ACP Releases First Clinical-Practice Guidelines for Patients with Dental Restorations

Posted on December 30, 2015



CHICAGO, Dec. 29, 2015-- Patients with dental restorations supported by natural teeth such as crowns, bridges and veneers, or supported by implants can keep their teeth healthy using a lifelong recall and maintenance approach according to new clinical practice guidelines that were published online Dec. 29 and in a special supplement to the January issue of the Journal of Prosthodontics.

"Often patients are unaware of the required brushing and general maintenance needs when they have expensive implant restorations. The take home message from the systematic reviews and clinical practice guidelines is that implant supported restorations require ongoing at-home maintenance and regular recalls for an enduring result," said Carl F. Driscoll, DMD, FACP, the President of the American College of Prosthodontists (ACP).

ACP led a scientific panel of experts appointed by the American Dental Association (ADA), the Academy of General Dentistry (AGD), the American Dental Hygienists Association (ADHA) and the ACP who critically evaluated and debated findings from two comprehensive systematic reviews covering ten years of the research literature: "Recall Regimen and Maintenance Regimen of Patients with Dental Restorations-Part 1: Tooth-Borne Restorations and Part 2: Implant Borne Restorations." The major outcomes and consequences considered during formulation of the clinical practice guidelines (CPGs) were risk for failure of tooth- and implant-borne restorations.

"The new clinical practice guidelines will help dentists and hygienists to standardize effective oral health maintenance and improve patient care," said Donald A. Curtis, DMD, FACP, who along with Lily T. Garcia, DDS, MS, FACP, put the guidelines to the test with rigorous peer review to ensure that they are sound, scientifically-based and can improve patient outcomes for long-lasting restorations.

In addition to maintaining regular dental hygiene practices, the new guidelines recommend that patients with restorations visit their dentists at least every six months for clinical examinations to clean, adjust, repair or replace their restorations. The guidelines not only recommend how and how often practitioners should see patients for dental restoration maintenance and follow-up, but how they should educate patients to take care of the restorations at home.

"Prosthodontists often take great pride in meticulously restoring smiles so that they look as natural as possible," said Avinash Bidra, DDS, MS, FACP, a prosthodontist and the lead researcher of the evidence-based review. "Patients with multiple restorations that are supported by natural teeth or implants need to know that professional and at home maintenance is a lifelong regimen. We are telling professionals what guidelines to follow and what to tell patients for at home maintenance."

"The American College of Prosthodontists will offer free access to selected research in the Journal of Prosthodontics from Dec. 29 through 2016 as a way to celebrate National Prosthodontics Awareness Week (NPAW) in April," added Dr. Avinash Bidra, who along with being the lead researcher is also NPAW Chair. "This is news oral health providers can comfortably share to maintain patients' implants, crowns, and veneers and natural teeth."

"Although clinical practice guidelines are often used in medicine, they have not been used as much in dentistry. Adding a clinical practice guideline on this important topic will establish a baseline and help to standardize care," added Dr. Donald Curtis of UCSF.

"If you don't take care of your restored teeth, you are at risk of losing your teeth and your investment in them," cautioned Dr. Lily T. Garcia, who serves as Vice Chair of the ACP Education Foundation.

Prosthodontists are specialized dentists with advanced training in oral health issues, who are committed to improving patient outcomes. From implants, crowns, veneers and tooth whitening, to full-mouth reconstruction, prosthodontists specialize in leading research, digital dentistry and oral health solutions.

The ACP is the only prosthodontic specialty organization whose membership is based solely on education credentials. ACP members must be in or have completed an ADA-accredited advanced education program in prosthodontics.

The findings of the systematic reviews and the Clinical Practice Guidelines of this peer review will also be published in The Journal of the American Dental Association, General Dentistry and the Journal of Dental Hygiene.

The project was funded in part by an unrestricted educational grant to the American College of Prosthodontists Education Foundation from the Colgate-Palmolive Company.

About the ACP

The American College of Prosthodontists (ACP) is the official sponsoring organization for the specialty of prosthodontics, which is one of only nine recognized specialties of the American Dental Association. Founded in 1970, ACP is a not-for-profit organization dedicated to enhancing patient care, advancing the art and science of prosthodontics, promoting the specialty of prosthodontics to the public and other dentists and healthcare professionals, ensuring the quality of prosthodontic education and providing professional services to its membership. Patients and consumers can visit GoToAPro.org and oral health professionals can learn more at Prosthodontics.org.

Article Link:

Journal of Prosthodontics

http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1532-849X

AAFP Supports Integration of Oral Health Into Primary Care

Posted on December 30, 2015

December 24, 2015 – The American Academy of Family Physicians (AAFP) has thrown its support behind a new model for delivering preventive oral health care as a component of routine medical care and enhancing partnerships between primary care and dentistry. The model, dubbed the Oral Health Delivery Framework, was presented in a white paper (www.safetynetmedicalhome.org) titled “Oral Health: An Essential Component of Primary Care,” which was released earlier this year by population healthcare consultant Qualis Health.

The framework has been endorsed by nearly a score of healthcare and dental professional, public health, and advocacy organizations.

The paper reviews the cost and consequences of oral disease, presents the Oral Health Delivery Framework with suggested actions to help primary care teams promote oral health, and offers guidance for primary care and dental teams that want to partner with one another.

"Oral disease is largely preventable and can complicate the management of other chronic conditions such as diabetes and heart disease," said Qualis Health President and CEO Jonathan Sugarman, MD, MPH, in a news release (www.qualishealth.org). "Engaging primary care teams in oral health is a critical strategy for reducing the impact of oral diseases and improving population health."

Mark Deutchman, MD, professor in the Department of Family Medicine at the University of Colorado Anschutz Medical Campus School of Medicine in Aurora, helped develop the Oral Health Delivery Framework along with family physicians Bruce Bagley, MD, and Russell Maier, MD.

"Oral health is closely linked to overall health across the lifespan," Deutchman told AAFP News. "Early childhood caries is the most common chronic disease of childhood."

He explained that children with severe cavities are in pain, can't eat properly, and have poor school performance and poor self-esteem. "Treatment is very costly and often needs to be repeated," said Deutchman. "As soon as physicians understand that dental caries is a vertically transmitted, infectious preventable disease, they understand that addressing it needs to be part of our care."

In adults, Deutchman continued, periodontitis is closely linked to poor diabetic control. "There also is emerging evidence that periodontal disease is linked with heart disease, stroke, obesity, adverse pregnancy outcomes and other systemic disorders," he said.

The Oral Health Delivery Framework consists of five actionable steps primary care teams can take to protect and promote oral health, including offering preventive interventions and structured referrals to dentistry.

The panel of experts that developed the framework included the aforementioned family physicians along with dental care providers; leaders from medical, dental and nursing associations; payers and policymakers; a patient and family partnership expert; and oral health and public health advocates.

The framework is being field-tested at 19 community health centers and private practices in five states to determine the viability of the model in diverse primary care settings.

Qualis Health is providing technical assistance to participants, as are primary care associations in Kansas, Massachusetts, and Oregon.

After field-testing of the framework is complete, an oral health integration toolkit will be published in 2016, including impact data, supporting resources and tools to help accelerate adoption among primary care practices nationwide.

Family physicians can support this initiative by educating their medical colleagues about the importance of oral health in overall health, said Deutchman.

"Until now, oral health has been a neglected topic in medical education," he said. "We need to communicate that it takes only a very short time to look at the teeth and gums and inquire about oral hygiene habits."

Physicians and many other healthcare professionals can readily identify dental and gum disease, counsel patients about diet and oral hygiene, and encourage patients to establish a dental home. "Look at the teeth and gums; teeth are part of the body, not just what's in the way when looking at the tonsils," said Deutchman. "Advise patients to see a dentist regularly. Inquire about diet, provide oral hygiene counseling and apply fluoride varnish to children's teeth at the time of well-child visits — nearly every state’s Medicaid program pays medical providers an extra fee to do this as part of well-child visits."


He said focusing on the oral health of all patients is important, but this is especially the case with patients at high risk for oral issues, including individuals with diabetes, those from low-income families and Native Americans.

"It also is important to note that the best predictor of a child’s oral health is the parents' oral health," Deutchman said. "Diet, oral hygiene habits and the bacterial load that is associated with cavities are all vertically transmitted."

Ultimately, to improve oral health care of patients, a better bridge must be built between family physicians and dentists.

"We need each other to provide complete care," he said. "Dental professionals need to be part of team-based care, even if they are physically located beyond our walls."

The AAFP has supported several oral health initiatives, including the Society of Teachers of Family Medicine's Smiles for Life (www.smilesforlifeoralhealth.org) and the American Academy of Pediatrics' Campaign for Dental Health (www.ilikemyteeth.org).

Deutchman pointed out that the Smiles for Life national oral health curriculum is an important tool in supporting the overall goal of integrating oral health in primary care.

"This was developed by the oral health group of the Society of Teachers of Family Medicine," he said. "It consists of eight modules that cover oral health across the lifespan. Each module takes about 45 minutes to complete. They can be completed online or downloaded for self-study or presentation to others. It is pre-approved for Prescribed AAFP credit and has been endorsed by 14 professional organizations."

The AAFP also has a member interest group on oral health.

Source: AAFP

Use of Antibiotic Prophylaxis for Dental Patients

Posted on December 30, 2015

HARRISBURG, Pa., Dec. 29, 2015--When the majority of patients go in for their dental visits there is not much of a risk for bacterial infection. But for a small number of people, the use of antibiotic prophylaxis may be recommended by your dentist.

The American Dental Association (ADA) defines antibiotic prophylaxis as "the taking of antibiotics before some dental procedures such as teeth cleaning, tooth extractions, root canals, and deep cleaning between the tooth root and gums to prevent infection." All of us have bacteria in our mouths, and even basic dental treatments can allow bacteria to enter the bloodstream. However the majority of people don't have to worry about this, since a healthy immune system prevents the bacteria from causing any harm.

Dr. Tamara Brady, a PDA member dentist in Downingtown, Pa., receives questions about prophylaxis from time to time.

"I tell patients who inquire about premedication for cardiac prophylaxis that we follow the recommendations of the ADA and the American Heart Association (AHA). If their physician recommends prophylaxis for a condition not recommended for prophylaxis by the AHA then they should get the prescription from their medical doctor."

Who should consider taking prophylaxis? According to the AHA, antibiotic prophylaxis should be used for people who have certain heart conditions. This includes those with artificial valves, a heart transplant in which a problem has developed, infection of the lining of the heart, or heart conditions that are present from birth. Talking with your dentist is always the best route to go if you are unsure whether or not to consider this premedication.

About the Pennsylvania Dental Association

Founded in 1868, the Pennsylvania Dental Association (PDA) is comprised of approximately 6,000 member dentists. It is a constituency of the American Dental Association (ADA), the largest and oldest national dental society in the world. PDA's mission is to improve the public health, promote the art and science of dentistry and represent the interests of its member dentists and their patients. PDA is the voice of dentistry in Pennsylvania. For more information on PDA, visit our website at www.padental.org.  

Deutsch Removable Bridge ZR Now Registered

Posted on December 29, 2015

Deutsch Dental Arts, LLC announced that the United States Patent and Trademark Office has registered the trademark for the Deutsch Removable Bridge ZR®.

The Deutsch Removable Bridge ZR concept is based on the longstanding success of 0° and 2° telescopic and conical connections, which have become a staple in Europe for both implant and tooth-borne scenarios. Combining this concept with modern materials led to the development of this new product and technique along with a very specific technical and clinical protocol.

The Deutsch Removable Bridge ZR is unique in that the primary custom abutment is designed within the prosthetic volume and requires much less space than current conical connections that are pre-manufactured.

Research and development of additional products to the Deutsch Bridge product line continues. Technical hands-on courses and licensing opportunities will follow in 2016.

Kids at Higher Risk of Cavities Not Getting Needed Preventive Treatments

Posted on December 29, 2015

OAK BROOK, Ill., Dec. 29, 2015 /PRNewswire-USNewswire/ -- A landmark study of more than 97 million dental claims, conducted by Delta Dental Plans Association, found two-thirds of children who are at higher risk of developing cavities aren't getting recommended preventive dental care.

The study determined that twenty-seven percent of children through age 18 are at a higher risk of developing cavities as measured by a history of recent fillings. Of those children:

The American Dental Association (ADA) recommends children at higher risk of tooth decay receive two fluoride treatments a year as well as sealants on their first and second permanent molars. Such treatments are commonly fully-covered benefits.

Children at higher risk of developing cavities aren't the only ones not receiving preventive care:

"Delta Dental is committed to improving the nation's oral health, and that means focusing on the very young to ensure they get a good start and are practicing a life-long approach to taking care of a crucial component of their overall health: their teeth," said Dr. Bill Kohn, vice president for dental science and policy for Delta Dental Plans Association. "Dental diseases like tooth decay and gum disease are preventable, so it is very important for children and adults at higher risk for dental disease to fully utilize the preventive dental benefits available to them."

Delta Dental encourages all employers to provide a dental benefits plan that covers sealants and two fluoride treatments annually, per ADA guidelines. Findings from the study will be used to educate individual consumers, parents and employers about the importance of preventive care. The findings will also help inform dental care providers about missed opportunities to provide needed care to their patients.

"This annual study helps Delta Dental identify ways to better ensure people have the information and benefits they need to maintain a healthy smile," said Dr. Kohn.

The risk of developing dental disease is related to personal and professional dental care, diet and genetics. Visit the Delta Dental MyDental Score tool for an online risk assessment survey.

Foundation Awards PTC Ness Grant

Posted on December 28, 2015

Tallahassee, Florida - The Foundation for Dental Laboratory Technology announced the five winners of the 2016 PTC John Ness Memorial Education Grant: Yojeong Cho, CDT (Costa Mesa, CA); Caitlin Dawson, RG (Norfolk, VA); Ghassan Halabia, CDT (El Cajon, CA); Yvette Morales, CDT, TE (San Antonio, TX); Odena Chinchilla Serrano, CDT (San Gabriel, CA).

The Foundation created this grant in order to support its purpose by recognizing the need for increased accessibility to fundamental education in dental laboratory technology, and partnered with PTC (Productivity Training Corporation). Each winner will be awarded one PTC Ness Academy Hands on Course at no charge, thanks to the generosity of PTC. 

“Attending a PTC Ness Academy Hands on Course is an incredible training opportunity for technicians to enhance their experience in the dental laboratory technology field and help ensure they are creating the best restorations possible," says Foundation Chair Leon Hermanides, CDT. "We couldn’t be more thankful for PTC’s generosity in donating these courses and joining us in determining the future of our profession, and we are excited to announce that PTC has committed to continuing the grant next year."

PTC is located in the southernmost part of Silicon Valley in Morgan Hill, California, and has been training dental professionals since 1978 through dental technician courses that use proven learning systems to help new and existing technicians quickly improve their technical ability. For additional information, visit www.ptcdental.com.

For additional information about the Foundation and its program, visit www.dentallabfoundation.org. The Foundation relies heavily on donations from individuals as well as companies to fund the scholarship and grant programs. Donations are accepted throughout the year.  To support the Foundation, click here.  

Surgeon General Endorses Community Water Fluoridation

Posted on December 28, 2015

WASHINGTON, D.C. – The American Dental Association (ADA) applauds U.S. Surgeon General Vivek Murthy, M.D., and his endorsement today of community water fluoridation. “Fluoride’s effectiveness in preventing tooth decay extends throughout one’s life,” he said, “resulting in fewer – and less severe – cavities.”

This year marks the 70th anniversary of community water fluoridation. Since its introduction in Grand Rapids, Michigan in 1945, optimally fluoridated water has dramatically improved the oral health of tens of millions of Americans.

“Studies show that community water fluoridation prevents at least 25 percent of tooth decay in children and adults, even in an era with widespread availability of fluoride from other sources, such as fluoride toothpaste,” said ADA President Dr. Carol Gomez Summerhays. “On behalf of the ADA, we wish to thank Dr. Murthy for reaffirming that community water fluoridation is the single most effective public health measure to prevent tooth decay. The ADA is proud to continue its efforts at the state and federal levels to support this safe and proven way to help fight dental disease.”

Community water fluoridation education is one of the initiatives supported by the ADA’s Action for Dental Health movement. For more information on fluoride and its health benefits, visit ada.org/fluoride. For more information on Action for Dental Health, visit ada.org/action.

Legislation Provides Increases in Funding for Dental Research, Education

Posted on December 23, 2015

December 22, 2015, Washington— Offering a clear win on key issues for organized dentistry and dental patients, the president signed into law Dec. 18 a package of legislation that provided significant increases in funding for dental research, education, and related matters, according to ADA News. The legislation also included important changes to the tax code that will help dentists, as well as employers and healthcare consumers. Finally, the massive bill effectively addresses several critical public health issues affecting oral and overall health. The ADA played an active role in advocating for all of these issues, in many cases taking the lead, and in several instances acting through coalitions.

To read the full ADA News report, click here.

Tooth Fillings of the Future May Incorporate Bioactive Glass

Posted on December 23, 2015

CORVALLIS, Ore. – A few years from now millions of people around the world might be walking around with an unusual kind of glass in their mouth, and using it every time they eat.

Engineers at Oregon State University have made some promising findings about the ability of “bioactive” glass to help reduce the ability of bacteria to attack composite tooth fillings – and perhaps even provide some of the minerals needed to replace those lost to tooth decay.

Prolonging the life of composite tooth fillings could be an important step forward for dental treatment, the researchers say, since more than 122 million composite tooth restorations are made in the United States every year. An average person uses their teeth for more than 600,000 “chews” a year, and some studies suggest the average lifetime of a posterior dental composite is only six years.

The new research was just published in the journal Dental Materials, in work supported by the National Institutes of Health.

“Bioactive glass, which is a type of crushed glass that is able to interact with the body, has been used in some types of bone healing for decades,” said Jamie Kruzic, a professor and expert in advanced structural and biomaterials in the OSU College of Engineering.

“This type of glass is only beginning to see use in dentistry, and our research shows it may be very promising for tooth fillings,” he said. “The bacteria in the mouth that help cause cavities don’t seem to like this type of glass and are less likely to colonize on fillings that incorporate it. This could have a significant impact on the future of dentistry.”

Bioactive glass is made with compounds such as silicon oxide, calcium oxide and phosphorus oxide, and looks like powdered glass. It’s called “bioactive” because the body notices it is there and can react to it, as opposed to other biomedical products that are inert. Bioactive glass is very hard and stiff, and it can replace some of the inert glass fillers that are currently mixed with polymers to make modern composite tooth fillings.

“Almost all fillings will eventually fail,” Kruzic said. “New tooth decay often begins at the interface of a filling and the tooth, and is called secondary tooth decay. The tooth is literally being eroded and demineralized at that interface.”

Bioactive glass may help prolong the life of fillings, researchers say, because the new study showed that the depth of bacterial penetration into the interface with bioactive glass-containing fillings was significantly smaller than for composites lacking the glass.

Fillings made with bioactive glass should slow secondary tooth decay, and also provide some minerals that could help replace those being lost, researchers say. The combination of these two forces should result in a tooth filling that works just as well, but lasts longer.

Recently extracted human molars were used in this research to produce simulated tooth restoration samples for laboratory experiments. OSU has developed a laboratory that’s one of the first in the world to test simulated tooth fillings in conditions that mimic the mouth.

If this laboratory result is confirmed by clinical research, it should be very easy to incorporate bioactive glass into existing formulations for composite tooth fillings, Kruzic said.

The antimicrobial effect of bioactive glass is attributed, in part, to the release of ions such as those from calcium and phosphate that have a toxic effect on oral bacteria and tend to neutralize the local acidic environment.

“My collaborators and I have already shown in previous studies that composites containing up to 15 percent bioactive glass, by weight, can have mechanical properties comparable, or superior to commercial composites now being used,” Kruzic said.

This work was done in collaboration with researchers from the School of Dentistry at the Oregon Health & Science University and the College of Dental Medicine at Midwestern University.

Source: Oregon State University

Ellison to Offer Implant Overdentures Clinic

Posted on December 22, 2015

Sterngold Dental, LLC announced that James Ellison, CDT, will lecture on “Implant Overdentures” on Saturday, February 27, 2016 from 1-3 p.m. at the Hyatt Regency Chicago.

The lecture will cover how to choose the best attachment for any patient needing a partial or overdenture, the preparation of the prosthesis for laboratory processing, and the advantages of resilient attachments for removable prosthetics.

Participants can earn two Scientific Continuing Education credits. To sign up for the clinic, call Sterngold at 800-243-9942.

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