People who take bisphosphonates, or bone-strengthening drugs for osteoporosis, may have a slightly higher risk of developing esophageal cancer, especially if they take them for several years, a study out this week in the British Journal of Medicine finds.

Researchers tracked almost 3,000 people with cancer of the esophagus or throat for eight years and compared them with a group of 15,000 people who did not have the disease. All were over age 40. The scientists found that 90 of the cancer patients had been prescribed the bone-building drugs, while 345 people in the larger group were taking the medication.

By figuring the odds, scientists estimated the risk of esophageal cancer increased with 10 or more prescriptions for oral bisphosphonates or with prescriptions over a five-year period. According to the study, in Europe and North America, the incidence of esophageal cancer in people ages 60-79 is typically one per every 1,000 over five years. This study estimated an increase of two per 1,000 in this age group, if the drugs were used for five years or more.

The researchers also looked at about 10,000 people with bowel cancer and 2,000 others with stomach cancer and found no increased risk with the use of these drugs… D-O-W-N-L-O-A-D


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Experts aren’t sure why the drugs might lead to throat cancer. They do know however, that bisphosphonates can cause inflammation in the esophagus, which could cause cancer to develop more easily.

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The front teeth are the first to erupt at around six to eight months; the back teeth erupt between 18 and 24 months. Teething, sometimes referred to as “cutting teeth,” occurs until all 20 primary teeth are in place. This is normally around two and a half years of age.

Normal Teething Sequence

Exactly when and how teething begins seems to be hereditary, does not have anything to do with the baby’s health, and tends to occur earlier in females than in males. However, if primary tooth eruption has not begun by 15 or 18 months, consult a pediatric dentist. While teething or eruption patterns vary greatly from child to child, primary teeth typically emerge in a specific sequence. The general eruption pattern is:

1. Two bottom front teeth (central incisors)
2. Four upper front teeth (central and lateral incisors)
3. Two lower lateral incisors
4. First molars
5. Four canines or eye teeth (on either side next to the upper and lower lateral incisors)
6. Remaining molars on either side of the existing teeth

When a child is five or six years old, the primary teeth start falling out because the permanent (secondary) teeth are erupting underneath them, pushing them out. The eruption of permanent teeth occurs in the same approximate manner and sequence as primary teeth. By about age 14, children have 28 permanent teeth, and at about age 16, four additional teeth called wisdom teeth or third molars.

Teething Symptoms

Experts disagree about whether teething actually causes symptoms – like fussiness, coughing, fever and diarrhea – or whether it is just a coincidence that these common maladies occur at the same time as teeth are erupting. While some lucky parents report no apparent negative side effects, many others maintain that their teething babies do suffer discomfort.

If your child is showing discomfort during teething, the symptoms he/she may experience include:

• Excessive drooling, which may lead to a rash on the face or chest
• Gum swelling and sensitivity
• Irritability or fussiness
• Low-grade fever (rare)
• Refusing food
• Rubbing of ears and cheeks
• Sleep problems
• Urge to bite on hard objects

As a tooth erupts, a watery sac (eruption cyst) may develop. Eruption cysts are usually harmless and should be left alone. As a tooth pushes through the gum, it will eventually rupture the sac.

If symptoms develop during teething, they usually occur approximately four days before and up to three days after the tooth erupts.

Mild teething symptoms that gradually improve should not cause concern. However, contact your pediatrician if your baby’s symptoms are severe or persist. Fever, diarrhea, frequent ear pulling, coughs and severe diaper rashes are not normal teething symptoms. You should be especially concerned if your child has a rectal temperature of 101 degrees Fahrenheit or higher (100.4 degrees Fahrenheit or higher for babies younger than three months). When in doubt, consult with your pediatrician to determine whether your baby is showing signs of a problem that requires medical attention.

Alleviating Teething Symptoms

There are several ways you can bring your child relief from teething symptoms, including:

• Use a cold, wet cloth for your baby to suck as a way to soothe gums. Clean the cloth after each use.
• Consider a pacifier, teething ring or other teething accessories and toys your child can chew. Make sure the object is big enough so it can’t be swallowed or break into small pieces. Stay away from liquid-filled rubber teething rings, which can break or leak, and do not freeze them to the point that they are frozen solid, as this may only aggravate sensitive gums.
• Gently rub your child’s gums with a clean finger, a small, cool spoon or a wet gauze pad.
• If drool causes a rash on your child’s face or chest, wipe the drool away often with a soft cotton cloth, or gently dab petroleum jelly on the affected area.
• If your child is eating solids, offer cold foods and liquids, like applesauce, pureed peaches or yogurt.
• Give your baby a mild pain reliever that is labeled for his/her specific age, but NEVER without first consulting your pediatrician to see if it is all right to do so, and if so, what the right dosage should be.

Keep in mind that although many parents use topical gels and other teething remedies, many experts question how effective and safe these products really are. Before using any kind of medication or remedy, speak with your pediatrician about specific product safety, dosage and usage issues. If you are using medication to comfort your child, double check with your pediatrician to make sure there isn’t another cause for his/her symptoms, such as a viral or ear infection.

There are a number of palliative treatments to avoid when alleviating teething symptoms, including:

• Do not use teething powder or aspirin on your baby’s gums. Breathing in small particles of either can cause lung problems. Aspirin should not be given to children because it has been associated with Reye’s syndrome, a rare but potentially life-threatening disease.
• Do not cut gums to make it easier for teeth to erupt, as this may lead to infection.
• Do not give your baby any type of alcohol, as this may be harmful. Read medicine labels carefully to avoid products that list alcohol as one of the first ingredients.
• Do not tie teething rings around your baby’s neck as they may pose a strangling hazard.
• Do not let your baby fall asleep with a bottle. The milk or juice can cause tooth decay anddental plaque.

When to Begin Tooth Brushing

It’s never too early to begin dental care. Even before your baby’s first tooth erupts, start using a warm, soft and clean washcloth or a moistened cotton swab to gently wipe the gums after every meal. This gets your child used to something in his/her mouth. As soon as the first tooth erupts, gently brush with a small, soft toothbrush and water. Do not use toothpaste – especially if it contains fluoride – until your child is two years old. At this time, apply only a pea-sized amount on the bristles. Teach your child proper tooth brushing techniques at around age three. To avoid a potentially harmful overdose of fluoride, never let your child swallow the toothpaste or eat it out of the tube.

When your child’s teeth have fully erupted, have him/her brush after every meal or at least twice a day. Start flossing, too. A good time to begin flossing is when two teeth are touching. Speak with your dentist for tips on flossing your baby’s teeth. Get your toddler in on the flossing habit by setting the example. Let him/her see how you brush and floss and have him/her follow along beside you in front of the bathroom mirror.

When to See the Dentist

The general rule is that children should see a dentist for the first time six months after eruption of the first tooth and no later than one year old. Taking your child to the dentist at a young age is a great way to give your child a healthy start on a lifetime of good oral hygiene habits.

Like adults, children should visit the dentist every six months. Some dentists may schedule visits for every three months when your child is very young in order to build a comfort level or to treat any developing problems. 

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2. Pediatric Dentists: Your Child’s Oral Care Specialist
3. Red Flags for Poor Oral Health in Your Child

Pediatric dentists are also good choices for the dental care of adults with special needs. Common conditions that require special needs dental care include Down syndrome, cerebral palsy, seizure disorders, HIV infection, vision/hearing impairments, cleft lip, cleft palate, and other craniofacial conditions, and learning and developmental disabilities.

Pediatric Dental Care

Among the care provided by pediatric dentists is regular oral health exams (including caries risk assessment for infant and mother); preventive dental care (such as brushing and diet/nutrition recommendations); regular cleaning and fluoride treatments; and use of sealants to prevent cavities.

A pediatric dentist also may:

• Provide mouth guards (to prevent sports injuries)
• Provide or recommend special preventive care to safeguard against problems, such asteething and gum disease
• Offer habit counseling (e.g., thumb sucking, pacifier use)
• Offer assessment and treatment for teeth straightening and improper bite in the young child (orthodontics)
• Repair tooth cavities and/or defects
• Diagnose oral conditions associated with diseases such as diabetes, congenital heart defects, asthma and attention-deficit/hyperactivity disorder
• Diagnose and treat dental developmental difficulties (e.g., root canals on adult teeth that have not fully formed)
• Provide management of gum diseases and conditions, such as pediatric periodontal disease, ulcers and tongue-tie (when the membrane that attaches the tongue to the floor of the mouth is shorter than normal. If tongue-tie interferes with breastfeeding, a pediatric dentist can clip the membrane to release the tongue)
• Care for dental injuries (e.g., fractured or knocked-out teeth)

Pediatric Dentists Versus General Dentists

Many children are treated by a general dentist, who already has a well-established relationship with the entire family. However, while not necessarily providing better care than general family dentists, pediatric dentists can offer the specialized focus on your child that general dentists may not be prepared or inclined to offer.

Unlike a general dentist, a pediatric dentist has two to three years of additional training after completing a four-year dental school curriculum. This program of study and hands-on experience emphasizes child psychology, growth and development. Pediatric dentists know how to examine and treat children — not always the most patient or cooperative of subjects — in ways that make them comfortable and safe. They use specially designed equipment in offices arranged, decorated and sized with children in mind.

Choosing a pediatric dentist as your child’s specialist helps ensure you are getting the latest and best treatments, care and resources to prevent, detect and treat all of your child’s dental/oral health needs throughout the various stages of development.

For instance, during infancy, your pediatric dentist may focus on prevention and education. During adolescence — when appearance and self-image often take center stage — the emphasis may shift to restoring/correcting teeth and teaching preventive dental health care, which includes information on sealants, oral piercing, tobacco/drug use, and cosmetic and/or restorative options such as tooth bleaching, veneers for teeth and crowns.

Pediatric dentists practice in private offices, dental schools and medical centers. Your pediatric dentist can work with pediatricians, other physicians and other dental specialists to ensure that your child is best served through a comprehensive team approach. If you’re having trouble deciding on the type of dentist for your child, ask your child’s pediatrician or your general dentist for recommendations.

Pediatric Dentists and Sedation Dentistry

Pediatric dentists are qualified to administer sedation to their patients. These sedation dentistrytechniques include:

Oral medication: The pediatric dentist selects a medication and dose that will relax your child but not render him/her unconscious. He/she is still responsive to touch and direction. This option may be recommended for children who are anxious, restless or very young.

Local anesthetics: A topical anesthetic — similar to teething gel — can be applied with a cotton swab to prevent pain on the mouth’s surface. A local anesthetic, such as Lidocaine, may be injected in a specific area of a child’s mouth to prevent discomfort during treatment. Local anesthetics cause temporary numbness that may last past the visit.

Nitrous oxide (“laughing gas”): Perhaps the safest sedative in dentistry, nitrous oxide can reduce anxiety and gagging in children, making long appointments easier. The child remains conscious during treatment; post-treatment recovery is fast and complete.

General anesthesia: Most often recommended for children who cannot tolerate extensive dental treatment, general anesthesia puts patients to sleep, making them completely unconscious and unable to respond to touch or voices. General anesthesia may be the preferred treatment for a child with a mental/physical disability for whom a hospital setting provides the safest option.

Discuss all aspects of the benefits and risks of sedation with your child’s pediatric dentist. For example, general anesthesia needs to be provided by qualified health professionals, including pediatric dentists with advanced education in anesthesiology, dental/medical anesthesiologists, oral surgeons and certified registered nurse anesthetists. Whether it takes place in a pediatric dental office or a hospital, treatment must feature special monitoring and emergency equipment, and trained support staff.

When and How Often to Visit Pediatric Dentists

The first dental visit should occur approximately six months after your child’s first tooth erupts and no later than age one. Children should visit their pediatric dentist every six months. Some pediatric dentists may recommend scheduling visits every three months in order to build up a comfort level or to treat developing concerns.

What to Expect During the First Visit

At the initial visit, a pediatric dentist will present a caries risk assessment, information about early childhood caries, and current facts about finger and pacifier habits.

After examining your child’s mouth and discussing any dental issues with you, the pediatric dentist may present information about:

• A program of preventive home care, including information on brushing, diet and fluoride use
• Information about preventing mouth and teeth injuries
• Information on growth and development

Selecting a Pediatric Dentist

Factors to consider when choosing a pediatric dentist include:

Is the dentist a member of the American Academy of Pediatric Dentistry?

Does the pediatric dentist keep current through continuing education classes and/or attendance at conferences, seminars, etc.?

Does the pediatric dentist’s professional/personal manner put you and your child at ease?

Is the staff friendly, knowledgeable and quick in addressing your child’s needs and your concerns?

Is the dental office child-centric? (Do they offer child-sized furniture and instruments, decorations, handouts, entertainment/distraction options for children of different ages, etc?)

What is the practice’s policy on parents staying with their children during treatment? (Some pediatric dental offices require parents to accompany their children in order to educate parents and help reassure nervous children. Other offices encourage children to return for treatment on their own in order for the pediatric dental team to focus exclusively on the child and begin building a sense of trust right away.) What policy makes you and your child most comfortable?

Does the practice accept your dental insurance?

Were you properly informed about your child’s tooth development and given prevention and at-home dental care education?

Were your questions and concerns (and those of your child) treated with respect and sensitivity and answered in an age-appropriate, reassuring manner? 

Related posts:

1. Teething (Primary Tooth Eruption)
2. What Can I Do to Prevent Bad Breath?
3. Pediatric Tooth Decay: Protect Your Child’s Oral and General Health

Nursing Bottle Syndrome: Also known as baby bottle tooth decay or nursing caries, nursing bottle syndrome can result when a baby constantly takes in milk, formula, breast milk, fruit juice or sugar water – just about any liquid containing sugar. For example, sleeping throughout the night with a bottle of liquid containing sugar increases the baby’s likelihood for developing caries. Sugar remaining on the teeth may encourage growth of bacteria that can cause tooth decay, an abscessed tooth or infection that may spread to other areas of the body. It isn’t necessarily the amount of sugar that a baby is exposed to (though this plays an obvious role); rather, it is the duration of time during which a baby’s teeth are exposed to sugar.

Dentists recommend that you give your baby a bottle of water or a pacifier instead of a sugary substance when your child needs comfort and at bedtime. Stop using a bottle and shift to a “sippy cup” when your dentist recommends it – often by age one.

Decayed or Missing Baby Teeth: Baby teeth serve as a pattern for the placement of permanent teeth. Decayed or missing baby teeth may result in crooked or misaligned permanent teeth, which can, in turn, cause a host of problems.

Children may have difficulty chewing with misaligned teeth. It may also be challenging for a child to maintain proper dental hygiene, fostering tooth decay, periodontal disease or premature tooth loss. Misaligned teeth can also interfere with the temporomandibular joint (TMJ), which connects the lower jaw to the skull. This interference may result in pain and discomfort as an adult. Dentists may use space maintainers so that surrounding teeth remain in alignment and do not become crooked.

Thumb Sucking and Lip Sucking: Thumb sucking is a normal and healthy activity that provides comfort and security for an infant.

That said, thumb sucking after permanent teeth have erupted (usually by five years of age), can create many problems. The child’s supporting bone structure may shift, causing misalignments in the jaw and roof of the mouth. The child’s teeth may shift, resulting in an overbite or protrusion of teeth. Finally, the results of inappropriate thumb sucking can affect speech, making it difficult to pronounce certain words. The extent of damage to the mouth depends on the regularity and intensity of thumb sucking.

A child sucking the lower lip either by using the upper teeth or during thumb sucking may face the same problems as a thumb sucker. Additionally, when teething, babies will often put their fingers in their mouth.

Typically, children stop thumb and lip sucking by age five. If not, reward your child when he or she doesn’t thumb or lip suck. Thumb sucking is meant to provide comfort and can be indicative of an underlying issue your child is dealing with. Try to understand the issue prompting your children to suck their thumb or lip, and you may be able to correct the underlying problem.

Tongue Thrusting: Tongue thrusting is a condition caused as a result of the chronic pressing of the tongue against the lips with a force that can lead to the protrusion of teeth. Speech pathologists can help change your child’s swallowing pattern and build on the chewing muscles to stop tongue thrusting, averting long-term dental problems.

Poor Nutrition: Choose fruits and vegetables for snacks, including melons, pears, celery and cucumbers. Limit sugary, sticky foods such as raisins, granola bars, jelly beans and syrup. If you offer sugary, sticky snacks, do so only after a meal. Usually saliva flow increases after meals, making it easier to wash away sugary, sticky food debris.

Always clean teeth after every snack or meal. Give your child water as often as possible. Do not offer sugared gum; instead, choose sugar-free or xylitol-sweetened gum.

Oral Health of the Parents: If a child’s parents suffer from oral diseases like periodontal disease or tooth decay, the child faces an increased risk of similar oral health problems. Bacteria from a parent’s mouth can be transferred to the child’s mouth when giving kisses, sharing food, etc. 

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2. Dental Health and Bad Breath
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Although cavities are common in children, they are not the norm, but rather a malady leading to chronic pain, slow weight gain, further tooth decay, misalignment of the permanent teeth and infection that, if left unchecked, may result in abscess or even death.

Yet cavities, also known as caries, are viewed to be a behavioral disease and therefore completely preventable.

Pediatric Tooth Decay: The Culprits

The underlying culprits of pediatric tooth decay have recently been identified as streptococci mutans, a group of infectious bacteria that leach out protective calcium and phosphate from tooth enamel and dentin (the hard tissue located in between the outer enamel and the pulp and roots further inside).

These bacteria are “nurtured” by frequent servings of sugar- and carbohydrate-rich prepared foods and beverages, as well as improper brushing and flossing habits. But before the bacteria can do their damage, they must be transmitted to the baby’s mouth. This occurs via saliva transfer soon after the first tooth appears, around six months of age. Usually, the saliva is the mother’s or that of a caregiver. The transfer typically occurs via a shared spoon, when the mother cleans the baby’s pacifier in her mouth or when she kisses or nuzzles the baby’s head – after which the baby picks up the saliva on his or her hand and transfers it to the mouth. Such transfers start a colony of bacteria that can last a lifetime.

Keys to Preventing Pediatric Tooth Decay

Cavities affecting baby teeth and permanent teeth are treated with the same “drill and fill” measures familiar to adults. But the emphasis today is placed on preventive measures, which are considered key to the control of tooth decay. These preventive measures include:

• Checkups with a pediatric dentist starting at 12 months of age.
• Good nutrition ensures your child has a balanced diet of fruits and vegetables, breads and cereals, milk and dairy products, and meat, fish and eggs. Sugar-rich foods and beverages need not be completely avoided. But in order to cut off the build-up of decay-inducing bacteria, their frequency should be limited.
• Supervised tooth brushing until approximately age six, when children are likely to demonstrate that they can capably brush on their own. Parents are advised to clean babies’ and toddlers’ teeth with a brush or washcloth and a pea-sized dose of toothpaste, starting the day the first tooth erupts.
• Check the teeth monthly for horizontal white or brown spots or lines close to the gums. These markings are signs of demineralization, the first indications of tooth decay. When babies are nursing – breast or bottle fed – they tend to appear on the inside surface of the upper teeth. In children with permanent teeth, they are often found on biting surfaces or in between teeth. If you see these spots or lines, make an appointment with your dentist immediately. It may be possible to re-mineralize the area and prevent a cavity with fluoride treatment.
• Get adequate amounts of fluoride. While children receiving therapeutic fluoride treatments do not need additional sources of fluoride, all others should brush with a fluoridated toothpaste and drink fluoridated water. This usually means tap water. Parents should keep in mind that most bottled water is not fluoridated. (One exception: Spring! by Dannon Fluoridated Spring Water.)
• Ask your pediatric dentist about dental sealants. These plastic coatings placed on the chewing surfaces of the permanent molars (which appear between ages six to 12) protect the teeth by shutting out cavity-causing food particles. They are recommended for children at moderate to high risk for decay.
• Use Xylitol, a natural sweetener, derived from hardwood trees, that has been shown to weaken the effect of streptococci mutans. Clinical studies show that mothers and other caregivers who start chewing high-concentration Xylitol gum three months after birth will not only lessen the strep mutans content in their own saliva, but will transfer that healthy saliva balance to their baby.
  • Suggested dose: Six grams per day, divided into three doses; make sure the gum has a minimum 50 percent concentration of Xylitol. Children old enough to chew gum or suck on Xylitol “candy drops” can also benefit. High-concentration Xylitol products are sold at health food stores and suppliers. 

Related posts:

1. What Can I Do to Prevent Bad Breath?
2. Teething (Primary Tooth Eruption)
3. Pediatric Dentists: Your Child’s Oral Care Specialist

In 2005, The Centers for Disease Control and Prevention found that tooth decay is the most chronic disease among children aged five to 17. Oral health problems affecting infants are no less serious.

Diet and the Oral Health Implications

What your children eat affects their teeth. Sugars (found in cake, cookies, candy, milk and juice) and starches (found in pretzels and potato chips) can cause tooth decay. Add to this the fact that it is more difficult to clean babies’ and children’s teeth and you can see why debris tends to remain in children’s teeth, resulting in bacteria growth and, ultimately, tooth decay.

Although baby teeth (deciduous or primary teeth) are eventually replaced with permanent teeth, healthy baby teeth are fundamental to a child’s overall health and development.

Baby-to-Child Dental Checklist

Some babies are born with neonatal teeth (teeth that develop in the first month) that requiredental hygiene or a visit to the dentist for their removal. At least one baby tooth erupts by six months of age. And, yes, it requires cleaning.

From six months to 24 months, children begin teething in earnest, indicated by irritability, biting on objects, drooling and ear pulling. As a parent, you can help teething progress by using strategies such as massaging your child’s gums, offering a chilled teething ring or cold, wet washcloth and asking your dentist for a teething ointment recommendation.

By three years of age, most if not all baby teeth have erupted. Soon after four years, spaces for permanent teeth begin to appear as the jaw, supporting bone structure and facial bones begin to grow.

From six to 12, it is typical for your child to have both baby teeth and permanent teeth in their mouth.

Oral Health Care Necessities for Children & Infants

Here’s a list of dental care necessities from birth on up:

• Baby Teeth Cleaning: Baby teeth should be cleaned as soon as they erupt. Clean your baby’s teeth with a soft washcloth or gauze after every bottle or meal. When more than one tooth erupts, you can soak a small-bristled child-sized (age-appropriate) toothbrush in warm water before using it on your baby’s teeth, as instructed by your dentist.

  Baby teeth should be brushed using a pea-sized amount of toothpaste. Use water without fluoride until approximately six months of age. Encourage your children to brush their own teeth once they have the coordination to do so. Replace toothbrushes every two to three months.

  Children’s teeth should be brushed after they are given medicine. Acids contained in medicines may eat away at tooth enamel, which serves as a natural protective coating for the teeth.

• First Dental Visit: It is important that your child see a dentist by age one to establish a long-term dental hygiene and professional dental cleaning plan.
• Dental Sealant Application: Dental sealants are used to protect teeth from decay and are appropriate as soon as a tooth erupts.
• Fluoride Treatments: Check with your dentist and water authority about the need for fluoride treatments. Fluoride is a major component in the prevention of childhood dental caries. This is because fluoride alters the molecular structure of the tooth, making it more resistant to acid attack and decay.

  However, children require the right balance of fluoride treatment. Too much fluoride could be problematic and lead to fluorosis.

• Dental Flossing: Parent-assisted dental flossing should commence when two teeth erupt next to each other. Independent flossing should occur when children have the ability to do it on their own (often by six years of age).
• Mouth Washing: Mouth washing is usually recommended by age seven, provided your child can perform the activity.
• Orthodontics: Orthodontics may be appropriate by seven years of age.

Keep in mind that these age ranges are estimates only; you should follow your dentist’s recommendations. 

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2. Teething (Primary Tooth Eruption)
3. Red Flags for Poor Oral Health in Your Child

• The most common route of transmission is needles shared among users of illicit drugs.
• Accidental needle-sticks in healthcare workers also have transmitted the virus.
• The average risk of getting HCV from a stick with a contaminated needle is 1.8% (range 0% to 10%).
• Prior to 1992, some people acquired the infection from transfusions of blood or blood products. Since 1992, all blood products are screened for HCV, and cases of HCV due to blood transfusionnow are extremely rare.
• HCV also can be passed from mother to unborn child. Approximately 4 of every 100 infants born to HCV-infected mothers become infected with the virus.
• A small number of cases are transmitted through sexual intercourse. The risk of transmission of HCV from an infected individual to a non-infected spouse or partner without the use ofcondoms over a lifetime has been estimated to be 1% to 4%
• Finally, there have been some outbreaks of HCV when instruments or sharp tool have been re-used without appropriate cleaning between patients.

Transmission of HCV can be prevented in several ways.

• Programs have been aimed at avoiding needle sharing among drug addicts. Needle exchange programs and educational interventions have reduced high-risk behaviors. However, the population of drug addicts is a difficult population to reach, and rates of HCV remain high among addicts (30% of younger users).
• Among healthcare workers, safe needle-usage techniques have been developed to reduce accidental needle-sticks. Newer syringes have self-capping needle systems that avoid the need to manually replace a cap after drawing blood and reduce the risk of needle-sticks.
• There is no clear way to prevent transmission of the HCV from mother to child.
• Persons with multiple sexual partners should use barrier precautions such as condoms to limit the risk of HCV as well as other sexually-transmitted diseases.
• Monogamous couples should consider the low risk of transmission when deciding whether to use condoms during intercourse. Some couples may decide to use them and some may not.
• Screening tests for blood products have almost eliminated the risk of transmission through transfusion, estimated by the CDC to be less than one in two million transfused blood products.
• People with HCV should not share razors or toothbrushes with others.
• It is critical that physicians and clinics follow manufacturer’s directions for sterilizing/cleaning instruments and that disposable sharp instruments be discarded properly.

It is important to realize that HCV is not spread by casual contact. Thus, shaking hands, kissing, and hugging are not behaviors that increase the risk of transmission. There is no need to use special isolation procedures when dealing with infected patients.

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Related posts:

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3. Hepatitis C

Hepatitis C is an infection of the liver caused by the hepatitis C virus (HCV). It is difficult for the human immune system to eliminate the virus from the body, and infection with HCV usually becomes chronic. Over decades, chronic infection with HCV damages the liver and can cause liver failure in some people. In the U.S., the number of new cases of infection with HCV has declined over the last 10 years from a peak of some 200,000 annually to about 19,000 in 2006. When the virus first enters the body, there usually are no symptoms, so these numbers are estimates. Up to 85% of newly infected people fail to clear the virus and become chronically infected. In the U.S., more than three million people are chronically infected with HCV. Infection is most common among people who are 40 to 60 years of age, reflecting the high rates of infection in the 1970s and 1980s. There are 8,000 to 10,000 deaths each year in the U.S. related to HCV. HCV is the leading cause of liver transplantation in the U.S and is a risk factor for liver cancer.

What is the nature (biology) of the hepatitis C virus?

‘Hepatitis’ means inflammation of the liver. HCV is one of several viruses that can cause hepatitis. It is unrelated to the other common hepatitis viruses (for example, hepatitis A or hepatitis B). HCV is a member of theFlaviviridae family of viruses. Other members of this family of viruses include those that cause yellow feverand dengue.

Viruses belonging to this family all have ribonucleic acid (RNA) as their genetic material. All hepatitis C viruses are made up of an outer coat (envelope) and contain enzymes andproteins that allow the virus to reproduce within the cells of the body, in particular, the cells of the liver. Although this basic structure is common to all hepatitis C viruses, there are at least six distinctly different strains of the virus which have different genetic profiles (genotypes). In the U. S., genotype 1 is the most common form of HCV. Even within a single genotype there may be some variations (genotype 1a and 1b, for example). Genotyping is important to guide treatment because some viral genotypes respond better to therapy than others. The genetic diversity of HCV is one reason that it has been difficult to develop an effective vaccine since the vaccine must generate viral proteins from each genotype.

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Technically known as sphygmomanometers, manual and mercury filled blood pressure machines usually require a trained technician to read and interpret measurements; but digital versions automatically calculate measurements and provide easy-to-read LED displays. Senior adults that live alone or non-ambulatory patients can easily obtain accurate readings of systolic and diastolic values. Systolic readings reflect the force of blood against arterial walls as the heart pumps; while diastolic values records the force of flow as the heart rests. People concerned about controlling hypertension can use electronic blood pressure monitors without leaving the comfort of home or taking a trip to the clinic or grocery store. Digital versions are more portable and come in models that can be worn on the wrist, fit easily on a tabletop, or packed inside a suitcase for convenient monitoring while traveling.

Newer electronic blood pressure monitors can be operated single-handedly; and many come with cuffs to accommodate nearly any size, which when wrapped around the arm automatically display readings at the touch of a button. High-tech devices come with high-speed motors that enable individuals to get readings quickly and relatively pain free. Gone are the manual cuffs which required nurses to pump repeatedly until the right amount of pressure could be applied for an accurate measurement. Today’s digital sphygmomanometers have automatic inflation features and can detect the correct amount of pressure for each user. Computerized devices can hold 30 to 60 measurements in memory and display an average value for more accurate comparisons. Users don’t have to memorize or write down each reading; electronic blood pressure monitors calculate, register, and display past and present measurements. Patients that suffer from hypertension can take portable devices to a doctor’s office rather than try to remember a history of measurements. Doctors can add data to patient records and access a powerful tool to determine treatment or prescribe medication based on electronic readouts.

Even patients that are blind or have impaired vision can benefit from electronic blood pressure monitors that audibly announce to the user or physician accurate results. In addition to offering automatic inflation, high-tech devices call out systolic and diastolic values and pulse rates as the unit measures them. People with less than 20-20 vision no longer have to strain to read monitors; and some devices come with a set of lightweight earphones for complete privacy. High-tech digital units also have time and date stamps for referring back to past readings.

People who have trouble remembering when to take readings will enjoy using the new electronic blood pressure monitors with alarms. Some units issue alerts three times a day to ensure that patients remember to take measurements. Individuals who suffer with chronic hypertension don’t have to worry about blood pressure getting out of control before remembering to take medication. A built-in alarm is lifeline for those who depend on timely, accurate and efficient monitoring of systolic and diastolic values. Other models include multiple features, such as the capacity to record measurements for two individuals and store them on one unit; extra or adjustable cuffs for the smallest to the largest sized arm; and accessories, such as devices to measure irregular heartbeats and replacement parts.

People who want to take advantage of user-friendly electronic blood pressure monitors loaded with high-tech features may surf the Internet for online vendors or visit the local medical supply company. Physicians may also prescribe and order units for patients who seek convenience, portability, and accuracy. Most units are affordably priced; models for home use are available for less than $100, while professional grade systems can run over $1,000. Online vendors may offer free shipping, extended warranties, carrying cases for travel, or training videos to ensure that individuals know how to operate each device. Web-based companies usually accept major credit cards or Paypal accounts; and units can be express delivered via standard parcel services.

In the final analysis, electronic blood pressure monitors not only enable individuals to keep track of fluctuations, but also offer a greater opportunity to manage hypertension. By using devices which measure, store and announce values at the touch of a button, people who are diagnosed with the disease are more likely to take control of their health. Even physically-challenged and visually-impaired persons can access accurate readings without worrying about finding someone to take and interpret readings. In just a few moments, users can make disease management a do-it-yourself delight and not a dreaded chore. Consumers need only browse online vendors to find the right device at the right price to start realizing the freedom of using today’s high-tech multi-functional monitors.

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