Home' Trinidad and Tobago Guardian : December 11th 2015 Contents A28
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Guardian www.guardian.co.tt Friday, December 11, 2015
Women who used contraceptive implants or injec-
tions after an initial termination were among those
with an increased likelihood of a repeat abortion
in the long term, finds a study published online in
the Journal of Family Planning and Reproductive
Health Care. The large UK study found that women
who used either implants or the contraceptive injec-
tion Depo-Provera were more likely to have another
abortion two to five years after the first termination
compared to those who used other methods.
Long-acting reversible contraception (Larc) such
as implants and Depo-Provera are often promoted
as the contraceptive method of choice for women
undergoing abortion. While LARC methods are "effec-
tive", explain the authors, "discontinuation rates are
high, and therefore make terminations more likely."
Reasons for discontinuation of implants and
injectable contraceptive methods include side effects
such as irregular bleeding, and the need for periodic
The authors do not advise against the use of con-
traceptive implants and injections. Instead, they call
for careful contraceptive counselling that takes into
consideration women s views, and for continued fol-
low-up, particularly after the initial two-year period.
Around one third of women have more than one
termination in the UK. Abortion in the UK is safe
overall, but can be distressing, and is ethically complex,
and occasionally leads to complications such as
preterm labour in subsequent pregnancies.
In the study, of the 13,621 women who had an
initial termination, 23.4 per cent went on to have a
repeat abortion. Results showed that women aged
below 20 years at the initial termination had an esti-
mated 5.59 times higher chance of having a repeat
termination. Women with two previous live births
at the time of their initial termination had an estimated
1.51 higher likelihood of having a repeat termination
compared to women with a single termination.
Women with more than one termination were
more likely to have had an implant as their post-
termination contraceptive method.
linked with repeat abortions
And women who were fitted with
an implant after their initial termination
had an estimated 1.78 times higher
chance of a repeat termination com-
pared to those with no method, or
unknown or natural methods of con-
traception two years after the initial
This is an observational study, so no
firm conclusions about cause and effect
can be drawn. Nevertheless, the authors
suggest "a targeted call/recall system
of follow up in the community may be
effective in reducing discontinuation
rates." Furthermore, they recommend
that "downloadable mobile phone
applications may play an important
role in the future in reminding women
that their contraceptive implant is due
for renewal." (BMJ)
YOUR DAILY HEALTH
News and Advice
Examples of contraceptive implants. Implanon is a
thin, matchstick-sized plastic rod that goes under
the skin of your upper arm, it contains etonogestrel,
a progestin hormone. Mirena is a plastic IUC that
releases a small amount of the synthetic hormone
progestin to prevent sperm from reaching the cervix.
ParaGard is an IUC made of copper, it has no
hormones. PHOTO: PLANNEDPARENTHOOD.ORG
"There is no health benefit to polishing," said
Julie Frantsve-Hawley, the editor of The Interna-
tional Journal of Evidence-Based Practice for the
Dental Hygienist. "It s not going to impact tooth
decay, gum disease or oral cancer."
In its latest position paper, the American Dental
Hygienists Association advises that polishing should
not be considered a routine part of a dental cleaning.
So feel free to skip it.
Polishing with a gritty paste can remove stains on
a tooth s surface. But to get rid of stains, hygienists
should also be scaling, said Marcia Lorentzen, the
dean of the Fones School of Dental Hygiene at the
University of Bridgeport in Connecticut. It used to
be standard for all teeth to be polished until research
showed that doing so removed enamel.
Then in the 1970s, an influential textbook, Clinical
Practice of the Dental Hygienist, by Dr Esther Wilkins,
recommended "selective polishing"---meaning the
hygienist should only shine stained parts of the teeth
and not the whole set.
As to whether enamel will be worn down, Dr
Frantsve-Hawley, a registered dental hygienist, said
twice-a-year polishing at the dentist s office, even
with the coarsest paste, is "not frequent enough to
cause significant damage to the enamel." (NYT)
No health benefit
to polishing teeth?
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