by Trish Walraven

We know that you want to protect your family from anything that you hear about in the media. Especially radiation. Especially now, with the leaks at the nuclear power plant happening in Japan and with Dr. Oz telling everyone that going to the dentist could endanger their thyroid glands.

Your perception is made reality here at Safe Smiles Dental Care. Are you afraid of the cumulative effects of flying in airplanes, going outdoors, and X-Rays? Good.

Why do we say good? Because the way we nurture your fear of radiation sets us apart from other dental offices. We won’t say, “Oops, let’s re-take that xray; it didn’t come out right” here. We will get it right the first time, because, gosh darn it, we care. And we spent a lot of money on rectangular collimators with little magnets and beepers that tell you that we’re all lined up. And what about “Sorry, the thyroid collar will obstruct our view so we can’t use it”? You won’t hear that in our office either. We’ll just not worry your pretty little head about that part of your jaw.

This is what we call scratching our niche, baby. Our practice is the ultimate low-radiation dental office, and you won’t find this level of concern down the street at Dr. Happy-go-lucky’s practice. No way. We’ll massage your fears away with our assurance that any cancer you get in your lifetime won’t be from dental radiation.

So give us a call today at (990) 648-2130 to schedule your complimentary screening exam. We also offer just radiological services if you prefer to have your dental x-rays taken at our office and then forwarded to a dentist of your choice. But that’s such a hassle. Come on, you know you’d rather stay here with us. Especially when you start seeing these warning symbols posted all over the signs of our local competition:

Stay safe, and we’ll look forward to seeing you soon!

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Yesterday on his network television show Dr. Mehmet Oz defended his remarks back in September about the necessity of lead thyroid collar use during dental x-rays whenever possible by stating that “there’s no good reason not to protect yourself against radiation.” While this is true, the bottom line is about using radiation in a way that leads to best outcomes in our patients, a point that several guest physicians also tried to make despite the protests of Dr. Oz.

Seriously, when you look at the sources of radiation in the world today, why worry about the miniscule intentional amounts? All radiation is dangerous, and it should be limited as much as possible, but the only way to avoid it totally is to dig a radon-free hole somewhere and live like a makedd roll gnat the rest of your life (ummmm. I mean naked mole rat. So hard to get that one right!). Calm your fears with this Radiation Dose Chart that was recently compiled, complete with facts about the Fukushima Nuclear plant (click on the image for full-size).

Another thing that I whipped up here for all you DentalBuzz readers is a Medical Radiation Dose Chart to download and show to your patients that have no idea how much radiation that they may be getting from the more common diagnostic procedures. I didn’t know a lot of it myself, so originally I created it to use in our office but you may find it helpful too. Did you know that it takes 10,000 PA radiographs to reach the annual limit of x-radiation? How many CT scans does it take to reach the limit? I’m too lazy to do all the math but it looks like 1 CT scan equals about 2,000 bitewings (film, not digital) according to this chart.

Regardless, we all have a responsibility to admit that we don’t know what we don’t know. And perhaps Dr. Oz may be a little right; we should do our best to protect our patients from radiation whenever possible, adapting the ALARA (As Low As Reasonably Achievable) principle with regards to radiation in dentistry.

Enter the media blitz. Interactive Digital Imaging (IDI) is re-introducing its rectangular collimator with a PR campaign targeting consumers. Dental patients will be encouraged to “Look for the Green Ring” at their dental offices, similar to the “Ask Your Doctor About” style of direct-to-consumer advertising used by the pharmaceutical industry. Originally priced at $1295, the newly redesigned Tru-Align collimator will be offered at $795 with improvements that overcome cone-cut errors and enhancements that make the positioner more user-friendly.

My favorite feature of the Tru-Align system is not that it can be used with any typical XCP holders (but still a good thing – this includes sensors, phosphor plates, and film), but that when you bump up the xray cone to the collimation ring, you get a magnetized lock-on and an audible beep to let you know that you will NOT be getting a cone-cut on that image. BAM! ZAP! If nothing else, the precision of this thing should impress our patients. And if they’re the kind that are really concerned about their radiation exposure, you can spew some factoids about reducing the absorbed dose from around 150 microsieverts to 30 microsieverts for an 18-image FMX series.

What it finally comes down to is having the right things to say to your patients when they ask about radiation, and addressing any real problems that you may be having in your office, like the assistant who has to re-take a periapical x-ray three times in order to get the one that you need. Or making sure that your thyroid collars are actually being Velcroed behind your patients’ necks. Or halting the bacteria-fest breeding on your lead aprons. My bet is that’s the biggest offense of all. Ahhh, a problem for another day…..

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Thanks to these blogs whose articles have helped shape this one:

The ALARA Principle: Dr. Jeffrey Hoos and Michael Razzano on Dentistry IQ

The Digital Dentist Lorne Lavine

Dr. Oz discusses Dental X-Rays and Thyroid Cancer: Dr. Todd Welch at The Science of Dentistry

by Trish Walraven

The Dramatization:

At first it was small. The outbreak began in Florida’s Tampa Bay Area as local hospitals noticed an influx of patients with complaints of turquoise discolorations of their lips and aversion to simple carbohydrates. Once case histories were correlated it was noticed that all those who were affected had either recently received an inoculation of a mutant version of Streptococcus mutans at their dentist’s office or had been in close contact with someone who had.

Initially the culprit was thought to be excessive consumption of blue raspberry slushies, but by the time the CDC discovered that an organism was responsible for these symptoms and that it was bacterial in origin and highly contagious the disease had spread far beyond Florida and had affected millions throughout the US and abroad.

There have been no reports of mortality, save the demise of the soft drink and candy industries. Sugar consumption has plummeted as more of the population becomes infected by this new strain of bacteria which was originally created to cure the problem of dental decay. Because persons who are affected display a noticeable change in their appearance, blue lips have become a strong signal of exclusion due to the fear surrounding this epidemic. However, as more evidence points to the positive outcomes of having been infected, the “blue look” is currently trendy in the larger cities. Blue-lipped patrons that had been banned from public venues such as restaurants and arena events are slowly trickling in, thanks to the assurances from the World Health Organization that this current situation has actually caused more good than harm. The long-term effects will be felt by dentists, who, in the next 30 years, will see an attrition of their necessity as caries becomes extinct, and possibly within the cosmetics industry with a shift in lip color preferences.

The Reality

Um, Yay? It’s been like, since the early 70′s that everyone’s been asking for a caries vaccine. And wouldn’t you know it? A company in the United States is already so ON this. Oragenics first initiated their first Phase 1 Clinical trials in 2005 but were halted by the FDA because of the fear of something happening like the above scenario. Think I’m kidding? Okay, maybe I was being sensational. But there can be genuine risks when you fiddle with a few genes, and the FDA seemed to be mainly concerned with the lack of a plan to eradicate attenuated strains in the test subjects’ children. AHHHHH!

It starts to get interesting when you look at the solution that Oragenics came up with to begin their second Phase 1 testing announced last week: The trial subjects will be inoculated with a strain of S. mutans that cannot survive without the amino acid D-alanine, which is not found in a normal human diet. This means that the subjects will have to feed their germs daily with a mouthwash to keep them from dying.

Are you excited yet? Well, you’d better hold those horses back for a while. A long while. It’s going to take a bunch of time and a lot more money to get this to the market.

The inoculation is designed to be a painless 5-minute treatment with a cotton-tipped swab to deliver the suspension of Oragenics’ patented bacterial strain into a patient’s mouth during routine dental visits. But this one won’t die without feeding. It will live forever.

And what is it supposed to do once it goes viral? Err… bacterial? Oragenics calls this treatment SMaRT Replacement Therapy™ and it promises to:

• Offer lifelong protection against tooth decay caused by S. mutans

• Eliminate the creation of lactic acid by oral bacteria

• Dramatically reduce the ability of S. mutans to cause tooth decay

• Be genetically stable

• Grow at a rate similar to non-genetically-altered S. mutans

• Aggressively displace the native, decay-causing strains of S. mutans and preemptive colonization of its niche

• Not cause any acute or chronic adverse side effects

I think it’s a foregone conclusion that this sort of genetic manipulation is probably the only way we’ll and break caries’ hold on humanity and the loss of teeth caused by decay. We can’t just kill all the bugs in our gut – all the Jamie Lee Curtis Activia commercials have given us TMI about probiotics lately – so it makes sense that this same premise is true in our mouths.

And the raspberry slushie is still your best bet for getting blue lips. Sorry, Oragenics will probably not be helping you there.