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Sugary drinks are repeatedly named as one of the biggest culprits when it comes to poor oral health, particularly in young children. Packed full of sugar and sweeteners and containing empty calories, or calories with no nutritional impact, they have been demonized by many associated with the beverage and health industries. 

Back in March of 2016, Chancellor George Osborne of the United Kingdom announced in his budget a plan to introduce a levy on drinks containing more than 5 g of sugar per 100 ml. Effectively, the decision created a tax on sugary drinks. 

Although the tax doesn’t come into force until April 2018, it already has been generating a lot of interest. Figures are not confirmed, but some experts suggest that the amount of the tax could be as much as 20% of the sale price. But is the tax a good thing?

A Positive Message

For anyone dealing with people’s teeth, encouraging the reduced consumption of sugary drinks has become a key step in improving oral health. In terms of supporting that sentiment, the new tax really adds weight to the idea that consuming these drinks isn’t a good idea. So, it’s a positive move for the government to stand up and hit the manufacturers producing beverages with such high levels of sugar where it will hurt them the most—in their profits.

Obesity and Oral Health

There is no getting away from the link between sugar-filled drinks, oral health problems, and obesity, particularly in children. The tax is largely thought to be a response to a report by Public Health England, which identified that 29% of 11- to 18-year-olds’ daily sugar intake comes from sugary drinks.

Many health and weight loss charities believe that the additional cost that the tax adds to the price of these kinds of drinks could have a direct effect on reducing consumption, as people respond to price. The British Dental Association is fully behind the tax as a way to reduce the impact of sugar on oral health, supporting its introduction via its Make a Meal of It campaign.

Spotlight on Really Sugary Drinks

Part of the battle with drinks that are high in sugar is that consumers often don’t realize just how much sweet content they have. One positive effect of the sugar tax is that drinks will become more expensive, drawing attention to the fact that they have been caught by the tax and perhaps motivating consumers to look at the label.

Raising Cash 

Estimates put the figure raised from the tax at around £276 million per year (or $339 million), which could be plowed back into the UK via government spending. Of course, this kind of revenue gathering can be quite controversial as it comes from the public. However, most experts predict that the tax would not disproportionately affect one income group over another, so there isn’t one social group that is being particularly squeezed.

Estimates put the figure raised from the tax at around £276 million per year (or $339 million), which could be plowed back into the UK via government spending. Of course, this kind of revenue gathering can be quite controversial as it comes from the public. However, most experts predict that the tax would not disproportionately affect one income group over another, so there isn’t one social group that is being particularly squeezed.

The Backlash

Inevitably, there has been backlash against the suggested tax, and plenty has come from soft drink manufacturers. Coca Cola and the British Soft Drinks Association have already spoken out against the introduction of the tax, denying any link between sugary drinks and obesity and calling the tax “ineffective.” Others have highlighted the impact that a tax like this could have outside of the direct effect on consumers.

The think tank Oxford Economics has produced a report stating that the tax will only reduce sales by around 1.6%. It also highlighted that this could result in job losses of around 4,000 and a drop of £132 million (or $162 million) in the contribution that the beverage industry makes to the British economy. It is, however, worth noting that Oxford Economics’ clients include Coca Cola.

Will a Tax Actually Work?

There’s no doubt that obesity levels and poor oral health do need to be tackled. But whether a tax is the right way to do it remains an unanswered question. Those who claim it isn’t cite the example of Denmark, where a controversial “fat tax” along similar lines was recently repealed. The tax was aimed at foods that contained more than a certain level of saturated fat (2.3%). After just a year, the Danish government decided to repeal the tax on the basis of it having a negative effect on business and consumer buying power.

Margo Wootan, director of nutrition policy at the Center for Science in the Public Interest in Washington, was quoted in The New York Times as saying she wasn’t surprised that the fat tax had problems and had been repealed. Interestingly, though, she was also quoted as saying, “It’s much easier to tax specific foods, say a tax on sugary sodas, than to tax at the nutrient level like a fat tax or a sugar tax.”

The sugar tax is due to come into effect in April 2018 with the taxable percentage announced just prior to that. It will be interesting to see whether the government goes ahead with its plans and, if it does, what kind of an impact it will have on both obesity and oral health.

Dr. Levenstein is the founder and director of Smile Pad, which specializes in smile transformation, dental implants, and Invisalign. He holds a BDS and MSc in dentistry and implantology from the University of the Witwatersrand in Johannesburg, South Africa. He can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..  

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Dentin does more than form the bulk of our teeth. It also may hold clues to evolution as mankind migrated from our earliest homes, thanks to a new methodology that examines the mineralization defects in dentin developed by an international research team. Plus, this methodology may have applications in improving health today.  

“This is exciting because we now have a proven resource that could finally bring definitive answers to fundamental questions about the early movements and conditions of human populations—and new information about the importance of vitamin D for modern populations,” said Megan Brickley, PhD, an anthropologist and Canada Research Chair (Tier 1) in bioarcheology of human disease at McMaster University.

In 2016, the researchers first established that dentin carries a permanent record of vitamin D deficiency, or rickets, by examining teeth ranging from Predynastic Egypt that were thousands of years old to samples taken from the twentieth century. During periods of severe deficiency, new layers of dentin cannot mineralize, leaving microscopic markers that scientists can read like the rings of a tree.

“Interglobular dentin (IGD) is mineralization defects (bubble-like spaces) that form in bands where dentine fails to mineralize properly along incremental lines due to low levels of vitamin D,” said Brickley. “More pronounced spaces indicate a greater level of disruption of mineralization, and the position of the bands of defects relative to incremental lines indicates that age at which the deficiency occurred.”

The researchers prepared thin sections of teeth and used a microscope to observe the presence or absence of IGD and its severity. They also evaluated the number and size of the defects or bubbles within the dentin and used the percentage of a set microscopic view covered by IGD to provide one of 4 grades. For example, Grade 0 indicated an absence of interglobular spaces, while Grade 3 meant more than 75% of the area was covered by interglobular spaces.

“From our work with archaeological skeletons, individuals with clear signs of childhood rickets had at least Grade 2 IGD occurring during periods of rapid skeletal growth,” said Brickley.

These markers can tell the story of human adaptation as early man moved from equatorial Africa into regions with less sunlight. They also may explain changes in skin pigmentation to metabolize more sunlight or how indoor living has silently damaged human health. And, vitamin D deficiencies have an effect on health today.

“There are vitamin D receptors in 36 major organs, and maintenance of adequate vitamin D levels has an important effect on immune function,” said Brickley. “In particular, vitamin D is essential to build and maintain healthy bones. Low levels will lead to an increase in fragility fractures. Although less widely studied, vitamin D deficiency also appears to be linked to poor dental health. Low levels of vitamin D are associated with the development of some cancers.”

Until now, there has been no reliable way to measure vitamin D deficiency over time. As the researchers have shown with examples from ancient and modern teeth, the method is valuable for understanding a health condition that today affects more than 1 billion people, and it may have clinical applications in the future.

“Naturally exfoliated teeth and teeth extracted for clinical reasons could be analyzed for interglobular dentin,” said Brickley. “Our team has been working with donated teeth and medical information to start to link serum 25-hydroxyvitamin D levels to changes observed.”

The study, “Ancient Vitamin D Deficiency: Long-Term Trends,” was published by Current Anthropology.

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The Center for Craniofacial Research at the University of Texas Health Science Center at Houston School of Dentistry needs people who are missing teeth that never formed for a research study. Associate professor Ariadne Letra, DDS, PhD, is studying the genetics of tooth agenesis, where one or more permanent teeth fail to develop.

A common craniofacial disorder, tooth agenesis affects about 10% of the general population. It can be mild, with up to 5 permanent teeth missing, or severe, with 6 or more teeth missing. If third molars are included, prevalence may be as high as 25%. Lower premolars and upper lateral incisors are the most frequently affected teeth. 

“Individuals with tooth agenesis face both aesthetic and functional consequences, which increase in severity depending on the number of missing teeth,” said Letra. “In addition to affecting a person’s smile, tooth agenesis affects masticatory function, occlusion, and even maxilla and/or mandible development.”

There are financial consequences for affected individuals as well, and dental rehabilitation costs are high. While a few genes have been identified as defective in some cases, the cause of the condition is still unclear. There is no current treatment for avoiding tooth agenesis either. Palliative treatment involves replacing the missing teeth with a bridge or implants.  

The study is looking to recruit 900 individuals or families missing one or more permanent teeth since birth. The large number is needed to achieve enough power to identify genetic variations that can contribute to the condition. Volunteers are required to come to one appointment lasting about 30 minutes.

“First, I explain the objectives and terms of our study,” Letra said. “Upon patient written consent, we collect some basic medical and dental information, perform a clinical and radiographic examination, and collect a saliva and/or blood sample as a source or DNA. Our study is completely voluntary and free of cost.”

Once the subjects have been examined, the researchers will conduct sophisticated genetic analyses of the DNA from subjects who have tooth agenesis and compare them to individuals or family members who do not have it. 

“Along with numerous genes already identified, our research hopes to identify additional causative genes that can be targeted for use in future treatment and prevention strategies,” Letra said.

For more information, call Letra at (713) 486-4228 or email This email address is being protected from spambots. You need JavaScript enabled to view it..

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Dental professionals from around the world soon will be arriving at the Palais des Congrés de Montréal for the 47th Journées Dentaires Internationales du Québec, scheduled for Friday, May 26 to Tuesday, May 30. Presented by the Ordre des Dentistes du Québec, the 3-day conference will provide seminars and hands-on courses led by top dental experts.

Howard S. Glazer, DDS, will be there to present “I Have It… You Need It!” During his lecture for dentists and their staffs alike, Glazer will discuss materials, technologies, and techniques that make dentistry easier, more productive, and more fun, on Friday, May 26 from 8:30 am to 3:30 pm. The course will be worth 6 continuing education credits.

“These are products that I use almost on a daily basis in my practice. Nothing comes into my lecture unless I actually use and like the product, and if you came to my office, chances are you’ll find it,” Glazer said. “So it’s real dentistry by a real dentist using the products of today. I evaluate materials based on if they are faster, easier, and better for me, the doctor, and better for the ultimate end user, who is the patient.”

Before procedures can begin, dentists need to know what they’re looking at. Glazer will delve into digital radiography during his lecture, comparing and contrasting phosphor plates and sensors and explaining why he prefers the Intraoral Phosphor Plates from Air Techniques, which he calls much more tolerable for patients to hold in their mouth than hard, rigid sensors. The company’s CamX Spectra Caries Detection Aid is another valuable tool he will discuss.

“I can actually get a reading of the depth of decay before I even pick up a drill or an anesthetic syringe. If I have something that’s not very deep, why would I bother giving somebody an injection? It’s really ideal in being able to fully diagnose the patient’s problem,” said Glazer.

Sometimes, the restoration is necessary. Glazer will discuss composite resin materials for both anterior and posterior use such as Shofu’s Beautifil II, which lets dentists blend in the gingival tone and color while performing restorations on patients who have more root exposed and a higher gumline. He also will explore the new realm of bioactive materials from GC America and Pulpdent, which go beyond repair to restore the tooth.

“We can begin to heal the tooth and replace the missing ions that are lost during the decay process,” said Glazer. “They help the formation of secondary dentin so that you’re helping to protect the pulp to ensure the health of the tooth. And we have great materials too if you get very near the pulp or to a pulp exposure of some sort. There’s a whole wealth of materials out there that could be helpful. 

Quality restorations need more than the right materials, though, and Glazer will look at today’s leading tools. Ring systems from companies like Garrison Dental and Ultradent Products help dentists place composites without the composite sticking to the instrument. He is particularly partial to Ivoclar Vivadent’s OptraSculpt Pad. Plus, Glazer will examine how soft-tissue diode lasers can assist in restorative dentistry.

“You can only restore what you can see,” Glazer said. “Very often we have decay that’s subgingival. How do you plan to restore that and maintain a dry field when doing restorative dentistry? You need to use a laser to expose that tissue and decay and ablate some of that tissue.”

Curing lights have seen some big changes lately, with some powerful models on the market now. Glazer recommends Ultradent’s VALO Grand and DentLight’s FUSION 5. Handpieces are seeing equally innovative developments, such as Bien Air’s iChiropro, which can be controlled via an iPad application. And on the other end of the technological spectrum, Glazer notes, burs remain essential to dental work too. 

“With moving decay, you’ve got to be able to just take the decay and leave healthy tooth structure. The best bur to help you do that, once you’ve gained access to the carious lesion, is the SmartBur II from SS White Burs. It’s basically used in a slow-speed handpiece at 5,000 or 10,000 rpm, with no water, and it will not cut hard tissue. It will only remove soft dentin, so you can’t really expose anything with it,” Glazer said. “In fact, you could run it on your hand, on your skin, and it wouldn’t cut it because it’s not soft dentin.” 

Of course, Glazer encourages dentists to bring their staff members so they have a better understanding of the new gear that the practice may be purchasing after his presentation. He also promises a very useful and timely look at today’s dental products market, exploring a variety of additional products beyond those mentioned here.  

“The things I talk about nowadays didn’t exist 5 years ago. A lot of them. And most of them will be replaced in 5 years,” Glazer said. “Dentistry is changing rapidly, and for the better.”

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Recreational marijuana is legal in 8 states and the District of Columbia, while 28 more states permit medical marijuana only. Yet even in states where it isn’t legal, the stigma attached to marijuana use is fading, and advocates are pushing for legalization. Overall, 22.2 million people have used marijuana in the past month, according to the National Institute of Drug Abuse.

That means dentists may be seeing more people who use marijuana in their chairs. When they do, dentists also can expect to see some of the drug’s effects on the oral cavity. Like any other kind of smoking, reports Harold Crossley, DDS, MS, PhD, marijuana increases the potential for periodontal disease. But that’s just the beginning when it comes to marijuana’s most ardent enthusiasts, according to the clinician. 

“Many marijuana smokers become dependent on marijuana, and so marijuana basically leads their life. So because of that, they’re not really taking care of themselves the way they should. They’re not brushing, they’re not flossing, they’re not taking care of their teeth,” said Crossley, who has written and lectured extensively on dentistry and pharmacology. “Maybe they don’t have the money to go to the dentist on a regular basis.”

Of course, not all marijuana smokers are so careless about their oral health, but it does happen, Crossley said. And aside from a possible stain on their teeth, there might not be any signs that these patients are marijuana smokers. In fact, Crossley notes significant differences between patients who may be under the influence of various drugs when they enter your office.   

“We separate drugs into uppers and downers. Uppers pose the greatest risk because we use local anesthetics with a vasoconstrictor, which can raise blood pressure. If patients come in and they’ve used cocaine, methamphetamines, or ecstasy in the last 24 hours and you use a local anesthetic with a vasoconstrictor, you run a risk of having a stroke in the chair,” said Crossley. 

“But somebody comes in that’s been snorting heroin, or smoking marijuana, or had a couple shots of whiskey, they’re not going to pose a threat. They’re going to be very compliant. They’re going to be very good patients,” said Crossley. “Say ‘Move your head over here,’ and there’s no argument.”

Still, marijuana may make IV and oral sedation more powerful, and Crossley says that’s a concern. Crossley also concedes that patients who are high during an appointment may be forgetful, so dentists may have to provide written instructions for anything that needs to be done once the patient has left the office.

Dentists additionally should be aware of the many different forms that today’s marijuana takes. Vaporizers pull the active ingredients including tetrahydrocannabinol (THC) from marijuana, so users can inhale the vapor without inhaling the smoke. Also, dabbing extracts THC-rich resins from marijuana for high dosages in products such as shatter, a hard, amber-colored solid.

“It looks like caramel. It’s translucent and very thin, and it’s called shatter because when you pop it, it shatters. That stuff is about 80% pure of marijuana,” said Crossley. “You take a little piece of that and you put it on a nail, and it’s heated. It will vaporize, and you inhale the vapors and get a high off of it.”

Overall, today’s marijuana is much stronger than the strains of decades ago, with THC levels rising from about 4% in 1995 to about 12% in 2014, reported a 2016 study from the University of Mississippi. Yet attitudes toward its use may continue to fluctuate, too. The University of Michigan’s 2016 Monitoring the Future project says that marijuana use remains high and has held steady for twelfth graders, but has been declining among tenth and eighth graders. 

“There have been studies that show that in fact some of the younger generation is turned off by the marijuana. But right now we’re finding mostly marijuana being used between 25 and 43 years of age,” said Crossley. “Really, it’s based upon the generation.” 

Crossley encourages dentists who would like to learn more about marijuana and its effects to visit drugfree.com and dea.gov.

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It seems like dentists already have lots to do during typical procedures. Yet the University of Buffalo School of Dental Medicine also requires its pre-doctoral students to assess the vital signs of all of their patients at every clinic appointment, including blood pressure, pulse rate, and pulse rhythm. These students are required to assess the capillary blood sugar (CBS) of all diabetic patients at every clinic appointment as well.

“The rationale was to train our students that these vital parameters are a normal component of the medical model for a patient workup, and our students should learn that medical model of patient assessment,” said Michael N. Hatton, DDS, MS, of the department of oral diagnostic sciences at the school. “We felt it would serve them well in their future professional lives to assess their patients in a medically templated way.”

Plus, this information provides baseline data in case of a medical emergency at the school, and personnel then could initiate resuscitative efforts in the best manner. With about 50,000 patient visits each year at the dental school, with many patients in their elder years, there are some high risks during dental care. And on a more practical level, these baseline figures would assist in a legal defense should the school face a lawsuit for a poor outcome.

“All students purchase blood pressure monitoring devices and stethoscopes. The school purchases glucometers and necessary accouterments for assessing CBS,” said Hatton. “All pre-doctoral students are taught blood pressure and blood sugar assessment techniques in their second year and assess all their patients, without exception, in their third and fourth years. They are competency tested on these techniques in their third and fourth years. Again, blood pressure for every patient, CBS for diabetic patients, every visit.”

But when the school surveyed its recent graduates to see if they maintained these practices in their professional lives, it found that only 77% of them generally assessed blood pressure, and only 23% assessed the CBS of diabetic patients—and most of these graduates didn’t follow the school’s strict policies in conducting these assessments, despite their training.

The obstacles to consistent performance of these assessments include a perceived “lack of time” on the part of the practitioners and a perception that they aren’t necessary in dental visits on the part of some patients and in some practices. In fact, when the school began including these assessments as part of its curriculum in 2010, some faculty felt that they were a waste of the dentist’s time, Hatton said, though that attitude has faded away.

“We found that graduates generally do not adhere strictly to what they were taught after graduation. They are apt to assess blood pressure on a case by case basis and more frequently than CBS assessment,” said Hatton. “These assessments may not be highly valued by dentist-owners who graduated long ago.”

These assessments often have practical use during dental procedures, too. For example, the CBS baseline enables dentists to make necessary treatment options based on glucose levels. Diabetic patients who have taken their anti-hyperglycemic medication but who have not eaten may experience dangerously low glucose levels after a lengthy appointment.

“If the glucose reading is what faculty deem low, we have the option of giving the patient a glucose-containing fluid to raise glucose levels prior to treatment,” said Hatton. “We also have the option of reassessing glucose levels prior to exiting the building to make sure they are acceptable for the patient to get home in a reasonably safe manner from a blood sugar standpoint.” 

Without a blood sugar assessment, consequences could be dire. A patient who succumbs to hypoglycemia, for instance, could be mistaken for someone who has simply fainted. Unless sugar is introduced into the patient’s system quickly, neurological deficits are possible—and introducing sugar into such an unconscious patient could be very difficult for dentists who aren’t trained in intravenous administration. Blood pressure can be a sign of danger, too.

“In one case, we diagnosed a third-degree heart block, often associated with high morbidity and mortality, simply by noting the abnormally low blood pressure and pulse, getting the patient into care, and having a pacemaker placed within 36 hours,” said Hatton. “That patient is still a patient of the school, but much healthier than when we found the abnormality. She was completely asymptomatic prior to our intervention. Dentists can save lives by doing simple vital assessments on their patients.”

Dentists who want to learn more about the role of vital signs in dentistry should read The ADA Practical Guide to Patients with Medical Conditions, edited by Lauren Patton, DDS, and Michael Glick, DMD, and Dental Management of the Medically Compromised Patient by James W. Little, DMD, MS, et al, Hatton recommends. He also suggests joining the American Academy of Oral Medicine and reading its associated journal.

“The Academy provides pathways for non-oral medicine dentists to achieve the status of Fellow,” Hatton said. “The annual and semi-annual meetings also provide a broad array of medically based issues for the practicing non-oral medicine trained dentist.”

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Patients see plenty of needles when they’re at the dentist’s office. But they may be seeing more, as some dentists explore the use of acupuncture in their work to address dry mouth, dental anxiety, gag reflexes, and even orofacial and postoperative pain. The treatment has evolved throughout the millennia from ancient mysticism to a more modern approach known as battlefield acupuncture (BFA).

“In traditional Chinese acupuncture, placing needles in specific locations of the body would cause a disruption of the bodily energy known as Qi. This in turn helps break down any blockades, allowing normal currents of Qi. These currents flow in 12 pathways known as meridians, 6 yin and 6 yang,” said Tyler Rallison, DMD, a US Air Force captain who discussed the subject during the 2017 Hinman Dental Meeting Table Clinics in Atlanta on March 23.

“In modern Western acupuncture, it’s believed that the placement of the needles in specific locations on the body releases autogenous molecules. These molecules are believed to work directly on the signals of the peripheral and central nervous systems. This aids in pain reduction and increases blood flow. The effectiveness may be affected by the location and the depth as well as what type of application you want to apply to those needles,” Rallison said.

Modern acupuncture uses hundreds of points on the body to effect treatment. In 2001, however, Col. Richard Niemtzow, MD, PhD, of the Air Force developed the abbreviated BFA technique. Practitioners inject a series of just 5 needles that are about the size of a pencil point—each known as auricular semi-permanent (ASP) needles—into the cingulate gyrus, the thalamus, the omega 2, point zero, and the shenmen, all located on the ear. The injections produce only minor transient discomfort.

“Niemtzow recommends placing the ASP needles in a specific sequence and then stopping at a point when the patient reports adequate pain relief,” said Rallison. “The first part would be the cingulate gyrus. You place that point. You have patients stand up, walk a short distance, come back, and report their pain. Then you go to the other ear, place the same point, and do the same thing. And you’ll go through that with each point.”

The needles are designed to stay where they have been injected for 2 to 4 days before falling out on their own. Niemtzow initially developed the procedure so it could be used on the battlefield when the use of western pain medications wasn’t advisable. Since then, it has been used to assist in the relief of both acute and chronic pain throughout the body, including facial pain, neck pain, and fibromyalgia, in addition to nausea and vomiting.

As for dentistry, in 2005, Morganstein found that regular acupuncture could increase salivary flow in patients who had received head and neck radiation due to cancer. In 2007, Karst et al showed a significant reduction in dental anxiety with acupuncture compared to midazolam and placebo treatments. And in 2010, Sari and Sari demonstrated a 58.9% gag reflex reduction using laser-stimulated acupuncture.

When it comes to pain, Lao et al concluded in 1999 that Chinese acupuncture could reduce postoperative dental pain in third molar extractions compared to a placebo. And in 2014, de Cassia Faglioni Boleta-Ceranto et al demonstrated a reduction in post-adjustment orthodontic pain. Rallison noted further areas where BFA could be employed in general dentistry.

“It could be used for something as simple as anxiety and nausea. It could be something xerostomic. Oral surgeons may use it for postoperative pain. Prophylactic pain. And that’s usually with orthognathic surgery, extractions, trauma, and cancer patients. Endodontists may utilize it for trauma cases. The orofacial pain specialists in the Air Force are currently utilizing this for most of our temporomandibular joint (TMJ) disorder cases,” Rallison said. 

Furthermore, periodontists may be able to use it in their osseo or grafting surgeries, while orthodontists may use it for separator or even band placements, Rallison said. However, he added, usage in the civilian sector will depend on state laws for scopes of practice and on insurance codings and reimbursements. For example, Aetna and Cigna currently reimburse for acupuncture in treating TMJ and post-op dental pain.

One of the primary benefits of BFA, Rallison noted, is its potential for reducing drug dependency, potentially eliminating the need for opioids and serving as an adjunct to other drug therapies. Also, costs are minimal. ASP needles cost between 50 cents and a dollar each. Effects last for a month to 2 months, and usage is repeatable. BFA is especially recommended for patients who already are being treated by a pain specialist, Rallison said. 

As with any treatment, there are risks, which include discomfort or pain, broken needles, inflammation or infection at the injection site, bleeding or bruising at the injection site, and nausea or dizziness. Also, contraindications include pregnancy, as acupuncture may induce labor, plus aversion to needles, active ear infections, bleeding disorders, coagulation medication, and new, acute pain in the area.

Resources are available for dentists who would like to learn more. For example, battlefieldacupuncture.net provides information online and seminars in person. The Defense and Veterans Center for Integrative Pain Management also offers information and training. And, Niemtzow provides webinars and weekend clinics on his technique as well. Still, Rallison admitted there is skepticism.

“That’s the biggest controversy with acupuncture. You’ve got people saying it doesn’t work because you can’t prove it. And it’s very true. You can’t prove it,” Rallison said. “But you’ve got patients who say it works, and that’s the biggest benefit. If the patient says it works? Then you’ve done your job. You may not know why it’s working, but it’s working.”

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Dentists often have a choice in posterior restorations: quick application or aesthetics. But 3M’s Filtek One Bulk Fill Restorative aims to bridge both demands with one-step placement that preserves opacity, with 5 different available shades. The material does not compromise when it comes to strength either, according to the company. 

“We’re trying to simplify posterior restoration placement for the dentist,” said Dan Krueger, a technical service specialist with 3M. “Traditionally, if you have a 4- or 5-mm deep restoration, those materials would have 2-mm depths of cures. So you would have to place an increment and light-cure it, and place another increment and light cure it, and then possibly another one.”

But with its 5-mm depth of cure, the Filtek One Bulk Fill Restorative can be applied in a single shot, which saves time. Despite that depth, the material remains opaque for a more natural look. Plus, its singular process and new chemistry eliminate the defects that may come with other materials as they shrink and stress the interface with incremental applications.

“Typically, materials have to be more translucent to let the curing light all the way down to the bottom. And when they’re that way, they tend to look a little grayish,” said Krueger. “With our new material, we’ve figured out how to manage the opacity and translucency better, still getting this depth of cure. And now the material is more opaque and aesthetic for the final restoration.”

The Filtek One Bulk Fill Restorative reduces shrinkage and relieves stress to allow bulk fill placement up to 5 mm, too. Its addition-fragmentation monomer relieves stress during polymerization. Also, its aromatic urethane dimethacrylate helps reduce the amount of shrinkage and stress that occurs during polymerization.

“It’s not sticky, which is really important because if it sticks and pulls back, it can create defects. Doctors like that it’s not sticky. And you can put in anatomy on the surface like that so it matches the other teeth,” said Krueger. “And then when we cure it, instead of doing the curing for each one of those increments, I do one cure from the occlusal surface. And it’s done, and the doctor goes to finishing the polishing.”

The material comes in A1, A2, A3, B1, and C2 shades, all matched to Classic VITA shade types, which is “probably 95% of what the dentist would ever want in the back of the mouth,” said Krueger. There is no need for layering or expensive dispensing devices, according to 3M. Also, 3M offers adhesive, curing light, finishing and polishing, and prevention products all designed to work together to help dental professionals practice more efficiently.  

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Dentists who want to check out new equipment in person before making a purchase don’t have many options. Trade shows highlight the latest and greatest tools and technology on expansive exhibit hall floors, though travelling to these conferences isn’t always convenient. Or, some dentists may be fortunate enough to visit fellow practitioners who already have some particular gear installed in their offices. Henry Schein offers a third alternative, with a recently opened, 13,000-square-foot facility in Moonachie, New Jersey.

“Typically, dentists think they’re coming here to look at a chair or an x-ray unit or something like that. But when they get here, they’re wowed by all the technology and all the equipment that’s here,” said Marty Schayowitz, a Henry Schein field sales consultant. “When they see this beautiful showroom with everything on display, they go, ‘Wow,’ and the mind starts thinking.”

When clinicians visit the new Henry Schein location, they can tour its selection of dental chairs, cabinetry, sterilization units, imaging systems, and more, including practice management software. Everything is on the showroom floor and operational, waiting to be tried. It’s not a retail location, though, where dentists drop in to browse the way they would their local hardware store. Henry Schein’s representatives simply build on their customer relationships.

“Most dentists that I work with don’t reach out to me. We’re creating the need for them to upgrade or replace their equipment. By being intimately involved in their practice, we know what their individual needs are and can appropriately advise them on how to help them grow their practice. By introducing that into the discussion, they then ask, ‘All right. What’s next?’ And that prompts the trip to this showroom, and the added assurance that they can rely on us as their trusted advisor,” said Schayowitz.

Figure 2. A complete operatory based on A-dec’s Inspire line of furniture is on display at the showroom. Figure 3. Clinicians interested in digital dentistry can get their hands on gear from 3Shape, Planmeca, and more.

 

“The goal of this facility is to bring doctors through whatever scenario they imagine, from adding on to their practice, to starting anew, or a doctor just out of school who is picturing what their practice would look like,” said Zach Harrison, regional manager of Manhattan and Westchester. “This gives them an opportunity to see cabinetry, integrated technology, CAD/CAM platforms, and 3-D platforms. It gives them a great overview of what they’re trying to envision.”

Inside the Practice

The showroom features a complete operatory based on A-dec’s Inspire line of furniture. Dentists can put the 500 model dental chair through its paces as they wheel around on their choice of stools, adjust the LED lighting, sort through gear in cabinets designed for easy and organized access, monitor their work on digital monitors, and connect instantly to imaging and other software.

The showroom also focuses on antimicrobial protection, with a full sterilization center on display. The station includes an area coded in red where assistants can put used trays, tubs, and other contaminated items, all foot-activated so they don’t have to worry about further dirtying their hands. Areas also are on hand for cleaning, with space for the ultrasonic and for rinsing instruments. A built-in dryer additionally is part of the package.

Intraoral scanners are playing a larger role as dentists and patients both begin to prefer digital impressions over the putties and trays of older analog systems. Practitioners who are interested in the technology can give the 3Shape TRIOS Intraoral Scanner, 3M True Definition Scanner or Planmeca PlanScan Scanner a try at the new facility. These handheld devices can craft virtual impressions and store those images with the practice’s software management system.

Plus, the scanners are compatible with Henry Schein’s Dentrix Ascend practice management software. Images are immediately stored with each patient’s file for comprehensive and easy to access treatment planning and record keeping. It also manages patient scheduling and finances. As a cloud-based system, it securely stores data on Henry Schein’s servers. Users access it via a browser-based portal that’s designed to be intuitive and easy to use.

Technological Training

Dentists who visit the facility and ultimately purchase any of the equipment are eligible for in-service training provided by Henry Schein, on site in their own practices and according to their own schedules. Depending on the gear they get, dentists also might travel to other facilities for more intense and hands-on workshops. The location in Moonachie includes a multifunctional conference room that could host continuing education classes on the products as well.

“Technology is always changing,” said Schayowitz. “The big conferences aren’t as intimate as this, where you can ask questions and not have any distractions. The team also is accessible here. The equipment and tech reps and field sales consultants all come here.”

“This gives dentists an opportunity to see cabinetry, integrated technology, CAD/CAM platforms, 3-D platforms,” said Harrison. “It gives them a great overview of what they’re trying to envision. And then whatever questions they have, our specialists are here to address them.”

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