Flap's Dentistry Blog

The Morning Drill: February 15, 2012

noreply@blogger.com (Gregory Flap Cole) — Wed, 15 Feb 2012 17:51:00 +0000

San Diego Padres’ Tony Gwynn
Tony Gwynn had 3,141 base hits and a .338 career batting average over his 20-year career with the Padres

Good Morning!

On to today's dentistry and health headlines:

Baseball Hall of Famer Tony Gwynn Blames Smokeless Tobacco for Oral Cancer

Tony Gwynn, the Hall of Fame outfielder who 18 months ago blamed smokeless tobacco for a malignant growth inside his right cheek, was in his 13th hour of surgery Tuesday evening to remove a new cancerous tumor in the same spot.

According to Gwynn’s wife, Alicia, doctors do not believe the cancer has spread outside of Gwynn’s salivary gland. But she expects to know more after Tuesday’s intricate surgery, in which she said five doctors would likely perform a nerve graft to preserve Gwynn’s facial functions. The operation began at approximately 9:15 a.m. PT, and, as of 11 p.m. PT, the 51-year-old Gwynn was still in the operating room.

Tony told them to take [the malignant tumor] all out,” Alicia Gwynn said Tuesday morning. “They said they may need to remove the facial nerve — they might have to go a lot deeper. But he just told them to take it out. And if they do remove the facial nerve, they’ll replace it with a nerve from his shoulder or his leg.

2 children dead after dental visits

Two sets of parents are demanding a criminal investigation into the same dentist in New Jersey.

A child from both families suddenly died after routine visits to the dentist.

"He was my dream.. My future. The light of my life," said Jose Quiej, the patient's father.

Little Juan Quiej was just three years old and suffered cardiac arrest during a routine dental procedure.

His mother watched helplessly as Juan slipped away.

"I started shaking and crying," Antonia Chajchalac-Garcia, the patient's mother said, "To this day, I don't know what happened or why."

She brought her son to Dental Health Associates in Irvington, New Jersey.

The procedure was conducted last week under local anesthesia by Patrick Bamgboye.

His dental license was suspended after a six-year-old patient died under somewhat similar circumstances in 2004.

Sinus infection? Antibiotics won't help

Roughly 20% of the antibiotic prescriptions written in the United States for adults each year are for sinus infections. That's an impressive statistic, given that doctors and public health officials have long doubted that antibiotics can successfully treat the condition.

A new study, published this week in the Journal of the American Medical Association, appears to confirm those doubts: The antibiotic amoxicillin was no better than placebo at improving the congestion, cough, runny nose, pain, and other symptoms that accompany sinus infections (also known as acute sinusitis), researchers found.

"Compared to placebo, amoxicillin doesn't seem to provide any benefits," says lead author Jane Garbutt, an associate professor at the Washington University School of Medicine, in St. Louis. "In terms of patient satisfaction, side effects, symptom relief, days missed from work, et cetera, we did not see any difference."

Most sinus infections are caused by viruses, which don't respond to antibiotics. But even bacterial sinus infections rarely require antibiotic treatment, according to the Centers for Disease Control and Prevention. In most cases, both types of infection go away on their own in less than two weeks.

"Most patients get better despite antibiotics, not because of them," says Garbutt. "There is a high rate of spontaneous resolution."

Doctors Warned About Counterfeit Avastin, a Popular Cancer Drug

This is troubling on so many levels. The maker of the Avastin cancer drug is currently warning doctors and hospitals that a fake version of the drug has been found, and it's really hard to tell if you might have the fraudulent version. Genentech, which makes Avastin, was short on details of how much fake medicine is out there and how many people are using it -- they simply found that some vials of "Avastin" did not contain the active ingredient. "It's not Avastin. It's not safe and effective, and it shouldn't be used," a spokeswoman said in a Wall Street Journal report.

Enjoy your morning!

Might Exercise Help in Prostate Cancer?

noreply@blogger.com (Gregory Flap Cole) — Wed, 15 Feb 2012 14:40:00 +0000

Here I am running up the Santa Monica Pier

Yes, according to a new study. Activity-induced genetic changes could slow or prevent disease progression, researchers say.

Vigorous exercise causes changes in some 180 prostate genes among men with early stage prostate cancer, a new study suggests.

Included are genes known to suppress tumor growth and repair DNA, which might mean that exercise could prevent or delay progression of the disease, the researchers said.

"There are many reasons to exercise," June Chan, associate professor of epidemiology and biostatistics, and urology at the University of California, San Francisco, said during a Tuesday press conference. "Here's yet another great reason to exercise and it may offer a prostate cancer-specific benefit."

For the study, Chan's team compared prostate genes from 70 men with low-risk prostate cancer to normal prostate genes from 70 men.

The cancer patients in the study were undergoing "active surveillance" -- also known as "watchful waiting" -- rather than active treatment.

The men answered questions about how much and what type of exercise they did.

Chan's group found 184 genes that were differently expressed in men who did activities such as jogging, tennis or swimming for at least three hours a week, compared with genes in men who did less exercise.

Genes more highly expressed in men who did vigorous exercise included well-known tumor-suppressor genes associated with breast cancer, BRCA1 and BRCA2, the researchers found.

In addition, these men also had increased expression of genes involved in DNA repair, they noted.

It was a small study, but promising.

Appropriate diet and exercise can pay dividends for a longer and healthful life.

California Legislature Pushes Dentistry For All Socialism

noreply@blogger.com (Gregory Flap Cole) — Tue, 14 Feb 2012 17:55:00 +0000

The Democrats have controlled the California Legislature for decades now and with a Democratic Governor in Jerry Brown, have control of state government. While the Dems in the legislature would love health care, including dentistry for all, there remains a problem - Who will pay for it, in a bankrupt state?

This is a good piece about what the Dems are doing to force the taxpayers of California to pay even more in taxes for a dental socialism scheme.

Gov. Jerry Brown has proposed shifting hundreds of thousands of residents eligible for both Medi-Cal and Medicare into managed care plans, and claims that the moves will save the state close to $700 million. Brown has proposed authorizing the Department of Health Care Services to submit a demonstration project proposal to the federal government this spring, which would shift thousands of people who are eligible for both Medicare and Medi-Cal, into managed or coordinated care plans in at least four counties, eventually expanding to 10 more counties.

Steinberg has his own answer to Brown’s plan: “I am seeking timely resolution to improving these vital dental services to enable patients to obtain the prevention and treatment services they deserve,” he wrote in the letter. “Furthermore, the significant issues identified here raise the overarching concern of whether or not the state is prepared and equipped to proceed with any Medi-Cal managed care program expansions this year as proposed in the Governor’s January budget.”

Where many voters disagree is with the use of the word “deserve.” While government is expected to provide basic services which individuals cannot provide for themselves — roads, water, utilities — expanding government into the health care for all is a growing bone of contention.

There has been NO adult dentistry medicaid (DentiCal) for the past two years in California. There is NO funding with the state's chronic structural budget deficits.

How does anyone think the California Legislature will be able to expand services for dentistry for children as mandated in ObamaCare? The state of California cannot afford the programs it has in place now.

Dental socialism in California?

Dentistry for all?

Not anytime soon...

The Morning Drill: February 14, 2012

noreply@blogger.com (Gregory Flap Cole) — Tue, 14 Feb 2012 14:41:00 +0000

Emmanouil Parisis, aka Neil McClaren, Dentist Who Faked His Own Death

Happy Valentine's Day!

On to today's dentistry and health headlines:

Dentist who faked his own death faces hearing

A DEBT-RIDDEN dentist who faked his own death in a £1.8 million life insurance scam is to appear at a disciplinary hearing of the General Dental Council later this month, accused of falsifying documents to obtain work in Britain.

Emmanouil Parisis was jailed for five years in March last year after he admitted forging documents to show he had died in a car crash while on holiday in Jordan and fraudulently claiming a total of £1.85 million in life insurance policies.

Following his fake death, he started a new life in Scotland under the name of Neil McLaren, working as a dentist in Peterhead, Aberdeenshire.

Plymouth Crown Court was told Parisis faked his own death because he was £395,000 in debt and was about to be barred from working as a dentist under his old identity after a string of complaints.

Accreditation issues shut down Calif. dental hygiene program

A dental hygienist training program in California abruptly shut down last week, leaving its students -- many of whom had prepaid up to $45,000 for the three-year program -- wondering what to do next.

On February 7, students in the dental hygiene program at the Institute of Medical Education (IME) received a letter stating that the institute would no longer be able to continue the program because its accreditation status was in jeopardy.

"I am so frustrated and depressed," said one first-year student who asked to remain anonymous. "My classmates and I get together and cry."

The school, which has campuses in Oakland and San Jose, offers certificate programs in vocational nursing, medical assisting, and other health-related fields, as well as associate degrees in dental hygiene. The three-year dental hygiene program included 18 months of prerequisites and 18 month of a focused clinical program.

IME officials say that because the school's accrediting body, the Western Association of School and Colleges (WASC), has withdrawn its participation with the U.S. Department of Education (DoE), IME can no longer offer the dental hygiene program and has lost its eligibility to receive Title IV financial aid.

"Per the Commission on Dental Association (CODA), in order to operate a dental hygiene program, an institution must be accredited by a regional or national accrediting agency that is recognized by the U.S. Department of Education," Khoi Lam, program manager at the IME Oakland campus, wrote in the letter. "In light of these new obstacles, the Institute of Medical Education will not be able to start a future cohort for the Dental Hygiene Program."

CODA, an agency of the ADA, is the national accrediting body for dental and allied dental education programs.

'Model' dental program proves painful for kids

Almost two decades ago, the state made Sacramento County the testing ground for a new model of delivering dental care to poor children. Officials envisioned a managed care system that would control costs and improve children's ability to see a dentist.

Today that model persists – but state data show that the county has consistently produced one of California's worst records for care.

Critics – including local dentists, county officials, school nurses and family members – contend that Sacramento's special model of care forces many children to wait months or even years before receiving needed treatment, even if they have broken or rotting teeth, or are in so much pain that they can't chew.

What’s the Best Way to Help Teen Girls Control Their Weight?

Remember being a teenager? You probably wanted to spend as little time with your parents as possible. So it’s not surprising that the usual weight-control strategy used for younger kids — counseling and advice delivered to the whole family at once — isn’t so appealing to adolescents.

Researchers at Kaiser Permanente wanted to test out an approach aimed specifically at teen girls: one that involved peer meetings, with parents meeting separately, and that also tried to avoid messages that might encourage eating disorders.

In a paper published online in Pediatrics, the researchers report some early, but modest, success with the program. “It’s a first step” says Lynn DeBar, lead author of the study and a researcher with the Kaiser Permanente Center for Health Research.

Enjoy your Valentine's Day!

Food and Drug Administration Shuts Down Dental Implant Manufacturer

noreply@blogger.com (Gregory Flap Cole) — Mon, 13 Feb 2012 20:19:00 +0000

Accurate Set must discontinue operations.

Federal health officials say a New Jersey company has been legally barred from making and selling a variety of dental products due to violations at its manufacturing facility.

The Food and Drug Administration says a court order against Accurate Set requires the company to discontinue operations until the agency has verified its dental implants meet federal standards.

FDA inspectors found numerous quality control violations at the company’s factory in Newark, N.J., during a recent inspection. The company did not have systems in place for reviewing customer complaints or correcting defective products, among other missing requirements.

The company is not currently manufacturing devices and will have to pass an FDA review process before resuming operations.

A consent decree was signed by the company last Thursday.

Here are the warning letters on the FDA website.

The Morning Drill: February 13, 2012

noreply@blogger.com (Gregory Flap Cole) — Mon, 13 Feb 2012 17:09:00 +0000

Good Monday morning!

On to today's dentistry and health headlines:

Dentist admits filing false Medicaid reports

Prominent Wilmington dentist Marieve Rodriguez admitted to 10 misdemeanor counts of filing false Medicaid reports today in exchange for state prosecutors dropping 19 felony counts of health care fraud.

In addition Rodriguez, who operates Gentle Care Family Dentistry on Gilpin Avenue, will pay a $100,000 fine, repay $72,000 to the state’s Medicaid program and $50,000 to cover the costs of prosecution.

She also agreed to have her license to practice medicine suspended for a year and to not participate in the state’s Medicaid program -- should she get her license back -- for at least five years.

By admitting to the 10 misdemeanor charges, Rodriguez faces up to 10 years in prison, but prosecutor Kathleen Vavala is only recommending one year of home confinement as part of the deal.

Judge John A. Parkins Jr. set sentencing for June 20.

Ill. man bilks Medicaid of $2M for erectile pumps

An Illinois man was sentenced Friday by a federal judge in Rhode Island to more than three years in prison for shipping unwanted penis enlargers to diabetes patients as part of a larger fraud scheme that prosecutors say bilked $2.2 million from Medicare over four years.

Gary Winner, 50, of Wheeling, Ill., must also forfeit more than $2.2 million that prosecutors say Medicare lost because of the plot.

U.S. District Court Judge William E. Smith also ordered Winner to pay a $12,500 fine and serve three years of supervised release following his prison sentence.

Lawyers for Winner had sought a maximum sentence of 1 ½ years. The guidelines for determining Winner’s punishment recommended he get a prison term between just under six years and a little more than seven years. Winner’s attorneys argued that punishment was too harsh, according to court papers.

Winner’s attorneys also asked that his emotional problems and difficult childhood, including physical and psychological abuse at his father’s hands, be taken into consideration, court papers show.

Prosecutors sought a prison term at the low end of the range that Winner was facing. He pleaded guilty in November to two counts of health care fraud, the introduction of an adulterated and misbranded medical device into interstate commerce and money laundering. He faced up to 33 years in prison.

California sets trends in health regulation

Beyond skateboards, Silicon Valley and hippies, California has a trendsetting streak of a different kind.

The state has been first to pass major public health initiatives that have spread throughout the country. California was first to require smog checks for clean air, pass anti-tobacco initiatives and bike helmets laws.

While these laws were met with skepticism and ridicule, they've often become standard practice in other states. The Golden State was first to ban smoking in workplaces, bars and restaurants in 1998. Now similar rules exist throughout the country.

Some advocates tout the state as a forward-thinking vanguard in which its health and safety laws are routinely emulated by other states.

"There have been progressive legislations in tobacco, environment and obesity prevention," said Mark Horton, a lecturer at the University of California Berkeley School of Public Health. "In some respect, the rest of the country looks to California as a laboratory for moving forward with those various types of initiatives."

But some critics liken the Golden State to a nanny state. California has 151,002 health and safety laws.

Alzheimer's Families Clamor for Drug

In the wake of research suggesting a skin-cancer drug may have benefits in treating Alzheimer's disease, physicians and advocacy groups are getting a flurry of calls from patients seeking to use the drug off-label.

The clamor underscores how urgently patients want solutions to the rising tide of Alzheimer's. But experts caution that more research is needed to determine whether the drug, bexarotene, is effective in humans at all, not to mention what the dosage should be.

The study, published Thursday in the journal Science, was conducted in mice, and the road to an effective Alzheimer's treatment is littered with failures that looked promising early on in animals.

"The Alzheimer's community is very desperate for anything that shows any sign of hope or promise," said Eric Hall, chief executive of the Alzheimer's Foundation of America, a New York-based advocacy organization that started to field calls from consumers as soon as the paper was published.

While Mr. Hall said he was "cautiously optimistic" about the drug, which appears to clear a sticky substance called amyloid from the brains of Alzheimer's mice, "I don't think people should be taking this in their own hands or running to it," he said.

Sam Gandy, a neurology professor at Mount Sinai School of Medicine and associate director of its Alzheimer's Disease Research Center, said he wasn't surprised to get inquiries from patients about bexarotene, as they also often ask for off-label use of another treatment on the market, intravenous immunoglobulin, which costs about $50,000 a year and is given in time-consuming infusions.

Enjoy your morning!

The Afternoon Drill: February 10, 2012

noreply@blogger.com (Gregory Flap Cole) — Fri, 10 Feb 2012 20:29:00 +0000

Good afternoon!

On to today's dentistry and health headlines:

FDA probes illegal sale of handheld dental x-ray units

The U.S Food and Drug Administration (FDA) is warning dental and veterinary professionals not to purchase or use certain potentially unsafe handheld dental x-ray units that are sold online by manufacturers outside the U.S. and directly shipped to U.S. customers.

The FDA is concerned that these devices may not be safe or effective and could expose users and patients to unnecessary and potentially harmful x-rays. The units have not been reviewed by the FDA and do not meet FDA radiation safety requirements, the agency noted in a press release issued February 10.

The Washington State Department of Health alerted the FDA after tests on a device purchased online revealed it did not comply with x-ray performance standards.

As a result, the FDA is investigating the extent of the problem and is notifying state regulatory authorities, dental professional organizations, and other health organizations about the safety risks. To date, no adverse events have been reported.

A handheld dental x-ray unit is a small, portable device that is intended for dental x-ray examinations. Use of these devices requires a prescription from a licensed practitioner, the FDA noted.

All units that have been cleared by the FDA bear a permanent certification label/tag, a warning label, and an identification (ID) label/tag on the unit.

The certification label should state "This product complies with 21 CFR 1020.30 - 1020.31," "This product complies with 21 CFR Subchapter J," or other similar language.

'Meth mouth' being seen more by local dentists

Oswego County has been the location of several meth lab busts, including a mobile lab seized in parking lot of Lowe’s Plaza, meth lab found in a Town of Williamstown, and two accused of making meth in Mexico.

Another sign of the growing meth problem in Oswego County is being noticed by local dentists.

General Dentistry's, Dr. Robert Schaefer, told News Channel 9 that he’s seeing more and more cases of a condition known as "meth mouth."

Schaefer said, “The cavities that occur with the use of methamphetamine usually develop on the front surfaces of the teeth. The decay from methamphetamine is very, very obvious. It's very different from other types of oral conditions.”

The American Dental Association's website says that dental health care professionals should be aware that methamphetamine use is widespread in the U.S. because it's cheap, easy to make and the high lasts much longer than crack cocaine. Meth is a potent central nervous system stimulant that can cause shortness of breath, hyperthermia, nausea, vomiting, diarrhea, irregular heart beat, high blood pressure, permanent brain damage and rampant tooth decay. Users describe their teeth as "blackened, stained, rotting, crumbling or falling apart." Teeth often cannot be salvaged and must be extracted.

New Attack on Alzheimer's: Cancer Drug Reverses Disease's Symptoms in Mice; Human Tests to Start Soon

A cancer drug quickly and dramatically improved brain function and social ability and restored the sense of smell in mice bred with a form of Alzheimer's disease, suggesting a new way to tackle the illness in people.

Alzheimer's is associated with the accumulation of protein fragments called amyloid-beta in the brain. The new research found that an existing skin-cancer drug called bexarotene cleared the protein in the brains of stricken mice within days. The study was published Thursday in the journal Science.

Because bexarotene is known to be safe for treating skin cancer, "it might be worth trying in Alzheimer's patients as well," said Rada Koldamova, a neuroscientist who works on Alzheimer's at the University of Pittsburgh and wasn't involved in the study. However, she added, the drug's effectiveness against the brain malady would first have to be established in human trials. Test results in mice often don't pan out in humans.

Everyone's brain produces amyloid-beta protein, but while a healthy brain can efficiently remove the protein fragments, the brain of a person with Alzheimer's can't. The resulting buildup is believed to result in impaired learning and memory functions.

The disease is a growing problem, especially in aging societies, but no effective treatment has been found. The drugs used today work just for a short time and only relieve symptoms, instead of halting the disease. Over the years, drugs in about a half-dozen late-stage human trials have failed to make the cut.

Enjoy your afternoon!

Tom's of Maine to Award Five $20K Grants to Non-Profit Dental Clinics

noreply@blogger.com (Gregory Flap Cole) — Thu, 09 Feb 2012 20:11:00 +0000

From the press release:

Every day, thousands of families go without basic dental care - not even able to afford an annual cleaning. This difficult reality is especially urgent in states with the highest percentage of their population living under the poverty level such as Alabama, Kentucky, New Mexico, Mississippi and Washington D.C., according to U.S. Census bureau statistics*. This year, Tom’s of Maine is directing its Dental Health for All program to help families in these areas and inviting non-profit clinics serving these four states and Washington D.C. to apply for a portion of $100,000 in funding.

Dental Health for All celebrates the goodness non-profit clinics bring to their communities by sharing their expertise and working to alleviate the stress and health concerns of people in need. This year the program plans to award one clinic from each of the four states and Washington D.C. with $20,000 in funding to grow and expand the reach of their services. Organizations that provide free or low-cost dental care can learn more about this year’s program and apply at tomsofmaine.com/dentalhealthforall.

“Many clinics simply need additional resources to keep up with demand, especially during this struggling economy when people are faced with losing or forgoing health benefits,” said Susan Dewhirst, goodness programs manager at Tom’s of Maine. “We often hear that dental care is among the first benefits to go yet it is vital to maintaining overall health. We encourage clinics in the designated states to apply for the funding and we hope people will alert local clinics of this opportunity.”

Tom’s of Maine has a decades-long commitment to supporting local non-profit clinics that provide greater access to quality, affordable oral care. To date, Dental Health for All has helped make 200,000 additional patient visits possible with $1 million in funding to more than 30 school and community-based dental clinics nationwide.

Applications for this year’s program must be received by March 15, 2012. Recipients will be announced in early April. Dental clinics in Alabama, Kentucky, New Mexico, Mississippi and Washington D.C. that are registered 501(c)3 non-profit organizations in good standing are eligible to apply.

Applications can be made here.

A great charity and thanks to Tom's of Maine for giving back....

Pennsylvania Dentist Disputes Failure to Register Dental X-ray Machines

noreply@blogger.com (Gregory Flap Cole) — Thu, 09 Feb 2012 17:09:00 +0000

Browser Center for Advanced Dentistry

This story seems confusing, especially since the dentists have signed a consent decree.

A Springettsbury Township dental center was fined recently by the state's Department of Environmental Protection, but an owner of the facility maintains the state is mischaracterizing the offense.

Bowser Center For Advanced Dentistry, 2161 E. Market St., must pay $12,840 for failure to register X-ray machines that were used to evaluate dental patients from 1992 through 2010, according to the DEP.

X-ray machines must be registered with DEP for inspection to make sure they comply with the Radiation Protection Act, which authorizes the agency to monitor X-ray equipment operation and procedures to ensure safety, said DEP South-central Regional Director Rachel Diamond.

The center was issued a notice of violation last September for failing to register X-ray machines with the state, said DEP spokeswoman Lisa Kasianowitz.

She said the machines were not inspected for those 18 years, but the DEP doesn't believe any harm was caused to patients. The dentists have since corrected the violations and are now in compliance with regulations, she said.

Center co-owner Dr. Carl Bowser said the $12,840 fine reflects the retroactive cost of registering the machines, which he concedes had not been done. But Bowser maintains the machines had been inspected all along.

He said the registration failure was a result of paperwork confusion, but the DEP continued to inspect the machines and never found any problems with them.

I realize the fine is very large, but we are talking about many years where the x-ray machines were not registered - 1992 through 2010!

Since the dentist owner signed a consent order and obviously agreed to pay the fine, the issue really is over.

But, a word to the wise dentist, comply early with the state government regulations in your state.

If you don't like the regulations and the fees involved, lobby your state legislators to get the law changed. But, in the meantime, fill out the forms and pay the registration fees (taxes).

If you don't the state will get you. Then, you get the bad PR and often times have to pay penalties.

Pennsylvania Dental Patient Sentenced to Prison for Stealing a Wisdom Tooth Extraction

noreply@blogger.com (Gregory Flap Cole) — Thu, 09 Feb 2012 14:39:00 +0000

Two wisdom teeth

Actually, the dental patient gave a false name and failed to pay for the dental services, including the extraction of his wisdom tooth.

The toothache may have hurt, but how can it compare to hearing you will spend a year in a state penitentiary?

Jay Meyerhoff, age 30, of Milford was sentenced Jan. 26 in Pike County Court to a State Correctional facility for one to three years. He was eventually charged with Theft of Services after he had a wisdom tooth pulled, and left the dental office without paying.

The incident stems from April 28, 2011, when Meyerhoff arrived at Horizon Dental Care, Palmyra Township, Pike County and said he needed a tooth extracted.

He filled out all the necessary paperwork indicating that his name was “James R. Irving.” Prior to going back to the examination room he said that he was going to pay by check.

After having the tooth extracted, he exited the examination room and advised the receptionist that he forgot his check book in his vehicle. He then walked out of the office and never returned to pay his bill of $322.00.

Now, you know why most dentists and oral surgeons request that you pay for extractions and other emergency dental services, prior to receiving treatment.

Ironically, the patient could have presented to the same dental office a few weeks earlier, when they were offering "free" dental services at the office's annual Dentistry From the Heart program.

Not For Profit Delta Dental Executive Pay and Perks Exposed

noreply@blogger.com (Gregory Flap Cole) — Wed, 08 Feb 2012 18:44:00 +0000

Extraordinary is not the word. How about excessive?

Delta Dental is the nation's biggest provider of dental insurance. It has 56 million patients in its network, about one-third of all dental patients in the country. Last year, the 39 non-profit Delta Dental groups across America combined for $15.2 billion in revenue. It's a massive organization. Since it's not-for-profit, Delta Dental doesn't pay federal or state income taxes.
Delta Dental is registered as a 501(c)(4) not-for-profit, which means it's a mission-driven organization and must give back to the community to retain it's non-profit status. Generally, according to the IRS, 501(c)(4) organizations have more lattitude than those classified as 501(c)(3), like Goodwill, which can accept tax deductable donations. Still, according to the IRS, organizations like 501(c)(4) organizations like Delta Dental must focus on the social mission, not the operation of a business.
A 501(c)(4) says "an organization is not operated for the promotion of social welfare if its primary activity is carrying on a business with the general public in a manner similar to organizations operated for profit."

Sounds to me that Delta Dental is being run like a for profit company.

It is time for the feds and IRS to re-evaluate their tax status.

And, to think, when I was in private practice all of those dental insurance denials for my patients and crappy annual maximums.

Go figure....

The Morning Drill: February 8, 2012

noreply@blogger.com (Gregory Flap Cole) — Wed, 08 Feb 2012 14:25:00 +0000

Good Morning!

On to today's dentistry and health headlines:

Educators, dentists consider mobile dental vans

Educators and dentists in Rockingham County are working together to try and provide a way to reach the population of Medicaid-eligible children who are still not seeing a dentist on a regular basis.

Several groups approached Rockingham County Schools three years ago wanting to come in and provide dental services to students. Dr. Jean Steverson, assistant superintendent for instructional services, said the service was initially turned down when they said they would only offer cleanings, X-rays and sealants. She said they wanted a more comprehensive program.

She said they were particularly interested in one that offered restorations because their goal is to provide the most comprehensive care for county students.

“We wanted to help because 36 percent of Medicaid-eligible students are not receiving dental care,” she said. “As much service as local people can provide with the dental clinic, Give Kids a Smile and other programs…we still have kids that aren’t seeing the dentist. There has to be a way to address those concerns.”

She said the conversation among local dentists and officials with the health department is having a positive impact on the problem.

“We’re thinking about what we can do with the resources we already have to make a difference,” she said. “We’ve set a common goal and it’s critical for us to come together on this. We don’t have a complete answer now – maybe it’s a mobile dental van – but we need to continue this dialogue.”

Obama boosts funds for Alzheimer's research

The Obama administration plans to spend an additional $156 million over the next two years to help find an effective treatment for Alzheimer's, a fatal brain-wasting disease that affects more than 5 million Americans.

The White House said on Tuesday it will spend and extra $50 million this year, and it will seek an extra $80 million in fiscal 2013 to bolster Alzheimer's research. Obama also plans to spend an additional $26 million in programs to support people who care for Alzheimer's patients.

The spending increase is intended help make good on a U.S. target set last month to find a way to treat or prevent Alzheimer's by 2025, a goal some experts fear is too ambitious.

Current drugs help manage symptoms but so far no therapy can stop the progression of Alzheimer's, which can start with vague memory loss and confusion before progressing to complete disability and death.

Experts predict that without an effective treatment, the number of Americans with Alzheimer's will double by 2050 and related healthcare costs could soar to more than $1 trillion a year.

Sports drinks can spell dental disaster

Dentists say kids are literally drinking their teeth away.

The culprits: energy drinks, sports drinks – the beverages every kid wants.

Milk is no longer the No. 1 drink in America. And sports drinks got a boost when schools brought them in to replace pop. It was meant to be a healthier option. But sometimes, it’s exactly the opposite.

Indiana dentists say the drinks can be devastating.

"Twenty years ago, I thought we had decay on the run,” said Dr. Diane Buyer, a dentist in Nora. “It has come back with a huge vengeance.”

She showed the teeth of a 21-year-old with rampant decay. Five years ago, he didn’t have any cavities.

She also showed the teeth of a 30-year-old man who admitted drinking a 2-liter bottle of Mountain Dew every day.

She said now that man’s mouth is undergoing major rehabilitation.

And she introduced us to Wes Bruemmer, a Brebeuf High School graduate who played baseball. Bruemmer said because he was so active, he drank a lot of sports drinks. He thought it was just as good as or better than water. He said he drank three sports drinks a day.

“After practice I was gulping them, but during school I was sipping,” he said.

Bruemmer had no cavities before braces. But 18 months later, he had 12 cavities.

Sports drinks can spell dental disaster: wishtv.com

Bread, Bologna, Cheese Top List of Salty Foods

Just 10 types of food account for nearly half of the nation's excessive sodium intake, government researchers found.

About 44% of Americans' mean daily sodium consumption -- almost 3,300 mg -- comes from breads, cold cuts, pizza, poultry, soups, sandwiches, cheese, pasta dishes, meat dishes, and snacks such as popcorn and chips, Mary Cogswell, PhD, of the CDC, and colleagues wrote in an MMWR Vital Signs report.

Although some of those foods, like bread, aren't inherently high in salt, the frequency with which they're eaten during the day ups their contribution to the total sodium count, the researchers said.

Brands also matter, they said. Sodium in different types of chicken noodle soup, for instance, can vary from a low of 100 to as much as 940 mg per serving, while a slice of bread can range from 80 to 230 mg.

Cogswell and colleagues wrote that food bought at supermarkets and convenience stores accounts for a majority -- 65% -- of the salt in Americans' diets, while another quarter is traced to restaurants, where it's often hard to tell how much salt is in each dish.

Almost all Americans (90%) consume more salt than they should, and the national average -- not including salt added at the table -- is 3,266 mg of sodium daily.

That's almost 1,000 mg more than the government's recommended daily intake, they wrote, and almost twice as much as the 1,500 mg per day recommended for specific groups: patients over 5o, blacks, and those with high blood pressure, diabetes, chronic kidney disease.

Enjoy your morning!

The Daily Extraction: February 7, 2012

noreply@blogger.com (Gregory Flap Cole) — Wed, 08 Feb 2012 03:37:00 +0000

Teeth #1, 4 and 5 are extracted for this patient

Here is Dr. Tommy Murph extracting these teeth in the video below:

Enjoy your daily extraction!

Dr. Murph is a South Carolina dentist who practices general dentistry who really excels in extracting teeth.

For patients in the Myrtle Beach area, I can heartily recommend Tommy as YOUR dentist.

For dentists, Dr. Murph has a number of resources for you in extracting teeth, including one on one courses in his office and travel (outside the USA) courses with "hands on" instruction.

Dr. Murph's website is here and his extraction manuals are here on e-Bay.

Previous:

The Daily Extraction Archive

Dental Assistant Pleads Guilty to Murdering Dentist Employer Dr. Albert Ro

noreply@blogger.com (Gregory Flap Cole) — Tue, 07 Feb 2012 20:17:00 +0000

Dentist, Dr. Albert Ro

The dentist was brutally murdered to cover up the dental assistant's embezzlement.

More than five years after Dr. Albert Woonho Ro was found beaten to death in his Glen Burnie dental office, his dental assistant admitted Monday that she siphoned more than $17,000 from his business and had him killed to cover it up.

Shontay Joyner Hickman, 36, of Baltimore pleaded guilty Monday to first-degree murder in the death of the dentist, who was from a family well-known in the local Korean-American community. She was sentenced to life in prison.

Hickman's plea agreement was sealed because of the continuing investigation — a man charged in Ro's killing is scheduled to go on trial in May.

A warning to dentists to have secure monitoring of their business office affairs and to interview for employees very carefully.

Ohio Veterans Administration Continues to Investigate Dental Infection Control Lapses

noreply@blogger.com (Gregory Flap Cole) — Tue, 07 Feb 2012 14:54:00 +0000

Well, it has been about a year since the flap began.

And, the investigation continues - asking the question: Did three veterans who tested positive for hepatitis contract the disease during visits to the hospital’s dental clinic?

One year after the Dayton VA Medical Center publicly disclosed infection control lapses that risked the health of hundreds if not thousands of veterans, hospital officials soon expect the answer to a key question: Did three veterans who tested positive for hepatitis contract the disease during visits to the hospital’s dental clinic?

The U.S. Department of Veterans Affairs has turned to the Centers for Disease Control and Prevention for help in answering that question. While an internal VA investigation has not identified a link between the three positive cases and the care they received at the dental clinic, a team with the CDC’s viral hepatitis branch for several months has been conducting a more in-depth analysis, called “ultra-deep sequencing.”

That genotype sequencing should show whether the specific hepatitis strains found in the veterans are identical or very similar to those found in other veterans seen previously in the clinic who contracted the disease elsewhere. A match would seemingly prove that poor infection control practices in the dental clinic was res-ponsible for the spread of one patient’s hepatitis infection to another patient.

The analysis is nearly complete, and VA officials expect results “within the next several weeks.”

“They say they’re close to getting us an answer,” said Glenn Costie, who in December became director of the Dayton VA.

The Dayton VA on Feb. 8, 2011, confirmed the infection control lapses and offered testing to 535 veterans it said could be at risk for hepatitis or HIV. Those patients had been seen by Dr. Dwight Pemberton, now 82, who allegedly failed to change latex gloves and sterilize dental instruments between patients for several years until whistle-blowers reported the alleged problems to outside VA officials in July 2010.

Pemberton, who retired just days after the VA publicly acknowledged potential infections, has vehemently denied the allegations.

Here is the report of the U.S. Department of Veterans Affairs (VA) Office of the Inspector General (Pdf) from April 25, 2011.

Stay tuned.....

Calls for more testing at Dayton VA: wdtn.com

The Morning Drill: February 6, 2012

noreply@blogger.com (Gregory Flap Cole) — Mon, 06 Feb 2012 15:07:00 +0000

Former Eagles fullback Kevin Turner, who has been diagnosed with ALS, is suing the NFL for negligence

Good Monday Morning!

On to today's dentistry and health headlines:

CDA pulls plug on Watsonville fluoridation project

Following a 10-year battle that went all the way to the California Supreme Court, a decision was made this week for the city of Watsonville, CA, not to adopt water fluoridation due to the cost of implementing the fluoridation system.

Watsonville's battle over water fluoridation dates back to 2002, when residents voted by a small margin to eliminate the practice. But the city lost a subsequent court battle that went all the way to the state Supreme Court, in which it contested a 1995 state law that requires any California city with a population of more than 10,000 to fluoridate its water if outside funding is provided.

Head-trauma lawsuits against NFL grow into hundreds

A nasty collision during a kickoff in 1997 left Kevin Turner seeing stars.

The former Philadelphia Eagles fullback, who spent eight seasons battering through defensive lines in the National Football League, said the hit left him wondering where he was.

Still, the team's medical staff looked him over and eventually sent him back out to play, he said.

"The doctor looked in my eyes," Turner recalled in a statement delivered by his attorney in response to questions from CNN. "He then told me to remember these words, either four or five simple, basic words."

But the task proved daunting.

"It was the weirdest thing ever and most frustrating because at the time I was clamoring to get back into the game," said Turner. "I was really trying so hard. And I remember it being just the most frustrating thing ever."

By the second half, he'd remembered.

"I went back in the game after halftime and played the rest of the game," he added in the statement to CNN.

A little over a decade later, the former Eagle is battling the debilitating effects of amyotrophic lateral sclerosis, often known as ALS or Lou Gehrig's disease.

Vaccine Eyed for Early-Stage Prostate Ca

The immunotherapy agent sipuleucel-T (Provenge) appears safe for use earlier in prostate cancer, researchers found.

Neoadjuvant treatment in localized prostate cancer didn't impact surgery or complications, though one of the 42 patients in the phase II trial experienced a serious infusion reaction, Lawrence Fong, MD, of the University of California San Francisco, and colleagues reported.

The trial also confirmed the expected immune-cell responses when given outside of the approved setting in patients with metastatic prostate cancer.

"What this opens the door to, far down the road, is perhaps taking high-risk patients and maybe pretreating them with sipuleucel-T to help their immune system recognize cancer before it has the chance to metastasize," commented Leonard Gomella, MD, of Thomas Jefferson University in Philadelphia and chair of the conference program committee.

That early stage setting theoretically is where the prostate cancer vaccine would work best, Fong noted in an interview with MedPage Today. "Men with more limited cancer will be less immune compromised," he explained.

Sipuleucel-T therapy involves collecting a patients' own peripheral white blood cells, which undergo ex vivo treatment to induce recognition and reaction to tumor cell antigens, and then infused back as a mix of activated and antigen-presenting cells.

The theory that this treatment induces an immune attack on the tumor has been suggested by post-treatment blood samples showing an uptick in certain types of immune cells, but advanced prostate cancer doesn't offer ready opportunities for biopsy to confirm an impact on the tumor itself.

New York City Defends Health Ads That Frighten the Viewer

The city’s health department uses no sugar-coating in its latest ads, which feature images of overweight people whose mobility is impaired to warn of the dangers of ever-growing portions of unhealthy food and soft drinks.

The ads are the latest installment in a campaign by the Bloomberg administration to jolt New Yorkers out of bad health habits; other ads, which have run in the transit system and on local broadcast outlets and the Internet, have depicted smokers who lost fingertips or their ability to speak normally.

The city’s approach — in one recent ad it sharpened its message by editing off a model’s leg — has drawn some criticism for its negativity. But it is not the health department’s first brush with controversy: In 2009, it ran an ad that suggested drinking a can of soda a day could add 10 pounds of fat a year. Internal e-mails exposed dissent about that claim among officials of the department.

On a lighter note, the department has been running an ad that claims a person would have to walk the three miles from Union Square in Manhattan to Brooklyn to burn off the calories in a 20-ounce soda.

Have a good morning!

The Daily Extraction: February 4, 2012

noreply@blogger.com (Gregory Flap Cole) — Sun, 05 Feb 2012 05:20:00 +0000

#16 and 17 removed with a Dr. Murph Crane Pick

In this case, Dr. Murph, removes two third molars (wisdom teeth) in short order.

Here is the pre-operative radiograph:

And, the teeth upon removal (look at the curved root on the #16!):

Enjoy your daily extraction!

The Morning Drill: February 2, 2012

noreply@blogger.com (Gregory Flap Cole) — Thu, 02 Feb 2012 14:43:00 +0000

Groundhog Club handler John Griffiths, left, holds Punxsutawney Phil, the weather prognosticating groundhog, during the 126th celebration of Groundhog Day on Gobbler's Knob in Punxsutawney, Pa. Thursday, Feb. 2, 2012. Phil saw his shadow, forecasting six more weeks of winter weather

Good Morning and Happy Groundhog Day!

On to today's dentistry and health headlines:

Some Downsides of Social Media for Doctors

With the preponderance of optimistic takes on physicians participating (some even suggesting we have an obligation to participate) in various forms of social media through blogging, Twitter-ing, and Facebook-ing, perhaps one of us should take a moment to acknowledge that there are some downsides to this practice for doctors and nurses. Increasingly, I have been thinking a lot about this topic and how to explain it without sounding like "Debbie Downer."

As my perspective has matured in the blog-o-sphere, I have had several insights that have tempered my unabashed enthusiasm for social media. Perhaps it would be helpful to share those to keep the discussion real for doctors considering a dive into this space.

Blogging, unlike diamonds, really is forever

Even if you try to delete a single published post or an entire blog, it's tough to delete all the references to the work that have been reprinted, reformatted or placed in an archived cache online. Further, the anatomy of a single tweet exposes us to the reality of the Internet: much more is contained in any post or tweet besides its content -- like time, computer type, location. Just as important: you are writing in pen (make that an indelible marker!), not pencil, when your publish a thought on a social media platform. While this might be a good thing for many, the potential to take prose out of context (sarcastic or not) could have significant legal ramifications for those involved in the care of patients. In my 6+ years of writing, I often think about this and wonder if the benefits I have garnered by sharing my insights could be rendered mute by a single legal reference to this blog.

Eating Patterns Tend to Mimic Dining Partner's

Women adjusted their eating patterns to match those of their dining companions, researchers found.

In a small study, young women were significantly more likely to take a bite when the person with whom they were sharing a meal drew her fork to her mouth (P<0.001), Roel Hermans, PhD, of Radboud University Nijmegen in the Netherlands, and colleagues reported online in PLoS One.

The finding suggests that behavioral mimicry -- the process by which people unwittingly imitate the behavior of another person -- may be at work during dinner.

Studies have shown that women eat more when the people they're dining with eat more, and tone down their consumption when their partners eat less. It's been hypothesized that behavioral mimicry was responsible for the behavior, but no studies had yet tested whether that's the case.

Enrollment Up, Premiums Down in Medicare Advantage Plans

Enrollment in Medicare Advantage plans has risen by 10% in the past year and premiums have dropped by 7%, despite billions of dollars in reimbursement cuts to the program, HHS officials announced Wednesday.

Enrollment in the plans -- which are run by private insurers -- has grown from 11.7 million Medicare beneficiaries in 2011 to 12.8 million in 2012, a 17% increase. The average premium has dropped by more than $2 per month since last year and now averages $31.54 per month, according to the Department of Health and Human Services (HHS).

Medicare Advantage plans were targeted by Democrats as an area in which to cut spending during debate over the Affordable Care Act (ACA), in part because the private plans used to be paid about 13% more than traditional Medicare plans. A recent Government Accountability Office study found the government overpaid private insurance companies administering Medicare Advantage plans by as much as $3.1 billion in 2010.

Current Medicare Advantage payments are closer to 7% higher than traditional Medicare plans, Jonathan Blum, MD, director of Medicare for the Centers for Medicare and Medicaid Service, told reporters on a Wednesday morning call.

Ultimately, the ACA cut more than $100 billion from Medicare Advantage over 10 years.

Path Is Found for the Spread of Alzheimer’s

Alzheimer’s disease seems to spread like an infection from brain cell to brain cell, two new studies in mice have found. But instead of viruses or bacteria, what is being spread is a distorted protein known as tau.

The surprising finding answers a longstanding question and has immediate implications for developing treatments, researchers said. And they suspect that other degenerative brain diseases like Parkinson’s may spread in a similar way.

Alzheimer’s researchers have long known that dying, tau-filled cells first emerge in a small area of the brain where memories are made and stored. The disease then slowly moves outward to larger areas that involve remembering and reasoning.

But for more than a quarter-century, researchers have been unable to decide between two explanations. One is that the spread may mean that the disease is transmitted from neuron to neuron, perhaps along the paths that nerve cells use to communicate with one another. Or it could simply mean that some brain areas are more resilient than others and resist the disease longer.

The new studies provide an answer. And they indicate it may be possible to bring Alzheimer’s disease to an abrupt halt early on by preventing cell-to-cell transmission, perhaps with an antibody that blocks tau.

Enjoy your morning!

The Morning Drill: February 1, 2012

noreply@blogger.com (Gregory Flap Cole) — Wed, 01 Feb 2012 14:43:00 +0000

Good Morning!

On to today's dentistry and health headlines:

Hazlet dentist Dr. Ping Cai indicted for alleged Medicaid fraud

Dr. Ping Cai of Holmdel, a dentist with a practice in Hazlet, has been indicted for allegedly submitting false claims totaling $39,000 to the Medicaid program, state Attorney General Jeffrey S. Chiesa said Tuesday.

Cai, 49, is charged with second-degree health care claims fraud and two counts of third-degree Medicaid fraud.

The Monmouth County grand jury indictment alleges that between Jan.1, 2007 and Jan.1, 2010, Cai fraudulently billed the Medicaid program for dental service purportedly rendered to Medicaid recipients. It is alleged that Cai submitted fraudulent claims for payment from Medicaid for relining and rebasing of dentures and filling of cavities when those dental services were not rendered.

An investigation by the state Office of the Insurance Fraud Prosecutor’s Medicaid Fraud Control Unit determined that, as a result of alleged fraud, Cai was allegedly paid the more than $39,000 by Medicaid for the services that were not rendered.

Dr. Ping Cai of Holmdel

Pfizer recalls 1M birth control packs after mixup

Pfizer Inc. is recalling 1 million packets of birth control pills because of a packaging error that could leave women with an inadequate dose of the hormone-based drugs and raise the risk that they will get pregnant accidentally.

The problem affects 14 lots of Lo/Ovral-28 tablets and 14 lots of generic Norgestrel and Ethinyl Estradiol tablets. Both products are manufactured by Pfizer and marketed in the U.S. by Akrimax Rx Products under the Akrimax Pharmaceuticals brand.

Pfizer found that some packets of the drugs had too many active tablets, while others had too few. Oral birth control products use a series of 21 drug tablets and 7 inactive sugar tablets to regulate the menstrual period while providing contraception.

The affected packets have expiration dates ranging between July 31, 2013, and March 31, 2014. Lot numbers are available at http://www.fda.gov/Safety/Recalls/ucm289770.htm

AAP Updates Childhood and Adolescent Immunization Schedules

The American Academy of Pediatrics (AAP) has issued its 2012 immunization schedules for children and adolescents, according to a policy statement published in the February issue of Pediatrics. Charts for the current immunization schedules are posted online and are openly accessible to all.

Are Diet Soft Drinks Bad for You?

A new study finds a potential link between daily consumption of diet soft drinks and the risk of vascular events.

Individuals who drink diet soft drinks on a daily basis may be at increased risk of suffering vascular events such as stroke, heart attack, and vascular death. This is according to a new study by Hannah Gardener and her colleagues from the University of Miami Miller School of Medicine and at Columbia University Medical Center. However, in contrast, they found that regular soft drink consumption and a more moderate intake of diet soft drinks do not appear to be linked to a higher risk of vascular events. The research appears online in the Journal of General Internal Medicine published by Springer.

In the current climate of escalating obesity rates, artificially sweetened soft drinks are marketed as healthier alternatives to sugar-sweetened beverages, due to their lack of calories. However, the long-term health consequences of drinking diet soft drinks remain unclear.

They found that those who drank diet soft drinks daily were 43 percent more likely to have suffered a vascular event than those who drank none, after taking into account pre-existing vascular conditions such as metabolic syndrome, diabetes and high blood pressure. Light diet soft drink users, i.e. those who drank between one a month and six a week, and those who chose regular soft drinks were not more likely to suffer vascular events

Ostrow Dentistry School launches new identity

The USC Ostrow Dentistry School is updating its brand and website.

The school launched a new site last week as part of a larger campaign aimed at demonstrating leadership and medical excellence.

The redesigned site now features a new web platform with updated information on the academic application process, requirements and courses for prospective students as well as information on the clinical services, opportunities and programs for its patients.

Dean Avishai Sadan tweeted Thursday that one of the goals for the modified site is “to accommodate our largest web audiences, prospective students and patients.”

Enjoy your morning!

Update With Video: Dentist Who Used Paper Clips in Root Canals Receives a Year in Jail

noreply@blogger.com (Gregory Flap Cole) — Tue, 31 Jan 2012 17:42:00 +0000

Mass. AG: Dentist used paper clips in root canals: MyFoxBOSTON.com

This is just in: the paper clip during root canal treatment using dentist has been sentenced to a year in jail.

A mother is blasting the one-year jail sentence given to a former Massachusetts dentist who used paper clips instead of stainless steel posts in her son's root canal.

Brenda Almeida says she is very upset about the sentence imposed Monday on Dr. Michael Clair, who pleaded guilty earlier this month to a list of charges, including assault and battery and Medicaid fraud.

Almeida says her teenage son's tooth turned black and had to be removed after Clair performed the root canal.

Judge Richard Moses said he considered Clair's acceptance of responsibility and "certain mental health issues" Clair is dealing with in imposing the one-year sentence.

Prosecutors sought a sentence of five to seven years.

The 53-year-old Clair, who had a dental practice in Fall River, now lives in Crofton, Md.

We certainly hope this dentist receives the mental health treatment that he desperately needs while in jail.

Obviously, he will never practice dentistry again.

Update:

Here is former dentist Michael Clair being sentenced:

The Morning Drill: January 31, 2012

noreply@blogger.com (Gregory Flap Cole) — Tue, 31 Jan 2012 15:37:00 +0000

Good Morning!

On to today's dentistry and health headlines.

Genetic Variation That Raises Risk of Serious Complication Linked to Osteoporosis Drugs Identified

Researchers at the Columbia University College of Dental Medicine have identified a genetic variation that raises the risk of developing serious necrotic jaw bone lesions in patients who take bisphosphonates, a common class of osteoclastic inhibitors. The discovery paves the way for a genetic screening test to determine who can safely take these drugs. The study appears in the online version of the journal The Oncologist.

Oral bisphosphonates are currently taken by some 3 million women in the United States for the prevention or treatment of osteoporosis. In addition, intravenous bisphosphonates are given to thousands of cancer patients each year to control the spread of bone cancer and prevent excess calcium (hypercalcemia) from accumulating in the blood. Bisphosphonates work by binding to calcium in the bone and inhibiting osteoclasts, bone cells that break down the bone’s mineral structure.

“These drugs have been widely used for years and are generally considered safe and effective,” said study leader Athanasios I. Zavras, DMD, MS, DMSc, associate professor of Dentistry and Epidemiology and Director of the Division of Oral Epidemiology & Biostatistics at the Columbia University College of Dental Medicine. “But the popular literature and blogs are filled with stories of patients on prolonged bisphosphonate therapy who were trying to control osteoporosis or hypercalcemia only to develop osteonecrosis of the jaw.”

Osteonecrosis of the jaw, or ONJ, often leads to painful and hard-to-treat bone lesions, which can eventually lead to loss of the entire jaw. Among people taking bisphosphonates, ONJ tends to occur in those with dental disease or those who undergo invasive dental procedures.

There are no reliable figures on the incidence of ONJ in patients taking oral bisphosphonates. Estimates range from 1 in 1,000 to 1 in 100,000 patients for each year of exposure to the medication, according to the American College of Rheumatology. ONJ is more common among cancer patients taking the intravenous form of the drug, affecting about 5 to 10 percent of these individuals, noted Dr. Zavras.

Studies have suggested that genetic factors play a major role in predisposing patients to ONJ.

Aetna’s dentists get iPads to help patients stop smoking

Aetna is set to begin a trial program that equips New York City-area dentists with iPads to help them better educate their patients about tobacco use in an effort to curb smoking. The trial program includes a clinical decision support system (CDSS) that is built on a medical knowledge base, patient data, and decision support technology that provides dentists with personally targeted advice for each patient.

The trial is still in its earliest stages: Aetna is working with Columbia University to design and implement the program.

Dr. David Albert DDS, Director of the Division of Community Health at the Columbia University College of Dental Medicine in New York City, is the principal investigator for the study, which aims to determine how impactful such a CDSS system is on the patient population.

The study is called, “The Dental Tobacco Cessation iPad” and it still has undergo testing and modifications before it rolls out formally at five NYC dental offices.

“The program is designed as an innovative interface between patients and dentists and we anticipate that devices like the iPad can be used to break down barriers between clinicians’ and their patients,” said Dr. Albert. “We will evaluate if we are able to encourage and assist dentists to provide tobacco cessation advice and assistance for their patients who use tobacco products. Tobacco use poorly affects the mouth and teeth and the patient’s overall health. Helping patients to quit tobacco use is a goal that the US Public Health Service encourages all dentists to adopt.”

Jaw Necrosis Common after Radiation for Oral Cancer

Osteoradionecrosis of the jaw (ORNJ) occurred more than twice as often as reported in the literature, according to a population-based study of patients treated with radiation for oral cancer.

A review of national medical records showed that 16.1% of patients had jaw complications or interventions consistent with ORNJ compared with published rates of 5% to 7%.

However, when investigators applied the definition of ORNJ to patients who had interventions associated with jaw complications, the rate approximated the published rates, as reported here at the Multidisciplinary Head and Neck Cancer Symposium.

"The rates of all jaw complications in the SEER-Medicare database are higher than reported rates from prospective and retrospective institutional reports," said Beth M. Beadle, MD, PhD, of the University of Texas MD Anderson Cancer Center in Houston. "If we limited the definition to interventions, the rates are similar to those of published reports."

Radiation therapy has documented efficacy for locoregional control of head and neck cancer, but therapy confers a substantial risk of long-term complications, even with modern delivery techniques.

ORNJ is recognized as a potential risk of radiation therapy. Prospective and retrospective single-institution studies have suggested that 5% to 7% of patients with head and neck cancer develop ORNJ following treatment with radiation.
The frequency of ORNJ in the general population of patients with head and neck cancers has not been studied extensively. Moreover, the true impact of newer radiation techniques, such as intensity-modulated radiation therapy (IMRT), on the frequency of ORNJ has not been clearly established.

Big BP Variation Between Arms Raises Red Flag

A substantial difference in blood pressure from one arm to the other could be a warning sign for overall cardiovascular and mortality risk, a meta-analysis determined.

A systolic pressure difference of 15 mm Hg or more between the right and left arm was linked to a 70% elevated risk of death from cardiovascular causes (P=0.01), Christopher E. Clark, MSc, of the University of Exeter, U.K., and colleagues found.

That pressure differential also pointed to a 60% higher likelihood of dying from any cause (P=0.02), the group reported online in The Lancet.

The reason appeared to be the close correlation with peripheral vascular disease and cerebrovascular disease, for which a 15 mm Hg-difference had high specificity of 96% and 93%, respectively.

Such patients would likely benefit from further cardiovascular assessment and aggressive risk factor management as a high-risk group, Clark's group concluded.

Measuring both arms should become part of routine care, argued Richard J. McManus, MSc, MBBS, of the University of Oxford, U.K., and Jonathan Mant, MD, of the University of Cambridge, U.K., in an accompanying commentary.

Enjoy your morning!

Dentist Who Used Paper Clips in Root Canals Receives a Year in Jail

noreply@blogger.com (Gregory Flap Cole) — Mon, 30 Jan 2012 17:12:00 +0000

Mass. AG: Dentist used paper clips in root canals: MyFoxBOSTON.com

This is just in: the paper clip during root canal treatment using dentist has been sentenced to a year in jail.

A mother is blasting the one-year jail sentence given to a former Massachusetts dentist who used paper clips instead of stainless steel posts in her son's root canal.

Brenda Almeida says she is very upset about the sentence imposed Monday on Dr. Michael Clair, who pleaded guilty earlier this month to a list of charges, including assault and battery and Medicaid fraud.

Almeida says her teenage son's tooth turned black and had to be removed after Clair performed the root canal.

Judge Richard Moses said he considered Clair's acceptance of responsibility and "certain mental health issues" Clair is dealing with in imposing the one-year sentence.

Prosecutors sought a sentence of five to seven years.

The 53-year-old Clair, who had a dental practice in Fall River, now lives in Crofton, Md.

We certainly hope this dentist receives the mental health treatment that he desperately needs while in jail.

Obviously, he will never practice dentistry again.

The Daily Extraction: January 27, 2011

noreply@blogger.com (Gregory Flap Cole) — Fri, 27 Jan 2012 23:55:00 +0000

Extraaction of Teeth #31 and #32 with a 302 straight elevator

In this case, Dr. Tommy Murph has to contend with a couple of bad teeth and a patient who is really scared.
Here is the pre-operative radiograph:

And, the grand result:

Enjoy your daily extraction!

The Morning Drill: January 27, 2012

noreply@blogger.com (Gregory Flap Cole) — Fri, 27 Jan 2012 15:27:00 +0000

The staff of the 143rd Dental Company (Area Support) Forward stand outside the dental clinic with their commander, Lt. Col. Daniel P. Alston

Good Friday Morning!

On to today's dentistry and health headlines:

Dental company commander brings lifetime of knowledge

After 21 years away from the Army and retiring from dentistry in the civilian sector, Daniel P. Alston returned to serve in the Army Reserve, and now commands the 143rd Dental Company (Area Support) Forward as a lieutenant colonel.

When the 143rd Dental Company (AS) FWD was assigned the Kuwait mission, Alston was offered the command.

"At first I wasn't interested, because as a commander, I would be on a 12-month deployment and not a 90-day rotation," said Alston.

After discussing it with his wife, Alston decided that since he was near retirement, taking the command made sense.

"I'm 65 now, so I would be able to finish my time on active-duty status," Alston said. "Reserve retirement changes a lot when you put in more days on active-duty."

Alston had hoped to reach 20 years in service while in Kuwait. However, his current assignment fell short. So when he got word that the 143rd Dental Company (AS) FWD had the 2013 mission as well, he volunteered to stay.

"My wife and I decided it would be the best for us," Alston stated. "It was certainly the best for the unit because they won't have to go through the entire mobilization process to send a replacement."

So now Alston's team will be under his leadership for a total of 20 months, which, according to Staff Sgt. Kevin Morgan, the 143rd Dental Company (AS) FWD noncommissioned officer in charge, will make for an enjoyable deployment.

"Lieutenant Colonel Alston is the easiest going guy I have ever worked for," said Morgan.

Having been a dentist since he was 24, as well as a private business owner, Alston brought a lifetime of knowledge to his command.

"He's a really good guy, and with the experiences in his life, it's easy for us to go to him when we have issues or any kind of problem," said Morgan. "He's like a father figure you can always lean on, which is good to have in this type of atmosphere."

Jury finds dentist not liable for dental malpractice

After a three-day trial, a Humboldt County jury found Dr. Jeremy Keener not liable for dental malpractice in a case involving a root canal gone wrong. The trial began with jury selection on Monday (Jan. 23) and concluded late Wednesday (Jan. 24).

Natasha Stilwell sued the dentist after a root canal temporarily left her face and a portion of her nose with raw sores. Additionally, she had lockjaw for months and developed a hole in the palate of her mouth.

She suffered no long-term injury as a result of the incident, but Stilwell sued to recover medical expenses as well as compensation for pain and suffering.

In finding Keener not liable of dental malpractice, the jury determined Keener’s actions did not fall below accepted standards of care.

Kennewick police accuse 3 of prescription drug scheme

Two employees of a Kennewick dental office are accused of pulling off a sophisticated scheme involving at least 167 forged prescriptions.

Nicole Bernice Polus and Chareise Louise Raugust, along with her fiance, Miljan Ignjatic, allegedly wrote, called in or picked up fraudulent prescriptions in the Tri-Cities during a four-year period, police said.

"There were so many names ... including fictitious names," Kennewick police Detective Rick Runge told the Herald. "It is just so large, we just went with the suspects' names and family" to try to track the forgeries.

Polus and Ignjatic made their first appearances Thursday in Benton County Superior Court and pleaded innocent to several charges of obtaining a controlled substance through fraud.

Polus, 40, faces an April 9 trial on eight charges of fraudulently obtaining Lorcet and Vicodin. The charges include the aggravating factor that she used a position of trust to commit the crime. Polus was a dental hygienist in William Craig Stout's dental office.

Ignjatic, 34, is charged with six counts of obtaining Lorcet, hydrocodone and diazepam through fraud. His trial is also set for April 9.

Raugust, who was Stout's office manager, pleaded innocent to one count of obtaining a controlled substance -- hydrocodone -- through fraud, with the aggravating factor that she used a position of trust to commit the crime.

She also was in court Thursday. Her trial is April 9.

Ex-Sussex County dentist accused of groping patient indicted for perjury

A former Sussex County oral surgeon who lost a civil lawsuit in 2009 that claimed he groped a 25-year-old woman as she recovered from anesthesia following surgery was indicted today on charges that he lied during the jury trial.

Joel P. Kurtz, 67, now of Bethel, Conn., was indicted on two counts of third-degree perjury and two counts of fourth-degree false swearing.

Following a six-week jury trial in Newton, Kurtz, formerly of Livingston, was found liable of groping Amy Metzler, now 27, of Frankford, at his Andover Township office in 2002 and 2003. The jury awarded Metzler $275,000 in compensatory damages and $100 punitive damages.

“The indictment relates to his claim made during the trial that he was never a plaintiff in any other lawsuit during his 30-year practice when, in fact, he had been sued earlier by another female patient,” said First Assistant Prosecutor Gregory Mueller, who presented the case against Kurtz to a grand jury.

In the earlier case, Mueller said Kurtz was sued in December 1976 by a woman who claimed she was sexually assaulted by him earlier that year. That case was resolved in 1979 when the victim reached a $20,000 out-of-court settlement, he said.

Enjoy your morning!

The Morning Drill: January 26, 2012

noreply@blogger.com (Gregory Flap Cole) — Thu, 26 Jan 2012 14:50:00 +0000

Good Thursday morning!

On to today's dentistry and health headlines:

Valrico Dentist Heads to Court Over Neighbor's Cigar Smoke

In the 23 years Dr. Edmund Rahal has had his dentist office in the strip shopping center at 3646 Lithia-Pinecrest Rd., Valrico, he's had his share of neighbors.

But, up until now, none of them have stunk, Rahal said.

That all changed when the Twisted Cigar moved into the storefront next to Rahal's dental office in October.

Rahal said smoke from the combination cigar shop and smoking lounge has filtered into his dental office, making employees sick and eliciting complaints from patients.

"It's not just a cigar shop. It's a place where patrons come in and smoke. There are big-screen TVs for them to watch," said Rahal. "And now they've applied for a beer and wine license.

"Since they opened, we've been losing existing patients, and there's no way to gauge how many new patients we've lost because of this," Rahal said. "We had a women just this morning complain. She said she couldn't stand the smell."

He said employees say they go home at night smelling of cigar smoke and one employee who's allergic to smoke coughs and wheezes in the office.

Twisted Cigar owner Jim Brown has tried to alleviate the problem by installing filters and sealing the drywall that separates the two storefronts.

However, Rahal said the problem persists. "The cigar store has done what it could, but nothing's made a difference," said Rahal.

Report outlines 5 elements for improving oral healthcare

Accountability, data collection, and new ways of delivering care are critical if the U.S. is going to improve the quality of its oral healthcare, according to "Oral Health Quality Improvement in the Era of Accountability," a new report funded by the W.K. Kellogg Foundation and the DentaQuest Institute.

Dental expenses are now among the highest out-of-pocket health costs to consumers, second only to expenses for drug prescriptions, according to the report.

The report, authored by Paul Glassman, DDS, MBA, a professor of dental practice and the director of the Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry, lists five elements for improving oral healthcare in the U.S.:

    Increased use of electronic dental records and integrated health records
    Better measurement of oral health outcomes
    New payment and incentive mechanisms
    Expanded delivery of care by nondental professionals, as well as new types of allied dental professionals
    Use of telehealth technologies to reach people in remote areas

Exercise may boost mood for some chronically ill

Working out regularly may brighten the mood of people with chronic health problems like cancer, heart disease and back pain, according to the first sweeping look at previous research.

But it's no miracle cure: On average, six people would need to hit the gym or go for a jog for one person to see a mood improvement.

"It's a nice piece of evidence and I'm pleased because I like the concept," said Dr. Alan J. Gelenberg, who chairs the department of psychiatry at Penn State University in Hershey.

Gelenberg, who wasn't involved in the new work, said the findings jibe with guidelines from the American Psychiatric Association, which recommends regular exercise against the blues.

"There is some evidence for its use to prevent depression, and there actually is evidence for exercise as a treatment in itself," he told Reuters Health.

The Write Diet: Lose Weight With Just 15 Minutes and a Journal

Can losing weight really be as simple as a 15-minute writing session? It worked for a group of women who recently took part in a psychological study. But it depends on what you write about.

Women who wrote about their most important values for 15 minutes lost an average of 3.4 pounds over the next few months. Women who wrote about something less important gained an average of 2.8 pounds.

The researchers think the weight loss was due to increased self-affirmation or self-esteem. Writing about their values made the women see themselves as better people and feel better about themselves. It may also serve to strengthen resolve. Often, heavy eaters eat in an attempt to elevate their mood. Who hasn't felt better after eating a brownie? But some people take this to an extreme and over time, the pounds can add up.

The researchers speculate that writing about one's values can kick off a chain reaction. It starts when writing about an important value makes you feel better about yourself. Maybe when you go home that night you skip the brownie or cookies you've been using as an emotional crutch. In time, skipping the brownie becomes a habit.

Enjoy your morning!