Pediatric tooth decay is a growing crisis in the United Kingdom (UK), affecting 34% of 12-year-olds surveyed in a 2013 study. Yet if all of the 12-year-olds in the UK chewed sugar-free gum after eating or drinking 3 times a day, the National Health Service (NHS) could save £8.2 million a year on dental treatment, according to the Plymouth University Peninsula Schools of Medicine and Dentistry.
“Crucially, whilst these figures are significant, they refer only to cost reductions for treating 12-year-olds in the UK,” said professor Liz Kay, co-author of the study. “If this model was to be applied to the whole population, then there is a real potential to create substantial NHS savings. Clinical evidence has already proved that sugar-free gum can help prevent caries, and now we can also see a clear financial advantage.”
Chewing sugar-free gum after eating and drinking increases saliva production, which helps to wash away food particles and neutralize harmful plaque acids. It also promotes the remineralization of tooth enamel. While the British Dental Health Foundation says that brushing for 2 minutes twice a day is the best way to maintain oral hygiene, chewing sugar-free gum can be extremely effective as well.
Studies have shown that poor oral health in childhood or adolescence can lead to poor oral health in adulthood, creating vast costs to the NHS throughout the patient’s lifetime through replaced fillings and implanted crowns, bridges, and prosthetics. Also, poor oral health can affect self-esteem, with 35% of 12-year-olds saying they were embarrassed to smile or laugh due to their teeth.
More than one million patients in the UK use NHS dental services each week, many for dental disease, costing the NHS £3.4 billion each year. With the NHS facing a huge funding gap, the researchers suggested, new solutions such as sugar-free gum should be encouraged to reduce tooth decay. The study was published in the British Dental Journal.
Plaque accumulates around the rough surfaces of retainers, and enamel demineralization may follow. According to research from the Hamadan University of Medical Sciences in Iran, adding silver nanoparticles to retainers can reduce the bacteria causing this demineralization.
The study comprised 36 orthodontic patients at the debonding stage of orthodontic treatment. One group of patients received conventional removable retainers. The other group received removable retainers that contained silver nanoparticles that measured about 40 nm in size and 500 PPM in concentration.
Next, the researchers took swab samples from the maxillary palatal side of each patient at retainer placement one week after debonding and again 7 weeks later. The researchers then measured the number of Streptococcus mutans colony-forming units in these samples.
The patients with the silver retainers had higher S mutans colony counts than the control group at the first measurement. Yet 7 weeks later, they showed a significant reduction in the number of colonies. The mean difference of colony counts between the groups was 40.31.
The researchers concluded that adding silver nanoparticles to the acrylic plate of retainers had a strong antimicrobial effect against S mutans under clinical conditions. The study was published by the American Journal of Orthodontics & Dentofacial Orthopedics.
Competition is the bane of a dental practice’s existence. It’s good for the patients, but bad for business.
Today it isn’t enough to “hang a shingle,” because you’re no longer the only game in town. Years ago, there was a neighborhood dentist, and that’s where everyone in a family went. But loyalty is a thing of the past. Technology replaced it.
Dental practices that reach patients via social media and other contemporary digital marketing techniques are the ones with the full appointment calendars.
If patients don’t feel appreciated or connected with a practice, it is a lot easier for them to switch to the dentist down the street who is offering an exceptional deal on whitening that they saw on Instagram.
Like it or not, you need to stay in front of your audience. Here are just a few tips that will go a long way toward patient retention:
- Use email and social media to build better, longer lasting relationships with patients outside of the two times a year you see them.
- Patients know when you are sending templated emails or social media posts. They’re easy to spot. Stop sending those boring pieces of content and customize the message. Make it fun!
- Provide interesting facts and helpful tips, and use a lighthearted tone.
- Show case studies and before and after photos.
- Provide your patients the benefits of accepting a treatment, not just the features. In other words, speak their language.
- Get your patients to engage with your social media pages with content they would like to see. Post about events going on in the office. Share photos of the doctor and staff. Ask them questions. Or, offer a contest.
It costs money to acquire patients. But you also hate to lose them because you’re in dentistry to help people, to see them thrive and cure what ails them. It’s not 1985 anymore. Your geographic desirability is no assurance of patient loyalty.
Patients can’t always come to the office. Sometimes, the office has to come to them. With the world’s largest mobile clinic—a trailer that’s 48 feet long and 22 feet wide—the Herman Ostrow School of Dentistry at the University of Southern California (USC) can reach many patients.
The trailer made its debut on Feb. 6 with a ribbon-cutting ceremony and more at the Westminster Presbyterian Church in Pasadena, Calif. Faculty, staff, and more than 85 dental students attended the event and provided dental treatment to 120 disadvantaged children.
“It is our hope that these community experiences engender in our students a lasting commitment to give back to the community,” said Avishai Sadan, DMD, dean of the dental school.
The trailer is the eighth mobile clinic in the school’s fleet, which, outside of the military, is the largest in the nation. The custom-made mobile facility is equipped with 8 dental chairs, a separate x-ray room, and the Synesthesia patient-calming system, which uses soft music and vibrant imagery to soothe anxiety.
“Today, my dream has come to fruition, to combine social work and dentistry and share my family’s good fortune,” said Catherine Hutto of the Hutto-Patterson Charitable Foundation, which supported the mobile clinic with a $3 million gift.
USC also will use the funding to provide faculty endowments and student scholarships to community-minded individuals in both dentistry and social work. It will help establish collaboration between the dental school and USC’s school of social work to better provide healthcare and outreach services to disadvantaged families as well—carrying on the legacy of the late Charlie Goldstein, a faculty member often called the “father of USC’s community dentistry.”
“You know, standing here today, I can’t help but think how happy Charlie Goldstein would be to see how the program he started has flourished,” said Dr. Roseann Mulligan, associate dean of community health programs and hospital affairs. “Charlie often said the best thing you can do in life is to help others,” she said. “I hope to impart that wisdom to every one of my students, year after year, so that one day no one will have to suffer through dental pain simply because they cannot afford to see a dentist.”
The cost of dental school can total hundreds of thousands of dollars, leaving graduates with significant debt before they even begin their career. Options are available, though, for aspiring practitioners who have a passion to serve both their patients and their country.
The US Navy is now recruiting students and recent graduates as well as established professionals for its Dental Corps. Those who enlist can benefit from scholarships and other financial aid that cover the costs of going to school completely, including specialty training after graduation, plus bonuses.
“If you’re an undergrad—say, a junior—and you’re about to take the Dental Admission Test (DAT) this summer, it would be best to talk to us right around the time you take the DAT,” said Chief Justin Rains, a naval recruiter. “That way we can start an application prior to your senior year and get it completed by the time you start applying to dental schools.”
The Navy then will pay for the dental school’s full tuition, regardless of whether it is a public or private school. It also will cover all books and fees. Plus, the Navy offers a $20,000 signing bonus and an approximately $2,200 a month stipend for expenses so students don’t have to worry about working to support themselves while they’re studying.
“Once you’re in dental school, you’re in dental school. That’s your main focus,” said Rains. “After that is when the service obligation will take effect, once you’re a fully trained dentist.”
Graduates report to Newport, RI, for the Navy’s 5-week Officer Development School as commissioned lieutenants. There, they learn leadership techniques in addition to naval history and culture. After that, they serve for 4 years with the Navy’s medical centers, with more than 250 facilities around the globe.
These recruits also could serve at sea on board the USNS Mercy and USNS Comfort, which are the Navy’s dedicated hospital vessels, or other larger ships like its aircraft carriers, where practitioners are responsible for the care of everyone on board. Procedures in any of these locations can range from exams to oral surgery. Dentists treat combat injuries as well.
“If you’re one dentist on a ship, and you have thousands of Marines and sailors, you do everything,” said Rains.
That broad range of treatment gives these recruits a wider variety of experiences than they would expect to get in the early years of private practice, Rains said. Naval dentists also can concentrate on treatment without worrying about malpractice insurance or getting reimbursed for providing care. The equipment is cutting-edge, too.
“We are on the forefront of emerging technologies,” Rains said. “Everything that comes out, the Navy is one of the first to get it. We’re a government agency, so a lot of the technology you see, we’re already into it.”
And like the civilian world, the Navy is concerned with ongoing learning. Its dentists can go on temporary assigned duty to attend seminars at conferences. For instance, many of its dentists in Newport travelled to the recent Yankee Dental Congress in Boston to catch up on their continuing education units. Courses also are offered in house.
These benefits aren’t just available to young dentists looking to establish themselves, though. The Navy is recruiting practitioners who are already working and willing to commit one weekend a month and 2 weeks a year for 3 years to the Naval Reserves. Typically, reservists simply report to a naval facility in their area for duty.
“You can keep your civilian job. You stay where you are. Your home is your home. Just that one weekend a month you travel to the nearest base to you. We have more than 10 in the New England area,” said Rains. “And then 2 weeks a year is when we utilize you more for your specialty.”
In fact, Rains said, many veterans who were on active duty in their youth join the Reserves later in life because of their commitment to service—though there are financial benefits too, including a $10,000 signing bonus for general dentists. New positions for general practitioners up to the age of 58 open up each October.
Right now, the Navy especially needs oral and maxillofacial surgeons. These specialists will receive a $75,000 signing bonus for the Reserves and a $300,000 signing bonus for active duty. Regardless of the specialty, and like their active duty colleagues, dentists in the Navy Reserve are commissioned as officers after completing training requirements.
To qualify for the Dental Corps, dentists must be US citizens currently practicing in the United States or graduates of an eligible dental school approved by the ADA. They also must be licensed to practice in a US state or territory. New graduates must get their license within a year of beginning active duty service.
Recruits get more out of serving than monetary rewards and practical experience, though. Dentists who serve gain valuable leadership skills, Rains said. Plus, there are opportunities for travel and a sense of community that can’t be found anywhere else.
“My family has grown while I’ve been in the Navy,” Rains said. “It’s been great to me. I’ve been able to see the world. I’ve been able to complete my education, and it’s given me security and a job that I love.”
In 2008, scientists recovered the skull of an Australopithecus sediba. This diminutive pre-human species that lived in southern Africa about 2 million years ago could be one of our ancestors or relatives. While research published in 2012 suggested its woodland diet consisted of hard foods, tree bark, fruit, leaves, and other plant products, new computer modeling of its jaw and teeth indicate that it couldn’t tackle such difficult foods—possibly affecting our evolutionary course.
“Most australopiths had amazing adaptations in their jaws, teeth, and faces that allowed them to process foods that were difficult to chew or crack open,” said David Strait, PhD, professor of anthropology at Washington University in St. Louis. “Among other things, they were able to efficiently bite down on foods with very high forces.”
“Then we find that A. sediba had an important limitation on its ability to bite powerfully,” said Justin Ledogar, PhD, Strait’s former student and a researcher at the University of New England in Australia. “If it had bitten as hard as possible on its molar teeth using the full force of its chewing muscles, it would have dislocated its jaw.”
The researchers biomechanically tested a computer-based model of the skull found in 2008. The work resembled testing used by engineers to determine if planes, cars, machine parts, and other mechanical devices are strong enough to avoid breaking during use. While the research did not address whether A. sediba is one of our close evolutionary relatives, it did provide evidence that dietary changes shaped the evolutionary paths of early humans.
“Examination of the microscopic damage on the surfaces of the teeth of A. sediba has led to the conclusion that the 2 individuals known from this species must have eaten hard foods shortly before they died. This gives us information about their feeding behavior,” said Strait. “Yet, an ability to bite powerfully is needed in order to eat hard foods like nuts or seeds. This tells us that even though A. sediba may have been able to eat some hard foods, it is very unlikely to have been adapted to eat hard foods.”
The consumption of hard foods is very unlikely to have led natural selection for favor the evolution of a feeding system that was limited in its ability to bite powerfully, Strait said. As a result, the foods that were important to A. sediba’s survival could have been eaten relatively easily without high forces.
The study, “Mechanical Evidence That Australopithecus Sediba Was Limited in Its Ability to Eat Hard Foods,” was published by Nature Communications.
Hand hygiene is essential to any procedure. Yet its implementation decreases among dental students as they gain clinical experience, according to researchers from Chulalongkorn University in Bangkok, Thailand.
The researchers collected bacterial samples on the hands of 120 first-, second-, and third-year clinical training and postgraduate students using a swab technique before and after they washed their hands for oral surgical procedures.
Next, the researchers cultured the samples and counted the colony-forming units. They also administered self-reported questionnaires to the students reflecting their knowledge, attitudes, and practices related to hand hygiene.
The handwashing eliminated more than 99% of the bacteria. However, significantly higher numbers of bacteria were recovered from the hands of the postgraduates compared to the hands of the clinical training students.
Also, the hands of the third-year clinical students had significantly higher numbers of bacteria than the first-year students after hand hygiene. The first-year clinical students had the highest attitude scores, while the postgraduates had the lowest practice scores. The knowledge scores were similar for all groups.
The researchers concluded that the effectiveness, attitudes, and practices of hand hygiene among dental students decrease as students gain more clinical experience, whereas knowledge did not. They also concluded that hand hygiene instruction should be provided throughout the duration of the dental students’ education.
The study, “Dental Student Hand Hygiene Decreased With Increased Clinical Experience,” was written by Nanmanas Yaembut, DDS, MS; Ruchanee S. Ampornaramveth, DDS, PhD; Pagaport P. Pisamturakit, DDS, PhD; and Keskanya Subbalekha, DDS, PhD. It was published by the Journal of Surgical Education.
Peri-implantitis not only affects the patient; it also affects the implant. One recent study compared what ligature-induced peri-implantitis can do to dental implants built using different surface treatments.
The researchers inserted 32 dental implants prepared with machined, sandblasted, acid-etched, sputter hydroxyapatite (HA) coated, and plasma-sprayed HA coated surface treatments into canine mandibles. Oral hygiene procedures were halted after 12 weeks. Silk ligatures then were placed around the implant abutments so plaque could accumulate for the following 16 weeks.
After retrieving the implants and surrounding tissue, the researchers next used scanning electron microscopy and energy dispersive x-ray spectroscopy to examine the bone-to-implant contact (BIC) and implant surfaces. Marginal bone loss and large inflammatory cell infiltrates were found in the peri-implant soft tissue.
The sputter HA implants had the largest BIC values at 98.1%, and the machined implants had the smallest BIC values at 70.4%. Also, the thin sputter HA coat was almost completely dissolved after 28 weeks, while the plasma-sprayed HA coat’s thickness was completely preserved.
The study, “Effect of Induced Peri-implantitis on Dental Implants With and Without Ultrathin Hydroxyapatite Coating,” was published by Implant Dentistry.