A Step Forward in Throat Cancer Research


Possible Cure for HPV+ Throat Cancer

New research shows that HPV+ OPC patients can be cured, even after the disease has spread to other organs

Certain types of human papillomavirus (HPV) can lead to persistent infections that may progress to cancer if left untreated. These cancers, including cancer of the oropharynx (base of the tongue and tonsils), can take years or even decades to develop after initial diagnosis. Such cancers are typically considered to be incurable and the goal of treatment is usually limited to symptom control.

Now, for the first time, researchers have found evidence to suggest that patients with cancer of the throat caused by the human papillomavirus (HPV+) have a better prognosis than those who are negative for the virus (HPV-).

Dr. Sophie Huang, Assistant Professor of Radiation Oncology at the University of Toronto, has discovered that the oropharynx can actually be cured even after the disease has already spread to other critical organs in the body, such as the lungs.¹ She conducted what is now the largest study to date with over 900 patients to investigate survival predictors for metastatic HPV+ oropharyngeal cancer (OPC) and HPV- OPC patients, or patients who have tumors appearing in an organ not directly related to the primary cancer site.¹ In fact, patients with OPC and oligometastasis (involving five or fewer lesions in one distant organ) can live for more than 2 years after intensive treatment without further disease growth.¹

“Our research […] has shown that cure is a realistic goal in those patients with oligometastasis.”

Sophie Huang, MSc, Assistant Professor, Department of Radiation Oncology, University of Toronto

Three main factors allow for a survival advantage for HPV+ OPC patients:

  1. This type of cancer is more sensitive to radiotherapy and chemotherapy
  2. Patients were generally younger and diagnosed 10 years earlier than average
  3. Patients had fewer health problems, including those associated with smoking.

This is an important step forward in head and neck cancer research, a cancer type with historically low awareness despite being the sixth most common type of cancer worldwide.

SOURCE

¹ European Society for Radiotherapy and Oncology (ESTRO). (2015, February 12). “New research shows possibility of cure for HPV positive throat cancer patients.” ScienceDaily. www.sciencedaily.com/releases/2015/02/150212183507.htm

 

Section 179 in 2014

Update on the 2014 Section 179 Tax Deduction

You still have thirty days to make the most of $25K

Section 179 of the IRS tax code has gotten a lot of heat for its diminished deduction limit in 2014. Compared to last year’s deduction limit of $500,000 for equipment purchases, the 2014 limit has been reduced to $25,000. Despite the ADA’s efforts in urging Congress to extend the Section 179 tax provision to 2013 levels, there hasn’t been any word on whether an extension will be granted.

The silver lining: although $25,000 isn’t as desirable as $500,000, Section 179 provides some real relief to dental practice owners purchasing small equipment in 2014. Section 179 can change each year without notice, so it’s beneficial to take advantage of any deduction while it’s still available.

Up to $25,000 in dental equipment can be written off in 2014

ELIGIBILITY AND QUALIFICATIONS

Most tangible goods qualify for the Section 179 Deduction. For basic guidelines on what equipment is covered under the Section 179 tax code, refer to this list of qualifying equipment. Note: To qualify for the Section 179 Deduction, the equipment and/or software purchased or financed must be placed into service between January 1, 2014 and December 31, 2014.

All new and used equipment is eligible for deduction up to $25,000 for 2014. All companies that lease, finance or purchase equipment with a total value of less than $200,000 still qualify for the Section 179 deduction. Expenses over that maximum amount begin to decrease on a dollar-for-dollar deduction scale, effectively gearing this tax code toward small and medium-sized businesses.

DEPRECIATION DEDUCTION BENEFITS

While Section 179 doesn’t increase the total amount you can deduct in a single year, it allows you to benefit from the deduction all at once. In other words, rather than having to deduct an asset’s value over the course of several years, Section 179 allows businesses to get the entire depreciation deduction in a single year, a practice known as first-year expensing.

According to regular depreciation rules, if you were to purchase new high-speed handpieces for each of your operatories, you’d be obligated to deduct a portion of each handpiece’s cost over multiple years. For the next five years, you’d only be able to deduct a fraction of the overall expense. With the Section 179 tax code, though, you are allowed to immediately deduct the entire expense of the handpieces in a single year instead of having to track their depreciation over time.

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Check out an example of Section 179 at work:

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 SOURCE: Section179.org

EPA Rule on Amalgam Separators

EPA Proposes Amalgam Separator Rule

Nationwide rule requires amalgam separators in every office

In an effort to reduce the discharge of dental amalgam into the environment, the U.S. Environmental Protection Agency (EPA) recently proposed a rule under the Clean Water Act requiring dentists to install amalgam separators.

Studies show that half of the mercury that enters publicly owned treatment works originates from dental amalgam. Tiny particles of amalgam can bypass chairside traps every time an amalgam filling is placed or removed. After water treatment, mercury is distributed back in the form of precipitation and consumed by fish, making its way into our food chain.  

The proposed rule would require all affected dentists to control mercury discharges to publicly owned treatment works. Specifically, it would require them to cut their dental amalgam discharges to a level achievable through the use of amalgam separators and the use of other best management practices. The EPA expects compliance with this proposed rule would cut metal discharge to treatment works, half of it from mercury, by at least 8.8 tons a year.

“The rule would strengthen human health protection by requiring removals based on the use of a technology and practices that approximately 40% of dentists across the country already employ”
– Kenneth Kopocis, Deputy Assistant Administrator for the EPA’s Office of Water

The rule would allow dentists to show they are in compliance by installing, operating, and maintaining an amalgam separator. However, if the existing separators in a dental practice do not remove the percentage of amalgam in the proposed requirements, a practice can still be ruled as compliant for the life of the existing separator. Finally, it would limit dental dischargers’ reporting requirements to annual certification and record-keeping instead of wastewater monitoring.

The EPA will accept public comments on the proposal for 60 days following publication in the Federal Register. A public hearing also is scheduled for November 10. The agency expects to finalize the rule in September 2015.

Ebola Virus and Dentistry

The Ebola Epidemic: A Concern for Dentistry?

The recent Ebola epidemic has the entire world on high alert. Although the majority of the 8,400 reported cases have been contained to West Africa, the Ebola virus has already made its way into the United States. Following the death of Thomas Eric Duncan (the first travel-related Ebola case in the U.S.), the CDC confirmed Sunday that a nurse who treated Duncan at a Texas hospital has contracted Ebola. Authorities presume that the infection may be a result of a “breach” of infection control protocol.

Since healthcare workers who come in contact with infected patients have the highest risk of contracting Ebola, now is the time to emphasize the importance of proper infection control procedures with your team.

Precautionary Checklist

To keep your staff and patients safe, consider the following precautions:

  • Monitor the Ebola situation online. Utilize the resources available on the CDC website.
  • Assess and ensure availability of appropriate personal protective equipment (PPE) and hand hygiene supplies.
  • Review facility infection control policies.
  • Review environmental cleaning procedures.
  • Be on the lookout for patients with fever or symptoms of Ebola who have traveled from Liberia, Guinea or Sierra Leone in the past 21 days.
  • Recognize a case of Ebola and be prepared to use appropriate infection control measures.
  • Begin education and refresher training for healthcare providers on Ebola virus disease signs and symptoms, diagnosis, triage procedures, employee sick leave policies, how and to whom Ebola cases should be reported and procedures to take following unprotected exposures.
  • Avoid contact with the blood or bodily fluids of an infected patient.
  • Ensure laboratories review procedures for appropriate specimen collection, transport and testing of specimens from patients who may be infected with Ebola virus.

Other Facts About the Ebola Virus

According to the CDC, a person infected with Ebola is not contagious until symptoms appear. Signs and symptoms of Ebola include fever (greater than 101.5°F) and severe headache, muscle pain, vomiting, diarrhea, stomach pain or unexplained bleeding or bruising. Symptoms can appear from 2 to 21 days after exposure. After 21 days, if an exposed person does not develop symptoms, they will not become sick with Ebola.

The Ebola virus is spread through direct contact (through broken skin or mucous membranes) with blood and bodily fluids (e.g., urine, feces, saliva, vomit and semen) of a person who is sick with Ebola, or with objects (e.g., needles) that have been contaminated with the virus. Ebola is NOT spread through the air or by water or, in general, by food.

The Triclosan Controversy


What’s the Trouble with Triclosan?

Antibacterial agent comes under fire for potential health risks

Colgate Total has been in the news lately, thanks to one of its active ingredients – triclosan. The antibacterial chemical has come under increased scrutiny as new studies have raised questions about its safety. These studies show that triclosan may be influencing cancer cell growth and disrupting the way hormones work in animals.1 Whether these undesirable side effects are present in humans is harder to determine, but it doesn’t bode well for the chemical.

So why include a questionable chemical? Total’s patented formula has proved effective in reducing the bacteria that cause plaque and gingivitis, which can lead to periodontal disease.

However, triclosan’s use in other products hasn’t been proven to be beneficial. Triclosan can be found in many different types of products – everything from cosmetics to clothing to rugs. Its presence in some of the products that dental healthcare professionals use every day for infection control purposes might be cause for concern.

For example, triclosan is a common ingredient in antibacterial hand soaps, even though it has not been proven to be more effective at reducing illness than washing hands properly with regular soap and water. It’s this fact that has the FDA re-examining the safety and efficacy of including triclosan in soap and body washes, outside of hospital settings.

According to FDA microbiologist Colleen Rogers, Ph.D., “New data suggest that the risks associated with long-term, daily use of antibacterial soaps may outweigh the benefits.” In addition to the cancer and hormonal effects, triclosan is also suspected of contributing to bacterial resistance of antibiotics – a problem with broad-reaching implications.

Fortunately, it’s easy to move away from hand soaps containing triclosan, while taking the opportunity to emphasize the importance of following a proper hand-washing protocol with your team. Hand sanitizers, which also might contain triclosan, are available in triclosan-free versions with alcohol as the active ingredient – look for at least 60% alcohol make sure to use enough to wet hands for at least 15 seconds.

1 Tiffany Kari, Colgate Total Ingredient Linked to Hormones, Cancer Spotlights FDA Process, (http://www.bloomberg.com/news), August 11, 2014

Bad News for BPA

Bad News for BPA

New research links BPA exposure to disrupted enamel formation and childhood obesity, among other problems

Bisphenol A (BPA), a chemical compound found in many everyday plastic products, caused widespread alarm outside of dentistry in 2010, after several studies linked it to health problems. Many manufacturers of plastic bottles, particularly those used by children, were prompted to exclude the substance from their formulations.

Since the first composite resin was introduced in the 1960s, dental composites and sealants containing BPA have been developed. Within the last 25 years, researchers have reported detectable levels of BPA in patients treated with dental sealants. This year alone, more and more evidence is mounting against BPA, with new studies suggesting that exposure to BPA may have harmful effects on human health, particularly during a child’s early development years.

DAMAGED/FRAGILE TOOTH ENAMEL
diversity-group-children1New research from France has suggested that BPA exposure in children can adversely affect cells that produce tooth enamel, making it fragile or brittle. The researchers studied the effects of low daily doses of BPA on the teeth of laboratory rats. Results showed tooth enamel damage in the rats to be characteristic of a childhood tooth enamel condition called Molar Incisor Hypomineralisation (MIH), which occurs selectively in permanent incisors and first molars1.

MIH affects about 18% of children between the ages of 6 and 8. Children with MIH are highly prone to dental caries and are very susceptible to tooth sensitivity and pain. Connections between this condition and the results studied in the rats’ teeth are even stronger due to the fact that the age at which children develop their first molars and permanent incisors is the age at which studies show that humans are most sensitive to BPA.

INCREASED RISK OF CHILDHOOD OBESITY
A study examining the relationship between BPA and obesity in school-age children found that girls between 9 and 12 years of age with higher-than-average levels of BPA in their urine had double the risk of being obese than girls with lower levels of BPA2.

The study was conducted in Shanghai as part of a larger national study of puberty and adolescent health, and may provide evidence that confirms recent and past findings from animal studies – that high BPA exposure levels could increase the risk of children becoming overweight or obese.

BPA acts as an endocrine disruptor, a substance that disturbs the endocrine system. The endocrine system is a series of glands — such as the thyroid, pituitary, and adrenal glands — that releases hormones affecting sexual development, growth and metabolism. Some chemicals, like BPA, can alter hormone levels.

“Girls in the midst of puberty may be more sensitive to the impacts of BPA on their energy balance and fat metabolism,” said De-Kun Li, MD, PhD, principal investigator of the study and a reproductive and perinatal epidemiologist at the Kaiser Permanente Division of Research in Oakland, California2.

OTHER NEGATIVE EFFECTS
Other studies have suggested that BPA exposure affects the reproductive systems of laboratory animals. A study published in January by researchers at the New York University School of Medicine found that even low levels of BPA may put children and adolescents at a higher risk of heart and kidney disease. Another recent study linked BPA exposure to childhood asthma.

BPA-FREE ALTERNATIVES
Did you know that PureLife offers a variety of BPA-free products? For example, Venus Diamond and Venus Pearl composites by Heraeus Kulzer boast a patented BPA-free urethane monomer chemistry. Also, the Embrace line of cements and sealants from Pulpdent and the new Toothfairy BPA-Free Pit & Fissure Sealant from Septodont utilize an advanced BPA-free resin technology.

REFERENCES
1 Early BPA exposure may adversely affect formation of tooth enamel. (2013, June 13). Dental Tribune.
2 Chemical in plastics may double obesity risk in puberty-age girls. (2013, June 14). Jagran Post