Friday, August 31, 2007
Patients Turn to No-Interest Loans for Health Care
By MILT FREUDENHEIM
Zero-interest financing, a familiar sales incentive at car dealerships
and furniture stores, has found its way to another big-ticket consumer
market: doctors' and dentists' offices.
For $3,500 laser eye surgery, $6,000 ceramic tooth implants or other
procedures not typically covered by insurance, millions of consumers
have arranged financing through more than 100,000 doctors and dentists
that offer a year or more of interest-free monthly payments.
Of course, going into debt to pay for medical procedures is nothing
new for many people. And this type of financing is still only a
fraction of the nation's $900 billion market for consumer revolving
But as the price of health care continues to rise and big lenders
pursue new areas for growth, this type of medical financing has become
one of the fastest-growing parts of consumer credit, led by lending
giants like Capital One and Citigroup and the CareCredit unit of
Big insurers, too, are devising new financing plans with various
payback options. Upstart players have also aggressively cut deals with
The room for expansion looks ample, as rising deductibles, co-payments
and other costs may force more of the nation's 250 million people with
health insurance to finance out-of-pocket expenses for even basic
"As more and more of the costs of care are shifted to consumers,
people are going to need more credit," said Red Gillen, a senior
analyst at Celent, an insurance and banking research firm. "They are
still going to need health care."
The zero-interest plans are not for everyone. In fact, they are
available only to the creditworthy - meaning they offer no help to
those among the nation's 47 million uninsured who are in difficult
And creditworthiness is starting to be judged even more stringently,
in light of the subprime mortgage crisis's impact on the debt markets,
according to David Robertson, publisher of The Nilson Report, a
newsletter for the credit card industry.
Even for those who can get credit approval, the plans make sense only
if users are able to make payments on time and close the loan on
schedule, typically within 12 months. Otherwise, the loans after
defaults can carry interest rates of 20 percent or more - similar to
the default penalty on a typical credit card.
"We are very careful to tell patients upfront, 'Be sure you can make
your payments,' " said Dr. Richard J. Mercurio, a dentist in Lincroft,
N.J. He arranges patient financing through the CareCredit unit of
G.E., the leader in consumer medical financing.
Dr. Mercurio says he knows of at least two patients who missed
payments and received monthly bills charging high interest rates.
"They were not happy," he said.
For those who are able to make their payments, though, the plans can
make it possible to receive treatments that otherwise might be out of
"There was no way I had $6,000 right out of my pocket," said Nancy
Schlachter, 40, who has dental insurance through her job as an
accounts payable manager for a national construction company. She went
to Dr. Mercurio for a series of dental procedures including a new
crown, fillings and a tooth implant.
"The implant was very expensive, and it was not covered," Ms.
Schlachter said. But the dentist's office arranged 12-month
zero-interest financing. "It was the only way I could do it," she
Some consumer debt experts warn that as more people try to bridge
widening gaps in their health insurance, paying for medical care on
credit could plunge the unwary into a financial crisis. In recent
years, the use of high-interest credit cards to pay big medical bills
has become a leading cause of consumer bankruptcy.
"Unless they are at risk of losing life or limb, people should be very
cautious about putting medical bills on credit cards," said Mark
Rukavina, executive director of the Access Project, a research and
consumer advocacy organization that helps people with their medical
Still, consumer credit companies and some insurers are now
experimenting with financing plans meant specifically for medical
For people who think they could not pay off a zero-interest loan
within a year, most credit companies also offer longer-term medical
financing deals with 12 percent to 13 percent interest payable over
several years. Those plans, though, must be arranged at the outset of
the medical expense; a zero-interest plan typically cannot be
converted to the longer-term program if consumers find themselves
unable to pay off the one-year loans.
Some insurers, including UnitedHealthcare, also have special credit
plans available for insured members whose policies are linked to
health savings accounts. Such policies combine high-deductible
insurance with tax-sheltered savings accounts where money can roll
over year to year until needed for medical expenses. But typically,
the amounts of money being set aside do not go very far toward meeting
even routine health expenses.
So far, among the 1.76 million health savings accounts in this
country, the average balance is $1,327, according to a recent survey
by Inside Consumer-Directed Care, a trade publication. To help people
with health savings accounts meet the shortfall, the Exante Bank unit
of UnitedHealth Group is trying out a card that extends credit at
rates currently averaging about 10 percent to 13 percent, depending on
the applicant's credit history.
UnitedHealthcare is also testing a medical credit card that would
offer reduced rates.
"There's a place for credit solutions that are integrated within
traditional health insurance programs, when an individual hits that
out-of-pocket expense," said Tom Beauregard, a senior vice president
at UnitedHealthcare. "The key is to make it voluntary, to make it
simple and to offer favorable credit terms."
As for the zero-interest deals, the credit providers say that most of
them end up being just that - interest-free. About 80 percent of the
medical loans that CareCredit provides are paid off on schedule and
incur no finance charges, according to the company's president,
Michael J. Testa.
That, the companies say, justifies the high default interest rates for
late payments, since that is the way they recoup the costs of doing
business. In fact, though, the credit companies make money even on the
interest-free deals, because they are typically keeping 10 percent of
the fee the doctor charges the patient. On a $5,000 cosmetic nose
operation, for instance, the plastic surgeon might receive only
Another of the medical finance companies, HELPcard, says that for
dentists whose customers are good credit risks, the lender's
commission might be only 4 percent to 5 percent. But for patients with
low credit ratings, a dentist eager to build a clientele might have to
accept as little as 75 percent of the bill, said Pat McGee, HELPcard's
senior vice president for sales and marketing.
The CareCredit unit of G.E., too, has special deals for patients whose
credit is not well established. Stephanie Waterman, a coordinator for
Dello Russo Laser Vision, a laser-surgery practice with offices in New
York and Bergenfield, N.J., said patients deemed less creditworthy
were required to pay $600 in cash and to agree to have 12 months of
zero-interest payments taken directly from their bank accounts.
One Dello Russo patient, Senior Airman Derrick Fields, 31, stationed
at Dover Air Force Base in Delaware, said that in June he paid $600
down on a $3,500 surgery bill for both eyes - a reduced charge the
practice offers to members of the military.
"They take about $250 a month from my bank account," said Mr. Fields,
who said he soon expected to not wear eyeglasses for the first time
since the second grade. "I owe $2,900."
Copyright 2007 The New York Times Company
Thursday, August 30, 2007
Wednesday, August 29, 2007
Horseback riding with Titus Schleyer, Larry Emmott and thats me on the far right.
A group picture after a tough day riding and before needing the spa!
A waterfall on the way to Sundance
A big Thank You to all the folks at Dentrix for a very enjoyable few days!
Now onto G2.
The third component update is out. But wait G3 is coming in the 1stQ of 2008. Some of the new features are an updated perio chart, and changes we have all been waiting for in the document center. Direct input of PDF and MS Office documents!You will be able to load G3 without loading G2 for those still using Dentrix 11.
The Guru- is a patient education module that will be tightly integrated into the software. Treatment planning root canal therapy will allow the Guru to load the video so that the procedure can be better explained to the patient.
Another new software will be LabNet. This will allow real time collaboration of return dates and information such as photographs and lab slips between the dental office and dental laboratory.
The new voice module is called Voice Pro. It seemed to work quite well but voice recognition technology can always be a trying endeavor to get working properly. We will see if this works in the office as well as it seemed to work in the demonstration.
If you are not using e-Services you should be. Using e-Claims and Quickbill are no brainers for any dental office. They both save your staff time and money. My staff would never go back to manual billing. I highly recommend all dental offices should have as part of your backup solution an automated off site component. So check out e-backup.
There are other e-services like webenabled so so check out the
e-services web site.
There are more exciting things coming we will just have to give Dentrix some time to implement them both in the software and in tech support.
Tuesday, August 28, 2007
I also got to voice some concerns I have with Dentrix and as a user I can tell they are listening.
I am learning about what Henry Schein Practice Solutions and Dentrix has in store for it users in the near future.
More information in the days ahead along with some photographs.
Saturday, August 25, 2007
Journal of Public Health 2007 29(3):303-307; doi:10.1093/pubmed/fdm038
Three separate incidents involving failure of decontamination of dental instruments were reported to our Unit in less than one year. We describe the risk assessment we undertook for the likelihood of detecting transmission of a blood borne virus infection. Even where 4000 patients attended the same dentist for seven years, there was no certainty of detecting even one person infected by the decontamination failure, while several people who had acquired infection by other routes would be identified. We conclude that these findings suggest that notifying patients is not usually justified.
Friday, August 24, 2007
Security of Patient and Study Data Associated with DICOM Images when Transferred Using Compact Disc Media
Fintan J. McEvoy1 Contact Information and Eiliv Svalastoga1
(1) Department of Small Animal Clinical Sciences, Faculty of Life Sciences, Frederiksberg Campus, University of Copenhagen, Copenhagen, Denmark
Received: 15 May 2007 Revised: 24 July 2007 Accepted: 5 August 2007 Published online: 21 August 2007
Abstract The transmission of patient and imaging data between imaging centers and other interested individuals is increasingly achieved by means of compact disc digital media (CD). These CDs typically contain, in addition to the patient images, a DICOM reader and information about the origin of the data. While equipment manufacturers attach disclaimers to these discs and specify the intended use of such media, they are often the only practical means of transmitting data for small medical, dental, or veterinary medical centers. Images transmitted by these means are used for clinical diagnosis. This has lead to a heavy reliance on the integrity of the data. This report describes attempts to alter significant patient and study data on CD media and their outcome. The results show that data files are extremely vulnerable to alteration, and alterations are not detectable without detailed analysis of file structure. No alterations to the DICOM readers were required to achieve this; changes were applied only to the data files. CDs with altered data can be readily prepared, and from the point of view of individuals viewing the images, function identically to the original manufacturer’s CD. Such media should be considered unsafe where there is a potential for financial or other gain to be had from altering the data, and the copy cannot be cross-checked with the original data.
Thursday, August 23, 2007
The risk is associated with morphine, a metabolite of codeine. Some women who can rapidly metabolize codeine and release high levels of it into their breast milk, which could poison their babies.
The FDA advisory was issued after the federal agency noticed a fatal case of codeine-derived morphine poisoning in a 13-day old breastfed baby, which was reported last year in the August 2006 issue of Lancet, a British medical journal.
The mother was taking less than the usual amount of codeine normally prescribed for episiotomy pain, said the FDA, citing the report. Lab results showed high levels of morphine in the baby's blood and the mother was an ultra-rapid metabolizer of codeine.
Ultra-rapid metabolizers of codeine are the individuals who can rapidly metabolize codeine. As a result, they may have high levels of morphine in their blood and other body fluids waiting to be further metabolized.
In nursing women who are ultra-rapid metabolizers, their milk can contain high levels of morphine. These higher levels of morphine in breast milk may lead to life-threatening or fatal side effects in nursing babies, the FDA said.
According to the FDA, as few as less than 1 percent to as high as 28 percent of the population depending upon the population can be ultra-rapid metabolizers, which can only be determined by genetic testing.
Codeine is an ingredient in many prescription pain relievers and some over-the-counter cough syrups. Once the body metabolizes codeine to morphine, the morphine relieves the pain or cough, but can also cause some side effects in some people.
The FDA advised that physicians should be careful when they decide to prescribe codeine-containing drugs to breastfeeding women. They should inform their patients about the potentially fatal risks and the signs of morphine overdose for their babies.
When a breastfeeding woman needs codeine, physicians should make sure to prescribe only the lowest effective amount for the shortest period of time although even low doses could still be a risk of morphine overdose in some babies.
Breastfeeding women taking codeine need to carefully watch their infants for signs of morphine overdose and seek medical attention immediately if they see their infants experiencing increased sleepiness (more than usual), difficulty breastfeeding or breathing, or decreased tone (limpness), the FDA said.
Breastfed babies usually nurse every two to three hours and should not sleep more than four hours at a time. Eating and or sleeping abnormally could be symptoms of overdosing of morphine.
Other signs to watch may occur in nursing mothers who take codeine. They may also experience overdose symptoms such as extreme sleepiness, confusion, shallow breathing or severe constipation.
The FDA has asked the makers of prescription codeine-containing products to put on the label information regarding the potential implications of taking codeine-containing products in the breastfeeding mothers and their babies.
The FDA published the common questions and answers regarding use of codeine products in nursing mothers, cited in verbatim, for those who are interested in more details about the issue.
Wednesday, August 22, 2007
Cavanna L, Bertè R, Arcari A, Mordenti P, Pagani R, Vallisa D.
Department of Medical Oncology and Hematology, Hospital of Piacenza, Italy.
Eur J Intern Med. 2007 Sep;18(5):417-22. Epub 2007 Jul 13
BACKGROUND: Bisphosphonates are commonly used as standard care in the management of patients with advanced-stage cancer involving bone. There has recently been growing concern that the use of bisphosphonates is associated with osteonecrosis of the jaw (ONJ). METHODS: Between 2001 and 2005, five patients with ONJ associated with pamidronate and zoledronate therapy were diagnosed at our department. The patients had breast cancer, renal carcinoma, mesothelioma, and multiple myeloma, all involving bone. The literature was reviewed. RESULTS: The duration of bisphosphonate therapy before presentation of ONJ ranged from 21 to 36 months. The lesions were localized to the mandible (n=3) and maxilla (n=2). All of the patients presented with pain and exposed bone; in two of them, symptoms began after tooth extraction. A review of the literature through March 2006 identified more than 250 reported cases of ONJ. CONCLUSIONS: The findings in our patients, combined with the literature review, suggest that: (1) the most common clinical presentation of ONJ is pain and exposed bone of the mandible or maxilla; (2) for patients who develop ONJ, conservative, non-surgical treatment is strongly recommended; (3) clinical dental examination and a panoramic jaw radiograph should be performed before patients begin bisphosphonate therapy; (4) dental treatment and other oral procedures should be completed before initiating bisphosphonate therapy; (5) patients should be informed and instructed on the importance of maintaining good oral hygiene and having regular dental assessment; and (6) the medical community needs to be aware of the association between bisphosphonate usage and ONJ so that unnecessary and harmful surgical procedures can be avoided.
Tuesday, August 21, 2007
Barry Kaplan had a thriving dental practice in Atlanta when he started experiencing debilitating pain and began to drop instruments when he was with patients.
After a doctor confirmed that he had ruptured disks in his neck, he went through treatments and surgery. When that failed to fully restore his motor skills, "it was time to hang up the mirror and drill."
"Not only was I making a nice living, I had just paid off my student loans and was about to pay off the practice note," says Kaplan, who went on disability at age 45. "This meant I was just about to enter the most profitable part of my career."
Fortunately, Kaplan, now 52, was financially prepared and had several disability insurance policies in force.
You don't have to be a medical professional to realize that you need to insure for the event of disability. Some 43 percent of Americans older than 40 will experience some health emergency that will take them out of the work force for 90 days or more, according to the Insurance Information Institute, an industry research organization.
Although most employers may provide disability insurance, coverage varies and may not allow you to make retirement fund contributions.
Read more of the article
Monday, August 20, 2007
there is a strong likelihood a local anesthetic reversal agent will be available in the USA sometime in 2nd quarter of 2008.
Just an FYI for all of us who were unaware of this.
Novalar Pharmaceuticals, Inc. announced that results from two Phase 3
studies and a pediatric Phase 2 study of NV-101, a local dental
anesthetic reversal agent, will be presented at the 85th Annual Meeting
of the International Association of Dental Research (IADR) in New
Orleans. John Yagiela, D.D.S., Ph.D., Professor and Chair, Diagnostic
and Surgical Sciences at UCLA's School of Dentistry will present data
from the Phase 3 studies and Sharon Gordon, D.D.S., M.P.H., Ph.D.,
Associate Professor, Department of Biomedical Sciences and Brotman
Facial Pain Center at the University of Maryland, Baltimore, College of
Dental Surgery, will present results from the pediatric Phase 2 study.
The IADR is the largest and most prestigious organization for oral,
craniofacial and dental research with over 11,000 active individual
members worldwide. At the annual meeting, scientists communicate the
latest peer reviewed data to facilitate the rapid dissemination and
application of dental research findings.
Data from two Phase 3 studies shows that NV-101 was well tolerated,
safe, and met its primary and secondary endpoints. In both studies, NV-
101 treated patients reported the return of sensation and function in
less than half the time it normally took after receiving local dental
anesthesia. NV-101 induced a 54.8 percent and a 62.3 percent decrease in
time to normal for those with anesthesia administered in the mandible
and maxilla respectively. These reductions were statistically different
than control (p < 0.0001) with no serious adverse events (SAE's)
In the Phase 2 pediatric study for NV-101, the time to normal sensation
was reduced by 55.6 percent, a clinically and statistically significant
(p < 0.0001) acceleration of the return to normal sensation. As in the
Phase 3 studies, NV-101 continued to be well tolerated with no SAE's
reported in the pediatric population studied.
"We were extremely pleased with the outcome of these studies, and we are
delighted that Dr. Yagiela and Dr. Gordon will unveil the results at
IADR, the most respected international dental research meeting," said
Donna Janson, President and Chief Executive Officer of Novalar. "Based
on these positive results, Novalar will continue to work closely with
the U.S. Food and Drug Administration (FDA) toward a successful
submission of our New Drug Application for NV-101 in the second quarter
of 2007, and to build the organizational infrastructure necessary to
launch NV-101 following FDA approval." If approved, NV-101 will be the
only local anesthetic reversal agent available for use in pediatric,
adolescent and adult patients.
The two multi-center, randomized, blinded, controlled Phase 3 studies
were conducted in 18 centers across the United States, including leading
dental schools, clinical research organizations and private clinics.
There were 484 dental patients enrolled across the two studies,
including adolescents and adults. In the first study, 244 patients
received anesthesia in the mandible (lower jaw) and in the second study,
240 patients were administered anesthesia in the maxilla (upper jaw).
Following anesthesia and completion of the dental procedure, patients
were administered either NV-101 or sham control.
"The fact that NV-101 met its endpoints so clearly, coupled with its
excellent safety profile, makes it a potentially useful treatment option
for the reversal of soft tissue anesthesia following routine dental
procedures," said Dr. Yagiela. "Its benefits are meaningful for both
dentists and patients."
Results from the Phase 2 pediatric, double blinded, controlled safety
study involving 11 study centers and 152 dental patients (aged 4-11)
complemented the Phase 3 results. In this study, the time to normal
sensation was reduced by a clinically and statistically significant (p
< 0.0001) 55.6 percent. There were no SAE's and no subjects withdrew
from the study due to adverse events (AE's). No differences were
apparent in the frequencies or types of AE's reported by the two
randomized treatment groups. All AE's resolved by the end of the study
"Children are especially at risk from biting and chewing their cheeks,
tongues and lips when numb. The pediatric results for NV-101 provide
further evidence that this product could be safe and beneficial in this
patient population," added Dr. Gordon.
If approved by the FDA, NV-101 will be the only local anesthetic
reversal agent that accelerates the return to normal sensation and
function following restorative and periodontal maintenance procedures.
The product has been tested in pediatric, adolescent and adult patients.
Phentolamine mesylate (a vasodilator), the active ingredient in the
investigational agent NV-101, has been approved and in use in specific
medical indications at significantly higher doses for over 50 years.
Saturday, August 18, 2007
Researchers at Umeå University, Sweden, studied short- and long-term temporomandibular joint (TMJ) pain and dysfunction in 60 patients in hospital emergency rooms directly after they were involved in a rear-end car collision and evaluated them again one year later.
According to the study, the incidence of new symptoms of TMJ pain, dysfunction or both between the initial examination and follow-up was five times higher in subjects than in uninjured control subjects. In the year between the two examinations, 7 percent of control subjects developed symptoms in the TMJ versus 34 percent of study subjects.
According to the American Dental Association, the TM joint is one of the most complex joints in the body. Located on each side of the head, these joints work together and can make many different movements, including a combination of rotating and translocational (gliding) action, used when chewing and speaking. Any problem that prevents this system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder.
When the patients reported having symptoms in the TMJ either before or after their accidents or both, the authors evaluated symptoms, including clicking, locking and TMJ pain. They also asked patients to rate their pain intensity and report the degree to which symptoms interfered with their daily lives, including sleep disturbances, use of pain relievers and the need to take sick leave.
"One in three people who are exposed to whiplash trauma, which induces neck symptoms, is at risk of developing delayed TMJ pain and dysfunction during the year after the accident," the researchers concluded.
This study was published in the Journal of the American Dental Association, but does not necessarily reflect the policies or opinions of the American Dental Association.
Friday, August 17, 2007
The impostor's closest brush with the dental profession was during the years 1962 to 1978, when he assisted an army dentist by carrying his bag on visits to plantation workers' homes, the New Straits Times reported on Wednesday.
"I watched the doctor diagnose and treat problems with teeth," the paper quoted the unidentified man as saying when officials raided his home this week.
"I also saw how he would extract teeth and make models and measurements for dentures."
The 63-year-old man, who convinced his neighbours he was a retired army dentist after being told he was too old to work as a dentist's assistant, charged 20 ringgit (about R40) for extractions and 130 ringgit for dentures, the paper said.
Health officials seized antibiotics, painkillers, syringes and bottles of Chinese medicine during the raid, but they needed more than six men to carry off his 1940s-era examining chair, tossed away by the Malaysian army in 1978. The paper said the raid occurred after a tip-off.
The man has been arrested for illegally practising dentistry and will face charges under Malaysia's private healthcare facilities and services act. He could face a fine of up to 30 000 ringgit or a six-year jail term, or both.
He did provide one unique service, however. "I also make house visits." he told the paper.
Thursday, August 16, 2007
The Good: Everything feels much better so I can leave on vacation without worrying about my tooth.
The Bad: I had recently ordered a new Dell PC for the office and I went to set it up and the hard drive was no good. The PC would boot up and that was it. So after about a half hour of trying to trouble shoot the PC I called Dell support.
The Good: In very quick fashion they offered to have a technician come out and replace the hard drive or would swap out the whole PC for a new one.
Today will be a better day...
Wednesday, August 15, 2007
Here is a really cool technology device for diabetics. Nothing to do with dentistry but since we all know someone with diabetes this is a great product to pass along. No more embarrassment about taking your blood sugar in public.
HealthPia America introduces the world's first all-in-one glucometer cell phone and service for managing diabetes remotely. Whether you're guardian, physician or healthcare insititution, we can provide your patients or loved ones with 24/7 support and emergency intervention through a GlucoPhone subscription - anytime, anywhere. It's a full disease management system.
Read everything about it along with watching a video on the HealthPia America web site.
CHICAGO—August 8, 2007—A literature review published in the August issue of the Journal of Periodontology (JOP) saw a strong relationship between stress and periodontal diseases; 57% of the studies included in the review showed a positive relationship between periodontal diseases and psychological factors such as stress, distress, anxiety, depression and loneliness. Literature Review Abstract *
“More research is needed to determine the definitive relationship between stress and periodontal diseases” said study author Daiane Peruzzo, PhD. “However, patients who minimize stress may be at less risk for periodontal disease.”
Researchers speculate that the hormone cortisol may play a role in the possible connection between stress and periodontal diseases. A study in the July issue of the JOP found that increased levels of cortisol can lead to more destruction of the gums and bone due to periodontal diseases. It is well known that periodontal diseases left untreated can ultimately lead to bone loss or tooth loss.
“Individuals with high stress levels tend to increase their bad habits, which can be harmful to periodontal health. They are less attentive to their oral hygiene and may increase their use of nicotine, alcohol or drugs,” explained Preston D. Miller, DDS and AAP president. “Patients should seek healthy ways to relieve stress through exercise, balanced eating, plenty of sleep and maintaining a positive mental attitude.”
Patients should to also keep in mind their “pocket size guide” to periodontal health; periodontal probing depths of one to two millimeters with no bleeding are not a concern but probing depths of three and four millimeters may need a more in depth cleaning called scaling and root planing. Probing depths in excess of 5mm may require more advanced treatment and patients should talk to their dental specialist.
A referral to a periodontist in your area, additional information, and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP's Web site at www.perio.org.
The American Academy of Periodontology is an 8,000-member association of dental professionals specializing in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of nine dental specialties recognized by the American Dental Association.
Tuesday, August 14, 2007
Dental amalgam contains a mixture of metals, including mercury, which combine to form a stable alloy that dentists have used safely for over 150 years to fill cavities. Numerous peer-reviewed, scientific studies, including those published as recently as 2006 in the Journal of the American Medical Association, attest to amalgam's safety and efficacy, leading health experts to recommend its continued availability as an option for treating dental decay.
Dr. L. Jackson Brown, a dentist, economist, epidemiologist and former ADA managing vice president for health policy agrees, saying, "The dental community and public health dentists have long known that amalgam restorations are a vital component in the arsenal to manage dental disease. This study documents the large impact the absence of amalgam would have."
A small group of activists has for years called on state and federal governments to ban amalgam, claiming, with no credible scientific basis, that it causes systemic diseases. The ADA and numerous state, national and international health authorities oppose such proposals.
"Dental care would cost more, and untreated caries (dental decay) is likely to increase," said Dr. Brown. "Unfortunately, this impact would fall disproportionately on the disadvantaged populations."
The article, "Economic Impact of Regulating the Use of Amalgam Restorations," can be viewed on the American Dental Association's Web site at: http://www.ada.org/prof/resources/topics/amalgam_economic_impact.pdf.
Monday, August 13, 2007
Read more here at PC World
Microsoft Corp. has had to create a new build of Windows XP Professional for computer makers because the six-year-old operating system's continued popularity has nearly exhausted the supply of product activation keys.
The new build, dubbed SP2c, includes no fixes or feature changes, but was created simply to address the shrinking pool of product keys. XP Pro SP2c, which has been released to manufacturing, will be made available to resellers and system builders next month, said Microsoft.
"Due to the longevity of Windows XP Professional, it has become necessary to produce more product keys for system builders in order to support the continued availability of Windows XP Professional through the scheduled system builder channel end-of-life date," wrote the Microsoft system builder team on its blog yesterday.
Previously, Microsoft has set Windows XP's EOL for retailers and resellers as Jan. 31, 2008, and for small-scale systems builders a year after that.
Bisphosphonate-Associated Osteonecrosis of the Jaw: Report of a Task Force of the American Society for Bone and Mineral Research
Read the entire report
Sunday, August 12, 2007
A 10-year prospective study of ITI dental implants placed in the posterior region I: Clinical and radiographic results
Clin. Oral Impl. Res.
Objectives: To evaluate the long-term fixture success rate, crestal bone loss and peri-implant soft tissue parameters around ITI dental implants placed in the posterior region of partially edentulous patients.
Material and methods: A total of 192 ITI dental implants were consecutively placed in premolars and molars of 83 partially edentulous patients admitted for treatment at Geneva Dental School. All implants were restored by means of ceramic-to-metal fused fixed partial dentures and single crowns. Patients were followed as part of a prospective longitudinal study focusing on implant success. Surgical, radiographic and clinical variables were collected at the 1-year recall after implant placement and at the most recent clinical evaluation.
Results: The mean observation time was 6 years (range 5–10 years). Four implants failed, yielding a 10-year cumulative survival rate of 97.9%. The mean annual crestal bone loss was −0.04±0.2 mm. Hollow-cylinder implants displayed more crestal bone loss (−0.13±0.24 mm) than hollow-screw implants (−0.02±0.19 mm; P=0.032). Clinical parameters such as age, gender, implant length and bone quality did not affect crestal bone levels. Increase in recession depth (P=0.025) and attachment level (P=0.011) were significantly associated with crestal bone loss.
Conclusions: ITI dental implants placed in the posterior jaw demonstrate excellent long-term clinical success. Hollow-cylinder implants seem to display a higher risk for crestal bone loss. Recession depth and attachment levels appear to be good clinical indicators of peri-implant bone loss.
Saturday, August 11, 2007
About half the size of a toaster, the portable device yields results in just under 10 minutes, or well within the duration of a routine visit to a dentist or doctor. Currently, patients must undergo an often painful tissue biopsy and usually wait three days to a week for the lab results. "What's exciting is the speed and efficiency that this test will bring to the diagnostic process," said John McDevitt, Ph.D., a scientist at the University of Texas at Austin and the senior author on the paper, published in the August issue of the journal Lab on a Chip. "No longer will patients need to endure referrals, long waits for test results, and scheduling follow up consultations. Patients will get immediate results and feedback from their dentist or doctor on how best to proceed."
McDevitt said his group's proof of principle study showed that their test could accurately measure levels of epidermal growth factor receptor, or EGFR, on three distinct types of oral cancer cells. This protein, which is normally displayed on the surface of our cells, tends to be overproduced in oral tumor cells and serves as a measurable marker of oral cancer.
His group's next step is to program the device to read not just EGFR levels but those of other proteins and genes that, when altered, are indicative of a developing oral tumor. This work already is well under way, and the group anticipates evaluating their test in the clinic with patients in the foreseeable future. "It could take several months to more than a year before we make the transition," said McDevitt. "But the diagnostic platform has been built, and it's just a matter of fine tuning the components that already are in place."
According to McDevitt, the lab on a chip evolved from a conversation that he had a few years ago with Dr. Spencer Redding of the University of Texas Health Sciences Center in San Antonio about the difficulties of diagnosing oral cancer. Redding explained that dentists routinely face the dilemma of whether or not to refer patients to an oral surgeon for biopsies of suspicious sores, particularly possible recurrences of a previously diagnosed oral cancer. On the one hand, early detection is a key to fighting cancer and saving lives and, on the other, if the pathology report comes back negative, dentists risk upsetting their patients.
McDevitt was uniquely qualified to consider the problem. He studied in his laboratory functional molecular assemblies, or manipulating individual molecules to assemble miniaturized electronic or sensor components. This area of research has contributed greatly toward developing nano scale devices and popularizing the new discipline of nanotechnology.
The McDevitt laboratory already had an excellent track record of assembling novel, easy-to-use sensing devices that involve microfluidics, the science of precisely controlling micro or nano volumes of fluid. Among their accomplishments were a novel, miniaturized sensor to detect anthrax spores for the Nation's biodefense efforts and thereafter a test for HIV infection and immune function in resource poor African nations. The laboratory also was working in the mouth, having received an NIDCR research grant to develop similar tests that use saliva, rather than blood, as a diagnostic fluid.
Combining these areas of research expertise, the McDevitt laboratory developed a test for oral cancer that begins with brushing cells from a suspicious lesion, suspending them in fluid, and loading roughly a drop of the mixture into their device. When activated, the device conveys the fluid down a tiny, microfluidic channel to a chamber with a porous membrane. "The cells stick to the membrane floor like starfish in a net," said Shannon Weigum, a member of the McDevitt laboratory and lead author on the paper. "The floor has little exit holes that drain the fluid out of the chamber and allow us to pump in a cocktail of, in this case, antibodies that are tagged with a fluorescent dye and that are programmed to seek out and attach to the EGFR displayed on the cells."
"The chamber creates a nice, miniaturized platform with a digital camera interface to display the fluorescent tags for analysis on a computer screen," she continued. "We can then read the level of fluorescence and determine how much EGFR is present on the cell surface. It automates a process that is done now by a pathologist. Think of the test as pathology on a chip."
In their initial experiments, the all-in-one test detected significantly higher levels of EGFR in three known oral cancer cell lines compared to normal cells, which would have been expected. This indicated that the lab on a chip had excellent specificity for its protein target. The scientists also found that their results correlated well with those using flow cytometry, the current gold-standard analytical technique to quantify protein expression.
The scientists reported that their lab-on-a-chip protocol took about nine minutes to complete, from sample collection to digital display. For flow cytometry, the protocol took two hours and five minutes. "We are doing our immune function test in eight minutes, and that includes the software manipulation and collecting the sample," said McDevitt. "I feel comfortable saying that, with further manipulations, the oral cancer test ultimately will be completed somewhere between five and ten minutes. We have developed tests that can be performed in thirty seconds, but there is some loss in accuracy when you do things in an ultra fast manner."
The Food and Drug Administration approved the EGFR-targeted monoclonal antibody called cetuximab in March 2006 to treat oral squamous cell carcinoma, the most common type of oral cancer. This marked the first new drug approved for this cancer in 45 years. But challenges remain to identify patients who might benefit from this therapy. With further development and clinical validation, the oral cancer lab on a chip could one day fill this diagnostic niche.
The National Institute of Dental and Craniofacial Research (NIDCR) is the Nation's leading funder of research on oral, dental, and craniofacial health.
The National Institutes of Health (NIH) -- The Nation's Medical Research Agency -- includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit
NHS Dental Reforms Yet To Inspire Trust Of Profession And Promote Access, Says British Dental Association
Commenting on the Department of Health's report - NHS Dental Reforms: One year on - out today, the Chief Executive of British Dental Association, Peter Ward said:
"This first year report on the new untested contract for dentists justifies our concerns and will do little to rebuild trust with the profession. By the government's own admission, we now have fewer NHS dentists and access to care for patients remains patchy. This is not a picture of success and confidence.
"The report recognises the importance of genuine local flexibility for patient care but this can only be achieved by moving away from the rigidity of this crude target-driven contract. The government must start listening to the profession and patients if local commissioning is to provide the services that local communities deserve."
The BDA has repeatedly called on the Government to scrap the currency of the new contract - the unit of dental activity (UDA) - as the only way of measuring performance.
Peter Ward said:
"Contractual performance has to be monitored but UDAs are only a single and very crude method. We need a more sophisticated approach which is sensitive to the reality of delivering dental care to patients and which supports preventive care, rather than works against it."
1. The British Dental Association (BDA) was responding to the Department of Health's publication which looked at the first year of dental reform.
2. There are at least 500 fewer NHS dentists under the new contract (page 26, para 6.5 of today's report).
3. Acording to the Department's own figures, access to NHS dental services has reduced by 47,000 patients since the introduction of the new contract. The NHS Dental Statistics for England for Quarter 4 (31 March 2007), page 6, state the following: click here. In the 24 months to 31 March 2006 - i.e. under the old contract - 28,145,000 patients were seen by an NHS dentist. In the 24 months to 31 March 2007 - i.e. first year of the new contract - 28,098,000 patients were seen by an NHS dentist.
4. The BDA carried out a survey of dentists in February and March 2007 to coincide with the first anniversary of the dental reforms. The findings are based on a 41% responses rate of 1,500 dentists in England and Wales. The research showed that 85 per cent of dentists believed that the new contract had not improved access to NHS dentistry for patients. Ninety-seven per cent thought the new contract had not removed dentists from the 'treadmill', and 93 per cent thought that the new system had not encouraged a more preventive approach to care. The BDA's research also showed that dentists' confidence in the future of NHS dentistry had fallen dramatically. Ninety-five per cent of respondents said that they were less confident about the future of NHS dentistry than was the case two years ago.
5. The British Dental Association (BDA) is the professional association for dentists in the UK. It represents over 20,000 dentists working in general practice, in community and hospital settings, in academia and research, and in the armed forces.
The British Dental Association
The better you can see something the better the outcome. MJ
Program offers affordable option
High Q Dental, manufacturer of award winning headlights for dentistry, is rolling out a new “lights for students” program. The concept, originally presented to the company by the President of a Dental Student Association, has been taken advantage of by several associations and student groups since.
The program involves High Q’s Starbright LED Headlight. The light, available on a headband or clip for most major loupes, is an exceptional introductory headlight that is powered by three AAA batteries and never requires a bulb change. The unit generally sells for only $125. Working with the dental association, High Q offered the lights at $75 per light when 10 or more students order together. The association has the option of passing the savings on to each student or offering the lights at $125 to the students and depositing the balance in the associations fund to support the groups activities and needs.
While this program is for students, the Starbright LED headlight is widely popular among practicing dentists, hygienists, and those who work out in the field.
Any dental school association or individual dental student who wishes to organize ten or more of their fellow students is invited to take advantage of this program.
For information on how you can participate or for more information on High Q Dental, please visit our web site at www.highqdental.com, call High Q at 1-800-775-3433, fax 480-905-0794 or E-mail at firstname.lastname@example.org.
Friday, August 10, 2007
The Orlando Sentinel
August 10, 2007
Virginia Adkins was puzzled. One day $150 disappeared from her checking account.
A short time later, something else odd happened: Target sent her a letter, congratulating her on her new line of credit, but no one in her household had applied for a Target credit card.
Adkins, 32, an Oviedo mother of three, was the victim of identity theft.
Seminole County deputies on Thursday said they solved the mystery: Adkins and at least eight other people were victims of a 21-year-old dental office assistant, who combed through medical files and personal information.
Carolina Cruz of west Orange County was arrested by Seminole County deputies Wednesday, accused of grand theft, fraud and four counts of identity theft. She was released Wednesday night on $6,000 bail and was unavailable for comment.
The victims all were patients at Blandon Dental, which has offices in Oviedo and Waterford Lakes, sheriff's Lt. Dennis Lemma said. Cruz worked at both offices, he said.
Dentist Alvaro Blandon would not comment.
Adkins said she was shocked by what happened and stunned that authorities had tracked the thief to her dentist's office.
'I would never in a million years have suspected that,' she said.
Read the rest in the Orlando Sentinel
Well if you have an iPhone and are missing your portable medical apps from your Palm or Windows device you now don't have to wait any longer.
Skyscape has all of there medical apps for your iPhone.
Skyscape's 5-Minute Clinical Consult
Harrison's Manual of Medicine
The Washington Manual® of Medical Therapeutics
Oxford Handbook of Clinical Medicine
DrDrugs®: Drug Guide for Physicians
A to Z Drug Facts
Go to the iPhone section on Skyscape to check it out.
Thursday, August 09, 2007
Check out the sugar
and while your at it go check out the diet caffeinated drinks also
click here to keep you awake
Wednesday, August 08, 2007
Here is the Rinsendo box. It contains syringes for your liquid of choice Bleach, EDTA, etc) a manual and a case.
Here is the case opened. It contains a coupler (your choice) that attaches to the air hose of your dental unit. The canulas and cap to prevent splash back.
A Rinsendo on top of the case.
Here is the Rinsendo on my dental unit.
The Rinsendo very effectively allows the irrigation of a tooth during Root Canal Therapy. Its simple to switch syringes and thus allows the effective use of all types of irrigants. Disinfecting root canals is a major part of successful endodontics. The Rinsendo pushes the irrigant into the canal at less pressure then a manual syringe and suctions out the irrigant. Using the Rinsendo makes it more efficient and provides greater penetration of medicaments then manual syringes.
More information can be found on the Air Techniques Web site.
Tuesday, August 07, 2007
OraPharma, Inc., maker of ARESTINR (minocycline hydrochloride) Microspheres,
1 mg, recently introduced the ARESTINR Student Access Program for dental and
hygiene schools. The program, which is scheduled to begin in September, is
open to all accredited two- or four-year dental and dental hygiene schools
that include instruction on the use of ARESTINR as part of a comprehensive
Periodontal Treatment Protocol. The launch of this program marks the first
time that ARESTINR will be widely available for clinical use by dental and
hygiene school students.
Read the press release
Bristles wielded with even gentle force tear holes in the epithelial cells that line the gums and tongue, causing a momentary rupture, researchers at the Medical College of Georgia in Augusta report in the cover article of the August issue of the Journal of Dental Research.
Tearing enables calcium, abundant in saliva, to move into the cells, triggering internal membranes to move up and patch the hole, says Dr. Katsuya Miyake, MCG cell biologist and the paper’s co-first author. But in the seconds that repair takes, growth factors that promote growth of collagen, new cells and blood vessels leak out of injured cells.
Cell injury also turns on expression of the c-fos gene, an early-response gene often activated under stress that may be the first step in a response such as cell division or growth, says Dr. Paul L. McNeil, MCG cell biologist and corresponding author.
“It’s very clear that brushing your teeth is a healthy thing to do; no one questions that brushing removes bacteria and that’s probably its main function,” Dr. McNeil says. “But we are thinking that there might be another positive aspect of brushing. Many tissues in our bodies respond to mechanical stress by adapting and getting stronger, like muscles. We think the gums may adapt to this mechanical stress by getting thicker and healthier. It’s the no pain, no gain theory the same as exercising.”
The research team, which also includes Dr. Kaori Amano, dental researcher, Kyorin University of Medicine in Japan, and Dr. James L. Borke, MCG physiologist, injected a fluorescent dye into the blood stream that can only get into torn cells. They then brushed the teeth, gums and tongue of rats with a modified electric toothbrush. “We saw lots of bright cells,” says Dr. Miyake, co-director of the MCG Cell Imaging Core Facility.
“… (W)e suggest that, in addition to its well-know ability to remove bacteria and their harmful products from teeth, brushing may, by causing plasma membrane disruptions, lead to local cell-adaptive responses ultimately of benefit to gingival health,” the researchers write.
“Viewing brushing from this novel context, as a direct physical stimulus that promotes gum health, opens up new avenues for research,” Dr. McNeil says. One immediate area of interest is to identify chemical signals produced by wounded oral cavity cells that could promote gum health. Moreover, the method and/or type of brush might strongly influence the extent of epithelial cell-wounding and subsequent liberation of factors that promote gum health, Dr. McNeil says.
Interestingly researchers found that brushing injures not only epithelial cells on the tongue’s surface but muscle cells underneath as well. “The mechanical forces must have been transmitted through the intact epithelium to the muscle cells,” says Dr. McNeil, director of the MCG Cell Imaging Core Facility. “It means our epithelium is tough and maintains a nice, resilient barrier but, not surprisingly, since it’s not a hard surface, it transmits forces quite readily.”
The gum, tongue and other surfaces in the oral cavity are covered with layers of epithelial cells that serve as a natural boundary between what goes in the mouth and the blood supply. As food digests, nutrients and other desirables move across the single layer of epithelial cells lining the gastrointestinal tract to get to the blood.
Source: Medical College of Georgia
Sunday, August 05, 2007
Here is a Treo Camera shot of the entrance to The Breakers Mansion. This was built in 1895. Its amazing the craftmanship that went into building this 70 room summer cottage.
Friday, August 03, 2007
HALF of Australia would struggle to pay for a basic preventative dental treatment, a new survey shows, and most people want the Federal Government to help meet the cost.
Activist forum Australia Fair, which is backed by The Australian Council of Social Service, said their survey revealed "gaping holes in the care and treatment of Australians' teeth and gums".
It found nine in ten people think regular visits to the dentist are important to maintain healthy teeth and mouths, but almost one quarter said they hadn't seen a dentist for more than two years.
About 46 per cent of people reported it would be difficult for them to shell out the estimated $300 for basic preventative treatment; and the same number said that cost of care influenced their decision to see a dentist regularly.
Three quarters said the Federal Government should share the cost of dental care, and only five per cent thought it should be just a state government responsibility.
"This research reinforces the fact that Australia has a crisis in access to dental care, particularly for low income and disadvantaged Australians," ACOSS Executive Director Andrew Johnson said.
"The survey also shows popular support for Federal Government action on dental care.
"With large budget surpluses and a strong economy, it's not fair that one in four Australians have told us they have not seen a dentist for two years or longer."
ACOSS wants Australians to lobby the Federal Government to fund dental care for people on low incomes.
In 1996 the newly-elected Federal Government scrapped the national dental scheme, handing sole responsibility for dental care to state governments.
The public dental waiting list has since blown out to 650,000 people.
Labor has pledged to restore the scheme, but is yet to release any details of its policy.
Health Minister Tony Abbott said the states should take responsibility for the problem.
But the May federal budget increased funding for a poorly-used Medicare scheme that gives dental care to people with a chronic illness, if that illness would be exacerbated by poor oral health.
The survey was conducted by Roy Morgan Research early last month.
Thursday, August 02, 2007
Wednesday, August 01, 2007
Sources tell Us Weekly that Spears’ friends and family have become concerned about the pop star’s mothering skills.
Case in point: The tooth fairy may be making early visits to 22-month-old Sean. “He’s having dental problems because Britney just shoves a bottle of juice in his mouth all the time to stop him from crying,” a family insider tells Us.
Another source says that, in April, Spears “asked an L.A. dentist if he would whiten her kid’s teeth!” The dentist refused.
Those close to the singer aren’t surprised that Spears’ lifestyle is wreaking havoc on her children’s teeth.
Read the rest on the Celebrity Mound web site
"It could be considered more readily by dentist and patients both as a first-choice analgesic, or to be taken alternately with doses of other analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs)," Dr. Kiaran Weil of The University of Manchester, UK, and colleagues conclude.
Paracetamol is commonly used to treat pain after wisdom tooth extraction, Weil and his team note. While the drug is frequently classified as an NSAID, they add, its anti-inflammatory effects are "relatively weak" compared to other drugs in the class. However, the drug is effective for pain relief and has few adverse effects.
The researchers conducted a review of the medical literature to gauge the effectiveness of paracetamol compared to placebo for pain relief after removal of the lower wisdom teeth and identify the best dosage and dosing time.
They analyzed 21 trials including 1,968 patients. Four and six hours after taking the drug, the researchers found that patients reported significantly less pain than with placebo. The optimal dosage was 1,000 mg, which the researchers determined could be taken safely every six hours.
Nineteen percent of patients on paracetamol reported adverse events, compared with 16 percent of the placebo group, not a statistically significant difference. The most serious side effect seen with the drug was a severe headache.
The researchers conclude that "Paracetamol is a safe, effective drug for the treatment of postoperative pain following the surgical removal of lower wisdom teeth."
SOURCE: Cochrane Database of Systematic Reviews, 2007, online.