Annemarie Mannion

Maryland dental school professor Huakun (Hockin) Zu, PhD, and a team of researchers at the 

University of Maryland School of Dentistry

 are using nanotechnology to create a new 

 that has the potential to aid dentists in the task of removing more harmful bacteria from a cavity and go one step further – rebuild the tooth.

According to Xu, who also heads up the school's Division of Biomaterials and Tissue Engineering, the new dental filling is comprised of nano-size particles of silver and calcium, along with antibacterial primer and antibacterial adhesive, that treat cavities while also destroying bacteria in the mouth and re-growing tooth structure lost to bacterial decay.

The technology features a primer that is applied to the surface of a drilled tooth, an adhesive to bond the filling to the tooth, and the filling material, which includes a high pH that has been shown to kill bacteria.

When dentists fill a cavity they try to maintain as much tooth structure as possible – which means it can be hard to remove all the bacteria.

New chemical sensor signals when bacteria develops

“It’s virtually impossible to get all the bacteria,” Xu said. “Dentists try to preserve as much tooth structure as possible. Bacteria can hide in there and produce acid.” 

When acid invades though cracks or the interface between the filling and tooth structure, the filling fails. Xu said another benefit of the filling he is working on is that he expects it will last much longer than the current standard of about five to 10 years.

Xu said the primer, adhesive and fillings have been tested on the biofilms of volunteers. The next step is to do more testing. Trials both using human teeth and those of lab animals are in the works.

“We will continue to improve and optimize the study,” he said.

The University of Maryland has patents pending on the nanocomposite and the primer and 

 technologies, and Xu said they are talking with manufacturers about the potential for bringing the product to market.  He said it is too early to say when it may be available.

A multi- and inter-disciplinary approach to the problem of tackling residual bacteria and how to remineralize teeth has led to the potential for what Xu said could be a revolutionary.

Although other labs are working on ways to kill residual bacteria, according to Xu, his team is the  one doing both (killing bacteria and remineralizing the tooth).

He said the technology is working to bring together engineering, biology and dentistry.

“That’s where you can have novel ideas,” he said. “I can look at things from angles that a person in one field would not be able to see.”

Articles

Maryland dental school professor Huakun (Hockin) Zu, PhD, and a team of researchers at the University of Maryland School of Dentistry are using nanotechnology to create a new dental composite that has the potential to aid dentists in the task of removing more harmful bacteria from a cavity and go one step further – rebuild the tooth.

A newly-developed dental composite based on nanotechnology kills bacteria and regenerates tooth structure

No one likes the look of wrinkles or sagging skin especially when they mar the look of a smile that has been newly improved by 

 has an answer for his dental patients who want to look their best by minimizing mouth lines, lifting a drooping lip or smoothing the skin of nasal labial folds that may appear even more visible after a dental procedure has improved the look of their teeth.

Williams, who practices in New Albany, IN, said a person’s smile is not only dramatically affected by their teeth, but by the wrinkles, appearance of their lips and folds around their mouths. 

That’s why Williams has become a member of the American Academy of Facial Esthetics. He has taken three levels of training offered by the academy and treats patients who express interest in Botox or Derma Fillers, an injectable gel that restores the skin’s volume and smooths wrinkles.

Williams believes in taking a comprehensive approach to helping patients improve their smiles. He has dubbed it a “neck up makeover,” which means that, in addition to improving their teeth, he studies patients’ lips and faces, and might treat them with Botox or Derma Fillers. 

He also has built relationships with local hair salons and a nearby Sephora store and refers patients who are interested in getting a new cut or hair color or makeup to complement their new smiles.

Nearly 60 percent of Williams’ patients are women, and often they are open to the idea of the neck up makeover.

“Not all people have an eye or can visualize what hair styles look or colors of makeup look good on them,” he said. “This can help them see the possibilities.”

Williams first tested the idea of doing a neck up makeover for a patient for whom he was providing a new set of dentures. She was in her late 40s, had been taking care of her elderly mother, and had little time or money to spend on her appearance.

“She signed a contact with me that said we’re going to the makeover,” he said. “The contract stated that we were going to let her have some say-so, but we wanted to give her the best look we could.”

 that made her dentures, and reached out to a hair stylist and cosmetician, both of whom offered their services for free to give the woman a makeover.

Williams took before and after pictures and used them in ads. He also discovered that networking with hair salons and cosmeticians could be a way to build his business – a practice that he has since continued.

“I’m marketing and trying to build a network with them,” Williams said.

He keeps a video of the makeover on a TV in his waiting room, and also has brochures available on Botox and Derma Fillers for patients to look at. He finds that patients increasingly are asking him about their teeth and about what else they can do to improve their appearance.

“I have a lot of patients asking me questions (about cosmetic procedures),” he said. “I’m becoming a lip man. My goal is to become a lip expert.”

 transfer easily to those of used doing Botox and dermalfillers.

“In dental school I learned the anatomy of the head and neck better than my friends in medical school did,” he said.

Dentists also are at ease using a needle.

“I have a needle in my hand every single hour of every single day,” he said. “I’m able to provide an experience for a patient where they don’t feel any pain.”

He does all of the Boxtox and Derma Fillers procedures himself unlike at some plastic surgeons’ or dermatologists’ offices where staff other than the doctor may do them.

“I’m not delegating it to a nurse,” he said.

Williams said his training with the American Academy of Facial Esthetics has been extensive, and he now serves as a mentor to others. 

“I go to classes where people are learning about Botox and Derma Fillers and help with the hands-on portion of the class,” he said. 

When necessary, he will refer a patient to a physician.

“I can’t correct some things,” he said. “Sometimes I need to say, ‘You need to go to a plastic surgeon.’”

Williams said his wife, Jean, first encouraged him to think a bit outside of the box by offering the Botox and Derma Fillers procedures.

“She wanted to do this,” he said. “She wants to look good. She’s first in line to get everything done.”

, and has focused on being able to understand and provide solutions for the concerns his patients may have about their appearance.

“I believe what’s in a person’s heart is the most important thing,” he said. “But why not look your best?”

No one likes the look of wrinkles or sagging skin especially when they mar the look of a smile that has been newly improved by teeth whitening, veneers, implants or other dental procedures.

Cosmetic dentist goes glamorous by coining the "Neck up Makeover"

A commitment to providing quality esthetic dentistry and staying ahead of new technology-along with a shared middle name-have been passed down from one generation to the next at Sikes Dental Studios in Charlotte, N.C.

Four generations have been or are currently employed at the company that was founded by Adam Lee Sikes, who got his start in the industry when he worked for a couple of dental labs before launching 

Adam was joined by his son, Raymond Lee Sikes, who purchased the lab in the late 1960s. Raymond’s son, Lindy, whose middle name is Lee, came into the business in the 1970s, and he continues to own and operate it. He is now working with his son, Shelton Lee, the newest Sikes to become part of the company.

“In the early days it was a small operation,” said Lindy. “They (Adam and Raymond) worked side-by-side. It was a 3- to 4-person operation.”

Like many who have grown up in a family business, Lindy had decided he was not headed toward a career in the dental lab industry. Instead, he tried other things, working for a time in sales and service in the boating industry. He returned to the lab business in the mid-1970s and, much to his surprise, discovered it was in his blood.

“When I got back into it, it was like falling in love,” he said. “Because I knew where I wanted to set my direction.”

He purchased the company in the late 1970s and has worked to continue the reputation for quality esthetics started by his father and grandfather. The studio takes pride in working with the some of the country’s premier cosmetic dentists.

 also strives to be at the forefront of new technology. The studio is a Beta center for 

, and works on new product development initiatives for the CAD/CAM and dental technology company.

When the CEREC AC Bluecam was developed, Sikes Dental Studios had a chairside unit in the laboratory months prior to its introduction to the rest of the dental community.

“It’s kind of cool because I see the stuff that nobody else gets to see,” Lindy Sikes said.
	
	As a past president of the 

National Association of Dental Laboratories

, the Southeast Conference of Dental Labs, and the North Carolina Dental Laboratory Association, Lindy Sikes has his finger on the pulse of the industry, and he enjoys being part of promoting it.

“This industry is made up of phenomenal people,” he said. “They all have this love for a craft. And you won’t find a more caring group.”

He said being involved in industry associations enables the exchange of information and helps lab operators to be ready for important changes, such as digital technology, that are coming and which he expects to change the way labs operate.

“We’ve already got the digital lab up and running,” he said. “Daily there are more and more digital impressions coming in.”

 will enable labs to serve dentists even quicker, and possibly expand their client bases.

“With the new digital technology we’re already working with doctors in 12 states and Canada,” Lindy Sikes said. “We can receive a file digitally and turn a case around in three to four days.”

He sees digital as having the potential to revolutionize the industry.

“In my career, the two most dramatic changes were the pressable ceramics that made better esthetics possible, and that was 30 years ago,” he said. “The second biggest thing is going to be the digital revolution.”

As thrilling as the future promises to be, his son, Shelton, said he also appreciates the older ways of doing things and believes they are important. Both Shelton and Lindy are certified dental technicians.

“This industry is rapidly changing,” Shelton Sikes said. “But it’s not all mechanized. It still involves techniques that my grandfather used.”

He said that those older techniques used by generations before appeal to him because he enjoys working with his hands.

“You still have to have the talent and the touch because everybody’s smile is different.”

A commitment to providing quality esthetic dentistry and staying ahead of new technology-along with a shared middle name-have been passed down from one generation to the next at Sikes Dental Studios in Charlotte, N.C. Four generations have been or are currently employed at the company that was founded by Adam Lee Sikes, who got his start in the industry when he worked for a couple of dental labs before launching his own business in 1944.

Legacy Laboratories: Sikes Dental Studios

 on the rise, Dr. Norman Holtz's New York-based 

The light may not always be burning in the dental office operated by Dr. Norman Holtz in Lynbrook, NY, but the 

 can always be roused by a phone call or a knock on the door, no matter what time of day it is.  

Operating a 24-hour office works for Holtz because he has a home office.

“If the phone rings, I pick it up,” he said. “If there’s a knock at the door, I answer it.”

Those calls are coming more often – if the results of a recent study by the Pew Charitable Trust are any indication. The study, “A Costly Dental Destination” estimated that preventable dental conditions were the main reason for 830,590 visits to the emergency room in the U.S. in 2009.

Being available at any hour day or night to handle emergencies has always been how Holtz has run his practice, which he founded in 1981.

He said he doesn’t mind the sleepless hours that usually result when he receives a late-night call for help.

“You’re either committed to what you’re doing or you’re not,” he said. “There are a lot of people who don’t have a regular dentist.”  

Over the years, Holtz said he has become the go-to person for three hospitals in his area who have his number on speed for when a patient comes to the emergency room with a dental issue.

“The emergency room gives them a Percodan and the phone number of a dentist,” he said. “They know they can send them to me. I’ve been doing this forever.”

According to the Pew study, the increase in dental-related hospital visits is due to the difficulty that disadvantaged people have in getting regular preventative care.

Holtz, too, attributes the need for emergency care to a bad economy and the financial stresses many people are feeling. He said he receives an emergency call once or twice a week.

“It’s the people who really need (a dentist) who can’t afford one,” he said.

He said his off-hour patient visits also are from people who do not work regular nine-to-five. Police officers, nurses and others who work shift jobs need to have access to a dentist at odd hours, he said. 

Nonetheless, Holtz said he sees his share of patients whose dental troubles are due to a fight or a drunken fall. They’re not always upfront about what caused their problem. It’s usually pretty easy for him to see when they are not being entirely truthful about how a tooth got loose.

“I had one guy in here who told me he broke his tooth in a fall,” he said. “And the other guy who was with him had his hand bandaged.”

Holtz said he sees it as his duty to stabilize the patient.

“I can do most any (type of procedure),” he said. “I can get the patient out of pain and stabilized.”

It’s not unusual for those patients who came in with an emergency to become regular patients.

“You treat a guy on Christmas Eve and he’ll never forget it,” Holtz said.

With dental-related ER visits on the rise, Dr. Norman Holtz's New York-based dental practice is available to patients at all hours.

24-hour dentist caters to nine-to-fivers

Thirty years ago a long-lasting friendship was formed between 

 Michael Chalef and Harold Enoch. Both were sitting in on the Georgia Dental Licensing Board exam when they first met. Their common interests have kept them together and include hobbies golf, cycling, glass blowing, scuba diving, and woodturning.

After taking the exam, Chalef, whose practice is in Sandy Springs, Ga., said the two men and their wives ran into each other at a party.

“I said, ‘Hey. We met at the boards. And we became fast friends,” Chalef said.

They shared, of course, an interest in all things dental and also are members of the same dental fraternity, Alpha Omega.

“We got to know each other through dental stuff,” said Chalef. “But we also got to know each other through community stuff. It was a metamorphosis.”

Golf was the first hobby they did together on their mutual day off.  Both were terrible golfers in the beginning, and now golf is one of Michael's favorite activities, improving over the years from a 30 handicap to a 6 handicap. Harold has decided he likes tennis more, and sometimes plays with Chalef's wife Ellen, who is an excellent tennis player.

Getting certified in scuba diving was the second hobby that the two dove into.

“It was Harold's 40th birthday, and his wife Ina bought him lessons. I said I always wanted to try scuba diving and he said, ‘Let’s do it together.’”

After receiving their certification in scuba, they ventured forward with another new interest, glass blowing. The hobby was a hit with Enoch, but no so much for Chalef.

“I tried it once, but it was way too hot for me,” said Chalef. “Harold is great at it. He’s very talented.”

Enoch, who still is involved in glass blowing with his son Ryan, said they simply follow their interests to see what hobby will have long-lasting appeal, and which will not.

“It’s not like we’d try one hobby and fail and move on to the next one,” Enoch said. “We’d do scuba diving for a while and then we’d do something else.”

“Some things are more to my liking and some aren’t really his thing,” Chalef added.

Woodturning has become a passion for both dentists. Woodturning is a form of woodworking that is used to create wooden objects on a lathe. They took some woodworking and cabinet-making courses and then signed up for some woodturning classes with several specialists. They are members of the American Association of Woodturners and are founding members of the Atlanta Woodturners Guild.

“It’s like dentistry,” said Enoch. “It’s very creative. You take a log and you make something out of it.”

Chalef prefers making larger projects such as bowls or platters. Enoch creates pens with wooden barrels that he gives to friends and patients.

“It’s really a nice little touch to let my dental patients pick out one,” he said.

Chalef said woodturning appeals to him because it reveals the hidden beauty in a natural object. 

“You let the wood speak to you,” he said.

They both keep their eyes and ears open to learn about trees that are coming down that they can turn into decorative objects.

“When someone (in the neighborhood) has a tree that’s chopped down we go over there with a chainsaw,” Chalef said.

The men said that having a day off during the week has enabled them to pursue their hobbies.

“We’ve been fortunate in having a day off in the middle of the week to pal around together,” Chalef said.

Recently, Chalef has taken up flying and is pursuing his private pilot’s license. Enoch has no interest in taking flying lessons.

“Between woodturning and glass blowing and working out –that’s enough to keep me busy,” he said.

Chalef said his various hobbies are an adjunct to the profession he enjoys. He has only one problem with dentistry –the early hours.

“If I didn’t have to get up so early there would be no problems with dentistry,” Chalef said with a laugh. I like to stay up late and watch television, play Gameboy, and just decompress at the end of the day. I just had to get used to early mornings as part of the dental lifestyle, which otherwise has been fantastic."

And both agree their hobbies, too, have been fantastic.

Thirty years ago a long-lasting friendship was formed between dentists Michael Chalef and Harold Enoch. Both were sitting in on the Georgia Dental Licensing Board exam when they first met.

Two dentists find a common bond in hobbies outside of the dental office

Marianne Benson is the mother of a 41-year-old son with a developmental disability. She knows about the difficulties of providing dental care to this underserved population, many of whom have never received dental care. Often, they are fearful, require sedation, or do not understand what's happening to them when they are in a dentist's office. Many have lost their teeth because of a lack of care and health coverage.

"A lot of them have no teeth because when the state provided coverage they'd pull them and not provide them with dentures or bridges," Benson said.

Three years ago, when the state of California, where Benson lives, slashed the Medicaid benefits that had provided some dental care to the developmentally disabled, Benson decided to take action. She co-founded Desert Friends of the Developmentally Disabled; a free clinic that provides dental care services to developmentally disabled children and adults.

"We realized that this population has been thrown under the bus, ignored and discriminated against," Benson said, adding that even when there was Medicaid coverage only about seven percent of those eligible received services.

For the first few years, a dentist let the group based in Rancho Mirage, Calif., use his office on Saturday to treat patients. Dentists, periodontists, hygienists and others volunteered their services. 

When the dentist decided it was no longer practical to let the group see patients in his office the desert friends decided they needed their own space. They launched a one-year quest to find a space, a search that was hampered by peoples' misunderstanding of and prejudices against people with developmental disabilities.

"As soon as people (prospective landlords) found out about the population that we'd be bringing in they said, 'No,'" Benson recalled.

Their persistence paid off, however, and the dream to be able to provide the developmentally disabled with dental care in their own facility is now a reality. The group expects to opened its first dental clinic in mid-August. It is located in a shopping center in Palm Springs. The group has renovated a 1,200 square foot office space where people –many of whom are on a waiting list --will be treated.

"We already have a waiting list of nearly 100 people from throughout Riverside and San Beradino counties who are in desperate need of dental care," Benson said

One of her chief supporters and co-founder is Dr. Melvin Glick, a retired dentist who volunteers his time. He said he works to help the developmentally disabled because the need among this underserved population is so great.

"These people have greater dental needs because so many of them haven't gotten treatment," he said.

It is estimated that California has 240,000 disabled children and adults, 24,000 of whom reside in Riverside and San Bernardino counties. About 1,500 of them live in the Coachella Valley. State statistics indicate that 88 percent of disabled children and adults have unmet dental needs.

The clinic will open with two chairs and expects to add two chairs in the coming months. When the clinic expands to four chairs "we can start doing a lot of dentistry," Glick said. He estimates that the group would be able to treat 12 to 15 people a day with four chairs.

Benson said developmentally disabled population have needs that require longer appointments than usual. An appointment that might usually require a half-hour to 45 minutes may require 90 minutes.

“A lot of them have to be put under because they can’t sit still in the dentist’s chair,” she said.

The organization is seeking the volunteer help of other dental professionals and said they have many needs.

 "Right now we're in need of everything. Most of what we've done has been out of our own pockets or with small grants,” Glick said.

Students from Western University School of Dentistry will volunteer, which Glick said will be a win-win for the clinic and students.

“It’s a training program for the students,” he said. “Maybe more people (when the students graduate) will be willing to treat the handicapped.”

The goal is to have the clinic open five days a week. Considering the magnitude of the problem of a lack of dental care for the developmentally disabled, it might seem like opening one dental clinic is far from enough to address the need.

"It may be a pebble in the ocean," he said. "For every pebble you get a ripple and we're hoping other people will see what we're doing and want to help us."

For more information about Desert Friends of the Developmentally Disabled, call Benson at 760-832-6555, email her at dfddnow@me.com or visit the organization’s website at 

"A pebble in the ocean.."

A green path decorated with oversized footsteps makes a trip to the dental clinic at St. Jude Children’s Research Hospital less scary for young patients. Add in new wood cabinets, softer lighting, soothing colors in the decor, and children’s artwork on the walls and the result is a clinic with a kid-friendly atmosphere that matches how the rest of the hospital looks.

The hospital-based clinic first opened its doors about 30 years ago, and its décor had remained frozen in time.

“Everything was pretty much white. When it was built they were going more for a medical, sterile environment,” said Chris Rowland, DDS, director of the clinic.

“It was old and out of date. It didn’t fit the first class nature of the hospital,” added Jeff Gardino, field sales representative for Henry Schein Dental’s local branch in Memphis.

The work to bring the clinic up-to-date took about three months to complete. 

 spearheaded the project, which included donations from Midmark, to provide new equipment, furniture and materials. Together, the two companies’ donations amounted to about $400,000. 

 gave a substantial donation of $200,000 to finish the renovation.

“We saw we could make it a first-class facility,” said Gardino. “We met at the hospital, talked to hospital officials, saw their needs and then worked with vendors.”

The clinic has three dental chairs. Two chairs are in an open bay and the other chair is in a private room. About 1,200 patients a year are treated at the clinic.

The hospital had been planning to renovate the dental clinic, but the plans were put on fast-forward when donations came in from Schein, 

“Without those donations we’d be a year or two out from even starting the project,,” Rowland said. “Henry Schein was the initial motivating factor. They said they really wanted to do this. The other two companies came along side at the perfect time.”

In addition to a more kid-friendly atmosphere, the new clinic has diagnostic technology, intraoral cameras and laser technology.

“We’d never integrated laser technology into the clinic, now we have it,” Rowland said. “We can perform some procedures with a laser and avoid numbing the patient, which makes the visit more pleasant for the patient.”

The hospital’s mission is to find cures for children with cancer and other catastrophic diseases through research and treatment. St. Jude has treated children from all 50 states and from around the world.

“Providing an on-site dental clinic also is in keeping with St. Jude’s philosophy of providing comprehensive patient care,” Rowland said.

He noted that the clinic helps protect the health of young patients who have cancer, sickle cell anemia or other catastrophic illnesses. The diagnosis of these young patients makes it more problematic for them to see a dentist at home.

Dr. Phil Wenk, president and CEO of Delta Dental,  said that’s why his company wanted to contribute to the project.

“The children being treated at St. Jude have immune systems that are very vulnerable, and with the mouth being the gateway to the body, their oral health is critical to the success of their treatment,” Wenk said. “This clinic allows children, particularly those not able to leave the hospital, the opportunity to get the care they need without ever having to leave St. Jude and risk exposure that may further jeopardize their health.”

Rowland said the more kid-friendly clinic has been received well by the children and their parents. The changes are most obvious to those who had visited the clinic when it was all white and sterile-looking.

“The kids who’ve been here before and are returning for dental treatment are the most impressed,” he said.

Gardino said he is pleased with how Henry Schein Dental and the other companies stepped up to make donations that made a significant change in the clinic and play a role in improving the lives of many young patients.

“The way we were able to do it in a top-notch fashion makes me very proud,” Gardino said.

A green path decorated with oversized footsteps makes a trip to the dental clinic at St. Jude Children’s Research Hospital less scary for young patients. Add in new wood cabinets, softer lighting, soothing colors in the decor, and children’s artwork on the walls and the result is a clinic with a kid-friendly atmosphere that matches how the rest of the hospital looks. The hospital-based clinic first opened its doors about 30 years ago, and its décor had remained frozen in time.

Upgrades to be proud of

	As a school nurse for 23 years, Sandi Delack has witnessed first-hand the needs of children who don’t have a dentist or receive regular dental or oral health care.

	“On a daily basis we have kids at school who say they can’t concentrate because they have a toothache or who’ve had pain for a while but say haven’t seen a dentist because their parents can’t afford it,” said Delack, who is president of the National Association of School Nurses (NASN) based in Silver Spring, Md.

	That’s why Delack and others in the fields of school nursing and dentistry welcome a new partnership between the NASN and the American Dental Association, which have launched a campaign to give school nurses the tools they need to better promote oral health among students. The Empowering School Nurses to Change Oral Health Perceptions is funded by a $160,000 grant from the DentaQuest Foundation.
	
	“The ADA looks forward to collaborating with school nurses to help children and their parents understand that oral health is an important part of overall health,” said Raymond F. Gist, president of the American Dental Association.
	
	“We focus so much on general health that oral health gets lost,” added Maria Lopez Howell, a dentist in San Antonio and a consumer advisor for the ADA. “This will bring the oral health piece into the framework for school nurses.”
	
	Statistics from the Centers for Disease Control show that more than two-thirds or 68 percent of children have decay in their permanent teeth. Poor oral health is linked to ear and sinus infections, weakened immune systems, as well as diabetes, and heart and lung disease.
	
	Studies also have found that children with oral health restricted their activities and miss more than 51 million of school hours each year, according to a report from Children International at the University of Arkansas, an organization that provides educational enrichment and health and dental care to children in the Little Rock area.
	
	Tapping into this network of nurses to better address oral health among children makes good sense, said Amy Garcia, executive director of NASN. She said that 98 percent of children spend their days at school and school nurses are a natural conduit for reaching them with the message about the importance of oral health. The school nurses association has 50,000 members nationwide.
	
	“We have a strong reach into the communities we serve,” Garcia said.  “School nurses know which families are struggling, which children need better hygiene or correctives or which parents might need help with an issue like bottle mouth.”
	
	The campaign is starting with a needs assessment that is already underway. A survey is being developed to be sent to school nurses to begin to understand what tools they need to better promote oral health and what problems they encounter among students.  
	
	“We’d like to know how often they see students with oral health needs and what they do when they see a problem,” Garcia said.
	
	Campaign organizers also want to know what educational resources nurses would find useful. New resources, whether they are informational fliers, posters or brochures may be developed, but Garcia said some of these materials already exist.
	
	“We want to make those credible resources more available and extend the reach to students who don’t have a regular dental provider and need one,” Garcia said. “Since many of these materials are for parents we want to be sure they are in a format that makes it into the home.”
	
	An important part of the project will be developing a website that nurses can access to find avenues for connecting a child with a dentist. Garcia said the website will have links to foundations and non-profit organizations that dentists work with to provide dental care to children who need, but can’t afford it.
	
	“A school nurse could go on the website to find help or a dentist could go on to the site to find a school nurse,” said Garcia, who hopes to have the website operational by the summer.
	
	Gist said the partnership will lead to greater recognition of the importance of oral health.
	
	“School nurses and dentists can help raise awareness about the need for good oral hygiene, good nutrition and regular dental visits in order to prevent dental disease,” Gist said. 
	
	Howell said it is never too early to try to tackle a problem that can have devastating implications for children.
	
	“Severe tooth decay can affect how children learn and their self-esteem,” Howell said. “Some children don’t want to smile. But tooth decay is so preventable.”
	
	Delack, who works at Nicholas J. Ferri Middle School in Johnston, Rhode Island, and Garcia are excited about the campaign’s potential to improve oral health among students, and make it a lifelong priority for young people.
	
	“I think it’s one of the smarter programs I’ve seen in a while because it builds on existing resources,” Garcia said. “We can really impact the lives of students.”

 As a school nurse for 23 years, Sandi Delack has witnessed first-hand the needs of children who don’t have a dentist or receive regular dental or oral health care.

School nurses and dentists team up for oral health

	Just about everyone can relate to having to laugh politely at a joke that’s fallen flat or trying to keep his or her eyelids open during a story that goes on and on.

	For dentists and dental hygienists, however, the question of whether it’s a good idea to indulge in a bit of humor to distract a patient or tell them a long, drawn-out tale is not just about relating to people, it’s about whether the end result is good customer service and helps patients maintain their health.

	Jeanne Bosecker, a dental hygienist for five years in the Chicago area, said she has listened in on some cringe-worthy conversations with patients initiated by one dentist with whom she worked. 

	Recalling the first time she assisted this dentist, Bosecker said she was wondering if a TV crew was going to pop up in the office.

	“I can honestly say that I thought I was on candid Camera,” she said. “Because he was dropping the “F” bomb and he always had some story that’s over the top.”

	In one case, he recounted how he had been called to treat a dental problem for Hilary Clinton, a story that Bosecker said grew more unlikely as he told it.

	“Honestly, now I just tune him out,” she said. “It’s in one ear and out the other. I don’t listen anymore.”

	Despite his style, Bosecker said some of the dentist’s patients love his free and easy manner.

	“It’s just his personality,” she said. “That’s the guy he always been.”

	“I had a patient tell me she was not happy with the crown he put in, and she wasn’t happy with the F-word,” Bosecker said.

	Learning how to relate to patients is a long-accepted part of the curriculum at dental schools, said Sheela Raja, a clinical psychologist and director of clinical behavioral science at the College of Dentistry at the University of Illinois at Chicago.

	“It’s such an important part of dental care,” she said. “Dentists have to be able to communicate with patients, talk about treatment plans and deal with anxious patients.”

	To help dental students develop a chair-side manner, Raja said the school audio tapes some visits (with a patient’s permission) between the dentist and the patient.

	Afterward, students and teachers listen to those tapes in small groups settings to brainstorm ways the student can better relate to and communicate with patients.

	The idea is to help dentists develop the skills that can help put patients at ease.

	“We talk about empathy and how to understand what a patient may be feeling, and reflective listening,” she said.

 Just about everyone can relate to having to laugh politely at a joke that’s fallen flat or trying to keep his or her eyelids open during a story that goes on and on.  For dentists and dental hygienists, however, the question of whether it’s a good idea to indulge in a bit of humor to distract a patient or tell them a long, drawn-out tale is not just about relating to people, it’s about whether the end result is good customer service and helps patients maintain their health.