Science Policy For All

Because science policy affects everyone.

Science Policy Around the Web – September 20, 2016

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By: Valerie Miller, PhD

Source: Flickr, under Creative Commons

Public Health

How More Kids Could Avoid the Dentist’s Drill

Earlier this summer, the question of whether or not to floss has gotten a lot of attention. As it turns out, there is not much evidence to support the idea that flossing can prevent cavities. Yet, for children, the use of dental sealants, which protect molars from plaque and decay, has been shown to reduce the risk of cavity formation by over 75 percent. According to guidelines from the American Dental Association (ADA) and the American Academy of Pediatric Dentistry, sealants can be used not only to prevent the start of tooth decay, but can also stop the progression of early decay that has already begun. An analysis of nine randomized control trials demonstrated that for each 1,000 sealants placed, 207 cavities would likely be prevented.

Despite overwhelming evidence that dental sealants can prevent tooth decay and cavities, sealants remain underused in children, with the CDC reporting that, in 2011-2012, only 41 percent of children between the ages of 6 and 12 had at least one dental sealant placed on a permanent tooth. This data also showed that 21 percent of kids between the ages of 6 and 12, and 58 percent of adolescents ages 12 to 19, experienced cavities in permanent teeth, demonstrating the underuse of dental sealants. Most concerning, of the kids in the 6- to 12-year age range, 44 percent of kids without dental insurance coverage were found to have untreated decay, indicating that kids in a population who don’t get regular dental care would likely benefit the most from the use of dental sealants. One way to reach more children is through the use of school-based programs, in which dental hygienists provide sealants in schools to at-risk students. Such programs have been shown to result in 50 percent fewer cavities in the following four years in students who received sealants, compared to students who did not get them.

Although the use of dental sealants is highly recommended by the ADA, concern has been raised because some sealant materials contain a small amount of bisphenol A (BPA), which has estrogenic properties. However, a 2010 study recommended the use of dental sealants while minimizing exposure by rinsing the mouth out after placement. In addition, despite ADA research and guidelines, a survey of dentists in 2011 found that 40 percent felt that sealing early tooth decay was not good practice, believing that decay may continue underneath the sealant. While it can be hard to change the mindset of getting rid of decay with a drill and filling, 24 percent of dentists reported that they didn’t currently seal early tooth decay lesions, but they would be willing to consider it. Thus, parents may have to ask for sealants for their children in order to receive them. (Katherine Hobson, FiveThirtyEight)

Cancer Treatment Guidelines

Prostate Cancer Treatment Doesn’t Save More Lives than Active Surveillance

In recent years, a number of concerns regarding prostate cancer screening have been raised by doctors, as screening may lead to so-called “over-treatment” of prostate cancer, increasing the risk of adverse effects while doing little to save lives. A new study published in the New England Journal of Medicine has shed light on this issue by demonstrating that 10-year outcomes following surgery, radiotherapy or “active surveillance,” which involves regular testing and monitoring of cancer progression while forgoing therapy, were nearly identical. In each case, the rate of death due to prostate cancer was around 1 percent. These results may help men who are reluctant to pursue treatment, which comes with adverse side effects including sexual and urinary dysfunction.

Although survival outcomes were nearly identical in all three groups studied, there were some differences noted between each group. For example, patients in the active surveillance group were found to have twice as much cancer progression, including metastasis to bone and lymph nodes, when compared with patients in either the surgery or radiotherapy group. While increased cancer progression did not necessarily lead to higher risk of death, nearly 55 percent of men in the active surveillance group chose to pursue surgery or radiotherapy after their cancers progressed. The results suggested that active surveillance is a safe choice, when taking into account various factors such as disease progression and aggressiveness, age, and overall health. For example, for men who are older and are suffering from other health issues, immediate action might not be necessary if diagnosed with prostate cancer, as these patients are more likely to die from other causes before dying from prostate cancer. Yet, for younger men who are diagnosed with prostate cancer when they are otherwise healthy, the choice to pursue treatment or active surveillance may be more difficult, due to the side effects from treatment, as well as the potential consequences and increased need for aggressive treatment if the cancer progresses. In any case, the results of this study will provide more information to help each patient make an informed decision regarding their treatment. (Alice Park, Time)

Sports Policy

Sorry Redskins Fans: Native American Mascots Increase Racial Bias

A debate that has perpetuated within the American sports world is the use of Native American mascots to represent sports teams. Proponents of Native American mascots argue that these symbols respectfully honor Native American history, while opponents believe that such mascots perpetuate negative stereotypes against Native American peoples. At the center of the debate is the Washington Redskins football team, which has faced numerous protests and lawsuits over the use of “Redskins” as a team name. Team officials have used the results of a recent Washington Post survey, which found that 9 out of 10 Native Americans don’t take offense to the use of “Redskins” to represent the team, as evidence that a change isn’t needed. However, polls and studies such as this ignore the possibility that the use of Native American imagery may affect how others perceive Native Americans, potentially reinforcing stereotypes.

Recently published research has provided evidence that Native American imagery could induce implicit bias. Study participants were unaware that their viewpoints regarding Native Americans were being affected by the images they were shown. These results led researchers to conduct a “real-world” study, which examined if there were differences in attitudes towards Native Americans when comparing participants from cities that host teams with Native American mascots, to participants from cities with neutral sports mascots. The study found that residents of cities with Native American mascots were more likely to associate Native Americans with warlike traits, thus demonstrating that incidental exposure to such representations can influence perceptions regarding actual members of a certain group, and cause the active promotion of stereotypes within the general population. (Justin Angle, The Washington Post)

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Written by sciencepolicyforall

September 20, 2016 at 10:04 am

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