Should General Dentists do Orthodontics ?

Survey Reveals How Dentists Refer

Some dentists send patients who need braces to orthodontists, while others treat them themselves, according to a recent Wealthy Dentist survey. One in four dentists reported that they treat most orthodontic patients themselves. By contrast, one in three refers out all orthodontic patients.

"It's a win for everyone," said an Illinois dentist who refers out all orthodontics. "Patients are well served, we are looked upon as caring, and orthodontists are geared specifically to do this."

A California dentist who refers less than 20% of orthodontic patients said, "I am happy to refer out those cases which I don't feel competent to treat or which I just don't want to treat for whatever reason. Having been actively treating orthodontic cases in my general practice for over 20 years now, there are not a lot of cases which I refer out."

"Minor tooth movement is within the purview of dentist and pedodontist. Treatment planning for major malocclusions is better done by an orthodontist and an oral surgeon," said a Minnesota oral surgeon.

The most remarkable differences were related to geographic location. Rural dentists were more likely to treat orthodontic patients themselves. More than half of rural dentists (54%) reported treating braces patients themselves, while only 9% of urban dentists and 26% of suburban dentists did. "I do orthodontic work in my office and have been for 20 years. I only refer out surgical ortho cases," said a general dentist in rural Wisconsin.

Gender differences were dramatic. Male dentists were more than twice as likely to treat orthodontic patients. Female dentists were more likely than their male colleagues to refer these patients out to a specialist. "I believe that only a good orthodontist can get really good, long-lasting results," said a female dentist.

"I don't need to refer for 95% of cases or more," said a male dentist.

Some dentists see it as their duty to refer patients out to dental specialists. "I feel the best treatment for my patients is for a specialist to do things for which they are better trained than I am. This goes for orthodontics, oral surgery, periodontics, and endodontic work. Weekend courses do not compare to the rigorous training that specialists receive in their residencies," said a North Carolina dentist who refers more than 80% of orthodontic cases. "Our profession is awash in undertrained dentists putting their bottom line ahead of their patients' best interest, and I feel this will marginalize our profession in the medical community."

Some general dentists have found that there's good money to be made in doing orthodontic work. "It is my understanding that GPs do 80% of all ortho in the USA," commented a Michigan dentist who refers less than 20% of orthodontic patients. "If we (GPs) as a whole just knew how easy ortho is, the vast majority could increase monthly income by 15 to 25%. I took my classes from USDI, love doing it, and now me and my stay-at-home wife are both driving Mercedes."

Invisalign is changing the role of general dentists in orthodontic treatment. "We offer Invisalign braces in our office, but all wire and brackets are referred to a traditional orthodontist," commented an Oregon dentist.

A Michigan dentist disagreed with that strategy, saying, "The vast majority of GPs have no formal training, so they should refer out. Most of the GPs who do Invisalign have no clue about ortho and are doing a disservice to their patients."

Oral Health Care cuts Hospitalization costs

It has been sometime since I posted, have been traveling attending various conferences. One things that hits hard is the state of scientific sessions, members attending conference are more keen to visit trade fair and food/drink and organizers have to face embarrassment of very few attendees in the lecture halls. Why this drama? why not do away with scientific talks and keynote addresses ?

Dentistry can not survive unless we are willing to face the challenges, there have been volume of research to show that Mouth Care is not OPTIONAL it should be given the very first priority if you want to enjoy sound health. This recent publication endorses this fact yet again. For all the resources visit Body mouth connection resource

A new study in the November issue of the Journal of Periodontology (JOP) found that prevention of periodontal diseases may lead to savings on not only dental costs, but also medical care costs. Periodontal, or gum diseases have been linked to systemic health conditions including diabetes, cardiovascular disease, and respiratory problems. For full news CLICK HERE

Japanese dentists unveil high-speed dental ID system

Japanese scientists on Tuesday unveiled a new device that could save drawn-out trauma for relatives of those killed in disasters, by vastly speeding up the identification of victims from their dental records.

The computerized device scans images of victims' teeth and aligns them with pictures from unidentified people's dental records, looking for a fit, according to Eiko Kosuge, a dentist and radiologist at Kanagawa Dental College in Japan who led the study.

When many people are killed in a disaster such as an earthquake, plane crash or attack, experts currently identify their bodies one by one by comparing teeth with radiograph images or casts supplied by the victims's dentists.

But the process can take weeks and is not fully reliable, Kosuge said in a report introducing the new device.

The new system can automatically compare an image of a victim's teeth with numerous dental records and offer a match in less than four seconds, reducing the workload of forensic experts by 95 percent, his team of researchers said in the report.

It uses a high-precision image-matching technique named Phase-Only Correlation, which aligns images and measures their similarities.

Kosuge presented the new system Tuesday in Chicago at the annual meeting of the Radiological Society of North America.

Are you promoting/ following MYTH in Endodontics

Sadly today science is preceded by Marketing Guru's. They know how to manipulate your minds. Believe me they even know where you will look at the Menu card in a restaurant and they position their dish (most profitable) in respective places accordingly. Are you the kind to fall prey or you want to take your own decision and choose your own combination ?

Dentistry is also going through the same trauma/drama. Vast majority of us have no time or inclination to search for TRUTH and they easily fall prey to marketing tricks.

All those who are concerned by the decline in standards of a supposedly comfortable dental practice, which is presented as self -explanatory, and is sometimes to the detriment of the patient’s health and often to the detriment of any medical ethics.Hard to believe look at these sites http://www.implant-warning.com/

Right now implantology and Endodontics are going thru a tough time, we need to be watchful so that knowingly or unknowingly we do not fall prey to clever marketing tricks and become guilty of not being able to give best to our patients, and also have procedural tensions and calls from suffering patients/or give them unwanted medication for prolonged durations.

And http://www.healthmantra.com/rotary/endo-truth.shtml

Golden opportunity to attend basic and advanced course in Smart Endo for those of you who are near Gwalior or Udaipur,

download the brochure and register NOW, CLICK HERE

Best bonders make best orthodontist

In olden days best wire benders made best orthodontist but today best bonders make best orthodontist. Bracket positioning determines the quality and speed of your treatment with straightwire appliance.

Before we go further all dentists must read this news by clicking on these links, and you will avoid all future problems in your clinic....
Dentist who danced while working
Dentists did to his patients, that should never be done

To very interesting studies just published in month in leading ortho journals:

What is the best method to bond the brackets ? Center of tooth or incisal edge?

A comparison of accuracy in bracket positioning between two techniques—localizing the centre of the clinical crown and measuring the distance from the incisal edge David Armstrong^*, Gang Shen^*, Peter Petocz^** and M. Ali Darendeliler^*

The European Journal of Orthodontics 2007 29(5):430-436

The placement of orthodontic brackets is guided either by localizing the centre of the clinical crown (CC) or by measuring the distance from incisal edge (ME). The purpose of this study was to examine if there are any significant differences in the accuracy of bracket positioning between these two techniques.

Typodont models were simulated with a Class I malocclusion with severe crowding. Nineteen experienced orthodontists (12 males, seven females) with a mean age of 40.6 years bonded pre-adjusted straight-wire brackets (Victory MBT) on the typodonts. Each orthodontist was asked to bond 20 brackets on one typodont using the CC method and 20 brackets on another typodont using the ME method. The teeth were removed from the typodont and photographed for imaging analysis. The errors of bracket placement in the vertical, mesiodistal, and angular/tip dimensions were measured and the data were statistically assessed.

Analysis of the teeth individually showed that the ME method was better in the vertical positioning for several upper and lower anterior teeth (P <> the upper first premolars. The mean time taken to bond the 20 brackets showed no significant difference between two methods (CC 28.53 ± 9.51 versus ME 28.21 ± 10.43 minutes, P > 0.05). It is suggested that bracket bonding guided by measuring the distance from incisal edge may result in improved placement for anterior teeth. Archwire bending or bracket repositioning is still necessary to compensate for the inaccuracies with both techniques.

Did you know that deep bite has a relation to fusion of your cervical vertebra ?

Cervical vertebral body fusions in patients with skeletal deep biteLiselotte Sonnesen^*,** and Inger Kjær^*

The European Journal of Orthodontics 2007 29(5):464-470

Cervical column morphology was examined in 41 adult patients with a skeletal deep bite, 23 females aged 22–42 years (mean 27.9) and 18 males aged 21–44 years (mean 30.8) and compared with the cervical column morphology in an adult control group consisting of 21 subjects, 15 females, aged 23–40 years (mean 29.2 years) and six males aged 25–44 years (mean 32.8 years) with neutral occlusion and normal craniofacial morphology. None of the patients or control subjects had received orthodontic treatment.

In the deep bite group, 41.5 per cent had fusion of the cervical vertebrae and 9.8 per cent posterior arch deficiency. The fusion always occurred between C2 and C3. No statistically significant gender differences were found in the occurrence of morphological characteristics of the cervical column (females 43.5 per cent, males 38.9 per cent). Morphological deviations of the cervical column occurred significantly more often in the deep bite group compared with the control group.

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Are you wasting your time, Giving Multiple Intracanal Dressings?

One study just published clearly shows that intra canal dressings are a waste of time.

Reference
M. E. Vianna, H.-P. Horz, G. Conrads, A. A. Zaia, F. J. Souza-Filho, B. P. F. A. Gomes (2007)
Effect of root canal procedures on endotoxins and endodontic pathogens
Oral Microbiology and Immunology 22 (6), 411–418. Read on ..........

Method: Twenty-four teeth were selected for the present study. Chemo-mechanical preparation was performed using 2% CHX gel and three different intracanal medicaments [Ca(OH)₂ paste; 2% CHX gel; and Ca(OH)₂ + 2% CHX gel]. A quantitative chromogenic Limulus amoebocyte lysate assay was used to measure the amount of endotoxin. Aerobic and anaerobic techniques were used to isolate and identify bacteria, and to determine the bacterial reduction by counting colony-forming units (CFU).

Results: Endotoxins and bacteria were present in 100% of the initial samples, with endotoxin concentration ranging from 62.93 to 214.56 UE/ml and CFU ranging from 4 × 10⁵ to 2.6 × 10⁶. After chemo-mechanical preparation a mean endotoxin reduction of 44.4% was found. Eight (33.3%) root canals were still positive by culture analysis with a mean reduction of bacteria (CFU) of 99.96%. After 7 days of intracanal dressing, endotoxin concentration decreased by only 1.4% compared with S2, and residual bacteria were recovered by culture analysis in 13 cases (54.1%). No significant difference was found among different intracanal medicaments.

Conclusion: Relatively high values of endotoxin were still present in the root canal after chemo-mechanical preparation although the majority of bacteria were eliminated. No improvement was achieved by 7 days of intracanal dressing.

To achieve best possible chemo Mechanical cleaning, you need to use non tapered instruments.

Take action today and it will change your life for sure, register for a course today.

New approach to perio Treatment

A new study published in the November issue of the Journal of Dental Research shows that application of beneficial bacteria as an adjunct to traditional therapy may become a valid, non-antibiotic treatment approach for periodontitis (gum disease). In this small-scale animal study, researchers applied a mixture of beneficial bacteria after scaling and root planing (removal of bacterial plaque from the crown and root of the tooth surface), a concept called Guided Pocket Recolonization, or GPR. With the emergence of antibiotic resistance and the lack of non-antibiotic treatment options, this GPR approach may provide a valuable addition or alternative to treatment options for periodontitis.

This is the first study to test the concept of bacterial replacement therapy in the treatment of plaque-related periodontal disease, and analysis of the data showed, in a beagle dog model, that when beneficial bacteria were applied in periodontal pockets adjunctively after root planing, repopulation by bacteria associated with gum disease was delayed and reduced, as was the degree of inflammation, at a clinically significant level. So keep watching for new developments in this area.