health – Page 19

Trust in scientists hasn’t recovered from COVID. Some humility could help.

Covid, health, humility, intellectual humility, public perception, public perception of science, research, Science, Trust / Mike M. / November 18, 2024

Study 3 essentially replicated study 2, but with the tweak that the articles varied whether the fictional scientist was male or female, in case gendered expectations affected how people perceived humility and trustworthiness. The results from 369 participants indicated that gender didn’t affect the link between IH and trust. Similarly, in study 4, with 371 participants, the researchers varied the race/ethnicity of the scientist, finding again that the link between IH and trust remained.

“Together, these four studies offer compelling evidence that perceptions of scientists’ IH play an important role in both trust in scientists and willingness to follow their research-based recommendations,” the authors concluded.

Next steps

In the final study involving 679 participants, researchers examined different ways that scientists might express IH, including whether the IH was expressed as a personal trait, limitations of research methods, or as limitations of research results. Unexpectedly, the strategies to express IH by highlighting limitations in the methods and results of research both increased perceptions of IH, but shook trust in the research. Only personal IH successfully boosted perceptions of IH without backfiring, the authors report.

The finding suggests that more research is needed to guide scientists on how best to express high IH. But, it’s clear that low IH is not good. “[W]e encourage scientists to be particularly mindful of displaying low IH, such as by expressing overconfidence, being unwilling to course correct or disrespecting others’ views,” the researchers caution.

Overall, Schumann said she was encouraged by the team’s findings. “They suggest that the public understands that science isn’t about having all the answers; it’s about asking the right questions, admitting what we don’t yet understand, and learning as we go. Although we still have much to discover about how scientists can authentically convey intellectual humility, we now know people sense that a lack of intellectual humility undermines the very aspects of science that make it valuable and rigorous. This is a great place to build from.”

Trust in scientists hasn’t recovered from COVID. Some humility could help. Read More »

Are standing desks good for you? The answer is getting clearer.

cardiovascular health, health, Science, sitting, standing / DJ Henderson / November 14, 2024

Whatever your office setup, the most important thing is to move.

Without question, inactivity is bad for us. Prolonged sitting is consistently linked to higher risks of cardiovascular disease and death. The obvious response to this frightful fate is to not sit— move. Even a few moments of exercise can have benefits, studies suggest. But in our modern times, sitting is hard to avoid, especially at the office. This has led to a range of strategies to get ourselves up, including the rise of standing desks. If you have to be tethered to a desk, at least you can do it while on your feet, the thinking goes.

However, studies on whether standing desks are beneficial have been sparse and sometimes inconclusive. Further, prolonged standing can have its own risks, and data on work-related sitting has also been mixed. While the final verdict on standing desks is still unclear, two studies out this year offer some of the most nuanced evidence yet about the potential benefits and risks of working on your feet.

Take a seat

For years, studies have pointed to standing desks improving markers for cardiovascular and metabolic health, such as lipid levels, insulin resistance, and arterial flow-mediated dilation (the ability of arteries to widen in response to increased blood flow). But it’s unclear how significant those improvements are to averting bad health outcomes, such as heart attacks. One 2018 analysis suggested the benefits might be minor.

And there are fair reasons to be skeptical about standing desks. For one, standing—like sitting—is not moving. If a lack of movement and exercise is the root problem, standing still wouldn’t be a solution.

Yet, while sitting and standing can arguably be combined into the single category of ‘stationary,’ some researchers have argued that not all sitting is the same. In a 2018 position paper published in the Journal of Occupational and Environmental Medicine, two health experts argued that the link between poor health and sitting could come down to the specific populations being examined and “the special contribution” of “sitting time at home, for example, the ‘couch potato effect.'”

The two researchers—emeritus professors David Rempel, formerly at the University of California, San Francisco, and Niklas Krause, formerly of UC Los Angeles—pointed to several studies looking specifically at occupational sitting time and poor health outcomes, which have arrived at mixed results. For instance, a 2013 analysis did not find a link between sitting at work and cardiovascular disease. Though the study did suggest a link to mortality, the link was only among women. There was also a 2015 study on about 36,500 workers in Japan, who were followed for an average of 10 years. That study found that there was no link between mortality and sitting time among salaried workers, professionals, and people who worked at home businesses. However, there was a link between mortality and sitting among people who worked in farming, forestry, and fishing industries.

Still, despite some murkiness in the specifics, more recent studies continue to turn up a link between total prolonged sitting—wherever that sitting occurs—and poor health outcomes, particularly cardiovascular disease. This has kept up interest in standing desks in offices, where people don’t always have the luxury of frequent movement breaks. And this, in turn, has kept researchers on their toes to try to answer whether there is any benefit to standing desks.

One study published last month in the International Journal of Epidemiology offers a clearer picture of how standing desks may relate to cardiovascular health risks. The authors, an international team of researchers led by Matthew Ahmadi at the University of Sydney in Australia, found that standing desks don’t improve heart health—but they don’t harm it, either, whereas sitting desks do.

Mitigating risks

For the study, the researchers tracked the health data of a little over 83,000 people in the UK over an average of about seven years. During the study, participants wore a wrist-based accelerometer device for at least four days. The devices were calibrated to determine when they were sitting, standing, walking, or running during the waking hours. With that data, the researchers linked their sitting, standing, and stationary (combined sitting and standing) times to health outcomes in their medical records.

The researchers focused on two categories of health outcomes: cardiovascular, covering coronary heart disease, heart failure, and stroke; and orthostatic circulatory disease events, including orthostatic hypotension (blood pressure drops upon standing or sitting), varicose veins, chronic venous insufficiency (veins in your legs don’t move blood back up to your heart), and venous ulcers. The reasoning for this second category is that prolonged sitting and standing may pose risks for developing circulatory diseases.

The researchers found that when participants’ total stationary time (sitting and standing) went over 12 hours per day, risk of orthostatic circulatory disease increased 22 percent per additional hour, while risk of cardiovascular disease went up 13 percent per hour.

For just sitting, risks increased every hour after 10 hours: for orthostatic circulatory disease, risk went up 26 percent every hour after 10 hours, and cardiovascular disease risk went up 15 percent. For standing, risk of orthostatic circulatory disease went up after just two hours, increasing 11 percent every 30 minutes after two hours of standing. But standing had no impact on cardiovascular disease at any time point.

“Contrary to sitting time, more time spent standing was not associated with a higher CVD [cardiovascular disease] risk. Overall, there was no association for higher or lower CVD risk throughout the range of standing duration,” the authors report.

On the other hand, keeping sitting time under 10 hours and standing time under two hours was linked to a weak protective effect against orthostatic circulatory disease: A day of nine hours of sitting and 1.5 of standing (for a total of 11.5 hours of stationary time) lowered risk of orthostatic circulatory disease by a few percentage points, the study found.

In other words, as long as you can keep your total stationary time under 12 hours, you can use a little standing time help you keep your sitting time under 10 hours and avoid increasing both cardiovascular and orthostatic risks, according to the data.

Consistent finding

It’s a very detailed formula to reduce the health risks of long days at the office, but is it set in stone? Probably not. For one thing, it’s just one study that needs to be replicated in a different population. Also, the study didn’t look at any specifics of occupational versus leisure standing and sitting times, let alone the use of standing desks specifically. The study also based estimates of people’s sitting, standing, and total stationary time on as little as just four days of activity monitoring, which may or may not have been consistent over the nearly seven-year average follow-up period.

Still, the study’s takeaway generally fits with a study published in January in JAMA Network Open. This study looked at the link between occupational sitting time, leisure physical activity, and death rates—both deaths from all causes and those specifically caused by cardiovascular disease. Researchers used a group of over 480,000 workers in Taiwan, who were followed for an average of nearly 13 years.

The workers who reported mostly sitting at work had a 16 percent increased risk of all-cause mortality and a 34 percent higher risk of dying from cardiovascular disease compared with workers who did not sit at work. The workers who reported alternating between sitting and standing, meanwhile, did not have an increased risk of all-cause or cardiovascular disease mortality. The findings held after adjusting for health factors and looking at subgroups, including by sex, age, smokers, never-smokers, and people with chronic conditions.

That said, being highly active in leisure time appeared to offset the mortality risks among those who mostly sit at work. At the highest leisure-time activity levels reported, participants who mostly sit at work had comparable risks of all-cause mortality as those who alternated sitting and standing or were didn’t sit at work. Overall, the data suggested that keeping overall stationary time as low as possible and alternating sitting and standing to some extent at work can reduce risk.

The authors call for incorporating breaks in work settings and even specifically recommend allowing for standing and activity-permissive workstations.

The takeaway

While prolonged standing has its own risks, the use of standing desks at work can, to some extent, help lessen the risks of prolonged sitting. But, overall, it’s important to keep total stationary time as low as possible and exercise whenever possible.

Beth is Ars Technica’s Senior Health Reporter. Beth has a Ph.D. in microbiology from the University of North Carolina at Chapel Hill and attended the Science Communication program at the University of California, Santa Cruz. She specializes in covering infectious diseases, public health, and microbes.

Are standing desks good for you? The answer is getting clearer. Read More »

Teen in critical condition with Canada’s first human case of H5 bird flu

avian influenza, bird flu, Canada, dairy herds, health, Infectious disease, outbreak, Science / Kelly Newman / November 13, 2024

A British Columbia teen who contracted Canada’s first known human case of H5 bird flu has deteriorated swiftly in recent days and is now in critical condition, health officials reported Tuesday.

The teen’s case was announced Saturday by provincial health officials, who noted that the teen had no obvious exposure to animals that could explain an infection with the highly pathogenic avian influenza. The teen tested positive for H5 bird flu at BC’s public health laboratory, and the result is currently being confirmed by the National Microbiology Laboratory in Winnipeg.

The teen’s case reportedly began with conjunctivitis, echoing the H5N1 human case reports in the US. The case then progressed to fever and cough, and the teen was admitted to BC’s Children’s hospital late Friday. The teen’s condition varied throughout the weekend but had taken a turn for the worse by Tuesday, according to BC provincial health officer Bonnie Henry.

“This was a healthy teenager prior to this—so, no underlying conditions—and it just reminds us that in young people, this is a virus that can progress and cause quite severe illness,” Bonnie Henry said in a media briefing streamed by Global News on Tuesday.

Health officials in the province have opened an investigation to understand the source of the outbreak. Around three dozen contacts of the teen have been tested, and all have been negative. “The source of exposure is very likely to be an animal or bird and is being investigated by BC’s chief veterinarian and public health teams,” health officials noted in the announcement over the weekend. The teen was reportedly exposed to pets, including dogs, cats, and reptiles, but testing so far has been negative on them.

Teen in critical condition with Canada’s first human case of H5 bird flu Read More »

Research monkeys still having a ball days after busting out of lab, policy say

escape, health, monkeys, research, Science / DJ Henderson / November 8, 2024

If you need any inspiration for cutting loose and relaxing this weekend, look no further than a free-wheeling troop of monkeys that broke out of their South Carolina research facility Wednesday and, as of noon Friday, were still “playfully exploring” with their newfound freedom.

In an update Friday, the police department of Yemassee, SC said that the 43 young, female rhesus macaque monkeys are still staying around the perimeter of the Alpha Genesis Primate Research Facility. “The primates are exhibiting calm and playful behavior, which is a positive indication,” the department noted.

The fun-loving furballs got free after a caretaker “failed to secure doors” at the facility.

Alpha Genesis staff have been keeping an eye on the escapees, trying to entice them back in with food. But, instead of taking the bait, the primates have been playing on the perimeter fence while still keeping in touch with the monkeys inside by cooing to them.

“They’re just being goofy monkeys jumping back and forth playing with each other,” Alpha Genesis CEO Greg Westergaard told CBS News Thursday. “It’s kind of like a playground situation here.”

Yemassee police note that the monkeys are very young and small—only about 6 or 7 pounds each. They have not been used for any testing yet, don’t carry any disease, and pose no health risk to the public. Still, area residents have been advised to keep their doors and windows locked in case the wee primates try to pay a visit.

This isn’t the first time—or even the second time—Alpha Genesis has had trouble keeping its monkeys under control. In 2018, the US Department of Agriculture fined the company $12,600 for violations between 2014 and 2016 that included four monkey breakouts. In those incidents, a total of 30 monkeys escaped. One was never found.

Research monkeys still having a ball days after busting out of lab, policy say Read More »

After decades, FDA finally moves to pull ineffective decongestant off shelves

decongestant, fda, health, phenylephrine, Science, sudafed / Kelly Newman / November 7, 2024

In a long-sought move, the Food and Drug Administration on Thursday formally began the process of abandoning oral doses of a common over-the-counter decongestant, which the agency concluded last year is not effective at relieving stuffy noses.

Specifically, the FDA issued a proposed order to remove oral phenylephrine from the list of drugs that drugmakers can include in over-the-counter products—also known as the OTC monograph. Once removed, drug makers will no longer be able to include phenylephrine in products for the temporary relief nasal congestion.

“It is the FDA’s role to ensure that drugs are safe and effective,” Patrizia Cavazzoni, director of the FDA’s Center for Drug Evaluation and Research, said in a statement. “Based on our review of available data and consistent with the advice of the advisory committee, we are taking this next step in the process to propose removing oral phenylephrine because it is not effective as a nasal decongestant.”

For now, the order is just a proposal. The FDA will open up a public comment period, and if no comments can sway the FDA’s previous conclusion that the drug is useless, the agency will make the order final. Drugmakers will get a grace period to reformulate their products.

Reviewed reviews

The slow-moving abandonment of phenylephrine is years in the making. The decongestant was originally approved by the FDA back in 1976, but it came to prominence after 2006. That was the year when the “Combat Methamphetamine Epidemic Act of 2005” came into effect, and pseudoephedrine—the main component of Sudafed—moved behind the pharmacy counter to keep it from being used to make methamphetamine. With pseudoephedrine out of easy reach at drugstores, phenylephrine became the leading over-the-counter decongestant. And researchers had questions.

In 2007, an FDA panel reevaluated the drug, which allegedly works by shrinking blood vessels in the nasal passage, opening up the airway. While the panel upheld the drug’s approval, it concluded that more studies were needed for a full assessment. After that, three large, carefully designed studies were conducted—two by Merck for the treatment of seasonal allergies and one by Johnson & Johnson for the treatment of the common cold. All three found no significant difference between phenylephrine and a placebo.

After decades, FDA finally moves to pull ineffective decongestant off shelves Read More »

For fame or a death wish? Kids’ TikTok challenge injuries stump psychiatrists

health, Mental Health, psychiatry, Science, suicide, tiktok, tiktok challenge / Beth Washington / November 6, 2024

Case dilemma

The researchers give the example of a 10-year-old patient who was found unconscious in her bedroom. The psychiatry team was called in to consult for a suicide attempt by hanging. But when the girl was evaluated, she was tearful, denied past or recent suicide attempts, and said she was only participating in the blackout challenge. Still, she reported being in depressed moods, having feelings of hopelessness, having thoughts of suicide since age 9, being bullied, and having no friends. Family members reported unstable housing, busy or absent parental figures, and a family history of a suicide attempts.

If the girl’s injuries were unintentional, stemming from the poor choice to participate in the life-threatening TikTok challenge, clinicians would discharge the patient home with a recommendation for outpatient mental health care to address underlying psychiatric conditions and stressors. But if the injuries were self-inflicted with an intent to die, the clinicians would recommend inpatient psychiatric treatment for safety, which would allow for further risk assessment, monitoring, and treatment for the suspected suicide attempt.

It’s critical to make the right call here. Children and teens who attempt suicide are at risk of more attempts, both immediately and in the future. But to make matters even more complex, injuries from social media challenges have the potential to spur depression and post-traumatic stress disorder. Those, in turn, could increase the risk of suicide attempts.

To keep kids and teens safe, the Ataga and Arnold call for more awareness about the dangers of TikTok challenges, as well as empathetic psychiatric assessments using kid-appropriate measurements. They also call for more research. While there are a handful of case studies on TikTok challenge injuries and deaths among kids and teens, there’s a lack of large-scale data. More research is needed to “demonstrate the role of such challenges as precipitating factors in unintentional and intentional injuries, suicidal behaviors, and deaths among children in the US,” the psychiatrists write.

If you or someone you know is in crisis, call or text 988 for the Suicide and Crisis Lifeline or contact the Crisis Text Line by texting TALK to 741741.

For fame or a death wish? Kids’ TikTok challenge injuries stump psychiatrists Read More »

“Havard”-trained spa owner injected clients with bogus Botox, prosecutors say

botox, counterfeit, fda, fraud, health, Science, skin fillers, spa / Shannon Garcia / November 5, 2024

Mounting evidence

Multiple clients and employees told investigators that Fadanelli also said she is a registered nurse, which is false. Though she is a registered aesthetician, aestheticians are not permitted to administer injections or prescription drugs.

Investigators set up an undercover operation where an agent went in for a consultation, and Fadanelli provided a quote for a $450 Botox treatment. Investigators also obtained videos and images of Fadanelli performing injections. And the evidence points to those injections being counterfeit, prosecutors allege. Sales records from the spa indicate that Fadanelli performed 1,631 “Botox” injections, 95 “Sculptra” injections, and 990 injections of unspecified “filler,” all totaling over $933,000. But sales records from the manufacturers of the brand name drugs failed to turn up any record of Fadanelli or anyone else from her spa ever purchasing legitimate versions of the drugs.

Despite the mounting evidence against her, Fadanelli reportedly stuck to her story, denying that she ever told anyone she was a nurse and denying ever administering any injections. “When agents asked Fadanelli if she would like to retract or modify that claim if she knew there was evidence showing that she was in fact administering such products, she reiterated that she does not administer injections.”

Ars has reached to Fadanelli’s spa for comment and will update this story if we get a response. According to the affidavit, clients who received the allegedly bogus injections complained of bumps, tingling, and poor appearances, but no infections or other adverse health outcomes.

In a press release announcing her arrest, Acting United States Attorney for Massachusetts Joshua Levy said: “For years, Ms. Fadanelli allegedly put unsuspecting patients at risk by representing herself to be a nurse and then administering thousands of illegal, counterfeit injections. … The type of deception alleged here is illegal, reckless, and potentially life-threatening.”

For a charge of illegal importation, Fadanelli faces up to 20 years in prison and a $250,000 fine. For each of two charges of knowingly selling or dispensing a counterfeit drug or counterfeit device, she faces up to 10 years in prison and a fine of $250,000.

“Havard”-trained spa owner injected clients with bogus Botox, prosecutors say Read More »

Drugmaker shut down after black schmutz found in injectable weight-loss drug

compounding pharmacies, eli lilly, fda, health, mounjaro, Novo Nordisk, Ozempic, safety, Science, wegovy, weight loss drugs, zepbound / Mike M. / November 4, 2024

It’s unclear how widely the pharmacy’s drugs were distributed. Fullerton Wellness could not be reached for comment.

Bigger battles

This is just the latest warning on weight-loss drugs from the FDA, which has repeatedly cautioned about quality and safety problems related to compounded versions of the drugs. The compounded drugs are intended to be essentially copycat versions of the blockbuster brand-name drugs. Compounding pharmacies can make copycat versions only as long as the drugs are in short supply, acting as a stopgap for patient access. But, with the popularity of the drugs and the high prices of the brand name versions, compounded formulations have become seen as affordable alternatives for many patients.

The situation has become a legal quagmire, with less-than-scrupulous compounding facilities drawing the ire of the FDA, and the big pharmaceutical companies fighting with their compounding competition. Eli Lilly, maker of Zepbound and Mounjaro (tirzepatide), and Novo Nordisk, maker of Wegovy and Ozempic (semaglutide), have both sued multiple compounding pharmacies over copycat versions of their lucrative drugs, which they claim are unsafe and fraudulent.

Meanwhile, in October, a trade organization for large-scale compounding pharmacies sued the FDA after the regulator removed tirzepatide from the drug shortage list, a move that blocks compounders from making copycat versions of the drug. But, the FDA quickly backpedaled in court, saying it would reconsider the removal and would allow compounders to keep producing off-brand versions in the meantime.

Also in October, Novo Nordisk asked the FDA to stop letting compounders make copycat versions of semaglutide, arguing that the drug is too complex for compounders to make and poses too many safety risks to patients. In response, the trade organization for compounders, the Outsourcing Facilities Association, submitted a letter to the FDA asking it to require Novo Nordisk to provide an economic impact statement to assess the cost and price increases that could occur if semaglutide were no longer available through compounding pharmacies.

Drugmaker shut down after black schmutz found in injectable weight-loss drug Read More »

Here are 3 science-backed strategies to rein in election anxiety

2024 election, anxieities, anxiety, health, Mental Health, Security, syndication / 9u50fv / November 3, 2024

In this scenario, I encourage my patients to move past that initial thought of how awful it will be and instead consider exactly how they will respond to the inauguration, the next day, week, month, and so on.

Cognitive flexibility allows you to explore how you will cope, even in the face of a negative outcome, helping you feel a bit less out of control. If you’re experiencing a lot of anxiety about the election, try thinking through what you’d do if the undesirable candidate takes office—thoughts like “I’ll donate to causes that are important to me” and “I’ll attend protests.”

Choose your actions with intention

Another tool for managing your anxiety is to consider whether your behaviors are affecting how you feel.

Remember, for instance, the goal of 24-hour news networks is to increase ratings. It’s in their interest to keep you riveted to your screens by making it seem like important announcements are imminent. As a result, it may feel difficult to disconnect and take part in your usual self-care behavior.

Try telling yourself, “If something happens, someone will text me,” and go for a walk or, better yet, to bed. Keeping up with healthy habits can help reduce your vulnerability to uncontrolled anxiety.

Post-Election Day, you may continue to feel drawn to the news and motivated to show up—whether that means donating, volunteering, or protesting—for a variety of causes you think will be affected by the election results. Many people describe feeling guilty if they say no or disengage, leading them to overcommit and wind up overwhelmed.

If this sounds like you, try reminding yourself that taking a break from politics to cook, engage with your family or friends, get some work done, or go to the gym does not mean you don’t care. In fact, keeping up with the activities that fuel you will give you the energy to contribute to important causes more meaningfully.

Shannon Sauer-Zavala, Associate Professor of Psychology & Licensed Clinical Psychologist, University of Kentucky. This article is republished from The Conversation under a Creative Commons license. Read the original article.

Here are 3 science-backed strategies to rein in election anxiety Read More »

As hospitals struggle with IV fluid shortage, NC plant restarts production

baxter, drugs, Fluid, health, hospitals, hurricane helene, iV, North Carolina, Science, shortage / Mike M. / November 1, 2024

The western North Carolina plant that makes 60 percent of the country’s intravenous fluid supply has restarted its highest-producing manufacturing line after being ravaged by flooding brought by Hurricane Helene last month.

While it’s an encouraging sign of recovery as hospitals nationwide struggle with shortages of fluids, supply is still likely to remain tight for the coming weeks.

IV fluid maker Baxter Inc, which runs the Marion plant inundated by Helene, said Thursday that the restarted production line could produce, at peak, 25 percent of the plant’s total production and about 50 percent of the plant’s production of one-liter IV solutions, the product most commonly used by hospitals and clinics.

“Recovery progress at our North Cove site continues to be very encouraging,” Baxter CEO and President José Almeida said. “In a matter of weeks, our team has advanced from the depths of Hurricane Helene’s impact to restarting our highest-throughput manufacturing line. This is a pivotal milestone, but more hard work remains as we work to return the plant to full production.”

Overall, Baxter said it is ahead of its previously projected timeline for getting the massive plant back up and running. Previously, the company said it had aimed to produce 90–100 percent of some products by the end of the year. Still, the initial batches now under production are expected to start shipping in late November at the earliest.

One of the many challenges to restoring the facility was the lack of access to the site; Helene had damaged an access bridge. In its latest announcement, Baxter said that a temporary bridge—built with support from North Carolina’s Department of Transportation and the federal Administration of Strategic Preparedness and Response (ASPR)—has allowed the transport of more than 885 truckloads of existing inventory out of the plant since Helene. A second temporary bridge, expected to be completed in early November, will enable further access of traffic and equipment to the site.

As hospitals struggle with IV fluid shortage, NC plant restarts production Read More »

A new dental scam is to pull healthy teeth to sell you expensive fake ones

dentistry, health, healthcare, implants, syndication / Beth Washington / November 1, 2024

It turns out you may not have needed those implants after all.

Becky Carroll was missing a few teeth, others were stained or crooked. Ashamed, she smiled with lips pressed closed. Her dentist offered to fix most of her teeth with root canals and crowns, Carroll said, but she was wary of traveling a long road of dental work.

Then Carroll saw a TV commercial for another path: ClearChoice Dental Implant Centers. The company advertises that it can give patients “a new smile in as little as one day” by surgically replacing teeth instead of fixing them.

So Carroll saved and borrowed for the surgery, she said. In an interview and a lawsuit, Carroll said that at a ClearChoice clinic in New Jersey in 2021, she agreed to pay $31,000 to replace all her natural upper teeth with pearly white prosthetic ones. What came next, Carroll said, was “like a horror movie.”

Carroll alleged that her anesthesia wore off during implant surgery, so she became conscious as her teeth were removed and titanium screws were twisted into her jawbone. Afterward, Carroll’s prosthetic teeth were so misaligned that she was largely unable to chew for more than two years until she could afford corrective surgery at another clinic, according to a sworn deposition from her lawsuit.

ClearChoice has denied Carroll’s claims of malpractice and negligence in court filings and did not respond to requests for comment on the ongoing case.

“I thought implants would be easier, and all at once, so you didn’t have to keep going back to the dentist,” Carroll, 52, said in an interview. “But I should have asked more questions … like, Can they save these teeth?”

Dental implants have been used for more than half a century to surgically replace missing or damaged teeth with artificial duplicates, often with picture-perfect results. While implant dentistry was once the domain of a small group of highly trained dentists and specialists, tens of thousands of dental providers now offer the surgery and place millions of implants each year in the US.

Amid this booming industry, some implant experts worry that many dentists are losing sight of dentistry’s fundamental goal of preserving natural teeth and have become too willing to remove teeth to make room for expensive implants, according to a months-long investigation by KFF Health News and CBS News. In interviews, 10 experts said they had each given second opinions to multiple patients who had been recommended for mouths full of implants that the experts ultimately determined were not necessary. Separately, lawsuits filed across the country have alleged that implant patients like Carroll have experienced painful complications that have required corrective surgery, while other lawsuits alleged dentists at some implant clinics have persuaded, pressured, or forced patients to remove teeth unnecessarily.

The experts warn that implants, for a single tooth or an entire mouth, expose patients to costs and surgery complications, plus a new risk of future dental problems with fewer treatment options because their natural teeth are forever gone.

“There are many cases where teeth, they’re perfectly fine, and they’re being removed unnecessarily,” said William Giannobile, dean of the Harvard School of Dental Medicine. “I really hate to say it, but many of them are doing it because these procedures, from a monetary standpoint, they’re much more beneficial to the practitioner.”

Giannobile and nine other experts say they are combating a false public perception that implants are more durable and longer-lasting than natural teeth, which some believe stems in part from advertising on TV and social media. Implants require upkeep, and although they can’t get cavities, studies have shown that patients can be susceptible to infections in the gums and bone around their implants.

“Just because somebody can afford implants doesn’t necessarily mean that they’re a good candidate,” said George Mandelaris, a Chicago-area periodontist and member of the American Academy of Periodontology Board of Trustees. “When an implant has infection, or when an implant has bone loss, an implant dies a much quicker death than do teeth.”

In its simplest form, implant surgery involves extracting a single tooth and replacing it with a metal post that is screwed into the jaw and then affixed with a prosthetic tooth commonly made of porcelain, also known as a crown. Patients can also use “full-arch” or “All-on-4” implants to replace all their upper or lower teeth—or all their teeth.

For this story, KFF Health News and CBS News sought interviews with large dental chains whose clinics offer implant surgery—ClearChoice, Aspen Dental, Affordable Care, and Dental Care Alliance—each of which declined to be interviewed or did not respond to multiple requests for comment. The Association of Dental Support Organizations, which represents these companies and others like them, also declined an interview request.

ClearChoice, which specializes in full-arch implants, did not answer more than two dozen questions submitted in writing. In an emailed statement, the company said full-arch implants “have become a well-accepted standard of care for patients with severe tooth loss and teeth with poor prognosis.”

“The use of full-arch restorations reflects the evolution of modern dentistry, offering patients a solution that restores their ability to eat, speak, and live comfortably—far beyond what traditional dentures can provide,” the company said.

Carroll said she regrets not letting her dentist try to fix her teeth and rushing to ClearChoice for implants.

“Because it was a nightmare,” she said.

“They are not teeth”

Dental implant surgery can be a godsend for patients with unsalvageable teeth. Several experts said implants can be so transformative that their invention should have contended for a Nobel Prize. And yet, these experts still worry that implants are overused, because it is generally better for patients to have their natural teeth.

Paul Rosen, a Pennsylvania periodontist who said he has worked with implants for more than three decades, said many patients believe a “fallacy” that implants are “bulletproof.”

“You can’t just have an implant placed and go off riding into the sunset,” Rosen said. “In many instances, they need more care than teeth because they are not teeth.”

Generally, a single implant costs a few thousand dollars while full-arch implants cost tens of thousands. Neither procedure is well covered by dental insurance, so many clinics partner with credit companies that offer loans for implant surgeries. At ClearChoice, for example, loans can be as large as $65,000 paid off over 10 years, according to the company’s website.

Despite the price, implants are more popular than ever. Sales increased by more than 6 percent on average each year since 2010, culminating in more than 3.7 million implants sold in the US in 2022, according to a 2023 report produced by iData Research, a health care market research firm.

Some worry implant dentistry has gone too far. In 10 interviews, dentists and dental specialists with expertise in implants said they had witnessed the overuse of implants firsthand. Each expert said they’d examined multiple patients in recent years who were recommended for full-arch implants by other dentists despite their teeth being treatable with conventional dentistry.

Giannobile, the Harvard dean, said he had given second opinions to “dozens” of patients who were recommended for implants they did not need.

“I see many of these patients now that are coming in and saying, ‘I’ve been seen, and they are telling me to get my entire dentition—all of my teeth—extracted.’ And then I’ll take a look at them and say that we can preserve most of your teeth,” Giannobile said.

Tim Kosinski, who is a representative of the Academy of General Dentistry and said he has placed more than 19,000 implants, said he examines as many as five patients a month who have been recommended for full-arch implants that he deems unnecessary.

“There is a push in the profession to remove teeth that could be saved,” Kosinski said. “But the public isn’t aware.”

Luiz Gonzaga, a periodontist and prosthodontist at the University of Florida, said he, too, had turned away patients who wanted most or all their teeth extracted. Gonzaga said some had received implant recommendations that he considered “an atrocity.”

“You don’t go to the hospital and tell them ‘I broke my finger a couple of times. This is bothering me. Can you please cut my finger off?’ No one will do that,” Gonzaga said. “Why would I extract your tooth because you need a root canal?”

Jaime Lozada, director of an elite dental implant residency program at Loma Linda University, said he’d not only witnessed an increase in dentists extracting “perfectly healthy teeth” but also treated a rash of patients with mouths full of ill-fitting implants that had to be surgically replaced.

Lozada said in August that he’d treated seven such patients in just three months.

“When individuals just make a decision of extracting teeth to make it simple and make money quick, so to speak, that’s where I have a problem,” Lozada said. “And it happens quite often.”

When full-arch implants fail, patients sometimes don’t have enough jawbone left to anchor another set. These patients have little choice but to get implants that reach into cheekbones, said Sohail Saghezchi, an oral and maxillofacial surgeon at the University of California-San Francisco.

“It’s kind of like a last resort,” Saghezchi said. “If those fail, you don’t have anywhere else to go.”

“It was horrendous dentistry”

Most of the experts interviewed for this article said their rising alarm corresponded with big changes in the availability of dental implants. Implants are now offered by more than 70,000 dental providers nationwide, two-thirds of whom are general dentists, according to the iData Research report.

Dentists are not required to learn how to place implants in dental school, nor are they required to complete implant training before performing the surgery in nearly all states. This year, Oregon started requiring dentists to complete 56 hours of hands-on training before placing any implants. Stephen Prisby, executive director of the Oregon Board of Dentistry, said the requirement—the first and only of its kind in the US—was a response to dozens of investigations in the state into botched surgeries and other implant failures, split evenly between general dentists and specialists.

“I was frankly stunned at how bad some of these dentists were practicing,” Prisby said. “It was horrendous dentistry.”

Many dental clinics that offer implants have consolidated into chains owned by private equity firms that have bought out much of implant dentistry. In health care, private equity investment is sometimes criticized for overtreatment and prioritizing short-term profit over patients.

Private equity firms have spent about $5 billion in recent years to buy large dental chains that offer implants at hundreds of clinics owned by individual dentists and dental specialists. ClearChoice was bought for an estimated $1.1 billion in 2020 by Aspen Dental, which is owned by three private equity firms, according to PitchBook, a research firm focused on the private equity industry. Private equity firms also bought Affordable Care, whose largest clinic brand is Affordable Dentures & Implants, for an estimated $2.7 billion in 2021, according to PitchBook. And the private equity wing of the Abu Dhabi government bought Dental Care Alliance, which offers implants at many of its affiliated clinics, for an estimated $1 billion in 2022, according to PitchBook.

ClearChoice and Aspen Dental each said in email statements that the companies’ private equity owners “do not have influence or control over treatment recommendations.” Both companies said dentists or dental specialists make all clinical decisions.

Private equity deals involving dental practices increased ninefold from 2011 to 2021, according to an American Dental Association study published in August. The study also said investors showed an interest in oral surgery, possibly because of the “high prices” of implants.

“Some argue this is a negative thing,” said Marko Vujicic, vice president of the association’s Health Policy Institute, who co-authored the study. “On the other hand, some would argue that involvement of private equity and outside capital brings economies of scale, it brings efficiency.”

Edwin Zinman, a San Francisco dental malpractice attorney and former periodontist who has filed hundreds of dental lawsuits over four decades, said he believed many of the worst fears about private equity owners had already come true in implant dentistry.

“They’ve sold a lot of [implants], and some of it unnecessarily, and too often done negligently, without having the dentists who are doing it have the necessary training and experience,” Zinman said. “It’s for five simple letters: M-O-N-E-Y.”

Hundreds of implant clinics with no specialists

For this article, journalists from KFF Health News and CBS News analyzed the webpages for more than 1,000 clinics in the nation’s largest private equity-owned dental chains, all of which offer some implants. The analysis found that more than 70 percent of those clinics listed only general dentists on their websites and did not appear to employ the specialists—oral surgeons, periodontists, or prosthodontists—who traditionally have more training with implants.

Affordable Dentures & Implants listed specialists at fewer than 5 percent of its more than 400 clinics, according to the analysis. The rest were staffed by general dentists, most of whom did not list credentialing from implant training organizations, according to the analysis.

ClearChoice, on the other hand, employs at least one oral surgeon or prosthodontist at each of its more than 100 centers, according to the analysis. But its new parent company, Aspen Dental, which offers implants in many of its more than 1,100 clinics, does not list any specialists at many of those locations.

Not everyone is worried about private equity in implant dentistry. In interviews arranged by the American Academy of Implant Dentistry, which trains dentists to use implants, two other implant experts did not express concerns about private equity firms.

Brian Jackson, a former academy president and implant specialist in New York, said he believed dentists are too ethical and patients are too smart to be pressured by private equity owners “who will never see a patient.”

Jumoke Adedoyin, a chief clinical officer for Affordable Care, who has placed implants at an Affordable Dentures & Implants clinic in the Atlanta suburbs for 15 years, said she had never felt pressure from above to sell implants.

“I’ve actually felt more pressure sometimes from patients who have gone around and been told they need to take their teeth out,” she said. “They come in and, honestly, taking a look at them, maybe they don’t need to take all their teeth out.”

Still, lawsuits filed across the country have alleged that dentists at implant clinics have extracted patients’ teeth unnecessarily.

For example, in Texas, a patient alleged in a 2020 lawsuit that an Affordable Care dentist removed “every single tooth from her mouth when such was not necessary,” then stuffed her mouth with gauze and left her waiting in the lobby as he and his staff left for lunch. In Maryland, a patient alleged in a 2021 lawsuit that ClearChoice “convinced” her to extract “eight healthy upper teeth,” by “greatly downplay[ing] the risks.” In Florida, a patient alleged in a 2023 lawsuit that ClearChoice provided her with no other treatment options before extracting all her teeth, “which was totally unnecessary.”

ClearChoice and Affordable Care denied wrongdoing in their respective lawsuits, then privately settled out of court with each patient. ClearChoice and Affordable Care did not respond to requests for comment submitted to the companies or attorneys. Lawyers for all three plaintiffs declined to comment on these lawsuits or did not respond to requests for comment.

Fred Goldberg, a Maryland dental malpractice attorney who said he has represented at least six clients who sued ClearChoice, said each of his clients agreed to get implants after meeting with a salesperson—not a dentist.

“Every client I’ve had who has gone to ClearChoice has started off meeting a salesperson and actually signing up to get their financing through ClearChoice before they ever meet with a dentist,” Goldberg said. “You meet with a salesperson who sells you on what they like to present as the best choice, which is almost always that they’re going to take out all your natural teeth.”

Becky Carroll, the ClearChoice patient from New Jersey, told a similar story.

Carroll said in her lawsuit that she met first with a ClearChoice salesperson referred to as a “patient education consultant.” In an interview, Carroll said the salesperson encouraged her to borrow money from family members for the surgery and it was not until after she agreed to a loan and passed a credit check that a ClearChoice dentist peered into her mouth.

“It seems way backwards,” Carroll said. “They just want to know you’re approved before you get to talk to a dentist.”

CBS News producer Nicole Keller contributed to this report.

This story originally appeared on KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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Idaho health district abandons COVID shots amid flood of anti-vaccine nonsense

COVID-19, health, idaho, misinformation, Science, Uncategorized, vaccines / Shannon Garcia / October 31, 2024

Slippery slope

In the hearing, board member Jennifer Riebe (who voted to keep COVID-19 vaccinations available) worried about the potential of a slippery slope.

“My concern with this is the process because if this board and six county commissioners and one physician is going to make determinations on every single vaccine and pharmaceutical that we administer, I’m not comfortable with that,” she said, according to Boise State Public Radio. “It may be COVID now, maybe we’ll go down the same road with the measles vaccine or the shingles vaccine coverage.”

Board Chair Kelly Aberasturi, who also voted to keep the vaccines, argued that it should be a choice by individuals and their doctors, who sometimes refer their patients to the district for COVID shots. “So now, you’re telling me that I have the right to override that doctor? Because I know more than he does?” Aberasturi said.

“It has to do with the right of the individual to make that decision on their own. Not for me to dictate to them what they will do. Sorry, but this pisses me off,” he added.

According to Boise State Public Radio, the district had already received 50 COVID-19 vaccines at the time of the vote, which were slated to go to residents of a skilled nursing facility.

The situation in the southwest district may not be surprising given the state’s overall standing on vaccination: Idaho has the lowest kindergarten vaccination rates in the country, with coverage of key vaccinations sitting at around 79 percent to 80 percent, according to a recent analysis by the Centers for Disease Control and Prevention. The coverage is far lower than the 95 percent target set by health experts. That’s the level that would block vaccine-preventable diseases from readily spreading through a population. The target is out of reach for Idaho as a whole, which also has the highest vaccination exemption rate in the country, at 14.3 percent. Even if the state managed to vaccinate all non-exempt children, the coverage rate would only reach 85.7 percent, missing the 95 percent target by nearly 10 percentage points.

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