DT U.S. 1310

ADA redesigns its website / News / Diagnose this... white lesions (Part 2 of 3) / ‘She has computer experience ...’ (just not the kind your office needs) / What every dentist should know about lease agreements / Making a good ‘first impression’ / CDA Meeting / IDEA: worldclass - hands-on education in the San Francisco Bay Area / Industry News (part1) / Industry News (part2)

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

May 2010

www.dental-tribune.com

Vol. 5, No. 13

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

Diagnose this, part II

Join oral pathologist Dr. Malhotra for part II of
this series on white lesions.
u page 5

Signing a commercial lease?

Learn from our newest author about what to
u page 11
consider before signing anything.

Have a good ‘impression’?

The ability to take good ones is amazing considering
the environment we work in.
upage 14

ADA redesigns its website
By Fred Michmershuizen, Online Editor

In an effort to make comprehensive oral health information easier to
access, the American Dental Association has redesigned its website, located
at ADA.org.
The site has many features that are
designed for both dental professionals
and the general public.
“The new ADA.org represents the
collective input from our members
and the public and provides enhanced
navigation tools for easier access to
the wealth of oral health information
we have online,” said Dr. Ronald L.
Tankersley, ADA president, in a press
release announcing the changes.
“This information includes tools
needed for practice management and
continuing education as well as news
about the latest developments in oral

health care.”
Highlights of the new ADA website
include the following:
• An enhanced “Find-a-Dentist”
feature with updated profile information and photos.
• A “Professional Resources” section where ADA members can find
tips and tools to help them thrive in
challenging economic times.
• “Education and Careers” with
information about licensure, education and online C.E. opportunities.
• “Science and Research,” which
features evidence-based dentistry
resources and dental standards.
• “Advocacy,” which addresses the
ADA’s efforts on behalf of the dental
profession on Capitol Hill and in state
capitols across the country.
The redeveloped site continues to
offer news and extensive informa-

Industry News

Small diameter implants
in prosthetic dentistry
Conventional complete dentures in
the mandible are among the least
predictable and least satisfactory treatments in prosthetic dentistry. The
placement of dental implants in the
edentulous mandible for the purpose
of supporting and retaining an over-

denture greatly improves both prosthetic predictability and patient satisfaction.
Despite a 30-year record of advance
and success with dental implants, several aspects of oral health in the 21st
century United States suggest that an
g DT page 24

Dental Tribune America
213 West 35th Street
Suite #801
New York, NY 10001

By Eugene LaBarre, DMD, MS

tion for members
of the public on
hundreds of dental topics, ranging
from basic dental
care to baby’s first
tooth to gum disease to tooth whitening.
According to
the ADA, the website redesign is the
result of 18 months
of research, planning and design.
“Refinements
to ADA.org will
continue as we
build on our efforts to make our general and proprietary oral health information easily attainable for ADA members,” Tankersley said.

(Photo/ADA.org)
“This will assist members in offering the highest level of patient care and
maintaining thriving practices.” DT

Dentistry in the land of Mickey
Go for the dentistry,
but stay an extra
day or two for the
rollercoasters and
all the other fun to
be had in Anaheim.
g See page 18

(Photo/stock.xchng.com)
AD

PRSRT STD
U.S. Postage
PAID
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Mechanicsburg, PA

[2] =>

News

Dental Tribune | May 2010

More cool stuff for your practice

DENTAL TRIBUNE
The World’s Dental Newspaper · US Edition

By Fred Michmershuizen, Online Editor

Publisher & Chairman
Torsten Oemus
t.oemus@dental-tribune.com

Kill germs with anti-

Vice President Global Sales
Peter Witteczek
p.witteczek@dental-tribune.com
Chief Operating Officer
Eric Seid
e.seid@dental-tribune.com

bacterial toothbrush covers
There are a lot of germs around
these days, including many pathogens that can harm children.
For parents who want to reduce
the risk of exposure and infection,
there’s a new snap-on toothbrush
sanitizer available from Dr. Tung’s,
a Kaneohe, Hawaii-based company
specializing in natural oral care
products.
The device snaps on over the
toothbrush head and releases antibacterial vapors onto the bristles.
“The best part is that the sanitizer uses a proprietary blend of
only natural essential oils to do
the germ killing, so children are
not exposed to unnatural, harsh
chemicals,” the company explains.
To make the device fun for children to use, lions and pandas are
pictured to “eat away” the germs.
According to Dr. Tung’s, the
covers are 100 percent biodegradable and will turn into biomass
within one to five years.
“With children being exposed
to more germs now than in the
past decades — and with germs
seeming more resistant than ever
— parents would do well to find
ways and means to reduce the risk
of exposure and infection,” a com-

Group Editor & Designer
Robin Goodman
r.goodman@dental-tribune.com

(Photo/Provided by White Towel
Services)
(Photo/Provided by Dr.Tung’s)
pany representative noted.
The sanitizer will soon be available in specialty stores such as
Bed, Bath & Beyond and in natural supermarkets such as Whole
Foods. More information can be
found online, at www.drtungs.com.

Pamper your patients
with heated towels
Want to make your patients feel
like they are in the lap of luxury
when they are sitting in your chair?
You might let them refresh
themselves with warm, moist towels available from White Towel
Services, a Fort Worth, Texasbased company.

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.
AD

The pre-moistened, individually wrapped towels come in several different options, from gently
scented, 100 percent cotton to a
synthetic fabric. Scented varieties
are also available.
The single-use, disposable towels are designed to help you offer a
touch of first-class service to your
patients.
The towels can be loaded into
a warmer to be used as needed
throughout the day. And if cold
towels would be better, you can
store them in a refrigerator or ice
chest.
To learn more, visit White
Towel Services online at www.
whitetowelservices.com — or watch
for the company at an upcoming
dental meeting. Just watch for the
people handing out the refreshing
towels. DT

Fight oral
cancer!
Did you know that dentists
are one of the most trusted professionals to give advice?
Prove to your patients just
how committed you are to fighting oral cancer by signing up to
be listed at www.oralcancerself
exam.com.
This website was developed
for consumers in order to show
them how to do self-examinations for oral cancer.
Early detection in the fight
against cancer is crucial and a
primary benefit in encouraging
your patients to engage in selfexaminations.
As dental patients become
more familiar with their oral
cavity, it will stimulate them to
receive treatment much faster.
If dental professionals do not
take the lead in the fight against
oral cancer, who will?
And in the eyes of our
patients, they likely would not
expect anyone else to do so —
would you? DT

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] =>

News

Dental Tribune | May 2010

Americans line up for free care

f DT page 2A
TK DT

By Fred Michmershuizen, Online Editor

Despite the passage of health
care reform legislation earlier this
year, many Americans today lack the
financial resources to afford medical
and dental care.
As a result, thousands of patients
are lining up at events in places
such as Los Angeles, Chicago and
even Idaho Falls, Idaho, to receive
free care.
One nonprofit volunteer organization, called Remote Area Medical (RAM), staged a weeklong free
clinic in Los Angeles from April 27
to May 3.
At the event, at which volunteer
medical and dental practitioners
offered free care daily from 6 a.m.
until 6 p.m., the demand for services
was so high that a wristband system
was put in place to ensure the orderly handling of the large numbers of
people who showed up.
RAM was founded in 1985 by Stan
Brock to offer free health-care services, including dental and vision
care, to people in underdeveloped
countries. Since then, the organization has also been running free clinics here in the United States.
“There really is a problem here
in the United States,” Brock told CBS
News. “It’s not just in the Amazon
and in places like Haiti.” Today,
Brock said, “64 percent of everything we do is here in America.”
Over the years, RAM has successfully held hundreds of free clinics
providing services to thousands of
men, women and children.
According to the organization,
dental services are one of its core
offerings and have provided relief to
thousands of patients over the years.
Poor dental health is a common
problem in the hills of the southern
Appalachians, where RAM’s services
are desperately needed.
Patients often arrive with serious dental problems, often affecting
their overall health. In a single visit,
many of these can be improved.
The RAM dental program has
grown from offering only emergency extractions in the early days
to include restorations, cleanings,
fluoride treatments and oral hygiene
instruction today.
Even advanced procedures, such
as dentures and simple root canals
for anterior teeth, can be performed.
Dedicated volunteer dentists provide services free of charge.
In all, 300 medical volunteers
served 1,200 patients a day for the
recent weeklong RAM event in Los
Angeles. At a RAM event there in
2009, more than 6,000 patients were
treated.
But not all free care events are so
large. In Idaho Falls, Idaho, recently,
Dr. Tom Anderson of Premier Dental
Care organized a local event called
“Great Friday” in which 40 professional volunteers treated more than
100 people, some of whom had to

wait more than five hours.
“It was so much fun, and the
patients were so gracious,” Anderson told Dental Tribune.
Two other dentists — Dr. Gene
Hoge of Pocatello, Idaho, and Dr.
John Hisel of Boise, Idaho — also
participated.
Anderson credited his wife, Lisa,
for organizing the event. He also
said companies like Sullivan Schein
Dental provided much-needed supplies and equipment. Anderson said
Shae Davis and Dennis Everly of
g DT page 4

About 40 dental professionals donated their time for ‘Great Friday.’ (Photos/
Provided by Premier Dental Care)
AD

[4] =>

4

News

Dental Tribune | May 2010

NCOHF video raises awareness of
pediatric dental disease
By Fred Michmershuizen, Online Editor

To help raise awareness of the
fight against pediatric dental disease,
the National Children’s Oral Health
Foundation: America’s Toothfairy
(NCOHF) has released a public service announcement video as part of
a continued effort against the No.
1 chronic childhood illness in the
United States.
The video — “America’s Toothfairy: Transforming Children’s Lives”
— was produced to educate the general public about the prevalence of
pediatric dental disease and highlight
the measures that the NCOHF nonprofit affiliate health-care facilities are
taking to provide underserved children nationwide with compassionate,
comprehensive oral health care.
“Millions of children are suffering
in silence from oral pain so severe

f DT page 3
Sullivan Schein were particularly
helpful.
Events like “Great Friday” come
at a welcome time for many people.
Many of the benefits of the new
health care legislation won’t kick
in for several more years, but even
when they do dental care will still be
unaffordable to many.
So it’s no surprise that with the
current state of the health-care system, such free care events, both
large and small, are likely to continue.
For its part, RAM is planning to

that it impacts their ability to eat,
sleep and learn on a daily basis,” said
Fern Ingber, NCOHF president and
CEO.
“With access to basic preventive
care and simple educational tools,
pediatric dental disease is completely
preventable. We hope this film will
create a robust public dialogue surrounding our country’s oral-health
epidemic and encourage increased
support for nonprofit health-care centers that work tirelessly with limited
resources to eliminate this disease
from future generations.” Two dental
health-care professionals video offer
their comments in the video.
“Dental caries is still very much
a disease, in fact it is the most common chronic disease in childhood,”
says Dr. J. Timothy Wright, professor
and chair of pediatric dentistry at the
University of North Carolina School

of Medicine. “Oral health is one of the
leading causes of children not being
in school.”
Dr. Rocio Quinonez, clinical associate professor at the University of
North Carolina School of Dentistry,
said, “We as a profession certainly share the same mission as the
NCOHF, and that is to get to kids
early enough so that we can not only
prevent disease but change the trajectory of oral health and general health
outcome.”
“America’s Toothfairy: Transforming Children’s Lives” was produced
by Emulsion Arts Film Production Co.
with funding from DENTSPLY International, a dedicated NCOHF underwriter.
The video may be viewed on the
Dental Tribune website’s media center, located at mediacenter.dentaltribune.com. DT

hold another free clinic Aug. 26 to 28
in Chicago, in response to that city’s
large number of medically underserved people.
“We are making a statewide plea
for Illinois-licensed dentists, ophthalmologists, optometrists, general
medical physicians, nurses, dental
hygienists and other medical specialists,” the organization said in a
recent press release.
Currently licensed dentists in any
state are invited to contact RAM to
learn more about volunteering.
Dental professionals may contact
RAM at volunteer@ramfreeclinic.org
or visit www.ramfreeclinic.org. DT

Dr. John Hisel of Boise, Idaho, is one of the dentists who participated in a
‘Great Friday’ special event offering free dental care.

AD

Visit us at the CDA Anaheim Booth #156

Children who have received care
thanks to the efforts of the National
Children’s Oral Health Foundation:
America’s Toothfairy are featured
in a new video. (Photo/Provided by
NCOHF)

[5] =>

Oral Pathology

Dental Tribune | May 2010

5

Diagnose this … white lesions

Part II of III
By Monica Malhotra

the pattern and site given:
A 28-year-old healthy male presented with the chief complaints of
mobility of tooth #33, sensitivity on
the lower left side of his teeth and a
non-scrapable, white, fissured patch
in the lower labial mucosa.
The patient had a habit of chewing smokeless tobacco for the past
two to three years.
1) The most suitable differential
diagnosis (D/D) is:
a. Oral submucous fibrosis (OSF)
b. White sponge nevus (WSN)
c. Tobacco pouch keratosis(TPK)
d. Verrucous carcinoma (VC)
e. Factitial injury
(Go to page 6 for the answer)
Let’s proceed step-by-step and
assemble all the clues toward a
diagnosis.

Clue No. 1
Age/sex/general health
• 28-year-old healthy male
2) We can’t exclude any differential
because of the variations seen with
respect to age/sex/general health,
but a few things should be remembered by solving the matching exercise given below. Match the lesion
with the correct age of occurance.
a. Verrucous carcinoma (VC)
occurs during old age / at birth or
during early childhood.
b. White sponge nevus (WSN)
occurs during old age / at birth or
during early childhood.

Clue No. 2
Affecting the dentition
3) Which of the lesions given below
can cause mobility and sensitivity
(circle all that apply)?
a. Oral submucous fibrosis (OSF)
b. White sponge nevus (WSN)
c. Tobacco pouch keratosis (TPK)
d. Verrucous carcinoma (VC)
e. Factitial injury

Clue No. 3
4) Mark scrapable (S) or nonscrapable (NS) next to the following
lesions:
a. Oral submucous fibrosis (OSF)
b. White sponge nevus (WSN)
c. Tobacco pouch keratosis (TPK)
d. Verrucous carcinoma (VC)
e. Factitial injury

Clue No. 4
Pattern and site
• White fissured plaque in the lower
labial mucosa.
5) Please write the D/D in front of

a. White, thin, almost “translucent” plaque with a border that
blends gradually into the surrounding mucosa. Usually in mandibular
vestibule.
b. White, thickened, shredded
areas exhibiting a ragged surface.
g DT page 6

(Photo/Dr. Monica Malhotra)
AD

[6] =>

Oral Pathology

f DT page 5

following.

Most common on the anterior buccal mucosa, labial mucosa and lateral border of tongue.

Factitial injury (morasicato
buccarum/labiorum/linguarum)

7) Mark true (T) or false (F) next to
the following questions:
a.This lesion can also occur
because of smoking tobacco.

f. Histologically, shows parakeratin chevrons, acanthosis, intracellular vacuolization and unusual depo-

t

a. Malignant transformation
potential of TPK is low.
b. Biopsy is needed only for
more severe lesions.
c. Alternating the tobacco chewing sites between left and right
sides will eliminate/reduce. DT

About the author
Dr. Monica Malhotra is an assistant professor
at the Sudha Rustagi Dental College in India and
also maintains a private practice.
Malhotra completed her master’s in oral
pathology at the Manipal Institute, India, in 2009.
In 2008 she was presented with a national
award for the best scientific study presentation by
the Indian Association of Oral and Maxillofacial
Pathology.
You may contact her at drmonicamalhotra@
yahoo.com.

Answers

ADS

Going further

e. Stretching of mucosa reveals
a distinct “pouch” (snuff pouch,
tobacco pouch) caused by flaccidity
in the chronically stretched tissues.

8) Mark true (T) or false (F) next to
the following questions:

1) Tobacco pouch keratosis

At this point, we have three D/Ds
to work upon (excluding OSF and
WSN).
Other features that would help
us reach the diagnosis include the

• Old age
• Usually becomes extensive
before diagnosis
• “Verrucae” show white, welldemarcated, thick plaque with papillary or verruciform surface projections (VC can become a D/D only in
the very early stages because later
it shows verrucae formation).
Thus, we made a diagnosis of
tobacco pouch keratosis.

Treatment and prognosis

2) a. VCN = old age; b. WSN = at birth or during early childhood

6) Mark chewer (C) or non-chewer
(NC) next to the following lesions:
a. Oral submucous fibrosis
b. White sponge nevus
c. Tobacco pouch keratosis
d. Verrucous carcinoma
e. Factitial injury

Identifying features of VC

d. It is seen at the same site
where the coarsely cut tobacco
leaves or finely ground tobacco
leaves (“snuff”) are kept.

g.Epithelial dysplasia is uncommon (if present, mild).

3) a, c, d
Explanation
Mobility of #33 and sensitivity of lower left side of teeth; mobility occurs
because of loss of attachment and loss of bone; sensitivity of a couple of
teeth would occur because of loss of tooth structure or attachment loss; the
two can occur because of the habit of keeping some abrasive material in
the oral cavity. This could be due to the use of “smokeless tobacco” as in
the case of TPK, OSF or VC. We can’t narrow down on this basis as there
could be some other etiology, e.g., incorrect toothbrush dexterity.

Chewing smokeless tobacco for the
past two to three years.

Site
Typically in the area where the
tobacco is habitually placed, e.g.,
mandibular vestibule.

c. Develops shortly after
heavy tobacco use and remains
unchanged indefinitely unless is
habit altered.

sition of amorphous eosinophilic
material in connective tissue and
salivary glands.

4) a, b, c, d are NS. Letter e is NS too, but might be scrapable in a few
cases.

Clue No. 5

Etiology
• Chronic tobacco chewing or
snuff.

b. This is a pre-cancerous lesion.

5) a = TPK; b = factitial injury; 3 = VC); 4 = OSF; 5 = WSN.
Thus, OSF is the only differential we can omit because it never presents
as a plaque.

e. Symmetric, thickened, white,
corrugated or velvety, diffuse
plaques. Affect the buccal mucosa
bilaterally.

Verrucous carcinoma vs. TPK

6) a = C; b = NC; c = C: d =C; e = NC.
Now we can exclude WSN because it is seen at birth or early childhood
and is not associated with chewing.

d. Blotchy, marble-like pallor or progressive stiffness due to
fibrous bands formation. Most often
involves the buccal mucosa or posterior part of oral cavity.

Etiology
• Due to chronic chewing/sucking on mucosa. Associated with
stress or psychologic condition.
• Patients are generally aware of
this habit.
• Infrequently combined with
intervening zones of erythema, erosion or focal traumatic ulceration.

7) a = F; b = F; c = T; d = T; e = T; f = T; g = T

c. The lesion appears as a white
diffuse, broad-based, well-demarcated, painless, thick plaque with
papillary or verruciform surface
projections. Site often corresponds
to the site of placement of tobacco,
e.g., mandibular ridge or gingivae.

Dental Tribune | May 2010

8) a = T; b = T; c = T

6

[7] =>

Dental Tribune | May 2010

Practice Matters

‘She has computer experience …’
(just not the kind your office needs)
How to determine if a potential employee has the necessary skills and experience a position requires
By Sally McKenzie, CEO

“Experience.” It’s a word that conveys different meanings to different
people. When seeking employment,
applicants naturally want to convince
their prospective bosses that they
bring the necessary experience to the
position.
Meanwhile, employers — dentists
specifically — often are in the difficult position of trying to fill vacancies quickly. Many don’t typically
need a lot of convincing that the
applicant with the pleasant smile and
friendly demeanor is the one for their
office, particularly when the applicant asserts that she/he has what it
takes to do the job.

A scenario
Let’s look at “Dr. Carrel.” His business employee of 12 years decided
it was time for a change of scenery
and accepted a position out of state.
That left Dr. Carrel frantically trying
to fill the position. In walks applicant
“Amanda.”
Amanda has worked as a receptionist and a clerk in the children’s
department at a large retail store,
which must mean that she’s good
with people and well organized.
“Both are very important qualities
for this job,” a stressed Carrel notes
to himself.
During the interview, Carrel dutifully covers the usual questions with
Amanda, listening closely for those
things he wants to hear.
“Do you have experience with
scheduling?” asks Carrel.
“Certainly,” Amanda says. Meanwhile, she’s thinking to herself: I
have to get in the shower by 7 a.m.,
make the train by 8 a.m., be at work
by 9 a.m., at the gym by 5:30 p.m. so
I can be out with friends by 8 p.m.
“Yes, I am very good at scheduling.”
“Do you have computer training?”
“Of course,” Amanda says emphatically. In her mind she ticks through
a variety of point and click responsibilities. I know how to buy and sell
on eBay, I have all the important websites organized in my Favorites List
and I have the absolute best Facebook
page, just ask all 500 of my Facebook
friends. “Yes, I have lots of computer
experience.”
“How would you rate your experience in effectively communicating
with others?” asks Carrel.
“Very high,” answers Amanda.
You should see my thumbs go. I can
text message while driving, applying
make-up, even during a movie. “I
consider myself to be an expert communicator.”
As the story goes, Amanda is hired
with the understanding that she is
bringing all her “technical expertise”

to the position.
While the scenario above may
be somewhat exaggerated, it is not
uncommon for practices to hire
new employees that bring “experience,” “knowledge” and “training” in
numerous areas, but oftentimes, it’s
not what the practice needs or what
the job really requires.

Specific computer literacy is
essential
Practice needs and expectations have
changed. Managing a dental practice
has always demanded excellent customer service skills and knowledge
of dental business systems such as
scheduling, financial arrangements,
insurance processing, collection and
billing, recall. etc.
Yet, today the need for specific
computer literacy is significantly
greater.
Even jobs that would not necessarily be described as “technical”
commonly require computer experience or technical skills. Dental
practice employees — both clinical
and business — are often expected
to understand and use spreadsheet,
word-processing and database software.
Although an applicant may bring
some computer experience, it doesn’t
mean she/he has the compulsory
knowledge to access and interpret
necessary reports or compile spreadsheets.
Historically, a college degree in
business was not a requirement to
get a position in the dental business
office, and many people employed
at the front office were former dental assistants or people who were
trained on the job in another practice.
In addition, although most of the
Generations X and Y and Millennials (those coming of age in the new
millennium) have been exposed to
computers virtually their entire lives,
if they do not go on to college or
receive specific training, the skills
often remain elementary.

Yesterday’s expert is today’s
amateur
When hiring someone to manage a
busy practice, formal business training and more than a basic knowledge
of computer software is essential.
The practice management reports
that can be generated by today’s
sophisticated software will tell you
virtually everything you must know
about your practice:
• whether it is growing or declining,
• what procedures are your “bread
and butter,”
• what other services or products
you need to market,

• how many new patients are coming in and how many patients are
leaving,
• how many children you see and
how many adults,
• what percentages of your practice is insurance and what is private
pay,
• what percentage of the insurance base is this company or that
and so on.
The wealth of critical information
is virtually boundless provided that
your team knows how to access and
use it.
If the job requires the employee
to compile spreadsheets using Excel,
but the applicant only has superficial
knowledge of the program, find out
before she/he is on the job.
If staff are expected to compile
letters to patients, doctors, insurance companies and others using
Microsoft Word and the applicant
has no idea how to use the formatting

options within the program, better to
learn that now than discover it in six
weeks.
Don’t allow yourself or your team
to be surprised by what a new recruit
doesn’t know. Test applicants’ skills
before you ever offer them a front
row spot on your team’s bench.
For example, if you’re hiring a
new office manager, this applicant’s
skills should be evaluated in a number of areas. Consider this approach.
First, make up a “dummy” patient
on the computer and ask the applicant to put together a treatment plan
and then schedule the patient for
multiple appointments.
Next, ask the candidate to post
from the treatment plan.
From
there, the applicant should be asked
to gather insurance information on
the “dummy patient.”
Finally, the applicant should be
g DT page 8

[8] =>

Practice Matters

f DT page 7
able to create a treatment proposal
and a financial option sheet. These
are the basics. When the applicant
performs these tasks, you will be able
to observe skill level and decide the
need for additional computer training.
Will the investment necessary to
bring this person up to speed be
too great or do her/his strengths
outweigh the weaknesses? Can the
shortfalls in her/his skill levels be
overcome with proper technical
training?
You’ll have clearer answers to
those important questions if you
carefully evaluate the applicant’s
current skill level. If you choose to
train, make the most of the teaching
opportunities across the entire staff.
If you’re planning to train the new
employee in-house, consider exactly
who is going to take on that responsibility. If it’s you, the dentist, do you
plan to see patients in the morning
and clear your afternoons so that you
can teach the new employee how to
use the systems?
Chances are great that you have
neither the time nor the inclination
to take on this responsibility. If the
responsibility falls to another staff
member, do you plan to pay her/him
extra so that training the new recruit
can take place after hours?
What is the competency level of
the person training the new employee? Is this person the “beneficiary” of
layers of information that have been
passed down from one worker to
the next and still just trying to figure
things out herself/himself? Alternatively, is the trainer truly an expert
on how to use the systems fully and
effectively?

Training? Make it real and relevant
Certainly, well-trained staff can be
helpful in familiarizing new employ-

Dental Tribune | May 2010

Office manager skills test for new hires
Step 1: Create a ‘dummy’ patient in the computer.
Step 2: Ask the applicant to:
• assemble a treatment plan for this patient.
• schedule multiple appointments for this
patient.
• post from the treatment plan.
• gather insurance information on this patient.
• create a treatment proposal.
• create a financial option sheet.
Step 3: Now that you know the applicant’s skill
level, ask yourself:
• Will the investment necessary to bring this
person up to speed be too great?
• Do the applicant’s strengths outweigh her/his
weaknesses?
• Can the shortfalls in her/his skill levels be
overcome with proper technical training?

ees with computer systems, but plan
to budget for professional training
and make the most of those dollars
spent.
Take specific steps to build a lineup of software superstars with an
effective training system.
Bring the software trainer in to
teach the employee specific skills
and document each session so that
the new employee, as well as others
in the practice, can review steps for
completing specific tasks and check
their level of mastery.
Keep the documentation in your
Dental Business Training Manual
along with a checklist of computer

system skills specific to your practice that each employee should have
mastered.
Each time you integrate new technology or make use of a new tool
in your computer software, add the
training steps to your training manual.
This will allow seasoned staff to
review procedures that they don’t
use regularly and new staff to master new systems more quickly and
efficiently.
Finally, remember the threemonth rule of thumb. In general,
it takes three months of supervised training to get a new hire up

Visit us at the CDA Anaheim, booth no. 415.

to speed. Don’t assume that new
hires know every aspect of their job
because they say they do.
Monitor a new hire’s performance
during the 90-day training period
and have a senior team member
check the accuracy of the work with
the intention of coaching, not criticizing.
Front office accuracy in new
patients, collections, production and
retention can be checked by the
daily and monthly reports run by the
computer. tInstructions on reading
these important reports should also
be incorporated into the curriculum
no matter which system you are
using. DT

About the author

Sally McKenzie is CEO of
McKenzie Management, which
provides success-proven management solutions to dental practitioners nationwide. She is also
editor of The Dentist’s Network
Newsletter at www.thedentists
network.net; the e-Management
Newsletter from www.mckenzie
mgmt.com; and The New Dentist™ magazine, www.thenew
dentist.net. She can be reached
at (877) 777-6151 or sallymck
@mckenziemgmt.com.

[9] =>

[10] =>

[11] =>

Practice Matters

Dental Tribune | May 2010

What every dentist should
know about lease agreements
By Stuart J. Oberman, Esq.

Whether you are starting a dental
practice from scratch or purchasing
an existing dental practice, your commercial lease agreement will be a
very important part of the process, not
to mention a huge investment.
Before you sign a lease agreement
and spend thousands of dollars over a
five to 10-year period, you should seek
legal counsel.

Lease commencement date
Once your lease is signed, you and the
property owner have opposite goals.
The property owner wants the lease
to start as soon as possible so that you
can begin paying rent immediately,
even though your office space may
still be under construction.
Conversely, the tenant wants to
delay the payment of rent as long as
possible in order to preserve capital.
If your property owner or contractor
is building out your office space, it
is important that you give him/her

detailed construction plans in order to
avoid any type of construction problems or delays.
However, it is also very important
to ensure that your payment of rent
does not start until the construction
work has passed inspection, and you
receive a Certificate of Occupancy,
which will allow you to occupy your
office space and start seeing patients.
Many lease agreements provide
that the build-out will be deemed
complete when the contractor or
architect certifies that the construction has been “substantially completed.” (An architect should be consulted
before construction begins.)
If you receive a Certificate of Occupancy and certain construction items
still need to be completed, this is usually called a “punch list” of items that
will be completed by the contractor
after your dental practice is open for
business. If you are building out your
office space, you should select the
most-qualified contractor and negotiate an appropriate build-out period

(i.e., generally 90 to120 days).
You may also want to insert a “liquidated damages clause” in your construction contract, which states that if
construction delays occur through no
fault of your own and the opening of
your practice is delayed, the contractor will pay your rent for a specified
period of time or pay you a certain
sum of money.
In addition, if your property owner
is building out your dental office, you
may seek free rent for a specified
period of time if the construction is not
completed within a specified period.

Rent increases
Nearly all lease agreements have a
rent escalation clause, which states
how much your rent will increase
over the term of the lease.
Escalation clauses may either be
specifically outlined in the lease (i.e.,
rent increases 3 percent per year)
or tied to an index, such as the Consumer Price Index (CPI). The best
practice is to set an exact amount of

rent you will pay each month over the
term of the lease. Any type of yearly
rent increase that is tied to an index is
very unpredictable and can hinder the
cash flow of a practice.

Rent during option periods
When negotiating your lease, you
should always include an option
period to renew your lease, and the
option period should specify the exact
amount of rent you will pay during the
option period.
The lease agreement will usually contain one or two methods that
will be used in order to calculate the
amount of rent you will pay during
the option period, which are: (1) rent
increase that is tied to the CPI or (2)
the prevailing market rent.
The option period should specifically state the rental period (usually
five to 10 years), and the amount of
rent you will pay for each option year
(i.e., during months 61 thru 72, rent
g DT page 13
AD

[12] =>

[13] =>

Dental Tribune | May 2010
f DT page 11
shall be $2,500).

Damage to office
What happens if your dental office is
damaged by fire or some other casualty loss, and you are unable to occupy
the building for four to six months?
Needless to say, this could devastate
your dental practice.
Many lease agreements impose no
real obligation on the property owner
to rebuild the damaged premises. In
fact, most lease agreements give the
property owner the greatest flexibility in determining whether or not to
rebuild a damaged office space.
By contrast, the tenant is typically required to move back into the
office space within a short period of
time after the office space has been
repaired.
Therefore, every lease should
include a provision that will allow a
tenant to terminate the lease if the
property owner has not completed
restoration of the office space within
a specified period of time. As a precaution, a lease should contain the
following requirements:
• That the property owner carry
full replacement-cost insurance on
the building.
• The property owner commence
repairs within 30 days of the loss and
complete the repairs within 120 days
of the loss.
• The tenant may terminate the
lease agreement if repairs are not
completed within a specified period of time. In addition, as a tenant,
you should always carry insurance
to cover the cost of any type of tenant
improvements and equipment.

Lease assignment upon sale
of the practice
The property owner always has the
option to grant or deny a tenant’s
request for an assignment of an existing lease. Imagine if you enter into a
contract to sell your dental practice,
and your property owner will not
assign your lease to the purchaser.
Ideally, a practice sale agreement
should contain a clause that states
the sale of the practice is contingent
upon the property owner assigning
your lease to the purchaser or the
property owner entering into a new
lease agreement with the potential
purchaser of your practice.
In today’s market, the growing
trend is to hold a previous tenant liable for the terms of their existing lease
agreement, even though a new tenant
(the purchaser of a dental practice) is
now occupying the space.

Other areas of concern
What happens to a tenant’s obligation
under a lease agreement if a tenant
dies or becomes disabled? Generally,
a property owner will not permit a
tenant or his/her estate to be absolved
of liability in the event of death or disability.
In most cases, unless otherwise
specified, a tenant or his/her estate
will be required to pay the specified
rent according to the terms of the
lease agreement, even if a tenant dies

or becomes disabled. Therefore, a
tenant should always attempt to negotiate a release (“buy-out”) or termination of the lease in the event of his/her
death or disability.
In addition, many leases contain
relocation clauses that state a property owner may move a tenant to
another location within the building
or complex. As a result, a relocation
clause must be carefully reviewed.

Summary
It is important to remember that the
property owner or his/her attorney
drafted the lease agreement. You
should always seek legal advice
before you sign a lease agreement.
As a tenant, if you fail to do your
due diligence, it may be a very costly
mistake. DT

Practice Matters

About the author
Stuart J. Oberman, Esq., has
extensive experience in representing dentists during dental
partnership agreements, partnership buy-ins, dental MSOs, commercial leasing, entity formation (professional corporations,
limited liability companies), real
estate transactions, employment
law, dental board defense, estate
planning and other business
transactions that a dentist will
face during his or her career.
For questions or comments
regarding this article, visit www.
gadentalattorney.com.
(Front Page Photo/Dreamstime.com)
AD

[14] =>

14
AD

Clinical

Dental Tribune | May 2010

Making a good
‘first impression’
By Todd Snyder, DDS

The ability to take a good
impression is nothing short
of amazing when considering
the environment we work in:
upside down, under water and
in the dark.
The
impression
technique has evolved considerably from the days of plaster
impressions, copper bands
and hydrocolloid.
You would think with all of
the modern technology and
science we would be capturing an amazing reproduction
of the oral environment within the blink of an eye.
Today there are many
materials and devices on the
market that can make the process easier for everyone and
provide great results too.
Current impression technologies have many forms
available to fit the needs of
each practitioner. The digital impression technique has
created quite a lot of interest
within the dental community.
Systems such as the CEREC
AC by Sirona, iTero by Cadent
and the Lava COS by 3M ESPE
all have a lot to offer dentists when compared to the
traditional cumbersome technique.
Avoiding a messy two-step,
putty wash system makes it
nice for patients in terms of
not having a mouth full of
impression material for many
minutes. Additionally, the
level of accuracy with digital
impressions is nothing short
of superb.
All of the units have various
proprietary software and capture devices, but for the most
part a large wand/capture
device on it takes a digital
image that can then be used
to create a three-dimensional
model.

Minor points of contention
Some minor grievances that
have been discussed with the
systems are that the quality of
the models that are fabricated
for some of the systems are
not as nice as hand-poured
models, and the turnaround
time to get models from the
fabricating companies can
sometimes be lengthy.
These are minor inconveniences when compared to
tissue and fluid management
during impression taking.
These are the biggest obstacles in capturing a quality
dental impression, neither of
which is addressed with these
modern marvels unless your
preparation margin is supragingival. In addition, the current price point may displace
some users from investing in
the technology.
The next generation intraoral scanners could quite possibly have technology that can
look through gingival tissues,
crevicular fluid and blood
to find the cavosurface margin without having to jump
through the same hoops of
tissue and fluid management.
These systems will become
a better investment regardless
of cost when that becomes a
reality.

Keeping tissues and liquids
at bay
Until the next level of technology evolves, we will all still
have to contend with moisture
and tissue retraction to expose
the elusive cavosurface margin. Fortunately, various combatant solutions and devices
can be used to hold tissues
and liquids at bay.
Hemostatic materials such
as Viscostat (Ultradent) and
Hemostasyl (Kerr Corporation) are excellent in handling bleeding issues. Simply

scrubbing either liquid into a
bleeding capillary will typically cause hemostasis. Rinse
the area vigorously to allow for
removal of any excess material
and identify any additional or
stubborn capillaries that need
more attention.
For displacement of gingival tissues, there is nothing
better than the placement of
the single or double retraction
cord techniques.
A single cord can work very
well at displacing tissues,
however, it will either need to
be removed, which can cause
bleeding, or if left in during
the impression technique it
will need to be pushed past
the margin enough to leave
the margin exposed along with
additional root surface.
Many dentists opt for the
double cord technique with
a small cord placed followed
by a larger second cord to
help with tissue displacement. When it is time for the
impression, the second cord is
removed leaving the smaller
cord behind.
Some interesting alternatives can be used instead of a
second cord or, in some cases,
in place of cords all together.
Products such as Expa-syl
(Kerr Corporation) and other
soon-to-be-released products,
are allowing for some decent
tissue expansion and hemostasis at the same time. After
placement, these materials
can either be washed out of
the gingival sulcus or lifted out
with an instrument.

Preparation technique
Although oftentimes overlooked, the preparation technique can provide substantial
benefits to control bleeding
issues. Preparing the tooth
structure along the gingival
tissues in a clockwise manner

Invest in your practice with HSFS
Henry Schein Financial Services (HSFS) business solutions
portfolio offers a wide range of
financing options that make
it possible for you to invest in
your practice for greater efficiency, increased productivity
and enhanced patient services.
HSFS helps health-care
practitioners operate finan-

cially successful practices by
offering complete leasing and
financing programs.
HSFS can help obtain
financing for equipment and
technology purchases, practice
acquisitions and practice startups.
HSFS also offers value-added services including credit

card acceptance, demographic
site analysis reports, patient
collections, patient financing
and the Henry Schein Credit
Card with 2 percent cash back
or 1 1 / 2 points per dollar spent.
For additional information,
please call (800) 443-2756 or
send an e-mail to hsfs@henry
schein.com. DT

[15] =>

Clinical

Dental Tribune | May 2010

Fig. 1: Dual cord technique where
the remaining cord came out in the
impression.

can cause bleeding of the tissues
from the bur abrasion as opposed
to a counter-clockwise movement
where the bur would be rolling on
the gingival tissues creating less
damage.
A modern device that creates no
damage to adjacent gingival tissues is a sonic handpiece (SF1LM
from Komet) that uses special
sonic tips to prepare and finish
margins.
Unlike the rotation cutting action
of traditional burs and handpieces,
this instrument vibrates back and
forth so there is no cutting effect
on gingival tissues.

Lasers
If bleeding occurs with any technique, the fastest approach to control bleeding, crevicular fluids and
tissue management is the use of
various types of lasers.
tLasers can be used to remove
excess tissues or to trough around
margins within seconds to expose
tooth structure and create a dry
field.
The ability of lasers to stop crevicular fluids and bleeding makes
for the driest field possible for
impression taking, and nothing
else is available in the dental market that can achieve this type of
result.
The availability of inexpensive diode lasers from companies
such as Discus and AMD LASERS
are, for the first time, making it
affordable for every office to utilize this technology and to simplify
the impression taking process for
everyone, including the patient.

Impression trays
Impression trays have also
gone through their fair share of
enhancements and developments
over the years. The metal, perforated trays and Rim-Lock border
trays have given way to disposable
plastic versions of the same.
The advent of the overwhelmingly popular triple tray has laid
claim to approximately 85 percent
of all current impressions sent to
dental laboratories.
These trays have been implemented like many other techniques and materials to cut down
on overhead on both impression
trays and materials because one
simple triple tray catn not only
take the impression of the prepared tooth, but also the opposing
teeth and register a bite reference.
The downside to this technique

Fig. 2: Ideal margin detail after
obtaining proper tissue retraction.

is the lack of ideal jaw movement that can be reproduced with
the models that are created, the
absence of cross-arch stabilization
and the inability to create an accurate interocclusal record.
This can create dental restorations that may need more adjustment when it comes time to deliver.
Custom trays made from traditional acrylic or modern materials
such as Triad (Dentsply Caulk),
although seemingly extinct in
most offices, still provide the best
impression results, but another
modern material may soon take
over.
The HEATWAVE mouldable
custom tray (Clinician’s Choice)
comes in a variety of sizes and is
anatomically shaped to provide an
excellent fit straight out of the box,
but the difference is that it can be
customized further.
When placed in a hot water bath
the tray becomes pliable and can
be custom molded to fit even more
precisely. Additionally, the ability to use less impression material
with a custom tray and to create
an ideal impression due to better
adaptation on the first attempt provides a substantial savings of both
time and money.
If someone does not have the
modern digital impression devices,
he or she is fortunate to still have
the ability to choose from numerous types of advanced impression
materials. Polyethers, polyvinyls,
blends and smart wetting surfactants are all various materials
available to practitioners.
Polyethers, having been known
for their affinity to moisture
(hydrophilic), and the polyvinyls,
typically having been more moisture sensitive (hydrophobic), have
changed.
Many of the polyvinyls are getting extremely good results via
improvements in their chemistry
over recent years. The bulk of
the market sales come from polyvinyl impression materials. They
are available in various viscosities, such as putties, heavy bodies,
medium bodies and light and extra
light bodies, which makes it easy
to find a viscosity to meet anyone’s
preferences.
Furthermore, most companies
offer variations in setting and
working time for those that want
speed for individual teeth or those
that need a longer setting time so
they can impress full arches.
The most common technique

that has been shown to provide
the best results is a heavy tray
material with a low viscosity wash
material placed around the tooth
that flows into the gingival sulcus
capturing the marginal detail.
Impression guns and volumixers such as Pentamix (3M ESPE) or
Volume Mixer (Kerr Corporation)
have simplified the mixing process
to achieve accurate material dispensing and proper mixing for better physical properties compared
to hand mixing techniques.
The most recent additions are
surface modifiers that allow for
better adaptation of impression
materials to the tooth structure
above and below the gum line.
These materials allow for better
surface adaptation via decreased
surface tension (B4, Dentsply
Caulk).

Impression technique
Start the indirect impression technique by preparing the tooth structure in a clockwise manner to
reduce tooth structure quickly, but
staying away from the gingival
margin. After breaking the interproximal contacts, place your first
retraction cord.
Continue preparing the tooth
and margins to ideal in a counter
clockwise direction, so as not dam-

age gingival tissues, or use a sonic
handpiece.
If a second cord is desired, it
can be placed and margins can be
refined again if necessary. Based
on tissue tension, pocket depth
and margin visibility, one can first
rinse and then remove, one or both
cords.
The advantage of leaving one
cord in is that it holds the tissues
away from the margins and alleviates most bleeding issues.
Bleeding typically occurs due
to previously irritated tissues, bur
trauma, cord packing trauma or
epithelial tears due to the cord not
being moistened before removal.
Should bleeding occur, chemical coagulants can be implemented quickly to resolve most bleeding issues. A laser could be used as
an alternative to retraction cords
and chemical coagulants to expedite the process.
An impression can then be captured either with a digital impression device or a heavy body and
wash material using the impression tray of your choice. However,
a full-arch custom tray will typically achieve the best results.
Upon retrieval from the mouth,
the impression needs to be evalug DT page 16
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[16] =>

16

Clinical

Dental Tribune | May 2010

AD

By line

Fig. 3: Heat Wave customizable
impression tray (Clinician’s
Choice) and Take 1 Advanced
Impression material (Kerr Corporation).

Fig. 4: Utilizationn of Expa-syl
(Kerr Corporation) to displace
tissues and control bleeding.

Fig. 5: Light body impression
material syringed into the gingival sulcus.

Fig. 6: Example of a triple tray impression.

Fig. 7: Broken tooth with
enlarged gingival tissue.

Fig. 8: Preparation margin
exposed by using a soft tissue
laser.

Fig. 10: Depiction of a
marginal defect in an
impression.

Fig. 9: Full arch custom
impression tray.

f DT page 15
ated for marginal accuracy extending past the margin and down the
root surface. Any tears, voids or
pulls mean that the laboratory will
be unable to provide an accurately
fitting restoration.
No matter what your preferences are when it comes to impression
techniques and materials, the key
to a quality impression is what
works in your hands.
The fact that dental manufacturers have many options available
for dentists to choose from makes
it easy to fulfill anyone’s needs and
to achieve excellent results. DT

(Photos/Provided by
Dr. Todd Snyder)

About the author
has authored numerous
articles in dental publications and is a consultant
for many dental manufacturers.
Snyder has been on the
faculty at UCLA in the Center for Esthetic Dentistry,
and currently at Esthetic
Professionals.
Todd Snyder, DDS
25500 Rancho Niguel Road,
Suite #230
Dr. Todd Snyder main- Laguna Niguel, Calif.
tains a private practice in 92677
(949) 643-6733
Laguna Niguel, Calif.
He lectures both nation- www.drtoddsnyder.com
ally and internationally, doc@tcsdental.com

AD

www.dental-tribune.com
Visit Dental Tribune
online to read the
last edition of this
newspaper, as well
as our speciality
newspapers (Endo
Tribune, Implant
Tribune and Ortho
Tribune) as ePapers.
Drop in for a ‘read’
anytime!

[17] =>

[18] =>

CDA Meeting

Dental Tribune | May 2010

Meeting will showcase clinical,
technological advancements
The California Dental Association will hold its spring meeting,
CDA Presents The Art and Science
of Dentistry, from May 13 to 16 at
the Anaheim Convention Center in
Anaheim. Meeting organizers expect
that 26,000 dental professionals from
around the world will attend to take
advantage of educational opportunities, to view new products in the
exhibit hall and to network with
colleagues.
Because the meeting is held in
sunny Anaheim, many attendees will
also partake in some of the recreational activities that are available
(see related article, page 20).

Continuing education
CDA Presents offers an excellent
opportunity for attendees to fulfill
continuing education requirements
in a fun, exciting atmosphere —
and at record speed. The meeting’s
workshops, free lectures and other
C.E. opportunities are a convenient
way for dental professionals to meet
AD

license renewal requirements.
The Dental Board of California
divides continuing education courses into two categories. Category I
courses must make up a minimum
of 80 percent of the credits in a
renewal cycle. Courses in this category shall include courses in the
actual delivery of dental services to
the patient or the community.
Category II courses can make
up only 20 percent of the credits
in a renewal cycle. Courses in this
category shall include other courses
directly related to the practice of
dentistry.
For every renewal cycle, California state law requires licensed
dentists and allied dental health professionals to complete two units in
infection control and two units in
the California Dental Practice Act.
Licensees are also required to complete a course in Basic Life Support.
Educational programs at CDA
Presents will be held at the Anaheim Convention Center and the

Hilton Anaheim Hotel. Symposia will
be held Thursday, and lectures and
workshops will be held Thursday
through Sunday.
Featured presentations will
include the following:
• “The New Quarterback: A New
2010 Treatment Planning Playbook
for the General Dentist,” presented
by Terry Tanaka, DDS, Friday from
9:30 a.m. to noon and continuing
from 2 to 4:30 p.m. at Hilton Pacific
C.
• “Update in Esthetic Restorative
Dentistry,” presented by Terry Donovan, DDS, Sunday from 9:30 a.m. to
12:30 p.m. at ACC Ballroom B.
• “Managing the Endodontic
Infection,” presented by Kenneth M.
Hargreaves, DDS, PhD, Friday from
10 a.m. to 12:30 p.m. at ACC Ballroom B.
• “Bread-and-Butter Adhesive and
Restorative Dentistry,” presented by
Harold O. Heymann, DDS, MEd, Saturday from 9 to 11:30 a.m. at ACC
Ballroom A.

• “Esthetic Continuum Workshop,” presented by Brian P. LeSage, DDS, FAACD, and Edward A.
McLaren, DDS, Friday and Saturday
at ACC Room 213A.
CDA Presents will also feature a
limited networking opportunity for
attendees — lunch with two of the
top speakers. These special events
will offer participants the chance
to get to know the speakers while
enjoying a meal. Participants can
choose the topics they would like to
discuss in a roundtable setting. This
networking opportunity is reserved
for dentists only, and each dentist
may buy only one ticket. Space is
limited.
Lunch with Terry T. Tanaka, DDS,
will be held Friday from 12:30 to 1:30
p.m. at Hilton Laguna B. Lunch with
Harold O. Heymann, DDS, MEd, will
be held Saturday from noon to 1 p.m.
at Hilton Laguna B. The fee for both
lunches is $70.
g DT page 22

[19] =>

[20] =>

CDA Meeting

f DT page 20

Exhibit hall
If you’re looking for the latest technology, products and services in dentistry, you need look no further than
CDA Presents. The Anaheim tradeshow will showcase about 40 product
launches. In all, approximately 600
companies will showcase their offerings.
The exhibit hall, located in the
Anaheim Convention Center, will be
open Friday and Saturday from 9:30
a.m. to 5:30 p.m. and Sunday from
9:30 a.m. to 2 p.m. Attendees can visit
a restaurant or one of several concession areas to relax and refuel.
Here are some exhibit hall highlights:
• Grand Opening, Friday, 9:30 a.m.
• Family Hours (children 10 and
younger permitted during these
hours only) daily, 9:30 to 11:30 a.m.
Please note: For safety, strollers are
not allowed on the exhibit floor.
• Kid Zone Hours, Friday and Saturday, 9:30 a.m. to 5:30 p.m. and Sunday from 9:30 a.m. to 2 p.m.
• Table Clinic Viewing — Hall D,
Friday, Saturday and Sunday from
noon to 2 p.m.

The Spot
Again this year, CDA Presents will
feature The Spot — a lounge for
learning, networking and fun. This
dynamic and interactive area is locat-

ed in the exhibit hall. The contemporary lounge is “the spot” to learn,
network and have fun. Attendees
can earn C.E. credit, see new products, plan an office renovation, check
e-mail and even enjoy a cup of coffee
while relaxing with friends.
The Spot will also be the location
for a wine party reception where participants will be able to learn about
wine with interactive activities at
wine tables, learn to distinguish the
various scents and flavors in wine
and practice new skills by “blind”
tastings of white varietals, explore
red wine varietals from a particular
area and discover new taste sensations by tasting wines paired with
both cheese and chocolate.
Participants will also be able to
put their new wine knowledge to the
test and win some prizes by playing
a wine trivia game. The wine tasting
will be held Saturday from 4 to 5:30
p.m.
The Spot will be located in Hall D
of the Anaheim Convention Center,
and it will be open Friday and Saturday from 9:30 a.m. to 5:30 p.m. and
Sunday from 9:30 a.m. to 2 p.m.

Fun in Anaheim
The CDA will hold a Membership
Party at Disney’s California Adventure Park. The excursion will take
place Friday evening, May 14.
From 9 to 11 p.m., the park will be
closed to the public, but CDA attend-

Dental Tribune | May 2010

The Queen Mary

ees wearing a wristband can remain
in the park in the Hollywood Backlot
area. A dessert reception, entertainment and a cash bar will be available.
Once the public has cleared the
park, CDA attendees will have exclusive access to the following attractions: Twilight Zone Tower of Terror,
Soarin’ Over California, Grizzly River
Rapids, Monsters Inc., Mike and Sulley to the Rescue!, and Muppet Vision
3-D.
Shuttles will begin departing in

front of the Anaheim Convention
Center at 6:30 p.m. They will run
throughout the evening. Shuttles will
drop off and pick up at the islands
outside the main shuttle area of the
Disney lots.
The fee for the trip is $65, and
each ticket holder will receive an
admittance ticket to California
Adventure, a wristband and Disney
dollars for food purchases prior to
park closing or drink purchases at
CDA’s exclusive event. DT

What’s there to do in Anaheim?
Want to have some fun in Orange
County when you are in town for the
CDA meeting? Check out the ideas
below.

GardenWalk
There’s no need to worry about
transportation to GardenWalk — no
matter where your hotel is, if you’re
close to the convention center, it’s
only a few footsteps away. It’s also
the perfect place to delight with a
stroll under sunny Southern California skies or starry nights.
GardenWalk is an open-air district (more than 400,000 square feet)
showcasing a who’s-who of restaurants, shops and cosmopolitan hotels
— all surrounded by lush landscaping, warterfalls and rich architecAD

ture.

Tasty treats
• Balboa Bar: On Balboa Island in
Newport Beach, enjoy the famous
Balboa Bar, a square vanilla ice
cream treat on a stick, dipped in
chocolate and rolled in your choice
of candies or nuts.
• Date Shake: The Crystal Cove
Shake Shack, a historical landmark
on Pacific Coast Highway in Corona
del Mar, opened in 1946 and was
recently purchased by Ruby’s. Today,
you can still ask for the famous Date
Shake, a blended drink of dates and
ice cream, or try the locals’ favorite Monkey Flip — a peanut-buttery
concoction.
• OC-tini: The Montage Resort
& Spa, an exclusive upscale resort

in Laguna Beach, welcomes guests
to enjoy The OC Martini — a mix
of Bacardi ‘O’ Rum, Cointreau and
fresh orange juice — in its lobby
lounge overlooking the beautiful
Pacific Ocean.
• Boysenberry pie: Today, every
boysenberry in the world can trace
its roots back to Knott’s Berry Farm.
The boysenberry — a cross between
a blackberry, a red raspberry and
a loganberry — was named after
its creator, Rudolph Boysen. Walter
Knott was the first to commercially cultivate the boysenberry on his
farm, which later became America’s
first theme park.
• In-n-Out Burger: Southern Californians and beyond crave the simple
and delicious menu at the Orange
County-based, In-n-Out. Made up
only of burgers, fries and shakes,
the menu does have a few secret
orders. If you’re especially adventurous, try your burger “animal-style”
with extra sauce and grilled onions.

Viewable views
• View from Heisler Park in Laguna
Beach: Laguna Beach’s Heisler Park
offers a beautiful view of the city’s
seaside village landscape, ocean
sunsets and surfers riding the waves.
Right next door, sip a margarita on
the outdoor patio at Las Brisas.
• Black Gold Golf Club: Hole No.12
at Black Gold Golf Club features the

highest tee box in Orange County
with great views of inland OC.
• Sunset flying: What better way
to view Orange County than by
plane? Sunset Flying takes couples
on a romantic, 45-minute flight with
views of the coast, The Queen Mary
and ending with a view above the
famous Disneyland fireworks.
• Emerald Vista Point: An intermediate hike in Crystal Cove State Park
leads you to Emerald Vista Point, a
lookout where you can view the vast
Pacific Ocean. Mornings are the best
time to head up.
• Orange Hill Restaurant: Built in
the early ’70s, this fine dining restaurant is situated on top of the hills in
Orange and features one of the best
views of the sparkling city lights in
Orange County and all the way out
to Catalina Island. The warm woodburning fire pits on the patio make
it a great location to enjoy cocktails
by night.

Flash your badge and save
That badge hanging around your
neck is worth much more than just
entrance to a variety of seminars,
workshops and the exhibit hall. It is
also worth money — in the form of
discounts at a myriad of restaurants
and shops around the area. DT
(Source: Anaheim/Orange County
Visitor’s & Convention Bureau)

(Photo/stock.xchng)

[21] =>

[22] =>

[23] =>

Dental Tribune | May 2010

Events

IDEA: worldclass, hands-on education
in the San Francisco Bay Area
By Fred Michmershuizen, Online Editor

Students from around the world
come to IDEA, the Interdisciplinary
Dental Education Academy, which
offers a wide range of courses taught
by a world-renowned faculty. Courses
cover topics from esthetic restorative
and surgical dentistry to orthodontics,
occlusion, treatment planning and
dental technology.
Located in the San Francisco Bay
Area of California, IDEA prides itself
on offering fully integrated training that is meant to give participants high-quality skills that they can
immediately use to improve patient
care and upgrade their practices.
In an effort to maximize each participant’s ability to learn one-on-one
with world-famous faculty, courses
are limited to 16 participants. The
small class size is meant to facilitate
direct mentoring.
Through the intense hands-on
training in the cutting-edge facility,
these innovative courses satisfy the
specific needs of all dental professionals — from general practitioner
to specialist to dental technician.
Hotel accommodations are provided. Meals are cooked on-site by
an executive gourmet chef. During meals and evening social time,
participants typically discuss practice styles, techniques and treatment
planning with both faculty and peers
from around the world.
IDEA is not sponsored or directly affiliated with any companies or
products. All honorariums are paid
by IDEA, which speaks to the academy’s mission of being “Just PURE
Teaching.
IDEA’s courses are designed for
participants to get the most out of
their innovative concept and the outstanding inspiration that brings the
company claim to life — “Excellence
Through Passion.”
“IDEA is a revolutionary facility,
which every dentist should attend a
program at,” said Dr. Graham Carmichael of Sydney, Australia. “[The] program [I attended] was a truly amazing
experience, well worth traveling halfway around the world. I’ll be back.”
Dr. Peter Kirmeier of Westminster,
Colo., said: “Over the past 35 years,
I have taken literally hundreds of
seminars, most of them hands-on.
This is by far the most organized and
best-equipped hands-on facility that
I’ve ever had the pleasure to take a
course at.”
IDEA is a certified provider for
continuing education credits for ADA,
AGD PACE, AACD PESA, the Dental
Board of California and NBC in Dental Technology.
More information on specific
course offerings, faculty and scheduling is available from IDEA at (650)
578-9495, info@ideausa.net or www.
ideausa.net. DT

(Photo/IDEA)
AD

[24] =>

Industry News

Dental Tribune | May 2010

XTend ceramic
kits and turbines

CDA BOOTH NO. 2338

(Photo/ProScore)

With the launch of its new XTend™ ceramic line of turbines and kits
last year, ProScore offers dentists the best quality do-it-yourself products for high-speed handpieces in the market.
Not only are XTend ceramic products backed with the best warranties in the business — one-year for turbines and six-months for rebuild
kits — XTend products outperform steel bearings, last longer and produce less noise and vibration.
The ceramic bearing technology incorporated into XTend ceramic
products provides many handpiece performance benefits:
• Reduced wear: ceramic balls are twice as hard as steel balls.
• Increased durability: ceramic balls are 40 percent lighter than
steel balls, which reduces the internal forces and loads caused
by high-speed rotation.
• Longer life: ceramic bearings perform better than steel under
marginal lubrication.
• Quieter and smoother operation: Noise and vibration are reduced
due to lower loads.
ProScore’s other EZ Solutions offer dentists various do-it-yourself
repair and maintenance options.

EZ Press III and EZ Rebuild Kits
The EZ Press III™ Repair System is the answer to the high costs and
downtime associated with sending high-speed handpieces out to be
repaired. Allowing the dentist to easily change those parts that have
worn out, the EZ Press III utilizes simple procedures, requires no
guesswork and ensures precision placement of the bearings on the
spindle.

EZ Install Turbines
For an instant repair, dentists can replace cartridges chairside with
EZ Install™ Turbines, which are manufactured with the highest quality parts and quality assurance procedures in the market, including
dynamic balancing. The result is a high-performance, long-lasting turbine that outlasts others in the market.

Smart Cleaner
The Smart Cleaner is a one-of-a-kind maintenance tool that not only
helps prevent residue build-up in handpieces and coupler waterlines,
but also clears away obstructions if they occur. Simply connect the
handpiece or coupler to the Smart Cleaner and activate the hand pump
to clear obstructions and debris.

EZ Care Cleaner and Lubricant
EZ Care™ Cleaner was formulated to flush debris and remove buildup from the handpiece’s internal rotating parts, improving long-term
handpiece performance and sterilization efficacy. EZ Care Lubricant
has been designed to minimize bearing wear and to resist corrosion.
When used together, EZ Care Cleaner and Lubricant ensure that
handpieces and accessories will achieve maximum longevity and maintain optimum performance.
ProScore has been dedicated to do-it-yourself handpiece repair and
maintenance since entering the dental market over 15 years ago as
Score International. Now ProScore is part of Henry Schein’s “Family of
PROs,” which includes ProRepair and ProService, to offer you the best
fit for your repair needs.
For more information, visit ProScore at CDA booth No. 2338, call
(800) 726-7365 or visit them at www.scoredental.com. DT

f DT page 1
alternative for standard implants is
needed.
• Tooth loss will continue in the
U.S. population. A decrease in edentulism rates is more than offset by
higher edentulism incidence in aging
and immigrant populations, which are
both growing exponentially.
The absolute number of edentulous
individuals and number of dentures
needed is expected to increase in the
coming decades.
• Edentulism rates vary across
regions of the U.S., but it is increasingly associated with lower socioeconomic status.
Low-income communities have a
greater need for prosthetic services,
but are least able to afford universally
recommended basic implant-overdenture protocols.
• Utilization of implant methodologies for edentulous patients is low.
The estimated market saturation in
the U.S., with fee-for-service as the
primary financial vehicle for implant
treatment and without the likelihood
of future third party support, is 1 to 2
percent.
In the Netherlands, with governmental and third party support for
implant treatment in edentulous
patients, the saturation among denture patients is 8 percent.
• Typical surgical placement of dental implants in the edentulous mandible is moderately invasive because
of the need to create a soft-tissue flap
and to expose the crestal aspect of the
alveolus for visualization.
Computer-generated
surgical
guides have the potential to improve
accuracy of implant siting and dramatically reduce invasivity. However,
guided implant surgery has high technology costs and is not widespread at
this time in the U.S.
• The most rapidly enlarging population cohorts are the advanced elderly. Polypharmacy and management of
multiple chronic medical conditions
are now routine in these populations
and require a conservative approach
in implant dentistry.
Surgical techniques with minimally
invasive aspects are often indicated for
these patients.
• The resorption patterns of the
edentulous mandible often create a
narrow ridge crest, which is problematic for placement of standard diameter implants (4 mm).
• The need for a healing interval of months following traditional
implant placement is inconvenient
for patients who increasingly expect
instant results.
Narrow-body implants (NBI) have
a diameter less than 3 mm and have
been commercially available in the
U.S. for more than 10 years. They are
made of titanium alloy and are placed
in alveolar bone for a variety of prosthetic purposes.
The optimal indication for these
implants is in the anterior edentulous
mandible for retention of a mandibular overdenture. If the placement is
sound (at least 20 Ncm of torque), the
implants can be immediately loaded.

Osseointegration will occur if the early
loading is optimized. Once integrated,
the long-term prognosis is favorable.
Several studies have documented
5-year individual NBI survival rates
around 94 percent with high patient
satisfaction.1
The minimally invasive nature and
reduced expense of NBIs are advantageous for patients compared with
conventional implant treatment. NBIs
are being used to solve mandibular
denture problems on a routine basis
in private practice, hospital and community clinics and in dental schools.
There is potential for widespread
use in dentistry because of the oralhealth issues presented above and
because NBIs broaden the spectrum
of treatable prosthetic conditions by
implant modalities.
The Dentatus Atlas NBI was engineered specifically for denture retention and is unique in its lack of an
additional attachment device inside
the denture. In the Atlas system, a
resilient silicon material (Tuf-Link)
is placed inside the patient’s existing
denture, creating a close fit around
the retention features in the Atlas
implant head.
The silicon material is simple to
use and replace. Dentists who lack
familiarity with attachments and
implants find the Atlas system to be
user-friendly and effective.
Patients are extremely gratified that
the surgical procedure is atraumatic
and that denture adhesive is no longer
needed to secure the denture in place.
A range of implant diameters and
lengths make the Atlas system very
versatile for treating a variety of edentulous patients and is particularly well
suited for those patients with narrow
ridges, complex medical histories and
financial restrictions.
In the real world of dental practice,
this means that the Atlas NBI is an
appropriate implant option that can
return hope and confidence to the
majority of patients with mandibular
dentures. DT

1. Cho S-C, Froum S, Tai CH, Cho YS,
Elian N, Tarnow DP. “Immediate loading of narrow diameter implants in
severely atrophic mandibles.” Practical
Procedures & Aesthetic Dentistry, Vol. 19,
No. 3, April 2007, pp. 167–174.

About the author
Eugene LaBarre, DMD, MS
Department of Removable
Prosthodontics
University of the Pacific Arthur
A. Dugoni School of Dentistry
San Francisco, Calif.

Visit Dentatus at
booth No. 471 at
the CDA Meeting

[25] =>

Industry News

Dental Tribune | May 2010

The STA is essential
for cosmetic dentistry
It’s great for the P-ASA injection
By Eugene R. Casagrande, DDS,
FACD, FICD
Director of International and
Professional Relations, Milestone
Scientific

The STA Injection System,
a computer-controlled local
anesthetic delivery, or C-CLAD,
is not only great for single tooth
anesthesia, but is also very useful to administer multiple tooth
anesthesia injections such as
the palatal-approach anterior
superior alveolar nerve block
(P-ASA).
The P-ASA is a single-site
palatal injection into the nasopalatine canal that can produce bilateral anesthesia to six
anterior teeth and the related
facial and palatal gingival tis-

sues without causing collateral numbness to the patient’s
upper lip, face and muscles
of facial expression. Patients
really appreciate this!
Using significantly less anesthetic, this easy-to-administer
injection can take the place
of at least four supraperiosteal
buccal infiltrations and a palatal injection. It is valuable for
cosmetic restorative dentistry
procedures such as composites,
veneers and crowns because
you can immediately assess the
patient’s smile line when the
lip is used as a reference point.
The P-ASA is also useful for
endodontic, periodontal and
implant procedures. In fact, it
is recommended as the primary
injection for any or all of the six

maxillary anterior teeth.
During administration and
postoperatively, the P-ASA is
a very comfortable injection
for your patients due to the
STA computer-controlled flow
rate below the patient’s pain
threshold, the use of minimal
pressure and the ability to easily control the needle using
the wand handpiece.
Check out the simple injection technique for the P-ASA
on the STAis4U.com website.
It’s easy to do. Try it.
You’ll like it, and so will your
patients. DT
Milestone Scientific
(800) 862-1125
milestonescientific.com

cda BOOTH NO. 1641

(Photo/Milestone)
AD

[26] =>

[27] =>

Industry News

Dental Tribune | May 2010

Dentsply Midwest revolutionizes handpiece
technology with the Midwest Stylus ATC
A new, high-speed, air-driven handpiece is promising an entirely new cutting experience for dentists, one that
is so smooth, powerful and efficient, it
doesn’t feel like work anymore.
The Dentsply Midwest® Stylus™ ATC
is the world’s first air-driven handpiece to automatically adjust speed
in response to load, offering superior
performance and precision.
The Midwest Stylus ATC introduces the dental world to Speed-Sensing
Intelligence (SSI) and Superior Turbine Suspension (STS), groundbreaking technologies that solve two longstanding challenges facing dentists:
load-based variations in speed that
can cause stalling and require timeconsuming feathering, and bur deflection and chattering that occur at high
speeds and can affect accuracy and
precision.

It’s the speed
The Midwest Stylus ATC’s Speed Sensing Intelligence automatically optimizes the delivery of power, no matter the
load, to provide smooth, consistent cutting speeds for unmatched efficiency
and the fastest removal of material.
A sensor in the coupler picks up
the frequency of vibrations caused by
the speed of the rotating bur. When
the bur encounters a higher load that
would normally cause a decrease in
speed, a signal from an advanced
“electronic brain” in the control source
increases air pressure and thereby the
rotation of the turbine, thus increasing
speed. The opposite occurs when the
bur encounters a lighter load.
In other words, in a split second,
the handpiece knows when to deliver
more power or when to reduce power.

It’s the suspension
The ATC’s Superior Turbine Suspension allows the handpiece to operate at
speeds of 330,000 rpm under load with
no noticeable bur deflection or chattering. This provides outstanding control,
every time.
The STS also creates a greater, more
consistent transference of power from
the handpiece to the bur for the absolute maximum in cutting efficiency. No
other handpiece on the market today
allows dentists to create this degree of
precision.
In fact, this smooth, precise control is especially beneficial for margin
refinement and fine restorative procedures.
“This is the greatest breakthrough
in high-speed, air-driven handpieces
since their introduction by Midwest in
the 1950s,” said Len Litkowski, DDS,
and director of professional relations
and clinical research for Dentsply Professional.
“Bringing electronic control to the
dental handpiece to provide a constant
speed, even under load, will make
the dentist’s experience more efficient,
effective and stress-free,” he said.

Controlled power in a small package

In addition to Speed-Sensing Intelligence and Superior Turbine Suspension, the Midwest Stylus ATC offers
these advantages:
• Exceptional visibility, access and
maneuverability with mini or midsized head.
• Outstanding swivel for freedom of
movement.
• Enhanced access to posterior surfaces with standard- and short-shank
bur compatibility.
g DT page 28

CDA BOOTH NOs. 1306/1406

(Photos/Dentsply)
AD

[28] =>

Industry News

Plak Smacker:
new ultrafine
toothbrush
CDA BOOTH NO. 156

(Photo/Plak Smacker)

Plak Smacker announces the
release of its new adult brush,
the Ultrafine Toothbrush.
Perfect for patients with
receding gum lines and sensitive surfaces, the Ultrafine’s
tapered extra-soft bristles provide up to three months of gentle brushing without compromising plaque removal.
The rubber grip handle offers
comfortable support and reduces slippage during use.
Available in four colors, the
Ultrafine Toothbrush is sure to
be a favorite among patients.
For more than 20 years, Plak
Smacker has been focused on
introducing new, innovative
products to help patients feel
good about a trip to the dental
office.
For more information or to
place an order, please call (800)
558-6684 or visit www.plak
smacker.com. DT

Dental Tribune | May 2010

Picasso Lite makes soft-tissue
laser treatment accessible
By Fred Michmershuizen, Online Editor

For those dentists who have
wanted to offer laser treatment to
their patients but have held back
because of the expense of the
equipment, now there is an answer.
The Picasso Lite is a soft tissue dental laser featuring an ultracompact, lightweight design. It is
manufactured by AMD LASERS, a
company based in Indianapolis that
was founded by Alan Miller. (AMD
stands for Alan Miller Designs.)
“AMD LASERS is committed to
our role as the leader in advancing
the use of laser technology in the
dental operatory,” said Miller, who
is CEO of the company.
Intended to replace the archaic
use of scalpels and electro-surge
in the treatment of soft tissue, the
Picasso Lite features 2.5 watts of
power, an adjustable aiming beam
and three customizable presets.
Perhaps the best thing about the
Picasso Lite is its affordable price.
“Not only do we have the best
price, we also have the best warranty,” said Scott Mahnken, director of sales and marketing at AMD
LASERS. “Quality is very important
to us.”
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.
New from AMD LASERS are
disposable tips that can be used
instead of the fiber optic cable,
making procedures even more convenient.
“We are very excited about the
latest product announcement,”
Miller said.
“Dentists wanted an option of
using convenient disposable tips or
the cost effectiveness of a strippable fiber. We delivered. This marks
just another breakthrough in technology by AMD LASERS.”
“We are committed to our one
vision, one goal — a laser in every
office and every operatory,” Miller

CDA BOOTH NO. 2536

Icon
debuts in
Reader’s
Digest
News about this treatment
for dental caries and white

(Photo/AMD LASERS)

said. “The research and development we continue to reinvest in our
current and future products only
solidifies AMD LASERS as the No. 1
company in the world.”
Bart Waclawik, chief operating
officer of the company, said the tips
were designed to meet the needs
of all soft-tissue dental procedures.
“The new disposable tips are available in various angles, lengths and
sizes to meet our clients’ needs,”
he said.
The Picasso Lite comes with a
setup DVD, online laser certification, accessories and an international adapter.
Personalized, one-on-one training is also available to dentists who
purchase the Picasso Lite.
A number of respected opinion
leaders are singing the praises of
the Picasso Lite.
“Picasso is very easy to incorporate into every practice, easy to use,
and extends the practice’s range of
services,” said George Freedman,
DDS, and international lecturer
and author.
“I think every dentist should
have a diode laser,” said Ross Nash,
DDS, of the Nash Institute. “AMD
has made it affordable for all. Picasso is even more impressive for its
remarkably low price.”
“The Picasso is small enough yet
powerful enough for every application that a diode can perform,” said
Ron Kaminer, DDS, an international lecturer.
More information about the
Picasso Lite is available from AMD
LASERS, (866) 999-2635, www.
amdlasers.com. DT

f DT page 27
• All-day ergonomic comfort; significantly lighter than electric handpieces.
• Brilliant fiber-optic light for superior illumination.
• Low pitch and tone for a more
relaxed patient and dentist.
The Midwest Stylus ATC is the most
powerful, yet precise, high-speed,
air-driven handpiece available in the
world today.
To schedule a free in-office demonstration, call (800) 989-8825. DT

spot lesions to reach a
global readership of more
than 16 million in May 2010
Reader’s Digest, known as “the
world’s best-read magazine,” featured Icon ®, the caries infiltrant
system by DMG America, in the
Next Big Things section of its May
2010 issue.
Reader’s Digest publishes 50
editions and is the world’s largest
paid-circulation magazine.
“It’s truly an honor to be featured in such an incredibly reputable and well-read publication,”
says Tim Haberstumpf, DMG
Director of Marketing.
“First we were on The Doctors,
then Fox News, and then featured
in Popular Science. More and
more people are hearing about
how dental professionals using the
Icon system can, in many cases,
potentially help them avoid drilling and anesthesia to arrest early
dental caries. It’s exciting to say
the least.”
Introduced by DMG America in
September 2009, Icon uses microinvasive technology to fill and
reinforce demineralized enamel
without drilling, anesthesia or
sacrificing healthy tooth structure.
Icon, which stands for Infiltration Concept, is a true breakthrough in restorative dentistry
indicated for the treatment of
white spot lesions and incipient
decay that has progressed up to
the first third of dentin.
Icon enables dentists to treat
incipient lesions upon discovery,
effectively removing white spots
and arresting the progression of
early carious lesions. It works by
capillary action and is light cured
to harden the resin after placement.
Previously, it was necessary
for dental professionals to “wait
and watch” early caries until they
were big enough to justify drilling and filling, and they had only
more invasive options for treating
discoloration such as white spot
lesions that could not be eliminated by tooth whitening.
“Icon is the first micro-invasive
dental product that can be used in
g continued

[29] =>

Dental Tribune | May 2010

Velopex’s
air abrasion
unit has
many uses
CDA BOOTH NO. 1587

f continued
just one patient visit to arrest caries progression, remove
white spot lesions and increase the life expectancy of treated teeth,” says Haberstumpf.
“All this recent press coverage has introduced millions of
patients to the concept that this type of treatment avoids the
pain of the drill that comes with a traditional restoration
and, most importantly, it saves tooth structure immediately
and in the long run. Patients really appreciate that!”
To view full clips from the television shows, complete
product descriptions and treatment steps, a training video,
and an overview of the international studies currently
being conducted with Icon, visit the Drilling No Thanks!
website at www.drilling-no-thanks.com. DT

Industry News

29

CDA BOOTH NO. 310

(Photo/DMG)

Most of the products on our industry pages will be available at the CDA Meeting.

AD

The Aquacut Quattro and stand.
(Photo/Velopex)
There are many uses of the
Velopex Aquacut Quattro Fluid
Air Abrasion Unit.
Cutting enamel, composite, dentine
• fissure cleaning and sealing
• composite repair
• cavity preparation
• white spot removal
• pre-bonding conditioning
of enamel
Stain removal
• fissure cleaning and sealing
• stain removal
• caries removal
Cleaning and polishing
• fissure cleaning and sealing
• stain removal
• caries removal
Etching
• etching
• porcelain repair
• metal bonding
• treating lab work
• pre-bonding conditioning of
enamel
• wash and dry
The Aquacut Quattro will give
you greater control and flexibility than any other piece of equipment you own. Some of its other
benefits include:
• no vibration, turbine noise,
heat generation or smell,
• greatly reduced need for
local anesthesia,
• a handpiece that creates a
fluid curtain around the powder
medium,
• a triple-action foot control
that speeds treatment by allowing cut, wash and dry operations through the same handpiece,
• no chipping or stress fracturing,
• minimal loss of sound tooth
material. DT

[30] =>

Industry News

Dental Tribune | May 2010

Directa makes restorations
quicker, easier and more efficient

CDA BOOTH NO. 2034

By Fred Michmershuizen, Online Editor

Directa AB, a Swedish manufacturing company that dedicates
itself to introducing innovative, high-quality and cost-effective
products into the dental marketplace, is perhaps best known
around the world for its Luxator® extraction instruments, which
allow dentists to remove teeth with less damage to the surrounding tissue, keeping a better anatomy for an implant site.
At the GNYM meeting in New York City, the company’s products
for restorations kept many people buzzing.
Many are already familiar with the Directa FenderWedge®
tooth protector, which separates and protects adjacent teeth
during preparation for a restoration. A combination of a wedge
and a protective stainless steel plate, the FenderWedge preseparates teeth by a few tenths of a millimetre, protecting the
adjacent tooth during preparation and aiding in the final building of the contact point.
Now, the Directa FenderWedge has a companion — the
Directa FenderMate®. The one-piece matrix and wedge is
designed to allow dentists to quickly and efficiently fill a cavity
and get a restoration with a tight contact and a tight cervical
margin.
(Photo/Directa)
Directa has taken a 10-minute procedure down to about
two minutes. In traditional methods of cavity preparation, the
emphasis has been to break contact and extend the walls of the
proximal box in order to accommodate the matrix band. With the facility to insert FenderMate lingually and/
or buccally the dentist can maintain a smaller, more traditional proximal preparation thus preserving healthy
tooth structure and easily restoring a proper contact.
The FenderMate combines a wedge and a matrix in its design so that dentists no longer have to fumble with
multiple pieces. A flexible wing separates the teeth and firmly seals the cervical margin, avoiding overhang.
It features optimal matrix curvature and a pre-shaped contact. No ring is needed, and when it is inserted as a
wedge, the tooth is ready for immediate restoration.
FenderMate has made a tremendous impact worldwide. The new product has been rated one of the best
products of the year with great positive feedback.
Dentists are pleased not only with FenderMate’s ease of use, but with its ability to help preserve more of the
natural tooth structure which is essential in providing better patient care.
The FenderMate is available in assorted kit of 72 pieces or Refill packs of 18 pieces in four different variations.
As with all products by Directa AB, dentists, not engineers, design the FenderWedge and the FenderMate,
which gives rise to the company maxim “Design by Dentists.”
Information about all Directa products and distributors may be found at www.directadental.com or by calling
(203) 788-4224. DT

The Junior Lift by Crescent Products
Do you have difficulty getting
your smaller-sized patients properly
positioned on your dental chair? Are
you constantly asking them to reposition themselves, hoping this will
enable your patient to fit the chair a
little better?
Is performing procedures more
AD

difficult for you because of this problem? If you find yourself dealing
with this very situation, rest assured,
there is a solution.
Crescent Products recently developed a product to permanently alleviate the problem of smaller patients
not fitting the dental chair properly.

The Junior Lift is a foam support
cushion designed specifically for
the dental chair. It boosts your
smaller patient to a better and
more comfortable position in the
dental chair, raising the height of
the patient.
Additionally, the Junior Lift
allows the patient to reach the
headrest on the dental chair
more easily. The cushion simply rests in place on the chair
and is ideal for older children
and smaller adults up to about
five feet in height.
As with all comfort products
by Crescent Products, this support is covered in a soft vinyl that
can be easily cleaned with disinfectant. The anti-slip material on
the bottom keeps the Junior Lift
in place.
With the introduction of this
new product, performing proce-

PhotoMed
G11 digital
camera
The PhotoMed G11 digital
dental camera is specifically
designed to allow you take all
of the standard clinical views
with “frame and focus” simplicity.
The built-in color monitor
allows you to precisely frame
your subject; focus and shoot.
It’s that easy.
Proper exposure and balanced, even lighting are
assured. By using the camera’s
built-in flash, the amount of
light necessary for a proper
exposure is guaranteed.
Also, PhotoMed’s custom
close-up lighting attachment
redirects the light from the
camera’s flash to create a balanced, even lighting across
the field.
More information is available at www.photomed.net or
call (800) 998-7765. DT

CDA BOOTH NO. 415

(Photo/
Crescent Products)

dures on smaller patients has never
been easier. The Junior Lift is a
must-have for every dental practice.
It is also available in three colors:
teal, beige and gray. DT
Judy McDonald
Crescent Productt
(800) 989-8085
judy@crescentproducts.com
www.crescentproducts.com/
dental.htm

[31] =>

Dental Tribune | May 2010

Industry News

NOMAD handheld X-ray verified safe
for user, study shows

CDA BOOTH
NO. 2141

An independent study presented
at the 41st Annual Conference on
Radiation Control, held May 18–21,
2009, concluded that the NOMAD
handheld dental X-ray system produces staff radiation-exposure
doses so low that the vast majority
of users received no measurable
radiation dose.
This conclusion contradicts the
common misperception that operator exposure would be higher with
a handheld X-ray system.
The study also found that the
image resolution and contrast of
the NOMAD were superior to the
wall-mounted system tested, and
the leakage and scattered radiation
were lower.
In addition, the study reported
that additional operator protection
measures, such as the use of lead
aprons or stands, are not warranted. According to the study, this is
largely due to improved shielding
techniques incorporated into the
NOMAD,
The paper, “Image Quality and
Radiation Dose Comparison for
Intraoral Radiography: Hand-held,
Battery Powered versus Conventional X-ray Systems,” was delivered as part of the annual meeting
of the Conference of Radiation Control Program Directors (CRCPD) in
Columbus Ohio in May 2009. Edgar
Bailey, MSEHE; Joel Gray, PhD; and
John Ludlow, DDS, authored the
study.
The NOMAD handheld X-ray system is manufactured in the USA
by Aribex of Orem, Utah, and was
invented by the company’s CEO, Dr.
D. Clark Turner.
“This study verifies what we
have known for some time, that
our handheld X-ray device is at the
cutting edge of X-ray technology in
terms of quality and safety,” said
Turner.
“Add to that the convenience of
the lightweight handheld design
and we have a product that has
changed the way X-rays are taken
in a dental office and has opened
the way to take X-ray imaging to
those who cannot come to a dental
office.”
The NOMAD is cordless and
rechargeable and requires no installation so it can easily be taken from
operatory to operatory in a dental
office. The operator can stand right
next to the patient while taking the
X-ray without having to leave the
room.
In addition, because it does not
require direct connection to an AC
outlet, it has been widely used for
humanitarian work in some of the
most remote areas of the world.
A copy of this independent study
as well as more information about
the NOMAD may be found www.
aribex.com.

About Aribex
Aribex has quickly become recognized as the worldwide leader in
innovative handheld X-ray products.
Aribex is a privately owned, Orem,
Utah-based company founded in 2003
with the mission to develop, manufacture and market new technologies in
the X-ray radiography fields.
Aribex flagship products are the
NOMAD and the NOMAD Pro handheld X-ray systems. For more information, visit www.aribex.com. DT

(Photo/Aribex)

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