FDA youth tobacco prevention campaign


Washington—The U.S. Food and Drug Administration will launch a national public education campaign targeting 12-17 year-olds with “real cost” messages about cosmetic, oral and other health consequences of tobacco use.

“Educating teens about the harms of tobacco use in a way that is personally relevant to them can be difficult, especially since many teens believe they won’t get addicted and that the long-term health consequences of smoking don’t apply to them,” the FDA said in announcing The Real Cost campaign at the National Press Club.

“But there are some ‘costs’ of tobacco use that do resonate with teens, such as cosmetic health effects like tooth loss and skin damage. Highlighting consequences that teens are concerned about is an effective approach to reducing youth tobacco use.”

The campaign will start with cigarettes and expand to smokeless and other tobacco products, the first TV ads airing Feb. 11 and extending across online, offline, print, radio, social and other media platforms for at least a year. Among the messages:

  • See what your smile could look like if you smoke.
  • Smoking could cost your teeth
  • Smoking cigarettes can cause yellow teeth, bad breath and gum disease.
  • If you’re playing with cigarettes, you’re harming your teeth.
  • Don’t smile, smoking may stain your teeth.
  • Smoking causes gum disease, which could cost you your teeth.
  • Smoking causes bad breath, may stain teeth and causes gum disease that can lead to tooth loss.

The U.S. Surgeon General’s 50th anniversary review of tobacco science since Dr. Luther Terry’s 1964 report on smoking and health updates evidence on the implications for oral health from tobacco use and the “expanding use of multiple products or the replacement of conventional combustible cigarettes with other nicotine delivery systems.”

ADA policy supports FDA regulation of all tobacco products as authorized by the 2009 Family Smoking Prevention and Control Act, including those with risk reduction or exposure reduction claims, explicit or implicit, and any other products offered to the public to promote reduction in or cessation of tobacco use. ADA’s National Action Plan for Tobacco Cessation supports the “launch [of] an ongoing, extensive paid media campaign to help Americans quit using tobacco.”

Visit MouthHealthy.org and the ADA.org tobacco control site for more information on Association tobacco policy and resources.

FDA’s ad campaign will target an estimated 10 million at-risk teens about the harmful effects of tobacco use. “We know that early intervention is critical, with almost nine out of every 10 regular adult smokers picking up their first cigarette by age 17,” said FDA Commissioner Margaret A. Hamburg, M.D. “This campaign will allow teens to rethink their relationship with tobacco,” FDA’s Kathy Crosby added.

“We view this campaign as a major investment in the power of prevention,” said Howard Koh, M.D., assistant secretary for health in the Department of Health and Human Services, FDA’s parent agency. The $115 million campaign, including research, creative development and media placement in more than 200 markets, is financed by industry user fees, the FDA said. The Tobacco Control Act authorized the FDA to collect tobacco user fees from manufacturers and importers of tobacco products to implement the law.

Action for Dental Health bill

Washington—The ADA Action for Dental Health movement gained the attention of the U.S. Congress with the introduction April 3 of legislation “to improve essential oral health care for lower-income individuals by breaking down barriers to care.”

Introduced by first-term Rep. Robin Kelly, D-Ill., H.R. 4395 was referred to the House Energy and Commerce Committee. The Action for Dental Health Act of 2014 would provide a $10 million annual grant program for constituent and component dental societies and others at the state and local levels offering free dental services for underserved populations. The bill would also provide an additional $10 million to implement ADH initiatives that reduce barriers to care.

In less than a year since the Association launched Action for Dental Health: Dentists Making a Difference on May 15, 2013, more than a dozen state and local projects have been initiated across the country. Visit Action for Dental Health at ADA.org for more information on these initiatives. The ADA News, starting with the March 17 issue, will provide continued coverage of these initiatives.

The Association invites you to share your ADH story by contacting Rhys Saunders in the ADA Public Affairs Department at saundersr@ADA.org.

NIDCR to issue 2014-19 strategic plan

Dr. Somerman: NIDCR director says strategic plan will be responsive to its constituencies.

Bethesda, Md.—The National Institute of Dental and Craniofacial Research will unveil a five-year strategic plan for dental research late this spring. “The plan offers a clear and concise narrative of where today’s research investments might yield tomorrow’s clinical advances,” said Dr. Martha J. Somerman, NIDCR director.

“Importantly, the plan seizes upon new research and training opportunities, particularly in harnessing diverse science to enable personalized classification and treatment of dental, oral and craniofacial health and disease,” Dr. Somerman said.

“The aim throughout is to be responsive to our many constituencies, including the American Dental Association, and to actively advance the breadth, depth and diversity of dental, oral and craniofacial research, training and career development.”

The Association commended the NIDCR “for drafting a plan that effectively balances the research needs of dentists with those of patients, public health agencies and the many other stakeholders in our health care system.”

“The ADA is pleased and impressed that all major areas important to our members have been addressed in the draft strategic plan,
including public health issues related to social, behavioral and biological determinants of oral and dental disease and, importantly, the advancement of research that strengthens the evidence-based foundation of dental care,” the Association said in Jan. 30 comments to the NIDCR with a cover letter signed by Dr. Charles Norman, ADA president, and Dr. Kathleen O’Loughlin, executive director.

The NIDCR, a branch of the National Institutes of Health, provides the lion’s share of funding for research to improve dental, oral and craniofacial health with an enacted fiscal year 2014 budget of $397.102 million.

The administration’s proposed FY 2015 budget for the NIDCR is $397.131 million.

Dr. Somerman told the ADA News that the next strategic plan to guide NIDCR 2014-19 research efforts will be available free of charge for downloading at the institute’s website when it is released this spring.

The strategic plan includes four goals and several objectives that provide continuity in key areas, Dr. Somerman said.

Let science drive

We will support the best basic, translational, clinical and community-based research to build a strong evidence base in dental, oral and craniofacial health. Doing so will help bridge the gap between research and health care practice for improved human health. Our first strategic goal affirms the basic tenet that rigor and reproducibility of experimental design and results are essential elements of scientific investigation.

Enable precise and personalized oral health care

As trusted providers of health care, dentists and physicians have long recognized variations among patients and have provided personalized care based on the many biological and behavioral components that shape health. NIDCR-supported research can help enhance personalized health care in two ways. We will encourage better integration between health-related researchers and health care providers, and we will work to identify influences on oral health at the molecular level through biomarker discovery and the development of risk-assessment tools.

Address oral health disparities

NIDCR’s involvement in oral health disparities research is a long-term, deliberate investment. It focuses on building a foundation of knowledge that has had, and will continue to have, a measurable impact on clinical practice, public policy and the oral health of many of the nation’s most vulnerable populations. Although our commitment to eliminating oral health disparities is steadfast, it will continue to take time to reach fruition. This strategic goal signifies the importance of sustained effort that requires collaboration with many partners in government and industry and with a range of organizations and individuals in communities.

Engage a diverse oral health research workforce

Our fourth strategic goal applies to all areas of this strategic plan. It articulates the notion that people—scientists and practitioners, individuals and communities—are the lifeblood of biomedical research. Innovation and problem-solving require a workforce that is multidisciplinary and inclusive of scientists from diverse backgrounds and life experiences. Promoting education, scholarship and training at all levels and types of institutions—from students to laboratory investigators to health care providers—helps ensure that evidence-based care reaches patients and communities. Novel and collaborative strategies to engage a diverse oral health research workforce and to disseminate evidence-based information will guide us through the highly dynamic landscape of 21st century biomedicine.

ADA urges student loan reforms

Washington—The ADA and dental coalition organizations urged Congress to support student loan reforms proposed in separate bills. “It will not eliminate the significant burden of dental student debt, but it is an important step in that direction,” the dental groups told House and Senate leaders.

The ADA, Academy of General Dentistry, American Dental Education Association and American Student Dental Association signed March 21 letters to the House Ways and Means and Senate Health, Education, Labor and Pensions committee leadership. H.R. 1527 would expand the federal income tax deduction for student loan interest. S. 1066 would authorize any dental school graduate currently repaying Direct Loans (or a Federal Direct Consolidation Loan) to consolidate or refinance loans at a lower fixed rate.

“We are extremely concerned about the alarming levels of educational debt that dental students face upon graduation,” the four dental organizations said in language common to both letters addressing the separate House and Senate student loan interest and repayment bills. “In 2013, the average educational debt per graduating dental school senior was $215,145,” the letters said.

The ADA and other health organizations also seek cosponsors for H.R. 3391, which would amend the tax code to provide for tax- free awards to health care providers under the Indian Health Service loan repayment program. Award recipients, including dentists, agree to serve in underserved areas under IHS jurisdiction.

To avoid reducing awards by the taxed amount, the IHS picks up the tab to the tune of an estimated $7.21 million annually, which could fund an additional 105 awards. The Indian Health Service Health Professions Tax Fairness Act, with 22 cosponsors, was referred to the Ways and Means Committee, which has jurisdiction for tax legislation.

Dental scientist probes mysteries of narwhal’s ‘unicorn’ tooth

Navigating the icebergs: Narwhals surface during spring migration outside Pond Inlet, Nunavut, Canada. Photo by Glenn Williams

Boston—Dr. Martin Nweeia and research colleagues cite new evidence of how “the most extraordinary tooth in nature” interprets its icy Arctic environment for the narwhal, the near mythological whale with the spiraling tusk that is a tooth 6 to 9 feet long.

But what use, that tooth of unicorn measure?

Dr. Nweeia views his explorations on the nature of teeth as relevant to the practice of dentistry. “The unusual properties of the tusk’s microanatomy and expression give us a new perspective of teeth,” he said of his narwhal tooth anatomy study published by the journal The Anatomical Record and first posted online March 18.

“In my own dental practice, I am always communicating how unusual and sensory our teeth are in function. We all tend to get this passive sense of teeth as instruments used in biting and chewing and often forget their tissue origins and abilities as sensory organs.”

Speaking of sensory organs, Dr. Nweeia’s narwhal research (visit narwhal.org for more information) reveals the sensory pathway between tooth and brain of the Arctic whale. The narwhal tooth system is a hydrodynamic sensor capable of detecting particle gradients, temperature and pressure and is able to detect high salt and fresh water gradients, the dental scientists reported.

Field work: Dr. Nweeia, left, and an Inuit hunter finish an experiment in Admiralty Inlet, Artic Bay, Canada. Photo by Gretchen Freund

Dr. Nweeia practices general dentistry in Sharon, Conn., teaches part time at the Harvard School of Dental Medicine and tracks narwhals in their native habitat between the Arctic Circle and the North Pole in search of understanding the function of that distinctive tusk/tooth. Research takes him to the northern tip of Baffin Island in the Canadian territory of Nunavut, where he perches on ice floes or does field sampling from shore-based camps, donning a dry suit to wade in 36-degree water, braving 120-mile winds and watching warily for polar bears.

“Animal health and safety is always the primary concern, and all experiments cease and the animal is released at the first sign of overt stress when indicated by the monitoring veterinarian,” the scientists reported. “Fortunately, none of the animals exhibited problems requiring early release, and most experiments, tagging and specimen collections were completed within 30 minutes.”

Dr. Nweeia’s team found nerves, tissues and genes in the narwhal tusk pulp that are known for sensory function and that help connect the tusk to the brain, said a Harvard news release. Armed with this new model, Dr. Nweeia needed to confirm that sensory information is actually transmitted along this pathway to the brain from the tusk in living narwhals.

The research team tested the hypothesis by slipping a “tusk jacket”–a clear tube sealed with foam at either end—onto several narwhal off Baffin Island, sloshing high- or low-salt water through the tube and over the tusk in separate tests. The scientists measured changes in heart rate and found significant changes depending on water salinity. Why salinity matters is another question for further research, though Dr. Nweeia advances several hypotheses, sexual attraction and food location among them.

“Imagine: Exploration, wonder and mystery are all wound up in this magnificent spiraled tusk and sensory organ,” he said. “This is the first tooth that has been shown by in vivo testing to have sensory function to a normal variable in its environment that is not necessarily associated with a flight or fright reaction.”

“Traditional knowledge has unlocked many of the mysteries our team has searched for,” Dr. Nweeia told the ADA News. “In the 10-year parallel study of Inuit traditional knowledge, collected from communities in the High Arctic of Western Greenland and Eastern Nunavut in Canada, there have been keen insights on behavior, migration, anatomy and morphology. The observations of hunters and elders in these Arctic areas have been invaluable in our work.

“My favorite illustration of the view from science and traditional knowledge lies in the definition of ‘environment,'” he said. “For the Inuit, the definition is ‘everything beyond your heart.”

The 2014 paper, “Sensory ability in the narwhal tooth organ system,” uses anatomy, histology, genetics and neurophysiology to “add to the discussion of the functional significance of the narwhal tusk,” the research abstract said. “The combined evidence suggests multiple tusk functions may have driven the tooth organ system’s evolutionary development and persistence.”

This study was funded by National Science Foundation grants with additional support from the Harvard School of Dental Medicine, the Museum of Comparative Zoology at Harvard, the Smithsonian Institution, the Explorers Club, the National Geographic Society, Castle & Harlan Inc., Natural Sciences and Engineering Research Council of Canada, Department of Fisheries and Oceans Canada and the Nunavut Wildlife Management Board.

See related story here.

MDA alerts members to possible tax identity theft

Some member dentists are among the many taxpayers reporting that they are victims of tax return identity theft.

The Internal Revenue Service said it has started more than 200 new investigations this filing season into identity theft and refund fraud schemes. The total number of IRS ID theft investigations in 2014 exceeds 1,800, said the notice posted April 10 at IRS.gov.

The IRS announcement stated that the agency has stepped-up its coast-to-coast criminal investigation to combat identity theft and refund fraud by pursuing identity thieves, preventing fraudulent refunds from being issued and helping victims of this crime. Additional information can be found at IRS.gov.

Several state dental societies say some member dentists submitting federal income tax returns were told that their returns had already been filed, most likely by an identity thief. An April 14 ADA email alert and an earlier Michigan Dental Association alert said some member dentists suspect tax return identity theft.

Other states where dentist members reported that they have been affected include Arizona, Colorado, Connecticut, Indiana, Kentucky, Maine, North Carolina, Ohio, Oklahoma, Tennessee, Texas and Wisconsin.

There are a number of steps dentists can take if they learn their identity has been used to file a tax return, the ADA and MDA member alerts said.

• Alert your own accountant and attorney as soon as possible. They can be helpful in the process.

• Notify the IRS Identity Protection Specialized Unit at 1-800-908-4490. More information on reporting tax fraud to the IRS and additional steps to take is available online at FTC.gov. You will need to complete Form 14039 and mail it with other documentation to the IRS.

• Notify the Federal Trade Commission online or by calling 1-877-438-4338.

• Contact the three credit reporting agencies to place a fraud alert on your credit report: Equifax (1-800-525-6285), Experian (1-888-397-3742), and TransUnion (1-800-680-7289).

• Notify local law enforcement and file a police report using the FTC Identity Theft Report.

An ADA member resource, Protecting Yourself from Identity Theft, is available at ADA.org. The Association will update members in ADA media and with other appropriate communications as this story develops.

Dental partnerships in Indian Country outlined

Dr. Charles Norman

Washington—The Association described an emerging public-private partnership to improve the oral health of Native Americans in congressional testimony April 8 and invited Congress to participate.

“The ADA is committed to working with you, the Indian Health Service and the Tribes to aggressively reduce the disparity of oral disease and to increase the level of dental care that currently exists in Indian Country,” the Association told Congress. “We know oral disease is preventable especially if an adequate dental workforce, individual and community-based prevention programs are in place, and an oral health literacy program supports the whole undertaking.”

Dr. Charles Norman, ADA president, testified on oral health issues that affect American Indians and Alaska Natives and the dentists who serve in the Indian Health Service and tribal programs.

“Tooth decay in Indian Country has reached epidemic proportions,” he told the House Appropriations subcommittee on interior, environment and related agencies, which convened two days of hearings on fiscal year 2015 IHS appropriations and included the American Dental Association among 77 scheduled American Indian and Alaska Native witnesses, each limited to five minutes of oral testimony.

“According to data from the Navajo tribe, tooth decay is present in 48 percent of one-year-olds and up to 94 percent of four-year-olds,” Dr. Norman testified. “The decay rate of preschool Navajo children is the highest in the nation.”

Several years ago the ADA organized the Native American Oral Health Care Project to work with tribes in Arizona, New Mexico, North Dakota and South Dakota, Dr. Norman told the House panel. The dental associations in those states have held many meetings with tribal leaders to hear their concerns regarding needed dental care, he said. These collaborations have resulted in several specific dental activities.

The Association’s written testimony offered information on seven dental activities in Indian Country.

• The North Dakota Dental Association conducted Pediatric Dental Days in October 2013 for the Standing Rock Sioux Tribe. During the two-day event, 367 children were seen and about $150,080 of donated dental services were provided.

• In 2013, the New Mexico Dental Association held a Mission of Mercy project in Farmington, which borders the Navajo reservation. More than $586,000 in free care was provided to almost 1,000 patients, one quarter of whom identified themselves as American Indian.

• The Arizona Dental Association and New Mexico Dental Association have offered a 10 Year Oral Health Plan for incorporation within the Navajo Nation’s 10 Year Health and Wellness Plan.

• The New Mexico Dental Association is expanding dental care through the use of Community Dental Health Coordinators who bridge the gap between the existing care resources and unmet need. The NMDA is in discussions with a New Mexico community college to incorporate the CDHC curriculum into its educational program to educate American Indian students as CDHCs. Their goal is to have a new class ready to begin in 2014.

• The South Dakota Dental Association, in concert with the Delta Dental Foundation of South Dakota, was awarded a CMS (Centers for Medicare & Medicaid Services) Healthcare Innovation Award to improve Native American oral health in 2012. The grant supported development of a modular CDHC training program to add oral health skills and understanding to existing Community Health Workers across reservations.

• The Arizona Dental Association has conducted regional roundtables with tribal representatives from 18 of the 22 Native American tribes in the state. The meetings have focused on oral health literacy, preventive programs, CDHCs, the educational pipeline and coalition building. Additionally, AzDA has been awarded a DentaQuest Development grant to support the work of the Native Oral Health Alliance, which was founded as an outgrowth of this collaboration. One of the most tangible pipeline project possibilities is in discussion with the San Carlos Apache Tribe.

• The ADA will be offering technical assistance and curriculum support as requested by the Navajo Nation for establishment of the Association’s Community Dental Health Coordinator program. Discussion is underway for a CDHC sabbatical to take place this summer.

The Association also called for a streamlined credentialing process for the Indian Health Service. “We know that if the IHS would streamline its credentialing process to make it easier for local dentists to volunteer we could ensure even more patients, especially children, receive needed care,” the Association testified.

Americans with Disabilities Act

Washington—The Department of Justice issued a final rule increasing civil penalties for violations of the Americans with Disabilities Act, which covers “professional offices of health care providers” including dental offices. This rule is effective April 27, 2014, according to the March 28 Federal Register notice. However, the DoJ announcement said, “The new maximums apply only to violations occurring on or after April 28, 2014.”

The final rule “adjusts for inflation” civil monetary penalties assessed or enforced by the Justice Department’s Civil Rights Division. “For the Americans with Disabilities Act, this adjustment increases the maximum civil penalty for a first violation under Title III from $55,000 to $75,000; for a subsequent violation the new maximum is $150,000,” the DoJ said.

Title III of the AwDA covers 12 types of public accommodations, a category that includes as covered service establishments “professional offices of health care providers” and “hospitals.” A professional office of a health care provider is a location where a state-regulated professional provides physical or mental health services to the public, according to the DoJ Title III technical assistance manual.

Title III imposes a number of requirements on public accommodations, such as taking certain steps to make their facilities accessible, making reasonable modifications in policies, practices and procedures that would deny equal access to individuals with disabilities, and furnishing auxiliary aids when necessary to ensure effective communication.

ADA members campaign for Congress

Washington—Three Association member dentists are running for Congress with ADPAC support.

The American Dental Political Action Committee supports the campaigns of Rep. Paul Gosar, R-Ariz., and Rep. Mike Simpson, R-Idaho, for re-election and Dr. Brian Babin, Republican, for election to an open seat in the House of Representatives. All are general practice dentists. In their congressional service, Reps. Gosar and Simpson have been advocates for oral health and have sponsored numerous oral health bills.

Dr. Gosar

Dentist/Rep. Gosar, representing Arizona’s 4th Congressional District, announced his first run for public office at the May 2009 ADA Washington Leadership Conference in the nation’s capital. In his first election in 2010 he defeated the incumbent with 49 percent of the vote and in his 2012 re-election won 76 percent of the vote though targeted from the right by a conservative advocacy group, the Club for Growth, which spent some $700,000 in an unsuccessful attempt to defeat him. ADPAC spent $392,000 in independent expenditures for Rep. Gosar in the 2010 and 2012 election cycles combined. The Republican primary filing deadline is May 28 and the primary is Aug. 26. He has a declared Democratic opponent in what is considered to be a relatively safe Republican district. Dr. Gosar practiced dentistry 1985-2010. He serves on the Natural Resources and Oversight and Government Reform committees.

Dr. Simpson

Dentist/Rep. Simpson, representing Idaho’s 2nd Congressional District, is serving his eighth term in Congress, having been first elected in 1998 after serving as Speaker of the Idaho House of Representatives and practicing dentistry 1977-1998. Rep. Simpson serves on the powerful House Committee on Appropriations, chairs one subcommittee and shares leadership on two others including the interior, environment and related agencies subcommittee. The Idaho primary election –the real race in this Republican-safe district—is May 20, and Rep. Simpson’s re-election is being challenged by a Club for Growth-backed candidate. This primary is ranked by political publications and experts as among the “Top 5 to Watch.” In previous elections, Rep. Simpson has faced little opposition. ADPAC spent $71,000 in independent expenditures on his campaigns in the 2010 and 2012 election cycles.

Dr. Babin

Dr. Brian Babin is a candidate for election to represent Texas’ 36th Congressional District in the House of Representatives. This is an open seat vacated by Rep. Steve Stockman when he decided to run for the Senate and is considered to be in a Republican safe district. A dozen Republicans ran for this open seat and Dr. Babin led the 12 candidates with 33 percent of the vote in the March 3 primary. This is not enough to avoid a runoff in Texas where 50 percent of the vote is required, and Dr. Babin faces a runoff May 27 with his nearest opponent, who garnered 23 percent of the primary vote. Dr. Babin is the former mayor of Woodville. He served in the U.S. Air Force, Army Reserve and Texas Army National Guard and has practiced dentistry since 1979.

Also in the Texas primary, Sen. John Cornyn, Republican, won more than 50 percent of the primary vote to avoid a runoff with Rep. Stockman. Dr. David Alameel, who garnered 47 percent of the votes in the Democratic primary among five candidates seeking to oppose Sen. Cornyn, faces a May 27 runoff.

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