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PROPHYLAXIS AFTER OCCUPATIONAL EXPOSURE TO HIV
LISTI
O
AOO
VWDENTAL PROGRAMS 1ED
AVALABLE
The Commission on Dental Acreditation has completed its 1996 evaluation Of denftalediuction programs. During 1996, the commission evaluated more than 350 educational proams including dental schools and programs for denW specialties, advanced general dentistry and allied dental health professions. A complete listing of the accreditation status of these programs is available from the ADA's Council on Dental Education. To obtain a copy, ADA members can dial the Association's toll-free number, Ext. 2686; nonmembers should dial 1-312-440-2686. The complete listing is also available on ADA ONLINE at "http:llwww.ada.org" under the Practice & Profession icon. LINK BETWEEN PERIODONTITIS, HEART DISEASE PROBED
With grant monies from the National Institute of Dental Research, scientists at the University of North Carolina are exploring a possible link between periodontal disease and heart disease. Data from previous studies indicate that people who have severe periodontitis are more likely to develop heart disease than those who do not have periodontal problems. Researchers theorize that the bacteria that causes plaque also may cause white blood cells to release clotting factors and proteins. These biochemicals in turn can contribute to heart disease and stroke. Armed with this information, UNC researchers will collect and evaluate data on the periodontal conditions of 14,000 adults currently enrolled in the Atherosclerosis Risk in Communities Study, or ARIC. By comparing the clinical measures of heart disease with periodontal data, researchers hope to 1298 JADA, Vol. 127, September 1996
determine whether a solid association exists between the two. If one does, other studies may be designed to identitfy what biological mechanisms might be at work. "This kind of research brings dentistry more into the realm of general health," says James Beck, Ph.D., an epidemiologist at UNC and a principal investigator in this project, "and can demonstrate that a patient's oral and gingival condition could be related to other diseases that the patient may have or may develop." Begun in 1987, ARIC is sponsored by the National Heart, Lung and Blood Institute and involves adults aged 45 to 64 years who live in North Carolina, Mississippi, Minnesota and Maryland. Dr. Beck estimates that data collection for the periodontal component of this study will run through 1999. PROPHYLAAXIS AFTER OCCUPATIONAL EXPOSURE TO HIV
The July 10 issue of the Journal of the American Medical Association carried provisional guidelines issued by the U.S.
Public Health Service for chemoprophylaxis following occupational exposure to HIV. Because the medications used to prevent HIV infection carry with them some risk of toxicity, the guidelines suggest that chemoprophylaxis be used only when the risk of HIV transmission is highest. Risk is considered highest when the percutaneous injury is deep, blood is visible on the device that causes the injury, the device has been placed in an HIV-infected patient's vein or artery, or the patient dies as a result of acquired immune deficiency syndrome within 60 days of the injury. If it is determined that the health care worker is at high risk of contracting HIV, the guidelines recommend that chemoprophylaxis with an antiretroviral agent begin within one to two hours of the injury and continue for four weeks. The guidelines also suggest any health care worker who is exposed to HIV through an occupational injury receive counseling and a medical examination that includes an HIV-antibody test at baseline and periodically for at least six months. Additional information about HIV postexposure prophylaxis is available from the Centers for Disease Control and Prevention at 1-404-332-4565, the National AIDS Clearinghouse at 1-800458-5231 and the HIV/AIDS Treatment Information Service at 1-800-448-0440. AGE MAY AFFECT PATIENT INPUT IN TREATMENT DECISIONS
Physicians may be less likely to Continued on page 1302
O
AOO
VWDENTAL PROGRAMS 1ED
AVALABLE
The Commission on Dental Acreditation has completed its 1996 evaluation Of denftalediuction programs. During 1996, the commission evaluated more than 350 educational proams including dental schools and programs for denW specialties, advanced general dentistry and allied dental health professions. A complete listing of the accreditation status of these programs is available from the ADA's Council on Dental Education. To obtain a copy, ADA members can dial the Association's toll-free number, Ext. 2686; nonmembers should dial 1-312-440-2686. The complete listing is also available on ADA ONLINE at "http:llwww.ada.org" under the Practice & Profession icon. LINK BETWEEN PERIODONTITIS, HEART DISEASE PROBED
With grant monies from the National Institute of Dental Research, scientists at the University of North Carolina are exploring a possible link between periodontal disease and heart disease. Data from previous studies indicate that people who have severe periodontitis are more likely to develop heart disease than those who do not have periodontal problems. Researchers theorize that the bacteria that causes plaque also may cause white blood cells to release clotting factors and proteins. These biochemicals in turn can contribute to heart disease and stroke. Armed with this information, UNC researchers will collect and evaluate data on the periodontal conditions of 14,000 adults currently enrolled in the Atherosclerosis Risk in Communities Study, or ARIC. By comparing the clinical measures of heart disease with periodontal data, researchers hope to 1298 JADA, Vol. 127, September 1996
determine whether a solid association exists between the two. If one does, other studies may be designed to identitfy what biological mechanisms might be at work. "This kind of research brings dentistry more into the realm of general health," says James Beck, Ph.D., an epidemiologist at UNC and a principal investigator in this project, "and can demonstrate that a patient's oral and gingival condition could be related to other diseases that the patient may have or may develop." Begun in 1987, ARIC is sponsored by the National Heart, Lung and Blood Institute and involves adults aged 45 to 64 years who live in North Carolina, Mississippi, Minnesota and Maryland. Dr. Beck estimates that data collection for the periodontal component of this study will run through 1999. PROPHYLAAXIS AFTER OCCUPATIONAL EXPOSURE TO HIV
The July 10 issue of the Journal of the American Medical Association carried provisional guidelines issued by the U.S.
Public Health Service for chemoprophylaxis following occupational exposure to HIV. Because the medications used to prevent HIV infection carry with them some risk of toxicity, the guidelines suggest that chemoprophylaxis be used only when the risk of HIV transmission is highest. Risk is considered highest when the percutaneous injury is deep, blood is visible on the device that causes the injury, the device has been placed in an HIV-infected patient's vein or artery, or the patient dies as a result of acquired immune deficiency syndrome within 60 days of the injury. If it is determined that the health care worker is at high risk of contracting HIV, the guidelines recommend that chemoprophylaxis with an antiretroviral agent begin within one to two hours of the injury and continue for four weeks. The guidelines also suggest any health care worker who is exposed to HIV through an occupational injury receive counseling and a medical examination that includes an HIV-antibody test at baseline and periodically for at least six months. Additional information about HIV postexposure prophylaxis is available from the Centers for Disease Control and Prevention at 1-404-332-4565, the National AIDS Clearinghouse at 1-800458-5231 and the HIV/AIDS Treatment Information Service at 1-800-448-0440. AGE MAY AFFECT PATIENT INPUT IN TREATMENT DECISIONS
Physicians may be less likely to Continued on page 1302