When you walk into your practice, you want things to run smoothly. No glitches, unexpected cancellations, staff conflicts or equipment failures. Unfortunately, these happen more often than we’d like because, to some extent, many things are out of our control. That’s when we modify, adapt and make the most out of the situation. But maybe we have more control than we think. Curious? Keep reading.
Dr. Steve Frost runs a successful endodontic office in Arizona and was looking to purchase new handpieces. He made the investment with KaVo and purchased the lubricating and maintenance accessories per the manufacturer’s recommendations as it is well-documented that daily handpiece maintenance is essential. The demand he put on his handpieces was high. Over time the amount of torque, stress, and strain of cutting through zirconia, metal and porcelain crowns took its toll.
After about a year and a half of heavy and intense use, as normal wear and tear would have it, the handpieces needed to be sent in for service and replacement parts. They were simple fixes. Or so he thought. He sent them out to a local repair provider and didn’t think anything of it when they came back.
However, after about 5-6 months, much to his dismay, he noticed the turbines grinding in several handpieces, which subsequently led to vibrating and overheating. Not good. He sent them back to the repair provider for a second time, and the same thing happened. Only this time, he noticed that the color on the head was different (albeit slightly) than the rest of the handpiece. So he called his KaVo sales representative. Dr. Frost was slightly frustrated as his investment up to this point was costly and getting a little out of hand. “Counterfeit parts,” the sales rep told him Those two words summed it up. “Original Equipment Manufacturer, or OEM parts comply with the highest standards and are manufactured to meet rigourous quality and regulatory requirements, whereas counterfeit parts may not be,” he explained. Unbeknownst to him, Dr. Frost’s handpiece was repaired with counterfeit parts and as a result, the turbines were more or less shot and the entire handpiece needed a complete overhaul. Not the kind of news he wanted to hear, especially after he had already spent enough on repairs to have paid for a new handpiece.
If this story sounds familiar, there’s good reason. I interviewed the repair managers of the top 5 dental handpiece repair companies that came up from a quick Google search. When asked about their service and parts protocol, 4 out of the 5 companies said that unless the customer stated otherwise, after-market parts are used over OEM parts. Why? Because they’re cheaper. Your first thought may be, “I don’t want to pay a big bill and if the parts are just as good, then I don’t have a problem with it.” That’s part of the dilemma – we are made to believe they are just as good, but are they? You know the old saying, “If it’s too good to be true, it probably is?” In the case of handpiece repair, it really is.
Handpieces are one of the most heavily-used pieces of equipment in a dental office. And yet, most practices don’t have contingency plans for repairs. Or if a repaired handpiece breaks, dentist often default to thinking the issue is with the handpiece, instead of the inferior parts used in an earlier repair.
To get better insight into why counterfeit parts are such a problem, I talked with Nichole Hansen who is the manager of the handpiece repair department at KaVo. The first thing she tells me is that repairs arrive at her facility daily because they were fixed without OEM parts. It gets even more interesting:
Counterfeit parts can significantly increase the risk of damaging other genuine internal parts — yes the parts may “fit,” but that doesn’t mean they will last or maximize the anticipated lifetime use of the handpiece.
Handpieces that come in with counterfeit parts will typically last less than 6 months The most common complaints include: gear grinding, loud noises, inadequate or inefficient cutting and overheating.
While cheaper repairs are initially more appealing, dentists might end up spending 2-3 times more using generic parts than had they repaired it properly with OEM parts in the first place.
This one is worth repeating: OEM parts comply with the highest standards and are manufactured to meet rigourious quality and regulatory requirements. Counterfeit parts may not be.
With counterfeit parts, the likelihood of the handpiece malfunctioning increases, which causes extreme safety concerns for your patients.
Not all after-market parts are considered counterfeit, but KaVo always recommends using only genuine parts to ensure the maximum performance and lifespan of the handpiece.
Both after-market and counterfeit parts could potentially void any manufacturer warranties on the handpiece.
When repaired at an authorized facility by a certified technician, notes, test outcomes and the technician ID will accompany the return.
We always look for ways to save money and be more efficient with what we do – that’s prudent and good business sense. So let me ask you this – do you want to spend your money twice when it comes to your equipment?
Let’s put this into perspective. A patient comes in with a broken tooth needing a crown. They want a cheap fix and you tell them their best investment is a crown because it returns the tooth to full form and function; a large filling is a temporary fix and they can ultimately lose the tooth. The key question then becomes: is it worth it in the long run to save a few bucks now, in exchange for increasing the risk of losing a tooth? I don’t know about you, but I’d get the crown done. The same goes with our handpieces. Don’t piece meal it because it’s cheaper. Insist on getting the best parts for a maximized return on your investment.
Dr. Greg Gillespie, a general dentist in Washington state, has had his own share of negative experiences with faulty parts and non-authorized repairs. He now insists on only OEM parts and recommends the following:
Use only repair providers who have been authorized by your device’s manufacturer.
Look for a guarantee. Many unauthorized repair providers do not guarantee that their repair will last.
Insist on only OEM parts. For example, KaVo uses OEM parts 100% of the time for all repairs, which allows them to return the handpiece back to its original performance.
Choose a repair provider who offers knowledgeable customer service to provide full support and answer any questions about your instrument.
Ask for a report on your handpiece repair. Most authorized repair teams perform tests on handpieces with every repair. They include the test results and detailed notes with each repair, giving you invaluable information for the life of your handpiece.
Mishaps will happen within every practice. While many are out of your control, handpiece repair isn’t. The next time it starts to grind or overheat, make the wise decision to get it fixed correctly. Although the less expensive alternative may be enticing, you should insist on an authorized repair facility that only uses OEM parts. This will save you time and money as you properly maintain one of the most important tools in your practice. Dentistry is your livelihood, and this is definitely worth the investment.
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Precision Dental
Patients need to be proactive for their health
By Alvin Danenberg, DDS, DrBicuspid.com contributing writer
April 3, 2019 — A male patient came to my office the other day and told me he wanted to get healthy. He had gum disease and various medical issues, including high blood pressure, excessive weight, and high cholesterol levels. The patient said he wanted to get healthy, but other things were going on that would make getting healthy difficult, if not impossible.
He was smoking a pack of cigarettes a day and was drinking a six-pack of beer at least twice a week. Eating healthy food could not offset the damage these toxic substances were causing his body.
Here’s an analogy that explains the dilemma.
A house is on fire, and a firefighter is attempting to put it out with a high-pressure water hose. However, a gasoline leak is steadily pouring gasoline on the fire. The firefighter can try as hard as he can to put out the fire with the water hose, but the gasoline will keep the fire going until the gasoline leak is stopped completely.
Stoking the flames
Likewise, the patient’s body is on fire with poor food and poor lifestyle choices stoking the flames. The body cannot heal if toxic substances are constantly being poured into it. The toxic substances must be stopped and removed.
I discussed my concerns and explained the spiraling downward path his body was on. The toxic elements he was putting into his body were highly destructive. The patient considered reducing his smoking and drinking, but I told him a reduction would not work. Tobacco and alcohol must be eliminated completely. Although repair would take many months, he needed to stop his smoking and drinking immediately and totally if he really wanted to begin a path to healing.
My offer to my patient
My initial efforts to help him move forward included the following:
“The body cannot heal if toxic substances are constantly being poured into it.”
I would help him eliminate the active infection in his mouth and teach him how to efficiently clean his mouth.
I would recommend a local support group that could offer necessary encouragement to help him with his smoking and drinking addictions. If necessary, smoking and alcohol cessation products could be considered for a short period of time. However, his commitment to total elimination of tobacco and alcohol would be critical for his ultimate success.
I’d also provide a three-day food journal to complete so I can evaluate his eating habits. I could then introduce a customized eating plan, including a nutrient-dense diet and the elimination of harmful foods.
This patient told me his goal was to get healthy. To begin a healing process, he needs to become proactive with his lifestyle changes. It could take several years for this goal to be realized. However, today could be the first day of his healthy recovery.
Alvin Danenberg, DDS, practices at the Bluffton Center for Dentistry in Bluffton, SC. He is also on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is drdanenberg.com.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
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Oral Piercings
Piercings
March 23, 2019 – by uniteddentist – in Health, Medical
Body piercing is a popular form of self-expression. Oral piercings or tongue splitting may look cool, but they can be dangerous to your health. That’s because your mouth contains millions of bacteria, and infection and swelling often occur with mouth piercings. For instance, your mouth and tongue could swell so much that you close off your airway or you could possibly choke if part of the jewelry breaks off in your mouth. In some cases, you could crack a tooth if you bite down too hard on the piercing, and repeated clicking of the jewelry against teeth can also cause damage. Oral piercing could also lead to more serious infections, like hepatitis or endocarditis.
If you pierce your tongue, lips, cheeks or uvula (the tiny tissue that hangs at the back of the throat,) it can interfere with speech, chewing or swallowing. It may also cause:
· Infection, pain and swelling. Your mouth is a moist environment, home to huge amounts of breeding bacteria, and an ideal place for infection. An infection can quickly become life threatening if not treated promptly. It’s also possible for a piercing to cause your tongue to swell, potentially blocking your airway.
· Damage to gums, teeth and fillings. A common habit of biting or playing with the piercing can injure your gums and lead to cracked, scratched or sensitive teeth. Piercings can also damage fillings.
· Hypersensitivity to metals. Allergic reactions at the pierced site are also possible.
· Nerve damage. After a piercing, you may experience a numb tongue that is caused by nerve damage that is usually temporary, but can sometimes be permanent. The injured nerve may affect your sense of taste, or how you move your mouth. Damage to your tongue’s blood vessels can cause serious blood loss.
· Excessive drooling. Your tongue piercing can increase saliva production.
· Dental appointment difficulties. The jewelry can get in the way of dental care by blocking X-rays.
If you already have piercings:
· Contact your dentist or physician immediately if you have any signs of infection—swelling, pain, fever, chills, shaking or a red-streaked appearance around the site of the piercing.
· Keep the piercing site clean and free of any matter that may collect on the jewelry by using a mouth rinse after every meal.
· Try to avoid clicking the jewelry against teeth and avoid stress on the piercing. Be gentle and aware of the jewelry’s movement when talking and chewing.
· Check the tightness of your jewelry periodically (with clean hands). This can help prevent you from swallowing or choking if the jewelry becomes dislodged.
· When taking part in sports, remove the jewelry and protect your mouth with a mouthguard.
· See your dentist regularly, and remember to brush twice a day and floss daily.
Of course the best option is to consider removing mouth jewelry before it causes a problem. Don’t pierce on a whim. The piercing will be an added responsibility to your life, requiring constant attention and upkeep. Talk to your dentist for more information.
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Safety warning – Burns caused by electric handpieces by Julian Hodges Get them serviced regularly to prevent this!
The most recent warnings, issued in December, identify significant risk to patients and users of even slightly inefficient electrical handpieces. They stress there is often no warning of malfunction until injuries are sustained.
In its industry safety statement, the US Food and Drug Administration (FDA) published its findings: “Patients have been severely burned when poorly maintained electric dental handpieces were used during dental procedures. Some patients had third degree burns which required plastic surgery.”
The warning continues: “Burns may not be apparent to the operator or the patient until after the tissue damage has been done, because the anaesthetized patient cannot feel the tissue burning and the handpiece housing insulates the operator from the heated attachment.”
The news is a timely warning to Australian dentists about handpiece risks, especially those using electric handpieces and speed increasing heads.
Director of leading Australasian handpiece repair specialists, Julian Hodges of Handpiece Hotline, says the risk of serious injury to users and patients is a growing concern.
“For quite a while the repair industry has been concerned about the risks of speed increasing handpieces,” he says. “There’s no doubt about it. The combination of extremely fast, heavily geared and electrically powered technology in handpieces means there is an absolute necessity for dentists to maintain and respect this equipment diligently.”
Hodges says the high performance of electric handpieces, especially with speed increasing heads, means that even the slightest compromise in precision – from usual wear and tear, poor repair, sterilisation proceduresor overdue maintenance – can lead to overheating and severe burns.
“The problem is that electricdriven handpieces compensate for performance problems with extra power – that’s a formula for burns,” he explains. “The dentist won’t feel the unit getting warm or even acting strangely in most cases, and the anaesthetised patient won’t know until they get home.”
The American watchdog has issued prevention guidelines across the nation with advice that regular maintenance will reduce the incidence of overheating as well as the risk of injury and costly compensation and replacement expenses.
They recommend dentists immediately check when rotary surgical handpieces were last serviced and lubricated.
“It’s really a question of treating this equipment with respect,” says Hodges. “And it makes senses which ever way you look at it, because regular, professional maintenance makes handpieces last longer, work better and cost less in the long run.
“When you add safety into it, it’s easy to see why there are some moves here in Australia toward a more thorough maintenance schedule for practices.”
Dental Health Services Victoria studied a scheduled servicing and instrument management program involving more than 7,000 handpieces and found “outstanding success” in extending the service life and reliability of handpieces in major clinics across the state.
Scheduled maintenance resulted in a 90% decrease in turbine replacements and a 70% decrease in head gear failures. As a result, handpiece servicing costs to the department have more than halved.
“There’s a smarter, safer, cleaner way to work than using handpieces until they fail,” says Hodges.
Get them serviced regularly to prevent this!
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Precision Dental
The Extraordinary Value to Dentistry of the Diminutive O-ring
by Julian Hodges in Articles
How a Simple Awareness of O-ring Care Can Reduce Dental Practice Handpiece Repair Bills
Some practices are unnecessarily incurring large handpiece repair bills simply because there is a need for a better understanding of the function and care of O-rings.
For many O-rings are insignificant. They are boring little black things that merit and are paid scant attention. But, they degenerate quickly because they operate in a hostile environment. They are stretched, squashed and abraded, continuously autoclaved and attacked by lubricants and cleaners and when they breakdown, or are missing, dentistry becomes messy and uncomfortable for dentists and patients.
There are thousands of different handpiece O-rings, each has a specific purpose. They range size from less than a millimetre (0.039 inch) to more than 30mm (>1 inch). Millions are used each year to repair handpieces.
Manufacturers go to remarkable and painstaking lengths to perfect O-ring function. To improve the seal on their couplings, KaVo increased O-ring diameter by the width of an average human hair or, for the more technically inclined, by 83 microns and then coated them with silicone to reduce wear and friction.
Dentistry is unable to function without O-rings and therefore the correct care for these small but essential components is paramount. For instance, more water blockages are caused by particles from O-rings than from any other cause while worn, old, low quality, or wrong O-rings will reduce handpiece performance and service life and may cause catastrophic equipment failure.
O-ring Functions
Handpieces are unable to function without O-rings. They:
Separate air and water. With wrong or poor O-rings, air and water become mixed. Water damages the bearings, rusts components and if water goes through the handpiece and down the exhaust, it goes into the unit which, understandably, can be disastrous
Seal joints inside handpieces. Failure here causes a loss in performance and water dripping from the handpiece
Provide the suspension in high speed turbines. If O-rings are too hard, too soft, too thin or made from the wrong compound (usually to save money) they have the same effect as a poor suspension on our cars. Who wants a rough ride!
Are essential for handpiece maintenance units. When O-rings are damaged or missing, insufficient quantities of lubricant are delivered and purging will be inadequate. Premature breakdown is guaranteed and if a cleaning solution is used as well (usually these are more aggressive than lubricants), the deterioration will be accelerated
O-ring Care
Include handpiece and coupling O-ring checks in standard operatory procedures
Replace coupling O-rings regularly, a minimum of once per year and more frequently in high volume environments
Schedule a regular check of maintenance unit O-rings. At least weekly.
Look for minor imperfections and do not wait until an O-ring fails
Use care when fitting and removing handpieces from couplings
Make sure coupling O-rings are not dry. Apply a thin film of oil if necessary
Choose a repairer who can accurately measure and test handpieces for internal leakage. That is, test the integrity of the O-rings inside a handpiece
Know what you are buying and be aware that sometimes low repair quotations may include non genuine or low quality O-rings or, replacing essential O-rings may have been omitted in the repair process
Keep a spare set of O-rings for all coupling systems and maintenance unit adaptors. That is do not wait for O-rings to fail before ordering replacements
Learn more by purchasing 19 Causes of Premature Handpiece Breakdown and How to Solve Them for less than the price of an O-ring.
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Remember This! – As Handpiece Awareness Increases, Repair Costs Decrease!
19 Causes of Premature Handpiece Breakdown and How to Solve Them:
Save thousands by correctly maintaining your dental handpieces.
Some Factors involved are:
Lubrication
O-rings
Purging
Autoclaving
Air pressures
Contamination
Clearing contamination when dark oil is coming from a handpiece
There are 19 Causes of Premature Handpiece Breakdown directly related to the procedures, training and level of care, or lack of it, in dental practices.
It is highly probable the solutions and advice we can offer will immediately reduce dental handpiece repair costs because if the statements by experts are correct, handpiece maintenance is inadequate in seven of every 10 practices.
Contact us today so we can offer ways to help save your practice money!
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Precision Dental
Helping Patients Live Longer and Better Lives by Dr. Kathryn Alderman
A New look at Systemic Inflammation, Microbiome, Gum Disease Diagnosis, Treatment and Keeping Dental/Gum Disease in Remission
Traditionally in dentistry we have been taught to ask our patients to brush, floss and visit us twice a year for checkups to stay healthy. In the last few years we have been hearing that by fixing dental problems and specifically dental/gum disease, we can help patients to prevent major medical problems, such as heart disease, diabetes, thyroid conditions and many other inflammatory related conditions.
It would be great to be able to help patients to be healthier by fixing their dental/gum disease but is it possible?
In this article, you can find the latest research and answer to the question:
Does the inflammation have a dental etiology or is the inflammation indicative of a systemic disease? What comes first, dental/gum disease or inflammatory-related medical condition?
As dental providers, we understand that the mouth is the gateway to the body. In our pathology classes, we learned about various intraoral soft tissue lesions that can often be the first indications that a patient may have an underlying chronic disease. We have known about the correlative links between untreated periodontal disease and diabetes or cardiovascular disease. Recent studies have shown that there may be links between dental/gum disease and many other auto-immune medical conditions. As dental providers, we often see that our patients who suffer from uncontrolled systemic inflammatory conditions have higher rates of dental/gum diseases.
When we examine a patient who shows signs of inflammation in the mouth, the question arises: Does dental/gum disease cause systemic inflammation or is the inflammation in a mouth is indicative of a systemic disease?
What is Inflammation?
Acute Inflammation is a good thing. It is our body’s natural response to injury and the first step in restoring health. The immune response is a protective mechanism against foreign invaders and toxic chemicals.
Acute inflammation (adaptive immunity) causes a complex cascade of events, sending white blood cells to the site of infection or injury. The inflammatory response causes chemicals to be released which help protect the body. The immune system brings red and white blood cells, dilates blood vessels, allowing more healing substances to travel in and out of the affected area. Once the foreign body has been defeated, the immune response reduces, leaving a few immune cells on guard in case of another attack.
When the acute inflammatory response does not successfully resolve an infection, the inflammation becomes chronic. Chronic inflammation (maladaptive immunity) is like having a slow burning fire in the body.
Chronic inflammation is a low-grade inflammatory response that can be present for months to years. Usually, chronic inflammation occurs because the body was unable to eliminate the initial injury or infection through the acute inflammatory response. When chronic inflammation continues long-term, it can begin a series of reactions that ultimately damage cells and lead to the clinical manifestations of disease. Chronic inflammation plays a role in all of the leading medical conditions like heart disease, diabetes, cancer and arthritis.
What is Microbiome and How it is Connected to the Overall Health?
The digestive system accounts for 70% of our immune system. The human microbiome is made up of more than 100 trillion different microorganisms. Half of these reside in the GI tract. Both the microbes as well as our own cells have co-evolved to share a symbiotic relationship. The microorganisms in our body are responsible for many of the necessary functions, such as vitamin and fiber processing. Another important job is to produce short-chain fatty acids that are precursors to many hormones, important part of diverse physiological roles in body functions. Microorganisms also play a role in gene expression regulation, including the acetylation of DNA-associated histone proteins and methylation of DNA. This is one of the major regulatory processes that is a part of many stages of genetic functions. This type of regulation is applicable to inflammatory genes that can affect the development of cancer, neuropsychiatric systems and many immune disorders as well as the progression of chronic disease.
When patients have an imbalance in our microbiome, they are more susceptible to chronic inflammation and infection. Some individuals are more sensitive to such imbalances due to genetic factors.
Inflammation in the Mouth
Having good dental health is not only about preventing decay, periodontitis or bad breath. Many medical conditions can be reflected by the oral health of the patient. The most common sign of chronic inflammation in the dental patient is gum disease. The level of severity of inflammation can be indicative of underlying systemic disease.
Acute Inflammation-Gingivitis
Every patient has thousands of bacterial species living in the oral cavity. Many of these bacteria are beneficial for the patient, however, an overgrowth of harmful bacterial pathogens can lead to inflamed gums, or gingivitis. The acute inflammatory response produces red, enlarged and bleeding gums to bring inflammatory chemicals and white blood cells in an effort to fight off the bacterial overgrowth.
Gingivitis is a reversible inflammatory condition and is successfully treated by a thorough debridement and effective daily plaque removal by the patient as well as maintaining a balanced diet with adequate vitamin C and D. A healthy body can effectively fight off gingivitis successfully in just a few days.
Chronic Inflammation-Chronic Periodontitis
Chronic periodontitis occurs when there are specific bacterial pathogens present in the mouth combined with the individual patient’s host response. If the acute inflammatory process is unable to eradicate the source of the infection, the patient will experience chronic inflammation in the mouth affecting the teeth and gums. The chronic inflammation causes the gum tissue to lose its integrity, detaching from the root surface and creating periodontal pockets where more harmful species of bacteria can colonize. The constant immune response to the presence of these pathogens creates inflammatory chemicals to be released, which is the cause of bone loss. When the condition is advanced, the teeth become loose and must be removed due to inadequate bone support.
Chronic periodontitis is one of the leading causes of tooth loss in adults.
The Oral-Systemic Link: Inflammation, Microbiome, Gum Disease Diagnosis and Treatment
There is a relationship between periodontitis and many other inflammatory conditions like rheumatoid arthritis, celiac disease, thyroid disease, heart disease, diabetes and Alzheimer’s. Chronic periodontal disease and these conditions share autoimmune characteristics, but the real question is, which came first? Is there a causal link between these conditions? Latest research shows that overall and gut health are more closely to dental health.
Below are three articles which discuss the connection between the microbiome, systemic inflammation and dental/gum diseases.
1. Gut Microbiota and Salivary Diagnostics: The Mouth Is Salivating to Tell Us Something
Authors: Kodukula Krishna, Faller Douglas V., Harpp David N., Kanara Iphigenia, Pernokas Julie, Pernokas Mark, Powers Whitney R., Soukos Nikolaos S., Steliou Kosta, and Moos Walter H., Published Online:1 Oct 2017 https://doi.org/10.1089/biores.2017.0020
Abstract Summary and Conclusion
The human microbiome is a network of microbes that affect every organ system in the body. Most of the microorganisms of this network are bacterial, but others include viruses, fungi and protists. Through study of the human microbiome, we have learned that most chronic medical conditions have microbial components. The oral cavity and GI portion of the microbiome account for the majority of the bacteria present in the body. By measuring the strains of bacteria in a mouth, the overall gut health can be predicted. By making modifications to the person’s microbiome, systematic health can be positively affected, including improved dental health.
2. Defining The Gut Microbiota In Individuals With Periodontal Diseases: An Exploratory Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6032013/
The purpose of this study was to test the gut microbiome of patients who presented with periodontal diseases and find any correlation with periodontal inflammation and destruction of tissues.
Abstract Summary and Conclusion
Those who presented with active periodontal diseases had less diversity in the microbiome which is consistent with other chronic inflammatory diseases. The high levels of oral bacteria that were associated with periodontal disease and active inflammation were also present in the gut of all individuals regardless of the status of the periodontal health. Findings concluded that every patient who had an inflammatory condition had less diversity in the gut. Periodontally involved patients had a higher level of harmful versus beneficial bacteria in both the mouth and the gut. This conclusion suggests that periodontal disease is an important risk factor for many other systemic inflammatory medical conditions.
3. Can Diet Improve Gum Disease?
Journal of Periodontology (May 2009, Vol. 80:5, pp. 759-768).
Abstract Summary and Conclusion
The article discusses if following an anti-inflammatory diet may help reduce symptoms of periodontitis:
The first study mentioned in this article is on diet and periodontitis: In the May 2009 issue of The Journal of Periodontology, a study was published titled “The impact of the stone age diet on gingival conditions in the absence of oral hygiene.” This study used 10 individuals who followed a diet of unprocessed, whole foods including vegetables and protein sources indigenous to the area of Switzerland where the study took place for 4 weeks. During this time, the subjects did not brush or floss at all. Before and after the study, bacterial cultures were taken for analysis to screen for periodontal disease. At the end of this study, participants had higher levels of plaque accumulation, but the number of pathogenic microbes present in the plaque remained unchanged.
The second study mentioned in this article is on diet and periodontal health is from the July 2016 issue of BMC Oral Health. The study is titled, “An oral health optimized diet can reduce gingival and periodontal inflammation in humans—a randomized controlled pilot study.”
A group of 15 subjects who exhibited signs of active periodontal disease were used in a randomized control trial. Five were part of the control group, leaving 10 as the experimental group. The 10 experimental subjects followed a diet low in carbohydrates, high in omega 3 fatty acids, and high in fiber and vitamins. The control group did not alter their existing diets. None of the subjects flossed during the study, but brushed normally. Periodontal exams and bacterial culture samples were taken before and after the experiment. After four weeks, all signs of gum disease in the experimental group decreased by half, while all of the inflammatory markers increased from the baseline in the control group.
Findings in this article offer proof that patient’s diet plays a critical role in forming microbiome and influencing the levels of overall chronic inflammation and ultimately leading to the progression of periodontal disease.
Answering the question: Does dental/gum disease or the inflammatory-related medical condition come first?
Now that we know how the microbiome impacts the likelihood of a person to develop chronic inflammation throughout the body, the answer is more likely that the underlying medical condition can be correlated with the imbalance of the microbiome. Some individuals may have genetic risk factors in addition to an imbalance in the gut biome, placing them at greater risk for developing medical conditions.
Chronic inflammation can travel to all of the organ systems of the body, including the tissues in the mouth and jaw due to the vascular environment of the oral cavity. Having chronic inflammation can be both the initial cause of cardiovascular disease as well as dental/gum disease.
What Can Be Done To Improve Patient’s Microbiome And Reduce Systemic Chronic Inflammation?
In addition to maintaining good oral hygiene and receiving professional dental care to help reduce the bacterial load in the mouth, patients should be counseled on lifestyle factors like their diet, tobacco cessation, obesity and stress.
1. Counsel patients to change their diet. Eating plenty of omega 3 fatty acids like those found in fish and flaxseed.
2. Encouraging patients to eat high-fiber diets rich in fruits and vegetables and avoid processed foods to improve the individuals’s microbiome.
3. Encourage patients to lower their sugar intake and avoid drinking soda and energy drinks.
4. Encourage supplementation of vitamin C and D on a daily basis as well as taking probiotics with multiple strains of beneficial probiotic.
5. Eliminate foods like gluten or dairy that may be triggering an allergy response and creating intestinal inflammation for some patients.
6. Exercising regularly
7. Reducing stress: Massage, yoga, meditation, etc.
8. Getting adequate sleep: 7-8 hours every night.
Case Study
A 35-year-old male patient comes to you with cardiovascular disease and issues with high blood sugar. This patient also shows signs of moderate chronic periodontitis.
Will performing traditional quadrant scaling and root planing be adequate for helping this patient reduce the overall levels of chronic systemic inflammation and improve his overall health? The answer is no. Performing scaling and root planing will definitely reduce the load of harmful bacteria that is present in his oral microbiome but not enough alone in order to help this patient to be at his healthiest.
It is important to help this patient identify lifestyle factors and the role these play in the long-term prognosis of his periodontal condition as well as managing other cardiovascular disease and blood sugar issues. By changing the lifestyle habits and decreasing the overall amount of inflammation, this patient can become healthier. By developing healthier lifestyle habits, the overall health will improve and ultimately leading to the shift to the healthier microbiome.
Conclusion
Do inflammatory related medical conditions lead to the developing gum disease or vice versa?
The answer: It is more likely that the underlying medical condition can be correlated with the overall lifestyle habits, the genetic risk factors and imbalance in the microbiome, placing patients at a greater risk for developing inflammatory related medical conditions, including dental/gum disease.
As dental professionals we can we help patients live healthier and longer lives by treating dental/gum disease. But besides traditional dental /gum disease treatment and giving home care recommendations, dental professionals can be an important part of the health-care team and help patients to improve the quality of their lives by helping them to be educating on importance of healthy lifestyle habits for improving the prognosis of dental/gum disease and overall health.
Traditional treatment for dental/gum disease can be combined with a thorough review of the medical history as well as follow-up with the primary care physician if patients present with dental/gum disease. Patients who have not been under the care of a physician and are showing signs of periodontal disease should be referred for wellness screenings to rule out underlying medical conditions, allergies or vitamin deficiencies.
Dental professionals can educate patients about the link between their dental health and their overall health. and give tips on improving overall health. Patients who have knowledge about what they can do are empowered to take control of their own health and play an active role in their treatment and prognosis of dental/gum disease, as well as positively impacting overall health.
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Precision Dental
The Top 25 Biological Functions of the Mouth
by G. P. Greenacre
Following over 50 years of study and listening to experts, I want to share with you why good growth and good functioning of the mouth is so important. Let me explain why the Mouth is the Mirror of your Life. Good jaws mean a better neck alignment and a better airway and less snoring and less sleep apnea, good gums mean less bloodstream inflammation and good teeth will ensure you good jaw support, a good smile and a long healthy life.
What are the top twenty-five biological functions of the mouth?
1. Nasal Breathing. Nasal (Nose) Breathing, the first system, depends upon a well-grown upper palate or maxillae and palatine bones. Our oropharynx is important because nasal breathing actually ionizes the air we breathe. The paranasal sinuses also add nitric oxide to our air as it passes to our lungs, which helps with our heart and our metabolism. Most of our breathing should be via the nose for this reason as well as their conditioning and the cleansing effect of nasal reaching.
2. Mouth Breathing is an alternative to nasal breathing. We are not supposed to mouth breath all the time. Breathing well is dependent on jaw and tongue position since the front half of our mostly muscular airway is the tongue. If your lower jaw is retruded or you bite too deeply then you might snore, or have a tendency to clench your jaw muscles while you sleep. This mouth breathing is second best and snoring is not far behind. Mouth breathers probably have more infections than nose breathers. Remember the pneumonia that kills old people usually comes from mouth breathing and inhaling or aspirating mouth organisms while sleeping and snoring.
3. Suckling for Breastfeeding. Breastfeeding is the number one health, prosperity and happiness measure function that we humans can partake in at birth. Not breastfeeding and not supporting breastfeeding is “wrong thinking” in life, in politics, in our economy and in modern medicine and modern dentistry. All breastfeeding mothers should have a tax deduction and a thank you note from their dentists. Plus, a financial incentive to continue breast-feeding from their government. This would recognize that breastfeeding is the number one health measure for newborns to grow and prosper. This pays off in the long run as an investment in preventive medicine. Every national government and the World Health Organization should pass a resolution that Breastfeeding is a birthright of all infants.
4. Swallowing lubricates our digestive tract and allows us to consume food unless we want a lifetime on an IV drip. The tongue is not a simple one-nerve muscle. The tongue is actually a specialized organ system powered by the five key cranial nerves of our basic embryonic developmental arches. Our incredible tongue–hyoid bone system is what drives swallowing and speech. Did you know that until about 6 months of age the human baby could both breathe through its nose and swallow through its throat to breastfeed at the same time?
5. Tongue-Powered Speech. Production of different speech sounds depends upon our all-powerful Tongue, which is powered by all five developmental nerves and is uniquely human in its construction and ability to produce speech sounds along with the unique airway of humans. Speech is just thought in action.
6. Assist balance, vision and hearing. Without a healthy tongue, trigeminal nerve system and healthy jaws, we can lose our balance and we can fail to walk in a straight line. Got a balance problem? Visit a dentist! Our ears are our balance and hearing organs, and they are intimately tied to our jaws. The upper jawbone supports our eyeballs and if it does not fully develop (as is often today the case) this puts strain on the eyeball and all the supporting muscles. Dr Harold Arlen was a strong proponent of medical-dental cooperation as he wrote in his article The Otomandibular Syndrome. Speaking about the connection between the Tensor Veli Palatini (TVP) muscle, the jaw, stuffy ears or hearing loss and the Trigeminal nerve says this, “The TVP is the only muscle of the soft palate innervated by the Trigeminal nerve and the only muscle that functions to open the Eustachian tube. This is the key to the relationship between the jaw and ear dysfunction that is plaguing modern man, along with the deterioration of other parts of the jaw and the dental apparatus.”
7. Posture. Man evolved painfully over millions of years to become an erect hominid. Today we are losing our erect posture and becoming bent forward with scoliosis, twisted spines and wrynecks. If the jaw is too far back or too deep, then that person tends to have a forward head posture. This is a brain compensation to preserve the airway since oxygen is the brain’s number one food. The modern human form is degenerating because our diet and lifestyle has changed for the worse. We are too connected to sugars and electronic devices. The number one symptom of poor jaw growth, posture and function, a sore neck or a headache.
8. Good Sinus Drainage. If the palate fails to grow to the dimensions in our genetic blueprint then our sinuses will not drain well.
9. Resisiting Inflammations and Infection. Resistance to microbial diseases of the mouth or resisting systemic Illness, Inflammation and Infection in general. Sir William Osler said, “The Mouth is the Mirror of all Disease.” Further some experts have suggested up to 85 % of all ailments in humans start via the oral route. Dr. Charles Mayo thought highly of oral care as well: “Dentistry is a distinctive health service and can extend human life ten years.”
10. Record our Mineral Density, which tells us about our Mineral Deficiencies. Teeth are the most mineral dense structures in our bodies; well, they used to be that way! The concentration of trace minerals in our baby teeth and adult teeth is a unique biological phenomenon. We should be using it more in medical diagnosis. Today soil depletion means we are getting only a small percentage of the trace minerals that our great grandparents did from eating the same food. LINUS PAULING SAID BEHIND EVERY DISEASE THERE IS A TRACE MINERAL DEFICIENCY! I predict the next 10 years in medical restorative nutrition all the talk will be about trace mineral deficiencies and enzymes. Enzymes are needed to incorporate minerals into our osteogenesis metabolism.
11. Mastication or Chewing Food. This is enjoyed by all of us every day. However, Life continues if there are no teeth present, as any denture wearer will tell you. Anyone can drink a green smoothes with no teeth and our diet generally is getting softer and softer all the time. Further, the “All on Four” implant program is making mastication possible when you have no teeth.
12. Spit and spitting is an important function of the mouth. Spit is full of powerful natural bacteria killing neutrophils. This is why dogs and cats lick their wounds. Spit helps digest food and all the cups and cups spit we produce and swallow every day helps lubricates our digestive system. Spit contributes good and bad bacteria to our micro biome.
13. Mouth Digestion starts with the mouth enzymes to begin digestion. Our mouth produces many enzymes to begin the process of digestion, amylases for carbohydrates lipases to start fat digestion and other enzymes emanate from our salivary glands. Saliva lubricates the whole digestive tract. Mouth organisms get swallowed and contribute to our Micro biome. Some enzymes like lysozymes are there just to attack foreign bacteria that get into our mouths on our foods. The rationale behind chewing your food slowly is to stimulate more digestive enzymes to enhance food digestion and minimize indigestion.
14. Singing is a specialized form of expressing ourselves with our voice. Singing involves not just the mouth and the vocal cords but the chest and our breathing system and even our sinuses and Eustachian tubes all interact. Apparently singing is uniquely a human phenomenon. We can all sing and some of us very badly. And yodelling, well that is special? Even Humming deserves an honourable mention.
15. Whistling this is as close to a bird call that humans can get. Several popular songs over the years have featured whistling and one you might enjoy is the song. “Don’t Worry, Be Happy.” By Bobby McFerrin it is on YouTube.
16. Coughing function. Coughing is a vital function to clear your throat or lungs of organisms or debris that should not be there. We have all had bouts of coughing from respiratory illnesses and the cough is an expectorating function that makes us feel better. Coughing can also be a sign of GERD and irritation of the trachea with stomach acids. There is a great difference clinically between short term coughing and chronic coughing.
17. Ideally, the first epigenetic function of the jaw is to have the jaws and teeth grow so fully and perfectly that there is no need for fillings, orthodontics or wisdom tooth removals. The tongue works in utero on the three embryonic plates of the forming palate to help grow the future palate. The small medial plate becomes the premaxilla or rugae area or the milk pad spot for breastfeeding and houses the incisive section of the second division of the trigeminal nerve while the lateral palatine plates start out vertically like stacked shelves then that the tongue turns them to become the body of the palate and to allow them to fuse with the nasomedial plate to grow the palate forward and laterally. All this palatal development happens about 8 to 9 weeks of age. Then the tongue continues to grow the palate to be more forward and wider up to our birth and even after we are born. So, the role of the tongue and the physiologic swallow is to be the master architect of the growth of the palate by touching the rugae area just behind the front teeth.
Ideally all dentists should work together to create better grown palates or a better next generation of children called “Paleo-Moderns”. The key to this is super nutrition and bone broth bone marrow and fishmeal supplements as used by the famous Swedish researcher Dr. Alfred Aaslander. His brilliant concept of Complete Tooth Nutrition was published in the Journal of Applied Nutrition and promptly forgotten. To create the best tooth and jaw growth possible we need an abundant and steady supply of trace minerals and enzymes and essential oils beside the standard vitamins and amino acids. An Ontario born dentist Dr. Westin Price also wrote about the Paleo diet and said we have lost facial dimension. The late orthodontist Robert Rubin told me this same concept in a telephone interview when I was a dental editor for Medifacts/Dentafacts. He said we should start excellent supplemented nutrition one year before the child is conceived for both parents and continue through the pregnancy and until the child reaches puberty and beyond. All our ancestors had this type of full facial and full palatal blueprint expression and thus needed no wisdom teeth removals, they needed no orthodontics and due to high trace mineral intake they had no cavities. However, periodontal disease is a different story since periodontal diseases were evident in the Egyptian mummies and many other ancient human remains worldwide. Our challenge is to create “Paleo-Moderns”. In 2002, the AMA stated that (due to soil depletion) we should all be taking multivitamin supplements. You need all the nutritional components to build a perfect human.
18. Laughter is valuable and uniquely human function. We recommend you Google TED talks and read about laughter from the experts. They say it well with humour and candour. By the way, do you still miss Robin Williams like me and my friends do?
19. Vomiting when needed. This can be a life saving manoeuvre.
20. Kissing and all the romantic potential of our mouths is another great mouth function. A 30-second kiss means a spit and bacteria exchange of epic proportions but nobody listens.
21. Stereognosis. This is the tactile exploration by the newborn infant of the world by tactile exploration with its tongue and lips.
22. Mandibular Startle Reflex No matters what part of your body is hurt or shocked you will have a Mandibular Startle Reflex and sometimes a vocal one. This is an innate function.
23. Act as good Skin. Skin is our biggest organ system and gum diseases are dermatological or skin diseases under another name. A dermatologist once told me that the purpose of skin is to keep the blood in and the bugs out. Dentists treat chronic and acute skin-gum infections and should talk at every dermatological conference in the world on periodontal infections and their local and systemic implications.
24. The Electrical Control Coordinator for the whole body.
Dr. Henry Ulhlemeyer was a very well-informed Ears, Nose, and Throat specialist who believed very strongly in physiologic jaw balancing for maximizing your overall health. Dr. Henry Ulhlemeyer said, “If the mandible is not physiologically positioned all stress hormones are automatically stimulated, all muscles tense, blood pressure rises to overcome resistance. Pulse quickens, respiration is shallow and loses efficiency. The body raises it blood sugar to fuel this emergency, releases adrenalin and increases the pain threshold. The gastrointestinal tract responds acutely…”
He then went on to say that the good functioning of the mandible was a key component in the basic concept of Integrative Medicine. “In my opinion the mandible is the electrical control coordinator for the whole body i.e. (in combination with the total chewing mechanism of teeth, periodontal tissues, and muscular assemblage through feedback to the brain). The mandible and all its associated muscles in proper physiologic relationship allow the body to relax refresh and replenish expended energies. The mandible has to be in a physiologically balanced relationship to make the total body work as one balanced unit.”
25. Facial Expression. The smile has intrinsic and extrinsic value to all humans. Socially we would never post a bad smile on Facebook or send a poor facial expression out to friends when we want to positively represent our lives. The psychological confidence and the power of a good smile are not to be underestimated. Dr. Edward Angle said, “It is not enough to correct the malpositions of the teeth in one arch, but also to establish the correct occlusion of all the teeth and restore facial expression.”
In summary, Archaeologists and Anthropologists know that the human faces are shrinking but they do not know why.
Actually palates and noses are getting measurably narrower this in turn causes maxilla –mandibular-airway dysfunction and also causes postural and airway distress.
This quote from Dr John Diamond tells us why your palate is important. We as dentist have to figure out why this is happening. Westin Price wrote a whole book on Nutrition and Physical Degeneration and he left us some clues!! Dr. Alfred Aaslander, a Swedish biochemist, who suffered from extensive tooth decay as a child, wrote about “Complete Tooth Nutrition” using bone meal for its trace mineral content over 50 years ago in the Journal of Applied Nutrition vol17 no4 1964. He applied the principles of trace mineral supplementation to his children and he raised kids with NO CAVITIES AND GOOD ARCHES!!
Dr. John Diamond stated this about the Maxilla or our palates.
“One of the greatest gifts a child can receive from his mother is a well-formed palatal arch. But it is doubtful whether any of us has ever even seen a normal arch because it may well be that only primitive man on his so-called primitive diet has a truly normal arch. With such an arch the following benefits are conferred:
There will be minimal occlusal problems.
The tongue is most likely to be in the normal position against the rugae with all the benefits incurred therefrom.
Three of the structures most to do with centering and balancing the body in space will most likely be free to function normally – the spenoid bone, hyoid bone and temporomandibular joint.
There will be an accompanying development of the lateral aspects of the face – especially of the malar and zygoma bones, rendering it very easy for the patient to smile.
Normal development and stimulation of the pituitary will be facilitated.
There will be overall health and well being of the child.”
Dr Diamond is in my opinion one of the smartest MD’s that North American Medical schools have ever produced. We all (doctors, dentists and osteopaths) should study his books and his lifetime of teachings and writings.
Here is Dr. Price’s quote:
“The most indelible impression left by my investigations among primitive races is that which came from examining 1276 skulls of (Peruvian). People who had been buried hundreds of years ago without finding a single skull with the typical marked narrowing of the face and dental arches. That afflicts a considerable proportion. Of the residents in modernized Peru…. the United States…. and many communities of Europe today. I know of no problem so important to our modern civilization as the finding of the reason for this, and the elimination of the cause… Few will recognize the significance of this important point.”
This last sentence sums up his lifetime’s work. “Few will recognize the significance of this.” Yes our faces are shrinking and we are oblivious to this major health problem. It is important that every family know this fact. The human face is shrinking! We should all know why it is shrinking and how to reverse this pathological trend. The key to reversing this is to keep our natural tongue to palate swallow, use no artificial nipples, intake more trace minerals and enzymes and probiotics in our diet through more veggies, more fruits, more bone marrow, more bone broth soups and of course more breastfeeding for our babies.
Dr. Charles Mayo is quoted as saying:
“Dentistry is a distinctive health service and can extend human life ten years.”
Another famous teaching MD, Sir William Osler said:
“The Mouth is the Mirror of all disease”.
Oral Health welcomes this original article.
About the Author
Dr. George Paul Greenacre, General Dentist D.D.S. (Doctor of Dental Surgery) Downtown Orthodontics, Ottawa ON Canada — Dr. George Paul Greenacre graduated from McGill University. He has served as a dental editor for nine years of his career. Fifteen percent of dentists have earned one fellowship. Dr. Greenacre has earned four fellowships and is working on three more in between his four hockey games per week and working on his several e books in process. His office theme is “smart dentistry for smart families.”
— Talk About Us —
Precision Dental
New survey looks at anesthesia trends, safety in 2019
By Theresa Pablos, DrBicuspid.com associate editor
March 20, 2019 — How safe is the use of anesthesia in traditional oral surgery? The results of a recent survey of oral and maxillofacial surgeons suggest that the most severe anesthesia complications are very rare, occurring in less than one person out of thousands of patients.
Researchers parsed data from thousands of oral surgery procedures in Massachusetts to estimate the prevalence of adverse effects following local and general anesthesia. They concluded that an office-based team model for outpatient anesthesia procedures is safe.
“On the basis of the results of our study, we can conclude that the office-based team model used by oral and maxillofacial surgeons in Massachusetts for the delivery of outpatient anesthesia is safe with a low complication rate,” wrote the authors, led by Evan Wardius, DMD, an oral and maxillofacial surgery resident at the Boston University Henry M. Goldman School of Dental Medicine (Journal of Oral and Maxillofacial Surgery, February 5, 2019).
Oral and maxillofacial surgeons have long performed outpatient anesthesia procedures in their offices. However, renewed scrutiny has focused on anesthesia and sedation in the dental office, and the researchers of the current study decided to investigate morbidity and mortality rates in oral and maxillofacial surgeons’ offices over time.
They used data from the Massachusetts Society of Oral & Maxillofacial Surgeons, which has surveyed members about anesthesia use for more than three decades. The researchers focused most of their analysis on the 2015 and 2016 surveys. These surveys included more than 431,000 patient visits to about 150 oral and maxillofacial surgeons in the state.
The majority of oral surgery patients underwent local anesthesia alone, followed by general anesthesia and parenteral sedation. The most commonly used anesthetic or adjunctive agent was midazolam, followed by nitrous oxide. For local anesthetic procedures, the vast majority of surgeons reported using lidocaine with epinephrine.
Overall, these procedures were safe, the authors noted. Syncope (fainting) was the most common complication, accounting for almost 70% of all reported complications. More severe adverse events occurred far less frequently, and no deaths were reported in the 2015 and 2016 survey years.
“The more knowledgeable [oral and maxillofacial surgeons] are about the potential medical emergencies that can be encountered during administration of outpatient anesthesia, the more prepared they will be in the management of these complications,” the authors wrote.
This study had a number of shortcomings, including that it relied on the oral and maxillofacial surgeons to report the adverse effects that occurred in their offices. The researchers hope their work informs these dental professionals about common adverse effects experienced in the office.
For more findings, see the infographic below.
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Precision Dental
Root Cause Netflix Movie: Fighting Mythical FIRE, with Scientific FACT
March 12, 2019 – by Gary Glassman, Chief Dental Officer, dentalcorp; Ian Watson, DDS, MScD, FRCD(C)
It has often been said that to bring attention to a controversial matter simply affirms its existence, memorializes it and gives it credibility. The corollary is to ignore it and allow wrong and negligent statements to pass as science. Instead of burying our heads in the sand, we would much rather bury bad science once and for all. We do this with the best interest of patients in mind.
In life, when things go wrong, it is human nature to search for reasons and causes. While searching for answers is a worthy endeavour, jumping to conclusions and ascribing blame without evidence is irresponsible. When this happens in medical circumstances, it is altogether misleading and unfair to patients to give them false information and send them on a wild goose chase.
If you haven’t heard, let me be the first to introduce you to a documentary on Netflix called “Root Cause.” The documentary follows an individual’s experience with root canal treatment, and the alleged systemic issues he claims arise directly from the root canal treatment.
Unfortunately, there is a small group of naysayers that look to root canal treated teeth as being the root of all evil. Or to put it more appropriately the Evil of all Root!
This misinformation is promulgated based on the flawed focal infection research by Dr. Weston Price in the 1930s, which states bacteria trapped in dentin tubules remaining after root canal treatment cause almost any type of ‘degenerative’ disease, including kidney disease, heart disease, rheumatic fever, and multiple sclerosis. With this decade old flawed research as his justification, it has been recommended that patients afflicted with such conditions consider extracting all their endodontically treated teeth!
Several examples of misinformation are cited in this movie. For instance, it was erroneously stated that “97% of patients with breast cancer had a root canal on the same side as the cancer.” I researched this declaration, and I found NOTHING! Not one iota of scientific evidence to support this claim. This is the equivalent of saying “100% of patients with cancer drink water.” Correlation does not equal causation.
As recently as 2013, a study published in a journal of the American Medical Association (JAMA Otolaryngology – Head & Neck Surgery) found that a patient’s risk of cancer doesn’t change after having a root canal treatment; in fact, patients with multiple endodontic treatments had a 45 percent reduced risk of cancer.
Another claim was “The #1 cause of heart attack is root canal treated teeth.” A study conducted over 44 years, called the Baltimore Longitudinal Study of Aging, published in the International Endodontic Journal in 2016, evaluated whether apical periodontitis, root canal treatment, and endodontic burden were associated with long term risk of cardiovascular disease. The study actually suggests a possible risk reduction with root canal treatment versus non-treated teeth with apical lesions, which supports the evidence that untreated abscessed teeth may contribute to an increased risk of cardiovascular disease and not root canal treated teeth as the contributing factor!
The American Association of Endodontists and Canadian Academy of Endodontics are continuing to educate its members and the general public by noting that no modern evidence exists to support claims that endodontically treated teeth serve as infection foci. In fact, untreated, infected teeth create that very cesspool from which consequences arise.
Predictable, successful endodontic treatment, using sophisticated techniques is the best strategy to reach a satisfactory conclusion. The removal of contaminants and organic substrate from within the root canal system in its totality is the indisputable biologic imperative of endodontic treatment.
Providing patients with access to comprehensive, proven facts about the safety and efficacy of endodontics and root canal treatment is the best strategy for countering misinformation. In fact, the practice of endodontics is rooted in scientific evidence that has evolved over decades. Anecdotal stories, in any realm of medicine and dentistry are hardly enough to change tried, tested and true treatment paradigms. Anecdotes can lead to hypotheses, but without empirical scientific evidence to back them up, they remain “one man’s story”.
The American Association of Endodontists website, http://www.aae.org has up to date content and resources which include “Root Canal Safety Talking Points”, “Myths About Root Canals”, and a “Root Canal Safety” video, all which can be shown to patients to dispel any myths and negative propaganda about root canal treatment.
As per a recent AAE communique: “Legal counsel has been consulted by the AAE and the ADA to discuss options to compel Netflix and other online hosts to remove this misleading and harmful content. After consultation, the AAE is filing formal complaints with the patient protection agencies, including state and medical boards. Additionally, the AAE is working with the ADA on formal outreach not only to Netflix, but all online platforms hosting the film, and urging removal for the safety of the public.”
Endodontic treatment has experienced, and will continue to experience some of the highest success rates found in dentistry, preventing unnecessary loss of teeth and contributing to a healthy, functional and aesthetically pleasing dentition.
Special thanks to Dr. Maneesh Sharma, President of the Canadian Academy of Endodontics and the CAE’s efforts for their position paper on this topic, Spring Hatfield, RDH for her helpful insight and the American Association of Endodontists for their powerful stand against harmful misinformation.
Canadian Dental Hygienists Start the Cannabis Conversation
January 9, 2019
by Canadian Dental Hygienists Association (CDHA)
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The beginning of a new year is a perfect opportunity to make a fresh start and set new personal and professional goals. With the recent legalization of cannabis in Canada, dental hygienists urge everyone to think carefully before using cannabis, given its negative impact on oral health.
“Cannabis use has many side effects that can alter the state of our mouths, teeth, and gums,” explains Tracy Bowser, president of the Canadian Dental Hygienists Association (CDHA). “We know that cannabis reduces saliva, leading to dry mouth. And those famous ‘munchies’ increase the time that teeth are exposed to sugars. As a result, cannabis users have a higher risk of cavities, gum disease, and oral infections.”
Dental hygienists—experts in oral health promotion and disease prevention—know that good oral health is essential for physical and mental well-being. As primary health care providers, they work with you to develop individualized oral care plans and can offer guidance on healthy food and lifestyle choices. Before beginning any dental hygiene treatment, they will remind you that cannabis use may increase bleeding and slow healing, and will confirm that your capacity to consent to care isn’t impaired. “Dental hygienists want you to enjoy optimal oral and overall health in 2019 and beyond, which is why they are ready to have the cannabis conversation,” adds Bowser. Schedule your next dental hygiene appointment today to learn more about the impact of cannabis on your oral health or visit http://www.dentalhygienecanada.ca/cannabis.
Serving the profession since 1963, CDHA is the collective national voice of more than 29,549 registered dental hygienists working in Canada, directly representing 19,000 individual members including dental hygienists and students. Dental hygiene is the sixth largest registered health profession in Canada with professionals working in a variety of settings, including independent dental hygiene practice, with people of all ages, addressing issues related to oral health. For more information on oral health, visit http://www.dentalhygienecanada.ca.
Despite a major in-depth investigation in the U.S. that found little evidence flossing prevents cavities and gum disease, dentists in Canada and the U.S. are standing by the daily oral hygiene practice.
The Associated Press reported Tuesday that after scrutinizing 25 different studies over the past decade it found the evidence for flossing is “weak, very unreliable,” of “very low” quality, and carries “a moderate to large potential for bias.” The U.S. government also quietly dropped flossing from its dietary guidelines in 2016 and acknowledged to the AP the effectiveness of flossing had never been researched.
Should you floss daily? Experts say it does little to prevent gum disease, cavities
But could flossing — a practice recommended by dentists and dental associations around the world for years — really be worthless?
Not so fast says Scott Tomar, professor and chairman of the department of community dentistry and behavioural science at the University Of Florida College of Dentistry.
“It comes as no surprise to most of us in the dental public health community,” Tomar told Global News. “We have known for years that there just aren’t a lot of studies, and those that are out there are either relatively small or short term studies.”
Indeed, the AP found that most of the studies it examined involved too few test subjects, used outdated methods, or did not last long enough.
Tomar said it would be extremely difficult to complete a high-quality, long term study on the effects of flossing because it would be too expensive and require a large, diverse number of people over a number of years
“A randomized control trial looking at disease ends points in dental care like tooth decay on the surfaces in between teeth, or periodontal diseases would be incredibly large and expensive studies to do,” he said. “The slow progression of those conditions would mean you would have to follow a fairly large number of people for three to five years.”
Tomar also said he was “skeptical” that The National Institutes of Health — the U.S. agency responsible for biomedical and health-related research — or private companies would step in to fund the research.
“I don’t think we are going to see the major manufacturers of dental floss pay to do this,” he said.
And despite the AP report, Tomar said he still recommends flossing and there is pretty good evidence it’s effective at removing debris and plaque.
“There are short term studies that show that regular flossing reduces the prevalence of gingivitis,” he said. “One thing worth bearing in mind is the absence of evidence is not equivalent to the absence of effectiveness.”
Natalie Archer, former vice-president of the Royal College of Dental Surgeons of Ontario, said while she hasn’t examined the studies in the AP report, she will keep advising patients to floss and keep flossing herself.
“I would probably bet there isn’t a dentist or [dental] hygienist out there who doesn’t floss their own teeth,” Archer told Global News. “We see patients for years, and if anyone is going to see the long-term benefits [it’s us]. It’s that flossing works.”
The Canadian Dental Association (CDA) also continues to support flossing as “one step of maintaining healthy teeth and gums.”
“Flossing is an effective preventative measure to remove plaque, the main cause of gum disease,” the CDA said in an email to Global News.
“The weakness of the evidence supporting the value of floss in the prevention of gum disease is a reflection of the difficulty of conducting the necessary studies, not of the value of flossing for the maintenance of good oral health.”
The American Academy of Periodontology (AAP) also acknowledged there is a problem with research on flossing, but encouraged patients to keep flossing.
“In the absence of quality research, patients should continue to include flossing as a part of their daily oral hygiene habit,” the AAP said.
Archer said floss remains the most effective, economical tool for cleaning between your teeth.
“Your mouth is your primary portal to your body. If you can’t keep it clean, all that bacteria is going through the rest of your body,” she said. “Having good bacteria in the mouth versus a lot of a bad bacteria…it affects our gut flora, everything.”
*With files from The Associated Press
Download the print version of The State of Oral Health in Canada report.
Access the digital version of The State of Oral Health in Canada report.
References available in print and digital versions (above).
Executive Summary
Good oral health is essential to overall health and quality of life. Good oral health enables us to speak, smile, breathe, drink, and eat. The oral cavity also plays a central role in the intake of basic nutrition and protection against microbial infections.
As the national voice for the dental profession, the Canadian Dental Association (CDA) is pleased to present this overview of oral health in Canada. In the following pages, you will find insights and information on:
the state of oral health around the world;
how Canada compares against other countries;
information on funding models, statistics on dental usage and access to oral care;
key trends;
priority areas for improving oral health;
programs being spearheaded by provincial dental associations and more.
Based on a wide range of metrics, we can state definitively that Canada is among the world leaders when it comes to the overall oral health of its citizens. In addition to ranking favourably in terms of oral health indicators such as decayed, missing and filled teeth (DMFT), severe chronic gum disease and instances of oral and lip cancer, Canadians also enjoy among the best access to oral health care in the world. Three out of every four Canadians visit a dental professional at least once per year, and 84% of Canadians believe they have good or excellent oral health. In Canada, wait times to see a dentist and receive treatment are among the shortest in the world. And for most Canadians, choice and availability of dentists is a non-issue.
However, there is still work that needs to be done in order to improve the state of oral health in Canada for specific groups. Like many other countries around the world, Canada faces challenges providing the most vulnerable segments of its population (e.g. seniors, low-income populations, people with special needs, children, Indigenous peoples, new immigrants with refugee status, etc.) with the oral health services they require. Research indicates that poor oral health is experienced by those Canadians who do not have access to regular dental care. In the following pages, we outline some of these challenges, along with work being done to address them.
There are nine nationally recognized dental specialties in Canada. The Commission on Dental Accreditation of Canada (CDAC) reviews and accredits the education programs in the nine dental specialties.
Accreditation is a process by which CDAC recognizes dental and allied dental education programs – as well as health facility dental services – as having met nationally-determined requirements or standards, as established by CDAC.
For more information on dental specialties in Canada, please visit the please visit the Canadian Dental Specialties Association. cdsa-acsd.ca
Dental Public Health
Endodontics
Oral and Maxillofacial Surgery
Oral Medicine and Pathology
Oral & Maxillofacial Radiology
Orthodontics and Dentofacial Orthopedics
Pediatric Dentistry
Periodontics
Prosthodontics
Dental Public Health
Dental Public Health is that branch and specialty of dentistry concerned with the diagnosis, prevention and control of dental diseases and the promotion of oral health through organized community efforts. Dental Public Health serves the community through research, health promotion, education and group dental care programs.
A public health dentist is a dental specialist who has successfully completed an accredited advanced educational program in dental public health and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Association of Public Health Dentistry http://www.caphd.ca
Endodontics
Endodontics is that branch and specialty of dentistry concerned with the morphology, physiology and pathology of the dental pulp and periradicular tissues. Its study and practice encompass the basic clinical sciences, including biology of the normal pulp, and etiology, diagnosis prevention, and treatment of diseases and injuries of the pulp and associated periradicular tissues.
An endodontist is a dental specialist who has successfully completed an accredited advanced education program in endodontics and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Academy of Endodontics http://www.caendo.ca
Oral and Maxillofacial Surgery
Oral and maxillofacial surgery is that branch and specialty of dentistry which is concerned with and includes the diagnosis, surgical and adjunctive treatment of disorders, diseases, injuries and defects, involving the functional and aesthetic aspects of the hard and soft tissues of the oral and maxillofacial regions and related structures.
An oral and maxillofacial surgeon is a dental specialist who has successfully completed an accredited advanced education program in oral & maxillofacial surgery and who currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Association of Oral and Maxillofacial Surgeons http://www.caoms.com
Oral Medicine and Pathology
Oral Medicine and Pathology is the branch and specialty of dentistry concerned with the diagnosis, nature and primarily non-surgical management of oral, maxillofacial and temporomandibular diseases and disorders, including dental management of patients with medical complications. Oral medicine and oral pathology are two applied components of this specialty.
A practitioner in oral medicine is a dental specialist who has successfully completed a formal advanced education program in oral medicine. A practitioner in oral pathology is a dental specialist who has successfully completed a formal advanced education program in oral pathology. A practitioner in oral medicine and pathology is a dental specialist who has completed formal advanced education programs in oral medicine and oral pathology. These practitioners currently hold such specialty designations from a Provincial Dental Regulatory Authority.
Canadian Academy of Oral and Maxillofacial Pathology and Oral Medicine http://www.cda-adc.ca/jcda/vol-69/issue-9/568.pdf
Oral and Maxillofacial Radiology
Oral and Maxillofacial Radiology is that branch and specialty of dentistry concerned with the prescription, production and interpretation of diagnostic images for the diagnosis and management of diseases and disorders of the craniofacial complex.
An Oral and Maxillofacial Radiologist is a dental specialist who has successfully completed an accredited advanced education program in Oral and Maxillofacial Radiology and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Academy of Oral and Maxillofacial Radiology http://caomr.org
Orthodontics and Dentofacial Orthopedics
Orthodontics and Dentofacial Orthopedics is that branch and specialty of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures and the diagnosis, prevention and treatment of any abnormalities associated with these structures.
An orthodontist is a dental specialist who has successfully completed an accredited advanced education program in orthodontics and dentofacial orthopedics and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Association of Orthodontists http://www.cao-aco.org
Pediatric Dentistry
Pediatric Dentistry is that branch and specialty of dentistry concerned with providing primary and comprehensive preventive and therapeutic oral health diagnosis, care and consultative expertise for infants and children through adolescence, including those of all ages with special care needs.
A pediatric dentist is a dental specialist who has successfully completed an accredited advanced education program in pediatric dentistry and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Academy of Pediatric Dentistry http://www.capd-acdp.org
Periodontics
Periodontics is that branch and specialty of dentistry concerned with the diagnosis, prevention, and treatment of diseases and conditions of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and aesthetics of these structures and tissues.
A periodontist is a dental specialist who has successfully completed an accredited advanced educational program in periodontics and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Academy of Periodontology http://www.cap-acp.ca
Prosthodontics
Prosthodontics is that branch and specialty of dentistry concerned with the diagnosis, restoration and maintenance of oral function, comfort, appearance and health of the patient by the restoration of the natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
A prosthodontist is a dental specialist who has successfully completed an accredited advanced educational program in prosthodontics and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Association of Prosthodontists of Canada http://www.prosthodontics.ca
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Non-profit dental clinic opens in North Surrey
The clinic will help ‘under-served and socially disadvantaged families’ as well as donate profits to charity
A non-profit dental clinic that provides discounts on dental care to those in need has opened in Newton, and it’s said to be the first of its kind in Surrey.
Located at the corner of 88th Avenue and 128th Street, the clinic’s mission is to “provide affordable and accessible dental care to under-served and socially disadvantaged families.”
It’s been eight years in the making and is the brainchild of Dr. Harpreet Dhillon and Dr. Belrup Patrola, who say it’s their way of giving back.
While the dentists say there are other models that provide discounted or free dental care in the region, they say the others are mostly student-driven and dentist-supervised.
Strive Dental, on the other hand, is run exclusively by professional dentists.
“We know that there’s a tremendous need for dentistry, generally speaking,” said Dhillon. “It’s not covered by general provincial health care, you either have funding from work-related insurance or you have to buy private insurance and most people can’t afford it. So if they’re not with a good job, they’re either paying out of pocket or looking for subsidized care, or not going at all.”
“We could get into the negative impacts of oral health on your systemic body, and it would be mind-boggling, but there’s such a dramatic negative effect on personality and live-ability,” added Dhillon, a South Vancouver resident who operates practices in Vancouver and Delta.
“The outward and psychological impact is quite tremendous. We know there’s a need and we see it in our day-to-day practices. We try to do what we can but we felt that if we can create an office where we can centralize that care and give back to the community, that would be the easiest way.”
The clinic will offer a 20 per cent discount to those who can’t afford dental treatment.
“There’s a large immigrant population here so with that a lot of them don’t have coverage,” said Patrola. “We ask them verbally, and we take them for their word.”
Patrola himself was unable to pay for dental care while he was in university. He was looking at a large bill for a root canal and crown, or, for much less money, have the tooth pulled. He chose the latter due to his financial limitations at the time.
“That kind of made me realize how many other people must have to make the same decision. It was tough on me. When I got into dentistry, I was talking to Dr. Dhillon and said once we’ve established ourselves, we have to find a way to give back.”
Beyond the discount they are offering to patients in need, Dhillon and Patrola say they will donate all of their net profits to local charities.
First to benefit will be Surrey Food Bank and Guru Nanak’s Free Kitchen. In the future, they plan to offer funding to other charities, and perhaps launch a scholarship program for high school students interested in the health field.
The clinic also accepts Ministry of Social Services dental coverage, and won’t charge patients the difference between the ministry fee guide and the British Columbia Dental Association fee guide. Both say most dental clinics don’t accept ministry insurance, due to the lower payment they’d receive.
And the dentists said they didn’t skimp on equipment just because it’s a non-profit.
“We got the best X-ray machines that we could get, the best equipment we could get,” said Dhillon, noting they current have three operatories that are active, with another four they can use to expand as demand increases.
“It’s exactly what it would be at any other office, there’s no cutting corners. At the end of the day it’s health related. We got into this because it’s what we really enjoy doing.”
(Dr. Belrup Patrola of Strive Dental Clinic with a pair of digital x-ray devices. Photo: Amy Reid)
It turns out, the inspiration for the clinic goes back decades, Patrola explained.
“It goes all the way back to 1906,” said Patrola, a Delta resident who operates a practice in Fort Nelson. “We come from pretty historic Sikh families. My family was one of the first Indian families in Canada and my great grandfather’s father built the first Sikh temple in Canada. My family profile’s in the museum in Abbotsford. It’s a national historic site now. Just hearing stories of what they did for the community, it’s just been ingrained in us. This concept of Seva.”
In Sikhism, seva is a word that describes “selfless service.”
“We follow our faith as best as we can,” Dhillon chimed in. “It always tells us to do good. Don’t steal, don’t harm anyone. That’s one pillar of our religion. The other pillar is do an honest day’s living. The third one is to give back to the community. What you have is good, but let others benefit from what you do and as a religious philosophy, if everyone does that there wouldn’t be poverty and all these challenges society faces these days.”
“So we’re trying to be as charitable as possible. The more the better,” Dhillon added.
The clinic opened with a soft launch in August, but its grand opening is set for this Saturday (March 9) at 2 p.m.
Strive Dental is located at #101-12837 88th Ave., Surrey.
Canadians of all ages can enjoy good oral health and benefit from regular professional dental care. Provided you look after them, your teeth and gums will look good and stay healthy for life.
As you age, however, you may need to make a few changes in the way you care for your teeth and gums. If you need advice on looking after your teeth and gums, or those of a dependent relative or friend, your dentist and the Canadian Dental Association can provide you with valuable information.
You are never too old to have healthy teeth and gums. And you are never old enough to stop seeing your dentist! Your dentist wants to make sure you maintain healthy teeth and gums for your whole life. This section explains how your needs change as you get older.
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Dental students best hygienists at scaling in new study
By Theresa Pablos, DrBicuspid.com associate editor
Dental students may be better at scaling and root planing than their hygiene counterparts, according to the findings of a new study. Dental students in Switzerland more effectively scaled a maxillary left canine model than both dental hygiene students and experienced hygienists.
The study authors, led by dental hygienist Deborah Hofer, were surprised that the dental students more effectively scaled the tooth model despite having significantly fewer training hours. They published their findings in the Swiss Dental Journal (February 26, 2019).
“Based on the results of this study, our hypothesis that periodontal instrumentation training time would be reflected in the students’ end results when scaling/root planing a tooth … must be rejected,” wrote Hofer and her colleagues from the University of Zurich. “In fact, the dental students displayed scaling/root-planing skills comparable to the [dental hygiene] students who received 80 hours of training.”
Education’s role in clinical mastery
“Dental students displayed scaling/root-planing skills comparable to the [dental hygiene] students who received 80 hours of training.”
— Deborah Hofer and colleagues
Dental school is rigorous, and dental students practice some clinical skills for a fraction of the time of dental hygiene students. Therefore, the researchers wondered how dental students’ scaling and root-planing abilities fared against their colleagues who get more training time.
To find out, they recruited 70 study participants with varying educational and dental backgrounds:
34 dental students
20 dental hygiene students from two local schools
8 experienced dental hygienists
8 laypeople with no dental experience
The researchers asked the participants to use the hand instrument of their choice to scale and root plane a maxillary left canine on a dental model. The tooth models all had identical periodontal defects and were coated with black nail polish to simulate calculus.
After the participants cleaned the teeth for five minutes, the researchers scanned the models and evaluated them against a reference tooth. The dental students most effectively cleaned the tooth, followed by dental hygiene students at one school, experienced dental hygienists, then dental hygiene students at a second school.
Tooth cleaning efficiency by profession
The researchers attributed the relatively poor performance of the experienced dental hygienists to the differences between scaling and root-planing model teeth as opposed to actual teeth. However, the difference between the dental students and the various hygiene students was harder to explain.
They hypothesized the dental students could be more efficient learners, as they needed to excel at high school and university before entering dental school. Meanwhile, dental hygiene students go down a skill-based, apprentice pathway in Switzerland.
“The academic challenges previously mastered by the dental students, and an acquired ability for efficient learning and knowledge/skills transfer, may be one reason that they scored so high in this manual test despite very limited training time,” the authors wrote. “However, this is only a suspicion, and it might well be that [dental hygiene] students, despite the discrepancy in their training times and level of proficiency displayed, could also reach levels of competency similar to those of dental students with an equally low number of training hours.”
Interpret findings with caution
While the findings are interesting, a number of study shortcomings prevent them from being clinically relevant, according to the authors. First, the feel of human dentin and calculus varies from that of the model, which could explain why the experienced dental hygienists, who are used to working on patients, did not perform as well as some of the students who have only worked on models.
Furthermore, academic and professional education is different in Switzerland than other countries, including the U.S. Therefore, the results may not be applicable to U.S.-dental training programs.
Finally, the researchers did not account for educational differences between the dental school and two dental hygiene schools, including staff credentials and classroom diversity. They hope a follow-up study will look at some of these factors.
“Within the limitations of this study, we have shown that 8.5-hours of preclinical training was sufficient for dental students to remove concrement from an upper right maxillary canine to a level equal to or greater than [dental hygiene] students receiving 80 or 64 hours of preclinical training in scaling/root planing,” the authors concluded. “These results point to the possibility of reducing the number of hours allocated to learning this preclinical skill by both dental and [dental hygiene] students and reallocating that time to other areas of the curriculum.”
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Caring for Your Teeth
Only your dentist has the skills, training and expertise to provide a comprehensive diagnosis about your oral health condition, and to advise you on appropriate treatment and care. Your dentist can help you establish a routine of daily cleaning and preventive visits to keep your oral health good for life.
Taking proper care of your teeth and gums is a lifelong commitment. It includes a good oral hygiene routine that you follow at home, as well as regular visits to your dentist and an overall “team” approach to your oral care. By taking these simple steps, there’s every reason why you should keep your “oral health – good for life.”
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New product: Oral-B debuts AI toothbrush
By DrBicuspid Staff
February 26, 2019 — Procter & Gamble brand Oral-B has introduced a new toothbrush with artificial intelligence (AI) technology.
The Oral-B Genius X toothbrush has accumulated the brushing behaviors of thousands of people to assess individual brushing styles and coach users to achieve better brushing habits. The AI technology tracks where people are brushing in their mouth and offers personalized feedback through the Oral-B app on the areas that require additional attention.
Users brush an average of 2 minutes and 22 seconds with the toothbrush, longer than the recommended time of 2 minutes, according to Oral-B. https://buff.ly/2peqeCk
Download the print version of The State of Oral Health in Canada report.
Access the digital version of The State of Oral Health in Canada report.
References available in print and digital versions (above).
Executive Summary
Good oral health is essential to overall health and quality of life. Good oral health enables us to speak, smile, breathe, drink, and eat. The oral cavity also plays a central role in the intake of basic nutrition and protection against microbial infections.
As the national voice for the dental profession, the Canadian Dental Association (CDA) is pleased to present this overview of oral health in Canada. In the following pages, you will find insights and information on:
the state of oral health around the world;
how Canada compares against other countries;
information on funding models, statistics on dental usage and access to oral care;
key trends;
priority areas for improving oral health;
programs being spearheaded by provincial dental associations and more.
Based on a wide range of metrics, we can state definitively that Canada is among the world leaders when it comes to the overall oral health of its citizens. In addition to ranking favourably in terms of oral health indicators such as decayed, missing and filled teeth (DMFT), severe chronic gum disease and instances of oral and lip cancer, Canadians also enjoy among the best access to oral health care in the world. Three out of every four Canadians visit a dental professional at least once per year, and 84% of Canadians believe they have good or excellent oral health. In Canada, wait times to see a dentist and receive treatment are among the shortest in the world. And for most Canadians, choice and availability of dentists is a non-issue.
However, there is still work that needs to be done in order to improve the state of oral health in Canada for specific groups. Like many other countries around the world, Canada faces challenges providing the most vulnerable segments of its population (e.g. seniors, low-income populations, people with special needs, children, Indigenous peoples, new immigrants with refugee status, etc.) with the oral health services they require. Research indicates that poor oral health is experienced by those Canadians who do not have access to regular dental care. In the following pages, we outline some of these challenges, along with work being done to address them.
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Public Statement from the Canadian Dental Association:
Make Informed Decisions Before Purchasing or Using Direct-to-Consumer Dental Appliances
There are many new options available for patients to purchase dental appliances directly from suppliers. Although claims of shorter treatment times, “doing-it-yourself,” in the comfort of your own home, or the convenience of purchasing dental appliances directly online or over-the-counter may seem attractive, you should be informed that using direct-to-consumer dental appliances may not give you the most appropriate care to achieve your desired results. Examples of direct-to-consumer dental appliances include but are not limited to bleaching kits to whiten teeth, transparent aligners to straighten teeth, occlusal splints to temporarily modify your bite and protect your teeth, and anti-snoring devices.
Your dentist, a general practitioner or a specialist such as an orthodontist, is in the best position to recommend dental treatment options that are right for you. Using direct-to-consumer dental appliances eliminates critical interactions between you and your dentist, such as:
receiving a complete clinical oral examination, diagnosis and recommendation for treatment that is unique to you and your overall oral health needs;
discussing treatment options and co-developing a treatment plan that achieves the most appropriate results for you;
monitoring the progress of your treatment; and
having direct access to follow-up care after completing your treatment plan.
The Canadian Dental Association (CDA) encourages you to make informed decisions about your oral and overall health. Make sure to ask your dentist or dental specialist if the appliance you are thinking about suits your individual oral health needs and that it’s considered within all aspects of your care. If using a direct-to-consumer dental appliance leads to unexpected complications or results that fall short of your expectations, your dentist or dental specialist may have limited choices to help, correct, or address your situation.
CDA is committed to sharing important information to help protect and promote the oral health of Canada’s population. To find a Canadian licenced dentist or dental specialist in your area, please visit http://www.cda-adc.ca/en/oral_health/talk/find.asp.
February 21, 2019 — In 2017, a dental practice in Tennessee discovered ransomware on an office computer. This malicious software blocked access to the health and financial information of almost 3,000 patients, and the dentist was unable to determine whether that patient information had been shared outside of the clinic.
The consequences to the practice were costly. The managing dentist had to designate a new privacy and security officer, change IT vendors, and create a new Health Insurance Portability and Accountability Act (HIPAA) training program.
Pat Little, DDS
Pat Little, DDS, president and founder of Dental Risk Concepts.
Incidents similar to this one are happening to dental and medical offices all over the U.S. In fact, on February 4, the U.S. government reported it was investigating a breach that could affect 10,000 patients at a Texas dental clinic.
But this doesn’t have to be your practice’s story. Dr. Pat Little, DDS, spoke about how dentists can protect themselves and their patients from medical identity theft at the Chicago Dental Society Midwinter Meeting on February 21.
“Dental and medical identity theft is the fastest-growing and most lucrative form of identity theft,” Dr. Little, president and founder of Dental Risk Concepts, told DrBicuspid.com. “Any breach that affects our patients’ private data can result in devastating legal and financial consequences.”
The value of a dental record
Medical identity theft is the fastest-growing form of identity theft simply because it is so lucrative, Dr. Little explained. To hackers, a dental chart is more valuable than a Social Security number because it often contains far more information.
“With a Social Security number, they can do damage typically with one person’s account,” Dr. Little said. “But if they can steal dental records, they have a medical record not only for that patient but also for all the other family members, which would include Social Security numbers, birth dates, everything they would need to open up multiple accounts in multiple locations.”
Hackers and identity thieves use three main methods to get access to protected patient information:
Dumpster diving: Identity thieves will literally dig through garbage and recycling bins, looking for information that hasn’t been properly shredded and disposed of.
Physical theft: Thieves will break into dental practices and cars to steal laptops, phones, computers, servers, and other devices that may contain unsecured patient information.
Phishing scams: Hackers will send an email with a hyperlink that someone in the practice clicks and opens. This link then infects the computer with malware, which can harvest patient information and/or lock the computer and demand a ransom to reopen it.
Phishing scams are the most common of the three methods, and they’re not always obvious. The best hackers can make emails and hyperlinks look legitimate, like they are coming from a patient, good friend, dental supplier, or credit card company.
Once hackers and thieves have patient information, they can monetize that data in a number of ways, including selling dental records on the black market, opening credit cards and bank accounts in your patients’ names, or even going to the dentist masquerading as one of your patients.
“The HIPAA fines for a breach can be staggering.”
— Pat Little, DDS
In addition, the financial consequences of a breach can be catastrophic for dentists and dental practices. Dentists may face fines of hundreds of thousands of dollars, and they’ll likely lose patient confidence and experience turnover.
“The HIPAA fines for a breach can be staggering,” Dr. Little noted. “The maximum fine is $1.5 million. I’ve never seen a dentist have to pay that much money, but [the fines] can easily go into six figures if the government decides the dentist acted with reckless disregard.”
How to protect yourself
Private practices are small businesses that often don’t have the IT resources of larger businesses, a weakness that thieves and hackers are all too happy to exploit. However, dentists can take certain steps to protect themselves and their patients’ information.
First, dentists can and should partner with an IT company that is knowledgeable about HIPAA compliance and security. Dr. Little recommends asking companies whether they represent other dentists and how familiar they are with HIPAA security and the dental profession.
It’s also important for dentists to educate themselves and their staff about HIPAA security. One of the most dangerous things dentists can do is think that a breach can’t happen to them because they’re careful or have antivirus software.
“Watch the mentality that this can’t happen to me,” Dr. Little cautioned. “It’s happening with alarming frequency now. Make sure you protect yourself with a good IT partnership.”
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Happy Friday!
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Precision Dental Winter Warm Up Event – Endo, Slowspeed, Highspeed & Electric
Our hearts go out to all the family’s with the Railway train derailment.
CN, United Steelworkers’ agreement includes improved dental, health benefits | Benefits Canada https://buff.ly/2WO5f8I
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Spruce up your office with some new Electric Handpieces! Compare your to this picture! Are yours running rough, look all black and chipped or worn out looking? Not using Electrics? Give a demo a try #Electric Handpieces #PrecisionDental #KaVo #NSK
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Spruce up your office with some new Highspeed Handpieces! Compare the difference in these pictures! Are yours running rough, look all black and chipped or worn out looking? #Highspeeds #PrecisionDental #KaVo #NSK
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Spruce up you hygiene department with some new Slowspeed Handpieces! Compare the difference in these pictures! Are yours running rough, look all black and chipped or worn out looking? #Slowspeeds #PrecisionDental #KaVo #NSK
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Which one are you? Are you enjoying the cold or ready for spring? I finally had to stop wearing shorts to work today. Let us know your thoughts.
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Our Mobile site is now live, so now you can book a repair pick up anytime anywhere!
We’re already offering PDC DEALS NOW – so no need to wait and that’s a Guarantee!
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CHeck out our current offers Here:
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Need help with Maintenance procedures on your E-Type dental handpieces or your electric handpieces? Contact us and we can help go through it with you and save you some money on your handpiece repairs! Maintenance is King! Check out our Highspeed Maintenance sheet. #Maintenance #HandpieceRepair #PrecisionDental
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Need help with Maintenance procedures on your dental handpieces? Contact us and we can help go through it with you and save you some money on your handpiece repairs! Maintenance is King! Check out our Highspeed Maintenance sheet. #Maintenance #HandpieceRepair #PrecisionDental
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Maintenance is King! Need help with Maintenance procedures on your dental handpieces? Contact us and we can help go through it with you and save you some money on your handpiece repairs! Check this out for Common Mistakes made. #Maintenance #HandpieceRepair #PrecisionDental
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Proper Maintenance Saves you money in the long run on your handpiece Maintenance and reduces risk of injury to a patient. Automatic lubricators offer you both ease of use and multiple functions to achieve proper complete cleaning and lubrication.
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Check us out at the PDC booth #1608 for some great show only specials!
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We look forward to seeing you at the PDC and if you’re not going to be there – No worries! Starting Feb. 15th: Just give us a call or email and get the Same PDC Deals Guaranteed – without the rush. Plus
With it being our 20th Year Anniversary in 2018 – Save up to an Additional 20% Off many Popular Products!
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Common Dental Handpiece Maintenance Mistakes – What is Important to know!
Check out our common Maintenance Mistakes Made to prevent early failure of Dental Handpiece Equipment.
Some Common Ones:
* Not Enough Lubricant
* Failure to Run Dentist Handpieces After Lubricating
* Lubricating the Incorrect Hole Check out the whole article here:
Cheaper Handpiece Repairs Aren’t Always Better—They’re Actually Worse
When you walk into your practice, you want things to run smoothly. No glitches, unexpected cancellations, staff conflicts or equipment failures. Unfortunately, these happen more often than we’d like because, to some extent, many things are out of our control. That’s when we modify, adapt and make the most out of the situation. But maybe we have more control than we think. Curious? Keep reading.
Dr. Steve Frost runs a successful endodontic office in Arizona and was looking to purchase new handpieces. He made the investment with KaVo and purchased the lubricating and maintenance accessories per the manufacturer’s recommendations as it is well-documented that daily handpiece maintenance is essential. The demand he put on his handpieces was high. Over time the amount of torque, stress, and strain of cutting through zirconia, metal and porcelain crowns took its toll.
After about a year and a half of heavy and intense use, as normal wear and tear would have it, the handpieces needed to be sent in for service and replacement parts. They were simple fixes. Or so he thought. He sent them out to a local repair provider and didn’t think anything of it when they came back.
However, after about 5-6 months, much to his dismay, he noticed the turbines grinding in several handpieces, which subsequently led to vibrating and overheating. Not good. He sent them back to the repair provider for a second time, and the same thing happened. Only this time, he noticed that the color on the head was different (albeit slightly) than the rest of the handpiece. So he called his KaVo sales representative. Dr. Frost was slightly frustrated as his investment up to this point was costly and getting a little out of hand. “Counterfeit parts,” the sales rep told him Those two words summed it up. “Original Equipment Manufacturer, or OEM parts comply with the highest standards and are manufactured to meet rigourous quality and regulatory requirements, whereas counterfeit parts may not be,” he explained. Unbeknownst to him, Dr. Frost’s handpiece was repaired with counterfeit parts and as a result, the turbines were more or less shot and the entire handpiece needed a complete overhaul. Not the kind of news he wanted to hear, especially after he had already spent enough on repairs to have paid for a new handpiece.
If this story sounds familiar, there’s good reason. I interviewed the repair managers of the top 5 dental handpiece repair companies that came up from a quick Google search. When asked about their service and parts protocol, 4 out of the 5 companies said that unless the customer stated otherwise, after-market parts are used over OEM parts. Why? Because they’re cheaper. Your first thought may be, “I don’t want to pay a big bill and if the parts are just as good, then I don’t have a problem with it.” That’s part of the dilemma – we are made to believe they are just as good, but are they? You know the old saying, “If it’s too good to be true, it probably is?” In the case of handpiece repair, it really is.
Handpieces are one of the most heavily-used pieces of equipment in a dental office. And yet, most practices don’t have contingency plans for repairs. Or if a repaired handpiece breaks, dentist often default to thinking the issue is with the handpiece, instead of the inferior parts used in an earlier repair.
To get better insight into why counterfeit parts are such a problem, I talked with Nichole Hansen who is the manager of the handpiece repair department at KaVo. The first thing she tells me is that repairs arrive at her facility daily because they were fixed without OEM parts. It gets even more interesting:
Counterfeit parts can significantly increase the risk of damaging other genuine internal parts — yes the parts may “fit,” but that doesn’t mean they will last or maximize the anticipated lifetime use of the handpiece.
Handpieces that come in with counterfeit parts will typically last less than 6 months The most common complaints include: gear grinding, loud noises, inadequate or inefficient cutting and overheating.
While cheaper repairs are initially more appealing, dentists might end up spending 2-3 times more using generic parts than had they repaired it properly with OEM parts in the first place.
This one is worth repeating: OEM parts comply with the highest standards and are manufactured to meet rigourious quality and regulatory requirements. Counterfeit parts may not be.
With counterfeit parts, the likelihood of the handpiece malfunctioning increases, which causes extreme safety concerns for your patients.
Not all after-market parts are considered counterfeit, but KaVo always recommends using only genuine parts to ensure the maximum performance and lifespan of the handpiece.
Both after-market and counterfeit parts could potentially void any manufacturer warranties on the handpiece.
When repaired at an authorized facility by a certified technician, notes, test outcomes and the technician ID will accompany the return.
We always look for ways to save money and be more efficient with what we do – that’s prudent and good business sense. So let me ask you this – do you want to spend your money twice when it comes to your equipment?
Let’s put this into perspective. A patient comes in with a broken tooth needing a crown. They want a cheap fix and you tell them their best investment is a crown because it returns the tooth to full form and function; a large filling is a temporary fix and they can ultimately lose the tooth. The key question then becomes: is it worth it in the long run to save a few bucks now, in exchange for increasing the risk of losing a tooth? I don’t know about you, but I’d get the crown done. The same goes with our handpieces. Don’t piece meal it because it’s cheaper. Insist on getting the best parts for a maximized return on your investment.
Dr. Greg Gillespie, a general dentist in Washington state, has had his own share of negative experiences with faulty parts and non-authorized repairs. He now insists on only OEM parts and recommends the following:
Use only repair providers who have been authorized by your device’s manufacturer.
Look for a guarantee. Many unauthorized repair providers do not guarantee that their repair will last.
Insist on only OEM parts. For example, KaVo uses OEM parts 100% of the time for all repairs, which allows them to return the handpiece back to its original performance.
Choose a repair provider who offers knowledgeable customer service to provide full support and answer any questions about your instrument.
Ask for a report on your handpiece repair. Most authorized repair teams perform tests on handpieces with every repair. They include the test results and detailed notes with each repair, giving you invaluable information for the life of your handpiece.
Mishaps will happen within every practice. While many are out of your control, handpiece repair isn’t. The next time it starts to grind or overheat, make the wise decision to get it fixed correctly. Although the less expensive alternative may be enticing, you should insist on an authorized repair facility that only uses OEM parts. This will save you time and money as you properly maintain one of the most important tools in your practice. Dentistry is your livelihood, and this is definitely worth the investment.
Patients need to be proactive for their health
By Alvin Danenberg, DDS, DrBicuspid.com contributing writer
April 3, 2019 — A male patient came to my office the other day and told me he wanted to get healthy. He had gum disease and various medical issues, including high blood pressure, excessive weight, and high cholesterol levels. The patient said he wanted to get healthy, but other things were going on that would make getting healthy difficult, if not impossible.
He was smoking a pack of cigarettes a day and was drinking a six-pack of beer at least twice a week. Eating healthy food could not offset the damage these toxic substances were causing his body.
Here’s an analogy that explains the dilemma.
A house is on fire, and a firefighter is attempting to put it out with a high-pressure water hose. However, a gasoline leak is steadily pouring gasoline on the fire. The firefighter can try as hard as he can to put out the fire with the water hose, but the gasoline will keep the fire going until the gasoline leak is stopped completely.
Stoking the flames
Likewise, the patient’s body is on fire with poor food and poor lifestyle choices stoking the flames. The body cannot heal if toxic substances are constantly being poured into it. The toxic substances must be stopped and removed.
I discussed my concerns and explained the spiraling downward path his body was on. The toxic elements he was putting into his body were highly destructive. The patient considered reducing his smoking and drinking, but I told him a reduction would not work. Tobacco and alcohol must be eliminated completely. Although repair would take many months, he needed to stop his smoking and drinking immediately and totally if he really wanted to begin a path to healing.
My offer to my patient
My initial efforts to help him move forward included the following:
“The body cannot heal if toxic substances are constantly being poured into it.”
I would help him eliminate the active infection in his mouth and teach him how to efficiently clean his mouth.
I would recommend a local support group that could offer necessary encouragement to help him with his smoking and drinking addictions. If necessary, smoking and alcohol cessation products could be considered for a short period of time. However, his commitment to total elimination of tobacco and alcohol would be critical for his ultimate success.
I’d also provide a three-day food journal to complete so I can evaluate his eating habits. I could then introduce a customized eating plan, including a nutrient-dense diet and the elimination of harmful foods.
This patient told me his goal was to get healthy. To begin a healing process, he needs to become proactive with his lifestyle changes. It could take several years for this goal to be realized. However, today could be the first day of his healthy recovery.
Alvin Danenberg, DDS, practices at the Bluffton Center for Dentistry in Bluffton, SC. He is also on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is drdanenberg.com.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
Oral Piercings
Piercings
March 23, 2019 – by uniteddentist – in Health, Medical
Body piercing is a popular form of self-expression. Oral piercings or tongue splitting may look cool, but they can be dangerous to your health. That’s because your mouth contains millions of bacteria, and infection and swelling often occur with mouth piercings. For instance, your mouth and tongue could swell so much that you close off your airway or you could possibly choke if part of the jewelry breaks off in your mouth. In some cases, you could crack a tooth if you bite down too hard on the piercing, and repeated clicking of the jewelry against teeth can also cause damage. Oral piercing could also lead to more serious infections, like hepatitis or endocarditis.
If you pierce your tongue, lips, cheeks or uvula (the tiny tissue that hangs at the back of the throat,) it can interfere with speech, chewing or swallowing. It may also cause:
· Infection, pain and swelling. Your mouth is a moist environment, home to huge amounts of breeding bacteria, and an ideal place for infection. An infection can quickly become life threatening if not treated promptly. It’s also possible for a piercing to cause your tongue to swell, potentially blocking your airway.
· Damage to gums, teeth and fillings. A common habit of biting or playing with the piercing can injure your gums and lead to cracked, scratched or sensitive teeth. Piercings can also damage fillings.
· Hypersensitivity to metals. Allergic reactions at the pierced site are also possible.
· Nerve damage. After a piercing, you may experience a numb tongue that is caused by nerve damage that is usually temporary, but can sometimes be permanent. The injured nerve may affect your sense of taste, or how you move your mouth. Damage to your tongue’s blood vessels can cause serious blood loss.
· Excessive drooling. Your tongue piercing can increase saliva production.
· Dental appointment difficulties. The jewelry can get in the way of dental care by blocking X-rays.
If you already have piercings:
· Contact your dentist or physician immediately if you have any signs of infection—swelling, pain, fever, chills, shaking or a red-streaked appearance around the site of the piercing.
· Keep the piercing site clean and free of any matter that may collect on the jewelry by using a mouth rinse after every meal.
· Try to avoid clicking the jewelry against teeth and avoid stress on the piercing. Be gentle and aware of the jewelry’s movement when talking and chewing.
· Check the tightness of your jewelry periodically (with clean hands). This can help prevent you from swallowing or choking if the jewelry becomes dislodged.
· When taking part in sports, remove the jewelry and protect your mouth with a mouthguard.
· See your dentist regularly, and remember to brush twice a day and floss daily.
Of course the best option is to consider removing mouth jewelry before it causes a problem. Don’t pierce on a whim. The piercing will be an added responsibility to your life, requiring constant attention and upkeep. Talk to your dentist for more information.
Safety warning – Burns caused by electric handpieces by Julian Hodges
Get them serviced regularly to prevent this!
The most recent warnings, issued in December, identify significant risk to patients and users of even slightly inefficient electrical handpieces. They stress there is often no warning of malfunction until injuries are sustained.
In its industry safety statement, the US Food and Drug Administration (FDA) published its findings: “Patients have been severely burned when poorly maintained electric dental handpieces were used during dental procedures. Some patients had third degree burns which required plastic surgery.”
The warning continues: “Burns may not be apparent to the operator or the patient until after the tissue damage has been done, because the anaesthetized patient cannot feel the tissue burning and the handpiece housing insulates the operator from the heated attachment.”
The news is a timely warning to Australian dentists about handpiece risks, especially those using electric handpieces and speed increasing heads.
Director of leading Australasian handpiece repair specialists, Julian Hodges of Handpiece Hotline, says the risk of serious injury to users and patients is a growing concern.
“For quite a while the repair industry has been concerned about the risks of speed increasing handpieces,” he says. “There’s no doubt about it. The combination of extremely fast, heavily geared and electrically powered technology in handpieces means there is an absolute necessity for dentists to maintain and respect this equipment diligently.”
Hodges says the high performance of electric handpieces, especially with speed increasing heads, means that even the slightest compromise in precision – from usual wear and tear, poor repair, sterilisation proceduresor overdue maintenance – can lead to overheating and severe burns.
“The problem is that electricdriven handpieces compensate for performance problems with extra power – that’s a formula for burns,” he explains. “The dentist won’t feel the unit getting warm or even acting strangely in most cases, and the anaesthetised patient won’t know until they get home.”
The American watchdog has issued prevention guidelines across the nation with advice that regular maintenance will reduce the incidence of overheating as well as the risk of injury and costly compensation and replacement expenses.
They recommend dentists immediately check when rotary surgical handpieces were last serviced and lubricated.
“It’s really a question of treating this equipment with respect,” says Hodges. “And it makes senses which ever way you look at it, because regular, professional maintenance makes handpieces last longer, work better and cost less in the long run.
“When you add safety into it, it’s easy to see why there are some moves here in Australia toward a more thorough maintenance schedule for practices.”
Dental Health Services Victoria studied a scheduled servicing and instrument management program involving more than 7,000 handpieces and found “outstanding success” in extending the service life and reliability of handpieces in major clinics across the state.
Scheduled maintenance resulted in a 90% decrease in turbine replacements and a 70% decrease in head gear failures. As a result, handpiece servicing costs to the department have more than halved.
“There’s a smarter, safer, cleaner way to work than using handpieces until they fail,” says Hodges.
Get them serviced regularly to prevent this!
The Extraordinary Value to Dentistry of the Diminutive O-ring
by Julian Hodges in Articles
How a Simple Awareness of O-ring Care Can Reduce Dental Practice Handpiece Repair Bills
Some practices are unnecessarily incurring large handpiece repair bills simply because there is a need for a better understanding of the function and care of O-rings.
For many O-rings are insignificant. They are boring little black things that merit and are paid scant attention. But, they degenerate quickly because they operate in a hostile environment. They are stretched, squashed and abraded, continuously autoclaved and attacked by lubricants and cleaners and when they breakdown, or are missing, dentistry becomes messy and uncomfortable for dentists and patients.
There are thousands of different handpiece O-rings, each has a specific purpose. They range size from less than a millimetre (0.039 inch) to more than 30mm (>1 inch). Millions are used each year to repair handpieces.
Manufacturers go to remarkable and painstaking lengths to perfect O-ring function. To improve the seal on their couplings, KaVo increased O-ring diameter by the width of an average human hair or, for the more technically inclined, by 83 microns and then coated them with silicone to reduce wear and friction.
Dentistry is unable to function without O-rings and therefore the correct care for these small but essential components is paramount. For instance, more water blockages are caused by particles from O-rings than from any other cause while worn, old, low quality, or wrong O-rings will reduce handpiece performance and service life and may cause catastrophic equipment failure.
O-ring Functions
Handpieces are unable to function without O-rings. They:
Separate air and water. With wrong or poor O-rings, air and water become mixed. Water damages the bearings, rusts components and if water goes through the handpiece and down the exhaust, it goes into the unit which, understandably, can be disastrous
Seal joints inside handpieces. Failure here causes a loss in performance and water dripping from the handpiece
Provide the suspension in high speed turbines. If O-rings are too hard, too soft, too thin or made from the wrong compound (usually to save money) they have the same effect as a poor suspension on our cars. Who wants a rough ride!
Are essential for handpiece maintenance units. When O-rings are damaged or missing, insufficient quantities of lubricant are delivered and purging will be inadequate. Premature breakdown is guaranteed and if a cleaning solution is used as well (usually these are more aggressive than lubricants), the deterioration will be accelerated
O-ring Care
Include handpiece and coupling O-ring checks in standard operatory procedures
Replace coupling O-rings regularly, a minimum of once per year and more frequently in high volume environments
Schedule a regular check of maintenance unit O-rings. At least weekly.
Look for minor imperfections and do not wait until an O-ring fails
Use care when fitting and removing handpieces from couplings
Make sure coupling O-rings are not dry. Apply a thin film of oil if necessary
Choose a repairer who can accurately measure and test handpieces for internal leakage. That is, test the integrity of the O-rings inside a handpiece
Know what you are buying and be aware that sometimes low repair quotations may include non genuine or low quality O-rings or, replacing essential O-rings may have been omitted in the repair process
Keep a spare set of O-rings for all coupling systems and maintenance unit adaptors. That is do not wait for O-rings to fail before ordering replacements
Learn more by purchasing 19 Causes of Premature Handpiece Breakdown and How to Solve Them for less than the price of an O-ring.
Remember This! – As Handpiece Awareness Increases, Repair Costs Decrease!
19 Causes of Premature Handpiece Breakdown and How to Solve Them:
Save thousands by correctly maintaining your dental handpieces.
Some Factors involved are:
Lubrication
O-rings
Purging
Autoclaving
Air pressures
Contamination
Clearing contamination when dark oil is coming from a handpiece
There are 19 Causes of Premature Handpiece Breakdown directly related to the procedures, training and level of care, or lack of it, in dental practices.
It is highly probable the solutions and advice we can offer will immediately reduce dental handpiece repair costs because if the statements by experts are correct, handpiece maintenance is inadequate in seven of every 10 practices.
Contact us today so we can offer ways to help save your practice money!
Helping Patients Live Longer and Better Lives by Dr. Kathryn Alderman
A New look at Systemic Inflammation, Microbiome, Gum Disease Diagnosis, Treatment and Keeping Dental/Gum Disease in Remission
Traditionally in dentistry we have been taught to ask our patients to brush, floss and visit us twice a year for checkups to stay healthy. In the last few years we have been hearing that by fixing dental problems and specifically dental/gum disease, we can help patients to prevent major medical problems, such as heart disease, diabetes, thyroid conditions and many other inflammatory related conditions.
It would be great to be able to help patients to be healthier by fixing their dental/gum disease but is it possible?
In this article, you can find the latest research and answer to the question:
Does the inflammation have a dental etiology or is the inflammation indicative of a systemic disease? What comes first, dental/gum disease or inflammatory-related medical condition?
As dental providers, we understand that the mouth is the gateway to the body. In our pathology classes, we learned about various intraoral soft tissue lesions that can often be the first indications that a patient may have an underlying chronic disease. We have known about the correlative links between untreated periodontal disease and diabetes or cardiovascular disease. Recent studies have shown that there may be links between dental/gum disease and many other auto-immune medical conditions. As dental providers, we often see that our patients who suffer from uncontrolled systemic inflammatory conditions have higher rates of dental/gum diseases.
When we examine a patient who shows signs of inflammation in the mouth, the question arises: Does dental/gum disease cause systemic inflammation or is the inflammation in a mouth is indicative of a systemic disease?
What is Inflammation?
Acute Inflammation is a good thing. It is our body’s natural response to injury and the first step in restoring health. The immune response is a protective mechanism against foreign invaders and toxic chemicals.
Acute inflammation (adaptive immunity) causes a complex cascade of events, sending white blood cells to the site of infection or injury. The inflammatory response causes chemicals to be released which help protect the body. The immune system brings red and white blood cells, dilates blood vessels, allowing more healing substances to travel in and out of the affected area. Once the foreign body has been defeated, the immune response reduces, leaving a few immune cells on guard in case of another attack.
When the acute inflammatory response does not successfully resolve an infection, the inflammation becomes chronic. Chronic inflammation (maladaptive immunity) is like having a slow burning fire in the body.
Chronic inflammation is a low-grade inflammatory response that can be present for months to years. Usually, chronic inflammation occurs because the body was unable to eliminate the initial injury or infection through the acute inflammatory response. When chronic inflammation continues long-term, it can begin a series of reactions that ultimately damage cells and lead to the clinical manifestations of disease. Chronic inflammation plays a role in all of the leading medical conditions like heart disease, diabetes, cancer and arthritis.
What is Microbiome and How it is Connected to the Overall Health?
The digestive system accounts for 70% of our immune system. The human microbiome is made up of more than 100 trillion different microorganisms. Half of these reside in the GI tract. Both the microbes as well as our own cells have co-evolved to share a symbiotic relationship. The microorganisms in our body are responsible for many of the necessary functions, such as vitamin and fiber processing. Another important job is to produce short-chain fatty acids that are precursors to many hormones, important part of diverse physiological roles in body functions. Microorganisms also play a role in gene expression regulation, including the acetylation of DNA-associated histone proteins and methylation of DNA. This is one of the major regulatory processes that is a part of many stages of genetic functions. This type of regulation is applicable to inflammatory genes that can affect the development of cancer, neuropsychiatric systems and many immune disorders as well as the progression of chronic disease.
When patients have an imbalance in our microbiome, they are more susceptible to chronic inflammation and infection. Some individuals are more sensitive to such imbalances due to genetic factors.
Inflammation in the Mouth
Having good dental health is not only about preventing decay, periodontitis or bad breath. Many medical conditions can be reflected by the oral health of the patient. The most common sign of chronic inflammation in the dental patient is gum disease. The level of severity of inflammation can be indicative of underlying systemic disease.
Acute Inflammation-Gingivitis
Every patient has thousands of bacterial species living in the oral cavity. Many of these bacteria are beneficial for the patient, however, an overgrowth of harmful bacterial pathogens can lead to inflamed gums, or gingivitis. The acute inflammatory response produces red, enlarged and bleeding gums to bring inflammatory chemicals and white blood cells in an effort to fight off the bacterial overgrowth.
Gingivitis is a reversible inflammatory condition and is successfully treated by a thorough debridement and effective daily plaque removal by the patient as well as maintaining a balanced diet with adequate vitamin C and D. A healthy body can effectively fight off gingivitis successfully in just a few days.
Chronic Inflammation-Chronic Periodontitis
Chronic periodontitis occurs when there are specific bacterial pathogens present in the mouth combined with the individual patient’s host response. If the acute inflammatory process is unable to eradicate the source of the infection, the patient will experience chronic inflammation in the mouth affecting the teeth and gums. The chronic inflammation causes the gum tissue to lose its integrity, detaching from the root surface and creating periodontal pockets where more harmful species of bacteria can colonize. The constant immune response to the presence of these pathogens creates inflammatory chemicals to be released, which is the cause of bone loss. When the condition is advanced, the teeth become loose and must be removed due to inadequate bone support.
Chronic periodontitis is one of the leading causes of tooth loss in adults.
The Oral-Systemic Link: Inflammation, Microbiome, Gum Disease Diagnosis and Treatment
There is a relationship between periodontitis and many other inflammatory conditions like rheumatoid arthritis, celiac disease, thyroid disease, heart disease, diabetes and Alzheimer’s. Chronic periodontal disease and these conditions share autoimmune characteristics, but the real question is, which came first? Is there a causal link between these conditions? Latest research shows that overall and gut health are more closely to dental health.
Below are three articles which discuss the connection between the microbiome, systemic inflammation and dental/gum diseases.
1. Gut Microbiota and Salivary Diagnostics: The Mouth Is Salivating to Tell Us Something
Authors: Kodukula Krishna, Faller Douglas V., Harpp David N., Kanara Iphigenia, Pernokas Julie, Pernokas Mark, Powers Whitney R., Soukos Nikolaos S., Steliou Kosta, and Moos Walter H., Published Online:1 Oct 2017 https://doi.org/10.1089/biores.2017.0020
Abstract Summary and Conclusion
The human microbiome is a network of microbes that affect every organ system in the body. Most of the microorganisms of this network are bacterial, but others include viruses, fungi and protists. Through study of the human microbiome, we have learned that most chronic medical conditions have microbial components. The oral cavity and GI portion of the microbiome account for the majority of the bacteria present in the body. By measuring the strains of bacteria in a mouth, the overall gut health can be predicted. By making modifications to the person’s microbiome, systematic health can be positively affected, including improved dental health.
2. Defining The Gut Microbiota In Individuals With Periodontal Diseases: An Exploratory Study
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6032013/
The purpose of this study was to test the gut microbiome of patients who presented with periodontal diseases and find any correlation with periodontal inflammation and destruction of tissues.
Abstract Summary and Conclusion
Those who presented with active periodontal diseases had less diversity in the microbiome which is consistent with other chronic inflammatory diseases. The high levels of oral bacteria that were associated with periodontal disease and active inflammation were also present in the gut of all individuals regardless of the status of the periodontal health. Findings concluded that every patient who had an inflammatory condition had less diversity in the gut. Periodontally involved patients had a higher level of harmful versus beneficial bacteria in both the mouth and the gut. This conclusion suggests that periodontal disease is an important risk factor for many other systemic inflammatory medical conditions.
3. Can Diet Improve Gum Disease?
Journal of Periodontology (May 2009, Vol. 80:5, pp. 759-768).
Abstract Summary and Conclusion
The article discusses if following an anti-inflammatory diet may help reduce symptoms of periodontitis:
The first study mentioned in this article is on diet and periodontitis: In the May 2009 issue of The Journal of Periodontology, a study was published titled “The impact of the stone age diet on gingival conditions in the absence of oral hygiene.” This study used 10 individuals who followed a diet of unprocessed, whole foods including vegetables and protein sources indigenous to the area of Switzerland where the study took place for 4 weeks. During this time, the subjects did not brush or floss at all. Before and after the study, bacterial cultures were taken for analysis to screen for periodontal disease. At the end of this study, participants had higher levels of plaque accumulation, but the number of pathogenic microbes present in the plaque remained unchanged.
The second study mentioned in this article is on diet and periodontal health is from the July 2016 issue of BMC Oral Health. The study is titled, “An oral health optimized diet can reduce gingival and periodontal inflammation in humans—a randomized controlled pilot study.”
A group of 15 subjects who exhibited signs of active periodontal disease were used in a randomized control trial. Five were part of the control group, leaving 10 as the experimental group. The 10 experimental subjects followed a diet low in carbohydrates, high in omega 3 fatty acids, and high in fiber and vitamins. The control group did not alter their existing diets. None of the subjects flossed during the study, but brushed normally. Periodontal exams and bacterial culture samples were taken before and after the experiment. After four weeks, all signs of gum disease in the experimental group decreased by half, while all of the inflammatory markers increased from the baseline in the control group.
Findings in this article offer proof that patient’s diet plays a critical role in forming microbiome and influencing the levels of overall chronic inflammation and ultimately leading to the progression of periodontal disease.
Answering the question: Does dental/gum disease or the inflammatory-related medical condition come first?
Now that we know how the microbiome impacts the likelihood of a person to develop chronic inflammation throughout the body, the answer is more likely that the underlying medical condition can be correlated with the imbalance of the microbiome. Some individuals may have genetic risk factors in addition to an imbalance in the gut biome, placing them at greater risk for developing medical conditions.
Chronic inflammation can travel to all of the organ systems of the body, including the tissues in the mouth and jaw due to the vascular environment of the oral cavity. Having chronic inflammation can be both the initial cause of cardiovascular disease as well as dental/gum disease.
What Can Be Done To Improve Patient’s Microbiome And Reduce Systemic Chronic Inflammation?
In addition to maintaining good oral hygiene and receiving professional dental care to help reduce the bacterial load in the mouth, patients should be counseled on lifestyle factors like their diet, tobacco cessation, obesity and stress.
1. Counsel patients to change their diet. Eating plenty of omega 3 fatty acids like those found in fish and flaxseed.
2. Encouraging patients to eat high-fiber diets rich in fruits and vegetables and avoid processed foods to improve the individuals’s microbiome.
3. Encourage patients to lower their sugar intake and avoid drinking soda and energy drinks.
4. Encourage supplementation of vitamin C and D on a daily basis as well as taking probiotics with multiple strains of beneficial probiotic.
5. Eliminate foods like gluten or dairy that may be triggering an allergy response and creating intestinal inflammation for some patients.
6. Exercising regularly
7. Reducing stress: Massage, yoga, meditation, etc.
8. Getting adequate sleep: 7-8 hours every night.
Case Study
A 35-year-old male patient comes to you with cardiovascular disease and issues with high blood sugar. This patient also shows signs of moderate chronic periodontitis.
Will performing traditional quadrant scaling and root planing be adequate for helping this patient reduce the overall levels of chronic systemic inflammation and improve his overall health? The answer is no. Performing scaling and root planing will definitely reduce the load of harmful bacteria that is present in his oral microbiome but not enough alone in order to help this patient to be at his healthiest.
It is important to help this patient identify lifestyle factors and the role these play in the long-term prognosis of his periodontal condition as well as managing other cardiovascular disease and blood sugar issues. By changing the lifestyle habits and decreasing the overall amount of inflammation, this patient can become healthier. By developing healthier lifestyle habits, the overall health will improve and ultimately leading to the shift to the healthier microbiome.
Conclusion
Do inflammatory related medical conditions lead to the developing gum disease or vice versa?
The answer: It is more likely that the underlying medical condition can be correlated with the overall lifestyle habits, the genetic risk factors and imbalance in the microbiome, placing patients at a greater risk for developing inflammatory related medical conditions, including dental/gum disease.
As dental professionals we can we help patients live healthier and longer lives by treating dental/gum disease. But besides traditional dental /gum disease treatment and giving home care recommendations, dental professionals can be an important part of the health-care team and help patients to improve the quality of their lives by helping them to be educating on importance of healthy lifestyle habits for improving the prognosis of dental/gum disease and overall health.
Traditional treatment for dental/gum disease can be combined with a thorough review of the medical history as well as follow-up with the primary care physician if patients present with dental/gum disease. Patients who have not been under the care of a physician and are showing signs of periodontal disease should be referred for wellness screenings to rule out underlying medical conditions, allergies or vitamin deficiencies.
Dental professionals can educate patients about the link between their dental health and their overall health. and give tips on improving overall health. Patients who have knowledge about what they can do are empowered to take control of their own health and play an active role in their treatment and prognosis of dental/gum disease, as well as positively impacting overall health.
The Top 25 Biological Functions of the Mouth
by G. P. Greenacre
Following over 50 years of study and listening to experts, I want to share with you why good growth and good functioning of the mouth is so important. Let me explain why the Mouth is the Mirror of your Life. Good jaws mean a better neck alignment and a better airway and less snoring and less sleep apnea, good gums mean less bloodstream inflammation and good teeth will ensure you good jaw support, a good smile and a long healthy life.
What are the top twenty-five biological functions of the mouth?
1. Nasal Breathing. Nasal (Nose) Breathing, the first system, depends upon a well-grown upper palate or maxillae and palatine bones. Our oropharynx is important because nasal breathing actually ionizes the air we breathe. The paranasal sinuses also add nitric oxide to our air as it passes to our lungs, which helps with our heart and our metabolism. Most of our breathing should be via the nose for this reason as well as their conditioning and the cleansing effect of nasal reaching.
2. Mouth Breathing is an alternative to nasal breathing. We are not supposed to mouth breath all the time. Breathing well is dependent on jaw and tongue position since the front half of our mostly muscular airway is the tongue. If your lower jaw is retruded or you bite too deeply then you might snore, or have a tendency to clench your jaw muscles while you sleep. This mouth breathing is second best and snoring is not far behind. Mouth breathers probably have more infections than nose breathers. Remember the pneumonia that kills old people usually comes from mouth breathing and inhaling or aspirating mouth organisms while sleeping and snoring.
3. Suckling for Breastfeeding. Breastfeeding is the number one health, prosperity and happiness measure function that we humans can partake in at birth. Not breastfeeding and not supporting breastfeeding is “wrong thinking” in life, in politics, in our economy and in modern medicine and modern dentistry. All breastfeeding mothers should have a tax deduction and a thank you note from their dentists. Plus, a financial incentive to continue breast-feeding from their government. This would recognize that breastfeeding is the number one health measure for newborns to grow and prosper. This pays off in the long run as an investment in preventive medicine. Every national government and the World Health Organization should pass a resolution that Breastfeeding is a birthright of all infants.
4. Swallowing lubricates our digestive tract and allows us to consume food unless we want a lifetime on an IV drip. The tongue is not a simple one-nerve muscle. The tongue is actually a specialized organ system powered by the five key cranial nerves of our basic embryonic developmental arches. Our incredible tongue–hyoid bone system is what drives swallowing and speech. Did you know that until about 6 months of age the human baby could both breathe through its nose and swallow through its throat to breastfeed at the same time?
5. Tongue-Powered Speech. Production of different speech sounds depends upon our all-powerful Tongue, which is powered by all five developmental nerves and is uniquely human in its construction and ability to produce speech sounds along with the unique airway of humans. Speech is just thought in action.
6. Assist balance, vision and hearing. Without a healthy tongue, trigeminal nerve system and healthy jaws, we can lose our balance and we can fail to walk in a straight line. Got a balance problem? Visit a dentist! Our ears are our balance and hearing organs, and they are intimately tied to our jaws. The upper jawbone supports our eyeballs and if it does not fully develop (as is often today the case) this puts strain on the eyeball and all the supporting muscles. Dr Harold Arlen was a strong proponent of medical-dental cooperation as he wrote in his article The Otomandibular Syndrome. Speaking about the connection between the Tensor Veli Palatini (TVP) muscle, the jaw, stuffy ears or hearing loss and the Trigeminal nerve says this, “The TVP is the only muscle of the soft palate innervated by the Trigeminal nerve and the only muscle that functions to open the Eustachian tube. This is the key to the relationship between the jaw and ear dysfunction that is plaguing modern man, along with the deterioration of other parts of the jaw and the dental apparatus.”
7. Posture. Man evolved painfully over millions of years to become an erect hominid. Today we are losing our erect posture and becoming bent forward with scoliosis, twisted spines and wrynecks. If the jaw is too far back or too deep, then that person tends to have a forward head posture. This is a brain compensation to preserve the airway since oxygen is the brain’s number one food. The modern human form is degenerating because our diet and lifestyle has changed for the worse. We are too connected to sugars and electronic devices. The number one symptom of poor jaw growth, posture and function, a sore neck or a headache.
8. Good Sinus Drainage. If the palate fails to grow to the dimensions in our genetic blueprint then our sinuses will not drain well.
9. Resisiting Inflammations and Infection. Resistance to microbial diseases of the mouth or resisting systemic Illness, Inflammation and Infection in general. Sir William Osler said, “The Mouth is the Mirror of all Disease.” Further some experts have suggested up to 85 % of all ailments in humans start via the oral route. Dr. Charles Mayo thought highly of oral care as well: “Dentistry is a distinctive health service and can extend human life ten years.”
10. Record our Mineral Density, which tells us about our Mineral Deficiencies. Teeth are the most mineral dense structures in our bodies; well, they used to be that way! The concentration of trace minerals in our baby teeth and adult teeth is a unique biological phenomenon. We should be using it more in medical diagnosis. Today soil depletion means we are getting only a small percentage of the trace minerals that our great grandparents did from eating the same food. LINUS PAULING SAID BEHIND EVERY DISEASE THERE IS A TRACE MINERAL DEFICIENCY! I predict the next 10 years in medical restorative nutrition all the talk will be about trace mineral deficiencies and enzymes. Enzymes are needed to incorporate minerals into our osteogenesis metabolism.
11. Mastication or Chewing Food. This is enjoyed by all of us every day. However, Life continues if there are no teeth present, as any denture wearer will tell you. Anyone can drink a green smoothes with no teeth and our diet generally is getting softer and softer all the time. Further, the “All on Four” implant program is making mastication possible when you have no teeth.
12. Spit and spitting is an important function of the mouth. Spit is full of powerful natural bacteria killing neutrophils. This is why dogs and cats lick their wounds. Spit helps digest food and all the cups and cups spit we produce and swallow every day helps lubricates our digestive system. Spit contributes good and bad bacteria to our micro biome.
13. Mouth Digestion starts with the mouth enzymes to begin digestion. Our mouth produces many enzymes to begin the process of digestion, amylases for carbohydrates lipases to start fat digestion and other enzymes emanate from our salivary glands. Saliva lubricates the whole digestive tract. Mouth organisms get swallowed and contribute to our Micro biome. Some enzymes like lysozymes are there just to attack foreign bacteria that get into our mouths on our foods. The rationale behind chewing your food slowly is to stimulate more digestive enzymes to enhance food digestion and minimize indigestion.
14. Singing is a specialized form of expressing ourselves with our voice. Singing involves not just the mouth and the vocal cords but the chest and our breathing system and even our sinuses and Eustachian tubes all interact. Apparently singing is uniquely a human phenomenon. We can all sing and some of us very badly. And yodelling, well that is special? Even Humming deserves an honourable mention.
15. Whistling this is as close to a bird call that humans can get. Several popular songs over the years have featured whistling and one you might enjoy is the song. “Don’t Worry, Be Happy.” By Bobby McFerrin it is on YouTube.
16. Coughing function. Coughing is a vital function to clear your throat or lungs of organisms or debris that should not be there. We have all had bouts of coughing from respiratory illnesses and the cough is an expectorating function that makes us feel better. Coughing can also be a sign of GERD and irritation of the trachea with stomach acids. There is a great difference clinically between short term coughing and chronic coughing.
17. Ideally, the first epigenetic function of the jaw is to have the jaws and teeth grow so fully and perfectly that there is no need for fillings, orthodontics or wisdom tooth removals. The tongue works in utero on the three embryonic plates of the forming palate to help grow the future palate. The small medial plate becomes the premaxilla or rugae area or the milk pad spot for breastfeeding and houses the incisive section of the second division of the trigeminal nerve while the lateral palatine plates start out vertically like stacked shelves then that the tongue turns them to become the body of the palate and to allow them to fuse with the nasomedial plate to grow the palate forward and laterally. All this palatal development happens about 8 to 9 weeks of age. Then the tongue continues to grow the palate to be more forward and wider up to our birth and even after we are born. So, the role of the tongue and the physiologic swallow is to be the master architect of the growth of the palate by touching the rugae area just behind the front teeth.
Ideally all dentists should work together to create better grown palates or a better next generation of children called “Paleo-Moderns”. The key to this is super nutrition and bone broth bone marrow and fishmeal supplements as used by the famous Swedish researcher Dr. Alfred Aaslander. His brilliant concept of Complete Tooth Nutrition was published in the Journal of Applied Nutrition and promptly forgotten. To create the best tooth and jaw growth possible we need an abundant and steady supply of trace minerals and enzymes and essential oils beside the standard vitamins and amino acids. An Ontario born dentist Dr. Westin Price also wrote about the Paleo diet and said we have lost facial dimension. The late orthodontist Robert Rubin told me this same concept in a telephone interview when I was a dental editor for Medifacts/Dentafacts. He said we should start excellent supplemented nutrition one year before the child is conceived for both parents and continue through the pregnancy and until the child reaches puberty and beyond. All our ancestors had this type of full facial and full palatal blueprint expression and thus needed no wisdom teeth removals, they needed no orthodontics and due to high trace mineral intake they had no cavities. However, periodontal disease is a different story since periodontal diseases were evident in the Egyptian mummies and many other ancient human remains worldwide. Our challenge is to create “Paleo-Moderns”. In 2002, the AMA stated that (due to soil depletion) we should all be taking multivitamin supplements. You need all the nutritional components to build a perfect human.
18. Laughter is valuable and uniquely human function. We recommend you Google TED talks and read about laughter from the experts. They say it well with humour and candour. By the way, do you still miss Robin Williams like me and my friends do?
19. Vomiting when needed. This can be a life saving manoeuvre.
20. Kissing and all the romantic potential of our mouths is another great mouth function. A 30-second kiss means a spit and bacteria exchange of epic proportions but nobody listens.
21. Stereognosis. This is the tactile exploration by the newborn infant of the world by tactile exploration with its tongue and lips.
22. Mandibular Startle Reflex No matters what part of your body is hurt or shocked you will have a Mandibular Startle Reflex and sometimes a vocal one. This is an innate function.
23. Act as good Skin. Skin is our biggest organ system and gum diseases are dermatological or skin diseases under another name. A dermatologist once told me that the purpose of skin is to keep the blood in and the bugs out. Dentists treat chronic and acute skin-gum infections and should talk at every dermatological conference in the world on periodontal infections and their local and systemic implications.
24. The Electrical Control Coordinator for the whole body.
Dr. Henry Ulhlemeyer was a very well-informed Ears, Nose, and Throat specialist who believed very strongly in physiologic jaw balancing for maximizing your overall health. Dr. Henry Ulhlemeyer said, “If the mandible is not physiologically positioned all stress hormones are automatically stimulated, all muscles tense, blood pressure rises to overcome resistance. Pulse quickens, respiration is shallow and loses efficiency. The body raises it blood sugar to fuel this emergency, releases adrenalin and increases the pain threshold. The gastrointestinal tract responds acutely…”
He then went on to say that the good functioning of the mandible was a key component in the basic concept of Integrative Medicine. “In my opinion the mandible is the electrical control coordinator for the whole body i.e. (in combination with the total chewing mechanism of teeth, periodontal tissues, and muscular assemblage through feedback to the brain). The mandible and all its associated muscles in proper physiologic relationship allow the body to relax refresh and replenish expended energies. The mandible has to be in a physiologically balanced relationship to make the total body work as one balanced unit.”
25. Facial Expression. The smile has intrinsic and extrinsic value to all humans. Socially we would never post a bad smile on Facebook or send a poor facial expression out to friends when we want to positively represent our lives. The psychological confidence and the power of a good smile are not to be underestimated. Dr. Edward Angle said, “It is not enough to correct the malpositions of the teeth in one arch, but also to establish the correct occlusion of all the teeth and restore facial expression.”
In summary, Archaeologists and Anthropologists know that the human faces are shrinking but they do not know why.
Actually palates and noses are getting measurably narrower this in turn causes maxilla –mandibular-airway dysfunction and also causes postural and airway distress.
This quote from Dr John Diamond tells us why your palate is important. We as dentist have to figure out why this is happening. Westin Price wrote a whole book on Nutrition and Physical Degeneration and he left us some clues!! Dr. Alfred Aaslander, a Swedish biochemist, who suffered from extensive tooth decay as a child, wrote about “Complete Tooth Nutrition” using bone meal for its trace mineral content over 50 years ago in the Journal of Applied Nutrition vol17 no4 1964. He applied the principles of trace mineral supplementation to his children and he raised kids with NO CAVITIES AND GOOD ARCHES!!
Dr. John Diamond stated this about the Maxilla or our palates.
“One of the greatest gifts a child can receive from his mother is a well-formed palatal arch. But it is doubtful whether any of us has ever even seen a normal arch because it may well be that only primitive man on his so-called primitive diet has a truly normal arch. With such an arch the following benefits are conferred:
There will be minimal occlusal problems.
The tongue is most likely to be in the normal position against the rugae with all the benefits incurred therefrom.
Three of the structures most to do with centering and balancing the body in space will most likely be free to function normally – the spenoid bone, hyoid bone and temporomandibular joint.
There will be an accompanying development of the lateral aspects of the face – especially of the malar and zygoma bones, rendering it very easy for the patient to smile.
Normal development and stimulation of the pituitary will be facilitated.
There will be overall health and well being of the child.”
Dr Diamond is in my opinion one of the smartest MD’s that North American Medical schools have ever produced. We all (doctors, dentists and osteopaths) should study his books and his lifetime of teachings and writings.
Here is Dr. Price’s quote:
“The most indelible impression left by my investigations among primitive races is that which came from examining 1276 skulls of (Peruvian). People who had been buried hundreds of years ago without finding a single skull with the typical marked narrowing of the face and dental arches. That afflicts a considerable proportion. Of the residents in modernized Peru…. the United States…. and many communities of Europe today. I know of no problem so important to our modern civilization as the finding of the reason for this, and the elimination of the cause… Few will recognize the significance of this important point.”
This last sentence sums up his lifetime’s work. “Few will recognize the significance of this.” Yes our faces are shrinking and we are oblivious to this major health problem. It is important that every family know this fact. The human face is shrinking! We should all know why it is shrinking and how to reverse this pathological trend. The key to reversing this is to keep our natural tongue to palate swallow, use no artificial nipples, intake more trace minerals and enzymes and probiotics in our diet through more veggies, more fruits, more bone marrow, more bone broth soups and of course more breastfeeding for our babies.
Dr. Charles Mayo is quoted as saying:
“Dentistry is a distinctive health service and can extend human life ten years.”
Another famous teaching MD, Sir William Osler said:
“The Mouth is the Mirror of all disease”.
Oral Health welcomes this original article.
About the Author
Dr. George Paul Greenacre, General Dentist D.D.S. (Doctor of Dental Surgery) Downtown Orthodontics, Ottawa ON Canada — Dr. George Paul Greenacre graduated from McGill University. He has served as a dental editor for nine years of his career. Fifteen percent of dentists have earned one fellowship. Dr. Greenacre has earned four fellowships and is working on three more in between his four hockey games per week and working on his several e books in process. His office theme is “smart dentistry for smart families.”
New survey looks at anesthesia trends, safety in 2019
By Theresa Pablos, DrBicuspid.com associate editor
March 20, 2019 — How safe is the use of anesthesia in traditional oral surgery? The results of a recent survey of oral and maxillofacial surgeons suggest that the most severe anesthesia complications are very rare, occurring in less than one person out of thousands of patients.
Researchers parsed data from thousands of oral surgery procedures in Massachusetts to estimate the prevalence of adverse effects following local and general anesthesia. They concluded that an office-based team model for outpatient anesthesia procedures is safe.
“On the basis of the results of our study, we can conclude that the office-based team model used by oral and maxillofacial surgeons in Massachusetts for the delivery of outpatient anesthesia is safe with a low complication rate,” wrote the authors, led by Evan Wardius, DMD, an oral and maxillofacial surgery resident at the Boston University Henry M. Goldman School of Dental Medicine (Journal of Oral and Maxillofacial Surgery, February 5, 2019).
Oral and maxillofacial surgeons have long performed outpatient anesthesia procedures in their offices. However, renewed scrutiny has focused on anesthesia and sedation in the dental office, and the researchers of the current study decided to investigate morbidity and mortality rates in oral and maxillofacial surgeons’ offices over time.
They used data from the Massachusetts Society of Oral & Maxillofacial Surgeons, which has surveyed members about anesthesia use for more than three decades. The researchers focused most of their analysis on the 2015 and 2016 surveys. These surveys included more than 431,000 patient visits to about 150 oral and maxillofacial surgeons in the state.
The majority of oral surgery patients underwent local anesthesia alone, followed by general anesthesia and parenteral sedation. The most commonly used anesthetic or adjunctive agent was midazolam, followed by nitrous oxide. For local anesthetic procedures, the vast majority of surgeons reported using lidocaine with epinephrine.
Overall, these procedures were safe, the authors noted. Syncope (fainting) was the most common complication, accounting for almost 70% of all reported complications. More severe adverse events occurred far less frequently, and no deaths were reported in the 2015 and 2016 survey years.
“The more knowledgeable [oral and maxillofacial surgeons] are about the potential medical emergencies that can be encountered during administration of outpatient anesthesia, the more prepared they will be in the management of these complications,” the authors wrote.
This study had a number of shortcomings, including that it relied on the oral and maxillofacial surgeons to report the adverse effects that occurred in their offices. The researchers hope their work informs these dental professionals about common adverse effects experienced in the office.
For more findings, see the infographic below.
Root Cause Netflix Movie: Fighting Mythical FIRE, with Scientific FACT
March 12, 2019 – by Gary Glassman, Chief Dental Officer, dentalcorp; Ian Watson, DDS, MScD, FRCD(C)
It has often been said that to bring attention to a controversial matter simply affirms its existence, memorializes it and gives it credibility. The corollary is to ignore it and allow wrong and negligent statements to pass as science. Instead of burying our heads in the sand, we would much rather bury bad science once and for all. We do this with the best interest of patients in mind.
In life, when things go wrong, it is human nature to search for reasons and causes. While searching for answers is a worthy endeavour, jumping to conclusions and ascribing blame without evidence is irresponsible. When this happens in medical circumstances, it is altogether misleading and unfair to patients to give them false information and send them on a wild goose chase.
If you haven’t heard, let me be the first to introduce you to a documentary on Netflix called “Root Cause.” The documentary follows an individual’s experience with root canal treatment, and the alleged systemic issues he claims arise directly from the root canal treatment.
Unfortunately, there is a small group of naysayers that look to root canal treated teeth as being the root of all evil. Or to put it more appropriately the Evil of all Root!
This misinformation is promulgated based on the flawed focal infection research by Dr. Weston Price in the 1930s, which states bacteria trapped in dentin tubules remaining after root canal treatment cause almost any type of ‘degenerative’ disease, including kidney disease, heart disease, rheumatic fever, and multiple sclerosis. With this decade old flawed research as his justification, it has been recommended that patients afflicted with such conditions consider extracting all their endodontically treated teeth!
Several examples of misinformation are cited in this movie. For instance, it was erroneously stated that “97% of patients with breast cancer had a root canal on the same side as the cancer.” I researched this declaration, and I found NOTHING! Not one iota of scientific evidence to support this claim. This is the equivalent of saying “100% of patients with cancer drink water.” Correlation does not equal causation.
As recently as 2013, a study published in a journal of the American Medical Association (JAMA Otolaryngology – Head & Neck Surgery) found that a patient’s risk of cancer doesn’t change after having a root canal treatment; in fact, patients with multiple endodontic treatments had a 45 percent reduced risk of cancer.
Another claim was “The #1 cause of heart attack is root canal treated teeth.” A study conducted over 44 years, called the Baltimore Longitudinal Study of Aging, published in the International Endodontic Journal in 2016, evaluated whether apical periodontitis, root canal treatment, and endodontic burden were associated with long term risk of cardiovascular disease. The study actually suggests a possible risk reduction with root canal treatment versus non-treated teeth with apical lesions, which supports the evidence that untreated abscessed teeth may contribute to an increased risk of cardiovascular disease and not root canal treated teeth as the contributing factor!
The American Association of Endodontists and Canadian Academy of Endodontics are continuing to educate its members and the general public by noting that no modern evidence exists to support claims that endodontically treated teeth serve as infection foci. In fact, untreated, infected teeth create that very cesspool from which consequences arise.
Predictable, successful endodontic treatment, using sophisticated techniques is the best strategy to reach a satisfactory conclusion. The removal of contaminants and organic substrate from within the root canal system in its totality is the indisputable biologic imperative of endodontic treatment.
Providing patients with access to comprehensive, proven facts about the safety and efficacy of endodontics and root canal treatment is the best strategy for countering misinformation. In fact, the practice of endodontics is rooted in scientific evidence that has evolved over decades. Anecdotal stories, in any realm of medicine and dentistry are hardly enough to change tried, tested and true treatment paradigms. Anecdotes can lead to hypotheses, but without empirical scientific evidence to back them up, they remain “one man’s story”.
The American Association of Endodontists website, http://www.aae.org has up to date content and resources which include “Root Canal Safety Talking Points”, “Myths About Root Canals”, and a “Root Canal Safety” video, all which can be shown to patients to dispel any myths and negative propaganda about root canal treatment.
As per a recent AAE communique: “Legal counsel has been consulted by the AAE and the ADA to discuss options to compel Netflix and other online hosts to remove this misleading and harmful content. After consultation, the AAE is filing formal complaints with the patient protection agencies, including state and medical boards. Additionally, the AAE is working with the ADA on formal outreach not only to Netflix, but all online platforms hosting the film, and urging removal for the safety of the public.”
Endodontic treatment has experienced, and will continue to experience some of the highest success rates found in dentistry, preventing unnecessary loss of teeth and contributing to a healthy, functional and aesthetically pleasing dentition.
Special thanks to Dr. Maneesh Sharma, President of the Canadian Academy of Endodontics and the CAE’s efforts for their position paper on this topic, Spring Hatfield, RDH for her helpful insight and the American Association of Endodontists for their powerful stand against harmful misinformation.
Check this out and support a great cause!
https://buff.ly/2W6KVhw
Canadian Dental Hygienists Start the Cannabis Conversation
January 9, 2019
by Canadian Dental Hygienists Association (CDHA)
——————————————————————
The beginning of a new year is a perfect opportunity to make a fresh start and set new personal and professional goals. With the recent legalization of cannabis in Canada, dental hygienists urge everyone to think carefully before using cannabis, given its negative impact on oral health.
“Cannabis use has many side effects that can alter the state of our mouths, teeth, and gums,” explains Tracy Bowser, president of the Canadian Dental Hygienists Association (CDHA). “We know that cannabis reduces saliva, leading to dry mouth. And those famous ‘munchies’ increase the time that teeth are exposed to sugars. As a result, cannabis users have a higher risk of cavities, gum disease, and oral infections.”
Dental hygienists—experts in oral health promotion and disease prevention—know that good oral health is essential for physical and mental well-being. As primary health care providers, they work with you to develop individualized oral care plans and can offer guidance on healthy food and lifestyle choices. Before beginning any dental hygiene treatment, they will remind you that cannabis use may increase bleeding and slow healing, and will confirm that your capacity to consent to care isn’t impaired. “Dental hygienists want you to enjoy optimal oral and overall health in 2019 and beyond, which is why they are ready to have the cannabis conversation,” adds Bowser. Schedule your next dental hygiene appointment today to learn more about the impact of cannabis on your oral health or visit http://www.dentalhygienecanada.ca/cannabis.
Serving the profession since 1963, CDHA is the collective national voice of more than 29,549 registered dental hygienists working in Canada, directly representing 19,000 individual members including dental hygienists and students. Dental hygiene is the sixth largest registered health profession in Canada with professionals working in a variety of settings, including independent dental hygiene practice, with people of all ages, addressing issues related to oral health. For more information on oral health, visit http://www.dentalhygienecanada.ca.
Here’s why Canadian and U.S. dentists say you should keep flossing
By Andrew Russell
National Online Journalist, Investigative Global News
https://globalnews.ca/news/2862441/to-floss-or-not-canadian-and-u-s-dentists-continue-to-urge-flossing/
Despite a major in-depth investigation in the U.S. that found little evidence flossing prevents cavities and gum disease, dentists in Canada and the U.S. are standing by the daily oral hygiene practice.
The Associated Press reported Tuesday that after scrutinizing 25 different studies over the past decade it found the evidence for flossing is “weak, very unreliable,” of “very low” quality, and carries “a moderate to large potential for bias.” The U.S. government also quietly dropped flossing from its dietary guidelines in 2016 and acknowledged to the AP the effectiveness of flossing had never been researched.
Should you floss daily? Experts say it does little to prevent gum disease, cavities
But could flossing — a practice recommended by dentists and dental associations around the world for years — really be worthless?
Not so fast says Scott Tomar, professor and chairman of the department of community dentistry and behavioural science at the University Of Florida College of Dentistry.
“It comes as no surprise to most of us in the dental public health community,” Tomar told Global News. “We have known for years that there just aren’t a lot of studies, and those that are out there are either relatively small or short term studies.”
Indeed, the AP found that most of the studies it examined involved too few test subjects, used outdated methods, or did not last long enough.
Tomar said it would be extremely difficult to complete a high-quality, long term study on the effects of flossing because it would be too expensive and require a large, diverse number of people over a number of years
“A randomized control trial looking at disease ends points in dental care like tooth decay on the surfaces in between teeth, or periodontal diseases would be incredibly large and expensive studies to do,” he said. “The slow progression of those conditions would mean you would have to follow a fairly large number of people for three to five years.”
Tomar also said he was “skeptical” that The National Institutes of Health — the U.S. agency responsible for biomedical and health-related research — or private companies would step in to fund the research.
“I don’t think we are going to see the major manufacturers of dental floss pay to do this,” he said.
And despite the AP report, Tomar said he still recommends flossing and there is pretty good evidence it’s effective at removing debris and plaque.
“There are short term studies that show that regular flossing reduces the prevalence of gingivitis,” he said. “One thing worth bearing in mind is the absence of evidence is not equivalent to the absence of effectiveness.”
Natalie Archer, former vice-president of the Royal College of Dental Surgeons of Ontario, said while she hasn’t examined the studies in the AP report, she will keep advising patients to floss and keep flossing herself.
“I would probably bet there isn’t a dentist or [dental] hygienist out there who doesn’t floss their own teeth,” Archer told Global News. “We see patients for years, and if anyone is going to see the long-term benefits [it’s us]. It’s that flossing works.”
The Canadian Dental Association (CDA) also continues to support flossing as “one step of maintaining healthy teeth and gums.”
“Flossing is an effective preventative measure to remove plaque, the main cause of gum disease,” the CDA said in an email to Global News.
“The weakness of the evidence supporting the value of floss in the prevention of gum disease is a reflection of the difficulty of conducting the necessary studies, not of the value of flossing for the maintenance of good oral health.”
The American Academy of Periodontology (AAP) also acknowledged there is a problem with research on flossing, but encouraged patients to keep flossing.
“In the absence of quality research, patients should continue to include flossing as a part of their daily oral hygiene habit,” the AAP said.
Archer said floss remains the most effective, economical tool for cleaning between your teeth.
“Your mouth is your primary portal to your body. If you can’t keep it clean, all that bacteria is going through the rest of your body,” she said. “Having good bacteria in the mouth versus a lot of a bad bacteria…it affects our gut flora, everything.”
*With files from The Associated Press
The State of Oral Health in Canada
Provided by: https://www.cda-adc.ca/stateoforalhealth/
Download the print version of The State of Oral Health in Canada report.
Access the digital version of The State of Oral Health in Canada report.
References available in print and digital versions (above).
Executive Summary
Good oral health is essential to overall health and quality of life. Good oral health enables us to speak, smile, breathe, drink, and eat. The oral cavity also plays a central role in the intake of basic nutrition and protection against microbial infections.
As the national voice for the dental profession, the Canadian Dental Association (CDA) is pleased to present this overview of oral health in Canada. In the following pages, you will find insights and information on:
the state of oral health around the world;
how Canada compares against other countries;
information on funding models, statistics on dental usage and access to oral care;
key trends;
priority areas for improving oral health;
programs being spearheaded by provincial dental associations and more.
Based on a wide range of metrics, we can state definitively that Canada is among the world leaders when it comes to the overall oral health of its citizens. In addition to ranking favourably in terms of oral health indicators such as decayed, missing and filled teeth (DMFT), severe chronic gum disease and instances of oral and lip cancer, Canadians also enjoy among the best access to oral health care in the world. Three out of every four Canadians visit a dental professional at least once per year, and 84% of Canadians believe they have good or excellent oral health. In Canada, wait times to see a dentist and receive treatment are among the shortest in the world. And for most Canadians, choice and availability of dentists is a non-issue.
However, there is still work that needs to be done in order to improve the state of oral health in Canada for specific groups. Like many other countries around the world, Canada faces challenges providing the most vulnerable segments of its population (e.g. seniors, low-income populations, people with special needs, children, Indigenous peoples, new immigrants with refugee status, etc.) with the oral health services they require. Research indicates that poor oral health is experienced by those Canadians who do not have access to regular dental care. In the following pages, we outline some of these challenges, along with work being done to address them.
https://www.cda-adc.ca/en/oral_health/specialties/
There are nine nationally recognized dental specialties in Canada. The Commission on Dental Accreditation of Canada (CDAC) reviews and accredits the education programs in the nine dental specialties.
Accreditation is a process by which CDAC recognizes dental and allied dental education programs – as well as health facility dental services – as having met nationally-determined requirements or standards, as established by CDAC.
For more information on dental specialties in Canada, please visit the please visit the Canadian Dental Specialties Association. cdsa-acsd.ca
Dental Public Health
Endodontics
Oral and Maxillofacial Surgery
Oral Medicine and Pathology
Oral & Maxillofacial Radiology
Orthodontics and Dentofacial Orthopedics
Pediatric Dentistry
Periodontics
Prosthodontics
Dental Public Health
Dental Public Health is that branch and specialty of dentistry concerned with the diagnosis, prevention and control of dental diseases and the promotion of oral health through organized community efforts. Dental Public Health serves the community through research, health promotion, education and group dental care programs.
A public health dentist is a dental specialist who has successfully completed an accredited advanced educational program in dental public health and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Association of Public Health Dentistry
http://www.caphd.ca
Endodontics
Endodontics is that branch and specialty of dentistry concerned with the morphology, physiology and pathology of the dental pulp and periradicular tissues. Its study and practice encompass the basic clinical sciences, including biology of the normal pulp, and etiology, diagnosis prevention, and treatment of diseases and injuries of the pulp and associated periradicular tissues.
An endodontist is a dental specialist who has successfully completed an accredited advanced education program in endodontics and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Academy of Endodontics
http://www.caendo.ca
Oral and Maxillofacial Surgery
Oral and maxillofacial surgery is that branch and specialty of dentistry which is concerned with and includes the diagnosis, surgical and adjunctive treatment of disorders, diseases, injuries and defects, involving the functional and aesthetic aspects of the hard and soft tissues of the oral and maxillofacial regions and related structures.
An oral and maxillofacial surgeon is a dental specialist who has successfully completed an accredited advanced education program in oral & maxillofacial surgery and who currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Association of Oral and Maxillofacial Surgeons
http://www.caoms.com
Oral Medicine and Pathology
Oral Medicine and Pathology is the branch and specialty of dentistry concerned with the diagnosis, nature and primarily non-surgical management of oral, maxillofacial and temporomandibular diseases and disorders, including dental management of patients with medical complications. Oral medicine and oral pathology are two applied components of this specialty.
A practitioner in oral medicine is a dental specialist who has successfully completed a formal advanced education program in oral medicine. A practitioner in oral pathology is a dental specialist who has successfully completed a formal advanced education program in oral pathology. A practitioner in oral medicine and pathology is a dental specialist who has completed formal advanced education programs in oral medicine and oral pathology. These practitioners currently hold such specialty designations from a Provincial Dental Regulatory Authority.
Canadian Academy of Oral and Maxillofacial Pathology and Oral Medicine
http://www.cda-adc.ca/jcda/vol-69/issue-9/568.pdf
Oral and Maxillofacial Radiology
Oral and Maxillofacial Radiology is that branch and specialty of dentistry concerned with the prescription, production and interpretation of diagnostic images for the diagnosis and management of diseases and disorders of the craniofacial complex.
An Oral and Maxillofacial Radiologist is a dental specialist who has successfully completed an accredited advanced education program in Oral and Maxillofacial Radiology and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Academy of Oral and Maxillofacial Radiology
http://caomr.org
Orthodontics and Dentofacial Orthopedics
Orthodontics and Dentofacial Orthopedics is that branch and specialty of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures and the diagnosis, prevention and treatment of any abnormalities associated with these structures.
An orthodontist is a dental specialist who has successfully completed an accredited advanced education program in orthodontics and dentofacial orthopedics and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Association of Orthodontists
http://www.cao-aco.org
Pediatric Dentistry
Pediatric Dentistry is that branch and specialty of dentistry concerned with providing primary and comprehensive preventive and therapeutic oral health diagnosis, care and consultative expertise for infants and children through adolescence, including those of all ages with special care needs.
A pediatric dentist is a dental specialist who has successfully completed an accredited advanced education program in pediatric dentistry and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Academy of Pediatric Dentistry
http://www.capd-acdp.org
Periodontics
Periodontics is that branch and specialty of dentistry concerned with the diagnosis, prevention, and treatment of diseases and conditions of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and aesthetics of these structures and tissues.
A periodontist is a dental specialist who has successfully completed an accredited advanced educational program in periodontics and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Canadian Academy of Periodontology
http://www.cap-acp.ca
Prosthodontics
Prosthodontics is that branch and specialty of dentistry concerned with the diagnosis, restoration and maintenance of oral function, comfort, appearance and health of the patient by the restoration of the natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.
A prosthodontist is a dental specialist who has successfully completed an accredited advanced educational program in prosthodontics and currently holds such specialty designation from a Provincial Dental Regulatory Authority.
Association of Prosthodontists of Canada
http://www.prosthodontics.ca
Non-profit dental clinic opens in North Surrey
The clinic will help ‘under-served and socially disadvantaged families’ as well as donate profits to charity
A non-profit dental clinic that provides discounts on dental care to those in need has opened in Newton, and it’s said to be the first of its kind in Surrey.
Located at the corner of 88th Avenue and 128th Street, the clinic’s mission is to “provide affordable and accessible dental care to under-served and socially disadvantaged families.”
It’s been eight years in the making and is the brainchild of Dr. Harpreet Dhillon and Dr. Belrup Patrola, who say it’s their way of giving back.
While the dentists say there are other models that provide discounted or free dental care in the region, they say the others are mostly student-driven and dentist-supervised.
Strive Dental, on the other hand, is run exclusively by professional dentists.
“We know that there’s a tremendous need for dentistry, generally speaking,” said Dhillon. “It’s not covered by general provincial health care, you either have funding from work-related insurance or you have to buy private insurance and most people can’t afford it. So if they’re not with a good job, they’re either paying out of pocket or looking for subsidized care, or not going at all.”
“We could get into the negative impacts of oral health on your systemic body, and it would be mind-boggling, but there’s such a dramatic negative effect on personality and live-ability,” added Dhillon, a South Vancouver resident who operates practices in Vancouver and Delta.
“The outward and psychological impact is quite tremendous. We know there’s a need and we see it in our day-to-day practices. We try to do what we can but we felt that if we can create an office where we can centralize that care and give back to the community, that would be the easiest way.”
The clinic will offer a 20 per cent discount to those who can’t afford dental treatment.
“There’s a large immigrant population here so with that a lot of them don’t have coverage,” said Patrola. “We ask them verbally, and we take them for their word.”
Patrola himself was unable to pay for dental care while he was in university. He was looking at a large bill for a root canal and crown, or, for much less money, have the tooth pulled. He chose the latter due to his financial limitations at the time.
“That kind of made me realize how many other people must have to make the same decision. It was tough on me. When I got into dentistry, I was talking to Dr. Dhillon and said once we’ve established ourselves, we have to find a way to give back.”
Beyond the discount they are offering to patients in need, Dhillon and Patrola say they will donate all of their net profits to local charities.
First to benefit will be Surrey Food Bank and Guru Nanak’s Free Kitchen. In the future, they plan to offer funding to other charities, and perhaps launch a scholarship program for high school students interested in the health field.
The clinic also accepts Ministry of Social Services dental coverage, and won’t charge patients the difference between the ministry fee guide and the British Columbia Dental Association fee guide. Both say most dental clinics don’t accept ministry insurance, due to the lower payment they’d receive.
And the dentists said they didn’t skimp on equipment just because it’s a non-profit.
“We got the best X-ray machines that we could get, the best equipment we could get,” said Dhillon, noting they current have three operatories that are active, with another four they can use to expand as demand increases.
“It’s exactly what it would be at any other office, there’s no cutting corners. At the end of the day it’s health related. We got into this because it’s what we really enjoy doing.”
(Dr. Belrup Patrola of Strive Dental Clinic with a pair of digital x-ray devices. Photo: Amy Reid)
It turns out, the inspiration for the clinic goes back decades, Patrola explained.
“It goes all the way back to 1906,” said Patrola, a Delta resident who operates a practice in Fort Nelson. “We come from pretty historic Sikh families. My family was one of the first Indian families in Canada and my great grandfather’s father built the first Sikh temple in Canada. My family profile’s in the museum in Abbotsford. It’s a national historic site now. Just hearing stories of what they did for the community, it’s just been ingrained in us. This concept of Seva.”
In Sikhism, seva is a word that describes “selfless service.”
“We follow our faith as best as we can,” Dhillon chimed in. “It always tells us to do good. Don’t steal, don’t harm anyone. That’s one pillar of our religion. The other pillar is do an honest day’s living. The third one is to give back to the community. What you have is good, but let others benefit from what you do and as a religious philosophy, if everyone does that there wouldn’t be poverty and all these challenges society faces these days.”
“So we’re trying to be as charitable as possible. The more the better,” Dhillon added.
The clinic opened with a soft launch in August, but its grand opening is set for this Saturday (March 9) at 2 p.m.
Strive Dental is located at #101-12837 88th Ave., Surrey.
Original Article from:
CDA (The Canadian Dental Association)
Canadians of all ages can enjoy good oral health and benefit from regular professional dental care. Provided you look after them, your teeth and gums will look good and stay healthy for life.
As you age, however, you may need to make a few changes in the way you care for your teeth and gums. If you need advice on looking after your teeth and gums, or those of a dependent relative or friend, your dentist and the Canadian Dental Association can provide you with valuable information.
You are never too old to have healthy teeth and gums. And you are never old enough to stop seeing your dentist! Your dentist wants to make sure you maintain healthy teeth and gums for your whole life. This section explains how your needs change as you get older.
Dental students best hygienists at scaling in new study
By Theresa Pablos, DrBicuspid.com associate editor
Dental students may be better at scaling and root planing than their hygiene counterparts, according to the findings of a new study. Dental students in Switzerland more effectively scaled a maxillary left canine model than both dental hygiene students and experienced hygienists.
The study authors, led by dental hygienist Deborah Hofer, were surprised that the dental students more effectively scaled the tooth model despite having significantly fewer training hours. They published their findings in the Swiss Dental Journal (February 26, 2019).
“Based on the results of this study, our hypothesis that periodontal instrumentation training time would be reflected in the students’ end results when scaling/root planing a tooth … must be rejected,” wrote Hofer and her colleagues from the University of Zurich. “In fact, the dental students displayed scaling/root-planing skills comparable to the [dental hygiene] students who received 80 hours of training.”
Education’s role in clinical mastery
“Dental students displayed scaling/root-planing skills comparable to the [dental hygiene] students who received 80 hours of training.”
— Deborah Hofer and colleagues
Dental school is rigorous, and dental students practice some clinical skills for a fraction of the time of dental hygiene students. Therefore, the researchers wondered how dental students’ scaling and root-planing abilities fared against their colleagues who get more training time.
To find out, they recruited 70 study participants with varying educational and dental backgrounds:
34 dental students
20 dental hygiene students from two local schools
8 experienced dental hygienists
8 laypeople with no dental experience
The researchers asked the participants to use the hand instrument of their choice to scale and root plane a maxillary left canine on a dental model. The tooth models all had identical periodontal defects and were coated with black nail polish to simulate calculus.
After the participants cleaned the teeth for five minutes, the researchers scanned the models and evaluated them against a reference tooth. The dental students most effectively cleaned the tooth, followed by dental hygiene students at one school, experienced dental hygienists, then dental hygiene students at a second school.
Tooth cleaning efficiency by profession
The researchers attributed the relatively poor performance of the experienced dental hygienists to the differences between scaling and root-planing model teeth as opposed to actual teeth. However, the difference between the dental students and the various hygiene students was harder to explain.
They hypothesized the dental students could be more efficient learners, as they needed to excel at high school and university before entering dental school. Meanwhile, dental hygiene students go down a skill-based, apprentice pathway in Switzerland.
“The academic challenges previously mastered by the dental students, and an acquired ability for efficient learning and knowledge/skills transfer, may be one reason that they scored so high in this manual test despite very limited training time,” the authors wrote. “However, this is only a suspicion, and it might well be that [dental hygiene] students, despite the discrepancy in their training times and level of proficiency displayed, could also reach levels of competency similar to those of dental students with an equally low number of training hours.”
Interpret findings with caution
While the findings are interesting, a number of study shortcomings prevent them from being clinically relevant, according to the authors. First, the feel of human dentin and calculus varies from that of the model, which could explain why the experienced dental hygienists, who are used to working on patients, did not perform as well as some of the students who have only worked on models.
Furthermore, academic and professional education is different in Switzerland than other countries, including the U.S. Therefore, the results may not be applicable to U.S.-dental training programs.
Finally, the researchers did not account for educational differences between the dental school and two dental hygiene schools, including staff credentials and classroom diversity. They hope a follow-up study will look at some of these factors.
“Within the limitations of this study, we have shown that 8.5-hours of preclinical training was sufficient for dental students to remove concrement from an upper right maxillary canine to a level equal to or greater than [dental hygiene] students receiving 80 or 64 hours of preclinical training in scaling/root planing,” the authors concluded. “These results point to the possibility of reducing the number of hours allocated to learning this preclinical skill by both dental and [dental hygiene] students and reallocating that time to other areas of the curriculum.”
Caring for Your Teeth
Only your dentist has the skills, training and expertise to provide a comprehensive diagnosis about your oral health condition, and to advise you on appropriate treatment and care. Your dentist can help you establish a routine of daily cleaning and preventive visits to keep your oral health good for life.
Taking proper care of your teeth and gums is a lifelong commitment. It includes a good oral hygiene routine that you follow at home, as well as regular visits to your dentist and an overall “team” approach to your oral care. By taking these simple steps, there’s every reason why you should keep your “oral health – good for life.”
New product: Oral-B debuts AI toothbrush
By DrBicuspid Staff
February 26, 2019 — Procter & Gamble brand Oral-B has introduced a new toothbrush with artificial intelligence (AI) technology.
The Oral-B Genius X toothbrush has accumulated the brushing behaviors of thousands of people to assess individual brushing styles and coach users to achieve better brushing habits. The AI technology tracks where people are brushing in their mouth and offers personalized feedback through the Oral-B app on the areas that require additional attention.
Users brush an average of 2 minutes and 22 seconds with the toothbrush, longer than the recommended time of 2 minutes, according to Oral-B. https://buff.ly/2peqeCk
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The State of Oral Health in Canada
Canadian Dental Association
Article from the https://www.cda-adc.ca/stateoforalhealth/
Download the print version of The State of Oral Health in Canada report.
Access the digital version of The State of Oral Health in Canada report.
References available in print and digital versions (above).
Executive Summary
Good oral health is essential to overall health and quality of life. Good oral health enables us to speak, smile, breathe, drink, and eat. The oral cavity also plays a central role in the intake of basic nutrition and protection against microbial infections.
As the national voice for the dental profession, the Canadian Dental Association (CDA) is pleased to present this overview of oral health in Canada. In the following pages, you will find insights and information on:
the state of oral health around the world;
how Canada compares against other countries;
information on funding models, statistics on dental usage and access to oral care;
key trends;
priority areas for improving oral health;
programs being spearheaded by provincial dental associations and more.
Based on a wide range of metrics, we can state definitively that Canada is among the world leaders when it comes to the overall oral health of its citizens. In addition to ranking favourably in terms of oral health indicators such as decayed, missing and filled teeth (DMFT), severe chronic gum disease and instances of oral and lip cancer, Canadians also enjoy among the best access to oral health care in the world. Three out of every four Canadians visit a dental professional at least once per year, and 84% of Canadians believe they have good or excellent oral health. In Canada, wait times to see a dentist and receive treatment are among the shortest in the world. And for most Canadians, choice and availability of dentists is a non-issue.
However, there is still work that needs to be done in order to improve the state of oral health in Canada for specific groups. Like many other countries around the world, Canada faces challenges providing the most vulnerable segments of its population (e.g. seniors, low-income populations, people with special needs, children, Indigenous peoples, new immigrants with refugee status, etc.) with the oral health services they require. Research indicates that poor oral health is experienced by those Canadians who do not have access to regular dental care. In the following pages, we outline some of these challenges, along with work being done to address them.
Public Statement from the Canadian Dental Association:
Make Informed Decisions Before Purchasing or Using Direct-to-Consumer Dental Appliances
There are many new options available for patients to purchase dental appliances directly from suppliers. Although claims of shorter treatment times, “doing-it-yourself,” in the comfort of your own home, or the convenience of purchasing dental appliances directly online or over-the-counter may seem attractive, you should be informed that using direct-to-consumer dental appliances may not give you the most appropriate care to achieve your desired results. Examples of direct-to-consumer dental appliances include but are not limited to bleaching kits to whiten teeth, transparent aligners to straighten teeth, occlusal splints to temporarily modify your bite and protect your teeth, and anti-snoring devices.
Your dentist, a general practitioner or a specialist such as an orthodontist, is in the best position to recommend dental treatment options that are right for you. Using direct-to-consumer dental appliances eliminates critical interactions between you and your dentist, such as:
receiving a complete clinical oral examination, diagnosis and recommendation for treatment that is unique to you and your overall oral health needs;
discussing treatment options and co-developing a treatment plan that achieves the most appropriate results for you;
monitoring the progress of your treatment; and
having direct access to follow-up care after completing your treatment plan.
The Canadian Dental Association (CDA) encourages you to make informed decisions about your oral and overall health. Make sure to ask your dentist or dental specialist if the appliance you are thinking about suits your individual oral health needs and that it’s considered within all aspects of your care. If using a direct-to-consumer dental appliance leads to unexpected complications or results that fall short of your expectations, your dentist or dental specialist may have limited choices to help, correct, or address your situation.
CDA is committed to sharing important information to help protect and promote the oral health of Canada’s population. To find a Canadian licenced dentist or dental specialist in your area, please visit http://www.cda-adc.ca/en/oral_health/talk/find.asp.
Don’t become a cautionary tale: How to protect from hackers
By Theresa Pablos, DrBicuspid.com associate editor
February 21, 2019 — In 2017, a dental practice in Tennessee discovered ransomware on an office computer. This malicious software blocked access to the health and financial information of almost 3,000 patients, and the dentist was unable to determine whether that patient information had been shared outside of the clinic.
The consequences to the practice were costly. The managing dentist had to designate a new privacy and security officer, change IT vendors, and create a new Health Insurance Portability and Accountability Act (HIPAA) training program.
Pat Little, DDS
Pat Little, DDS, president and founder of Dental Risk Concepts.
Incidents similar to this one are happening to dental and medical offices all over the U.S. In fact, on February 4, the U.S. government reported it was investigating a breach that could affect 10,000 patients at a Texas dental clinic.
But this doesn’t have to be your practice’s story. Dr. Pat Little, DDS, spoke about how dentists can protect themselves and their patients from medical identity theft at the Chicago Dental Society Midwinter Meeting on February 21.
“Dental and medical identity theft is the fastest-growing and most lucrative form of identity theft,” Dr. Little, president and founder of Dental Risk Concepts, told DrBicuspid.com. “Any breach that affects our patients’ private data can result in devastating legal and financial consequences.”
The value of a dental record
Medical identity theft is the fastest-growing form of identity theft simply because it is so lucrative, Dr. Little explained. To hackers, a dental chart is more valuable than a Social Security number because it often contains far more information.
“With a Social Security number, they can do damage typically with one person’s account,” Dr. Little said. “But if they can steal dental records, they have a medical record not only for that patient but also for all the other family members, which would include Social Security numbers, birth dates, everything they would need to open up multiple accounts in multiple locations.”
Hackers and identity thieves use three main methods to get access to protected patient information:
Dumpster diving: Identity thieves will literally dig through garbage and recycling bins, looking for information that hasn’t been properly shredded and disposed of.
Physical theft: Thieves will break into dental practices and cars to steal laptops, phones, computers, servers, and other devices that may contain unsecured patient information.
Phishing scams: Hackers will send an email with a hyperlink that someone in the practice clicks and opens. This link then infects the computer with malware, which can harvest patient information and/or lock the computer and demand a ransom to reopen it.
Phishing scams are the most common of the three methods, and they’re not always obvious. The best hackers can make emails and hyperlinks look legitimate, like they are coming from a patient, good friend, dental supplier, or credit card company.
Once hackers and thieves have patient information, they can monetize that data in a number of ways, including selling dental records on the black market, opening credit cards and bank accounts in your patients’ names, or even going to the dentist masquerading as one of your patients.
“The HIPAA fines for a breach can be staggering.”
— Pat Little, DDS
In addition, the financial consequences of a breach can be catastrophic for dentists and dental practices. Dentists may face fines of hundreds of thousands of dollars, and they’ll likely lose patient confidence and experience turnover.
“The HIPAA fines for a breach can be staggering,” Dr. Little noted. “The maximum fine is $1.5 million. I’ve never seen a dentist have to pay that much money, but [the fines] can easily go into six figures if the government decides the dentist acted with reckless disregard.”
How to protect yourself
Private practices are small businesses that often don’t have the IT resources of larger businesses, a weakness that thieves and hackers are all too happy to exploit. However, dentists can take certain steps to protect themselves and their patients’ information.
First, dentists can and should partner with an IT company that is knowledgeable about HIPAA compliance and security. Dr. Little recommends asking companies whether they represent other dentists and how familiar they are with HIPAA security and the dental profession.
It’s also important for dentists to educate themselves and their staff about HIPAA security. One of the most dangerous things dentists can do is think that a breach can’t happen to them because they’re careful or have antivirus software.
“Watch the mentality that this can’t happen to me,” Dr. Little cautioned. “It’s happening with alarming frequency now. Make sure you protect yourself with a good IT partnership.”
Credit given to article writter: Theresa Pablos, DrBicuspid.com associate editor.
Posted here: https://www.drbicuspid.com/index.aspx?sec=sup&sub=pmt&pag=dis&ItemID=324227 – May require login to see.
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