D e n t a l    F o l l i c l e               

             The        Monthly     E-newsletter                   Vol - I       Number- V                       October-2006

In this Issue:

Editorial :

      Dear Dentists,

                              More and more I browse through articles on www ,more and more articles I see on Mercury  usage intraorally  slowly becoming a major controversy.There are enough number of esteemed clinicians who still hold on to the age old silver-amalgam as one of the best restorative material dentistry ever produced! Some countries are said to have put on a restricted clinical application of Mercury! If any of the dentists reading "Dental Follicle" would like to contribute to this ongoing controversy thru our E-NewsLetter you are most welcome!The best article will be published in Dental Follicle and the remaining articles will be loaded as files on DentistryUnited on Yahoo groups which now has over 108members from across the globe,from every speacility of dentistry!

                            I am pleased to inform you that one of most widely used software by Orthodontists "OrthoFlash" will soon be available @ DentistryUnited for a very special price!

Click here to join DentistryUnited
Click to join DentistryUnited

Yours truly

Dr.S. Nabeel

Editor - Dental Follicle


News :


·         Ormco Corporation Launches Simpli 5(TM) Express Aligner System

·         An Investigation Into The Relationship Between Periodontal Disease And Ischemic Stroke

·         Periodontal Disease and Adverse Pregnancy Outcomes

·         What the Dental Professional Must Know About Bisphosphonate Medications

·         Gene behind cleft lip and palate identified

·         Pediatric HIV: Oral Lesions Are Commonly Associated With The Disease



Laughter The Best Medicine :

One day, a man walks into a dentist's office and asks how much it will cost to extract wisdom teeth.

"Eighty dollars," the dentist says.

"That's a ridiculous amount," the man says. "Isn't there a cheaper way?"

"Well," the dentist says, "if you don't use an anesthetic, I can knock the price down to $60."

"That's still too expensive," the man says.

"Okay," says the dentist. "If I save on anesthesia and simply rip the teeth out with a pair of pliers, I can knock the price down to $20."

"Nope," moans the man, "it's still too much."

"Well," says the dentist, scratching his head, "if I let one of my students do it, I suppose I can knock the price down to $10."

"Marvelous," says the man, "book my wife for next Tuesday!"





                        C-reactive protein and Periodontal disease Part III

by- Dr.Vinayak Joshi


Periodontal disease especially in form of chronic periodontitis forms a chronic source of inflammation in any subject. The increased CRP during the periodontal infection can have a dual effect i.e a local and a systemic effect. The local inflammation in the periodontal structure along with the bacterial toxins could drive the CRP levels higher in the local tissues. The role or CRP in the local periodontal environment is quite unclear at this moment, however its role in stimulating the tissue factor and in turning on the humoral immunity may play role in altering the balance between health and disease1, 2. The recent invitro and invivo studies regarding CRP causing increased nitric oxide (NO) production3, affecting the monocyte adhesion4 and in expression of the adhesion molecules like intercellular adhesion molecules (ICAM) and vascular adhesion molecule (VCAM) support the hypothesis that CRP plays a pro-inflammatory role5.

I hypothesize that in presence of periodontal disease the subgingival bacteria and its toxins increases the level of the various proteinases, cytokines (which Interleukin6 (IL6) is known to regulate CRP) and acute phase proteins. Increase in acute phase protein of which CRP in specific could act as a proinflammatory factor by expressing the adhesion molecules, and NO production, causing a vicious cycle to build up. Its atherosclerotic effects of CRP could occur in the local vessels which could decrease the total blood flow in the already diseased area. The known affect of CRP in complement binding and humoral response along with its above mentioned actions could exacerbate the already persistent inflammation and thus alter the course of the periodontal disease. 

The increase in the CRP during the periodontal infection is seen to emerge as a risk factor with results of various clinical trials associating it with cardiovascular disease and preterm delivery. A recent study found that the periodontitis may increase the CRP levels in pregnant women and it could mediate the association of periodontitis with advance pregnancy outcomes6. The relationship between cardiovascular disease and periodontitis has been extensively researched in recent times. It is proposed from these studies that the periodontal infection and subsequent release of the proteinases ( matrix metalloprotienases 9) and cytokines (IL6, TNFα) and acute phase proteins ( CRP being one of them) can  systemically affect the events like platelet aggregation, thrombus formation and atherogenesis and thus increase the risk for atherosclerosis, coronary heart disease and stroke. (Figure1)9 A study by Ebersole et al7 showed that periodontal debridement reduced the serum level of CRP and another study by Ridker et al8 have showed that lower serum levels of CRP is associated with reduced risk of myocardial infraction. These studies indirectly support the hypothesis that periodontal treatment can potentially reduce the likelihood of systemic disease9.

Data regarding CRP and its affect periodontal disease is insufficient and calls foe more studies. However further research is needed to understand the association between periodontal disease, inflammation and its range of effect on the systemic health.


…….So is my own personal view.

All comments, criticism and discussions on the above topic is welcome



  1. Saran de Ferranti, Nadir Rifai, C-reactive protein and cardiovascular disease: a review of risk prediction and interventions. Clinical Chimica Acta 2000; 317: 1-15

  1. G.M. Hirschfield and M.B. Pepys, C-reactive protein and cardiovascular disease: new insights from an old molecule. Q J Med 2003; 96: 793 – 807.

  1. Clapp BR, Inflammation and endothelial function: direct vascular effects of human C-reactive protein on nitric oxide bioavailability, Circulation. 2005;111(12):1530-6.

  2. Woollard KJ, Direct modulatory effect of C-reactive protein on primary human monocyte adhesion to human endothelial cells. Clin Exp Immunol. 2002 ;130(2):256-62.

  1. Vincenzo Pasceri, MD Direct Proinflammatory Effect of C-Reactive Protein on Human Endothelial Cells, Circulation. 2000;102:2165.
  1. Waranuch Pitiphat, Periodontitis and Plasma C-Reactive Protein During Pregnancy, Journal of Periodontology 2006, Vol. 77, No. 5, Pages 821-825
  1. Paquette DW, et al. The concept of “risk” and the emerging discipline of periodontal medicine, The journal of contemporary dental practice 1999;1: 1-8
  1. Ebersole JL, et al. Systemic acute-phase reactants, C-reactive protein and haptoglobin, in adult periodontitis. Clin Exp Immunol 1997;107: 347-352.
  1. Ridker PM, et al. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Eng J Med 1997;336: 973-979.

other links;





5 Reasons You Should Be More Organized

                                                              by- Cathy Warschaw




Some people think being organized requires a lot of work or maybe a complete system where you have to do a complicated set of tasks. In short, many people view being organized as impossible to achieve. While that is not really true, it takes a  disciplined person not to resort back to his/her old habits. It’s really easy to do and you get many benefits when you’re organized. Here are some of them.


1. You will have more room.

Being organized will provide you additional “uncluttered” space. You won’t need to necessarily throw anything out, you just need to place things in some sort of order and maintain that order at all times.


2. You will be able to save time.

Looking for files at work? It’s organized alphabetically in the cabinet. Being organized lets you look for files that you might need in a hurry in the future. Looking for your book? It’s safely stashed behind your bed. This is a really good time-saving technique which would help you when you’re in a hurry.


3. You will also save money.

You don’t believe that? Try thinking why you bought another ballpoint pen today? Isn’t it because you lost your old one? Or think of the countless items you bought because you thought you didn't have one of them at your house. Just think of how much you could save in a year just by being organized.


4. You will feel more in control.

Did you know that clutter around your house and at work causes the stress you’re feeling from time to time? It’s no wonder you’re feeling more irritated at work. As your clutter goes, you’ll feel that it is easier to breathe and take charge of your own life.


5. You will make a great impression to others.

This should be a good enough reason why you should make a considerable effort to be organized. Just think of your employer or office manager not pestering you to clean your work area again. Or just think how you’ll never forget that you have a scheduled meeting.


Being organized requires a lot of discipline to maintain. Nobody ever said it was easy. You need to make sure you don’t lapse back to your old habits or all of what you have done will be for nothing.



© Warschaw Learning Institute 2006

Cathy Warschaw is the Director of the Warschaw Learning Institute an online educational site offering; Dental Office Management Program, Telephone Training,  HIPAA and various e-books.  For more information go to or call (323) 822-0917(323) 822-0917