Impressions

Study: Oral Health Workers are Burned Out Too

An analysis of a 2021 Health Choice Network survey found that oral health providers reported high levels of burnout at rates similar to other medical providers involved in patient care, with 79.3% of oral health providers surveyed reporting burnout compared to 80.1% of surveyed primary care providers and 76.2% of mental/behavioral health providers.

The analysis was conducted by researchers from the Oral Health Workforce Research Center (OHWRC) at the University at Albany to explore the prevalence and effects of burnout and stress among the oral health workforce in safety-net dental organizations during the COVID-19 pandemic. The Health Choice Network surveyed clinicians working in 25 community health centers across the U.S.

OHWRC researchers also conducted key-informant interviews with individuals in various positions at safety-net dental organizations throughout the U.S. in 2022. The goals of the interviews were to collect information about the impact of COVID-19-related stressors on dental staffs’ stress and anxiety levels and to determine if burnout and stress affected employee recruitment and retention.

At the organizational level, reported stressors were primarily related to obtaining sufficient personal protective equipment, changing clinical protocols, reassigning clinicians to nontraditional roles, and workforce shortages. The most common individual-level stressors were related to child care, primarily for single parents, with women being disproportionately impacted. The lack of child care was among the main reasons dental assistants and hygienists chose to leave their jobs.

“It’s not only important to be aware of burnout, but to understand the reasons why health workers are experiencing it,” said CHWS Director Jean Moore. “Once specific stressors have been identified, then strategies to address them at both organizational and personal levels can be implemented to reduce burnout for these providers.”

To address these stressors, organizations implemented various strategies to support work-life-balance among their staff, including more time off, extra pay, more break time for staff, and increased work-schedule flexibility for parents.

Report Shows Cheap, Flavored Cigars are Flooding the Market

Small, cheap, flavored cigars are the second-most popular tobacco product among youths in the U.S., according to a new report from Rutgers University Institute for Nicotine and Tobacco Studies and the Campaign for Tobacco-Free Kids. The report shows how tobacco companies have flooded the market with these products that appeal to children.

The U.S. Food and Drug Administration is poised to issue a final rule prohibiting flavored cigars after announcing a proposed rule in April 2022. The ruling is based on evidence that cigar use poses serious health risks and that flavors increase their appeal, especially to youths. Removing them from the market would reduce the number of kids who smoke them. The FDA is also expected to bar menthol-flavored cigarettes.

Overall, cigar sales more than doubled between 2000 and 2021, largely driven by increased sales of smaller cigars, and flavored cigars comprise half the market. About 500,000 youths use cigars, with more than 800 children a day trying cigar smoking for the first time. Black youths have the highest rates of cigar smoking, and black high school students use cigars at 1.5 times the rate of white high schoolers, the report shows.

The report also found that a majority of youths who smoke cigars start with a flavored cigar. Flavors mask the harshness of tobacco, making cigars easier for a beginner to use, according to the report. Nearly three-quarters of youth who smoke cigars said they do so “because they come in flavors I like.” The brands most popular with kids come in a variety of candy and fruit flavors, which the report says give the impression a product is less harmful.

Authors of the report are calling on the FDA to implement the new cigar rules without delay. They also called on states and cities to continue efforts to end the sale of all flavored tobacco products.

Listening to Music May Reduce Pain

Music has long been found to relieve pain, with recent research suggesting the effect may even occur in babies and other studies revealing that people’s preferred tunes could have a stronger painkilling effect than the relaxing music selected for them.

Now, researchers from McGill University in Montreal, Canada, have found evidence that the emotional responses generated by music can also reduce pain.

“We can approximate that favorite music reduced pain by about one point on a 10-point scale, which is at least as strong as an over-the-counter painkiller like [ibuprofen] under the same conditions. Moving music may have an even stronger effect,” said Darius Valevicius, a senior undergraduate in cognitive science at McGill and the first author of the research.

For the study published in the journal Frontiers in Pain Research, Valevicius and colleagues asked 63 healthy participants to attend McGill’s Roy Pain Lab, where researchers used a probe device to heat an area on their left arm – a sensation akin to a hot cup of coffee being held against the skin.

During the process, the participants either listened to their favorite song tracks, relaxing music selected for them, scrambled music or silence. As the music, sound or silence continued, the participants rated the intensity and unpleasantness of the pain. Each participant experienced each condition for around seven minutes, with eight pain stimulations and eight ratings

When the auditory period ended, participants were asked to rate the music’s pleasantness, their emotional arousal and the number of “chills” they experienced – a phenomenon linked to sudden emotions or heightened attention, that can be felt as tingling, shivers or goosebumps.

The results reveal participants rated the pain as less intense by about four points on a 100-point scale and less unpleasant by about nine points when listening to their favorite tracks compared with silence or scrambled sound. Relaxing music selected for them did not produce such an effect.

“We found a very strong correlation between music pleasantness and pain unpleasantness, but zero correlation between music pleasantness and pain intensity, which would be an unlikely finding if it was just placebo or expectation effects,” Valevicius said.

Further work revealed that music that produced more chills was associated with lower pain intensity and pain unpleasantness. Lower scores for the latter were also associated with music rated more pleasant.

“The difference in effect on pain intensity implies two mechanisms – chills may have a physiological sensory-gating effect, blocking ascending pain signals, while pleasantness may affect the emotional value of pain without affecting the sensation, so more at a cognitive-emotional level involving prefrontal brain areas,” said Valevicius, cautioning that more work is needed to test these ideas.

Research Finds Oral Pathogen Increases Heart Attack Damage

In a study published in the International Journal of Oral Science, researchers from Tokyo Medical and Dental University revealed that a common oral pathogen can stop cardiac myocytes from repairing themselves after a heart attack caused by coronary heart disease.

Heart attacks occur when blood flow in the coronary arteries is blocked, resulting in an inadequate supply of nutrients and oxygen to the heart muscle, and ultimately death of cardiac myocytes. To prevent this, cardiac myocytes use a process known as autophagy to dispose of damaged cellular components, keeping them from causing cardiac dysfunction.

“Previous studies have shown that the periodontal pathogen Porphyromonas gingivalis, which has been detected at the site of occlusion in myocardial infarction, can exacerbate post-infarction myocardial fragility,” said lead author of the study Yuka Shiheido-Watanabe, PhD. “However, the mechanisms underlying this effect remained unknown.”

To investigate this, the researchers created a version of P. gingivalis that does not express gingipain, its most potent virulence factor, which an earlier study showed can inhibit cells from undergoing programmed cell death in response to injury. They then used this bacterium to infect cardiac myocytes or mice.

The viability of cells infected with the mutant bacterium lacking gingipain was found to be much higher than that of cells infected with the wild-type bacterium. In addition, the effects of myocardial infarction were significantly more severe in mice infected with wild-type P. gingivalis than in those infected with the mutant P. gingivalis lacking gingipain.

More detailed investigation of this effect showed that gingipain interferes with fusion of two cell components known as autophagosomes and lysosomes, a process that is crucial to autophagy. In mice, this resulted in an increase in the size of cardiac myocytes and accumulation of proteins that would normally be cleared out of the cells to protect the cardiac muscle.

“Our findings suggest that infection with P. gingivalis producing gingipain results in excessive autophagosome accumulation, which can lead to cellular dysfunction, cell death, and ultimately cardiac rupture,” said Dr. Shiheido-Watanabe.

Given that P. gingivalis appears to have a substantial impact on the cardiac muscle’s ability to health itself after a heart attack, treating this common oral infection could help reduce the risk of fatal heart attack, according to the study.