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Essential Dental SystemsEnvy self-etch, self-adhesive, multi-surface cement is designed to solve the problem of adhesion to zirconia. Its unique chemistry provides tack curing for easy cleanup. Also, after a light cure for a few seconds, it becomes a gel-like material that flakes right off in one clean piece.

As the first of its kind, Envy’s multiple adhesion promoter technology allows practitioners to depend on one single cement for all types of restorations. It ensures virtually no post-op sensitivity and has proven high retention not only to zirconia but also to enamel, dentin, PFM, lithium disilicate, gold, and many others. To meet various clinical needs, it’s available in translucent, white, and A2.

For more information, call Essential Dental Systems at (201) 487-9090 or visit edsdental.com.

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Errors happen in dentistry and across medicine, with the worst mistakes causing as many as 250,000 fatalities each year. Guidelines to normalize and encourage error disclosure are available to improve patient safety and healthcare outcomes, though they don’t address the psychology that influences how and when practitioners disclose errors and manage their consequences. Researchers now are calling for better education and training focused on these psychological challenges to reduce the number and severity of these errors. 

“We must transform the culture of error disclosure in the medical community from one that is often punitive to one that is restorative and supportive,” said Neha Vapiwala, MD, an associate professor of radiation oncology, vice chair of education at the Perelman School of Medicine at the University of Pennsylvania, and co-author of the study. “And to do that, we must tend to the psychological challenges that medical professionals wrestle with when they face the possibility of disclosing an error.” 

Initiatives such as the Disclosure, Apology, and Offer model have helped make moderate gains in creating a culture of transparency in health systems, according to the researchers. But these efforts primarily focus on the legal and financial aspects of error closure and do not address other barriers, such as the fear, shame, and guilt that come with error disclosure.

“Arguably, these psychological factors are harder to overcome, especially in this modern age of social media where healthcare providers can be reviewed and scrutinized in very public forums,” said Vapiwala. “There is real concern that any little slipup can live on the Internet for the rest of someone’s career.”

The researchers identified a pair of main cognitive biases that often hinder error disclosure: Fundamental Attribution Error, which is the tendency to overestimate one’s own role in a situation, and Forecasting Error, which is the tendency to overestimate the impact and duration of negative consequences while underestimating the ability to recover from those circumstances.

For example, if an error led to a patient injury, the physician might initially overstate his own role in that error rather than examine any systematic reasons for why that error occurred. The physician may then also overestimate the long-term consequences or recovery time for the patient, leading to feelings of both self-blame and exaggerated doom, both of which damage the physician-patient relationship and may impede a care provider from reporting the error.

“Overcoming these biases is akin to suppressing a reflex. It requires self-awareness, practice, and, most importantly, education and training,” Vapiwala said.

The authors offer several strategies to overcome these patterns, utilizing elements of social psychology to transform the current culture of error disclosure. Recommendations include incorporating standardized patients (SPs), actors who simulate patients not only to “practice” difficult patient encounters but also to help model interactions with family members, peers, and administrators to teach various behavior and coping mechanisms. SPs can effectively mimic the psychological elements of error disclosure, including profound guilt, feelings of ineptitude, and fear of repercussions, the researchers said. 

Virtual reality (VR) also can offer an immersive and realistic experience to supplement traditional curricula while providing tremendous scalability at a lower cost than SPs, the researchers said. For example, one recent VR exercise allowed viewers to experience the perspective of a 12-year-old Syrian refugee to incite more compassion and understanding. While similar VR medical content doesn’t currently exist, it is on the horizon for many medical trainees and professions. Still, SP and VR are limited, as users know they are using simulations. 

“Standardized patients and other simulated scenarios provide an excellent foundation. But until you are put into a real-world situation and forced to confront your mistake and its potential consequences, you can’t truly understand the psychosocial challenges,” said Jason Han, a fourth-year student at the Perelman School of Medicine and co-author of the study.

Finally, the researchers recommend implementing a professional standard for trainees, including a formal evaluation of the skills needed to disclose and cope with medical errors. This standard would further normalize error disclosure and make it a common practice among physicians and trainees, they said. The researchers conclude that the primary change will need to be cultural, not just among trainees but at every level of medical practice to successfully pivot away from the current stigma related to error disclosure.

“Administrators must make a shift from asking who is at fault to asking why and how did a situation occur, creating a culture that embraces error disclosure and seeks to solve the many systematic factors that led to an error in the first place,” Vapiwala said. “This approach will not only normalize error disclosures but also help us better understand why they happen so we can prevent more of them in the future.”

The study, “Applying Lessons from Social Psychology to Transform the Culture of Error Disclosure,” was published by Medical Education.

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The WannaCry ransomware attack hit more than 150 countries, locking up more than 300,000 computers and demanding a $300 payment before files could be restored. But that was only one incident, as the number of ransomware attacks increased more than 6,000% in 2016, according to IBM. Today, there are more than 9 million ransomware variants now active on the Internet. To help practices protect themselves, DDS Rescue offers a 12-step data security assessment. It includes: 

  • Up-to-date information on HIPAA/HITEC Act;
  • Ransomware (cryptowall) management strategies
  • Physical safeguards for the server and backup appliance;
  • Encrypting data and safeguards for patient information;
  • Encrypted email strategies; 
  • Backup evaluation; 
  • Antivirus program verification;
  • Firewall verification; 
  • Safe remote access strategies and management (external account password complexity); 
  • Password strategies and management (complexity and expiration);
  • HIPAA insurance explanation; 
  • Guest WiFi security strategy.

DDS Rescue also provides a full report and action plan for physical and technology risk management. Assessments are performed remotely, with no interruptions. And, there is no charge for current DDS Rescue customers.

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Orthodontic treatment before the age of 18 years moderately improves oral health-related quality of life (OHRQoL), with the most improvement in emotional and social well-being, reports the University of Sheffield School of Clinical Dentistry. These findings are significant, according to the researchers, because there has been little evidence that orthodontic treatment improves OHRQoL until now.

“As practicing orthodontists, we are constantly being told by our patients that they are pleased they had their teeth straightened and that they are no longer embarrassed to smile or to be photographed. We wanted to find all the research that has tried to measure this effect with young people,” said Philip Benson, PhD, FDS, professor of orthodontics at the university and director of research of the British Orthodontic Society (BOS).

“We did a thorough search and found 13 studies that were relevant. Four of these studies used similar questionnaires to measure what young people thought about their teeth and how their dental appearance affects their life, before and after orthodontic treatment. We combined the data from these 4 studies to show that the improvement was measurable and moderately large in the areas of emotional and social well-being,” Benson said. 

The overall number of young people included in the research was relatively small, Benson added, so further research is needed. Hanieh Javidi, BDS, one of the study’s co-authors and who has just received the 2017 joint Faculty of Dental Surgery Royal College of Surgeons BOS Research Fellowship, will investigate OHRQoL in youth age 18 years and younger for her PhD research project.

Meanwhile, the British Orthodontic Society has launched “The BOS Guide: Better Teeth for Life,” an online resource that highlights the positive impact that orthodontic treatment can have on oral health and emotional well-being. It also provides patients with practical tips for achieving excellent results, all supported by the university’s study of orthodontics and OHRQoL in adolescents.

“The new BOS Guide demonstrates how life-enhancing orthodontic treatment can be,” said BOS president Alison Murray, BDS, MSc. “We know that patients in braces are encouraged to keep their mouths really clean, and there is evidence that once treatment has been completed, patients continue to look after their teeth. Orthodontics should be the start of a lifetime of excellent dental health.”

The study, “Does Orthodontic Treatment Before the Age of 18 Years Improve Oral Health-Related Quality of Life? A Systematic Review and Meta-Analysis,” was published by the American Journal of Orthodontics and Dentofacial Orthopedics.

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Dental anxiety is universal. According to a survey conducted by the Oral Health Foundation and Procter & Gamble in honor of National Smile Month, 67% of British adults are apprehensive about visiting a dental professional. Of those who worry, 33% are anxious about the discomfort of the treatment, while 26% worry about its costs.

Perhaps the anxiety is the result of poor oral health habits, the Oral Health Foundation and Procter & Gamble suggest. The survey found that 28% of those polled attempt to fix or improve their oral health just days before their visit to the dentist. Also, 50% had weakened enamel and 30% had tooth decay, likely caused by diets rich in sugar and acid.

“Cake culture and unhealthy options of high-sugar foods and drinks in vending machines and canteens are not only contributing to oral health problems but major issues with health overall, with increased levels of diabetes and obesity,” said Dr. Nigel Carter, CEO of the Oral Health Foundation.  

The Oral Health Foundation aims to turn these attitudes around with its National Smile Month campaign, May 15 through June 15. It encourages people to brush their teeth right before they go to sleep and at least one other time during the day with a fluoride toothpaste, reduce the number of sugary foods in their diet, and visit the dentist as often as recommended.

“Too often our oral health takes a backseat when we think about our overall health and well-being. This simply shouldn’t be the case,” said Carter. “National Smile Month is all about re-engaging the nation about the importance of a healthy mouth and the benefits our smile can have.” 

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If current consumers of sugar-free chewing gum increase their consumption by just one piece per day, $4.1 billion could be saved worldwide on dental expenditures from treating tooth decay each year, according to the Institute of Empirical Health Economics (IEHE). These savings would include $2.07 billion in the United States, $1.1 billion in Europe, and $149 million in China.

Chewing increases salivary flow, which helps remove leftover food debris while neutralizing and washing away the acids that are produced when food is broken down by the bacteria in plaque on teeth. This acid can break down tooth enamel. Also, the increased saliva provides more calcium and phosphate to help strengthen the enamel.

According to the ADA, chewing sugarless gum for 20 minutes after a meal can help prevent tooth decay. While sugarless gum should not replace brushing and flossing with a fluoride toothpaste twice a day and flossing once a day, the ADA reports, it can be an effective adjunct to oral care.

“In addition to the well-established clinical benefits, for the first time, this study models the reduction in the relative risk of tooth decay and subsequent cost savings for dental care as a result of increased consumption of sugar-free gum as part of a complete oral hygiene routine,” said Michael Dodds, BDS, PhD, lead oral health scientist with Wrigley, which funded the study and produces a range of sugar-free gum brands.

The study modeled the potential decrease in dental health costs from caries for 25 industrial countries. According to the researchers, 60% of dental service costs around the world are related to tooth decay, while 60% of all children and 90% of all adults have tooth decay. The IEHE and Wrigley both call for the inclusion of sugar-free gum in national oral healthcare advice, alongside other proven oral hygiene behaviors.

“While further studies are needed, these are exciting new insights that add to the extensive body of evidence on the benefits of sugar-free gum in oral care,” said Dodds.

The study, “A Global Approach to Assess the Economic Benefits of Increased Consumption of Sugar-Free Chewing Gum,” was published by the American Journal of Dentistry.

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The Professional Education Society (PES), an ADA CERP Recognized Provider provides CE travel opportunities to healthcare professionals. Combining worldwide destinations with continuing education seminars, its customized CME/CE cruise and travel programs give dental, medical, nursing, and allied healthcare professionals opportunities for learning experiences and networking between faculty and participants. Additionally, its in-country healthcare visits provide an inside look into unique healthcare systems around the world, all while enabling its participants to earn 12 to 20 CE credits. Enjoy possible tax benefits by taking your continuing education in exciting travel destinations. During the past 37 years, PES has traveled to more than 135 countries, providing cross-cultural experiences.

For more information, call the Professional Education Society at (877) 737-7005 or visit pestravel.com.

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Biomarkers in saliva may identify those at risk of developing Alzheimer’s disease, according to investigators at the Beaumont Research Institute. With no cure and few reliable diagnostic tests, Alzheimer’s affects more than 5 million Americans at a cost of $259 billion and will affect 15 million to 16 million by 2050, reports the Alzheimer’s Association. However, the researchers believe these biomarkers may lead to early diagnosis and improved treatment before brain damage occurs and dementia begins, potentially improving the lives of millions.

“We used metabolomics, a newer technique to study molecules involved in metabolism. Our goal was to find unique patterns of molecules in the saliva of our study participants that could be used to diagnose Alzheimer’s disease in the earliest stages, when treatment is most effective. Presently, therapies for Alzheimer’s are initiated only after a patient is diagnosed, and treatments offer modest benefits,” said researchers Stewart Graham, PhD. 

Metabolomics is used in medicine and biology for the study of living organisms. It measures large numbers of naturally occurring small molecules, called metabolites, present in the blood, saliva, and tissues. The pattern or fingerprint of metabolites in the biological sample can be used to learn about the health of the organism.

“Our team’s study demonstrates the potential for using metabolomics and saliva for the early diagnosis of Alzheimer’s disease,” said Graham. “Given the ease and convenience of collecting saliva, the development of accurate and sensitive biomarkers would be ideal for screening those at greatest risk of developing Alzheimer’s. In fact, unlike blood or cerebrospinal fluid, saliva is one of the most noninvasive means of getting cellular samples, and it’s also inexpensive.”

The study participants included 29 adults in 3 groups: mild cognitive impairment, Alzheimer’s disease, and a control group. After specimens were collected, the researchers positively identified and accurately quantified 57 metabolites. Some of the observed variances in the biomarkers were significant. From their data, the researchers were able to make predictions as to those at most risk of developing Alzheimer’s.

“Worldwide, the development of valid and reliable biomarkers for Alzheimer’s disease is considered the number one priority for most national dementia strategies,” said Graham. “It’s a necessary first step to design prevention and early intervention research studies.” 

The study, “Diagnostic Biomarkers of Alzheimer’s Disease as Identified in Saliva Using 1H NMR-Based Metabolomics,” was published by the Journal of Alzheimer’s Disease.

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Air Techniques and US Energy Recovery have pledged $5,100 to Mercy Ships. A global charity, Mercy Ships operates a fleet of hospital ships that serve developing nations. Its more than 1,000 volunteers hail from 45 nations, and it operates offices in 16 countries.

Charitable donations are put to use with 77.91% of donations used to support ship and field programmatic operations, 13.81% supporting fundraising efforts, and 8.29% going to general and administrative costs.

“Mercy Ships hits a spot near and dear to the Air Techniques Corporation,” said Christoph Roeer, CEO of Air Techniques. “Seeing the photos and videos of the procedures and care that Mercy Ships performs makes us proud to support this amazing charity. 

New sugar-rich diets and a lack of oral healthcare infrastructure are leading to growing rates of dental caries and periodontal disease in the countries that Mercy Ships serves. And without treatment, these infections can lead to prolonged pain, diseases of the jaw, and even death.

Mercy Ships provides dental hygiene education and training to patients and local personnel as well as treatment, including extractions and fillings. Since 1978, the organization has performed more than 390,000 dental treatments and procedures to more than 147,000 patients.

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The Sunstar Foundation has awarded its first Innovation Grant to Yvonne Kapila, DDS, PhD, of the University of California at San Francisco School of Dentistry. Her project, “Natural Bacteriocins as Pre/Pro-Biotics to Promote Oral Health and Prevent Periodontal Disease,” is investigating the use of prebiotics or probiotics containing nisin or nisin-secreting bacteria to maintain a healthy oral microbiome and prevent the formation of pathogenic biofilms associated with periodontal disease. 

Under the Innovation Grant program, the Sunstar Foundation will award 6 research grants of $30,000 each to select members of the American Academy of Periodontology (AAP) over a 3-year period, starting in 2017. The program is designed to support research endeavors with significant potential to advance the science and practice of periodontology. It is open to all AAP members, with abstracts judged on established criteria developed by Sunstar and the AAP.

“The Sunstar Innovation Grant will allow our team of clinicians and scientists to explore nisin’s effects on oral biofilm composition using both in vitro and in vivo model systems. Nisin has a long history of safety and a broad range of biomedical applications, and it could add value in our understanding of periodontal health and periodontal disease prevention,” said Kapila. “I am so pleased and honored that this very important initiative was chosen by the AAP and Sunstar to receive additional funding.”

“Sunstar and the AAP share a common interest in innovative treatments and research that serve to alleviate the high burden of periodontitis in the United States,” said Aaron Pfarrer, senior director of professional relations with Sunstar. “We are confident that Dr. Kapila’s study will lay the groundwork for novel methods of periodontal disease prevention. We look forward to many important updates on this groundbreaking research.”

Kapila will present the results of her study at a future AAP Annual Meeting. AAP members who are actively conducting scientific research in a clinical setting are invited to submit research abstracts and proposals for the consideration of future grant awards. Applications will be accepted this fall. For more information about the Sunstar Innovation Grant, contact scientific affairs manager Stephanie Heffner at This email address is being protected from spambots. You need JavaScript enabled to view it..

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