by Trish Walraven

Alabama’s reputation in dentistry has recently been elevated to EPIC FAIL status.

According to today’s news at DrBicuspid.com, dental students at the University of Alabama at Birmingham (UAB) are deficient in their education. They’re playing video games at the retirement homes instead of doing dentistry, unless you count “brushing someone’s teeth” as doing dentistry. A whole lot of other allegations are being raised as well, but I thought this one especially was worth a hoot and a holler.

SPANK!

Take that, Alabama! This little slap will teach you not to hand out licenses to dental professionals without requiring students to take a national board exam first. Or even go to college first. Hey, does this mean that a dentist from Alabama will only be able to get work as a dental assistant in all the other states, like licensed dentists from other countries, until they pass the OTHER states’ board exams? The good news is that now that there’s a bunch of eyes on the situation brewing at this dental college, maybe there will be a tasty intervention coming. Remember, the first step in recovery is admitting that you have a problem.

Get the whole story here at Dr. Bicuspid (you may need to subscribe first). And if you’re from Alabama, sorry for the smack. Does it help you forgive me a little if I say I loved Alabama in Forrest Gump?

Tomorrow the an FDA panel will “probe cavity fillings” (that’s really the title of this segment shown on CBS this evening):
http://www.cbsnews.com/stories/2010/12/14/eveningnews/main7150398.shtml

Once again the media is out to sensationalize the debate by conjuring up images of daily vomiting, years of sinus congestion, and children who can’t go an hour without a seizure or two. And once again, it is mercury that is the alleged culprit.

If it really were as bad as it appears for the few people that are willing to testify before the panel, don’t you think that there would be a significantly larger population of people affected by mercury poisoning?

Four years ago, a panel decided that further study was necessary to understand whether amalgams give off more vapors when being placed or removed versus the amount of mercury vapor produced with chewing and brushing.

Maybe they were on to something there! What the FDA should do is launch a study of mercury levels in the blood, urine, and body tissues of the dentists who regularly place and remove amalgams, correlating symptoms described by those afflicted with mercury toxicity with the dentists in the study. If those symptoms are consistent in the dentists who have high levels of mercury, then go from there to decide whether amalgams are truly a problem.

The ADA stands behind the science. And until it is refuted, they are doing the right thing by not wavering on their position.

UPDATE – December 20th, 2010

Last week, an advisory panel to the US Food and Drug Administration (FDA) convened a professional panel review to again look at the safety issues associated with mercury amalgam in dentistry. A group of scientists and dental and medical professionals, lead by the International Academy of Oral Medicine and Toxicology (IAOMT), had called for FDA to reconsider its July 2009 “no risk” classification of mercury fillings. The FDA panel concluded that there are no huge scientific flaws in the agency’s 2009 finding that mercury-based dental fillings are safe for adults and children aged 6 years and older. The panel, however, recommended that the FDA look at more data, including the latest data, on the possible health risks dental amalgam poses to pregnant women and their fetuses and to young children, particularly nursing infants whose mothers have these fillings. The panel also said the FDA should consider adding warnings for these groups to the material’s product instructions.
 The ADA commended the panel’s call for continued research while offering support for the FDA’s current amalgam regulation. The panel’s call for more scientific data acknowledged concerns of dental amalgam opponents who link mercury exposure to dozens of diseases ranging from autism to Alzheimer’s disease.

The idea of dozens of dentists lined up, hoping to have their bowls filled with a ladle of delicious….CLEAR PLASTIC IMPRESSIONS….is weird. “NO INVISALIGN FOR YOU!” screamed the white-coats at Align Technology. Dentists completing less than 10 cases per year were suspended from their accounts, and sent away, bowls empty, furious with the scare-tactic attempt to boost sales and case acceptance.

Until yesterday. Instead of getting your soup in a bowl at the counter,  you complainers will be able to get it in a to-go container, from the “Concession Stand”:

Align Technology Eliminates Annual Case Requirement for Invisalign(R) Providers

SANTA CLARA, Calif., Apr 22, 2010 (GlobeNewswire via COMTEX News Network) — Align Technology, Inc. (Nasdaq:ALGN) today announced a strategic change to the Invisalign proficiency program the Company launched last June to help ensure Invisalign providers build a baseline of Invisalign product experience and knowledge through minimum annual case and continuing education (CE) goals. Effective immediately, doctors will no longer be required to start a minimum of ten shipped cases per year to maintain their active provider status. Doctors are still required to complete a minimum of ten Invisalign continuing education (CE) hours per year.

“Despite continued strong efforts by our customers to meet the annual proficiency requirements, many customers remain frustrated with the program, particularly the case requirement,” said Dan S. Ellis, vice president, North American Sales. “While we remain deeply committed to ensuring great treatment results for Invisalign doctors and patients, we are equally committed to listening to our customers and responding to their needs.”

Align will continue to emphasize the importance of Invisalign professional education in treatment success by maintaining the annual ten Invisalign CE hour requirements. In addition, Align will focus on continued product innovation and performance improvements and customer loyalty and rewards programs to help drive great treatment experiences and results. As part of this focus, Align will continue to promote the benefits of Invisalign Preferred Provider status for doctors who start ten or more cases each year.

Doctors who do not complete a minimum of ten Invisalign CE hours in a calendar year will have their Invisalign accounts temporarily suspended until they complete the minimum CE hours. With more than 200 hours of lecture-based and online learning opportunities, Align’s robust educational curriculum makes it convenient for doctors of every Invisalign experience level to stay current with product and clinical advancements.

Doctors whose customer accounts were deactivated or changed to limited status for failing to meet the 2009 proficiency requirements can reactivate their account and start using Invisalign again at any time by completing a Clear Essentials I or Clear Principles training course and thereafter meeting the annual ten CE hour requirement. More information on the proficiency program and related changes are available at http://vip.invisalign.com/proficiency.

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Also worthy of reading are the frustrations aired at Jim DuMolin’s great website: http://www.thewealthydentist.com/SurveyResults/162-Invisalign-Dentists.htm.

Just so we have this straight: lasers are okay, but needles? Not so much. Texas is a bit behind the times regarding local anesthesia. But the great news is that their state board just recently issued a statement that affirms the legality of laser use by formally trained hygienists for treating periodontal disease that is not responding to traditional therapy.  Here it is in the Board’s own words:

Texas State Board of Dental Examiners’ Position Statement on the Use of Lasers by Dental Hygienists

The Texas State Board of Dental Examiners is aware that lasers can be used to replace or supplement traditional dental instruments such as handpieces, scalpels, curing lights, and the explorer.

It is the position of the Board that licensed dental hygienists may use lasers that are not capable of cutting or removing hard tissue, soft tissue, or tooth structure to perform clinical tasks that are otherwise within the hygienist’s scope of practice. Dental hygienists must perform intraoral procedures involving a laser under the general supervision of a licensed dentist.**

Whenever a new treatment modality is brought forward, it is the Board’s policy that the licensee must have proficiency and training in the use of the technology for the procedure performed. Licensees utilizing new technology must maintain documentation of the satisfactory completion of formal continuing education or training using the technology for the procedures performed. The particular technology utilized performing any particular clinical task does not alter the requirement that a dentist is ultimately responsible for any procedure delegated to an auxiliary and the auxiliary performing the procedure remains responsible for performing the task within the standard of care.

** “General supervision” means that the dentist employs or is in charge of the dental hygienist and is responsible for supervising the services performed by the dental hygienist. The dentist may or may not be present on the premises when the dental hygienist performs the procedures.