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

Kristen Mott

	Oral bacteria has been linked to a wide range of serious medial conditions, including pancreatic cancer, stroke and lung cancer. New research shows that oral bacteria may also be linked to esophageal cancer.

	Esophageal cancer makes up about 1 percent of all cancers diagnosed in the United States. The 

 estimates that about 17,290 new esophageal cancer cases will be diagnosed in 2018.

	While previous research has shown that periodontal disease caused by certain oral bacteria has been linked to several types of cancer, 

, an associate professor in the department of population health and the department of environmental medicine at NYU Langone Health in New York, wanted to investigate the connection between oral microbiota and the risk of esophageal adenocarcinoma (EAC) or esophageal squamous cell carcinoma (ESCC).

, Ahn and her colleagues collected oral wash samples from 122,000 participants in two large health studies: the American Cancer Society Cancer Prevention Study II Nutrition cohort and the National Cancer Institute Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. According to the research, in 10 years of follow-up, 106 participants developed esophageal cancer.

More from the author: The risks and rewards of mail-order braces

	In a prospective case-control study, the researchers extracted DNA and sequenced oral wash samples, which allowed them to compare the oral microbiomes of the esophageal cancer cases and the cancer-free cases. Certain bacteria types were found to be associated with a higher risk of esophageal cancer, such as the Tannerella forsythia bacteria, which was associated with a 21 percent increased risk of EAC. Another periodontal pathogen, Porphyromonas gingivitis, was associated with a higher risk of ESCC.

	However, the researchers also discovered that a few types of oral bacteria were associated with a lower risk of EAC. Bacterial biosynthesis of carotenoids was also associated with protection against esophageal cancer, according to the study. Ahn told 

 that certain bacteria may actually have a protective effect, and future research on the topic is required.

 says additional research is needed to examine whether certain bacteria could play a role in preventing esophageal cancer.

	“The study underscores the importance of taking care of your teeth and gums,” the ADA says in a statement. “We know for sure that good dental hygiene - brushing your teeth twice a day with a fluoride toothpaste, cleaning between your teeth once a day, eating a healthy diet and seeing your dentist regularly - helps reduce the population of gum disease-causing bacterial species in the mouth, among which were the microbes found by the study to be associated with higher rates of esophageal cancer.”

	This isn’t the first time research has shown a link between oral bacteria and esophageal cancer. 

, researchers from the University of Louisville School of Dentistry examined the relationship between a bacterial species that causes gum disease and esophageal cancer. In a study of 130 patients, the researchers discovered that 61 percent of patients with esophageal cancer had the bacteria present.

Centers for Disease Control and Prevention

, 47.2 percent of adults ages 30 and older have some form or periodontal disease. Periodontal disease increases with age, and the condition is more common in men than women. In order to prevent periodontal disease, the 

 recommends regular tooth brushing and flossing, swishing with mouthwash, and consulting with a dental professional or periodontist about your risk factors.

Oral Microbiome Composition Reflects Prospective Risk for Esophageal Cancers

Articles

New research shows that certain oral bacteria that cause periodontal disease may also cause esophageal cancer. 

Study finds link between oral bacteria and increased risk of esophageal cancer

	A handpiece is one of the most important pieces in a dentist’s tool kit. These powerful drills are capable of removing decay, shaping teeth,  cleaning root canals, and extracting fillings or crowns.

	Dentists who are in the market to purchase a new handpiece are in luck. Whether you prefer electric or air-driven, high-speed or low-speed, the latest handpieces feature increased torque and an ergonomic design, leading to more efficient procedures. Many also feature more compact heads and reduced noise levels, allowing for enhanced patient comfort during various procedures. Some even come equipped with customizable settings and fiber optics.

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	The next several pages feature some of the newest and most advanced dental handpieces currently in the market. Take a look, and you may just find the perfect one for your dental practice.

Whether your patient treatment calls for a high-speed handpiece to easily remove a zirconia crown or a low-speed model to delicately scoop out the demineralized dentin of a deep cavity prep, the EA-53 electric handpiece system can do it all. Optimize the most valuable real estate in your practice by integrating this flexible and precise tool right into your A-dec delivery system with either one or two holder positions to cover hygiene, general restorative and endodontic treatments. A-dec’s deluxe touchpad is the control center for the dental team to operate the system. The EA-53 is also available in a tabletop version that you can use independently or integrate into your existing delivery with the detachable touchpad interface.

In procedures making use of electric handpieces, the briefest 12-newton contact between the instrument’s push button and the patient’s inner cheek causes the former to overheat, resulting in possible burn injuries. Equipped with patented COOLTOUCH+™ heat-arresting technology, EVO.15 is reportedly the only contra-angle proven never to exceed human body temperature. After years of research and development, it is engaged to protect both the patient and the clinician during some of this profession’s most frequently performed procedures. Additionally, EVO.15 is said to feature a considerably smaller and lighter shockproof head and premier technological innovations, ranging from a new spray/illumination system to an improved bur-locking system.  

The high-performance EndoSync cordless handpiece from Brasseler USA is said to provide numerous safety features, including Optimized Torque Reverse (OTR) technology, torque slowdown and an Apical Action mode, which gives the user the ability to seamlessly connect to the EndoSync Apex Locator. With six fully programmable settings, a broad speed range of 50-1,000 rpms, auto reverse and torque control, EndoSync reportedly provides the power and versatility required for any case, including re-treatments. The EndoSync is the perfect balance of precision and safety.  

	The 430 Torque is the newest member of the 430 high-speed handpiece family, delivering power and choice. An independent test by The Dental Advisor shows 430 Torque has the highest watts of power of all the handpieces tested: 27 watts. The 430 Torque is available with or without fiber optics. Clinicians can choose from a lubricated version or StarDental’s patented LubeFree version that provides dental practices with substantial cost and time savings.  

Midwest Phoenix™ series handpieces reportedly offer superior cutting performance with diamond-like, carbon-coated ceramic bearings in multi-port heads that provide improved power, reduced friction and noise, unique Dynamic Free Speed Control that maintains bearing life, and a special diamond grip for improved tactile feel. Only Midwest reportedly offers patented Dynamic Speed Control that limits free speed but does not limit power. Tuned air flow in the head manages rotor speed to help protect bearings and limit noise generation, even at higher psi. Choose from Midwest Phoenix™ Pro, for use with an ATC Control System for maximum power; Midwest Phoenix™ ZR, equipped with a larger, powerful head that is ideal for cutting solid zirconia; and Midwest Phoenix™, equipped with a small head and ideal for everyday use.

	AG Neovo Dental has achieved a significant development in dental handpiece design with the Evolve series with Enduro

 Chuck. Designed to meet a higher level of durability and reliability to dental handpieces, the Enduro® Chuck is specially built with a hybrid of stainless steel and tungsten carbide - the hardest composite material on earth. With the Enduro® Chuck as the core, the turbine reportedly has industry-leading durability and uncompromising concentricity, contributing to state-of-the-art smoothness and best noise reduction.  

	E-Statis Advantage Electric motor system with SANAO electric handpieces

The E-Statis Advantage touchscreen is reportedly fast and easy to use with the added benefits of customization of many settings. Clinicians can optimize performance by instantly using the presets to work with the correct RPM for any type of bur or polishing system for the most effective implementation. The ability to reverse the direction of the bur is designed to contribute to faster polishing in hard-to-reach areas. Whether a dentist is using the electric handpiece to quickly cut tooth structure, remove old restorations or refine margins, there are customizable settings to optimize performance. The small, ergonomic shape of the SANAO handpieces and the customizable E-Statis SLM motor with its torque/speed presets are said to allow for optimal speed, visibility, control and ergonomic comfort for the dentist in any restorative situation. All of these attributes are designed to allow a dentist to be more efficient, productive and comfortable.  

The Master 3 line was reportedly upgraded to provide 20 percent more torque in a more durable and modern design. With an updated surface pattern for enhanced grip and a stainless-steel head to prevent dents, the Master 3 is said to maintain its most recognizable feature - a clean head canister cartridge for quick chairside repairs.  Additionally, a non-optic swivel model was developed. In keeping with the look and feel of the Master 3 line, the Master Torque 3 Premium E-Type Lowspeed line has a matching updated surface grip pattern. In addition, the line was upgraded with no lube motors and a 4:1 attachment for disposable prophy angles. The Master 3 and Master Torque 3 motors come with a 1-year warranty.  

The Maxima ELITE Series is said to offer powerful, quiet and high-performance high-speed handpieces that incorporate all the features you would expect in an elite handpiece. Both standard and mini head models have 4-port cooling sprays and operate at under 60 dB while providing 23 W and 19 W of cutting power, respectively, because of the patented power boost system that is incorporated into the handpiece and turbine design. In addition, the Maxima ELITE’s ActiveStop technology puts the breaks on turbines to reduce the suckback effect associated with stop time, which pulls airborne droplets and particles into the head and bearings. All of these features, plus a new ceramic bearing technology that resists the rigors of autoclaving, are incorporated into an all stainless-steel body and forged stainless-steel head that are titanium coated to increase durability and control while resisting corrosion. Maxima ELITE handpieces come with a 2-year warranty.

Patented Prometheus™ Couplers are a line of quick disconnect couplers with self-contained LED fiber optics that fit all your favorite fiber optic handpiece brands. The couplers are engineered to create bright white LED light with no additional power source or fiber optic system needed. They use patented air drive technology to energize the LED. Simply connect the Prometheus Coupler to your favorite fiber optic KaVo, StarDental, NSK Dental or Midwest handpiece for bright fiber optics instantly. Connect to any dental tubing and the Prometheus Coupler will provide brilliant light to your preferred fiber optic handpiece. The Prometheus Couplers also reportedly have complete compatibility with other manufacturers’ couplers.   

The New T75 third-generation Illuminator series LED quick connect handpiece features self-illumination generated in the handpiece connector. The light generator is kept out of the harmful conditions of the high heat and steam of an autoclave. This reportedly results in years of reliability. Additional features are said to include a florentine gripping area for a positive nonslip grip and a high-quality ceramic bearing turbine that runs at a very concentric 400,00 rpm and at a low noise level. Available in T75SAR-3G standard head, T75TAR-3G torque head and T75AR-SUR-3G 45 degree surgical.   

 reportedly offers improved visibility in the working area and optimal patient comfort. Despite its small size, the Tornado

 is said to offer exceptional power output. Like the Tornado turbine, the Tornado

 is equipped with Bien-Air SteadyTorque™ technology. With its 24-watt power output, the TornadoS is reportedly the most powerful turbine with a compact head. The efficient new Bien-Air turbine is engineered to reduce the length of operations, improving the productivity of dental clinics around the world. This exclusive technology is complemented with ceramic ball bearings reportedly capable of handling the highest speeds and heaviest loads, guaranteeing superior durability and resilience. 

Taking a look at some of the most powerful and efficient dental handpieces in the market. 


The power of a handpiece

	It’s no secret that most people desire pearly white, straight teeth. Perhaps it’s our obsession with Hollywood or our irrational need to capture the perfect selfie to post on Instagram. Regardless of the reason, one thing is certain: The demand for cosmetic dentistry is skyrocketing.

	Most adults don’t want their mouths filled with wires and brackets, but unfortunately not everyone has the financial resources to afford inconspicuous clear aligners. That’s where mail-order orthodontic businesses like 

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	SmileDirectClub was founded in 2013 as the first digital brand for straightening consumers’ smiles. The process is broken down into a few simple steps. First, the patient has a 3D image created of his or her teeth either by using an at-home impression kit or stopping by a local SmileShop for a scan. Next, a SmileDirectClub affiliated licensed dental professional reviews the case and determines whether the patient is a candidate for the invisible aligners. If the patient is deemed a candidate, SmileDirectClub sends a preview of what the patient’s new smile will look like and begins production of the invisible aligners. Once the aligners are delivered, the patient is instructed to wear them for a prescribed number of months. Invisible retainers are also available for purchase after treatment is complete.

	The treatment is designed for minor to moderate tooth correction such as spaces between teeth, crowding and rotations. Patients who have missing teeth, implants or wisdom teeth have their cases evaluated to determine if they are a candidate for the treatment, according to the manufacturer’s website.

One of the reasons mail-order aligners like those from SmileDirectClub are so appealing to consumers is the price. SmileDirectClub aligners can be created for a one-time payment of $1,850 or 24 monthly payments totaling $2,170. Compare that to Invisalign, which can range from $3,000 to $8,000, according to the manufacturer.

	But is the low cost worth it? Maybe not, according to several organizations.

, which represents 19,000 orthodontist members, has cautioned consumers from using do-it-yourself orthodontic treatments. According to its website, nearly 13 percent of orthodontists who are members of the AAO are seeing patients who have tried DIY teeth straightening treatments, with some attempts causing irreparable damage.

	“Moving teeth is a medical procedure and needs personal supervision by an orthodontist,” the AAO says on its 

. “Moving teeth without a thorough examination of the overall health of the teeth and gums could result in the permanent loss of teeth, which may result in expensive and lifelong dental problems.”

 also “strongly discourages” the use of DIY orthodontic treatments, according to a 

 passed by the 2017 ADA House of Delegates.

More from the author: Are dentists causing a dealy infection in patients? 

	“Patients are being inundated with direct marketing campaigns encouraging them to initiate and manage their own orthodontic treatment,” says Dr. Craig Ratner, chair of the ADA Council on Dental Practice. “This year’s ADA House of Delegates recognized the need for the ADA, as America’s leading advocate for oral health, to take steps to educate patients about the potential pitfalls of self-managed orthodontic treatment. This new policy supports the importance of dentists being in charge of diagnosing and treating patients to ensure the safe delivery of appropriate care.”

, says he has conducted market research and seen some poor outcomes experienced by SmileDirectClub customers. Take, for instance, Charlene Burnham, a 60-year-old SmileDirectClub customer who told 

 that the aligners she received were too tight, which ended up cutting her gums and exposing part of her tooth near the root. Burnham claims she spent a week trying to speak with a SmileDirectClub dentist on the phone to no avail.

, 205 consumer complaints have been lodged against SmileDirectClub in the last three years. Most of the complaints are about the product itself, while others deal with shipping or billing issues.

	“Although there will be people that SmileDirectClub gets right, there will be many they don’t. What is the acceptable number of patients that are harmed by this method? This will have to be answered by the regulators and marketplace,” LaTrace says.

 on SmileDirectClub’s website, the clear aligners are offered through a network of more than 225 Endorsed Local Providers (ELPs) throughout the country. The network is reportedly comprised of state-licensed, board-certified orthodontists and general dentists who assess each individual case.

	“An individual who is requesting treatment by using SmileDirectClub’s aligners is receiving the same level of care from a treating ELP as an individual visiting a traditional orthodontist or dentist for treatment,” says Jeffrey Sulitzer, DMD, chief clinical office at SmileDirectClub. “The teledentistry platform allows for more convenient access and flexibility for individuals who may not have access to local care.”

	However, most patients don’t visit a dental office or orthodontist during their invisible aligner treatment, which is an area of concern for the 

. The MDA created a resolution stating that “supervision by a licensed dentist is necessary for all phase of orthodontic treatment.”

	From a commercial perspective, LaTrace says, SmileDirectClub is another outside threat to the orthodontic profession.

Read more from the author: Dental care, south of the border

	“Orthodontists have faced stiff competition from general dentists who prescribe orthodontic procedures or aligners, and more recently from the ‘do-it-yourself’ tooth realignment crowd,” he says. “SmileDirect, unlike the teenager who ties their teeth with elastic, does provide a level of screening before producing and supplying the clear aligners to correct a person’s malocclusion. From publicly posted results, it is apparent that at times the end results do not meet the customers’ expectations. In contrast, an orthodontist provides a continuum of care to make the necessary adjustments to assure good patient outcomes.”

	SmileDirectClub, however, stands by its product and treatment process.

	“The medical industry has been here before,” says co-founder Jordan Katzman in a release. “Products like hearing aids, contact lenses and dialysis supplies faced resistance at first too. We are confident in our product as well as our process and independent providers and will not let the opposition keep us from providing more accessible and affordable services.”

While mail-order aligners continue to grow in popularity, several organizations are speaking up about the risks associated with this treatment. 

The risks and rewards of mail-order braces

	American news media is filled with reports on the status of the border with Mexico. Talking heads expound endlessly about the number of Mexican migrants crossing the border into the United States. Debates are had about a wall or  opposition to a border wall. Whether fleeing violence in home countries, just seeking some better life options, or another reason entirely, migrants cross the border - legally or illegally - and the conversation stateside rages on.

	But one topic ripe for debate is discussed much less often: What about the reverse trend?

	Reports have often focused on spring break escapades to Tiajuana, Mexico, or Californians crossing the border for more affordable and easily accessible prescription drugs. But many in the American dental community may be surprised to learn that during the winter months, as many as 7,000 Americans per day are traveling to Los Algodones, Mexico, a small town located on the northeastern tip of Mexicali. Why are so many making this trek?

	Los Algodones, also known as Molar City, is home to more than 600 dentists working in 300 clinics, according to a report from 

. Many of the clinics advertise their affordable costs for dental care and treatment on their websites. According to Molar City’s 

, dental services there are reportedly about 70 to 75 percent less than the cost in the United States and Canada.

More from the author: Are dentists causing a deadly infection in patients? 

	It’s no surprise that cost is one of the major reasons Americans are considering traveling to another country to receive dental care. According to the 

, roughly 114 million Americans have no dental coverage. Medicare doesn’t cover most dental care or dental procedures, leaving about 46.3 million Americans over the age of 65 uninsured. A research brief by the Health Policy Institute and American Dental Association suggested that financial barriers are keeping adults from visiting the dentist, noting that one out of five American adults is unable to afforded needed dental care.

Sani Dental Group, which claims to be the largest dental group in Los Algodones, Mexico, has been providing dental care since 1985. Its three offices see approximately 750 American patients each month, depending on the season.

	“Some Americans just love being treated in our facilities. They say that it’s because it has the same high quality at more affordable prices,” says Dr. Javier Muñiz Pérez.

	Dr. Yasmin Carvajal of Dental Betel in Los Algodones says her office sees about 100 American patients from November to April and about 50 per month the rest of the year. Dr. Carvajal says the cost of dental care is lower in Mexico because all expenses are paid by the patients, rather than being negotiated by insurance companies, and the cost of living in the country is lower than that of America. She adds that education in Mexico is much more affordable, which allows dentists to be able to offer their services at reasonable rates.

	“The cost of insurance and health care in the USA is very high for the average American,” she says. “In Mexico, the medical costs are between 20 to 30 percent of the cost of U.S. health care. The process to claim your benefits is time-consuming and deductibles are high.”

	While the low cost of dental care in Mexico may be attractive to many Americans, the question remains: Is it safe to receive treatment there?

	Up next: Low cost, high risk? Not necessarily...

	Dr. Maria Lopez Howell, DDS, works at a dental practice in Garden Ridge, Texas, close to the U.S-Mexico border. She has family members who work on the Mexican side of the border and has known about Americans traveling to Mexico to receive dental care for most of her life.

	“Even as a child, there were people who would go to south Texas near the border and settle there for the winter to get away from the Midwest, and they would come over the border and have dental work done there. I was in my aunt’s dental office [as a child] and there were Americans there,” says Dr. Howell, who serves as a national spokesperson for the 

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	Dr. Howell says she’s had some of her own patients travel to Mexico to receive dental care. Some have had great experiences while others did not. Doing your homework before you go is key - Dr. Howell recommends asking the practices what sort of qualifications their dentists have as well as seeking out referrals.

	“When it goes right, it can work out well, but if you’re going to another country, find out what your recourse is,” she says. “What happens if you get an infection and you’re back here and your home dentist is then faced with an issue that they weren’t involved with to begin with? How do you get back there? All the money you might’ve saved in going away, now you have to go back. Is there any cost savings at that point?”

	She also cautions people to be on the lookout for travel advisories.

	“If not for disease, it might be for patient safety. I’m not even talking about whether the dental care is safe, it can be the environment or political situation that’s unsafe,” Dr. Howell says.

	Dr. Perez, on the other hand, believes that there is no risk associated with receiving dental or medical care in a different country as long as the procedures are done by a certified doctor and the facility followed every established safety standard.

	“Press and television tend to exaggerate and generalize the facts about security in Mexico,” he says. “Another aspect is that the patient may think that the procedures are done differently or with other materials, but this is not true. Our doctors are always in continuing education and the materials and instruments are the same that an American doctor uses.”

	Dr. Carvajal agrees that Mexico being unsafe is one of the biggest misconceptions about the country. However, she notes that there are both good and bad dentists in Mexico, just as in any country.

	“Each country has its own health department that regulates that any dental office, hospital or medical clinic fulfill all the standards and regulations for disease control and prevention as well as verify that all the medical staff has its licenses and continuing education in order to be certified to be in business,” she says.

	It’s unclear what sort of long-term effect this migration of Americans to Mexico to receive dental care may have on the U.S. While the cost of U.S. health insurance is largely in the hands of the federal government, Dr. Howell says one of the best ways to make dental care more affordable is to prevent needing it in the first place.

More from the author: Can dentists use squid ink to check for gum disease? 

	“I’m not aware of another area of health care where the old adage ‘An ounce of prevention is worth a pound of cure’ is truer than in dentistry,” she says. “You can guide your patients to brush for two minutes twice a day, clean in between their teeth and use a fluoride toothpaste with a seal of approval. Having a balanced and mindful diet is also helpful. I think that’s a really, really good start at reducing health care costs for families.”

Examining the surprising trend of American dental migration to Mexico. 

Dental care, south of the border

	Antibiotics are prescribed by dentists for various treatments and the prevention of infection. And the rate of antibiotic prescribing by dentists seems to be increasing, according to a May 2016 study published in the Journal of the American Dental Association.

	But what happens when, rather than preventing infections, those antibiotics end up causing infections in patients? According to research presented at 

 in San Diego, antibiotics prescribed by dentists may be contributing to a serious and potentially deadly infection.

	According to the study, Clostridium difficile infections (C.diff) are the leading cause of health care-associated diarrhea. Two of the greatest risk factors for C.diff infections are antibiotic use and health care exposure.

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 tracked community-associated C.diff infections in five counties in the state. From 2009 to 2015, 2,176 presumptive community-associated C.diff infection cases were reported to the health department. Of the 1,626 infection cases that were confirmed and interviewed, 926 (57 percent) were prescribed antibiotics and 136 (15 percent) were prescribed antibiotics for dental procedures. The health department also discovered that 46 cases (34 percent) reported being prescribed antibiotics that weren’t documented in their medical records.

	Stacy Holzbauer, DVM, MPH, lead author of the study and career epidemiology field officer for the Minnesota Department of Health, explains that the health department, which is part of the 

, collects data to measure the burden of C.diff infections in the population, characterize different strains associated with the disease and monitor trends in the disease over time.

“In Minnesota, the majority of C. diff infections occur outside the hospital and are driven by antibiotic use in community or outpatient settings,” Holzbauer says. “In addition to reviewing outpatient and hospital medical records of cases reported to the health department, we interview patients with C. diff who were not hospitalized or had an overnight stay in a nursing home prior to their infection (community-associated C. diff cases) to identify potential risks for developing C. diff infection, including identifying antibiotics received outside of routine healthcare settings.

	“During routine collection of surveillance data of community-associated C. diff cases, we noticed that patients were consistently reporting in interviews taking antibiotics for dental reasons,” she continues. “In our summary of six years of surveillance data, upper respiratory infections were the most common indication for antibiotics in CA-CDI cases, followed by dental procedures.”

	The Minnesota Department of Health concluded that dental antibiotic prescribing rates are likely underestimated and recommended that stewardship programs should address dental prescribing and alert dentists to C.diff infections subsequent to antibiotics prescribed for dental procedures.

	This isn’t the first time antibiotics have been put under a microscope. In 2015, 

 looked for a solution to deal with antibiotic resistance when treating dental disease. They discovered that a material called graphene oxide can help to eliminate antibiotic-resistant bacteria in the mouth. They concluded that the material could have practical applications in dental care.

	Holzbauer says that dentists aren’t always aware of the complications that develop from antibiotic use, and that better communication is needed between patients, dentists and medical providers.

More from the author: Can dentists use squid ink to check for gum disease?

	“Because our knowledge of best antibiotic use practices continues to evolve, dentists should routinely review and incorporate available guidelines into their daily clinical practice and seek continuing education on proper treatment and management of oral infections,” she says. “Guidelines from the ADA, the American Academy of Pediatric Dentistry and the American Association of Endodontists exist to help dentists make informed decisions on antibiotic prescribing.

	“Dentists have often been overlooked as major partners in programs that promote appropriate antibiotic use, and it is critical dentists are included in efforts to improve antibiotic prescribing,” Holzbauer continues. “All prescribers, including dentists, should examine prescribing behaviors for appropriateness.”

Antibiotic Prescribing for Dental Procedures in Community-Associated Clostridium difficile cases, Minnesota, 2009–2015

New research shows that antibiotics prescribed by dentists may be contributing to a potentially deadly infection. 

Are dentists causing a deadly infection in patients?

	Dental lab technicians pride themselves on skillfully fabricating crowns, bridges, dentures, and other fixed or removable appliances. Precision and accuracy are key when it comes to their work.

However, when it comes to Halloween, the opposite rings true. The more distorted and deformed the teeth, the better!

Related reading: The top 10 dental-themed Halloween costumes

	We’ve rounded up some of the best denture decorations for Halloween. Whether you’re looking for some grisly veneers to complete your costume or you need some inspiration for when it comes time to carve jack-o’-lanterns, we think you’ll enjoy these spooky options.

	Click through the slides to check out some of the best denture Halloween decorations.

	Vampires are a classic Halloween monster, and your vampire costume won’t be complete without a pair of their signature fangs. Sink your teeth into these veneer fangs to transform into a bloodsucker.

	Why settle for a classic jack-o’-lantern when you can take things up a notch? These glow-in-the-dark pumpkin teeth will give your pumpkin a unique - and ominous - smile.

	Pop in these werewolf fangs and you’ll soon be howling at the full moon! These veneers are crafted to mimic gnarly werewolf teeth.

	If you’re looking for a way to create a sinister jack-o’-lantern, then this pumpkin is for you. Carve out an evil looing smile and place your jack-o’-lantern on your front porch to give your trick-or-treaters a fright.

	“It” is one of the most popular movies this fall season, and like it or not, there are sure to be plenty of people dressed up as evil clowns this Halloween. (Just please don’t follow any of them down a sewer!) Join in on the fun with these creepy Pennywise veneers.

	No trick-or-treaters will miss your house with this set of chompers sitting on your front steps!

	Who said only humans can be vampires? Bring your pumpkins to life with some vampire dentures.

	From the “Night of the Living Dead” to “The Walking Dead,” zombies have been a part of pop culture for decades. Pop in these decaying zombie veneers to turn yourself into one of the undead. Just don’t eat anyone alive!
	
	Available at 

	Apparently not all pumpkins are blessed with straight teeth! Give your jack-o’-lantern a goofy smile with these plastic buck teeth.

	Who said pumpkin teeth only had to be white? Opt for some silver or gold fangs to create a futuristic look for your jack-o’-lantern.

From razor sharp vampire fangs to buck tooth jack-o'-lanterns, these denture decorations will get you in the Halloween spirit. 

10 denture decorations for Halloween

10 Denture Decorations for Halloween

	Halloween is the perfect opportunity to dress up and let your imagination run wild. What better way to show off your passion for your profession than with a dental-themed costume?

	Have you always wanted to dress up as a giant tooth? Do you want to relive your childhood by dressing up as the tooth fairy? Or what about something more sinister like a killer dentist on the loose?  

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	Whether you prefer your costume to be humorous or scary, you’re sure to appreciate this year’s top options.

	Click through the slides to check out the best dental-themed costumes.

	The tooth fairy is one of the most popular childhood legends. What does she do with all of those baby teeth she collects from underneath children's pillows? Nobody knows! Regardless, you can bring some fairy magic to your office or Halloween party with this classic costume. 

	Hygienists are constantly reminding their patients to brush their teeth at least twice a day. You can really hammer home the point by showing up in this costume!

	"Fishy? Fishy! Wake up! WAKE UP!! Why are you sleeping?!" Who can forget this sweet yet terrifying character from “Finding Nemo”? Dress up as Darla and cross your fingers that her twin never shows up in your dental chair!

	Hygienists are used to dealing with scary things - blood and saliva, bad breath and irritable patients, just to name a few. If you're immune to being scared, or you just prefer a low-key costume when it comes to Halloween, opt for a humorous T-shirt like this one instead.

	Are you a die-hard fan of a certain brand of toothpaste? Do you love to craft? If that sounds like you, then get your creative juices flowing and try your hand at making a DIY costume resembling your favorite tube of toothpaste.

	Oh, floss. Loved by hygienists, yet hated by so many patients. Maybe dressing up as dental floss will finally motivate your patients to clean in between their teeth? Here's to wishful thinking!

	Every hygienist has most likely heard these six words from a patient, and each one knows when that patient is lying! Spook your friends, or your trick-or-treaters, with this bloody good costume.

	Most hygienists enjoy working on teeth, but if you want to take your passion up a notch, consider dressing up as a sparkling giant tooth this Halloween. Just be sure to stay away from any tooth fairies!

	Many patients have a fear of the dentist. Dressing up as a crazed killer dentist probably won't help any of them overcome that fear, but hey, it'll make for a great Halloween costume!

	Dirty mouth? Clean it up with Orbit White - and this costume. If you’re in need of a couples’ costume, this is a cute and simple DIY option.

From spooky to funny, there are plenty of costumes to choose from this fall season.


The top 10 dental-themed Halloween costumes

	Using a periodontal probe is the most common way for dentists to measure a patient’s pocket depth and check for gum disease. However, using a probe can often be invasive and sometimes uncomfortable for the patient. So, what if dentists were able to use a different method?

	A team of researchers at the University of California San Diego say they have developed a new imaging method to examine the entire pocket depth around a patient’s teeth.

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	“Using the periodontal probe is like examining a dark room with just a flashlight and you can only see one area at a time,” says Jesse Jokerst, a nanoengineering professor at UC San Diego and senior author of the study, 

. “With our method, it’s like flipping on all the light switches so you can see the entire room all at once.”

, the researchers used photoacoustic ultrasound for high-spatial resolution imaging of probing depths. The ultrasound involved shining a light signal onto a sample, which heated up and expanded, creating an acoustic signal that the researchers could analyze. Specific contrast from dental pockets was achieved using food-grade squid ink mixed with water and cornstarch.

	In the experiment, 39 porcine teeth, 12 of which featured artificially deeper pockets, were treated with the squid ink solution. Probing depths were then measured with novel photoacoustic imaging and a Williams periodontal probe.

	The researchers explain that squid ink contains melanin nanoparticles, which absorb light. During the oral rinse with the squid ink solution, the nanoparticles became trapped in the pockets between the teeth and the gums. When the researchers shined a laser light onto the area, the squid ink heated up and swelled, creating pressure differences in the gum pockets that could then be detected using an ultrasound.

	While the results of the squid ink solution were similar to those taken using a periodontal probe, the team concluded that there were statistically significant differences between the two measurement approaches for distal, lingual and buccal sites. The new approach offered 0.01-mm precision and could cover the entire pocket, compared with the probe-based approach that’s limited to just a few sites.

	“This report is the first to use photoacoustic imaging for probing depth measurements with potential implications to the dental field, including tools for automated dental examinations or noninvasive examinations,” the researchers state.

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	The team hopes to soon test their method in humans as well as work to minimize the taste of the squid ink solution for patients.

Photoacoustic Imaging for Non-Invasive Periodontal Probing Death Measurements

	To learn more about the researchers’ method, check out the video below.
	 

A team led by engineers has developed a more comprehensive way to detect gum disease.

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	Nearly half of U.S. adults ages 30 and older suffer from periodontitis, according to a study by the Centers for Disease Control and Prevention published in the Journal of Periodontology in 2015. While less severe cases can be treated with scaling and root planing, advanced cases require surgical treatment.

Many surgical treatments are costly and invasive, resulting in post-operative discomfort and additional follow-up appointments. However, patients now have another option.

	The U.S. Food and Drug Administration recently approved the use of the LANAP

 protocol to treat gum disease by regenerating bone and tissue. The LANAP protocol is said to be the only laser-based gum disease treatment with the proven ability to regenerate alveolar bone, periodontal ligament and cementum lost to disease. By using the 

, an optimized free-running ND:YAG laser from 

, clinicians are able to target the source of the inflammation without hurting or removing any healthy gum tissue.

, co-founder of Millennium Dental Technologies and president and chairman of the board. “It’s no cut, no sew. There are no sutures, no cutting of the gums. There’s no gum recession involved because we remove no gum tissue. That’s a huge positive for patients to not have to cut gum tissue away.”

	Dr. Gregg says the LANAP protocol requires fewer appointments, which appeals to patients who are hesitant to take off time from work.

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	“Patients have three visits with LANAP versus 10 with conventional surgery. We do half of the mouth during the first visit, a week later we do the other half and then a post-op. Then it’s just routine maintenance,” he says.

	“Conventional treatment is usually four separate appointments of scaling and root planing and a post-op visit, then four separate appointments for surgery and a post-op. It’s a huge imposition to go through that. That’s one of the reasons patients don’t follow through.”

	One of the key benefits of the LANAP protocol, Dr. Gregg notes, is that patients who receive treatment aren’t prescribed any opioids.

	“We have a protocol and from the beginning the protocol stipulated anti-inflammatories only, antibiotics only, that was it. To this day, we use Motrin for anti-inflammatory purposes. We don’t have a recommended regimen for opioids at all. The patients don’t need it because they’re not in any pain,” he says.

	Almost anyone is eligible for treatment, Dr. Gregg says, including patients who are suffering from the most advanced stages of gum disease. Recovery time is a few hours compared to many days or even weeks of recovery with conventional surgery, he notes. Dentists who are interested in offering the LANAP protocol at their practices receive comprehensive, hands-on training from world-renowned periodontists and experts in the field.

	“There are all of these associated consequences of gum disease,” Dr. Gregg says. “It seems like I read something about it every week. It affects the heart, it causes strokes, diabetes, cancer, Alzheimer’s. I just read this week that it inhibits conception in women. It seems like there’s nothing it doesn’t affect. There’s no excuse for a patient not to seek out this treatment.”

	Dr. Gregg says being able to treat patients in this manner is often a life-changing experience.

	“It’s profoundly satisfying and rewarding as a professional – and everybody wins,” he says. “It costs less for the patient, it’s a new revenue stream for GPs, and it’s a big revenue boost for periodontists because we only get about 30 percent treatment acceptance and this jumps it up to 90 percent. … We can treat the most severe, advanced cases of the disease that not even I would have dared to treat conventionally.”

How the LANAP protocol aids in treating gum disease and reducing patients’ risk for developing other harmful diseases. 
