Newsletter

Fall 2011

Infective Endocarditis

You may recall our discussion back in 2008 announcing the cessation of antibiotic use before dental procedures. If you had a history of common heart conditions, most notably a heart murmur, you were required to take an antibiotic before having dental care.  A history of heart murmur, one sign of possible valvular defect, signaled antibiotics to prevent bacteria from lodging at the valve causing the infection known as subacute bacterial endocarditis (SBE). Patients with this condition have been required to take antibiotics – the standard of care for the past 50 years, that is, until 2008.

No clinical test has ever been attempted to answer the question if antibiotics are necessary. Due to ethical, medicolegal issues, costs and the rather large population needed to gain statistically significant results, a controlled trial has never been attempted. A new review, published in the British Journal of Medicine (BMJ 2001:342:d2392), looked at the number of cases of SBE since the regime was essentially eliminated.

The results of this retrospective review found no increase or decrease in the number of SBE cases. In other words, dropping the antibiotic prophylaxis requirement for dental care resulted in no increase in the number of cases of SBE. Conclusion – antibiotics generally are no longer needed to prevent SBE.

History rewritten by studying teeth

Seems that our ancestors may not have lived in separate insular communities after all. Our grade school teachings related to early societies was that of small groups creating tools for farming, understanding metal use, even pottery for water vessels for their own use. Clashes with other societies were reported as rare, and at the same time providing elements of change to the culture. New research however paints a different picture.

A new technique is being used to which analyizes the isotopes of the basic elements that make up teeth. This “tooth analysis” reveals a very different story.  With teeth forming in childhood and again at adolescence, the tooth structure is built from elements in the diet. These isotopes can be correlated with the time and place where the foods were consumed. By measuring strontium and oxygen isotopes, scientists at the NERC Isotope Geosciences Laboratory can now match teeth with landscape, temperature, altitude and distance from the sea where the individual lived.

Samples taken from various sites shows a Goth from the Black Sea who died near Bristol, England, an African near Hadrian’s Wall, and a Viking woman found in Yorkshire. This suggests a new view that some people may have travelled frequently across cultural and geographic ranges. Like today, Europe may have always been a multicultural area.

Yeah Charlie

You may have read about our patient Charlie Livermore in the Marin IJ August 11. Charlie came in for a new patient exam at the insistence of Theresa, one of our hygienists. Charlie is a cycling coach who operates a performance-training center for cyclists and triathletes in Mill Valley. At the exam we found a lump.  Was it cancer?  Reports Charlie,“Soon after Dr. Collins discovered the lump, I had it biopsied and found out it was cancer. Thanks to Theresa’s persistence that I get a checkup and Dr. Collins’ thorough exam, we detected it early and a year later, I’m cancer free and feeling great!”

We can’t express how vitally important early diagnosis is. Charlie won. Oropharyneal cancers make up only 4% of all forms of cancers. Of the top 7 forms of cancer, two can be seen, skin cancer and mouth cancer.

As Theresa notes, sometimes “getting in for a cleaning” isn’t just a cleaning, it can be life-saving.

Your dental team in action

Wende travelled to Hawaii, learned how to paddle board with her stepdaughters, scared the family to death with a helicopter ride but had a great time. Back home her “doggies and kitties” enjoy life. She looks forward to a warm winter break down in Cabo for the holidays.

Theresa continues to figure out how to make having fun into a full-time paid profession. She notes she’s “had the joy and privilege of traveling this year”.  Bareboat sailing in the British Virgin Islands, skiing with her younger son in Colorado and visiting her oldest son, daughter-in-law and sweet granddaughter in Oregon.  Throw the south of France and Tahoe in the mix.  Lots of sailing and cycling as well.   Currently, she’s in the throes of attaining her Scuba certification.  Never a dull moment!  

Olga enjoyed some quality time with her family in Cabo San Lucas in the beginning of summer, soaking up the heat and relaxing.  Afterwards she hosted her parents from Ukraine with a trip traveling in California. They were impressed with spectacular waterfalls in Yosemite and Sand Harbor Lake at Tahoe.

Sylvia enjoyed her summer with her usual trip to Graeagle in July with a group of friends. While her husband hits the long ball while golfing, Sylvia grabs a good book and relaxes. She also enjoyed her first Hornblower Bay Cruise on Fleet Week in October. One of her co-workers taught her to knit and she is busy trying out new yarns! Her friends are enjoying her creative scarves.

Dr. C and Pam saw their kids off to college and eagerly await their return for the holidays. Dr. C enjoyed mountain biking up at Spooner Lake and in October climbed Yosemite Falls for an arduous hike of 2700’. He recently completed CERT (community emergency response team) training with the City of San Rafael. His final was 2 disaster scenarios both earthquakes. If you saw fires, arching electrical wires and heard the screams of victims in the fire tower by Montecito, that was his class. He continues to serve on the Budget Committee with San Rafael City Schools, and as needed with his Boy Scouts at Troop 101 in San Rafael.

We wish you all a happy and safe holiday. Thank you also for your referral of friends and family as we all strive to maintain a healthy life.

Thomas P. Collins, DDS                                     Wende, RDH, Dental Hygienist
Sylvia,  RDA, Front Desk                                   Theresa, RDH, Dental Hygienist
Olga, RDA, Clinical Dental Assistant