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Centrix Highlights Caries ‘Prevention for Life’ in Purposeful Campaign

Centrix Highlights Caries ‘Prevention for Life’ in Purposeful Campaign

Centrix Highlights Caries ‘Prevention for Life’ in Purposeful Campaign 

Prevention for Life logo As the nation grapples with the COVID-19 crisis, the word “prevention” is top of mind for everyone in the healthcare profession, as we all do our part in preventing the spread of the virus. Of course, for dental healthcare professionals, prevention—as in caries prevention—has its own connotation. Everyone in the dental profession is looking forward to the day when they can get back to providing non-emergency, preventative dental treatment.  

Coronavirus has given the entire nation pause. While this pause isn’t what anyone wanted, it does present a time for some “spring cleaning” (wordplay intended). The downtime from the day-to-day hustle presents an opportunity to rethink practice fundamentals, including preventive care. 

Question: Why Does Preventative Care Stop at Age 18?

This is an interesting question recently posed by Centrix, a company that specializes in preventive care products and education. Preventive care is applied to patients aged 0 to 18, and recent ADA data shows a decreasing rate of caries for patients in the 0-18 age range1, as represented in the chart below. 

Decreasing rate of caries for patients in the 0-18 range
Decreasing Rates of Caries Patients Ages 0-18

Good preventive care, that includes direct fluoride varnish treatment, has resulted in a decreasing rate of caries in kids.2 However, preventive care tends to stop around age 18, and  the data shows an increase in the rates of caries ages 19 and up. Represented below are adults ages 19 to 64 (left) and ages 65+ (right).  

Graph of increase in the rates of caries

So why does preventive care stop in adulthood? Part of it may be cost. For example, at one point, sealants were not reimbursed, but insurance companies changed their mind and are now covering this treatment. Centrix is hoping to do the same with fluoride varnish.

The other part may be awareness. Dental professionals need to advocate for patients to receive these treatments, and ideally patients should advocate for themselves.

According to Centrix, the problem of increasing adulthood caries speaks to the fact that we’re not treating patients based on an individual basis. The facts are a wake-up call: 

•92% of U.S. adults have some form of dental decay.3
•The simple, most effective caries prevention tool is fluoride varnish.4
•Although caries is increasing in adults, only about 10 adult patients will receive fluoride varnish per month.5

This is why Centrix started a movement called “Prevention for Life.” It’s based on the premise that great preventive dentistry maintains great oral health throughout the patient’s lifetime. With the tagline “Combat Caries for All,” Prevention for Life is designed to help deliver improved oral health to every patient. It’s supported by specific informational tools that help a dental office profitably treat all patients, at every age, according to their needs and risk level, and not limited by their insurance reimbursement.

The Prevention for Life Movement answers its own call-to-action with a 4-part plan:

1. Patient self-assessment and CAMBRA (Caries Management By Risk Assessment)
2. Treatment with FluoroDose Fluoride Varnish from Centrix
3. Submitting codes and CAMBRA forms to insurance to show why treatment was provided
4. Scheduling recall intervals based on patient risk 

FluoroDose fluoride varnish flavorsAfter patient assessment, a simple, yet effective way to maintain oral health for all patients is through the routine application of Centrix FluoroDose. FluoroDose fluoride varnish contains 5% sodium fluoride, the maximum dosage allowed in a convenient, single-use package. Submit the CAMBRA risk assessment forms, that indicate adult caries risk, to insurance to show the patient threat as well as preventive treatment. Once you begin a fluoride varnish treatment plan, it’s important to continue scheduling your patients for follow-up and preventive treatment, according to ADA recommendations.6

Centrix also acknowledges the importance of “practice health” in delivering treatment modalities that are profitable. For most offices, FluoroDose costs less than $1 per treatment and only takes 1 extra minute to apply to adult patients. Fees for preventative care treatments that virtually every adult will accept can add hundreds of dollars a day in incremental practice profits. In one year, that can mean a 5-figure increase to current revenue. Use Centrix’s Practice Health Calculator to assess an optimal pricing approach that increases patient acceptance, patient health, and practice health.

Be sure to visit Centrix’s designated website www.cariesprevention.com for a link to download CAMBRA forms, as well as information on an in-office Lunch & Learn and On-Demand CE Courses. There’s also a link to an e-book, “First Tooth to a Lifetime of Smiles” written by hygienists who address important topics, such as:    

•Treating an infant’s first tooth with fluoride varnish
•Care for primary teeth through prevention
•Maintaining oral health during orthodontic treatment
•Nutrition and oral health
•Oral health care for adults of various ages  

 

Download the E-Book

 

Sources 

1. http://www.ada.org/~/media/ADA/Science%20and%20Research/Files/HPIgraphic_0916_3.pdf?la=en
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504868/
3. https://www.nidcr.nih.gov/research/data-statistics/dental-caries/adults
4. https://ebd.ada.org/en/evidence/guidelines/topical-fluoride?_ga=2.71272851.260867461.1584974459-514480790.1584375062
5. http://sikkablog.com/compare-your-stats-for-adult-fluoride-treatment-with-other-dental-practices-by-kevin-henry/
6. https://www.ada.org/en/~/media/EBD/Files/JADA_updated_executive_summary_Nov_2013

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CAD/CAM Makes Dentistry Predictable & Rewarding

CAD/CAM Makes Dentistry Predictable & Rewarding

CAD/CAM Makes Dentistry Predictable & Rewarding

Advancements in dental technology over the past several years have paved the way for dentists to be able to confidently and predictably deliver indirect restorations in a single visit. We now have so many wonderful material choices at our fingertips that we can easily employ to fabricate indirect crowns, veneers, inlays, onlays, and implant restorations—all in the convenience of one appointment.

The very first generation of CAD/CAM dentistry hit the market back in 1985 with the release of the CEREC 1. Its capabilities were limited to milling only chairside inlays. Fast forward to today, and in-office digital dentistry procedures encompass so much more. With CAD/CAM technology, the dentist is able to take a digital impression of the prepared tooth/teeth, design the restoration, and mill in a matter of minutes. The chairside design software is loaded with a large database of teeth with different morphologies, shapes, and occlusal anatomies. The program’s artificial intelligence uses this information to produce a restoration that mimics the patient's natural dentition. In addition, the dentist has an extensive choice of materials from which to choose—feldspar, glass ceramics, polymer-based materials, and zirconia. Each case can be customized to fit the patient’s unique clinical situation.

The patient’s experience also has been greatly improved by the use of CAD/CAM technology to fabricate indirect restorations. It is much more comfortable for the patient to have a digital impression taken rather than endure the traditional elastomeric “gooey” impression, while a single appointment means the patient only needs to be anesthetized once. Patients value their time more than ever before, and providing same-day delivery with CAD/CAM in-office milling versus the 2-stage lab-made delivery of restorations is highly desirable. Patients greatly appreciate not having a temporary and not having to return for a second visit.

For the dentist, the switch to digital can be career changing. That is how it was for me 10 years ago when I started using CAD/CAM. Most notable was the ability to control all aspects of the restoration design process. Color matching and adding characterizations chairside provided a more natural, lifelike restoration. Stepping back and seeing the final result blend in with adjacent teeth is very rewarding.

Ultimately, the quality of the final indirect restoration depends on the skill of the dentist and his or her understanding of the technology. I encourage practitioners who are new to this type of dentistry to attend as many training courses as possible. Once the power of digital dentistry is seen and the many possibilities are realized, it’s hard to imagine how we ever practiced without it.

Shivi Gupta, DDS
San Diego, CA

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Dental Office Technology: 3 Things Can Help Your Office Comply with HIPAA Requirements

Dental Office Technology: 3 Things Can Help Your Office Comply with HIPAA Requirements

Dental Office Technology: 3 Things Can Help Your Office Comply with HIPAA Requirements

by Lawrence F. Emmott, DDS

Henry Schein One PracticeIn the early days of in-office computer use, dental offices had very limited choices for professional IT support. They would rely on just about anyone who was good at computers, including their patient’s nephew. Today, hardware has become more sophisticated, but some dentists make the same unsophisticated mistake. Many practices still don’t have proper IT support.

Part of the problem is mindset. Dentists wrongly think their practice network is just another piece of equipment, like a dental chair.  It’s delivered, they unbox it, they get it up and running and do not have to think about it again for many years. Computer hardware does not work that way, your network is a system that needs to be cared for, upgraded, and supported. This is of serious concern, as failure to properly maintain yourpractice IT network can potentially violate the federal Health Insurance Portability and Accountability Act (HIPAA).

The HIPAA Security Rule is comprised of three sets of “requirements”: technical, physical, and administrative.1 From my experience as a dental technology lecturer, and consultant, dentists face a two-fold responsibility in following these requirements. There’s the legal obligation to follow the law, and there’s also a moral obligation. I have never met a dentist who didn’t agree that they in fact have a moral as well as a legal obligation to protect patient health information (PHI) and their patients’ confidentiality.

Despite good intentions, some dentists won’t deliver on this obligation. It’s not because they don’t care enough. It’s because when it comes to following the requirements, they simply “don’t know what they don’t know.” Therefore, they’re unaware of what they really need to be HIPAA-compliant.

Given recent statistics on healthcare data breaches, it’s important dentists change their mindset and become aware of what they need to do in order to protect PHI. Healthcare data breaches continue to occur at extraordinary rates, according to research.2 Between 2009 and 2017, 2,184 healthcare data breaches were reported to the Department of Health and Human Services (DHHS)3, and breached facilities face heavy fines and litigation.4  According to the HIPAA Breach Notification Rule, “A breach is, generally, an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of the protected health information.”5 Under the rule, healthcare providers must notify the Secretary of DHHS of breaches of unsecured personal health information affecting 500 or more individuals in no case later than 60 days following a breach. They must also inform patients affected by the breach within 60 days of the breach discovery.

Password thiefDentists should be concerned about three real scenarios that can potentially result in a data breach: cyber criminals or hackers who break into the system to steal data, physical theft of hardware, and increasingly prevalent ransomware attacks, in which you’re locked out of your network and are asked to pay a ransom to regain access to your information, including PHI.    

While cyber crime attacks have gained much media attention in the past few years, we also need to pay attention to physical theft, which was the most common data breach type in the 10-year window.4 It’s important to secure your server and other hardware components. Put them in a locked closet, use a secure cable, or bolt them to the floor.

After you’ve physically secured your hardware, you need to ensure network security. This is where many dentists need professional help.

Here are the 3 things your dental office technology needs from an IT service provider to help your office comply with HIPAA requirements:

1. Up-to-date software and hardware. If you’re behind on your software updates, you’re more exposed to cyber attacks. Years ago, before cybercrime was prevalent, I would say that practices didn’t need to update right away, and they could wait until the bugs and kinks were worked out. Today, I give the exact opposite advice. New versions of software are designed to patch vulnerabilities and better protect you, so you want to be running the latest version of everything. A knowledgeable IT service provider should guide you on the protections you need.

2. Multiple backups. Backups have also evolved. Running your backup on a single hard drive that you take home each night is no longer the safest or most secure method. Today, if your practice is the victim of ransomware or otherwise gets hacked, you need a copy of the data that’s stored remotely. You should have multiple backups, including offsite backups that rely on secure cloud-based technology and encryption. Your IT service provider should handle the complexities of this setup. 

Under the HIPAA Breach Notification Rule, a dentist would be relieved from providing notifications following  a data breach if their data is encrypted as specified in the HIPAA Security Rule.6 Encrypting data is essential for every dental practice. However, it’s not a do-it-yourself project and can actually slow down your system if done improperly. I advise dentists to hire a professional that specializes in dentistry, like TechCentral by Henry Schein One, to help set up an encryption system for local data and backup data.

3. Basic protections and reliable IT support. Basic protections like malware, antivirus software, and firewalls are not all created equal. They should be enterprise-grade solutions maintained by a good, reliable IT professional. This is another reason to hire a reputable company like TechCentral.

National Service Provider or Local IT Company?

Look for an IT service company that has a local office as well as a national presence, plus years of dental experience that can help you navigate HIPAA risk assessment requirements. Don’t do it halfway and don’t do it cheaply. Be willing to look into a reputable IT provider that will not only make your life easier, but help you deliver on the promise of data security.

While local IT providers can easily reach your office, they may not specialize in dentistry and all the idiosyncrasies of dental software, such as Dentrix. TechCentral has the capability and resources to fix many problems in a remote session that spares an in-office visit and disruption of business. But in the event they do need to fix a problem in-person, they’ll send a locally based team member. It’s the best of both worlds!

Omnicore from Henry Schein Dental practices should also consider national providers for their hardware-as-a-service offerings. For instance, TechCentral offers a solution called OmniCore, a “network-in-a-box” solution that eliminates many of the concerns of routine monitoring and maintenance. After helping to install OmniCore, TechCentral takes care of all the maintenance and monitoring remotely. Importantly, they make sure your backup is working properly. Unfortunately, I’ve heard numerous stories where dentists thought they had a backup and discovered the hard way that it wasn’t working. This is one of the things TechCentral will regularly audit.

TechCentral offers services such as secure data backup and storage and remote system monitoring that can help you as you work on your HIPAA Risk Assessment. This support provides tremendous value, delivers peace of mind, and eliminates time-consuming hassles. Ultimately, working with a company like TechCentral allows you to focus on being a better dentist and a better business owner.

In closing, don’t look at your in-office technology like it’s an extra burden. Rather, look at is as a way to make practice/life easier. As I like to conclude my lectures, “The future is coming, and it will be amazing!”

1. https://www.hipaajournal.com/hipaa-compliance-checklist/
2.  McLeod Alexander, Dolezel D. “Cyber-Analytics: Modeling Factors Associated with Healthcare Data Breaches.” Decision Support Systems. (April 2018);108:57–68.
3.US Department of Health and Human Services “Breach Portal.”https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf
4. Dolezel D, McLeod A. Cyber-Analytics: Identifying Discriminants of Data Breaches. Perspect Health Inf Manag. 2019;16(Summer):1a. Published 2019 Jul 1.
5. US Department of Health and Human Services “Breach Notification Rule.” Available at https://www.hhs.gov/hipaa/for-professionals/breach-notification/
6.Ibid

This article is paid for by Henry Schein TechCentral, a division of Henry Schein One LLC. Certain components of the products or services described may be provided by third parties. Henry Schein One LLC and its affiliates are not responsible for, and expressly disclaim, all liability for damages of any kind arising out of the use of those third-party products or services.

About Dr. Larry Emmott    

Dr. Emmott is recognized as the nation's top expert on computer technology in the dental office. His high-energy programs provide the tools needed to make wise technological decisions, saving time and thousands of dollars. Learn more about his presentations at www.drlarryemmott.com and read his blog, Emmott on Technology, at www.emmottontechnology.com.

 

 

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Universal Dental Cleaner Offers Greater Efficiencies

Universal Dental Cleaner Offers Greater Efficiencies

Universal Dental Cleaner Offers Greater Efficiencies  

The COVID-19 crisis has temporarily paused non-emergency procedures, and practices are using this spare time to reevaluate protocols, procedures, and their most commonly used products. Over the course of a busy day, you may not stop to consider updated or enhanced versions of your go-to chairside materials. This temporary downtime is an opportunity to “catch up” on new products that can significantly improve efficiencies in the restorative workflow. 

Katana CleanerFor instance, have you ever considered how much time it takes to clean off a prosthetic during trial fitting, or how you can’t use the same cleaner on the tooth structure? Good news: there’s now a universal cleaner that works quickly and can be used intraorally, too. 

Released in February 2020, KATANA Cleaner from Kuraray is a non-abrasive intraoral and restoration cleaner. KATANA Cleaner is unique compared to other similar products on the market because its pH value of 4.51 allows it to be used not only extraorally on prosthetics but also intraorally on tooth structure. That makes KATANA Cleaner the first restorative cleaner to market with the capability for intraoral and extraoral use, according to the company.

As dentists are aware, when cementing a restoration during trial fitting of the prosthetic, bond strength is reduced because of contamination with saliva and blood in the oral cavity. Now, you can reach for just one product to clean the tooth structure inside the mouth and the prosthetic after try-in. KATANA Cleaner works in an efficient two-step process: just rub for at least 10 seconds on the abutment tooth or prosthetic restoration, and then rinse and dry. The product’s high effectiveness quickly restores original bonding strength so the restoration can be cemented.  

KATANA Cleaner is indicated for the following uses, specifically: 

1. Cleaning of contaminated prosthetic materials, including:

•Ceramics (zirconia, lithium disilicate, dental porcelain)
•Resin-based materials (CAD/CAM crowns, composite resin)
•Metals (precious/non-precious metal alloys)
•Posts (glass fiber posts, metal posts)

2. Cleaning of contaminated prepared tooth structure (cavity, root canal, and tooth abutment) and implant abutment

So, how exactly does it work? KATANA Cleaner has a high cleaning effect due to the surface active action of MDP salt that adheres to contamination. The MDP salt weakens the surface tension of contamination by surrounding and breaking it up. Then, the MDP salt floats the contamination away from the surface. The contaminants are removed by simply rinsing with water until the color of the product is completely gone; the surface air dries. 

For a closer look at this process, watch the video below.

After using KATANA Cleaner, the restoration and dental structure are free of contamination and are ready for preparation using your favorite dental cement. If you’re upgrading to a universal cleaner, you may consider upgrading to a universal, everyday cement, such as PANAVIA SA Cement Universal from Kuraray. This material offers high bond strength to virtually all materials and eliminates adding silane or primer because it’s already in the paste.

 

 

Restorative materials are continuously evolving, and all-in-one, universal products are improving efficacy. While this pause in your regular routine of restorative dentistry was unanticipated, consider using the time to research new innovations that can save time and money, while reducing the number of products needed in your armamentarium. 

 

To learn more about KATANA Cleaner visit www.kuraraydental.com.

 

 

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As Dentists, We Have an Essential Role in Sleep Medicine

As Dentists, We Have an Essential Role in Sleep Medicine

As Dentists, We Have an Essential Role in Sleep Medicine

"Struggling with snoring and sleeplessness? Call your dentist.” That simple recommendation is what your patients receive if they use any of the popular online consumer healthcare resources, such as WebMD or Mayo Clinic. If they do call you, will you be ready?

As many as 22 million Americans may suffer from obstructive sleep apnea (OSA), which is acknowledged as the most common cause of disordered sleeping and snoring, according to the American Sleep Apnea Association, and the great majority of these cases go undiagnosed. Untreated sleep disorders and chronic sleep loss are associated with health issues ranging from an increased risk of heart disease and type 2 diabetes to anxiety, depression, and more. We, as dentists, can and should play an essential role on a team that includes the general physician and other healthcare professionals. This is not just my professional mantra—in 2017, the American Dental Association adopted a policy urging dentists to screen for sleep-related breathing disorders.

My practice focuses on the treatment of sleep-disordered breathing such as snoring and OSA. We use a custom-fitted oral device that advances the mandible, thereby creating an opening to alleviate the collapsibility of the upper airway. More and more physicians are aware of the efficacy of this type of oral device and are recognizing dentists as partners in the effort to help manage OSA. Physicians are now referring their sleep apnea patients who are intolerant of, or who prefer not to use, the CPAP machine.

“You'll be amazed at how many patients you can truly impact by pointing them in the right direction.”

I have extensive training in the area of dental sleep medicine and was one of the first in my state to obtain diplomate status with the American Board of Dental Sleep Medicine. This expertise is key when building strong referral networks, and it has made me confident when working with doctors, nurse practitioners, and physician assistants. I follow the protocol established by the American Academy of Dental Sleep Medicine and keep the treating physicians involved in the care of our mutual patients. When treatment is completed, I refer patients back to their sleep doctor or primary care provider for continuing care. Treating sleep disorders definitely requires a whole healthcare team. For example, an OSA patient also may present with insomnia, high blood pressure, or atrial fibrillation, requiring the management of a psychologist, internist, or cardiologist.

As general dentists, we spend our days looking at arch forms, occlusion, abrasion patterns, and oropharynxes. There are multiple associated presentations of sleep-disordered breathing that should set off a conversation about the patient's sleep history. For example, significant bruxing wear along with narrow arch forms and a crossbite should suggest a deeper analysis of the patient's sleep history and a referral for a sleep study to rule out OSA. Knowing the classic presenting signs offers you the opportunity to truly change your patient's quality of life!

Once you learn about the symptoms, the orofacial features, and the common medical comorbidities of OSA patients, you’ll be amazed at how many you can truly impact by pointing them in the right direction. Dental sleep medicine is fascinating and can bring a new level of care for your patients and a renewed passion for your professional life.

Daniela Sever, DMD, earned her degree from the Harvard School of Dental Medicine, followed by a general practice residency at the Boston V.A. Hospital. In the last 12 years, Dr. Sever became interested in the field of dental sleep medicine and has undertaken extensive study in this area. She has studied with nationally and internationally renowned educators and clinicians. Several years ago, her office was accredited by the American Academy of Dental Sleep Medicine, one of the first 20 in the United States. Dr. Sever is also certified by the American Board of Dental Sleep Medicine.

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Optimize Moisture Control and Patient Comfort with DryDent®, A Unique Super Absorbent

Optimize Moisture Control and Patient Comfort with DryDent®, A Unique Super Absorbent

Optimize Moisture Control and Patient Comfort with DryDent®, A Unique Super Absorbent

DryDent moisture control pad The moisture-rich oral cavity is an ideal environment for many natural processes, but not for dental work. Saliva, produced at a rate of up to 3mL per minute, poses a major obstacle for clinicians, especially when placing composite restorations. Resin materials are notoriously technique-sensitive and, due to their hydrophobic nature, successful outcomes depend on maintaining a clean, dry field. Preparation and impression-taking also require a moisture-free working area for accurate results. In the absence of a dry environment, everything from bond failure, postoperative sensitivity, and microleakage can occur, undermining the longevity of the restoration and patient health.

To ensure a successful, long-lasting restoration, a dry working area is critical. While the market offers many options for isolating the field from moisture, they are often less than ideal—placement can be cumbersome or time-consuming and patients may experience discomfort. With innovative designs that deliver optimal moisture control and patient comfort, DryDent® Sublingual and DryDent® Parotid by Directa Dental offer simple yet effective solutions to common clinical woes.

As a replacement for traditional isolation, the slim but super-absorbent DryDent excels. In a recent Dental Product Shopper “Why I Use” testimonial, Robert Beatty, DDS, reports that DryDent “surpasses traditional cotton rolls and dry angles,” providing “better moisture control, ideal patient comfort, excellent coverage, and zero leakage when absorbed to capacity.” DryDent is made of a soft, flexible foam with smooth edges, allowing for gentle, easy placement. Unlike other absorbents, DryDent is thin and stays put when wet, never sliding out of place or obscuring visibility.

DryDent is available in two versatile designs: DryDent Sublingual and DryDent Parotid. The former is intended for placement under the tongue to collect moisture from the sublingual and submandibular glands, while DryDent Parotid is placed directly over the parotid glands for optimal saliva absorption. The sublingual version can also serve as a barrier between saliva ejectors and patient soft tissues.

Both DryDent Sublingual and DryDent Parotid are available in small and large sizes to fit any patient. For optimal results, DryDent Sublingual and DryDent Parotid can be used together—Dr. Beatty has had success deploying both products through every phase of the restoration process, ensuring a clean, dry field and patient comfort from preparation to final restoration placement.

To learn more about how DryDent can enhance your restorative workflow and order products for your practice, visit Directa’s website.

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GUIDOR easy-graft CLASSIC: A Simple, Synthetic System for Bone Grafting Success

GUIDOR easy-graft CLASSIC: A Simple, Synthetic System for Bone Grafting Success

GUIDOR easy-graft CLASSIC: A Simple, Synthetic System for Bone Grafting Success 

GUIDOR easy-graft CLASSICImplant therapy offers an ideal, esthetic solution for patients with missing teeth. Unfortunately, when a patient also presents with significant bone loss due to trauma, disease or injury, performing the procedure becomes much more of a challenge. In such cases, a bone graft made of autogenous, allograft or xenograft materials—derived from human or animal sources—is commonly used to build a foundation for the implant and restoration. The downside is that these organic materials may be rejected by the body, can provide avenues of transmission for infectious pathogens and often require a membrane covering or collagen plug to stay in place. Additionally, some patients simply aren’t comfortable with having animal- or cadaver-derived materials in their mouths.

Synthetic bone grafting materials have become an alternative preferred by many clinicians, as they minimize the risk of infection, rejection and patient disapproval. In a February 2020 Dental Product Shopper feature article, Yusuke Hamada, DDS, MSD, a Clinical Assistant Professor in the Department of Periodontology at Indiana University School of Dentistry, details how he found great success with Sunstar’s GUIDOR® easy-graft® CLASSIC, a 100% synthetic, fully-resorbable alloplastic bone grafting material. GUIDOR easy-graft enables safe, reliable and simple treatment of bone defects, often without the need for a membrane. According to Dr. Hamada, the GUIDOR system is “extremely easy to use, saves time and simplifies the entire bone grafting procedure.”

The first material of its kind designed for direct syringe delivery into the bone defect, GUIDOR easy-graft’s polymer-coated granules harden into a stable, porous scaffold just minutes after contact with blood. BioLinker®, a liquid activator included in each unit-dose application of GUIDOR easy-graft, softens the granules’ polymer coating, allowing them to stick together. The moldable, interconnected granules can be shaped to fit defect morphology and promote clot formation and bone regeneration thanks to their porosity. GUIDOR easy-graft and BioLinker work together to form a comprehensive system that reduces the need for a membrane and eliminates the guesswork of whether to mix granules with blood or saline. In Dr. Hamada’s words, the combination “saves us time and cuts down on product.”

A recent case of Dr. Hamada’s is a testament to just how perfectly-suited GUIDOR easy-graft is for socket preservation and implant placement immediately following extraction:

•In this instance, a fractured and non-restorable tooth No. 9 extraction revealed buccal bone absent 10mm from the crestal part of the socket.
•GUIDOR easy-graft was placed in the socket where it precisely contoured to the buccal bone shape.
•For this case, a membrane was required—GUIDOR® Bioresorbable Matrix Barrier was placed atop the bone graft material due to the lack of buccal bone.
•Despite slight buccal bone concavity, the implant was placed without complications and post-op radiographs show a successful, solid framework for a long-lasting restoration.

 

To learn more about GUIDOR easy-graft CLASSIC and order the product for your practice, visit Sunstar’s website.

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COVID-19: 3 Things to Remember When Closing and Reopening Your Dental Practice

COVID-19: 3 Things to Remember When Closing and Reopening Your Dental Practice

COVID-19: 3 Things to Remember When Closing and Reopening Your Dental Practice

As coronavirus disease progresses throughout the U.S., dental health care professionals are following state and local guidelines to treat only emergency cases. This is part of a coordinated effort to help curb the spread of COVID-19 and alleviate the burden on hospital and emergency departments. For many dentists, the decision to temporarily close their practice was unimaginable up until this point, but it’s the reality they now face as they struggle to balance operating expenses and lost revenue. 

On March 18, the ADA  provided its members and their patients detailed guidance on what to consider dental emergencies and nonemergency dental care. The difficulties of maintaining business operations are compounded by federal guidelines for social distancing, which have been extended until April 30. Perhaps instead of shuttering completely, you decide to keep one operatory functional for emergency procedures and have only certain staff members on call. The choice is yours under these guidelines.

While the ADA provides helpful practice management resources for COVID-19, they don’t detail product- and equipment-specific protocols for opening and closing your practice. Thankfully, there’s a concise resource, “Dental Clinic Temporary Closure & Reopening Instructions,” from DENTALEZ that can help practices prioritize critical tasks.

3 Things to Do When Closing and Opening

Even if you’ve already closed your practice in the last 14 days, there are some areas you may want to focus on to properly shut down for the longer term.

Ramvac dry vacuum1. Maintain Your Utility Room

Before you lock the door to your office, you’ll first need to open the utility room for maintenance of compressors, dry vacuums, and wet vacuums.

DENTALEZ advises that you follow your vacuum instructions carefully to properly clean the unit before shutting it down. For instance, the company’s Ramvac dry vacuum requires users to flush all the vacuum lines with hot water and SlugBuster line cleaner. After flushing, the vacuum system runs for several minutes with an HVE open in the clinic, which helps clean out the vacuum lines and the trunk line.

If the clinic has a wet ring pump, the lines should also be flushed. The solids collector bowl at the pump intake should be cleaned, and the water supply to the pump should be turned off to prevent possible flooding.

An advantage of Ramvac air compressors is that they’re oil-less and will be fine to shut down for an extended period of time, DENTALEZ explains. The company also developed an Owl Touch dental control panel with a Master Shutdown that turns off the entire utility room when activated.

If you’re shutting down completely, it’s acceptable to turn off the high voltage to the utility room at this time.

Reopening: DENTALEZ advises that certain vacuum pumps may need to be purged when the clinic starts back up. When the vacuum sits for an extended time, the pump can collect extra oil and may sound loud.

2. Run water and air through your delivery system

Delivery units are a critical point of infection control and prevention, and need to be included in your opening and closing to-do list. 

If the clinic runs on city water, simply turn off the water source at the delivery unit, DENTALEZ advises. You may choose to turn off the water to the clinic at the master water control.

If the clinic uses bottled water, empty the water bottles and reinstall them. Turn the water bottle toggle to “ON” and then purge the system of all the water through each handpiece tubing and syringe. Then use the flush valve so that the water lines are purged with air to dry them out. Also remember to run air through the tubing to dry the lines out and prevent biofilm from growing in both the lines and valves. 

When it’s time to reopen, fill the water bottles and run each handpiece tubing, syringe, and flush valve to purge the air out of the system.

DENTALEZ handpiece3. Handpiece maintenance

For its own Star handpieces, DENTALEZ recommends cleaning each device with isopropyl alcohol and then sterilizing them. The company also recommends cleaning the auto-chuck mechanism with its Junk-Out High-Speed Chuck Cleaner. This will eliminate debris that forms inside the mechanism of high-speed handpieces from everyday use and sterilization.

After sterilization, make sure the handpiece is completely dry. Remember that if there’s moisture in the bags or in the sterilizer, there is moisture in the handpiece. It’s recommended to increase the dry time to insure dryness, but if that’s not possible, load fewer handpieces into the sterilizer per cycle. Finally, store the handpiece in a clean, dry, and cool place at room temperature, so it will be ready to go when your practice reopens.

The Takeaway

In this time of an unprecedented health crisis, everyone is trying to find a new “normal.” While downtime allows, consider ways to make your practice more efficient and safer. The designs of your air compressor unit, delivery unit, and handpiece can help mitigate the transmission of infection disease for patients and providers. Learn more from DENTALEZ’s COVID-19 resources

Hopefully when this crisis has passed, your practice will see an influx of patients due for non-emergency procedures and checkups. When your practice is ready to be fully operational again, you’ll be glad you took this time to make sure the “workhorses” of your practice are up for the task.

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Doctor's Favorites: Indirect Restorations

Doctor's Favorites: Indirect Restorations

What Are Your Favorite Products To Use for Indirect Restorations?

Kristine Aadland, DMD, a CEREC mentor and advocate of CAD/CAM technology for bridges, implants, orthodontics, and same-day smile makeovers, practices in Vancouver, WA. Here, she shares her top products for indirect restorations.

Primescan I can honestly say that if you took my Primescan away, I would no longer practice dentistry. In a world that demands instant grat­ification, I can deliver high-quality, beautiful restorations in a single visit. We use it to restore with anterior and posterior crowns, implants, and bridges, as well as scan for aligners, night guards, and sleep devices. With the soft­ware's artificial intelligence con­stantly learning about my margins and design preferences, I have to do very little to the proposals.

With a busy practice that runs lean on team members, DryShield mouthpieces are crucial. Not only do they allow fantastic isolation in an environment where we are constant­ly bonding, but they allow me to work alone if my assistant needs to help another patient or go grab an instrument. Dry­Shield has both autoclavable and disposable options, and the mouthpieces are comfortable for the patient.

While I use DryShield for posterior regions, I love to use Ivoclar Vivadent’s OptraGate for retraction in the anterior. This makes CAD/CAM scanning and anterior fillings easier. I don’t have to deal with cotton rolls or the lips and cheeks getting in the way.

Cosmedent’s Pink Opaque is the best-kept secret if you do any cosmetic dentistry or use translucent porcelains. I use this material every day to block out metals, sclerotic dentin, and dark teeth prior to the final restoration. It works like a flowable composite: You bond the opaquer on the tooth, add a thin layer of material, light-cure, and it will turn your prep white.

PANAVIA SA Cement UniversalCervitec Plus from Ivoclar Vivadent is one of those rare gems my hygiene team raves about. We apply this chlorhexidine varnish on root surfaces for sensitivity, on inflamed gingival tissue after restorative cases, and even use it during SRP.

Kuraray’s PANAVIA SA Cement Universal has become our go-to resin cement in both practices I own. Its built-in long chain silane coupling agent (LCSi monomer) produces a chemical bond to porcelain, lithium dis­ilicates, and composite resins, and the original MDP mono­mer allows for chemical reac­tiveness with metals, dentin, and enamel. It's simple to use, and we have not experienced sensitivity or debonds.

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Waterpik Water Flosser Improves Oral Health

Waterpik Water Flosser Improves Oral Health

Waterpik Water Flosser: Significantly More Effective

WaterPik Water FlosserWaterpik recently evaluated the efficacy of a water flosser in addition to an oscillating power toothbrush, in a four-week randomized controlled clinical trial. The study found that while brushing with an oscillating power brush alone did improve oral health, the addition of the Water Flosser provided significantly superior results for people with mild to moderate gingivitis.

This study complements previously published research using a manual or sonic-powered toothbrush, and shows that no matter the toothbrush used, even high-end power toothbrushes, the addition of a Waterpik Water Flosser is significantly more effective at removing plaque and improving gum health than brushing alone.

The trial studied 70 adult participants who were randomized and assigned to either the Waterpik Water Flosser plus Oral-B Pro 2000 with Precision Clean Brush Head group (WF), or the Oral-B Pro 2000 with Precision Clean group (OR), to study the efficacy on the reduction of gum inflammation and plaque. After the clinical trial, study results revealed:

•Using a Waterpik Water Flosser in conjunction with the Oral-B Pro 2000 with Precision Clean Brush Head was significantly more effective than using the same brush and brush head alone:

•37% more effective in reducing gingival bleeding

•36% more effective in reducing gingival inflammation

•33% more effective in reducing plaque

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A-dec Joins the Fight Against COVID-19 By Manufacturing PPE

A-dec Joins the Fight Against COVID-19 By Manufacturing PPE

A-dec Joins the Fight Against COVID-19 By Manufacturing PPE

It’s not unheard of for employees in the midst of a big company project to work extra hours and come in on Saturday or Sunday to get the job done. But when staff members go the extra mile for a completely different reason, for example, to help healthcare workers in desperate need of personal protective equipment (PPE) such as gloves, masks, and face shields, it’s worth spreading the word. 

After realizing the full magnitude of the COVID-19 crisis, Oregon-based dental manufacturer A-dec immediately launched several programs and infection control resources to support oral healthcare professionals continuing to practice dentistry during the crisis. But it wasn’t until A-dec was contacted by a local healthcare worker from Legacy Health, a regional healthcare system serving Oregon and Washington, that the company decided to take their efforts a step further. 

A-dec making protective helmets for Covid 19 pandemic

A group of 25 A-dec employees worked around the clock over the course of a weekend to convert several of their manufacturing facilities into spaces appropriate to produce PPE for healthcare workers and emergency responders in their local area, including those at Legacy Health’s 6 area hospitals. This included developing prototypes of the most critically needed supplies, as well as determining which raw materials would be needed to meet the production goal and which suppliers might be able to help.

For the time being, A-dec is focusing its new manufacturing efforts on producing plastic shield coverings for powered air purifying respirator (PAPR) helmets. The initial goal is to produce 9,500 of these PAPR helmets, which are worn by healthcare workers to protect them against airborne illnesses, over the course of the next 3 months. When production begins there will be about a dozen people involved in manufacturing the plastic shield coverings, but the company expects the number of volunteers to increase as production ramps up to meet the growing demand for PPE.

“For more than 55 years, A-dec has lived by the principle of prioritizing concern for people above all else,” said Scott Parrish, A-dec President and CEO. “As a family-owned, Newberg, OR, manufacturer, A-dec is proud to bring much-needed PPE to Oregon’s healthcare workers. This is what we should be doing during this unprecedented time: working together to solve problems and take care of communities.”

While production is expected to run smoothly, along with many other manufacturers stepping up to the plate during this global healthcare crisis, there is a chronic shortage of raw materials needed to make PPE equipment such as plastic shields for PAPR helmets. A-dec is urging other suppliers, manufacturers, and organizations to support their efforts in reducing the continued exposure of healthcare workers and patients by helping to source the raw materials needed to create these essential supplies.

The most pressing raw material need is PET-G, which is a type of plastic. Any organization that might be able to help source this material, as well as anyone who is curious about other ways to help A-dec in its mission can reach out to PR@a-dec.com.

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We All Can Help to Narrow the Gap in Access to Care

We All Can Help to Narrow the Gap in Access to Care

We All Can Help to Narrow the Gap in Access to Care

If you don't have access to oral healthcare, you're already behind the eight ball. And for the disabled community in the United States today—numbering over 60 million and including those with conditions ranging from intellectual and psychological disabilities to spinal injuries, PTSD, and aging—it's 4 times more difficult to access dental care than the most socioeconomically disadvantaged person.

The Awareness Deficiency

There are myriad reasons for this unfortunate situation. However, at its core, the problem is that so many people are simply unaware that there is even an issue. Among providers, the most notable challenges are the general lack of adequate training and cultural competency. Up until this year, the Commission on Dental Accreditation requirements for dental education did not include any hands-on clinical training for dental students on a disabled patient. Additionally, the reimbursement rate for procedures is extraordinarily low in light of the amount of specialized equipment and physical space required (even though less than 20% of people with disabilities require restraint or sedation).

Another contributing factor is the lack of awareness among patients and caregivers that oral health is a critical component of overall healthcare. In a recent survey, parents were asked to list the top 10 health needs of their disabled children. Oral health came in 14th—not even on their radar!

Helping to Close the Gap

Efforts are being made to not only raise awareness about the importance of oral care for people with physical, intellectual, and developmental disabilities, but to develop strategies and concrete recommendations for providers who want to treat this underserved community.

Henry Schein is involved in partnerships and initiatives to help improve care in this arena. One group that Henry Schein works with is the Viscardi Center’s Project Accessible Oral Health (PAOH). With the participation of more than 30 organizations, PAOH is helping to create a training clinic at the University of Pennsylvania School of Dental Medicine that will emphasize new techniques and equipment, including sedation/calming, wheelchair access, and more. Expanding on this partnership along with AmeriHealth Caritas, Henry Schein has helped to increase third-party reimbursement for treating individuals with disabilities, and to develop specialized CE at the Penn and Temple dental schools.

We also are working with the National Council on Disability on enforcing the guidelines of the Americans with Disabilities Act. We’ll be using the strength of our media to call out certain aspects of the regulations that will help dentists accommodate and treat patients with special needs. Additionally, Henry Schein offers design services that address compliance issues. In addition, we are working to stimulate innovation from the manufacturing sector in creating, adapting, and modifying products—from toothbrushes and toothpaste caps to adaptive chairs and delivery systems.

Moving Forward

The overriding goal is to raise awareness about the issues surrounding the delivery of oral healthcare to a very heterogeneous disabled community and to build a grassroots movement including caregivers and other concerned citizens. With a groundswell of awareness and compassion, the access-to-care gap is becoming more visible on the radar screen. I urge you to get involved. To see why you should and how you can, start with the Special Care Dentistry Association and the American Academy of Developmental Medicine and Dentistry.

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