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Teeth can be saved for future stem cell harvesting / Editor’s Letter & News / $22b for health information technology - but not quite so much for dentistry / Do you need 8- - 10- or 15-megapixels? How to choose a digital camera (part1) / Practice transition planning (part 2 of 2) / Do you need 8- - 10- or 15-megapixels? How to choose a digital camera (part2) / Practice transition planning (part 2 of 2) / Diode lasers: the soft-tissue handpiece / Industry News / HYGIENE TRIBUNE 2/2010

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DENTAL TRIBUNE
The World’s Dental Newspaper · U.S. Edition

March 2010

www.dental-tribune.com

Vol. 5, No. 5

HYGIENE TRIBUNE
The World’s
World’s Dental
Dental Hygiene Newspaper · U.S. Edition
The

Dentistry and the HITECH Act

So just how much of that $22 billion is earmarked
u page 5A
for dentistry?

Want to buy a digital camera?

Hygiene and ortho

Learn exactly what you need to know before maku page 7A
ing your choice.

What are the connections you should be aware of
before, during and after ortho?
upage 1B

Teeth can be saved for future
stem cell harvesting
By Fred Michmershuizen, Online Editor

The Save-A-Tooth system can
be used to transport teeth destined
for cryopreservation and stem cell
treatment of disease.
Recent research has shown that
normally shedding baby teeth and
extracted wisdom teeth can be a
source of stem cells that are the
equivalent of umbilical cord blood
stem cells.
The use of umbilical cord blood
as a source of stem cells has been
routine for several years. However,
this method has many problems.

The window of time for the
retrieval of the cord blood is very
short, the hospital staff needs to be
well trained in the technique and
it is expensive.
Every child loses 20 baby teeth
over a period of six to eight years,
and 1.4 million wisdom teeth are
extracted each year. Each of these
is a rich source of stem cells.
In the past, these teeth were
thrown in the trash, but now they
can be saved and shipped to a
cryopreservation facility and the
stem cells stored until needed for
the many possible future clinical

Deliberating about a diode laser?

applications.
“This
potential
source of stem cells
from teeth is a tremendous breakthrough,”
said Dr. Paul Krasner,
professor of endodontics at Temple University School of Dentistry.
“Four million baby
teeth a year normally
fall out, and for a small
cost and virtually no
effort, each can have
g DT page 2A

Olympians screened
for oral cancer
By Fred Michmershuizen, Online Editor

Many of the world’s top athletes
were competing for medals during
the 2010 Winter Olympic Games,
held in Vancouver, British Columbia. When they weren’t skiing
down slopes, skating around ovals
or whooshing down tracks, several
If you think you cannot afford a diode laser or it’s just too complicated to
use, think again. Read what a dentist who is not a ‘high-tech’ junkie has to
say about incorporating this technology into her practice.
g See page 13A
							

The Save-A-Tooth system can be used to
transport teeth destined for cryopreservation and stem cell treatment of disease.

hundred of the athletes were undergoing screening for oral cancer.
That’s because the International
Olympic Committee (IOC) mandated that 20 percent of athletes
competing in the games receive a
comprehensive examination that
g DT page 2A
AD

Dental Tribune America
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New York, NY 10001

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News

Dental Tribune | March 2009
f DT page 1A

Unless it is placed in
a preservation
solution, a knockedout tooth dies

At the Winter Olympics in Vancouver, British Columbia, the
VELscope System was used to
screen athletes for oral cancer.
The device was developed in
British Columbia.

included screening for oral cancer. The device used to conduct the
screenings was the VELscope system, which happened to have been
developed right in British Columbia
by LED Dental, in collaboration with
the British Columbia Cancer Agency.
During the games, a team of 72
dentists and their volunteer assistants were offering about 800 athletes everything from routine dental
care to trauma surgery. All who
were being treated received the oral
cancer screenings.
“Year-round, the alpine athletes
follow winter around the world to
train, and they are at higher risk of
lip and mouth cancers because of
the altitude and sun exposure,” said
Dr. Jack Taunton, co-chief medical
officer of the games. “The skin on
the lips is thin and poorly protected.
The damage is cumulative, and you
have to consider they are exposed to
these intense ultraviolet rays for up
to 30 years, through their training
and post-competitive coaching years
in many cases.”
Moreover, Taunton said, some
athletes in Nordic events chew
tobacco, which contains numerous
carcinogens that can cause oral cancers.
The VELscope, a device that

within one hour.

emits a special blue light inside
the mouth to help detect suspect
tissue that needs further investigation, was used to screen for cancerous and precancerous lesions in the
athletes. According to LED Dental,
the VELscope is the No. 1 oral cancer screening device in the world,
having been used to conduct an
estimated 3 million screenings in
the past year.
“It’s a terrific adjunctive visual tool being integrated more and
more into general dentistry practices,” said Dr. Chris Zed, associate
dean of dentistry at the University
of British Columbia and co-head of
dental services for the 2010 Olympic
Games.
The athletes were also receiving
education about the importance of
wearing sunscreen to prevent oral
cancers. Alpine sports athletes who
train year-round at high elevations
are especially prone to damaging
ultraviolet rays, raising the risk of
developing skin and lip cancers.
The problem is compounded by the
additional reflection of ultraviolet
radiation off the snow and ice.
Zed cited a German study that
showed outdoor athletes seem
unaware of the elevated cancer risks
associated with their training. DT

Tell us what you think!
Do you have general comments or criticism you would like to share? Is
there a particular topic you would like to see more articles about? Let us
know by e-mailing us at feedback@dental-tribune.com. If you would like
to make any change to your subscription (name, address or to opt out)
please send us an e-mail at database@dental-tribune.com and be sure
to include which publication you are referring to. Also, please note that
subscription changes can take up to 6 weeks to process.

their stem cells stored for future
medical use.”
The Save-A-Tooth System from
Phoenix-Lazerus — one method
for storage of knocked out teeth —
can be used to transport teeth that
can be used as a source of stem
cells.
Provia Laboratories, the provider of the Store-A-Tooth service and
a company that preserves the valuable stem cells found in extracted
wisdom teeth and baby teeth, is
now using the Save-A-Tooth system to transport these teeth.
“We get the best results banking these stem cells if the teeth
that contain them are not damaged during the transport,” said
Dr. Peter Verlander, chief scientific officer of Provia.
“The Save-A-Tooth system has a
patented suspension and retrieval
net that protects the teeth during
transport, and none of the other
methods of transporting teeth have
this safety factor.”
There are stem cells present
on the roots of extracted wisdom
teeth that are especially delicate
and subject to crushing damage.
The Save-A-Tooth method protects
these delicate cells.
These stem cells are found at
the root end of the wisdom teeth
and could be damaged by banging
against container walls or crushing during removal from the container.
The Save-A-Tooth system has
the American Dental Association
Seal of Acceptance for transporting
knocked out teeth and is used by
dentists, schools, hospitals, ambulances and the U.S. Olympic teams.
Because knocked out teeth will
die within one hour of their being
knocked out, the Save-A-Tooth
should be purchased ahead of time
and kept in first aid kits just like
bandages, burn cream and gauze.
If the Save-A-Tooth is used within 60 minutes of the accident, over
90 percent of knocked out teeth
can be saved by reimplantation.
The Save-A-Tooth system has
been used to store, preserve and
transport knocked out teeth for
over 20 years.
Its preservation fluid, Hank’s
Balanced Salt Solution, has been
shown to be an effective preservation solution for knocked out teeth.
The value of a complete system for the storage of knocked
out teeth is outlined in the dental
trauma blog, Dental911.org. DT

DENTAL TRIBUNE
The World’s Dental Newspaper · US Edition

Publisher & Chairman
Torsten Oemus
t.oemus@dental-tribune.com
Vice President Global Sales
Peter Witteczek
p.witteczek@dental-tribune.com
Chief Operating Officer
Eric Seid
e.seid@dental-tribune.com
Group Editor & Designer
Robin Goodman
r.goodman@dental-tribune.com
Editor in Chief Dental Tribune
Dr. David L. Hoexter
d.hoexter@dental-tribune.com
Managing Editor/Designer
Implant Tribune & Endo Tribune
Sierra Rendon
s.rendon@dental-tribune.com
Managing Editor/Designer
Ortho Tribune & Show Dailies
Kristine Colker
k.colker@dental-tribune.com
Online Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Product & Account Manager
Mark Eisen
m.eisen@dental-tribune.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dental-tribune.com
Sales & Marketing Assistant
Lorrie Young
l.young@dental-tribune.com
C.E. Manager
Julia E. Wehkamp
j.wehkamp@dental-tribune.com

Dental Tribune America, LLC
213 West 35th Street, Suite 801
New York, NY 10001
Tel.: (212) 244-7181
Fax: (212) 244-7185
Published by Dental Tribune America
© 2010 Dental Tribune America, LLC
All rights reserved.
Dental Tribune strives to maintain the
utmost accuracy in its news and clinical reports. If you find a factual error or
content that requires clarification, please
contact Group Editor Robin Goodman at
r.goodman@dental-tribune.com.
Dental Tribune cannot assume responsibility for the validity of product claims
or for typographical errors. The publisher also does not assume responsibility
for product names or statements made
by advertisers. Opinions expressed by
authors are their own and may not reflect
those of Dental Tribune America.

Editorial Board
Dr. Joel Berg
Dr. L. Stephen Buchanan
Dr. Arnaldo Castellucci
Dr. Gorden Christensen
Dr. Rella Christensen
Dr. William Dickerson
Hugh Doherty
Dr. James Doundoulakis
Dr. David Garber
Dr. Fay Goldstep
Dr. Howard Glazer
Dr. Harold Heymann
Dr. Karl Leinfelder
Dr. Roger Levin
Dr. Carl E. Misch
Dr. Dan Nathanson
Dr. Chester Redhead
Dr. Irwin Smigel
Dr. Jon Suzuki
Dr. Dennis Tartakow
Dr. Dan Ward

[3] =>

0A
Dental TRubric
ribune | March 2010

Dental Tribune
| Month 2010
3A
Editor’s Letter
& News

TK
An iconic icon

www.dental-tribune.com
Missed the last edition of
Dental Tribune? You can
now read some of its content
online!

TK
Recognizing
today’s dentists who have devoted time outside their practice to help others
By David L. Hoexter, DMD,FACD,FICD,
By TK in Chief
Editor

Each generation has a different
concept
TK DT or image of an icon of contemporary culture. D. Walter Cohen
is such an icon of dentistry. He is a
pinnacle of energy and accomplishment with a glitter of idealism. Even
today, in his 80s, he will play tennis
early in the morning before he practices periodontics at his office.
He understands the “gestalt” of
life. For example, he talks about
Dr. Harry Sicher, author of Bone on
Bones: Fundamental of bone biology,
as not only being a great orthopedist
but someone who loves music and
catching butterflies as well.
Cohen makes the time and effort
to enhance the lives of others and
to encourage peace through education and understanding. Sharing his
vision through unselfish seeds of
giving, Cohen fertilizes the seeds
with education and an interchange
of knowledge.
With his nurturing, the seedlings
grow into trees with strong roots
and wide branches with spreading
leaves. It is underneath the shade of
these leaves that people learn and
share knowledge.
He even manages to open eyes
and ears that have been waxed shut
through years of prejudice and ignorance.
In 1997, Cohen established the

D. Walter Cohen Middle East Center for Dental Education in Israel
at Jerusalem’s Hebrew University.
Today, it continues to set the tone
of learning for citizens all over the
world.
It also allows for the exchange
of dental students at Hebrew University with the students at the AlQuds School of Dentistry in Jerusalem. This exchange illustrates true
sharing between Israeli and Palestinians in Jerusalem by stressing
knowledge, human compassion and
understanding.
Cohen is a passionate man who
has given the world a real opportunity to enhance peace efforts and
change humanity through education and understanding.
Cohen is also helping to make
strides in lowering the number of
preterm, low birth weight babies.
He is guiding the treatment and
cure of periodontal disease during
pregnancy, especially among pregnant teenagers.
This may be a major step in order
to lower the number of preterm,
low birth weight babies. A favorite
phrase of his is that “we have to
keep trying so we can break through
the glass ceiling.”
Cohen helped establish the University of Pennsylvania’s first department of periodontics and served as
its first chair. Growing from professor to dean, Cohen advanced new

Implants displaced into
the maxillary sinus
By Dov M. Almog, DMD,
‘Dr.
D. Walter
Kenneth
Cheng,
DDS
& Mohammad Rabah, DMD
Cohen makes the
www.dental-tribune.com/articles/content/scope/specialities/
time to enhance the
section/implantology/id/542

lives ofcracks
others
Washington
downand
on big tobacco
toFred
encourage
peace
By
Michmershuizen,
Online Editor
through education
www.dental-tribune.com/articles/content/id/480

Dr. David Hoexter, left, and
Dr D. Walter Cohen at a recent
charity function.

concepts and raised educational
standards.
During his career he has found
the time to write and publish 22
books and hundreds of articles.
Despite his busy schedule, he
always finds the time to participate
as dean emeritus of the University
of Pennsylvania’s School of Dental
Medicine.
Among his many honors, he has
received the Legion of Merit from
France, was named president of the
Medical College of Pennsylvania,
chair of the Pennsylvania Diabetes
Academy, president of the National
Museum of American Jewish History and chancellor emeritus of
Drexel University College of Medicine.

and understanding.’

Five of the top 10 reasons
why associateships fail
By Eugene W. Heller, DDS
These are just a few examples of
www.dental-tribune.com/
thearticles/content/id/507/scope/
awards and leadership recognition
that he has received.
specialities/region/usa/section/
When I asked Cohen what he conpractice_management
sidered his greatest achievement to
date,
he unhesitatingly
‘Aren’t
you that guy onreplied “my
family.”
His Makeover”?’
daughters would prob“Extreme
ably
agree.
An interview with the face of
Proudly,cosmetic
he related
the wondermodern
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Dr.
fulWilliam
family M.
home
in which he was
Dorfman
raised,
and
that
his
By Robin Goodman,father
Groupwas the
first
periodontist in Philadelphia.
Editor
Aswww.dental-tribune.com/
he related it, the encouragement
and
love that his family gave to him
articles/content/scope/specialimade
it easy for him to give so much
ties/section/cosmetic_dentistry/
back.
id/543
If the question were posed to me
as New
to who
and
what
an icon in
smile,
new
life:isInnovative
dentistry,
I would
reply, “D.
technologies
andswiftly
techniques
DT
Walter
Cohen.”
can transform a smile
By Lorin Berland, DDS, FAACD
& Sarah Kong, DDS
www.dental-tribune.com/
articles/content/scope/specialities/section/cosmetic_dentistry/
id/544

Limit staff access to drugs
the entire article, “Who Should Have
Access to the Controlled Substances
in Your Office?” at: www2.allenpress.

DT
com/pdf/anpr-56-4fnl.pdf.
Here’s some other online

content that might be of
Progress)
interest(Source:
to youAnesthesia
…01.11.2009
Anzeige METAL-BITE USA 2009/10:METAL-BITE
2009/10
22:31 Uhr
AD

Protective extraoral and
reinforced instrumentation
strategies
Universal and scanable
By Dianeregistration
Millar, RDH,
MA
material,
www.dental-tribune.com/artithat’s it!
cles/content/scope/specialities/
section/dental_hygiene/id/545

Special Operations Forces
dental clinic brings smiles to
Iraqi children
By Jeffrey Ledesma, USA
www.dental-tribune.com/
articles/content/id/535/scope/
politics/region/usa

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E-mail: info@r-dental.com

dental

be much less likely to succumb to a
disaster,” Weaver writes.
“Accredited hospitals already have
strict rules to help prevent drug theft,
but private unaccredited offices without mandatory controls are highly
vulnerable to drug theft and deception.”
By taking sole responsibility for
storing, filling and handling syringes
with controlled substances, dentists
reduce the chance for illegal drug use
and mistaken dosages.
It’s important to rely only on those
licensed to handle medications,
Weaver says, such as physicians, dentists, nurses and pharmacists. Other
employees who receive on-the-job
training also may be more likely to
make mistakes with drug dosages and
concentrations.
“Who should have access to controlled substances in the dental office?
The answer is simple: only licensed
professionals and as few of them as is
reasonable,” he says.
For more information on limiting prescription drug access, read

Dental offices and the pharmaceuticals used there present the risk
for drug abuse, but dentists can put
policies in place that help reduce the
chance of illegal use of controlled
substances, according to an article in
an issue of Anesthesia Progress (2009
edition, 56:112–113).
Joel M. Weaver, DDS, PhD, writes
that dentists who place too much trust
in their employees make themselves
and their practices vulnerable to people who abuse controlled substances.
Dentists who regulate drug access
and distribution are protecting more
than their practice — they’re also protecting their patients, employees and
reputation.
While it’s often easier to stick with
the way things have traditionally been
done, making a few changes to drug
access policies makes good business
sense, Weaver says.
“Although change is difficult and
usually meets with resistance, the
thoughtful practitioner who can step
back and observe his or her practice
for potentially fatal weaknesses will

pattersondental.com

r-dental.com Biß zur Perfektion

Sei

[4] =>

[5] =>

0A
Dental TRubric
ribune | March 2010

Dental
Tribune Act
| Month 2010
5A
HITECH

$22b for health information technology,
TK
www.dental-tribune.com

but not quite so much for dentistry

Missed the last edition of
Dental Tribune? You can
now read some of its content
online!

By Thankam Thyvalikakath, BDS, MDS,
MS and Titus Schleyer, DMD, PhD
By TK

When the Health Information
Technology for Economic and
Clinical
Health Act (HITECH) was
TK DT
signed into law in 2009, $22 billion
was set aside to improve patient
outcomes through increased use
of electronic health records (EHR)
by clinicians during the next five
years (2011–2015).
The proportion expected to go
to dentistry: negligible. Prorating
dentistry’s share of the health-care
market (approximately 5 percent)
would yield over $1 billion of the
allocated amount, but we will be
lucky if we receive a fraction of
that.
You may ask why. After all, dentistry, with its more than 150,000
practitioners in the United States,
is an important primary care discipline that cares for almost 200 million Americans in any given year.
The main reason we are pretty
much left out is because the legislation was written with the interests of physicians and hospitals,
not with those of other health-care
providers, in mind. The consequence is a huge missed opportunity for dentistry.
The federal government requires
providers to fulfill three criteria to
become eligible for Health Information Technology (HIT) stimulus
funds from the HITECH Act. They
must use certified EHRs, demonstrate the capability to measure
meaningful use of EHRs based on a
pre-defined framework and have a
patient population that includes at
least 30 percent Medicaid or Medicare beneficiaries for oral health
care procedures.
Unfortunately, these criteria
make it very difficult for any dentist to qualify. At this time, not
one dental EHR has been certified
by the Certification Commission
for Health Information Technology
(CCHIT).
Meaningful use criteria have
been developed mainly based on
general, not dental, health needs.
In addition, few dentists have
patient pools that include a large
share of Medicaid/Medicare beneficiaries.
Electronic health records, the
use of which can be supported by
the HITECH Act, are certified by
CCHIT. CCHIT is an independent,
501(c)3 nonprofit organization that
has been recognized by the U.S.
Department of Health and Human
Services (HHS) as the official certification body for EHRs since 2006.
CCHIT conducts the certification process by following industry
standards for EHRs and checking
how suitable EHR are in achieving
the meaningful use requirements

specified by the HHS. As of today,
no dental EHR has undergone this
certification process.
Another stumbling block is the
way meaningful use has been
defined by the Office of National
Coordinator for Health Information Technology (ONC).
The idea of meaningful use is
to define a set of process measures that reflect good health care
practices, for instance, periodically
checking the blood pressure for

hypertensive patients and monitoring glucose levels of diabetics.
While some meaningful use
measures, such as generating
problem lists for oral health conditions, maintaining lists of active
medications and allergies, and
recording primary language, insurance type, gender, vital signs and
other patient-specific variables are
certainly appropriate for dentistry,
many measures only apply to physician or hospital settings.

Unfortunately,
the
meaningful
Implants
displaced
into
use
measures,
currently defined,
the
maxillaryas
sinus
include
very
few
By Dov M. Almog,criteria
DMD, that are
relevant
oral DDS
health. Dentists
KennethtoCheng,
are
unlikely to Rabah,
demonstrate
the
& Mohammad
DMD
capability
to
enter
orders
through
www.dental-tribune.com/artiancles/content/scope/specialities/
EHR, perform medication reconciliation,
submit information to
section/implantology/id/542
immunization registries and electronically
submit
reports to
Washington
crackslab
down
public
health
agencies.
on big
tobacco
By Fred Michmershuizen,
g DT page 6A
Online Editor
www.dental-tribune.com/articles/content/id/480
AD

Five of the top 10 reasons
why associateships fail
By Eugene W. Heller, DDS
www.dental-tribune.com/
articles/content/id/507/scope/
specialities/region/usa/section/
practice_management
‘Aren’t you that guy on
“Extreme Makeover”?’
An interview with the face of
modern cosmetic dentistry, Dr.
William M. Dorfman
By Robin Goodman, Group
Editor
www.dental-tribune.com/
articles/content/scope/specialities/section/cosmetic_dentistry/
id/543
New smile, new life: Innovative
technologies and techniques
can transform a smile
By Lorin Berland, DDS, FAACD
& Sarah Kong, DDS
www.dental-tribune.com/
articles/content/scope/specialities/section/cosmetic_dentistry/
id/544

Here’s some other online
content that might be of
interest to you …
Protective extraoral and
reinforced instrumentation
strategies
By Diane Millar, RDH, MA
www.dental-tribune.com/articles/content/scope/specialities/
section/dental_hygiene/id/545
Special Operations Forces
dental clinic brings smiles to
Iraqi children
By Jeffrey Ledesma, USA
www.dental-tribune.com/
articles/content/id/535/scope/
politics/region/usa
Ancient teeth question
origin of men
By Daniel Zimmermann, DTI
www.dental-tribune.com/articles/content/scope/news/region/
asia_pacific/id/505

[6] =>

HITECH Act

Dental Tribune | March 2010

f DT page 5A
Thus, in general, meaningful
use does not work for dentistry.
Dentists and dental schools also
need to have at least 30 percent of
their patient population qualify for
Medicaid reimbursement or Medicare services.
Very few dentists will qualify
based on this criterion. Most likely,
it will be those who provide dental
care in federally qualified health
centers or some dental schools.
So, why would all this matter
to us? As our studies have shown,
more and more dental practitioners are adopting electronic patient
records for a variety of reasons.
Some see them as a more efficient
way to manage patient information
and their practice.
Others use them to keep track
of individual, group and population health outcomes. (What is the
average survival time of a veneer
for all your patients? A difficult
question to answer without an
electronic patient record.)
Down the road, more widespread
adoption of EHRs in dentistry will
enable us to track incidence and
prevalence of various dental diseases; identify patients at risk for
developing disease; systematically
follow up on patients with certain
AD

American Dental Association
211 East Chicago Ave.
Chicago, Ill. 60611-2678
Tel.: (312) 440-2500
Office of the National
Coordinator for Health
Information Technology
200 Independence Ave. SW,
Suite 729-D
Washington, D.C. 20201
Fax: (202) 690-6079
E-mail: onc.request@hhs.gov

The HITECH Act clearly shows that oralhealth outcomes were not on the radar screen
when the legislation was drafted.
conditions; and expand research
through practice-based research
networks. This is indeed a missed
opportunity.
The HITECH Act clearly shows
that oral-health outcomes were not
on the radar screen when the legislation was drafted.
As health-care professionals
who have played a major role in
improving the oral health of Americans, it is important that we as a

community make our voices heard
on behalf of our dental care and
our patients.
We encourage you to write to the
American Dental Association and
the Office of the National Coordinator for Health Information Technology (see box at right for complete address and fax information)
and your local representatives to
ask that dentistry be included in
support from the HITECH Act. DT

Contact information
Thankam Thyvalikakath, BDS,
MDS, MS
Assistant Professor
E-mail: tpt1@pitt.edu
Titus Schleyer, DMD, PhD
Associate Professor & Director
E-mail: titus@pitt.edu
Center for Dental Informatics
School of Dental Medicine
University of Pittsburgh
3501 Terrace Street
Pittsburgh, PA 15261
Tel.: (412) 648-8886
www.di.dental.pitt.edu

[7] =>

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Dental TRubric
ribune | March 2010

Dental Tribune
| Month 2010
7A
Digital
Matters

Do
you need 8-, 10- or 15-megapixels?
TK
How to choose a digital camera

www.dental-tribune.com
Missed the last edition of
Dental Tribune? You can
now read some of its content
online!

By Lorne Lavine, DMD
By As
TK a technology consultant, I

work with many dentists who have
a variety of questions regarding
the
addition of technology to their
TK DT
dental practices.
Many of the questions are related to topics that I have previously written about in Dental Tribune: an overview of how to decide
which technologies to purchase,
how to choose dental software,
digital radiography, etc.
The topic that seems to receive
the most attention, and the most
confusion, is digital photography
and digital images in general. The
sheer number of choices perplexes
most dentists.
This two-part article will examine a number of issues that need to
be answered when adding digital
imaging to the dental practice.
We’ll explore:
• the pros and cons of both intraoral and extraoral cameras;
• examine the criteria that dentists should use in picking a digital
camera for their office;
• look at the software choices
that exist for storing and manipulating these images (part two);
• delve into the myriad of options
for digitizing existing non-digital
images (in part two);
• choices for storing these images;
• printing images;
• and other options for sharing
these images with other people
(such as the patient, insurance
companies and other dental colleagues).

Intraoral cameras
Intraoral cameras have been used
for dental applications since the
early 1990s. One of the first products was the AcuCam, made by
New Image Industries. At one point,
New Image held over 40 percent of
the market share for these systems.
For many years, intraoral cameras were the cameras of choice.
Although there was a bit of a learning curve, they were relatively easy
to master and still have widespread
acceptance today. Recent surveys
have shown that intraoral cameras
are found in about 50 percent of all
dental offices, which seems to indicate that they may have reached
their peak in this regard.
Anyone that has used an intraoral camera is aware of the advantages that these systems offer.
Most cameras are capable of
magnifying images at 40–52x. This
can be an invaluable tool in allowing the dentist to see pathology,
such as open margins, fractures
and caries, which wouldn’t easily
be seen without this level of magnification.

The ability to have images on
a computer monitor screen that
is visible to the patient is of great
benefit. Most experts agree that
one of the keys to improving patient
acceptance to our treatment plans
is the concept of “co-diagnosis.”
In other words, allowing the
patient to see the problems that we
see will allow them to participate
in the diagnosis of their dental
problems, and they will then be
more inclined to accept our recommendations for treating problems
that they may have been previously unaware that they had.
The cameras allow us to have
a permanent record of a patient’s
condition before we begin treatment. This can be quite beneficial for cosmetic cases where we
can show patients before and after
photos of their teeth.
In addition, for legal reasons,
it will often be valuable to have
a record of a patient’s condition
before treatment began, just in
case the patient is unhappy with
the results and is considering legal
action.
The cameras can be used to
take photos of X-rays, which frees
us from having to send in our
original radiographs to the insurance companies. Moreover, adding
photo documentation to an insurance claim will often speed up the
approval of that claim.

How to evaluate intraoral
cameras
When evaluating intraoral cameras, there are a number of factors
to consider.
I would highly recommend that
anyone considering the purchase
of an intraoral camera attend a
dental meeting where many of the
different vendors will be on hand

so that you can evaluate the different aspects of the cameras.
• Ability to handle multiple views.
According to many experts, there
are six standard intraoral camera
views that should be evaluated
when choosing a camera.
These are divided into intraoral
and extraoral views. The intraoral
views are the distal of the upper
last molar, the buccal of the upper
last molar and the lingual surfaces
of the lower anterior teeth.
As far as the extraoral shots
are concerned, test the camera’s
ability to take a full lower arch,
a full-face photo and a photo of a
bitewing radiograph that is being
lit by an X-ray view box.
Test all of these shots to see
which camera can handle the
majority of them with ease.
• Portability. Many dentists have
large offices and, to save costs,
they will consider using a camera
that can easily be moved from one
operatory to another.
Do not fool yourself into believing that if a camera system is on a
large cart that you will be willing
to wheel the cart from room to
room — I tried it myself years ago

and
it just doesn’t
work!
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the
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www.dental-tribune.com/artiand
should have a range of motion
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the
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ties/section/cosmetic_dentistry/
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be turned off when taking these
types of photos.
• Unique features. Most camera
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light
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printstrategies
ing
portable
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By from
Diane aMillar,
RDH, MA
and
color adjustments and image
www.dental-tribune.com/articles/content/scope/specialities/
g DT page 10A
section/dental_hygiene/id/545
Special Operations Forces
dental clinic brings smiles to
Iraqi children
By Jeffrey Ledesma, USA
www.dental-tribune.com/
articles/content/id/535/scope/
politics/region/usa
Ancient teeth question
origin of men
By Daniel Zimmermann, DTI
www.dental-tribune.com/articles/content/scope/news/region/
asia_pacific/id/505

[8] =>

Financial Matters

Dental Tribune | March 2010

Practice transition planning
This is part 2 of a two-part series on this topic
By Eugene Heller, DDS

For most dentists, ownership of
their dental practice is the major
focus of their energy expenditures,
financial situation and professional
lives.
Years of blood, sweat and tears,
coupled with the relationships
formed with both staff and patients,
have caused dentists to form a
deep-seated emotional attachment
to their practice. For many, the dolAD

lar value of that practice represents
a significant portion of their financial assets.
For the new dentist, there is
a definite value in acquiring the
patient base that has taken the
transitioning dentist years to develop and will provide an immediate
and substantial cash flow.

Patients’ evaluation of the new
dentist
Most senior dentists know and

understand that the senior dentist’s
own patients judge their clinical
competence by non-clinical factors, such as personality, gentleness, office appearance, etc. It is
generally not possible to assess
clinical competence until a year or
more of actual clinical procedures
performed by the new dentist are
reviewed.
Unless the transition is preceded
by a period of employment prior
to the actual ownership change,

senior dentists must understand
they will not be able to address the
clinical competence issue.
Senior dentists must accept the
fact that the only control they have
over this subject is the fact that the
new dentist has been tested and
licensed.

Determining the transition plan
The first step in formulating a transition plan involves an appraisal
of the practice. The information
gathered and evaluated during the
appraisal process will aid in determining available transition options.
These options may include: (1)
an outright sale, (2) role reversal
sale, (3) partnership, (4) merger or
(5) production acquisition transaction.
In addition, the appraisal will
typically provide a comparison with
other practices involved in transitions, thereby allowing an understanding as to how salable this
particular opportunity might be.
Finally, the appraisal should also
provide ideas regarding enhancing
the value of the practice and its
desirability as a transition candidate.

Locating a competent transition
consultant
The next step is locating a competent transition consultant. A transition consultant is one who understands the entire transaction, the
various types of transitions, contractual matters, the operational
issues of running a dental practice
and the need to have the relationships of the buyer, seller, staff and
patients intact after the deal is
done.
The best source for these individuals is word of mouth referrals
and/or a recognized reputation. He
or she may be a national or regional “transition guru;” the dentist’s
personal accountant or another
accountant who restricts his or her
practice to health care providers
and is familiar with the health care
transition field; or an experienced
local dental practice broker.
Some of the dental supply companies also have knowledgeable
consultants who have been assisting in transitions for years.
The transition consultant will
help the dentist identify various aspects of his or her transition. Questions that need answers
include the dentist’s financial ability to retire and his or her personal
transition goals.
For example, how long does the
dentist wish to stay on as an associate and/or remain available to aid
in the transition process? What is
g DT page 11A

[9] =>

[10] =>

10A Digital Matters

Dental Tribune | March 2010

The image on the computer monitor will
look the same whether you are using
an 8-, 10- or 15-megapixel camera.
f DT page 7A
scrolling through the foot pedal.

Extraoral cameras

Matrix

Inserts as a wedge

Convex Contact
Point Maker

While intraoral cameras have many benefits,
there have always been some roadblocks for
dentists who wished to use them in the office.
As I stated earlier, there is a learning
curve associated with their use; most have an
upside-down image and so using them is similar to using a mirror in the mouth.
What most dentists wanted was a way to use
cameras that they are already familiar with,
which is the extraoral camera. The problem,
for a long time, was the unavailability of digital cameras.
While there are many ways to get traditional photos into a digital format (more on
that in part two of this article), it is still much
more desirable and easy to have digital images
from the start.
When the first digital cameras for consumer
use were introduced, they were very expensive and, although they were suitable for the
home, they did not meet the criteria for producing diagnostic dental photographs.
The first units that came out were 1.3
megapixel cameras. Since then, we have seen
2.1 megapixel units, 3.3 megapixel units and,
lately, 12 and 15 megapixel cameras.
Because the issue of pixels is often misleading and confusing, here is a short primer on
pixels.

Pixels primer

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It helps to remember that pixel count doesn’t
determine how good the image is — only how
large a good print you can make! Image quality is determined more by lens quality, the
imaging chip and its control circuitry, etc., not
to mention the ability of the photographer to
control those factors.
To put the “how big” issue in some kind
of perspective: the rule of thumb I use is that
with a continuous-tone print device such as
a dye-sub or good quality ink-jet printer, you
need to provide 300 pixels per inch in the print
to provide “high quality” photographic results
— ones that will stand up to close scrutiny and
still look photographic.
If you can settle for “snapshot” photo quality, i.e., images that will be examined casually
at normal reading distance or better, then you
can get by with 200 pixels per inch in the print,
and for “display” quality — meaning prints
that will be viewed from several feet away —
you would be OK with 100 pixels per inch or
even less.
(Keep in mind that these quality levels are
strictly my own personal preferences. Some
people might be perfectly happy with 50-pixels-per-inch images.)
Anyway, if you’ve got a 2-megapixel camera
(typically about 1,200 by 1,600 pixels in the
image) the biggest print you can make and
retain what I think of as “high quality” is 4 by
6 inches.
A 3-megapixel camera (let’s assume it’ll be
1,500 by 2,000 image pixels) will let you make
a print of 5 by 7 inches at the same “high quality” level. That’s a difference of about an inch
each way.

If your usual need is for “snapshot” quality,
you can bump up these figures by 50 percent,
but either way, I think it makes it pretty clear
that the 12- and 15-megapixel cameras won’t
make a big difference, unless you plan to print
8-by-10 inch photos.
The image on the computer monitor will look
the same whether you are using an 8-, 10- or
15-megapixel camera.
Or to put it another way: if you have a choice
of a 10-megapixel camera that’s perfect for your
needs and preferences, or a 15-megapixel camera that would force you to compromise on the
features and controls you want, don’t buy the
15-megapixel model just because it has more
pixels.
When you are evaluating digital camera systems, I would recommend that you work with a
company that specializes in systems designed
for the dentist. Two well-known companies are
PhotoMed and Lester A. Dine.
Both produce systems that include all the
hardware and software that a dentist would
need to get started in digital photography,
although they take different approaches and
have subsequently different costs of their systems.
The PhotoMed systems are typically cameras
with all components included, such as a macro
lens, flash diffuser or ring flashes, memory
cards and battery charger.
These systems normally start around $1,200
and can go as high as $5,000 depending on the
camera type and attachments that you purchase.
In part two of this article, we’ll cover making
the move from analog to digital. DT

About the author

Dr. Lorne Lavine, founder and president of Dental Technology Consultants, has more than 20 years
invested in the dental and dental technology fields.
A graduate of USC, he earned his DMD from
Boston University and completed his residency at
the Eastman Dental Center in Rochester, N.Y. He
received his specialty training at the University of
Washington and went into private practice in Vermont until moving to California in 2002 to establish
DTC, a company that focuses on the specialized
technological needs of the dental community.

[11] =>

0A
Dental TRubric
ribune | March 2010

TK

f DT page 8A

the dentist’s preferred timetable?
Are there any preliminary steps
required to enhance the value of
the practice? Which method of tranTK
sition
has the greatest chance of
successful completion?

Make a plan outline

By TK answers to these questions
The
should result in a brief written outline of the plan. The topics should
include:
TK DT

(1) goals,
(2) a timetable,
(3) appraised value,
(4) anticipated post-tax and sale’s
expense net sale proceeds,
(5) planned transition options and
(6) a list of consultants to be
involved.

begin as soon as the appraisal is
completed.
A stockbroker will advise that
one should set a target sale price
the day one acquires a stock. Similarly, the exit strategy is part of
the potential financial reward of
practicing.
Good business sense dictates
the plan should really have been
started when the practice was first
acquired.
Part of a transition plan started
early in one’s career will allow for
inclusion of a well-funded pension
plan and less reliance upon practice sale proceeds for retirement
needs.
The timetable for the actual
implementation of the plan will be
dependent upon the personal wish-

Dental Tribune
| Month11A
2010
Financial
Matters
es, needs and financial resources of
the dentist.
Metro areas are seeing a common market time of one to two
years from listing to sale. Rural area
practices face three to five years if
they can be transitioned at all.
The length of time required for
location of a prospect and transitioning of the practice requires that
the practice opportunity be listed at
the earliest time that the dentist is
willing to complete the transition.
If the seller is fortunate enough
to immediately locate a buyer after
listing, the dentist needs to be ready
to act.
At the time of listing, the dentist
must also realize that he/she may
continue to own the practice for a
long time.

An alternative

www.dental-tribune.com

For dentists considering retirement, many have a difficult time
Missedthe
theprocess
last edition
of of the
starting
because
Dental Tribune?
Youtocan
emotional
attachment
their pracnow read some of its content
tice.
These dentists, unless or until
online!
they find something else they
would
rather
do thaninto
practice denImplants
displaced
tistry,
will be sinus
unable to activate
the maxillary
their
transition
plan.
By Dov M. Almog, DMD,
If the practice
of dentistry is
Kenneth
Cheng, DDS
their
only interest,
theirDMD
hobby and
& Mohammad
Rabah,
thewww.dental-tribune.com/articenter of their later life, there is
nocles/content/scope/specialities/
law stating that they must transition
their practice.
section/implantology/id/542
For these dentists, their transition
plan is tocracks
practice
until they
Washington
down
can
on no
big longer
tobacco do so. Their plan
may
be
as
simple as one day closBy Fred Michmershuizen,
ingOnline
the doors
and retiring. DT
Editor
www.dental-tribune.com/articles/content/id/480
AD

The plan should also contain
an action plan for completion of
any activities that will enhance the
value of the practice or increase the
chances the practice will be selected by prospective new dentists.
Understanding that an inactive
practice loses five percent of its
value per week, an important part
of the plan should also include a list
of people to be called in the event
of an un-anticipated career-ending
disability or death.
A letter of instructions to family
members should be included that
lists those contacts and stresses
the urgency to act expediently in
transitioning the practice. A part of
the plan needs to include sharing
this letter and plan with significant
family members.
Many dentists, especially if
incorporated, will execute a power
of attorney authorizing a specific
individual to immediately begin
transition proceedings if required
due a dentist’s death.

When and how to start
If an appraisal has not been completed or updated within the past
two years, this is the first step.
Developing an exit strategy plan,
even if it is years away, should also

About the author
Dr. Eugene W. Heller is a 1976
graduate of the Marquette
University School of Dentistry.
He has been involved in
transition consulting since 1985
and left private practice in 1990
to pursue practice management
and practice transition consulting on a full-time basis.
He has lectured extensively to
both state dental associations
and numerous dental schools.
Heller is the national director
of transition services for Henry
Schein Professional Practice
Transitions. For additional
information, please call (800)
730-8883 or send an e-mail to
ppt@henryschein.com.

Five of the top 10 reasons
why associateships fail
By Eugene W. Heller, DDS
www.dental-tribune.com/
articles/content/id/507/scope/
specialities/region/usa/section/
practice_management
‘Aren’t you that guy on
“Extreme Makeover”?’
An interview with the face of
modern cosmetic dentistry, Dr.
William M. Dorfman
By Robin Goodman, Group
Editor
www.dental-tribune.com/
articles/content/scope/specialities/section/cosmetic_dentistry/
id/543
New smile, new life: Innovative
technologies and techniques
can transform a smile
By Lorin Berland, DDS, FAACD
& Sarah Kong, DDS
www.dental-tribune.com/
articles/content/scope/specialities/section/cosmetic_dentistry/
id/544

Here’s some other online
content that might be of
interest to you …
Protective extraoral and
reinforced instrumentation
strategies
By Diane Millar, RDH, MA
www.dental-tribune.com/articles/content/scope/specialities/
section/dental_hygiene/id/545
Special Operations Forces
dental clinic brings smiles to
Iraqi children
By Jeffrey Ledesma, USA
www.dental-tribune.com/
articles/content/id/535/scope/
politics/region/usa
Ancient teeth question
origin of men
By Daniel Zimmermann, DTI
www.dental-tribune.com/articles/content/scope/news/region/
asia_pacific/id/505

[12] =>

[13] =>

0A
Dental TRubric
ribune | March 2010

Dental Tribune
| Month13A
2010
Clinical

TK
Diode
lasers: the
soft-tissue handpiece
www.dental-tribune.com
Missed the last edition of
Dental Tribune? You can
now read some of its content
online!

By TK

By Fay Goldstep, DDS, FAACD, FADFE

Ease of use

TK DT

Early-adopter dentists thrive on new
technologies. They enjoy the challenges that come with being the first
to use a product. Most dentists, however, are not early adopters.
Over the past two decades, lasers
have intimidated mainstream dentists with their large footprint, lack

While dental lasers have been
commercially available for several decades, and their popularity
among patients is unparalleled, the
dental profession has taken to this
treatment modality rather slowly.
Lasers have been thoroughly
documented in the dental literature.
They are an exciting technology,
widely used in medicine, kind to
tissues and excellent for healing.
So why have they not been more
widely embraced by the practicing
dentist?
There is a general perception in
the profession that somehow the
dental laser is not useful, is too complicated and too expensive. These
parameters have changed forever
with the arrival of the diode laser
onto the dental scene.
There is now a convergence of
documented scientific evidence,
ease of use and greater affordability
that makes the diode laser a “must
have” for every dental practice.

The science behind the laser
“Laser” is an acronym for light
amplification by stimulated emission of radiation. Lasers are commonly named for the substance that
is stimulated to produce the coherent light beam.
In the diode laser, this substance
is a semiconductor (a class of materials that are the foundation of modern electronics, including computers, telephones and radios).
This innovative technology has
produced a laser that is compact
and far lower in cost than earlier
versions. Much of the research has
focused on the 810 nm diode laser.
This wavelength is ideally suited
for soft-tissue procedures because
it is highly absorbed by hemoglobin
and melanin. This gives the diode
laser the ability to precisely cut,
coagulate, ablate or vaporize the
target soft tissue.1
Treatment with the 810 nm diode
laser (Fig. 1a, Picasso diode laser,
AMD LASERS) has been shown to
have a significant long-term bactericidal effect in periodontal pockets.
A. actinomycetemcomitans, an
invasive pathogen associated with
the development of periodontal disease and generally quite difficult
to eliminate, responds well to laser
treatment.2,3
Scaling and root planing outcomes are enhanced when diode
laser therapy is added to the dental armamentarium. The patient is
typically more comfortable during
and after treatment, and gingival
healing is faster and more stable.4,5

of portability, their high maintenance profile, confusion about operating tips and complex procedural
settings.
Common questions include:
When do I use which tip? What setting works for which procedure?
Why do I need a laser when I have
been managing well without one?

Implants displaced into
the maxillary sinus
By Dov M. Almog, DMD,
Kenneth Cheng, DDS
the diode
laser.DMD
It is com&Enter
Mohammad
Rabah,
pact.
It
can
easily
be
moved
www.dental-tribune.com/arti-from
one
treatment room to another. It is
cles/content/scope/specialities/
self-contained
and does not have to
section/implantology/id/542
be hooked up to water or air lines.
It Washington
has one simple
fiber-optic
cable
cracks
down
that
be utilized as a reusable
on can
big tobacco
By Fred Michmershuizen,
g DT page 14A
Online Editor
www.dental-tribune.com/articles/content/id/480
AD

[14] =>

14A Clinical
f DT page 13A
operating tip.
The units come with several presets, although after a very short
time, the operator becomes so comfortable that they are rarely needed.
The power and pulse settings are
quickly adjusted to suit the particular patient and procedure.
On a personal note, I am a dentist
who does not thrive on the challenge
of brand new high-tech, high-stress
technology. I have tried many lasers
in the past that promised to be userfriendly; they were anything but.
After a short in-office demonstration of the 810 nm diode laser, I
was able to pick up the handpiece
and felt comfortable enough to perADS

Dental Tribune | March 2010
form some simple procedures. I
have since taken online training, as
well as lecture courses, which have
enhanced both my comfort level and
my competency.

Fig. 2

Affordability
Laser technology has traditionally
come with a high price tag. Manufacturing costs are high and cuttingedge technology commands steep
pricing. Diode lasers are less expensive to produce.
Breakthrough pricing for this
technology has now arrived at under
$5,000. At this level, the diode laser
becomes eminently affordable for
the average practicing dentist.

Why do I need this technology?

The 810 nm diode laser is specifi-

Fig. 1

cally a soft-tissue laser. This wavelength is ideally suited for soft-tissue
procedures because hemoglobin and
melanin, both prevalent in dental
soft tissues, are excellent absorbers.
This provides the diode laser with
broad clinical utility: it cuts precisely, coagulates, ablates or vaporizes
the target tissue with less trauma,
improved postoperative healing and
faster recovery times.6–8
Given the incredible ease of use
and its versatility in treating soft
tissue, the diode laser becomes the
“soft-tissue handpiece” in the dentist’s armamentarium.
The dentist can use the diode
laser soft-tissue handpiece to
remove, refine and adjust soft tissues in the same way that the traditional dental handpiece is used
on enamel and dentin. This extends
the scope of practice of the general
dentist to include many soft-tissue
procedures.
The following procedures are
easy entry points for the new laser
user:
• Gingivectomy, haemostasis, gingival troughing for impressions
The diode laser makes restorative
dentistry a breeze (Picasso, AMD
Lasers). Any gingival tissue that covers a tooth during preparation can
be easily removed because hemostasis is simultaneously achieved.
The restoration is no longer compromised due to poor gingival conditions. There is no more battling
with unruly soft tissue and blood
(Figs. 1–5). Excess gingival tissue
can be readily managed (Figs. 5a, b)
for improved restorative access to
Class V preparation (ezlase, Biolase
Technology).
Gingival troughing prior to taking
impression (Picasso, AMD LASERS)
ensures an accurate impression
(particularly at the all-important
margins) and an improved restorative outcome. Packing cord is no
longer necessary (Figs. 6, 7).
Diode lasers make restorative
dentistry less stressful, more predictable and more enjoyable for the
dental team and the patient.
• Operculectomy, excision and/or
recontouring of gingival hyperplasia,
frenectomy
These procedures are not commonly offered or performed by the
general dentist. They are examples
of the expanded range of services
readily added to the general practice.
The dentist becomes more proactive in dealing with hyperplastic tis-

Fig. 3

sues that can increase risk of caries
and periodontal disease (Figs. 8–10,
courtesy of Ivoclar Vivadent).
A frenectomy is now a simple and
straightforward procedure (ezlase)
(Fig. 10a).
• Laser-assisted periodontal treatment
The use of the diode laser in
conjunction with routine scaling
and root planing is more effective than scaling and root planing
alone. It enhances the speed and
extent of the patient’s gingival healing and postoperative comfort.4,5
This is accomplished through laser
bacterial reduction (Picasso, AMD
LASERS), debridement and biostimulation (Figs. 11, 12, courtesy of Dr.
Phil Hudson).
A. actinomycetemcomitans, which
has been implicated in aggressive
periodontitis, may also be implicated in systemic disease. It has been
found in atherosclerotic plaque,9
and there has been recent data suggesting that it may be related to
coronary heart disease.10 The diode
laser is effective in decreasing A.
actinomycetemcomitans2,4 and thereby indirectly improving the patients’
heart health.

Laser education
Most diode laser manufacturers provide some education to get the new
user started quickly and effectively.
The most comprehensive online
diode laser introductory course with
certification — which includes the
science, safety and clinical procedures — can be found at the International Center for Laser Education, www.dentallaseredu.com (telephone, (877) 522-6863).
This course provides everything
necessary to get started with softtissue diode laser therapy. Advanced
courses are available for more complex procedures.

In conclusion
The soft-tissue diode laser has
become a “must have” mainstream
technology for every general practice. The science, ease of use and
affordability make it simple to incorporate. The laser is now the essential “soft-tissue handpiece” for the
practice.
In fact, there is a case for having
a diode laser in each restorative and
hygiene treatment room. As a result,
restorative dentistry becomes easier,
more predictable and less stressful.
Laser therapy expands the clinical scope of a practice to include

[15] =>

0A
Dental TRubric
ribune | March 2010

TK
TKFig. 4

By TK

TK DT

Fig. 9

Dental Tribune
| Month15A
2010
Clinical
www.dental-tribune.com
Missed the last edition of
Dental Tribune? You can
now read some of its content
online!

Fig. 5

Fig. 6
new soft-tissue procedures that keep
patients in the office.
The patient’s gingival health is
improved in a minimally invasive,
gentler manner. Every time the dentist picks up the diode laser the
question is: Where have you been all
my life? DT
A complete list of references is
available from the author.

Implants displaced into
the maxillary
sinus
Fig.
8
Fig. 7
By Dov M. Almog, DMD,
Kenneth Cheng, DDS
& Mohammad Rabah, DMD
About the author
www.dental-tribune.com/artiDr. Fay Goldstep sits on the Oral Health cles/content/scope/specialities/
Editorial Board (healing/preventive
dentistry), has served on the teaching faculties
of the post-graduate programs in
section/implantology/id/542
esthetic dentistry at SUNY Buffalo, the University of Florida (Gainesville) and the
University of Minnesota (Minneapolis), and is
a former ADA
Seminar
Series feaWashington
cracks
down
tured speaker. Goldstep is a consultant to a number
dental companies, and she
on big of
tobacco
maintains a private practice in Markham, Ontario,
Canada.
She can be reached at
By Fred
Michmershuizen,
goldstep@epdot.com.
Online Editor

www.dental-tribune.com/articles/content/id/480
AD

Five of the top 10 reasons
why associateships fail
By Eugene W. Heller, DDS
www.dental-tribune.com/
articles/content/id/507/scope/
specialities/region/usa/section/
practice_management
Fig. 10

Fig. 11

Fig. 12

‘Aren’t you that guy on
“Extreme Makeover”?’
An interview with the face of
modern cosmetic dentistry, Dr.
William M. Dorfman
By Robin Goodman, Group
Editor
www.dental-tribune.com/
articles/content/scope/specialities/section/cosmetic_dentistry/
id/543
New smile, new life: Innovative
technologies and techniques
can transform a smile
By Lorin Berland, DDS, FAACD
& Sarah Kong, DDS
www.dental-tribune.com/
articles/content/scope/specialities/section/cosmetic_dentistry/
id/544

Fig. 13

Fig. 14

Special Operations Forces
dental clinic brings smiles to
Iraqi children
By Jeffrey Ledesma, USA
www.dental-tribune.com/
articles/content/id/535/scope/
politics/region/usa
Ancient teeth question
origin of men
By Daniel Zimmermann, DTI
www.dental-tribune.com/articles/content/scope/news/region/
asia_pacific/id/505

[16] =>

16A Industry News

Dental Tribune | March 2010

Isodry makes its debut
By line

AFFINIS
360 putty
Coltène/Whaledent
announces the introduction of
AFFINIS System 360 putty. This
new polyvinylsiloxane impression material combines the viscosity and positioning pressure
of putty with the convenience of
automatic mixing device delivery.
AFFINIS 360 putty delivers a
tactile, kneadable consistency
directly after automated mixing. The material is hand pliable and can be molded and
preformed without sticking to
gloves.
By using the automatic mixing device, AFFINIS System
360 Putty is consistently and
homogeneously mixed, which
prevents problems associated
with improper dosing or mixing
techniques. Likewise, the system saves time by eliminating
the hand mixing and kneading
necessary with traditional jar
putty material.
In addition, the larger 380 ml
capacity hard cartridges reduce
material waste and provide up
to 10 percent more material
than foil bag systems.
With exceptional dimensional stability, the material resists
shrinking and expanding to
provide detailed impressions
and restorations.
The new AFFINIS System 360
putty fits all commercially available mixing units and blends
perfectly with regular set AFFINIS and AFFINIS Precious wash
materials.
For more information, please
visit www.coltenewhaledent.
com or call (800) 221-3046. DT

Isolite Systems, maker of innovative dental isolation technology,
introduced Isodry Ti at the Chicago Midwinter Meeting. The new
product was assessed while conducting market research on the
company’s original award-winning Isolite dryfield illuminator
dental isolation system.
The original Isolite provides
five levels of intra-oral illumination, comfortably retracts the
patient’s tongue and cheek, protects the throat and keeps the
mouth gently propped open with
continuous suctioning of the dental patient’s mouth.
With the tongue out of the way
and a bright, dry field in which to
work, dental procedures are completed an estimated 20–30 percent
faster, with less stress for the
dental professional and improved
comfort for the dental patient. The
new product, Isodry, is exactly
like the Isolite, but without the
internal oral lighting.
“After
conducting
market
research, we found that there
is a segment of dental practitioners who, after years of practicing dentistry, prefer to work
only with external lighting, so we
created the Isodry, which has all
of the same retraction, protection, mouth-propping and ongoing
aspiration of the original Isolite,
but without the advanced intraoral illumination of our premier
product,” explained Jim Hirsch,
president and product designer.
With no computer circuitry or
advanced lighting technology, the
Isodry has a lower manufacturing cost and the resulting price
may make the company’s dramatic dental isolation benefits even
more affordable to some dental
practices.
“We have found many dental
practices wanting to have our
isolation technology installed in
every operatory of their practice,
but they don’t necessarily need
the intra-oral illumination feature
in every room.
“In addition, we have clinics
and teaching facilities with capital
budget constraints, and the lower
price point of Isodry will help
them bring state-of-the art isolation to more operatories, allow-

Picasso
Lite

ing them to serve more patients,”
added Sandra Hirsch, general
manager.
As with the original Isolite, the
Isodry utilizes the patented, allin-one Isoflex mouthpiece. The
unique shape and softness of the
mouthpiece is key to the system’s
advanced dental isolation. The
latex-free mouthpiece comfortably allows fluids and debris to
be aspirated from deep within the
oral cavity.
A built-in tongue, cheek and
throat shields protect the patient
from injury and provide an added
measure of assurance that the
airway is better protected from
possible dental debris.
Single-use Isolite mouthpieces
are available in five sizes to fit the
spectrum of patients from small
child to large adult.
Isolite Systems advanced isolation technology has earned a loyal
following and broad recognition
in the industry for its premier
product, the Isolite dryfield illuminator.

About Isolite Systems
Isolite Systems was founded in
2001 by Thomas R. Hirsch, DDS,
his brother, James Hirsch, industrial designer, and Sandra Hirsch,
CPA, to bring to market the Isolite dryfield illuminator and other
products.
The company is committed to
transcending the limitations of
existing dental technology with
innovative, ergonomically efficient products that help dental
professionals work more productively with less stress and fatigue.
For more information about
Isolite Systems, please call (800)
560-6066 or visit www.isolite
systems.com. DT

In January, AMD LASERS
announced the introduction of
the Picasso Lite soft-tissue dental
laser.
Priced at $2,495, offering 2.5
watts of power and three customizable presets, Picasso Lite is
the most affordable and easy-tooperate dental laser in the world,
according to AMD LASERS.
It was designed specifically to
replace the archaic use of scalpels
and electro-surge in the treatment
of soft tissue.
“With Picasso Lite, we accelerated the paradigm shift in dentistry that began with the introduction of the Picasso soft-tissue
laser in 2009,” said Alan Miller,
president/CEO of AMD LASERS.
“We have ‘One Vision, One
Goal’ — equipping every operatory with a laser. Record numbers
of dentists are purchasing Picasso,
and I’m sure Picasso Lite’s more
attractive price and ease of use
will quickly make it the most popular laser in the world.
“Picasso Lite was designed specifically for first-time laser dentists
and hygienists, and at one-fifth
the cost of other lasers, it’s truly
affordable. We’ve shipped Picassos to more than 50 countries,
and the number of dentists and
distributors interested in Picasso
is truly amazing. I think the real
winners are the patients.”
Picasso Lite cuts and coagulates tissue with reduced trauma,
bleeding and necrosis of tissue
and is used for soft-tissue surgery, including troughing, gingivectomies, frenectomies, exposing
implants/teeth/ortho brackets and
treating aphthous ulcers and herpetic lesions.
Featuring an ultra-compact,
lightweight and sleek design,
Picasso Lite comes with an easyto-learn DVD that exaplains setup; online laser certification,
accessories; a world power adapter and a two-year warranty.
Another first for the laser
industry is Picasso Lite’s ability to
use convenient disposable tips or
a low-cost strippable fiber.
“We are proud to offer Picassos and now Picasso Lites free of
charge to universities and dental
schools, globally illustrating our
commitment to education and
charity,” said Miller. DT

[17] =>

[18] =>

18A Industry News

Dental Tribune | March 2010

Prophy
Magic
Deck
Ashtel Dental and 7 Day
Handpieces
Dental donate toothbrushes
for Hatian relief efforts
In wake of the earthquake that
devastated Haiti, Ashtel Dental of
Fontana, Calif. and 7 Day Dental
of Anaheim, Calif., donated a combined 20,000 children’s toothbrushes
to the Giving Children Hope Foundation of Buena Park, Calif., for their
relief efforts in Haiti.
The donation was given to the
foundation after executives from
Ashtel Dental and 7 Day Dental
heard of the foundation’s plans to
send them to the children in Haiti
that had lost their homes and their
families in the earthquake.
“We want to help however we
can,” said Yousuf Nabi, vice president of marketing for Ashtel Dental.
“Our prayers are with everyone in
Haiti and we hope our small donation helps those in need during this
tough time.”
AD

Giving Children Hope (GCH) has
already sent 47,000 pounds of medical supplies and disaster relief, as
well as $1 million worth of lifesaving pharmaceuticals to treat the
survivors in Haiti.
GCH has also sent two relief
teams to Haiti to administer and distribute aid, as well as assess current
needs on the ground.
The foundation will “continue to
accept monetary donations and new
relief product for those in Haiti,” said
Harmony Trevino, the foundation’s
communications coordinator. “This
is an ongoing relief effort where Giving Children Hope will continually
send food, water, hygiene products
and medical supplies.”
To learn more about GCHope’s
Haiti relief work or to donate, please
visit www.aidtohaiti.org. DT

Buying disposable prophy
is something you need to do,
so why not get something in
return? Prophy Magic is pleased
to announce “incredible deals”
where you get the highest quality prophy angles in bulk and
free handpieces.
Get unmatched deals on your
disposable prophys and keep
something tangible every time
you order.
Introducing the ideal hygiene
handpiece for your RDH that
won’t break the bank.
The Prophy Magic Hygiene
Handpiece is ultra lightweight,
perfectly balanced and accepts
all prophy angles. The price is:
Free! (Yes, you read that correctly: Free!)

For details, please visit prophy
magic.com
or
call
(866)
DT
54-MAGIC (62442).

Implantology starts at
the time of extraction

Fig. 1 Using the Luxator instrument.
By Michael Liebler, DDS

If there is sufficient bone available, the placement of implants is
a relatively simple and straightforward surgical procedure of modern
dentistry. However, if there is massive loss of bone due to periapical or
periodontal pathosis, implants can
only be placed with bone augmentation.
In some cases, it is the extraction procedure itself that causes the
loss of mostly the buccal wall of the
alveolar socket. This also makes it
very difficult to place the implant.
Careful removal of the tooth from
the alveolar socket, however, will
leave the bony walls intact.
Even without augmentation materials, there will be good wound healing resulting in good bone height
and width at the level of the alveolar
ridge.
Luxators are ideal instruments
for such a careful tooth removal.
The action of the Luxator is based
on the possibility of bone expansion.
The Luxator is introduced in a
rotating fashion, parallel to the long
axis, down the periodontal ligament.

The shape of its blade allows the
instrument to be advanced to the
apical third of the root (Fig. 1). This
will lead to an enlargement of the
alveolar socket so the tooth can be
easily removed with a slight rotational movement with forceps. Concial roots will sometimes literally
“jump” out of the socket.
Even though Luxators look like
classic elevators, the mode of action
of these instruments has nothing in
common with classic elevators. Luxators are much more delicate than
any elevator. You should not use the
Luxator as an elevator because this
will cause the instrument to bend.
Your patients will be thankful for
the atraumatic extraction even if you
don’t place an implant. They will
experience less discomfort operatively and postopertively.
For more information about Luxator visit www.directadetal.com. DT
Dr. Michael Liebler received his
DDS from the University of Iowa.
You may write him at:
Kaiserstrasse 36
90 403 Nürnberg
Germany

[19] =>

Dental Tribune | March 2010
0A
Dental TRubric
ribune | Month 2010

19A
Industry
News
Dental Tribune
| Month 2010
0A
Rubric

TK
oral
Visteo is introduced Fight
cancer!

f DT page 2A

www.dental-tribune.com

TK DT

The first intra-oral magnetic induction, rotatable sensor

TK

Dental imaging and software distributers Owandy

By USA
TK and Ashtel Dental showcased the revolutionary

new intra-oral induction sensor, Visteo at the 2010 Chicago Midwinter Meeting.
TK DTVisteo is the first digital X-ray sensor to use magnetic
induction (patented exclusively by Ownady) combined
with integrated positioning and versatile 360-degree
angulator rotation. Its liberating design makes it a
groundbreaking advancement in the world of dental
imaging, allowing practitioners more mobility and ease
0
in working with patients.
360
“The Owandy Visteo is an ‘Innovation Prize’ winner,
an intra-oral sensor that features magnetic induction
that makes it very easy to use because the cable isn’t
fixed, and the sensor can be attached and detached
with a snap,” said Anish Patel, CEO of Owandy USA.
“The sensor also rotates and is more comfortable for
patients.”
Visteo’s unique design revolutionizes the practitioner
and patient experience with more comfortable sensors, which are smaller, thinner and designed with rounded
edges for patient comfort. The sensor’s full rotation function makes it more convenient and faster to reposition
in the patient’s mouth.
Beyond ease and comfort features, Visteo provides true resolution greater than 20 pl/mm, making it one of
the highest real resolution sensors on the market. Technical specifications can be found at www.owandy.net/
uk/Products/Sensore/Visteo/spe_tech.php.
Visteo features seven pre-defined sensor positions or an infinite number of positions using its free angulation
option. It also features parallel positioning or the option to position it with the bisecting technique.
“Visteo has already received the ‘Professional Innovation Prize’ at the AD Dental Fair in Paris,” said Patel.
Distributers will also be featuring Owandy’s I-MAX Touch pan + ceph + tomo digital panoramic imaging
handsets at dental meetings across the country.
For more information or to purchase Visteo or other Owandy products, contact Ashtel Dental, www.ashtel
dental.com. DT

D4D makes charitable donation
to Red Cross Haiti Disaster Relief

D

id youdisplaced
know thatinto
dentists are
Implants
one of thesinus
most trusted prothe maxillary
fessionals
to
give
By Dov M. Almog, advice?
DMD, Thus,
no
other Cheng,
medical
professionals
Kenneth
DDS
are
in a better Rabah,
position
to show
& Mohammad
DMD
patients
that
they
are
commitwww.dental-tribune.com/artited
to detecting and treating oral
cles/content/scope/specialities/
cancer.
section/implantology/id/542
Prove to your patients just how
committed
you
are todown
fighting this
Washington
cracks
disease
by signing up to be listed
on big tobacco
at
www.oralcancerselfexam.com.
By Fred Michmershuizen,
This
new
Web site was developed
Online
Editor
for
consumers in order to show
www.dental-tribune.com/artithem
how to do self-examinacles/content/id/480
tions for oral cancer.
Self-examination
can help
Five
of the top 10 reasons
your
patients
to
detect
why associateships fail abnormalities
or incipient
By Eugene
W. Heller,oral
DDScancer
lesions
early. Early detection in
www.dental-tribune.com/
the
fight
against cancer is crucial
articles/content/id/507/scope/
and
a primary benefit in encourspecialities/region/usa/section/
aging
your patients to engage in
practice_management
self-examinations.
If dental
professionals
‘Aren’t
you that
guy on do not
take
the lead
in the fight against
“Extreme
Makeover”?’
oral
cancer,
who
will?
An interview with
the And
face in
of the
eyes
of our
patients,
they likely
modern
cosmetic
dentistry,
Dr.
would
not
anyone else to
William
M.expect
Dorfman
do
so
—
would
you?
By Robin Goodman, Group
Editor
www.dental-tribune.com/
articles/content/scope/specialiwww.dental-tribune.com
ties/section/cosmetic_dentistry/
id/543

Have you
read an
ePaper yet?

New smile, new life: Innovative
technologies and techniques
can transform a smile
By Lorin Berland, DDS, FAACD
& Sarah Kong, DDS
www.dental-tribune.com/
articles/content/scope/specialiYou can access the most recent
ties/section/cosmetic_dentistry/
edition
id/544 of Dental Tribune, Cosmetic

Tribune, Hygiene Tribune, Implant
Tribune and Ortho Tribune as ePaper.
In addition, regular online content
Here’s
some other online
includes dental news, politics,
content
that
might
be of
business and
events,
as well
as clinical
interest
to all
you
content from
the…dental specialities.
Do you speak a language other
Protective
extraoral
and can also
than English?
If so, you
reinforced
access foreigninstrumentation
language ePapers of all
strategies
our international editions: Croatian,
By
Diane Millar,
MAGreek,
Bulgarian,
French, RDH,
German,
www.dental-tribune.com/artiHungarian, Italian, Korean, Polish,
cles/content/scope/specialities/
Russian, Spanish and more!

Andre Rovulus is
handed a package of
heater meals by Peterson Delord (Fontara
47, Port-au-Prince.)
The American Red
Cross is working with
the World Food Programme to distribute
3 million ready-to-eat
meals to earthquake
survivors. (Photo/
Talia Frenkel, American Red Cross)
Through the generous donations by
its employees and contribution matching by Basil Haymann, chairman and
CEO, D4D Technologies was able
to present a check to American Red
Cross representative Emily Allbright
totaling $15,695.78.
D4D continues to accept donations
from its employees and partners in
an effort to make the greatest impact
possible in helping those who are in
desperate need.
The contributions will be used to
help open three hospitals, provide
water and sanitation, and provide
nourishment, clothing and shelter to

Missed the last edition of
Dental Tribune? You can
now read some of its content
online!

section/dental_hygiene/id/545
thousands in Haiti.
“It is important to remember how
fortunate we all are and to recognize
our social responsibility to help those
who are less fortunate,” said Haymann.
“While others may look the other
way, the pain and hardship continues
for our brothers and sisters who have
been affected by this disaster.
“The need in Haiti will not end this
month, or this year, or even five years
from now.”
For more information, or to learn
how you can be a part of the relief
efforts in Haiti, visit www.redcross.
org. DT

Special Operations Forces
dental clinic brings smiles to
Iraqi children
By Jeffrey Ledesma, USA
www.dental-tribune.com/
articles/content/id/535/scope/
politics/region/usa
Ancient teeth question
origin of men
By Daniel Zimmermann, DTI
www.dental-tribune.com/articles/content/scope/news/region/
asia_pacific/id/505

AD

[20] =>

[21] =>

HYGIENE TRIBUNE
The World’s Dental Hygiene Newspaper · U.S. Edition

March 2010

www.dental-tribune.com

Vol. 3, No. 2

How can hygienists ‘straighten up’?

Offering patients information about orthodontic treatment will help the practice
By Keverly Sugden, RDH, BASDH

Hygienists are the health drivers
for the dental practice. We are very
fortunate to be able to create lasting
relationships with our patients.
We see our patients many times per
year. At each visit, we perform comprehensive oral cancer examinations,
thorough periodontal examinations
and caries screenings.
We listen to our patients’ questions,
educate and motivate. We recommend
and explain treatment and listen to
our patients’ wants and desires. Many
patients want straight, white teeth, but
they do not discuss this with the dentist.
The hygienist can open up a dialogue with the patient about desired
treatment by asking a few simple questions. When you ask the patient, “Would
you like straighter teeth?” this can lead
to much information about the patient
and his or her dental desires.
Hygienists understand proper occlusion and can identify malocclusion
and explain this to the patient. Dental
hygienists play a very important role in
identifying patients that require orthodontic treatment, and we are often the

first ones to recognize when a patient
has an orthodontic problem.
We often see the havoc that improper alignment and crowding have on a
patient’s overall oral health.

Ortho 101
The American Association of Orthodontists recommends that all children
receive orthodontic check-ups no

later than age 7. An early orthodontic
checkup enables the orthodontist to
determine if permanent teeth will be
crowded and result in bite problems.
Early treatment can preserve or
create space for erupting teeth and
correct harmful oral habits.
Hygienists need to understand orthodontic appliances and technologies so
they can effectively explain treatment

and the benefit of orthodontic treatment to their patients. Many orthodontists offer seminars to hygienists and
this is a great way to learn about new
techniques in orthodontics.
Many general dentists are offering
Invisalign® to their patients, and this
is another awesome opportunity for
hygienists to learn about orthodontics.
Dentists and orthodontists have to
be certified to perform Invisalign treatment. More than 70 percent of U. S.
orthodontists offer Invisalign.
Invisalign treatment involves clear,
customized aligners that can straighten teeth with fewer visits than traditional orthodontics. The aligners are
unnoticable, comfortable, removable
and effective.
One thing patients always ask about
is time and price. Traditional orthodontics can take between 15 and 30
months and Invisalign takes 9 to 15
months.
There are many types of systems
available for traditional orthodontics.
Orthodontic patients can now customize their look with multicolored bands,
g HT page 3B

New CD-ROM educates patients about oral hygiene
The National Museum of Dentistry has partnered with United Concordia to distribute the MouthPower oral health education CD-ROM
Fred Michmershuizen, Online Editor

Everyone could use a reminder
now and then about the importance of
good oral hygiene.
To that end, the National Museum
of Dentistry, located in Baltimore,
has partnered with United Concordia
Dental to produce a CD-ROM version
of the museum’s popular MouthPower oral health education program.
The CD-ROM, which is modeled
on the museum’s MouthPower online
program, is designed to assist dentists and hygienists in educating their
patients about the benefits of good
oral health.
It will be distributed to 45,000
United Concordia participating dentists nationwide, as well as to those
who request the program through the
museum.
“The secret to a healthy smile is
simple – taking good care of your
teeth,” said National Museum of Dentistry Executive Director Jonathan
Landers, in a press release announcing the CD-ROM. “The MouthPower
program shows kids how to do that in

a fun and educational way.”
The program features the “chatterteeth” character, Mouthie, in an interactive laboratory, where children can
learn how to brush and floss, make
smart food choices and steer clear of
the pitfalls of tobacco.
The CD-ROM includes easy-touse, bilingual lessons and fun activity
sheets that will help children learn
good oral health habits.
“We are excited to partner with
the National Museum of Dentistry
to share this outstanding oral health
education program with our participating dentists,” said Karen A. Whitesel, United Concordia Dental corporate vice president of professional
relations.
“Our hope is that this exciting tool
will help dentists teach their young
patients lifelong habits that maintain
healthy smiles.”
The National Museum of Dentistry’s MouthPower oral health education program teaches children about
good oral health around the world
through its online game (available in
English and Spanish at www.mouth-

power.org), across the country in a
popular traveling exhibit and on site
at the museum in Baltimore in a
hands-on exhibit.
The program is also being adapted
to be used with Head Start programs
in Baltimore and as a mentoring program for Girl Scouts.

United Concordia Dental
Headquartered in Harrisburg, Pa.,
United Concordia Dental is one of the
nation’s largest dental insurers, with
nearly 8 million members worldwide
and 2008 revenues of $1.4 billion.

The National Museum of Dentistry
The Dr. Samuel D. Harris National
Museum of Dentistry, an affiliate of
the Smithsonian Institution, is a lively
national center where visitors discover the power of a healthy smile and
the rich history of dentistry.
Designated by Congress as the official museum of the dental profession
in the United States, the museum’s
collection of 40,000 objects tells the
story of dentistry through changing
and traveling exhibits, school tours

and family days.
Highlights include George Washington’s lower denture, Queen Victoria’s personal dental instruments and
an extraordinary collection of toothbrushes ranging from the 1800s to the
present. Call (410) 706-0600 or visit
www.smile-experence.org for more
information. HT

[22] =>

Editor’s Letter & News

Hygiene Tribune | March 2010

Dear Reader,
During a recent seminar, there
was a pointed discussion about “I
can” vs. “I will.” As I sat there
listening to the lecturer, I began to
think about these two statements
in a way I hadn’t before.
I scribbled the two phrases on
my note pad hoping to reflect on
them after I returned home.
About a month after that meeting I was still thinking about “I
can” vs. “I will” when a situation
arose to help me crystallize it for
myself.
One day, a fellow hygienist
asked if I could help her find
someone to fill in at her office
for two days during a planned
absence. I of course said, “Yes, I
can.” To both of us this actually
meant, “Yes, I will.”
In actuality, I was successful
locating a fill-in for one day, but
not the other. When I realized I
might not find someone to fil in the
second day I began contemplating
covering the day myself.
“I can work that day,” I thought,
but I didn’t make the statement,
“I will work that day,” until I had
exhausted all other possibilities.

My point here is that saying “I
can” didn’t mean I wanted to. Not
until I had no other choice did my
thought become, “I will.” However,
once my train of thought switched
to I will, real action took place.
As a result of this, I have realized that our professional world
is made up of those who choose
either an “I can” or “I will” mentality.
When you treat patients, do you
think about what you can do and
then opt not to because you don’t
want to? Do you live in an “I can”
world until there are no other
options and only then switch to “I
will”?
Hygienists with an “I can” mentality are not treating patients optimally. Although living in an “I can”
world is easy, it is an “I will” world
where the rubber meets the road
and patients are truly taken care of
to the best of our abilities.
Here is another thought: Maybe
there needs to be a third statement
added to this lecturer’s discussion:
1) “I can.” 2) “I will.” 3) “I
must.”
We owe to our patient’s to

HYGIENE TRIBUNE
The World’s Dental Hygiene Newspaper · U. S. Edition

Publisher & Chairman
Torsten Oemus
t.oemus@dental-tribune.com
Vice President Global Sales
Peter Witteczek
p.witeczek@dental-tribune.com
Chief Operating Officer
Eric Seid
e.seid@dental-tribune.com
Group Editor & Designer
Robin Goodman
r.goodman@dental-tribune.com
Editor in Chief Hygiene Tribune
Angie Stone RDH
a.stone@dental-tribune.com
Managing Editor/Designer
Implant Tribunes & Endo Tribune
Sierra Rendon
s.rendon@dental-tribune.com

decide if the answer we choose is
in the best interest of our patients’
oral hygiene. HT
Best Regards,

Survey/Research Center will be
launched.
The goal for the ADHA Survey/
Research Center is to become the
professional association resource
for information on the dental
hygiene profession and to support
data/information needs for ADHA
on the national, state and local
level.
“Advancing the dental hygiene

Online Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.
com
Product & Account Manager
Mark Eisen
m.eisen@dental-tribune.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dental-tribune.com

Angie Stone, RDH, BS

ADHA set to launch
Survey/Research Center
The American Dental Hygienists’ Association, the largest
national organization representing the professional interests of
more than 150,000 dental hygienists across the country, recently
announced that in concert with
its Strategic Plan commitment to
operational excellence through the
use of data- and knowledge-based
decision making, that a new ADHA

Managing Editor/Designer
Ortho Tribune & Show Dailies
Kristine Colker
k.colker@dental-tribune.com

profession and building our association require solid data to facilitate
the decision-making process,” said
ADHA President Lynn Ramer, LDH.
“Increasingly, top performing
professional associations consistently use data for decision making. The ADHA Survey/Research
Center will formalize the data
gathering process for our profession and allow us to make solid,
data based decisions.”
McKenzie Smith, MPH, MEd,
will be responsible for directing
the ADHA Survey/Research Center and will oversee association
research initiatives in his capacity
with the center.
“This is an exciting development
for the ADHA. The establishment
of the ADHA Survey/Research Center is the first step toward building
our dental hygiene research capabilities and working with a broad
array of users including corporate
partners, government agencies
and national and state groups who
need the latest data on the profession of dental hygiene,” said ADHA
Executive Director Ann Battrell,
RDH, MSDH.
For more information on the
activities of the ADHA Survey/
Research Center, contact McKenzie Smith at surveycenter@adha.net
or visit www.adha.org. HT

Sales & Marketing Assistant
Lorrie Young
l.young@dental-tribune.com
C.E. Manager
Julia E. Wehkamp
j.wehkamp@dental-tribune.com

Dental Tribune America, LLC
213 West 35th Street, Suite 801
New York, NY 10001
Tel.: (212) 244-7181
Fax: (212) 244-7185

Published by Dental Tribune America
© 2010 Dental Tribune America, LLC
All rights reserved.
Hygiene Tribune strives to maintain
utmost accuracy in its news and clinical
reports. If you find a factual error or
content that requires clarification, please
contact Group Editor Robin Goodman at
r.goodman@dental-tribune.com.
Hygiene Tribune cannot assume
responsibility for the validity of product
claims or for typographical errors.
The publisher also does not assume
responsibility for product names or
statements made by advertisers. Opinions
expressed by authors are their own and
may not reflect those of Dental Tribune
America.

Tell us what you think!
Do you have general comments or criticism you would like to share? Is there
a particular topic you would like to see
articles about in Hygiene Tribune? Let
us know by e-mailing feedback@dentaltribune.com. We look forward to hearing
from you!
If you would like to make any change
to your subscription (name, address or
to opt out) please send us an e-mail
at database@dental-tribune.com and be
sure to include which publication you are
referring to. Also, please note that subscription changes can take up to 6 weeks
to process.

[23] =>

Clinical

Hygiene Tribune | March 2010
f HT page 1B
clear bands or the traditional metal
brackets. Teens and children like the
idea of having a choice and creating their own personal style. Brackets
come in gold, ceramic and stainless
steel.
There are various types of appliances that are also used with traditional orthodontics. Head gear is
used on patients with an overbite.
The headgear gently restricts forward
growth of the maxillary teeth. The
Herbst Appliance is used on younger, growing patients and reduces the
overbite by encouraging the lower
jaw forward and the maxillary molars
backward.
The palatal expander puts gentle
pressure on the maxillary molars and
expands the palate. Positioners are
clear, plastic appliances that complete traditional orthodontics and are
an interim treatment between braces
and a retainer. Retainers can be fixed
or removable and hold the teeth in
position when orthodontics has been
completed. Seperators are small rubber bands that are placed before braces to space the teeth and ready them
for brackets.

Hygiene after ortho treatment
Hygienists continue their role with
the orthodontic patient by providing
home care instruction and products

for preventative care. Orthodontic
patients are at a very high risk for
demineralization, the dreaded white
spots.
White-spot lesions are the earliest microscopic evidence of enamel
caries. Once saliva pH reaches 5.5
or lower, acid begins to dissolve the
enamel. Teens are one of the main
age groups in braces and one of the
main groups to use sports drinks and
sodas. These beverages have a pH
almost as low as battery acid: their pH
is about 2.3 and battery acid is 1.0.
There are many types of remineralization products. MI Paste or
MI Paste Plus, available through GC
America, combines amorphous calcium phosphate (ACP) and casein
phosphopeptide-amorphous calcium
phosphate CPP-ACP, also known as
Recaldent™.
Tricalcium phosphate, TCP, is
available in Clinpro 5000. Calcium
sodium phospho-silicate is also available in many professional and overthe-counter products. Fluoride and
remineralization products should be
used in combination in orthodontic
patients to prevent white spot lesions.
Xylitol is another necessity for
orthodontic patients. Xylitol reduces the bacteria that cause caries.
Xlear manufactures the Spry Dental Defense System® that contains
an oral rinse, toothpaste, oral mist,
mints and gum.

A final word

Orthodontic patients face challenges
in home care and maintaining gingival health. Electric toothbrushes,
such as Sonicare by Phillips and
Oral-B by Braun, are excellent products that make for easier and more
effective homecare for the orthodontic patient. Water-pik by Teledyne
and the in-shower H20 irrigator are
both very useful home care tools as
well.
Adults, teens, children and parents
need to understand periodontal disease and the destructive effect of periodontal bacteria. OralDNA manufactures a saliva test, MyPerioPath, that
determines the patient’s periodontal
bacteria. The dentist and hygienist can
then recommend antibiotic therapy to
reduce these bacteria.
Remember, orthodontic patients
have invested heavily in their mouths
and they want a pretty smile after
treatment. We owe it to our patients to
explain, educate and motivate about
technologies, treatments and products
that will make their orthodontic treatment a success.
Of course, it goes without saying
that hygienists need to do a thorough
periodontal examination on all
patients. Technologies like the
DentalR.A.T. 2.0., developed by hygienist Becky Logue, make periodontal
charting easier by incorporating a foot
pedal that can be used while doing

computerized periodontal charting.
(You can get more information at
www.dentalrat.com.) Also, American
Eagle Instruments (www.am-eagle.
com) offers lightweight, ergonomic
instrument handles with XP technology tips that stay sharp. HT

About the author
Keverly
Sugden RDH,
BASDH, is an
author, speaker and practicing dental
hygienist.
She is also an
adjunct faculty member at
State College
of Florida.
Sugden is a member of the
American Dental Hygiene Association, a vice president for her local
component and works with local
legislators on access to care for
children.
She has written a training program for large group dental practices and has organized corporately
sponsored continuing education
courses for dental hygienists.
Sugden can be contacted at keverly
sugden@yahoo.com.
AD

[24] =>

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