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News Bulletin : ADA News Bulletin October 2011
47 OCTOBER 2011 clinical hints ALCATRAZ Almost all readers will know that this is the name of a rocky island in San Francisco Bay, 2.4 km (about 1.5 miles) from the city. This stretch of water is notorious for very strong tidal flows, treacherous waves and cold water. It is for these reasons, among others, that Alcatraz* was used as a prison, first by the Military, then by the US Federal Government. It is said that no prisoner ever made a successful escape from it, but the TV show ‘Mythbusters’ showed that it is possible. These days it is a nature reserve and tourist destination. It is also the starting point for the annual ‘Escape from Alcatraz’ swim. On 22 May 2011, 167 men and 100 women of all ages attempted the swim, and most of them finished. Of these, 262 wore wetsuits. Two of the five who did not were Australian women, Luane Rowe, age 22 and Jane Gillings, age 46. Luane came 5th overall, with a time of 31 minutes 11 seconds and won her age group. Jane came 71st overall, with a time of 36 minutes, 7 seconds, and won her age group. Both Luane and Jane won their non-wetsuit categories, not surprisingly, because they were the only ones in them. The water temperature was 12 degrees Celsius. We should be proud of our women endurance swimmers. The aforesaid Luane has now swum the English Channel. In June this year, Penny Palfrey, a 48 year old grandmother from Queensland, has set a world record for the longest solo, unassisted swim of 108 kilometres, from Little Cayman Island to Grand Cayman Island in the Caribbean. The water was warm, but on the downside, there were sharks and jellyfish. She did it without a shark cage and without a wetsuit and it took her 40 hours 41 minutes. The distance is the equivalent of 2,420 olympic pool laps. We breed ‘em tough in Oz! SPOT THE LOUSE Some years ago, your Anecdotist developed a fluorescent plaque-disclosing system for use in public health displays by the Dental Health Foundation. It demonstrated plaque dramatically, but was not visible in daylight, hence its effectiveness as a public dental health activity. The same system has now been adopted by parents seeking to detect and remove louse eggs from children’s hair. The usual method used for removing lice from children’s hair is a permethrin shampoo, but most lice have become resistant to it and related pesticides. This means that the parents must now ‘nit-pick’, using a fine-toothed comb to remove the nits and the eggs. But the eggs are small and stick strongly to the hair, and if just a few are missed, the hair quickly becomes re-infected. Sydney Speisel, a paediatrics professor at Yale University, developed a fluorescent shampoo dye that adheres to the chitin coating the eggs. So now, the louse eggs, which can be very difficult to see, especially on blonde hair, glow like stars in the sky when lit by UV light and can be completely removed. OnE Of THEIR SUbMARInES CATCHES fISH The Swedes guard their marine borders assiduously, and have a network of hydrophones listening for the tell-tale sounds of submarine propellers. They had thousands of reports over a 15-year period, and rightly deduced that the sounds were more likely to be the natural movement of water. But then they got suspicious. So they did some tests, and found that swimming mink and otter made the same sounds as submarines. They are now probably making a fortune in the fur trade. A PLETHORA Of OPTIOnS Bill Bryson, an American who spent some time in the UK, returned to New Hampshire and was astonished to find the vast variety of products available in US supermarkets: 18 varieties of incontinence pads, for example, and cups of coffee with 20 different choices. TV viewers will know that clever Australian advertisement where the customer wants to buy milk, and is confused by the shop lady who asks him to choose from an extensive range, when all he wants is something that tastes like milk. Your Scrivener was inspired by Bill’s experience to count how many varieties of biscuits were available at the local supermarket, and not the fancy ones, just the crispbread, cracker types. He stopped counting after 100. The fancy types were almost twice that. Bill Bryson was right! This made your Recorder recall that when he was a consultant to a toothbrush manufacturer, they were manufacturing brushes with soft, medium and hard bristles, with adult- and child-sized heads. The heads had sharp corners, but your Recorder could not persuade them that the heads should be rounded, not sharp. They, and all the other toothbrush manufacturers, now offer a bewildering variety of head sizes, bristles, handle configurations, colours, and mechanical additions, vibratory, oscillatory or rotary, and battery powered, either disposable, replaceable or rechargeable. The count yesterday was over 50 separate items, at prices from, say $4 to $80+. Wise shoppers buy at $2 shops. But, as they say on television, “there’s more”. There were 22 different presentations of toothpaste on offer. How can this be justified? But the really worrying situation concerns mouthwashes. There were nearly 50 different presentations of these, some with alcohol, and some boasting that they were alcohol-free. There were varieties of flavours and colours, and some contained fluoride (concentration not specified). Some were claimed to reduce plaque or whiten teeth. If the toothbrushes and the toothpastes are effective (and they are when used properly), why do we need mouthwashes? If you go to a fishing tackle shop, you will see lures in a bewildering variety of shapes and sizes. Marketing experts have designed them to catch fishermen, not fish. Your Narrator believes that a similar argument could be applied to some mouthwashes and the more outlandish toothbrushes. IT MUST bE TRUE, IT WAS In THE SCIEnTIfIC AMERICAn Clinical Hints readers may recall that a past column† noted that the routine domestic use of sterilising agents is counter- productive, and will result in development of germs we can’t kill. This is supported by the 5 July 2011 Scientific American Guest blog by Rob Dunn, which is headed: “Scientists discover that antimicrobial wipes and soaps may be making you (and society) sick”. A quote from the Blog: “Most people who use antibiotic soap are no healthier than those who use normal soap. AND those individuals who are chronically sick and use antibiotic soap appear to get SICKER”. The article quoted nine references from refereed scientific journals. Our skin is populated by many kinds of micro-organisms, native species that live quite happily there and cause no harm. We use the word commensal to describe them. Then there are the tourists, the ones that can cause problems. Washing with ordinary soap removes most of the micro- organisms, but the natives re-establish themselves, and most of the tourists are removed. This is why soap is so helpful to us. Using antimicrobial soaps kills most of the organisms, but the survivors finish up in the drains, then in the environment, and eventually reappear somewhere and are resistant to the antibacterial soaps. Some of them can actually metabolise the antibiotic (triclosan) meant to kill them.‡ This same argument should perhaps be applied to the use of mouthwashes. Effective use of the toothbrush and ordinary toothpaste is the way to go. Mouthwashes may kill germs, but Homo *The word means, in Spanish, pelican/sea eagle/gannet. † February, 2011: GERM WARFARE. ‡ McBain A J et al. Exposure of sink drain microcosms to triclosan. Appl Environ Microbiol 2003;69:5433-42.
ADA News Bulletin September 2011
ADA News Bulletin November 2011