A preliminary study finds that receipt of the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in the third trimester of pregnancy did not increase the risk of adverse events for the mother or infant, according to a study in the May 7 issue of JAMA, a theme issue on child health. In addition, the authors found high concentrations of pertussis antibodies in infants during the first 2 months of life, a period during which infants are at the highest risk of pertussis-associated illness or death. This issue is being released early to coincide with the Pediatric Academic Societies Annual Meeting.

Pertussis is a highly contagious and potentially fatal vaccine-preventable disease that has re-emerged in the United States despite high childhood immunization rates. Infants younger than 6 months are at greatest risk of disease, hospitalization, and death and account for more than 90 percent of all pertussis-associated deaths in the United States. Infants too young to receive the primary diphtheria and tetanus toxoids and acellular pertussis (DTaP) immunization series (recommended at 2, 4, and 6 months of age) depend on maternal antibodies for protection against pertussis. However, pregnant women have very low concentrations of pertussis antibodies to transfer to their newborn at the time of delivery; maternal immunization with the Tdap vaccine could help prevent infant pertussis, according to background information in the article.

Flor M. Munoz, M.D., of the Baylor College of Medicine, Houston, and colleagues randomly assigned 48 women to receive the Tdap vaccine (n = 33) or placebo (n = 15) at 30 to 32 weeks' gestation to evaluate the safety and immunogenicity (ability to produce an immune response) of the vaccine administered during pregnancy. Women who received placebo during pregnancy were given Tdap vaccine postpartum prior to hospital discharge, and women who received Tdap during pregnancy were given placebo postpartum.

The researchers found that injection site and systemic reactogenicity (adverse reactions) rates in pregnant women were not significantly different than those observed among postpartum or nonpregnant women. No Tdap-associated serious adverse events occurred in women or infants. Growth and development were similar in both infant groups. No cases of pertussis occurred.

Also, concentrations of vaccine-induced pertussis antibodies in infants born to mothers immunized with Tdap during pregnancy were significantly higher at birth and at age 2 months than in infants whose mothers were immunized postpartum.

In addition, maternal immunization with Tdap did not substantially alter infant responses to scheduled DTaP.

"Further research is needed to provide definitive evidence of the safety and efficacy of Tdap immunization during pregnancy," the authors write.

VANCOUVER, BRITISH COLUMBIA – Conventional wisdom holds that when the risk of catching a disease is high, people are more likely to get vaccinated to protect themselves.

This may not be the case, however, according to a study to be presented Monday, May 5, at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

Researchers, led by Elizabeth R. Wolf, MD, FAAP, compared rates of infant vaccination with the diphtheria, tetanus and pertussis vaccine (DTaP) before and during an epidemic of pertussis (whooping cough) in Washington state. Surprisingly, they found no difference in vaccination rates.

"We have always assumed that when the risk of catching a disease is high, people will accept a vaccine that is effective in preventing that disease. Our results may challenge this assumption," said Dr. Wolf, the Ruth L. Kirschstein National Research Service Award Fellow in General Academic Pediatrics at University of Washington, Seattle Children's Research Institute.

Washington state experienced a pertussis epidemic from Oct. 1, 2011, through Dec. 31, 2012, and infants were hit the hardest. The highly contagious bacterial disease causes uncontrollable, violent coughing that can make it hard to breathe. Pertussis also is known as whooping cough because a "whooping" sound often is heard when the patient tries to take a breath. Pertussis can lead to pneumonia, seizures (jerking and staring spells), brain damage and death.

Dr. Wolf and her colleagues compared the proportion of 3- to 8-month-olds who had received the recommended number of doses of pertussis-containing vaccine before the epidemic and during the epidemic. Infants who received at least one dose by 3 months of age, at least two doses by 5 months and at least three doses by 7 months are considered up to date by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.

"We hypothesized that a whooping cough epidemic would result in more parents getting their children immunized against whooping cough," Dr. Wolf said. "But compared to a time before the 2011-2012 whooping cough epidemic in Washington state, there was no significant increase in receipt of whooping cough vaccines for infants during the epidemic."

Results did show considerable variability in vaccination rates among different counties.

"Vaccination rates in the U.S. are still below public health goals," Dr. Wolf noted. "We don't fully understand what improves vaccine acceptance. This study found no significant increase in vaccination coverage statewide during the 2011-2012 pertussis epidemic. This finding may challenge the assumption that vaccine acceptance uniformly increases when risk of disease is high."

TORONTO—Less than 1% of healthy urban children surveyed in Toronto had received dental care by the recommended age of 12 months and less than two per cent had seen a dentist by the age of 24 months. Children most susceptible to cavities were least likely to receive early dental care, according to the study by Dr. Jonathon Maguire, a pediatrician and researcher at St. Michael's Hospital.

Of the 2,505 children around 4 years of age who were surveyed from 2011-13, 39 per cent had never been to a dentist. The children were part of TARGet Kids! (The Applied Research Group for Kids!), a unique collaboration between doctors and researchers from St. Michael's Hospital and The Hospital for Sick Children. The program follows children from birth with the aim of preventing common problems in the early years and understanding their impact on health and disease later in life.

Dr. Maguire's study was published today in the journal Pediatrics.

The study found never having been to a dentist was associated with younger age, lower family income, prolonged bottle use and higher daily intake of sweetened drinks such as juice. With each one-cup increase in the amount of sweetened drinks consumed daily, the odds of never having visited a dentist increased by 20 per cent.

Of children who had visited a dentist, 24 per cent had at least one cavity.

Dr. Maguire said prolonged bottle use, especially at night, and sweetened drinks are suspected risk factors for cavities because the carbohydrates in the beverages promote the growth of the bacteria that causes cavities.

Among children who had been to a dentist, older age, lower family income and East Asian maternal ancestry were also associated with having one or more cavities.

Cavities can cause not just pain in children but also contribute to feeding problems, poor nutritional status and behavioural problems, Dr. Maguire said.

He said previous studies have found that children who receive preventive dental care in the first year of life have less dental disease, are less likely to require restorative or emergency treatment and have lower dental-related health care costs – particularly among high-risk populations. Barriers to dental care for families with young children may include financial cost, access to transportation, school absence policies and a belief that dental health may not be important to overall well-being, he said.

"It's one thing for primary health care providers to be recommending early preventive dental care but for many families this is unrealistic," said Dr. Maguire. "Publically funded universal early preventive dental care just makes sense"

Dental care is not part of Canada's universal health care system and, as in the United States, it is primarily provided in private practice settings on a free-for-service basis.

MADISON, Wis—The American Academy of Cosmetic Dentistry (AACD) has launched “The Smile Story Contest” that will enhance the smiles and change the lives of up to five lucky people, while raising awareness about the benefits of cosmetic dentistry.

The Smile Story Contest launched April 30 at AACD 2014 in Orlando, the Academy’s 30th anniversary scientific session. Entrants will submit their smile story telling why they deserve a new smile, plus a photo, at www.yoursmilebecomesyou.com. A public voting period, June 11-June 30, will allow entrants to ask their friends, family, and social networks to vote for them. The top 20 will meet with a participating AACD dentist for a treatment consultation, and then a panel of dental professionals will select up to five winners, who will be announced in September through AACD’s Facebook page. The winners will have a chance to show off their smile makeovers onstage at AACD 2015 in San Francisco, the Academy’s 31st annual scientific session, for the big reveal.

All AACD Member Dentists and Laboratory Technicians are invited to participate. For more information about becoming an AACD makeover smile designer, visit www.aacd.com/contest. Dentists and laboratory technicians have until June 27 to indicate their interest.

“Recent AACD research has shown that a smile can help make a great first impression,” said Dr. Bill Dorfman, AACD Accredited Fellow and celebrity dentist who announced the launch of The Smile Story Contest in Orlando. “But sometimes that smile isn’t telling the whole story. Through this contest, AACD Member dentists and laboratory technicians will help our winners write new smile stories, while giving them the smiles of their dreams. AACD helps change lives, while spreading awareness about the benefits of cosmetic dentistry and responsible esthetics.”

The Smile Story Contest is part of AACD’s Your Smile Becomes You campaign to raise awareness of the benefits of cosmetic dentistry and working with an AACD dentist. The contest’s host website, www.yoursmilebecomesyou.com, also offers a Smile Analyzer, information about cosmetic dentistry procedures, patient education videos, a Smile IQ Quiz, a Smile Gallery, and much more.

The contest is supported by Ivoclar Vivadent’s IPS e.max, Ivoclar’s all-ceramic system for crowns, inlays, onlays, thin veneers, abutments and bridges. The product has been used in more than 75 million restorations in 6,000 North American labs.

CHICAGO—When it comes to buying a mouthguard, parents who want to reduce their child's risk of a sports-related concussion should visit a dentist instead of a sporting goods store.

High school football players wearing store-bought, over-the-counter (OTC) mouthguards were more than twice as likely to suffer mild traumatic brain injures (MTBI)/concussions than those wearing custom-made, properly fitted mouthguards, reports a new study in the May/June 2014 issue of General Dentistry, the peer-reviewed clinical journal of the Academy of General Dentistry (AGD).

"Researchers and, most importantly, parents, are looking for ways to better protect children against concussions," said lead author Jackson Winters, DDS, a pediatric dentist who also served as a high school and collegiate football official for 28 years. "Consumers may believe that today's advanced helmet design provides sufficient protection, but our research indicates that, when compared to over-the-counter versions, a custom-made, properly fitted mouthguard also is essential to player safety."

The study followed 412 players from six high school football teams. Three teams (220 athletes) were randomly assigned to wear custom-made mouthguards, and three teams (192 athletes) wore standard OTC mouthguards of their own choosing. All players wore the same style of football helmet.

According to the study, 8.3 percent of athletes in the OTC mouthguard group suffered MTBI/concussion injuries. For those with custom-made mouthguards, however, the rate was only 3.6 percent.

Many variables contribute to MTBI/concussion injuries, and mouthguards—whose primary function is protecting the teeth—cannot completely prevent them from occurring. Previous studies have theorized that mouthguards can reduce concussion risk, however, because they help absorb shock, stabilize the head and neck, and limit movement caused by a direct hit to the jaw.

Mouthguard thickness also has been shown to be a factor that contributes to the level of protection. The average thickness of the custom-made mouthguards in this study was 3.50 millimeters, while the average thickness of the OTC mouthguards was only 1.65 millimeters.

"Although more research on this topic is needed, our study shows the value of a custom-made mouthguard," Dr. Winters said. "The benefits of protecting your child far outweigh the costs associated with a dental or medical injury, which is likelier to occur with a store-bought model."

Custom-made mouthguards also can last longer than store-bought models and may be less prone to damage by the athletes, said AGD Spokesperson Eugene Antenucci, DDS, FAGD. "Over-the-counter mouthguards are not fitted to the athlete's mouth, making them less comfortable than custom guards made by a dentist," said Dr. Antenucci. "When a mouthguard is not comfortable, the athlete is likely to chew it, reducing its thickness and resulting in less protection."

Dr. Antenucci offers the following tips for caring for a custom-made mouthguard:

1. After each use, brush your mouthguard with a toothbrush and cool (not hot) water.

2. Keep your mouthguard in a well-ventilated, plastic storage box when not in use. Your dentist will provide you with a case for your mouthguard.

3. Heat is bad for a mouthguard, so don't leave it in direct sunlight or in a hot car. The heat can melt the mouthguard, altering the way it fits in your mouth and resulting in less protection.

4. When you see your dentist twice a year for your regular cleanings, bring your mouthguard with you. Your dentist can give your mouthguard a thorough cleaning and check its structure and fit.

5. Call your dentist if you have any concerns about your mouthguard.

To get custom-made mouthguard for your child, talk to your general dentist.

To learn more about other oral health issues, visit KnowYourTeeth.com.

Geneva - A new report by the World Health Organization (WHO)–its first to look at antimicrobial resistance, including antibiotic resistance, globally–reveals that this serious threat is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country. Antibiotic resistance–when bacteria change so antibiotics no longer work in people who need them to treat infections–is now a major threat to public health.

“Without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” says Dr Keiji Fukuda, WHO’s Assistant Director-General for Health Security. “Effective antibiotics have been one of the pillars allowing us to live longer, live healthier, and benefit from modern medicine. Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating.”

Key findings of the report

The report, "Antimicrobial resistance: global report on surveillance", notes that resistance is occurring across many different infectious agents but the report focuses on antibiotic resistance in seven different bacteria responsible for common, serious diseases such as bloodstream infections (sepsis), diarrhoea, pneumonia, urinary tract infections and gonorrhoea. The results are cause for high concern, documenting resistance to antibiotics, especially “last resort” antibiotics, in all regions of the world.

Key findings from the report include:

-Resistance to the treatment of last resort for life-threatening infections caused by a common intestinal bacteria, Klebsiella pneumoniae–carbapenem antibiotics–has spread to all regions of the world. K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, infections in newborns and intensive-care unit patients. In some countries, because of resistance, carbapenem antibiotics would not work in more than half of people treated for K. pneumoniae infections.

-Resistance to one of the most widely used antibacterial medicines for the treatment of urinary tract infections caused by E. coli–fluoroquinolones–is very widespread. In the 1980s, when these drugs were first introduced, resistance was virtually zero. Today, there are countries in many parts of the world where this treatment is now ineffective in more than half of patients.

-Treatment failure to the last resort of treatment for gonorrhoea–third generation cephalosporins–has been confirmed in Austria, Australia, Canada, France, Japan, Norway, Slovenia, South Africa, Sweden and the United Kingdom. More than 1 million people are infected with gonorrhoea around the world every day.

-Antibiotic resistance causes people to be sick for longer and increases the risk of death. For example, people with MRSA (methicillin-resistant Staphylococcus aureus) are estimated to be 64% more likely to die than people with a non-resistant form of the infection. Resistance also increases the cost of health care with lengthier stays in hospital and more intensive care required.

Ways to fight antibiotic resistance

The report reveals that key tools to tackle antibiotic resistance–such as basic systems to track and monitor the problem–show gaps or do not exist in many countries. While some countries have taken important steps in addressing the problem, every country and individual needs to do more.

Other important actions include preventing infections from happening in the first place–through better hygiene, access to clean water, infection control in health-care facilities, and vaccination–to reduce the need for antibiotics. WHO is also calling attention to the need to develop new diagnostics, antibiotics and other tools to allow healthcare professionals to stay ahead of emerging resistance.

This report is kick-starting a global effort led by WHO to address drug resistance. This will involve the development of tools and standards and improved collaboration around the world to track drug resistance, measure its health and economic impacts, and design targeted solutions.

How to tackle resistance

People can help tackle resistance by:

-using antibiotics only when prescribed by a doctor;

-completing the full prescription, even if they feel better;

-never sharing antibiotics with others or using leftover prescriptions.

Health workers and pharmacists can help tackle resistance by:

-enhancing infection prevention and control;

-only prescribing and dispensing antibiotics when they are truly needed;

-prescribing and dispensing the right antibiotic(s) to treat the illness.

Policymakers can help tackle resistance by:

-strengthening resistance tracking and laboratory capacity;

-regulating and promoting appropriate use of medicines.

Policymakers and industry can help tackle resistance by:

-fostering innovation and research and development of new tools;

-promoting cooperation and information sharing among all stakeholders.

The report–which also includes information on resistance to medicines for treating other infections such as HIV, malaria, tuberculosis and influenza–provides the most comprehensive picture of drug resistance to date, incorporating data from 114 countries.

Paris--Oral-B has launched the world's first connected toothbrush to help consumers improve their oral health. The brand sought inspiration for this new product by crowdsourcing ideas on eYeka, asking a community of consumers what a connected electrical toothbrush should offer to change their lives for the better. The outcome of this contest has not only helped Oral-B bring these innovations to market, but will fuel the brand's innovation pipeline for the years to come.

To accelerate the development of the world's first connected toothbrush, Oral-B launched an unbranded contest on eYeka's crowdsourcing platform to seek original ideas on what such a product could offer consumers. In just 22 days, Oral-B received 67 unique and innovative ideas from community members in 24 countries across the globe.

Stephen Squire, BFO Marketing Director, Procter & Gamble commented, “We knew time was critical and the company that could launch the first product would have a huge first mover advantage. The eYeka community gave us a the head start needed and helped us anticipate some of the problems that we had to consider in the development of the product; in particular the importance of content, gamification, family interaction and socialisation.”

Out of these 67 creative ideas, Oral-B selected three winning ideas that came from Yao Peipei from China ("ypp1117" on eYeka), Javier Alcazar from Spain ("moebius" on eYeka) and Thibault Berrido from France ("thaubyas" on eYeka). The three winners shared €2,500 of prize money.

These three winning ideas, as well as the whole set of creative contributions, were analysed by eYeka, and helped Oral-B develop and bring a branded smartphone app to market in September 2013. This was followed in February 2014 by the launch of Oral-B’s SmartSeries, the world’s first ever Bluetooth connected toothbrush which leverages the app's technology to help consumers get the most from their oral care routines.

François Pétavy, CEO, eYeka said, “Brands need to bring innovations that stand-out to market fast if they want to meet consumers’ ever increasing expectations. The fact that Oral-B could launch this revolutionary product in record time and feed its innovation pipeline for the years to come shows that crowdsourcing with consumers offers the breadth of freshness needed to deliver the breakthroughs that resonate.”

The app recognizes the brush's motor sound and automatically activates a timer for a dentist-recommended two-minute brushing session. It also keeps track of your brushing technique and progress through comprehensive stats and notifies users when it is time to change the brush head. The app also offers oral care tips as well as news and entertainment to make brushing your teeth more enjoyable.

Squire added, “Thanks to the richness of the ideas, we have successfully made interactivity the new vector of innovation for Oral-B. It opened thousands of opportunities that are now feeding our Initiative Master Plan.”

The new Oral-B SmartSeries interactive electric toothbrush with Bluetooth 4.0 connectivity is available in limited quantities in Germany this spring. It will be available worldwide in June 2014. The new Oral-B App is available on Apple's app store and an Android version will be launched in August 2014.

Contest Winner Quotes:

Yao Peipei, ‘ypp1117’: “I participated in this contest because when I first saw the brief, I found it particularly interesting and challenging. The idea came when I was brushing my teeth and I added in new ideas and more details when I brushed them every morning.  While working on my creation, I always asked myself: how can I make the process of brushing teeth more efficient and interesting, both for adults and for kids?

“I really put a lot of effort into this contest and I thought the brand would like my idea. Still, I was excited to know that I had really won! Winning on eYeka gave me so much confidence and participating in such creative contest is part of my life now.”

Javier Alcázar, ‘moebius’: “These kind of contests are exciting because they involve a high degree of creativity. You have the chance to create something that can be the basis for a change; something that had not been done before and challenges the norm.

“The idea of "Let's Play" is the result of my experience of trying  to motivate my children to brush their teeth daily. Their education is the most important thing to us as parents. For them (10 year old twins) the most important thing is play. I mixed what is important to them and what is important to us. Winning a prize is always very gratifying, especially in a community like eYeka where you can find so many people with great talent!”

Thibault Berrido, ‘Thaubyas’: "I work in a design collective called "dafox" which aims to make design and communication accessible to all. With the internet and touch screens, a lot of new experimentations are possible, and we want to encourage this experimentation. eYeka is a fabulous playground to experiment with new ideas, and in this contest I liked the fact that I could really experiment by adapting game mechanisms to oral care, which is not the most fun chore in our daily life.

When I found out that I won, I was surprised and happy because it acknowledges the quality of my ideas, which is always pleasant. I donated all the prize money to a French charity called Reporters Sans Frontières because it's a social cause I deeply care about."

About eYeka:

Welcome to the World's biggest creative playground! eYeka is an online community of over 260,000 very creative individuals active in over 150 countries. We connect with brands and their agencies to increase the ROI of their marketing activities by delivering relevant innovation ideas and social content that attract, engage and sell. We offer end-to-end solutions from ideation, curation, validation to amplification. And we guarantee our results! Leading brands such as Unilever, P&G, Mondelez, Coca-Cola, Nestle, Danone, Hyundai and Toyota are already in eYeka's playground. Discover how we boost their marketing ROI on www.eyeka.net

Relevant Links:

The contest brief on eYeka - https://en.eyeka.com/contests/7281-power-interactivity/brief

The contest results on eYeka - https://en.eyeka.com/contests/7281/results

The announcement of the Oral-B App - https://news.pg.com/press-release/pg-corporate-announcements/oral-b-announces-launch-new-digital-tool-better-oral-care

The announcement of the Oral-B Interactive Electric Toothbrush - https://news.pg.com/press-release/pg-corporate-announcements/oral-b-debuts-worlds-first-available-interactive-electric-t

Oral-B's "Connected Toothbrush" Website- https://connectedtoothbrush.com/

Videos:

Introduction to Oral-B’s Power Toothbrush Bluetooth App - https://www.youtube.com/watch?v=lRvYQXruyKk

Interview with Stephen Squire, BFO Marketing Director, Procter & Gamble on eYeka and Oral-B’s collaboration - https://www.youtube.com/watch?v=AMJPay3deFE

(HealthDay News) -- Romantic intimacy in long-term relationships often suffers when one partner gets a diagnosis of mouth or throat cancer caused by HPV, the sexually transmitted human papillomavirus. But new research suggests these couples can kiss as much and as deeply as they ever have, without worry.

Click here to read more.

WASHINGTON UPI) -- About 1 in 3 U.S. adults did not visit the dentist with the past 12 months, a survey found -- similar to results of a survey in 2008.

The Pew Charitable Trusts commended the Maine legislature and governor for authorizing midlevel dental practitioners. These providers, who function similarly to a nurse practitioner or physician’s assistant on a medical team, allow dentists a way to extend care to the many thousands of residents who currently need—but have been going without—dental care.

"The need for dental care in our rural part of Maine is huge. We see it every single day,” said Julian Kuffler, M.D., M.P.H., and medical director of the Community Health Center at Mount Desert Island Hospital in Southwest Harbor, Maine. “This legislation will give us the flexibility we need to offer dental care in a financially sustainable way. We'll be able to hire a dentist knowing that we can also hire a dental hygiene therapist to work as part of their team to extend their care for the most needed routine services. Our Community Dental Center in Southwest Harbor that is up and running looks forward to the day when we can add a dental hygienist therapist to our team."

The law, passed with bipartisan support and signed by Governor Paul LePage (R), authorizes dental hygiene therapists who will be licensed to perform both preventive and routine restorative dental care, such as filling cavities, and who will work under the supervision of dentists.  

“Dental hygiene therapists will serve as part of the overall oral health team, working with dentists to improve the access to care for all Mainers,” said House Speaker Mark Eves (D). “The bipartisan effort that brought this bill through the Legislature is a perfect example of legislators working together to ensure that all Mainers have the tools they need to lead healthy lives.”

 “I am proud of the work accomplished by the Legislature on this important issue,” said Senator David Burns (R). “By implementing a midlevel provider, we can strengthen our oral health teams with new resources to serve our children’s needs. I believe this legislation gets us on the path of providing more access and professional dental care to underserved areas of Maine. This bill is a wonderful example of legislators working together and putting the people of Maine before politics.”  

Currently, areas in 15 of Maine’s 16 counties have dentist shortages, making it hard for 180,000 residents to find care. More than 62 percent of low-income children in the state went without access to dental care in 2011.

“This is a victory for the people of Maine. Dental hygiene therapists will make a real difference in improving access to care,” said Shelly Gehshan, director of Pew’s children’s dental campaign.  “This law is a testament to the broad coalition that has worked diligently to address the state’s oral health needs and Pew was proud to be a part of their efforts.”  

A recent Pew study that examined how a dental therapist was used in a rural private practice found that in the therapist’s first year new patients increased by 38 percent, the share of Medicaid patients increased from 26 percent to 39 percent, and the dentist was able to focus on more advanced procedures. The study also showed that hiring dental therapists can be a good business decision for dentists, over 90 percent of whom own or work in private settings.

Research has confirmed that midlevel providers offer high-quality, cost-effective care and improve access to treatment in places where dentists are scarce. In the United States, dental therapists are already working in two states, Alaska and Minnesota, and 15 states are considering legislation to authorize midlevel providers.