A new orthodontic patient engagement platfrom from Tops. 

Tops DPX from Tops

Yapi Leap from Yapi 

A new series of dental handpieces from NSK America. 

Ti-Max Z2 Series from NSK America

OSSIX Agile from Dentsply Sirona

A new pathology detection and image analysis platform from DEXIS.

DEXassist from DEXIS

SureSmile Simulator from Dentsply Sirona

DentXcel.ai Dental Software 

Pro Sonic Toothbrush from BURST Oral Care

Curve Sonic Toothbrush from BURST Oral Care

New Dental Products – October 2 - 6, 2023

Articles

Taking a look at all the new dental product and technology releases from this past week. 

Benevis Expands Oral Care Access and Affordability in Underserved Louisiana Communities. Image credit: © Benevis

Benevis, a dental health care delivery organization, is making waves in oral care accessibility and affordability through its 9 Louisiana-based dental and orthodontic offices at Taylor Dental & Braces. During National Dental Hygiene Month, the organization announced an initiative aimed at decreasing the cost of care for Medicaid and Children’s Health Insurance Program (CHIP) patients, simultaneously increasing investment in preventive oral care.

With over a decade of service in Louisiana and a staggering 101,000 patient visits annually, Taylor Dental & Braces aims to be a beacon of hope for underserved communities, where 94% of patients rely on Medicaid or CHIP. Recognizing the unique needs of their diverse patient population, the dental provider has strategically invested in proactive and preventative dental hygiene to address the long-term costs of poor oral health.

Taylor Dental's commitment to routine preventive care has results, per a press release from the company. Data spanning from 2019 to 2021 revealed lower costs of care per patient, averaging over $78 in savings. Despite catering to underserved populations, the practices demonstrated significantly lower costs compared to the state's dental provider network. Key findings include a higher proportion of spending on diagnostic and preventive services, increased utilization of sealants, and a notable decrease in the need for composite fillings and stainless steel crowns.

Bryan Carey, CEO of Benevis, emphasized the win-win nature of Taylor Dental's approach. "Taylor Dental & Braces’ early intervention and education of patients on the importance of oral health not only supports better care, but also lower costs of care. It means that their care teams have spent more time on patient exams, X-rays, and sealants, and less time and expense on fillings and crowns. This model is a win-win for the patient with healthier teeth and less invasive care, and the provider in their ability to deliver a better patient experience and improved outcomes."

Dr Carl Boykin, DMD, Benevis district dental director, underscored the mission's critical nature, stating, "Making sure that every child and adult in Louisiana has access to affordable, high-quality dental care is mission critical to Benevis and our Taylor Dental & Braces practices."

Louisiana, ranking among the lowest in the United States for dental health, faces the challenge of scarce dental practitioners, ranking 49th for fewest dentists per capita, according to the press release. Benevis, serving over 500,000 children, 82% of whom are Medicaid patients, is part of the 18% of dental providers managing a Medicaid population with more than 100 child visits annually.

While Louisiana has historically struggled with dental health access, recent policy changes have paved the way for improvement. Policymakers increased reimbursement rates for dental Medicaid in July 2023, injecting over $50 million in funding across the state. This substantial investment aims to expand the number of dentists available to Medicaid-covered Louisianans.

To further support families navigating changes in coverage, Benevis has highlighted resources available to those affected by the redetermination process. Benevis encourages families to explore 

This health care delivery organization has found success in lowering the cost of dental care for Medicaid and the Children’s Health Insurance Program, effectively expanding care and access for patients who need it.  

Benevis Expands Oral Care Access and Affordability in Louisiana Communities

2 New Toothbrushes Now Available from BURST Oral Care | Image Credit: © BURST Oral Care

BURST Oral Care has introduced 2 new oral hygiene products this week—the Pro Sonic Toothbrush and Curve Sonic Toothbrush. Featuring innovative designs and new technology, both brushes were developed in partnership with BURST’s Ambassador network of over 35,000+ dental professionals with a focus on ensuring high-quality performance at an economical price.

"We introduced the Original Sonic Toothbrush in 2017, backed by stellar clinical results, an innovative design, and the enthusiastic support of our dental Ambassador network. It remains a sought-after brush on the market today," states BURST Co-Founder and President Brittany Stewart in a press release. "Six years of feedback from our Ambassadors has led us to evolve and enhance to create the Pro, bringing forth the next generation of BURST with a modernized design and upgraded intelligent features that prioritize our hygienists' and dentists' needs."

The new BURST Pro Sonic Toothbrush includes new features and is designed to elevate the user experience. Created to provide optimal cleaning and whitening experiences, the Pro boasts a new high-end color LED screen, smart responsive software to provide optimal care, and an impressive (up to) 9-month rechargeable battery life. The toothbrush’s sensor provides feedback for every brushing session via a score graded on how many seconds users remained in the proper pressure zone to help them brush better, the company states. There’s also a range of 5 custom brushing modes including Whitening, Clean, Sensitivity, Freshen, and Massage.

The new BURST Pro Sonic Toothbrush features a range of 5 custom brushing modes including Whitening, Clean, Sensitivity, Freshen, and Massage. | Image Credit: © BURST Oral Care

The Pro continues to embrace the company’s iconic hygienist-approved bristles that are soft and tapered to clean without damage and reach plaque below the gumline. These bristles help the brush maintain its impressive clinical claims, including removing up to 10 times more plaque* than a manual brush.

Also, this week, BURST introduced their new Curve Sonic Toothbrush. The company’s dental professional Ambassadors helped develop the uniquely curved powerhouse to target neglected back molars with precision while fitting seamlessly into the user’s bag—thereby ensuring fresh breath and optimal oral health for anyone on the go. The Curve is fully equipped with super soft tapered bristles, cleansing sonic vibrations from a powerful motor, whitening and sensitive modes, and a 2-minute timer. The on-the-go toothbrush has a battery life of up to 75 days, a compact design, and a sanitary travel top. 

"Amid the pandemic, people recognized the value of dependable at-home oral care and the impact of oral health," notes BURST Co-Founder and CEO Hamish Khayat, in the press release. "The Curve emerged as our response, directly resulting from collaboration with our dental professionals. It effortlessly merges professional-grade cleaning tech with stylish design to offer a consistent oral health companion at an affordable price. It's perfect for newcomers and those seeking a minimalistic, on-the-go option."

Both toothbrushes can be found online at burstoralcare.com and Amazon. The Pro model can also be purchased exclusively in-store at Walmart, while the Curve is available in-store at both Walmart & CVS.

Since launching in 2017, BURST's key differentiator has been its partnership with and stewardship of 35k+ Ambassador oral healthcare providers. These dental professionals help BURST build the products they want to see for their patients.

Pro Sonic Toothbrush and Curve Sonic Toothbrush designed based on the feedback and expertise of company’s BURST’s Ambassador network of dental professionals.

2 New Toothbrushes Now Available from BURST Oral Care

All the Right Moves: A Guide to Moving to a New Dental Practice Location. Image credit: © Vadym - stock.adobe.com

Whether you already know you want to move or it is still on the “someday” list, we spoke to real estate and dental practice transition experts to find out what to do—and what not to do—when moving your dental practice.

Stanton Kensinger, lead broker at Professional Transition Strategies, advises dental practice owners to allot a minimum of 6 months to a year to look at options. However, even before looking, there are things to consider, such as finding the right commercial real estate broker with dental experience. In addition, knowing details such as how many chairs they need now and in the future is essential.

“Knowing that plan before you go and shop the market is very important,” Kensinger says.

Greg Auerbach, practice transitions consultant, Henry Schein Dental Practice Transitions, says build-out time is the wild card in this scenario as it depends on the contractor and marketplace.

“Generally speaking, from start to move, it’s reasonable to expect a 9- to 18-month process time,” Auerbach says. “This would likely assume there is a foundation already in place whereby it’s a matter of planning, permitting, and completing the construction. If starting from an empty parcel, plan for extra time in the initial acquisition, at least 30 to 60 days, but additional time for permitting and developing the initial structure itself.”

Kristen “KJ” Jordan, practice solutions manager for practice coaching and transitions at Benco Dental, agrees that the time line for moving from one dental practice to another can vary depending on several factors, including the specific circumstances of the transition, contractual obligations, and individual preferences. However, she says a general time line might look like this

Preparation (3-6 Months Before Transition):

Research and identify potential practices.

Negotiate terms of the transition, including contracts and financing.

Ensure all legal and regulatory requirements are met.

Notify current patients and staff about the transition

Begin the transition process while maintaining patient care.

Collaborate with the previous owner to ensure a smooth handover.

Implement necessary changes in practice management.

Continue building relationships with staff and patients.

Implement any additional improvements or modifications to the practice.

Monitor financial performance and adjust strategies as needed.

Taylor Haight, MS, NCIDQ, interior designer II on Benco’s practice design team, thinks the earlier, the better regarding design. It gives the design team and equipment specialists time to get to know the doctor and understand the project, facilitating a smooth project.

For example, the designer and equipment specialists use the move goals to determine the necessary square footage, design the layout to fit it, and match the clinician with an experienced dental contractor. Without expertise guiding the decisions, the project can have extra headaches for everyone involved.

“There’s so many factors,” Haight says. “It never hurts to start earlier than you think is necessary.”

As an office manager, regional manager, and operations executive for several large practices, Jordan offers several points of advice for dentists regarding practice transitions, which include the following:

 A well–thought-out transition plan can alleviate stress and promote a successful move.

 Maintain open communication with patients to retain their trust and loyalty.

 Collaborate with existing staff to ensure a seamless transition.

 Evaluate the financial health of the new practice and create a solid financial plan.

 Consider long-term goals like practice growth and retirement planning.

Regarding future planning, Kensinger thinks the commercial real estate agent should know the ramifications of moving a dental practice too far from the existing space. Relocating up to 3 miles from the current location can result in a 15% attrition rate, and that attrition rate only increases from there.

“When you get to 5 or if you’re hopping highways, all of a sudden you potentially are looking at losing up to 30% of your patient base, especially if you’ve been in a certain area for a long time,” Kensinger explains.

After identifying the geographic qualifications, clinicians should bring in their team, Kensinger says, including the equipment vendor and an architect with dental experience. Moreover, it is essential to have the end in mind regarding the space a clinician will need as their practice grows.

Sometimes, the space is perfect but will hold fewer operatories than the dentist envisions for their future. In that case, the real estate broker can arrange for the landlord to give the dentist the right of first refusal if an adjacent space becomes available. 

“In a perfect-world scenario, having that landlord aware that you’re looking to grow, they’re going to come to you first,” Kensinger explains.

Auerbach agrees engaging with an architect, real estate broker, design firm, and equipment specialist who know dentistry is a vital first step to identifying the best location and planning correctly for growth. From there, relocation can come with benefits ranging from more space, better workflow, and improved access to target patients. These all should allow for more significant revenue generation if not other additional personal benefits, Auerbach explains.

“In considering a relocation, though,” Auerbach continues, “it’s important to look at the specific facility or plot of land to ensure that it’s well suited for your current and future needs as it relates to the size, flow, and access factors and that it’s also supporting the type of practice you want to operate. While in many cases a dental practice can be successful so long as a patient can find it, there are certain situations where location likely dictates the type of practice that can find success.”

Haight thinks dentists should inventory the challenges at the existing space that could improve. She starts many of her conversations with practice stakeholders here.

For example, the treatment rooms could be too small or don’t work with the flow of the space. Maybe there isn’t enough storage or the practice needs more offices. Perhaps it’s time for a change in the type of delivery. As experts on these details, Haight says her team can improve the design of the new office by making minor improvements that have a major impact.

Haight agrees planning with growth in mind is essential. If leasing, the practice stakeholder should build in time to grow in the space. If building or buying it, the dentist should determine how many treatment rooms they want or whether they will add an associate. These factors change the plan, too.

“It’s not just where they see themselves right now, but what they’re planning for the growth of their office in the future. It helps us ensure we’re designing the space accordingly,” Haight says.

Haight thinks a realistic budget is also critical. Otherwise, the project falls through once reality hits.

“It’s always going to cost way more than they think it’s going to cost,” Haight says. “But if they meet with a financial expert at the beginning, it helps them to have the proper expectations to plan for it.”

So if those are the right moves, what are the wrong ones when designing and moving to a new dental practice? There are a few.

Jordan offers clinicians the following 7 common mistakes to avoid when designing a practice:

 Failing to budget for construction, equipment, and operational expenses accurately can lead to financial stress.

 Choosing a location without a thorough understanding of the local demographics and competition can hinder success.

 An inefficient practice layout can impact workflow, patient satisfaction, and productivity.

 Neglecting marketing efforts can slow patient influx and revenue growth.

 Without a clear business strategy, navigating financial and operational challenges effectively is challenging.

 Failing to invest in modern dental technology can hinder patient care and practice efficiency.

 Hiring the wrong team members or not providing proper training can lead to dissatisfaction among both staff and patients.

“To avoid these mistakes,” Jordan says, “it’s crucial to consult with experts, conduct thorough research, and have a well-defined business plan before designing and launching a new dental practice. Proper planning and execution can lead to a successful and profitable venture.”

Another challenge is timing the move, Kensinger says. For example, dentists should know the renewal terms of the current lease. It’s usually 3 months, but sometimes 6. Missing this detail can lead to periods where the dentist can’t see patients.

“The last thing you want is to say, ‘Oh, we’ll be shut down for 3 months,’” Kensinger says. “Where’s everyone going to go during those 3 months? Are they going to wait for the new practice to open? So you want to ensure you time it where there is very little time between when you occupy the space and when it’s ready so that you are not missing out on revenue coming into the practice.”

Kensinger also recommends avoiding the seduction of the brand-new retail center with all the major retailers. The new location has to make sense for the practice and the dentist’s growth plan in the long term. The better move might be a lateral one to a less shiny (and less expensive) retail center. In addition, moving to an area with 10 dentists serving it already might not be as wise as going to another part of town with only 5.

“I always run a demographic study of the surrounding dentists to ensure that the new location isn’t oversaturated. These are some things that the commercial real estate broker can help you with,” Kensinger says.

Practice stakeholders should hire the vendor, rather than the moving company, to move the equipment. The vendor knows how to move it without breaking it and how to install it. Also, get the high-ticket items insured.

“The last thing you want to do is pay out of pocket because it was broken and you didn’t have insurance on it, and you signed waivers that the movers are not responsible,” Kensinger says.

Kensinger also thinks having a general contractor who has dental experience is essential. While they often cost more, the knowledge and expertise they have navigating the requirements of a dental practice makes the higher bid worth it. From plumbing to Americans with Disabilities Act requirements to creating a proper flow, there are a lot of little things that can cause big headaches.

“There’s always going to be something that goes wrong,” Kensinger says. “But the more you can plan ahead of time, the more time and money you will save in the long term.”

Notifying patients ahead of time is critical, too, Kensinger says. Have a display in the waiting room and on the website. Also, update Google Ads, professional associations, and online directories with the new address. 

“You don’t want to miss a new patient because you had an old address listed,” Kensinger says.

Dentists should also avoid moving everything. Moving time can be a great time to update and refresh. Auerbach says physical relocation is generally easy, but being penny-wise certainly can lead to being pound-foolish.

“It may be financially attractive to reuse those cabinets or older chairs, but they may not properly support you in the new build or location. Put yourself in your patient’s shoes and even have a third party advise you on, at least, the aesthetics. Our integrated design studio at Henry Schein, for example, would advise on the proper flow and look of a practice, and there may also be additional functionality in newer furnishings,” Auerbach says.

When picking a location, understanding the demographics of the area’s potential patients and future growth is vital, Auerbach continues.

“Just because there’s a beautiful space in the middle of the downtown…can your commuters easily park and access your office, not to mention your staff?” he says. “On another note, be careful not to overbuild. Do you need more than 3000 square feet to accommodate 8 to 10 operatories? If it’s a multi-tenant building, do you really want to be a landlord? And don’t take this question lightly.”

Haight agrees that not using a contractor familiar with dental office design and construction is a common problem. It leads to more change orders during construction because dental is so specific.

Benco’s practice design team has designers who work alongside the equipment specialists and partner with the doctors to design their floor plans and help them choose their finishes. They can provide everything a doctor needs—even a referral to a contractor with dental experience.

“Our equipment specialists do typically have a list of contractors they recommend for the area where the doctor is familiar with dental. It makes the whole process much smoother because you do not have to overexplain things. They know what they are getting into with the plumbing, electrical, and the mechanical equipment. If there’s med gas, they understand what to do.”

Sometimes, dentists don’t have realistic time lines for the project either. Haight says many times the projects take longer than one might think.

“If they tell you 6 months, it’s probably 8 months. Always add more time because finishes take longer. Lead times on materials are taking longer and some dental equipment is taking longer,” Haight says. “So having that realistic time frame helps a lot.”

We spoke to real estate and dental practice transition experts to find out what to do—and what not to do—when moving your dental practice. 

All the Right Moves: A Guide to Moving to a New Dental Practice Location

This week's podcast features TorqTech Ultra Mini from J. Morita, Ormco Digital Bonding, Presto Smile, Eaglesoft 22, and Sonendo’s CleanFlow instrument.

Product Bites— October 6, 2023

Welcome to Product Bites, a weekly podcast from Dental Products Report providing you with a rundown of recently launched and updated dental technologies, materials, instruments, and everything else you might use with patients or while running your practice.

I'm your host for this week DPR editorial director, Noah Levine, and on this week's podcast, we've got the TorqTech Ultra Mini from J. Morita, Ormco Digital Bonding, Presto Smile, Patterson Dental's Eaglesoft Version 22.00, and Sonendo's second generation CleanFlow procedure instrument. So let's dive right into the weekly look at the newest products in the dental industry.

J. Morita recently introduced the TorqTech Ultra Mini, a new addition to their contra angle handpiece lineup designed to provide stability and durability in a compact form. With a short head height, the Ultra Mini ensures excellent visibility, making it perfect for patients with limited jaw mobility or children. Despite its size, this 1:5 contra angle offers exceptional cutting capacity and an extended lifespan. The Ultra Mini accommodates standard and short shank burrs up to 21 mm. Its advanced water spray provides consistent cooling, and it is compatible with both air and E-type electric motors. Additional benefits include the lightweight design, a durable chuck, and optimal illumination.

Ormco Digital Bonding is an innovative orthodontic technology designed to work in conjunction with Damon Ultima brackets and Spark Approver software. The solution aims to help clinicians achieved consistent bracket bonding and customized positioning with less effort. Digital workflows are now accessible for all patients, providing flexibility and new treatment options. Ormco Digital Bonding aims to make orthodontists' lives easier, offering more treatment options along with a streamlined workflow.

Presto Smile is a new mobile app that uses artificial intelligence to help clinicians show patients their potential post-treatment smile, enhancing chairside discussions and informed decision making. The user-friendly platform integrates seamlessly into dental practices and generates instant realistic smile mock ups through its AI algorithms. With its intuitive design, Presto Smile is easy to use. It's designed to enhance trust and increase patient acceptance of proposed treatments. This new app facilitates discussions enabling patients to actively participate in their dental care decisions.

Patterson Dental's Eaglesoft Version 22.00 practice management software offers new features to enhance performance, maintain security and ensure HIPAA compliance. New maintenance and optimization capabilities are designed to automate workflows, save staff time, and increase practice efficiency. CAESY Cloud integration aims to increase treatment acceptance while the built in PDF viewer simplifies document handling. Improved email integration with Gmail, Yahoo! Mail, and Outlook 365 enhances communication. Finally, security updates in the utilities zone ensure data protection.

Finally this week, Sonendo, the developer behind GentleWave endodontic technology, recently debuted the second generation CleanFlow procedure instrument. This upgraded release boasts a redesigned matrix system for a secure and lasting seal, streamlining the root canal treatment process. The improved design allows clinicians to use a single instrument for all teeth enhancing treatment efficiency. Approved for use on anterior teeth, this innovation simplifies use of the GentleWave System, which provides effective disinfection and cleaning inside root canals, making procedures safer and more efficient.

That does it for this week's episode of Product Bites. To stay up to date on all the latest dental products. You can go to 

dentalproductsreport.com/newdentalproducts

, or check back next week for the next episode of Product Bites. I'm Noah Levine. Thanks so much for listening.

Podcasts

This week's Product Bites podcast features the TorqTech Ultra Mini from J. Morita, Ormco Digital Bonding, Presto Smile, Patterson Dental's Eaglesoft version 22.00 and Sonendo’s second generation CleanFlow procedure instrument.

New SureSmile Simulator Shows Patients What Their Smiles May Look Like |  Image Credit: © Dentsply Sirona 

Simulator from Dentsply Sirona is a software tool that uses the company’s Primescan scan data to create a custom 3D visualization of the patient's possible smile following SureSmile® Clear Aligner Treatment. Powered by the company’s DS Core, a cloud-based platform that combines products, services, and technology to help shape the future of dental practices, users can easily access multiple patient records including scans, x-rays, and documents from multiple devices through the web-based browser facilitating a seamless start to your SureSmile workflow. 

With the simulator, clinicians can show their patients their new smiles before they start treatment. Minutes after uploading an intraoral scan from the Primescan intraoral scanner, the SureSmile Simulator creates a 3D visualization of the patient’s potential new smile following the clear aligner treatment. The simulation is designed to help support treatment acceptance, enhance case evaluation capabilities, set expectations, educate patients, and streamline the SureSmile Workflow with DS Core and Primescan. 

A 3D visualization is a great way for patients to see the potential value of their investment. Additionally, this workflow educates patients about their estimated treatment duration and potential results. You can save and send images to your patients so they can show family and friends. Once you receive a commitment from the patient, clinicians can initiate the SureSmile aligner treatment, including uploading photo records, scan data, and x-rays directly from DS Core to SureSmile.

New software tool from Dentsply Sirona uses Primescan data to create a custom 3D-visualization that can improve case acceptance for company’s clear aligner therapy.

New SureSmile Simulator Shows Patients What Their Smiles May Look Like

DEXIS to Launch DEXIS 10 Imaging Suite with DEXassist Feature. Image credit: © DEXIS

Dental imaging technology group DEXIS has announced the launch of the DEXassist solution, featuring assisted intelligence (AI)-enabled 2D findings as an addition to the DEXIS 10 Imaging Suite Software. Assisted Intelligence is a term often used to describe a form of AI that works in conjunction with human users to enhance their capabilities, decision-making processes, and overall performance. AI capabilities integrated into the software are intended to support dental practitioners in the analysis and interpretation of dental images. The AI algorithms assist in identifying specific pathologies or abnormalities in 2D intraoral X-rays, providing additional information and insights to aid clinicians in their diagnosis and treatment planning. This solution aims to redefine how practitioners approach the interpretation of intraoral x-rays, according to a press release from DEXIS.

The DEXassist solution, which is said to seamlessly integrate with the DEXIS 10 software, draws on the power of AI from DTX Studio™ Clinic. It is designed to empower dental professionals to identify and analyze 6 crucial pathologies in 2D intraoral x-rays. These include cavities, calculus, bone loss, periapical radiolucency, root canal filing deficiency, and discrepancies at the margin of an existing restoration.

Lori Clements, Vice President, Commercial, North America at DEXIS, emphasizes the user-friendly nature of the DEXassist solution, stating in the press release, “Integration with current DEXIS software means that installation is quick and easy for practices that are already familiar with DEXIS systems. This allows staff to begin using DEXassist right away without having to learn how to operate a new system.”

DEXassist is able to integrate with existing DEXIS sensors which may be a boon for dental practices that want to eliminate the need for additional training. This ensures a smooth transition for dental practices, promoting efficiency and minimizing disruptions to daily workflows, according to Brian Gooch, Vice President, Global Product Management.

“DEXassist’s AI solution helps to identify and supports diagnoses in up to 6 areas of dental pathologies, helping clinicians and staff to save time and optimize patient care,” Gooch says im the press release. “DEXassist also allows practitioners to share AI findings with patients in an easy-to-understand format when discussing their diagnosis and treatment plan."

In a click, clinicians can now identify key focus areas when taking x-rays directly within the DEXIS software, enhancing diagnostic accuracy and streamlining the decision-making process. Moreover, the DEXassist solution is said to facilitate effective communication with patients by presenting AI findings in an easily understandable format. Built on the robust DEXIS Imaging Suite Software platform, the DEXassist solution not only maintains high-performance standards but also introduces new efficiencies and diagnostic capabilities. The solution encourages standardization in workflows, ensuring consistency and reliability in dental practices.

For practitioners eager to experience the benefits of DEXassist, DEXIS is offering a 30-day free trial. This provides an opportunity for dental professionals to explore the capabilities of this solution and witness firsthand the impact on diagnostic confidence, efficiency, and overall productivity that may occur in their dental practice.

To learn more about the DEXassist solution and take advantage of the 30-day free trial, 

New technology from DEXIS integrates directly into sensors, streamlining x-ray analysis and pathology detection for clinicians for more efficient care. 

DEXIS to Launch DEXIS 10 Imaging Suite with DEXassist Feature

DentiMax President David Arnett (second from left) traveled to Samoa, where he donated dental equipment to the Samoan government and The Church of Jesus Christ of Latter-day Saints. | Image Credit: © DentiMax

David Arnett, co-founder and president of DentiMax, recently traveled to Samoa, where he donated DentiMax sensors, laptops, and software to the Samoan government and to the Church of Jesus Christ of Latter-day Saints. DentiMax provides practice management software and dental x-ray sensors and solutions for dental practices that want to increase their productivity and profitability.

Arnett learned about the need for equipment in Samoa when speaking to Brad Smith, former dean of the Midwestern University College of Dental Medicine-Arizona. “He told me there was a need and I asked him what I could do to help,” Arnett says in a press release.

Samoa’s dental clinics are dwindling as dentists move to nearby islands like New Zealand for better pay and equipment. Currently, only a handful of dental offices are left on the island, including the government clinic and the clinic for the Church of Jesus Christ of Latter-day Saints. With Samoa’s limited resources, access to proper dental care is challenging.

Steven Titensor, DDS, (center) and his wife Lisa Titensor are volunteer missionaries who run the Church of Jesus Christ of Latter-day Saints’ dental clinic in Samoa. | Image Credit: © DentiMax

The clinics’ new DentiMax equipment will not only allow these dental professionals to see more patients but also allow them to diagnose and treat patients more effectively. “The government clinic has been using film, which takes time to develop. Now that they are able to use digital radiography, they can provide care to more patients,” adds Arnett in the press release. DentiMax offers a variety of sensors and imaging software solutions, including the Dream Sensor and the Open Sensor, which are said to deliver high-quality images and work with most of the imaging software.

Steven Titensor, DDS, and his wife Lisa Titensor are volunteer missionaries who run the Church of Jesus Christ of Latter-day Saints’ dental clinic in Samoa. This clinic offers free dental treatment for children and adults. “We were always bottlenecked because we only had 1 sensor and 6 chairs. Being able to not wait for a sensor and computer in between patients makes a huge difference and can really speed things up,” says Lisa Titensor in the press release. “Plus, if that one sensor goes down, that’s all we have. Getting a sensor and supplies over here would take months.”

The couple regularly travels to educate children about proper dental hygiene in local schools. “We encourage parents to come and see how to brush and floss their kids’ teeth. Plus, the sensors are great at showing decay in between teeth, which helps patients understand the importance of proper oral hygiene,” Dr. Titensor says. “Without sensors, that would be impossible.”

 it was reported that there is just 1 dentist for every 2,000 Samoans when it comes to oral healthcare in the nation. Samoa Dental Association President, Sala Dr. Ioanatana Faatonu shared concerns about this lack of access to oral care. He also at the scientific seminar that the demand for oral healthcare was increasing daily and clinicians in Samoa were doing their best.

DentiMax’s charitable program has also donated to Tonga and Guatemala. For more information on DentiMax’s sensors, visit 

Company president David Arnett traveled to Samoa, where he donated dental equipment to the Samoan government and The Church of Jesus Christ of Latter-day Saints.


DentiMax Donates Digital X-ray Equipment to Help Samoan Clinics

Susan Sheahan, DMD, graduated from Nova SE University and has over 20 years of experience. She is a member of the International Dental Implant Association, Academy of General Dentistry, ADA, FDA, American Academy of Sleep Medicine, and an Ambassador of The Breathe Institute. Dr. Sheahan is passionate about dental sleep medicine and how breathing and sleep disorders can lead to many health problems. She is also interested in how a tongue-tie can lead to sleep and breathing disorders and how functional frenuloplasty with myofunctional therapy can improve quality of life. Dr. Sheahan served in the Air Force as a dentist and received advanced training after dental school.

Nitric oxide (NO) has been at the forefront of scientific research since 1998 when 3 US scientists, Robert F. Furchgott, Louis J. Ignarro, and Ferid Murad, won the Nobel Prize in Physiology or Medicine for discovering that NO is a powerful signaling molecule in the cardiovascular system.

 NO is not only a potent vasodilator, it also plays a part in the immune system and in neural transmission. Since this discovery, the media has occasionally promoted the purported benefits of NO supplements for improving virility and overall health.

Still, NO is now known to be a major component for optimal health, and a lack of or deficiency of NO is the cause of many chronic disease processes.

 One unique way NO is produced is through symbiotic bacteria in the mouth. Dentists should be aware of this process and be able to discuss NO with their patients.

Additionally, it has been suggested that nasal breathing improves NO bioavailability and dentists should know the scientific basis for this. The goal of this paper is to explore the evidence of the benefits of NO, the consequences of decreased NO, and how to enhance NO production in dental patients. A secondary goal is to use this knowledge to aid the dental practitioner in educating patients about this important biological process.

In 2017, the American Dental Association set out guidelines for dentists to screen for sleep related breathing disorders.

 Since then, dental sleep medicine has gained wide interest and many dentists seek to learn more about the consequences of obstructive sleep apnea (OSA). OSA is characterized by episodic reductions of airflow for 10 or more seconds caused by a collapse or total obstruction of the upper airway. Untreated OSA can lead to many adverse conditions such as hypertension, heart attack, stroke, gastroesophageal reflux disease (GERD), depression, obesity, diabetes mellitus, and hypercholesterolemia.

 It is important to note that NO bioavailability is compromised in all of these conditions.

As a powerful signaling molecule in the cardiovascular system, NO dilates blood vessels and brings oxygen rich blood to the body, and in turn lowers blood pressure. Due to the nature of this vasodilation, NO improves athletic performance and brain tissue is further perfused with oxygen rich blood. Conversely, a deficiency of NO leads to decreased blood flow to the brain, organs, and extremities.

NO also plays a part in the immune system along with stem cells, macrophages, T-cells, and other pathogen fighting entities.

 Furthermore, NO acts as a neurotransmitter in the brain. Here it regulates synaptic plasticity, behavior, and cognitive function as well as blood flow. A lack of NO could lead to high blood pressure, increased risk of Alzheimer’s, and erectile dysfunction.

NO is made in several ways. One is endogenously through endothelial cells which line every blood vessel in the body. Amino acids in the body L-arginine (Arg) and L-citrulline (Cit) are needed for this process. Arg is a semi-essential amino acid which is a NO substrate and Cit acts as an L-arginine precursor which is also converted to NO. In this pathway, NO synthase of the endothelial cells is utilized (eNOS) and intracellular calcium (Ca) concentration is decreased which relaxes smooth muscles producing a vasodilation effect.

Arg is made in the body or found in various foods. This amino acid is used in many metabolic processes in the body and only a fraction of Arg is used in the NO synthase pathway.

 Cit is a non-essential amino acid, and interestingly, the only food found to contain Cit is watermelon. Arg and Cit are added to NO supplements in hopes to improve athletic performance and possibly lower blood pressure. Early studies have shown that Arg and Cit do have a measurable effect on lowering blood pressure. Some studies show that adding Arg may boost athletic performance in young healthy individuals but in the presence of endothelial dysfunction, it could actually have harmful effects.

 Interestingly, other studies show that NO supplements benefit individuals who are mildly or moderately trained but don’t benefit those who are well-trained athletes.

Another way NO is produced is from our diet by eating nitrates. In this pathway, nitrate is converted to nitrite and NO is then made in the stomach. Nitrates are eaten and facultative anaerobic bacteria in the crypts of the posterior dorsal tongue reduce the nitrate to nitrite. This nitrite is swallowed with saliva and converted to NO in the stomach. NO here has gastrointestinal benefits and the nitrite is recycled back into the bloodstream.

The enterosalivary nitrate-nitrite-NO pathway is dependent on pH, enzymes, and oxygen tension.

 Benjamin et al conducted an experiment on exposing various pathogens to nitrite. He used saliva with measurable amounts of nitrite and acidified this saliva to reproduce the environment of the stomach. The experiment showed that nitrite killed 

, salmonella, and shigella in the presence of acid and likely kills other harmful gut bacteria such as 

The oral microbiome must have homeostatic balance, humans can not reduce nitrates otherwise. Particular to note, mouthwash can kill the symbiotic nitrate reducing bacteria and essentially interrupt the NO conversion pathway.

 A study was done on subjects who used Chlorohexidine for 7 days and saw a 25% decrease in plasma nitrite with an increase in blood pressure.

An acidic environment in the stomach is crucial for the nitrate-nitrite-NO pathway. Proton pump inhibitors (PPIs), collectively known as antacids, can disrupt this cycle. PPIs work by inhibiting stomach acid production thereby increasing stomach pH. PPIs were never meant to be taken on a long-term basis. A study on the chronic use of PPIs on 87 participants revealed impaired NO production and that PPIs taken for 3-5 years will increase the risk for heart attack and stroke by 30%.

 Because of the greater risk for adverse cardiovascular events, pharmacovigilance must be employed for these drugs.

Nitrates are found in vegetables, some processed foods, and drinking water. The amount of nitrate in vegetables varies depending on nitrate in the soil, fertilizers, time of year grown, cooking temperatures, or light in which the plant was grown. Ironically, plants grown in low light have higher nitrate content.

 Historically, nitrates and nitrites were thought to be environmental pollutants and carcinogenic. We now see their important role in cardiovascular health.

 Nitrites are made in the body, in fact, breast milk has high concentrations of nitrite because infants lack nitrate reducing bacteria,

Some of the benefits of nitrates and nitrites are found in the literature. Even dietary nitrite without the dependance of an enzyme can repair heart tissue.

 Duranski et al performed an experiment on 2 groups of mice, one group having a 7-day pretreatment of nitrite and the other control group having no nitrite. Both groups of mice were given a myocardial injury, and the mice who were given nitrite had a cardiac infarct size 67% less than that of the control group and an improved recovery.

 Another study showed that drinking beetroot juice rich with nitrates lowers blood pressure within 6 hours.

Due to the fact that NO is a gas with a half-life of about 1 second, it is difficult to measure. A deficiency of NO is initially discovered from symptoms, and one of the first signs of NO deficiency is sexual dysfunction. Many times, erectile dysfunction in both men and women is dismissed by the individual because of the stigma attached to this condition. One study showed that subjects with a decrease in the NO synthase substrates Arg and Cit may be a major factor in male erectile dysfunction.

Vasodilation occurs when NO stimulates guanylate cyclase which produces cyclic guanosine monophosphate which in turn decreases intracellular Ca leading to relaxed smooth muscle.

 This is the pathway that regulates female sexual organ blood flow. Estrogen regulates endothelial NO production and is known to improve female sexual arousal disorders.

 A mouse model study of impaired sexual behavior in female mice improved with pharmacological NO.

Stress and disease states compromise the production of NO.

 Patients with OSA suffer from oxidative stress because of the repeated hypoxic episodes of apnea they endure all night. Oxidative stress reduces endothelial NO synthase (eNOS) thereby inhibiting NO production.

 In one experiment, OSA patients were treated with a CPAP (continuous positive airway pressure) machine, and NO and L-arginine levels were restored overnight, conversely, NO and L-arginine levels dropped when the CPAP was not used in OSA patients.

Although Nitric oxide production can be present in all cells and with different substrates, here are some primary pathways and targets of nitric oxide production.

Nasal breathing produces a considerable amount of NO through the paranasal sinuses. The paranasal sinuses have beating cilia and this is where NO is produced. This NO kills bacteria, viruses, and fungi as a first line defense in the immune system. NO furthermore increases the ciliary beating thereby promoting mucus clearance.

The paranasal sinuses, both epithelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) occur.

 The isoform of iNOS is not dependent on Ca to perform and is associated with the pathogen fighting ability of the immune system whereas eNOS is expressed as vasodilation. A third form of NO synthase occurs as nNOS which acts as a neurotransmitter in the neuronal cells and also has pathogen fighting abilities 

The isotope iNOS is expressed in white blood cells, epithelial cells, and other proinflammatory cells and generates a volume of NO greater than that of blood vessels and nerves. Nonetheless, iNOS is found in healthy tissue and is present even in infants thus there is no need for a pathogen for the expression of iNOS to occur.

Nitric oxide is found to be 7-fold higher in the sinuses than in the nose and the act of humming increases nitric oxide 15-fold as compared with quiet exhalation. Humming causes oscillation of the air and stimulation of the ciliary in the sinuses. The amount of NO produced in the sinuses is dependent on the size of the ostium.

 Low levels of NO may lead to more susceptibility to sinus infections.

If nasal breathing is a predictable source of NO, then it should seem that taping during sleep could be one way to improve perfusion of NO in the body. One study showed an improvement in snoring and sleep apnea scores with mouth taping during sleep.

 More scientific studies need to be devoted to this topic given the fact that mouth-breathing and snoring are precursors to OSA. OSA has detrimental effects on patients in terms of high risk for heart attack, stroke, inflammatory conditions, as well as motor vehicle accidents, daytime drowsiness, and quality of life issues, not to mention the economic toll on society. Restoring NO production by eating a diet rich in nitrates, optimizing vascular health with exercise, and incorporating the practice of nasal breathing are good lifestyle choices. Caution should be exercised with antiseptic mouthwash and drugs that may disrupt the formation of nitric oxide.

Although the literature describes NO being produced by various pathways and under various conditions, optimal levels of NO and the benefits are far-reaching 

Koshland DE Jr. The Molecule of the Year. 

Understanding the health benefits of Nitric Oxide, and the biological processes by which it can be created, or destroyed is a key part of understanding the links between oral and systemic health.