Archive | October, 2016

What are the ethical issues of terminating a patient?

An interesting article titled “The ethical issues of saying good-bye to a patient” appears in the July 2016 issue of JADA and written by Gary Herman. The article addresses the ethical issues that result from terminating a relationship with a patient. There are certain reasons for terminating a patient. This includes discharging a patient who is difficult or noncompliant, a patient who notifies you that he or she is choosing to go elsewhere, and a patient who just seems to disappear. A dentist of course is always concerned with treating a patient well. If you terminate a patient the practice goes against this goal. An article on risk management lists failure to recognize problem patients and failure to dismiss those patients properly as some of the biggest mistakes dentists make. The article states “When patients make unreasonable demands, have impossible expectations, or prevent you from meeting the standard of care, it is important to maintain control of your practice and terminate relationships with those patients from your practice, both for their benefit and yours.” The article states that it is essential to let a patient know you are discontinuing care. Dentists should follow up with a written notification detailing the reason for the termination and providing […]

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What Makes the Best Dentists?

There’s plenty of dentists to choose from and we know that finding the best one can be quite difficult. Dental health is not a matter that can be taken for granted and you need to know that your dentist will efficiently see to your needs. A good dentist will be concerned for his patients well being and will focus on it. A good dentist is also honest and won’t try and get you to buy all unnecessary dental treatments and products. After all he’s a dentist, not a salesman. You Should Feel Safe In Your Dentist’s Office: In a dentist office, it’s easy to feel vulnerable. Dentists see everything in your mouth, and regardless of what you’ve told them, they can tell how often you’re brushing, flossing and rinsing with mouthwash. When you have to undergo a procedure, from tooth extractions to implants, that feeling of vulnerability can escalate quickly. Does your dentist inspire trust and confidence from you? Do you feel safe, knowing they’ll take care of you? Any good dentist will work hard to provide an environment where you feel safe to drool from the Novocain, and where you completely trust them to perform the procedure thoroughly and correctly. […]

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Nanoparticles can be used to break up plaque and prevent cavities

Bacteria living in dental plaque contribute to tooth decay which is often resistant to traditional antimicrobial treatment. Researchers at the University of Pennsylvania took advantage of pH sensitive and enzyme like properties of iron containing nanoparticles to catalyze the activity of hydrogen peroxide. The activated hydrogen peroxide produced free radicals that were able to degrade the biofilm matrix associated with tooth decay and kill bacteria thus preventing plaque and reducing tooth decay. The researchers said that even a low concentration of hydrogen peroxide was effective at disrupting the biofilm. It was found that adding nanoparticles increased the efficiency of bacterial killing more than 5,000-fold. The work built off a seminal finding published in 2007  showing that nanoparticles, long believed to be biologically and chemically inert, could in fact possess enzyme-like properties. This study showed that an iron oxide nanoparticle behaved similarly to a peroxidase, an enzyme found naturally that catalyzes oxidative reactions, often using hydrogen peroxide. Some of the researchers were skeptical to use nanoparticles in an oral setting to kill bacteria because the free radicals can also damage healthy tissue. However the nanoparticles’ activity is dependent on pH and had no catalytic activity at neutral or near-neutral pH of 6.5 or 7, which are […]

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Additional link between cardiovascular and periodontal disease

A new study has shown a relationship between chronic periodontitis (gum disease) and lacunar infarct which both impact the eldery. Chronic periodontitis is an inflammatory disease of the gums while lacunar infarct is a type of cerebral small vessel disease that has the possibility of leading to a stroke. Researchers hypothesize that periodontitis leads to systemic inflammation and the health of the blood vessels can be affected. Furthermore, chronic periodontitis and lacunar infarct may share some common vascular risk factors such as high cholesterol, hypertension, and diabetes. The researchers observed that people diagnosed with periodontal disease had roughly a 4-fold increased risk of developing lacunar stroke compared to those without periodontitis. The researchers feel further interventional studies should be performed to assess the potential benefit of periodontal therapy in patients with lacunar stroke and periodontitis. Periodontal treatment may also decrease systemic inflammation and may reduce the risk of developing lacunar infarct. There have been several posts before on this blog discussion periodontitis. See for example http://blog.teethremoval.com/blueberry-extract-could-help-treat-periodontitis/, http://blog.teethremoval.com/oral-bacteria-that-causes-periodontitis-delievers-a-one-two-punch/, and http://blog.teethremoval.com/patients-with-moderate-to-severe-periodontitis-need-to-be-evaluated-for-cardiovascular-problems/. So the bottom line is that you should keep your mouth healthy and regularly see a dentist for examinations and cleanings. For those who have gum disease it it is important to get treated to help reduce cardiovascular problems like lucunar infarct. […]

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Can you fight cavities by taking a pill?

Researches from the University of Florida have have identified a new strain of bacteria in the mouth that may keep bad bacteria in check. They believe this could lead to the development of a supplement (a probiotic) that patients could take orally to prevent cavities. While developing an effective oral probiotic will require more research, a possible candidate organism has been identified: a previously unidentified strain of Streptococcus. To maintain a healthy mouth the oral environment must have a relatively neutral pH. When the environment in the mouth becomes more acidic, dental cavities can develop. At this point bacteria on the teeth make acid and acid dissolves the teeth. Researchers were aware that bacteria were responsible for breaking down these compounds but wanted to investigate which bacteria do this best which they found to be called A12. The researchers wondered if a probiotic formulation could be developed from natural beneficial bacteria from humans who had a very high capacity to break down arginine. A12 has a potent ability to battle a particularly harmful kind of streptococcal bacteria called Streptococcus mutans, which metabolizes sugar into lactic acid. The researchers found that A12 not only helps neutralize acid by metabolizing arginine in the mouth, it also often kills […]

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