Saturday, July 30, 2011

Shifting dental landscape in the UK

The commissioning of NHS dental services is experiencing a turbulent period as it contends with structural change in the NHS, the launch of pilots for a new dental contract and pressures on funding. That's according to the British Dental Association's (BDA's) 2011 Dental Commissioning Survey.

The research reflects a shifting landscape for primary care trusts (PCTs), in which more than a quarter (28%) of those questioned said that their commissioning functions had merged with those of other PCTs. Although a very small proportion of respondents (8%) reported that clustering had had a negative impact on their ability to answer local needs, most did not, reporting no change or a positive impact or saying that they did not know what the effect of clustering had been. Half of those questioned said that clustering had improved their ability to manage contracts.

Pilots for a new dental contract also received a largely positive verdict, with 79% of those surveyed stating they believed a new contract based on capitation and quality would increase the quality of care patients receive. More than half (53%) of respondents also believed that such a contract would improve the oral health of the local populations for which they are responsible.
The survey did uncover concerns about funding issues, however, with 21% of those surveyed reporting cuts of as much as more than 4% to their budget for salaried primary dental care, and 18% reporting smaller decreases in the budgets for hospital dentistry.

Dr Susie Sanderson, chair of the BDA's Executive Board, said:
'This survey reveals a complex picture of the state of NHS dental commissioning, with tentative steps being taken towards a better future. The BDA has fought hard for a new contract and supported changes to commissioning arrangements that we believe will lead to a greater consistency of approach, and this is an encouraging snapshot of progress towards those goals.

Friday, July 29, 2011

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

Journal of Esthetic and Restorative Dentistry 

Article first published online: 18 JUL 2011

DOI: 10.1111/j.1708-8240.2011.00455.x



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, July 28, 2011

GaAlAs Laser Irradiation Induces Active Tertiary Dentin Formation after Pulpal Apoptosis and Cell Proliferation in Rat Molars

Journal of Endodontics
Volume 37, Issue 8 , Pages 1086-1091, August 2011



This study aimed to clarify pulpal responses to gallium-aluminum-arsenide (GaAlAs) laser irradiation.


Maxillary first molars of 8-week-old rats were irradiated at an output power of 0.5 or 1.5 W for 180 seconds, and the samples were collected at intervals of 0 to 14 days. The demineralized paraffin sections were processed for immunohistochemistry for heat-shock protein (HSP)-25 and nestin in addition to cell proliferation assay using bromodeoxyuridine (BrdU) labeling and apoptosis assay using deoxynucleotidyl transferase deoxyuridine triphosphate nick end labeling (TUNEL).


Intense HSP-25 and nestin immunoreactivities in the odontoblast layer were weakened immediately after 0.5-W irradiation and recovered on day 1, resulting in slight tertiary dentin formation by day 14. On the contrary, 1.5-W irradiation immediately induced the loss of HSP-25 and nestin-immunoreactivities in the odontoblast layer. On day 1, numerous TUNEL-positive cells appeared in a degenerative zone that was surrounded by intense HSP-25 immunoreactivity. BrdU-positive cells occurred within the intensely HSP-25–immunopositive areas during days 2 through 5, whereas TUNEL-positive cells gradually decreased in number by day 5. HSP-25– and nestin-positive odontoblast-like cells were arranged along the pulp-dentin border by day 7, resulting in remarkable tertiary dentin formation on day 14.


The output energy determined pulpal healing patterns after GaAlAs laser irradiation; the higher energy induced the apoptosis in the affected dental pulp including odontoblasts followed by active cell proliferation in the intense HSP-25–immunoreactive areas surrounding the degenerative tissue, resulting in abundant tertiary dentin formation. Thus, the optimal GaAlAs laser irradiation elicited intentional tertiary dentin formation in the dental pulp.

Wednesday, July 27, 2011

eDossea Introduces Dental File Sharing Portal

DES MOINES, IA:  July 22, 2011— eDossea, a company that provides online tools for handling patient data within HIPAA guidelines, has introduced its file sharing and storage portal, eDossea™ Version 1.0. The web-based platform allows doctors to transfer patient records safely and securely online (while maintaining x-ray image quality), and does not conflict with patient management software programs.

eDossea 1.0 gives dental professionals an easy way to securely store patient files, share them between offices, and provide them to dental labs or specialists (the recipients do not have to be eDossea clients). When an office refers patients to a specialist—such as an oral surgeon or an endodontist—or sends cases to a dental lab, there is a need to transfer x-rays and other patient information. This is often done in ways that are unsecure or costly, such as mailing printed records, emailing files, using unprotected online file-sharing programs, or exporting files from patient management software. In addition to the costs of staff time, printing, and possible data loss, these methods can expose the practice to HIPAA violations, fines, and potentially large lawsuits. eDossea 1.0 provides a secure system that facilitates easy sharing of the records within HIPAA guidelines, giving the specialist’s office or dental lab easy access to files while preserving image quality and data integrity. 

eDossea 1.0 requires little or no training for staff, does not require special software or downloading, and is available for a reasonable monthly fee. Clinicians can try the service free for 30 days by clicking “Free Demo” at

Monday, July 25, 2011

EGSolutions Launches DScan 3D Scanner for Dental Labs

BOLOGNA, Italy, July 18, 2011 - EGSolutions, a leading developer of cutting-edge solutions for processing digital models from data captured with 3D scanners, launches DScan.DScan is a 3D scanner designed specifically for the dental market. EGSolutions offers a complete solution for dental professionals by seamlessly integrating DScan with DentalCAD 2012, a computer-aided design (CAD) program to model crowns, bridges, anatomic prostheses and customized implants.
DScan key features include:
  • High precision and reproducibility: accuracy as high as 15 microns, tested in a metrology environment;
  • Customizable acquisition strategies: arc jaws, stumps, bridges, antagonists and wax-ups;
  • Impressions acquisition;
  • Maximum reliability: high-quality mechanical and electronic components;
  • Compact size: fits in any laboratory due to DScan's reduced size and weight;
  • Tailored configuration: users are able to completely customize acquisition parameters and options;
  • Open system: datasets are exported in common formats, including STL, PLY and ASC, which can be read in any CAD/CAM system.
EGSolutions relied on its extensive expertise in electronic and mechanical design in order to create DScan. DScan is also a testament to its location in Bologna, which is a world-renowned centre for precision mechanics, particularly in the packaging and automotive fields.
EGSolutions’ partners are designers and producers of high-quality components for multinational companies, such as GD, Marchesini Group and IMA as well as the exemplary carmakers Ferrari, Ducati, Lamborghini and Maserati.
“DScan is produced entirely in Italy (Bologna) near EGSolutions' headquarters. This allows us to ensure high production standards and excellent quality—all at a very competitive price,” said Gabriele Canella, Chief Executive Officer of EGSolutions. “We are able to oversee the entire process by applying our vast knowledge of software development and mechanical and electronic design. The result is a complete solution to interface with milling and rapid prototyping machines: DScan and DentalCAD 2012.”
DScan has an actual and reproducible precision of 15 microns. It is an open system, thus allowing exporting data in the most common formats used by CAD/CAM applications. The scanning process is completely automated and is based on two synchronized axes driven by an industrial PLC. Users can customize acquisition parameters and options.
The high precision and robust technical features of DScanenables professionals to acquire complete arc jaws, stumps and impressions, thanks to a unique design of the optics.
The DScan scanner is a perfect companion to DentalCad 2012. Available from EGSolutions, the DScan + DentalCad 2012 bundle represents a complete and proprietary solution for the dental market.
Visit EGSolutions’ YouTube channel for more information and videos of our technologies, and connect with our Facebook profile for the latest news and offers.
About EGSolutions
With over 15 years of experience, EGSolutions is a leading developer of technologies for the elaboration of digital models acquired by 3D scanners. EGSolutions is a preferred partner for companies wanting to innovate and enhance their creative and production processes. EGSolutions provides a single solution to manage 3D scans that includes both scanner and software. EGSolutions’ technologies can be applied to a wide variety of industries, including industrial design, engineering, architecture, healthcare, entertainment and media. EGSolutions' headquarters is located in Bologna, Italy, with additional offices in Italy and Russia.
Visit to learn more.

Saturday, July 23, 2011

Tempur-Med® Dental Chair Pad and Head Cushion Back by Popular Demand

NORTH CANTON, Ohio, July 18, 2011 /PRNewswire/ -- BioTech Medical, Inc. announces the addition of the BioTech Medical Original Tempur-Med® Dental Chair Pad and Head Cushion to its ever expanding line of innovative support surface products.
"There isn't a day that goes by that our office doesn't receive a call for this product," said Cathy Tippey, Director of Medical Operations for BioTech Medical, Inc.  "We listened to our customers, and now, through an "exclusive" licensing agreement with Tempur Medical, BioTech Medical is able to offer the only dental chair overlay and head cushion made of Tempur-Pedic's proprietary material," said Tippey.
The addition of the BTM Original Tempur-Med® Dental Chair Pad and Head Cushion, the same pad and cushion that dental offices have trusted for years, is just another step towards providing BioTech Medical's customers a one stop shopping experience in offering their patients the best choices available.
BioTech Medical, Inc.  is a leading distributor and provider of  innovative products and support surfaces to the DME and Worker's Compensation industry.  BioTech Medical's comprehensive product and service offerings are used to enhance the safety and quality of patient care in extended care facilities and home care settings.
BioTech Medical, Inc. is a North Canton, Ohio based division of privately held Suarez Corporation Industries (SCI), a leading international marketing company.  For more information, please visit

Friday, July 22, 2011

Use of Twitter for public health surveillance of dental pain

The microblogging service Twitter is a new means for the public to communicate health concerns and could afford health care professionals new ways to communicate with patients. With the growing ubiquity of user-generated online content via social networking Web sites such as Twitter, it is clear we are experiencing a revolution in communication and information sharing. In a study titled "Public Health Surveillance of Dental Pain via Twitter," published in the Journal of Dental Research—the official publication of the International and American Associations for Dental Research (IADR/AADR), researchers demonstrated that Twitter users are already extensively sharing their experiences of toothache and seeking advice from other users. Researchers Natalie Heaivilin, Barbara Gerbert, Jens Page and Jennifer Gibbs all from the University of California San Francisco (UCSF), Preventive and Restorative Dental Sciences, authored this study.

The researchers investigated the content of Twitter posts meeting search criteria relating to dental pain. A set of 1,000 tweets was randomly selected from 4,859 tweets over seven nonconsecutive days. The content was coded using pre-established, non-mutually exclusive categories, including the experience of dental pain, actions taken or contemplated in response to a toothache, impact on daily life and advice sought from the Twitter community.

After excluding ambiguous tweets, spam and repeat users, 772 tweets were analyzed and frequencies calculated. Of those tweets, 83% were primarily categorized as a general statement of dental pain, 22% as an action taken or contemplated, and 15% as describing an impact on daily activities. Among the actions taken or contemplated, 44% reported seeing a dentist, 43% took an analgesic or antibiotic medication and 14% actively sought advice from the Twitter community.

This research was funded by grants from the National Institutes of Health, the National Center for Research Resources, the National Institute of Dental and Craniofacial Research, the Office of the Director, and the UCSF Clinical & Translational Science Institute.

"This paper highlights the potential of using social media to collect public health data for research purposes," said JDR Editor-in-Chief William Giannobile. "Utilizing Twitter is an interesting, early stage approach with potential impact in the assessment of large sets of population information."

A perspective article titled "Using Social Media for Research and Public Health Surveillance" was written by Paul Eke of the Centers for Disease Control. In it, he states that the extensive reach of Twitter is currently being used successfully in public health to distribute health information to the segments of the public who access Twitter, but there are major limitations and challenges to be overcome before Twitter and its data products can be used for routine public health surveillance.

Visit for links to the complete articles or contact Ingrid L. Thomas at to request the PDFs.

About the Journal of Dental Research

The IADR/AADR Journal of Dental Research is a multidisciplinary journal dedicated to the dissemination of new knowledge in all sciences relevant to dentistry and the oral cavity and associated structures in health and disease. At .02261, the JDR holds the highest Eigenfactor Score of all dental journals publishing original research and continues to be ranked number one in Article Influence Score, reflecting the influential nature of the Journal's content.

About the International Association for Dental Research

The International Association for Dental Research (IADR) is a nonprofit organization with nearly 11,000 individual members worldwide, dedicated to: (1) advancing research and increasing knowledge to improve oral health, (2) supporting the oral health research community, and (3) facilitating the communication and application of research findings for the improvement of oral health worldwide. To learn more, visit The American Association for Dental Research (AADR) is the largest Division of IADR, with nearly 4,000 members in the United States. To learn more, visit

Thursday, July 21, 2011

CAD/CAM Panel at AGD Meeting

Join Paul Feuerstein and I along with others will be part of a  panel discussion that will assist you with information on all aspects of CAD/CAM dentistry at this years AGD convention.

So join us in San Diego on Friday July 29th.

Wednesday, July 20, 2011

Dentists can identify people with undiagnosed diabetes

(NEW YORK, NY, July 14, 2011) – In a study, Identification of unrecognized diabetes and pre-diabetes in a dental setting, published in the July 2011 issue of the Journal of Dental Research, researchers at Columbia University College of Dental Medicine found that dental visits represented a chance to intervene in the diabetes epidemic by identifying individuals with diabetes or pre-diabetes who are unaware of their condition. The study sought to develop and evaluate an identification protocol for high blood sugar levels in dental patients and was supported by a research grant from Colgate-Palmolive. The authors report no potential financial or other conflicts.

"Periodontal disease is an early complication of diabetes, and about 70 percent of U.S. adults see a dentist at least once a year," says Dr. Ira Lamster, dean of the College of Dental Medicine, and senior author on the paper. "Prior research focused on identification strategies relevant to medical settings. Oral healthcare settings have not been evaluated before, nor have the contributions of oral findings ever been tested prospectively."
For this study, researchers recruited approximately 600 individuals visiting a dental clinic in Northern Manhattan who were 40-years-old or older (if non-Hispanic white) and 30-years-old or older (if Hispanic or non-white), and had never been told they have diabetes or pre-diabetes.
Approximately 530 patients with at least one additional self-reported diabetes risk factor (family history of diabetes, high cholesterol, hypertension, or overweight/obesity) received a periodontal examination and a fingerstick, point-of-care hemoglobin A1c test. In order for the investigators to assess and compare the performance of several potential identification protocols, patients returned for a fasting plasma glucose test, which indicates whether an individual has diabetes or pre-diabetes.
Researchers found that, in this at-risk dental population, a simple algorithm composed of only two dental parameters (number of missing teeth and percentage of deep periodontal pockets) was effective in identifying patients with unrecognized pre-diabetes or diabetes. The addition of the point-of-care A1c test was of significant value, further improving the performance of this algorithm.
"Early recognition of diabetes has been the focus of efforts from medical and public health colleagues for years, as early treatment of affected individuals can limit the development of many serious complications," says Dr. Evanthia Lalla, an associate professor at the College of Dental Medicine, and the lead author on the paper. "Relatively simple lifestyle changes in pre-diabetic individuals can prevent progression to frank diabetes, so identifying this group of individuals is also important," she adds. "Our findings provide a simple approach that can be easily used in all dental-care settings."

Monday, July 18, 2011

How Cavity-Causing Microbes Invade The Heart

Scientists have discovered the tool that bacteria, normally found in our mouths, use to invade heart tissue, causing a dangerous and sometimes lethal infection of the heart known as endocarditis. The work raises the possibility of creating a screening tool - perhaps a swab of the cheek, or a spit test - to gauge a dental patient's vulnerability to the condition.

The identification of the protein that allows Streptococcus mutans to gain a foothold in heart tissue is reported in the June issue of Infection and Immunity by microbiologists at the University of Rochester Medical Center.

S. mutans is a bacterium best known for causing cavities. The bacteria reside in dental plaque - an architecturally sophisticated goo composed of an elaborate molecular matrix created by S. mutans that allows the bacteria to inhabit and thrive in our oral cavity. There, they churn out acid that erodes our teeth.

Normally, S. mutans confines its mischief to the mouth, but sometimes, particularly after a dental procedure or even after a vigorous bout of flossing, the bacteria enter the bloodstream. There, the immune system usually destroys them, but occasionally - within just a few seconds - they travel to the heart and colonize its tissue, especially heart valves. The bacteria can cause endocarditis - inflammation of heart valves - which can be deadly. Infection by S. mutans is a leading cause of the condition.

"When I first learned that S. mutans sometimes can live in the heart, I asked myself: Why in the world are these bacteria, which normally live in the mouth, in the heart? I was intrigued. And I began investigating how they get there and survive there," said Jacqueline Abranches, Ph.D., a microbiologist and the corresponding author of the study.

Abranches and her team at the University's Center for Oral Biology discovered that a collagen-binding protein known as CNM gives S. mutans its ability to invade heart tissue. In laboratory experiments, scientists found that strains with CNM are able to invade heart cells, and strains without CNM are not.

When the team knocked out the gene for CNM in strains where it's normally present, the bacteria were unable to invade heart tissue. Without CNM, the bacteria simply couldn't gain a foothold; their ability to adhere was about one-tenth of what it was with CNM.

The team also studied the response of wax worms to the various strains of S. mutans. They found that strains without CNM were rarely lethal to the worms, while strains with the protein were lethal 90 percent of the time. Then, when Abranches' team knocked out CNM in those strains, they were no longer lethal - those worms thrived.

The work may someday enable doctors to prevent S. mutans from invading heart tissue. Even sooner, though, since some strains of S. mutans have CNM and others do not, the research may enable doctors to gauge a patient's vulnerability to a heart infection caused by the bacteria.

Abranches has identified five specific strains of S. mutans that carry the CNM protein, out of more than three dozen strains examined. CNM is not found in the most common type of S. mutans found in people, type C, but is present in rarer types of S. mutans, including types E and F.

"It may be that CNM can serve as a biomarker of the most virulent strains of S. mutans," said Abranches, a research assistant professor in the Department of Microbiology and Immunology. "When patients with cardiac problems go to the dentist, perhaps those patients will be screened to see if they carry the protein. If they do, the dentist might treat them more aggressively with preventive antibiotics, for example."

Until more research is done and a screening or preventive tool is in place, Abranches says the usual advice for good oral health still stands for everyone.

"No matter what types of bacteria a person has in his or her mouth, they should do the same things to maintain good oral health. They should brush and floss their teeth regularly - the smaller the number of S. mutans in your mouth, the healthier you'll be. Use a fluoride rinse before you go to bed at night. And eat a healthy diet, keeping sugar to a minimum," added Abranches.

Abranches presented the work at a recent conference on the "oral microbiome" hosted by the University's Center for Oral Biology. The center is part of the Medical Center's Eastman Institute for Oral Health, a world leader in research and post-doctoral education in general and pediatric dentistry, orthodontics, periodontics, prosthodontics, and oral surgery.

Additional authors of the study include laboratory technician James Miller; former technician Alaina Martinez; Patricia Simpson-Haidaris, Ph.D., associate professor of Medicine; Robert Burne, Ph.D., of the University of Florida; and Abranches' husband, Jose Lemos, Ph.D., of the Center for Oral Biology, who is also assistant professor in the Department of Microbiology and Immunology. The work was funded by the American Heart Association.

Saturday, July 16, 2011

Incisor raiding: Viking marauders had patterns filed into their teeth

Archaeologists say filed patterns in teeth of Viking warriors found in mass grave in Dorset may have been to frighten opponents. The fashion for dental bling goes back 1,000 years, according to a new discovery by archaeologists. Long before contemporary trends for gold dental caps or teeth inlaid with diamonds became popular, young Viking warriors were having patterns filed into their teeth.

Friday, July 15, 2011

Gene Implicated In Craniosynostosis, Delayed Tooth Eruption And Supernumerary Teeth

Researchers have described a new, recessively inherited human syndrome featuring craniosynostosis, maxillary hyperplasia, delayed tooth eruption and extra teeth. They also identified causative mutations in a gene IL11RA.

In craniosynostosis, the sutures between skull bones become ossified prematurely, affecting skull shape and limiting space for the growth of the brain. It is observed in 1:2500 and often requires operative surgery. Supernumerary teeth are more common, and in most cases they also require dental surgery.

A combination of these anomalies was observed in four children of a Pakistani family living in Denmark. Extra teeth developed in positions suggesting that they may represent a third set of teeth, the formation of which is normally prevented in humans.

The parents of the family were first cousins, which made it possible to localize the gene in the genome (so called homozygosity mapping) and identify the mutation, causing a change of a single amino acid, in a gene for interleukin 11 receptor alpha (IL11RA). This is a protein on cell surface that binds the extracellular interleukin 11 and makes possible for the cells to sense the presence of this factor. When tested in cultured cell lines, the mutation inactivated the function of the receptor.

The researchers also found four other mutations in IL11RA in patients from Pakistan, England and The Netherlands.

"This is a quite novel discovery as IL11 - or the signaling pathway it belongs to - has not previously been associated with any inherited human disorders", says Dr. Pekka Nieminen, the leader of the study (University of Helsinki). "The results show that IL11 signaling is essential for the normal development of craniofacial bones and teeth, and that its function is to restrict suture fusion and tooth number."

"We believe that normally IL11 mediates the complex tissue interactions that regulate replacement tooth development in mammals. In skull, IL11 signals are probably needed to regulate a process called bone remodeling in the edges of the skull bones, including site-specific regulation of bone apposition and bone resorption. Eruption of permanent teeth was also delayed in the patients with IL11RA mutations, and it may well be explained by defects in bone resorption that is necessary for teeth to erupt."

Exactly how and why the mutations lead to craniosynostosis may be possible to study in a knockout mouse model as the researchers also registered a peculiar growth anomaly, shortening and skewing of the snout.

"In the future it may be possible to use modulation of IL11 signaling for treatment of craniosynostosis", Dr. Nieminen believes.

Thursday, July 14, 2011

The 30 Best Blogs for Dental Students

The dental profession has progressed a great deal since ancient times, with new technological tools replacing the much scarier and more primitive ones of old. One of the tech tools that many dentists are using with great success these days is the web, whether advertising their own practices or sharing advice on all things dental. Dental students still in college or preparing to graduate soon can find a great deal of information on these blogs that can make dental school and the ensuing transition into professional business world a little bit easier. Here are 30 blogs we think dental students should give a read to learn more about everything they’ll need to succeed in school and beyond.

My blog is listed in the list.

Go check out the list of blog

Wednesday, July 13, 2011

Curve Hero Captures Panorex Live Online

As the thought of moving to cloud based software is intriguing one very large limitation was how to capture your digital images both intra oral and radiographic. Cure Hero has done just that. This information was provided by Curve Dental which is still testing its cloud based software.
This morning we captured our first pan image using Curve Hero's imaging features. The attached image was captured using a Planmeca ProOne unit using a TWAIN driver (I took this photo using my iPhone). I imagine the pan unit took eight seconds to scan, and then after that the image appeared on screen in about five to six more seconds. So, the image was captured directly to the Curve servers and then bounced back to the computer we were working on in less than 15 seconds. There are two clinician at this practice and they were both impressed with the speed and were of the opinion that the image quality was not a factor (they didn't notice anything different about image quality).

We also captured intra-oral images this morning without a hiccup, using a USB intra-oral camera that the practice purchased off eBay for $100 (Chinese made; I imagine that with a "real" intra-oral camera the experience will only be better). We also captured PA's using a Suni sensor. If you stop and think about what we just did--capture images directly to the cloud--it's pretty awesome.

FDA approval is pending but we expect clearance very soon.

Also, as we were leaving the doctors' Patterson rep came into do his thing. We left the pan image up on the screen for him so he could take a closer look, if he so desired.

Tuesday, July 12, 2011

Research examines dentists' role in painkiller abuse

PROVIDENCE, R.I. [Brown University] — The Obama administration turned a bright spotlight on prescription painkiller abuse in April when the Office of National Drug Control Policy released a national action plan and a statement from Vice President Joe Biden. With a cover article in the July edition of the Journal of the American Dental Association (JADA), dentists focus that spotlight on themselves both as major sources of opioid drugs and as professionals with largely untapped power to recognize and reduce abuse.

"Many dentists really haven't even perceived there to be a problem," said George Kenna, an assistant professor of psychiatry and human behavior at the Warren Alpert Medical School of Brown University, an addiction psychologist at the Center for Alcohol and Addiction Studies, and the corresponding author of the article. "Dentists write the third-most prescriptions for immediate release opioids in the United States, but they often don't know the appropriate number of doses to prescribe, how many doses a patient uses, or most importantly what patients do with the leftover tablets they have. Just ask someone the last time they threw away opioid prescriptions in particular. These leftover tablets — accumulated from various sources, not just dentists — that are often left in closets across the country are the primary source for prescription drug use initiation for children and adolescents."
As outlined by the administration's policy, facilitating ways to reduce the number of leftover painkillers such as hydrocodone and oxycodone that can become a supply of drugs in the home for those who would abuse them, dentists and other prescribers would be taking a significant step, said Kenna who is also a pharmacist. The National Survey on Drug Use and Health has found that seven in 10 people who have used painkillers nonmedically got the drugs through a family member or friend who had a prescription.
Last year Kenna helped lead a meeting of dentists and fellow addiction experts and pharmacists at the Tufts Health Care Institute Program on Opioid Risk Management, where he serves as a scientific adviser. The group produced this month's cover article for JADA, which offered several recommendations for dentists, including:
  • Discuss with patients whether they need an opioid for their pain and how likely they are to use what you prescribe.
  • Consider writing small quantities and limit refills.
  • Do not prescribe drugs to patients you do not know; be suspicious of those who claim their drugs were lost or stolen.
  • Use prescription monitoring programs (i.e., state databases), if available, to verify drug-use history.
  • Advise patients either to destroy or lockup any excess medication.
  • Keep prescription pads locked up.
In the article, the nine authors also call for more research to make the most effective use of opioid and non-opioid painkillers, for instance to determine how much painkiller and which kind patients really need. Without enough evidence to guide them, dentists have often felt obliged to prescribe opioids too often and in too great a quantity, Kenna said.
"Some new data show that ibuprofen as an anti-inflammatory does as well as many painkillers to kill pain for many dental procedures," Kenna said.
One in two dentists surveyed Despite the large role dentists have as painkiller prescribers, there has been very little research on dentists' prescribing practices and experiences, particularly in the context of opioid addiction. To inform their discussion, the group commissioned a survey in 2010, led by Michael O'Neil, a pharmacy professor at the University of Charleston in West Virginia. In all, 52 percent of the state's dentists responded.
The survey revealed that nine in 10 of the dentists surveyed prescribed opioids in the prior year. Two-thirds prescribed between 10 and 20 doses of the painkillers, but 41 percent acknowledged that patients would probably have some left over.
The survey also found some evidence that dentists can sometimes be shy about raising substance abuse as an issue with patients, even as they realize they are sometimes being used to get drugs. One in three of the dentists said they did not routinely ask new patients about substance abuse, but 58 percent of the dentists said they believed they have been the victim of prescription fraud or theft.
While dentists should guard against over-prescribing addictive drugs, especially to patients they don't know well, Kenna said, they retain an obligation to help all patients, even ones who are addicted, to manage pain.
"There are ways that dentists can work with patients," he said. "People who have a substance abuse problem do have legitimate pain. They do have a right to have some pain control and may even need more. But you hope there is a family member who will take control and make sure they only take the recommended dose."
For all the things dentists could do, especially with more research to clarify the best prescribing practices, Kenna acknowledged that dentists are not currently compensated for the time required to investigate the drug use preferences and habits of their patients.
Kenna said he hopes to learn more about how the profession approaches opioids and addiction with a national survey of dentists.
"It's a growing problem in the United States," he said. "It's a serious problem."

Monday, July 11, 2011

MetLife Selected As Provider For TRICARE Dental Program

MetLife, which has been administering oral health benefits for U.S. workers and their families for nearly 50 years, has been chosen by TRICARE Management Activity to be the provider of comprehensive dental coverage to family members of uniformed services active duty personnel, as well as members of the selected reserve and individual ready reserve and their eligible family members around the world.

"MetLife is looking forward to the opportunity to provide quality dental coverage and oral health educational programs to the more than two million TRICARE Dental Program (TDP) beneficiaries," said William J. Mullaney, president, MetLife U.S. Business. "We believe that our program provides TDP beneficiaries with great value and flexibility, including lower premiums and access to a dental provider network that is significantly larger than the current network."

MetLife's Preferred Dentist Program is one of the country's largest participating provider dental networks with more than 150,000 provider locations. TDP beneficiaries will have greater choice and opportunities to reduce out-of-pocket expenses when they visit participating dentists. Under the TDP, beneficiaries will have the freedom to utilize any dentist of their choice and receive benefits for covered services. Significant discounts apply when using in-network dental providers. In addition, when the MetLife program becomes effective, TDP beneficiaries will begin enjoying new and enhanced benefits, including an increase in the annual maximum.

"MetLife's offering provides additional benefits and savings designed to encourage beneficiaries to seek the level of oral health care that is most appropriate for themselves and their families," added Mullaney. "Good oral health is essential considering the extensive research linking certain oral diseases and overall medical health."

Saturday, July 09, 2011

American Dental Association Offers New Dental Billing Code Check App

Newswise — CHICAGO, July 1, 2011 –The American Dental Association (ADA) is making it easier and faster for dentists to find dental billing codes by introducing the new CDT Code Check app for the iOS (iPhone, iPad) and Android-powered mobile devices (phones and tablets).
The CDT Code Check, which contains every Code on Dental Procedures and Nomenclature, is a portable resource designed to assist dental professionals who use procedure codes for developing treatment plans, managing patient medical charts and submitting insurance claims. Because the app is portable, it’s the perfect tool for dentists and dental staff who travel between offices.
The app includes new and revised codes with marked changes. The app includes a complete listing of each CDT Code, including category of service, subcategory, procedure code, nomenclature and descriptor. Users can also search by code number or keyword. The app is available for $19.99 in the Apple iTunes Store and the Android Market by searching for the phrase “CDT Code Check.”

Friday, July 08, 2011

New iPhone App for when you get food stuck in your teeth

 Toothpict, an iPhone app aimed at eradicating awkward food-in-teeth moments.  It allows you to notify a friend with a detailed map of where they've got food stuck, and has a built in mirror so you can check your own teeth. It's a simple and playful solution to the awkwardness caused by teeth that haven't yet learned to auto-floss themselves. The more of us using it, the better defended our food-free smiles become.

To show you how the app works we wrote
a) A screenplay about you and Steve Jobs
b) FAQ page (with digital assets)

Thursday, July 07, 2011

dental advisor Selects PULPDENT Tuff-Temp™ as 2011 Preferred product

WATERTOWN, MA:  June 30, 2011— The Dental Advisor, which provides the dental profession with evidence-based and clinically relevant information on dental restorative products, infection control products, and dental equipment, recently rated Pulpdent Tuff-Temp Provisional Veneer, Crown & Bridge Resin 4½ (out of 5) and selected it as a 2011 Preferred Product. The product was evaluated by 27 consultants and received a 91% rating. The Dental Advisor reports objective clinical evaluations, product comparisons, comprehensive long-term clinical performance studies, and unbiased laboratory test results.

Tuff-Temp Provisional Veneer, Crown & Bridge Resin is a new rubberized-urethane provisional material with advantages over acrylics and bis-acrylics. Tuff-Temp is the first innovation in temporary materials in almost two decades. The proprietary chemistry, available only from Pulpdent, provides greater strength and dimensional stability, and a tighter fitting provisional restoration.

With Pulpdent Tuff-Temp Resin, temporaries are tough, impact-resistant, and grip the teeth. Chipping, breaking, debonding, and recementations are minimized or eliminated.

Tuff-Temp is designed to grind and powder, producing crisp and accurate margins that do not soften or distort. It does not gum up or clog finishing instruments. Exceptional results can be achieved by trimming with a slow speed acrylic bur, fine grit diamond bur, or finishing and polishing disk system. A fast application of Tuff-Temp Provisional Glaze provides enhanced esthetics and patient satisfaction during temporization.

Tuff-Temp is dual cure. It both self-cures and has a light cure option to produce a final set, full strength restoration on demand. The fast light cure option is also ideal for use with a clear vinyl polysiloxane template.

For alterations or smile design, the Tuff-Temp system includes Tuff-Temp Provisional Add-on, a shade-matching, light cure, flowable resin formulated from the Pulpdent’s proprietary rubberized-urethane chemistry. It is packaged in a 50 mL automix cartridge that fits into a standard one-to-one gun used for impression materials and is available in six popular shades: A1, A2, A3, A3.5, B1 and Bleach.

Pulpdent manufactures high-quality products for the dental profession, including adhesives, composites, sealants, cements, etching gels, calcium hydroxide products, endodontic specialties and bonding accessories. For more information call 800-343-4342 or visit  

Wednesday, July 06, 2011

Patterson Dental Introduces CAESY Cloud

I am currently beta testing Caesy Cloud and it is easy to use and convenient. MJ

Cloud-based Online Access to CAESY DVD’s 280-Plus Multimedia Presentations

ST. PAUL, Minn. – (July 5, 2011) – Patterson Dental Supply, Inc. introduces CAESY Cloud, an online portal giving instant access to CAESY DVD’s multimedia presentations via the Cloud, compatible with PC and Mac desktop computers, Smartphones, and the iPad, iPhone and iPod. With CAESY Cloud, dental professionals will have access to valuable patient education resources from multiple locations at the same time. While this is a new format of the CAESY Patient Education System, CAESY Cloud offers the same cutting edge technology, with more presentations than any other patient education software on the market. With content accessible through the Cloud, subscribers have instant access to the latest videos and updates.
CAESY Cloud requires no installation; dental professionals can simply sign up for the service by visiting to gain access to the presentations for immediate chairside use. A low monthly subscription fee makes CAESY Cloud available to dental practices with little initial investment. All that is needed to access CAESY Cloud is an Internet connection. Network connections between participating computers is not required. After subscribing, users simply visit the website to access the full library of CAESY’s robust patient education presentations.
With the addition of CAESY Cloud, dental professionals now have more tools and more options than ever before, with three delivery formats to choose from — CAESY Cloud, CAESY DVD or CAESY Enterprise. Countless dental professionals have seen how CAESY optimizes staff time, eliminates the fatigue of repeating explanations, and increases case acceptance. With full-motion video, full-color graphics and dynamic 3D animation, CAESY makes it simple for patients to see and understand the message.
CAESY Education Systems has been dentistry’s premier developer of leading-edge patient education technology and content since 1993. Patterson Dental Supply, Inc. acquired CAESY in May 2004. The award-winning multimedia information on preventive, restorative and esthetic treatment options helps dental practices worldwide educate their patients and grow their practices. The CAESY content is distributed via video and computer networks or DVD players, and now CAESY Cloud throughout the clinical and reception areas of the dental practice. The family of products includes CAESY Cloud, CAESY DVD, Smile Channel DVD, and CAESY Enterprise, which includes CAESY, Smile Channel and ShowCase. For more information, visit or call 1-800-294-8504; to gain instant access to CAESY presentations in your practice, visit

Dental Practice Marketing: A Baseline Study

Follow the link to a great article about dental practice marketing trends. This research is a snapshot of 44 practices located in the New York, New Jersey and Connecticut tri-state area. Data was gathered in person from principle dentists who own their own practices. We wanted to better understand how dentists perceive marketing and how they implement marketing plans and activities in their daily business activities.  It will serve as a baseline for future, more in-depth studies.More then half the dentists have no marketing plan.
Read the study

Tuesday, July 05, 2011

Many who skipped dental visits in the recession now face pricey procedures

Here is a good article to forward to patients who may be putting off needed dental work.

When the economy tanked and some people felt they had to choose between their groceries and their gums, many went with the groceries and skipped those dental cleanings and checkups.
Now, some dentists locally and nationally are reporting a modest return to the waiting room. But few returnees are smiling.
What was once a cavity is now a root canal. What was once a minor inconvenience (with, say, a $150 price tag for the cavity) is now a larger health problem that requires intervention (and can cost $1,000 or more).

Read the rest

Saturday, July 02, 2011

New Office Managers Course

Red Bank, NJ:  June 29, 2011The American Association of Dental Office Managers (AADOM) will introduce a new course created specifically for new attendees or dental office managers with less than five years experience. AADOM President Heather Colicchio has noticed demand from not only office managers but from dentists asking how they can best prepare their employees for leadership of the team. Colicchio is excited about the course, stating that “this will help to lay a strong foundation for our new managers. We are proud to offer this as a resource to both new members and new dental office managers.”
The course will focus on management essentials such as structuring a team, essential office systems and leadership as a dental office manager. Emphasis will be placed on financial systems such as accounts receivable and insurance management. The team-taught course will also discuss the common situations that new managers face. Colicchio further emphasized that “management by trial and error is not the ideal way to run a practice. We’re here to shorten the learning curve.”
The team-taught course will feature material taught under the instruction of Teresa Duncan, MS, FAADOM. Duncan says “Our goal is to help dental office managers be prepared for most situations that a team leader will run into. I’m excited to be a part of AADOM’s new initiative.”
AADOM’s 7th Annual Conference will be held September 8th-10th in Nashville, TN. The “Introduction to Dental Office Management” course will be held on the first day of the conference. Registration information and course specifics can be found online at

The American Association of Dental Office Managers (AADOM) is an organization of professional office managers, practice administrators, patient coordinators, insurance and financial coordinators, and treatment coordinators of general and specialized dental practices.  The largest association of its kind, it is our mission to provide our members with networking, resources and education to help them achieve the highest level of professional development. For more information please call 732-842-9977 or email us:

Friday, July 01, 2011

New Caries Detection Device-University dental device wins medical innovation award

A team of scientists from the University of Liverpool has won an award for developing a device that can identify early tooth decay and plaque before it is visible to the human eye.

The innovation, iDENTifi, comprises a clinical digital camera which incorporates Qualitative Light Induced Fluorescence (QLF) technology to take images of the mouth using blue light and special filters which can show up cavities and plaque. The images can then be transferred using wireless technology to a computer, laptop, ipad or smart phone for immediate assessment and evaluation by a dental care professional.
The tool shows up early stage plaque, tiny cavities, secondary cavities which develop when fillings start to fail and cavities which can occur on the smooth surfaces – or biting surfaces - of teeth. The device can identify more mature and potentially damaging plaque without the need for current methods using unsightly dyes or disclosing agents and has the potential to improve preventive dental strategies, and could change patient's dental care and dietary behaviour. iDENTifi will be of particular benefit to orthodontic patients to highlight plaque left behind after cleaning as this is more difficult with orthodontic appliances in the mouth.
Professor Sue Higham, from the Department of Health Services Research and School of Dentistry, said: "Winning a prestigious Medical Futures Award is a great honour and proves that iDENTifi is not only highly innovative but, importantly, has real commercial and market potential. Winning this award will give us access to business expertise and networks which will help iDENTifi secure the recognition and investment needed to become a viable dental healthcare product."
Plaque which isn't removed becomes thick and "mature" and may lead to gingivitis, or bleeding gums, and decay. Tooth decay is one of the most widespread health problems in the UK. More than half (55%) of adults in the UK have one or more decayed teeth and it is particularly common in children and young adults, fuelled by an increased frequency of consuming sugars in the diet and poor dental hygiene. It is estimated that between 52% and 77% of children aged 8 to 15 have some obvious tooth decay in their permanent teeth and in young people alone £45 million is currently being spent every year on the problem.
iDENTifi has been developed by a team from the University of Liverpool in collaboration with dental healthcare developers Inspektor Research Systems BV. The original concept for the device began over a decade ago when the Liverpool team wished to incorporate QLF technology into clinical SLR cameras. iDENTifi will continue to be used in clinical trials and a launch is anticipated in summer 2012.