Some days you can find Christy Jo Fogarty at Children’s Dental Services in Minneapolis, checking kids for cavities. Other times she’s at an elementary school or driving a mobile clinic to towns beyond the suburbs, where shopping centers abruptly give way to cornfields.
Many of the 4,000 children she sees each year have never been to a dentist, Ms. Fogarty says. As a dental therapist, she focuses on those without much access to care—something all too common in Minnesota’s immigrant and rural communities. Only about one-third of dentists nationally, according to a 2014 survey by the American Dental Association, take patients covered by public assistance, such as Medicaid.
Ms. Fogarty holds dental therapy license No. 2 from the state of Minnesota, which in 2009 became the first state to recognize these midlevel professionals. Dental therapists are not massaging patients’ teeth and gums; they are specialists with years of training. At the University of Minnesota, getting a dual bachelor’s in dental hygiene and master’s in dental therapy requires 32 months of dedicated course work, taking the same classes as dental students who stay for the full program. After passing a state exam, dental therapists are authorized to clean teeth and fill cavities, though they cannot do orthodontic or reconstructive work.
Once in the field, therapists must work under the supervision of a licensed dentist, either in private practices or a public health clinic like the one where Ms. Fogarty works. Seven years after the first dental therapists were licensed, there are now more than 60 across the state.
Children’s Dental Services, Ms. Fogarty’s employer, treats about 30,000 patients each year, mostly from the Twin Cities’ Hispanic, Hmong and Somali immigrant communities. The dental therapy model was first adopted by nonprofits and community clinics to lower costs, says Karl Self, the director of the University of Minnesota’s therapy program. But now, Dr. Self adds, private practices are hiring dental therapists, too. “We’re seeing that dental therapists can add value to the overall oral health team,” he says.
A few other states—Alaska, Maine and Vermont—have also authorized dental therapy. A Native American tribe in Washington state has licensed a therapist who was certified in Alaska. Two Oregon tribes have been approved to hire a dental therapist under a pilot program.
Other states are considering dental therapy, but professional associations of dentists stand opposed. Take Michigan, where state Sen. Mike Shirkey introduced a dental therapy bill in June. Shortly thereafter, the Michigan Dental Association urged its members to oppose the bill. The association says that Michigan already has 7,500 dentists and 10,300 hygienists, which it insists should be enough to cover the state’s needs.
Mr. Shirkey says that despite the raw numbers, some communities face shortages. Guidelines from the U.S. Department of Health and Human Services suggest that an area has a shortage if there are more than 5,000 people for every dental provider. As of 2014 there were 212 such areas in Michigan, covering more than 876,000 people. Seventy-six of the state’s 83 counties have at least one designated shortage area, with the highest concentrations in the urban cores of Detroit and Flint and rural areas of the Upper Peninsula. Sixty-one percent of Michigan’s Medicaid-eligible children didn’t receive any dental treatment in 2011, according to an analysis by the Pew Charitable Trust.
Part of the problem is the nature of dentistry. Many dentists graduate with high debt and naturally set up practices in wealthy areas where people can afford regular care. Mr. Shirkey says the state’s persistent shortages show the current system isn’t working. “It’s time to evaluate what are our other options,” he says. His proposal would require dental therapists to spend the majority of their time treating patients on Medicaid or without insurance. It would also require therapists to work with licensed dentists, as in Minnesota, so they wouldn’t be in direct competition.
Staff at the Federal Trade Commission have urged dental-school accreditors to clear the way for midlevel professionals like therapists, arguing that they can “increase the output of basic dental services, enhance competition, reduce costs, and expand access.” But in dozens of states the idea is contentious. A bill in Texas was torpedoed last year after the state’s dental association argued that therapists were insufficiently trained and would put patients at risk.
In Minnesota, though, a 2012 study by the W.K. Kellogg Foundation found that dental therapists increased access to care while providing “competent, safe and effective” treatment. But the proof is in the sugar-free pudding: John Powers, a dentist in Montevideo, Minn., in the state’s rural western reaches, says dental therapists have helped his private practice grow. He recently hired a fourth therapist.
It’s easy to forget now that Minnesota’s transition was fraught, too. “It was awful,” Ms. Fogarty says, “just terribly contentious.” She recalls overhearing the dean of her dental school telling other students that they wouldn’t have jobs thanks to the new therapists. “There’s no reason for us to be against each other,” she says. The point isn’t to compete, it’s to get dental care for those who need it—like the 6-year-olds whose smiles she sees every day.
Heraeus Kulzer today announced the introduction of My Digital Denture, the company’s latest initiative in the digital denture space. My Digital Denture is a private label opportunity that relieves dental laboratories of the challenging and time-consuming setup and design steps in the denture process while still allowing them the freedom to use their preferred workflow prior to setup. This enables the laboratory to offer the exceptional fit and precision facilitated by digital dentures while freeing their technicians’ time to focus on other, more critical work.
My Digital Denture enables laboratories to offer exceptional fit and precision dentures facilitated by digital design while freeing their technicians’ time to focus on other, more profitable work. This is made possible through the hands-on training provided by Heraeus Kulzer’s Pala Digital Team to laboratory technicians on the processing and finishing of a digitally designed denture.
“In 2015, our Pala Digital Denture revolutionized the way laboratories process dentures, providing them and their dental practice customers with unprecedented precision in two to three visits versus six or more visits with conventional dentures,” said Christopher Holden, president of Heraeus Kulzer North America. “While the Pala Digital Denture System has helped laboratories grow their business, we know there is also a desire by many laboratory partners to control more of the processing and finishing. With My Digital Denture, we are giving laboratories more control than ever in choosing their level of involvement in delivering a digital denture.”
My Digital Denture is the first digital solution that gives laboratories the freedom to use their preferred workflow prior to setup by enabling them to scan models with bite rims without requiring special impression trays or changing the dentist’s workflow. This innovative system also gives laboratories the option of choosing either Heraeus Kulzer’s state-of-the-art Mondial®/Mondial i denture teeth or the company’s economy-priced Artic® Digital denture teeth. The Pala Digital Denture team will train partner laboratories on the use of various processing techniques, including injection, pouring and press-pack.
Heraeus Kulzer offers each laboratory the marketing flexibility of treating My Digital Denture as a private label offering so the laboratory can brand the final denture in whatever way best meets their marketing needs. Laboratories will also benefit from a nearly 50% increase in productivity due to the fact that their more skilled technicians will be freed up from having to perform the setup and design steps. Laboratory bottom lines will grow as these technicians are able to devote more time to higherrevenue cases.
To make it as convenient as possible for laboratories to enjoy the benefits of My Digital Denture, Heraeus Kulzer provides Friday hands-on training sessions near its South Bend, Indiana headquarters. Training dates for 2016 include October 21 and December 2. In addition, the company will offer training at LMT Lab Day East in Atlantic City, New Jersey on September 17, and in-lab sessions may also be arranged upon request. For more information, laboratories may contact their Heraeus Kulzer representative, or visit http://paladigitaldentures.com/handsontraining.
Debra Zafiropoulos, RDH, a leading dental hygiene key opinion leader known for her tireless advocacy for the early detection of oral cancer is broadening her efforts to include other forms of cancer with the formation of the National Cancer Network, a non-profit 501(c)(3) organization.
According to Zafiropoulos, commonly known as “Debbie Z”, “Dental professionals are the early warning system of the healthcare profession because we see our patients on an average of once a year and they spend a lot of time in our chairs. In addition to conducting a thorough oral exam, we can be paying closer attention to any abnormalities we notice on the patient’s skin or any complaints described in their patient history form such as persistent sore throat, cough, zone tingling or tenderness, etc.”
When something suspicious is discovered, Zafiropoulos says it is the responsibility of all dental professionals to integrate with other allied health professionals and make the appropriate qualified referrals sooner rather than later. “By taking the initiative to break down the silos between the various health care disciplines, we can significantly reduce the mortality rates of a wide variety of cancers.
Two of the cornerstones of the National Cancer Network are consumer awareness and professional training in the form of live patient screening events and professional training courses throughout the country.
What’s more, at the heart of NCN’s consumer and clinician awareness campaign is the introduction of a new exam protocol called “Screening for Oral and Skin Abnormalities” or SOSA™.
The first event of this type is being held in conjunction with the First District Dental Hygiene Society component of the Tennessee Dental Hygiene Association on September 16th in Kingsport, TN. The event will be based around one of Debbie Z’s most popular lectures, “HPV: It’s Not the Hanky-Panky Virus the Media Says it Is”.
To learn more about this and other upcoming NCN events, visit http://nationalcancernetwork.org/hpv/. For more information on how you or your organization can support NCN, contact Debra Zafiropoulos at DebbieZ@NationalCancerNetwork.org. Individual and corporate donations are can be made via PayPal at http://nationalcancernetwork.org/donate/
The Thomas P. Hinman Dental Meeting has named its first female General Chairman in its 105-year history. Dr. Jane Puskas, Hinman member and prominent Atlanta dentist, will lead Hinman 2017 at the Georgia World Congress Center in Atlanta on March 23-25, 2017. The meeting’s theme is “The Changing Face of Dentistry.”
“The theme of the meetings says it all. Hinman 2017 will focus on the changing face of dentistry and how we can take advantage of new technology and medical advancements to deliver the best possible care to our patients,” said Puskas. “We’ll celebrate our past, but also celebrate change in our profession with more contemporary techniques, more diversity and more innovative tools at our fingertips.”
Puskas has been planning for Hinman 2017 for the past 3 years, along with her program chairmen, Dr. Bob O’Donnell and Dr. Eddie Pafford. The meeting will feature many fan-favorite speakers, such as Dr. Gordon Christensen, Dr. Robert Edwab, Dr. John Svirsky, and Dr. Harold Crossley. In addition, many of dentistry’s most prominent women dentists will be speaking, including: Drs. Rella Christensen, Mollie Winston, Barbara Steinberg, Linda Niessen, and Lee Ann Brady. The program also will include many new speakers, including several affiliated with Spear Education - Drs. Jim Janakievski, Greg Kinzer, and Ricardo Mitrani.
“I’m truly honored to be the first female General Chairman for the Hinman,” added Puskas. “There are so many great women leaders in dentistry here in Georgia. I feel a strong responsibility to serve them well and host a meeting that not only features the latest in dentistry, but celebrates the different insights and strengths that women bring to the profession.”
A busy mom, wife and dentist in private practice, Dr. Puskas has risen through the ranks of Hinman, serving in many leadership roles, including President of the Hinman Dental Society in 2014. She is a graduate of the Harvard School of Dental Medicine and practiced in both Boston and Toronto before moving to Atlanta in 1994 with her husband, John, a cardiothoracic surgeon.
She became a Hinman member in 1996 and said that the organization helped her become established in the Atlanta dental community. The following year, Puskas bought the dental practice of Dr. Harold Lanier, a personal mentor to her and a Hinman past general chairman. She continues to practice today in the Buckhead area of Atlanta.
When not practicing dentistry or volunteering with Hinman, Puskas has been very focused on her three children and husband. She has been very involved in the lives and activities of her children – serving as team mom and volunteering at the Westminster Schools where all three of her children graduated high school. Her son Alex (24) graduated from Wake Forest and works in New York City at Ad Media Partners; daughter Jillian (22) is a senior at Princeton; and youngest daughter Caroline (19) is a sophomore at Dartmouth.
“I knew that I wanted a strong family life and felt that dentistry would better enable me to achieve a more rewarding work-life balance,” she said. “I am so happy that I did choose dentistry as I have managed to attain a happy family life with a successful professional life. I also love being a general dentist because of the special bond and relationship I share with my patients. It is rewarding to be an integral part of their health and smile.”
Registration for Hinman 2017 will open on December 1, 2016. Please visit www.hinman.org for more information.
An event designed for dedicated clinicians interested in a comprehensive approach to 3D imaging integration in their practices, the second annual Dental 3D University (3DU), features a lineup of world-class educators. Recent updates and additions to this roster include:
-Highly respected in the dental corporate and education community, President and CEO of Cellerant Consulting Group Dr. Lou Shuman, will be taking on the moderator role, bringing his unparalleled ability to make innovation accessible and help dentists across the technology adoption spectrum get the answers they need to make smart choices. Cited by Dr. Gordon Christensen as “one of the most influential dentists in the country today,” Dr. Shuman will also offer his unique expertise in Internet strategy, emerging technologies, e-learning and digital marketing as they relate to the dental community, speaking from his perspective as a Venturer in Residence at Harvard’s Innovation Lab.
-A new name on the esteemed list of presenters is Dr. Kevin AminZadeh, an international speaker and a key opinion leader in the field of digital dentistry, implantology, and microscope enhanced dentistry. He has built his practice upon digital treatment planning of complex oral rehabilitations. He is a consultant for oral and maxillofacial surgeons, periodontists, and general dentists. In 2015 Dr. AminZadeh founded Implant Genius, an implant treatment planning company based in Vancouver. He is an expert in digital workflow stages from digital record taking, implant treatment planning using implant planning software, implant placement using surgical guides, and custom prosthodontic restorations.
Held October 7-8, 2016, in Boston, MA, 3DU is hosted by KaVo Kerr Group imaging brands Gendex™, NOMAD™, SOREDEX™and Instrumentarium™. The 2-day event offers dental professionals an educational environment dedicated to Cone Beam 3D (CBCT) solutions — worth up to 11 CE credits — that will enhance their practice and put them in full control of treatmentoutcomes. In addition to Drs. Shuman and AminZadeh, other speakers include:
-Lou Graham, DDS, on his Journey to 3D
-Gy Yatros, DMD, on 3D Airway Analysis
-Kaveh Ghaboussi, DMD, on using 3D for Implant Planning and more
-Douglas Chenin, DDS, on Success with surgical guides
-Terry Work, DMD, on Simple, Predictable Implant Planning
-Lisa Koenig, BCHD, DDS, MS offering Anatomy and Pathology Review
-Christine Taxin on Medical Billing and Insurance Reimbursement
The complete agenda will dive into the role of 3D in endodontics, reading 3D scans, real life case presentations and software training, and best practices for incorporating 3D into the practice in order to maximize your investment.
For a limited time, dental professionals can enter to win FREE tuition and a 2-night stay in Boston for the event. Go to dental3DU.com/winfor details and additional information about the event.
Albensi Dental Laboratory, Inc. announced that it was named a Pittsburgh Post-Gazette Top Pittsburgh Workplace for the fourth consecutive year. This year, the laboratory took the No. 1 spot, despite moving to the mid-sized company category (150-399 employees) for the first time. Albensi also took the No. 1 award spot for Top Executive Leadership.
“We are truly humbled and would like to thank our entire team for voting us for this honor and award,” says Don Albensi Jr., COO.
To make this annual list, a company must first be nominated, and then thousands of employees are polled. Part of the polling process allows comments to be made and examples to be given by employees to support the rankings. As one Albensi employee said: “Our owners/bosses have helped me grow into the position I have. The training they have provided gives me the confidence to fulfill daily functions with minimal guidance. The atmosphere in the lab promotes a positive work environment where hard work comes with great reward.”
Tokyo – The part of the jawbone containing tooth sockets is known as alveolar bone, and its loss over time or following dental disease may ultimately result in tooth loss. While dentures can be used as a tooth replacement, the mechanical stimuli under the dentures causes further bone loss. An alternative and more permanent solution is strongly hoped for. Recombinant human bone morphogenetic protein 2 (BMP-2) has been used to stimulate osteogenesis (bone formation) in humans, but high levels can cause inflammation and tumor development. Therefore, agents such as peptide drugs for accelerating bone augmentation need to be developed, even in the presence of lower levels of BMP-2. Additionally, there are no known means of stimulating local bone augmentation without performing surgery.
The peptide OP3-4 has been shown to inhibit bone decay and stimulate the differentiation of cells (osteoblasts) that form bone. Now, an international team centered at Tokyo Medical and Dental University has injected a gelatin-based gel carrying OP3-4 and BMP-2 into mice jawbones to trigger local augmentation of bone around the injection site. The study was recently reported in the Journal of Dental Research.
Use of this injectable gelatin-based gel to carry the agents avoids the need for surgical implantation and resulted in no swelling or other such complications in the experimental mice. The researchers observed a region of increased bone mass around the BMP-2 + OP3-4 injection site that was larger than that seen in mice injected with BMP-2 alone, or with other controls. This mass also had a significantly higher bone mineral content and density.
Microscopic examination revealed the deposition of calcified tissue (mineralization) throughout the newly formed bone of BMP-2 + OP3-4-treated mice.
“Mineralization of the outer region evidently took place before that of the inner region,” lead author Tomoki Uehara says. “We speculate that the size of the new bone is determined before calcification starts, and that OP3-4 plays an important role in making a regeneration site at the early stage of bone formation.”
Corresponding author Kazuhiro Aoki adds: “OP3-4 further enhanced the number of bone-forming cells induced by BMP-2 treatment, and greatly increased the expression of genetic markers of bone formation.”
The article “Delivery of RANKL-Binding Peptide OP3-4 Promotes BMP-2-Induced Maxillary Bone Regeneration” was published in the Journal of Dental Research at DOI: 10.1177/0022034516633170.
Alexandria, Va., USA – The International and American Associations for Dental Research (IADR/AADR) have published a special issue of the Journal of Dental Research (JDR) on orofacial pain. Ronald Dubner, University of Maryland, Baltimore, USA, served as the guest editor of this special issue.
Today, pain is a health problem that requires a broader perspective than in the past. Millions of people suffer from overlapping chronic pain conditions that share co-morbid behavioral, physiological and psychological characteristics as well as genetic determinants. Many of these conditions affect the orofacial region uniquely or have accompanied widespread systemic manifestations. This includes temporomandibular disorders (TMD), headache, arthritis, and fibromyalgia, to name just a few.
The recognition of the above issues and their importance to students, dental scientists and practitioners has led to this special issue, which highlights the latest developments in the field of chronic orofacial pain. This issue was inspired by the November 2015, 8th AADR Fall Focused Symposium in Washington, D.C., USA, themed "Advances in the Biology and Management of Chronic Pain."
"I am honored that I was able to serve as the guest editor of this special JDR issue on orofacial pain," said Guest Editor Ronald Dubner. "It's pertinent that we focus on the management of orofacial pain for the benefit of our patients and researchers in the field. The articles in this issue include the impact of persistent orofacial pain beyond the orofacial region, its presence as a component of generalized illness and the important evolution of TMD diagnosis in the last decade. I am thankful to the outstanding basic and clinical researchers who contributed their science for publication."
To read the JDR special issue on orofacial pain, please visit http://jdr.sagepub.com.
Since 2009, United States residents have adopted more children from China than any other country. Since China has a high prevalence of cleft lip and palate, some of these children require extra medical care early in their lives. Many prospective families are fearful of the treatment costs needed by a child affected by cleft lip and palate. However, recent research suggests that the costs are not nearly as high as previously thought.
A study conducted between 2010 and 2013 and published in The Cleft Palate–Craniofacial Journal reviewed the records of 138 patients from the Children’s Hospital of Pennsylvania who underwent first-time cleft palate repair. For the purposes of the study, 118 US-born children were surveyed against 20 international adoptees, with payments to surgeons, anesthesiologists, and the hospital compared between the two groups.
When analyzing the breakdown of payments made by parents of children with cleft palates, they made a few surprising finds. Twenty-six percent of US-born children were covered by Medicaid insurance, but none of the adoptees were eligible. This resulted in the average adoptees’ payments being much higher as compared to the average payments for US-born patients. However, the payment to anesthesiologists and the hospital were actually lower for international adoptees. As a result, the total payment for treatment was relatively similar for both groups.
Overall, the authors of the study concluded that families considering adoption of a child with cleft palate should not be concerned with incurring excessive costs for the child’s repair surgery. As international adoptions and wait times have increased dramatically since the mid-1990s, considering a child with a birth defect could expedite the process of family placement and lead to more children in need finding a home.
Full text of the article, “Economic Analysis of Cleft Palate Repair in International Adoptees,” The Cleft Palate–Craniofacial Journal, Vol. 53, No. 5, 2016, are available at http://www.cpcjournal.org/doi/full/10.1597/14-227.
Newswise — FAYETTEVILLE, Ark. – A biological anthropologist at the University of Arkansas and her colleagues at Johns Hopkins School of Medicine and Marquette University have received a $219,000 grant from the National Science Foundation to study skull and jaw anatomy in 16 closely related primate species, including humans.
The study will focus on how the teeth, jaw and related joints work together as a chewing system and how the components are affected by aging and abnormal changes.
“We’re trying to provide a more complete picture of the anatomical interrelationships of this complex system,” said Claire Terhune, assistant professor of anthropology in the
J. William Fulbright College of Arts and Sciences. “We hope not only to address how the different components are correlated but also show how changes occur during the lifetime of an individual, and how primate species differ from one another in these changes. By changes, we mean both normal and pathological dental wear, as well as normal and abnormal, or arthritic, changes in the temporomandibular joint.”
The temporomandibular joint (or TMJ) connects the jaw to the temporal bones of the skull and sometimes develops pathologically in primates, resulting in an arthritic joint. But very little research has been done regarding which primate species experience these arthritic changes and how often this occurs. The research may help to explain these pathologies and inform clinical studies of dental problems in humans.
In addition to studying changes that occur at different ages, the researchers will compare the 16 closely related primate species and look for similarities in the degree of evolutionary change over time.
“Do two shapes or pathologies vary in relation to one another?” said Terhune. “Do you always see dental pathologies, such as tooth loss or abscesses, occurring with osteoarthritis in the temporomandibular joint? These are the kind of questions we’re asking.”
Data from the study will be made available to both anthropological and biomedical researchers.
In addition to travel for data collection, the grant will support a post-doctoral researcher at the University of Arkansas and involvement by undergraduate students.
Terhune’s colleagues are Siobhán Cooke at Johns Hopkins University and Claire Kirchhof at Marquette University.