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

Kristen Mott

	While most patients know the importance of brushing and flossing, they may not understand the benefits of the various in-office preventive care treatments available to them. Preventive dentistry is critical to maintaining good oral health, and this is especially true for pediatric patients. According to the National Institute of Dental and Craniofacial Research, 42 percent of children ages 2 to 11 have had dental caries in their primary teeth.

Trending article: The states with the best and worst oral health in 2018

	Fortunately, there are many products at clincians’ disposal to alter this statistic and help patients of all ages take charge of their oral health. From in-office treatments such as fluoride varnishes and sealants to home care products like oral irrigators, we’ve compiled some of the top options available.

	Click through the slides to check out the products.

• Riva Star is a new-generation silver diamine fluoride desensitizer that’s designed to immediately relieve tooth sensitivity.
	• Unlike any other SDF-based system, Riva Star’s two-step globally patented procedure minimizes the risk of staining the tooth black.
	• The unique capsule system is color coded and extremely easy to use, saving the clinician and patient time.

	• Pro-DenRx 5% Sodium Fluoride varnishes are single-unit doses that eliminate the need for cleanup or mixing.
	• Application provides 22,600 ppm of fluoride that’s said to be able to offer hypersensitivity relief for up to six months.
	• The varnish is designed to set rapidly in the presence of saliva, which improves patient comfort.

• Iris, a 5% NaF Varnish, is an in-office topical fluoride treatment packaged in a convenient unit-dose package.
	• The varnish is visible for ease of use, and it blends to a natural white tooth color and is virtually undetectable following application.
	• Iris sets rapidly on contact with saliva and has an advanced uptake - up to 8-hour fluoride release.

• FluoroDose fluoride varnish is designed to dry in seconds upon contact with saliva and remain on the tooth for six to eight hours for optimum fluoride uptake.
	• It contains 5 percent sodium fluoride, the maximum dosage allowed, in a convenient single-use LolliPack®.
	• FluoroDose is FDA-cleared for treating dental sensitivity.

	• Icon Proximal is a revolutionary resin infiltration solution for treating incipient caries.
	• Its breakthrough micro-invasive technology is designed to fill and reinforce demineralized enamel with no drilling or anesthesia in just one visit.
	• Icon Proximal is engineered to arrest the progress of early enamel lesions up to the first third of dentin without unnecessary loss of healthy tooth structure.

• Nupro White Varnish, a uniquely formulated varnish for hypersensitivity relief, is designed to release more than seven times the amount of fluoride than the leading varnish brand over a two-hour period and requires a shorter wear time compared to other leading varnish brands.
	• Nupro Prophy Paste features excellent stain removal and polishing performance in a unique proprietary formulation designed to deliver consistent, splatter-free performance.

	Dentsply Sirona Preventive
	844-848-0137  |  

dentsplysirona.com/en-us/products/preventive.html

	Advantage Arrest Silver Diamine Fluoride 38%

• Advantage Arrest Silver Diamine Fluoride 38%, the first and only American-made SDF, features a tinted formula to enhance placement visualization.
	• It’s an immediate and effective desensitizer (D9910) and discloser of incipient lesions (D1354).
	• Advantage Arrest is available both in an economical 8 mL bottle as well as unit-dose packaging for enhanced asepsis and patient presentation.

	• A two-in-one application (toothpaste and MI Paste Plus®) containing RECALDENT™ (CPP-ACP) and fluoride in a cool mint flavor.
	• The paste is designed to release bioavailable calcium, phosphate and fluoride as much as MI Paste Plus®, and it’s free of sodium lauryl sulfate.
	• MI Paste® ONE is engineered to be gentle to the tooth but with high cleaning efficacy.

• An easy-to-use, translucent varnish that’s designed to set on contact with saliva and dry to a natural tooth color.
	• The varnish is said to deliver the highest fluoride concentration available with a smooth and even application.
	• The 5% sodium-fluoride varnish is available in convenient 0.4 mL unit-dose packaging with an application brush and five great-tasting flavors.

• A self-etching sealant intended to be used as a preventive measure in patients with a higher risk for developing cavities.
	• The material works by sealing the occlusal pits and fissures in permanent teeth with a waterproof layer resin.
	• Its excellent bonding strength on enamel is designed to provide a long-lasting seal, and the fluoride release protects against tooth decay.

	• Cervitec Plus is the only chlorhexidine varnish recommended by the ADA for applying a 1:1 mixture of chlorhexidine/thymol varnish every three months to reduce the incidence of root caries.
	• It’s designed to firmly adhere to tooth surfaces creating a thin, clear shield of long-lasting protection.
	• Cervitec Plus is supplied in a high-yielding multi-dose form and individually portioned single-dose units.

• TEETHMATE DESENSITIZER is a powder/liquid HydroxyApetite (HAP)-based desensitizer.
	• It’s designed to be used for treatment of exposed dentin, treatment of dentin after scaling/root planning, and treatment of surfaces before/after bleaching.
	• The material is engineered to form a physical plug inside the dentinal tubules, which offers clinical relief in excess of six months.

	Kuraray Noritake Dental
	800-879-1676  |  

• The varnish is ideal for the treatment of dentinal hypersensitivity and the reduction of postoperative sensitivity.
	• It has a smooth consistency for fast and easy application of a thin, even layer on the tooth surface.
	• Can be applied to enamel and dentin.

	• With new triple-burst technology, Philips Sonicare AirFloss Pro delivers three bursts of air and liquid designed to disrupt and remove plaque along the gumline and in hard-to-reach areas.
	• Philips Sonicare AirFloss Pro is proven to remove 99.9 percent of plaque biofilm.
	• The power flosser is equipped with a high-performance nozzle and customizable burst settings for a personalized flossing experience.

• Award-winning BioCoat™ with SmartCap Technology is said to be the only bioactive resin sealant that delivers daily remineralization.
	• This patented technology is engineered to provide the benefits of extended release of calcium, phosphate and fluoride ions to strengthen tooth enamel and protect against acid attacks.
	• BioCoat’s 56 percent filled resin formula provides added strength and excellent long-term resistance to wear.

• The VellaMini 5% Fluoride Varnish package is uniquely designed to dispense easily on the back of a glove, moving your workspace closer to the oral cavity and freeing up one hand for cheek retraction.
	• VellaMini’s clear, thin layer formula is designed to go on easy, offering improved esthetics and mouth feel to help with patient compliance.
	• The formula features patented NuFluor®, a combination chemistry containing fluoride, calcium and phosphate to give patients added protection, and it delivers fast fluoride release and uptake at two hours.

	Preventive Technologies (Preventech)
	800-474-8681  |  

	• Embrace™ Varnish is said to release 10 times more fluoride than the leading varnish in four hours.
	• The varnish also contains xylitol-coated calcium and phosphate to help restore minerals to teeth that have been weakened by dietary sugars.
	• Embrace Varnish is designed to act as a desensitizer and fill superficial, non-carious enamel lesions, and it’s ideal for patients of all ages.

• Enamelast is a 5% sodium fluoride varnish with a patented adhesion-promoting agent for enhanced retention, allowing for superior fluoride release and uptake.
	• In addition to its silky texture, Enamelast is designed to appear nearly invisible against the teeth.
	• Available in Walterberry, Cool Mint, Bubble Gum and Orange Cream flavors.

Articles

From in-office treatments to home care products, we’ve compiled some of the top options available. 

Achieving optimal oral health with preventive care products

	It’s no secret that working in a dental office can take a physical toll on your body. From cramped hands and painful wrists from holding dental instruments all day to back pain from leaning over patient after patient in the chair, hygienists feel the physical effects of their career choice almost every day.

 can go a long way toward enjoying a long and healthy career. Are you using the correct type of chair in the operatory? Do your workouts incorporate moves that will help and not exacerbate your strained muscles? Are you doing stretches at night to alleviate back pain?

Related reading: 5 steps to a pain-free dental career

	To make sure you’re well-informed when it comes to ergonomics, we compiled a list of the top seven ergonomics articles by our ergonomics editor, 

, that we feel all dental professionals should read.

	Click through the slides to see the tips.

	What do many seated dentists have in common with a box? 90-degree angles; of the hips, knees and elbows. Why? At some point in the transition to seated dentistry, it was decided that the perfect position of the seated dentist should be with the body’s major joints at right angles. And it stuck, until recently.

Trending article: The top 5 pediatric trends of 2018

	If you are sitting right now, the probability is high that you are seated in a chair with a flat seat. If so, don’t move your spine. Place one hand on your low back and feel the position of your lumbar spine. Without moving your hand, scoot to the edge of your seat so that your thighs slope downward. Did you feel the position of your lumbar spine change?  If you are like most people, the spine moved from flat to a curved position.

	Trigger points and low back pain in dentistry

	As a dental professional, you have probably already experienced trigger points, whether you know it or not!

More from the author: 6 awkward dental office situations - and how to deal with them

	A trigger point is a group of muscle fibers that are in a constant state of contraction. It feels like a hard knot, and when pressed upon may be painful locally or refer pain to a distant part of the body. Trigger points may be active (painful) or latent (causing stiffness and restricting range of motion). Because they are caused by prolonged muscle contraction, postural asymmetry and mental stress, it is easy to see why trigger points are so common among dental professionals.

	If allowed to persist untreated, some trigger points can cause compression on nerves and contribute to syndromes such as thoracic outlet syndrome or pronator teres syndrome (a carpal tunnel-type pain). Trigger points are often the cause behind “mysterious” pain syndromes that elude Western medicine practitioners.

	From an ergonomic standpoint, your operator stool is the most important chair in the treatment room. Patients come and go, but you are there for the duration of the day, so proper and safe positioning of your body should be paramount. Dental stool models claimed to be "ergonomic" run the gamut from backrest with armrests, to backrest without armrests, to armrests without backrests, to no backrest and no armrests.

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	To add to the conundrum, there is a dearth of dental studies regarding the benefits (or lack thereof) of these two features on the health of the dentist. But what is certain from the literature, is that these features definitely have an impact on your health, so they deserve more in-depth evaluation.

	Neck pain is the most prevalent musculoskeletal complaint among dentists. The interventions are numerous, and it can be a daunting task to figure out exactly where to start.

Related reading: How shoulder pain can cripple your dental career

	Try these five strategies to put yourself on the road to wellness.

	Resolving upper back pain in dental professionals

	Myofascial pain syndrome is a little recognized diagnosis, but one of the most common causes of upper back pain. After ruling out what would seem the least likely (but is actually one of the most common) cause of upper back pain - scalene trigger points - one can turn one’s attention to the more obvious players.

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	These muscles are actually located in the same area as one feels pain: rhomboids, middle trapezius and lower trapezius. Symptoms of trigger points in these muscles include tightness, stiffness and ache in the shoulder blade or interscapular area. Pain is usually worst toward the end of the day. Sleep patterns can be disturbed, and bruxism is common. Of course, one should also rule out the non-musculoskeletal etiologies: gall bladder and pancreatic disease.

	Recent research shows that these “stabilizing” muscles are hard-wired to your sympathetic nervous system, so they respond strongly to mental stress or anticipated stressful activities. When the fight or flight signal is received, they contract in anticipation of the life-threatening fight that (hopefully) never happens. The muscles are left in a contracted state and easily develop painful trigger points.

	8 things dental professionals need to know about exercise

	As I have discussed in previous articles, dental professionals are prone to unique muscle imbalances and require corrective exercise to prevent pain and injury and ensure a long career. Certain exercises that aren’t a problem for the general public can throw dentists into the ‘vicious pain cycle.’ 

Trending article: The medical history mistake every dental provider makes

	The research on exercise is constantly evolving. Let’s take a look at some interesting exercise facts that dentists may want to consider when selecting an exercise program.

	Delivery systems – Is yours delivering pain?

	When one thinks of ergonomics, one often imagines the equipment we wear, hold or sit upon. The equipment that surrounds us can have just as great of an impact as the equipment that is in constant contact with our bodies. Delivery systems impact the operator’s body mechanics and can result in movement dysfunction and shoulder joint or lower-back problems.

Trending article: A day in the life of a dental hygienist

	Each delivery system has its pros and cons and can profoundly impact the operator’s musculoskeletal health and productivity - either positively or negatively. Some are better suited to four-handed operatories, some to hygienist operatories, some work best for taller operators and others facilitate higher productivity. Understanding these differences can help you select the right system for your team.

Aching back? Cramped hands? These tips can help to ensure that you have a long and healthy career.

7 MORE ergonomics tips that can save your career

Aching back? Cramped hands? These tips can help to ensure that you have a long and healthy career.


	Does the mere mention of the name “OSHA” send a shiver down your spine? You’re not alone. OSHA violations can have a detrimental effect on your reputation in the community as well as your bottom line.

 published the penalty amounts that were adjusted for inflation to be effective as of Jan. 2, 2018. They are $12,934 per violation for a serious, other-than-serious, or posting requirements violation,” says Mary A. Borg-Bartlett, president of 

. “If an employer is cited and doesn’t abate, which means notify OSHA of their corrections, then OSHA can issue a penalty of $12,934 per day beyond the abatement date. For a willful or repeated violation, the penalty is $129,336 per violation.”

	OSHA complaints are typically reported by phone or online directly to OSHA and can be made by current employees, former employees, or someone outside of the practice. Once a complaint has been made, it’s OSHA’s responsibility to follow up.

Read more: 10 MAJOR infection control risks

	“We are now seeing employers receiving phone calls from OSHA followed up with a copy of the complaint, which requires the employer to abate, or correct, the complaint and inform OSHA how the complaint was resolved. If the complaint didn’t result in an on-site inspection by OSHA at the onset of the complaint, then an on-site inspection could occur in the future to affirm that the employer made the correction(s) reported to OSHA,” Borg-Bartlett explains.

	Despite your best efforts, complaints may still be reported, 

 and various penalties. For that reason, it’s a good idea to stay up to date on best practices and evaluate the systems and processes within your practice.

	Click through the slides to find out how to avoid an OSHA inspection.
	

	Failing to train your dental staff won’t result in an OSHA inspection itself, but if staff members aren’t aware of the proper way to dispose of sharps or how to properly wear 

, then that could lead to complaints and violations down the road.

	Borg-Bartlett recommends dentists conduct practice-specific new employee safety training immediately upon hire as well as conduct annual training for all employees.

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	“This safety training must be specific to the safety policies and practices in the practice,” she says. “Taking staff to a trade show and having them attend an infection control course can be part of the annual training; however, the specific safety policies developed and implemented should also be reviewed with the staff, including the dentist.”

	Borg-Bartlett notes that it’s crucial for dentists themselves to also attend annual safety training since they are employees of the practice. New dentists hired on to the practice must also receive training.

	“Upon hire, they must be trained on the hazards they will or can encounter in the practice,” she explains. “These hazards may be biological, chemical, electrical and emergency situations. The Bloodborne Pathogens Standard requires that the dentists who are employees of the practice receive infection control training. This can include identification of biological hazards, education on safe practices for preventing exposure to potentially infectious items, sharps handling and disposal, post exposure management, use of personal protective equipment, and an update on transmission of diseases.”

	2. Improperly using personal protective equipment

 is usually the No. 1 reason dental practices receive OSHA inspections and violations, Borg-Bartlett says. According to the United States Department of Labor, the Bloodborne Pathogens Standard prescribes safeguards to protect workers against the health hazards caused by bloodborne pathogens. It address items such as exposure control plans, personal protective equipment, post-exposure follow-up, recordkeeping and more.

	Infection control and properly wearing personal protective equipment play a big role in this.

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	“The citations that we at SafeLink have seen relate to improper use of personal protective equipment,” Borg-Bartlett says. “For instance, whenever it is anticipated that spray or spatter may be generated during patient treatment, the dentist and the staff must wear PPE over their scrubs or street clothes. This PPE must be changed between patients and not re-used until laundered. Many practices now find that a disposable gown works best as it can be disposed of immediately after patient treatment.”

	Staff members must also wear a gown, gloves, safety eyewear and a mask while preparing dirty instruments for sterilization.

	3. Non-compliance with the Hazard Communication Standard

 is another area of concern. Revised in 2012, it requires that the chemical manufacturer, distributor or importer provide Safety Data Sheets (SDSs, formerly MSDSs) for each hazardous chemical to downstream users to communicate information on these hazards.

	“Not that the MSDS is no longer in use, we are seeing citations being issued when an employer is not making the more up-to-date SDS available to its employees,” Borg-Bartlett says.

Related reading: 6 questions about infection control you might be afraid to ask

	According to federal OSHA information regarding standards cited for dental practices, the guidelines for the use of formaldehyde often causes trouble.

	“This standard directs the employer to protect employees from this chemical both through skin contact and inhalation,” Borg-Bartlett explains. “Exposure monitoring is required to ensure that the exposure level to the employees is below the Permissible Exposure Limit (PEL) and that safety controls are in place to protect employees.”

	4. Failing to have sharps safety policies in place

	Although the implementation of the OSHA Bloodborne Pathogens Standard has helped to protect dental healthcare personnel from sharps injuries and blood exposure, the 

Centers for Disease Control and Prevention 

notes that sharps injuries continue to occur in dental practices and pose the risk of bloodborne pathogen transmission to both dental staff and patients.

	Most injuries involve burs, needles and other sharp instruments. To prevent these types of injuries from happening, every dental practice should have policies and procedures in place that address sharps safety.

	“They [the CDC] emphasize the need for dental practices to have good policies and practices in place to address sharps safety, particularly when dental staff are using sharps, during cleanup and during disposal,” Borg-Bartlett says. “Engineering controls are the primary method for reducing these types of exposure incidents. These controls should remove or isolate the hazard and are frequently technology-based. Some examples of this technology would be self-sheathing anesthetic needles, safety scalpels and needleless IV ports.”

	If sharps injuries do occur, it’s the responsibility of the dental practice to document them and identify, evaluate and select devices with engineered safety features. Work practice controls are also important, Borg-Bartlett says.

	“This involves an evaluation of how the worker is performing the task and if changes can be made to improve the safety of performing the task by the worker,” she explains. Examples would be using a one-handed scoop technique for recapping needles. The CDC’s document points out that the handling of needles and syringes during patient treatment can result in injuries to the dentist and to the staff. Some of the injuries they mention can be caused by bending or breaking needles during disposal, unsafely passing a syringe, and using your fingers instead of instruments for tissue retraction or palpation during suturing and administration of anesthesia.”

	The location of sharps containers is also key. The Bloodborne Pathogens Standard indicates that sharps disposal should be at the point of use, so Borg-Bartlett says it’s best to have sharps containers in each treatment room rather than a large central container in the sterilization area.

	“Even when the sharps containers are in treatment rooms, they should be easily accessible,” she adds. “Having them located in a cabinet where the cabinet door must be opened or on a counter behind other equipment or tools that must be moved in order to get to the sharps container is not a safe practice.”

	An often overlooked aspect of the dental practice is having proper emergency equipment on hand. Policies vary from state to state, but Borg-Bartlett says she sees many citations issued to dental practices regarding this type of equipment.

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	“Fire extinguishers must be inspected monthly by the employer and not just annually by an outside company. This is an easy-to-find violation for an OSHA inspector,” she says.

	First aid materials must also be available and inspected frequently to ensure that any medications included in the kit haven’t expired, she adds.

	Now that you know the most common ways to receive an OSHA inspection or violations, what can you do to prevent this from happening?

	“Assign the responsibility of the position of safety coordinator to a staff member who is knowledgeable about worker safety and provide them the time and resources to effectively perform that function,” Borg-Bartlett says. “This individual should understand the OSHA Standards that apply to the practice. Give this individual the authority to enforce the safety practices and be committed to providing a safe and healthy workplace.”

Related reading: How to conduct an infection control risk assessment in your office

	Making sure that written health and safety programs are specific to each dental practice is also key.

	“Buying a ‘canned’ safety program is a start; however, it must be customized to reflect the hazards in your practice and the policies that have been developed and implemented to protect your workers.”

	In addition to training new staff members immediately upon hire, educate them about possible exposure to potentially infectious items. Borg-Bartlett also recommends offering them the Hepatitis B vaccine within 10 days of hire.

	“Document their acceptance or refusal for the vaccine series. Ensure that the practice is paying for the Hepatitis B vaccine and the titer test, which must occur within four to eight weeks after completion of the series,” she says. “If a worker refuses the vaccine because they have already taken it, then ask them to provide you with as much information as they can on when they had it and the results of the titer test. If they can’t provide you with that information, then still have them sign a refusal and make a note that you were unable to confirm their participation in the Hepatitis B vaccine series prior to their employment with your practice.”

OSHA violations can be detrimental to your reputation and your practice’s bottom line. Here’s how to avoid an on-site inspection. 

5 surefire ways to get an OSHA inspection

	Community water fluoridation was a major breakthrough for national oral health when it was first introduced in 1945 in Grand Rapids, Michigan. In fact, the Centers for Disease Control and Prevention deemed it one of the 10 great public health achievements of the 20th century.

	Although many studies have been conducted highlighting the benefits of fluoride in water over the last 70 years, including preventing tooth decay, there isn’t that much recent research on the topic. That’s why researchers affiliated with the University of North Carolina at Chapel Hill School of Dentistry set out to analyze the correlation between the availability of community water fluoridation and dental caries experience in U.S. child and adolescent populations.

	The cross-sectional study took county-level estimates of the percentage of the population served by community water fluoridation from the CDC’s Water Fluoridation Reporting System and merged it with dental examination data from 10 years of National Health and Nutrition Examination Surveys. According to the study, dental caries experience in the primary dentition was calculated for 7,000 children ages 2 to 8 as well as in the permanent dentition, along with filled tooth surfaces for 12,604 children and adolescents ages 6 to 17.

	The researchers discovered that counties in which more than 75 percent of the population had access to community water fluoridation saw a 30 percent reduction in dental caries experience in the primary dentition and a 12 percent reduction in the permanent dentition compared to counties in which less than 75 percent had access to community water fluoridation.

Dr. Howard Pollick, an ADA spokesperson and the director of the dental public health residency program, department of preventive and restorative dental sciences at the School of Dentistry, University of California San Francisco, says this study provides more contemporary evidence of the continued benefit of water fluoridation in the United States.

	“Tooth decay continues to be a problem for a small portion of the population,” Dr. Pollick says. “Typically the poor suffer more than the more affluent in terms of tooth decay, and that’s probably related to diet, eating sugar frequently, as well as maybe not using fluoride toothpaste on a regular basis. Just by virtue of where you live, because there’s fluoride in the water or not, will determine the risk you have for getting cavities.”

	We’re currently living in an era in which most people are using fluoride toothpaste on a daily basis, so is fluoride in the water even still necessary? Dr. Pollick says yes.

	“This study demonstrates that. Having fluoride in the water as well as fluoride toothpaste, you’re getting the maximum benefits in terms of a reduced chance of getting tooth decay, whether that’s tooth decay that causes a small cavity or that causes a large cavity that might need a root canal treatment or extractions and replacement with more expensive therapy,” he says.

	The study focused on children and teens, and for good reason. About 42 percent of children ages 2 to 11 have had dental caries in their primary teeth, according to the National Institute of Dental and Craniofacial Research, while 23 percent of children ages 2 to 11 have untreated dental caries. Parents play a critical role when it comes to preventing dental decay and teaching their children healthy habits. That includes finding a dental home.

	“We want very young children to start using fluoride toothpaste from the time that their first teeth come in, about 6 months of age, and for infants to be seen by a dentist by the time they’re 1 year old,” Dr. Pollick says. “This is important not so much because we’re going to fix the cavities that they may have, but hopefully we’ll provide guidance to the parents on how to prevent getting cavities. If it’s deemed that the child is at high risk of tooth decay, then additional fluoride can be used. It can be applied in the form of a varnish to the teeth and that provides an added benefit to those children that are deemed as high risk of tooth decay.

	“In areas where there’s very little fluoride in the water, where they don’t have fluoridated water either naturally occurring or adjusted, if the child is deemed to be at high risk by a pediatrician or a dentist, then in those low fluoride water areas, a fluoride supplement can be prescribed to be taken on a daily basis to supplement the diet where they’re not getting the fluoride from the water,” he adds. “That’s an additional way of providing the needed fluoride to prevent getting cavities.”

Water Fluoridation and Dental Caries in U.S. Children and Adolescents

Community water fluoridation has been around for 70 years, but not much research has been conducted over the last several decades. A new study provides contemporary evidence on the topic.

Study confirms water fluoridation prevents tooth decay in children and teens

	Dry mouth is a common condition, affecting roughly 30 percent of the population, according to a 2017 study. To treat it, oral care products such as dry mouth lozenges or oral moisturizers are often prescribed.

	But what if these dry mouth products were actually doing more harm than good? That’s the concern of 

, a Washington-based dentist. Dr. Grillo recently 

 targeting seven companies that are making and selling oral moisturizer products that are dangerously acidic and causing erosion of the teeth.

, to be safe, oral moisturizers prescribed to treat dry mouth should contain a pH level of 6.7 or higher. Any product with a pH level below 5.5 is considered dangerous.

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 researchers out of the University of Florida measured dentin tooth erosion when exposed to acidic dry mouth lozenges. The research identified seven oral moisturizers for dry mouth sold in the United States that have a pH level below 5.5 and caused significant amounts of tooth erosion, including:

		CVS Pharmacy™ Dry Mouth Discs (5.3 pH)

	Dr. Grillo’s petition urges these manufacturers to remove their dry mouth products from the market.

	DPR recently spoke with Dr. Grillo to discuss the effect of acidic oral moisturizers on tooth erosion.

Q: How did you become interested in the topic of oral moisturizer acidity and tooth erosion?  

A: This problem is fundamental to what we do for people. Patients routinely complain about dry mouth and ask me if I have suggestions to help them deal with the unpleasant sensation. With about 20 percent of the population dealing with xerostomia and up to 40 percent of the elderly, it's not just an outlying issue. I've routinely recommended oral moisturizers, and as a practice we've worked hard to search out the best options. When I read a recent research article that many of these products actually dramatically lower mouth pH, I was alarmed because it counters what we're trying to accomplish.

Q: What are some of the main health concerns for consumers who may be using highly acidic oral moisturizers?

	A: The greatest frustration to me is that the vast majority of patients have no idea that acidity is a problem to start with. They look to us for help with something that's lowering the quality of their lives, and unknowingly, compromising their oral health. If they're using highly acidic oral moisturizers, they're dramatically increasing the risk of decay and erosion. This often leads to areas that are difficult to restore around crown margins and root surfaces. Tooth loss or expensive treatment becomes a real risk to patients, and it doesn't need to be.

Q: What do you hope to achieve with the petition?

	A: We owe it to our patients to call on manufacturers to provide responsible products. There's no good reason for oral moisturizer formulations to put patients at greater risk. They need to go back to the lab and change the pH of their products to meet acceptable guidelines. As guardians of oral health, if we don't do it, who will? My goal is simple: change it.

Q: What should consumers be on the lookout for when purchasing oral moisturizers?

	A: That's tough because the average consumer doesn't have a good way of knowing what the pH of an oral moisturizer is or why it matters. In the Florida study we refer to, only two of 11 products were non-acidic whereas the other nine lowered pH into a range that promotes erosion and decay. We need to point our patients to safe products until the other manufacturers make corrections.

Q: Should dentists be having broader conversations with patients about acid and tooth erosion? 

	A: Absolutely. Patients are already suffering from dry mouth issues and they don't need to compound the problem when they're looking for relief. It doesn't take long to explain what acid does in the mouth and how they can choose the right products for greater comfort and better health. The two aims don't have to be mutually exclusive. 

The petition targets seven manufacturers of oral care products that are proven to cause tooth erosion.

Dentist creates petition to stop sales of dangerously acidic dry mouth products

It’s no secret that 3D printing is changing the shape of the dental industry. This technology is opening up new possibilities never before imagined for lab technicians and dentists.

 currently on the market faciliate the high-speed printing of a number of prosthetic devices, and many feature a smaller footprint to accommodate labs of all sizes. In addition, more chairside 3D printers are being created, which will be a game-changer for patients and dental pratices’ bottom lines. 

Trending article: What the future holds for digital dentistry

	Interested in applying this technology at your lab or office? We’ve rounded up some of the most advanced options available.

Powered by Figure 4™ technology, NextDent™ 5100 is designed to facilitate high-speed 3D printing for production of dental devices and fixtures.

Dental labs and clinics are said to be able to produce dental services up to four times faster than other available solutions while reducing material waste and capital equipment expenditure.

The printer is compatible with industry-standard, state-of-the-art intraoral scanning and software solutions, delivering more precise results.

The r.Pod® desktop 3D printer is said to be the first thermoplastic filament printer for dental labs, and the only 3D printer optimized for Valplast® partials and appliances.

Featuring dual extrusion technology, r.Pod is engineered to print Valplast partials and appliances, study models, custom impression trays and soft tissue gingiva for implant models.

The printer is designed to be compatible with digital impressions and desktop scanners.

The highly accurate EnvisionTEC Vida 3D printer from Axsys Dental Solutions is said to be the perfect printer for small to mid-sized dental practices.	

The open architecture desktop printer is designed to be extremely versatile, low cost, easy to maintain and user friendly.

Vida is capable of printing dental or orthodontic models, surgical guides, partial frameworks and bite guards.

Axsys Dental Solutions
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The DFAB 3D printer is said to be the first ever true chairside 3D printer for dentists and prosthodontists that streamlines workflow and quickly delivers high-precision, color-matched prosthetics.

The DFAB’s high speed printing can produce Class IIa restorations in one session without the use of external dental labs, and it guarantees a 20-minute building time for a 5-element bridge.

The printer is designed to be easy to use with a guided user interface and ready-to-use cartridges.

EvoDent 3D printers are designed to produce products for more than 10 different dental indications with typical print times of less than one hour.

The combination of DLP printing technology and nearly 20 years of proven 3D printing experience is said to create a highly reliable and versatile 3D printer.

An open material platform gives users the option and flexibility to print with qualified third-party materials.

The Form 2 3D printer brings the power of stereolithography 3D printing to dental professionals and is said to produce cost-efficient, high-quality biocompatible dental appliances.

The printing system is designed to work with open architecture CAD/CAM systems and is ready to produce dental models, surgical guides, splints and retainers.

The Form 2’s speed, precision and compact footprint are said to make it perfect for dental offices and labs.

cara Print 4.0 is a 3D-DLP printer that’s engineered to produce monochrome dental appliances, layer by layer, using a high-quality photopolymer.

Thanks to a user-friendly interface, both beginners and those experienced in CAD/CAM can benefit from the production speed of this 3D printer.

With most indications printing in one hour or less, cara Print 4.0 is said to be the ideal solution for all dental restorations.

Targeted for one-visit dentistry, Planmeca Creo C5 is said to be one of the fastest 3D printers on the dental market, with print speeds of approximately eight to nine minutes for a surgical guide or a dental model and less than 10 minutes for a temporary crown.

The 3D printer allows in-office printing of dental models, surgical guides and temporary prosthetics.

Slated to be available in the third quarter.

With the Objet30 Dental Prime™, lab techs and dentists can implement professional-grade 3D printing on a desktop system.

The 3D printer is designed to allow users to expand a lab’s capabilities with the ability to print crown and bridge models, RPD patterns, diagnostic wax-ups and surgical guides.

Stratasys printers are engineered to provide a faster overall throughput and require less labor, post-processing and handling.

This fast and reliable new 3D printing technology is said to be able to produce a surgical guide in as little as 16 minutes, and it changes materials in less than 30 seconds.

The printer sets the bar in connectivity with certified open systems and multiple applications in one unit.

Slated for full market release in September.

Built using Structo’s proprietary Mask Sterolithography (MSLA) technology, the DentaForm is designed for high throughput, round-the-clock production in large dental labs.

With a large build platform, the system is engineered to be able to print up to 10 models in 30 minutes, a throughput that’s said to be unmatched in the industry for its price category.

DentaForm is designed to meet the demands of any large dental lab with high production value.

The Asiga MAX is said to be the world’s most advanced digital dental 3D printer, offering exceptional productivity in a small footprint.

With 62µm HD print precision, the MAX is optimized for orthodontics, crown and bridge, surgical guides, dental models, custom trays and partial denture frameworks.

The MAX is open to materials from any supplier, and material changeover is designed to be completed in under 30 seconds.

Rounding up some of the most advanced options available.

Roundup: Revolutionizing Dentistry with 3D printing

	Do the residents of your state abide by all the rules when it comes to oral health, or do your neighbors’ teeth and gums need a little TLC? Thanks to a new study conducted by Toothbrush.org, you can find out how your state stacks up.

, an organization dedicated to ensuring oral health equity and advocating for the need of oral health, analyzed data from organizations such as the Centers for Disease Control and Prevention, the American Dental Association, the U.S. Census and others and evaluated each state based on 20 different metrics. The metrics ranged from overall condition of the mouth and teeth to dental-related work absences to the number of adults who visited a dentist in the past year. All metrics were graded on a 100-point scale. Scores were then totaled and the overall rank was determined.

Read more: The top 10 worst states to be a dentist

How does your state stack up against the competition?