can significantly increase the risk of developing oral cancer.
The International Olympic Committee’s decision to screen more athletes for oral lesions this year is a step in the right direction and an acknowledgement that oral health forms part of general health. However, having these examinations every four years won’t change much in the general oral-health behaviour of athletes. Dentists, physicians and training staff need to drive home to them that a little investment in their mouths will help to remain more healthy not only during their active career, but also later in life.
Let’s hope that the competition for better oral health will already have begun when the Olympic flame shines over Sochi in 2014.
It’s all about saliva
A friend of mine recently had a bacterial infection. In telling me about his problems, the first thing he mentioned was that he had experienced symptoms of dry mouth and matured biofilm. He had also suffered from hypersensitive teeth.
My friend’s example, though trivial in nature, is a good example by which to demonstrate the way the oral cavity functions as a window to our inside world. The latest research has shown that it can be a very reliable indicator of our inner state of health. Every day, the salivary glands secretes over 1.5 litres of saliva into the oral cavity, carrying with it valuable information. These biomarkers can be from sites of disease, or the salivary glands themselves can produce surrogate biomarkers of disease. The good news is that the information provided by these can be obtained non-invasively, painlessly and with no embarrassment to the patient—without needles or cringing.
Owing to these salivary properties, a dental examination today is no longer only about teeth and gums. Dentists should be aware that they are probably the first to detect signs of systematic diseases in their patients. Take HIV/Aids for example: despite new, effective medication, the latest infection rates still demonstrate a continued increase in poor and developing countries alike. According to a recent report by UNAIDS, for example, an estimated 50 million women in Asia alone are at risk of becoming infected with HIV/Aids by their intimate partners in the next decade. Early detection could significantly reduce morbidity here.
Oral fluid testing technologies are under development and already in use in several dental offices in Europe and the US. It will be years, perhaps even decades, before these tests are a regular part of every visit to the dentist, but there is no doubt that they will play a valuable part in the management and control of worldwide epidemics, such as HIV/Aids or cancer.
Eye on India
Being the Group Editor of DTI, I am in regular contact with dental publishers around the world and, occasionally, I am honoured to welcome new faces to our group. This year, for example, I am particularly looking forward to our new collaboration in India. Jaypee Brothers (JP), who joined the DTI network in March, is not only one of the biggest medical and dental publishers on the subcontinent, but also the perfect addition to our group. JP represents a country with a large population and the biggest output of dentists worldwide. I am sure that Dental Tribune Asia Pacific (DTAP) will benefit from their expertise and knowledge in the future.
Unfortunately, another disturbing issue is still with us. Although the media frenzy about the swine flu outbreak has died down, the world is still far from having overcome the crisis. Over the last two months, the virus has found its way from North America through Europe to Asia. There, the World Health Organization has warned, it could combine with avian flu and mutate into a more virulent form, sparking an influenza pandemic that could be expected to circle the globe up to three times. Infection control has never been more important!
Some words about our new website
Do you remember sending your first e-mail? I see myself in 1995 sitting in a dark basement in my first year at university , exchanging short messages with a friend sitting next to me, on a 486 PC that was state-of-the-art at the time. Since then so much has changed. What was just fooling around back then has become an everyday commodity that most of us cannot imagine living without.
Some experts have claimed that the Internet is one of the most important inventions of the last 50 years and, indeed, some projects have changed our lives significantly. With the Internet, it has never been easier to access and share information all around the world within just a few seconds. Today, we are able to buy goods or talk to people around the globe with just the click of a mouse. Giants like Google offer so many services that we can hardly escape them in our everyday lives.
However, in dentistry, especially in dental publishing, the race for revolutionary projects is still on. Many publishers, including ourselves, have long underestimated the many possibilities that the Internet has to offer, sometimes because we were afraid of neglecting our print offers. But this is changing. Dentists have been conservative when it comes to new technologies but now the age structure is shifting in many countries, making way for a new generation of dentists who have grown up with Internet technologies and are open to their opportunities. With our new website and the DT Study Club online education platform, Dental Tribune is striving to take the lead. We invite you to join us in this endeavour.
Dental trade shows in decline?
Have you attended a trade show lately? Did you feel that the experience was somewhat lacking compared to previous years? In a recent article published by the US consulting company Edge Marketing, the author and dental industry veteran Scott Mahnken states that dental trade shows are experiencing a decline in both quality and participation numbers. He attributes this to increased travel expenses and the losses dentists incur in closing their practices during exhibition times. In addition, taking online CE courses instead of attending seminars has become more attractive due to the increase in quality of these online courses, he claims.
Although Mahnken’s observations are accurate in terms of travel costs, clearly a result of the global financial crisis, online seminars cannot even begin to equal the actual experience dentists are able to gain at hands-on workshops or trade show booths. Should technology be so far developed as to simulate dentistry through 3-D technology or robotics, humans will remain essential for developing and identifying suitable materials and techniques for effective and appropriate patient treatment. Trade shows will be indispensable in assisting professionals in the planning and decision process.
This month, the world’s biggest marketplace in dentistry is set to open to dental professionals from Germany and around the world. The organisers of the International Dental Show in Cologne in Germany have projected an increased number of visitors to this year’s show compared with 2007. Over 1,700 exhibitors will give dentists the chance to get their hands on the latest in dentistry, be it designer furniture from Italy or handpieces that illuminate and feel fantastic in your hand. If you plan to attend, we wish you an enjoyable time and encourage you to tell us about your experience.
My outlook for 2009
As the year draws to a close I would like to extend my best wishes for 2009 to all our readers. The problem we all face next year is uncertainty about the future. The financial crisis that started on Wall Street this autumn has just begun to unfold in other parts of the world, and although there are many opinions about the short- and long-term effects, no one is really able to foresee whether it will affect us for only a few months or in the years to come.
The latest news from the market place in Asia is not very promising. China, as one of the key players in the region, has just witnessed its largest drop in exports in nearly a decade. At the same time, foreign direct investment has fallen by 36.5 per cent compared to November 2008. The Asia Development Bank in Manila recently predicted a significant slowdown in economic growth of more than 5 per cent for the entire region. Policy makers and industry players have to act swiftly if the industry is to withstand the crisis.
Prospects look rather uncertain for the dental profession. In recent years, dentistry in most markets has been driven mainly by high-cost procedures, like dental implants and cosmetics, but these sectors will probably be the first to suffer from the economic slowdown. One of the factors that could help the profession is health tourism. Ironically, fuel prices have seen a sharp decrease in the last two months, which could boost the influx of patients from overseas to destinations like Singapore, Thailand, and the Philippines.
Despite what happens in 2009, we will continue to put our best efforts into informing you of the latest developments in Asian and international dentistry. We hope that you will benefit from this knowledge, and encourage you to send us regular feedback on our articles and suggestions for future articles on matters that interest you. As official publishing partner of the FDI World Dental Federation, we will also be present at the Annual World Dental Congress in Singapore next year September. We look forward to possibly meeting you there or at future international events.
Asia - A new dental Superpower
Recently, a report by the US National Intelligence Council made it into headlines around the world, forecasting that the current financial crisis on Wall Street is just the first phase of a global economic reordering, with the United States in decline and countries like China and India competing for more influence in a multipolar world. Global wealth was also seen as shifting from the developed West to the energy-rich Gulf States and Russia, as well as to Asia, a rising centre of manufacturing and service industries.
With a new presidential agenda in the United States, it might be hard to predict what is going to happen in the years to come. Maybe Barack Obama will become a great president who will help markets to re-establish and sustain America’s post-cold war role. Perhaps he will be hindered by the political and financial constraints that the politics of his predecessor leaves behind. More predictably, whatever the outcome of his politics, he won’t have much to play with on the international field.
In dentistry, we are already experiencing these developments and we are not just talking about China’s steady rise to a dental laboratory superpower. In most Asian countries, the majority of dentists are not only internationally educated, but also eager to stay up-to-date with the latest technical developments in the field. They also have state-of-the-art equipment at their disposal. Nowadays you will probably find more dental practices with the latest equipment and more treatment options in Singapore or Shanghai than you will in a practice in New York, Sydney, or Auckland. In addition, local manufacturers, especially those from China, are constantly gaining more market shares, not only in their domestic markets, but also internationally.
A Wall Street Journal article recently said that more and more insurers and employers in the United States are offering their clients and staff medical or dental treatment in countries abroad (see “Medical tourism: A new option for patients in the US, Dental Tribune Asia Pacific, 9(2008):8). This shows that, even in the West, people are increasingly considering the Asian continent a rising superpower, in general, and particularly, in dental health care. Asian dentists should be aware of this. They could soon be on the forefront of shaping the future of the profession.
The amalgam dilemma
Recently, the European Commission announced a full export ban on elementary mercury by 2011. Only days later, and with no obvious connection to the European initiative, the United States followed with their own restriction, to be achieved by the year 2013. Though anti-mercury groups welcomed these decisions as a much-needed step to take the toxin off the market, the bans—surprisingly—excluded the mercury widely used in amalgam fillings.
There has been much discussion on the health risks of amalgam in the last century. But let’s face it, this is no longer only about health concerns. It is also about the environmental footprint that the material is leaving on our world. Did you know that in Sweden mercury waste from used amalgam fillings and other sources has the same classification as nuclear waste? Or, that although it is being safely stored in salt mines, it still seeps into the ground and is expected to reach groundwater in approx. 100–150 years? Then, consider the tons of mercury that are released into the air, through burning the deceased with their dental fillings in crematoria.
Besides fossil fuels, amalgam fillings are the main source of mercury waste globally. Sure, its use is constantly decreasing, and it is being replaced by alternatives, like composites. In the developing world, however, it is often the only affordable choice for treating oral decay. Therefore, even if we stop using amalgam here in the West, the problems resulting from mercury waste will still affect people in large parts of Asia, Africa, and Latin America.
The only solution to this problem is to educate dentists in these parts of the world about the effects of mercury released into the environment. It is also up to national dental associations to pressure governments to make tools, like separators mandatory, or to reform their health care systems, to help people gain access to safer fillings. If we do not care, our children will certainly suffer the consequences.
The crisis ahead
When I turned on the news this morning, there was a report claiming that every third employee in Japan has considered suicide at least once, because of the economic crisis and rising unemployment in the country. Although suicide is not unusual in Japan, this survey clearly shows to what extent the global economic crisis has affected and is still affecting people here in Asia.
And the crisis is thought to be far from over. American banks and companies have been significant lenders and investors in the Asia Pacific region, not only for their own companies but also in terms of bank loans and investment in financial instruments. Therefore, experts say that the current crisis could have an impact similar to the impact that the Asian Financial Crisis in 1997 had on markets in Europe and the United States. Let us hope, they’re not proved right.
Something about China
In a few weeks, the eyes of the world will finally turn to China as Beijing hosts the 2008 Olympic Games. While the organisers together with the Chinese government are trying to present the country as a perfect host, certain issues have been raised that will cast a shadow over the games: one of them is the country’s human rights situation and the other the autonomy of Tibet.
Apart from this, two major subjects in dentistry have also found its way into the headlines. While the appearance of counterfeit dental products such as fake Chinese toothpaste caused only minor concern, the other has to be taken more seriously. Dental work contaminated with lead and made in China was recently discovered in the United States.
Though these appear to be single cases, the issue is far from being over. With a number of 8,000 dental labs in the country and only 100 dealing with overseas clients (see also the interview with Chinese lab consultant Ma Yun Xiu in Dental Tribune Asia Pacific, 6(2008):11), China is still away from having reached its full potential in the worldwide denture market. Rising economic pressure in western markets also make a steady flow from dental work “Made in China” most likely in the years to come. In Europe, e.g., the import from China has more than doubled in the last three years.
The responsibility to guide this development will be in the hands of every single dentist. China will continue to penetrate the worldwide market with low-cost products and it might be tempting for dentists who are under economic pressure to save some money. But patients also want a safe product and they trust their dentist to give it to them. If dentists follow the calls of the market, they will certainly start to loose that trust.
