Glasgow dentist reports ten-fold increase in demand for implants after lockdown extractions

A LEADING dentist says he has seen a ten-fold increase in demand for implants amid fears that lockdown caused a spike in tooth extractions that might have been avoided.

Duncan Black, one of Scotland’s most experienced dental implantologists, said many patients are coming to him after having teeth – including front teeth – removed at emergency dental hubs which under normal circumstances dentists would have tried to save.

Mr Black, who is based at Halo Dental in Glasgow but treats patients from as far afield as Ayrshire and Lanarkshire and also runs an outreach clinic in Galashiels, said it is probably an inevitable consequence of lockdown.

He said: “People have not been able to access their usual dental care, that’s the crux of the matter.

“We were told by the Chief Dental Officer to leave the practices and not come back again, but no one thought it would be nearly three months before we came back.

“During that time we had to provide an emergency service.

“I don’t want to beat up on them [dental hubs] too much because it was scary times for everyone.

“Some people were in extreme pain.

“There was probably a lack of PPE available for normal dentistry to carry on so the hubs were the best solution, but yes, I think that due to Covid some people had teeth removed rather than, if they had been accessing normal care through their own dentist, attempts would have been made to save the tooth.

“I think that’s fair comment.”

CASE STUDY: Ayrshire man’s lockdown ordeal as rotten tooth has to be pulled out without anaesthetic

Mr Black’s practice, which is part of the Clyde Munro dental group, re-opened in mid-July and since then has seen ten times as many people requesting dental implants as they have in previous years, with most patients self-referring.

Implants are titanium screws which dentists attach directly to the jawbone, replacing the missing tooth root. A false tooth, such as a crown, can then be held securely in place.

Unlike dentures, which tend to last around five to 10 years, implants can last as long as natural teeth provided they are cared for properly.

However, they are more expensive. Mr Black said a single implant, without any other complications, will cost around £2000 in Glasgow.

The service is only available on a private basis, meaning NHS patients have to pay the full cost of the treatment.

Mr Black said: “Normally, if someone goes to their dentist and says ‘I have a problem with this tooth’ and the dentist takes and X-ray and concludes it’s unsalvageable, that they need an implant or whatever, they’d be sent along to us and we’d order everything for them so that they wouldn’t go without a front tooth.

“They’d have a temporary of some description.

“But because the dental labs weren’t open either during lockdown there wasn’t even a possibility for any sort of temporary provision to be made for people.

“So quite often they just had to

AHA News: Strokes and Heart Attacks Increase When Flu-Like Illnesses Rise | Health News

(HealthDay)

THURSDAY, Oct. 8, 2020 (American Heart Association News) — Heart attack risk increases quickly after a flu-like illness, while stroke risk rises slower, according to new research.

The study, published Oct. 8 in the Journal of the American Heart Association, examined the relationship between the flu, heart attacks and strokes, which all occur more frequently during winter months.

Researchers looked at New York state public health data from 2004 to 2015 and focused on adults who were hospitalized or came to the emergency department for stroke, heart attack or “flu-like illnesses.” Study author Amelia Boehme said pinpointing people with the flu from administrative records is difficult. Instead, her study relied on an algorithm developed by the U.S. Centers for Disease Control and Prevention to identify influenza and influenza-like symptoms through billing codes.

The study found that strokes and heart attacks increase during times of high flu-like illness rates, with a “time lag” occurring only for strokes.

“We found that if someone’s going to have a heart attack, it’s going to occur within seven days of the flu-like illness, during the acute phase,” said Boehme, an assistant professor of epidemiology in the department of neurology at Columbia University in New York City. “With stroke, we see an increased risk seven to 15 days after, similar to heart attacks. But with stroke, there is an additional higher-risk period after 30 days.”

She called for more research to help uncover why the flu and flu-like illnesses increase the risk of stroke and heart attack. “Our study is just a small piece of the pie in understanding this. It raises a lot of questions about mechanisms,” Boehme said.

The researchers didn’t have information on whether people included in the study had received a flu vaccine. But they did find that “in the years where the vaccine effectiveness was higher, overall, the number of people who had influenza-like illness and the number of people who subsequently had strokes and heart attacks after influenza-like illness was lower.”

Past studies have shown that those who skip a flu shot are six times more likely to experience a heart attack.

“We keep hearing from patients who say, ‘Oh, I’m young and healthy so I don’t need a vaccination. It’s no big deal.’ But it really is a big deal,” Boehme said.

Dr. Daniel Muñoz, who was not involved in the research, called it an important study that shines a light on a potential link to life-altering or life-ending events. “The flu may be what tips people over into a heart attack or a stroke.”

The study also “reinforces the importance of broadening our perspective to other things outside of traditional cardiovascular risk factors that might make our patients vulnerable,” said Muñoz, an associate professor of cardiology at Vanderbilt University Medical Center in Nashville.

With hundreds of thousands of people in the United States still testing positive for COVID-19 each month, public health officials have been warning of a possible “twindemic” of severe flu and COVID-19 in

Having a baby later in life may increase longevity, study suggests

Women who have kids later on in life may live longer, according to the findings of a recent study.

Following the birth of a woman’s last child, certain measurements may be linked with her projected lifespan, according to a study published Wednesday in Menopause, the journal of The North American Menopause Society (NAMS).

More specifically, leukocyte telomere length – telomeres “are repeating DNA-protein complexes that protect the ends of chromosomes and have proven to be critical for maintaining genomic stability,” per a news release on the findings – may play a role in a woman’s longevity. A woman’s age at the birth of her last child may affect telomere length, ultimately impacting long-term health, the researchers said.

Longer telomeres are thought to be beneficial for long-term health, while shorter ones can signify “various chronic conditions such as cardiovascular disease, type 2 diabetes, some neurologic conditions, and various cancers,” past studies have suggested, according to the news release.

CORONAVIRUS OUTBREAK AT VERMONT APPLE ORCHARD SICKENS DOZENS OF MIGRANT WORKERS

At least one previous study has suggested that a woman’s age at the birth of her last child affected telomere length, said researchers. The study published Wednesday was larger, including more than 1,200 perimenopausal and postmenopausal women of “various ethnicities and backgrounds.”

“In addition, unlike previous studies, this study took into consideration sociodemographic factors related to childbearing patterns and health decisions,” per the release.

The researchers who conducted the new study found that a woman’s age at the birth of her final child “is positively associated with telomere length, meaning that women who delivered their last child later in life were likely to have longer telomeres, a biomarker of long-term health and longevity.”

THE CORONAVIRUS CAN SURVIVE ON SKIN FOR THIS MANY HOURS, STUDY SUGGESTS

However, “more research is needed to determine whether older maternal age at last birth causes telomeres to lengthen or whether telomere length serves as a proxy for general health and corresponds with a woman’s ability to have a child at a later age,” said Dr. Stephanie Faubion, NAMS medical director, in a statement.

The findings were also limited to women who had one or two live births or those who had used birth control orally, they said.

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Does Cancer Chemotherapy Increase My Covid Risks?

Q. I have cancer and am being treated with chemotherapy. Am I at increased risk of getting sick and dying from Covid-19?

A. People with cancer, and particularly those with leukemia, seem to have a higher death rate from Covid-19 than the general population, though cancer chemotherapy does not appear to further increase the risk of dying from Covid. Studies, however, have been limited and results are sometimes difficult to interpret.

Many types of chemotherapy work by disrupting the cancer cell’s machinery that allows it to divide and grow so rapidly. Unfortunately, chemotherapy can also disrupt healthy cells that grow rapidly in the body, including the bone marrow cells that make our immune system. Consequently, people receiving chemotherapy are at risk of becoming immunocompromised. The immune system, our body’s primary line of defense against microbes, can also be corrupted directly by blood and bone marrow cancers such as leukemia, which can prevent the immune system from maturing, rendering it incompetent to fight infections.

It’s a logical assumption that people with compromised immune systems would be more susceptible to catching the novel coronavirus and getting sick from it. In one recent study, patients with cancers of the blood and bone marrow had higher coronavirus viral loads, which was associated with higher mortality. But there have been a paucity of population-based studies of coronavirus infection rates in people with cancer, so we don’t know for sure.

A few studies have explored the severity of Covid-19 infections in people with cancer. One study from Britain of more than 1,000 cancer patients seen over a seven-week period during the pandemic found a twofold higher death rate for patients with leukemia, but not for those with other cancers, compared to a similar group of cancer patients from three years earlier, before Covid.

In another study of more than 900 patients with ongoing or previous cancers and Covid-19 infections from the United States, Canada and Spain, 13 percent died and 26 percent either died or had illness severe enough to require intensive care. These rates are much higher than for the general population; among those with Covid-19, the estimated case-fatality rate is about 3 percent in the United States. Cancer patients receiving chemotherapy did not appear to have higher death rates or more severe disease than other cancer patients, though in patients with cancers of the blood or bone marrow, such as leukemia and lymphoma, 14 percent died and 35 percent developed severe illness.

Another international study of almost 200 patients with chronic leukemia found even higher death rates from Covid-19, 33 percent, though again, rates were no greater for those receiving chemotherapy. Interestingly, patients receiving palliative cancer care, which focuses on improving quality of life and providing symptom relief rather than active cancer treatment, were more likely to die outside of an intensive care unit, likely because they declined aggressive therapy given their cancer prognosis.

In an ongoing Covid-19 registry through the American Society of Hematology, the death rate among almost 600 patients with blood

D.C. residents to see small increase in health insurance marketplace rates

Rates for individual coverage will increase overall by 0.2 percent and rates for small-group coverage, such as small businesses, will decrease by 0.5 percent, according to the D.C. Department of Insurance, Securities and Banking, which reviews and approves rates for the online marketplace.

The 2021 rates are a “big win for D.C. residents in making health care more affordable and accessible,” said William Borden, a professor of medicine and health policy at George Washington University. He pointed to how people struggled to keep up with rising health insurance premiums even before the novel coronavirus took hold.

“Having health insurance is clearly associated with better health outcomes, and so if there was going to be a sharp increase in insurance premiums that really could be devastating, especially as individuals, small businesses are already struggling financially,” Borden said.

Insurers initially asked for rate increases as high as 30 percent, but most of the insurers decreased their initial rate filings after a virtual public hearing in September.

During that hearing, leaders of the D.C. Health Benefit Exchange Authority, which operates D.C. Health Link, the online health insurance marketplace, advocated premium reductions or freezing rates at 2020 levels. More than 30 people signed up to testify.

The gap between what insurers initially proposed and what the DISB approved after the hearing will save D.C. residents more than $17 million, according to the department’s news release Friday.

Open enrollment in the District runs from Nov. 1 through Jan. 31.

Other jurisdictions also have moved to limit increasing rates.

Maryland Gov. Larry Hogan (R) approved an average 11.9 percent premium rate decrease for individual health insurance plans through Maryland Health Connection, the state-based health insurance marketplace, in 2021. This is the third consecutive year that individual premium rates have gone down in Maryland. Open enrollment in Maryland runs from Nov. 1 through Dec. 15.

The open enrollment period for all three jurisdictions will begin just as the Supreme Court will hear oral arguments on a case to overturn the Affordable Care Act, which could leave more than 23 million people without health care, according to a report from the liberal think tank Center for American Progress.

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Twindemic fears increase flu vaccine demand and trigger shortages in Europe

Major pharmacies have halted flu shot appointments. Doctors’ offices are putting people on waiting lists — or telling them to call back in December. Although the government has urged calm and said more supplies are on the way, a survey of general practitioners in Britain found that only a quarter expect to have enough flu vaccine to last the winter. 

The story is similar in many countries across Europe. As coronavirus cases rise, urgings from public health officials about the need to avoid a “twindemic” has upped demand for flu vaccines — and, in some places, triggered shortages. Governments are rationing flu shots to those most vulnerable, while they scramble for supplies.

In a limited way, it’s a trial run of what governments may face if and when coronavirus vaccines are available. It may also be an early indication that, even in countries traditionally skeptical of vaccines, large swaths of the population will be willing to get inoculated for covid-19.

Ann Moen, World Health Organization’s chief of influenza preparedness and response, has acknowledged that some Northern Hemisphere countries are having trouble sourcing additional flu vaccines. The United States says it has plenty of doses stocked, but many countries in Europe don’t.

This past flu season was relatively mild in the Southern Hemisphere. Australia, New Zealand, Chile and Argentina all glided through with low numbers. South Africa barely had any cases at all. But Europe is worried that even an average flu season, combined with the stresses of covid-19, could be disastrous.

The vaccine supply problem stems in part from orders placed in 2019, before anyone knew that the second wave of a global pandemic might coincide with the northern flu season.

Still, public health experts have been surprised by the eagerness for flu shots this year, both in vaccine-embracing countries such as Britain, where more than 70 percent of people over 65 normally get a flu jab, and in nations where uptake is usually low.

Poland, for instance, has a reputation for rejecting vaccines and distrusting pharmaceutical companies. Last year, only 4 percent of the population got flu vaccinations and 100,000 doses went unused. But this fall, Poland’s health minister said the country is facing a flu vaccine shortage and trying to negotiate new shipments, amid increased demand.

In Italy, the country’s regional health authorities have placed orders for 17 million shots, almost 50 percent more doses than last year.

“We were preparing for an increase, but not such a significant number,” Massimo Scaccabarozzi, president of the association that represents Italy’s pharmaceutical companies, told the Guardian newspaper. “It’s a big challenge.”

In Britain, Prime Minister Boris Johnson’s government promised an unprecedented campaign, to double last year’s effort and deliver flu vaccines to 30 million people in England — more than half the population — including free shots for anyone aged 50 and over.

“There is no national shortage of the flu vaccine. . . . It is completely wrong to suggest otherwise,” said a spokesman for the Department of Health

Pentagon urges caution in linking steep increase in Army suicides to pandemic

“It’s too early to determine whether suicide rates will increase for calendar year 2020,” said Dr. Karin A. Orvis, director of the Defense Suicide Prevention Office, at a briefing that made public the Pentagon’s suicide rates for 2019. “We’ll need to have the full year of data and investigations completed to determine the cause of death.”

“What may be looking like an increasing or decreasing trend in raw counts may not be statistically meaningful once we have all the data,” said Orvis.

Through Aug. 31, there has been a 30% increase in the number of active-duty Army deaths by suicide, with 114 deaths compared to the 88 through that same time frame in 2019, a defense official told ABC News. The total number through Aug. 31 increases to 200 including Army National Guard and Reserve suicides, up from 166 for the same period in 2019, said the official.

The increase in Army suicides was first reported by The Associated Press.

PHOTO: Members of the military attend a ceremony at Andrews Air Force Base, Md., Dec. 20, 2019.

Members of the military attend a ceremony at Andrews Air Force Base, Md., Dec. 20, 2019.

Members of the military attend a ceremony at Andrews Air Force Base, Md., Dec. 20, 2019.

With only a slight increase in the number of active-duty suicides during the first three months of 2020, the bulk of the 30% increase occurred during the spring and summer months that correlates to when the novel coronavirus pandemic was at its peak.

The increase has also translated to an increase in the suicide rate of 36 per 100,000 individuals, through Aug. 3, from 30.6 per 100,000 the year before, according to the official.

But Orvin stressed that the full annual rate is what is needed to make a full assessment of the year’s trends in the military overall. Current numbers for the other services do not indicate a spike like the Army. For example, the 98 total Air Force deaths by suicide this year (including guard, reserves and civilians) are comparable to last year’s, and the 34 active-duty Navy suicides are on pace to be lower than last year. The Marine Corps did not provide current statistics for this year.

“We have seen in the past that at times, where it looks like if we were just looking at counts, there may have been an increase, but once we had the full years of data, it was not statistically significant,” said Orvin.

The Army National Guard said in a separate briefing that the number of suicides in its ranks through Oct. 1 is comparable to last year’s numbers.

“Caution should be used when examining changes

Congress may limit Medicare Part B premium increase for 2021

Congress may be poised to head off a potential premium spike for some Medicare beneficiaries.

As part of a short-term government funding bill passed by the House last week and expected to be considered by the Senate on Wednesday, any increase in Medicare Part B premiums for 2021 would be capped.

While it’s still uncertain what the standard premium would be for 2021 — it is based on an actuarial formula and typically revealed in early November for the next year — estimates have proved tricky this year due to economic upheaval from the coronavirus pandemic.

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“One thing that’s really hard about this year is that there’s been increased costs from treating Covid, but decreased cost from people delaying care or avoiding being in hospitals or doctors offices,” said Casey Schwarz, senior counsel for education and federal policy at the Medicare Rights Center.

“Normally, we’d pretty much know by this time what the premium will be,” Schwarz said.

Although the Senate could seek changes to the House-approved funding bill — which keeps the government going through Dec. 11 — the measure passed with bipartisan support in the House. Additionally, Senate Republicans had included a provision to mitigate a possible Part B premium spike in their most recent stimulus bill, proposed in July.

If the House provision makes it into the final funding bill, any increase to the Part B premium would be capped at 25% of what it otherwise would be for 2021.

Normally, we’d pretty much know by this time what the premium will be.

Casey Schwarz

Senior counsel for education and federal policy at the Medicare Rights Center

Part B covers outpatient care, medical equipment and certain other medical services. Part A, which has no premium and is funded separately by a trust fund, provides hospital coverage. Together, those parts comprise basic Medicare.

The Medicare trustees forecasted in April that the standard 2021 Part B premium would rise to $153.30 in 2021 from $144.60 this year ($8.70 more monthly, or a 6% increase). However, the trustees’ report noted that the impacts of Covid-19 were unknown and therefore could not be factored into the estimates.

While many of Medicare’s 62.7 million beneficiaries are protected from large Part B premium hikes, others are not. And, higher-income beneficiaries already pay extra each month.

Part of the issue is how those premiums interact with Social Security benefits and the associated annual cost of living adjustment, or COLA.

If a Part B premium increase would eat up more than a Social Security recipient’s COLA in any given year, the person is “held harmless” and won’t see their Social Security benefits go down. (Their Part B premiums generally are withheld from their Social Security payments.)

“People who are held harmless can see a premium increase, but it can’t be larger than their