Fluoride is essential to healthy teeth. However, diet plays a widely varying role in supplying children with beneficial amounts of fluoride. A team of researchers at the Indiana University School of Dentistry, then, recently examined how much fluoride is present in the foods and beverages typically consumed by children in the Midwest who are aged 2 years. 

The researchers used total diet study food lists cross-referenced with the National Health and Nutrition Examination Survey—What We Eat in America. They also determined concentrations of fluoride via a modification of the hexamethyldisiloxane microdiffusion technique. Daily dietary fluoride intake was estimated using a simulation analysis.

The study, “Fluoride in the Diet of 2-Years-Old Children,” was published by Community Dentistry and Oral Epidemiology. E. A. Martinez Mier, DDS, PhD, MSD, of the department of cariology at the Indiana University School of Dentistry shared her insights about the study’s results with Dentistry Today.

Q: What are the main sources of fluoride for children?

A: There are different fluoride sources depending on the age of the children. The relative contribution of these sources to the total amount of fluoride ingested in a day also varies according to the children’s age. Our study showed that the daily intake from the diet for 2-year-old children will depend on the foods typically consumed by each child based on his or her choice of foods and beverages.

Q: Specifically, what foods provide the most fluoride?

A: In our study, popsicles, mild cheddar cheese, raisins, saltine crackers, creamy peanut butter, beef cheese tacos, chicken/pork franks, and plain wavy potato chips were the items with the highest fluoride content. Previous reports have included fish, tea, and sardines as items with high fluoride content.

Q: What role does public water fluoridation play in children’s fluoride intake?

A: Water and swallowed toothpaste are the greatest sources of fluoride intake for children younger than 6 years. It is estimated that water and water-based beverages contribute to approximately 75% of the total fluoride consumed though the diet in communities that are optimally fluoridated. This should not place these children at risk for excessive consumption. At the currently recommended levels, community water fluoridation has been proven to be safe and effective.

Q: How can parents tell if their children are getting enough fluoride to prevent dental caries?

A: Children who live in communities where water is fluoridated are already receiving the benefits of fluoride. In addition, parents should ensure their children are brushing their teeth with a toothpaste that contains fluoride. They also should visit their dentist, who may recommend additional fluoride.

Q: What impact does too much fluoride have on developing teeth?

A: Too much fluoride consumed when teeth are developing may result in enamel fluorosis. No other negative health effects have been associated with the consumption of water fluoridated at the recommended levels.

Q: Is there anything parents can or should do to mitigate this impact?

A: Parents should supervise their children while brushing to prevent them from swallowing toothpaste. If they consume well water, they should have it tested to find out if it has too much fluoride.

Q: What role should dentists play in ensuring that children are getting the right amounts of fluoride to ensure oral health?

A: Dentists should continue to support community water fluoridation and assess their patients’ risk of developing caries in order to develop individualized fluoride recommendations.

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The residents of southeastern Kentucky, including many people who live in the Appalachian Mountains, lack dental care because of poverty as well as transportation difficulties and a lack of dentists. To better serve them, the University of Louisville (UofL) School of Dentistry will work with the Red Bird Clinic to offer comprehensive general dentistry to the region.

“Our collaboration with the Red Bird Clinic is a significant step for the university as we seek to systematically serve our mission to provide healthcare throughout the Commonwealth and improve the overall well-being of its citizens, said Greg Postel, MD, interim UofL president.

Beginning February 23, dental and dental hygiene students will begin clinical rotations at the Red Bird Clinic. Each week, 6 students will travel to Beverly, Ky, and help staff the dental clinic there, open Thursday through Saturday. The clinic provides a variety of services to about 20 to 25 patients daily, including cleanings, fillings, root canals, crowns, bridges, and extractions.

“This new clinical site enhances the education of our students with enriching cultural and clinical practice experiences that will make them compassionate, exceptional dental healthcare providers,” said Gerard Bradley, DMD, BDS, MS, dean of the UofL School of Dentistry.

The Red Bird Clinic is a nonprofit that grew out of the Red Bird Mission, which started in 1921 with a private school and expanded to include medical and dental services, job training, a clothes closet, a food pantry, adult education, services for senior citizens, and more. Its relationship with the UofL School of Dentistry aims to increase the availability of dental treatment for the underserved.

“It is our hope that some of these students will be drawn to practice in rural areas,” said Kari Collins, executive director of the Red Bird Clinic. “Perhaps someone will return to serve at Red Bird Clinic in the future.”

“Everything is not cut and dry at outreach clinics. High difficulty levels provide challenges for the students and increase their abilities. It’s amazing to watch as they begin to put things together and their eyes and faces become bright with satisfaction,” said Bill Collins, DMD, dental director at the Red Bird Clinic.

“I try to ask students to learn one new thing each day. If they continue this, it will make them good, confident practitioners,” said Collins.

Other UofL School of Dentistry alumni—Greg Bently, DMD, Susan King, DMD, and Bob McGuinn, DMD—will serve on rotation as gratis faculty to oversee the UofL students. Already, some dental students have engaged in clinical dental services at the Red Bird Clinic, including the school’s 4 Outreach Scholars.

“It has been a blessing to pursue a career in dentistry, and it is important for me to use my education to give back to fellow Kentuckians as I gain valuable experience in outreach clinics,” said fourth-year dental student and Outreach Scholar Robbie Troehler, who also has served in 5 other clinics throughout the state as part of the Outreach Scholar program.

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The North Dakota House defeated House Bill 1256 on Wednesday, February 8, which would have allowed mid-level oral healthcare providers also known as dental therapists to obtain licenses and treat patients. Under the bill, dentists would have remained responsible for the quality of care that their employees provide, and no dentist would have been required to hire dental therapists.

“The North Dakota House affirmed our position that the dental therapy model does not fit North Dakota at this time and that we should continue to focus on education, prevention, collaboration, and outreach specific to our state—strategies that are showing results,” said Brent L. Holman, DDS, executive director of the North Dakota Dental Association.

“By voting to continue North Dakota’s blockage of dental therapists, House lawmakers deprived dentists of their right to hire and patients of their right to choose qualified providers who would have lowered oral healthcare costs and increased access,” said Michael Hamilton, research fellow of healthcare policy at the Heartland Institute.

The bill would have required dental therapists to graduate from an accredited dental therapy education program and pass exams administered by the state’s dental board. Also, dental therapists would have been required to complete 500 hours of clinical practice under the supervision of a dentist to qualify for licensure.

Also, the bill outlined a series of procedures that dental therapists would have been allowed to perform under supervision of a dentist, including but not limited to application of topical disease prevention agents; preparation and placement of direct restorations; extractions of primary teeth; extractions of some badly diseased permanent teeth; pulpotomies; preparation and placement of some crowns; direct pulp capping; and suturing and suture removal.

In January, the Heartland Institute and the Texas Public Policy Foundation released a joint policy brief titled “The Case for Licensing Dental Therapists in North Dakota.” According to the Heartland Institute, dental therapy is a 95-year-old profession used in more than 50 countries to expand oral care services to underserved patients in rural and low-income regions.

The organizations also report that nearly 10% of the state’s population live in 35 areas with dental health professional shortages. A third of all residents age 65 years and older with teeth needed “early or urgent dental care” in 2016. And, 72% of children on Medicaid in the state in 2015 did not use preventive dental care, even though they were eligible.

“All the House accomplished by banning dental therapists was blowing up a bridge by which innovative dentists might have reached underserved patients,” said Hamilton. “The entrenched interest special interest groups of dentists who opposed this measure may now congratulate themselves for robbing each other of a chance to innovate, grow their practices, and treat needy patients.”

The ADA opposes the authorization of non-dentists to perform surgical procedures. While the organization acknowledges the challenges in providing dental care to everyone, it notes the growing numbers of practicing dentists and believes efforts should focus on better connecting patients with them.

Maine, Minnesota, and Vermont all allow dental therapists, while Washington and Oregon have authorized access to midlevel dental providers for native tribes while considering their use statewide. Alaska native tribes also have authorized dental therapy. Arizona, Hawaii, Kansas, Massachusetts, New Hampshire, New Mexico, and Texas all are now exploring the issue.

“Lawmakers in North Dakota chose to look backward, not forward, by rejecting dental therapy as an option for the people of their state,” said John Davidson, senior fellow with the Texas Public Policy Foundation and a policy advisor with the Heartland Institute. “Liberalizing the dental workforce so that more people have access to basic dental care is the wave of the future.”

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This February, dentistrytoday.com celebrates National Children's Dental Health Month with news stories, interviews, and blogs all about safeguarding pediatric oral health. #NCDHM 

Henry Schein has announced the finalists for its second annual Henry Schein Cares Medal, an award given to nonprofit organizations that demonstrate excellence in expanding care for the underserved. An independent panel of judges selected 3 finalists among applicants from each of 3 fields: oral health, animal health, and medicine.

The oral health medalists include Community Dental Care (CDC) of Minnesota; Gaston Family Health Services of Gastonia, NC; and Interfaith Dental Clinic of Nashville, Tenn. Each of these medalists will receive a case award, including $15,000 for gold, $10,000 for silver, or $5,000 for bronze, as well as $10,000 worth of products from Henry Schein Cares. 

Crystal Yang, development coordinator at CDC, recently discussed the organization’s work and how the award will impact its efforts with Dentistry Today.  

Q: What kind of care does CDC provide?

A: CDC is a nonprofit organization and Minnesota Health Care Programs community clinic established to provide quality dental services for low-income and minority patients. CDC served as a for-profit clinic for 22 years before incorporating as a nonprofit in 2004. Today, CDC is one of the largest safety-net clinics in Minnesota and is recognized by the Minnesota Department of Health as one of 6 successful models statewide that provide dental services for underserved communities.

CDC currently has 4 clinics—3 in the Twin Cities and one in Rochester, Minn—with a total of 58 dental operatories. We will open a fifth, 18-operatory clinic in Rochester in the fall of 2017. Our mission is to provide culturally sensitive community oral healthcare, preventive education, and professional training and to advocate for access to all. Our vision is that all people will have access to high-quality, affordable dental care to improve their overall health in a convenient, caring, and respectful environment.

All 4 clinics provide comprehensive dental services, including preventive, restorative, endodontic, oral surgery, pediatric, prosthodontic, and emergency procedures. In 2016, we provided 134,274 patient encounters for 46,868 unduplicated patients. Of these, 91% of patients were enrolled in public programs or uninsured with income at or below 275% of the federal poverty level, 64% were a racial/ethnic minority, and 47% were children. To serve more patients and provide care outside of school and work hours, our clinics offer early morning and evening appointments. All clinics dedicate time daily for emergencies, and in 2016 we treated 14,140 emergency patients.

CDC also provides clinic training for dental professionals (dental hygienists, assistants, and advanced dental therapists), nursing students, and community health workers from 12 universities and colleges in Minnesota. In 2016, we provided clinical training for 308 students.

Q: Does CDC have any programs specifically for children?

CDC also has 2 community programs that improve access to oral health care for low-income families and children. Our Program to Improve Community Oral Health (PICOH) provides in-clinic oral health prevention and education for children and pregnant women, outreach to the general community, and school-based preventive oral health programming, including screenings, dental sealants, prophylaxis, and fluoride varnish for low-income children. This is the key program we described in our Henry Schein Cares Medal application.

This past year, PICOH began a pilot project to test strategies for educating and empowering parents of babies and toddlers, up to the age of 2 years, before their children have experienced dental caries and developed poor oral hygiene habits. Since PICOH’s inception in 2006, it has provided preventive care, risk assessment, education, and oral health kits to more than 83,000 children, pregnant women, and parents.

Q: How does it feel to be recognized for this work?

A: We are incredibly honored to be a finalist, and the entire PICOH team was thrilled to hear we were chosen! Our application for the Henry Schein Cares Medal highlighted PICOH as the program we consider our most cutting edge and best practice in its field. PICOH is grounded in evidence-based strategies that build knowledge and skills to last a lifetime. The model is designed around the belief that children (and their parents) need consistent reinforcement of good oral health practices during their early years to positively affect their health throughout their lives.

The staff promotes this long-term impact through strategies such as one-one-on motivational interview-style instruction and anticipatory guidance, proven-to-impact behaviors that reduce cavities. In addition to teaching oral hygiene, PICOH builds oral health literacy and educates families on the proven links between poor oral health, poor nutrition, and chronic diseases. Our results show that the program is making a sustainable impact in childhood caries (cavities) reduction.

PICOH has also received national recognition by the Robert Wood Johnson Foundation and ICF International as one of 12 promising models nationwide that increase access to oral health access for children. The Henry Schein Cares Medal award will add tremendously to the pride and commitment of our PICOH staff, and our entire CDC staff will also share in this sense of accomplishment. We also anticipate that as we advertise this award to our patients and PICOH participants, it will encourage them even more to reach their oral health goals and be a part of this significant success story!

Q: How do you plan on using the award?

A: The cash award and donated products from the Henry Schein Cares Medal will be used by PICOH to expand access to oral health prevention and education services for underserved children in the Twin Cities and Rochester. In 2016, 94% of the children served by PICOH were on public programs, and 85% were minority. These are children from low-income families with limited access to affordable dental care. Also, a majority of the families we serve in PICOH are recent immigrants or refugees who do not understand the importance of good oral health and preventive services. As evidence continues to show a systemic connection between oral health and overall health, it is important to increase access for these most vulnerable populations.

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For the past 14 years, the ADA Foundation’s Give Kids a Smile (GKAS) has provided free oral health services to more than 5.5 million children. Working with a broad range of corporate and academic partners, the program’s mission continues as it celebrates its 15th anniversary this February, which also is National Children’s Dental Health Month.

“This is a time to celebrate all that GKAS has accomplished during the past 14 years. So many good things have occurred, but we realize there is still more to do in the years ahead,” said William R. Calnon, DDS, president of the ADA Foundation. “It is driven by people wanting to truly make a difference.”

And these volunteers have their work cut out for them. The Centers for Disease Control and Prevention report that dental caries is the most prevalent infectious disease among children in the United States, affecting more than 40% of infants and preschoolers before they reach kindergarten and about half of all children from lower-income families. 

Kicking Things Off

The festivities began as members of the ADA Foundation joined representatives of Henry Schein to open the Nasdaq Stock Market on Friday, February 3. Henry Schein has served as the official GKAS professional products sponsor since the ADA launched the program nationally in 2003 to raise awareness of the need to expand access to oral healthcare for children.

“For too long, poor oral health has been a silent epidemic affecting our nation’s children, and for 15 years, Henry Schein has supported the Give Kids a Smile program so that volunteer oral health professionals can have the products they need to treat underserved children,” said Stanley M. Bergman, Henry Schein CEO and chairman of the board.

Henry Schein has donated more than $15 million in oral care products to the program, which also has involved more than 550,000 volunteers. This year, more than 1,300 GKAS events are scheduled, where nearly 300,000 underserved children will receive free oral health screenings, education, and treatment courtesy of about 40,000 volunteers.

Events continued on February 3 with the program’s official kickoff, held at the Rutgers School of Dental Medicine in Newark, NJ. More than 300 children attended the event and received pro bono dental screenings, exams, cleanings, and preventive treatments as well as an oral health goody bag and education from more than 100 Rutgers student and faculty volunteers.

“Dentists and dental students all over America have been reminded that we can make a difference in the lives of kids who aren’t fortunate to get a checkup every 6 months,” said Cecile A. Feldman, DMD, MBA, dean of the Rutgers School of Dental Medicine. “Because of GKAS, millions of smiles are brighter.”

A Yearlong Program

The Creighton University School of Dentistry got an early start as its students and faculty visited Nelson Mandela Elementary School in North Omaha, Neb. The school-wide assembly about the importance of brushing that they presented is just the start of a year-long relationship that will create a “dental home” for students and families at the school.

“Bringing dental health to the kids at school works,” said Stuart Tucker, a third-year dental student. “When we look at dental health, there are really 2 sides to it. There’s the biological side, which tells us that oral health is crucial to overall health, and then there’s a social element. Kids are more confident learners, more comfortable in what they pursue, when they have a bright, happy smile.”

Dental faculty and students will begin making regular visits to the school. Creighton also will help defray some of the costs of dental care with a voucher system that will allow children to receive as much dental care as can be provided in a visit to the School of Dentistry’s clinic for $10. The partnership aims to have a cavity-free school by 2023.

After the assembly, students returned to their classrooms, where Creighton faculty and students provided tutorials on proper tooth brushing. All of the students received their own toothbrushes, which will be stored on a rack in each classroom. Going forward, students will brush in class twice a day.

“Making tooth brushing a part of the school day just makes sense,” said Susan Toohey, EdD, principal of the elementary school. “When you’re 5, 6, 7 years old, there’s a ripple effect that we hope will help establish good habits for the rest of your life, and it’s also something our students can help spread at home to siblings and parents.”

Creighton faculty and students returned to Nelson Mandela to provide dental screenings, fluoride treatments, and dental education. Future visits to the elementary school will include dental sealant programs, nutrition education, and a health fair with games for the children.

Other Events

Also, students, faculty, and staff at the University of Tennessee Health Science Center College of Dentistry provided free dental services including screenings and cleanings to about 80 sixth, seventh, and eighth grade students from the Freedom Prep Academy on Thursday, February 2. Fourth year dental students performed the care, under faculty supervision.

“Outreach is part of what we teach every dental student,” said Tim Hottel, DDS, dean of the College of Dentistry. “From the onset of our participation in this national initiative, our students and faculty have performed approximately 2,200 dental procedures on more than 400 children.”

About 200 dental and dental hygiene students, faculty, and staff from the University of Louisville School of Dentistry joined with community volunteers to visit 6 local elementary schools in Jefferson County, Ky, on February 3 to provide dental screenings to nearly 3,000 children. Dental hygiene students also discussed proper brushing and flossing, the importance of seeing a dentist, and healthy snacking and drinking options.

“Good dental care is vital to our students’ overall well-being and confidence, key elements in them coming to school happy, healthy, and ready to learn,” said Jefferson County Public Schools Superintendent Donna Hargens, EdD. “We’re excited to partner with the University of Louisville School of Dentistry and other community collaborators on this important health initiative. 

The oral health evaluations met the Kentucky dental screening requirements for school entry. Also, children received goody bags with toothbrushes, dental floss, and oral health educational materials. Parents and legal guardians also were encouraged to find a dental home for their children, such as the university’s pediatric dentistry division, which is accepting new patients.

And, multiple events are planned in Chicago, which has particular challenges in providing oral healthcare. According to the University of Illinois at Chicago College of Dentistry, city residents with high economic hardship have 40% more dental related emergency room visits than the city average. Plus, half of children under the age of 11 years have cavities, and more than 65% of third graders have cavities, with more than half going untreated.

To help, students and faculty at the school provided more than 100 children from St. Malachy School and Chicagoland Easter Seals with exams, cleanings, fluoride treatments, and oral health education on February 2. Plus, the Chicago Dental Society (CDS) offered free routine exams and other services on Saturday, February 4. More than 100 CDS member dentists will visit Chicago schools to distribute oral hygiene products and educate children throughout February as well.

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In 2014, 74.4% of the US population were served by community water systems that received fluoridated water, according to the Centers for Disease Control and Prevention (CDC). Yet many of these systems are old and require significant maintenance and updates. Also, many towns and cities that don’t have fluoridation would like to add it to their systems, but they lack the money to do so. To help these communities, the CDC is working with the National Association of County and City Health Officials (NACCHO) to fund capital improvements.

“Tooth decay is one of the most chronic diseases in children. Left untreated, tooth decay can cause pain, infection, and problems eating, speaking, and learning,” said Jennifer Li, senior director of environmental health and disability at NACCHO. “Fluoride protects against tooth decay. Water fluoridation is the best method of delivering fluoride to all members of the community regardless of age, education, income level, or access to regular dental care.

NACCHO will award $2,000 to $35,000 to qualified applicants. These one-time awards must be used for capital improvements associated with purchasing new equipment to start water fluoridation or replacing aging water fluoridation equipment. State and local government entities, oral health coalitions, rural water associations, state dental organizations, and other organizations affiliated with public community water systems are eligible to submit applications for the funding.

“According to the ADA, more than 70 years of scientific research has consistently shown that people living in communities with an optimal level of fluoride in their water have up to 25% fewer cavities than people living in communities without water fluoridation,” said Li. “Simply by drinking water, Americans can benefit from fluoride’s cavity protection whether they are at home, work, or school.”

Technical assistance will be available as well throughout the term of the funded proposals to facilitate successful implementation. NACCHO will act as the central coordinator for technical assistance requests, providing the assistance or directing award winners to the state direct dental director or the CDC. Assistance may include facilitating the collaboration between health departments and public water agencies, feedback on equipment recommendations, and identification of possible training sources for operators.

Many grassroots efforts, however, have emerged on the local and national levels questioning the efficacy and even the safety of public fluoridation. In addition to dozens of smaller municipalities, many major cities have eliminated their fluoridation programs, including Albany in 1994; Colorado Springs in 2002; Quebec City in 2008; Calgary in 2011; Portland, Ore, in 2013; and Albuquerque in 2016.

“Many expert panels in the United States and other countries have studied the issue of water fluoridation and potential adverse health effects. The only documented risk of community water fluoridation is dental fluorosis, a change in the appearance of the tooth enamel. Most dental fluorosis is very mild to mild, appearing as white spots on the tooth surface and often barely noticeable,” said Li, who suggests communication in addressing activists’ concerns.

“Start with obtaining a better understanding of why local groups or grassroots efforts are concerned with fluoridation. Community leaders can help to develop messaging to emphasize local values. They should also consider the impact on the community if water fluoridation is removed,” said Li. “Even with the use of other fluoride products such as toothpaste, fluoridated water reduces tooth decay by 25% among children and adults. A recent Health Affairs study estimated that communities average a per capita savings of more than $32 in averted treatment costs.”

Applications are due by Wednesday, March 1. NACCHO and the CDC will review applications, awarding up to 50 points based on a statement of need, up to 30 points on the applicants’ collaboration plans between the public health department and water system in educating the public about their project and about fluoridation, and up to 20 points on their sustainability plans. The organization will notify award winners on March 17. Equipment purchases and installation will occur between April 7 and June 30.

For more information about community water fluoridation, Li suggests the websites of the CDC, including its information for state-based oral health programs, the Association of State and Territorial Dental Directors, and state affiliates of rural water associations.

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This February, dentistrytoday.com celebrates National Children's Dental Health Month with news stories, interviews, and blogs all about safeguarding pediatric oral health. #NCDHM

Orthodontics are a rite of passage for many adolescents. Once treatment is finished, these young patients often display newfound confidence and pride in their appearance. However, the road to that improved self-esteem can be perilous as other kids can be cruel, using braces as a subject for teasing, bullying, and victimization. Yet these victims are finding self-expression and even solace on social media as they describe their experiences.   

Researchers from the University of Otago in New Zealand recently took to Twitter to examine the phenomenon for themselves, searching the website’s database from 2010 to 2014 for keywords relating to bullying, teeth, and orthodontics. Then, they qualitatively analyzed the 321 relevant posts they found to uncover key trends. Joseph Antoun, BDS, DClinDent, of the university’s Faculty of Dentistry shared his insights about their work.

Q: Children with braces have always been bullied. How has social media changed this?

A: Although our research did not look at cyberbullying per se, there is plenty of media around the topic of peer victimization in general. Our study, which focused on personal accounts of bullying victims, does suggest that bullying may not always be physical. Verbal actions and name calling are a few common examples of other forms of bullying. Interestingly, we identified tweets where victims reported being teased about their braces as well as feeling grateful about receiving treatment and having a great smile. I think future studies should certainly focus on cyberbullying as it relates to orthodontic treatment.

Q: How did you analyze these personal accounts? 

A: We identified 4 primary categories and several secondary categories that captured the content of the tweets we included in our study. The first primary category, morphological features of teeth or malocclusion, included tweets that contained specific (eg, crooked teeth) and nonspecific (eg horrible and ugly) adjectives to describe an individual’s teeth. The second primary category, psychological and/or psychosocial impact of bullying, included tweets that seemed to have had some effect on an individual’s emotional and/or social well-being (eg, self-hate). The third primary category, coping mechanisms, included a wide range of strategies that victims seemed to have relied on to get through their bullying experiences. Examples included tolerance of bullying, pursuing self-acceptance, reliance on personal or religious beliefs, physical relocation, sharing of personal bullying experiences, and treatment seeking. The last category related to the role of the family. We noted that family members may either offer support to victims of bullying or even be perpetrators of peer victimization!

Q: How could families play both a contributory and mediatory role in bullying?

A: This was a really interesting finding. For instance, we identified 2 posts that highlighted the importance of the role of family members. In one post, the tweeter’s mother was portrayed as a hero, whereas in the other she was described as displaying bullying-related behaviors. Although less common, we have to be aware of this issue when we see young patients reporting bullying experiences.  

Q: Could you provide some examples of tweets that you studied?


A:  • “front teeth gaps aren’t fun bc throughout my whole childhood I was bullied about it to the point where i stopped smiling & talking”

      “i used to always get teased about my overbite..but I got braces and now I have a beautiful smile so look at me now ^_^”

      “Before I got braces I was teased because of my teeth. I still feel insecure even without braces today.”

      “i was walking at the mall today & some guys started making horse noises at me bc of my teeth. everyone gets bullied. don’t ever feel alone.”

     • “I love my smile! Used to get teased bout my teeth then my braces... wonder what their teeth look like these days…”

Q: What were some of the psychological impacts of this bullying?

A: The psychological and/or psychosocial impact of bullying episodes seemed to indicate self-hate or behavioral changes with some describing a state of self-hate with potential long-term psychological sequelae. However, many Twitter users who indicated receiving orthodontic treatment were generally thankful for having braces, with many expressing its positive impact on their psychological well-being, self-esteem, and general life.

Q: What can orthodontists do, in terms of orthodontic treatment, to mitigate bullying?

A: As an orthodontist, I always find the patient’s main reason for seeking treatment one of the most important bits of information that we collect. Victims of bullying, however, may not be forthcoming with this information, so we have to try and build a good rapport with them and their parents in order to tap into this area of their lives. Understanding the motivation for treatment may give us an immense advantage in delivering patient-centered care—the new paradigm of health and dental care nowadays. For instance, a patient who is receiving a great deal of bullying because of something like a midline diastema may benefit from early closure of that space during the early phase of treatment. We may also play an active role in identifying patients who may be suffering from a great deal of distress and could benefit from a referral to a psychologist.

Q: Are there any behavioral approaches that orthodontists and other physicians can take to help mitigate bullying?

A: As I mentioned previously, some patients cope with bullying by sharing their own experiences and seeking treatment. We are in a prime position to help them with both—ie, with our hands, but also our ears. I personally believe that we should never limit our focus to teeth. At the end of the day, we are health professionals who are personally and clinically enriched by making a difference in someone’s life. 

The study, “Accounts of Bullying on Twitter in Relation to Dentofacial Features and Orthodontic Treatment,” was published by the Journal of Oral Rehabilitation.

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This February, dentistrytoday.com celebrates National Children's Dental Health Month with news stories, interviews, and blogs all about safeguarding pediatric oral health. #NCDHM

February is National Children’s Dental Health Month (NCDHM), and the ADA and America’s ToothFairy are ready to help practices spread the message of good oral health and serve children who are most in need. Considering the role that sugar-sweetened beverages play in today’s rates of tooth decay and the effectiveness of public water fluoridation programs in improving oral health, this year’s theme is “Choose Tap Water for a Sparkling Smile.”

“There’s a solution out there. It’s just a matter of engaging the dental community. They’ve been so wonderful and supportive, and building upon that as well as promoting oral health to educate the public about its importance,” said Jill Malmgren, executive director of America’s ToothFairy. “Oral health has often been overlooked, and it’s so critical to one’s overall health, so there’s a great opportunity to really impact lives.”

Clinicians can begin their celebration with the NCDHM Program Planning Guide, provided by the ADA. It offers program coordinators resources for promoting the benefits of good oral health to children, such as easy activities, timetable tips, a sample NCDHM proclamation, and more. It also provides instructions for publicizing the month through reaching out to schools, conducting free screenings, and getting local media coverage.

Plus, dentists can order or download colorful posters in both English and Spanish from the ADA website featuring familiar NCDHM characters promoting the value of tap water and daily brushing to oral health. Activity sheets with stories and puzzles that young patients can color—all while learning about better eating and brushing habits—are available online as well in both English and Spanish.

Meanwhile, America’s ToothFairy is celebrating by promoting its Smile Drive program, which collects toothbrushes and other oral hygiene products to donate to children in need. It offers instructions and other resources for dentists to conduct drives in their communities and connect with local nonprofits that could use the donations. Those who can’t conduct their own drives are encouraged to donate to the Toothbrushes and Oral Care Supplies Fund instead.

The City of Charlotte, NC, is all in with this year’s Smile Drive to serve the nearly 50,000 children living in poverty in Mecklenburg County. So far, America’s ToothFairy has collected 30,000 toothbrushes for distribution there and aims to get more. Toothbrush collections and other fundraisers are scheduled throughout February at several locations, with some bars and taverns even offering a dollar off of each pint of beer for each brush donated.   

“We always need oral care products. That’s something that you can see go right back into your local community,” said Malmgren. “It’s a great way to give back to your local community and a fun way to participate and raise awareness of oral health and get people involved and talking about it and help people understand there’s a real need there. It’s also an area where we can make a difference.”

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It’s almost time to pack your bags if you’re heading to the Yankee Dental Congress, scheduled for January 25 through January 29 at the Boston Convention and Exhibition Center. Nearly 28,000 dental professionals are expected to take part in more than 300 continuing education courses and interact with the more than 450 exhibitors that will be on hand. And since all work and no play makes for a dull show, the Massachusetts Dental Society has entertainment lined up too.

Across the nation, dentists are struggling with the tragic consequences of the opioid epidemic. Fortunately, the Yankee Dental Congress is offering guidance via the “Interprofessional Symposium: CLT-ALT-DELETE: Rebooting the Approach to Pain Management.” Plus, the show’s Fast Track program will include a series of 6 hour-long lectures covering pain management and prescription monitoring, according to current best practices and regulations.

Clinicians also are growing more aware of the dangers of sleep apnea and the role they can play in treating it. Professionals who want to learn more can visit the Sleep Apnea Pavilion, which will showcase the latest technologies that can help patients regain peaceful and restful nights. For example, attendees can learn about oral appliance therapy and laser procedures, as well as pediatric dental sleep medicine, all for complementary continuing education credits.

The focus on technology will continue with 3-D Printing in Dentistry: The Present and the (Very Near) Future. Sponsored by Formlabs, the exhibit will showcase 3-D printers and biocompatible materials, which combine for streamlined workflows, improved outcomes, and lower costs. Meanwhile, Pete Gardell, DDS, and Rich Rosenblatt, DDS, will bring tech to the floor with “CAD/CAM for All,” which will include both lectures and hands-on programs.

Other coursework will cover a range of clinical topics, including aesthetics, anesthesia, composites, endodontics, implants, infection control, restorations, and more. Speakers also will discuss practice management issues, such as coding and reimbursement, the front desk, social media, and the work/life balance. Plus, Dentistry Today’s editor in chief Damon Adams will have a pair of lectures on innovations, controversies, and clinical tips on Thursday, January 26.

On Thursday, January 26, the show will host “A Conversation with Dr. Lisa Genova.” Genova is a neuroscientist and the author of the bestseller Still Alice, a novel about a woman struggling with Alzheimer’s disease that also was turned into a movie, featuring Julianne Moore in an Oscar-winning performance. And on Friday, January 27, Nancy Frates of the ALS Ice Bucket Challenge will speak. Her son Peter was diagnosed with ALS in 2012 and inspired the viral sensation that raised $115 million for research into the disease and other support.

The Yankee Dental Congress also is an opportunity to recognize leading clinicians for their service to the profession and to the community. Among the accolades that will be bestowed on Wednesday, January 25, Steven J. Tonelli, DMD, will receive the 2017 Etherington Award for his extensive work on behalf of organized dentistry. James Cinamon, DMD, will be named the 2017 Clinician of the Year. And, Jacklyn Ventura will be named the 2017 Hygienist of the Year.

Finally, attendees get head to the Wild West with the Yankee Roundup on Thursday, January 26 from 5:30 to 7:30 pm. Cowboys and cowgirls alike can enjoy grub, music, and prizes, along with a best costume contest. And for a few chuckles, attendees can head to Laugh Boston for premier standup comedy on Friday, January 27. Doors will open at 7:00 pm.

With all that and more to navigate, attendees will have their hands full. That’s why the show’s organizers are offering the Yankee 2017 Mobile App. Compatible with iPhones, Androids, and even Blackberries, the free software maps out courses and exhibitors, manages continuing education credits, provides real-time updates and show specials, and offers access to all information about the show via a single icon.

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Augmented reality isn’t just for gamers anymore. A cross-disciplinary team of researchers at the University of Western Australia (UWA) is developing software that will enable dentists wearing augmented reality glasses to use hand gestures to access information that then will be displayed in their peripheral vision. 

“A big problem at the moment is the amount of interruptions dentists face when performing procedures, with an estimated 20% of their day carrying out nonclinical tasks and a significant amount of time away from patients during a procedure to review critical information,” said lead developer Marcus Pham, an electrical engineering and computer science student.

“The technology we are developing will change this by providing dentists with all the information they need without them needing to interrupt a procedure, so they can focus entirely on the patient,” Pham said. “This means the time taken to carry out procedures will be drastically reduced, and the quality of dental work will also improve.”

Aside from providing these patient benefits, the technology also is designed to decrease costs in dentistry and help train dental school students. For example, it could provide students with accurate and fast feedback as they learn intricate manual tasks such as tooth preparation, instead of students seeking feedback from a teacher’s interpretation of their work. 

The researchers have been selected as one of 10 teams in Australia to be included in the Commonwealth Scientific and Industrial Research Organization ON Accelerate3 program, a 12-week collaboration that connects experienced and aspiring researchers to develop business models, find funding, and improve marketing before commercialization.

The team also includes Paul Ichim, DMD, of UWA Dentistry, Thomas Braunl, PhD, of UWA Engineering, and Rob Shannon, project manager of the UWA Innovation Quarter. After developing and testing the technology with students at UWA Dentistry, the researchers hope it will be available for commercialization as early as next year.

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