Onset™ is the name of a new buffering agent created by Onpharma™ Inc. that will be available as soon as the final FDA review is complete. If you can answer yes to these questions, read on:

Do you want to eliminate the sting that can be caused by the acidity of local anesthetic? Would you like to be able to give an injection and go to work immediately? Are you interested in a product that will help you get your patients profoundly numb, even when infection is present? What about tissue necrosis? Would you like to prevent it if possible?

The idea behind the pH buffering isn’t novel, but the patented device is. Onpharma™ has created a simple system that can be used with all anesthetics and also solves the problems of shelf life and proper dosing. Product previews aren’t yet available on the internet so all images and details will be withheld here at DentalBuzz until further notice (it’s so hard to hold a secret, though!).

If your curiosity is now piqued, make sure to click over to the Onpharma™ website and sign up so that the company can let you know when you can purchase Onset™.

Just don’t expect it to be rapid.  

⣿

]]> http://www.dentalbuzz.com/2010/07/15/onset/feed/ 3 http://www.dentalbuzz.com/2010/07/01/pedopapoose/ http://www.dentalbuzz.com/2010/07/01/pedopapoose/#comments Thu, 01 Jul 2010 20:07:33 +0000 admin http://www.dentalbuzz.com/?p=346 No one likes the idea of seeing a child being restrained. Especially not at the dental office. But on the same hand, if a child is admitted to a hospital, has thousands of dollars spent to knock them out with potentially risky gas, and is in need of a procedure that takes only minutes to perform, which care is the right one?

Notorious press has given the papoose board a bad name. Granted, its utilization can be abused, especially as seen in the story that was profiled on ABC’s 20/20. General anesthesia isn’t without its opponents as well, especially when a child dies.

With that somber note hanging in the air, you may want to revisit David After Dentist and pick yourself up with a little sedation dentistry humor. Even if you don’t agree that his dad should have ever posted the video on YouTube, it’s still so freakin’ funny.

Children who can’t be cooperative still need a means of getting their dentistry done, so pedodontists must make choices that sometimes include the use of papoose boards or general anesthesia. For entertainment’s sake, let’s just call this polarizing dilemma by another name: Hugs vs. Drugs.

There have been accusations from both sides: allegations of “nest feathering” by morally outraged dental anesthesiologists, abuses of public funds to pay for unnecessary procedures, the ultimatums given that any child restraint is considered grounds for lawsuits, equating papoose boards with third-world dental care, or offering general anesthesia for simple extractions when a combination of restraint and other sedation would be less expensive and as effective.

As a dental professional, it is your responsibility to make well-informed choices about sedation and restraint methods. For instance, individuals with autism or cerebral palsy may find that restraints are not only necessary, but even welcomed when compared to the use of drugs that can do more harm than the good that the dentistry is trying to achieve. Restraints may not be a better choice for toddlers whose biggest problem is a helicopter parent or two who are freaked out about the psychological trauma of having an irreparable tooth pulled. If a parent freaks, most likely so will the child, so it may be your choice to pander to the whiny world of children who are more in charge than their parents. After all, it’s no big deal to go under GA for a five-minute ear tube procedure with the ENT, right? That’s expected.

No matter what you decide to do, as long as you’re doing it from a level of comfort with your ability, and most importantly, from a sense of compassion, you should be able to confidently make the call for each patient, no matter where it falls on this line.

But sometimes, you just want to throw up your hands and say “AHHHHH I QUIT!” because you don’t know how to manage a patient. That’s when it’s awesome to have someone in your contact list who you trust to make this call.

And then pass the buck to them, because referring out can be very, very gratifying at times.

A free, volunteer-staffed program offered at a West Virginia high school found that three patients and two clinicians came down with Hepatitis B viruses that were tested and matched at a molecular level, indicating that the infections came from a common source.

All people involved at the Mission of Mercy clinic last summer were mailed letters last week encouraging that they be tested for the virus. The testing is being paid for by the state of West Virginia. (Insert your best West Virginia joke here. And then be ashamed of yourself for doing it).

If you have any response to this news, it should be to check your own infection control systems, to be sure that your high speed evacuation is up to par, that you aren’t just wiping down handpieces, and that every patient is treated with those universal precautions that were so important in dental school.

After all, you wouldn’t want this happening in an elite state, like Washington. 

But that’s not the case today.

The economy has since tanked and the price of gold is higher than ever (currently over $1,100 per ounce). The only one glinting a smile of 14 karats these days is Lady Gaga, and she safely skirts the hip-hop genre by going all Team Edward with vampire fangs.

So when dental gold is out (literally), you can impress your patients with a small token of your appreciation. Take out their gold crowns, inlays, bridges, and then give it to the patient along with a postage-paid envelope.

What’s cool about this deal is where the envelope goes. Not to some shady “Cash4Gold” operation. It goes to a reputable company that will pay your patients back a fair price.

And here comes the best part: Garfield Refining Company is so generous, they’ll give you ten percent for the referral. Don’t be afraid to let your patients know that you’re getting a kickback. They’ll just be happy that you’re not keeping all the dental gold for yourself.

So click this Garfield box on the left to enroll in the Patient Bling Program and get a few envelopes for your office. Nevermind that they still call it the Scrap Program; they just haven’t seen this review yet.

You also might want to look through Dental Products Report’s list of gold refining companies. And in case you were wondering, this is not a paid advertisement. Garfield Refining simply has a great idea that spreads goodwill and makes money for everyone.

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.

_________________

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.

We were impressed that when put on the spot between inaugural balls today, President Barack Obama was able to outline his plan to give all people in the United States of America the right to a beautiful, healthy smile. The big question is: just

Obama’s Mastication Initiative for America (MIA)

The people of the United States should realize that teeth are a quality of life issue. The government cannot force a citizen to take care of his or her body, nor should a person be penalized for issues that are beyond their control. We have seen the insurance industry take hold of healthcare and overvalue its services. Furthermore, dentists throughout our great nation have resisted the tide of managed medicine and are now capable of not only improving the quality of their patients’ lives, but even the very length of the average American lifespan.

When we look at the technological advances that have been made in dentistry, we know that now is the time for change. It is this administration’s hope that by combining personal responsibility with expert guidance, my Mastication Initiative for America will fulfill the needs of all Americans, not just the ones barely getting by; not just the wealthy, but every one of us.

The details will be forthcoming when I have more than a few breaths of air between dipping my wife on dance floors, but here is a brief outline of the plan:

1. Participation in the plan is voluntary, both for dental providers and for patients.

2. Payments will be made directly to patients on a yearly basis, with the exception of the Lump Sum plan that is described in line 6.

3. All participating dental practices will engage the use of a government-approved method of data gathering and reporting, to be agreed upon in the future, but possibly a special watermarked panoramic digital image that can be submitted to the Department of Health and Human Resources. This will significantly decrease the ability for fraudulent reporting on patient status.

4. Each person under the age of 30 will be required to have yearly dental images submitted on their behalf for reimbursement by the federal government. There will be a fixed amount allowed per person, regardless of actual care rendered. i.e. $500 per year per person under 30. Under no circumstances will any funds be reimbursed if basic preventive measures were not pursued by the patient or their family.

5. Third Molar Extraction will be considered a medical expense, as will any congenital deformity that is currently considered the arena of oral maxillofacial surgeons, so is excluded from the MIA plan.

6. At the age of 30, regardless of previous dental history, all citizens will be eligible for Dental Implant Screening (DIS). Because of the excellent properties of implants versus natural teeth regarding the elimination of the periodontium and thus the link to systemic disease, it is the MIA’s recommendation for DIS to be implemented before dental disease is likely to permanently affect a person’s whole health. Those who are at risk for losing their teeth, who have already lost teeth, or who simply make the choice of not wanting to maintain their teeth will, at this time in their lives, be given the opportunity to have all their teeth removed and have dental implants placed instead. This is a Lump Sum, and will include a preventive appliance to be worn at night. Any person who has implants with DIS will not be able to participate in the MIA after having implants placed.

7. DIS practitioners will work directly for the government, be well-trained, and well-compensated for their expertise.

8. From the age of 30 onward, payments from the MIA will be based on the number of healthy, maintained teeth that a patient displays in the accepted yearly imaging submitted. Included as healthy teeth: those with no restorations, restored teeth with no active defects, teeth with successful root canal therapy, periodontally involved teeth with no bone loss noted within the past year, and dental implants. Teeth that would not be counted for MIA payments: Broken teeth, retained root tips, teeth with active decay, and teeth showing periodontal involvement that has progressed since the previous submitted image.

This is the plan that will ensure that all Americans will be able to smile proudly, whether it is a God-given smile or one granted to them by choice, and no longer will we as a nation be faced with lost work time, emergency room visits, and other troubles caused by bad teeth. After all, this is the very soil where the “Hollywood Smile” was born, and so I ask you to consider what is best for our country, for our children, and for dentistry in the new economy to come.

Dear Santa,

This is so hard; I didn’t know who else I could write that could help me in my dilemma. My college finals are over and I recently went to oral surgeon’s office about my wisdom teeth. The plan is to have them taken out right after Christmas. The deal is, they’re not hurting. In fact, they are so buried in the bone that they aren’t even close to my other molars.

The weird thing was when I went to the oral surgeon for a consultation, he told me that when he took the wisdom teeth out, he could send all of them to a cryogenics lab where they would extract my stem cells and freeze them in case I needed them in the future to grow new nerve, cartilage, bone, a liver, or even a new heart.

I thought about it a lot, I really did, Santa. Did my research, too and realized that you’ve got some experience dealing with people who want to deep freeze everything they can touch. Here’s what I came up with:

• The company that my dentist is using is called StemSave. It costs about $700 for StemSave to process and store my wisdom teeth for the first year and $100 per year afterwards. Until I use them or die, whichever comes first. 
•  BioEden is another company that also cryopreserves teeth for future use, with methods and fees similar to StemSave’s.
• The technology for the actual preservation seems good, and wisdom teeth may have more useable adult stem cells compared to bone marrow if I get sick and need them later in life.
• As teeth age, they have fewer stem cells in them.
• There is a bit of controversy on the subject – I’m worried that stem cell banking may be more beneficial for the cryobanking investors than for the patients. There’s not really enough long-term data to suggest anything but hope on the researcher’s parts.

Then I got to thinking in the opposite direction. What if I just left my wisdom teeth in place? Doesn’t my own body work pretty good as an incubator for all those stem cells? Guaranteed to stay a steamy 98.6 degrees (or more), whether or not I make the payments each month? And the future, being so bright and all, maybe there will be a way to harvest my wisdom teeth with lasers instead, and then tease out all those precious tidbits from the insides.

Now I know you’re not a dentist yourself, Santa. But didn’t I hear that one of your elves become part of the North Pole Cavity Patrol? I’ve enclosed a copy of my X-Ray for Dr. Hermey to look at. All I want for Christmas is my four back teeth, one way or the other. Please help me decide what to do, Santa!

Signed,

Blue Christmas Girl               

Nice product presentation on the left, don’t you think?

Now what exactly are they? The latest in clear maxillary molar implants?

Wrong. You stick them in your ears. You. The dental professional.  Yes, you, the person who is losing their hearing and doesn’t mind spending about a grand to protect what’s left of your stereocilia.

Not losing your hearing? Then prove it to yourself. Take the test below in a quiet place. Naturally you need to have speakers turned up to about medium to hear all the frequencies. The higher ranges are what are known as the “mosquito” ringtones, which are outside the audible range of people over 30, and often used by the young-uns to send stealth text messages to each other.

There have been a few inconclusive studies published in the dental journals this decade about the concern that high decibel-level noise is an occupational hazard in dental practices. We thought that now would be a good time to gather a little of our own anecdotal evidence, and see how dentists’ hearing stacks up to the general population.

Play each of these tones to yourself and then please fill out the anonymous survey below so that we can publish the results in a future post.  

Play	Frequency	Age Range
	8 kHz	Everyone
	10 kHz	60 & Younger
	12 kHz	50 & Younger
	14 kHz	45 & Younger
	15 kHz	39 & Younger
	16 kHz	30 & Younger
	17 kHz	24 & Younger
	18 kHz	22 & Younger
	19 kHz	20 & Younger
	20 kHz	18 & Younger
	21 kHz	17 & Younger
	22 kHz	16 & Younger

Be sure to use your browser’s “back” button to come back to this page each time until you’ve figured out which frequency is your upper limit.

cforms contact form by delicious:days

The University of New South Wales in Australia has posted this test if you’d like a more comprehensive hearing exam. And if it looks like your future may be one of geriatric deafness, you might want to give thought to the benefits of a pair of DentalEars.

For a moment, imagine that this is one of the forms your patients fill out at an initial visit:

Anesthesia Options

We understand that each person has unique concerns when it comes to pain management, and would like to give our patients the opportunity to explore all of the anesthetic techniques available in our modern practice. Please read the following paragraphs and make a checkmark next to the one that best describes and addresses your needs:

No matter which method you prefer, the best way to administer anesthesia is always with a caring touch.

So for all you dentists who mail out postcards to potential patients, please don’t advertise that you’re gentle if you’re not. With all the options available, painful dentistry is pretty much inexcusable.