*dentist not included (with clear aligners)

September 26, 2014 By Trish Walraven 147 Comments

This post is from the time when SmileDirectClub first began its marketing campaign, from the standpoint of a general dentist’s practice, and the feelings of whether or not online-ordered cosmetic aligners would be taking away market share for dentists. The reviews are posted below the article, from those who have used the product or who have questions about it. The company declared bankruptcy in 2023. Way to take the money and run!

If you’re not an orthodontist, but you straighten teeth in your dental practice, I’ve got a fistfight just waiting for you. Where? Thankfully someone else went through the trouble of making this cute little scroll-ey infographic, so I’ll just post it here and save myself the trouble, and the punches.

SmileCareClub Wants to Disrupt Dentists- Crowdfunding Insider (no longer available)

(sorry, looks like the infographic wasn’t sanctioned by Smile Care Club… anyways, here’s another link on IndieGogo)

A full set of dental aligners, just like the Invisalign® ones, for a third of the cost or less, can you simply order them online? With no visit to a dental office? Heck, why not? I mean, all you have to do is worm two pieces of putty together and then squish them onto your teeth for an impression, mail them to the lab, upload a few photos from your smartphone, and wait for your trays to magically appear at your doorstep.

What is it with blue boxes? Is blue, like, a confident color or something? See how the SmileCareClub box compares to an aligner box from our office:

And then there’s the involvement of the aligner-providing dentist. The ClinCheck inclusion is a facade, a joke? You mean to tell me that the lab could do all of this via 3D imaging and just cut the middleman dentists out of the deal?

Not completely. You’ve got interproximal reductions that still need to be managed in some cases, and the SmileDirectClub is looking for ~~suckers~~ Endorsed Local Providers to saw those big fat teeth into submission. And who the heck knows whatever happened to attachments? I personally had Invisalign attachments placed a decade ago, and cannot imagine what my results would have been without them.

Orthodontists are probably chuckling to themselves. They saw this coming with all of the cosmetic tooth straightening programs being marketed to general dentists over the last decade.

It makes the whole teeth whitening mall kiosk issue seem petty, now, doesn’t it?

SmileCareClub doesn’t appear to have a single dentist on its management team, but they employ a few, I guess, to keep it legal, I guess. It’s really hard to tell. This aligner system is also sold on the Sharper Image website, in case you want to forward a link to any patients who look at you sideways and curse under their breath when you tell them what their in-office aligner treatment is going to cost. Sharper Image– that’s legit, right? Maybe you didn’t realize that the original Sharper Image went bankrupt. Interestingly, the brand name was bought by the same VCs that, guess what?- own SmileDirectClub.

Orthodontists, are you feeling disrupted yet?

I didn’t think so.

A blogger since 1997, Trish Walraven, RDH, BSDH is a practicing dental hygienist and marketing manager for an indie dental software development company. Her mission with DentalBuzz is to offer a fresh podium of discourse for those involved in dentistry and to expose fun in our professional lives.

Update: SmileCare Club is now called SmileDirectClub, which you can see at SmileDirectClub.com. The cost is $1500, and if you Buy Today!, they’ll include GloScience gel (interestingly enough, here’s what DentalBuzz had to say about GloScience in 2011).

Aug 2016 Update:

Invisalign has announced that they are building aligners for Smile Direct Club. See the notice in the comments below. The similarity of the boxes now makes sense!

2017 Update:

Invisalign now owns a 19% interest in SmileDirectClub. But that kind of backing will cost you $350 more, which now brings the cost of aligner therapy to $1850.

September 2019 Update:

Smile Direct Club just had their IPO, and now the founders are billionaires. It’s all about disruption of the status quo, apparently, because if you can afford $80/month instead of $150/month (the cost to see a real orthodontist) you should Do Orthodontics Yourself. Smile Direct Club have no more than 250 dentists that “check” the cases. That’s one dentist per 3000 patients (750,000 people served so far)! Bottom Line? If you think of teeth as ornaments, not functional body parts, then that’s on you if they rot out or you can’t chew with them afterwards. Story here: https://www.bloomberg.com/news/articles/2019-09-13/smiledirectclub-s-ipo-creates-a-pair-of-30-year-old-billionaires

October 2023 Update:

Melissa Busch, Dr. Bicuspid.com

Clear aligner company SmileDirectClub filed for voluntary protection under Chapter 11 of the U.S. Bankruptcy Code on September 29 in the U.S. Bankruptcy Court for the Southern District of Texas, according to a company press release.

The bankruptcy comes on the heels of recent legal pitfalls involving SmileDirectClub. In August, a California court confirmed an order requiring the orthodontics company to pay $63 million to Align Technology, a former partner and the maker of Invisalign, over a supply agreement dispute. SmileDirectClub had planned to appeal the decision.

In June, SmileDirectClub settled a suit with the Washington, DC, attorney general’s office, which claimed the company made injured and dissatisfied customers sign nondisclosure agreements (NDAs) to receive refunds for their clear aligner therapy. Under the terms of the settlement, SmileDirectClub was required to release 17,000 U.S. consumers from provisions in its NDAs. Also, the company had to change its refund policy, notify consumers who previously signed NDAs that they could now freely speak about their experiences, and stop forcing people to sign NDAs that prevented information sharing before refunds were provided.

December 2023 Update:

The SmileDirectClub website is gone. You’ll find this message there instead:

Customer FAQ

SmileDirectClub has made the incredibly difficult decision to wind down its global operations, effective immediately. For new customers interested in SmileDirectClub services, thank you for your interest, but aligner treatment is no longer available through our telehealth platform. For existing customers, we apologize for the inconvenience, but customer care support is no longer available. Thank you for your support and letting us improve over 2 million smiles and lives.

I placed an order for SmileDirectClub aligners, but have not yet received my aligners. What should I do?
Unfortunately aligner treatment is no longer available through the SmileDirectClub platform. All orders that have not yet shipped have been cancelled at this time, and you will not receive your aligners.

Should I continue to conduct my 60-day check-ins? Is my treating doctor still available to complete my treatment?
We apologize for the inconvenience, but aligner treatment is no longer available through the SmileDirectClub platform. If you wish to continue treatment outside of our platform, please consult your treating doctor or your local dentist with any questions around future aligner treatment.

I’m on the SmilePay Plan. Do I need to keep paying for my aligners?
HFD is the service provider for your SmilePay payment plan. For questions regarding your financial obligations please contact HFD at 1-877-874-3877, [email protected] or visit their website at www.gohfd.com/.

Is the Lifetime Guarantee still in place?
No. Effective immediately the Lifetime Smile Guarantee no longer exists.

How do I ask for a refund?
There will be more information to come once the bankruptcy process determines next steps and additional measures customers can take.

Is Arestin® a red flag?

September 5, 2014 By Trish Walraven 70 Comments

Not long ago, all dental practices were owned by the dentist who took care of you. Sure, they might not have given you any anesthetic before they smashed silver crunchy metal into your cavities, and they may have slapped you around and given you Post Traumatic Stress Disorder any time you thought about opening your mouth wide for anyone, but at least you knew that the dentist shoving their knuckles into your nostrils was the one dictating how things were done around there.

Since then, dentistry has gone all Wal-Mart on the public. There are thousands of dental offices that are part of large chains, where the dentists who take care of you are merely employees, where the quality of dental care provided to patients is secondary and instead the amount of profit generated by each provider becomes the indication of that person’s worth within the company. Can you imagine a leaderboard, like in a sales department, where all the dentists’ production numbers are on display for the entire office, so it’s a race to see who can make the most money?

As a patient, don’t you get giddy at the thought of being ridden like a thoroughbred horse? Me neither. My health is not a commodity.

Dentistry is a little different creature than regular medicine in the sense that TEETH ARE OPTIONAL. You can be a very healthy individual, only with no teeth. It’s kind of like having a hand amputated – your quality of life may be affected, but a hopelessly infected hand should be removed and replaced with a prosthetic. If your body is rejecting your teeth for whatever reason, that’s when there are health concerns as well. Dental professionals make it their life’s work to help you keep your teeth in as close to original condition as possible.

The problem is that when money is involved, you can bet that there are those who will abuse this relationship. There’s scare tactics, there’s bait-and-switch, there’s all the usual sleazy sales pressure used to extract as much income from each patient as possible. New patients often bring us treatment plans that they are unsure of, looking for second opinions, trying to figure out why they don’t trust the previous dental offices’ diagnoses. I just want to say it straight, “They’re taking you for a ride, dear.”

Whip. Whip.

Well crud, I never wanted this article to be an analogy of horse racing with the big hats and Bourbon and milk-drinking and jockeys. So, let’s start over and begin talking instead about Red Flags and Grey Areas.

Red flags, of course, are the signals you get when you realize something that seems good, isn’t so good. Red flags are big fat warning signs.

Grey areas, are, well, not really black and not really white. Grey areas are where black and white kind of blur into each other, and sometimes they end up looking a little suggestive (!) like the image above. Yeah, sorry about how weird that looks when I take it out of context.

When it comes to the health of your mouth we usually look at two things: your teeth, and the stuff that holds your teeth in your mouth. That’s what we’re going to talk about in this discussion, what you think of as your gums. Dental professionals call this part of you your periodontium. If your gums are in excellent condition, you have what is called periodontal health. On the other hand, if your gums are seriously letting go of your teeth you have periodontal disease.

As you can see, the biggest part of this diagram is the Grey Area. This is where most people land, especially if they haven’t been to the dentist in a while. Even if your front teeth are mostly healthy often you’re automatically categorized into the Very Diseased category because you have too many spots in your mouth that are infected with bacteria to treat you as a Very Healthy person. That’s when you’ll get a treatment plan designed to minimize the effects of your disease.

When your mouth is in the Grey Area, this is where treatment recommendations can vary the most from office to office and even from person to person. Almost every dentist will prescribe the same treatment course if your case is black and white (very diseased or very healthy). If you’re in the Grey Area though, this is when Red Flags will start to stick out.

There’s one Red Flag in particular that keeps showing up. Arestin® is a yellow powder containing minocycline microspheres – an antibiotic designed to help diseased gums heal faster. The powder is puffed deep into an infected spot under the gumline where it hardens upon contact with moisture and time-releases the antibiotic for about three weeks. Here’s what the package of cartridges looks like, with the yellow powder in the tip:

Arestin is a great product! I’ve seen stubborn gum disease completely disappear when we’ve used it very selectively in our practice. So the Arestin itself isn’t a problem. The problem is how it’s being prescribed.

Say you had your gum disease treated with scaling and root planing (a “Deep Cleaning”), but a few spots are still unhealthy a month or two or three later. If your dentist or hygienist sees that you still have open sores that are higher than a certain parameter (over 4mm is considered the standard) this is when Arestin therapy provides the most benefit.

So when is Arestin a Red Flag? You’ve visited a new dental office, and not only are they recommending that you have treatment for your periodontal disease, they’re also saying you need a course of Arestin to be placed on the same day that you have your initial treatment. It’s even a bigger red flag if you floss regularly and never see your gums bleed.

The thing is, Arestin isn’t cheap. Just a single cartridge costs your dentist upwards of $15. Then there is the insertion fee; in other words, what the patient is billed for placement, and than can run as much as $60 per site.

Here’s where it gets crazy. An average mouth has 28 teeth. Each of your teeth has as many as six sites where Arestin can be placed. Let’s see, that’s $90 in material costs, $360 in placement costs. That’s potentially going to cost you $450 – per tooth.

You’re seeing the big picture now: treating gum disease can be quite profitable! This is why Arestin is such a big deal in the offices that are part of corporate dental chains designed for maximum shareholder profit. This antibiotic is marketed to dental professionals as a way to help us make money, all in the name of “helping our patients.”

So how do you end up getting prescribed Arestin therapy if your mouth is pretty healthy? If your hygienist or dentist was instructed to “force the probe” to create a deep measurement, that’s how. Stab ’em hard and voila! Fake gum disease! Here’s a story that exposes some of the bad things that have allegedly happened in corporate dentistry, including this example:

http://www.pbs.org/dentalworks-chain-misdiagnosed-for-money-dentists-say/

As you can see, lots of other stuff can be exaggerated as well to make sure that the dentistry performed on you is as profitable as possible. For now, though, we’ll stick to talking about the Red Flag, because this one cue may help you decide whether or not you’re being over treated.

Here are the professionally accepted general guidelines about Arestin usage, then:

Now please don’t use this to go and bash your well-meaning dentist and hygienist, or the Arestin company, or worst of all, to justify the reasons you tell yourself why you don’t go to the dentist ’cause it’s all one big scam and you can’t trust anyone. Most of us really do want the best for you.

The point is simply this: if more people understand the difference between dental care that is patient-centered and dental care that is profit-centered, then greedy dental corporations are less likely to thrive.

If you think you have ever had this happen to you, I wrote this story for you. For you, so that you don’t feel so dumbfounded the next time you wonder whether or not a dental office is looking out for your health or only for their own. As a hygienist who knows fraud when I see it, I wanted to be sure that patients have a resource to help them defend themselves against predatory practices.

I’d like to end this with a small confession, then: I actually love placing Arestin, because when the dentist and I decide that it’s a good fit for a stubborn case of gum disease, it just feels so right.

So much for being objective.

References and resources:

Explanation of insurance coding of Arestin therapy after initial SRP: http://www.practicebooster.com

An example of Arestin-based fraud in a DHMO: http://caldentalplans.org/downloads/Henderson.pdf

Arestin drug label and study that shows slight improvement of using Arestin with SRP vs. SRP alone: http://dailymed.nlm.nih.gov/arestin

Criticism of Arestin studies and concerns about Arestin therapy : http://periodontist.org/is-arestin-a-therapeutic-treatment-for-reducing-gum-pockets/

Phocal fluoride disks

April 25, 2014 By Trish Walraven 2 Comments

What in the phôc is Phocal? The name is oh-so-clever, the way it changes up the F-sound, pinpoints the precision of its delivery mechanism, adds in a little calcium and acid/base interplay there. Plus, the little disks sorta kinda look like contact lenses. Phocal – the latest in fluoride therapy.

Phocal disks were brought to market last year, but I just discovered them a few days ago at Hygienetown, one of my favorite online dental hangouts, where they were met with a vague sort of shrug and a huh? Which got me to wondering, why in the world aren’t these things getting more press, more attention, more rave reviews?

Of course! It’s because they haven’t been DentalBuzzed yet.

The few articles that I’ve read about Phocal so far are as exciting as your average WHAT’S NEW IN DENTISTRY dreck. DentalBuzz is here to change that, to present to you all the facts about Phocal Therapy in an entertaining, yet insightful package designed to bring the maximum exposure possible to a product that will sink or swim on its own merit in the end.

Problem #1: Incipient interproximal lesions

If you’re not in dentistry you probably don’t know what these are. Let’s just call them future “Cha-Ching!” You know when dentists take radiographic images inside your mouth with x-rays? They’re looking for cavities between your teeth, where sugar and decaying bacteria ferment into acids that dissolve the surface of enamel into a mass of tiny swiss-cheese chalky goo.

When an interproximal lesion has gone too far, expect your dentist to drill it, fill it, and bill it (sorry for such a stale joke!). But Phocal disks promise to change all that. These cute little frisbees are designed to be inserted between your teeth (interproximal) before they’ve decayed, at the first sign of a beginning (incipient) cavity, to minimize the damage done to your teeth, as well as to your bank account.

Problem #2: Isocaps

Even many dentists have forgotten what an isocap is, so that’s why I’m going to explain them to you and why a Phocal disk inhibits their formation. Essentially an isocap is a bubble created between two flat surfaces that prevents liquids from wicking into it. Isocaps have to do with capillary action and surface tension.

Most fluoride delivery systems rely on a liquid to get the tooth-strengthening bits to soak deep into dental structure. If you’ve got a bunch of isocap bubbles between your teeth you can see how there’s no way that you’ll get a liquid-based fluoride to wick into the space where it may be needed most.

The Solution: Jam Some Stuff Between Your Teeth

If you can’t penetrate an isocap, well then, just obliterate it, take it out of existence, displace it. Whatever it takes, just put something ELSE there. Fluoride has been proven in many studies to increase the remineralization of a tooth that has begun to weaken, which is why fluoride is the active ingredient in the Phocal disks.

I’d explain how this whole process works, the options available, and even the studies that show how Ah-May-Zing this new fluoride therapy is except that someone at Collident paid a production company to make this perky animated video that does the job for me pretty well. Yes, you DO have three minutes to watch it. And there’s no voice-over, so feel free to turn off your sound before you click the arrow to start it up.

The Obstacles: Price, Chair Time and FDA Approval

What…you were expecting that these disk are THE answer to cavities between our teeth, forever and ever, end of discussion? If they were perfect we’d all have them in our mouths right now. For one thing, they’re not cheap: a box of 20 Phocal disks cost the dentist around $125 – that’s over $6 for each insertion. And because they are “technique sensitive” (read: only an experienced professional can place them) you’ve also got to deal with the dental office overhead fees. As far as the FDA approval goes, as of the time of this publication it appears that the Food and Drug Administration says that the Phocal Disc is unapproved, stating “this drug has not been found by the FDA to be safe and effective, and this labeling has not been approved by the FDA.”

Does this mean, then, that Phocal disks are doomed to obscurity and demise? Not necessarily. Dentists have no problem purchasing a box from the usual channels, but they may not be aware that this therapy exists in the first place, because there are all these flashy things in dentistry that many dentists prefer to spend their time learning about besides prevention. Besides, there’s more money to be made by fixing decayed teeth versus trying to preserve demineralized ones. That’s why the 5th dentist never recommends sugarless gum to his patients who chew gum (!). Cavities keep dentists profitable.

Which is why it’s now YOUR job to ask for Phocal disk therapy the next time your dentist wants to “watch” a spot between your teeth. And that is because watching is a very, very unhealthy type of voyeurism in the dental world.

References:
University of Michigan: Capillary Action around Dental Structures
National Library of Medicine: http://dailymed.nlm.nih.gov/dailymed/Phocalfluoride

Crest toothpaste embeds plastic in our gums

March 4, 2014 By Trish Walraven 347 Comments

This is polyethylene:

Did you know that polyethylene is the most common plastic in the world? It is used primarily for containers and packaging, such as these bottles and plastic grocery bags, and has been a concern for the environment because polyethylene lasts practically forever and isn’t biodegradable. It only breaks down into smaller and smaller particles until you can’t see it anymore. That’s why a couple of states are trying to ban it in body scrubs and dental products.

This is also polyethylene:

Well, not all of it. Most of it is toothpaste. But do you see those blue specks? That’s plastic. This is the suggested pea-sized amount that you should use when you brush your teeth. Yes, there is plastic in this toothpaste.

Want to see how many pieces of plastic are in this exact sample?

Not that I’m counting the bits but that seriously looks like A LOT of plastic… err…high density polyethylene. That’s what plastic trash cans are made from! If you throw away the box like most people do, the ingredients aren’t actually listed on the tube (sneaky, sneaky, Procter & Gamble!) However, I was able to track down the box here at this link. We’re not talking about polyethylene glycol, which is soluble in water. This stuff won’t dissolve in water, or even acetone or alcohol for that matter. How do I know it won’t dissolve? Because I put on my little scientist hat and tested it.

Like many of you, we often let our daughter pick out her own toothpaste at the store. She liked the tween vibe of this particular product so much that she chose it twice, but eventually the squeezed-out tubes ended up in the back of her toothpaste drawer.

When I first got wind that plastic was in some toothpastes, it was kind of exciting to realize that we had some on hand! And a bit concerning, because, after all, this is in my own home, used by my own child. Able to confirm that, sure enough, there was polyethylene in this toothpaste, I squirted out a pea-sized sample, mixed it up with some water, strained out the undissolved particles and let them dry on a paper towel. Oh, and I used a hair dryer to speed things up because I’m impatient. Then I shook approximately half of the sample into each of two pyrex bowls and added some household solvents:

They didn’t dissolve in the acetone, (nail polish remover) or in the alcohol either. I even left the samples in the solutions overnight, then re-hydrated them. No change in the particles.

So it has been established here that polyethylene will not dissolve in the mouth, or even in household products. It is an inert substance, which means that it doesn’t change at all. You know, that’s pretty good in some ways, because at least it’s probably not morphing into big blobs of plastic evil cancer bait.

Here’s where the story gets scary, though.

You see, I’m not just a concerned mom. I’m also a dental hygienist. And I’m seeing these same bits of blue plastic stuck in my patients’ mouths almost every day.

Around our teeth we have these little channels in our gums, sort of like the cuticles around our fingernails. The gum channel is called a sulcus, and it’s where diseases like gingivitis get their start. A healthy sulcus is no deeper than about 3 millimeters, so when you have hundreds of pieces of plastic being scrubbed into your gums each day that are even smaller than a millimeter, many of them are getting trapped:

The thing about a sulcus is that it’s vulnerable. Your dental hygienist spends most of their time cleaning every sulcus in your mouth, because if the band of tissue around your tooth isn’t healthy, then you’re not healthy. You can start to see why having bits of plastic in your sulcus may be a real problem, sort of like when popcorn hulls find their way into these same areas. Ouch, right?

Like I said, I’ve been seeing these blue particles flush out of patients’ gums for several months now. So has the co-hygienist in our office. So have many dental hygienists throughout the United States and Canada who have consulted with each other and realized that we have a major concern on our hands.

This is what an actual polyethylene speck looks like when it’s embedded within the sulcus, under the gumline:

I am not saying that polyethylene is causing gum problems. I’d be jumping too soon to that conclusion without scientific proof. But what I am saying definitively is that plastic is in your toothpaste, and that some of it is left behind even after you’re finished brushing and rinsing with it.

Do you want plastic in your toothpaste? So far the only mention of polyethylene on the Official Crest website at this link is that it is added to your paste for color, not as an aid in helping to clean your teeth or to disperse important anti-plaque or anti-cavity ingredients. [Note: as of 9/3/14 Crest took down the link about polyethylene, but I saved a copy of it here in case this ever happened.]

In other words, according to Crest:

Polyethylene plastic is in your toothpaste for decorative purposes only.

This is unacceptable not only to me, but to many, many hygienists nationwide. We are informing our patients. We are doing research separately and comparing notes. And until Procter & Gamble gives us a better reason as to why there is plastic in your toothpaste, we would like you to consider discontinuing the use of these products.

Here are some of the brands (click each to see their ingredient list and labeling) that we currently are aware of which contain polyethylene:

• Crest 3D White Radiant Mint

• Crest Pro-Health For Me

• Crest 3D White Arctic Fresh

• Crest 3D White Enamel Renewal

• Crest 3D White Luxe Glamorous White

• Crest Sensitivity Treatment and Protection

• Crest Complete Multi-Benefit Whitening Plus Deep Clean

• Crest 3D White Luxe Lustrous Shine

• Crest Extra White Plus Scope Outlast

• Crest SensiRelief Maximum Strength Whitening Plus Scope

• Crest Pro-Health Sensitive + Enamel Shield

• Crest Pro-Health Clinical Gum Protection

• Crest Pro-Health For Life for ages 50+

• Crest Complete Multi-Benefit Extra White+ Crystal Clean Anti-Bac

• Crest Be Adventurous Mint Chocolate Trek

• Crest Be Dynamic Lime Spearmint Zest

• Crest Be Inspired Vanilla Mint Spark

• Crest Pro-Health Healthy Fresh

• Crest Pro-Health Smooth Mint

What you can do

At this point, it’s probably best if you leave your flaming torches back in the barn. We’re not going after witches or Frankenstein here; you’re using your power as a consumer to send a message that you do NOT want plastic in your toothpaste. Heck, you might even be worrying about what may happen if you or your children swallow some of it.

1. If you’ve already purchased one of these toothpastes you can take it back to the retailer where you bought it, make sure that the manufacturer knows why you’re returning it, and ask for a refund.

2. Lodge a Crest consumer complaint at (800) 959-6586 and report an adverse health effect, namely, that you’re concerned that plastic pieces may be getting trapped in your mouth.

3. Click here to send an email to Procter & Gamble, the makers of Crest.

4. Share this! Let your friends and family know that you are also concerned about the plastic in their toothpaste by clicking on your favorite social media link below and getting the word out.

Response to criticism

Procter & Gamble’s current party line? “We will discontinue our use of PE micro plastic beads in skin exfoliating personal care products and toothpastes as soon as alternatives are qualified.”

And your response then may be, “I will discontinue MY use of Crest toothpaste until there are no more decorative microplastics entering my mouth.”

Trish Walraven RDH, BS is a mom and practicing dental hygienist in the suburbs of Dallas, Texas. She is also the co-creator of BlueNote Communicator, the top selling intra-office computer messaging system for dental and medical offices.

References and acknowledgements

Plastic Trades Industry: http://www.plasticsindustry.org/AboutPlastics
US National Library of Medicine: http://dailymed.nlm.nih.gov/crest
HygieneTown: http://www.hygienetown.com/blue-dots-in-patients-mouths

And a HUGE thank you goes out to my friend and colleague Erika B. Feltham, RDH for bringing this problem to our attention and for her extensive research. Erika is dedicated to providing the best possible care for her patients. She has been active in the dental profession for over 30 years, is a recipient of the 2008 American Dental Hygiene Association/Johnson and Johnson Hygiene Hero Award, the 2010 RDH Sunstar Americas (GUM Dental)Award of Distinction, lectures extensively about the harmful effects of sour candies, energy and sports drinks, and along with her San Diego component, she is responsible for presenting the resolution on sour candy labeling at the 2009 CDHA House of Delegates.

Update on 9/10/14:

As requested, here’s a quick video I made today that demonstrates polyethylene microbeads becoming embedded after brushing. This is for real; I didn’t poke the plastic in my gums (although I may have brushed a little more rough than normal!).

Update on 9/20/14:

This story got picked up nationally over the past week, with these notable entries:

The American Dental Association issued this press release regarding the safety of plastic in toothpaste and whether or not to remove the ADA Seal of Approval on Crest products.

FDA says that plastic is not approved as a food additive: NBC National News – Today Show

Interview in Phoenix, AZ mentioning the influence of DentalBuzz on Procter & Gamble:

Trish’s interview on Good Morning America:

http://abcnews.go.com/video/embed?id=25560562

Brian Williams on NBC:

http://player.theplatform.com/p/2E2eJC/nbcNewsOffsite?guid=nn_09_bwi_toothpaste_140917

A concise writeup at the Washington Post

And a final word on why we shouldn’t even be so preoccupied with toothpaste in the first place:

https://www.dentalbuzz.com/2014/12/30/toothpaste-can-do-more-harm-than-good/

An interview with the Duck Dynasty dentist

September 28, 2013 By Trish Walraven 6 Comments

Not too many dentists are portrayed positively in the media, we all pretty much know that. Even when something so routine as a third molar extraction becomes fodder for reality TV it becomes as heinous as possible. Oh, and thanks, sound teams, for when you add that special bone-cracking celery effect during tooth removal. You really help the cause there.

Want to know why I think that this dentist is truly one of the good guys? Not only was Dr. Kevin Finley, DDS gracious in accepting an interview request a few days after his appearance on the A&E Network, he was able to work it in amongst…get this!….fooling his whole dental team into thinking they were working, but he had secretly booked the day full of fake patients and instead thrilled all of them with a birthday party, complete with a shopping spree, a scavenger hunt, fine piano bar dining, board games (with big fat bills for winning!) and an early send-home. That takes heart. So thank you, Dr. Finley, for doing your best to make dentistry go well on TV, and for being the kind of dentist that everyone wants to work for.

With that said, here’s our conversation:

DentalBuzz: It’s intriguing to see a dentist doing a little bloodletting on unscripted television, especially on a show that’s as popular as Duck Dynasty. How long have you known the Robertson family?

Dr. Kevin Finley: I have known the Robertson’s for over 25 years. Phil has been a patient in the past. Korie has been a patient for over 10 years and her children have been patients since their first dental visit.

DB: So Willie’s not a patient? Why not?

KF: By his own admission, he does not like going to the dentist. Korie says that she is going to get him in sometime. They do seem to be very busy people.

DB: Maybe it’s time for a dental intervention! Or at least a postcard. Speaking of postcards, Wal-Marts all over the country seem to have postcards and everything else, for that matter, branded to Duck Commander this and Duck Dynasty that. Is the whole town of West Monroe like that too? How has their success changed your community?

KF: It is important to know that Phil is a great businessman. The Duck Commander and the Buck Commander have both been fantastic businesses long before Duck Dynasty. Don’t let the beards and accents fool you. Phil ( and the rest of the family) are really smart and VERY hard workers. (Filming my part of the episode was more work than i could have imagined).

It appears that the entire community is elated that they are so successful. The old adage that “a profit is not without honor, save in his own city”, does not apply here. We all love the Robertson family and they have brought nothing but positive influence to our community. It is no secret that they are Christians and they are not ashamed of who they are. They proclaim their love for God, their family and their country. They really are a phenomenal family. That being said– the business of Duck Dynasty has been great for our community. It is fantastic to see the local West Monroe police having to direct traffic in and around their store because people are coming here from all over the place. Duck Dynasty has put West Monroe Louisiana on the map, so to speak.

As for Wal-Mart, it is not an easy thing to get your products in Wal-Mart, they, too, are great business people and they know what sells. I can honestly say that the success of the Robertson family has been a wonderful benefit to our community.

DB: It gives a whole new meaning to living one’s faith, huh? They get to be who they were meant to be and lift everyone else around them up in the process, including all their TV viewers and fans. Which brings us to how they’ve elevated your world for a while, at least. In last week’s episode you extracted the third molars of both John Luke and Sadie in the same day. That’s eight teeth in front of a camera crew! No pressure, right? What was that like?

KF: It is unique to human nature that if you know a celebrity, it kind of makes you feel special– sort of like a celebrity yourself. I got to feel famous for about 1 minute. As a side note, when I have gone to dental meetings and met other dentists and they find out I live in West Monroe, Louisiana, they all ask if I know the Duck Dynasty family. I tell them that I do and that some of the family are patients of mine–they usually look at me kind of sideways and say “that’s great”, but all the while thinking that I am lying.

I really love to see success stories, especially in person, and is even more of a thrill to be asked to participate in their story. You would have to know this family to really feel what I am saying. As to the treatment, I have been in practice for 29 years and the dentistry itself was quite normal for us. I remember from dental school reading in our oral surgery textbook that “wisdom teeth extractions are easy, except for those that aren’t”. I really didn’t know what that meant until I did my share of third molar extractions. They either come right out in a few minutes or it’s “hold on to your butts”, we are going to be here for a while. Usually on teenagers, the surgery goes very well, as was the cases for John Luke and Sadie.

I guess if I was going to have any anxiety it would be with the anesthesia–we all know that the unexpected can happen and we would not like it to happen while parents were in the room or while the filming was going on. As it turned out, thanks to Delvin Price our Certified Registered Nurse Anesthetist, who is off the charts amazing, conscientious and caring, and our wonderful dental assistants, Frances and Kim, the Robertsons went to sleep, stayed asleep for their procedure and woke up when it was over, only slightly worse for the wear. I would call this quite a successful operation! Of course, after they woke up, then the real fun began, as you saw on the show. I can’t say enough good things about this family and my life has been enhanced just by knowing them—regardless of how famous they may be.

DB: Fame and good fortune sometimes goes to the right people, that’s what it sounds like you’re saying. As an insider looking out (because after all, you do live and work in the Beard Bubble there!) your experiences with the Robertson family seem to explain their phenomenal success to the rest of us: Duck Dynasty is not so much about characters as it is about character. Thank you, Dr. Finley, for sharing a juicy little slice of what it’s like to be a dentist in the middle of reality TV.

So there’s a final serious answer everyone wants to know about working with the Robertson family: How have you and your team ever managed to do dentistry through all that facial hair?

KF: (crickets chirping).

Didn’t catch this episode of Duck Dynasty? You can watch it now in its entirety by clicking this link to the A&E website: John Luke After Dentist