The Morning Drill: May 23, 2012

Dentist Dr. Robert Edgar Stark

Good Wednesday morning!

On to today's dentistry and health headlines:

Upstate dentist accused of threatening woman, saying he'd 'cut her like a fish'

An Upstate dentist has been charged with unlawful communications after being accused of telling a woman that he wanted to put a bullet in her head and “cut her like a fish,” according to an arrest warrant.

Robert Edgar Stark, 64, of 6208 Yellow Jasmine Drive, Simpsonville, also is charged with resisting arrest, simple possession of marijuana and possession of drug paraphernalia, according to a written statement from the Greenville County Sheriff’s Office.

According to the warrant, the incident occurred Sunday, and Stark also is accused of threatening to burn down the woman’s house.

About 4 p.m. Sunday, deputies went to Stark’s home to arrest him on the unlawful communication charge, and authorities said he became “very argumentative,” refusing to place his hands behind his back. When deputies escorted Stark to retrieve some pants for him to wear to jail, they found a homemade tinfoil smoking device that contained a small amount of marijuana, according to the statement from the sheriff’s office.

Bob Mihalic, governmental affairs coordinator for Greenville County, confirmed Stark performed dental work on a contract basis for that county’s detention center. That contract, he said, is under review.

Film industry offers umbrella license to pediatric dentists

The Motion Picture Licensing Corporation (MPLC), an independent copyright licensing agency, is introducing an umbrella license for pediatric dentists that will allow them to show movies and children's programming in their practices in a compliant manner.

The American Academy of Pediatric Dentistry (AAPD) is among the first to partner with MPLC to offer this license to its members. Through their agreement, AAPD members can obtain the umbrella license at a discounted rate, the academy noted in a press release.

Once a license is secured, pediatric dentist office administrators can rent or purchase movies and play them in their exams or waiting rooms without any further reporting.

Gov. Hickenlooper signs dental assistance bill at Murphy Center

Colorado’s senior citizens have something to smile about.

Gov. John Hickenlooper stopped by the Sister Mary Alice Murphy Center for Hope in Fort Collins on Tuesday morning to sign into law a bill that will provide dental care assistance for Colorado residents age 60 and older.

House Bill 12-1326, sponsored by Rep. John Kefalas, D-Fort Collins, will provide funding for dentures, partials, extractions, fillings and cleanings for Colorado residents who qualify for dental assistance.

“There’s a lot of research that shows we could reduce health-care costs by providing better dental care,” said Eileen Doherty, executive director of the Colorado Gerontological Society.

Prudential Dental Insurance Goes National

Prudential Financial, Inc.'s (NYSE:PRU) Group Insurance business is now offering Dental Insurance in all 50 states. With the expanded offerings of three networks, each with different strengths and regional presence, employees have access to 190,000 provider locations for their dental care, allowing them to choose the dental provider that best meets their particular needs.

"Employees consistently rank dental coverage as one of their most valued benefits," said John Rice, vice president, Product Management for Prudential Dental. "We're very proud of our ability to bring dental coverage at an affordable price to small businesses throughout the country. Prudential Dental is an especially good fit for small businesses when bundled with our other products -- life, disability, and long term care insurance. In fact, more than 30% of our dental clients have already bundled their plans with our life and disability products, to provide their employees with a compelling and competitive benefits package."

With both PPO and Indemnity Plans, Prudential Dental is supported by the nationwide provider networks of DenteMax, CAREington and CONNECTION Dental, along with the 4Most Network in West Virginia and surrounding areas. The CONNECTION Dental Network was added to the Prudential Dental product on May 1.

Enjoy your morning!

The Morning Drill: May 22, 2012

Good Tuesday morning!

On to today's dentistry and health headlines:

Allcare Dental president surrenders NH license

Allcare Dental president Robert Bates, DDS, has surrendered his dental license to resolve allegations of professional misconduct by the New Hampshire Board of Dental Examiners, New Hampshire Attorney General Michael A. Delaney announced in a press release.

Allcare closed all of its dental offices in 13 states, including two in New Hampshire, in January 2011. Patients arriving for appointments found a note on the door informing them that the offices were closed. Allcare has since filed for Chapter 7 bankruptcy protection in U.S. Bankruptcy Court in Buffalo, NY, according to the release.

After Allcare closed, the New Hampshire Department of Justice and the state dental board received more than 143 complaints from patients claiming to have had their dental treatment discontinued, according to the New Hampshire Attorney General's office. Many patients had had their teeth extracted and were waiting for permanent dentures that they never received, and many of these patients had pre-paid for dental care that they did not receive.

PSA test for prostate cancer should be dropped, task force says

The PSA test should be abandoned as a prostate cancer screening tool, a government advisory panel has concluded after determining that the side effects from needless biopsies and treatments hurt many more men than are potentially helped by early detection of cancers.

At best, one life will be saved for every 1,000 men screened over a 10-year period, according to the U.S. Preventive Services Task Force. But 100 to 120 men will have suspicious results when there is no cancer, triggering biopsies that can carry complications such as pain, fever, bleeding, infection and hospitalization.

And if cancer is detected, 90% of men will be treated with surgery or radiation even though most tumors are not life-threatening.

Of 1,000 screened men, as many as 40 will suffer impotence or urinary incontinence as a side effect of treatment, two will have heart attacks or strokes and one will develop a dangerous blood clot in the legs or lungs, the task force concluded after a review of the scientific literature. As many as five of 1,000 men who undergo surgery will die within a month.

"There is a small potential benefit and a significant known harm," said Dr. Virginia A. Moyer, a professor of pediatrics at Baylor College of Medicine in Houston, chairwoman of the task force. The PSA test, she said, "should not be part of your checkup.

"Instead, men who want to protect their health should talk with their doctors about prostate-related problems, such as issues with urinary flow, said task force member Dr. Michael LeFevre of the University of Missouri in Columbia. The digital rectal exam is also an option, he added, although there is not much support for that exam either.

Mission of Mercy dental care truly was one to hundreds

With the still-struggling economy, cuts in social welfare, hikes in college tuition and an increasingly divisive society, it's hard to find something to smile about.

But there were plenty of smiles Friday and Saturday as about 1,650 people received about $1.2 million worth of free dental services at Modesto Centre Plaza.

The first Mission of Mercy clinic in the state drew patients from as far as Oregon, and more than 240 oral surgeons and dentists from Stanislaus County as well as Carmel Valley, Long Beach and other areas throughout the state. More than 1,000 volunteers and 70 sponsors helped, too.

The huge public service event was a collaboration of the Stanislaus Dental Society, the California Dental Association Foundation and the America's Dentists Care Foundation, based in Kansas. The day started with X-rays and led to 7,200 procedures, including fillings, infection care, decayed tooth removals, even one-step dentures.

Many patients said they could not get regular dental care because of layoffs and cutbacks in Medi-Cal funding. Dr. Andy Soderstrom of Modesto, who spearheaded the day, said some patients were desperate for dental treatment.

The need was so great that by 4 a.m. Friday, the line stretched around the convention center.

Charity 'Tooth Taxi' fights decay in Oregon kids

Oregon children have one of the highest rates of dental problems in the nation. But a unique clinic is trying to change that.

From the outside, the Tooth Taxi looks kind of like a tour bus. But step inside, you'll find a state-of-the-art dental office on wheels.

“We are a dental clinic that provides free care and oral health education to under-served children all over state of Oregon,” said Charlie LaTourette, executive director of the Dental Foundation of Oregon.

On Monday, the Tooth Taxi stopped at Rigler Elementary School in Northeast Portland.

Students jumped on-board and got a full dental exam complete with X-rays. Some of the kids had only been the dentist one or two times before.

“Some have never been to the dentist, so everything is new, so we take the time to explain what we are doing, “ said Dr. Jennifer McLeod, the staff dentist on-board.

More than 50 percent of Oregon children suffer from tooth decay. Experts point to a shortage of dental professionals and poor nutrition as causes, but say poverty is the number one reason.

Many parents simply can't afford to take their kids to the dentist and that leads to more than just cavities.

“Untreated dental decay is the leading cause of absenteeism and the leading cause of not being able to focus ... not being able to do homework,” said Cassandra Griffin, with Upstream Public Health.

Enjoy your morning!

The Morning Drill: May 21, 2012

From Dr. Sherri Worth's website

Good Monday moring!

I am recovering from yesterday's Pasadena Half Marathon, but here are today's dentistry and health headlines:

'Dentist to stars' pays $641K in malpractice lawsuit

A prominent cosmetic dentist in California whose ads boast of treating movie stars and sports celebrities has paid a $641,542 award in a malpractice lawsuit, one of six such lawsuits filed against her in nine years.

Newport Beach dentist Sherri Worth, DDS, paid the award following an arbitrator's finding that she did excessive preparation of 22 teeth, plus laser surgery, during a two-hour and 40-minute procedure on March, 5, 2009. As a result, the patient, Ingrid Valdez, suffered irreversible pulpitis and nerve damage which required several root canals.

"She went too fast and too deep and removed too much gum tissue without removing bone, which is needed to treat a 'gummy smile' for a crown lengthening procedure," Valdez's attorney, Edwin Zinman, DDS, a San Francisco attorney who specializes in dental law, told DrBicuspid.com. "She should have referred her to a periodontist before doing the prep work."

Several dentists testified in hearings that Dr. Worth had violated the biologic width of Valdez's gums during laser surgery and did overcontoured restorations that resulted in gross malocclusions that could not be corrected by adjustment. They also testified that Dr. Worth's dental work needed to be removed, the crowns lengthened, and new restorations placed.

The award was one of the largest decisions involving crowns, veneers, and bridges, according to Dr. Zinman.

iPhone records doctor's questionable behavior

The sound of a dentist's drill can make even the toughest patients panic. But for one Valley man, it wasn't the drill that worried him. It's what was said during his dental procedure.

"I had told him I was very uncomfortable going under general anesthesia," said Donovan Cade, who was scheduled to have his wisdom teeth pulled. "He convinced me to anyway during our consultation." 

Both Cade and the dentist, Dr. Brown Harris, will tell you they got off to a rough start after an initial consultation turned into a heated billing dispute. So Harris offered to perform the surgery at a steep discount. Cade booked it and then did something that many of us might not even think of.

"I went ahead and turned on the voice recorder on my phone and left it on the table next to the chair," said Cade.

It's a simple action, taken in a moment of vulnerability, that would capture something unthinkable.

"I know everybody wants to write Dick on his forehead," said a male voice that can be heard on Cade's iPhone recording. He says the voice is that of Dr. Harris, who can then be heard saying, "But I'll just have to sit back and think I could and I chose not to, thus I feel better."

Cade can be heard in the recording multiple times saying, "Ow Ow Ow."

At one point the person identified as Harris asks, "You want to do another shot?" Someone else responds, "Eh, I don't care."

Several people are heard laughing before the man believed to be Harris says, "Well, I tell you this much. I don't think I would go back to a place where I was so mean to just in case they decide to give me a tattoo."

Cade says the entire 28-minute procedure was recorded on his iPhone.

"It had a pretty big impact on me," said Cade. "I was as anybody would be when you find yourself mistreated, when you were completely vulnerable in somebody's care."

State-regulated professionals urge court reversal of FTC order

The Federal Trade Commission lacks jurisdiction over the North Carolina State Board of Dental Examiners, the ADA and associations of state-regulated health care professionals and state dental and medical boards contend in a brief filed May 17 with the U.S. Court of Appeals for the Fourth Circuit.

The eight organization friend of the court brief urges the court to reverse an FTC final order against the North Carolina board. The FTC administrative ruling has drawn congressional and judicial attention.

“Each amicus (interested party) supports the determination by the states that the health professions should be regulated by knowledgeable health care professionals who have practical experience in the profession they are regulating,” says the brief filed on behalf of the American Dental Association, American Osteopathic Association, American Veterinary Medical Association, American Academy of Pediatric Dentistry, American Academy of Periodontology, American Association of Orthodontists and the American Association of Dental Boards and Federation of State Medical Boards.

“Each has a direct interest in assuring that state regulatory boards are able to discharge their statutory responsibilities with accountability to the state legislatures that created them – without intervention and second guessing by the Federal Trade Commission, a federal agency that lacks jurisdiction over these boards, that has no particular expertise in the professions regulated by these boards, and that, by misapplying the federal antitrust laws, seeks to substitute its concept of the public interest for the position taken by the board charged by the state legislature with determining what is in the public interest in the area of its regulatory authority.”

Dr. Ron Goodlin, of Aurora, Ontario, is the new president of the American Academy of Cosmetic Dentistry.

Dr. Ron Goodlin of Aurora, Ontario, took the helm as president of the American Academy of Cosmetic Dentistry (AACD) during the AACD’s 28th Annual Scientific Session in Washington, DC, May 2-5.

Dr. Goodlin is an Accredited member of the AACD and has been involved in the organization since 1997.

Dr. Goodlin practices dentistry at Smiles Dental, located in Aurora, Ontario. In his free time, he is an amateur photographer and is working to open a dental clinic in Tanzania. His objective is to encourage dentists from Canada, the U.S., and Europe to spend a day or two at the clinic as they pass through Tanzania during safari vacations, as well as create an opportunity for dental students to visit and do some work there.

“I am so excited about the upcoming year as president of the Academy,” Goodlin said.
“Together, all of us at the Academy will make a great team and I know we will accomplish a lot and have fun doing it!”

In addition to his work at AACD, he is currently the president of the Toronto Academy of Cosmetic Dentistry, is a co-founder of the Canadian Academy of Cosmetic Dentistry, and served as the Editor of the Canadian Journal of Cosmetic Dentistry from 2000-2008. He remains the Associate Editor and is on the editorial boards of both Spectrum and Teamwork dental journals. He graduated from the University of Toronto Faculty of Dentistry in 1980.

Enjoy your morning!

The Morning Drill: May 17, 2012

Photo courtesy of Raven Maria Blanco Foundation

Good Thursday morning!

On to today's dentistry and health headlines:

Drugmaker discontinues pediatric oral sedative

Pharmaceutical Associates, a South Carolina-based drug manufacturer, has discontinued production of chloral hydrate oral solution, an anesthetic used in pediatric dentistry. The company cited "business reasons" as the source of the decision, which came in March.

I think it's probably going to have a fairly wide impact," Stephen Wilson, DMD, PhD, professor and director of the Division of Pediatric Dentistry at Cincinnati Children's Hospital Medical Center, said in an interview with DrBicuspid.com. "I talked to a couple of colleagues who use it, and they're not quite sure what they're going to do to substitute it with a different drug or combination of drugs. That is the case with us, as well."

A bulletin from the American Society of Health System Pharmacists (ASHP) noted there are no other manufacturers of the oral solution form of the drug. However, 500-mg capsules or powder forms that can be used to create a solution are still available, according to Dr. Wilson.

But its use in dentistry has not been without controversy, and there are mixed opinions about its usefulness.

"Quite frankly, I'm surprised the manufacturer didn't discontinue it sooner," John Liu, DDS, immediate past president of the American Academy of Pediatric Dentistry, told DrBicuspid.com. "There were issues and questions about its effectiveness and safety that I could clearly see in some of the patients I treated with chloral hydrate that concerned me enough that I stopped using it in the late 1980s."

The University of Florida discontinued its use after the death of a five-year-old boy in 2010 who had been sedated with the drug. Dylan Shane Stewart went into cardiac arrest during a procedure to have four fillings and eight crowns placed. The amount administered was reportedly "far more" than the recommended dosage, causing a toxic reaction. While the drug is safe and effective if the exact dosage is used, some experts say it can be "unforgiving" if too much is used.

Former Helena dentist on probation with dentistry board

A 45-year-old dentist charged inHelenafor a sex crime is now on probation with the state Board of Dentistry for not being forthcoming on his renewal about the charge and for being convicted of a charge involving violence.

Jason James Roan, who currently lives inBillings, initially charged with sexual intercourse without consent, entered an Alford plea on a lesser charge of felony criminal endangerment. Roan received a three-year deferred sentence after admitting to creating a substantial risk of serious bodily injury to his victim.

After the charges were filed in April 2010, Roan renewed his dentistry license. On the paperwork, he answered no to a question asking if any legal or disciplinary actions had been instituted against him since his last renewal, according to documents released by the Board of Dentistry on Wednesday.

The board ordered Roan’s license be placed on probation for three years with quarterly updates from his state probation officer, employment-supervising dentist and psychotherapist. He also was fined $4,000 and must be supervised while working.

Sports dentistry symposium to focus on female athletes

For the first time in its 30-year history, the Academy for Sports Dentistry Annual Symposium will offer continuing education that focuses on female athletes as ASD celebrates the 40th anniversary of Title IX.

The special track at the meeting, to convene June 21-23 at the Minneapolis Marriott City Center, will include the courses Girls & Women in Sport: Key Issues 40 Years After Title IX; Women in Sport–From Title IX to 2012; Treating the Female Athlete; Body Image Sports/Eating Disorders; and The Female Athlete Triad and Energy Deficiency. Title IX of the Education Amendments of 1972 protects people from discrimination based on sex in education programs and activities that receive federal financial assistance.

“Saturday, June 23 is the 40th anniversary of Title IX and the ASD is proud to recognize the occasion by discussing the issues affecting treatment for the female athlete,” said Dr. Paul Nativi, ASD president. “Drs. Nicole Lavoi, Joel Boyd, Jillian Lampert and William Roberts will present various topics unique to the female athlete. Women athletes make up an increasing percentage of the athletes we see, making this a very appropriate topic.”

DenMat officially announces move to Lompoc

DenMat Holdings LLC, a dental products provider and major employer with plans to grow, announced Wednesday that it will vacate its facilities in Santa Maria and relocate its 350 employees to Lompoc.

The move by DenMat, which as been talked about behind the scenes for several months, will begin in June and take place over six months, according to Steve Semmelmayer, chief executive officer of DenMat.

“Our current and future space needs dictate a move to a facility where we can consolidate operations under one roof as well as provide room for expansion,” Semmelmayer said in a prepared statement.

DenMat, which also provides laboratory services to dentists in more than 68 countries, will be moving to 1017 W. Central Ave. in Lompoc. The building is now occupied by Central Plastics, Inc., a supplier for DenMat, which is expected to eventually relocate to another building in Lompoc, according to city officials.

Lompoc Mayor John Linn, who was out of town Wednesday but in touch with city hall, said the DenMat announcement is important news for Lompoc.

“This is the largest single-employer gain since the Space Shuttle,” Linn said, referring to the aerospace industry expansion in the 1980s. “It’s going to put a bunch of folks in Lompoc every day.”

Although few if any new hires will occur in Lompoc, DenMat’s expansion plans bode well for the city’s future, Linn said.

Enjoy your morning!

The Morning Drill: May 15, 2012

Diaco Dental Chair

Good Tuesday morning!

On to today's dentistry and health headlines:

Dental chairs developed for large patients

The dental school at the University of Texas Health Science Center, San Antonio is using a new line of dental chairs for large patients who have difficulty fitting into conventional dental chairs.

The school has installed a special chair designed to tilt, raise, or lower dental patients weighing up to 1,000 pounds, according to a story in the San Antonio Express-News.

The chair, built by Diaco Dental, cost $30,000, compared to about $10,000 for a standard chair.

Brownback signs bill to help fill Kansas dentist shortage

Gov. Sam Brownback has signed into law a bill that's intended to help the state cope with a dentist shortage but critics say doesn't go far enough.

Brownback signed a law the expands the ability of dental hygienists to deal with tooth decay to help deal with the fact that 93 Kansas counties don't have enough dentists to serve their residents and 13 others don't even have a dentist.

The bill is a much scaled down approach compared to another proposal that would have created a midlevel provider called a registered dental therapist who could perform some of the duties now handled by dentists, including filling cavities and pulling teeth.

Other states have considered similar bills, but only Alaska and Minnesota have comparable laws.

But the Legislature coalesced around the bill supported by dental industry, which feared that the other proposal would put dental patients at risk by giving hygienists the ability to provide types of oral treatment best left to dentists.

Actor Michael Douglas Partners With Oral Cancer Foundation For Early Detection PSA Campaign

Two-time Oscar Winner and Cancer Survivor Encourages Regular Screenings as Counter to Rising Incidence Rates of Oral Cancer-

Actor and producer Michael Douglas has donated his time to help create a television public service announcement (PSA) on behalf of the Oral Cancer Foundation (OCF), a non-profit organization dedicated to helping those affected by the disease. The PSA will support the Foundation's efforts to educate the public about the need for annual screenings to catch oral cancers in their early, most survivable stages. The public service announcement will begin airing in June, and will continue to air nationwide through summer and autumn.

Approximately 40,000 people in the US will be newly diagnosed with oral cancer in 2012. This includes those cancers that occur in the mouth itself, in the very back of the mouth known as the oropharynx, and on the exterior lip of the mouth. There are two distinct pathways by which most people come to oral cancer. One is through the use of tobacco and alcohol, and the other is through exposure to the HPV-16 virus (human papilloma virus version 16), a newly identified etiology, and the same virus which is responsible for the vast majority of cervical cancers in women. While oral cancer has historically been linked to tobacco and alcohol use, this is not simply a smoker's disease any longer. New data shows that the fastest-growing segment of newly diagnosed cases is now young, non-smokers. Most startling, is the fact that while many other cancers have been in decline in recent years, the occurrence of oral / oropharyngeal cancers has increased each of the last six years, and peer reviewed published data shows that the numbers of HPV-related oral cancers will surpass cervical cancers in the near future.

Odd law blocks dental professionals from treating spouses

Dental professionals in Ontario, Canada, hope a review by the province's health minister and a recently tabled bill will correct a problem they call "ridiculous" and "offensive."

Based on current law, a dentist, dental hygienist, or other healthcare professional in Ontario who treats his or her spouse has committed sexual abuse and can be immediately barred from practicing for at least five years without the possibility of an appeal.

In April 2011 the province's health minister commissioned a report on the issue; that report is expected to be completed by June 1. And last month a member of the Ontario parliament introduced a bill focused on dentists that calls for the law to be changed so they can provide treatment to their spouses without fear of punishment.

Enjoy your morning!

All Smiles Dental Files for Bankruptcy

You remember the story on Texas Orthodontic Medicaid fraud investigations.

Now, one of the dental corporations involved, All Smiles Dental, has filed for bankruptcy protection.

All Smiles Dental Center has filed for bankruptcy.

But even today, at least one of its clinics is still advertising "Frenos Gratis Con Medicaid," or free braces with Medicaid, flaunting state regulations which were never supposed to routinely provide free braces.

For the past several months, the chain has been shrinking. From dozens of clinics a year ago, to a handful now. One high-volume clinic on Garland Road in Dallas has closed.

In Chapter 11 filings, All Smiles lists $50-100 million in liabilities, and $1-10 million in assets.

Founder Dr. Richard Malouf is listed as owning 28 percent of the company, while Valor Equity of Chicago owns the remaining 72 percent.

At one point, All Smiles billed as much for Medicaid braces as the entire State of Illinois.

Founder Malouf flaunted two corporate jets, a Bentley in the garage and a Porsche Carerra in his driveway.

And the driveway is connected to a mansion that is a counter to any argument that says a dentist can't make money under Medicaid. The French chateau, listed on tax rolls at $11 million, is nestled among Dallas' most ostentatious properties on Strait Lane.

The mansion is untouchable in the bankruptcy.

In March, Malouf agreed to settle a Medicaid billing case for $1.2 million. The federal government charged him with fraudulent Medicaid billing for four years, ending in 2007, before his biggest billings for Medicaid braces. In settling the case, he admitted no wrongdoing.

And, who gets left holding the bag?

Well, American taxpayers that is who.

Can you imagine what will happen if the United States Supreme Court holds the Affordable Care Act (ObamaCare) as constitutional and the Feds take over the entire medical system?

Here is the video investigation:

The Morning Drill: May 10, 2012

Dr. Bruce Fisher - charges dropped

Good Thursday morning!

On to today's dentistry and health headlines:

Charges against Lewes dentist dropped

Delaware Department of Justice has dropped its offensive touching case against Lewes dentist Dr. Bruce Fisher in Sussex County Family Court.

Jason Miller, spokesman for the Department of Justice, said the charges were dropped because of insufficient evidence before trial. He said the department had no further comment at this time.

Fisher, 44, was arrested March 9 after he allegedly covered the mouth of an 8-year old and told him to shut up. Police said the child was at Fisher’s First State Oral Surgery for a medical procedure and began screaming after the procedure was finished. A family member was in the room and reported Fisher to Delaware State Police.

Cavity-fighting measure sinks along with civil unions

A bill aimed at thwarting cavities in babies became collateral damage in the fight over civil unions in Colorado late Tuesday night.

Senate Bill 12-108 had sailed through earlier hearings and was expected to pass in the House on Tuesday night, then be up for final approval today.

But the bill died along with nearly three dozen other measures that were held hostage during the civil unions standoff.

SB 108 would have provided funding for dental benefits for pregnant moms on Medicaid. Research has shown that mothers who have tooth decay and untreated cavities can pass bacteria to their babies, thus infecting their teeth and causing some babies and toddlers to lose all their baby teeth before age 3. Poor dental health of mothers also has been associated with premature birth, another highly expensive health problem.

Numerous dental experts from Children’s Hospital Colorado and the Colorado Dental Association had worked with advocates for low-income patients and members of the legislature’s Joint Budget Committee to find funding to help pregnant mothers take better care of their teeth.

“We are disappointed,” said Dr. Ulrich Klein, a doctor of dentistry at Children’s Hospital and chair of the pediatric dentistry at the University of Colorado School of Dental Medicine. “We have been fighting this battle for so long.”

New Cautions About Long-Term Use of Bone Drugs

In an unusual move that may prompt millions of women to rethink their use of popular bone-building drugs, the Food and Drug Administration published an analysis that suggested caution about long-term use of the drugs, but fell short of issuing specific recommendations.

The F.D.A. review, published in The New England Journal of Medicine online on Wednesday, was prompted by a growing debate over how long women should continue using the drugs, known as bisphosphonates, which are sold as generic versions of brands like Fosamax and Boniva, as well as Novartis’s Reclast.

The concern is that after years of use, the drugs may in rare cases actually lead to weaker bones in certain women, contributing to “rare but serious adverse events,” including unusual femur fractures, esophageal cancer and osteonecrosis of the jaw, a painful and disfiguring crumbling of the jaw bone.

Although the concerns about the long-term safety of bone drugs are not new, the F.D.A. performed its own systematic review of the effectiveness of bisphosphonates after years of use. The agency’s analysis, which found little if any benefit from the drugs after three to five years of use, may prompt doctors around the country to rethink how they prescribe them.

Scientists Identify Neurotranmitters That Lead to Forgetting

While we often think of memory as a way of preserving the essential idea of who we are, little thought is given to the importance of forgetting to our wellbeing, whether what we forget belongs in the "horrible memories department" or just reflects the minutia of day-to-day living.

Despite the fact that forgetting is normal, exactly how we forget -- the molecular, cellular, and brain circuit mechanisms underlying the process -- is poorly understood.

Now, in a study that appears in the May 10, 2012 issue of the journal Neuron, scientists from the Florida campus of The Scripps Research Institute have pinpointed a mechanism that is essential for forming memories in the first place and, as it turns out, is equally essential for eliminating them after memories have formed.

"This study focuses on the molecular biology of active forgetting," said Ron Davis, chair of the Scripps Research Department of Neuroscience who led the project. "Until now, the basic thought has been that forgetting is mostly a passive process. Our findings make clear that forgetting is an active process that is probably regulated."

Enjoy your morning!

The Morning Drill: May 9, 2012

Good Wednesday morning!

I was traveling yesterday for my locum tenens dentistry practice and did not have a chance to post. But, here we go for today.

On to today's dentistry and health headlines:

Story of vengeful jilted dentist WAS too good to be true

A hugely popular news story about a jilted dentist accused of pulling out all her ex-boyfriend's teeth has unraveled as a hoax.

News websites around the world ran the story last week about a woman in Poland named Anna Maćkowiak who took revenge on a man named Marek Olszewski when he turned up at her clinic complaining of toothache, days after dumping her for another woman.

Among the numerous U.S. news sites that picked up the story were Fox News, the Los Angeles Times, the San Francisco Chronicle, Huffington Post, Yahoo! News, MSN, the New York Post, and The New York Daily News. (Msnbc.com is a joint venture of Microsoft, which operates MSN, and Comcast.)
The story even included quotes from the scorned dentist and her toothless ex.

"I tried to be professional and detach myself from my emotions. But when I saw him lying there I just thought, "What a b******," Maćkowiak was quoted as saying.

Quotes attributed to the boyfriend victim meanwhile read: "I knew something was wrong because when I woke up I couldn’t feel any teeth ... When I got home I looked in the mirror and couldn't f******* believe it. The b**** had emptied my mouth."

From secret service to dentist

At 42, age isn’t the only thing non-traditional about Cat Guerrero, a fourth-year dental student at ASDOH. Named by her father after the 1965 movie, “Cat Ballou,” Guerrero decided on dentistry after having two other successful occupations.

Guerrero’s career began in administration with the United States Secret Service where she worked more than five years. She completed background checks, worked in the counterfeiting division, and was also responsible for special details with foreign dignitaries. She even worked a detail for President George H.W. Bush.

It was while working with the Secret Service that the idea of becoming a dentist first occurred to her.

“I was discussing my career with an agent that I knew,” says Guerrero. “At the time, I was taking classes at the Maryland Institute of Art, thinking that I could one day work for Disney doing animation. When the agent said his wife was a dentist, I was impressed. It was the 80s, and women’s career opportunities were limited – mostly clerical jobs or grocery shop clerks.”

After moving to Arizona in 1992, Guerrero found a second career at a large computer distributing company where she configured network systems. But she soon decided that the corporate world was wearing thin.

“I wanted to spend more quality time with my family and be more involved with them,” she says. “I was tired of 60-hour work weeks.”

The thought of becoming a dentist still echoed in her mind. At age 32, Guerrero volunteered at the Central Arizona Shelter Services (CASS) Dental Clinic in Phoenix where she met students from ASDOH.

Dentists 'inventing work to defraud NHS'

Dental surgeries are exaggerating or inventing work they have done for the National Health Service in order to swindle tens of millions of pounds out of taxpayers, according to a check up of dentists’ honesty.

Among the rogue practices were submitting false claims for more treatment than had been carried out and submitting claims on behalf of patients do not exist.

Claims for ‘ghost patients’ were the most blatant in a catalogue of illegal practices uncovered by an audit of 5,000 dentists’ invoices examined by NHS Protect, the anti-fraud unit of the health service.

Overall, 3 per cent of claims examined were deemed to be fraudulent, indicating that dishonest dentists defrauded the NHS out of £73.1m in 2009-2010, when the check was made. By 2014, the NHS could lose a further £146.3m unless the deception was halted, the report, Dental Contractor Loss Analysis Exercise, published today.

The Conservatives claimed the losses exposed in the report stemmed from a new NHS contract introduced by Labour in 2006. Labour blamed the dentists for swindling the taxpayer and called for tougher action from regulators.

Under the new dentistry contracts introduced by Tony Blair, dentists were paid by three broad bands of work rather than for each procedure on a long and complex list.

42% of American adults will be obese by 2030, study says

The ranks of obese Americans are expected to swell even further in the coming years, rising from 36% of the adult population today to 42% by 2030, experts said Monday.

Kicking off a government-led conference on the public health ramifications of all those expanding waistlines, the authors of a new report estimated that the cost of treating those additional obese people for diabetes, heart disease and other medical conditions would add up to nearly $550 billion over the next two decades.

The sobering projections also contained some good news, the researchers said: Obesity's growth has slowed from the record pace of most of the last 30 years. If those trends were to continue, 51% of American adults would qualify as obese in 2030.

Study leader Eric Finkelstein, a health economist at Duke University in Durham, N.C., said it was unclear whether growth had slowed thanks to public policy initiatives aimed at preventing childhood obesity, greater societal awareness of obesity's health risks, or because Americans have hit the maximum level of fatness a population can sustain.

Enjoy your morning!

The Morning Drill: May 7, 2012

Centuries ago, dental calculus would build up through the years, layer after layer, like a stalagmite, sometimes reaching impressive proportions. University of Nevada, Reno researchers have discovered that analysis of tiny fragments of this material can be used effectively in paleodietary research – the study of diets of earlier ancient and populations – without the need to destroy bone, as other methods do

Good Monday morning!

On to today's dentistry and health headlines:

Anthropologists Discover New Research Use for Dental Plaque: Examining Diets of Ancient Peoples

While we may brush and floss tirelessly and our dentists may regularly scrape and pick at our teeth to minimize the formation of plaque known as tartar or dental calculus, anthropologists may be rejoicing at the fact that past civilizations were not so careful with their dental hygiene.

University of Nevada, Reno researchers G. Richard Scott and Simon R. Poulson discovered that very small particles of plaque removed from the teeth of ancient populations may provide good clues about their diets. Scott is chair and associate professor of anthropology in the College of Liberal Arts. Poulson is research professor of geological sciences in the Mackay School of Earth Sciences and Engineering.

Nothing to Smile About

MacKenzie Doolittle, 9, isn’t afraid of the dentist. As she climbs into Dr. Nikki Stone’s exam chair, she chats amiably and explains that she knows all about plaque, cavities, and the importance of brushing her teeth. She started brushing every morning and afternoon after hearing in school that, if she didn’t, she could have “all false teeth” by the age of 28.

“I decided that I didn’t want that,” she says.

Thanks to an enterprising local public-health provider, Doolittle is the rare rural child with access to free dental services that come to her. Every year, a mobile van—donated by the Ronald McDonald House and affiliated with a nearby community health center—visits Doolittle’s elementary school so the dentist can clean teeth, apply sealants, and dispense fluoride treatments.

But when the second-grader opens her mouth, it’s clear she’ll need more than that. Despite her newfound vigilance, she has nine cavities, and Stone can’t fix them. The traveling clinic offers free care, but its mandate is limited to prevention: Kids who need cavities drilled or teeth pulled have to go elsewhere. And in Hazard, like many other rural areas, that’s not easy.

The United States faces a shortage of dentists that is particularly acute in poor, rural regions. Huge pockets of the country have few (or no) providers. The federal government counts 4,503 mostly rural regions where more than 3,000 people share one dentist, making it tough for many residents to find someone to fix their teeth.

Dentistry lacks consistency in restoration decision-making

Dentists who take a conservative approach to placing restorations tend to stay conservative when replacing or repairing them. And dentists who aggressively treat primary caries also stick with their preferred strategy when assessing existing restorations.

But majorities were lacking among decisions dentists made about the repair and placement of restorations, according to a study presented during a poster session at the recent American Association for Dental Research (AADR) annual meeting in Tampa.

"In contrast to the consistency of an individual practitioner-investigator's treatment planning approach, there was considerable variation among practitioner-investigators in their treatment recommendations on the same teeth," noted researchers from the Dental Practice-Based Research Network (DPBRN) Collaborative Group.

Enjoy your morning!

The Morning Drill: May 4, 2012

Augusta Pediatric Dentistry assistant Molly Turner, left, and hygienist Diana DeRocher apply dental sealants to the teeth of Blin Rollins, 8 of Augusta, Maine. Photo: MSNBC

Good Friday morning! It is almost the weekend.

On to today's dentistry and health headlines:

Decay dilemma: Do kids need dental sealants?

But what Rollins didn’t know is that her child’s mouth is part of an ongoing debate over whether enough kids get the liquid plastic coverings that protect what Shenkin calls “the most decayed tooth in the mouth.”

Only about 20 percent of children at poverty level and only 40 percent of kids from higher-income homes actually receive recommended sealants, according to studies by the Centers for Disease Control and Prevention.

That confounds Shenkin, a pediatric dentist and spokesman for the American Dental Association. He says decades of research demonstrate that coating the biting surfaces of 6-year molars with a resin-based sealant can reduce cavities by up to nearly 80 percent immediately -- and up to 60 percent for four years or more.

“It’s imperative that as soon as those adult teeth erupt, that they be sealed,” he said.

In practice, however, less than 40 percent of dentists actually follow the recommendations of the ADA, according to a 2011 study by researchers at Temple University. The study tracked whether dentists were willing to seal teeth with the beginnings of decay, but no actual cavities.

“The lack of dentists doing sealants is a very silent and probably the most significant issue to care we face among children,” said Shenkin. “Parents should be asking for sealants and not taking no for an answer.”

But one of the profession’s most well-regarded dentists has been publicly cautious about sealants, saying there can be a high failure rate -- 50 percent within five years -- and arguing that they shouldn’t be placed if there’s any evidence of decay.

Gordon J. Christensen, who publishes Clinicians Report, widely regarded as the “Consumer Reports of dental products,” says that sealants done properly are “an excellent technique” for combatting decay. But, he adds, the success of the sealant depends largely on the skill of the person who applies it.

 “They have to seek out a practitioner who knows what they’re doing,” he said.

“If they see failure immediately, that opens the window for decay.”

Christensen is concerned about so-called “non-cavitated caries lesions,” early signs of tooth decay that have not yet resulted in cavities. He worries that sealants trap plaque on the tooth, creating an environment that fuels future decay.

CDC researchers say studies have shown that decay does not progress once sealants are added, but Christensen maintains that he’s not convinced.

Dentist charged with possession of crystal meth with intent to sell

A Silver Spring dentist has been busted for allegedly possessing methamphetamines and charged with intending to distribute the drugs.

Dr. Siar Karmand was arrested early Thursday morning at his home in the gated Beekman Place community in Northwest D.C.

D.C. Police claim to have found $11,000 worth of crystal meth and seven ounces of GHB in Karmand's home.

"There's a common denominator to drug use," says Ward 3 D.C. Councilmember Jim Graham. "It applies across the board. It doesn't have any particular group, class or income that it favors over another. It's just that we have stereotypes about all this. And this cuts through the stereotypes."

Karmand maintained an office at a medical building on Georgia Avenue in Silver Spring. At the dentist office next door to his, the staff told us this was a sad day for dentistry. They told us they rarely saw Karmand. They say he kept odd hours.

Aspen Dental Donates More Than $16,000 to Oral Cancer Foundation

Aspen Dental, one of the largest networks of dental care providers in the U.S., is donating $16,255 to the Oral Cancer Foundation in recognition of Oral Cancer Awareness Month. As a commitment to early oral cancer detection, 340 Aspen Dental practices in 22 states donated $5 from every Vizilite Plus screening conducted during the month of April. A total of 3,251 screenings were conducted throughout the month.

"The Oral Cancer Foundation is steadfast in its commitment to saving lives through prevention, research and advocacy, and we're proud to support their efforts through this donation," said Maureen Howes, RDH, MS, director of hygiene services at Aspen Dental Management, Inc.

According to the Oral Cancer Foundation, close to 37,000 Americans will be diagnosed with oral or pharyngeal cancer this year, which is responsible for approximately 8,000 deaths annually. Common risk factors for oral cancer include use of tobacco products (smoked and smokeless), excessive alcohol consumption, and HPV infection.

Coffee Stains Teeth More Indelibly Than Tobacco

Coffee stains return on bleached teeth, whereas cigarette stains may not. In addition, coffee stains cannot be removed by brushing alone, researchers report in an article published in the May issue of the Journal of the American Dental Association.

Soaking cows' teeth in coffee and exposing them to cigarette smoke darkened them about the same amount, but tooth brushing only lightened the smoke-stained teeth, not the coffee-stained teeth, note Juliana Zavala Bazzi, DDS, MDS, from Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil, and colleagues.

"We didn't expect that cigarette staining would be so easily removed either by tooth bleaching or toothbrushing," corresponding author Evelise M. Souza, DDS, MDS, PhD, a professor of restorative dentistry at the Pontifical Catholic University, told Medscape Medical News in an email.

Although bleaching is well established as a method of whitening teeth, there is not much research to show the susceptibility of bleached teeth to being stained once again, they note.

Enjoy your morning!

The Morning Drill: May 3, 2012

Architect's vision of the new Arthur A. Dugoni School of Dentistry building in the San Francisco, California's South of Market district. (Photo courtesy University of the Pacific)

Good Thursday morning!

On to today's dentistry and health headlines:

University of Pacific dental school to relocate

The University of the Pacific Arthur A. Dugoni School of Dentistry will be relocating its operations to a newly acquired, seven-story building in San Francisco's South of Market district.

SmithGroupJJR has been selected to provide architectural services for the new dental school campus located at 155 Fifth Street in a 395,000 gross square feet building.

The space will undergo a comprehensive renovation, including a complete replacement of the exterior facade and interior spaces and is expected to open in mid-2014. It will contain simulation laboratories, classrooms, and research and support space for the dental school, and will also accommodate clinical changes and technology enhancements to support patient care.

Extraction Only Dental Office Opening in Pacific

Facing a struggling economy and a need for a more practical kind of dentistry, Dr. William B. McHugh, a Marthasville dentist, is opening an extractions only dental office in the flagship McHugh-Dailey family building at 107 E. Orleans St.

Some 80 years after his father, Dr. William O. McHugh, opened his dental office in what is now the smoking room of the Great Pacific Coffee Company restaurant, Dr. McHugh has transformed the first floor of the old annex into a dental office.

The dentist’s decision to locate on the first floor of the McHugh living quarters, adjacent to the space where his father opened his first dental office in 1927, created a family gathering that included his brother James McHugh, nieces, nephews and numerous Dailey cousins of several generations.

The waiting area for the new office is created in an alcove, which can be entered via a ramp at the east end of the former McHugh annex or by the Orleans Street grand entrance that leads up the wide staircase to the upper floors. Waiting patients can sit in a row of wood theater seats rescued from the third floor opera house, which is being restored for public use.

“We sanded them down and rubbed linseed oil into them,” said Gloria Yanker, McHugh’s office manager.

McHugh and his brother James are now part owners of the building with two Dailey brothers, Tom and Mike, grandsons of building co-founder James Dailey.

McHugh, who graduated from St. Louis University High School and dental college, became a dentist in 1964. He now has a full service dental office in Marthasville. He plans to keep both the Pacific and Marthasville offices open.

Extraction is most often the dental procedure of choice in these economic conditions, McHugh said. Extraction will be done for a flat fee of $150.

American Academy of Implant Dentistry Sues Texas Dental Board

The American Academy of Implant Dentistry (AAID) has filed a lawsuit in U.S. District Court in Austin seeking to invalidate a Texas regulation that severely restricts dentists from advertising their bona fide AAID credentials in implant dentistry.  In 2009 and 2010, AAID won judicial verdicts overturning similar rules enforced by state dental boards in Florida and California.

AAID's chief legal counsel, Frank Recker, JD, DDS, informed the Texas Board of Dental Examiners in writing about the unequivocal judicial precedents and hoped to convince the Board to rescind its restrictions and avoid litigation.  "The Board did not respond to our communications for two years.  Since AAID's credentialed members continue to be in jeopardy if they advertise their credentials, the Academy decided to pursue legal action," said Recker.  Two Texas dentists holding AAID's dental implant credentials, Dr. Jay Elliott of Houston and Dr.  Monty Buck of Galveston joined the lawsuit as individual co-plaintiffs.   

AAID is seeking a permanent injunction and declaratory judgment to strike down the Texas regulation, which allows unrestricted advertising only for dental credentials and accreditations issued by organizations recognized as dental specialties by the American Dental Association (ADA).  Dentists with bona fide credentials not issued by ADA-recognized specialty organizations are required to include lengthy disclaimers in their advertising in Texas.  This limitation, contends AAID, is burdensome and prohibits dentists from advertising true statements about credentials in implant dentistry earned from AAID and American Board of Oral Implantology (ABOI).   In Florida and California, the presiding judges ruled that such advertising restrictions violate the First and Fourteenth Amendments to the U.S. Constitution, which protect freedom speech and equal protection of the laws.  Recker said the legal precedents solidly favor AAID and Drs. Elliott and Buck.

Salem health center gets $500K for dental clinic

North Shore Community Health Inc. will receive $498,500 of the $728 million the federal government awarded to health centers across the U.S. this week for capital investments.

At NSCH, the grant will go toward much-needed equipment upgrades and a relocation and expansion of their Salem dental clinic, CEO Margaret Brennan said.

NSCH offers primary care, from immunizations to counseling services, at facilities in Peabody, Gloucester and two locations in Salem: Salem High School and 47 Congress St. The majority of NSCH's patients are at or below the federal poverty level, Brennan said, but the facility treats anyone who walks through the door, "whether they can pay or not."

The grant money will allow NSCH to relocate its Salem dental clinic, which treats between 2,000 and 3,000 patients each year in a cramped space with six treatment rooms.

The clinic has to turn away roughly 1,000 patients each year who need more complicated oral surgeries, Brennan said. Facility staff ask the patients to go into Boston for the surgery, but many are unable to make the trip and end up in an emergency room, and eventually, back at NSCH.

NSCH is looking to relocate the dental clinic from its Congress Street facility to a nearby site. In doing so, it will be able to reclaim the existing dental clinic space to provide more medical services.

"We're hopeful with expanded dental services we'll be able to treat those folks (that need oral surgery), which will be a tremendous service to our community," Brennan said. "This is going to go a long way ... This will only improve our ability to provide even better care."

The grant money will also go toward upgrading dental equipment as well as a telephone call center, which has seen a spike in call volume; NSCH's patient load has increased by 43 percent since 2007.

NSCH applied for the federal grant in November and found out Tuesday morning it was one of 13 recipients in Massachusetts.

In the Commonwealth, $33 million was distributed through the new health care law, often dubbed "Obamacare." The grant program is meant to support renovation and construction projects.

U.S. Health and Human Services Secretary Kathleen Sebelius announced the grants Tuesday, touting the program as creating jobs and boosting health centers' ability to care for additional patients.

Enjoy your morning!

The Morning Drill: May 2, 2012

Good Wednesday morning!

On to today's dentistry and health headlines:

Clogate Technology Center

I was very fortunate to spend the day at the Colgate Technology Center in New Jersey. The focus of the conference was the use of the Internet in general and social media in particular to provide accurate medical dental information. That was all good and interesting.

As a bonus we were given a tour of the lab facilities and it was very impressive. My attitude, fostered by my dental school instuctors from many years ago, was that toothpaste is a generic commodity and they are all essentially alike. My eyes were opened. We were shown how the various products are formulated to kill bacteria, reduce sensitivity or whiten intrinsic stains. The lab testing equipment included DNA samplers, artificial mouths, and scanning microscopes. Not to mention a machine (or two) that mimics the brushing action.

Oregon Board of Dentistry addresses dental x-ray confusion

Fearing they may become the subject of malpractice litigation or licensing violations, some Oregon dentists are reportedly refusing to treat patients who refuse to be x-rayed before routine cleaning appointments.

The February 2012 issue of the Oregon Board of Dentistry's professional newsletter included the following statement on the standard of care regarding dental radiographs:

    "The Standard of Care in Oregon requires that current radiographs are available prior to providing treatment to a patient. If a patient without a medical justification refuses to allow radiographs to be taken, even with the offer to sign a waiver, then providing treatment to that patient would violate the Standard of Care in Oregon."

Since then, according to an Associated Press story, dentists have been "erring on the side of caution" to protect themselves from malpractice claims and avoid putting their licenses in jeopardy.

Some dentists say the description provided by the dental board is confusing with regard to what constitutes "current," the AP reported.

The rule of thumb is spelled out in guidelines from the ADA and the U.S. Food and Drug Administration (FDA), according to Patrick Braatz, executive director of the Oregon Board of Dentistry.

Those guidelines call for posterior bitewing exams every 24-36 months in established adult patients with no caries and no increased risk of developing caries and every 18-36 months for adolescents with permanent dentition (Journal of the American Dental Association, September 2006, Vol. 137:9, pp. 1,304-1,312). For recall adult patients with caries or at increased risk of developing caries, the exams are recommended at 6- to 18-month intervals.

"A patient refusing to have x-rays taken is not something that a dentist can agree to as it violates the standard of care," Braatz told DrBicuspid.com in an email. "X-rays are a diagnostic tool, and based on the condition of a patient's oral health and the guidelines from the ADA and the FDA and what is taught in dental school is what is considered the standard of care for dentists."

School of Dentistry Invents Dental Fillings That Kill Bacteria and Remineralize the Tooth

Scientists using nanotechology at the University of Maryland School of Dentistry have created the first cavity-filling composite that kills harmful bacteria and regenerates tooth structure lost to bacterial decay.

Rather than just limiting decay with conventional fillings, the new composite is a revolutionary dental weapon to control harmful bacteria, which co-exist in the natural colony of microorganisms in the mouth, says professor Huakun (Hockin) Xu, PhD, MS.

"Tooth decay means that the mineral content in the tooth has been dissolved by the organic acids secreted by bacteria residing in biofilms or plaques on the tooth surface. These organisms convert carbohydrates to acids that decrease the minerals in the tooth structure," says Xu, director of the Division of Biomaterials and Tissue Engineering in the School's Department of Endodontics, Prosthodontics and Operative Dentistry.

After a dentist drills out a decayed tooth, the cavity still contains residual bacteria. Xu says it is not possible for a dentist to remove all the damaged tissue, so it's important to neutralize the harmful effects of the bacteria, which is just what the new nanocomposites are able to do.

The researchers also have built antibacterial agents into primer used first by dentists to prepare a drilled-out cavity and into adhesives that dentists spread into the cavity to make a filling stick tight to the tissue of the tooth. "The reason we want to get the antibacterial agents also into primers and adhesives is that these are the first things that cover the internal surfaces of the tooth cavity and flow into tiny dental tubules inside the tooth," says Xu. The main reason for failures in tooth restorations, says Xu, is secondary caries or decay at the restoration margins. Applying the new primer and adhesive will kill the residual bacteria, he says.

Fillings made from the School of Dentistry's new nanocomposite, with antibacterial primer and antibacterial adhesive, should last longer than the typical five to 10 years, though the scientists have not thoroughly tested longevity. Xu says a key component of the new nanocomposite and nano-structured adhesive is calcium phosphate nanoparticles that regenerate tooth minerals. The antibacterial component has a base of quaternary ammonium and silver nanoparticles along with a high pH. The alkaline pH limits acid production by tooth bacteria.

"The bottom line is we are continuing to improve these materials and making them stronger in their antibacterial and remineralizing capacities as well as increasing their longevity," Xu says.

American Dental Association Comment on the New York Times Story, 'E.R. Doctors Face Dilemma On Painkillers'

A story in today's New York Times points up a new aspect of the unfortunate phenomenon of people seeking treatment for dental problems in hospital emergency rooms: patients claiming to be in agony from dental disease in order to procure prescription pain medication, and emergency room physicians trying to sort out which of them actually need those drugs.

The Times did not explore the underlying problem--there is virtually no consistent, substantive dental safety net for low-income adults. Medicaid dental programs, which vary state by state, generally focus only on covering children. The children's programs range from pretty good to abysmal. There is less variation in states' Medicaid adult programs, because there is no federal requirement for adult Medicaid coverage. It is virtually nonexistent.

Uninsured and indigent people cannot get routine dental care, small problems become big ones, and the pain becomes intolerable. As a result, they flock to emergency rooms with dental pain. That they have dental problems is apparent to ER physicians. But whether they actually need pain medication is a judgment call.

The one certain thing is that ERs, except in those rare cases where there are staff dentists, cannot actually treat dental problems. Patients are given antibiotics or pain medication and sent on their way, only to return with the same complaints, because ER physicians cannot address the disease, only the symptoms. The irony is that this revolving ER door costs Medicaid more than treatment by dentists would. States would actually save money by providing basic care, such as fillings and extractions, to these patients.

Ultimately, the ER/dental phenomenon points out the fundamental shortcomings in how this country provides and does not provide oral health care to those who can't afford regular dental visits. Virtually all dental disease, especially the advanced cases that show up in emergency rooms, is preventable. When the nation shifts to a prevention rather than surgical model of public oral health and provides basic dental services to more people who otherwise cannot afford them, the ER physicians' dilemma will be greatly diminished. Until then, we can expect more of the same.

Enjoy your morning!

The Morning Drill: May 1, 2012

Good Tuesday Morning!

And, a special good morning to the attendees of the Colgate Connect Conference in New Jersey. A family illness has required me to remain in California and I hope to join you next year.

On to today's dentistry and health headlines:

Grand Blanc dentist arrested for allegedly faking prescriptions to get painkillers

Anthony Carbajal

A 55-year-old dentist who had an office in Grand Blanc was arrested last week near a Fenton pharmacy after he picked up a prescription he filed under a fake name, according to police.

Anthony Carbajal of Livonia is charged with three counts of obtaining a controlled substance by fraud and a count of possession of hydrocodone, according to police. Police allege Carbajal was calling in prescriptions for the pain killer under a fake patient's name and then going to pick them up at various pharmacies.

Carbajal picked up a prescription on April 23 at the Walgreens Pharmacy on Silver Lake Road, but employees suspected fraud and called police. Police made a traffic stop and found 40 pills of hydrocodone.

He admitted to having a drug problem, according to police.

Carbajal has had a history of drug use, according to the state department of licensing and regulatory affairs. He was put on probation in 2009 after testing positive for cocaine, according to state records. He was ordered to take random drug screenings.

After entering a 10-day substance abuse program in July 2009, he returned to his Grand Blanc office located about a month later, according to records.

Phoenix dental clinic helps kids, teens without insurance

Elizabeth Mize, 15, was reluctant to open her mouth on a recent visit with dentist Dr. Zoltan Varadi despite the pain niggling by her tooth.

The Phoenix teen, suffering an oral infection, admitted to Varadi that she brushes her teeth maybe “once a day.”

“And do you eat candy?” Varadi said.

“I eat a lot of chocolate,” Elizabeth said.

“I think you have to change a little bit your diet,” Varadi said before he prescribed Elizabeth a medicated rinse and antibiotics. “Almost none of your teeth is completely healthy.”

Elizabeth is the typical kind of case Varadi encounters working at the Boys & Girls Club Children’s Dental Clinic near 15th Avenue and Grant Street, southwest of downtown Phoenix, where he treats uninsured children and teens every week.

“The biggest issue I see in this clinic is neglect,” Varadi said. “Until they find the clinic, until their parents actually find it … sometimes these kids don’t see a dentist for years and years. I see kids who are 15, 14, 13 who have never seen a dentist.”

The club recently renovated its 15-year-old clinic to add two more dentist chairs — raising its number to four — so it can also treat twice as many patients as the 800 it normally sees in a year.

Bridget McDonald, a vice president for the area club, said the clinic has an even broader mission: to address oral-health problems that have worried health, school and city officials for years.

E.R. Doctors Face Quandary on Painkillers

Dr. Bruce Lobitz, an attending physician in the emergency department at Upstate Carolina Medical Center in Gaffney, S.C., sees about 10 patients a week complaining of toothaches. “The bane of our existence,” he calls them.

It’s not just that doctors like him lack the training and tools to solve their dental problems. Many of these patients, he fears, complain of tooth pain simply as a ruse to get prescriptions for narcotics.

“Almost all dental patients request a prescription for narcotic pain pills,” Dr. Lobitz said. “ ‘I just need something to tide me over until I can see a dentist’ — that’s the classic line.” Sometimes, drug-seekers will show their cards: “They’ll say they’re allergic to everything except Vicodin.”

Dental patients — mostly uninsured or indigent — are not unusual in emergency rooms. Poor patients may forgo preventive care and delay treatment until they face a medical crisis. In many states, adult dental benefits under Medicaid, the government insurance program for the poor, have been scaled back or eliminated. And dentists often don’t accept Medicaid patients.

But emergency physicians like Dr. Lobitz cannot know whether someone who claims to be in agony from dental issues is telling the truth — or simply plans, he said, to “go to the next emergency room, next town over, and get another 30 Vicodin.”

Dr. Gail D’Onofrio, chairwoman of the emergency medicine department at Yale School of Medicine, has studied alcohol and drug abuse in emergency rooms. “The overuse of narcotics is a huge problem, and when a patient presents, especially for dental pain, it’s difficult to make an objective assessment,” she said. “It puts the physician in a difficult situation to assess whether or not someone truly needs pain medications. We err on the side of treating pain, and it is a huge potential for abuse.”

The frequent prescription of narcotics in emergency departments for dental pain has been quantified for the first time by research financed by the National Institutes of Health, bringing to light another way opioids get into circulation and contribute to the rampant abuse of painkillers in the United States.

Oral Health – More Than Just Cavities - A Report by Ontario’s Chief Medical Officer of Health

Ontario’s low income dental programs need to be reviewed to improve their effectiveness, efficiency and reach, says the province’s Chief Medical Officer of Health.

Dr. Arlene King says Ontario has made significant progress in providing dental care to low-income Ontarians, but more needs to be done. There are a number of publicly funded programs available including the Children In Need of Treatment (CINOT) dental program, Healthy Smiles Ontario, Ontario Works and the Ontario Disability Support Program. According to Dr. King, these programs amount to a patchwork of services that are difficult for people to navigate, and difficult to assess in terms of health outcomes achieved and return on investment.

In her report, “Oral Health – More Than Just Cavities,” Dr. King calls on the province to consider integrating these programs to make it easier for people to access the care that is needed, when it is needed.

Dr. King also calls on the province to :

•     Ensure all Ontarians have access to fluoridated drinking water
•     Review how publicly funded oral health programs are monitored and evaluated
•     Improve access to oral health care as well as awareness of oral health services available to First Nations people in Ontario.

Enjoy your morning!

The Morning Drill: April 30, 2012

Center of Oral Health

Good Monday morning!

I was supposed to be on a flight to New Jersey this morning for a Colgate sponsored Social Media Conference scheduled for tomorrow. But, unfortunately, family medical problems have left me staying home. I hope I have the opportunity to attend in the future.

On to today's dentistry headlines:

California pediatric dental care program to shut down

After providing preventive dental care to more than 7,000 low-income children in Los Angeles for the past few years, the Center for Oral Health's WIC Dental Collaborative Project will end in June when funding runs out.

The L.A. WIC project was initially funded by Kaiser Permanente and the U.S. Health Resources and Services Administration. It was originally intended to operate for only two years and would have end in December, but recently received a six-month extension from the First 5 Commission of Los Angeles, a children's advocacy group.

"This program is one of the most successful prevention strategies at a time when we can really help prevent early childhood caries at a very early stage, before they're really rampant in the mouth of 3- or 4-year-olds," Francisco Ramos-Gomez, DDS, MPH, professor of pediatric dentistry at the University of California, Los Angeles (UCLA) School of Dentistry, told DrBicuspid.com.

The children received a risk assessment, toothbrush prophy, examination, and fluoride varnish application, while the parents received nutritional guidance for parents, with emphasis on avoiding sweets and not putting youngsters to bed with bottles of milk or juice.

"We tell them the last thing that touches their baby's teeth at night should be fluoridated toothpaste," Dr. Ramos-Gomez said. "They keep saying they brush their child's teeth three times a day, but they don't say that after they brush their teeth they give them ice cream, a Snickers bar, or a bottle."

Hal Christensen, ‘dentistry in Washington’ 1957-1985

When he hired me, Hal Christensen said he needed a writer to describe the American Dental Association’s activities in the nation’s capital, of which he was the greater part as I was to learn, and that I must leave deadline-a-minute journalism and report to the ADA Washington Office May 1, 1978.

He didn’t tell me I’d have to put up with his cornball humor, his Monday morning off-key “Hail to the Redskins, hail victory” bluster, which might or might not describe his beloved football team’s recent performance, which he no doubt witnessed as a season ticket holder unless he had offered you his seat on a given Sunday, or his “George Washington Bridge” doggerel doggedly babbled to “Sesame Street” sing-along diction if not tone when mood struck and audience presented.

Though he may have lacked the finesse of a modern-day BlackBerry lobbyist, Hal defined the ADA in Washington with canny corridor smarts in the lobbying of lawmakers during some 28 years of unprecedented expansion of government health care activity during the 1960s and ‘70s. “In short, he has been dentistry in Washington, and this profession is the better for it,” said Thomas J. Ginley, Ph.D., Association executive director when Hal retired in 1985.

Hal Merrill Christensen, born Jan. 31, 1926, in Richfield, Utah, passed away April 18, 2012, in Bountiful, Utah. For 40 years, including his 1957-1985 ADA Washington Office years, he and his family lived in nearby Chevy Chase, Md. Their roots were in Beaver, Utah, and Hal and his wife, Mary, would return to Beaver in 2002.

Cedartown dentist arrested

Gerald D Palatini
Photo credit:
Polk County Sheriff's Office

A Cedartown dentist was arrested Saturday on warrants out of Floyd County. Gerald David Palatini, 55, was arrested by Polk County deputies and released to Floyd County deputies on a warrant charging him with felony false statements and writings.

The charges are a result of untruthful answers given by Palatini when he filled out a U.S. Department of Justice firearms transaction record. Palatini answered "no" to a question regarding whether or not he was under indictment for a felony.

Palatini was charged with five counts of sexual exploitation of children. The charges against Palatini were brought forth in April of 2009 when he was arrested by GBI agents as a result of an investigation of the Georgia Internet Crimes against Children Task Force.

Palatini has practiced dentistry in Cedartown since 1994 and was given special recognition in 2003 for his contribution to the families of Polk and surrounding counties by accepting Peach Care for kids, a health insurance program administered by the state and designed for working families that do not have access to health insurance.

Police: LI man practiced dentistry with no license

Police say a Long Island man with a sixth-grade education and no formal medical training has been charged with practicing dentistry without a license.

Manuel Carranza of New Cassel pleaded not guilty at his arraignment Thursday. Bail was set at $2,500. He was represented by Legal Aid, which does not comment on pending cases.

Nassau County Police say Carranza operated the practice for a year and a half out of his home.

They say he used a multilevel mechanics drawer for his dental instruments and had no equipment to sterilize them.

Police said the cash-only business provided fillings for $20 to $30 and root canals for $50.

Lt. Ray Cote added that a sign offered free extractions if the fillings or root canals did not ease a patient’s suffering.

Enjoy your morning!

The Morning Drill: April 26, 2012

"Happy" the hippo has his tusks filed by keeper Anthony Dorrian at Taronga Western Plains Zoo on April 20, 2012 in Dubbo, Australia. The popular 35 year old Dubbo zoo is set in 3 square km of bushland and is home to over 700 animals.  (Photo by Mark Kolbe/Getty Images)

Good Thursday Morning!

On to today's dentistry and health headlines:

Picture Post: Dental hygiene at the Zoo

Dental hygiene is no laughing matter, whether you’re a human… or a hippopotamus. However, a sparkling smile – or a sparkling yawn – is often worth enduring a little discomfort under the dentist’s drill, or in this case, a 30cm file.

See the other photos here.

An app twice a day keeps the dentist away

Dentist Ben Underwood has developed a unique free toothbrush timer app called Brush DJ to make brushing less boring! The app plays 2 minutes of a song taken at random from the music library stored on the user’s device. This encourages people to brush for an effective length of time whilst rediscovering their music collection.

This short YouTube video gives an overview of the free Brush DJ app.

Brush DJ also allows users to set reminders to brush twice a day, floss, use a mouthrinse and when next to visit their dentist or hygienist.

A recent survey by the British Dental Health Foundation reported nearly 59% of women and 35% regularly skip brushing their teeth at bedtime. The government’s latest dental health survey found only 21% of people use dental floss and only 26% use an electric toothbrush. A US study reported that the average time spent brushing is 45 seconds- considerably shorter than the recommended 2 minutes.

Ben says he had the idea for Brush DJ after watching an episode of the BBCs Apprentice, where candidates were asked to design an app. He felt this would be an ideal tool to make people aware of the latest advice and encourage them to brush twice a day for the right length of time, to help reduce the risk of gum disease, decay and bad breath.

The Evolution of the Runner’s High

Ferrets don’t often figure in studies of exercise, perhaps because they don’t exercise much. They slink like fog through tunnels, sprint briefly over open ground and spend much of their time sleeping. They are, in biological terms, what’s called a noncursorial species, meaning that they are reluctant and lousy distance runners.

Which is why they were ideal subjects for a new experiment conducted at the University of Arizona in Tucson looking at whether humans and other species evolved to like running.

Many anthropologists and distance runners believe that running guided the evolution of early humans. We ran in search of dinner and away from predators.

But running is costly, metabolically. It incinerates energy. It can also cause injury. A twisted ankle would have removed your typical early human from the gene pool.

So why did our ancestors continue to run over the millennia “and not evolve other strategies for survival?” asks David A. Raichlen, a professor of anthropology at the University of Arizona, who led the study, which was published in The Journal of Experimental Biology. “We wondered if natural selection might have used neurobiological mechanisms to encourage exercise activity,” he continues.

No evidence that mobile phones harm health: study

There is no convincing evidence that the use of mobile phones damages human health, a "comprehensive" review of scientific evidence said on Thursday.

Studies have not demonstrated that the use of mobiles causes brain tumours or any other cancer, according to the review by the Health Protection Agency (HPA)'s independent advisory group on non-ionising radiation.

But it said it was important to monitor evidence as the use of mobile phones has become widespread only recently.

The HPA also recommends that excessive use of mobile phones by children be discouraged.

"Overall, the results of studies have not demonstrated that the use of mobile phones causes brain tumours or any other type of cancer," the group said.

"The evidence suggests that radio frequency field exposure below guideline levels does not cause symptoms in humans."

The group's report reviewed scientific studies on exposure to radio frequency electromagnetic fields produced by mobile phones and wireless devices, such as wi-fi, as well as television and radio transmitters.

It said the presence of radio frequency fields cannot be detected by people, including those who report being sensitive to them.

And it added that research on long-term effects was limited but there was no evidence as yet of negative health effects.

Enjoy your morning!

The Morning Drill: April 25, 2012

Good Wednesday morning!

On to today's dentistry and health headlines:

Rutgers Merger Might Carry Big Price Tag

Support for a controversial merger of Rutgers University with two other schools in New Jersey has hinged, in part, on just how much the restructuring will cost. But the proposals’ backers, including New Jersey Gov. Chris Christie, have yet to release an estimate.

The topic is expected to be addressed during a legislative hearing on higher-education funding Wednesday. The plan would Rutgers  merge with Rowan University in Glassboro and the University of Medicine and Dentistry in New Jersey.

While the potential expenses associated with the latest school merger proposal remain unclear, a report on a previous plan to form a consortium of universities could shed some light on the cost.

A 2002 blue-ribbon commission convened under then-Gov. Jim McGreevy  found that merging Rutgers, UMDNJ and the New Jersey Institute of Technology would cost $1.3 billion over a 10 year period. That estimate covered restructuring and money for significant capital improvements to the colleges’ infrastructure.

“It’s the additional capital for building additional buildings, and then the expense money that has to be added,” said Dr. Roy Vagelos, the former chairman of Merck and the merger commission’s chair, during testimony in 2006.

The merger was conceived to save on administrative costs while helping to strengthen New Jersey’s scientific and medical research. ”It [would have] improved their research capabilities. There’s so much interactive, interdisciplinary research that is done today,” Vagelos said in an interview Tuesday.

The plan met opposition of Essex County leaders concerned about the future of UMDNJ — which runs a hospital that serves Newark — and it died during the McGreevy years.

California dental clinic makes disabled patients a priority

It took Michelle Hickey and her daughter Christina, both in wheelchairs, nearly six hours to get to the We Care Dental Center, but it was worth it. Most dentists had turned them away because they didn't have the thousands of dollars in down payments required for the extensive treatment they both needed.

Although they qualify for California's Denti-Cal program, it only covers extractions, not restorations.

"They'll pull our teeth out, but fillings aren't covered," Michelle, a quadriplegic, told DrBicuspid.com.

So she and her 32-year-old daughter -- who suffered a traumatic brain injury in an accident -- set out in their wheelchairs at 6:30 a.m. last week from Riverside to catch the first of many buses that would take them to the dental clinic in Rancho Mirage, a community in Southern California's high desert.

"My teeth are falling out, and my daughter's teeth are turning black," Michelle said. "She brushes her teeth twice a day but has lots of cavities and barely has any teeth left."

Before her husband died, the family had great dental care. Now Michelle and her daughter depend on Medicaid and Medicare.

At We Care Dental, Melvyn Glick, DDS, co-founder of the center, examined them, took x-rays, and cleaned Christina's teeth.

"Oh, God, it means everything," Michelle said of the opportunity to finally obtain dental care for her daughter. "They were very kind and personal. I do everything I can, but I'm stuck between a rock and a hard place."

The main way we treat our patients is with kindness and love, Dr. Glick told DrBicuspid.com.

“That's what they respond to. You just need to take time with them, let them know what you're going to do, stroke them a little, talk to them a lot, have someone hold their hand if necessary, and believe me, you get results.”

Hidden America: Medicaid's Youngest Face Dental Crisis

With more than 16 million low-income U.S. children on Medicaid not receiving dental care -- or even a routine exam -- in 2009, according to the Pew Center on the States, dentists and ERs say they are treating very young patients with teeth blackened from decay and bacteria and multiple cavities.

"I see it in their eyes before they tell me it's that way," Dr. Gregory Folse told ABC News. "We are able to intervene and take the pain away from their teeth and it brings the spark back. And that's my goal."

Folse's Outreach Dentistry mobile clinic travels to schools around Louisiana, filling cavities and teaching children and parents about the importance of oral hygiene.

In 2007, Congress held a hearing on the issue of children's dental health after Deamonte Driver, a 12-year-old Maryland boy, died when a tooth infection spread to his brain. His mother, Alyce Driver, had been unable to find a dentist to treat him on Medicaid and could not afford to pay out of pocket.

At the time, Leslie Norwalk, then-acting administrator for the Centers for Medicare and Medicaid Services, called his death "a failure on many levels."

And although she said that these types of dental services were covered, many dentists said that Medicaid reimbursement rates are too low.

A study published in May 2011 demonstrated that despite efforts to boost the number of patients and providers in the Medicaid system, low-income families still had limited access to dental care -- except when they were able to pay cash.

The state of Florida got an F in children's dental health in a 2011 report from the Pew Center on the States. In 2009, according to Pew, only 25.7 percent of Florida children on Medicaid saw a dentist.

Fish Oil Could Be Therapy for Periodontal Disease

Periodontitis, inflammation of the tissue surrounding the teeth, affects more than half of adults and is linked to an increased risk of stroke and other heart problems. To evaluate whether fish oil supplementation could be an adjunct therapy for periodontitis, Dr. Alison Coates from the University of South Australia and colleagues from the School of Dentistry at University of Adelaide in Australia reviewed evidence from eight unique studies that involved humans.

The group reports that the evidence for fish oil being effective in reducing periodontal symptoms is building but there is a need for more well designed studies that evaluate the supplement both alone and in combination with aspirin to be able to tease out whether fish oil by itself is effective. It is important that compliance to treatment is considered and that the dose and length of supplementation is appropriate. A clinical trial is underway in Australia that is investigating the effects of fish oil as adjunct therapy for periodontitis.

Enjoy your morning!