Monday, October 31, 2011

Most U.S. toddlers haven't seen a dentist

ANN ARBOR, Mich., Oct. 25 (UPI) -- Child health experts recommend children begin dental care by age 1, but most U.S. children ages 1-2 have not yet seen a dentist, researchers say.
Sarah Clark, associate director of the Child Health Evaluation and Research Unit at the University of Michigan, said the National Poll on Children's Health asked 571 parents of children ages 1-5 about dental healthcare for young children.
The survey, conducted in May, indicated 23 percent of 1-year-olds had been to the dentist and 44 percent of 2-year-olds had been to the dentist.

Saturday, October 29, 2011

Antibiotics: Use and misuse in pediatric dentistry

 This is a very interesting read. MJ 


Peedikayil FC. Antibiotics: Use and misuse in pediatric dentistry. J Indian Soc Pedod Prev Dent 2011;29:282-7
Antibiotics are commonly used in dentistry for prophylactic as well as for therapeutic purposes. Most often antibiotics are used in unwarranted situations, which may give rise to resistant bacterial strains. Dentists want to make their patients well and to prevent unpleasant complications. These desires, coupled with the belief that many oral problems are infectious, stimulate the prescribing of antibiotics. Good knowledge about the indications of antibiotics is the need of the hour in prescribing antibiotics for dental conditions.

Read the entire article.

Friday, October 28, 2011

Effects of different concentrations of carbamide peroxide and bleaching periods on the roughness of dental ceramics

Sérgio Augusto Morey Ourique; César Augusto Galvão Arrais; Alessandra Cassoni; Cláudia Ota-Tsuzuki; José Augusto Rodrigues
Department of Restorative Dentistry, Guarulhos University - UnG, Guarulhos, SP, Brazil 
Brazilian Oral Research

Print version ISSN 1806-8324

Braz. oral res. vol.25 no.5 São Paulo Sept./Oct. 2011

The wide use of dental bleaching treatment has brought concern about the possible effects of hydrogen peroxide on dental tissue and restorative materials. The objective of this study was to evaluate in vitro the effect of nightguard bleaching on the surface roughness of dental ceramics after different periods of bleaching treatment. Fifteen specimens of 5 × 3 × 1 mm were created with three dental ceramics following the manufacturers' instructions: IPS Classic (Ivoclar-Vivadent); IPS d.Sign (Ivoclar-Vivadent); and VMK-95 (Vita). A profilometer was used to evaluate baseline surface roughness (Ra values) of all ceramics by five parallel measurements with five 0.25 mm cut off (Λc) at 0.1 mm/s. Afterwards, all specimens were submitted to 6-h daily bleaching treatments with 10% or 16% carbamide peroxide (Whiteness- FGM) for 21 days, while control groups from each ceramic system were stored in artificial saliva. The surface roughness of all groups was evaluated after 18 h, 42 h, 84 h, and 126 h of bleaching treatment. The surface roughness of each specimen (n = 5) was based on the mean value of five parallel measurements in each time and all data were submitted to two-way repeated measures ANOVA and Tukey's post-hoc test (α = 0.05). No significant differences in ceramic surface roughness were observed between untreated and bleached ceramic surfaces, regardless of bleaching intervals or bleaching treatments. This study provided evidence that at-home bleaching systems do not cause detrimental effects on surface roughness of dental ceramics.

Thursday, October 27, 2011

Updates from Patterson Dental

Caesy Cloud is Patterson's new patient education service which is available online. It can can be accessed from a PC, Mac or tablet.

Eaglesoft 17 is slated for a summer release. Look for a customizable medical history form, along with better imaging integration and other software updates.

Dr. Larry Emmott

Entering the facility

Digital Support Room

Lots of cool imaging products

Cerec Room

Patterson Technology Center

I am at the opening of Paterson's new technology center. Getting ready for a busy day. More updates as the day goes on.

Wednesday, October 26, 2011

The Progressive Dentist Magazine- Teaching the Business of Dentistry

After two years of publishing The Progressive Orthodontist magazine, Owner and Executive Editor, Bonnie Hixson, has launched The Progressive Dentist magazine. I spoke with her recently at the ADA meeting in Las Vegas, and asked her about the new magazine.  The Progressive Dentist examines the business side of dentistry. In today's world, dentists have to be savvy business men and women as well as excellent clinicians. TPD has access to respected experts and resources and provides new insights and fresh ideas to help great practitioners compete in an ever more competitive marketplace." 

The magazine is different in several ways. I asked Bonnie about the logic behind charging an annual subscription of $139 for The Progressive Dentist Magazine.  "There are lots of good "free" publications available to dentists today. But somehow, someone has to pay to produce them, and it’s not an inexpensive task. Our model makes the subscribing dentist our customer and allows us the freedom to write about the things that are of interest to them - topics that are vital to their success. Also, because we are not dependent on advertising revenue, we can be very particular about what products and services we promote. A subscription model is the only one that gives us journalistic independence and the ability to stand behind our convictions".

Given the fact that they offer an unconditional money back guarantee, this is a minimal and worthwhile investment for any practice.  They partner with some of the industry’s most respected experts, as well as leaders in the business community to offer expertise on the business of running a profitable practice.  The Progressive Dentist will also be available in digital format beginning in the first quarter of 2012, and if you subscribe before November 15th, 2011 you’ll get both print and digital magazines, and access to additional online content for just $139 per year.

To start your subscription, go to
Click subscribe and in the comments section, type "Marty" to receive a special bonus book from TPD's suggested reading list!

Tuesday, October 25, 2011

CAO Group Announces SheerWhite!® Special Offers for Both New and Existing Users

West Jordan, UT (October 21, 2011) – The CAO Group, Inc. (CAO), a worldwide provider of innovative dental devices and materials, recently announced two special limited-time offers for dental professionals who purchase SheerWhite!® teeth whitening films.  Both new and existing users of SheerWhite! can take advantage of these two separate special limited-time offers. 

Effective through December 31, 2011, the special offers are as follows:

New users – Purchase 1 Sheer White! 24-pack Bulk Kit and receive 1 SheerWhite! Intro Kit
(6-pack) FREE!  25% More Product FREE!  We guarantee that you will like it – try it for 30 days; if you are unhappy for any reason, return the product for a full refund.

Existing users – Purchase 3 Sheer White! 24-pack Bulk Kits and get 1 Bulk Kit FREE!  33% More Product FREE! 

“We hope that these special promotions make SheerWhite! more accessible to dental professionals, especially those who may not have had the chance to try our superior teeth whitening films,” remarked Robert Nordquist, VP of Sales and Marketing for the CAO Group.  “Patients and dentists who have tried SheerWhite! agree that our SheerFilm technology is like no other.”

Sheer White! was developed to provide the patient with a fast, effective, more comfortable whitening experience and to provide the office with a system that increases patient satisfaction, decreases the cost and time involved, and increases the profitability of the procedure.  No more trays!  Unlike traditional “whitening strips,” patients can actually whiten with SheerWhite! anytime, anywhere.

Users who are not completely satisfied with SheerWhite! teeth whitening films are able to return the product with no questions asked. 

For more information on all SheerWhite! promotions, please contact your local Henry Schein® sales consultant, or call 800-372-4346 to take advantage of these limited-time special offers.

For more information on SheerWhite!, please call 877-236-4408, or log onto 

About the CAO Group, Inc.

For over a decade, the CAO Group has been a leading OEM company in dental devices and materials.  They are the original pioneers of the LED curing light and innovators of diode laser technologies for dentistry, and every product produced by the CAO Group is from its own innovation.  CAO has more than 90 issued and 80 pending US and international patents.  Advanced technology, high quality, superior service, and competitive prices enable all CAO Group products to be easier to use, faster to apply, and better than other products in their class.  Easier.  Faster.  Better.™  That’s the CAO way. 

Monday, October 24, 2011

MIS Implants Technologies Launches New Website Dedicated to its New PeriZone™ Brand of Oral Care Products Explains and also Enables Dentists to Request
Free Samples of its Debut Oral Wound-Healing Product, PerioPatch®

Fair Lawn, NJ (October 20, 2011) – PeriZone™, an oral health product division of MIS Implants Technologies, Ltd., recently launched an independent new website, which will serve as the main means for dental professionals and the general public to learn about all aspects of PeriZone and its products. was designed to be very informative, and features a highly intuitive layout and easy navigation.  Upon visiting the website, dental professionals and patients alike can learn more about PeriZone’s first product, PerioPatch®, a unique oral wound barrier that absorbs wound exudates and thus promotes the natural healing of gingival inflammation and irritated gums. features general information about PerioPatch, including how to use the hydrogel patch and how the product works to promote oral wound healing.  What’s more, the website enables dentists to request free samples of the unique oral care product.

According to Noel Wilford, RDH, Director of MIS Implants’ Oral Health Division, “We’re very excited about having an independent PeriZone website and believe strongly in the effectiveness of PerioPatch for oral wound management, which is why we are offering dentists free samples of our innovative hydrogel wound dressing.  We intend to keep this site updated with useful information regarding PerioPatch and other innovative PeriZone oral care products that we have in the in the pipeline.”

About PeriZone™

The PeriZone™ brand of oral health products was founded in 2011 by MIS Implants Technologies, Ltd., a company known for its comprehensive range of dental implants, surgical kits, and superstructures.  In extending the company’s product development expertise into the oral health sector, a division of PeriZone products is being developed to provide dental professionals and their patients with advanced technologies in non-invasive oral care.

MIS Implants intends to develop and commercialize a number of products under the PeriZone brand that will provide dental professionals with the products they need to provide their patients with advanced oral care.  To learn more about PeriZone, please visit or follow on Facebook at

Saturday, October 22, 2011

Comparison among four commonly used demineralizing agents for root conditioning. A scanning electron microscopy

Journal of Applied Oral Science

J. Appl. Oral Sci. vol.19 no.5 Bauru Sept./Oct. 2011

Dental roots that have been exposed to the oral cavity and periodontal pocket environment present superficial changes, which can prevent connective tissue reattachment. Demineralizing agents have been used as an adjunct to the periodontal treatment aiming at restoring the biocompatibility of roots.
OBJECTIVE: This study compared four commonly used demineralizing agents for their capacity of removing smear layer and opening dentin tubules.
METHODS: Fifty fragments of human dental roots previously exposed to periodontal disease were scaled and randomly divided into the following groups of treatment: 1) CA: demineralization with citric acid for 3 min; 2) TC-HCl: demineralization with tetracycline-HCl for 3 min; 3) EDTA: demineralization with EDTA for 3 min; 4) PA: demineralization with 37% phosphoric acid for 3 min; 5) Control: rubbing of saline solution for 3 min. Scanning electron microscopy was used to check for the presence of residual smear layer and for measuring the number and area of exposed dentin tubules.
RESULTS: Smear layer was present in 100% of the specimens from the groups PA and control; in 80% from EDTA group; in 33.3% from TC-HCl group and 0% from CA group. The mean numbers of exposed dentin tubules in a standardized area were: TC-HCl=43.8±25.2; CA=39.3±37; PA=12.1±16.3; EDTA=4.4±7.5 and Control=2.3±5.7. The comparison showed significant differences between the following pairs of groups: TC-HCl and Control; TC-HCl and EDTA; CA and Control; and CA and EDTA. The mean percentages of area occupied by exposed dentin tubules were: CA=0.12±0.17%; TC-HCl=0.08±0.06%; PA=0.03±0.05%; EDTA=0.01±0.01% and Control=0±0%. The CA group differed significantly from the others except for the TC-HCl group.
CONCLUSION: There was a decreasing ability for smear layer removal and dentin tubule widening as follows: AC>TC-HCl>PA>EDTA. This information can be of value as an extra parameter for choosing one of them for root conditioning.

Friday, October 21, 2011

UCLA study pinpoints types of bacteria in saliva associated with pancreatic cancer

A UCLA study has found variations in the types of bacteria found in the saliva of patients with pancreatic cancer and pancreatitis, compared with healthy controls. The findings may offer a new non-invasive biomarker to diagnose and track the development of these diseases. Pancreatic cancer is extremely deadly — only 5 percent of patients survive five years after diagnosis.
Previous studies have highlighted periodontal disease, which is related to inflammation of the gums, as playing a possible role in the development of systemic diseases such as heart disease. The current study demonstrates a possible link between this type of inflammation and pancreatic cancer and pancreatitis.
Researchers found that 31 types of bacterial species were increased in the saliva of patients with pancreatic cancer, compared with healthy controls, and that 25 types of bacteria were reduced. For example, a type of bacteria known as Granulicatella adiacens, which is associated with systemic inflammation, was found to be elevated in pancreatic cancer patients. Also, a bacteria called Streptococcus mitis, which may play a protective role against inflammation, was lower in patients with pancreatic cancer.
The findings add to growing evidence that saliva may be a credible biomarker source to track and diagnose non-oral diseases. The study also offers new research directions for focusing on inflammation as a contributor to pancreatic diseases.      

Thursday, October 20, 2011

Character traits of malodor patients.

Bull Tokyo Dent Coll. 2011;52(3):123-8. 


Division of General Dentistry, Tokyo Dental College Chiba Hospital.


Many patients visit oral malodor clinics because of malodors which are brought to their attention by friends and family, or because they note the behavior of people around them, they suspect a problem and develop a fear of having an oral malodor. However, only around 30% of such patients actually have levels of malodor high enough to bother other people. Many patients exhibit halitophobia symptoms, which present as selfperception of malodor, and thus have a strong obsession about their smell which results in distress. Here, we carried out a study on 300 outpatients who visited the Tokyo Dental College Chiba Hospital Odor Clinic. We used the Tokyo University Egogram (TEG) to elucidate character traits of affected outpatients and compared the occurrence of TEG types in these patients with those of normal individuals. We discovered that 10.4% of patients were A-dominant type, which was 10.6% lower than the 21.0% of normal individuals. On the other hand, 18.4% of patients were N-type (NP high, FC low), which was 9.9% higher than the 8.5% of normal individuals. Results revealed that very few of the malodor outpatients exhibited the trait that shows intelligence, calm judgment, and self-affirmation, and as a result enjoy their life. Instead, many of these patients tended to show high levels of kindness and appeared to be holding themselves back and exercising patience.

Wednesday, October 19, 2011

Q3 Healthcare Transparency Index Reveals Wide Cost Variances for Dental Services

Report from Change Healthcare finds women and seniors more likely to visit dentist; frequency of visits declines rapidly after midyear

NASHVILLE, Tenn., Oct 17, 2011 (BUSINESS WIRE) -- Healthcare costs continue to rise, driving more employers to stop offering dental coverage -- resulting in only 57 percent of Americans covered by a dental plan, as compared to more than 85 percent who have medical insurance. In addition, dental plan designs typically vary widely from medical coverage, creating higher out-of-pocket costs for patients and making the market for dental services much more consumer-driven. These cost and economic concerns have combined to create an alarming trend: employees and their dependants are skipping regular visits and neglecting dental care.
With an estimated $108 billion spent on dental services in 2010 according to the Centers for Disease Control (CDC), Change Healthcare's latest Healthcare Transparency Index revealed considerable price disparities and local savings potential for the most common dental services, including adult and pediatric preventive exams with and without x-rays, adult cavity repair, application of braces with pre- and follow-up visits, and wisdom teeth removal with sedation or anesthesia. The Index, compiled from a sub-set of the Change Healthcare client database, which analyzed more than 30,000 in-network claims nationwide over a 12-month period, found that the billed amounts for dental services could vary by more than 400 percent in the same area for the same service.
-- Preventive Dental Exams: Routine dental exams are the primary way to prevent tooth decay and gum disease. An estimated 75 percent of adults suffer from gum disease, and while tooth decay is the most common and preventable disease in children, a U.S. Department of Health and Human Services study cites that only 48 percent of children entering kindergarten had seen a dentist in the previous year. With cost now a significant barrier to proper care, the Index found that the same preventive exam for adults could cost as much as $240 and as low as $55 in the same area, and pediatric exams ranged from $180 to just $35.
-- Cavity Fill and Repair: One of the most common dental corrective procedures, cavity repair offers great savings potential. The Index revealed that patients could be paying up to three times as much per cavity. Claims data indicated that cavity repair at the high-end could cost as much as $360, making these services unattainable for many -- leading to much more expensive long-term health issues.
-- Orthodontics: Having braces is a fact of life for millions of American children and even adults. However, insurance carriers often offer a fixed amount or maximum benefit allowance for braces application, and in many cases individuals may need braces twice in their lifetime. This Index reported a high cost for orthodontic services (including a pre-visit, braces application and follow-up visit) of $6,960, compared to a low cost of $2,400 in the same area.
-- Wisdom Teeth Removal: Recommended by most dentists as a way to maintain oral health and appearance, removal of wisdom teeth is a generally painful procedure, both physically and economically. The Index revealed that a patient could save more than $2,000 by simply switching providers. Many medical plans cover wisdom teeth removal, and as more employers and consumers switch to consumer-driven health plans, cost transparency offers tremendous savings opportunities.
Interestingly, the Index also uncovered other trends regarding dental utilization rates. The data indicated there was a steady decline in dental visits in each quarter, with 38 percent of all services occurring in Q1 and trailing to only 16 percent in Q4. This is in stark contrast to the medical industry, where claims typically increase toward year-end. In addition, women were more likely to receive dental care, averaging 1.31 visits per year versus only 1.11 for men. Seniors aged 60 and above were also the most likely to receive dental care, compared with young adults aged 21 to 30 representing the least likely.
"Unfortunately, dental services are one of the first benefits to be cut when the budget gets tight, creating risk related to a lack of compliance with recommended dental care, including checks for secondary conditions such as mouth cancer," said Howard McLure, Change Healthcare's chairman and CEO. "This quarter's Healthcare Transparency Index demonstrates that patients do have significant cost saving options for common dental services, especially important as the employee's share of these expenses increases."
Additional Resources
-- Report:
-- Blog:
-- Tweet this: Q3 #Healthcare Transparency Index from @askch reveals savings on #dental services
About the Healthcare Transparency Index
Due to rising healthcare costs, employers are increasing deductibles and considering aggressive benefit plan design changes. Employees and their families will be increasingly accountable for "shopping" and paying for their healthcare, making it more critical than ever to understand the costs involved. Currently, consumers of healthcare have no information and no tools to help them make decisions. The Healthcare Transparency Index (HCTI) is the first to provide healthcare consumers with ongoing trends data about actual healthcare costs, offering insight into critical opportunities for savings. The data is sourced from Change Healthcare's proprietary, HIPAA-compliant database generated from client activity. This quarter's Healthcare Transparency Index includes data compiled from a sub-set of the company's database including more than 30,000 dental claims. The report's pricing and behavioral content is derived from the Change Healthcare Transparency Messenger(TM). For more information, please call 800-655-0732.
About Change Healthcare
Change Healthcare ( ) has set the industry standard for true healthcare cost transparency -- a critical component to combating rising healthcare costs and insurance premiums while also reducing out-of-pocket responsibilities for consumers. Built on more than three years of medical claims data, the company's web-based solution, Transparency Messenger(TM), provides employees with personalized views of pricing information and proactive alerts that highlight opportunities to save money on routine care and prescriptions in their local area. By enabling informed decision-making prior to selecting and receiving care, Change Healthcare delivers substantial cost savings to both employers and employees. Change Healthcare works with more than 400 self-insured businesses across the U.S., representing more than 212,000 lives.

Tuesday, October 18, 2011

Patients' attitudes toward screening for medical conditions in a dental setting

Greenberg, B. L., Kantor, M. L., Jiang, S. S. and Glick, M. (2011), Patients' attitudes toward screening for medical conditions in a dental setting. Journal of Public Health Dentistry. doi: 10.1111/j.1752-7325.2011.00280.x


Objectives: Previous studies demonstrated the efficacy of chairside medical screening by dentists to identify patients who are at increased risk for developing cardiovascular-associated events and the favorable attitude of dentists toward chairside medical screening. This study assessed patient attitudes toward chairside medical screening in a dental setting.
Methods: A self-administered questionnaire of eight five-point response scale questions was given to a convenience sample of adult patients attending an inner-city dental school clinic and two private practice settings. Wilcoxon–Mann–Whitney tests and t-tests were used to compare responses between study groups. Friedman nonparametric analysis of variance was used to compare response items within each question.
Results: Regardless of setting, the majority of respondents was willing to have a dentist conduct screening for heart disease, high blood pressure, diabetes, human immunodeficiency virus infection, and hepatitis infection (55-90 percent); discuss results immediately (79 percent and 89 percent); provide oral fluids, finger-stick blood, blood pressure measurements, and height and weight (60-94 percent); and pay up to $20 (50-67 percent). Respondents reported that their opinion of the dentist would improve regarding the dentist's professionalism, knowledge, competence, and compassion (48-77 percent). The fact that the test was not done by a physician was ranked as the least important potential barrier. While all respondents expressed a favorable attitude toward chairside screening, the mean score was significantly lower among clinic patients across most questions/items. The priority rankings within an item were similar for both groups.
Conclusions: Acceptance by patients of chairside medical screening in a dental setting is a critical element for successful implementation of this strategy.

Monday, October 17, 2011

High-risk human papillomavirus (HPV) screening and detection in healthy patient saliva samples: a pilot study.

BMC Oral Health 2011, 11:28doi:10.1186/1472-6831-11-28

Published: 10 October 2011


The human papillomaviruses (HPV) are a large family of non-enveloped DNA viruses, mainly associated with cervical cancers. Recent epidemiologic evidence has suggested that HPV may be an independent risk factor for oropharyngeal cancers. Evidence now suggests HPV may modulate the malignancy process in some tobacco- and alcohol-induced oropharynx tumors, but might also be the primary oncogenic factor for inducing carcinogenesis among some non-smokers. More evidence, however, is needed regarding oral HPV prevalence among healthy adults to estimate risk. The goal of this study was to perform an HPV screening of normal healthy adults to assess oral HPV prevalence.


Healthy adult patients at a US dental school were selected to participate in this pilot study. DNA was isolated from saliva samples and screened for high-risk HPV strains HPV16 and HPV18 and further processed using qPCR for quantification and to confirm analytical sensitivity and specificity.


Chi-square analysis revealed the patient sample was representative of the general clinic population with respect to gender, race and age (p < 0.05). Four patient samples were found to harbor HPV16 DNA, representing 2.6% of the total (n = 151). Three of the four HPV16-positive samples were from patients under 65 years of age and all four were female and Hispanic (non-White). No samples tested positive for HPV18.


The successful recruitment and screening of healthy adult patients revealed HPV16, but not HPV18, was present in a small subset. These results provide new information about oral HPV status, which may help to contextualize results from other studies that demonstrate oral cancer rates have risen in the US among both females and minorities and in some geographic areas that are not solely explained by rates of tobacco and alcohol use. The results of this study may be of significant value to further our understanding of oral health and disease risk, as well as to help design future studies exploring the role of other factors that influence oral HPV exposure, as well as the short- and long-term consequences of oral HPV infection.

Saturday, October 15, 2011

Are sugar-free confections really beneficial for dental health?

British Dental Journal 211, E15 (2011)
Published online: 7 October 2011 | doi:10.1038/sj.bdj.2011.823

  • Sugar-free does not mean calorie-free. Some sugar-free products generate nearly 50% of calories produced by table sugar.
  • In general, sugar-free products may help prevent dental caries. However, if they contain acidic additives, it may increase the probability of demineralising enamel, thus causing dental erosion.
  • Avoiding acid-containing, usually fruit-flavoured sugar-free products may be beneficial.
Background Various sugar substitutes have been introduced and are widely used in confections and beverages to avoid tooth decay from sugar and other fermentable carbohydrates. One group of sugar substitutes are sugar alcohols or polyols. They have been specifically used in foods for diabetic patients because polyols are not readily absorbed in the intestine and blood stream, preventing post-prandial elevation of glucose level. Additionally they may lower caloric intake.
Methods We searched PubMed, Cochrane Controlled Trials Registry, Cochrane Oral Health Review, Centre for Reviews and Dissemination in the UK, National Library for Public Health and a Centre for Evidence Based Dentistry website up to the end of October 2010, using the search terms 'sugar alcohol' or 'sugar-free' or 'polyols' and combined with a search with terms 'dental caries' or 'dental erosion'.
Results Xylitol, a polyol, has been approved by the US Food and Drug Administration for its non-cariogenic properties that actually reduce the risk of dental decay and recently, the European Union also officially approved a health claim about xylitol as a 'tooth friendly' component in chewing gums. Although the presence of acidic flavourings and preservatives in sugar-free products has received less attention, these additives may have adverse dental health effects, such as dental erosion. Furthermore, the term sugar-free may generate false security because people may automatically believe that sugar-free products are safe on teeth.
Conclusion We concluded that polyol-based sugar-free products may decrease dental caries incidence but they may bring another dental health risk, dental erosion, if they contain acidic flavouring. There is a need for properly conducted clinical studies in this area.

Friday, October 14, 2011

The estimation of patients' views of organizational aspects of a general dental practice by general dental practitioners: a survey study

BMC Health Services Research 2011, 11:263doi:10.1186/1472-6963-11-263


Considering the changes in dental healthcare, such as the increasing assertiveness of patients, the introduction of new dental professionals, and regulated competition, it becomes more important that general dental practitioners (GDPs) take patients' views into account. The aim of the study was to compare patients' views on organizational aspects of general dental practices with those of GDPs and with GDPs' estimation of patients' views.


In a survey study, patients and GDPs provided their views on organizational aspects of a general dental practice. In a second, separate survey, GDPs were invited to estimate patients' views on 22 organizational aspects of a general dental practice.


For 4 of the 22 aspects, patients and GDPs had the same views, and GDPs estimated patients' views reasonably well: 'Dutch-speaking GDP', 'guarantee on treatment', 'treatment by the same GDP', and 'reminder of routine oral examination'. For 2 aspects ('quality assessment' and 'accessibility for disabled patients') patients and GDPs had the same standards, although the GDPs underestimated the patients' standards. Patients had higher standards than GDPs for 7 aspects and lower standards than GDPs for 8 aspects.


On most aspects GDPs and patient have different views, except for social desirable aspects. Given the increasing assertiveness of patients, it is startling the GDP's estimated only half of the patients' views correctly. The findings of the study can assist GDPs in adapting their organizational services to better meet the preferences of their patients and to improve the communication towards patients.

Thursday, October 13, 2011

Periodontal healing following avulsion and replantation of teeth: a multi-centre randomized controlled trial to compare two root canal medicaments

Day, P. F., Gregg, T. A., Ashley, P., Welbury, R. R., Cole, B. O., High, A. S. and Duggal, M. S. (2011), Periodontal healing following avulsion and replantation of teeth: a multi-centre randomized controlled trial to compare two root canal medicaments. Dental Traumatology. doi: 10.1111/j.1600-9657.2011.01053.x

Abstract –  Background: Non-setting calcium hydroxide (Ultracal XS®) is recommended by the International Association of Dental Traumatology as the initial medicament following avulsion and replantation for mature teeth. There is experimental evidence to suggest Ledermix®, placed as an alternative inter-visit dressing may improve periodontal healing. Aim: This study investigated, using a multi-centre randomized controlled trial, the effect of two root canal medicaments, Ledermix® and Ultracal XS®, on periodontal healing of avulsed and replanted teeth. Material and methods: Children were recruited if they fulfilled all inclusion criteria. Treatment followed a standardized protocol. Assessment of periodontal healing or ankylosis was made clinically and radiographically by an experienced, ‘blinded’, clinician at 12 months. Results: Over 200 patients were assessed for eligibility at five centres. Twenty-nine patients were eligible for inclusion. Final analysis involved 22 patients with 27 teeth. Ankylosis was detected in four of the 12 teeth in the Ledermix® group and nine of 15 in the Ultracal XS® group. No significant difference between medicaments was found in the proportion of teeth or patients showing periodontal healing. Discussion: There was no significant difference in periodontal healing between the two medicaments at either a tooth or patient level. The numbers recruited fell short of an estimated power calculation. For patients meeting the inclusion criteria and completing the trial, periodontal healing was seen in 52% of teeth at the 12-month assessment between both groups. The only factor found to significantly influence the periodontal outcome was dry time.

Wednesday, October 12, 2011

Study Shows Bone Growth From Implanted Tooth And Dental Pulp Stem Cell

Researchers in Japan have completed a study showing that stem cells derived from deciduous canine teeth and dental pulp can be grafted and produce bone regeneration between parents and offspring. Their results are published in the current issue of Cell Transplantation (20:7), now freely available on-line.

"Bone defects can occur for a number of reasons, and autogenous bone grafting - using the patient's own bone - has been a standard approach to treatment," said study corresponding author Dr. Yoichi Yamada of the Center for Genetic and Regenerative Medicine at the Nagoya University School of Medicine. "However, considering severe invasiveness in self-donor bone sites, and the limited supply of autogenous bone, alternative donor sources are needed."

The researchers note that previous studies have shown that oral and maxillofacial dental tissues contain a variety of stem cells, such as dental pulp stem cells and stem cells from deciduous teeth. Stem cells, they note, can be easily extracted from deciduous teeth, which are routinely lost in childhood and generally discarded.

"Stem cells from human exfoliated deciduous teeth were identified as a novel population of stem cells, capable of differentiating into various cell types, such as osteoblasts, odontoblasts, adipocytes and neural cells," explained Dr. Yamada.

Their study extracted deciduous teeth from canine puppies and grafted them onto parent canine mandibles as an allograft. After four weeks, bone defects were prepared on both sides of the host mandible. The newly formed bone was evaluated at two, four and eight weeks. When compared to controls, the study group demonstrated well-formed mature bone and neovascularization.

The researchers reported that stem cells derived from dental pulp "display increased immunosuppressive activity when compared to bone marrow mesenchymal cells" and will likely have "immunosuppressive activity with potential clinical applications in allogenic in vivo stem cell transplantation, particularly for calcified tissue reconstruction."

Their pre-clinical study could pave the way for stem cell therapy in othropedics and oral maxillofacial reconstruction, concluded Dr. Yamata.

"This study highlights the promise of obtaining stem cells from unusual sources, such as teeth, and their potential benefit in familial treatments for bone reconstruction" said Dr. Julio Voltarelli, professor of Clinical Medicine and Clinical Immunology at the University of Sao Pãulo, Brazil, and section editor for Cell Transplantation. "Due to their potential to also become other cell types such as neural cells, it will be interesting to see what future studies reveal about the possible uses of these cells."

Tuesday, October 11, 2011

Laser-textured surfaces on the adhesion of composite to dentin

Dental Materials
Volume 27, Issue 10 , Pages 1038-1044, October 2011



To assess the influence of laser-textured surfaces on the adhesion of composite to dentin after being rotary prepared.


Thirty healthy teeth were kept in 0.1% thymol solution prior to being ground down to dentin to create a 4×4mm2 flat surface. Teeth were divided into 3 groups (n=10). Groups 1 and 2 utilized the prototype Erbium doped, Yttrium–Aluminum–Garnet Er:YAG laser by Dental Photonics, Inc. A single pulse was delivered to each spot to create an equally spaced square 4×4mm2 matrix of micro craters. All craters had 100μm diameter/45μm depth; two different spacing patterns were prepared in Groups 1 and 2. In Group 1, distance between crater centers was 50μm; Group 2 had 100μm. In Group 3 (control), 10 samples were prepared without laser texturing. G-bond (GC America) was applied to testing area of all samples in all groups according to manufacturer's instructions. Bonding resin was applied and shear-bond strength tests were employed using an Instron machine to measure adhesive strength.


One-way analysis of variance (ANOVA) was used to compare the 3 groups. Pair wise t-tests implementing the Bonferroni correction for multiple comparisons found a statistically significant difference between Group 3 and Group 2 (p=0.019) but no statistically significant difference between Group 3 and Group 1 (p=0.263) or Group 1 and Group 2 (p=0.743).


The bond strengths between bonded composite to laser-textured dentinal surfaces with larger spacing patterns are greater than that of non-textured surfaces.

Monday, October 10, 2011

Is self interdental cleaning associated with dental plaque levels, dental calculus, gingivitis and periodontal disease?

Crocombe, L. A., Brennan, D. S., Slade, G. D. and Loc, D. O. (2011), Is self interdental cleaning associated with dental plaque levels, dental calculus, gingivitis and periodontal disease?. Journal of Periodontal Research. doi: 10.1111/j.1600-0765.2011.01420.x

Background and Objective:  To ascertain whether interdental cleaning behaviours of Australian adults were associated with lower levels of plaque, gingivitis and periodontal disease.
Material and Methods:  Data were obtained from the National Survey of Adult Oral Health 2004–06. Outcome variables were three indicators of oral hygiene outcomes (the presence or not of dental plaque, dental calculus and gingivitis) and two of periodontal disease (the presence or not of at least one tooth with a periodontal pocket or clinical attachment loss of ≥ 4 mm). The independent variable was classified into the following three groups: regularly clean interproximally ‘at least daily’ (daily+); ‘less than daily’ (< daily); and ‘do not regularly clean interproximally’ (reference group). Poisson regression with robust variance estimation was used to calculate prevalence ratios (PRs) and 95% confidence intervals (95% CIs) relative to the reference group, adjusted for covariates.
Results:  Regular self interdental cleaning was associated with less dental plaque (< daily, PR = 0.89, 95% CI = 0.84, 0.95; and daily+, PR = 0.89, 95% CI = 0.82, 0.96), less dental calculus (< daily, PR = 0.88, 95% CI = 0.80, 0.97; and daily+, PR = 0.79, 95% CI = 0.70, 0.89) and lower levels of moderate/severe gingivitis (daily+, PR = 0.85, 95% CI = 0.77, 0.94). Periodontal pocketing was less likely for the < daily group (PR = 0.61, 95% CI = 0.46, 0.82), but was not associated with daily+ cleaning (PR = 0.99, 95% CI = 0.663, 1.49). There was not a significant association between interdental cleaning and clinical attachment loss (< daily, PR = 0.90, 95% CI = 0.77, 1.05; and daily+, PR = 1.17, 95% CI = 0.95, 1.44).
Conclusion:  Regular interdental cleaning was associated with better oral hygiene outcomes, such as dental plaque and gingivitis, although there was no significant association between regular interdental cleaning and clinical attachment loss.

Saturday, October 08, 2011

Missing dental check-ups by even just a short period can seriously increase the risk of gum disease

Missing dental check-ups by even just a short period can seriously increase the risk of gum disease, warn oral hygiene experts from Eludril and Elgydium.
It follows increasing concern in the media that the cost of dental care and challenging economic conditions are prompting more families to skip dental check-ups.
This has become a growing issue. A British Dental Health Association study in 2009 showed that one-fifth of adults had delayed treatment because of cost. Two years later purse-strings are now even tighter.
Regular check-ups are vital to ensure that plaque – the main cause of gum disease – is identified and removed by dental professionals.
If not removed by twice-daily tooth brushing, it takes only 48 hours for the plaque biofilm to harden and become tartar, which is then very difficult to remove.
Plaque and tartar left unchecked can swiftly lead to the early signs of gum disease – such as swollen gums, warn the manufacturers of Eludril mouthwash and Elgydium toothpaste.
People should have dental check-ups at least every six months – or even more frequently if they are already suffering from gum disease.
“Missing dental check-ups is a false economy that will lead only to the need for more serious and expensive treatment for dental cavities and the effects of gum disease,” said a spokesperson for Eludril and Elgydium.
“The old saying of ‘a stitch in time saves nine’ has always been a good principle when it comes to dental care. One should always get treatment at the first signs of gum disease.”
Unfortunately, it is often not until people suffer from sore gums that they start to notice a problem – and by then they could have saved themselves the pain and damage to their gums.
Bleeding gums are an all-too visible sign of gum disease that has been left untreated for too long. And yet some people still mistakenly believe that they are an occasional ‘normal’ occurrence.
Ignoring the problem can lead to receding gums – putting teeth at risk. They can become loose, potentially requiring extraction.
Missing a dental check-up means that gum disease symptoms could go undiagnosed for months and can leave gums in a particularly vulnerable state.
This all makes our daily oral routine even more important, as this will help reduce the cost of dental care by keeping gum disease at bay.
So what should we be doing on a daily basis?
Brushing teeth regularly and properly is an obvious first step – but not everyone realises the importance of regularly checking and replacing worn toothbrushes.
Poor quality toothbrushes are a false economy. The first sign of wear should be the signal to discard and replace a toothbrush. Never use the same toothbrush for more than three months. Bin it and buy another.
Choosing the right toothpaste is also important. It can be difficult with such a bewildering array on offer.
Elgydium is a high quality medicinal toothpaste that can be used every day to help prevent gum disease. Unlike many other toothpastes, it contains chlorhexidine – recognised by oral health care professionals as the antibacterial and antifungal treatment of choice against gum disease.
The Elgydium range includes:
  •     Elgydium Anti-Plaque – first introduced in the UK in 1998
  •     Elgydium Sensitive – which contains Fluorinol, a fluoride that binds to enamel five times more effectively than ordinary fluoride
  •     Elgydium Whitening with micropulverised sodium bicarbonate for non-abrasive polishing and in-depth cleansing.
Chlorhexidine is also the active ingredient in Eludril medicated mouthwash, which is recommended as a short-term treatment for gum disease. A single rinse can work for up to 12 hours.
Chlorhexidine is a tried and trusted gingivitis treatment with a medical track record that dates back at least three decades.
It is highly effective at killing off the bacteria that cause plaque and gum disease, making it dentists’ antiseptic of reference in periodontics and implantology.
For maximum efficacy, Eludril should be used in a dosage of 15ml (for adults and children aged over 6) that has been diluted with lukewarm water using the special measuring cup provided. Eludril has a pleasant menthol flavour and comes in three pack sizes.
Eludril can also be used as a disinfectant for dentures. They should be soaked for an hour in a one in three dilution of Eludril with water.
For further information about protection against gum disease, please contact Nikki Pounds, Ceuta Healthcare on +44 (0)1202 780558.
Eludril and Elgydium are represented in the UK by:
Ceuta Healthcare Ltd
Hill House
41 Richmond Hill
Tel: +44 (0)1202 780558
Eludril Mouthwash is an antibacterial and analgesic solution which can be used to manage a number of oral health problems.
Its main use is to treat and prevent dental plaque formation and gum disease (gingivitis, also known as periodontitis) by preventing the build-up of bacteria.
Eludril Mouthwash can also be used to maintain oral hygiene in situations where tooth brushing is difficult, for instance, following oral surgery or in physically or mentally handicapped patients.
Eludril can also be used as a disinfectant for the cleansing of removable dentures and in the management of common mouth ulcers and oral candidiasis infections (fungus infections).
Elgydium Anti-Plaque toothpaste is specially formulated for sensitive gums and helps to prevent dental plaque and tartar build-up, the major causes of tooth decay and gum disease (gingivitis).
Elgydium Whitening, Sensitive and Decay Protection are also available as part of the Elgydium range of toothpastes.

Friday, October 07, 2011

Study: MRSA Common Among Some Dental Students

1 in 5 UAW Dental Students Tested Carried the Drug-Resistant Staph Strain

Dental students in a Seattle study had very high rates of colonization with MRSA, the drug-resistant strain of staph, raising new questions about the prevalence of the bacteria outside of hospitals in community health care settings.

Read the article

Thursday, October 06, 2011

Goodbye Steve


As a technology blog I cannot let the passing of Steve Jobs, one of the three founders of Apple go by. I do use Apple products. They may not all have been great but they have changed the way I do things. So for making my life just a bit easier and better I want to say thank you. I have read the book about presenting like Steve but I will never achieve that skill level. I will keep trying.

Steve's words are inspiring. Steve Jobs was—and will long remain—an inspiration for so many. 
"Your time is limited, so don't waste it living someone else's life. Don't be trapped by dogma — which is living with the results of other people's thinking. Don't let the noise of others' opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary."                               
                                                         — Steve Jobs

Wednesday, October 05, 2011

DentalEZ® Group Celebrates 100 Years of StarDental® Innovation During Lancaster, PA Celebration

Lancaster, PA (September 28, 2011) – DentalEZ® Group, a supplier of innovative products and services for dental health professionals worldwide, recently celebrated the 100th year of its StarDental® product line at its StarDental headquarters located in Lancaster, PA.  Corporate executives and employees from all divisions of DentalEZ were on hand to join in on the festivities, as well as representatives from the Lancaster Chamber of Commerce and Industry. 

Vice President Cheryl Irwin from the Lancaster Chamber of Commerce and Industry was on hand to present a plaque to DentalEZ President Jeffrey Perelman.  “StarDental’s 100-year anniversary is really a celebration for the entire community to embrace,” remarked Irwin.  “Any establishment that celebrates 100 years in business is something that’s meaningful to the entire community.  StarDental is a prime example of what sustains us, the private sector, as well as what provides us the great quality of life that we enjoy here in Lancaster County.”     

“We are as committed today as we were 100 years ago to establishing new industry standards for design, quality, and service to the community and our industry,” remarked Perelman.  “We hope to be of service here in Lancaster for 100 more years.” 

Over the last hundred years, StarDental has introduced many new technologies to the dental community, including the LubeFree™ handpiece, built-in handpiece light source, and the
sonic scaler. 

The company began in 1911 as a simple operation.  Today, as part of the DentalEZ product family, StarDental is a global leader in the manufacture and distribution of innovative and reliable handpieces for the dental professional. 

While its history stretches back more than a century, the StarDental brand is looking toward the future of dentistry with a continuous launch of products, such as the lightweight Solara® and 430® Series of lubricated and LubeFree high-speed handpieces; the latest advancement in programmable electric handpiece systems, the NuTorque® and NuTorque® Lite; and, most recently, Identafi®, an oral cancer screening device.  For more information on all StarDental products, please visit

Tuesday, October 04, 2011

If you are going to the ADA in Las Vegas there is an App for that!

Many of us will be in Las Vegas for the upcoming American Dental Association Annual Session. Instead of looking for the book that tells everything  and have to lug around consider getting the
The 2011 Annual Session Mobile App. It is now available. With a simple touch, you can:
  • Conduct searches for exhibitors and product listings
  • Explore the exhibit hall floorplan
  • Click through to exhibitor websites
  • Use email contacts to set appointments with exhibitors you want to see
  • Read exhibitor e-brochures and product information
  • Get information on show specials

Image: Apple icon iPhone
Image: Android icon Android
Image: Blackberry icon Blackberry


Monday, October 03, 2011

22-Year clinical evaluation of the performance of two posterior composites with different filler characteristics

Dental Materials
Volume 27, Issue 10 , Pages 955-963, October 2011



This retrospective longitudinal study investigated the longevity of posterior restorations placed in a single general practice using 2 different composites in filler characteristics and material properties: P-50 APC (3M ESPE) with 70vol.% inorganic filler loading (midfilled) and Herculite XR (Kerr) with 55vol.% filler loading (minifilled).


Patient records were used for collecting data. Patients with at least 2 posterior composite restorations placed between 1986 and 1990, and still in the practice for regular check-up visits, were selected. 61 patients (20 male, 41 female, age 31.2–65.1) presenting 362 restorations (121 Class I, 241 Class II) placed using a closed sandwich technique were evaluated by 2 operators using the FDI criteria. Data were analyzed with Fisher's exact test, Kaplan–Meier statistics, and Cox regression analysis (p<0.05).


110 failures were detected. Similar survival rates for both composites were observed considering the full period of observation; better performance for the midfilled was detected considering the last 12 years. There was higher probability of failure in molars and for multi-surface restorations.


Both evaluated composites showed good clinical performance over 22 years with 1.5% (midfilled) and 2.2% (minifilled) annual failure rate. Superior longevity for the higher filler loaded composite (midfilled) was observed in the second part of the observation period with constant annual failure rate between 10 years and 20 years, whereas the minifilled material showed an increase in annual failure rate between 10 years and 20 years, suggesting that physical properties of the composite may have some impact on restoration longevity.