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Prosthetic joint wha-what?

December 19, 2012 By Trish Walraven Leave a Comment

Bendy fake joints may not be susceptible to the bacteria introduced during dental procedures after all.

According to a systematic review of the research involving prosthetic knees and hips conducted collaboratively by the American Dental Association and the American Academy of Orthopaedic Surgeons, it was announced yesterday that there was no increase in the odds of developing a prosthetic joint infection as a result of invasive dental procedures.

This means that the Antibiotic Prophylaxis Guidelines have been updated with some sort of vague blurburbmush gabble guhg that essentially states what I’ve been saying for YEARS! When patients ask why they have to choke down those four huge amoxicillin capsules an hour before their dental visit, my answer has been something along the lines of “because it protects the dentist against liability.” This has taken some tact, of course, with explanations of how open sores in the mouth allow bacteremias every time that a toothbrush pops open a pocket and causes untold blood-squirtage- these aren’t necessarily negotiated with daily doses of doxycycline. We’ve all realized it’s good homecare, not an antibiotic, that is the key to preventing oral bacteria from getting into the bloodstream and infecting artificial joints.

Thank you, ADA, for affirming the overkill of antibiotic prophylaxis.


For the rest of the story, here’s the link:


 

http://www.ada.org/news/8061.aspx

_________

 Update 1/2/2015:

Antibiotic premedication for joints is still not recommended.This clarification was published by the ADA yesterday:

Background. A panel of experts (the 2014 Panel) convened by the American Dental Association Council on Scientific Affairs developed an evidence-based clinical practice guideline (CPG) on the use of prophylactic antibiotics in patients with prosthetic joints who are undergoing dental procedures. This CPG is intended to clarify the “Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures: Evidence-based Guideline and Evidence Report,” which was developed and published by the American Academy of Orthopaedic Surgeons and the American Dental Association (the 2012 Panel).

Types of Studies Reviewed. The 2014 Panel based the current CPG on literature search results and direct evidence contained in the comprehensive systematic review published by the 2012 Panel, as well as the results from an updated literature search. The 2014 Panel identified 4 case-control studies.

Results. The 2014 Panel judged that the current best evidence failed to demonstrate an association between dental procedures and prosthetic joint infection (PJI). The 2014 Panel also presented information about antibiotic resistance, adverse drug reactions, and costs associated with prescribing antibiotics for PJI prophylaxis.

Practical Implications. The 2014 Panel made the following clinical recommendation: In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection. The practitioner and patient should consider possible clinical circumstances that may suggest the presence of a significant medical risk in providing dental care without antibiotic prophylaxis, as well as the known risks of frequent or widespread antibiotic use. As part of the evidence-based approach to care, this clinical recommendation should be integrated with the practitioner’s professional judgment and the patient’s needs and preferences.

CONCLUSIONS

Evidence fails to demonstrate an association between dental procedures and PJI or any effectiveness for antibiotic prophylaxis. Given this information in conjunction with the potential harm from antibiotic use, using antibiotics before dental procedures is not recommended to prevent PJI. Additional case-control studies are needed to increase the level of certainty in the evidence to a level higher than moderate.

The entire content can be read here:

http://jada.ada.org/content/146/1/11.full

Filed Under: News, Operative Dentistry Tagged With: American Dental Association, antibiotic prophylaxis, antibiotics before dental procedure, dental premedication for prosthetic joints, joint replacement

No more freedom flossers

October 27, 2012 By Trish Walraven Leave a Comment

The Wall Street Journal must have been having a slow day yesterday when they published this article about all the ways that dental floss has been used as a weapon or as a means of escape by inmates over the years. Seems that last month a group of New York prisoners decided to sue because they were getting cavities from not flossing.

What an excuse for American ingenuity to strike – let’s make a floss out of those annoying rubber bands that are sewn into new clothes to keep them on the hanger in the store! By the way, here’s how to break those off of your T-shirts:

Notice how he’s wearing a white dress shirt backwards to make him look like a mental patient…err… dentist. And wrapping the floss professionally around HIS INDEX FINGERS. Every dental professional knows that the middle finger is the way to go. Flip the bird, double flip, point ’em high. That’s the way to break it. Otherwise you’re also suggesting that users should cut their circulation off when they floss. Next thing you know the inmates will be suing because they’ve got gangrene in their nailbeds.

So anyways, here’s the Floss Loops website. The guy who owns the patent also sells inmate-safe soft toothbrushes so if you’re curious about those go take a look. At this posting all the brochures are 404-not-found, but at least you can get an idea of the toothbrush and floss you might have to use when you do finally go all “insane dentist” on the last patient that just really has it coming.

 

Filed Under: News, Preventive Care, Products Tagged With: dental care for inmates, Floss loops, prison dentistry

Bad hair restoration

August 29, 2012 By Trish Walraven 1 Comment

Last week, when the story of the botched fresco restoration in Spain went viral, I couldn’t help but wonder if this were the worst… or best… thing that had ever happened to the little church. I imagine the humiliation that the well-intentioned elderly parishioner has been feeling for her actions, and the fear that she will be sued for defacing this work of art which used to depict Jesus. She is reportedly suffering from anxiety attacks ever since her work became known.

But the Internet has turned her into a celebrity. Instead of taking the terrible painting at face value, it is becoming known as “a masterpiece of contemporary surrealism” and “perhaps its own kind of metaphor for modern man.” The church has become a tourist attraction, and there’s even a petition to prevent the fresco from being altered from its current state.

Best of all, the image has become a sort of meme, parody-ing its way into every crevice of Twitter and Facebook. If I were ever in Spain, I definitely would have to visit this fresco now and would be sad if it were ever restored in the normal convention.

And forgotten.

So when Jay Leno picks on a dentist for having bad hair, well, sometimes mainstream is the WORST thing you can be, and if there’s one thing Leno panders to, it’s the mainstream. What’s bad to the mainstream might be… postmodern !!! to those clients that you’re hoping to attract. Fellow dental blogger Mike Barr shares this video clip from The Tonight Show:

I

It’s not so bad. I mean, he’s an LVI-trained dentist, he’s a sculpted work of art himself – either you get him, or you don’t. Challenging? Yes. Dismissable? Let’s just say that I couldn’t leave this one alone:

 

Try as I might, I REALLY couldn’t leave it alone. Maybe the dentist would look better on the fresco itself????

 

On third thought, maybe it’s just best to preserve him in raw form and let the art speak for itself:

 

 

A big thanks goes out to Dr. G for being such a sport, knowing that it’s all in fun, and that anyone who picks on your hair is just jealous of your ripped body.

Filed Under: Fun, Humor, Marketing, News

How do you say “titillating” in Japanese?

July 27, 2012 By Trish Walraven Leave a Comment

If you think that this sort of thing doesn’t happen here in the US, you’re wrong. Only we don’t use boobs, because that’s too obvious (not to mention, quite unacceptable in our culture). When times are tough, desperation can drive dentists to other ethical edges, like hiring only hygienists that are willing to sell unnecessary treatment to patients… instead of their own bodies.

 

Japan’s zoftig hygienists keep dental patients coming back for tender, rubbing care

A clinic hires only cute women in order to attract patients

by Kazutaka Shimanaka, The Tokyo Reporter

I was so shocked, my jaw was hanging in astonishment. After all, I am a dental hygienist.”

So says Hiromi, a 24-year-old native of Shizuoka Prefecture, who, after graduating from an occupational training school, sought work in a Tokyo dental clinic as a hygienist.

“The head doctor’s a real slimeball, he only hires cute women in order to attract patients,” she reveals to Shukan Taishu.

Hiromi and three cute colleagues at the clinic filled out their tight, white uniforms, which in addition to exposing cleavage are also designed to show lots of leg.

“The clinic attracts salarymen working in the area,” she says. “We were told the uniform went with the job.”
About three months after she was hired, Hiromi was told by the doctor to emulate an older assistant named Megumi. While the sensei was filling a patient’s cavity, Megumi would lean up against their shoulder, giving them a generous feel of her substantial mammaries.

So good was her service that the patients were in the practice of requesting Megumi by name when they phoned for an appointment.

“Well then, I’ll give the patients an oppai (tittie) rub, the way Megumi does,” Hiromi informed her employer, who nodded in approval.

“Please do understand that in this business, times are hard, and that’s what we’ve got to do if we want to eat,” he explained. “If you emulate Megumi, patients will be able to disregard their pain, and want to come back again, you see? It’s a good form of communication beween the hygienist and the patients. And they’ll come back for more expensive treatments that aren’t covered by their health insurance.”

Actually Megumi was extremely talented in persuading patients for such elective services, cooing softly into their ear as she motherly nudged them, saying things like, “Rather than a silver crown, which will make you look older, a ceramic one will be much more attractive.”

But then something happened that discouraged Hiromi from working at that particular clinic.

It seems that while removing tar stains from the teeth of a middle-aged patient, he began returning the skinship, using his shoulder.

“He also began licking my finger while it was in his mouth,” she complained.

No longer able to restrain himself, the patient shifted to a full manual assault on her breasts, to which she loudly voiced her objections.

The head of the clinic, seeing that the patient was a good customer, told Hiromi to grin and bear it, and she resigned in a huff.

“The market for dental clinics in Tokyo is saturated, with more clinics than convenience stores. The situation has become severe,” says 26-year-old physician Mariko Yamashita. “What’s more, other businesses have been draining off dental patients, such as cosmetic surgeons who perform implants and estheticians who can do tooth whitening.”

In the past, dentists were once one of Japan’s “big three” most profitable operations, along with pachinko shops and obstetricians. But those days are gone for good.

“Patients who used to go running to their dentist whenever they felt a twinge of pain now refrain, or else only request work that is covered by their health insurance,” journalist Junji Maki tells Shukan Taishu. “That’s why I suppose clinics have become increasingly aggressive in efforts to attract more patients.”

A recent white paper on dental care reported that dentists need to treat 20 patients per day to break even, and that one dentist in five earns less than three million yen per year — less than the average cab driver.

Under such circumstances, the article concludes the emergence of doctors who expect hygienists to perform “breast massages” on patients may be a harbinger of a coming collapse in the dental profession. (K.S.)

Source: “Bijin shika eiseishi ga kokuhatsu! Shika iin no oppai eigyo gyoten jittai,” Shukan Taishu (August 6, 2012 issue, page 190)

 

 

Filed Under: Anecdotes, Money, News Tagged With: dental hygiene ethics, Japanese dentists, workplace harassment

‘Dollars and Dentists’ Frontline PBS Report

June 27, 2012 By Eva Watson 1 Comment

‘FRONTLINE and the Center for Public Integrity investigate the shocking consequences of a broken dental care system.’

If those in the industry have not viewed this report please do so.

It’s an important story that greatly affects the unemployed, underemployed, and working poor of this country.

On the flip side, if a dental professional wishes to be a part of a corporate dentistry practice, backed up by a multi-million dollar, private equity firm to make big bucks, this PBS airing is for you, baby!

America! Profits! Woot!

Filed Under: Money, News

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DentalBuzz explores rising trends in dentistry with its own slant. The speed at which new products and ideas enter the dental field can often outpace our ability to understand just exactly the direction in which we are heading. But somehow, by being a little less serious about dentistry and dental care, we might get closer to making sense of it all.

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