Joe Hannan

 in the United Kingdom, a campaign aimed at reinforcing the need for dentists to 

 during every check-up. While this campaign is taking place overseas, there are takeaways for American dentists as well.

National Cancer Institute (NCI) estimates

 that there will be 48,330 cases of oral cavity and pharynx cancer, resulting in 9,570 deaths. That’s about 3% of all cancer cases in the US. Typically, according to NCI, oral cancer affects men more prevalently than women, especially among those who are heavy smokers or alcohol users. It also tends to affect people with the human papillomavirus (HPV). Currently, NCI estimates that 64% of patients survive 5 years.

The organizers of Mouth Cancer Action Month—the Oral Health Foundation&mdash;emphasize that early detection is critical.

Oral Health Foundation CEO Nigel Carter (OBE, BDS, LDS), is quoted in the organization’s 

 as saying, “Catching mouth cancer cases early significantly increases a person’s chance of survival to 90 per cent from 50 per cent, early diagnosis is incredibly vital. … I am calling on dental professionals to have a refresh on how to carry out an effective mouth cancer examination to ensure they do not miss any chance to save someone’s life. … Be on the lookout for ulcers which have not healed within three weeks, red and white patches in the mouth and any unusual lumps or swellings in the mouth, head and neck area.”

The Oral Health Foundation encourages dentists to follow these 7 steps for cancer checks.

Do both sides of the head and neck look the same? Are there any asymmetrical lumps, bumps, or swellings?

Is there any tenderness or any lumps in the patient’s neck? Press the neck to check.

 Pull down the lower lip to look for sores or color changes. Then feel the lip for lumps, bumps, or texture changes. Repeat for the upper lip.

 Look inside. Notice any red, white, or dark patches? Again, check for lumps, tenderness, or ulcers and repeat for the other cheek.

: Visually inspect the roof of the patient’s mouth for lumps or color changes. Then use your finger to feel for lumps.

: Have the patient stick out their tongue and look for color or texture changes. Then examine the underside of the tongue, looking for the same things.

Look again for changes in color. Run your finger along the floor and underside of the tongue to check for swellings, ulcers, or lumps. 

Articles

In the United Kingdom, November is Mouth Cancer Action Month, a campaign aimed at early detection of oral cancer. The campaign offers useful screening tips that also apply to American dentists.

7 Steps for Better Oral Cancer Checks

Health officials in Orange County, CA allowed an Anaheim children’s dental clinic at the center of a 

 outbreak to resume using its water on Tuesday.

attorney announced a class-action lawsuit

 representing the families of 57 children who became ill after receiving treatment at the Children’s Dental Group.

The source of the outbreak was traced to the practice’s water supply, which had somehow been contaminated. Practice staff were ordered to stop using the water on Sept. 15, the 

 from the Orange County Health Care Agency, the practice has since addressed the issue to the agency’s satisfaction.

“Since the Order was served, Children’s Dental Group has been fully cooperative with the investigation, and in consultation with the Centers for Disease Control and Prevention, a plan for remediation was approved,” said Eric Handler (MD, MPH), County Health Officer. “The on-site water system has been completely removed, replaced with new equipment, and the water from the new system has been tested to ensure it meets the standards established by the American Dental Association.”

The release from the agency also says that the practice will continue to monitor its water supply as well as take precautions to avoid further contamination. These precautions include “the use of a treatment designed to prevent bacteria from adhering to equipment as well as the installation of purification cartridges at every dental chair connected to the on-site water system.”

 bacterium are typically found in dust, water, and soil, and are a common contaminator of medical devices. The bacteria can cause abscesses and infections of the skin, soft oral tissue, and bone. Infections typically require long courses of antibiotics to clear.

Since receiving treatment at the Children’s Dental Group, 57 children have become ill and have received treatment for mouth and neck abscesses that were the result of procedures such as pulpotomies. 

Orange County, CA health officials say the dental practice has taken sufficient steps to resolve the contamination issue that sickened 57 children.

Dental Clinic Cleared to Use Water After Removing Source of Outbreak

 that has sickened 57 children, a new class-action lawsuit accuses an Anaheim, CA children’s dental practice at the heart of the outbreak of malpractice and fraud.

, comes after the Orange County Health Care Agency determined the source of the infections to be the Children’s Dental Group’s water supply.

According to CBS, the civil suit, which was filed on Nov. 4, includes the families of 57 children who, since the exposure, have received treatment for mouth and neck abscesses that were the result of procedures such as pulpotomies.

While the malpractice allegations in the suit stem from the water contamination, the fraud allegations pertain to unnecessary procedures, the lawsuit alleges. CBS reports that parents were allegedly pressured into purchasing excessive or unnecessary dental work for their children.

Catherine Lombardo is the attorney representing the families in class-action suit. CBS quotes her as saying, “This is a high-volume, high-profit clinic that cares about one thing … money.” Lombardo also has said that a 6-year-old patient with autism underwent two pulpotomies without any local anesthetic, but instead was restrained, according to CBS.

The news agency did receive comment from the Children’s Dental Group regarding the lawsuit. They are quoted as saying:

“We provide this service and do this work because we care for children, and we deeply regret that any patient had complications following treatment here. We have not been served with any complaint.”

In addition to malpractice, the civil suit levels allegations of fraud, stemming from reportedly unnecessary procedures, at the practice.

Families File Lawsuit Over Infection Outbreak at California Dental Clinic

 circulating that call into question the health benefits of flossing. Your non-flossing patients might even be throwing them in your face when you point out their lack of attention to the spaces between their teeth.

But you can tell at a glance who flosses and who doesn’t. There are the telltale signs of bleeding or swollen gums. It’s hard to argue that flossing doesn’t have obvious benefits. But for your more stubborn patients, here’s some new ammunition for your flossing battle.

The National Institutes of Health (NIH) in its 

 highlights precisely why patients shouldn’t “toss the floss.” The report, which is written for the layperson, is as good resource to which you can refer patients who aren’t doing their flossing duty.

It highlights some of the fundamentally flawed underpinnings of the existing flossing research, primarily that there have been few “long-term, large-scale, carefully controlled studies of flossing.”

The other major flaw, according to the NIH report, is that all flossing studies have relied on self-reported data. In studies such as these, the NIH says, “people tend to report what they think is the ‘right’ answer when it comes to their health behaviors—whether flossing, exercising, smoking or eating.” As a result, the NIH says, well-controlled studies tend to show flossing benefits, whereas studies outside of the lab tend to be less conclusive about the benefits.

In other words, study participants outside of the lab might not 

Furthermore, the NIH points out that small clinical studies have shown modest flossing benefits. The group says that 12 well-controlled studies revealed that flossing, in combination with tooth-brushing, did a better job reducing gum disease or gingivitis than tooth-brushing alone. Plus, the same studies showed faster reduction of plaque when brushing and flossing were combined.

And if all of that fails to sway your patients toward flossing, perhaps pointing out the unsightly remnants of last night’s dinner that are caught between their front teeth will.

New guidance from the National Institute of Health (NIH) may help sway some of your more stubborn, non-flossing patients.

How to Get Patients to Floss

In response to the state’s addiction epidemic, the 

 (NJDA) has released what it is calling a first-of-its kind overview of guidelines for the safe prescription of opioids.

, cover safe dosing and prescription with the intent of educating prescribers as well as fostering a discussion of the risks among dentists and patients, or parents of patients.

“The NJDA has also developed an informed consent document that provides an opportunity for dialogue between the dentist and patient or the patient’s parent or caregiver about the potential for dependency, misuse and side effects, and the need to properly secure these medicines and dispose of them properly,” the news release said.

, cover five general categories: efficacy of opioids and non-opiates in acute pain, dispensing opioids, patient communication and informed consent, safe disposal of unused medications, and the state’s prescription monitoring program.

“The NJDA and our member dentists realize there is no ‘single face’ of addiction and abuse, and therefore we must take the necessary steps and have the sometimes difficult discussion with each of our patients prior to prescribing,” said Giorgio T. DiVincenzo, DMD and president of the NJDA, in the organization’s news release. “With the rising tide of abuse in NJ and nationwide, we must be part of the solution.”

New Jersey has been contending with the rise of opioid addiction over the past decade. A recent 

, the state’s largest news organization, estimated that if all of New Jersey’s opioid addicts lived in one town, they would total 128,000 in number, comprising the state’s fourth-largest city.

NJ.com also wrote that in 2014, New Jersey experienced more than 

3 times the national average in heroin-related deaths, with 781 in total

. In 2014, heroin- and opioid-related admissions to New Jersey hospitals 

accounted for 49 percent of all substance abuse admissions

New Jersey has one of the highest rates of opioid addiction in the nation. In response, the New Jersey Dental Association (NJDA) has issued new guidelines for prescribers.

State Dental Association Creates 'First Of Its Kind' Set Of Opioid Guidelines

If you think a young patient’s malocclusion might be caused by finger sucking, but you aren’t sure, you might want to check their fingers for calluses.

new study published in the Pediatric Dental Journal

 identifies these calluses as a reliable indicator of malocclusion in children.

Finger sucking has been proven to affect dentition and occlusal development. However, according to the study, it is often difficult for dentists to determine whether or not a child has formed a finger-sucking habit. Study data suggest that the presence of a callus on the sucking finger is an indicator of malocclusion.

In 2009, researchers examined the fingers of 719 Japanese children, ages 0 to 6 years, who were students at 10 kindergartens in Sendai City, Japan to look for evidence sucking calluses. Among 2-year-olds, 13.6% were found to have a finger sucking callus and 11% were found to have malocclusion, the study says.

“Maxillary protrusion was detected in 42.9%, 56.2%, 42.9%, and 37.5% of the children with a sucking callus at the age of 1, 2, 3, and 4 years old, respectively. In those with maxillary protrusion, a sucking callus was detected in 42.9%, 75%, 75%, and 60%, respectively,” the study said.

Researchers concluded that dentists can use these calluses as “a useful indictor for malocclusion caused by an oral habit.”

Japanese researchers have established a link between the presence of calluses on children's fingers—an indicator of finger sucking—and malocclusion.

Calluses on Children's Fingers Can Indicate Malocclusion, Study Says

2 Dentists Accused in Separate Sexual Assaults of Patients

Two more incidents of alleged sexual assault of patients by dentists make national news.

The Truth About George Washington’s Teeth

 What the first president's teeth were actually made of, the pain they caused him, and how they may have altered the course of American history.

5 States with the Highest and Lowest Property Taxes

If selling your house and moving is a part of your retirement plan, you will want to factor in your property tax burden at your desired location.

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A new tool is being developed to help dentists identify and diagnose dental caries much earlier than usual.

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The DMD Top 5 for the Week Ending Nov.  4

Just how serious is your patient’s off-hours emergency?

And how many times have you found yourself asking that question? A new mobile application developed by a team of researchers with the Regenstrief Institute and Indiana University School of Dentistry could provide dentists with a clearer picture of how severe a patient’s after-hours dental emergency is—saving you the guess work and them a trip to the emergency room.

, which was published in the October edition of the Journal of the American Dental Association. According to the study, dental emergencies tend to happen when dental offices are closed. This leaves patients with no option except for visiting a local emergency room for pain management. Additionally, the study notes that dentists are often heading into these emergency visits blind, relying only on a patient’s descriptions.

That’s where the mobile app comes in. Here’s how it works. Users are asked a series of questions about their condition, “designed to capture clinically meaningful data,” the study says. Then, using a smart phone camera, the app allows patients to capture intraoral images, then share those images with a dentist.

 quotes Thankam Thyvalikakath (DMD, MDS, PhD), senior author of the study, as saying that a dentist on the receiving end of the app would be sent a report from the patient, including his or her questionnaire answers, and the images.

The study notes that so far, testing of the application has been successful.

“All participants were able to complete a report within 4 minutes, and all clinical information was comprehended by users,” the study said.

The study concludes that the combination of high-resolution images and the questionnaire may help dentists gauge the severity of a patient’s condition as well as prepare “necessary treatment resources.”

“This technology allows dentists to assess care remotely when direct patient contact is less practical.” 

A new study analyzed the efficacy of a mobile application that allows patients to report, and dentists to determine the severity of dental emergencies. 

Mobile App May Help Dentists Triage Emergencies

 that a team of British academics have developed a guide that uses Cognitive Behavioral Therapy (CBT) to make children feel more at ease about seeing the dentist. The researchers’ work was first published online by 

 (NAMI), CBT “focuses on exploring relationships among a person's thoughts, feelings and behaviors. During CBT a therapist will actively work with a person to uncover unhealthy patterns of thought and how they may be causing self-destructive behaviors and beliefs.”

Medical Express quotes study author Zoe Marshman (BDS, MPH, DDPH, FDS, PhD) of the University of Sheffield’s School of Clinical Dentistry as saying, “Children who are scared of the dentist often end up with poor dental health and stay scared of the dentist for the rest of their lives.

"At the moment, most of these children end up having sedation or being given a general anesthetic for their dental treatment. This can be a traumatic experience for children and their parents."

A 2013 study published in the Journal of Medical Internet Research

 reinforces just how widespread the issue of childhood fear of the dentist is. The study estimates that internationally, anywhere from 5-20% of children and adolescents have dental fear and anxiety (DFA). The guide and CBT are steps toward addressing those patients’ needs.

In this particular study, researchers at the University of Sheffield first created the guide in collaboration with 24 families and 25 dental professionals to develop and analyze its efficacy.

Researchers then gathered a group of children, ages 9-16, who reported experiencing stress and anxiety about seeing the dentist. This group was then surveyed prior to the administration of CBT to gauge their baseline level of dental anxiety. Fifty-six agreed to go through with the trial and 48 completed the study by making use of the guide.

Children who used the CBT material experienced a statistically significant decline in their self-reported anxiety levels. Sixty percent said they felt better about receiving dental treatment after using the CBT guide.

Researchers at the University of Sheffield developed the guide, which uses Cognitive Behavior Therapy (CBT), to help children feel more at ease.

New Guide May Help Your Young Patients Conquer Dental Fear

A dentist in charge of New York State’s dentistry program for incarcerated youth was arrested on Wednesday, Nov. 2 for 

 from the New York State Inspector General’s office, Neil Schachter, MD, was arrested and charged with second-degree grand larceny, second-degree forgery, and first-degree offering a false instrument for filing. The charges constitute first-degree felonies.

Dr. Schachter, 61, in his capacity as director of dentistry at the State Office of Children and Family Services’ Division of Juvenile Justice and Opportunism for Youth, managed a staff of dentists and hygienists that care for jailed minors throughout the state.

According to the news release, an investigation of Dr. Schachter’s timesheets revealed that he billed the state $75,000 for hours he didn’t actually work. During the time period in question—between September 2013 and earlier this year—the hours he billed coincided with hours he worked in private practices in Saratoga Springs and Amsterdam.

The investigation also revealed that Dr. Schachter allegedly created a fake letter from one of his supervisors that falsely allowed him to collect two salaries: one from the state for his work, and one from the private practices.

“This defendant exploited his government role and defrauded the State to criminally supplement his six-figure salary at taxpayer expense,” said New York Inspector General Leahy Scott. “I will continue to use all resources at my disposal to pursue and hold accountable anyone who violates the public trust.”

Dr. Schachter was arraigned and released on Nov. 2. His next court appearance will on Nov. 23.

The head of dentistry for New York's incarcerated youth is accused of billing $75,000 for hours he didn't work.