Key to tooth loss is 'in the spit' says dental charity

THE UK's leading oral health charity has revealed that a simple saliva test could soon be used to tell dentists which patients are more likely to lose their
teeth.  The British Dental Health Foundation was speaking after new research presented at the International Association of Dental Research meeting in America last month found that a protein found in saliva could be used to predict which patients are more likely to lose the bone that keeps their teeth in their gums.

The findings, which came from the University of Buffalo, could allow dentists in the future to provide special guidance for people at extra risk of tooth loss, helping thousands of people to avoid dentures.

Dr Nigel Carter, chief executive of the Foundation, commented:- "Although still very much in its early stages this could be a very important development.  If a test as simple as this can be used to predict future problems with bone loss in the gums, then dentists will be able to take measures to prevent this extra risk from having an effect.  It could also be used as a way of monitoring patients over a period of time and determining whether or not a particular treatment is working. The fact that it could be carried out so quickly and cheaply would make it a remarkably convenient way of carrying out such an important test."

The scientific study involved researchers comparing dental x-rays of 100 patients with analyses of their saliva.  The researchers found that higher-than normal levels of a salivary protein called IL-1-beta were associated with increased bone loss while lower levels of osteonectin could also be a marker of gum health.

Dr Carter continued:- "While this research may in the future help dentists to distinguish which patients are likely to suffer gum problems, the emphasis will still be on the individual to keep problems at bay by maintaining a good oral healthcare routine.  A good oral healthcare routine should include twice daily brushing with fluoride toothpaste, flossing daily and cutting down on the frequency of sugary foods and drinks. Regular visits to the dentist are also vital in ensuring that the gums and teeth are kept as healthy as possible."

HEWITT ANNOUNCES FULL SCALE CLINICAL AUDIT

HEALTH Secretary Patricia Hewitt this week announced a review of the quality of care provided by NHS treatment centres run by the independent sector.
Giving evidence to the Health Select Committee Inquiry into Independent Sector Treatment Centres (ISTCs), she said that although all existing evidence pointed to a safe, high-quality service, the Healthcare Commission would carry out a wide-ranging clinical audit of the programme to date.

Patricia Hewitt said:- "Although ISTCs are required to meet exactly the same standards as NHS care, and are subject to a rigorous monitoring regime, the review will be a timely and appropriate way to assess their work with the NHS so far.  As well as assessing the delivering of care in the centres, the review will assess any clinical views and concerns expressed by professional bodies about aspects of the programme.  All of the existing evidence points to a safe and efficient service.  However, as the ISTC programme develops further it is right that wider-scale scrutiny is given to the independent sector's contribution to the NHS which is why the Chief Medical Officer has asked the Healthcare Commission to undertake a review."

ISTCs have played a major role in increasing capacity and choice for NHS patients. The first wave of ISTCs has already ensured that almost 50,000 patients have received their treatment faster.  The 250,000 procedures the independent sector has delivered have
played a significant part in helping the NHS to eradicate the long waiting lists that many patients used to endure.

ISTCs have helped bring down the waiting times for cataract operations to a maximum of 3 months, a target achieved 4 years earlier than promised.  ISTCs are now helping to deliver the new maximum wait of 18 weeks from GP referral to hospital treatment. The NHS can only cut waits for MRI scans and other diagnostic tests by expanding independent as well as NHS provision. NHS diagnostics provision is expanding, but
the NHS alone does not have the capacity to do this.

Patricia Hewitt added:- "ISTCs are doing an important job and it is vital that they bring maximum benefits to patients. But we also need to keep it in perspective. This year, ISTCs will treat only 3% of those NHS patients having routine elective surgery; by 2008, that proportion will still only be around 7 or 8%. The £1.2 billion spent on independent sector treatments will then represent just over 1% of an NHS investment totalling over £90 billion."

The Healthcare Commission review will publish its full findings by the end of the year, but will publish an interim report which will outline emerging findings.