Study finds link between contraceptive and periodontitis

An injectable contraceptive administered every three months may be putting women who opt for this method at increased risk for periodontal disease, according to a new study in the Journal of Peridontology.

Depot medroxyprogesterone acetate (DMPA) is a progestin-only, injectable contraceptive that is most often seen under the brand name Depo-Provera, marketed by Pfizer.
It has been suggested that progestins may have an inflammatory component and/or stimulate the synthesis of prostaglandins, which is why the extended use of DMPA may be associated with a higher risk of periodontal diseases, according to the study authors.

"There are many hormonal contraceptive options out there for women to prevent or delay pregnancy, yet we have little information on how they may affect women's oral health," lead author Susan Taichman, RDH, MPH, PhD, assistant professor at the University of Michigan School of Dentistry, said in an interview with DrBicuspid.com.  Information regarding the pill and gingival inflammation is mixed, she added, with some studies showing an association and others not.

"There remains some controversy over the impact of new, low-dose oral contraceptives and periodontal diseases," she said. "We previously reported in an analysis of National Health and Nutrition Examination Survey (NHANES) data that low-dose oral contraceptives had no significant association with decreased periodontal health."

Economic status plays a role

In the current JOP study, Taichman and her co-authors found that although women of all socioeconomic backgrounds and ages use DMPA, roughly twice as many blacks and one-third Hispanics and Latinas use it as compared with whites. In addition, the majority of DMPA users are women of low socioeconomic status who are already at risk for increased levels of gingival disease, they noted.

“Women ... who use this method of birth control may be at a higher risk for gingivitis” says Susan Taichman, RDH, MPH, PhD.  "Given that DMPA use is common among high-risk women, it is important to learn more about potential deleterious effects on periodontal tissues," the researchers wrote.

The study authors collected the data from the 1999-2004 NHANES, a set of cross-sectional studies designed to obtain information on the health and nutritional status of the non-institutionalized population of the U.S.

They looked at 4,460 U.S. women between 15 and 44 who were asked about their use of DMPA. In the final sample, 4% were current DMPA users while 12 % indicated a past history of DMPA use.  In addition, they included data on the women's periodontal health, which was assessed using randomly assigned half-mouths (one upper and one lower quadrant) for each individual using a periodontal probe.

The authors also took into account sociodemographic and behavioral factors, which have been shown to be associated with DMPA use, they noted.  They found significant differences in pocket depths, gingival bleeding, and CA loss between DMPA users and non users. The prevalence of gingivitis was 53.9% for women who reported having used DMPA, compared to 46.1% for never having used DMPA.

DMPA use was associated with an increased risk of gingivitis and periodontitis after adjusting for age, race, education, poverty income ratio, dental care utilization, and smoking status, the researchers noted.

More research needed

The study findings suggest that DMPA use may be associated with periodontal disease, they concluded.  "Although many women of child-bearing age use DMPA, a large portion of DMPA users are young, non-white women of low socioeconomic status with a history of smoking, and thus may be at an already increased risk for periodontal diseases," explained Taichman.

"Women and adolescents who use this method of birth control may be at a higher risk for gingivitis and periodontitis," she said. "Dentists should encourage women who use DMPA contraceptives to maintain good oral health habits and seek regular dental examinations."
Future clinical studies that also look at oral health behaviors and duration of DMPA use are required to further understand the relationship between DMPA use and the incidence of periodontal health, she and her co-authors concluded.

Excerpt of article by Rabia Mughal, Contributing Editor of drbicuspid.com.  See original article here.

Franchise lending shortfall robbing the nation of jobs, economic output

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Lenders continue to fall shy of the overall loan volume sought by franchise business owners, a shortfall that’s holding back the recovery by choking job creation and economic production.

New lending to franchises will total $9.5 billion this year, according to new data released by the International Franchise Association. While that’s up slightly from 2011, it falls well short of the $11.72 billion those franchise owners will seek in loans over the course of 2012.

“As a result of demand for more business units, there has been an increase in demand for new loans,” IFA Educational Foundation President John Reynolds said at the 2nd Small Business Lending Summit in Washington on Tuesday. “But unfortunately, lending hasn’t kept pace with the demand from franchise businesses.”

During a time when the economic recovery is still struggling to gather momentum, that 18.6 percent gap in loan demand and loan supply will rob the economy of an estimated 94,000 new jobs and $12.9 billion in gross domestic output in 2012, experts said. Contributing to the shortfall are factors like tighter credit standards, heightened regulatory scrutiny and uncertainty surrounding the tax code, according to the report, which was conducted by the the IFA in partnership with FRANdata.

The gap draws a distinction between the credit challenges facing franchises and those facing small businesses as a whole. Recently, an overwhelming majority (92 percent) of small firm owners reported either no problems securing loans or no need for a loan in response to a study published by the National Federation of Independent Business. Those findings were backed up in a recent Wells Fargo/Gallup survey, which showed that the number of small employers who believe credit will be hard to come by this year is on the decline.

“In the competition for limited credit, franchise businesses must prove credit worthiness by showing strong unit economics and system performance,” IFA President Steve Caldeira said in a statement. “With a still slow, uneven and sluggish economic recovery, coupled with a stricter regulatory environment as a result of Dodd-Frank, the pressure to maintain and create jobs has never been greater for franchisees, franchisors and the overall small business community.”

When they do manage to get their hands on the capital they need, franchise owners have proven themselves effective job creators. SBA Administrator Karen Mills, who also spoke at the summit on Tuesday, pointed to research that showed franchises create roughly 34 new jobs for every $1 million they receive in new loans. 

“Two thousand franchises, 825,000 franchise units and 18 million people that you employ,” Mills said. “This is a real constant job creator, and it’s a great business model, an American business model. It’s really one of our competitive assets around the world.”

On the bright side, the overall health of the franchise industry appears to be improving and the gap between loans sought and loans acquired is growing smaller rather than larger. A year ago, lenders fell 19.6 percent short of franchise loan demand, and the year before, they missed the mark by 22.8 percent. Moreover, the IFA estimates nearly 36,000 new franchise units will be financed this year.

Hoping to accelerate that growth, the IFA on Tuesday announced an expanded partnership with the Financial Services Roundtable and the Consumer Bankers Association. The consortium has asked members of the administration and lawmakers in Congress to sit down with their respective members to address the current regulatory and lending hurdles facing franchises, small businesses and lending institutions.

Article by J.D. Harrison, posted April 18, 2012 on www.washingpost.com.  See original article here.

You can purchase a Dental Support Plus Franchise unit for only $25,000, using funds from an IRA.  For more information on Dental Support Plus Franchise, please visit our website.   

For information on how to purchase a franchise with funds from a self-directed IRA, visit www.theirainstitute.com. 

Treating Gum Disease May Help Diabetics Avoid Complications

Good periodontal care helped reduce hospitalizations, medical costs over time, study found

 Treating gum disease in people with diabetes reduces their medical costs and hospitalizations, new research shows.

The three-year study included diabetes patients with gum (periodontal) disease who were randomly selected either to receive periodontal therapy or no treatment (control group).

Those in the treatment group underwent periodontal therapy in the first year and their gum health was maintained for the following two years. The patients in the control group had incomplete periodontal therapy before the study and did not receive regular periodontal maintenance during the study.

The total annual per-patient cost of hospital admissions, doctor visits and overall medical care was an average of more than $1,800 lower in the treatment group than in the control group. The patients in the treatment group had 33 percent fewer hospital admissions.

The study was presented March 26, 2012 at the annual meeting of the American Association for Dental Research, in Tampa, Fla.

"There have been emerging links between oral infections and systemic diseases such as diabetes, which is increasingly prevalent in our population," lead researcher Marjorie Jeffcoat, professor and dean emeritus of the University of Pennsylvania School of Dental Medicine in Philadelphia, said in an association news release.

"My research team and I had looked at other data sets and we knew that health care costs could be reduced, but we wanted to look at the hospitalizations and see how those could be reduced," Jeffcoat said. "This study provided direct insight as to how lower hospitalizations could be achieved through periodontal therapy, and we will further this study by analyzing other chronic diseases and conditions such as heart attacks, strokes and pregnancy with pre-term birth."

Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

It's also important to note that although the study showed an association between better gum care and lowered health costs for diabetics, it didn't prove that healthier gums directly resulted in fewer hospitalizations or lowered costs.

SOURCE: American Association for Dental Research, news release, March 23, 2012

See story here.

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New Bill Offers Steep Tax Breaks for Veterans to Open a Franchise

Tax rebate would make franchise ownership possible for a larger number of returning veterans

Veterans looking to start their own business may get a big assist from the United States Senate, which is considering a bipartisan bill that would provide tax rebates to veterans who become franchisees.

The American Growth, Recovery, Empowerment and Entrepreneurship Act is cosponsored by Senators Marco Rubio (R-FL) and Chris Coons (D-DE), who introduced the legislation in November. The bill proposes to give veterans a 25 percent tax rebate on the cost of franchise fees, up to $100,000.

“The AGREE Act is a meaningful step to find common ground and create a better environment for job creators to start businesses or expand existing ones,” Rubio said in announcing the legislation.

A report by the International Franchise Association shows that for every $1 million of lending obtained by a franchised business, more than 34 jobs are created. The IFA and other organizations are lobbying Congress to help entrepreneurs create jobs for themselves and others by making it easier to borrow the money they need to start and operate a franchise.

The help would come at the same time that federal agencies are aggressively trying to send more of contracting dollars to veteran-owned small businesses. Executive Order 13360, signed by President George W. Bush, directed all federal agencies to send at least 3 percent of their contracting dollars to businesses owned by service-disabled veterans.

“Now is an excellent time for veterans to use the skills they’ve acquired and open new franchised businesses,” said Jania Bailey, COO of FranNet, a national franchise consulting firm. “These incentives make a franchise purchase much easier for veterans.”

With government contracting adding up to more than $425 billion a year, that means there is $12.5 billion that the government is eager to send to veteran-owned businesses.

The U.S. General Services Administration notes, though, that agencies have fallen far short of the 3 percent goal — largely due to the lack of identified veteran-owned small businesses in the marketplace.

The tax rebate on franchise fees would give service members an ideal way to start businesses that already have a proven business model — many of which are well-suited for government contracting work. 

The AGREE Act also reflects a growing realization in Congress that if the economy is going to regain its strength, something needs to be done to free up money to start franchises and other small businesses. Small businesses have accounted for 65 percent of new jobs over the past 17 years, according to the Small Business Administration.

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