Ankur Gupta, DDS, after completing a 1-year GPR in Cleveland, Ohio, started a practice from scratch in 2005. Armed with what he considered adequate knowledge, hand skills, and a personable demeanor, he watched as his practice floundered, finances became unpredictable, and his lower back and spirit toward life became worrisome. Rather than continue the trend, he made a guinea pig out of his office, family, and self, attempting any and all personal and professional “experiments” in self-improvement. More than a decade later, he enjoys enviable new patient numbers and case acceptance, a solution- oriented dental team, and, most importantly, a meaningful and positive identity. He happily shares the failures and successes with dental and community groups throughout the country, always ending his presentations with practical, implementable, step-by-step ways to be better.

Why This Retraction Paste Is So Special | Image Credit: © Ankur Gupta, DDS

In 2016, one of my patients—a frustrated mom who was about the same age as me—humorlessly asked me, “Isn’t there, like, a magic coating you can put on my teeth so I don’t get any more cavities?”

If I could sum up everything I learned in dental school in 1 sentence, it would be this: Blood ruins everything.

Sadly, blood is here to stay. Even the most talented and extraordinary periodontist in history would have to admit that a significant percentage of his or her patient population comes in regularly with the type of gums that just ooze.


VOCO Retraction Paste is an astringent paste with aluminum chloride. It is designed to widen and dry the gingival sulcus, creating ideal conditions for successful impressions. The material is a bright turquoise color, providing high contrast to tooth structure and gingiva. It saves clinicians up to 50% of procedural time compared with other methods. Its 2-phase viscosity makes for simple application.


Having graduated dental school 20 years ago, I was taught 2 effective strategies to mitigate the headaches that blood causes:

The second one is easy and liberating. My dental work is difficult, and I can just blame the patient for their horrible home care.

The first one, sadly, is difficult and does not always work. If I were to survey every general dentist in the US about whether they enjoy packing cord, I am quite confident that the majority would mark the “no” checkbox. Not only is packing cord difficult, time-consuming, and painful (for the patient and the dentist), it does not always work. This is made worse in the presence of copious gingival hemorrhage. One of the worst of all clinical incidents is the rare occasion when a handpiece bur gets entangled with a stray fiber from a poorly packed cord. Blood and the remaining cord rotate like a helicopter around the shank of the handpiece. Not only does this ruin the procedure, but it also ruins lunch, it might ruin your white coat, and quite possibly might ruin your day. How ironic—we pack cord in attempts to gain control over blood, but it is the blood that can also make cord packing more difficult and less predictable.

The good news is that I graduated dental school 20 years ago, before iPhones,Amazon, and smartwatches were ubiquitous. Technology was very different. It would stand to reason that, although other areas of our lives have benefited greatly from the exponential increase in technological development, our work as dentists should benefit as well. The good news is that it has.

Several dental technologies and innovations have made the most difficult aspects of general dentistry easier, more predictable, and more patient friendly. Listed below are several incredibly easy and innovative agents to mitigate and often eliminate the presence of blood during difficult dental procedures, all of which I had never learned about in the early 2000s as I progressed through my dental education.

HybenX from EPIEN Medical and PerioDT from Young Specialties:

 These nonantibiotic chemical desiccants kill subgingival bacteria and desiccate the treated gingival tissue. They have not been marketed as agents designed to limit gingival bleeding but, in my experience, have been quite effective.

 These allow for incision, excision, tissue modulation, and cauterization. Lasers are incredibly effective at eliminating gingival bleeding, but drawbacks include the following:

Time-consuming to set up and activate compared with the other listed options

Postoperative pain can be expected in the affected areas

ViscoStat or Astringedent X from Ultradent Products:

 These are topical ferric solutions that, when scrubbed onto the affected gingiva, result in excellent hemostasis. Sadly, this does not result in any gingival retraction.

This solution was introduced to my clinical repertoire most recently and will be the focus for much of the remainder of this article. This is an aluminum chloride-based astringent paste.

It is both an astringent and retraction agent. Designed as a 2-stage formula, it allows precise application without injury to the gingiva, and then offers increased stability in the sulcus, leading to effective temporary widening.

VOCO Retraction Paste is dispensed from an incredibly thin plastic tip, allowing maximum depth into the sulcus, and is packaged in a single-dose blister pack at 0.3 g per cap. This provides enough material for about 3 crown preps.

What differentiates it from the options summarized above is its ability to progress from phase 1 (dispensing) to phase 2 (increased viscosity). It is easily dispensed using a composite placement gun, and comes packaged in a single-use compule. Upon dispensation, the material quickly becomes more rigid, achieving gingival retraction as cord might. This transformation happens in 2 minutes or less.

After the more rigid phase of the retraction paste has created displacement of the gingiva away from the tooth prep, the material is rinsed off with a combination of air, water, and occasionally cotton, resulting in dry, highly visible margins. It has a bright turquoise color, so there is never any doubt about whether I have rinsed off all of the material.

Although there are clinical scenarios that require use of all the hemostatic and retraction options above, my preference usually is the VOCO Retraction Paste. It is inexpensive, user-friendly, and incredibly effective.

Not only does it work well with crown impression and/or scanning, but I have found myself using it in any restorative instances in which I need to control bleeding and achieve gingival retraction. This includes class V composites, class II composites, crown cementation, and endodontic procedures. Although plenty of clinical scenarios require packing cord, I have found that, even in those infrequent and inconvenient cases, I will still use the VOCO Retraction Paste to complement the cord.

Most clinical cases are traditional crown preps, just prior to taking an impression or scan. During this procedure, the material is dispensed around the entire gingival margin through a thin tip designed to allow material to extrude into the gingival sulcus.

I then place a cotton compression cap over the tooth (not required) and have the patient bite, causing more gingival displacement as the material transitions into more viscous phase 2. This process allows me to leave the operatory and see a patient in another room. Upon returning, the material is thoroughly removed, and I can have confidence in taking an excellent scan or impression.

Articles

VOCO Retraction Paste helps clinicians deal with blood and, in most cases, cut the cord.

Deep Dive: Why This Retraction Paste Is So Special 

Stan Goff is a Managing Editor with MJH Life Sciences, which includes Dental Products Report, Dental Practice Management, Dental Lab Products, Modern Hygienist, and Dentist's Money Digest. He has covered the dental industry since 1999 and can be reached at sgoff@mjhlifesciences.com.  

CDOCS’ Clear Aligner Hands-On Workshop Focuses on Both the Practice and the Patient | Image Credit: © CDOCS

CDOCS’ latest clear aligner course is designed to provide clinicians with everything they need to grow their practices with clear aligners, as the 2-day workshop features hands-on training as well as business tips.

With clear aligner patient demand continuing to rise, CDOCS is taking a distinct approach to clear aligner hands-on training to help digital dentists on their journey to clinical excellence and economic success. The first day focuses on the practice and the second day emphasizes the patient.

“We’ve seen workshops that tackle the business side of clear aligners. We’ve seen workshops tackle the clinical side.We are exceptionally positioned to provide expert training on both in one workshop,” CDOCS Faculty Chair Dan Butterman, DDS, says in a press release.“Clear aligner therapy is a digital experience. No one has trained and supported more digital dentists successfully than CDOCS.”

Taught by Drs. Vishal Sharma and Ankur Gupta, CDOCS introduces its 

Practice to Patient Blueprint for Clear Aligner Success

Ankur Gupta, DDS | Image Credit: © CDOCS

Utilizing a practice-to-patient approach over the 2 days of learning, this workshop combines both the integration and implementation of clear aligner protocols into the whole practice and the clinical essentials needed to deliver predictable, esthetic results. Attendees will receive ideas on how to get their existing patient population to think about their malocclusion with just a few key words, along with free marketing techniques to drive patient acquisition and case acceptance.

On day one, attendees can expect to learn best practices and strategies for marketing, billing, team engagement, and patient acquisition.

Participants will also receive the proven “

Clear Aligners Success Guide: Team Scripts to Boost Case Acceptance

,” highlighting practical scenarios encountered in practices and providing detailed guidance on how different team members should respond.

Vishal Sharma, DDS | Image Credit: © CDOCS

On day two, the focus shifts to clinical essentials needed to deliver predictable, esthetic results efficiently and effectively every time, including attachment placement and IPR. These methods were developed to build confidence in a dentist’s ability to do more cases and make seamless “when to treat, when to refer” decisions by implementing straight forward clinical protocols that simplify case selection, delivery, and follow-up, CDOCS states.

“Dr Sharma and I are practicing dentists, so we know the issues our peers face,”Dr Gupta adds in the press release. “We know it’s hard to not sound sales-y when talking clear aligners with your patients. We know case selection can be difficult. We know attachment placement and IPR can seem daunting. Well, Dr Sharma and I have learned the strategies that have created some of the world’s most successful clear aligner practices and are ready to share them with you to address all your questions in a relatable manner.”

This workshop is ideal for all clear aligner systems and all general dentists and their team members, no matter where they are in their clear aligner journey. CDOCS is a Spear company and consists of a large community of digital dentists that provides digital dentistry education by equipping dental professionals with the clinical training and resources to achieve modern dental excellence.

The 2-day course for dentists addresses training, education, and business growth around clear aligners.

CDOCS’ Clear Aligner Hands-On Workshop Focuses on Both the Practice and the Patient

Kellie Nock is the assistant editor for Dental Products Report. She graduated from Kent State University in 2018 with a Bachelor's in Journalism. Kellie enjoys multimedia content creation with a focus on audio and video storytelling. 

A bite-sized look at all the latest dental product launches. 

Product Bites – May 31, 2024

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 Editor Kellie Nock, and on this week’s podcast we’ve got 3 new products with launches from Carbon, Solmetex, and Planmeca

So let’s get to it and learn about these newly launched dental products.

First up, let's talk about Carbon's latest innovation in 3D printing. Carbon, a leader in dental 3D printing, has just announced their new Automatic Operation feature, AO Stack, for their M2 and M3 printers. According to Carbon, AO Stack software allows dental labs to print multiple DPR10 models in a single print run, which can triple production without the need for direct supervision. This integration into everyday operations is set to enhance efficiency and productivity for dental labs. AO Stack is now available for Carbon M2 and M3 users with DPR10 subscriptions.

Next, we have news from Sterisil, a name synonymous with dental water safety. Sterisil has launched the FASTCheck15™ in-office waterline test. This new product promises to simplify the process of ensuring clean and safe water in dental practices. With FASTCheck15, you get reliable results in just 15 minutes, eliminating the need for time-consuming lab tests. The test is not only quick but also cost-effective, priced at about half the cost of traditional paddle tests and significantly less than lab tests. Plus, it’s easy to interpret—one line means a pass, and two lines mean a fail. Supported by Sterisil’s Water Safety Team and the Solmetex My Solutions Center, FASTCheck15 integrates seamlessly with the Sterisil SafeWater Protocol, ensuring your practice meets all regulatory requirements efficiently and economically.

Finally, in the realm of imaging technology, Planmeca has expanded its line with the Planmeca Viso® G3. This multifunctional CBCT device is designed to handle all 2D and 3D extraoral imaging needs, making it a versatile addition to any dental practice. Ideal for endodontics and implantology, the Planmeca Viso G3 offers a field of view ranging from 3 x 3 to 20 x 10 cm, providing high-quality images of the full dentition and detailed panoramic and bitewing images. It features the Planmeca Ultra Low Dose™ protocol, scientifically proven to reduce patient radiation dose without compromising image quality, and the Planmeca CALM® algorithm for motion artifact correction. The unit's user-friendly design ensures patient comfort and efficient workflow, and it can be upgraded to the Viso G5 model for larger 3D volumes as your practice grows.

That does it for this week's Product Bites from Dental Products Report. Stay up to date on all the latest dental product news by visiting dentalproductsreport.com/newdentalproducts.

I'm Kellie Nock saying thanks for listening. And we'll be back next week with all the latest new dental products on Product Bites from Dental Products Report.

Podcasts

A bite-sized look at all the latest dental product launches. This week's episode features products from Carbon, Solmetex, and Planmeca. 

What Impact Will the FTC’s New Rule on Non-Compete Clauses Have on Healthcare Providers | Image Credit: © iQoncept - stock.adobe.com

[Updated: This article was originally published on May 30, 2024. This updated version includes details on the federal judge’s recent decision to block the FTC’s ban on noncompetes and what it means for dentists and other physicians going forward.]

in August to block a near-total ban on worker noncompete agreements on grounds it ran afoul of the agency’s legal authority, Amanda Hill of the Hill Health Law Group, suggests dentists and physicians should fight for reasonable and narrowly tailored agreements, considering that noncompetes will most likely be in place for some time.

"Dentists and doctors are not going to get relief from the Federal Trade Commission, but it doesn’t mean that the conversation is over," says Hill. "Contracts have always been a state law issue, and it’s going to be the states who change the tide. I’d encourage all dentists to argue on a local level to fight for more reforms. 

"Sure, a reasonable non-compete around a small local practice may make sense. But it doesn’t mean that large dental groups with multiple locations and the ability to recruit and hire other dentists should stop a dentist from practicing in the community where they live and work."

Hill adds that the judge's ban means well and may also lead to reforms at the state level that could benefit dental professionals seeking more opportunties than currently available because of noncompoetes.

"I think the ban has a good intention — to show that many workers, including those in healthcare, are being squeezed. And it’s not fair to ban a worker from a large area simply because the organization says it wants to 'protect their investment.' Dentists spend years honing their own skills and working to build relationships patients — it’s the dentist that brings the expertise, not the other way around."

For now, non-competes may still exist. But it’s shedding light on the practice as something to pay attention to, and it may yield traction on local state levels to create reasonable reform," Hill explains.

In August, Judge Ada Brown of the US District Court for the Northern District of Texas ruled in favor of the plaintiff in the much-anticipated 

case. The court stated that the FTC doesn’t have the authority to ban practices it deems unacceptable, Hill explains. Brown added the FTC exceeded its statutory authority in implementing this rule and stated the ban was arbitrary and capricious.

Below is the original article published in May at dentalproductsreoport.com.

When the Federal Trade Commission (FTC) finalized a rule banning non-compete clauses last month (April of 2024), it not surprisingly stirred concerns among physicians and dentists alike about their contracts and the rules they must follow. This decision could raise more questions than answers if it becomes law.

The FTC split 3-2 on the new rule about contract clauses that affect physicians and other health care workers—voting to ban noncompete clauses between employers and workers, calling the agreements unfair restrictions on trade that hurt employees and stifle innovation.

“Non-compete clauses in employment agreements are regulated by state law, with varying levels of restrictions across states (with some banning them outright). However, the new FTC rule introduces a new ban, which some view as a political maneuver rather than a measured approach benefiting physicians,” says Amanda Hill, JD, a health care attorney based in Austin, Texas.

“As much as I’d like to see non-competes banned so my clients can have freedom of where to work after they quit a job,” says Hill, “I’m worried this ban seems problematic in its scope and breadth.”

If the rule goes into effect, it would have a significant impact on dentists in particular, since most dental associate agreements currently contain a non-compete clause.

Brent Pohlman, a labor and employment partner in Mandelbaum Barrett PC’s practice group, says this process first got underway when President Biden’s administration came into office in 2021. Pohlman says President Biden had indicated an intent to address an overt expansion of the use of non-competition agreements, against lower wage earners, specifically, the fast food industry. Then, in January of 2023, the FTC issued their 

Brent R. Pohlman, partner, Mandelbaum Barrett PC

proposed rule regarding non-competition agreements and the proposed rule which was more expansive than what the administration talked about, Pohlman explains. Basically, the FTC suggested placing an absolute ban on all non-competes, and it would have had less exemptions and exclusions than the final rule, which was voted on on April 23. 2024.

“What was proposed in January of 2023 was more stringent or had less exemptions or exclusions, then the final rule that was just issued, particularly with respect to the sale of a business and with respect to what type of employees could be excluded from the scope of the rule,” Pohlman says. “I suspect that the reduction in the scope of the rule was the result of the significant amount of commentary that the FTC received during its public comment period.”

Hill adds “with over 26,000 comments to this initial rule, there were a lot of special interest groups at play espousing their opinions.”

At the time the FTC promulgated this rule a lot of the National Business Organizations, including the National Chamber of Commerce, made it known that they intended on challenging this. Pohlman suspects this along with other public commentary led the FTC to walk back some of what they had initially sought to regulate. “The FTC likely was motivated by the anticipated legal challenges and revised the rules to, in the FTC’s opinion, be able to better withstand a legal challenge,” he adds.

The FTC rules would go into effect 120 days after publication in the federal register, and as of early May, the rules had yet to be published. Also, Pohlman points out, at least 3 legal challenges have already been filed against this rule.

“The arguments being asserted are that the FTC went beyond the scope of its authority in issuing this rule,” Pohlman explains. “The question is whether the FTC’s action exceeded its rule making authority and falls into the realm of the legislative powers of Congress, and that by enacting this rule, the FTC usurped the authority of Congress, and that any regulation or ban on non-competition agreements would have to go through Congress.”

Each of the lawsuits assert differing argument ideas, but the overarching argument against the rule that was promulgated by the FTC is that it goes outside its authority.

Hill adds, “The U.S. Chamber of Commerce brief made some good points. It argues that the rule was overreaching past the commission’s authority and even went on to say the rule would cause harm.” It remains to be seen how and when these lawsuits will be resolved.

The final rule bans non-compete agreements for workers with the exception of senior executives earning $151,164 annually and are in a “policy-making position.”

“But what does that mean?” Hill asks. “Does a partner in a practice mean they influence policy? The definitions are vague, adding to the uncertainty and opening this up for many legal challenges in the future.” says Hill, who writes for 

“What does a ‘senior executive’ mean exactly? Only time will tell on how that definition is fleshed out. The rule indicates that this is a ‘small, narrowly defined group.’ Mostly the rule seems to exclude healthcare providers as not meeting the test, but it also says that partners in a business, such as members of an independent practice, would ‘generally qualify as senior executives under the duties prong and have authority to make policy decisions about the business.’ It goes on to say ‘CEOs and Presidents are presumed to be in a policy-making position under § 910.1 and will not be otherwise subject to a job duties test, while highly paid workers in a non-executive role such as many physicians will not.’”

“It’s a bit of a mess,” Hill repeats. “If the FTC had been more narrowly tailored and didn’t try to bite off so much, it may have made more sense. But trying to knock out all of the nation’s non-competes in one swoop may come back to haunt them.”

If this non-compete rule becomes official, then dental associates would no longer be restricted from going to work for another practice nearby, or from opening their own practice in the vicinity. Currently, it is common with non-compete clauses to preclude associates from working for a dental practice and from providing dental services from being an owner of a dental practice, within say ‘x’ number of mile radius around the office they currently work in. That radius varies, depending on the location and maybe even the size of the practice, Pohlman says.

“There would be a pretty significant impact because, almost all dental associate agreements contain a non-competition clause,” he says. “ If this rule goes into effect, non-competition clauses in employment agreements will be illegal. An associate will be able to open a practice right down the street from their current employer.”

But, it's important to understand what this rule doesn't do. The rule does not on its face address non solicitation provisions, which are provisions in an employment agreement that prohibit an associate from soliciting the patients of the employer’s practice.

“Now, while non-solicitation clauses are not prohibited, one thing practices have to be aware of is that if the non-solicitation provision is overly broad to the extent that it would essentially serve to prevent an associate from working in a geographic region the FTC may consider it to be a de facto non-competition clause and would prohibit,” Pohlman says. “So going forward, non-solicitation provisions are going to have to be carefully drafted to ensure that the clause is narrowly tailored.”

Pohlman adds that there are other federal regulations and rules that govern on non-disparagement clauses, and there is no change to such clauses through this latest FTC rulemaking process.

In terms of associate freedom and desires to move around, the rule may have different outcomes for larger practices and dental service organizations than it would for a solo practice with maybe just 1 associate.

“A lot of it's going to depend on the type and the size of the practice,” Pohlman says. “I think all associates would obviously prefer to not have a non-compete so they can go wherever they want whenever they want. They're going to be free to move about.”

From a practice perspective, this rule might impact practice growth. Pohlman believes a small practice may be less likely to bring on another associate if that clinician someday can turn around and be a competitor on the same block.

“Maybe a practice is going to be hesitant going forward to bring somebody on and introduce them to its patients and help the associate develop their career if the associate is just going to be able to leave and open up right up the street,” Pohlman says.

Pohlman cautions that even if the rules go into effect, the rules may be scaled back as “there are very strong arguments as to as to why the FTC does not have the authority to implement such a broad prohibition on non-competition agreements.”

Exemptions for Non-Profits and Bona Fide Sales


If a non-profit organization acts as a true nonprofit, it is 

subject to the FTC’s jurisdiction or the non-compete ban, Hill states. Therefore, nonprofit companies such as hospitals, museums, charities, FQHCs, and research institutes may still be able to utilize reasonable non-competes.

But courts are divided on when a non-profit truly has a charitable purpose or whether they are designed to make their members a profit despite the IRS characterization, so this area of the law is unsettled, she adds.

The final rule does not apply to non-competes entered into by a person pursuant to a bona fide sale (a sale made in good faith, without fraud) of a business entity nor does it not apply where a cause of action related to a non-compete accrued prior to the effective date. “As a health lawyer,” Hill says, “I see both sides of this coin. But this rule just opens the door for more questions than answers, and does not provide relief. Instead of a more measured approach that may have had some real impact, this is an act of overreaching and useless political posturing allegedly designed to help the workforce.”

She adds that the rule may not provide the help that the healthcare industry desires. “Ultimately, while the FTC aims to protect workers from restrictive contracts, the healthcare community is left in limbo, calling for clearer guidelines and protections that balance both business interests and professional freedom,” Hill says.

This new rule highlights the ongoing struggle between regulatory actions and practical impacts on the ground, according to Hill. “What was meant to be a helpful ban for workers is turning into a legal battle that will likely stretch on for years. Dentists, like other healthcare professionals, need real answers, not overreaching rules that will likely be overturned.” Hill says.

One thing practice owners may want to consider should the rule go into effect, is attempting to make their place of employment one in which workers want to stay. For example, Pohlman says, for years the state of California has prohibited non-competition agreements and yet the tech industry has obviously flourished there.

Many tech companies stress good life-work balance and this may be a key in keeping some employees from wanting to leave and work for a competitor.

“Knowing that they can’t prohibit their employees from going to competitors, you always hear the tech companies talk about the quality of life to keep them invested and keep them working there,” Pohlman says. “This may push the [dental] industry to offer different types of ownership, pathways to partnership, better benefits and a better work-life balance to make the practice a more attractive place to work.”

Pohlman says the FTC’s rule, and any possible changes to it, or legal blocks, is something that most industries are watching closely, especially dental and physician workforces.

“It’s going to be a transformative event in not just employer-employee relations, but in business culture in the United States,” he says. “If the rules go into effect, the impact on employees outside of this dental industry will be significant. Currently, there are limits on mobility for sales people in all industries because of non-compete agreements, and the prohibition of those clauses will open up the labor market.”

“Right now, we're looking at this from a 10,000-foot view. We are taking steps to educate our clients on the rule, its impact, and what options they will have in the event it is upheld. There is a lot of uncertainty right now,” Pohlman says. “We don't know if it's going to be stayed. We don't know what the ultimate outcome is going to be.”

The key for now is to be aware of the rule, and be prepared to conduct business regardless of the outcome of the legal challenges.

“At the end of the day it’s a balancing act,” Hill says. “Dentists want to own their own practice and have vibrant businesses, and yet smaller groups want to protect the assets they worked so hard to build. The key is using this ban as a catalyst for change on the local and state level, so that eventually the dominant voices will be heard.”

If the rule goes into effect as is, the dental associate relationship with practice owners would change dramatically.

[Updated:] What Impact Will the FTC’s New Rule on Non-Compete Clauses Have on Healthcare Providers

Staff at Dental Health Arlington in Arlington, Texas share their thanks after receiving donated dental burs. To date, 31 nonprofit clinics have received dental burs from a recent donation from America’s ToothFairy and SS White Dental worth more than $1.2 million. | Image Credit: © America’s ToothFairy 

Children across the country are lacking proper access to oral care and as we all know, putting off regular treatment is asking for more serious, and more costly dental problems.

Thankfully, several corporations have been making generous donations to groups such as America’s ToothFairy, which in turn provides resources to nonprofit dental care providers enabling them to treat more children in need.

America’s ToothFairy—which is set to exceed $20 million in donated products for safety-net dental clinics—shares the story below to illustrate just how impactful dental care, or the lack thereof, is for children and their families.

When Edward [the child’s name has been changed here] brought his family to their local food pantry in Summit, New Jersey to pick up fresh produce, his children had more than hungry bellies. Sadly, his 4-year-old daughter and 2-year-old son had learned to live with dental pain. Everything changed for them that day when Edward learned that the KinderSmile Oral Health Program would be visiting the food pantry to connect families with essential dental services.

Upon examination, the KinderSmile team discovered 12 cavities and the need for multiple root canals, deep fillings and extractions for Edward’s daughter, and 8 cavities in her little brother’s mouth. It was a predicament KinderSmile is all too familiar with; delayed treatment turning minor tooth decay into an urgent dental crisis.

For families like Edward’s, dental care is a luxury that is often out of reach for many reasons.

In communities with high poverty rates or a shortage of affordable dental care providers, safety-net clinics like KinderSmile can struggle to keep up with demand. Children who live in these communities often wait a year or longer to get an appointment, leading to more costly treatment.

“Dental insurance, transportation, inconvenient hours for working parents, and lack of professionals who are willing to spend the extra time and resources to treat patients who are very young, those who may have behavioral problems, or those who need more time because of a disability, are some of the barriers that underserved communities typically face,” KinderSmile’s Founder and CEO, Dr. Nicole McGrath-Barnes says in a press release.

In recent years the organization has seen an increase in the cost of infection control and clinical supplies required to maintain the health and safety of their staff and patients. Although their monthly supply expenses have nearly doubled, they are not seeking any additional fees from patients to close the gap and provide access to oral health education and dental care regardless of insurance status.

“We rely on donated supplies to maintain the high standard of care and volume of children that we are able to serve,” McGrath-Barnes adds. “We are proud to provide dental homes with the feel of private dental offices, where patients are treated with dignity, respect, and cultural sensitivity.”

As a member of the Dental Resource Program of America’s ToothFairy, KinderSmile qualifies for free resources including donated dental supplies and equipment to help them stretch their budget and serve more children.

KinderSmile was one of 31 nonprofit dental care providers that recently received donated dental burs from SS White Dental, which donated more than 1.2 million dollars’ worth of carbide and diamond burs to America’s ToothFairy. Now in their 19th year, the nationwide nonprofit organization will reach more than 20 million dollars in distributed dental supplies and equipment to their Dental Resource Program (DRP) members this year.

“We believe that nonprofit dental clinics are the best way to ensure that all families can access the dental home their children need to treat dental disease and prevent tooth decay from happening in the first place,” Jill Malmgren, executive director of America’s ToothFairy, states in the press release. “Safety-net clinics can break the cycle of poor oral health in low-income and underserved areas with support from the dental community.”

To increase access to dental care, America’s ToothFairy leverages its partnerships with major dental companies to provide donated supplies so that nonprofit dental clinics can stretch their budgets and serve more kids than they could alone. Since 2006, DRP membershave provided oral health services in under-resourced communities across the United States, serving more than 10 million kids and caregivers, including Edward’s family.

Since his encounter with KinderSmile, the nonprofit reports that Edward has been bringing his children regularly for comprehensive care. After several visits the kids have been receptive to treatment, and their mouths are nearly fully restored. They will be able to start school free of pain and infection, better equipped to eat, speak, sleep, play, and learn, with better confidence and self-esteem.

“We are so thankful to have SS White as a partner to help more kids get the dental care, they need to be healthy,” Malmgren adds. “Our program members count on the generosity of others to expand care to the kids that need it most. Donated supplies free up resources to help our members serve more children and shorten wait times.”

“We strive to change the shape of dentistry every day. It’s critical to us that kids receive dental care and resources to improve their oral health,” adds Tom Gallop, CEO of SS White. “We are proud to support America’s ToothFairy and their mission to increase access to dental care for children and teens living in underserved communities.”

Other recently donated products include an assortment from Cosmedent, GC America, and Tokuyama, toothbrushes and toothpaste from Crest and Oral-B, and dental puppets and toothbrushes from SmileMakers, the organization says.

For more information about donating dental products and equipment or office supplies to the nonprofit dental care providers served by America’s ToothFairy, visit 

Recent donations from SS White and other corporations are helping nonprofit dental clinics to provide restorative care to more kids in need.

America’s ToothFairy Helping More Children as Donated Products Set to Exceed $20 Million

Wellfit Technologies Partners with Patterson to Launch CarePay+™. Image credit: © Wellfit Technologies


Wellfit Technologies has announced a new partnership with Patterson Dental to launch its new CarePay+ solution. CarePay+ is a payment manager and patient care platform that will now integrate directly with Eaglesoft practice management software.

“We are excited to collaborate with Patterson Dental to launch the CarePay+ solution,” CEO of Wellfit Technologies, Fulton Collins said in a press release from the company. “Patients today expect a more convenient, efficient, and transparent financing experience. CarePay+ addresses these needs by integrating the ease of use of the Eaglesoft solution with the various payment options provided with CarePay+.”

This platform aims to help patients better communicate with dental practices and vice versa, according to Patterson VP of Software Product Management Brad Joseph.

“Our mission has always been to support dental professionals in delivering high-quality care,” Joseph said in the press release. “The integration of CarePay+ with Eaglesoft aligns perfectly with this goal. We’re confident this innovative financing solution will change the way dental practices operate and engage with patients.”

CarePay+ aims to make patient communication and payment management easier for dental practices. 

Wellfit Technologies Partners with Patterson to Launch CarePay+™

Kuraray's Dinesh Weerasinghe and Richard Young, DDS, talk to Dental Products Report managing editor Stan Goff about Kuraray's 2 newest products [7 minutes].

CDA 2024 Interview with Kuraray Noritake's Dinesh Weerasinghe and Richard Young, DDS

. I am at the CDA. I am very thrilled to have just seen an amazing presentation here with Kuraray. We have Dinesh [Sinha] here with Kuraray and we have Dr Richard Young and it was a couple of new products [launched] today. It seems like Kuraray has had a long line of great products and I'm always wondering like how you're going to top it. It kind of looks like you guys may have done that this time, but you tell us about that.

 Yes, this year at CDA we are launching 2 new products. A new adhesive CLEARFIL™ Universal Bond Quick 2 and a new composite, a flowable composite. Maybe Dr Young will explain a little bit why it's a different flowable composite that you can use it not just as your regular liner, but a material that you can use to fill cavities. It's called CLEARFIL MAJESTY™ ES Flow Universal.

 During the presentation, I was amazed by some of the cases you showed and then also just the viscosity. I mean, why don't you tell us a little bit about…there's a lot of benefits…but some of the many benefits of the product.

 Yeah, I mean I've done a lot with composite over the years and I love flowables and I always have my favorite of theirs, [CLEARFIL] MAJESTY Flow because it would go where I wanted it and stay, but I've always wanted a little more viscosity especially for I do a lot of black triangles with the Bioclear Matrix and that kind of work. So, I'm wanting some hydraulics and I wanted to have a one composite that would have the hydraulics and flow and do what I wanted it to do and wouldn't always have to be heated if I didn't want to heat it. But I could heat it and it still wouldn't be too runny. And when this composite came along with its ability to pull shade, especially in the black triangle areas, it's like wow, this is really cool because now you got kind of a no brainer. And you just go and inject and it works and then it literally goes like an ice cream cone to whatever height you want. Plus, it's strong, and we'll have Dinesh talk about its strength because I'm going to trust it a lot of places.

 Yeah, I mean, obviously bond strength. I mean, you need it, you want it and Kuraray is kind of known for it. In the presentation earlier today. I got the impression this is very darn strong.

 Yeah, especially when it's bonding. As Dr Young mentioned. It's very important for us because that's how we started our business in dental by developing first dental adhesives in the 1970s then we introduce MDP Monomer. So, we came a long way with the different, different, different adhesives. But this year this particular adhesive is stronger because we are introducing a new adhesive, a new monomer introducing to the adhesive called UTM monomer that will really increase the strength of the adhesive layers. And when it comes to the composite, what we are doing is we have a special filler loading technology that you can increase your filler loading without adding so much monomers. So, composite is strong enough that you can use in all cavity classes. Not only are the class Vs, not as a liner, but as a restorative material because 78% filled and it's physically strong that you can it's indicated use for all cavity classes.

 And you talked too, in the past, I mean one-bottle solutions I mean, a while back that wasn't something you thought you were going to do and it seems like companies like Kuraray keep surprising you and keep coming up with newer, better products. Why don’t You tell us a little about that?

 Well, yeah, so I've been with the company since 1985. Ray Bertolotti [DDS] introduced it to us at The Kahala Hilton in Hawaii with [CLEARFIL] New Bond and I've never left the company for 38 years nor has my wife, who is my partner practicing dentistry, and we both use these products. So, we and I didn't mention this earlier, and I should have brought them, we have some postop Class IIs, that we're done in 1990. They still look like they were today. And so, I've always had a belief in their bonds and never have we had one fail. But when they brought the one-bottles out, I was really pretty hesitant and I have friends who would say ‘well, you're crazy’. But I thought well, we've trusted Kuraray this long. They've never failed us. I've used PANAVIA since day one. And if they're making a one-bottle, I don't think they're going to throw something out there that's going to really screw us up and mess up the whole thing. And so far, it’s been pretty amazing, and this new one has really got me intrigued because of the film thickness, increase in bond strength, and just the chemistry behind it with MDP and the Amide and all these monomers. So, you know, I have a lot of faith in this company but so do all of you because you're using it in a lot of ways you don't realize. A lot of your leather and your synthetic leathers and your products, windshields, there's a lot of stuff so we trust them in other ways we don't know.

 And it's always nice that you can keep coming up with new materials that docs have confidence in. They try and they work and then they show other clinicians how well it works and it's just, it's great when you’ve got a really good clinician wanting to try, and trusting you…wanting to try the new product.

 Yeah, absolutely. As Dr. Young mentioned, we never want to put the product that's not tested enough at our R&D. We have a very good R&D team. They commit their time to develop great chemistry. Then we have great quality control team. We want the first drop of the bonding agent and the last drop of your bonding agent, the bottle that have the same qualities. So great quality control, and great R&D that made this possible. Not staying with the same chemistry that we used 20 years ago. Move forward developing new products. People like Dr. Young who does bonding, after how many years they stay in the places that you put them.

 And you know, the funny thing is, is when they brought out UBQ [Universal Bond Quick], my friends that know me, you know they're going ‘are you nuts man? Why would you ever use a one bottle, it's got no history?’ Then I go you don't realize with Kuraray it's been tested for 6 years at Tokyo University before they even brought it out. So, it already had some coverage so I went I kind of laid it out and went for it.

 I think you impressed a lot of people with these 2 latest products and now it's like, you have to get back to work. It's going to be hard to top these.

 Yeah, always we test immensely inside the company, and all the people and great clinicians like Dr Young, and dental schools in Japan and in the United States, they help us to test our products, validate ourselves and give great ideas in the new developments. Without them we are not here. So, we always appreciate as I mentioned, because of them, we can develop this great products and people like us thank you so much.

Videos

At CDA 2024, Dinesh Sinha, PhD, senior technical and marketing manager, dental division, Kuraray America, and Richard Young, DDS, talk with Dental Products Report managing editor Stan Goff about 2 new dental materials unveiled by Kuraray Noritake. [7 minutes]


CDA 2024 Interview with Kuraray Noritake's Dinesh Sinha and Richard Young, DDS

New Study Says Increased Oral Health Investment Helps Overall Health and the Economy | Image Credit: © World Economic Forum

In news that is not much of a surprise to the industry, investing in oral health pays off in both the form of improved overall health outcomes and economic growth, according to a new World Economic Forum report released last week.

The Economic Rationale for a Global Commitment to Invest in Oral Health – published in collaboration with the American Dental Association, Colgate-Palmolive Company and Henry Schein, Inc. – was released on May 23 ahead of the World Health Assembly 2024. The study illustrates how a lack of investment in oral health globally has created a significant health crisis and placed an economic burden on many governments, businesses and individuals.

Almost half of the world’s population is impacted by oral diseases, with the number of cases growing faster than the population worldwide, according to the report. With plenty of research on the oral-systemic link, we know those who suffer from oral diseases are at higher risk of other severe illnesses such as heart disease, diabetes, stroke, cancer, respiratory diseases, and more.

“The evidence is overwhelmingly clear: an investment in oral health is an investment towards a productive workforce and a healthy society overall,” Shyam Bishen, Head, World Economic Forum Centre for Health and Healthcare, says in a press release. “Immediate action is needed from all sectors to address the growing burden of oral diseases.”

According to the World Health Organization,

 oral diseases affect some 3.5 billion people annually 

 in treatment costs and productivity losses. Vulnerable populations globally with unmet needs for oral care are disproportionately paying the substantial economic penalty associated with these access to care limitations.

The report calls for greater investments in oral health, with a united public-private collaboration. The white paper stresses that it would also boost overall health outcomes. In particular, better oral health has been associated with improved outcomes for people suffering from several serious illnesses, as well as with dementia, arthritis, and for pregnant women.

Improving oral health equity globally would also help advance the health-related Sustainable Development Goals, the World Economic Forum states.

While stressing the importance of a global commitment to invest in oral health, the report explores the role of various sectors in improving oral health. It outlines key measures each sector can take to improve oral health, such as improving health insurance programs and benefits around oral health. Mentioned in the report is the need for governments to integrate oral health within public health insurance programs and benefits packages as part of universal health coverage policies; for businesses to expand coverage for oral healthcare services in employer-provided health insurance programs; multilateral organizations to include oral health in policy dialogues for strengthening health systems; and civil society organizations to invest in oral health activities as part of philanthropic support for in-country, health-systems strengthening.

Recognizing the obstacles, the World Economic Forum launched the Oral Health Affinity Group (OHAG) in 2023 under its Global Health Equity Network, a group of more than 50 companies committed to advancing health equity to create stronger and more productive societies. OHAG members and collaborators are leaders from sectors and industries working to highlight the impact of poor oral health on health outcomes and the global economy. The group recommends steps that governments and private sector companies can take to advance global oral health. Following the report findings, OHAG plans to work with partners to accelerate public-private partnerships and investment designed to improve oral health globally.

White paper says a growing oral health crisis is impacting billions of people and straining health systems and economies worldwide.

New Study Says Increased Oral Health Investment Helps Overall Health and the Economy

Chlorhexidine gluconate (CHX) is well known and frequently referred to as the “gold standard” in dentistry due to its antimicrobial and antiseptic properties utilized in conjunction with and following a wide variety of dental procedures.

After several decades of use, it would seem that CHX has stood the test of time and therefore should remain the gold standard. However, as ongoing research and advancements are made in dentistry, it is vital for dental providers to continually educate themselves on both traditional and alternative treatments in order to uphold and advance the standard of patient care. Ethical considerations including the risks and benefits associated with widespread use, despite the lack of supporting evidence for it, should be made when providing patient care. The purpose of this article is to highlight key points of the science related to the indicated use, risks, and benefits of CHX so you as a dental provider can advance and be confident in the standard of care and quality of the information provided to your own patients.

Research suggests that CHX is indicated as an effective, short-term, adjunctive treatment for gingivitis.¹ However, it is commonplace to see CHX used as a blanket recommendation despite its limited, indicated use as an adjunctive treatment for gingivitis.² Researchers concluded that daily application of CHX may be successful in preventing gingivitis, with the proviso that the agent is applied in a manner that allows it to reach all affected tissues.³

Another consideration to make when evaluating its overall effectiveness in the treatment of gingivitis is its limited recommended use time of only 2 to 4 weeks.¹ Additionally, there is a lack of evidence to support its effectiveness in managing or preventing acute necrotizing ulcerative gingivitis (ANUG), peri-implantitis, extraction-related infections, periodontal disease, and dental caries.¹ Furthermore, studies concluded that even as an adjunctive treatment, CHX mouthrinse was ineffective at decreasing moderate to severe periodontal disease.¹

Both dental professionals and patients are familiar with the more commonly known negative side effects associated with the use of CHX which include calculus formation, altered taste, staining, and xerostomia. Additionally, recent studies have been conducted regarding more serious side effects associated with CHX

An in vitro study evaluated the effects of CHX in various concentrations on gingival fibroblasts and found that the regenerative cells treated with the greatest concentration had the highest frequency of apoptosis (cell death).⁴,⁵

In addition to research highlighting the inhibitory effects of CHX on regenerative cells, research has suggested that CHX can be highly cytotoxic to cells. Another in vitro study demonstrated its cytotoxic nature when finding that CHX has the ability to significantly reduce the vitality of regenerative cells including fibroblasts, myoblasts, and osteoblasts.⁶

Why is this relevant? Following dental procedures such as scaling and root planing or nonsurgical periodontal therapy, the aim is to promote healing rather than hinder it. Gingival fibroblasts are cells essential to wound healing. Hence, inhibition of these cells can delay the regeneration of tissues. Another study concluded that CHX affected cell survival, specifically in osteoblasts (bone-forming cells) through necrotic apoptosis and interference of mitochondrial function.⁷

Lastly, CHX has been shown to be inactivated in the presence of saliva, which may decrease the effectiveness of its use in the decontamination of the oral cavity.⁸ All of this data poses the question: Is it more harmful than beneficial to use CHX post-operatively? If so, shouldn’t a safer, more effective rinse hold the title of dentistry's “gold standard?” After all, it is 2024. While these findings are significant, it should be noted that further in vivo research is needed to comprehensively evaluate the inhibitory effect of CHX on human gingival fibroblasts.

The limited benefits that CHX offers should be considered alongside the negative side effects mentioned above prior to use with patients. Professional rinse alternatives to CHX, such as OraCare mouthrinse, which utilizes activated chlorine dioxide and xylitol, should also be considered when looking to provide patients with the most beneficial, adjunctive care.

Chlorine dioxide mouth rinses have been demonstrated to meet or exceed the antimicrobial properties of CHX.⁹ In a recent study, OraCare was evaluated for its effectiveness on gingival improvement, bleeding points, plaque accumulation and probing depths against brushing alone. Respectively, it showed a 604% in overall gingival improvement, 455% improvement in bleeding, 225% reduction in plaque, and an amazing 4,450% improvement in probing depths.

All in all, dental professionals should be well informed on both traditional and alternative rinses available while maintaining an investigative and progressive mindset. If we do this, then as dentistry evolves we can evolve with it. Because what seems to have been the “gold standard” for decades may not be the best choice to advance the standard of care in your practice.

Brookes ZLS, Bescos R, Belfield LA, Ali K, Roberts A. Current uses of chlorhexidine for management of oral disease: a narrative review. 

. 2020;103:103497. doi:10.1016/j.jdent.2020.103497

Sanz M, Herrera D, Kebschull M, et al. Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline [published correction appears in 

. 2020;47 Suppl 22(Suppl 22):4-60. doi:10.1111/jcpe.13290

Löe H, Schiott CR. The effect of mouthrinses and topical application of chlorhexidine on the development of dental plaque and gingivitis in man. 

. 1970;5(2):79-83. doi:10.1111/j.1600-0765.1970.tb00696.x

Chlorhexidine: An Investigation of the Gold Standard on Wound Healing

 (Undergraduate Research Scholars Thesis). Caruth School of Dental Hygiene, Texas A&M University. doi:https://oaktrust.library.tamu.edu/bitstream/handle/1969.1/188419/SMITH-FINALTHESIS-2020.pdf

Wyganowska-Swiatkowska M, Kotwicka M, Urbaniak P, Nowak A, Skrzypczak-Jankun E, Jankun J. Clinical implications of the growth-suppressive effects of chlorhexidine at low and high concentrations on human gingival fibroblasts and changes in morphology. 

As the world of dentistry continuously evolves and new science emerges, it is imperative for dental professionals to evaluate both past and current research in order to make informed decisions and provide patients with the most accurate information and ethical care.