Preventive care provided by dentists for children before the age of 2 years enrolled in Medicaid in Alabama may lead to more long-term care, reports the University of Alabama at Birmingham School of Public Health. A study there has associated early preventive care with more frequent subsequent treatment for tooth decay, more visits, and more spending on dental care.
While professional dental organizations all recommend children see a dentist once their baby teeth begin to come in, limited evidence has been available about the effectiveness of early preventive dental care or whether primary care providers can deliver it. And despite the focus on preventive dental care, dental caries in children under the age of 5 years has been rising, according to the researchers.
The study compared tooth decay-related treatment, visits, and dental expenditures for children receiving preventive dental care from a dentist or primary care provider and those receiving no preventive dental care. It analyzed Medicaid data from 19,658 children in Alabama, 25.8% of whom received preventive care from a dentist before they were 2 years old.
Compared to similar children without early preventive dental care, children who received early preventive care from a dentist had more frequent tooth decay-related treatment (20.6% versus 11.3%), a higher rate of visits, and higher annual dental expenditures ($168 versus $87). Preventive care delivered by primary care providers was not significantly associated with tooth decay-related treatment or expenditures, according to the results.
“This study highlights the need for continued careful evaluation of the evidence basis for clinical recommendations,” said Justin Blackburn, PhD, assistant professor in the Department of Health Care Organization and Policy at the school. “What we find is that we cannot definitively say whether early preventive dental visits reduce tooth decay with the available data.”
The researchers note that the study had limitations. For example, it did not measure other benefits of preventive dental care such as improved quality of life, nor did it include information about oral health behaviors such as teeth brushing. Also, it did not include information regarding water fluoridation.
Regardless of the provider, the researchers observed little evidence of the benefits of this care. The preventive care from dentists even seemed to increase caries-related treatment, which surprised the researchers, who concluded that additional research among other populations and beyond administrative data may be necessary to elucidate the true effects of early preventive dental care.
The study, “Outcomes Associated With Early Preventive Dental Care Among Medicaid-Enrolled Children in Alabama,” was published by JAMA Pediatrics.
Dr. Chiann Fann Gibson, president of the American Academy of Cosmetic Dentistry (AACD) and the Chicago Midwest Academy of Cosmetic Dentistry, dropped by the Dentistry Today booth during the Chicago Midwinter Meeting (CMW). A general dentist with expertise in aesthetics, she also is the author of our February issue’s cover story, “A Multidisciplinary Approach to Cosmetic Rehabilitation.”
With CS Boost, dentists have in-office and out-of-office web and mobile access to their clinical and practice management information. A new software solution for Carestream Dental cloud users, it provides secure, fast access to appointments, patient searches, and clinical information via a web app on traditional computing devices or via a native mobile app on iOS and Android devices.
Dentists can easily access their schedules and filter them by provider and/or location. And when viewing schedules, appointment details can be accessed to view notes, alerts, provider, and even chair location.
The app is HIPAA-compliant, with built-in audits and logs to protect practices. It’s currently available for free to all CS PracticeWorks Cloud, CS OrthoTrac Cloud, and CS WinOMS Cloud users and can be found on Google Play and in the Apple Store.
For more information, call Carestream Dental at (800) 944-6365 or visit carestreamdental.com.
Patients with trigeminal neuralgia endure sharp, lancinating pain in their teeth and face triggered by touch, such as when they shave, shower, and brush their teeth. But current pharmaceutical treatments sometimes leave patients tired and unable to concentrate. Now, the Center of Dental Medicine at the University of Zurich has developed a substance that effectively inhibits the pain without these unwelcome side effects.
Pain signals reach the brain via the activation of sodium channels located in the membranes of nerve cells. A sodium channel known as “1.7” is frequently expressed on pain-conducting nerves, and higher pain intensity is linked to higher channel activity. Blocking this sodium channel via treatments such as local anesthetics can inhibit the pain.
The neuropathic pain that comes with trigeminal neuralgia happens as a result of irritation of the trigeminal nerve, which is responsible for the sensory innervation of the face, parts of the scalp, and the oral cavity. In trigeminal neuralgia, the nerve damage is presumed to be at the base of the skull. This region is difficult to reach by local injections, though, requiring drug treatment and even surgery, depending on the case.
A substance called BIIB074 inhibits the 1.7 sodium channel state-dependently, meaning the more active 1.7 gets, the stronger it is blocked by BIIB074. Current medications, however, block 1.7 regardless of the nerve activity, resulting in burdening side effects. These results were demonstrated in an international Phase II study.
“Unlike conventional drugs, which often cause tiredness and concentration problems, BIIB074 was not only effective, but also very well tolerated,” said Dominik Ettlin, MD, DMD, a dental specialist at the university. “We will now test the new substance in a lot more subjects during the next study phase, which will reveal whether the new hope for more effective pain relief is justified.”
Trigeminal neuralgia occurs most often in people older than age 50 years, reports the National Institute of Neurological Disorders and Stroke, and it is more common in women than in men. There are about 12 new cases per 100,000 people in the United States each year. The typical form of the disorder involves sudden burning or shocking sensations that last from a few seconds to 2 minutes, while the atypical form involves constant but less intense pain.
The study, “Safety and Efficacy of a Nav1.7 Selective Sodium Channel Blocker in Trigeminal Neuralgia: A Double-Blind, Placebo-Controlled, Randomized Withdrawal Phase 2a Trial,” was published in The Lancet Neurology.
In 2008, 40% of Department of Defense Selected Reserve troops were classified as unfit for duty due to their dental readiness. Many others sent downrange developed dental problems during their deployment.
“When they reported to their deployment centers before leaving the United States, they said their teeth didn’t hurt and were told they were deployable,” said Army Col. David DuBois, a dental surgeon for the US Army Reserve Command. “When they got to their destination, it turned into a disaster.”
To correct the situation, the Armed Services put new dental programs in place. In the past 8 years, the services have reduced the proportion of unfit troops due to dental problems from 40% of all military reservists to 10%.
“Historically, dental readiness was the most problematic Department of Defense individual medical readiness requirement,” said Army Col. James Honey, chief of the TRICARE military healthcare program’s dental care section. “But we put more resources on the problem and now see better dental readiness within the services.”
For example, the Army Selected Reserve Dental Readiness System uses the Reserve Health Readiness Program as the primary contact vehicle to allow soldiers to receive no-cost exams and treatment of Dental Fitness Classification (DFC) 3 conditions and no cost. DFC 3 indicates a dental condition that, if not treated, will result in a dental emergency within 12 months.
The Army Selected Reserve Dental Readiness System helps commanders at all levels reach unit dental ready status. It also sends reminders to soldiers about upcoming dental appointments and tracks dental readiness to prevent the need for examination and DFC 3 treatment when the unit is alerted and arrives at the mobilization station.
Enhancements to prevention and access to dental care help increase readiness for all service members, Honey said.
“We see this as the same as any physical fitness requirement or wearing the uniform properly,” said Honey. “We expect everyone to have dental readiness.”
Teeth need to be as healthy as possible before deployment because rough conditions in deployed locations can tax the body’s abilities to respond to health issues, including dental problems. the Military Health System reports. The choice between dental care at home and dental care downrange is obvious, DuBois said.
“If I had to choose between a nice, air-conditioned office or a makeshift clinic in tough conditions, I know which one I would want,” said DuBois. “It’s much better to take care of this stuff at home.”
Last week’s Chicago Midwinter Meeting saw the release of new products, technology, procedures, and more, and the Dentistry Today team was there to bring you the top dental news. In case you missed any of our coverage, click on this week’s Wednesday Watch to see some highlights. Full videos can be seen at dentistrytoday.com.
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Convergent Dental’s latest software upgrade for its Solea laser, Solea SW 3.1.1, is designed to provide more usability and control while further enhancing the patient experience without anesthesia. With updated algorithms that control how the laser cuts both hard and soft tissue, Solea SW 3.1.1 facilitates the onset of analgesia more quickly and effectively than ever before, according to the company, for exceptional cutting speed ability in both hard and soft tissue.
“We are constantly gathering data on how our customers use Solea and how their patients experience it. That gets fed into the product development process and incorporated into software improvements that improve cutting speed, analgesia, the ability to control bleeding, and more,” said Michael Cataldo, CEO of Convergent Dental. “Simply put, the more Solea is used, the smarter it gets. All of that accrues to the benefit of our customers and their patients, no matter when Solea was integrated into the practice.”
Solea SW 3.1.1 is available at no charge to all Solea customers with an active service contract. Customers simply type a 4-digit personal identification number into their Solea unit, and the laser automatically downloads the update via Wi-Fi. No additional external service calls or technician visits are needed.
“After a quick and simple download, from the first use of Solea SW 3.1.1, it offered an improved experience for both me and my patients,” said Dr. Yooson Kim, who took part in the update’s beta test phase. “The onset of analgesia was almost automatic, and the cutting speed just keeps getting faster. I didn’t think it was possible for Solea to be even simpler to use, but Convergent Dental has exceeded my expectations once again.”
Unlike conventional NiTi files, for example, the XP-3D Shaper features the company’s MaxWire Technology, which allows the instrument to expand and become more robust when exposed to body temperature. Once an adequate glide path is established, the XP-3D Shaper can clean the entire canal without the need for multiple files.
The XP-3D Shaper also features a small flexible core (No. 30.01) that is extremely resistant to cyclic fatigue, according to Brasseler USA. Its unique serpentine design allows the instrument to gently abrade the inner walls of the root canal without the stress associated with conventional NiTi files.
With conventional solid-core NiTi files, clinicians often are forced to over-prepare or under-prepare the canal. The XP-3D Shaper’s unique free-floating adaptive core, however, allows the instrument’s smaller central core to move freely and adapt to the canal’s natural anatomy. It also creates enhanced turbulence for improved irrigation.
XP-3D Shapers are packaged in single-use sets of 3 files each for simplified handling and sterile application. They can be used with any endodontic handpiece, though Brasseler USA suggests use with its EndoSync Endodontic Handpiece System, which provides real-time apex locator readings as users progress down the canal.
The CORE Chair includes an adjustable and double-articulating, pinch-style headrest that fits a wide range of patients. Built with a fluid hydraulic cantilever mechanism, it swivels 15° to the left and to the right. Located on its back, the brake secures the chair in a stationary position and features emergency shut-down functionality. A touchpad provides control for each of the chair’s functions, and an optional foot control comes with 4 programmable preset positions. Plus, the CORE Chair is outfitted with seamed, durable NaugaSoft upholstery. It rests on a foundation made of durable cast iron, while its back, base, armrest, and headrest are outfitted with aluminum casting.
The CORE Delivery Unit comes with 5 integrated handpiece holders. Snap-on caps are available to cover unused holders for a clean, streamlined look. Also, its recessed, secure tray placement is designed for stability. Magellan mounted, it allows for right- or left-handed dentistry and comes with a side handle break for easy maneuvering. With 4 different positions, its rear assistant instrumentation can be located wherever the assistant is seated or standing. Designed for easy accessibility, a solids collector is located in the middle of the unit. Optional integrated touchpads are available as well.
The rectangular CORE LED Light features 3 long-lasting, energy-efficient LED bulbs. With dual-axis movement, the CORE Light is designed to be effortlessly controlled by a sensor that reacts to a simple wave of the hand, turning the light on or off and changing intensity levels to low (10,000 lux), medium (20,000 lux) or high (30,000 lux) light. Its removable handles are magnetic, and the lens can be removed so it can be cleaned.
Developed by VIAX Dental Technologies, NOVO Smile Shapers are noninvasive, reversible cosmetic arches that slide over existing teeth to create a beautiful, dazzling white smile. They transform worn, misshapen, broken, and discolored teeth into the most natural and beautiful smile possible.
To utilize NOVO Smile Shapers, no shots or anesthetic are required. The procedure is entirely pain-free, and no reduction of tooth structure is required. And unlike other dental procedures that require grinding, cutting, and removal of tooth structure, NOVO Smile Shapers do not touch natural teeth.
Made of patented resin material made exclusively by VIAX Dental Laboratory, the arches create no postoperative sensitivity, and they are extremely natural looking because they are so thin. Patients can eat and drink while wearing them. In many cases, these arches can provide a viable alternative to expensive porcelain veneers, and they can be placed over crowns to rejuvenate old dental work.
For more information, call VIAX Dental Technologies at (844) 842-9522 or visit viaxdental.com.