Overtreatment, Lax Scientific Standards Raise Concerns in Dentistry | Forum | Forum | KQED

Chances are a dentist has told you to floss more. But studies from the Cochrane Institute and the American Dental Association have found that many common oral health recommendations such as biannual cleanings, yearly x-rays and flossing have not been verified through scientific research. Forum discusses efforts to steer dentistry toward more evidence-based practices and we’ll talk about challenges facing the field, including charges that many dentists overtreat their patients.

Mentioned on Air:
The Truth About Dentistry (The Atlantic)

Joel White, distinguished professor in restorative dentistry, UCSF School of Dentistry; vice chair, Department of Preventive and Restorative Dental Sciences

This content was originally published here.

Dentacoin Combines Forces with MobiDent to Promote Preventive Digital Dentistry

June 20th, 2018: We are beyond thrilled to announce our new partnership with MobiDent, an India-based company aimed at making in-home, prevention-oriented dental care accessible and affordable to everyone.

“MobiDent is attempting to create a new Ecosystem for dentistry by creating a new generation of dentists (called Digi Dentists), who are trained in home dental care at the MobiDent Academy for Digital Dentistry, empowered with Caddy Clinic and connected to families who can use our Digital Dentistry Revolution Platform to avail on-demand preventive dental care that is convenient, inexpensive and safe. Now if there is a currency available to all connected parties, why wouldn’t we use it?”, shares Vivek Madappa, Co-Founder at MobiDent.

MobiDent’s Caddy Clinic: “Dental Clinic in a Suitcase”
for Affordable & Accessible Dental Care

MobiDent was founded in January 2011 by Dr. Devaiah Mapangada and serial entrepreneur Vivek Madappa in Bangalore, India’s Silicon Valley. Its unique proposition is called Caddy Clinic, or “dental clinic in a suitcase” and it comprises a portable dental chair and dental instruments and equipment required for basic dental procedures.

Through its revolutionary mobile dental care services, MobiDent brings benefits to both patients and dentists. Patients receive regular dental care right at lower costs and without the unpleasant time-consuming visits in the dental offices. Practicing dentists have the opportunity to treat more patients and young professionals can start their career with lower risk and great savings compared to the investment needed for opening a conventional dental practice*. For the last 4 years the concept has attracted 40 dentists across India with 65 000 patients.

In 2016, MobiDent was placed among the Top 10 from 19,000 business ideas, participating in India’s largest entrepreneurship competition organized by The Economic Times & IIM-A. From the same 10 projects, MobiDent won the first prize awarded by the Royal Academy of Engineering, London.

* Unlike in conventional dentistry where founding a clinic typically costs upwards of Rs.8 lakh ($12,000), the MobiDent taxi model costs only Rs.75,000 ($1,125) and its van model – between Rs.1.5 lakh ($2,250) and Rs.3 lakh ($4,500). Source: www.knowledge.wharton.upenn.edu

Intelligent Prevention & Digital Technology:
Where MobiDent Aligns with Dentacoin

MobiDent also differs from traditional dentistry by its strong focus on preventive dental care, which reduces the chances for serious problems by 80-90%, and thus reduces the costs and pain, according to Dr. Devaiah Mapangada. On that note, MobiDent offers special annual packages for home services which include two home visits per year for a check-up, cleaning and polishing, as well as unlimited tele-consultations, a dental health report, and 10% off on any further treatment.

“This digitized, prevention-oriented, patient-centered approach towards dentistry is in complete alignment with the core mission of Dentacoin. We believe that our cooperation with MobiDent will help dentists achieve the needed higher efficiency while simultaneously dramatically improve patients’ access to preventive dental care,” comments Ali Hashem, Key Account Manager at Dentacoin Foundation.

Dentacoin (DCN) Implemented by MobiDent
for Payments & Rewards

“The moment I heard about Dentacoin, I was open to explore its potential. If the world is heading into a digital revolution, it is necessary to have a new, universal currency, which is not influenced by governments, countries and politics. A currency that can connect all of us digitally, ensuring trust and transparency”, explains Vivek Madappa, Co-Founder at MobiDent.

Now each purchase of Caddy Clinic (available on Indiegogo) will allow dentists to receive a 5% discount and claim their reward in Dentacoin, if they start using Dentacoin Trusted Reviews and accept DCN as a means of payment for their services.

In the upcoming months, MobiDent plans to release a mobile app to easily connect patients with dentists, where Dentacoin will also be implemented.

MobiDent in cooperation with Dentacoin sets a new direction in dentistry, focused on improving dental care and making it affordable through shifting the paradigm from “sick care” to patient-centered preventive dental care and utilizing the digital technology advantages. This partnership will also help expand the Dentacoin network, which currently consists of 4000+ dentists using our tools and thirty five clinics in 14 countries, accepting DCN as a means of payment for dental services. See all Dentacoin partner clinics

This content was originally published here.

‘Dental Therapists’ Filling Gaps In Rural Dentistry Care

AUGUSTA, Maine (AP) — It can be hard to keep smiles healthy in rural areas, where dentists are few and far between and residents often are poor and lack dental coverage. Efforts to remedy the problem have produced varying degrees of success.

The biggest obstacle? Dentists.

Dozens of countries, such as New Zealand, use “dental therapists” — a step below a dentist, similar to a physician’s assistant or a nurse practitioner — to bring basic dental care to remote areas, often tribal reservations. But in the U.S., dentists and their powerful lobby have battled legislatures for years on the drive to allow therapists to practice.

Therapists can fill teeth, attach temporary crowns, and extract loose or diseased teeth, leaving more complicated procedures like root canals and reconstruction to dentists. But many dentists argue therapists lack the education and experience needed even to pull teeth.

“You might think extracting a tooth is very simple,” said Peter Larrabee, a retired dentist who teaches at the University of New England. “It can kill you if you’re not in the right hands. It doesn’t happen very often, but it happens enough.”

Dental therapists currently practice in only four states: on certain reservations and schools in Oregon through a pilot program; on reservations in Washington and Alaska; and for over 10 years in Minnesota, where they must work under the supervision of a dentist.

The tide is starting to turn, though.

Since December, Nevada, Connecticut, Michigan and New Mexico have passed laws authorizing dental therapists. Arizona passed a similar law last year, and governors in Idaho and Montana this spring signed laws allowing dental therapists on reservations.

Maine and Vermont have also passed such laws. And the Connecticut and Massachusetts chapters of the American Dental Association, the nation’s largest dental lobby, supported legislation in those states once it satisfied their concerns about safety. The Massachusetts proposal, not yet law, would require therapists to attain a master’s degree and temporarily work under a dentist’s supervision.

But the states looking to allow therapists must also find ways to train them. Only two states, Alaska and Minnesota, have educational programs, and they aren’t accredited. Minnesota’s program is the only one offering master’s degrees, a level of education that satisfies many opponents — dentists generally need a doctorate — but is also expensive.

“I would have to relocate to another state to go to school, and if you need to work and you still have a job, why would you do that?” said Cathy Kasprak, a dental hygienist who once hoped to become a therapist under Maine’s 2014 law.

Some dental therapists start out as hygienists, who generally hold a two-year degree, do cleanings and screenings, and offer patients general guidance on oral health. Some advocates of dental therapists argue they should need only the same level of education as a hygienist — a notion that horrifies many opponents.

Some lawmakers in Maine, which will require therapists to get a master’s from an accredited program, are optimistic about Vermont’s efforts to set up a dental therapy program with distance-learning options. It’s proposed for launch in fall 2021 at Vermont Technical College with the help of a $400,000 federal grant.

Nearly 58 million Americans struggle to afford and make the trip to dental appointments in thousands of communities short on dentists, according to the Kaiser Family Foundation.

One of the biggest benefits of dental therapists, proponents say, is that they can make preventive care easier to get by lightening the load of dentists, whose appointment slots are often stolen by complex procedures.

Even in states where therapists must practice in dental offices, like Minnesota, they can shorten travel times by opening slots for simple procedures closer to home, a small but growing body of evidence shows.

Christy Jo Fogarty, Minnesota’s first licensed advanced dental therapist, said the nonprofit children’s dental care organization she works for saves $40,000 to $50,000 a year by having her on staff instead of an additional dentist — and that’s not including the five other therapists on staff.

Dental therapists make $38 to $45 an hour in Minnesota, according to the Minnesota Dental Association. Dentists, meanwhile, average over $83 an hour, according to the Bureau of Labor Statistics.

According to state law, at least half of Fogarty’s patients must be on governmental assistance or otherwise qualify as “underserved.” She has also achieved the level of “advanced” therapist, meaning she has practiced with at least 2,000 hours of supervision and can make outreach trips on her own, to places like Head Start programs and community centers.

“Why would you ever want to withhold these services from someone who was in need of it?” she said.

Ebyn Moss, 49, of Troy, Maine, went without dental appointments for seven years before breaking a tooth below the gum line in 2017.

Moss has since had four teeth pulled, a bridge installed, a root canal, two dental implants and seven cavities filled at a cost of $6,300, and expects to shell out another $5,000 in the next year — a bill Moss is paying off with a 19% interest credit card and $16,000 in annual income.

“That’s the cost of choosing to have teeth,” Moss said.

Now, Moss gets treated at a dental school in Portland — a two-hour drive for appointments that can last 3 1/2 hours.

A dental therapist nearby would have made preventive care easier in the first place, Moss said.

The ADA and its state chapters report spending over $3 million a year on lobbying overall, according to data from the National Institute on Money in Politics. The Maine chapter paid nearly $12,000 — a relatively hefty sum in a small state — to fight the 2014 law that spring.

Some opponents of dental therapists argue they create a segregated system that gives wealthy urbanites superior care and puts poor, rural residents on a lower tier. Dental groups in Nevada and Michigan had argued lawmakers should instead boost Medicaid reimbursement to encourage dentists to accept low-income patients.

Some see less noble reasons for opposition: competition and potential loss of profits.

“They’re afraid if dental therapists come in to take care of the poor, they’re going to compete for their patients,” said Frank Catalanotto, a dentistry professor at the University of Florida.

Despite signs of more openness, successes aren’t uniform. Legislation failed in North Dakota and Florida this spring. Bills are pending in Kansas, Massachusetts and Wisconsin, as well as Washington, where therapists could be authorized to practice outside reservations.

“Available data have yet to demonstrate that creating new midlevel workforce models significantly reduce rates of tooth decay or lower patient costs,” ADA President Jeffrey Cole said in an email.

But the recent authorization of dental therapists in so many states may indicate the lobby’s influence and the arguments of other opponents are beginning to lose power.

“There is no justification, no evidence to support their opposition to dental therapists,” said dental policy consultant Jay Friedman.

He and some cohorts suggest dental therapists may need only as much education as a hygienist and argue they shouldn’t be working primarily in clinics. Such rules don’t help vulnerable groups like poor children in rural schools, he said.

“It’s no longer a question of if dental therapists will be authorized in every state,” said Kristen Mizzi Angelone, manager of the Pew Charitable Trusts dental campaign, which has waged its own push for dental therapists. “At this point it’s really only a matter of when.”

(© Copyright 2019 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)

This content was originally published here.

La Jolla Dentistry: Dr. D’Angelo and team know the power of a smile – La Jolla Light

The dental trio of Dr. Joseph D’Angelo, Dr. Ashley Olson and Dr. Ryan Hoffman comprise one of the largest dental practices in La Jolla — in both number of dentists and office space.

Recently, they expanded their hours to make their comprehensive dentistry services more convenient for their patients. Now, the La Jolla Dentistry office is open Monday and Wednesday evenings, and also on Saturdays, which is quite unusual for a dental practice.

Dr. Ryan Hoffman, who joined the team almost two years ago, told the Light that accommodating the lives of their busy patients is important. “In addition to the technology and all the services we provide, the convenience of coming here is key for working families with children in school, or for college students with strict schedules.”

The D’Angelo, Olson, Hoffman dental office has been located at 1111 Torrey Pines Road since 2004, when Dr. D’Angelo ran a solo practice. “I started out with one or two treatment rooms and gradually doubled in size,” he said. “Then, we doubled again. We have 10 treatment rooms now, and we’ve increased the types of services we provide.”

He said the office is fully equipped to handle just about any dental concern — from implants to veneers, gum recontouring, cosmetic and restorative dentistry, and Invisalign treatments.

Dr. Olson, who joined Dr. D’Angelo seven years ago, noted: “We are continually evolving technology in our office so it gives us added tools to provide exceptional care.”

The philosophy of providing impeccable care permeates throughout the staff, and Dr. D’Angelo is proud of creating such a culture. The office space has a warm and welcoming feel and the treatment rooms have TVs in the ceiling and mounted on the wall.

Dr. Hoffman pointed out that more younger clients are coming in the door these days: “I’m seeing and hearing a lot more in terms of cosmetics, whether it’s Invisalign or veneers, or before-and-after products, because social media makes dentistry so accessible to many more people these days.”

Dr. D’Angelo added: “Every patient seems to have an understanding that they need to take care of their teeth, and fillings and crowns and cleanings are part of that. But I still say two-thirds of what we do is want-based. For the vast majority of people, even though they have regular dental needs, the things they want seem to take precedence over things they know they need.

“People have come to realize that a smile they feel comfortable with — and a smile they can share with other people — impacts everybody around them.”

He explained that patients aren’t accepting ugly removable appliances and bridges anymore, either, they want implants and Invisalign, and they want their teeth white. Those desires drive the practice, with 3,000 patients and more walking through the door each day.

All three dentists agree that it really all comes down to the power of a smile.

As Dr. Olson put it: “(A beautiful smile) improves your work life, your love life, and your sense of self-esteem.” Dr. Hoffman added that on a personal note, “I have friends who’ve never been in a serious relationship and they’ve invested in their smile and now they’re engaged! It’s not necessarily the smile that did that, but it’s the confidence that came from the smile that altered their personality.”

And that smile power is also reaching seniors. Dr. D’Angelo commented: “It’s amazing how many people in their 70s are still highly concerned about how their smile looks. When they feel confident about their smile it makes them feel younger, feel healthier, feel more engaged. We’re changing people’s lives. From that standpoint, what we do is incredibly rewarding.”

The La Jolla Dentistry office of Dr. Joseph D’Angelo, Dr. Ashley Olson and Dr. Ryan Hoffman at 1111 Torrey Pines Road, Suite 101 in La Jolla is a fee-for-service practice, which means it participates with all PPO plans as an out-of-network provider. (858) 459-6224. joethedentist.com

Business Spotlight features commercial enterprises that support La Jolla Light.

Courtesy Photo
The reception area at La Jolla Dentistry, 1111 Torrey Pines Road, Suite 101, La Jolla. (858) 459-6224. joethedentist.com
The reception area at La Jolla Dentistry, 1111 Torrey Pines Road, Suite 101, La Jolla. (858) 459-6224. joethedentist.com (Courtesy Photo)

This content was originally published here.

SUNDAY SOLILOQUY: Front Porch Dentistry – it was the only way during the old days – Alabama Pioneers

Front Porch Dentistry

by

Shannon Hollon

I remember my grandmother(Pauline Campbell Bearden) telling me a story once when they were staying with her grandparents( Pappy and Grandma) during the Great Depression.

Dr. Charles Campbell (Pappy) served as the local country doctor for Fosters and surrounding Tuscaloosa county area for many years.

Dr. Charles M. Campbell MD 1867-1939

On this certain occasion she and her brother(HT Campbell) watched out the front window as Pappy pulled a neighbor(John Ed)teeth with nothing but forceps and a cane bottom chair.

She said John Ed would hold on to the chair and give a grunt with each tooth extraction.

Dr. Campbell’s only claim to fame is he delivered a local baby Lurleen Burns Wallace who became the first and only female Governor of Alabama…By the way he was payed a calf for his delivery services of the future governor.

is a collection of lost and forgotten stories about the people who discovered and initially settled in Alabama.

Some stories include:

  • The true story of the first Mardi Gras in America and where it took place
  • The Mississippi Bubble Burst – how it affected the settlers
  • Did you know that many people devoted to the Crown settled in Alabama –
  • Sophia McGillivray- what she did when she was nine months pregnant
  • Alabama had its first Interstate in the early days of settlement

See historical books by Donna R. Causey


By (author):  Donna R Causey

List Price: $12.97 USD
New From: $12.97 USD In Stock

About Shannon Hollon

Shannon Hollon lives in McCalla Alabama graduated from McAdory High School and the University of Alabama at Birmingham. Served 9 years in the US Navy Seabees with one tour in Afghanistan.Currently employed with US Steel and serving on the board of directors for the West Jefferson County Historical Society. http://wjchs.com/

Liked it? Take a second to support Alabama Pioneers on Patreon!

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Biological Dental Hygiene: A Whole Body Approach to Oral Health – International Academy of Biological Dentistry and Medicine

By Carol Wells, RDH

dental scalingThink of a visit with your usual dental hygienist, and you probably think: Yeah, I’ll get my teeth cleaned and a little lecture about flossing, and that’s it. Every appointment is just like another – though each patient’s dental needs are not.

Fortunately, there are growing numbers of hygienists who think outside this box. Free from its confines, we can take a “whole body systems” approach to oral and overall health.

We call this Biological Dental Hygiene.

As a biological dental hygienist, I’m concerned with how the mouth affects the body and how the body affects the mouth. Each patient’s treatment plan is unique, customized to their personal oral-systemic health situation and needs.

What Makes a Biological Hygiene Appointment Different

Conventional dentistry has a pretty set plan for how a hygiene appointment should go:

Things go a bit differently at a Biological Hygiene appointment. For one, we start by talking with you outside of the operatory. We want to know

In other words, we want the big picture before we move on to the operatory.

Though each biological dental hygienist may work a little differently, I always start by taking your blood pressure and giving a blood glucose test. (There’s a strong relationship between diabetes and gum disease!) I also screen for head and neck cancer.

phase contrast microscopeIf any x-rays are needed, we take them – digitally, to minimize radiation exposure. (Some also provide homeopathics to counter the effects of radiation.) I also take intra-oral photos of your mouth and then look at a sample of your subgingival plaque with a phase contrast microscope, to get a glimpse of the health of your oral microbiome.

You get to see this in real time, too, observing pathogens – “bad bugs” that may be wreaking havoc with your health. When you do, it raises an obvious question: “How do I get rid of them?” You can see the infection for yourself.

We know that infection produces inflammation not just in the mouth but throughout your body. With the phase contrast microscope, you can see its cause – and have a better understanding of how your teeth, gums and the bone that supports their teeth are affected by these disease-related bacteria.

The biggest difference between this and a conventional dental visit, though, is the conversation we have with you. We’re not there to lecture you on flossing. Instead, together we explore a set of factors that play a big role in both oral and systemic health, identifying your challenges and creating a plan for conquering them.

These factors are summed up nicely in an acronym: HONEST AGE.

H – HYGIENE
O – OCCLUSION
N – NUTRITION
E – EXERCISE
S – STRESS
T – TOBACCO
A – AGE
G – GENETICS
E – EXERCISE/ EXPERIENCE

Let’s break down what these mean:

Hygiene: How does the way you brush your teeth impact the health of your teeth, gums, and body? Do you floss? Do your gums bleed when you brush or floss? How many times a day do you brush and floss? How effective are you?

Occlusion: How do your teeth fit together? Which teeth are affecting your bite relationship? How does this affect your mouth? Are there areas that are hard to reach?

Nutrition: Is your diet well balanced? What can you do to improve it?

Exercise: Are you getting enough physical activity? What can you do to get more of it into each day?

Stress: How do you handle stress? How would you rate your stress level on a scale of 1 to 10, where 10 is “maxed out” and 1 is “pretty mellow”? What can you do to lower that number?

Tobacco: Do you smoke or chew? How much is too much? Do you want to quit?

Age: Are you having any difficulties with mobility and dexterity as you age? Are there other, easier ways to do what you need to get done?

Genetics: Are you predisposed to certain illnesses? How do the ones that affect you affect your oral health?

Experience: Do negative dental experiences in your past keep you from seeing your dentist or hygienist regularly? Are you able to take care of yourself in the environment you live in?

Talking about these points in an open, honest, and nonjudgmental way empowers you to take charge of your oral and overall health. The info we uncover and share becomes the basis of a game plan for improving both.

After this strategizing, we’ll have you swish a disclosing solution in your mouth that will highlight any plaque on your teeth. (Dental plaque is invisible to the naked eye.) You’ll be able to see where you’ve been cleaning effectively, as well as areas you’ve been missing with brush and floss. I’ll take an intra-oral picture of this, as well, so we can compare it to results at your next visit. That way, we can track your progress.

And so you can progress, I’ll give you a mirror to look in as we review home care techniques. Most patients don’t realize how hard it can be to remove mature dental plaque. So I ask you to show me your brushing technique so I can advise on what you can do to get better at removing those soft deposits of bacteria. We may review flossing technique, as well.

interdental brushAnd I may suggest other tools you can incorporate into your home care routine to get better results – for instance, oral irrigators, interproximal/interdental (“proxy”) brushes, rubber tips, power brushes, sulcus brushes, and more.

Once we’re done with that, I’ll ask you to rinse with a fluoride-free, alcohol-free rinse in preparation for your cleaning. Before scaling – scraping the biofilm from your teeth – I’ll irrigate with ozonated water or use a subgingival laser (i.e., a laser that goes below your gumline) to reduce the bacterial load in the pockets (sulci) that flank each of your teeth. This lessens the bacterial cascade into the body that can happen during a deep cleaning.

I then scale the teeth to remove both hard and soft deposits (calculus and plaque, respectively). If I’m using an ultrasonic scaler, I’ll use ozonated water in it to further eliminate harmful bacteria. Afterwards, I’ll irrigate again with ozonated water and then polish your teeth with a fluoride-free, organic prophy paste, followed by a good flossing.

Your next appointment is then booked based not on some predetermined schedule but your actual needs.

Another biological dental hygienist may do these things in a different order or in a different way, but all of us take into account the whole body picture with respect to your oral health and opt for the least invasive nontoxic ways of providing the care you need.

YOU Take an Active Role

Conventional dentistry trains patients to be relatively passive in their care. The dentist and hygienist are the ones who “do things.” The patient is the one “done to.”

We want to bring about an end to what I call “the Yes Syndrome” – where patients agree with whatever the hygienist or dentist says, just to get on with the cleaning so they can get out of the dental chair and on with the rest of their day’s business.

In the biological model, though, we expect you to be engaged in your own treatment plan, as well as your home care routine. We want you to be involved in your own oral and overall health.

After all, it’s YOUR mouth we’re working on.

This content was originally published here.

Dentacoin Goes Beyond Dentistry: East Tremont Medical Center Joins the Dentacoin Partner Network

August 9th, 2018: Following this week’s signing of Dr. Gupta, inventor of PerioQ, we are happy to announce that East Tremont Medical Center, based in Bronx, NY, USA has begun accepting Dentacoin as a means Read more…

This content was originally published here.