California Dentist Arrested for Providing Drugs and Alcohol to Minors

It wasn't Dr. Lavonne Sawyer's first brush with the law regarding drugs and it wasn't just marijuana and alcohol.

A San Joaquin County dentist who was arrested on drug charges in 2008 is once again in trouble with the law.

Lavonne Sawyer, 53, was arrested in her Lodi home after police received a call about alleged drug activity there.

"When officers arrived, they found a half dozen teenagers under the influence of drugs and alcohol and Ms. Sawyer was home," said Officer Misty Springmeyer with the Lodi Police Department.

Police say Sawyer claimed to not be aware of the drugs in her home.

"She said she could not smell the marijuana because her nose was stuffed," Springmeyer said.

Sounds like a suspended dental license, rehab and many years of probation, if this dentist is ever to practice again.

Hope she gets some help, but she obviously should not be practicing dentistry.

Teeth and Gums: The Gateway to Your Body and Health

This is a good video from the Wall Street Journal on why dentists will play a larger role in everyone's health.

The eyes may be the window to the soul, but the mouth provides an even better view of the body as a whole.

Some of the earliest signs of diabetes, cancer, pregnancy, immune disorders, hormone imbalances and drug issues show up in the gums, teeth and tongue—sometimes long before a patient knows anything is wrong.

There's also growing evidence that oral health problems, particularly gum disease, can harm a patient's general health as well, raising the risk of diabetes, heart disease, stroke, pneumonia and pregnancy complications.

"We have lots of data showing a direct correlation between inflammation in the mouth and inflammation in the body," says Anthony Iacopino, director of the International Centre for Oral-Systemic Health, which opened at the University of Manitoba Faculty of Dentistry in Canada in 2008. Recent studies also show that treating gum disease improves circulation, reduces inflammation and can even reduce the need for insulin in people with diabetes.

More work for dentists = I like that prospect!

Merry Christmas 2011

Wishing you and your family the happiest of the holiday season.

The Social Media Persecution of Dr. Edward Dove Continues

You remember the Flap?

And, on it goes with an online petition to pressure the California Dental Board to revoke Dr. Dove's dental license.

Well, this father, Chris Cook knows how to work the social media, but the California Dental Board does not work in this way. Then, there is the California Attorney General and an Administrative Law Judge whose findings are all subject to appeal in the regular court system.

I have a feeling this "bad blood" will be continuing for a while.

The Morning Drill: December 21, 2011

Good Morning!

As most dental practices are in the process of closing for the holidays, I wish to take this opportunity to wiish the very best of the season to everyone and a happy new year.

On to today's dentistry and health headlines:

Dentist accused of groping KOP mall employees

An itinerant dentist accused of groping two women employees at King of Prussia Mall stores waived his preliminary hearing Thursday.

Vasanth Dharmaraj, 33, a former Upper Merion resident who relocated to Connecticut, is charged with indecent assault, harassment and disorderly conduct, according to court papers

When Dharmaraja lived in the Philadelphia region, he practiced dentistry in a variety of Pennsylvania cities and towns including Philadelphia, Gilbertsville, Phoenixville, York, Reading, Harrisburg and Temple, according to the Upper Merion police’s Detective Division.

The defendant is free on $25,000 unsecured bail. An arraignment is scheduled in Montgomery County Court of Common Pleas on Feb. 1 at 9:30 a.m.

FTC: Dental Board Cannot Order Nondentists to Stop Whitening

The North Carolina Board of Dental Examiners cannot order nondentists to stop whitening teeth, the US Federal Trade Commission (FTC) has ruled.

The December 2 ruling could have implications for tooth whitening by nondentists in other states, and for the scope of dental boards in general.

The North Carolina board plans to appeal, board attorney Noel Allen told Medscape Medical News. "It's a very unique and radical position that the FTC is taking," said Allen. "It runs contrary to the way states protect their citizens."

At the heart of the case is a question about whether the board is acting more as an arm of the state government, enforcing the law, or as a trade association, to benefit its members.

“Painless” Plasma Brush Is Becoming Reality In Dentistry, MU Engineers Say

University of Missouri engineers and their research collaborators at Nanova, Inc. are one step closer to a painless way to replace fillings. After favorable results in the lab, human clinical trials are underway on the “plasma brush.”

In less than 30 seconds, the plasma brush uses chemical reactions to disinfect and clean out cavities for fillings. In addition to the bacteria-killing properties, the “cool flame” from the plasma brush forms a better bond for cavity fillings.  The chemical reactions involved with the plasma brush actually change the surface of the tooth, which allows for a strong and robust bonding with the filling material.

“There have been no side effects reported during the lab trials, and we expect the human trials to help us improve the prototype,” said Qingsong Yu, associate professor of mechanical and aerospace engineering of MU, and Meng Chen, chief scientist from Nanova, Inc., which holds a co-patent for the plasma brush with MU.

“200 million tooth restorations cost Americans an estimated $50 billion a year, and it is estimated that replacement fillings comprise 75 percent of a dentist’s work. The plasma brush would help reduce those costs,” said Hao Li, associate professor of mechanical and aerospace engineering in the MU College of Engineering. “In addition, a tooth can only support two or three restorations before it must be pulled. Our studies indicate that fillings are 60 percent stronger with the plasma brush, which would increase the filling lifespan. This would be a big benefit to the patient, as well as dentists and insurance companies.”

U.S. bill would create grant program for dental charities

A bill introduced to the U.S. Congress in November would make it easier for charitable programs such as Donated Dental Services (DDS) to provide necessary dental care to low-income children and adults with serious medical conditions.


S.1878, the "Coordination of Pro-Bono Medically Recommended Dental Care Act," was introduced November 16 by Sen. Robert Menendez (D-NJ). The bill would create a grant program that will support national dental programs such as DDS to coordinate medically recommended dental care for these patients.

The care would be provided by volunteer dentists at no cost to patients with medical conditions such as diabetes, cancer, autoimmune disease, and kidney disease or who need heart or joint replacements or transplants.

Enjoy your morning!

The Morning Drill: December 20, 2011

Good Morning!

On to today's dentistry and health headlines:

Lack of dental care costing Australia $1.3B annually

Millions of Australians are financially locked out of the country's dental health system, undermining their ability to gain and keep employment and costing the economy more than $1 billion annually, according to a report released December 8 by the advocacy group Brotherhood of St. Laurence.

The Brotherhood of St. Laurence was established in the 1930s to eliminate poverty in Australia.

The report analyzed existing data to estimate the disease burden of untreated dental conditions and the resulting economic burden. The report's authors, Jeff Richardson, PhD, a professor of economics and the foundation director of the Centre for Health Economics at Monash University and Bronwyn Richardson from Campbell Research and Consulting, found that the direct and indirect costs to the economy are significant.

Dentist who helped pimps wants to work again

Onetime Chicago dentist Gary Kimmel went to prison in 2009 after he admitted he aided pimps in a prostitution trafficking ring.

The aid included providing space in Marina Towers for paid sex acts to happen, buying luxury cars for pimps in his name and keeping his office open late to fix the teeth of battered prostitutes.

In one case, Kimmel fixed a prostitute’s teeth for free in exchange for her performing sex acts for his friend, according to prosecutors.

That was back when Kimmel, affectionately referred to as “Doc” by those who know him, ran a popular and successful dental practice at 233 E. Erie.

In an emergency bid at the time of his indictment, the state stripped Kimmel of his ability to practice dentistry. He was sentenced to 37 months in 2009.

Now, Kimmel is already out of prison.

And despite his felony conviction, the Chicago Sun-Times has learned he is ready to practice dentistry again — and eligible to renew his license.

In early December in federal court, Judge Blanche Manning granted an early end to his court supervision, shaving off one year. That cleared the first major legal hurdle to restoring his license.

“We hope to have him back working as a dentist in no time,” his lawyer, Joseph Lopez said.

Vitamin D and Calcium Supplementation Reduces Fracture Risk

Combined supplementation with vitamin D and calcium can reduce the risk for fracture, according to the findings of a meta-analysis.

Mei Chung, PhD, MPH, from Tufts Medical Center in Boston, Massachusetts, and colleagues published their findings in the December 20 issue of the Annals of Internal Medicine.

The authors mention that active forms of vitamin D participate in a number of biological processes in addition to their indirect effects on bone mineralization. "For example, as recently noted, 1,25-(OH)2D inhibits parathyroid hormone secretion and promotes insulin secretion, inhibits adaptive immunity and promotes innate immunity, and inhibits proliferation and stimulates differentiation of cells," the authors write. "These functions suggest a possible role of vitamin D in cancer prevention."

Oral Bacteria Enables Breaking Bond On Blood Vessels to Allow Invaders in

A common oral bacteria, Fusobacterium nucleatum, acts like a key to open a door in human blood vessels and leads the way for it and other bacteria like Escherichia coli to invade the body through the blood and make people sick, according to dental researchers at Case Western Reserve University.

Yiping Han, professor of periodontics at the Case Western Reserve School of Dental Medicine, made the discovery in her continued work with the Fusobacterium nucleatum bacterium, one of the most prevalent of the more than 700 bacteria in the mouth.

She found the gram-negative anaerobe has a novel adhesin or bonding agent she's named FadA that triggers a cascade of signals that break the junctures in an interlocking sheath of endothelial cells on blood vessel's surface just enough to allow F. nucleatum and other bacteria into the blood.

A description of bond-breaking process was described in the Molecular Microbiology article, "Fusobacterium nucleatum adhesin FadA binds vascular endothelial cadherin and alters endothelial integrity."

Enjoy your morning!

The Afternoon Drill: December 19, 2011

Venice Beach, California

Good afternoon.

I had some errands to run this morning, including some last minute Christmas mailings, so the Morning Drill is now in the afternoon.

On to today's dentistry and health headlines:

Maine dental board votes to restrict IPDHs in pilot project

Despite opposition from the U.S. Federal Trade Commission (FTC) and the governor of Maine, the Maine Board of Dental Examiners voted today to restrict what x-rays independent practice dental hygienists (IPDHs) can take during an upcoming pilot project.

In June 2011, Maine passed LD 230, directing the board to implement a two-year pilot project that expands the scope of practice of IPDHs to allow them to take x-rays in underserved areas without the presence of a dentist. The board was also directed to develop rules for the pilot project.

As written, the board's proposed rules allow IPDHs to take only bitewing and periapical x-rays without a dentist present and prohibit them from taking other types of x-rays.

Last month the FTC told the board that the proposed rules were too restrictive and could undermine the project's purpose.

Supreme Court sets Obama healthcare arguments

Oral arguments on President Barack Obama's sweeping U.S. healthcare overhaul will last 5-1/2 hours spread over three days from March 26-28, the Supreme Court said on Monday.

The Supreme Court last month agreed to hear the 5-1/2 hours of oral arguments, one of the lengthiest arguments in recent years. There have been similar marathon sessions in a handful of big cases dating back over the past 70 years.

New head for Ohio VA center that had dental issues

The new director of a southwest Ohio VA medical center that was rocked earlier this year by dental-clinic hygiene problems said Monday he plans more community outreach to build confidence and attract more veterans to its services.

Glenn Costie, the director at the John J. Pershing VA Medical Center in Poplar Bluff, Mo., the last two-plus years, took over Monday at the Dayton Veterans Affairs Medical Center, which serves some 37,000 veterans. In a message to his new staff, he said he wants an environment that is "patient-centric, strives for perfection and is innovative."

He replaces William Montague, the former Cleveland VA director called out of retirement in March to serve as acting director in Dayton. The previous director was reassigned after an investigation found a clinic dentist wasn't regularly changing latex gloves or properly sterilizing equipment.

Some 535 veterans who had undergone invasive procedures in the clinic had their blood tested as a result. Hospital officials said three of the patients tested positive for hepatitis, which can cause liver damage, but they weren't certain how they contracted it.

Costie said he wants to make sure the region's veterans know they are can get high-quality, safe health care at the center. He will focus on "building trust with the community," he told The Associated Press.

Posting Calorie Information On Sugary Drinks Curbs Sales Among Teens

During our daily subway commute to and from Health Blog HQ, we’ve noticed  posters telling us exactly how far we’d have to walk to work off various sugar-sweetened drinks.

Now a study just published online by the American Journal of Public Health makes us think that the NYC Department of Public Health, which is behind the posters, may be on to something.

Researchers wanted to know what would happen to sales of sugary drinks including soda, sport drinks and fruit drinks if they posted calorie information about those drinks on beverage cases at corner stores in Baltimore. They were also curious about whether the way that calorie information was presented would make a difference.

So they rotated three different signs through four different corner stores. One sign pointed out that a bottle of soda or fruit juice has about 250 calories. Another pointed out that such a drink has about 10% of a person’s daily calories. And another pointed out that working off a bottle of soda or fruit juice takes about 50 minutes of running.

The researchers collected data for about 1,600 beverage purchases by black teens — who are more likely to drink sugary beverages and to be obese — across the different information strategies and, for comparison, a baseline period.

Giving any type of calorie information lowered the likelihood of a sugary-drink purchase by about 40% compared to no signs at all, says Sara Bleich, an author of the study and an assistant professor of health policy at Johns Hopkins Bloomberg School of Public Health. The study also found that giving information about the physical activity equivalent lowered the likelihood of a sugary-drink purchase by about 50%.

Enjoy your afternoon and evening!

The Morning Drill: December 16, 2011

Santa Monica, California looking towards Malibu

A Friday morning drill today even though most dentists take Fridays off.

The reason: I am on call for Jury Duty at the Ventura County Court on Monday.

On to today's dentistry and health headlines.

Should dentists offer health screenings?

Each year, nearly 20 million men, women and children in the United States fail to see a family physician or similar health care professional, but they do pay at least one visit to the dentist, according to a new study in the American Journal of Public Health.

For this segment of the population, dentists may be the only doctors in a position to spot the warning signs of chronic illnesses, such as diabetes, and provide referrals or advice to prevent serious complications, says Shiela M. Strauss, Ph.D., the lead author of the study and an associate professor at New York University's Colleges of Dentistry and Nursing.

Oral or dental abnormalities can signal a broad range of body-wide health problems, including HIV, sexually transmitted diseases, eating disorders, and substance abuse, in addition to diabetes. In a previous study, for instance, Strauss and her colleagues found that 93% of patients with gum disease (such as gingivitis) also met the criteria that should trigger blood-sugar screening under American Diabetes Association guidelines.

"I'm not advocating for dentists to become general health care providers," Strauss says. But, she adds, dentists can easily measure blood pressure and administer simple screening questionnaires - both of which could potentially make a big difference to the health of someone at risk for diabetes who hasn't seen a doctor recently.

In the new study, Strauss and her team analyzed data from the Medical Expenditure Panel Survey, a nationally representative government-sponsored survey of health care use. In 2008, the researchers found, roughly one-quarter of adults did not see a physician, nurse practitioner, or other general health care provider - but of that group, 23% did see a dentist. The pattern was similar among children.

Will Regrowing Your Teeth Replace Fillings?

For anyone who has ever lost a tooth—including the 25 percent of Americans over 65 who have lost all theirs due to decay or gum disease—it may be possible to get natural replacements someday, thanks to breakthroughs being made at the University of Illinois at Chicago. On the fourth floor of the school’s College of Dentistry, researchers are inducing lab rats to form new dentin to fill cavities in their choppers. It’s the first step toward the holy grail of dentistry: regrowing teeth. Eventually people may be able to get replacement teeth—even a whole set of 32—made of human dentin and enamel and attached to the jaw with human fibers (rather than the titanium posts used today).

To create those new teeth, researchers are attacking the problem layer by layer, attempting “to copy how nature has done it,” says Anne George, professor of oral biology at UIC. George and her ten-member team of students and scientists are focusing on ways to produce dentin, the part-mineral, part-protein material inside teeth that provides cushioning during chewing. They drill a hole in a rat’s tooth and fill the cavity with a protein that attracts cells that make dentin. “It’s best to get cells to do the work,” she says. “What we are trying to do is see what molecules will help us repair and make new dentin.” George predicts that within five to ten years people will be able to generate their own natural fillings.

More Floridians are taking their toothaches to the ER

More Floridians who go without routine dental care are resorting to hospital emergency rooms when the pain of tooth decay or infection becomes too terrible to bear, costing taxpayers and hospitals nearly $90 million last year.

In Southwest Florida, the cost of ER dental care amounted to more than $3.2 million in 2010.

Health experts said too few dentists accept Medicaid patients in Florida, where reimbursement rates are among the lowest in the nation.

The average ER charge of $770 per visit contrasts with an estimated $130 to cover a year’s worth of preventive oral care in childhood, said Frank Catalanotto, who chairs the Department of Community Dentistry at the University of Florida.

And in many cases, ER visits only result in treating the pain — not the underlying cause, resulting in a costly cycle of return visits.

Supreme Court Denies Petition for Review in California Dentist Suit Over Disclosure of Medical Records

The U.S. Supreme Court Dec. 12 said it will not review a California Supreme Court decision that held the federal Fair Credit Reporting Act (FCRA) does not preclude a lawsuit alleging a debt collector disclosed medical records in violation of a California medical information privacy statute (Mortensen v. Brown, U.S., No. 11-434, review denied).

The high court action leaves standing a June decision in which the California Supreme Court reinstated claims brought against Stewart Mortensen, d/b/a Credit Bureau Services, alleging he violated California's Confidentiality of Medical Information Act (CMIA), Cal. Civ. Code §56 et seq., in sending personally identifiable family dental records to credit reporting agencies (see previous article).

The state high court said the FCRA provisions impose obligations on debt collectors that furnish information to credit bureaus, but those provisions do not evince an intent by Congress to preempt state laws that impose additional health information privacy obligations on, or provide for additional remedies against, debt collectors.

The court noted that the Consumer Credit Reporting Reform Act of 1996, which amended FCRA to add provisions applicable to “furnishers,” was passed nearly contemporaneously with the Health Insurance Portability and Accountability Act. HIPAA, the state supreme court continued, expressly allowed for more stringent state law regulation of health information privacy.

Enjoy your morning!

The Morning Drill: December 15, 2011

Good Morning!

On to today's dentistry and health headlines:

Study of the Day: Cold Can Help Runners Recover From Exercise

Whole-body cryotherapy in extreme temperatures repairs athletes' damaged muscles much faster than radiation or rest, new research shows

RESULTS: Whole-body cryotherapy, wherein the participants were exposed to temperatures as cold as -166°F, was the most effective recovery aid. One session conducted one hour after exercise enabled the runners to gain back maximum muscle strength much faster than the other strategies. Three sessions performed after 48 hours also accelerated recuperation more than the other two methods over the same time period.

CONCLUSION: Athletes benefit more from cryotherapy than from exposure to far-infrared radiation or no treatment. Hausswirth explains in a statement that this method enhances "post-exercise recovery in well-trained runners by limiting the maximal force loss and sensations of pain."

American Diet Gets Failing Grade

Americans are still falling short of national dietary recommendations, eating too many sweets and not enough vegetables and whole grains, according to the CDC.

On a national healthy-eating index that measured compliance with U.S. dietary guidelines from 2005, the average overall diet score was only about 60 points out of 100 -- "indicating Americans' diets need improvement," Bethene Ervin, PhD, RD, wrote in a National Health Statistics Report.

The Healthy Eating Index, or HEI-2005, assesses specific intake of various nutritional categories, including whole fruits, dark green and orange vegetables, whole grains, milk, meat and beans, oils, fats, sodium, alcohol, and added sugar.

To come up with the estimates, Ervin looked at data on 4,448 adults ages 20 and up from the National Health and Nutrition Examination Survey (NHANES) 2003-2004.

She found that American adults were well below the maximum standard for all the HEI-2005 component scores except for total grains and meat and beans.

Colo. dental care firm leverages nonprofit loophole

Colorado law, like in most states, specifies that only licensed dentists can own or control dental practices in order to protect doctor/patient relationships and ensure that decisions are made based on patient care, not corporate profits.

But when state officials last year shut down HomeCare Dental Services, which had been providing dental care services to 70 nursing homes in the Denver area, owner and nondentist Ken Kucera took advantage of an exemption in the Dental Practice Act that allows nondentists to own dental practices if they are nonprofits.

Kucera reregistered his company as Visiting Ancillary Services, a nonprofit that also provides dental care to nursing homes. But he insists it isn't a dental practice.

As Doctors Use More Devices, Potential for Distraction Grows

Hospitals and doctors’ offices, hoping to curb medical error, have invested heavily to put computers, smartphones and other devices into the hands of medical staff for instant access to patient data, drug information and case studies.

But like many cures, this solution has come with an unintended side effect: doctors and nurses can be focused on the screen and not the patient, even during moments of critical care. And they are not always doing work; examples include a neurosurgeon making personal calls during an operation, a nurse checking airfares during surgery and a poll showing that half of technicians running bypass machines had admitted texting during a procedure.

This phenomenon has set off an intensifying discussion at hospitals and medical schools about a problem perhaps best described as “distracted doctoring.” In response, some hospitals have begun limiting the use of devices in critical settings, while schools have started reminding medical students to focus on patients instead of gadgets, even as the students are being given more devices.

Enjoy your morning!

The Daily Extraction: December 14, 2011

Here Dr. Murph uses a 301 straight elevator to remove this periodontally involved lower left first molar.

The pre-operative radiograph:

Here is Dr. Murph's video:

 

Enjoy your daily extraction!

Dr. Murph is a South Carolina dentist who practices general dentistry who really excels in extracting teeth.

For patients in the Myrtle Beach area, I can heartily recommend Tommy as YOUR dentist.

For dentists, Dr. Murph has a number of resources for you in extracting teeth, including one on one courses in his office.

Dr. Murph's website is here and his extraction manuals are here on e-Bay.

Previous:

The Daily Extraction Archive

The Morning Drill: December 14, 2011

Good Morning!

On to today's dentistry and health headlines:

Rainier dental hygienist charged with stealing $14,500 from DSHS Medicaid

A Rainier dental hygienist has been charged with stealing more than $14,500 from the state Department of Social and Health Services’ Medicaid program.

On Thursday, the state Attorney General’s Office filed eight criminal charges against 57-year-old Karen Ann Lockhart – five counts of first-degree theft, two counts of second-degree theft and one count of making a false statement for Medicaid reimbursement, according to criminal information filed in Thurston County Superior Court.

Lockhart could not be reached for comment Tuesday.

According to a probable-cause statement, also filed last week:

The Attorney General’s Medicaid Fraud Unit began an investigation of Lockhart, who owns and operates Rainier Dental Hygiene Services, in January 2010.

The investigation began when DSHS’s Medical Audit Unit sent a referral to the Attorney General’s Office after DSHS performed an audit examining three years of Lockhart’s billing practices.

In 2002, Lockhart had signed a contract to provide dental hygiene services to DSHS’s Medicaid clients. Most of Lockhart’s clients received their treatment in skilled-nursing facilities and in “supported/assisted living environments.”

“As a result of the audit, an overpayment to Lockhart in the amount of $177,884.49 was identified,” court papers state. “As a result of the audit, Lockhart’s provider agreement was terminated effective January 20, 2010.”

FDA Warns Surgery Centers to Drop 'Misleading' Lap-Band Ads

Eight California surgical centers and an affiliated marketing firm have been warned by the US Food and Drug Administration (FDA) to drop "misleading" ads for laparoscopic adjustable gastric banding (LAGB) that fail to inform patients about the risks of the weight-loss procedure.

The Los Angeles Times reports that since 2009, at least 5 individuals have died after they underwent the procedure at clinics targeted by the FDA.

The marketing firm in question, 1-800-Get-Thin, has swamped southern California with highway billboards, bus placards, and advertising inserts touting LAGB performed with the Lap-Band Adjustable Gastric Banding System (Allergan). The advertising features trim, smiling men and women who testify to losing as much as 130 pounds through the procedure, described as "Safe, 1-Hour, FDA Approved."

The Lap-Band is one of 2 devices approved by the FDA for gastric banding. Both bands wrap around the upper part of the stomach to form a pouch. The narrowed opening can be adjusted to control the flow of food into the main part of the stomach. The band limits how much a person can eat and thereby helps create a sense of fullness that curbs appetite.

The Lap-Band is indicated for adults age 18 or older who have not lost weight with nonsurgical methods and have either a body mass index (BMI) of at least 40 kg/m2 or a BMI of 30 kg/m2 or more and at least 1 health problem related to obesity.

The FDA announced today that it had issued its warning letters to 1-800-Get-Thin and the surgical centers earlier this month. In those letters, the FDA complains that the Lap-Band advertising omits warnings, precautions, contraindications, and possible side effects of the procedure. The warnings in some of those ads that instruct would-be patients to consult their physicians about risks and to read online safety information "may be so small as to render the information illegible," the agency added.

The risks of the surgery, which include death, are heightened for obese individuals, according to the FDA. Risks after the Lap-Band procedure include nausea and vomiting, difficulty swallowing, gastroesophageal reflux disease, stretching of the stomach pouch, and the need for further surgery when the band shifts position or erodes into the stomach.

"FDA's concern is that these ads glamorize the Lap-Band without communicating any of the risks," Steven Silverman, director of the Office of Compliance in the agency's Center for Devices and Radiological Health, said in a press release.

House Okays Medicare 'Doc Fix' That Appears Doomed in Senate

Setting up physicians for another likely disappointment, the House today passed a bill that would avert a 27.4% reduction in Medicare reimbursement scheduled for January 1.

The disappointment will probably come compliments of the Senate, where Democrats have vowed to block the legislation. Their ire is aimed not at the latest "doc fix" to the Medicare reimbursement crisis but, rather, at other provisions regarding a payroll tax cut and the controversial Keystone XL oil pipeline.

Approved in a 234-193 vote, the House bill would extend a temporary cut to the Social Security payroll tax paid by workers for 1 more year, keeping it at 4.2%. Without this renewal, the tax will return to its former level of 6.2% on January 1. House Republicans propose paying for the extension by, among other things, increasing Medicare premiums for high-income beneficiaries and freezing compensation for federal workers through fiscal 2013. Senate Democrats, however, want to offset the cost by imposing a surtax on millionaires, a move already kiboshed by their Republican opponents.

Another contested provision in the House bill would require the Obama administration to reach a decision within the next 60 days on a permit for the proposed Keystone XL pipeline, which would carry Canadian crude to Texas. Republicans contend that the pipeline will not only improve the country's energy security but also create thousands of jobs.

The Obama administration had put off the permit decision off until 2013, ostensibly to gain more time to study the project's environmental ramifications. Pundits also think the White House would rather make the decision, which pits jobs against environmental safety, until after the 2012 presidential election. Senate Democrats want the pipeline divorced from the payroll cut extension, and Obama has threatened to veto any bill that combined the 2 items.

Latest Doc Fix Would Lead to 37% Cut in 2014

Seemingly lost in the gunpowder clouds of partisan politics, once again, is the latest doc fix to the Medicare reimbursement crisis. The House bill passed today would essentially postpone a pay cut for 2 years and, instead, give physicians a 1% raise in both 2012 and 2013.

The bill requires Congress, in the meantime, to work with the Medicare Payment Advisory Commission, the Governmental Accountability Office, and the Department of Health and Human Services to replace Medicare's current method for setting physician reimbursement, called the sustainable growth rate (SGR) formula. This formula, approved by Congress in 1997, is responsible for triggering the massive pay cut set for 2012.

Policymakers will feel mounting pressure to devise a replacement: In 2014, the SGR formula will call for an estimated 37% cut in physician pay, according to the Congressional Budget Office.

Survey: Doctors Have Mixed Feelings About Health Law

Doctors’ feelings about the health-care overhaul law passed last year are about as mixed as their patients’, research released today shows.

Some 44% of doctors said the law was “a good start,” according to a survey carried out by the Deloitte Center for Health Solutions consulting group. Another 44% agreed that the law was “a step in the wrong direction.”

Many of the 501 physicians surveyed indicated that they had sour feelings about specific aspects of the law.

Around three-fourths of the doctors worried about physician shortages and longer wait times as more people get health coverage, and also that emergency rooms would become overwhelmed. And 90% thought they would be paid less by insurance companies as a result of the law.

Seven out of ten believe that some would-be doctors won’t go into the profession now, and 60% think some physicians might retire because of the law.

The survey had some less-than-surprising results, too: three-quarters of physicians favor tort reform to limit the amount that can be awarded to victims of medical malpractice.

Surgical specialists were angriest about the law — 60% of those participating in the survey said they opposed it, compared with 39% of primary-care providers and 36% of other specialists.

Enjoy your morning!

Allcare Dental Equipment/Assets Sold in Bankruptcy Court

The sale was yesterday and that should be the end of the road for AllCare Dental.

A bankrupt New York-based dental chain that abruptly closed offices in 13 states last year has sold off virtually all of its equipment to pay creditors, executives said at a bankruptcy meeting Monday.

Some equipment remains in a Greensburg, Pa., office because the landlord has denied access to the building, Allcare Dental Management's chief executive officer, David Pennington, and its president, Dr. Robert Bates, said. Patient files have been transferred to other dental practices, except for a box full of charts from one office whose location is unclear, the executives said.

Buffalo-based Allcare Dental Management Inc. and 14 related companies filed for Chapter 7 liquidation last month in U.S. Bankruptcy Court, nearly a year after running out of money. Without warning patients, the company closed more than three dozen offices in New York, Illinois, Iowa, Massachusetts, Michigan, New Hampshire, North Dakota, Nebraska, Ohio, Pennsylvania, Tennessee, West Virginia and Wisconsin.

The closing prompted lawsuits by patients who said they'd prepaid for services they never received, as well as investigations by attorneys general in New Hampshire, Indiana and elsewhere.

Of course, there will be the continuing investigations by the various attorney's generals of the different states and the associated lawsuits (but if there is no money, then...).

However, I would not be surprised if there were criminal investigations/prosecutions into the operations of Allcare Dental.

Neither Pennington nor Bates would comment following Monday's initial creditors hearing, during which they explained how Allcare operated but not how it failed.

Bates said that as president and the only shareholder of each Allcare office, he trained the dentists on denture fabrication, covered for them on days off and for several years after the company was incorporated in 2001 worked six days a week in the clinics.

Pennington ran the parent company, Allcare Dental Management Inc., which owned another entity, Allcare Dental Management LLC that provided advertising and staffing for the various locations, arranged leases and purchased equipment. The branch offices paid management fees to Allcare LLC, which were derived from patient fees, Pennington said.

The executives acknowledged that patients sometimes paid in advance for work. At the time of the closing, Allcare said it couldn't tell patients of the closing because its phone and computer service had been shut down.

The Morning Drill: December 13, 2011

Good Morning!

Medicaid fraud and the indictment of dentists/professional dental corporations for abusing the system have been increasing in the news lately. Today's first headline is just one example.

The Feds are taking an increasingly active role in prosecuting these cases. My advice to dentists is to tread lightly in these government programs. Should you not dot your I's and cross your T's, you could be confronted with a federal investigation into your financial affairs.

But, as far as those dentists who abuse the system and enrich themselves with our taxpayer money - hope you enjoy cuddling with your prison cell mate.

On to today's headlines:

Mass. dentist accused of $250K in Medicare fraud

SmileCenter, a dental office in Plymouth, MA, received at least $253,519 in unallowable reimbursements from MassHealth, the state's Medicaid program, according to the state auditor's office.

Most of the billing was for orthodontic services performed by a dentist who did not possess the required accreditation, State Auditor Suzanne Bump stated in a press release.

According to MassHealth regulations, dentists who practice orthodontics must complete a minimum of two years of training in a specialized program administered by the ADA.

SmileCenter's sole dentist, Christopher Freyermuth, DDS, who is also its sole proprietor, did not complete such a program, but still billed and received $201,509 from MassHealth for orthodontic services.

As a result of the investigation, MassHealth will terminate SmileCenter's specialty as an orthodontic practice, transfer its members for treatment to other dentists, and seek restitution, according to the state auditor.

The review of the $1.2 million SmileCenter received from MassHealth for dental services between 2007 and 2010 cited a pervasive pattern of excessive treatments, duplicative payments, and payments for services that were possibly never performed, officials said.

Dental X-rays predict fracture risk

A new study reveals that it is now possible to use dental X-rays to predict who is at risk of fractures.

Researchers at the University of Gothenburg's Sahlgrenska Academy reported in the journal Nature Reviews Endocrinology that it is possible to use dental X-rays to investigate the bone structure in the lower jaw, and so predict who is at greater risk of fractures in the future.

Lauren Lissner, a researcher at the Institute of Medicine at the Sahlgrenska Academy, said: 'We've seen that sparse bone structure in the lower jaw in mid-life is directly linked to the risk of fractures in other parts of the body, later in life.'

The study draws on data from the Prospective Population Study of Women in Gothenburg started in 1968.

Given that this has now been running for over 40 years, the material is 'globally unique'.

Teen dies after wisdom teeth surgery

Law enforcement is investigating after a 14-year-old boy died after having his wisdom teeth removed.

Ben Ellis underwent surgery Wednesday morning, and was found dead Thursday morning.

The Gilmer County Sheriff's Office and the Georgia Bureau of Investigation are looking into the cause of death.

Ben's family told the Sheriff's Office that he seemed fine on Wednesday after the surgery.

"He had dental surgery at approximately 10:30 Wednesday morning. Through the rest of the day he seemed to be doing fine. He went to bed. Through the day he had taken one penicillin tablet and one Oxycodone, that we're aware of. They (his parents) checked on him around 1 .a.m., and again, he was doing fine. Then at 6 a.m., when they went to get him up, they found him deceased," Lt. Frank Coleman said.

Ben was a freshman at Gilmer County High School and the youngest of four Ellis children to attend the school.

The school's bulletin board was covered with messages of condolence on Friday after students were notified of his death.

Hope for Hemophiliacs: Gene Therapy Stops the Bleeding

Hemophilia is a rare blood-clotting disease famously known for afflicting the royal families throughout Europe. One type, Hemophilia B, also called Christmas disease after Stephen Christmas, the first patient described with it, is caused by a defect in the eponymous gene on the X chromosome that leads to less than 1 percent of normal expression of Factor IX (FIX), an important blood clotting factor. Hence patients, who are usually male because they only have one X chromosome, require regular intravenous transfusions of Factor IX to prevent internal bleeding, or hemorrhage. These injections cost an individual patient about $300,000 a year, which may add up to around $20 million over a lifetime.

That may soon change due to a “landmark” study published this weekend in the New England Journal of Medicine. An international research team led by scientists at the University College London successfully used gene therapy (adeno-associated viral vectors) to replace the defective or missing copy of the FIX gene in a small cohort of patients, prompting the New York Times to write that Hemophilia B may be “the first well-known disease to appear treatable by gene therapy, a technique with a 20-year record of almost unbroken failure.” The viral vector used by the team inserted the replacement gene into the liver cells of the hemophiliac patients, carefully avoiding the chromosomes to reduce the risk of inducing cancerous mutations, and induced physiologically relevant expression of the coagulation factor up to 22 months post-therapy.

Enjoy your morning!

The Morning Drill: December 12, 2011

At the Los Angeles Auto Show a few weeks ago

Good Morning!

It is a rainy Monday here in Southern California today. Winter is arriving.

On to today's dentistry and health headlines.

Dentists to Receive Minor Surgery Training to Help Save NHS Money

Dentists in the Bolton area are to receive training in minor surgery, in a move that will save NHS Bolton around £1 million.

At the moment, patients are visiting hospitals for operations and procedures, which could be carried out by dentists and is contributing to huge hospital care bills. The cost of treating a patient in hospital is up to ten times higher than treating them in a health centre and health bosses have consequently decided to provide additional training for dentists so that they can provide surgery in the future.

Health bosses will provide training for dentists at a new centre. Procedures will include extractions and minor surgery and patients can also be referred to the centre by their dentists if they feel that they cannot carry out the operation themselves.

NHS Bolton has confirmed that the range of treatments available will constitute those that “can and should be done” by dentists at a dental surgery, rather than doctors in a hospital setting.

UCLA researchers identify new method for generating stem cell-like cells from human skin

Researchers from the UCLA School of Dentistry investigating how stem cells can be used to regenerate dental tissue have discovered a way to produce cells with stem cell–like characteristics from the most common type of human skin cell in the epidermis.

These skin cells, called keratinocytes, form the outermost layer of skin and can be cultured from discarded skin tissues or biopsy specimens.

The findings, published in the Nov. 4 edition of the peer-reviewed Journal of Biological Chemistry, may be beneficial for individuals with limited sources of endogenous stem cells.

What types of noncarious lesions are most often restored?

What types of noncarious lesions do dental practitioners most often choose to restore, and why?

That was the question addressed in a new study in the Journal of the American Dental Association (December 2011, Vol. 142:12, pp. 1368-1375).

Researchers from the University of Florida (UF) College of Dentistry in Gainesville analyzed data collected by a dental practice-based research network (DPBRN) over 30 months to quantify the reasons restorations are placed in noncarious lesions and assess the characteristics of the tooth, patient, and practitioner performing the restorations.

"The various types of NCTDs [noncarious tooth defects] can affect tooth sensitivity, dental plaque retention, structural integrity, and pulpal vitality, which also may be conditions that require placing a restoration," the researchers wrote. "Thus, the decision to restore NCTDs may be not only based on the need to replace lost tooth tissue, but also aimed at preventing further damage or based on aesthetic reasons."

GOP Bill Calls for 2-Year Medicare 'Doc Fix' With 1% Raise

House Republicans today unveiled a "doc fix" for the Medicare reimbursement crisis that would not only avert a 27.4% pay cut on January 1 but also raise rates by 1% annually through 2013.

The measure is part of an omnibus bill that would, among other things, extend unemployment benefits as well as a temporary cut in the Social Security payroll tax through 2012. House Republicans, who command a majority in that chamber, intend to vote on the bill next week. If passed, the bill faces Democratic opposition in the Senate, which that party controls, and a threatened veto from President Barack Obama.

Earlier this week, House Republicans were considering a doc fix that would merely freeze Medicare rates over 2 years. The Congressional Budget Office (CBO) had put its cost at $38.6 billion over 10 years.

The latest doc fix from the GOP is more generous, with a 1% raise in both 2012 and 2013. The CBO priced that at $38.9 billion.

The bill requires the Medicare Payment Advisory Commission, the Governmental Accountability Office, and the Department of Health and Human Services to help Congress devise a new way to set Medicare rates for physicians. The method used now — the sustainable growth rate (SGR) formula — is what triggered the 27.4% cut scheduled for 2012.

Organized medicine as well as the GOP Doctors Caucus, which consists of 21 physicians and other clinicians in the House, has lobbied hard for a permanent repeal of the SGR formula. Its cost — almost $300 billion for merely freezing rates through 2021 — appears too expensive for a budget-minded Congress to stomach right now, especially because fiscal conservatives insist that every increase in spending be offset elsewhere in the federal budget.

Enjoy your morning!

VizVocus Develops High Definition Camera that Attaches to Dental Loupes

VizVOCUS Portable HD Digital Camera Records Feline Thyroidectomy performed by Dr. Neal B. Neuman. The video is recorded from the view of the surgeon, Dr. Neuman of Montgomery Village Medical Hospital. The camera is fitted securely to his loupes

Finally a very portable and economical way to record procedures in High Def for teaching and documentation.

• HD Video Capture Digital Output create .AVI and .JPEG files
• Take up to 7.6MP Still Images in .JPEG format
• HD Video Recording in .AVI format
• Built-In Microphone
• Straight Digital Output – No conversion!
• USB 2.0 Connectivity to directly connect to your Laptop
• Plug-and-Play Technology
• Smallest digital camera: only 0.5 oz (14 grams) to mount on Loupes/Headlights

I think these folks are going to sell a bunch of these to dentists and with more sales, the prices will come down.

The Morning Drill: December 8, 2011

Las Vegas Strip during Las Vegas Half Marathon, December 4, 2011

Good Morning!

The above photo was taken by my wife, Alice, during our race this past Sunday.

On to today's dentistry and health headlines:

Md. dentist gets 2 years for $1.9M in unpaid taxes

A U.S. district judge in Baltimore has sentenced a dentist to two years in prison followed by three years of supervised release for failure to pay $1.9 million in employment taxes from 2001 to 2006.

Jay Hustead, DDS, DMD, will also have to perform 200 hours of community service, pay restitution of nearly $66,000, and enter a closing agreement with the Internal Revenue Service (IRS) to pay the full amount of taxes due.

Dr. Hustead's corporation, Hustead Dental and Orthodontics of Annapolis, employed several dentists, technicians, and office employees and had annual payrolls exceeding $1 million from 2001 to 2006. He was the company president and sole owner, and was responsible for the dental operations.

Susan Hustead, his wife, was responsible for business management, including working with company accountants on tax issues. She pleaded guilty for her role in the scheme and will be sentenced on December 14, 2011.

Hispanic Women More Likely to Die of Breast Cancer

Hispanic women have a 20 percent greater risk of dying from breast cancer than non-Hispanic white women, according to a new study.

Biological differences in the women's tumors could explain this discrepancy, the researchers suggested.

"This difference may be associated with a tumor phenotype that is less responsive to chemotherapy," Kathy Baumgartner, an epidemiology professor at the School of Public Health and Information Sciences at the University of Louisville, in Kentucky, said in a news release. "Increased awareness of this ethnic disparity is needed to improve survival in Hispanic women with breast cancer."

Researchers looked at breast-cancer risk in 692 Hispanic and non-Hispanic white women in New Mexico from 1992 to 1996. A separate study followed the 577 women with invasive breast cancer until 2008 to assess the differences in survival rates.

Hispanic women were roughly 20 percent more likely to die from breast cancer than non-Hispanic white women. However, Hispanic women's risk dropped to nearly the same rate as the other women after the researchers adjusted for age, progression of their disease, lymph node involvement and estrogen receptor. As a result, they suggested the ethnic difference in breast cancer mortality may be mostly "biologically based."

Researchers also found that Hispanic women who received chemotherapy were about 1.5 times more likely to die from breast cancer than non-Hispanic white women.

The research is slated to be presented Wednesday at the 2011 San Antonio Breast Cancer Symposium.

FDA Orders Safety Review of Pradaxa

The FDA said it will begin a safety review of reports of excess bleeding associated with dabigatran (Pradaxa), an oral direct thrombin inhibitor that is approved for prevention of stroke in patients with nonvalvular atrial fibrillation.

The FDA's announcement comes a month after post-marketing reports of about 50 cases of fatal bleeding worldwide surfaced.

The FDA said it wants to determine whether the reports of bleeding are occurring more commonly than would be expected.

In the RE-LY clinical trial, which compared two doses of dabigatran (150 mg bid and 110 mg bid) with warfarin in more than 18,000 patients, the bleeding rates between the two arms were similar.

When the FDA approved the drug in October 2010, it limited its approval to two doses: 150 mg bid and 75 mg bid, a decision that was immediately questioned because the 75 mg dose had never been tested in a clinical trial. Last spring, the New England Journal of Medicine published a commentary in which two FDA researchers involved in the approval decision explained the agency's reasoning, acknowledging a prevailing concern about the potential for excess bleeding.

Calls for national dental health scheme

The Federal Government is under growing pressure to set up a Medicare-style dental health scheme, following a report revealing the extent of Australia's dental health problems.

A study commissioned by the Brotherhood of St Laurence has found that millions of Australians can't afford to visit a dentist.

The study says the cost of dental care in Australia is costing the national economy more than $A1.3 billion in lost employment, and that at least one million work -days and at least 600,000 school-days are lost each year because of poor dental health.

Nicola Ballenden from the Brotherhood of St Laurence says the cost of poor dental health is borne by people at least able to afford it.

The Brotherhood is calling for urgent action to provide affordable dental care, and the introduction of a universal dental scheme.

"For disadvantaged people (a universal scheme) means cost isn't a barrier to care so they're not going to delay going to a dentists because of cost," Nicola Ballenden told SBS.

It's a proposal that has been backed by a government advisory group, the National Advisory Council on Dental Health.

The Greens have seen the group's confidential interim report. They say it recommends a major investment in dental health.

"It also says that the aim should be a universal scheme a scheme like Medicare so that essentially the mouth is treated like the rest of the body, so there's no good reason to separate the two," Greens Senator Richard Di Natale told SBS.

Enjoy your morning!

The Morning Drill: December 7, 2011

Santa Monica, California

Good Morning.

Getting a later start this morning here in California, so on to day's dentistry and health headlines:

La. Medicaid reimburses physicians for fluoride varnish

Effective December 1, the Louisiana Medicaid program is now reimbursing physicians for applying fluoride varnish twice each year to the teeth of Medicaid recipients between the ages of 6 months and 5 years.

Previously, Medicaid only covered this service when performed by a dental provider, according to the state Department of Health and Hospitals.

With the implementation of the updated fluoridation varnish policy, physicians, nurse practitioners, physician assistants, registered nurses, and licensed practical nurses will now be reimbursed for applying fluoride varnish.

Medicaid money runs out, and braces stay on

When you don't have much money, and receive medical and dental care at state expense, it's rare to complain.

Texas received only 712 complaints from Medicaid patients in the last year. But sometimes the quality of care becomes so questionable, patients speak up.

The case of a Garland girl points to some weaknesses in Medicaid Orthodontics, a program that's paid out hundreds of millions of dollars to Texas dentists in the last three years.
     
You can actually watch Anntornett Taylor grow up through her dental records, in the still photos taken of her when she visited her orthodontist.

Medicaid paid for her first set of braces when she was 12 years old. Now she is 21. She has had braces for nine years. And they are still on.
   
"It would be extremely unusual for a patient to be in braces for nine years," said Dr. Larry Tadlock, Associate Clinical Professor at Baylor College of Dentistry.

Prospect of new tax to cover expense of universal dental care

A DRAMATIC expansion in access to dental services, estimated to cost $9 billion over four years, has been proposed in a confidential report by a committee appointed by the government.

The report recommends that the Gillard government begin developing the first stages of a universal dental scheme next year with a view to scaling the scheme up in later years, taking account of the strains on the government's promise to deliver a surplus in the May budget.

The interim report, delivered recently to the government by the National Advisory Council on Dental Health, has called for priority to be given to ensuring dental treatment for young people and those on low incomes.
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It also raises the prospect that a new tax to fund a full-scale public dental scheme may be necessary, stating that ''other financing options may be required''.

The council, chaired by a former senior health official, Mary Murnane, is believed to have proposed a range of options including a mix of the existing state government and school dental schemes, the teen dental scheme and the present Medicare chronic disease dental scheme.

Three Ways an Athlete Can Prevent Dental Injuries During Sports

Broken teeth and various dental injuries can be common during sports, especially for an athlete that participates in contact sports. There are a lot of different ways that dental injuries can occur to an athlete, including if he or she gets hit in the mouth with a ball or hard object. Dental injuries can be very painful, cause a lot of internal problems, and can be very costly to fix.

Here are three ways that an athlete can prevent dental injuries during sports, which can help keep him or her safe and healthy.

• Always Wear a Mouthguard
• Use Helmets or a Faceguard
• Always Remove Retainers Prior To Playing Sports

Enjoy your morning/afternoon!

The Morning Drill: December 6, 2011

Good Morning!

I am back from the Las Vegas Half Marahton weekend and am happy to report a new personal record. A race report and recap will be over at Smilesforalifetime.com later in the day or tomorrow.

On to today's dentistry and health headlines:

Dental program takes root

Experts from throughout the dental hygiene field and child advocacy groups convened Wednesday at Fort Hays State University to discuss possible curriculum for a future mid-level dental care degree.

FHSU President Edward H. Hammond announced in October the school's intent to create a four-year dental care program pending the approval of a bill by the Legislature and approval by the Kansas Board of Regents.

Wednesday was a part of the information-gathering process.

"The whole purpose of the summit today is to answer a question for me, which is, 'What will this curriculum look like?' " Hammond said.

Bills in the Kansas House and Senate propose the creation of registered dental practitioners with the intent of providing more care to underserved areas of the state.

It is estimated 93 Kansas counties are experiencing a dental care shortage, and rural counties in western Kansas have particularly struggled with this problem. In October, it was estimated 17 counties in western Kansas do not have a dentist, while many other counties are in shortage areas.

"We are the only institution of the six state schools that is in the western third of the state," Hammond said. "We tend to be the institution that addresses the rural needs of the state of Kansas."

The proposal in the Legislature suggests mid-level providers should be able to provide some care dental hygienists cannot. Under the supervision of a licensed dentist, registered dental practitioners could perform 34 specific tasks, such as extracting primary teeth.

Registered dental practitioners would be based out of a dentist's office, but they also could leave the office to work in satellite locations.

Effectiveness of Systemic Amoxicillin/Metronidazole as an Adjunctive Therapy to Full-Mouth Scaling and Root Planing in the Treatment of Aggressive Periodontitis: A Systematic Review and Meta-Analysis

Fabrizio Sgolastra*, DDS; Ambra Petrucci*, DDS; Roberto Gatto*, MD; Annalisa Monaco*, DDS

*Department of Health Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy.
Correspondence: Dr. Fabrizio Sgolastra, School of Dentistry, Dental Clinic, University of L'Aquila, San Salvatore 1, Building Delta 6, 67100 L'Aquila, Italy, Phone: 0390862434816, Fax: 0390862434815 Italy, E-mail: fabrizio.sgolastra@gmail.com.

Background: The systemic use of combined amoxicillin and metronidazole (AMX/MET) as an adjunctive treatment to full-mouth scaling root planing (FMSRP) has been proposed for the treatment of generalized aggressive periodontitis (GAgP); however, its effectiveness and clinical safety remain to be defined. The purpose of the present meta-analysis was to assess the effectiveness of FMSRP + AMX/MET compared to FMSRP alone.

Methods: An electronic search of eight databases and a hand-search of ten international dental journals were conducted through September 11, 2011. Gain in clinical attachment level (CAL), reduction in probing depth (PD), secondary outcomes and adverse events were analyzed. A random-effect model was used to pool the extracted data. The weighted mean difference with 95% confidence interval (CI) was calculated for continuous outcomes, while risk difference (RD) with 95% CI was used for dichotomous data; heterogeneity was assessed with the Cochrane χ2 and I2 tests. The level of significance was set at p < 0.05.

Results: After the selection process, six randomized clinical trials were included. Results of the meta-analysis showed significant CAL gain (MD: 0.42; 95% CI: 0.23 -0.61; p < 0.05), PD reduction (MD: 0.58; 95% CI: 0.39-0.77; p < 0.05) in favor of FMSRP + AMX/MET; moreover, no significant RD was found in the occurrence of adverse events (RD: 0.01; 95% CI: -0.02-0.04, p > 0.05).

Conclusion: The findings of the meta-analysis seem to support the effectiveness and the clinical safety of FMSRP + AMX/MET; however, future studies are needed to confirm these results.

Worthington dentist indicted on 16 prescription counts

A Worthington dentist was indicted yesterday on 16 counts of illegally processing drug documents.

Mark S. Jerman, 45, is accused of writing prescriptions for hydrocodone pills to employees and friends who obtained the pills from pharmacies and delivered them to him, said Franklin County Prosecutor Ron O’Brien.

Hydrocodone is prescribed as a pain medication but also is a popular recreational drug.

Jerman, of 4630 Burbank Dr. in Upper Arlington, has a dental practice at 510 High St. in Worthington. He is among the “Top Dentists” listed in the current issue of Columbus Monthly magazine.

Dentist gets 6 months in jail

A Rotterdam dentist who admitted in October to groping several teenage patients in his office over the past few years was sentenced Monday to six months in jail.

Frank Izzo of Schenectady had pleaded guilty to two misdemeanor counts of sex abuse and agreed to surrender his license to practice and to register as a sex offender. He appeared Monday before Rotterdam Town Justice Kenneth Litz with his attorney, Stephen Coffey.

After the sentencing, Assistant District Attorney Jessica Lorusso said a court-mandated order of protection applies to the nearly dozen victims, ranging in age from 13 to 22, whom Izzo was accused of touching inappropriately. The sex abuse charges specifically relate to 14- and 17-year-old girls, the prosecutor said.

She previously said Izzo touched them on their breasts over their clothing as they sat in his dental chair and that the criminal investigation started when one of the victims told an employee.

Enjoy your morning!

The Morning Drill: December 1, 2011

Ministers will say that there have been no reported transmissions in Britain, despite more than 25 cases in the last 12 years where a patient has been exposed to an HIV-infected doctor Photo: ALAMY

Good Morning!

Today is World AIDS Day, as is every December 1.

On to today's dentistry and health headlines:

Doctors, dentists and health workers with HIV could work in NHS

The Department of Health has launched a consultation into the issue with a view to lifting the ban that has been in place for 20 years.

As reported in the Daily Telegraph last week, ministers fear a backlash from patients, but hope that those concerns can be allayed when presented with the facts about possible dangers.

Some countries already permit HIV positive doctors and dentist to work, but despite evidence that any risk is ‘negligible’ the UK still has tough restrictions in place.

The issue is certain to cause controversy. Three years ago a London doctor, Allan Reid, sparked a health scare after treating thousands of patients without telling them he was HIV-positive.

A current court case, in which a dentist with HIV is bringing an action against the Department of Health claiming the current ban is discriminatory and unlawful, also explains why ministers are considering the change. Because of the case, the possibility of a judicial review is hanging over the Government.

Ministers will say that there have been no reported transmissions in Britain, despite more than 25 cases in the last 12 years where a patient has been exposed to an HIV-infected doctor, dentist or other health worker. More than 10,000 patients have been tested.

A working group has recommended that those with HIV should be allowed to undertake “exposure prone procedures” provided they are taking antiretroviral drugs and are being monitored.

A document, seen by the Daily Telegraph, concludes that evidence built up over a number of years shows that the risk of transmission from an infected doctor or dentist to a patient is “extremely low for the for the most invasive clinical procedures such as major surgical operations.”

For less invasive procedures such as normal dentistry the risk is described as “negligible.”

Dentists grinning as demand for new smiles soars

IT WAS once the essential beauty feature for celebrities obsessed with appearance. But that dazzling white smile has moved beyond the Hollywood hills and into the Australian suburbs.

Dentists are reporting a boom in cosmetic dentistry as some surgeries experience a 60 per cent increase in demand.

Middle-aged women are partly driving the trend, using their later-in-life disposable income to fix stained and crooked teeth, with some procedures costing upwards of $15,000.

Dentist who dabbles in opera-singing says patients can't criticize her crooning: lawsuit

A Manhattan dentist who moonlights as an opera singer can’t stand her patients booing her online about her work, a lawsuit charges.

Dr. Stacy Makhnevich, who bills herself as “the Classical Singer Dentist of New York,” is being accused in a Manhattan Federal Court lawsuit of trying to muzzle her patients’ criticism — even before it’s made.

Former patient Robert Lee claims Makhnevich forced him to sign an agreement not to bash her online before she worked on his sore tooth, according to the suit, filed Tuesday.

Lee claims the crooning tooth doctor then hit a sour note when he accused her on the website Yelp of overbilling him by $4,000.

“Avoid at all cost!” his Yelp posting read. “Scamming their customers!”

He said Makhnevich accused him of breaching the “Mutual Agreement to Maintain Privacy” that he signed.

Lee, who has since moved to Maryland, said the dentist began billing him $100 a day for every day his negative Yelp posting remained online.

“I have to wonder what this dentist’s other patients have said to make her feel it was necessary to go to this extreme,” Lee said Wednesday.

Makhnevich — who just released a CD of arias titled “European Opera” — did not return calls left Wednesday at her offices on the 69th floor of the Chrysler Building.

Lee’s lawyer, Paul Levy of the consumer protection group Public Citizen, said the agreement that Makhnevich makes her patients sign violates their constitutional right to free speech and breaches dental ethics.

“This is using these contracts to suppress the other side and deprives the consumer of valuable information,” Levy told the Daily News.

Completing the Circuit to Curb Obesity

Obesity is the most significant chronic healthcare crisis facing the United States, as well as other countries. Already 1 out of every 3 adults, and 1 out of every 6 children or adolescents, in the U.S. is obese! Leptin is a hormone that has received considerable attention since its discovery in 1994 for its role in regulating metabolism (like a thermostat, or adipostat) and implications for obesity. High leptin levels are associated with feeling satiated and an active metabolism. Though many overweight people have high levels of circulating leptin, it’s been found that their hypothalamic neurons do not receive the signal – a phenomenon known as “leptin resistance.” An animal model that mirrors this is db/db mice, which lack leptin receptors on the surface of they hypothalamic neurons and are therefore morbidly obese...

Enjoy your morning!