Kristen Mott is the associate editor for Dental Products Report and Digital Esthetics.

Kristen Mott

	Periodontitis can have a serious impact on your overall health. Not only does it break down your bone, ligaments and gums, but periodontitis also has been linked to other serious health conditions.

	For instance, in 2016 Chinese researchers found that individuals with periodontal disease may be at an increased risk of developing lung cancer. Also last year, a study jointly led by the University of Southampton and King’s College London discovered a link between gum disease and greater rates of cognitive decline in people with early stages of Alzheimer’s disease.
	 
	Last month, researchers 

 at The International Liver Congress 2017 in Amsterdam, The Netherlands from a prospective study in patients with cirrhosis, or irreversible scarring of the liver, that demonstrated severe periodontitis strongly predicts higher mortality.
	 
	The study enrolled 184 patients with cirrhosis, all of whom had their oral health assessed. The patients were clinically followed-up for one year on average. At the start of the study, about 44 percent of the patients had severe periodontitis. According to the results, nearly half of the patients died during the follow-up period. Severe periodontitis was associated with higher all-cause mortality with an even stronger association in patients with cirrhosis.

	The association of periodontitis with higher cirrhosis mortality was adjusted for gender, age, alcohol use, cirrhosis etiology, smoker status, comorbidity, nutritional risk score, Child-Pugh score and Model of End-Stage Liver Disease score.
	 
	“Our study showed that severe periodontitis strongly predicted higher mortality in cirrhosis, says Lea Ladegaard Grønkjaer, PhD, RN, Aarhus University Hospital, Denmark, and lead author of the study. Periodontitis may act as a persistent source of oral bacterial translocation, causing inflammation and increasing cirrhosis complications. As it can be treated successfully, however, we hope that our findings motivate more trials on this subject.”
	 
	

, president of the American Academy of Periodontology, says the results of the study are not surprising, given the growing body of evidence linking periodontal disease to other systemic conditions. He believes additional research is needed for researchers and clinicians to gain a better understanding of this topic and the impact it has on patients.
	 
	“Awareness of a patient’s physical and dental health is important for both periodontists and physicians,” Griffin says. “I’ve long advocated for the team approach to care for periodontal disease, particularly for individuals who are undergoing treatment for systemic ailments. While we have yet to learn more about the relationship between liver disease and periodontal disease, we advise medical and dental professionals to ask patients questions about their overall health and to confer with each other when necessary to ensure that the patient is receiving optimal care."

Articles

The results of the study were presented at The International Liver Congress in Amsterdam. 


Study finds link between severe gum disease and higher mortality rate in cirrhosis patients

	CDA South wrapped up last week in Anaheim, California. Nearly 600 companies packed the 130,000-square-foot exhibit hall at the Anaheim Convention Center. The DPR team was there to check out the latest in dentistry, and to soak up a little California sun in the process.

Companies from around the world showcased new products as well as innovations in technology and software. Everything from state-of-the-art milling machines and intraoral scanners to operatory furniture and handpieces were on display at this year’s show. We’ve put together a list of the five coolest products we saw at the conference.

Trending article: 10 things we saw at IDS 2017 that blew us away 

 launched its next generation intraoral camera, the 

, at CDA South. The new camera features the award-winning features of its predecessor, as well as new high-definition imaging with an innovative acquisition software, DEXcapture.

Related reading: Using DEXIS Platinum digital sensors and DEXIS CariVu

	By using this camera, clinicians can create highly detailed, true-to-color photos that are said to remain clear even when enlarged, allowing patients to better understand their diagnosis and treatment. In addition, the images can be sent directly from patients’ records to partnering doctors. The camera was on display on the show floor, and users could see the improved imaging results first-hand from several surrounding screens.

Carestream Dental expanded its popular CS 8100 3D CBCT system to include a cephalometric imaging option and several new 3D applications.

	While other scanning celphalometric units scan vertically and can take anywhere from eight to 25 seconds, the CS 8100SC 3D reportedly scans horizontally and takes as little as three seconds. The system includes exclusive Carestream Dental imaging software.

Trending article: Carestream Dental introduces CS Solutions for Implants

	In addition to the cephalometric capabilities, the CS 8100SC 3D includes several updated 3D applications, including an optional prosthetic-driven implant planning module and the CS Adapt module, which allows doctors to customize panoramic and cephalometric images’ look and feel to suit their clinical needs. The entire workflow was showcased from the Carestream Dental booth, demonstrating the increased possibilities for practicioners who leverage all of their imaging solutions together. 

Shofu Dental Corporation recently launched its new HC Blocks and Disks, proprietary hybrid ceramic materials for CAD/CAM-based restorative dentistry with CEREC. We got to see them at CDA South, and saw how they are formulated to bring Shofu’s material prowess into the CAD/CAM world.

Related article: An in-depth look at the BurButler from Shofu Dental

	The blocks and disks are available in multiple shades and translucencies, and are said to have remarkable stain resistance and excellent polishability for lasting esthetics. The blocks are bilayered and modeled after the layering of natural teeth with a chromatic opaque dentin layer and a translucent layer of enamel.

	The materials can be used for minimally invasive inlays and onlays, cosmetic veneers, full crowns for anterior and posterior teeth, and implant-supported restorations.

 One Bulk Fill Restorative on display, giving conference attendees the chance to experience using the new material. CDA attendees could try out the product on a model, and no doubt every dentist who used the product did so much more smoothly than the DPR editors who tried!

Trending article: I Use That: 3M Filtek One Bulk Fill Restorative

	Designed for the posterior, the unique optical properties and improved opacity of the bulk fill material are said to enable the simplicity of one-step bulk placement – up to 5 mm – with improved esthetics. With 3M’s unique Smart Contrast Ratio Management technology, the product is designed to feature increased opacity without reducing depth of cure.

	The material is available in five shades. 

ACTEON North America showcased its new X-Mind

 Trium 3D CBCT device. The upgradeable system is said to provide exceptional image quality and facilitates osseointegration with instant volume measurement and bone density assessment.

Related reading: Applying the X-Mind Trium in your practice 

	The machine works with the ACTEON Imaging Suite and produces all scans in STL format for export into surgical guide design software. The software also has a virtual endoscope feature for airway evaluation and nerve canal tracing for improved implant planning.

Highlights from the California Dental Association’s biannual conference.

5 Cool Things We Saw at CDA Anaheim 2017

	There are certain things one expects to see when visiting the dentist for a checkup: toothbrushes and floss, mouth mirrors, X-ray machines and various instruments. Then there are things that have no business being in a dental office, like say, a hoverboard.

	Apparently, Anchorage dentist Seth Lookhart of Clear Creek Dental didn’t get that memo. Lookhart was charged with 17 counts of Medicaid fraud in 2016 and “unlawful dental acts.” What constitutes an unlawful dental act? Investigators say they found a video on Lookhart’s phone of him pulling out a sedated patient’s tooth while riding a hoverboard. To make matters worse, Lookhart allegedly texted the video to a few of his buddies, joking that it represented a “new standard of care.” The patient told investigators she had no idea what had taken place while she was sedated.

Trending article: The top 16 worst dental patients ever

	Besides being designed to be used in open spaces and not inside a dental office, hoverboards are also known for their safety risks, as evidenced by 

. Clearly, Lookhart didn’t learn anything from Mike Tyson!
	
	As if the hoverboard incident isn’t bad enough, Lookhart is also accused of billing nearly $2 million in IV sedation without proper justification and illegally diverting funds from his employer. His office manager, Shauna Cranford, is facing 16 charges herself and is allegedly the person who told Lookhart to use IV sedation more frequently for procedures that didn’t require it.
	
	If Lookhart is convicted, he can face up to 10 years in jail, up to $100,000 in fines and be ordered to repay Medicaid and affected defendants as much as $2.5 million in fees, according to 

. His next court hearing is scheduled for June 6.

Alaska dentist Seth Lookhart is facing 17 counts of fraud and ‘unlawful dental acts.’


Dentist arrested after allegedly pulling patient’s tooth while riding a hoverboard

	Brasseler USA recently unveiled the XP-3D Shaper

. The endodontic debridement instrument reportedly addresses the shortcomings of traditional NiTi instrumentation and ushers in a new biological standard of care in endodontic practice.

	The XP-3D shapers are packaged in convenient single-use sets of three files for simplified handling and a sterile application for every case. They are engineered to be used with any endodontic handpiece.
	
	Safe: The XP-3D Shaper is said to feature a small flexible core that is extremely resistant to cyclic fatigue. The unique serpentine design reportedly allows the instrument to gently abrade the inner walls of the root canal without the stress often associated with conventional NiTi files.

Related reading: Brasseler USA releases new handpiece 

	Simple: The XP-3D Shaper was designed with Brasseler USA’s exclusive MaxWire

 Technology, which reportedly allows the instrument to expand and become more robust when exposed to body temperature. Once an adequate glide path is established, the shaper is engineered to be able to clean the entire canal without the need for multiple files.
	
	Anatomical: The shaper is said to feature a unique, free-floating adaptive core that allows the smaller central core of the instrument to move freely and adapt to the canal’s natural anatomy. This dynamic movement reportedly creates enhanced turbulence for improved irrigation.

The instrument is designed to address the shortcomings of traditional NiTi instrumentation.

Applying the Brasseler USA XP-3D Shaper in your practice

Nutrition is essential when it comes to promoting good oral health for your patients. 


The top 10 foods for healthy teeth and gums

	We all know the foods that are bad for patients’ teeth: sticky candy, carbonated beverages, potato chips and ice, just to name a few. But what about foods that are actually 

The foods and beverages we consume can have a major impact on our oral health. Maintaining a healthy, balanced diet is key to ensuring that teeth and gums stay strong and healthy for years to come. 

Trending article: 8 candies that make dental professionals scream

	To help your patients on their journey toward healthy teeth, we’ve compiled a list of the top 10 foods that are good for teeth and gums. 

	Continue to the next page to see which foods made the list. 

	Cheese lovers, rejoice! This dairy product has been shown to boost dental health and restore enamel thanks to its high levels of calcium and whey protein, according to 

. However, try to stick with natural cheese as processed cheese products like dips and sprays can wear down enamel and increase your chance for cavities. 

	Another dairy product makes the top of the list: milk. Milk not only helps build strong bones but also can protect your tooth enamel by providing the calcium and phosphorous needed to remineralize teeth, according to 

	Chewing raw vegetables like celery and carrots can help stimulate your gums and in turn maintain the health of your teeth, according to 

. As an added bonus, carrots and celery also are sources of beta carotene, which the body needs to create Vitamin A. Vitamin A is a key nutrient for building strong teeth. 

	Apples have been called “nature’s toothbrush,” and for good reason! Apples stimulate the gums and reduce the build-up of cavity-causing bacteria, according to an article in 

. Chewing an apple also stimulates saliva flow, which can help to decrease mouth acidity and wash away food particles. 

	Leafy greens such as spinach and kale have been touted for their health benefits. It turns out they can promote oral health, too. 

 notes that leafy greens are high in calcium, which helps build your teeth’s enamel, and they contain folic acid, a type of B vitamin that has several health benefits and may even be able to treat gum disease in pregnant women. 

	Omega-3 fish oils DHA and EPA have been shown to reduce the risk of periodontitis, says research in the Journal of the 

. In addition, cold water fish such as tuna, trout and wild salmon are good sources of vitamin D and heart-healthy fats. 

	Chewing on nuts can produce extra saliva, which helps to neutralize bacteria that causes cavities, states an article in 

. A handful of almonds can provide you with plenty of calcium while walnuts contain a whole host of vitamins and minerals, including vitamin E, potassium and zinc, which are beneficial for teeth. 

, scientists have discovered that a compound in cranberries can stop bacteria from clinging to the teeth and block formation of plaque deposits. It’s best to stick with fresh cranberries though as items like cranberry juices and other cranberry-containing products can be high in sugar. 

 a food, we couldn’t pass up noting the health benefits of black and green tea. Black and green teas are rich in polyphenols, which can help slow the growth of bacteria associated with cavities and gum disease, states an article on 

. Polyphenols in black tea can also help fight bad breath. 

	While raisins may seem detrimental to oral health due to their sticky appearance and sweet taste, the opposite may in fact be true. 

 cites a study in which researchers found certain phytochemicals found in raisins appear to actually fight bacteria in the mouth that causes cavities and gum disease. Raisins also don’t contain sucrose, which many experts believe to be the main cause of some oral diseases. 

Nutrition is essential when it comes to promoting good oral health for your patients. 


	About 25 percent of adults age 60 and older no longer have any natural teeth, according to the CDC. As a result, the 

American College of Prosthodontists (ACP)

 estimates that 15 percent of the edentulous population has dentures made each year.

	While dentures can serve practical and esthetic purposes, they also come with some risks. In 2015, 

 found that elderly patients who wore dentures while sleeping had a higher risk of developing pneumonia than those who removed their dentures before bed. The researchers also discovered that patients who slept with their dentures were more likely to have gum inflammation, tongue and/or denture plaque and other oral health issues.

	Now, researchers in India have determined that dentures may also be associated with an additional health risk.

	During a recent study, researchers conducted a systematic search of several medical databases, including MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Web of Science.

Trending research: New discovery could reduce the dental implant failure rate

	They used search terms such as “oral cancer,” “mechanical irritation,” “risk factor,” “dental irritation” and “dental trauma,” among others. They ultimately included 22 studies that were relevant to their research.

	During review of the literature, the researchers found multiple studies that showed an association between ill-fitting denture use and subsequent cancer formation. For instance, a population-based case-control study in Sweden showed that defective or malfunctioning complete dentures were significant risk factors for the development of oral squamous cell carcinoma. Another study found that 44 percent of the patients examined showed a correlation between the site of oral cancer development and the site of some form of chronic dental irritation. 

	“From this review, we can conclude that chronic mucosal irritation resulting from ill-fitting dentures may be considered a risk factor for subsequent development of oral cancer. Such trauma-related cancers may be seen more often over the lateral border of tongue and also over the alveolus,” the study states.

	Board-certified prosthodontist Dr. David A. Felton, who is the current editor-in-chief of the 

, notes that while research suggests a correlation between ill-fitting dentures and oral cancer, there is currently no known process through which ill-fitting dentures cause oral cancer.

	“While these studies show a potential risk, patients shouldn’t lose sight of the fact that well-fitting dentures are an important part of overall health. I conducted an extensive review of the literature and found that missing or unrestored teeth were a risk factor in a host of health conditions, including cancer, diabetes, dementia and COPD,” Dr. Felton says.

	Following a recall schedule set by a dentist or prosthodontist is key to avoiding potential problems.

	“At a minimum, patients should be strongly encouraged to see their dental health care provider on an annual basis in order to determine the fit of the prostheses and, most importantly, to do an oral cancer screening. It’s just good patient management,” Dr. Felton says.

	“That being said, it is often challenging to get denture wearers back into the office for annual check-ups (if they don’t hurt, or aren’t broken, patients will often not return for annual visits). Steps that can be taken are to carefully assess the fit and retention of the dentures, to carefully assess the health of the oral denture supporting tissues and to evaluate the wear of the dentures (broken or missing teeth, sharp areas, etc.) in addition to doing the oral cancer screening.”

 on a similar topic as the study done in India, says that more longitudinal studies on denture-wearing patients are needed.

	“There are few studies that evaluate fit and retention of the dentures long-term, the use of denture adhesives (no studies are longer than six months in duration), to determine if dental implants can improve or reduce the rates of oral cancer in the denture-wearing patient, and only a few emerging retrospective case control studies on the relationship between the ill-fitting dentures and oral cancer,” he says. “Definitely, more prospective research needs to be done!”

The role of chronic mucosal trauma in oral cancer: A review of literature

Indian Journal of Medical Paediatric Oncology

Researchers in India have determined that dentures that fit improperly can be a risk factor for developing oral cancer.

Can ill-fitting dentures increase your oral cancer risk?

	Dentists and hygienists are playing a crucial role in early detection of oral cancer, and for good reason. About 49,670 people will be diagnosed with oral cavity or oropharyngeal cancer this year alone, according to the American Cancer Society, and an estimated 9,700 people will die of these cancers.

While the overall rate of new cases of oral cancer has been stable in men and dropping slightly in women, the American Cancer Society notes that there has been a rise in cases of oropharyngeal cancer in both men and women linked to infection with HPV. Being able to detect and treat these cancers in their early stages is key and can lead to noninvavise treatments and higher survival rates for patients.

Related reading: The importance of oral cancer screening in the dental practice 

	Fortunately, oral cancer detection tools continue to evolve and take advantage of the latest technology. From utilizing specific wavelengths of light to implementing fluorescence visualization technology to incorporating imaging technology, these devices are enabling clinicians to detect oral diseases early on and help stop them from spreading. Ensuring the entire dental team has the necessary education and training to understand and use these oral cancer tools is critical and can be a key aspect of providing effective patient care.

	Click through the slides to view some of the top oral cancer sensors available today.
	

	The Bio/Screen Oral Examination Light by AdDent Inc., is said to be a new and improved oral cancer biofluorescence screening device. This device can reportedly be used in full room light due to its exceptionally powerful shortwave LEDs. It is made of lightweight aluminum and ergonomically designed for comfort and ease of use. Special optical filters are engineered to improve the contrast between healthy and abnormal tissue to improve visualization of potential problems at an early stage.

	AdDent Inc.
	855-211-3413  |  addent.com
	 

	The DOS SE is said to be a small yet extremely powerful fluorescent imaging system. With patent-pending LED Beam technology and a high-contrast fluorescence viewer, it reportedly enables both intra and extraoral access for early detection of both HPV and traditional viruses associated with oral cancer without the need for rinsing the mouth. The DOS SE also comes with low-cost disposable barrier sleeves, allowing dentists and hygienists to perform affordable and effective routine oral exams.

	DentLight
	800-763-6901  |  dentlight.com
	 

	The Identafi oral cancer screening system reportedly dramatically enhances the appearance of suspicious tissue. The product is said to use three wavelengths of light, revealing mucosal abnormalities that may lead to oral cancer or premalignant dysplasia that may not be apparent to the naked eye during traditional screenings. Identafi’s compact design is engineered to make it easy to inspect hard-to-reach areas and fit seamlessly into existing screening routines.

	DentalEZ
	866-DTE-INFO |  identafi.net
	 

	OralID, a simple and efficient oral cancer screening device, was reportedly designed to innovate the current fluorescence oral screening devices on the market. Designed to screen every patient, OralID is said to be the only product that has no per patient costs. A proprietary SmartFilterID

 is engineered to easily photo document lesions with any smart device.

	Forward Science
	855-696-7254  |  forwardscience.com

“Most all of our patients have really enjoyed the fact that we are using new technology and that we really are taking oral cancer screening seriously and care about our patients’ health.”

	Cordless and compact, the VELscope Vx reportedly implements fluorescence visualization technology to detect oral disease, including cancer. Used as an adjunct to routine oral soft-tissue exams, this product is said to be completely noninvasive. VELscope Vx is battery-operated and rechargeable and compatible with the Vx Camera System and standard digital cameras for photo documentation. An Imaging Adapter is engineered to be combined with a custom-designed Apple iPod 6 Touch holder and a state-of-the-art application to make framing and acquiring images simple.

	LED Dental
	844-952-7327  |  leddental.com

Dentists are the front line of defense when it comes to detecting oral cancer.

Using detection tools to prevent oral cancer: A product roundup

	Sleep bruxism, or excessive clenching or grinding of the teeth, can be a serious problem for some people. The most common form of treatment for sleep bruxism is wearing a night/occlusal guard.

 is a relatively new dental guard that is designed to alleviate symptoms of bruxism. The Ora-GUARD is reportedly made from soft, medical-grade material to provide a cushion during clenching as well as a patented hard surface design that allows the teeth and jaws to slide naturally and protects teeth from the damaging effects of grinding. 

	Dr. William Balanoff, DDS, MS, FICD, shared his insight regarding the development of the Ora-GUARD and how patients are responding to this new product.

	How can people determine if they’re grinding their teeth in their sleep?

	Patients can determine if they grind or clench their teeth in usually two ways. The first is that the gnashing of teeth will wake up a spouse or partner. This unsettling sound of enamel grinding against enamel is startling and alarming. I have heard from patients that their spouse or partner will wake them up with the hopes of stopping the grinding. The second common way to realize that you grind or clench your teeth in your sleep is when your facial and chewing muscles are fatigued or sore upon waking up. What is truly amazing is that when patients wear a night/occlusal guard, they report that they wake up and their face doesn’t feel tired. It may seem like an odd way to describe a clinical situation, but patients know the difference in the morning with and without a night/occlusal guard.

	How was the concept for Ora-GUARD developed? 

	Patients are told that they need to protect their teeth from the harmful effects of bruxism by wearing an occlusal/night guard. Ora-GUARD was developed and cleared by the FDA to help patients find an inexpensive yet effective device to protect their teeth from grinding and clenching.

Trending research: Study finds obstructive sleep apnea causes complications in dental implants 

	How does the Ora-GUARD help with teeth grinding? 

	To date, dentists have not figured out how to stop patients from grinding and clenching. What Ora-GUARD does is protect teeth from grinding and clenching by covering the teeth with a removable piece of plastic, which has been specially designed and cleared by the FDA.  

	Anyone who wants to protect their teeth from the harmful effects of grinding and clenching can use this product. Most dentists agree that 30 percent to 40 percent of their adult patient population should wear an occlusal/night guard to protect their teeth from excessive wear.

	How does Ora-GUARD differ from other mouth guards available? 

	Ora-GUARD is FDA cleared and manufactured by 

. Bite Tech is the industry leader in teeth protection. No other company has spent more money on research and development, with the sole intent of helping patients keep their smile. Unlike other grind guards, Ora-GUARD is a soft and hard surface wedge design oral appliance. The soft medical grade fit material cushions your jaws during clenching, while the patented hard surface design protects your teeth from the damaging effects of grinding. The patented bite plate wedge design is specially constructed to slide your lower jaw down and forward, releasing tension on the TMJ muscle while preventing tooth damage. No other product on the market can make this claim.

	What has been the feedback so far from patients? 

	We hear from patients that they wake up rested and their face doesn’t feel tired from grinding and clenching all night. Patients are grateful that there is an inexpensive, effective and FDA approved solution for a problem that has plagued them for many years and, up until now, has been left untreated. The smaller size, along with a tight fit, helps bruxism sufferers with the discomfort usually experienced with other grind guards, as well as prevents them from waking up in the morning with jaw tension and pain.






The dental guard is designed to reduce the damage of excessive teeth grinding and offer relief for TMJ.Sleep bruxism, or excessive clenching or grinding of the teeth, can be a serious problem for some people. The most common form of treatment for sleep bruxism is wearing a night/occlusal guard.

Ora-GUARD offers new solution for sleep bruxism

	Click through the slides to view some of the top oral cancer sensors available today.

	DentLight
	800-763-6901  |  dentlight.com






Dentists and hygienists are playing a crucial role in early detection of oral cancer, and for good reason. About 49,670 people will be diagnosed with oral cavity or oropharyngeal cancer this year alone, according to the American Cancer Society, and an estimated 9,700 people will die of these cancers.