Operative Dentistry

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

DIY dentistry kit for preppers

October 23, 2013 By Trish Walraven 11 Comments

It’s getting closer to 2014 and you can pretty much guess what that means: the Obamacarepocalypse is almost upon us. Yee Haw. Preppers convinced that TEOTWAWKI (the end of the world as we know it) is imminent will be pleased that they will no longer need to add a dentist to their list of People We Would Like To Have With Us when it all hits the fan.

What can you add to your hoard instead of another mouth to feed? A home dental kit, of course! The DentiDrill comes complete with a handpiece, a curing light, a wee bit of composite, a vial of topical lidocaine, a lithium-ion battery charger, 1 tungsten steel drill head, a silicon polisher, a stainless steel dentist mirror, and the DVD tutorial.

You’d better pre-order soon, though. As soon as the FDA and other authorities get wind of this there will be an immediate shutdown of all shipments. You know how good our government is at shutdowns. Product is supposed to begin its journey to the US tomorrow if it all goes as planned, however.

Currently the DentiDrill is being marketed to moms who feel that their options are otherwise limited when it comes to taking care of their children’s teeth. Does a mother have the legal right to practice dentistry on her kids without a license? After the apocalypse comes, who cares about licenses? See, the marketers have got it ALL WRONG! You’re not scaring people away from managed healthcare, you’re inviting chaos and STUPID FEAR! I say bring it, if that’s what you want. This is only clever and useful if you’re desperate, and in the United States, trust me, we are not. At least not yet.

Curious to learn more? You’ll just have to see this video to believe it.

Still don’t believe it’s real? Just look! There’s More! DentiDrill has a Facebook page here that details design and production going back a year or so. It certainly doesn’t seem too fishy.

If you’re ready to drop $275 for one or are just trying to figure this thing out, visit DentiDrill.com and get one step closer to feeling like you’re doing the right thing for yourself and your family.

As far as me and how far I’ll go to prep for the end of civilization? I’ll probably just learn how to take out teeth. Much more practical skill, no batteries needed, just a strong stomach and hey, maybe a couple of swigs from that bottle that you were counting on your drinking buddy to bring.

Interesting Note: The DentiDrill website domain owner shares the same address as the Kentucky Dental Association. Thanks to Dr. Shad Lewis at DentalTown for this wonderful bit of sleuthing.The American Dental Association says that the KDA denies the address connection in this announcement published October 25.

THE FINAL WORD? (updated October 28, 2013) The DentiDrill isn’t real. It’s a hoax. The Dutch dental insurance company responsible for the publicity stunt probably didn’t realize that it would just make their business model seem like a joke as well.

You've been #hoaxed man RT @SubEWL: Ready to start saving on your healthcare? It's time to take control. #Dentidrill http://t.co/LzOq5hwGyH

— ixorg (@ixorg2) October 28, 2013

IV sedation can be fun – for the oral surgeon

September 13, 2013 By Trish Walraven 1 Comment

Haven’t you wondered what your patients experience when you send them to your most trusted oral surgeons? Here’s an in-depth video that explains the process of taking out their third molars:

I have to give the Awkward Spaceship sketch comedy group a HUGE thank-you for making this a top-notch, truly hilarious, dental-wanna-see video. I wish I could say I’ve seen a funnier skit or parody about dentistry but no one else even throws a paper ball anywhere close to where you guys throw ’em. So for now I’ll say congratulations and suggest a new challenge for Dentally Challenged:

Offering a smile makeover to someone whose teeth are the LEAST of their problems.

WWII dentistry video

September 3, 2013 By DentalBuzz Staff 3 Comments

What was ideal dentistry like seventy years ago?

Thanks to dentist Dr. Mac Lee of Edna, Texas for bringing this Navy training video to our attention for this edition of TimeWarp Tuesday. You will be both impressed by the way things were done back then and relieved that dentistry has progressed so much since. Even though it’s a bit longer than you’d usually sit through, remember PEARLS! There are pearls here, even in the way, way back times.

Like Smears! They were doing bacterial profiles in 1944! And Check Out That Piece of Autoclave Artwork. That is definitely something that would look good in your practice, and you would have to drive it, like you would a classic auto, not daily, but just BECAUSE. Sure, the new one is faster, but the old is a CLASSIC and you would use it because it’s too cool just to keep it locked up in a museum somewhere.

Be sure to look out for these bitty tids of juice as well:

• Procaine. That looks like some scary stuff to be injecting into people.
• The long exposure time on the radiograph.
• 10 minute sterilization in a water bath? Really?
• The surgery cart and tongs are creepy awesome.
• What the heck kind of toothbrushing technique is that?

With an emphasis of keeping everything super clean, this is probably the most memorable line in the video:

“Never should there be a sign of the last patient.”

We should all hope there’d be no bits of him anywhere afterwards.

Serious tongue action

August 28, 2013 By Trish Walraven 3 Comments

Are you in a state of media overshock after this gratuitous display of tongue-adge on a certain video awards show? No? But it may give you pause to think about all the naughtiness that tongues present to you as a dental clinician on a daily basis.

Most tongues behave themselves very well when you’re working in their realm. It IS the tongue’s kingdom after all; the mouth is where this majestic muscle rules supremely, preventing any dangerous objects from being inhaled or swallowed. However, there are some tongues that simply won’t cooperate, no matter how much you comfort and reassure them. See if you recognize any of these personalities in the tongues you have worked with.

The Stalker

This is a tongue that hangs back, ominously, but sort of follows you a tiny bit, like it’s planning to MURDER you while you’re simply blowing an occlusal surface dry. It is the godfather of tongues, so you had better not refuse its offer of allowing you to LIVE.

The Fist

If you encounter The Fist, you will be lucky to gain power over it. Usually appears when you’re working on an upper posterior tooth. The tongue will ball up and tighten so hard that you cannot wedge anything, not even oxygen itself, between the tooth and the tongue.

The Dive Bomber

You know you’re working with a Dive Bomber tongue when the tip of it continuously pounds you from every direction. It wouldn’t be surprising at all if the patient were actually whistling downward and making the CRRR crash sound with every hit. Your dentistry may feel like the crumbled buildings in Space Invaders by the time this appointment is over.

The Wave

A tongue doing The Wave is bad. Not that it’s doing anything to get in your way, but when the ripple of peristaltic action starts quivering along the rim of the tongue, that usually means that the patient is about a half-second away from a gag and a wretch. Have your high-speed suction available for…um…incidentals.

The Bulldozer

Everyone has had experience with this tongue. It’s one big bully, pushing you around, scooping up the rubber dam clamp and pelting it against the wall before you even consider straightjacketing it with your square of latex. The Bulldozer will warp impression vinyl into a freakshow of “was that a human or an octopus?” when questioned by your lab, and is generally violent towards anything you try to put in the attached patient’s mouth.

The Lover

This tongue is so embarrassing! You’re working along, minding your manners, when it just sort-of slinks up the handle of your mouth mirror and begins pole dancing. Worst of all is seeing this happen to a straight male dentist by an apparently straight male patient who has no idea that his tongue is lovingly caressing the tools. You just. Can’t. Say. Anything. But your assistant will, after the appointment, behind your back. Or worse, to your face.

The Exorcist

I’ve only seen The Exorcist once. Okay, twice, but it was the same patient, and I would have never believed that a tongue could move like that unless I’d seen it with my own eyes. The Exorcist stands up, perfectly straight in the center of the mouth and slowly and continuously rotates in a clockwise direction while you’re cleaning the left side of the mouth, and then stops and begins rotating in the opposite direction when cleaning the other side. The only reason I didn’t call a priest was because the patient’s health history showed she was taking some major antidepressants and schizophrenia medications.

The Puppy Dog

Like a real puppy dog, this tongue is actually kind of cute. It bounces, following you around while you’re touring a patient’s mouth, stopping to sniff while you check the edge of an old amalgam, wagging its tail when you give it a little attention. It’ll even pee on itself if it gets nervous. Yeah, you’ve seen that submandibular salivary gland gleek squirt piddle.

The Cobra

The Cobra should be heeded, but it is more of a display than an actual threat. When a patient’s tongue slowly raises up and looks like a curved shield about to strike, get out your clarinet. It’s time for a little snake charming.

The Victim

This tongue acts like it’s been maimed and waterboarded, cowering in the back of the throat like it’s trying to make itself as small as possible. You actually feel sorry for The Victim, and find yourself trying to convince the patient that you’re not the dentist from The Marathon Man, which can cause some funny looks from the oblivious. One problem with The Victim is that it may end up consoling itself by acting out its former abuse and become The Lover. NOOOOOOOOOO!

And if this is the best tongue-in-cheek humor you’ve EVER READ you need to share it now. Oh that was bad. But share, because the world needs more tongue humor, at least.