Unlike Scandinavia, Israel's national health insurance system does not include dental care. Instead, it is paid for by individuals, and those who can't afford it (or the costly copayments charged by their health funds for dental care) go without. This was decided by the Treasury, which worried about the potentially high costs of dental treatments, when the National Health Insurance Bill of 1994 was prepared. However, there is growing evidence that what is going on in one's mouth can trigger or worsen systemic disease, and studies have linked gum disease to premature births, heart disease and diabetes. Now it has been shown that rheumatic disease, including arthritis, is linked to periodontal disease. People who suffer from any form of arthritis should take care of their gums, as there is a close biochemical association between microbes in inflamed gums, the toxins they create and the joints. Researchers at Case Western Reserve University School of Dental Medicine and University Hospital of Cleveland have found that treating pediodontal disease reduces arthritic pain, the number of swollen joints and the degree of morning stiffness. Their study appeared in the Journal of Periodontology. "It was exciting to find that if we eliminated infection and inflammation in the gums, then patients with a severe kind of active rheumatoid arthritis reported improvement on the signs and symptoms of that disease," said Dr. Nabil Bissada, head of the school's periodontics department, who worked with Dr. Ali Askari, chairman of the department of rheumatology at the hospital. "It gives us a new intervention." The study results should prompt rheumatologists to encourage their patients to be aware of the link between periodontal disease and rheumatoid arthritis, said Askari. Both inflammatory diseases share similarities in the progression of the disease over time - the soft and hard tissues are destroyed from inflammation caused by toxins from bacterial infection. One toxin from the inflamed areas, called tumor necrosis factor-alpha, is a marker present in the blood when inflammation is present in the body and can initiate new infections or aggravate sites where inflammation already exists. "I'm optimistic that someday, the biologic agents that we use in treatment of rheumatoid arthritis will lead to improvement of periodontitis," says Askari. "Again we are seeing another link where good oral health improves the overall health of an individual," said Bissada. COMMUNICATIONS DESPITE MRI NOISE Rooms with magnetic resonance instrument (MRI) scanners are noisy places due to loud whistling and thumping by the magnetic and electronic equipment. An Israeli company, Optoacoustics, has developed an optimal communications system that cancels noise in the MRI room, making it possible for doctors, nurses, technicians and patients to converse normally and minimizing the chance of medical errors. The Tel Aviv company, whose CEO is Dr. Yuvi Kahana, has sold its IMROC (interventional MR optical communications) system at the the University of Texas M. D. Anderson Cancer Center, one of the world's leading oncology centers. The IMROC system, claimed to be unique, uses optical headphones and optical microphones that support up to eight concurrent dialogues, eliminating MRI noise and providing previously unheard voice quality. The system has a highly directional fiber-optic microphone integrated with patented, fiber-optic headphones, an optics-based switching unit worn by staffers in the scanning room and a six-channel mixing console. Dr. Kamran Ahrar, the lead interventional radiologist at the Texas hospital, said that since the IMROC technology was installed, MRI rooms have become much more efficient as staffers are able to understand each other. For its various interventions, the MRI room staff use up to five IMROC headsets to communicate. The new system is now being installed at three additional leading MRI facilities in the US. One hopes the money will be found so that Israeli hospitals can purchase it too.