jrohde
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Wednesday, January 14, 2009
Doctors at Case Western Reserve and Yale think they have uncovered the secret behind 80 percent of pre-term births. It turns out that Bergeyella is part of the normal flora in our mouths, and was found to be in higher concentrations in women who delivered an early preterm baby (32 weeks gestation or less). In these cases, there was a strong correlation with poor oral hygiene.
Of all the things to do and not do during pregnancy, I didnt think brushing your teeth would have to be something to remind an expectant mother. One more thing for the list which includes smoking, sushi, and jacuzzi's.
I wonder if it would work the other way, and induce labor at the right time? No more castor oil, just stop brushing for a week...
Eric Bland from MSNBC has a nice full review of the research that was done. Just click on the link below.
link
jrohde
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Tuesday, January 06, 2009
A little competition is good for the market. It seems that nothing sparks innovation like a threat on reputation and revenue.
I just got done watching a virtual press conference online with Sirona. They have just introduced the CEREC AC. It uses a highly accurate camera using a Blue wavelength to capture images. Considering last years continued introduction of high quality digital impression cameras, Sirona needed to get this one right. And it seems they have:
- Blue wavelength LED camera has shorter wavelength than the CEREC 3D, and greater accuracy. I didnt complain about the margins before. Now it should be amazing.
- The camera can automatically capture the image when your hand is steady, eliminating motion blur.
- It has an integrated battery backup so you can unplug the unit, and move it room to room. (No more warranty busting UPS's zip tied to the unit)
- Full arch impressions are possible, with no distortion. Ortho applications are sure to follow. (Are you listening Invisalign?)
- In addition to buying the full unit, they have pay-as-you-go plans. Afforable CAD/CAM? Jeez, it already made good ROI sense. What's the excuse for not getting one now?
Dentalcompare will keep you posted on availability as information is released.
jrohde
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Monday, December 01, 2008
Novartis is sponsoring a series of web based seminars, or Webinars, entitled "Benefits of Bisphosphonate Therapy Vs Frequency if Oral Complications". Over the past few years, this has been a hot topic for dentistry, and they are continuing to discover more on its impact with your patients. This is one not to miss.
Topics include:
- Overview of bisphosphonates and uses in treatment of osteoporosis and metastatic bone disease
- Osteonecrosis ofthe jaw (ONJ) background
- ONJ frequency in oncology and osteoporosis patients treated with bisphosphonates
- Review of ONJ studies and management
Check it out and sign up for a session here:
link
jrohde
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Monday, December 01, 2008
Now available on iTunes: Dentalcompare Podcasts. These are audio presentations of various topics from clinical tips to practice management. And best of all...its FREE.
To get started, download the free copy of iTunes for the Mac or PC, and install it on your computer. Once it launches, click on the iTunes store. On the upper right corner, type in "Dentalcompare" into the search bar, and hit enter.
Once the results come up, you will see Dentalcompare, and a button for "Subscribe". Click on that to link your iTunes to the Dentalcompare podcasts. Once you have subscribed, click on your own podcasts on the left column, double click on "Dentalcompare Podcast", and you are ready to listen.
At this point, you can listen to them on your computer, or sync with any iPod, iPhone, or other music player. If there are future topics you would like to see, feel free to comment below.
Enjoy!
To download the free copy of iTunes, click here:
link
jrohde
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Monday, October 27, 2008
Everyone has had it happen. Someone comes in to your practice and says "I had this crown done a few months ago. It never felt right, and now the pain is worse. Now they are telling me I need a root canal, and I'm hoping you can give me a second opinion."
Now you take a look at the crown. Sometimes, it looks great. Good margins, excellent esthetics, perfect occlusion. The patient symptoms are consistent with irreversible pulpitits. Common sense, along with good ethics, dictates that you reinforce what the patients previous dentist had diagnosed, and encourage them to continue treatment there.
Other times, however, the crown looks worse than anything I ever did in dental school. Margins you could parallel park in, cement caked interproximally, and surrounding tissue resembling hamburger meat. One look at this thing and you know it needs to be replaced. So what do you say to the patient?
We still have an obligation to our colleagues, not to unecessarily cover for them, but because we have no idea what was happening when that crown was placed. We have all had that difficult patient with which the clinical outcome of the crown or filling was not quite what we wanted it to be. Plus, patients will often have a much different tale of their circumstance from what actually happened in the office. The point is that you give that colleague the benefit of the doubt. Encourage the patient to return to address their concerns with the original treating dentist.
But what do you do when you are consistently seeing the same clinically poor work from the same office? Week after week, literally, patients come to you, with work from the same dentist that you yourself would be embarrased to put in someones mouth. The work represents a disregard for good dentistry and a patients well being. What are supposed to say then, with potential harm being done? Do you still send them back, knowing that even if the crown is replaced, it will be traded for one possibly worse? Or do you tell the patient just how bad their dentist is, and to run as fast as they can in the opposite direction? Do we have an obligation to call that dentist and inform them they are better suited for a job in plumbing for all the crap they consistently put their hands on? What if you know that this isn't a matter of competency, but that the dentist is fully aware of the quality of their work, and doesn't care?
What would you do? (Click on "Comment on this entry" below...)
jrohde
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Tuesday, October 14, 2008
Each year the ADA convention travels to a different city, this year dropping down in San Antonio, Tx. I think they are trying to compete in more ways than one with some of the other conventions. The Chicago Midwinter Meeting in February tends to be one of the biggest, with loads of new product launches. Last year, however, the frozen rain drove people to the airport to catch an early flight, rather than sending them indoors to buy dental products.
This year, with the potential close of Section 179 breathing down our necks, the ADA has pulled the stops. They will have three different clinical arenas, covering CAD/CAM, lasers, and 3D imaging. Many of the top minds in dentistry will be speaking this year, and even Tom Brokaw is making an appearance.
Our editor Gail Weissman has also scooped the story on tons of new products, from Laser (No Needle) Anesthesia, to Ozone caries treatments, to a fresh batch of 3D applications.
Stop in here to check out some highlights over the next week. We will be showcasing the best parts of the show, and will even run down any products you want more information about. Just leave a comment if you are unable to make it, and we will do as Dentalcompare always does: deliver the best and latest news on dental products. Time to get those tax write-offs working...
jrohde
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Friday, September 26, 2008
Collecting money from patients is a daunting but necessary evil in today's dental practice. Our office has had its fair share of collection calls to patients falling off the payment plan wagon. We have battled with insurance companies, arguing over clinically indicated sealants on a 17 year old whose insurance only covered them till age 16. (Call them D2391, PRR's, btw).
Some of the best advice I have gotten was from Dental Guru Bob Margeas, whose advice was to use Small Claims Court, and avoid the leg sweep of the collections agency. Simple, fair, justice.
But recently, one German dentist took matters into his own hands. After an insurance company failed to pay on a pair of bridges, he went to the patients home, tied her up, and yanked them right out of her mouth.... without saying a word.
I'm sure some kids who have experienced the papoose board can identify with this woman's horror. Assualt charges are pending.
With theft and violence like this, it sounds like a workup for the movie "Snatch 2".
Full story here: link
jrohde
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Monday, September 22, 2008
News from the front lines on the war against tobacco:
New York City, always the pioneer in cleaning up the town, has been in the news for launching several anti-smoking campaigns. The most recent is a slew of matchbooks with nasty pictures that show what smoking does to your gums and teeth. Granted, the image itself looks more like a recent picture I saw showing the gums of King Tutankhamun, but it gets the point across.
For you collectors out there, you can also find versions with tumors, oral cancer, and black lung.
Expect the Meth Mouth campaign in time for Christmas.
Full story, and pictures, here: link
PS. Don't check this out during lunch...
jrohde
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Tuesday, September 16, 2008
You gotta love the ADA. Always keeping us up on current issues.
They have now posted an updated version of Bisphosphonate-associated Osteonecrosis (BON) on their website. What was once turning into an industry freak-out has now mellowed into cautious recommendations. Basically, a patient on oral bisphosphonate therapy is at "very low" risk for developing BON.
Catch up at the link to make sure you know how your treatment of patients is affected by the medications they are on: link
jrohde
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Tuesday, September 09, 2008
With credit card companies topping the list of unwelcome visitors on college campuses, tobacco companies are a close second. These off campus invaders are about as helpful to college students as a pedophile at an elementary school.
A recent report from the American Lung Association noted that tobacco companies spend 1 million dollars a day on college campuses to promote smoking. The report also states that 1 in 5 college students still smoke.
Im not so naive to think that most coeds don't think its much cooler to smoke at a party than to pull out a floss-card. But the universities don't have to make it so easy. Letting these wolves on campus can hardly be seen as anything else but a promotion of oral cancer.
At least they can use the credit cards to pay for the cigarettes.
Full story here: link
jrohde
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Friday, September 05, 2008
MSNBC published an article recently by Laura Flynn McCarthy about "Quiet Cancers", or cancer that is often overlooked by doctors. One of these is Oral Cancer.
Overlooked? Seems like it. She quotes that "Oral cancer is lethal more often than it needs to be because people tend to ignore symptoms (it's typically caught in late stages)." Other cancers are more in your line of site since doctors regularly talk about the importance of screening and early detection.
Putting aside the patient who never comes in for their recall visit, it is staggering to think we are not all doing oral cancer screening for every patient.
Are we afraid to talk about it, afraid the mention the "C" word? Do we not have time? Are we afraid to invest and learn about tools like Oral CDX and Velscope?
Maybe we have just moved away from our primary care positions as health practitioners and prefer to spend thousands of dollars learning how to place prep-less veneers.
Link to the story here: link
Comments can be entered below...
jrohde
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Wednesday, August 20, 2008
Researchers at the Monell Chemical Senses Center in Philadelphia think they have discovered a sixth sense of taste in the tongue. Adding to sweet, salty, bitter, sour, and savory, they have detected that lab rats can detect calcium in foods. It hovers on the side of bitter, and is in higher concentrations veggies such as collard greens, bok choy, kale and bitter melon.
Jury is still out. Human trials will begin as soon as they can find people who actually like collard greens. Reminds me of a joke about kids and brussel sprouts....
Full story on MSNBC here: link
jrohde
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Friday, July 25, 2008
MIT has once again proven why its so hard to get in there. Researchers have developed a new type of microscopy, called "two-photon" imaging, that allows them to be able to look inside healthy tissue and identify mutant cells.
Still in development, it makes the idea of early detection, and better survival rates, more plausible than ever.
Science Daily has the story for you here. link
jrohde
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Thursday, April 17, 2008
A report recently came out that greater than 23.1 million people in Britain received no dental care in the last two years. link
Amazingly, this represents half of the population. It was also found that there was an increase in the number of hospital admissions for dental treatment, rising 6% to almost 240,000 people. In the article, the shadow health secretary said that "there are people out there who are pulling out their own teeth because they can't find an NHS dentist".
This is on the same day that Britain's cancer czar admitted that they are spending half as much on cancer drugs than other countries. link
We all know that healthcare access is limited and that this is a constant, nagging problem. But it doesnt seem to be working over there.
Anyone out there have a better idea?
jrohde
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Friday, March 14, 2008
Wenyuan Shi at UCLA has discovered a unique part of licorice which actually acts as an antimicrobial agent against cavity causing bacteria.
Check out the video here:
link
jrohde
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Monday, March 10, 2008
A few days ago, I wrote a blog on the future death of physical media. link With this topic on my mind, I couldn't help but notice this rusting pile in the back of a parking lot recently. More indication of the future? I don't see any iPods in there...
jrohde
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Monday, March 10, 2008
It seems like every time I turn around, something toxic is coming out of China. First, I have to do toxicology studies on every one of my daughters toys. Next, I find out about airborne mercury being discharged from factories burning coal. (link) Even pesticide containing dumplings are on my growing list of imports to avoid.(link)
These stories are hitting closer to home again. The story about lead found in crowns manufactured in Chinese dental labs (link) could only be trumped by the FDA smacking a lawsuit down on the importers of Cooldent (link). It turns out that while ethylene glycol is great from keeping your engine from freezing in the winter, its not really good for us to brush our teeth with it.
Kudos to the EPA, ADA and FDA for staying on top of this. Maybe we should trade up that embargo against Cuba and drop it on China. At least with a Montecristo, I know what poisons I'm ingesting.
jrohde
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Wednesday, February 27, 2008
Well not really, but the ADA did an awesome job today of sending out an email to alert its members about an Ohio news channel reporting on lead found in crowns fabricated overseas.
Click on "Link" below to see the email.
link
The article covers the complete story, what really happened, how to protect ourselves as dentists, and how to talk to our patients about it. The story airs tonight.
Two things of note on this:
1) If you ever think your dues aren't worth anything, its nice to get these reminders that the ADA has our back
2) That news program airs TODAY. As stated in my post from a few days ago on the death of print, how refreshing it is to have this arrive in my Outlook Inbox. By the time this notice would have arrived in the mail, I may have already gotten battered with questions with only ignorance to the topic for an answer.
jrohde
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Tuesday, February 26, 2008
On DentalCompare, we are constantly updating our product directory, adding new product releases and updating specs on what we already have.
If there is ever anything that you find to be missing, or if there is a new product category you would like to see researched, just let us know. It only takes a few days for us to do the research and get it posted online.
For example, we recently received a request for more information on Local Anesthesia Delivery systems similar to the old "Wand". Click on the link below to jump in and check it out.
link
As our Editorial Director Steve Diogo says, "This is your site. Use it well."
jrohde
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Monday, February 25, 2008
I stopped by the office of a friend of mine this afternoon. Under his desk, I noticed a pile of our industry's journals piled up. When I asked if he ever reads them, he said no. When they come in the mail, they are deposited there and cleaned out every 3-4 months. Its been about a month since the last trove was relegated to the round file. When asked what journals he does keep and read, he mentioned JADA due to their peer reviewed, unbiased journal articles. He also reads articles and newsletters from Dentalcompare. (This, of course, was nice to hear.)
I am not making this up. The picture is real.
Personally, I get all my information online. News, stock quotes, movie times... and information on dental products. The internet is not a fad. It is has completely upended the way we communicate with each other, the outside world, and our own industry.
Its amazing that while the world has been tensely watching the HD format war, companies like Apple, Microsoft, and Netflix have made the disc obsolete by streaming the content on the internet. And the CD? With the cheapest MP3 players holding 250 songs, whats the point of that disc player popping out an "amazing" 11 songs? Don't even get me started on comparing a high-res intraoral digital x-ray with film.
Physical media may always have its place, but I think in the near future we may see a burst of the print bubble in dentistry. And when the dust settles, only the most respected journals will survive.
Meanwhile, I'm going to go email some radiographs to the specialist, send off our eclaims for the day, catch up on new products from the Midwinter meeting, watch a video on how to custom stain a CAD/CAM crown, and check on Obama's campaign progress... all online.
jrohde
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Sunday, February 24, 2008
Anytime a new product hits the industry, it is always met with healthy skepticism. "What is the science behind this product? Do I need it? Is it going to make practicing dentistry easier? Is it better for my patients?"
Often times, many of these questions are unanswered. Some laboratory data is not sufficient to properly judge how a product will do in real life situations. Hard research and science always brings the cream to the top.
Orapharma understands this. Over the last few years, they have conducted study after study, digging in with the doctors and hygienists who use their product Arestin. They have published this data, reinforcing the claims of what it can do.
This "Don't take our word for it; let the research speak for itself" approach is refreshing. A product that stands on its own does not need to be pushed by sales people in your office.
jrohde
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Friday, February 22, 2008
I had a chance to sit down with some of the great people at Oral CDX. An interesting concept came up in discussion. Cervical cancer was the number one killer of women in 50's. With the initiation regular pap smears, the disease has dropped to number 8. Why is this possible? The problem was caught before it was cancer, when the dysplastic cells had not invaded the basement membrane. Not early detection of cancer, detection before it even started.
Every day in my practice, I see lesions that are white, red, or both. Rarely are these lesions cancer, yet I have no way of truly visualizing whether or not there is any dysplasia. We are not going to do a scalpel biopsy of every spot in the mouth. What Oral CDX allows me to do is to perform a simple brush biopsy of anything suspicious, and determine whether or not it may someday in the future turn into cancer.
Are we too busy in our practice to do this? Are we worried what patients will think about the change from the normal hygiene visit? We have the opportunity to dramitically reduce the incidence of oral cancer. Maybe we have a responsibility to look into this system.
Pap smears have become so routine; no one thinks twice about it. Shouldnt oral cancer be the same?
jrohde
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Friday, February 22, 2008
Every conference seems to have its big exciting product releases. Once again, 3D cone beam CT seems to be a the forefront. New from PracticeWorks is the Kodak 9000 3D. Availalble as a digital pano, it can be easily upgraded to 3D without severe hardware changes. At 0.75 mm resolution, I'm wondering if I need to really take that FMX anymore.
With these machines, its all about the software and what it can do with the aquired image. Dig in to this tech and you will find its not just for oral surgeons placing implants anymore...
jrohde
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Wednesday, January 16, 2008
It's official. Gordon Christensen has bestowed his blessing on CAD/CAM dentistry in the world of chairside dentistry in the January 2008 edition of JADA. To some in the dental world, that's as good as the pope himself. Actually, if you have been to any of his lectures in the last few years, you will have heard it before. He gives a nice personal and literary review of why these restorations are as good as anything you may get from the lab, cautioning that "the principles of restorative care" need to be observed.
Said differently, the CEREC is the ultimate "Garbage In, Garbage Out" piece of machinery. I have had several colleagues complain about the fit and the esthetics of its restorations. When proper preparation, fabrication, and customization (stain/glaze) is done, you can hardly tell the difference between that and a natural tooth. It just takes a little bit of time and care.
If you still think these things put out junk, stop by the CEREC booth at the next convention. You'll be surprised what you see.
jrohde
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Wednesday, November 28, 2007
I remember being so jealous when schools started to get full simulation labs in the Operative Dentistry classes. I still have nightmares from the rubber masked average white patient, and my lungs still rale from ivorine dust.
Now, the next generation has a reason to be jealous. Japanese researchers have created a simulation patient that can react to pain, has moving facial "muscles" and even exhibits a gag reflex. I hate to see what comes out.
Click on "Link" below to see a video of the robotic patient:
link
jrohde
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Thursday, November 15, 2007
In recent years, ACP seems to have given fluoride a run for its money in decay prevention. Now, there is a new competitor. Recently, researchers in Japan have found that compounds in the outer husk of a cocoa been have an antibacterial effect to held reduce tooth decay. Unfortunately, this doesn't mean that we can recommended eating chocolate to our patients since this particular part of the chocolate is usually discarded during production. There is word of human trials however, with hopes that they will one day incorporate the compound into mouthwash and toothpaste, or even back into chocolate. Who knows... maybe we will even see it in products like whitening or varnishes.
jrohde
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Monday, August 20, 2007
It has been about 9 months now that our office has been using CEREC. For all the promises Sirona throws out there during their sales pitch, I can honestly admit it delivers on almost every one. The restorations are accurate with the occlusion, have good marginal fit, the patients can go home the same day with the final restoration, and they are super esthetic.... sort of. I have to admit that I was a bit disappointed with the way they looked. They were fine as a DOL on #15, but even the mulitcolored blocks were not as good as anything from my lab. Until...
We bought the Programat CS oven from Ivoclar Vivadent. A half day class with tips and tricks for staining/glazing was all it took to start making our CEREC restorations near invisible. Calcifications, staining, translucency simulation, occlusal to cervical color gradations. The cycle time for the oven is only 12 minutes from start to finish, and you can obviously do several at once.
When you buy the CEREC machine, they throw in credits for CE courses, and credits for accessory equipment. It would be nice after dropping 100K if they would just throw in the oven. To me, its not an accessory, its a necessity.
jrohde
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Thursday, August 09, 2007
The Annals of Plastic Surgery has published an article this month that women who have cosmetic breast augmentation are THREE times more likely to commit suicide. The authors did a retrospective study of 3,527 women, and also found "an excess of deaths from accidents and injuries consistent with substance abuse or dependence." They advised careful "screening for preimplant psychiatric morbidity and postimplant monitoring".
While I have never done any cosmetic work other than dental procedures, I have had to think twice about what this article means to our profession. As dentistry moves toward a greater number of elective, and most often, cosmetic procedures, we may find ourselves fulfilling a greater role than we have realized. I have often felt that, as dentists, we become chairside psychologists. People look to us for more than answers on how to floss better, and a set of 16 veneers may be viewed as a solution to some of life's greater problems.
Is it the responsibility of a dentist to "Pre-screen" a patient who asks for cosmetic procedures? Is it our responsibility to deny them if we decide that they are getting it done "for the wrong reasons"?
As in business training, I am once again pondering the lack of preparation dental school ever gave us for these difficult ethical decisions. Perhaps it comes down to a lesson learned in residency: Now that I CAN cut a crown prep, the next question to ask is "SHOULD I?"
link - Excess Mortality From Suicide and Other External Causes of Death Among Women With Cosmetic Breast Implants
jrohde
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Friday, April 20, 2007
The American Heart Association updated its guidelines today for antibiotic prophylaxis
before dental treatment. Interesting to note is that someone is 154,000 times more likely to develop bacterial endocarditis brushing their teeth twice a day than they would from a single tooth extraction.
New guidelines recommend antibiotic prophylaxis for only a select few and have removed mitral valve prolapse, rheumatic heart disease, bicuspid valve disease, calcified aortic stenosis, or congenital heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy.
Besides reducing the amount of medication that a patient has to take, this should definitely reduce holes in our schedule from patients forgetting to take their meds before a cleaning appointment.
jrohde
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Tuesday, April 17, 2007
My friends from dental school and I have spent the last few years being bewildered at how a dental practice is evaluated for a sale. At times, the price of the practice seemed to be astronomically elevated simply because it had "30 years of goodwill".
Huh? What am I paying for?
Let me get this straight... A practitioner has a bunch of old equipment, gross collections ranging in the high six figures, and a loyal patient base which has known him since he started practicing out of dental school. He will be retiring following the sale, and I'm supposed to buy in at 80 percent of collections. Why so much? "30 years of Goodwill!!"
Well I'm not buying it...No pun intended. I have no guarantee a single patient or staff member will walk through the door after he leaves. Now I'm stuck contemplating my massive loan sitting alone in a 30 year old J-Chair. Besides, what does it say about the dentist who literally hands the keys over without informing his patients and is gone the next day?
So when does it actually matter? I would definitely pay for "goodwill" in a practice if the previous dentist was either not retiring soon, or willing to stay on for a set amount of time. The idea is that there is a transfer of that patient loyalty to the new dentist, and the former dentist ensures his patients are properly cared for.
There are few communities left that allow you to simply hang your shingle and get to work. My advice: Find a respectable dentist who is considering retiring soon. Learn from him or her, get to know the patients, put in the hours. Your investment will truly be returned to you.
jrohde
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Wednesday, April 11, 2007
As I create this Blog, I think about the amount of time it actually took me to write a first post. Working full time as a dentist, and helping to develop Dentalcompare another 20+ hours a week doesn't leave me much free time. But its all a blast. Every day I get to work with great patients, an amazing team on Dentalcompare, and go home to a great family. Its never work when its what you love.
In the coming months, check here for the latest updates on what Dentalcompare has to offer, interesting cases we encounter in the office, and a breakdown of whats happening in the industry. The dental profession changes daily with news, technology updates, and product changes. Lets get this ball rolling...
jrohde
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Wednesday, April 11, 2007
This month on Dentalcompare, we are highlighting CAD/CAM technology. You will find information on all the latest equipment, videos on techniques of fabrication, and a great case study from Dr. Sameer Puri. These monthly features with Dentalcompare have become a State of The Art showcase for the current topic. We are able to bring every aspect of CAD/CAM in the dental industry, and provide insights to its future. Check it out...