Tuesday, 22 January 2013

Adstra offers standalone dental charting


Adstra offers standalone dental charting
By DrBicuspid Staff
October 2, 2008 -- Adstra Systems has announced that its Adstra Charting treatment planning and charting software is now available as a standalone program, after more than six years of being available only as an add-on to Adstra's practice management software.
Adstra Charting software allows users to create and manage odontograms for examinations, completed treatment, and planned treatment. There are four chart views: maxillary, mandibular, buccal, and palatal-lingual. The charting tools are grouped by type: general, periodontal, restorative, and endodontic. Multiple charts can be opened at the same time, and pockets and recessions are represented graphically. A number of reports -- or the whole chart as it's viewed -- can be printed.
Adstra Charting offers an array of tools for charting all kinds of tooth conditions, according to the company. Users can set their own preferences for general chart, periodontal chart, restoration materials, and the connection between procedures and tools. Users can also define exam templates and incorporate them into the patient's chart.

Copyright © 2008 DrBicuspid.com

Court suspends intoxicated dentist's license


Court suspends intoxicated dentist's license
By DrBicuspid Staff
October 2, 2008 -- An Ohio dentist who was found drunk at his practice during a state inspection has lost his license, according to a news story in the Chronicle-Telegram.
The Ninth District Court of Appeals upheld the Ohio State Dental Board's decision to suspend John Brooke's license this week.
"According to the dental board, Brooke was intoxicated when a state inspector showed up to investigate a tip that the dentist was drunk at his office on March 21, 2006," the paper reported. "The investigator said Brooke's eyes were glassy, his face was red, and he was brushing his teeth while he was being questioned."
Brooke had previously been convicted of handling a firearm while intoxicated and a DUI (in 2005 and 2006, respectively), but the board said his efforts to deal with his drinking problem since weren't up to their standards, according to the news story.

United Concordia to offer premium-free dental care to reservists


United Concordia to offer premium-free dental care to reservists
By DrBicuspid Staff
October 1, 2008 -- The U.S. Department of Defense has awarded its Tricare Active Duty Dental Program contract to United Concordia Companies. The contract provides for premium-free dental healthcare services to active duty service members referred from military dental treatment facilities (DTFs) for civilian care and dental coverage for those active duty service members under the Remote Active Duty Dental Program.
Reservists and National Guard members who are on orders to active duty for a period of more than 30 continuous days are considered active duty service members from their initial activation date. In certain circumstances, service members no longer on active duty may also be eligible for coverage when injured while serving on orders.
Many features of the new contract, which is slated to begin services August 1, 2009, are currently handled by the Military Medical Support Office under Tricare Management Activity. Establishing a network of providers is new under the contract.
"Tricare aims to ensure the highest level of beneficiary satisfaction and contractor performance in controlling costs," stated Army Maj. Gen. Elder Granger, Tricare Management Activity deputy director, in a press release. "Network dentists will provide the same dental benefits that are received at military DTFs, to include comprehensive preventive services such as oral cancer screenings."

Monday, 21 January 2013

Riemser buys Curasan's dental business


Riemser buys Curasan's dental business
By DrBicuspid Staff
August 20, 2008 -- German pharmaceutical company Riemser Arzneimittel has acquired the dental business of Curasan.
Curasan had been marketing bone regeneration and membrane products in the U.S. since 2004. Its three leading products include Cerasorb, Epi-Guide, and Revois.
"Given the rapid growth in the U.S. of Cerasorb bone regeneration material and Epi-Guide membrane -- which have doubled in users and sales during each of the past two years -- we are eager to bring additional financial resources to the expansion of these and other dental products," Norman Braun, head of Riemser's dental division, stated in a company press release.

Copyright © 2008 DrBicuspid.com

Dentistry and depression: Part I -- Are dentists more suicidal?


Dentistry and depression: Part I -- Are dentists more suicidal?
By Rochelle Sharpe, DrBicuspid.com contributing writer
August 20, 2008 -- Dentistry has the highest suicide rate of any profession. Or so they say. The perception is so entrenched in the popular culture that it once cropped up in an episode of the TV comedy "Seinfeld."
But researchers from the National Institute for Occupational Safety and Health (NIOSH) are saying it may be a myth. In a recent study, they report that, overall, white male dentists had slightly lower suicide rates than the general working population (Occupational Health, January 2008, Vol. 58:1; pp. 25-29).
So where did the notion get started?
There's no question that dentists struggle with depression. "Dentists are under such horrible pressure," said Dorothea Lack, Ph.D., a San Francisco psychologist who used to work as a dental hygienist. "It's not surprising that they have psychological problems."
In the "Seinfeld" episode, Jerry Seinfeld's Jewish dentist Tim declared, "You have no idea what my people have been through."
"The Jews?" Seinfeld asked.
"No, the dentists," Tim replied.
After Tim states that dentists have the highest suicide rate of any profession, Seinfeld retorted: "Is that why it's so hard to get an appointment?"
The perception may have originated in the 1960s when an Oregon study found that the state's dentists had the highest suicide rate of any professional group. A few other statewide studies showed high rates, too. Washington dentists had the second highest suicide rate in a 1983 analysis (behind sheep herders and wool workers), while California dentists ranked third for suicides in a 1973 inquiry (behind chemists and pharmacists).
Some national studies had similar findings. A 1971 examination of data collected by the U.S. Public Health Service showed that dentists had the third highest suicide rate of 36 occupations (behind managers and police officers). Then, in 1996, Steven Stack, a Wayne State University sociologist, analyzed more recent public health service data, using sophisticated statistical techniques to ensure that the high rate was not due to age, race, gender, or marital status. He concluded that being a dentist increases the risk of suicide by 564%.
Other studies reached completely different conclusions, however, finding that dentists' suicide rates did not differ much from the general working population. Those included a 1985 analysis of North Carolina dentists and at least two national studies in the mid-'70s, one of which was published by the ADA. The ADA even convened a conference on the topic in 1977, with experts declaring that reports of high suicides rates were exaggerated.
Settling the question is not easy. The research is inherently complicated, given that people sometimes won't list suicide as their loved one's cause of death. In addition, not all states collect suicide data by occupation.
The NIOSH researchers wrote that their colleagues have reached conflicting conclusions because they analyzed the data differently. "Only older white male physicians and dentists have elevated suicide rates, which partially explains the varied conclusions in the literature," they wrote.
Overall, they found that dentists older than age 50 had elevated suicide rates. Those between 60 and 64 years, the oldest working dentists studied, had the highest rates: 47.5 of 100,000 dentists committed suicide, compared to 42.6 of 100,000 workers of this age in the general population.
Medical doctors between 60 and 64 years had even higher rates, with 54.8 of 100,000 of these older doctors committing suicide.
But whichever profession is the most stressful, it's clear that many dentists need new ways to cope with the emotional burdens of their jobs.
In part II of this series, we take a look at techniques that psychologists and stressed-out dentists themselves are offering.

New bacteria could help battle tooth decay


New bacteria could help battle tooth decay
By Rabia Mughal, Contributing Editor
August 19, 2008 -- Dentists battle tooth decay and gum disease on a daily basis. Now British researchers have lent them a hand by discovering a new species of bacteria that could be a possible contributor to both.
Identifying and cataloguing new and existing oral bacteria could aid in developing new prevention methods and treatment of oral diseases. However, it is still unclear how relevant these particular new bacteria will be to treating periodontal disease.
The research team, led by William Wade, a professor of oral microbiology from the Dental Institute at King's College London, found three strains of the bacteria in oral mucosal tissue.
The new organism belongs to the Prevotella species, which are part of the normal microbial flora in humans and are associated with various oral diseases and infections in other parts of the body, and has been named Prevotella histicola, from the Latin wordhisticola -- "inhabitant of tissues."
"The healthy human mouth is home to a tremendous variety of microbes, including viruses, fungi, protozoa, and bacteria," Wade stated in a Kings College press release. "The bacteria are the most numerous: there are 100 million in every milliliter of saliva and more than 600 different species in the mouth."
Researchers performed a thorough phenotypic and genotypic characterization of these strains and published the results in the International Journal of Systematic and Evolutionary Microbiology (August 2008, Vol. 58:8, pp. 1788-1791).
The three strains form a homogenous group and are clearly distinct from any species with validly publishable names, the authors noted.
"Cells are saccharolytic and are able to ferment fructose, glucose, lactose, maltose, mannose, raffinose, and sucrose, but not arabinose, cellobiose, mannitol, melezitose, melibiose, rhamnose, ribose, salicin, sorbitol, trehalose, or xylose," they stated. "Major amounts of acetic acid and succinic acid and trace to minor amounts of isovaleric acid and lactic acid are produced as end products of metabolism."
The researchers found the new species living inside both healthy tissue and oral cancer cells.
"This confirms other work showing that oral bacteria can invade both tissues and individual cells," Wade stated.
This discovery is part of a larger goal of describing oral microbiota, Wade told DrBicuspid.com in an e-mail interview. Less than half of oral bacterial species have yet been named, and around half cannot even be cultured in the laboratory, he noted.
"Although we are looking for life on Mars, we are still largely ignorant of the microbial world of our own mouths!" Wade said.
"Very few single discoveries consist of major breakthroughs. In this case, the discovery of a new human oral species of Prevotella (a genus of gram-negative bacteria) is important, but further information will be needed to determine its specific importance related to periodontal diseases," said Chris H. Miller, Ph.D., a professor of oral microbiology at Indiana University. "According to the current NIDCR [National Institute of Dental and Craniofacial Diseases] listing of oral microbial species, there are already five species of oral Prevotella."
Tooth decay and gum disease are not traditional infectious diseases; they result from an imbalance between the human host and its commensal microbiota, influenced by environmental factors, Wade explained.
"To understand the interactions between host and microbiota, we need to fully characterize the microbial communities present," he said.
Wade's team, in collaboration with scientists at the Forsyth Institute in Boston, compiled a list of oral bacterial species earlier this year. That list comprises 600 species and provides descriptions of each species together with tools for analysis of their DNA.
Although most bacteria in the mouth are important for oral health, some can potentially cause disease. This database will help scientists study the role of specific bacteria in human health and disease, according to the college press release.
A better understanding of oral bacteria can also assist in developing new prevention methods and treatment of oral diseases.
"In the case of gum disease, it is clear that individuals who are susceptible display a greater degree of inflammation than those who are not susceptible, to the same level of bacterial challenge," Wade told DrBicuspid.com. "New treatments will be aimed at restoring tolerance to the normal microbiota in susceptible individuals."

Sunday, 20 January 2013

Beyond x-rays: Part II -- The glow of demineralization


Beyond x-rays: Part II -- The glow of demineralization
By Kathy Kincade, Editor in Chief
June 26, 2008 -- For years the mineral loss from enamel and dentin has been known to alter the optical properties of teeth. Now some technology developers are hoping to capitalize on this phenomenon with a diagnostic device that uses fluorescence to identify demineralization and thus pinpoint dental caries much earlier than is possible with x-rays or visual examination -- before cavitation begins.
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A series of studies conducted by Swedish researchers in the 1980s demonstrated laser-based autofluorescence of enamel and a direct relationship between the mineral content of the enamel and its optical properties, particularly fluorescence (Journal of Dental Research, July 2004, Vol. 83:Spec Iss C, pp. C84-C88). Subsequent studies utilized this phenomenon -- known as quantitative light fluorescence (QLF) -- to characterize the dental caries process with in vitro, in situ, and in vivo models.
"The only instruments available at present that measure mineral loss use QLF," said George Stookey, Ph.D., distinguished professor emeritus at Indiana University and president and CEO of Therametric Technologies, a company founded to commercialize this technology for dental diagnostics. "This technology is based on using a wavelength of light in conjunction with a filtering system to measure the diffraction of light on the tooth surface. When the mineral content of the enamel changes, so do the optical properties."
Attempts to commercialize this technology have so far met with limited success. Inspektor Research Systems of Amsterdam launched the first QLF system, the Inspektor Pro, in Europe in 2004 (price: $24,000). The system subsequently gained FDA clearance and reportedly was being sold in the U.S. by Omnii Oral Pharmaceuticals; however, that company's Web site indicates it sells only pharmaceuticals, not medical devices. (Efforts to contact both Inspektor and Omnii yielded no response from either company.)
Smaller, less expensive
Therametric is now developing a "next-generation" version of QLF that utilizes a high-intensity halogen lamp as the light source rather than a laser, reducing both the size and cost of the system, according to Stookey. In Therametric's Professional Caries Detection System, a probe relays data and images via a universal serial bus interface to a computer with software that pinpoints sites of impending decay up to two years before these spots could be located using traditional visual and x-ray examination methods, Stookey said.
By catching a potential lesion at such an early stage, dentists should be able to help reverse the demineralization process before cavitation begins, he emphasized. The precavitation portion of caries development involves daily periods of enamel demineralization over two to five years. According to Stookey, it is possible to reverse the caries process through measures that induce and facilitate remineralization of the enamel.
"If you detect a lesion before cavitation, it is reversible chemically," he said. "You can apply fluoride or fluoride gels and get rid of the white spot, although it takes some time. But it takes three to four years for a lesion to develop to the point of cavitation, so at any point you can intercept it prior to this, you can reverse it chemically."
The Professional Caries Detection System by Therametric Technologies.
A study being presented in July at the International Association of Dental Research meeting supports Stookey's claims. Researchers from the Eastman Dental Center in Rochester, NY, used QLF to study the effectiveness of remineralizing agents on early smooth-surface caries. While they found no significant difference between the teeth of those who rinsed twice daily with a combination calcium and fluoride rinse and those who didn't in terms of preventing the progression of caries, they did conclude that QLF could be a useful diagnostic aid in caries management.
Not everyone is convinced that QLF will be that useful, however. According to Allan Farman, B.D.S., Ph.D., M.B.A., D.Sc., a professor of radiology and imaging science at the University of Louisville School of Dentistry, the problem with the QLF technology is that it is largely restricted to evaluating smooth tooth surfaces that are not interproximal.
"As most dental caries occur in regions of stagnation (i.e., pits and fissures on the occlusal surfaces) and interproximally, this technology is not an ideal replacement for traditional radiographic methods for detection of lesions needing restoration as light penetration with the system is around 2 mm at best," Farman stated in an e-mail.
"The technology is acceptable for examining early demineralization in primary teeth without proximal contacts and might be of value for clinical trials into toothpaste, oral rinses, etc.," he added. "The argument that this is a move toward prevention could be made; however, the reimbursements from insurance companies are uncertain for such an approach."
The Therametric product is now undergoing clinical evaluation at several sites and could be on the market by the end of this year, according to Stookey. The price should be "quite competitive with the other instruments that are presently being marketed to assist with caries detection," he noted.
The next generation of dental imaging systems -- notably optical coherence tomography -- promises greater detail than QLF, plus the possibility of 3D. Part III of this series will look at near-infrared imaging and OCT and where they are in commercial development.