For the first time ever, I learned to care about the millimeter increment and the position of our mandibular condyle in the resting position. I was even taught a different language. Mesial, distal, occlusion, mastication, halitosis and bruxism became my new buzz words. I was taught to act differently. I was taught to have compassion yet inflict pain. I was taught to serve and heal and to drill and fill. But truthfully, I grew into a professional different from other professionals outside of the dental industry.
The practice of dentistry is both a profession and a handcraft. It's also one of the most valuable skills and blessings to others in this world.
After all we keep people smiling by eliminating their pain and fixing their teeth. We give them confidence and self worth. I’ve done it, I’ve seen it and I love it. But this result, this influence, comes about more from the handcraft than from the profession. Professionals are not characterized as repair men (or women) in the literal sense. Professionals are more about the business side, the operational side and the management side.
I had an EXCELLENT dental education. But I was barely taught how to enter the business world or what the business world was for that matter.
Fourth year offered one limited business class, and in that class instead of learning correct business principles and practices, I learned the dental way of owning and operating a practice. You know the dental way, have one class your senior year, buy a practice for a lot of money and hire an office manager with a lot of experience to run your office.
As a result I spent a lot of my career not understanding what the rest of the world’s business professionals do to be successful. And so like most, I determined my success on clinical cases, awesome crown and bridge and margins so clean a blind lab tech could nail it. But truthfully, on a business level, I wasn't very good at running a practice, leading a team, marketing or anything else. My clinical skill and personality was the bedrock of my practice success.
So, I tried to learn more about the business of dentistry, but I found that there was still some misalignment with “dental” business and the rest of the business world. Take for instance our unique understanding of patient attrition. No, we aren't talking about tooth attrition, but about patients who leave the practice. In the latter sense, what we may characterize as patient attrition rate is commonly known in the real business world as churn rate. The general idea that you have people leaving out the back door of your practice.
Small differences like this can make our profession less professional. To further complicate things sometimes the handcraft or “clinical” side even puts up barriers to joining other professionals in word and action. Truth be known, true professionals drive business, professionals direct, lead and stand up and focus on business success. Some frown on these ideas for a dental practice, after all we provide a service in the true sense of the word.
I am not a master in business and I would barely consider myself equivalent to a first year student. I’ve been around the block only to realize that my experience is just that, only one block. There’s a whole lot more out there, right now and more to come in the future.
So where do I learn to keep my profession professional and where do I learn about what's on the horizon? Well it starts with some good business organizations in our space that I’ve come to know like the DEO, ADSO and the ADA. It comes from good books, facebook groups and great connections with vendors. But it really comes because I make the choice to educate myself. A move that Blockbuster wished they had made before Netflix came around and a move that Netflix made when streaming became mainstream.
Our profession is changing, time to head back to school and learn to be different.
Titanium has many properties that make it a great choice for use in implants. Its low density, high stiffness, high biomechnanical strength-to-weight ratio, and corrosion resistance have led to its use in several types of implants, from dental to joints. However, a persistent problem plagues metal-based implants: the surface is also a perfect home for microbes to accumulate, causing chronic infections and inflammation in the surrounding tissue.
Consequently, five to 10 percent of dental implants fail and must be removed within 10-15 years to prevent infection in the blood and other organs.
New research from the University of Pittsburgh's Swanson School of Engineering introduces a revolutionary treatment for these infections. The group, led by Tagbo Niepa, PhD, is utilizing electrochemical therapy (ECT) to enhance the ability of antibiotics to eradicate the microbes.
"We live in a crisis with antibiotics: most of them are failing. Because of the drug- resistance that most microbes develop, antimicrobials stop working, especially with recurring infections," says Dr. Niepa, author on the paper and assistant professor of chemical and petroleum engineering at the Swanson School, with secondary appointments in civil and environmental engineering and bioengineering.
"With this technique, the current doesn't discriminate as it damages the microbe cell membrane. It's more likely that antibiotics will be more effective if the cells are simultaneously challenged by the permeabilizing effects of the currents. This would allow even drug-resistant cells to become susceptible to treatment and be eradicated."
The novel method passes a weak electrical current through the metal-based implant, damaging the attached microbe's cell membrane but not harming the surrounding healthy tissue.
This damage increases permeability, making the microbe more susceptible to antibiotics. Since most antibiotics specifically work on cells that are going to replicate, they do not work on dormant microbes, which is how infections can recur. The ECT causes electrochemical stress in all the cells to sensitize them, making them more susceptible to antibiotics.
The researchers hope this technology will change how infections are treated.
Researchers focused their research on Candida albicans (C. albicans), one of the most common and harmful fungal infections associated with dental implants. But while dental implants are one exciting application for this new technology, Niepa says it has other potential applications, such as in wound dressings.
The toothbrush as we know it today was not invented until 1938. However, early forms of the toothbrush have been in existence since 3000 BC. Ancient civilizations used a “chew stick,” which was a thin twig with a frayed end.
The first signs of a toothbrush being used by human beings dates back to 3500 B.C. in ancient Egypt. The Babylonians and Egyptians would chew on a stick about six inches long until one end would become soft like a brush. They would use this softened twig to brush and pick between their teeth. In 1600 B.C., the ancient Chinese even used aromatic tree twigs to chew on and give them fresh breath.
These ‘chew sticks’ were rubbed against the teeth. The bristle toothbrush, similar to the type used today, was not invented until 1498 in China.
The bristles were actually the stiff, coarse hairs taken from the back of a hog’s neck and attached to handles made of bone or bamboo.
Boar bristles were used until 1938, when nylon bristles were introduced by Dupont de Nemours. The first nylon toothbrush was called Doctor West’s Miracle Toothbrush. Later, Americans were influenced by the disciplined hygiene habits of soldiers from World War II. They became increasingly concerned with the practice of good oral hygiene and quickly adopted the nylon toothbrush.
Some other interesting toothbrush facts:
The first mass-produced toothbrush was made by William Addis of Clerkenwald, England, around 1780.
The first American to patent a toothbrush was H. N. Wadsworth, (patent number 18,653,) on Nov. 7, 1857.
Mass production of toothbrushes began in America around 1885.
One of the first electric toothbrushes to hit the American market was in 1960. It was marketed by the Squibb company under the name Broxodent.
Tooth decay is a disease that causes the destruction of enamel, which is the hard outer surface of a tooth. As tooth decay progresses, it can attack deeper layers of a tooth. However, some treatments can help prevent or stop the spread of tooth decay.
This article will cover the causes, symptoms, and treatments for a person with tooth decay.
Tooth decay, also known as dental caries or cavities, is a disease that causes the breakdown of tooth enamel.
Once tooth decay has eroded the enamel, cavities can start to form.
According to the American Dental Association (ADA), a tooth consists of three layers:
Enamel: Enamel is the hard outer layer that protects the inner layers of a tooth. Tooth enamel contains no living cells and is the hardest structure in the human body.
Dentin: Dentin is the second layer of a tooth. When the enamel is damaged, it may expose the dentin. Small tubes within the dentin allow hot and cold food to stimulate the nerves of the tooth. The stimulation of these nerves can cause pain and sensitivity in the tooth.
Pulp: The pulp is the center of the tooth. The pulp contains blood vessels, nerves, and connective tissue.
Tooth decay can occur in varying degrees of severity. Damage from tooth decay can range from causing wear to the enamel to painful abscesses within the pulp of the tooth.
Symptoms of tooth decay can vary depending on the severity of the damage caused.
According to the National Institute of Dental and Craniofacial Research (NIDCR), some people in the early stages of tooth decay may feel no symptoms. However, as tooth decay advances, a person may experience the following:
1. tooth sensitivity to sugary, hot, or cold food
2. constant tooth pain
3. white or dark spots on the teeth
4. bad breath
5. loose fillings
6. cavities in teeth
7. food frequently trapped in teeth
8. difficulty biting certain foods
9. abscesses on teeth that cause pain, facial swelling, or fever.
Tooth decay can affect people of any age. The Center for Disease Control and Prevention (CDC) estimate that around 20% of children aged 5–11 years have at least one untreated decayed tooth.
Older adults may experience gum recession, which is where the gums pull away from the tooth, exposing the root of the tooth.
Treatment:
A dentist will be able to recommend treatment for a person with tooth decay, depending on its severity.
Treatment for tooth decay can include:
Early-stage fluoride treatments
Fluoride is a mineral that can help strengthen enamel. A dentist can use fluoride in various forms to help stop and even repair the damage that has occurred due to tooth decay.
A dentist can apply professional fluoride treatments directly to the teeth.
These fluoride treatments are generally quick, taking only a few minutes. The fluoride comes in the form of a gel, varnish, foam, or solution.
Fillings:
When cavities occur from tooth decay, a filling can be a treatment option.
After drilling the tooth to remove any decay, the dentist shapes the cavity to fit the filling.
The dentist then fills the cavity, using materials such as dental amalgam or composite.
Crowns:
According to the ADA, larger cavities that occur due to tooth decay may require a crown instead of a filling.
To place a crown, the dentist first removes the outer portion of the tooth, as well as any decay.
The dentist will take an impression of the tooth and fit a temporary crown until the permanent one is ready for fitting, usually 1–2 weeks later.
Root canals:
A dentist can perform a root canal to help prevent the need for extraction when the pulp of the tooth is damaged.
According to the American Association of Endodontists (AAE), the dentist first numbs the tooth before removing the pulp. They will then clean and shape the root canal inside of the tooth.
The dentist may also apply medicine in the tooth to get rid of any bacteria.
The dentist will then fill the root canals with a rubber-like substance and place a crown or filling on the tooth to restore and strengthen it.
Tooth extraction:
A dentist may recommend a person has a tooth extraction if the tooth decay has caused severe damage.
The dentist will first numb the damaged tooth. Once they have removed the tooth, the dentist will recommend a post-extraction regime.
Is it reversible?
According to the NIDCR, tooth decay, if caught in the early stages, is reversible. However, once the enamel of the tooth has lost too many minerals and the tooth has a cavity, it is unable to repair itself.
A dentist can treat damage and prevent it from spreading further.
A person experiencing any pain or discomfort from their teeth should contact their dentist.
A person should also visit their dentist regularly for checkups to prevent decay.
A Neanderthal who lived 130,000 years ago appears to have carried out some “prehistoric dentistry” in an attempt to deal with an impacted tooth, researchers have said.
Teeth found at a site in Krapina, Croatia, at the start of the last century were re-examined by scientists and found to have a number of grooves, scratches and chips.
While it is possible there is another explanation, the scientists, from the US and Croatia, said they appeared to be evidence of attempts to use a toothpick to deal with the impacted tooth and the misalignment of another one.
If true, this would add to the growing body of evidence that Neanderthals were significantly more intelligent than previously believed.
The Krapina Neanderthals have previously been found to have created jewellery out of eagle talons, in another sign that they were more sophisticated than generally given credit for.
Professor David Frayer, of Kansas University, said the marks on the teeth suggested the individual was in some pain and was trying to do something about it.
“As a package, this fits together as a dental problem that the Neanderthal was having and was trying to presumably treat itself, with the toothpick grooves, the breaks and also with the scratches on the premolar,” he said.
“It was an interesting connection or collection of phenomena that fit together in a way that we would expect a modern human to do.
“Everybody has had dental pain, and they know what it’s like to have a problem with an impacted tooth.
The Krapina Neanderthals have previously been found to have created jewellery out of eagle talons, in another sign that they were more sophisticated than generally given credit for.
Professor David Frayer, of Kansas University, said the marks on the teeth suggested the individual was in some pain and was trying to do something about it.
“As a package, this fits together as a dental problem that the Neanderthal was having and was trying to presumably treat itself, with the toothpick grooves, the breaks and also with the scratches on the premolar,” he said.
“It was an interesting connection or collection of phenomena that fit together in a way that we would expect a modern human to do.
“Everybody has had dental pain, and they know what it’s like to have a problem with an impacted tooth.
For most people, teeth cleaning may just be a normal part of your daily routine. But what if the way you clean your teeth today might affect your chances of getting Alzheimer’s disease in years to come?
There is an increasing body of evidence to indicate gum (periodontal) disease could be a plausible risk factor for Alzheimer’s disease. Some studies even suggest your risk doubles when gum disease persists for 10 or more years. Indeed, a new US study published in Science Advances details how a type of bacteria Porphyromonas gingivalis – or P. gingivalis – associated with gum disease has been found in the brains of patients with Alzheimer’s disease. Tests on mice also showed how the bug spread from their mouth to the brain where it destroyed nerve cells.
The report in question was carried out and self-funded by founders of the US pharmaceutical company Cortexyme, which is researching the cause of Alzheimer’s and other degenerative disorders. Scientists from the San Francisco drugs firm will launch a human trial later this year.
What is gum disease?
The first phase of gum disease is called gingivitis. This occurs when the gums become inflamed in response to the accumulation of bacterial plaque on the surface of the teeth.
Gingivitis is experienced by up to half of all adults but is generally reversible. If gingivitis is left untreated, “sub-gingival pockets” form between the tooth and gum, which are filled by bacteria. These pockets indicate gingivitis has converted to periodontitis. At this stage it becomes almost impossible to eliminate the bacteria, though dental treatment can help control their growth.
The risks of gum disease are significantly increased in people with poor oral hygiene. Factors such as smoking, medication, genetics, food choices, puberty and pregnancy can all contribute towards the development of the condition.
Mouth-brain connection:
At the University of Central Lancashire, we were the first to make the connection with P. gingivalis and fully diagnosed Alzheimer’s disease. Subsequent studies have also found this bacteria – responsible for many forms of gum disease – can migrate from the mouth to the brain in mice. And on entry to the brain, P. gingivalis can reproduce all of the characteristic features of Alzheimer’s disease.
The recent US research which found the bacteria of chronic gum disease in the brains of Alzheimer’s disease patients gives additional very strong research-based evidence – but it must be interpreted in context. And the fact of the matter is that Alzheimer’s disease is linked with a number of other conditions and not just gum disease.
Brush your teeth:
The latest research adds more evidence to the theory gum disease is one of the things that can lead to Alzheimer’s disease. But before you start panic brushing your teeth, it’s important to remember that not everyone who suffers from gum disease develops Alzheimer’s disease, and not all who suffer from Alzheimer’s disease have gum disease.
To find out who is “at risk”, scientists now need to develop tests that can show the dentist who to target. Dental clinicians can then advise those people as to how they can reduce the risk of developing Alzheimer’s disease through better management of their oral health. But until then, regularly brushing your teeth and maintaining good oral hygeine is recommended.
The American Dental Association Board of Trustees has adopted an ad interim policy stating dentistry is essential health care to help guide advocacy for the dental profession during the COVID-19 pandemic.
The Board established the ad interim policy via a video call July 27, and the House of Delegates will consider it as a resolution during its virtual meeting in October.
"This policy was created to recognize that dentistry is an essential service. Whether it's the current pandemic, a future epidemic or a natural disaster in a particular area, this policy recognizes the need for people to be able to continue to access the full range of dental services," ADA President Chad P. Gehani said (photo).
"Doing so will help people maintain their oral health and contribute to their overall health. Oral health is integral to overall health — staying well often depends on having access to health care, which includes dental treatment.
"From March 16-April 30, the ADA called for dentists to postpone all but urgent and emergency procedures to help mitigate the spread of COVID-19, keep patients out of overburdened hospital emergency departments and conserve personal protective equipment. By the end of May, most state governments had lifted restrictions on dental offices, but as COVID-19 cases continue to rise in many states, the dental community is concerned governors may again limit dental services to urgent and emergency care, which could negatively impact dentists and the oral health of the public, Dr. Gehani said.
The policy states oral health is an integral component of systemic health and dentistry is an essential health care service because of its role in evaluating, diagnosing, preventing and treating oral diseases, which can affect systemic health.
It advises that the ADA use the term "essential dental care" — defined as any care that prevents and eliminates infection and preserves the structure and function of teeth and orofacial hard and soft tissues — in place of "emergency dental care" and "elective dental care" when communicating with legislators, regulators, policymakers and the media about care that should continue to be delivered during pandemics and other disasters.
"Using the term 'elective dental procedures' implies oral health care is optional and diminishes the evidence validating that oral health is an integral component of overall health," Dr. Gehani said.
The policy also states the ADA will urge state agencies and officials to recognize the oral health workforce when designating its essential workforce during public health emergencies. Government agencies such as the Department of Homeland Security and Federal Emergency Management Agency have already acknowledged dentistry as an essential service.
Colgate-Palmolive’s history traces back to the early 19th century when William Colgate, a soap and candle maker, began selling his wares in New York City under the name William Colgate & Company. After his death in 1857, the company was run by his son, Samuel Colgate, under the new name Colgate & Company. In 1890 Madison University in Hamilton, N.Y., was renamed Colgate University in recognition of the Colgate family’s longtime financial support. The current corporate name was adopted in 1953.
Colgate & Company sold the first toothpaste in a tube, Colgate’s Ribbon Dental Cream, in 1896. In 1928 the firm was bought by Palmolive-Peet Company, whose founder, B.J. Johnson, had developed the formula for Palmolive soap in 1898. At the turn of the 20th century, Palmolive—which contained both palm and olive oils—was the world’s best-selling soap.
In 1955 Colgate-Palmolive lost its number-one ranking in the toothpaste market when the rival consumer-goods manufacturer Procter & Gamble Co. began selling Crest, the first toothpaste with fluoride. Colgate-Palmolive added MFP fluoride (sodium monofluorophosphate), an enamel strengthener and cavity reducer, to its toothpaste in 1968. Colgate Total, a line of toothpaste designed to protect against a number of conditions including gingivitis, was introduced in Europe in 1992 and in the United States in 1997.
In addition to toothpaste, Colgate-Palmolive manufactured a number of successful personal-care and household products in the United States and other countries, including Palmolive dishwashing liquid and Irish Spring bar soap. The firm’s acquisition of a variety of companies from the 1960s onward enabled it to expand both its market share and its product lines in the United States, Latin America, Europe, and East Asia. In 1976 Colgate-Palmolive acquired Hill’s Pet Nutrition, a worldwide leader in veterinary and pet-nutrition products, and in 1987 it purchased Softsoap liquid soap. From the 1990s Colgate-Palmolive was a major producer of all-purpose cleaners, wipes, and sprays.
After years of criticism and boycotts by animal-rights groups, Colgate-Palmolive established a moratorium on animal testing for its adult personal-care products in 1999. Major product categories remain toothpastes and mouthwashes, toothbrushes, deodorants, bar soaps and liquid soaps, dish soaps and dishwasher detergents, floor- and surface-cleaning products, and pet food.
The American Dental Association released a statement Aug. 12 stating it "respectfully yet strongly disagrees" with the World Health Organization's interim guidance recommending that "routine" dental care be delayed in certain situations because of COVID-19."Oral health is integral to overall health.
Dentistry is essential health care," ADA President Chad P. Gehani said. "Dentistry is essential health care because of its role in evaluating, diagnosing, preventing or treating oral diseases, which can affect systemic health."The ADA Board of Trustees adopted an ad interim policy stating dentistry is essential health care during a video call July 27, and the House of Delegates will consider it as a resolution during its virtual meeting in October.
As U.S. COVID-19 cases began to rise in March, the ADA called for dentists to postpone all but urgent and emergency care in order to understand the disease and consider its effect on dental patients, dental professionals and the greater community, Dr. Gehani said.
Both the ADA and Centers for Disease Control and Prevention then issued interim guidance for dental professionals related to COVID-19, calling for the use of the highest level of personal protective equipment available, such as masks, goggles and face shields.
To minimize aerosols, the ADA guidance also recommended dental professionals use rubber dams and high-velocity suction whenever possible and hand scaling instead of ultrasonic scaling when cleaning teeth.
"Millions of patients have safely visited their dentists in the past few months for the full range of dental services," Dr. Gehani said. "With appropriate PPE, dental care should continue to be delivered during global pandemics or other disaster situations."
Toothaches are one of the most uncomfortable types of pain that we can experience, and they sometimes occur at inconvenient times, says Dr. Kyle Bogan, a dentist based in Lewis Center, Ohio.
"What do you do when your tooth starts to hurt and it's the middle of the night?" Bogan says.
Fortunately, you don't necessarily have to wait until you can get an appointment with your dentist to find temporary relief for a toothache.
Here are five home remedies commonly used by patients for toothaches:
1. Warm salt-water rinse.
2. Clove oil.
3. Ice packs.
4. Moist heat compresses.
5. Tea bags.
Warm salt-water rinse. A rinse of warm water mixed with salt can be helpful when the toothache is caused by a dental abscess, says Dr. Cathy Hung, a board-certified oral and maxillofacial surgeon in Monroe Township, New Jersey. Warm salt water helps rinse away pus and kills bacteria, providing temporary relief. "Remember, as long as the source of the infection in the tooth is untreated, the pain will not go away permanently," Hung says. She advises dental treatment for long-term relief.
Clove oil. Some patients have told Hung they use clove oil to mitigate toothache pain. Clove oil can be found in some dental materials, as it's proven to be therapeutic, but dental professionals don't use clove oil to treat toothache by applying it directly, she says. Some patients use clove oil for a toothache by dipping a cotton swab, cotton ball or clean tissue into it and then wiping it over the gum at the location of the pain. Some people place whole cloves on the painful area for several minutes at a time.
Ice packs. Applying an ice pack to the face, where the tooth is aching, can temporarily relieve the pain and reduce swelling from an infection or an oral surgery procedure, Hung says.
Moist heat compresses. Heat therapy can be an effective home remedy for temporomandibular joint disorder, widely known as TMJ disorder, Bogan says. "Heat therapy is extremely beneficial as a TMJ home remedy because it increases elasticity of the muscles and promotes blood flow into the affected area," he says. Heat contributes to increased elasticity and blood flow that speeds healing of inflammation. Moist heat compresses are the most beneficial because research suggests that moist heat penetrates the tissues more quickly and deeply than cool compresses, providing a more quick-acting and effective therapy.
Tea bags. If you're running out of gauze in the middle of the night after a tooth extraction and experiencing pain and bleeding, biting down gently on tea bags can provide temporary relief until you can see a dentist in the morning, Hung says. Many tea bags contain tannin, which is an astringent that shrinks blood vessels. Black tea bags can be particularly effective.
It's important to keep in mind that home remedies for toothaches are temporary solutions, Hung says.
"As dental professionals, we recommend that patients visit local dentists to mitigate their discomfort," she says. "There are many different reasons why you may have a toothache. When you come to a dental office, your dentist may use a combination of clinical examination and X-rays to diagnose the problem."
Hung notes that dental decay is mostly non-reversible, and treatments such as fillings, root canals or extractions may be needed.
