Wednesday, August 31, 2011

Detection of odoriferous subgingival and tongue microbiota in diabetic and nondiabetic patients

 Kamaraj DR, Bhushan KS, Laxman VK, Mathew J. Detection of odoriferous subgingival and tongue microbiota in diabetic and nondiabetic patients with oral malodor using polymerase chain reaction. Indian J Dent Res 2011;22:260-5







Background: Halitosis has been correlated with the concentration of volatile sulfur compounds (VSCs) produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal pockets and the dorsum of the tongue. It has been assumed that there is a relationship between periodontal disease and diabetes mellitus.
Objectives: The aim of the study was to assess the malodor using the organoleptic method and tanita device; to quantify odoriferous microorganisms of subgingival plaque and tongue coating, such as P. gingivalis (Pg), T. forsythia (Tf), and F. nucleatum (Fn) using polymerase chain reaction (PCR) in nondiabetic and diabetic chronic periodontitis patients.
Patients and Methods: Thirty chronic periodontitis patients (with and without diabetes) with 5-7 mm pocket depth, radiographic evidence of bone loss, and presence of oral malodor participated in this study. Subjective assessment of mouth air was done organoleptically and by using a portable sulfide monitor. Tongue coating was also assessed.
Results: The scores of plaque index, gingival index, gingival bleeding index, VSC levels, and tongue coating between the nondiabetic and diabetic patients were not significant (P>0.5). In nondiabetic patients, Fn was found to be significantly (P<0.5) more in tongue samples, whereas Pg and Tf have not shown significant values (P>0.5). In diabetic patients, Fn and Tf have shown significant (P<0.5) an increase in subgingival and tongue samples, respectively, whereas Pg has not shown significant difference between subgingival and tongue samples.
Interpretation and Conclusion: The results confirm that there is no difference in clinical parameters between nondiabetic and diabetic periodontitis patients, but the odoriferous microbial profiles in tongue samples of diabetic patients were found to be high. However, there is a weak positive correlation between VSC levels, clinical parameters, and odoriferous microbial profiles.

Tuesday, August 30, 2011

Facebook squabble over dental care draws a crowd

A Facebook page created to attack the care given by a well-known local dentist has gone viral, attracting nearly 100 members since being created Monday night.
Bakersfield parent Chris Cook created the "I Hate Dr. Dove of Bakersfield" page. He is angry about the treatment given to his five-year-old son by Dr. Edward Dove.
Some of the people on the Facebook page have added their own complaints.

Read the rest...

Monday, August 29, 2011

Future Products In Dentistry

I have recently returned from two trips where I was lucky enough to add my input on future products for dentists.

Kerr is developing many new materials and products that ultimately will make practicing dentistry easier. Kerr has already launched Sonicfill which is a new way to place composite in bulk. This makes placing restorations much easier.
 See the video below:


So look for more exciting things from Kerr in the future.

The other trip was to see what Dentrix has in store for the upcoming G5 release. As I reported a year ago look for a new SQL database structure. This will make the software much more flexible and secure. There are many new additions coming to the Dentrix e-Services that will be a must for dental offices.  One item that is available now and many Dentrix offices may not be taking advantage of is the Profitability Coaching.  For under $1000 this maybe one of the best values in dentistry to see what your office is doing and how to do it better.

I love looking into the future.





Saturday, August 27, 2011

Saliva promotes survival and even proliferation of Candida spp. in tap-water

FEMS Microbiology Letters
DOI: 10.1111/j.1574-6968.2011.02379.x

Abstract

Candida yeasts colonize humans’ oral cavities as commensals or opportunistic pathogens. They may be isolated from water circulating in dental unit waterlines mixed with saliva traces mainly because of dysfunction of anti-retraction valves. This study deals with the growth ability of C. albicans, C. glabrata and C. parapsilosis in tap-water with saliva (0% to 20% v/v). Results show that C. glabrata is the most susceptible species in tap-water. Furthermore, saliva promotes both survival and proliferation of the three studied Candida species in tap-water.

Friday, August 26, 2011

Danaher Corporation Leads the Global Dental Radiology Equipment Market with 24% Share

The global dental radiology equipment market was estimated at $2.1 billion in 2010


LONDON, Aug 24, 2011 (BUSINESS WIRE) -- --The US is the largest dental radiology equipment market, accounting for 39% of the global market
--Leading companies include Danaher Corporation, Plenmeca, Sirona and Carestream Health / Kodak Health Group
The global dental radiology equipment market was estimated at $2.1 billion in 2010, according to a new report available on companiesandmarkets.com. The dental radiology equipment market is forecast to grow at a CAGR of 5% to reach $3 billion by 2017.
Dental Radiology Equipment - Global Pipeline Analysis, Competitive Landscape and Market Forecasts to 2017
http://www.companiesandmarkets.com/Market-Report/dental-radiology-equipment-global-pipeline-analysis ,-competitive-landscape-and-market-forecasts-to-2017-683472.asp?prk=7c4ed5b510c1ffe12b50d9829eddaba2
The US is the largest dental radiology equipment market, accounting for 39% of the global market in 2010. The US dental radiology market, valued at $838m in 2010, is forecast to grow by 4% annually during 2010-2017 to reach $1,092.7m by 2017. Japan accounts for 17% of the total global dental radiology market. The remaining 44% of the market share is accounted for by other countries, such as the UK, France, India, China, Australia and Brazil.
In 2010, Danaher Corporation was the leader in the global dental radiology equipment market with a 24% share, followed by Planmeca Oy, Sirona Dental Systems, Inc. and Carestream Health/Kodak Health Group.
This report provides key data, information and analysis on the global dental radiology equipment market. The report provides market landscape, competitive landscape and market trends information on the dental radiology equipment market.
-- Key geographies covered include the US, Canada, the UK, Germany, France, Italy, Spain, Japan, China, India, Australia, and Brazil.
-- Key segments covered include Extra Oral Radiology Equipment and Intra Oral Radiology Equipment.
-- Annualized market revenues data from 2003 to 2010, forecast forward for 7 years to 2017. Company shares data for 2010.
-- Qualitative analysis of key market trends, market drivers, and restraints by each category within dental radiology equipment market.
-- The report also covers information on the leading market players, the competitive landscape, and the leading pipeline products and technologies.
-- Key players covered include Danaher Corporation, Planmeca Oy, Sirona Dental Systems and Carestream Health, Inc. / Kodak Health Group
Report Details: http://www.companiesandmarkets.com/Market-Report/dental-radiology-equipment-global-pipeline-analysis ,-competitive-landscape-and-market-forecasts-to-2017-683472.asp?prk=7c4ed5b510c1ffe12b50d9829eddaba2
SOURCE: Companies and Markets

Thursday, August 25, 2011

Sesame Communications Named to Inc. 500 |5000 List of Fastest-Growing Private Companies



Ranking Acclaims Sesame’s Impressive Three-Year Sales Growth of 125%


Seattle, WA, August 25, 2011 – Sesame Communications, a dental industry pioneer in online patient connection systems, today announced that it has been named to the fifth annual lnc. 500|5000, an exclusive ranking of the nation's fastest-growing private companies. In its debut year on the list, Sesame is ranked an impressive #2024 for its 125% growth over three years and $9.2 million in revenue in 2010. Sesame’s ranking can be found at: http://www.inc.com/inc5000/profile/sesame-communications 

“Our high ranking on the Inc. 500 |5000 is a milestone for Sesame Communications,” said Diana P. Friedman, CEO of Sesame Communications. “Over my tenure at the company, Sesame has bolstered its commitment to providing an excellent customer experience, best in class service, and the most functional online communications solutions to meet the needs of dentists. We’re proud that our hard work has been recognized by a leading business publication and we look forward to increasing our ranking next year.”   

Sesame Communications helps dental practices thrive in the digital age. The internet has forced dentists to communicate with their existing and potential patients where they are, online 24-7. Sesame’s award winning complete online solution suite integrates websites, patient portals, automated reminders, search engine optimization, social media, and online marketing. Dental care providers are seeking industry expertise in streamlined solutions that are effective and provide measurable ROI.  Sesame is answering their call.

Sesame’s steep growth trajectory can be attributed to its award-winning product that meets the needs of today’s dental providers and patients and to its strong and innovative management team. So far in 2011, Sesame has grown revenues by nearly 37% over the same period in 2010. In a stagnant economic environment, Sesame is honored to be recognized on a list that includes numerous prominent brands and represents the most comprehensive look at the most important segment of the economy – America’s independent entrepreneurs. The median growth rate of 2011 Inc. 500|5000 companies remains an impressive 94 percent. The companies on this year’s list report having created 350,000 jobs in the past three years, and aggregate revenue among the honorees reached $366 billion, up 14 percent from last year.

With several new product releases scheduled for the months to come, Sesame is currently on track to meet its growth goals for 2011 and looks forward to another year as category leader in online patient communications.


About Sesame Communications
Sesame Communications is the premier provider of online services for the dental industry. An emerging growth company, Sesame has steadily built its market penetration, presence, and reputation since its inception in 2000, emerging as the category leader in patient connection systems. One of the fastest-growing companies in the Pacific Northwest, Sesame continues to expand its team and service offerings based on market research studies and consistent analysis of dental professional patient needs in the digital age. As of January 2011, more than 9 million patients communicate with their dental providers using Sesame 24-7™. More information regarding Sesame and Sesame 24-7 can be found at www.sesamecommunications.com or by calling 877·633·5193.

Wednesday, August 24, 2011

Lollipops Reduce Risk of Tooth Decay


A recent study, published by the European Academy of Pediatric Dentistry, demonstrated that sugar-free lollipops containing licorice root extract significantly reduced the bacteria that causes tooth decay, specifically in pre-school children with high-risk of tooth decay.

The study, funded by the Research and Data Institute of the affiliated companies of Delta Dental of Michigan, Ohio, Indiana, Tennessee, Kentucky, New Mexico and North Carolina, analyzed 66 preschool students ages 2 to 5 enrolled in the Greater Lansing Area Head Start Program. Each student received a lollipop for 10 minutes twice daily for three weeks.

"Dental decay is one of the most common childhood diseases with more than half of children ages 5 to 17 having had at least one cavity or filling," said Jed J. Jacobson, D.D.S., M.S., M.P.H., chief science officer at Delta Dental. "We are working to find simple, effective regimens that will encourage prevention and control of dental disease. While the results of this pilot clinical trial are encouraging, more research is needed to confirm these early findings."

Results showed a significant reduction in Streptococcus mutans (S. mutans), the primary bacteria responsible for tooth decay, during the three-week period when the lollipops were being used and lasting for an additional 22 days before beginning to rebound.

Using a saliva test, the amount of S. mutans in the patient's mouth was measured before and during the three-week period where lollipops were used, as well as for several weeks thereafter.

"The use of the licorice root lollipops is an ideal approach as it will stop the transfer and implantation of the bacteria that cause dental decay from mothers to their infants and toddlers," said Martin Curzon, editor-in-chief, European Academy of Pediatric Dentistry. "It also has the merit of being a low cost-high impact public dental health measure."

"This study is important not only for dental caries prevention research, but also demonstrates the feasibility of a classroom protocol using a unique delivery system suitable for young children," said Jacqueline Tallman, R.D.H., B.S., M.P.A., principal investigator of the study. "Early prevention is key for lifetime oral health and effective innovative protocols are needed."

The investigation was a collaborative effort of the Greater Lansing Area Head Start Program, the University of Michigan and the University of California – Los Angeles (UCLA). Delta Dental's Research and Data Institute provided the grants as part of its mission to remain on the cutting edge of finding solutions to oral health problems.

"Our Head Start program was excited to participate in the Lollipop project," said Teresa Spitzer, R.N., Health Programs Manager, Capital Community Head Start Inc. – Head Start and Early Childhood Programs. "Staff and parents were intrigued by something as simple as a special Lollipop having the ability to decrease the incidence of dental caries in children. The outcomes only reinforced the value the parents placed on the project."

The lollipops, manufactured by Dr. John's Candies of Grand Rapids, Mich., were developed using FDA-approved materials by Dr. Wenyuan Shi, a microbiologist at the University of California – Los Angeles (UCLA), and C3 Jian, Inc., a research and development company in California. The orange-flavored, sugarless lollipops contain extract of licorice root (Glycyrrhiza uralensis), which targets and is thought to kill the primary bacteria (Streptococcus mutans or S. mutans) responsible for tooth decay.

About Streptococcus mutans - There are approximately 700 types of bacteria in the human mouth. While most are harmless, Streptococcus mutans (S. mutans) is considered the primary culprit in tooth decay. They live in a biofilm (plaque) that adheres to the teeth, consume sugar and release acid that erodes tooth enamel, causing decay. Regular brushing and flossing, along with dental checkups, can help to keep S. mutans and Lactobacillus casei in check.

About Delta Dental - The affiliated companies of Delta Dental of Michigan, Ohio, Indiana, Tennessee, Kentucky, New Mexico and North Carolina, collectively comprise one of the largest dental plan administrators in the nation. In 2010, the enterprise paid more than $2 billion for dental care for nearly 8 million people. Offices are located in Okemos and Farmington Hills, Mich.; Columbus and Cleveland, Ohio; Indianapolis and Greenwood, Ind.; Nashville, Knoxville, and Memphis, Tenn.; Louisville, Ky.; Albuquerque, N.M.; and Raleigh and Charlotte, N.C.

About Delta Dental's Research and Data Institute - The Research and Data Institute was established in 2005 to develop innovative and scientifically based dental benefits that improve health. The institute, which has the world's largest database of dental claims information, works closely with researchers from the University of Michigan, UCLA and other leading universities in the United States.

The full study results can be viewed at http://www.deltadentalmi.com/pdf/LollipopsResults.pdf



Tuesday, August 23, 2011

Complications associated with implant migration into the maxillary sinus cavity


Clinical Oral Implants Research
Article first published online: 15 AUG 2011

DOI: 10.1111/j.1600-0501.2011.02278.x

Abstract
Background

Migration of dental implants into the maxillary sinus is an uncommon, but increasingly reported complication. Implant migration may result from initial lack of primary stability, intrasinusal and nasal pressure changes, autoimmune reaction to the implant or incorrect distribution of occlusal forces. This retrospective study aims at analyzing the factors that may influence implant migration into the maxillary sinus cavity.
Material and methods

Fourteen patients presenting a total 15 implants that migrated into the maxillary sinus were recruited. Diagnosis of this complication was based on imaging techniques, such as cone beam computerized tomography scan and panoramic radiography. Clinical data were recorded in all cases and processed for statistical analysis.
Results

ABH was below 6 mm in the majority of cases. However, almost 50% of the patients did not receive any site preparation treatment prior to implant insertion. Five patients (33.3%) were treated by osteotome techniques, but only one of them had bone grafting. Therefore, 73.3% of sites did not receive any biomaterial to increase available bone height. The most common complication-associated factors found on this study were related to implant design (cylindrical), implant dimension (diameter), implant restoration/rehabilitation method (partial removable denture), site-specific anatomy (initial residual bone height between 5 and 6.9 mm), demographics (age), and biomaterials.
Conclusion

Technical and patient related factors highlighted through this retrospective study highlights important aspects that could assist us in identifying the circumstances that may predispose or increase the susceptibility to implant migration into the sinus cavity.

Monday, August 22, 2011

Long-term effectiveness of four pulpotomy techniques: 3-year randomised controlled trial



Clinical Oral Investigations
DOI: 10.1007/s00784-011-0602-3Online First™


 Abstract
A pulpotomy is the therapy for management of pulp exposures due to caries in symptom-free primary molars. The aim was to longitudinally compare the relative effectiveness of the Er:YAG laser, calcium hydroxide and ferric sulphate techniques with dilute formocresol in retaining symptom-free molars. Two hundred primary molars in 107 healthy children were included and randomly allocated to one technique. The treated teeth were blindly reevaluated after 6, 12, 18, 24 and 36 months. Descriptive data analysis and logistic regression analysis accounting for multiple observations per patient by generalised estimating equation were used. Additionally, various influences including tooth type, upper and lower jaws, type of anaesthesia, operator and the final restoration on treatment success were evaluated (Wald chi-square test). After 36 months, the following total (considering clinical and clinically symptom-free radiographic failures) and clinical success rates were determined (in percent): Formocresol 72 (92), laser 73 (89), calcium hydroxide 46 (75), ferric sulphate 76 (97). No significant differences were detected between formocresol and any other technique after 36 months. However, the odds ratio of failure appeared to be three times higher for calcium hydroxide than for formocresol. No significant differences in total success rates were seen regarding the aforementioned influencing clinical parameters. The correct diagnosis of the pulpal status, bleeding control and the specific technique are highly important for long-term success of pulpotomies in primary molars. According to the presented long-term data, pulpotomies using ferric sulphate revealed the best treatment outcome among the used techniques, while calcium hydroxide resulted in the lowest success rates after 3 years. Therefore, we can recommend ferric sulphate for easy and successful treatment of primary molars with caries-exposed pulps.

Saturday, August 20, 2011

Dental students and intimate partner violence: Measuring knowledge and experience to institute curricular change.
Connor PD, Nouer SS, Mackey SN, Banet MS, Tipton NG. J. Dent. Educ. 2011; 75(8): 1010-1019.
Affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, 600 Jefferson Avenue, 3 Floor, Memphis, TN 38105;. dconnor@uthsc.edu.
DOI: unavailable  
PMID: 21828294
(Copyright © 2011, American Association of Dental Schools)
Our study documents the shortage of intimate partner violence (IPV) content exposure within one dental school curriculum, with an eye toward utilizing this information to revise an existing comprehensive family violence curriculum that will be fully integrated into required university coursework to improve competence and help overcome knowledge gaps. IPV is defined by the Centers for Disease Control and Prevention as physical and sexual violence, threats of physical and sexual violence, or psychological/emotional abuse including coercive tactics that adults or adolescents use against current or former intimate partners. We report on the results of a four-part (background, IPV knowledge, opinions, and personal experience), sixty-seven-item validated survey instrument used to measure knowledge, attitudes, beliefs, and self-reported behaviors among dental students preparing to become health care professionals working in the field. Survey responses from the nearly 80 percent of fourth-year dental students who completed the survey were examined within the context of students' actual IPV knowledge, as well as opinions and attitudes that could directly or indirectly influence patients. Our findings indicate that a sizeable number of students received no IPV training prior to or during dental school, leading to perceptions that they lack knowledge about IPV and are not well prepared to address IPV with patients. A notable percentage of students (20 percent) also reported personal experience with IPV.

Friday, August 19, 2011

Influence of gaseous ozone in peri-implantitis: bactericidal efficacy and cellular response. An in vitro study using titanium and zirconia

I use ozone in my practice and it can benefit many patients. MJ

Clinical Oral Investigations
DOI: 10.1007/s00784-011-0603-2

Abstract
Dental implants are prone to bacterial colonization which may result in bone destruction and implant loss. Treatments of peri-implant disease aim to reduce bacterial adherence while leaving the implant surface intact for attachment of bone-regenerating host cells. The aims of this study were to investigate the antimicrobial efficacy of gaseous ozone on bacteria adhered to various titanium and zirconia surfaces and to evaluate adhesion of osteoblast-like MG-63 cells to ozone-treated surfaces. Saliva-coated titanium (SLA and polished) and zirconia (acid etched and polished) disks served as substrates for the adherence of Streptococcus sanguinis DSM20068 and Porphyromonas gingivalis ATCC33277. The test specimens were treated with gaseous ozone (140 ppm; 33 mL/s) for 6 and 24 s. Bacteria were resuspended using ultrasonication, serially diluted and cultured. MG-63 cell adhesion was analyzed with reference to cell attachment, morphology, spreading, and proliferation. Surface topography as well as cell morphology of the test specimens were inspected by SEM. The highest bacterial adherence was found on titanium SLA whereas the other surfaces revealed 50–75% less adherent bacteria. P. gingivalis was eliminated by ozone from all surfaces within 24 s to below the detection limit (≥99.94% reduction). S. sanguinis was more resistant and showed the highest reduction on zirconia substrates (>90% reduction). Ozone treatment did not affect the surface structures of the test specimens and did not influence osteoblastic cell adhesion and proliferation negatively. Titanium (polished) and zirconia (acid etched and polished) had a lower colonization potential and may be suitable material for implant abutments. Gaseous ozone showed selective efficacy to reduce adherent bacteria on titanium and zirconia without affecting adhesion and proliferation of osteoblastic cells. This in vitro study may provide a solid basis for clinical studies on gaseous ozone treatment of peri-implantitis and revealed an essential base for sufficient tissue regeneration.

Thursday, August 18, 2011

Chairside vs. labside ceramic inlays: Effect of temporary restoration and adhesive luting on enamel cracks and marginal integrity

Dental Materials
Volume 27, Issue 9 , Pages 892-898, September 2011

Abstract 

Objectives

To assess the influence of different temporary restorations and luting techniques of labside and chairside ceramic inlays on enamel defects and marginal integrity.

Methods

120 extracted human third molars received MOD preparations with one proximal box each limited in either enamel or dentin. 64 Cerec 2 inlays and 56 IPS Empress I inlays were randomly assigned to the following groups (fabrication mode: chairside (CS)=no temporary restoration (TR), labside (LS)=TR with Luxatemp (L) inserted with TempBond NE, or Systemp.inlay (SI) without temporary cement), luting technique: SV=Syntac/Variolink II, RX=RelyX Unicem: A: Cerec inlays were luted with (1) CS/SV. (2) CS/SV/Heliobond separately light-cured. (3) CS/RX. (4) LS/L/SV. (5) LS/L/RX. (6) LS/SI/SV. (7) LS/SI/RX. (8) LS/SI/RX with selective enamel etching. B: Empress. (9) L/SV. (10) L/SV/Heliobond separately light-cured. (11) L/RX. (12) SI/SV. (13) SI/SV, Heliobond separately lightcured. (14) SI/RX. (15) SI/RX after selective enamel etching. Before and after thermomechanical loading (TML: loading time of TR 1000×50N+25 thermocycles (TC) between +5°C and +55°C; clinical simulation: 100,000×50N+2500 TC) luting gaps, enamel cracks, and marginal adaptation to enamel and dentin were determined under an SEM microscope (200×) using replicas.

Results

Loading time of temporary restorations negatively affected enamel integrity and enamel chipping (p<0.05). Luxatemp resulted in less enamel cracks than Systemp.inlay (p<0.05). Syntac/Variolink achieved better marginal enamel quality than RelyX Unicem in all groups (p<0.05). Marginal quality in dentin revealed no differences when no temporary cement was used (p>0.05). Temporary cement negatively affected dentin margins when RelyX Unicem was used (p<0.05).

Significance

Chairside-fabricated Cerec inlays reduce the risk of enamel cracks and marginal enamel chipping due to omitted temporary restorations. Syntac/Variolink revealed a significantly better performance than RelyX Unicem.

Wednesday, August 17, 2011

Periowave antimicrobial therapies

Periowave Dental Technologies, Inc., is developing and commercializing antimicrobial photodynamic therapies for the treatment of a broad spectrum of bacterial, fungal and viral infections in the oral cavity without encouraging the formation and spread of antibiotic resistance. The photodisinfection technologies were developed by Professor Michael Wilson and colleagues at the Eastman Dental Institute, University College London.
The company's Periowave™ Photodisinfection System is a simple, pain-free, non-surgical and non-antibiotic approach for the treatment of gum disease (periodontitis, endodontics, peri-implant disease) and other oral infections. Photodisinfection is a powerful non-thermal antimicrobial technology that has been proven in clinical trials to generate superior patient outcomes such as gains in clinical attachment and reductions in pocket depth and bleeding without requiring any patient compliance. This new license agreement will allow the company to expand the indications for its Photodisinfection technology.
Periowave Dental Technologies, Inc., is based in Toronto, Ontario, Canada. For additional information and to learn more about Periowave and photodisinfection technology, please contact info(at)periowave(dot)com or visit the Company's website at: www.periowave.com

Tuesday, August 16, 2011

Ultraviolet-B and Vitamin D Reduce Risk of Dental Caries

Newswise — Large geographical variations in dental health and tooth loss among U.S. adolescents and young adults have been reported since the mid-1800s. The first study finding a north-south gradient in dental caries was a report of men rejected from the draft for the Civil War for lost teeth, from 8 per 1000 men in Kentucky to 25 in New England.
Studies by Clarence Mills and Bion East in the 1930s first linked the geographical variation in prevalence to sunlight exposure. They used data for adolescent males aged between 12 and 14 years from a cross-sectional survey in 1933–1934. East later found that dental caries were inversely related to mean hours of sunlight/year, with those living in the sunny west (3000 hours of sunlight/year) having half as many carious lesions as those in the much less sunny northeast (<2200 hours of sunlight/year).
Several studies conducted in Oregon in the 1950s noted that dental caries prevalence was lower in the sunnier regions of the state than in the cloudy regions, a finding that persisted after considering other factors that affect dental caries rates. The mechanism was attributed to vitamin D through its effects on calcium metabolism.
There were also several studies reported on vitamin D and dental caries in the 1920s and 1930s. May Mellanby and coworkers in Sheffield, England, did studies on the role of vitamin D on teeth in the 1920s. The first experiments were with dogs, where it was found that vitamin D stimulated the calcification of teeth. Subsequently, they studied the effect of vitamin D on dental caries in children, finding a beneficial effect. Additional studies were conducted on children in New York regarding dental caries with respect to season, artificial ultraviolet-B (UVB) irradiance, and oral intake of vitamin D with the finding that it took 800 IU/d to prevent caries effectively.
The mechanism whereby UVB reduces risk of dental caries is through production of vitamin D, followed by induction of cathelicidin, which attacks oral bacteria linked to dental caries. Cathelicidin is well known to fight bacterial infections, with findings reported for several bacterial infections including pneumonia, sepsis, and tuberculosis. Several recent papers reported that cathelicidin reduces the risk of caries, but did not link cathelicidin to vitamin D.
Serum 25-hydroxyvitamin D concentrations around 30-40 ng/ml (75-100 nmol/L) should significantly reduce the formation of dental caries. (The average white American has a level near 25 ng/ml, while the average black American has a level near 16 ng/ml.) To obtain these levels, oral intake of 1000-4000 IU/d of vitamin D3 or 15-20 minutes in the sun near solar noon in summer with 20-30% body surface area exposed is suggested.
Good dental health also involves a healthy diet low in sugar, regular tooth brushing, and regular dental checkups.
Use of vitamin D appears to be a better option for reducing dental caries than fluoridation of community water supplies as there are many additional health benefits of vitamin D and a number of adverse effects of water fluoridation such as fluorosis (mottling) of teeth and bones.
The paper is published online with open access:
Grant WB. A review of the role of solar ultraviolet-B irradiance and vitamin D in reducing risk of dental caries. Dermato-Endocrinology, 3:3, 1-6; July/August/September 2011; epub
http://www.landesbioscience.com/journals/dermatoendocrinology/article/15841/

Monday, August 15, 2011

MetLife Announces New Resources for Comparing Dental Provider Networks to Determine Maximum Value


NEW YORK, Aug 10, 2011 (BUSINESS WIRE) -- It is important to look at multiple metrics, not simply size and discounts, when evaluating a dental provider network to determine the value it delivers to employers and plan participants. MetLife, a leading provider of dental plan administration for nearly 20 million people, today announced the availability of two new free resources for employers and benefits professionals that offer tips for evaluating the value of dental provider networks. The guide "Taking a Deeper Look at Dental Networks" and the video "Building Blocks of Dental Benefit Plans" are both available at www.metlife.com/dentalinsights .

"While accessibility, disruption, and discount reports can provide valuable information when evaluating a carrier network, it is important to recognize each report's inherent limitations," states Dr. David Guarrera, DDS, vice president, MetLife Dental Products. "The new resources help one learn the value and proper use of these reports as well as a new metric, effective discounts. In fact, this metric may be the best indication of the overall impact on benefit plan costs and participant out-of-pocket expenses."
A large network with negotiated fees for covered services is only valuable if the participants use in-network dentists. The effective discount -- the combination of in-network utilization and discount level or total percentage savings on claims from all dentists -- may be the best measure of how often the in-network discounts are being used and the overall savings, or value, provided by the network. Analyzing the effective discount along with a carrier's recruitment strategy, service efficiencies and practice pattern review process, can help ensure a more informed assessment of a network's value.
"The effective discount is a powerful metric to know," notes Dr. Guarrera. "It is also important to consider criteria like plan design, claims management and service excellence to optimize plan value and employee savings and satisfaction."

Saturday, August 13, 2011

Risk of onlay fracture during pre-cementation functional occlusal tapping

Dental Materials
Volume 27, Issue 9 , Pages 942-947, September 2011

Abstract 

Objective

To evaluate in vitro the pre-cementation resistance of CAD/CAM onlays subjected to functional occlusal tapping.

Methods

An extracted tooth model (molar and premolar) with simulated bone and periodontal ligament was used to make a mesio-occlusal onlay preparation (two mesial cusps covered). Immediate dentin sealing was applied to the prepared tooth. The corresponding onlays were fabricated with Cerec either using composite resin (Paradigm MZ100) or ceramic (e.max CAD and Mark II) (n=14). An elevated marginal ridge was designed with the intention of generating hyper-occlusion. Pre-cementation occlusal tapping was simulated using closed-loop servo-hydraulics at 2Hz, starting with a load of 40N, followed by 80, 120, 160, 200, 240 and 280N (10 cycles each). All samples were loaded until fracture or to a maximum of 70 cycles. Groups were compared using the life table survival analysis (p=.016, Bonferroni method).

Results

Survival probability was MZ100>e.max CAD>Mark II. The restorations made from e.max CAD and Mark II failed at an average load of 157N and 123N, respectively with no specimen withstanding all 70 load cycles (survival 0%); with MZ100 the survival rate was 36%.

Significance

Material selection has a significant effect on the risk of CAD/CAM onlay fracture during pre-cementation functional occlusal tapping with composite resin onlays showing the minimum risk compared to ceramic ones.

Friday, August 12, 2011

Dental Organization iPhone/iPad App Now Available


New free App will aid offices in making decisions about tubs, trays, mirrors and other office organizational items
OXNARD, California, August 10, 2011- Dental office organization can be confusing and overwhelming. Questions like “why do I need so many trays?” or “should I buy cassettes?” and “am I in compliance?” come up all the time when speaking with dental professionals.  That’s why the Office Organization Calculator iPhone/iPad App and PC desktop program were created. These new Apps will do the planning for you when you enter in some basic office information. The App will create a complete customized shopping list that you can submit for order or use to plan with your favorite dental dealer. Visit www.duxdental.com/calculator to download the App or desktop program. Call 1-800-833-8267 and ask for Mike if you have any questions.


About DUX Dental
DUX Dental has been manufacturing and distributing the highest level of dental products worldwide for over 50 years. Our goal is to manufacture products that outperform other products of their type, and to look for innovations wherever possible.  No matter the product, our principle remains the same.  We make high quality products that, we think, are better for the dental team. DUX Dental manufactures Identic and KromaFaze Alginate, ZONE temporary cement, ShortCut GingiBRAID, Xenolite™ Lead-Free X-Ray Aprons, PeelVue+ Pouches and Bib-Eze disposable bib holders to name a few products. To learn more about our extensive, quality product line please visit www.duxdental.com or call 1.800.833.8267 and speak with customer service.

Thursday, August 11, 2011

Curve Dental's New Web-based Digital Imaging Technology Poised to Change How Dentists Capture, Store and Access Patient Information

This is a first in the dental industry a web based practice management system that does imaging too! I have previously reported it but it will be going live. MJ


OREM, UT— Curve Dental, developers of Web-based dental software, announced the completion of new digital imaging features, which allow doctors and staff to capture x-ray and intraoral images directly to the cloud. The technology developed by Curve Dental, which is the first of its kind in dentistry, provides doctors with a digital imaging solution that is entirely web-based. Using the cloud to capture and store patient images eliminates the need for a server, affords unlimited storage and a proven backup and business continuity solution, and provides the dentist with access to the data from any computer with Internet access at anytime from anywhere.

“Our digital imaging features are revolutionary within the dental profession,” said Matt Dorey, Founder and Managing Director of Curve Dental. “With our software a doctor only needs a computer with Internet access and a browser to capture digital images. They don’t need a server, powerful and expensive hardware, nor do they need to worry about backups or space limitations. Moreover, our strategy is to allow doctors to connect any digital x-ray sensor, intraoral camera, or digital panoramic imaging system to our software, which is an advantage to the dentist because most dental professionals already have these types of digital devices in their practices. Switching to our software shouldn’t require the dentist to invest in new digital devices; that is our goal.”

Compatibility with as many different digital devices as possible is Curve Dental’s strategy. Currently the software is compatible with the Schick, Suni, Gendex, Eva, and Owandy digital x-ray sensors and will soon be compatible with the Kodak sensor. Additional compatibility will be added as quickly as possible. TWAIN-compatible intraoral cameras and panographs will connect directly with the software now, but may require the dentist to install additional drivers supplied by the manufacturer.

Curve Dental’s imaging software is native to its practice management software using a single database and set of code, which provides the doctor and staff with a consistent look and feel throughout the software. Native code also makes the software easier to learn and less demanding on a practice that must train new team members. A stand-alone version of the imaging software will also be available in the near future. “Because our imaging software is ‘native’ to our practice management software it is more efficient and more stable than an integrated or bridged solution,” says Dorey. “‘Integrated’ or ‘bridged’ solutions equate to separate databases, separate sources for technical support and two applications that may work and look differently from each other.”

Curve Dental recommends a DSL or faster Internet connection. “With digital imaging the user experience is enjoyable on almost any high-speed Internet connection,” says Dorey. “We focused our attention on processes and efficiencies to make sure the image could be compressed quickly, without changing or degrading quality, and uploaded to the cloud instantly. We’re happy with the results and our customers are finding the experience to be comparable to capturing and saving an image locally.”

Like the company’s practice management features the imaging features are sold on a subscription basis with an additional setup fee. Introductory pricing is being offered until the end of the year. Interested parties should call for additional information. Although Curve Dental has received FDA approval for US dentists, Health Canada approval is still pending. Canadian dentists are not able to use the imaging features yet.

About Curve Dental, Inc.

Founded in 2005, Curve Dental provides web-based dental software and related services to dental practices within the United States and Canada. The company is privately-held, headquartered in Orem, Utah with offices in Calgary, Canada and Dunedin, New Zealand. The company strives to make dental software less about computers and more about the user experience. Their creative thinking can be seen in the design of their software, that’s easy to use and Web-based. Dentists can call 888-910-4376 or visit www.curvedental.com for more information.

Wednesday, August 10, 2011

Is dentistry ready for 'the cloud'?

Another article on cloud based computing in dentistry. Go read it on DrBicuspid.com and it has a quote form yours truly.

Tuesday, August 09, 2011

Bone Fluoride Levels Not Associated With Osteosarcoma

The International and American Associations for Dental Research have released in its Journal of Dental Research a study that investigated bone fluoride levels in individuals with osteosarcoma, which is a rare, primary malignant bone tumor that is more prevalent in males. Since there has been controversy as to whether there is an association between fluoride and risk for osteosarcoma, the purpose of this study, titled "An Assessment of Bone Fluoride and Osteosarcoma," was to determine if bone fluoride levels were higher in individuals with osteosarcoma.


No significant association between bone fluoride levels and osteosarcoma risk was detected in this case-control study, based on controls with other tumor diagnoses.

In the case-control study, by lead researcher Chester Douglass of Harvard University, patients were identified by physicians in the orthopedic departments from nine hospitals across the U.S. between 1993 and 2000. In this report, the study sample included incident cases of primary osteosarcoma and a control group of patients with newly-diagnosed malignant bone tumors. Specimens of tumor-adjacent bone and iliac crest bone were analyzed for fluoride content. The study was approved by the Institutional Review Boards of the respective hospitals, Harvard Medical School and the Medical College of Georgia.

Logistic regression of the incident cases of osteosarcoma (N=137) and tumor controls (N=51), adjusting for age and sex and potential confounders of osteosarcoma, was used to estimate odds ratios (OR) and 95% confidence intervals (CI). There was no significant difference in bone fluoride levels between cases and controls. The OR adjusted for age, gender, a history of broken bones was 1.33 (95% CI: 0.56-3.15).

"The controversy over whether there is an association between fluoride and risk for osteosarcoma has existed since an inconclusive animal study 20 years ago," said IADR Vice-president Helen Whelton. "Numerous human descriptive and case-control studies have attempted to address the controversy, but this study of using actual bone fluoride concentrations as a direct indicator of fluoride exposure represents our best science to date and shows no association between fluoride in bone and osteosarcoma risk."

Monday, August 08, 2011

Is it time for the cloud to come to your practice?

Read my latest article for Dental Economics about cloud computing for your office. It is available online now.
Click here to read it.

Saturday, August 06, 2011

Coast Dental Services Inc.bizWatch completed the acquisition of the assets of Dental Technology Inc. and Community Dental Services Inc.

Coast Dental Services Inc. completed the acquisition of the assets of Dental Technology Inc. and Community Dental Services Inc.
Dental Technology and its subsidiaries operate 57 SmileCare dental practices in California, Nevada and Texas. The purchase price was not disclosed in a company statement.
Coast Dental, a privately held dental practice management company headquartered in Tampa, also has affiliated dental practices in Florida and Georgia.

Friday, August 05, 2011

Practitioner and Patient Perceptions of Orthodontic Treatment: Is the Patient Always Right?

Journal of Esthetic and Restorative Dentistry

  1. NATHAN MCKETA DMD,
  2. DANIEL J. RINCHUSE DMD, MS, MDS, PhD,
  3. JOHN M. CLOSE MA, PMSD
Article first published online: 18 JUL 2011
DOI: 10.1111/j.1708-8240.2011.00455.x

ABSTRACT

Purpose:  As dentists embrace evidence-based clinical practice, we place increased emphasis on patient values. Standards like Angle Classification are not related to patient perceptions of the tangible benefits of treatment. This study quantifies the differences dentists and patients perceive in orthodontic treatment outcome.
Materials and Methods:  A survey is used to quantify a patient's perception of orthodontic treatment. It was completed by 30 patients who completed treatment at the University of Pittsburgh School of Dental Medicine. Their responses were compared with the perceptions of five orthodontists, three general dentists, and two prosthodontists.
Results:  Multivariate analysis of variance found the differences between and within the subjects to be significant at p < 0.004. Univariate analysis of variance of the initial scores showed the data to be significant at p < 0.002 and pairwise comparisons showed significant mean differences. Final score analysis of variance was significant at p < 0.001 and pairwise comparison showed significant mean differences.
Conclusions:  Patients and general dentists have a significantly less favorable initial perception of their dental esthetics and function when compared with orthodontists. Final scores of esthetic and functional perceptions between the patients and all three dentist groups showed significant differences, with patients perceiving the results of their treatment more favorably than practitioners.

Thursday, August 04, 2011

When primary care providers apply fluoride varnish, young Medicaid-insured children have fewer cavities

Tooth decay among children younger than 5 years, referred to as early childhood caries (ECC), is preventable. Yet as many as 11 percent of 2-year-olds and 44 percent of 5-year-olds develop ECC, with children from low-income families bearing a disproportionate burden of the disease. According to a new study, application of topical fluoride varnish by non-dental pediatric primary care providers can reduce dental caries-related treatments among children. A North Carolina Medicaid program called "Into the Mouths of Babes" (IMB), initiated in 2000, had primary care providers apply fluoride varnish to children's teeth during office visits. Analysis of the State's Medicaid enrollment and claims data from 2000 to 2006 showed that the program reduced dental caries-related treatments among children with 4 or more IMB visits by 17 percent up to 6 years of age compared with children with no IMB visits.

When Bhavna T. Pahel, Ph.D., and her University of North Carolina colleagues simulated data for initial IMB visits at 12 and 15 months of age, there was a cumulative 49 percent reduction in dental caries-related treatments at 17 months of age. However, there was an increase in treatments for children from 24 to 42 months of age. The authors hypothesize that this increase in dental caries-related treatments likely occurred due to greater detection of disease in teeth of children who received and benefitted from the program, longer time since fluoride application, and emergence of teeth not initially treated with fluoride. Therefore, the authors concluded that multiple applications of fluoride at the time of primary tooth emergence seem to be most beneficial. In total, the reduction in caries-related treatments from the IMB preventive dental services represents a substantial improvement in the oral health of Medicaid-enrolled children, who historically have had high rates of dental caries but poor access to care from dentists, comment the researchers.
The IMB Program was based on the perception that, although very young children are unlikely to get checkups at the dentist, they frequently make well-child visits to their pediatricians or other primary care providers. The study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00032).
See "Effectiveness of preventive dental treatments by physicians for young Medicaid enrollees," by Dr. Pahel, R. Gary Rozier, D.D.S., Sally C. Stearns, Ph.D., and Rocio B. Qunonez, D.M.D., in Pediatrics 127, pp. e682-3689, 2011.

Wednesday, August 03, 2011

Recommendations for using regenerative endodontic procedures in permanent immature traumatized teeth

Dental Traumatology 

DOI: 10.1111/j.1600-9657.2011.01044.x


Abstract –  The regeneration of immature permanent teeth following trauma could be beneficial to reduce the risk of fracture and loss of millions of teeth each year. Regenerative endodontic procedures include revascularization, partial pulpotomy, and apexogenesis. Several case reports give these procedures a good prognosis as an alternative to apexification. Care is needed to deliver regenerative endodontic procedures that maintain or restore the vitality of teeth, but which also disinfect and remove necrotic tissues. Regeneration can be accomplished through the activity of the cells from the pulp, periodontium, vascular, and immune system. Most therapies use the host’s own pulp or vascular cells for regeneration, but other types of dental stem cell therapies are under development. There are no standardized treatment protocols for endodontic regeneration. The purpose of this article is to review the recent literature and suggest guidelines for using regenerative endodontic procedures for the treatment of permanent immature traumatized teeth. Recommendations for the selection of regenerative and conventional procedures based on the type of tooth injury, fracture type, presence of necrosis or infection, periodontal status, presence of periapical lesions, stage of tooth development, vitality status, patient age, and patient health status will be reviewed. Because of the lack of long-term evidence to support the use of regenerative endodontic procedures in traumatized teeth with open apices, revascularization regeneration procedures should only be attempted if the tooth is not suitable for root canal obturation, and after apexogenesis, apexification, or partial pulpotomy treatments have already been attempted and have a poor prognosis.

Tuesday, August 02, 2011

3M Donation Advances Digital Dentistry at U.S. Dental Schools

Schools that meet established criteria to receive Lava Chairside Oral Scanner C.O.S. Systems

ST. PAUL, Minn. - (August 1, 2011) - By the end of 2011, dental programs from selected schools across the nation will be able to offer hands-on training with some of the most advanced technology in the industry. 3M Community Giving, the charitable giving arm of 3M,  announced that it will donate Lava™ Chairside Oral Scanner C.O.S. impression-taking systems as part of its goal to advance academic excellence in higher education. The donation includes support from 3M’s dental division, 3M ESPE, to successfully integrate the technology into dental schools.   Dental schools selected will meet several criteria, including number of students, proximity to 3M facilities and demonstrated capability to integrate digital dentistry into their curriculums. 

“Digital-related products are expected to revolutionize the next generation of dentistry, making it essential that students receive training to ensure that they are properly prepared to enter the marketplace,:” said Ian Hardgrove, senior vice president of marketing and sales and president of the 3M Corporate Giving Committee. “Connecting universities with the desire to offer cutting edge technologies with the worldwide leader of dental innovations was a natural fit given our organizational goal of preparing students for future opportunities and 3M ESPE’s commitment to transform the dental industry. The Lava C.O.S. system will provide the basis for assisting universities to enter the digital age of dentistry.”

The Lava C.O.S. is a powerful teaching tool to advance the learning techniques between students and teachers. It is an innovative digital impression-taking system that allows dentists to view continuous 3D video images captured in a patient’s mouth in real-time on a touch-screen monitor. This real-time visibility allows dentists to confidently and immediately assess the data capture before a patient leaves the office. The technology also allows dentists and labs to have the same advanced tools to review cases knowing that they are seeing exactly the same images. Dentists using the Lava C.O.S. report increased productivity‚ lower remake rates‚ better patient satisfaction and more reliable communication with their labs. Having hands-on experience with the system prior to graduation will help graduates transition their pre-clinical experiences to the patient clinic.


3M ESPE will help facilitate the donations to schools that meet the required criteria in order to ensure that the technology is used to its fullest advantage. “Embracing new technology is a challenge for any organization,” said Larry Lair, president and general manager of 3M ESPE. “3M ESPE is committed to helping 3M Community Giving ensure that selected universities successfully integrate this into their curricula. We are thrilled that they are committed to supporting education and supplying these schools with leading technology.”

 
3M Community Giving donates cash and products to education and nonprofit organizations to strengthen communities in the United States where the company has facilities. Investments are primarily in technical, engineering, and business schools and efforts that further teaching and learning.

Monday, August 01, 2011

'Get dental work done then plead poverty'

I cannot imagine any journalist would advocate theft as a means to get treatment. It appears that Kevin Milne has done just that. I wonder if Mr. Milne will give similar advise for legal representation if people follow his advise. At least the informal poll they are taking shows most people are honest. MJ

From the NZHEARLD.com
http://www.nzherald.co.nz/health/news/article.cfm?c_id=204&objectid=10740845
By Hayley Hannan
If you can't afford dental work, simply get the work done and force a "flexible" response from the dentist, suggests a consumer champion.
In the latest edition of Woman's Weekly, former Fair Go presenter Kevin Milne offers a few options in response to a query from a woman whose son needed $5000 of dental repairs, including root canal work.
The magazine's consumer columnist recommends approaching the dentist to organise a scheduled payment option. Another "controversial" option, he says, is to get the work done "before he tells the dentist he doesn't have the funds right now".
"That could force a flexible response from the dentist. They may assess your son's wealth, and decide it's better to get some payment than spend money on legal action," he wrote.
"I'm not recommending this option, as your son may end up in worse difficulties than poor teeth, including court action and possibly a bad credit rating.
"But I'm sure it's an option some would feel they had to take."
Milne declined to comment further yesterday.
David Crum, chief executive of the Dental Association, said he did not agree with a patient simply saying they couldn't afford to pay.
"Dentists are to discuss the fees prior to providing treatment. To suggest patients should have treatment and then not pay on the amount agreed, that is dishonest.
"To then not pay would be considered as theft ... it's like someone going to work at the beginning of the week and then the employer saying we are not going to pay you."
He said some clients had dental work done and then admitted they could not afford to pay for the service.
"My response to them is, 'Well, I can't say to my staff, I haven't been paid so I can't pay you this week'."
He said he had often seen clients set up week-by-week payments and in his practice about 10 per cent of people paid by instalment.
Dental hygiene has come under fire for being too expensive over the last 20 years, with MP Jim Anderton repeatedly pushing for free dental care.
The Progressive Party leader announced a policy of free dental health care for all last month, saying dental care prices were extortionate.
"About 44 per cent of New Zealanders don't get any dental treatment at all," he said. "At Middlemore Hospital any day, you'll find queues of people waiting for six hours to get their treatment because they can't afford to go to the dentist."
Mr Anderton proposes a free dental policy to start with vulnerable groups such as people over 65.
He said Britain, Germany, Scandinavia and France all had more affordable dental plans.