The Future of Dentistry by LuLu Stavinoha

North Texas

Dentistry

special issue

a business and lifestyle magazine for north texas dentists

Shaping Smiles Science vs. the Tooth Fairy SPOTLIGHT The Future of Mission Dentistry

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from the publisher

North Texas

Dentistry Publisher | LuLu Stavinoha Photographer | Ray Bryant, Bryant Studios Contributing Writers | Tina Cauller, Marc Fowler, Sloan Hildebrand, DDS Although every effort is made to ensure the accuracy of editorial materials published in North Texas Dentistry, the publisher cannot be held responsible for opinions expressed or facts supplied by its contributing authors. Copyright 2011. All rights reserved. Reproduction in part or in whole without written permission is prohibited. Advertise in North Texas Dentistry For more information on advertising in North Texas Dentistry, call LuLu Stavinoha at (214) 629-7110 or email: lulu@northtexasdentistry.com. Send press releases and all other information related to this publication to: North Texas Dentistry P.O. Box 12623 Dallas, Texas 75225

What do you think the future of dentistry will hold? I believe this is a very exciting time to be a part of the field of dentistry. New research and technologies are changing the way dentists relate to and treat their patients. With the use of soothing spa treatments and procedures that can be performed without injections, maybe someday soon people will no longer “dread” the trip to the dentist. Dentistry has strived to address the busy lives of patients. With new technology you can get a crown in one appointment and even an implant. Implant procedures continue to be improved and are becoming the norm in many dental treatment plans. Digital dentistry has changed the process of taking impressions and milling crowns. New systemic research is leading the way to many intriguing findings. The harvesting of stem cells found in the pulp of teeth is being explored as an effective treatment in some diseases. Some people believe that in the not too distant future, scientists will be capable of growing a tooth in the laboratory from stem cells. Genetic testing of saliva is also being used to evaluate patients and improve their treatment. Continued research endorses the connection between a healthy mouth and a healthy body. As those in the practice of dentistry know, the mouth mirrors the health of the rest of the body.

Another look at the future of dentistry is a bit overwhelming, the underserved population. Our look at Mission Dentistry is very heartwarming and informative. Help is needed in our own backyard as well as in the four corners of the world. Funding cuts to dental health programs have been staggering and are not likely to improve in the near future. Take a look and consider what contributions you can make to brighten this population’s future. The Future of Dentistry has been inspired by doctors, businesses and products who are on the cutting edge of many of these topics. These leaders have incorporated the latest research and technology to improve the practice of dentistry. Through a series of Q&A’s and Custom Profiles you will find more insight into The Future of Dentistry. I hope you enjoy this Special Issue of North Texas Dentistry! It has been a pleasure working with the team that has made this issue go from an idea to a publication! Take care and keep smiling!

LuLu Stavinoha, RDH Publisher lulu@northtexasdentistry.com (214) 629-7110

www.northtexasdentistry.com

NORTH TEXAS DENTISTRY

The Future of Dentistry

PROFILES 10

DR. STEPHEN BASS & DR. ELLEN HALL

SEDATION RESOURCE Keeping Sedation Simple

Dental Implant & Periodontal Partners

12 DR. DENNIS M. ABBOTT

Dental Oncology Specialists of North Texas

DR. DOUGLAS DINGWERTH & DR. MAXWELL FINN

Oral Surgery Associates of North Texas

17 STEVE BILT

CEO, Smile Brands, Inc.

DR. EDUARDO TANUR & DR. RUBEN OVADIA Periodontal Associates

20 STEVEN LUGER

Beaird Harris Wealth Management, Inc.

DR. J. HADLEY HALL Co-Developer, SockIt!

DR. HAROON ISMAILI

24 25

BLAKE EATON

Founder, 3i Outsourcing Solutions, Inc.

31 4 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com

Park Forest Oral & Maxillofacial Surgery

North Texas

special issue

Dentistry 13

FEATURES 6

EMERGING TECHNOLOGIES

in DENTISTRY ENHANCE PATIENT CARE A look at new technologies and techniques to improve the practice of dentistry

THE FUTURE of MISSION DENTISTRY

THE FUTURE of DENTAL MARKETING

27 28

in UNDERSERVED COMMUNITIES Examining portable equipment options and volunteer opportunities at home and around the world

A properly implemented online marketing campaign is the most effective way to reach potential new patients

THE ROLE of SALIVARY DIAGNOSTICS

in TODAYâ&#x20AC;&#x2122;S PRACTICE Salivary diagnostics presents a new scientific tools that affords dental practices the opportunity to provide lab-based data in educating patients and dental professionals

SCIENCE vs THE TOOTH FAIRY Exciting new promise in baby teeth

27 SHAPING SMILES

Making dentistry digital with CAD/CAM

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EMERGING TECHNOLOGIES IN DENTISTRY ENHANCE PATIENT CARE At the start of the 20th century, around the time when Texas A&M Health Science Center Baylor College of Dentistry in Dallas began as State Dental College, most Americans expected to be toothless by age 45, and unfortunately they were. Today people are living longer and are keeping their natural teeth, thanks to advancements in dental equipment, materials and procedures that are redefining oral health and dentistry. These advancements are helping transform what was once the dreaded visit to the dentist into a more comfortable, educational and stress-free experience. As the new technologies replace or enhance traditional practices, dental students expect to learn about these emerging trends and master them. In turn, patients will benefit from more efficient and effective delivery of oral health care.

Quick Crowns In some offices, gone are the days of long waits to get dental crowns. The traditional process of creating a crown means forming a mould of the patient’s tooth and shipping it off to a lab that produces the crown and sends it back to the dental office, a process that can take a few weeks. With the newest technology, dentists can use a wand with a laser sensor to get a 3D digital image of the patient’s teeth and mark the spot for crown. The images can be manipulated to get the exact fit for crown placement, and crowns can be manufactured within about 20 minutes. This eliminates the period of wearing temporary crowns, which can be susceptible to fracture and can come off the teeth.

Implant Dentistry In recent years, implant dentistry has advanced exponentially, making it by far the fastest-growing segment in dentistry. Today’s implants are far more predictable in the rate of success for placement and functionality. Dentists have discovered that implant technology works well in a broader range of dental areas such as orthodontics and prosthetic care for patients who have lost facial structure due to trauma or cancer. Leading a national effort by dental schools to prepare their graduates for the 6 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com

increased demands in this area, HSC-Baylor College of Dentistry has developed a comprehensive program for pre-doctoral students to gain experience with dental implants. More specifically, we are seeing a surge in mini implants, which are relatively simple to place and cost less than traditional implants. These implants are smaller in diameter than traditional implants and are designed for patients with higher bone density. Unlike standard implants, mini implants can be placed immediately. This means that in many cases, the patient can walk out of the office on the day of surgery with a lower denture which is not only stable, but can be used for chewing immediately. Mini implants often can be placed in the lower jaw without an incision in the gums.

Digital X-rays Digital radiographs (x-rays) have grown in popularity in dental schools as well as private dental offices and clinics. Although digital x-rays look similar to film x-rays, there’s no film developing process and dentists are able to optimize digital images to make better diagnoses. During the last five years, the number of dentists using digital x-rays has increased to the point that many patients are accustomed to seeing a computer monitor next to the dental chair. The technology has become so sophisticated that by using cone beam radiographs, dentists can get a three-dimensional image of the patient’s mouth that outlines the nerves and blood vessels and can even produce a surgical guide for placing implants. For patients who are unable to visit the dentist’s office, new portable digital x-ray units allow dentists to more effectively treat patients in nursing homes, hospital rooms or other settings where patients may have difficulty with mobility.

Healthy Mouth, Healthy Body As dentists, we know the mouth is the window to the body and it speaks volumes about the overall well being of patients.

Researchers continue to look at the association between cavities, periodontal (gum) disease and heart disease. According to the American Academy of Periodontology, people with periodontal disease are twice as likely to suffer from coronary artery disease. The American Heart Association also concludes that poor oral health could increase your chances of developing heart disease. Other conditions that are related to poor oral health and poor oral hygiene are stroke, preterm and low birth weight babies. There also are some diseases that are associated with an increased risk of infections. Diabetes, for one, increases the risks of gingival and periodontal inflammation and infections. Or your dentist may tell you that osteoporosis, a disease that causes the bones to become less dense over time as the body loses calcium, could be at the root of tooth loss.

Access to Care Although Americans in general are experiencing better oral health care, some populations, including the poor, minorities, institutionalized, elderly and other groups do not have adequate access to dental care. As the largest provider of oral health care in North Texas, we are well aware of the need for more access to care. Last year, the college received more than 96,000 patient visits, and more than 170,000 people were served through our community-based care, screening and education programs. With more resources, we could have served tens of thousands more. One way we are addressing the access to care issue is through our Bridge to Dentistry dental pipeline programs, which seek to introduce the dental profession to young people from disadvantaged backgrounds and/or underserved communities. Research has shown that many of these students who choose to pursue dentistry as a profession will incorporate service to the underserved as practicing dentists.

another method of strengthening patients’ teeth. Patients using fluoridebased toothpaste continue to receive the benefits of this composite filling as use of fluoride toothpaste will recharge the ionomer. However, with all the new advancements in dentistry, some things never change — dental professionals still focus on prevention as key to maintaining a healthy mouth. Our message of practicing good daily oral hygiene with toothbrushing and flossing, eating a proper diet and seeing your dentist on a regular basis, still rings true. n Founded in 1905, Baylor College of Dentistry in Dallas is a college of the Texas A&M Health Science Center. HSC-BCD is a nationally recognized center for oral health sciences education, research, specialized patient care and continuing dental education. The HSC serves the state as a distributed, statewide health science center that is present in communities throughout Texas.

Improved Preventative Therapies Although not a new technique, fluoride varnish has improved as a caries (cavity) prevention therapy. It may be applied to the enamel, dentin or surface layer of the tooth root to remineralize the tooth, treat hypersensitivity and make teeth more decay resistant. The new varnishes also have better flavor, an added bonus for the patient. The use of glass ionomers — a composite-type filling material that continually releases fluoride — is www.northtexasdentistry.com

NORTH TEXAS DENTISTRY

Dental Oncology Professionals of North Texas (972) 226-6947 www.dopnt.com

Photo by: Susan Coleman, True Blessings Photography

Dr. Dennis M. Abbott CURRENT ROLE Founder and CEO, Dental Oncology Professionals of North Texas www.dopnt.com Private Practice www.abbottdds.com EDUCATION AND TRAINING BA, Biology - Rice University, Houston, TX, 1990 DDS - Baylor College of Dentistry, Dallas, TX, 1994 Postdoctoral studies in Oral Biology and Oral Medicine, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, 1994-1997 PROFESSIONAL AFFILIATIONS Member, American Dental Association Member, Texas Dental Association Member, Dallas County Dental Society Member, American Academy of Oral Medicine Member (pending), Oral Cancer Foundation

Dr. Dennis M. Abbott Dental Oncology Professionals of North Texas

Q &

8 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com

What do you think is the most surprising development on the horizon in the dental field?

Dr. Abbott: Attention to overall wellness and the inclusion of oral concerns in the concept of total health will increase in the next decade. From a more prominent role in the care of cancer and transplant patients to an emphasis on oral health for patients concerned with an overall healthy lifestyle, aspects of dentistry will blend with medicine, nutrition, and fitness in an increased focus on oral healthcare. I believe that within the future of dentistry lies a place where the marked delineation between dentistry and medicine is more blended into oral medicine; where the focus is on the removal of harmful bacteria, be it from hard or soft tissue, and the systemic benefits are realized by the patient. As advances in bioengineering, gene therapy, and nano-technology are applied to the realm of dentistry, tomorrow's dentist will practice in a world with new materials, new drugs and new procedures.

What is the first thing that needs to happen to improve dental care in America?

Dr. Abbott: Unfortunately, dental care is often dictated by the patient's ability or inability to pay for services. Too many times, a patient will delay necessary treatment because insurance will not cover the expense or the yearly maximum has already been met. Although I don’t have the solution to the problem, until patients can pay for necessary treatments and not be limited by insurance companies willingness to pay claims, necessary treatments will go unrendered.

What new development in dentistry excites you the most for it's potential effect on patient care and why?

Dr. Abbott: Dental oncology is one of the most exciting area of dentistry that I see on the horizon. Dentists are in a unique position to care for the variety of oral health needs of patients battling all kinds of cancer. Modern treatments for cancer such as chemotherapy and radiation therapy can be detrimental to the oral health of the patient, often increasing the risk of pain and infection. Severe mucositis and xerostomia can plague patients, reducing their quality of life and compromising planned cancer treatments at a time when continued care is essential. Dentists who enjoy complex treatment planning and caring for medically compromised patients can be a valuable member of the patient's oncology care team while dentists focused on prosthodontics can restore oral maxillofacial defects that are often realized in patients with head and neck cancers.

What do you think will be the biggest change in dentistry in the next 10 years?

Dr. Abbott: I hope the next ten years of dentistry see an increased emphasis placed on the, as of yet, underserved population of patients battling cancer. So much of medicine is focused not only on cancer treatments but also cancer research and long-term care for cancer survivors. We, as dentists, have so much that we can do to eliminate pain, reduce the risk of infection and improve the quality of life for these patients, that I hope the next ten years – and ten years beyond that – see an increase in the number of dental professionals dedicated to caring for the unique dental and oral health needs of individuals battling cancer.

Why are you so passionate about dentistry?

Dr. Abbott: I truly believe that we, as dentists, help people. Although a dental office is the last place most patients want to be, I believe we are part of a noble profession that cares about the well-being of our patients and does everything we can to improve their lives. Knowing that what I do makes a difference in the lives of the people I treat makes me still passionate about dentistry.

Do you have a personal motto that you live by?

What or who inspired you to pursue a career in dentistry?

Dr. Abbott: “Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles, and let us run with perseverance the race marked out for us.” – Hebrews 12:1

Dr. Abbott: Three classes I took at Rice as an undergraduate inspired me to pursue dentistry: microbiology, immunology, and a course on cancer.

What aspect of modern clinical care, in your opinion, has made the greatest difference in the lives of the most people? Dr. Abbott: Hands down...local anesthetics!

In general, do you think patients today are better informed about dentistry that in earlier times and why or why not? Dr. Abbott: Yes... and no. There is no doubt that patients have more access to more information that ever before. Unfortunately, the information that they get as “Internet-trained dentists” is not always correct. I sometimes find myself spending more time explaining “why not” than “why”. But that, too, is part of my job.

What message about dental health do you most wish to communicate to your patients?

Dr. Abbott: Dental plaque and calculus are comprised of bacteria. It is not OK to walk around with 20 years of deposits on the teeth, even if it doesn't hurt. Inattention to dental health is a compromise to your systemic health.

Q: Q:

What is the key to being successful? Dr. Abbott: Dream big. Work hard.

What motivates you each day? Dr. Abbott: My patients depend on me. My staff supports me. My sons inspire me. My wife loves me. This gets me through the day.

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NORTH TEXAS DENTISTRY

larger profit for my company,” explains Rose. “My staff is there to ensure that every customer is cared for. Whether it is a large purchase or a simple walk through the initial stages of sedation set-up.”

Sedation Resource Is Keeping Sedation Simple Photo Courtesy of Solis Surgery Arts Center

www.advancedanesthesia.org

Sedation Resource brings a fresh and innovative approach to the sedation market. With headquarters in East Texas, Sedation Resource provides superior service to its customers and seeks to foster an environment of integrity and education by participating in sedation courses across the nation. Collaborating with the ADSA, AAPD, AAOMS, ADA and others, Sedation Resource has built relationships with some of the top minds in the industry in order to stay current on advancements within dentistry. “Our goal is to focus on the importance of education over salesmanship, which isn’t always easy for a small, family owned company” explains founder, Rose Dodson, “We believe if we remain honest and ethical, helping our customers advance their knowledge of necessary products, fiscal responsibilities will take care of themselves.” State regulations vary for sedation dentistry. In the spirit of “education over salesmanship,” Sedation Resource staff members are continually updated on guidelines, and work hands-on with products and equipment to ensure that every customer receives professional service, along with the most effective and relevant products for their state requirements and office needs. Depending on the size of the practice, or a particular situation, it may not be necessary for a dentist to buy a certain product. “I’m not going to sell one product over another because it will produce a

Sedation Resource 10 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com

In 2003, the inception of Sedation Resource came from the frustration of doctors not knowing where to find products that were being implemented into state regulations for certain monitoring and emergency equipment. As an independent sales representative for Welch Allyn monitors and AEDs, part of Rose’s job was to attend Continuing Education courses to generate sales and leads. It became apparent that a single source was needed to provide these items that were not readily available. Starting as a few products to simply help, Sedation Resource has developed a company culture of helping by assisting CE courses in various ways, and providing flexible jobs in the local community.

One of the most successful products that Sedation Resource distributes is the Sedation Stethoscope. After explaining the culture of Sedation Resource and their desire to help the sedation community to Dr. Mort Rosenberg at a sedation course, Dr. Rosenberg described the need for a precordial stethoscope that could be operated wirelessly. Over the next couple of years, Rose, and her husband, Fred, developed this item and in 2007 debuted their first amplified precordial stethoscope with Bluetooth – the Sedation Stethoscope. This piece of equipment has become an essential monitoring device in dental practices around the globe and an invaluable tool in teaching institutions across the nation. “We’re excited to use Bluetooth to allow the clinician freedom from the tether associated with the traditional precordial. It brings dentistry back to the foundational principles of real time monitoring, while allowing the convenience to move around the room,” explains Dr. Robert Bosack (www.dentalanesthesiaonline.com). Sedation Resource is continually expanding its knowledge base and acquiring more experience in order to assist dental professionals, students and residents in any way possible. Whether it is a specific piece of equipment or a crash course on the latest state regulations, Sedation Resource strives to provide everything needed with genuine customer service and integrity. It doesn’t take many words for Dr. Ken Reed, cocourse director with Dr. Stanley Malamed (www.learnivsedation.com), to sum up Sedation Resource, “They simply have the supplies and equipment that dentists doing sedation need. The prices are fair and service is outstanding.”

How is Sedation Resource contributing to the future of dentistry?

As the demand for technology increases, Sedation Resource is constantly updating its product line in an effort to stay current with the market trends and offerings. The development of a Bluetooth® wireless precordial stethoscope is one of the ways Sedation Resource is encouraging progress in the sedation dentistry market. Regardless of technology, the doctor is still the most important monitor in the room and the type of equipment chosen should extend his or her senses. The Sedation Stethoscope by Sedation Resource allows the doctor to move about freely and still have early warning of potential airway difficulties.

What is the Sedation Stethoscope?

The Sedation Stethoscope is an amplified Bluetooth® wireless stethoscope used to monitor ventilation. The Piezo version of the Sedation Stethoscope has the microphone built into the chest piece, which reduces ambient noise and produces diagnostic quality sound. With the Sedation Stethoscope Classic, the microphone is built into the line, which allows the ability to interchange various sizes of Wenger chest pieces or use an esophageal probe. With either type of the Sedation Stethoscope, you can obtain the mobility you want with the continuous monitoring you need.

How is the Sedation Stethoscope different than a traditional precordial/pretracheal stethoscope?

The Sedation Stethoscope provides amplified auscultation with the mobility of a wireless headset or speaker. Bluetooth® technology removes the tether previously associated with a traditional precordial stethoscope. The range of sound is approximately 30 feet which allows the clinician to move about the procedure room while continuously monitoring the patient. Foundational monitoring of ventilation is listening to breath sounds. Bluetooth® technology and the amplification of the Sedation Stethoscope is allowing doctors to return to the standard principal of listening to the airway for those subtle clues that tell when a patient is about to obstruct, enabling early intervention and prevention of respiratory distress.

How is the Sedation Stethoscope advancing hands on education?

When listening to your patients breathing, it is not necessary to watch a waveform or wait for an alarm to realize your patient is having respiratory difficulty. Because of this, the Sedation Stethoscope has become an invaluable tool in many teaching institutions across the country. The instructor can monitor respiration alongside the student, helping to ensure the patient’s airway patency and increasing instructional opportunities.

What else does Sedation Resource provide for dentists?

Sedation Resource carries an extensive line of sedation equipment and supplies, as well as everything needed for an emergency in the dental office. From syringes to vital signs monitors, AEDs to emergency drugs – Sedation Resource has the products you need to keep sedation simple, safe, and effective.

Sedation Stethoscope

What is your Customer Service Policy?

Our company policy is simple – we will do our job, get your order out in a timely manner and provide excellent customer service. If you have questions, we will answer them or point you in the right direction to find a solution. Please feel free to give us a call for more information at (800) 753-6376 or visit us at www.sedationresource.com.

Modern Technology for Sedation Dentistry

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What new development in Periodontics excites you the most for its potential effect on patient care and why?

Dental Implant & Periodontal Partners, LLP (972) 612-2040 www.implantperioteam.com

Dr. Stephen Bass CREDENTIALS Diplomate of the American Board of Periodontology Fellow of the Institute for Advanced Laser Dentistry EDUCATION BS, Biology - Southwestern University, Georgetown, 1985 DDS - UTHSC, San Antonio, 1990 MS / Periodontal Certificate - UTHSC, San Antonio, 1993 PROFESSIONAL AFFILIATIONS Dallas County Dental Society Texas Dental Association American Dental Association Texas Society of Periodontists, President, 2003 Southwest Society of Periodontists, President, 2011-2012 American Academy of Periodontists

Dr. Ellen Hall CREDENTIALS Diplomate of the American Board of Periodontology EDUCATION BS, Zoology - Texas A&M University, College Station, 1991 DDS - UTHSC, San Antonio, 1995 MS / Periodontal Certificate - UTHSC, San Antonio, 1998 PROFESSIONAL AFFILIATIONS Dallas County Dental Society Texas Dental Association American Dental Association Texas Society of Periodontists Southwest Society of Periodontists American Academy of Periodontists

Q &

Dr. Bass: Though lasers in dentistry have been available for many years, a relatively new FDA approved technology for treatment of periodontal disease is showing impressive results. We recently incorporated the Millennium Dental Technologies PerioLase® MVP-7 laser to perform the patented Laser Assisted New Attachment Procedure (LANAP™). This technique utilizes a specific laser wavelength and proprietary laser settings to provide the necessary energy to treat the periodontal disease without compromising healthy tissues. After approximately one year follow-up, patients treated in our office have demonstrated results that are comparable to traditional osseous surgery, including bone grafting. One of the chief advantages of this technique is that no incision and no suturing are required. This is much more appealing to patients who need periodontal treatment. It also is more cost effective because bone graft material is not required. It is important to note that the technique tends to provide better results if the patient has not undergone soft tissue management prior to treatment, because the laser energy is more effective in inflamed tissue, rather than in patients previously treated with non-surgical techniques.

Many of my patients have gingival recession and dentin hypersensitivity. Can the periodontist address this problem? Dr. Hall: Gingival grafting can cover exposed root surfaces and increase the zone of keratinized gingiva. Covering these root surfaces can eliminate dentin hypersensitivity and improve the overall health and appearance

of the tissues. In addition, old composite restorations can be removed and grafted over to improve the esthetics and in some cases cover the exposed crown margins.

What enhancements are coming in dental implant technologies?

Dr. Bass: The next development in dental implant technology that will become routine in our offices will be the use of CT imaging and planning the implant placement on the computer. This will allow placement in a position that will require the least bone manipulation and also will allow for fabrication of custom abutments that will enhance the soft tissue management of the implant restoration. Though these technologies have existed, the costs associated with fabrication of the computer guided surgical guides as well as the custom abutments are now more in line with that of a stock abutment.

What can a restorative dentist do to maximize the cosmetic result and achieve Perio-Restorative harmony? Dr. Hall: It is important for clinicians to consider the perio/restorative connection in their smile design. The amount of gingival display and gingival symmetry should be considered in order to optimize anterior esthetics. The perio-restorative team needs to have an understanding of the epithelial attachment, biological width and supra-crestal fibers and how to manage them to provide patients with beautiful restorations. Crown lengthening or gingivectomy surgical procedures should be in the treatment plan to improve the restorative outcome and create balance and periorestorative harmony.

Dr. Stephen Bass & Dr. Ellen Hall Dental Implant & Periodontal Partners, LLP

12 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com

THE FUTURE OF

Mission Dentistry IN UNDERSERVED COMMUNITIES by Sloan Hildebrand, DDS

Dr. Sloan Hildebrand attending a traditional Maasai wedding ceremony alongside the Mara River, Kenya.

hen asked to brainstorm the future of volunteer dentistry, I sought out several individuals that I believe are at the forefront of breaking the trail in this growing movement, I was blown away at the paralleling desire and commitment of individuals and organizations around the world that continue to reach out to underserved communities locally and abroad. Being that there are underserved pockets right here in the Dallas area as well as around the globe, I found that the needs of these organizations and sectors of population are vastly different dependent on their geographical location alone. The common thread is the need for dental help alongside the yearning for knowledge and advancement in equipment in order to serve within these different locations. There is an ancient Chinese proverb that says â&#x20AC;&#x153;Give a man a fish and feed him for a day, teach a man to fish and feed him for a lifetimeâ&#x20AC;?. Both aspects of the Chinese proverb are valid. The first addresses relief efforts and the second addresses community development. Often times the two overlap in that when disaster strikes, it seems that the undeveloped and underdeveloped communities suffer the greatest losses. Many organizations that I have worked alongside globally are passionately involved in both the relief and development efforts. Efforts most impactful are interwoven with the message of hope and education for these people that are seemingly less fortunate. Whether these individuals are truly less fortunate remains a mystery to me in many facets of our lives.

I believe the most important skill that can be taught to individuals when serving overseas or within our underserved communities locally is simply education in the areas of oral hygiene and preventative dental health. The future of missions and care for others can be exponential in terms of impact when children are taught the value of oral healthcare and this lesson can be passed down from generation to generation. Follow up care is also imperative to ensure that this message is correctly passed on within families and that care to subsequent generations is allocated appropriately. According to UNICEF, two out of three people globally live on less than $2 per day and have inadequate access to clean water. Ongoing wars, corruption, natural disasters, climate change, and increased costs for both food and energy ensure that these miserable statistics will not improve any time soon. The need for help in the developing world is literally limitless. For most of these people the possibility of dental care is nonexistent due to financial constraints or geographic isolation. Thus, the future for missionary dentistry is unlimited. With the continual advancement of technology as well as the drive for more comprehensive treatment within these developing communities several key products have become available to better serve in remote locations and more comprehensively treat those in need. Villages devoid of electricity still require the basic elements and instruments to perform exodontias of hopeless or infected teeth, basic oral hygiene care www.northtexasdentistry.com

NORTH TEXAS DENTISTRY

Kenyan children waiting "semi patiently" to jump on the soccer pitch with our crew.

and fluoride treatment. Areas where a clinic has previously been established or there is some semblance of rudimentary clinical supplies are more equipped to serve patients with restorative, cosmetic, surgical or a basic dental prophylaxis.

Ethiopian children living in remote mountains need basic dental care.

Local Maasai village where our team resides while serving the children's dental needs daily.

These remote areas of the earth require portable dental equipment, which is available from over twenty manufacturers and distributors. There are many parameters to consider before purchasing portable dental equipment for a mission such as; the source of electric, your parameters of service, the country where the equipment will be used, and availability of a compressor for air pressure in some instances. Even the altitude where the team sets up to work can be a concern for your equipment’s performance. When it comes to portable dental units and handpieces, one company truly stands out. Bell Dental Products, www.belldental.com is an innovative company developing dental products utilizing proprietary state-of-the-art core technologies. The company designs, develops, and manufactures precision dental equipment based on electric motor technology. It was founded on a heritage of product development and program management in the aerospace, medical, and dental industries.

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These products listed below are used exclusively by the U.S. Army, U.S Navy and U.S Marine Corps in the most remote corners of the earth. The PortaBELL™ Portable Dental Operatory includes fiber optic electric motor and hand pieces, high speed and slow speed hand pieces, HVE, saliva ejector, air/water syringe, over patient delivery for convenience, reduced fatigue and standard hospital grade duplex outlet. The PortaBELL™ is a totally self-contained portable dental operatory that has been designed and manufactured specifically for the demanding environment of the field dentist. The downside of such a unit is that the unit alone weighs 60 lbs. (27.2kg) and the unit including the shipping container weighs 130 lbs. (46.8kg). The cost is approximately $20,000 and therefore a hindrance to some smaller dental mission organizations. This unit is fully operational at 10,000 ft. (3,000m), with a torque speed of 40,000 rpm and fiber optic illumination of 70,000 LUX. A smaller, more affordable unit that is portable and completely self-contained, the TravelBELL™ is a light, six-pound, versatile field dental system with capabilities you’d expect from your office. The TravelBELL™ goes anywhere, anytime in a rugged, compact brief-

case. With the optional solar panels, you will never need to be leashed to a wall plug. A fully charged battery will last approximately eight hours with a recharge life of 1,000 times. The TravelBELLâ&#x201E;˘ is an ultra-lightweight, full featured battery powered field dental system that is engineered for high-performance dentistry anywhere you can go. The E-type motor will accept any standard E-type nose cone providing a broad range of capability and flexibility, from 200 to 150,000 rpm. The purchase price is $3,295 and it has been used all over the world in remote places from the jungles of the Amazon basin to the high peaks of the Himalayas. With the availability of portable dental radiography, including the new â&#x20AC;&#x153;Nomadâ&#x20AC;? x-ray unit from Aribex, volunteers now have the opportunity to bring more precise and diagnostic dental services to isolated areas. The compact design of these units and low weight, 5.5 pounds, allows a team to check them as regular luggage for international travel. Most complete radiograph units retail for approximately $7,495. These products present marvelous opportunities for service organizations to fund raise for a specific purpose and see the benefits of their donations. For those interested in donating their dental skills, many organizations are available to partner alongside providing a wide variety of experiences. Given that caries is still the most pervasive dental problem, volunteers can provide care in multiple venues, ranging from restorative treatment in traditional clinics, to extractions in isolated villages. Organizations such as World Dental Relief (www.worlddentalrelief.com) provide critically needed supplies and instruments donated by major dental retailers, manufacturers, and wholesalers to their mission warehouses. World Dental Relief supplies over 400 teams a year with the necessary equipment to more than 80 countries globally. Individuals can both rent equipment from this organization as well as go to their website to learn of upcoming volunteer opportunities in their community and worldwide.

You do not have to be a trained dental professional to make a lasting impact on the lives of others. No matter what facet you choose to serve in, I can assure you that the need is always great, your services will always be appreciated and most certainly your life will be changed eternally. You can also check out www.dentalmissiontrips.com or visit www.drsloanhildebrand.com to keep abreast of opportunities to serve locally or globally for any length of time and in virtually any capacity. Dr. Sloan Hildebrand is honored to serve his dental family with the utmost excellence. His team provides complete dental health care, specializing in prosthodontics, full mouth reconstructions, implant supported prostheses and elderly care. Dr. Hildebrand has been blessed to travel literally around the world to share his God-given talents to those less fortunate in dental care, education or simply being geographically isolated. Whether he is serving in the high Himalayas of Nepal, the jungles of Cambodia, the plains of Africa, the underserved communities of Dallas or a remote island in the south Pacific, he feels the need is global and the need is now. n

Dr. Hildebrand and his team set up a makeshift dental clinic under the "big tree" out in the Maasai Mara plains, Kenya with anesthesia, sterilization, forceps, medicine, shade and a chair. Villagers will walk for miles to be treated.

Watch www.drsloanhildebrand.com to see where Dr. Hildebrand is serving next as well as to become informed as to where you can help serve others in a variety of capacities locally or globally this year!

Maasai women wait to be seen at the clinic in the African plains with Dr. Hildebrand.

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emember the days when you could place an ad in the yellow pages and sit back and wait for the phone to start ringing? That doesn’t happen today.

For most consumers, the internet (particularly Google) has replaced the yellow pages when searching for local products & services. There are several reasons for this: n Most people have instant access to the internet (PC, smart phones, iPad, etc.) n Too many versions of the yellow pages, most are thrown out immediately n Doing a Google search is much faster than looking for a phone book A properly implemented online marketing campaign is the most effective way to reach potential new patients at the exact moment they are actively searching for the services you offer.

The

Future of Dental Marketing by Marc Fowler

When you position yourself well on the major search engines like Google, Yahoo and Bing, they can deliver highly targeted consumers directly to your website. While most dentists understand the importance of having a presence on the internet, many still believe they simply need to have a website. With online marketing, the “build it and they will come” approach does not work. You can have the most beautiful website in town, but if consumers can’t find it, it’s nothing more than an expensive brochure. Most consumers (according to one popular study – 89%) never go past the first page of the search engine results. That means if you aren’t on the first page of Google, Yahoo, Bing – then to those consumers, you don’t exist.

According to Google, the average number of monthly searches conducted over a 12-month period for some select keyword phrases are:

Dentist Dentist Dentist Dentist Dentist

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Dallas..........14,800 Flower Mound.....3,600 McKinney.........4,400 Rockwall.........1,300 DFW..............8,100

Keep in mind, this is only the term “dentist” and doesn’t include all the possible variations such as “cosmetic dentist”, “dental office”, “dental implants”, etc. Let’s assume you are a dentist in Flower Mound. How many postcards would you have to mail to put your marketing message in front of 3,600 people who are currently looking for a new dentist? It is the dentists on the first page of Google who are getting those searchers as new patients. Most consumers assume (often incorrectly) that the dentists on the first page of Google are the “best” dentists in town. We often hear from dentists that a competitor with inferior clinical skills to theirs has a much larger, more successful practice than them. Upon investigation we always find that dentist with the inferior clinical skills has superior marketing. The bottom line is – the best marketer always wins. The foundation of a successful online marketing strategy is a properly optimized practice website that ranks high in search engines, presents a positive first impression and gives a compelling reason why visitors should select you as their new dentist. Once your main website is ranking well and converting visitors into new patients, you can add additional strategies such as microsites, Google Places optimization, patient reviews and reputation management, online videos and social media. In future articles in North Texas Dentistry, we’ll take a deep dive into each of these strategies so you’ll have a better understanding of what it will take to become the dominant dentist in your market. n Marc Fowler is President of Bullseye Media, LLC, a McKinney, TX based digital marketing agency that specializes in helping dentists leverage the internet to grow their practices. He can be reached at 214-592-9393 or by visiting www.OnlineDentalMarketing.com.

Are there new options for patients who want dental implants but have inadequate bone?

Douglas J. Dingwerth, DMD MD Photo by Ray Bryant, Bryant Studios

CREDENTIALS Diplomate, American Board of Oral & Maxillofacial Surgery EDUCATION DMD - Southern Illinois University (1995) MD -Texas Tech University (1998) Internship in General Surgery/Oral & Maxillofacial Surgery Residency - Baylor University Medical Center, Dallas, TX

Photo by Ray Bryant, Bryant Studios

PROFESSIONAL AFFILIATIONS American Association of Oral and Maxillofacial Surgeons, Southwest Society of Oral and Maxillofacial Surgeons, Texas Society of OMS, North Texas Society of OMS

Maxwell D. Finn, DDS MD CREDENTIALS Diplomate, American Board of Oral and Maxillofacial Surgery EDUCATION DDS - Baylor College of Dentistry (1991) MD -Texas Tech University (1995) Internship in Oral & Maxillofacial Surgery/General Surgery Residency, Oral & Maxillofacial Surgery - Baylor University Medical Center Dallas, Dallas, TX PROFESSIONAL AFFILIATIONS American Association of Oral and Maxillofacial Surgeons, Southwest Society of Oral and Maxillofacial Surgeons, Texas Society of OMS, North Texas Society of OMS, American College of Dentists

Oral Surgery Associates of North Texas (214) 363-6040 www.northtexasoral surgery.com

Q &

What new development do you find exciting for its potential to impact patient health ? Dr. Finn: We hear a lot about stem cells and their amazing potential for use in medical therapies because they can be directed to differentiate into almost any type of human cells. Recently, researchers at NIH discovered stem cells in extracted teeth with healthy dental pulp. In one study, dental pulp stem cells were differentiated into functional pancreatic cells that may be useful in treating Type I diabetes. Now, with a new, affordable process called StemSave™, the oral surgeon can preserve valuable stem cells from a child, teen, or adult when there is a wisdom tooth, baby tooth, orthodontic or other tooth extraction planned.

Are there any new options for edentulous patients?

Dr. Finn: With All-on-4™, we can create a restoration using just four implants to support an immediately loaded full-arch provisional prosthesis. All-on-4™ offers improved stability because it uses tilted implants that increase bone-to-implant contact and reduces the need for vertical bone augmentation. This technique can be performed using digital methods to ensure accurate diagnostics and treatment planning, and an individualized surgical template that guides exact implant placement.

Dr. Dingwerth: Yes. Bone Morphogenetic Protein (BMP) is an isolated protein that is found naturally in the human body and helps stimulate new bone development. The bone morphogenetic protein clinical trials were done over 10 years ago by multiple oral and maxillofacial surgery institutes. This protein has been approved by the FDA, and BMP is now used mainly by orthopedic and oral surgeons to regenerate and augment bone volume. BMP can eliminate the need for bone harvesting from a donor site so the recipient can avoid the discomfort and possible complications associated with the graft harvest site. This bone growth and regeneration, therefore, can assist with placing implants in people who may lack appropriate bone volume.

How has new technology changed orthodontic treatment options?

Dr. Dingwerth: A new option that has been around for a few years is the Bollard mini plate. The Bollard mini plate is used for skeletal anchorage to help modify the growth pattern of the patient’s jaws. The plates help coordinate the development of these jaws during a patient’s growth phase. Bollard plates do not apply forces on the teeth during this growth modification process, which can eliminate the undesirable movement that can occur with the teeth. These anchors can take the place of many auxiliary orthodontic appliances. These plates can help to improve patient compliance due to their more aesthetic presentation since they are located intraorally. These plates, in conjunction with orthodontic treatment, can limit or eliminate the need for potential orthognathic surgery for patients who have skeletal growth abnormalities.

Dr. Douglas Dingwerth & Dr. Maxwell Finn Oral Surgery Associates of North Texas www.northtexasdentistry.com

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SHAPING SMILES Making Dentistry Digital with CAD/CAM By Tina Cauller

ack in the days before CAD/CAM technology, most all manmade products began with ink and paper. The initial concept flowed through the hand of a skilled draftsman who painstakingly rendered successive iterations until ultimately arriving at a final design, which was given in blueprint form to the manufacturer. In the 1960s and 70s, demand by the military as well as the aircraft and auto industries for a more efficient way to model industrial products busied brilliant minds at MIT and other thinktanks.

To address the need for optimum precision, CAD/CAM technology was first introduced in restorative dentistry by Francois Duret in 1971. Since the first CAD/CAM restoration was created in the 1980s, dentists and laboratory technicians have found that it helps them reliably and efficiently fabricate all-ceramic crowns and bridges with great precision.

Early versions of computer aided design software relied on massive mainframe computers that filled entire floors, required their own A/C systems, and munched miles of information punched into paper tape. Over three decades, the growth of CAD/CAM technology closely paralleled the development of the digital computer as computers evolved from clunky multi-million dollar monstrosities into affordable desktop necessities. Each step forward made CAD/CAM solutions smaller, cheaper, faster and vastly more powerful, and pushed industry through the looking glass into a world that was once unfathomable. The impact has rippled outward to every corner of product design.

CAD/CAM has also dramatically impacted the patient experience. After the area is prepared, the dentist electronically captures an image of the preparation. Alternatively, images can be obtained by scanning a traditional model created from conventional impressions of the preparation. Newer systems are clinically and economically superior to first-generation systems, so more dentists are now choosing to completely replace traditional impressions with optical impressions taken with a digital scanner or camera. This can be a valuable marketing device since it is especially attractive to patients who prefer to avoid the sensory unpleasantness of the traditional impression process.

The computer scientists who breathed life into those early applications probably didnâ&#x20AC;&#x2122;t have time to imagine that their work would revolutionize manufacturing so completely that it would affect everything from aerospace to zippers, including the way dentists restore a patientâ&#x20AC;&#x2122;s smile.

After the exact size and shape of the restoration required to fill the defect is precisely specified using an on-screen cursor to draw the design for the restoration on a three-dimensional image, the dentist relays the digital information to a CAM milling apparatus, located either in the office or in an off-site laboratory.

CAD/CAM Restorations Even a minute discrepancy in fit between the tooth preparation and the crown can result in an increased chance of infection and shifting, so precision is critical. 18 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com

In about 20 minutes, the milling machine fabricates a ceramic restoration, which conforms to the defect within 50 microns, from a solid block of ceramic material that matches the surrounding teeth. When the

restoration is complete, it is sectioned from the unmilled ceramic block and tried in place in the patientâ&#x20AC;&#x2122;s mouth. Depending on the material chosen, the restoration may be finished with stains and glazes to create a highly natural look. A final seat is accomplished in about an hour, and the restoration is held in place by traditional bonding methods. Many experts believe that there is less risk of sensitivity or subsequent root canals following treatment since the leakage sometimes associated with a temporary restoration is eliminated. Since there is no dark metal substructure, the result is highly natural and aesthetic. The restoration also does not block x-rays, so dentists can monitor the area for decay without the interference created by gold or porcelain-fused-to-metal crowns.

embrace CAD/CAM technology. There is a learning curve required to use CAD/CAM properly, and dentists make a significant capital investment to acquire CAD/CAM equipment. However, practitioners report that by eliminating laboratory fees and second appointments, overall restoration costs are actually reduced. CAD/CAM dental technology is here to stay and growing numbers of practitioners find that the advantages far outweigh the drawbacks. The genie is unlikely to go back in the bottle and is probably the forerunner of further technological marvels that will continue to advance dentistry beyond the current bounds of our imagination. n

CAD/CAM and Dental Implants In the early 1990s, CAD/CAM entered into the world of dental implants, bringing an alternative to stock or cast implant abutments and frameworks. CAD/CAM implant frameworks are milled from a homogenous block of material without waxing, investing, or casting so inaccuracies are eliminated and production costs are reduced. CAD/CAM also helps meet the challenge to correct unfavorable implant angulations and achieve a proper emergence profile. CAD/CAM technology has enabled dentists to use special computercontrolled milling equipment to create completely customized implant abutments and gain precise control over the margin design, emergence profile, angulation and retention. Customized implant abutments provide a better fit and can offer greater durability since materials such as titanium, alumina and zirconium can be used. CAD/CAM ceramics offer highly natural optical properties so the result is predictable and esthetic. In order to achieve the highest possible level of accuracy during implant placement, dentists sometimes use stereolithography to manufacture CAD/CAM surgical templates. In select cases, dentists with chairside CAD/CAM technology can place and complete the dental implant in a single visit, without impressions, temporary restorations, or a return visit. This allows the implant to be placed without a flap using minimally invasive surgery, and the prosthesis can then be delivered with immediate functional loading to the implants. As with all new technologies, there are those who are reluctant to fully

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What new development in dentistry excites you the most for its potential effect on patient care and why? Dr. Tanur: The advances that have been made in Implant Dentistry and their success rate. With the ongoing research and better technology in this field we are able to increase the scope of alternatives to replace missing teeth and better serve our patients.

For a patient who has health issues and severely compromised teeth that will need to be extracted, is there an alternative to wearing removable dentures?

Dr. Ovadia: Today, dental implants are one of the most common and successful types of treatment for replacing teeth. If natural teeth are compromised due to periodontal disease, caries, fractures or other reasons, dental implants may be a wonderful option.

Q: Photo by Ray Bryant, Bryant Studios

Periodontal Associates

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8722 Greenville Ave. Suite #100 Dallas, TX, 75243 www.dallasimplant.com

Eduardo Tanur DDS MS (214) 503-1000 Ruben Ovadia DDS MS (214) 503-1000

When patients complain that a denture is unstable, uncomfortable and awkward, is there an alternative that provides a permanent solution?

Dr. Tanur: For the denture wearer, implants can mean a life without pain or embarrassment, and a return to healthy eating habits. Implants that are placed strategically in the jawbone are able to support a full arch fixed prosthesis, and give the patient replacement teeth that function and feel like natural, healthy teeth.

Dr. Eduardo Tanur & Dr. Ruben Ovadia â&#x20AC;&#x2C6; Periodontal Associates

20 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com

What are dental implants?

Dr. Ovadia: Dental implants are small screws made of titanium that a specialized implant surgeon can place in the area where teeth are missing. Implants can be utilized to support a permanent fixed prosthesis.

What makes a patient a good candidate for dental implants? Dr. Tanur: A thorough review of the personâ&#x20AC;&#x2122;s medical history and a clinical examination with radiographs will allow the implant surgeon to determine if an individual is healthy enough and has sufficient bone for implant placement.

How many implants are required to stabilize a full arch fixed prosthesis? Dr. Ovadia: A minimum of four or more dental implants is required to support a full permanent prosthesis using the All-On-4 technique. All-On-4 is a treatment concept designed to replace missing teeth with a full dental bridge supported by just four dental implants.

What are the advantages with All-On-4?

Dr. Tanur: Since fewer implants are needed, the All-On-4 is the most cost-effective permanent prosthetic solution. There is less need for bone grafting, and less overall treatment and healing time. Typically, temporary provisional teeth are placed the same day. All-On-4 is a scientifically proven and extensively documented option.

What level of comfort can a patient expect with an implantsupported prosthesis?

Dr. Ovadia: Recent studies have shown that an implant-supported prosthesis increases biting forces up to 10x within the first year and can increase biting forces up to 300x over three to five years. Patients can have a prosthesis that feels, functions and looks like natural teeth when they smile. They can chew, speak, and smile with ease again.

How predictable is treatment with dental implants?

Dr. Tanur: Dental implants have been available since 1975. Extensive research worldwide for almost 40 years supports their use. They are highly predictable and have a 97% success rate. Dental implants have helped millions of people have the naturallooking, fully functional smiles they deserve.

How long do implants last?

Dr. Ovadia: With adequate hygiene and regular maintenance, implants normally can be expected to last a lifetime.

Do implants help prevent further bone loss?

Dr. Tanur: Implants stimulate bone like natural teeth do. When bone is being stimulated, its natural physiologic properties allow normal, healthy remodeling and turnover to take place. Without the presence of teeth or dental implants, bone begins to resorb and collapse because it loses volume and density, which affects the profile, phonetics, esthetics and function.

Dr. Eduardo Tanur CREDENTIALS Diplomate of the American Board of Periodontology Former Faculty Member, Baylor College of Dentistry EDUCATION DDS - University Technological of Mexico, Mexico City Certificate and MS in Periodontics and Implant Dentistry, Baylor College of Dentistry, Dallas TX PROFESSIONAL AFFILIATIONS American Academy of Periodontology American Academy of Osseointegration Southwest Society of Periodontics American Dental Association Dallas County Dental Association Texas Dental Association Alpha Omega Dental Fraternity Hispanic Dental Association

Dr. Ruben Ovadia CREDENTIALS Diplomate of the American Board of Periodontology EDUCATION DDS - University Technological of Mexico, Mexico City GPR - National Institute of Perinatology Residency in Periodontics - Tufts University School of Dental Medicine MS - Tufts University School of Dental Medicine PROFESSIONAL AFFILIATIONS American Dental Association American Academy of Periodontology Hispanic Dental Association Texas Dental Association North Texas Hispanic Dental Association Dallas County Dental Society Alpha Omega Dental Fraternity

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Steve Bilt

President & CEO Smile Brands Inc.

As the head of the largest dental support services company in the U.S., what do you think is the biggest challenge facing dentistry today?

Steve Bilt: Dentistry’s biggest challenge was and continues to be that a significant majority of the country underutilizes dental care. This includes people not in care at all and people who aren’t receiving full and adequate care. Between 45-50% of the population doesn’t go to the dentist regularly. It might be that someone gets a diagnosis that a tooth could use an inlay, but he waits. Then he gets a crown diagnosis but he still waits because it doesn’t hurt. Then suddenly he needs a root canal or he loses that tooth.

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Underutilization can also mean people are not getting adequate periodontal care and therefore suffer bone loss then ultimately tooth loss. Or perhaps they are suffering from other illnesses, such as cardiovascular disease, that can stem from poor oral health. Underutilization could even mean not getting an oral cancer screening which will obviously have catastrophic results.

What are the barriers to people seeking dental care and what do Smile Brands affiliated offices offer patients to increase utilization of dental care?

Steve Bilt: One barrier is that private practice dentists have to do it all. They have to be CEOs, financiers, marketers, experts on real estate and demographics, and more. Those activities distract a dentist from delivering the best dental care possible. Smile Brands has developed a model that includes understanding a market so we can help the dentist land in a location that’s going to be best suited to him or her. We find and develop that location and provide the financing to complete it. We develop marketing material to attract patients and provide call center support. We also handle billing and collections and offer patients financing – all of which frees the practitioner to focus on dentistry.

What makes the Smile Brands business model attractive to dentists?

Steve Bilt: The first time you go into business you better be prepared to take a few lumps. Some dentists start as an associate in a private practice and work with a more experienced dentist to learn the business aspects of running a practice. If the goal is to be in a private practice, that model has worked well for many years. Smile Brands has spent nearly 15 years and tens of millions of dollars learning and improving the business support side of dentistry. It’s a learning curve that some dentists want to climb themselves, but other dentists say, “You know what? Smile Brands has developed a package of support services that allows me to focus on dentistry. That means I can serve a middle market that I probably couldn’t efficiently serve if I were doing it all myself.” Smile Brands lowers the risk of starting out in a dental practice so providers can be more predictably successful. Why is that? Because there are elements of risk in any business; to the extent we can take away some of those variables, your chance of success improves. The Smile Brands model works really, really well and it’s really predictable. It allows doctors to focus on dentistry and oral hygiene and serve the patients well, then we limit the risk on the downside because of the support services we provide and what results, mathematically, is a much higher chance the dentist will be successful. In addition, Smile Brands provides forums for continuing education and best practice sharing, and facilitates mentoring. Plus, affiliated practices offer a career path because these locations have multiple job layers for doctors to grow in their career.

What do you think the most significant changes to dentistry will be over the next 5 – 10 years?

Steve Bilt: First, there are many of ways to think about change. There’s the future of technology in the dental space and all the clinical innovations that are on the way. But there are many people far more qualified than I am to opine on those changes.

Today more dentists are supported by business organizations that allow them to better define their niche and target the middle market without competing, per se, with other dentists. The Smile Brands model is specifically designed to support the needs of a middle market consumer who is price sensitive or may need financing. We’ve designed our support model to enable the dentist to effectively and profitably reach a market that’s unserved or underserved. This shift in how dentistry is provided could raise the number of people in regular care from 50% to perhaps 90% someday. And that’s the dream – to make sure patients are served, and that dentistry is accessible to them so they can stay in regular dental care.

What does the future, or at least the next decade, hold for Smile Brands?

Steve Bilt: First, it’s probably more informative to look back 5 to 10 years at where we’ve come from. A decade ago, we were supporting 45 offices – today there are 350. Back then, we were just in three states on the West Coast – now we’re all across the country. Plenty will change around the technology in the offices – information systems; digital radiography; impressions and milling; laser technology – it’ll be dramatic. As our footprint grows, there will be more places for patients to access regular care, plus have easier access to specialty services as these become more fully integrated with the dental office teams. There will also be innovations to improve how the doctor and patient interact. It’s hard to predict what those might be but it will likely involve PDAs or smart phones with access to patient records and other useful information. Over time, this advanced communication will improve both the patient’s understanding of their care and their interactions with their providers. Those are all things that Smile Brands will help facilitate and that will be a very powerful experience.

A different type of change is how the business of dentistry will change. Historically, dentistry has been accessed through the sole practitioner model and that’s a great model. But dentistry is a $120 billion space today, a huge healthcare sector. Over the next 5 to 10 years, you’re going to see more business models emerging to serve niche segments of the market. For an example of this, look at retail. There are retailers that focus specifically on the high-end consumer and retailers that target the discount consumer, and they don’t compete. You don’t hear debate in the Nordstrom boardroom over how they’re going to reach the Walmart customer, and conversely, Walmart isn’t wondering how they’re going to capture the Nordstrom customer. www.northtexasdentistry.com

NORTH TEXAS DENTISTRY

Throughout my 40 years in the dental field (30 years as an oral surgeon), I have been troubled by the fact that we create oral wounds on a daily basis but have never had an effective means of taking care of those wounds. For example, we routinely extract teeth and send patients home with a gaping hole in the mouth. The wound is subject to a hostile environment teeming with pathogens and exposed to various noxious chemicals (food, drink, tobacco, etc.). Yet the treatment plan generally consists of nothing more than a prescription for pain medication. Ignoring wounds in other parts of the body would be considered substandard, at the very least. Dressings are routinely applied to external wounds to protect them from further damage and contamination, and to allow optimal healing to take place. In dentistry, however, wound dressings have not existed. Some dentists apply topical antibiotics after surgical extractions, or have their patients use antiseptic rinses. These therapies are of questionable benefit and, because of toxicity to the cells of wound healing, can adversely affect the healing process. I found it unacceptable that, in the 21st century, dentistry was so far behind medicine when it came to taking care of wounds of the mouth.

Dr. J. Hadley Hall Co-Developer of SockIt! CREDENTIALS Diplomate of the American Board of Oral and Maxillofacial Surgery Board Certified in 1986 Licensed in Texas, Oklahoma and Colorado Texas State Board of Dental Examiners 1995-1997 (President 1996) EDUCATION AND TRAINING DDS - Baylor College of Dentistry (1973) Residency in Oral and Maxillofacial Surgery, Oklahoma Health Sciences Center, Oklahoma City, Oklahoma PROFESSIONAL AFFILIATIONS American Association of Oral and Maxillofacial Surgeons American Dental Association Texas Dental Association Texas Society of Oral and Maxillofacial Surgeons Southwest Society of Oral and Maxillofacial Surgeons Twelfth District Dental Society American Dental Society of Anesthesiology

Dr. J. Hadley Hall Co-Developer of SockIt! 24 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com

I posed this problem to Dr. Bill McAnalley. Bill is a pharmacologist and toxicologist with more than 30 years experience in the wound care arena. He has been awarded 35 U.S. patents and hundreds of international patents for technology associated with natural-source health products. Bill and his team had already developed the world’s first widely marketed hydrogel wound dressing for external wounds. I knew that, with his vast knowledge and experience, he was the ideal person to develop a suitable wound care product for the mouth. I was pleasantly surprised and gratified that Bill immediately understood the urgency of this problem. After studying the properties required for an ideal oral wound dressing, we agreed that such a product should protect oral wounds from contamination, provide pain relief, enhance healing and, most importantly, be safe to swallow. Exhaustive research led to Bill’s newest innovation – an oral hydrogel wound dressing that consists of 100% all-natural food ingredients, something that had never been done before. After extensive experimentation, we learned to utilize the natural characteristics of the food ingredients, blend those ingredients and optimize their potent and synergistic effects. Upon approval by FDA for management of all oral wounds, ulcers and lesions, SockIt! Oral Hydrogel Wound Dressing was born!

I was introduced to SockIt! by Dr. Hadley Hall shortly after I moved to Texas. I was initially skeptical. First, I had not heard of it, and I try to stay on top of current technology. Second, the idea of an oral wound dressing does not automatically come to mind as far as oral surgery is concerned. However, when you realize that just about any surgical procedure, or treatment of a traumatic injury, anywhere else on the body is accompanied by placement of a wound dressing, similar treatment of oral wounds makes sense. Wound dressings perform several functions. An important one is to protect wounds from further injury, whether from trauma or from the environment, such as chemicals and pathogens. Patients are pretty good at protecting oral wounds from trauma. However, the mouth is a hostile environment for wounds when one considers the chemicals introduced from food, drink, tobacco, etc., and the bacteria, fungi and viruses that are inhabitants. With SockIt! we have a simple, effective means of treating oral wounds with the same respect we give any other wound of the body. In addition to general wound care, SockIt! is very effective in managing pain. It starts to provide pain relief in less than a minute, and does not cause numbness. It does not contain any drugs, and the mechanism for pain relief is different from that of anesthetic agents. SockIt! does prevent the influx of sodium ions, which is the first step in the generation of the pain impulse, but it is not absorbed into the tissues, and it does not paralyze neurons and produce local anesthesia. People like that. They want pain relief, but they don’t generally like that numb sensation. Patients also like the words “drug-free” and “all-natural.” With SockIt! patients know they have a means to address discomfort anytime they need to, without worrying about toxicity. Patients stay comfortable and they heal nicely without complications. From the practice standpoint, the significant reduction in post-op complications is huge. We are informed of a great deal of patients with very good pain control upon follow-up and it certainly reduces the number of post op patients on the schedule. At Park Forest Oral and Maxillofacial Surgery, we keep up with the latest in technology and innovation and use SockIt! for virtually every procedure, from extractions (it is especially good for immediate denture patients), to implants, to graft procedures, biopsies, etc. SockIt! is a chargeable service and there is an insurance code for reimbursement. In addition to the value of reduced post-operative discomfort for our patients, it also allows for a modest income stream. SockIt! is a very valuable addition to our practice*. We have a safe, effective means to provide patients pain relief and wound care that brings dentistry and oral surgery more into line with medicine as far as patient care is concerned. Patients are happier which makes life in the office much more pleasant.

Dr. Haroon Ismaili

Park Forest Oral and Maxillofacial Surgery (817) 466-8080 www.pfoms.com CREDENTIALS Diplomate of the American Board of Oral and Maxillofacial Surgeons Fellow of the American College of Oral and maxillofacial Surgery Fellow of the International Society of Oral and Maxillofacial Surgery EDUCATION AND TRAINING DDS - New York University Residency in Oral and Maxillofacial Surgery, Washington Hospital Center, Washington DC PROFESSIONAL AFFILIATIONS American Association of Oral & Maxillofacial Surgeons American College of Oral and Maxillofacial Surgeons Southwest Society of Oral and Maxillofacial Surgeons American Dental Association International Society of Oral and Maxillofacial Surgeons

* Dr. Ismaili is not affiliated in any way with SockIt! gel or its manufacturers.

Dr. Haroon Ismaili

Park Forest Oral and Maxillofacial Surgery www.northtexasdentistry.com

NORTH TEXAS DENTISTRY

What’s the difference between a fee-only and a fee-based advisor?

Steve: In a word, huge! The vast majority of dentists, and other professionals as well, probably don’t appreciate the difference and what it means to them. In short, in addition to an asset-based percentage fee, a fee-based advisor can also receive other compensation, such as commissions, from selling financial products and insurance policies. This additional compensation can create conflicts of interest that are not easily discerned by a client. Conversely, fee-only advisors accept no compensation or commissions from the products or services that they use to implement the client’s financial plan.

Steven M. Lugar, CFP® Beaird Harris Wealth Management, Inc. 12221 Merit Drive, Suite 750, Dallas, TX 75251 (972) 503-1040 SteveL@bh-co.com www.bhcocapital.com Beaird Harris Wealth Management is an independent, fee-only wealth management firm in Dallas, Texas. We provide objective, fee-only advice to financially established individuals and families, trust funds, retirement plans and non-profit organizations – with a particular emphasis in the medical, dental and healthcare industries. Beaird Harris is dedicated to helping clients maximize their assets, reduce their financial stress and realize their personal and financial goals.

Q &

When should a dentist consult a financial advisor?

Steve: Ideally, the day they graduate from dental school. While the tendency may be to defer that consultation for a few years until they are somewhat established, that decision can result in tens, or even hundreds of thousands, of wasted dollars. The decisions that are made in the early years of a career, i.e., whether to buy an existing practice or start your own, evaluating what rate to pay down debt vs. save for retirement, what kind of retirement plan to establish, and determining how much house to buy, are really important. They have a material impact on lifetime wealth accumulation. After almost thirty years in the business, I can say with conviction that the people who get good advice early in their careers have a huge jump on those who wait. There is simply no way to overstate the importance of avoiding mistakes that have negative repercussions for many years to follow. Most individuals find that they make better financial decisions when they tap into the expertise, experience and discipline provided by a feeonly financial advisor.

What experience do you have working with dentists specifically?

Steve: For more than fifteen years, Beaird Harris has worked with dental practices of all sizes and specialties. They include recent graduates working as associates prior to their “buy-in,” sole practitioners as they launch their practice and large dental groups with multiple owners. We provide expertise and objective advice in the myriad of subjects that dental school did not equip them to deal with. This includes making correct decisions in the areas of life and disability insurance, business entity structure, proper choice and design of their company retirement plan, and tax-efficient strategies for building a substantial net worth, separate and apart from their dental practice.

Do you serve your clients in a fiduciary capacity?

Steve: Yes, and simply put, “fiduciary” is a legal term meaning to put the clients’ interests ahead of our own. However, in the financial services industry, true fiduciaries are difficult to identify. Most financial advisors adhere to the “suitability” standard – meaning that they only have to document why their investment advice was “reasonably justified” for you. A financial advisor operating under this standard could still win an incentive prize for selling you a particular “suitable” investment. The line is blurred between functioning as a fiduciary and almost functioning in a fiduciary capacity. Lesson learned? Don’t expect financial gurus or salespeople to act in your best interest. Ask your financial advisor to put in writing whether he or she upholds the fiduciary standards.

How are you compensated?

Steve: Beaird Harris is a fee-only financial planning and wealth management firm. This independence allows us to remain totally impartial and deliver objective fiduciary advice to clients.

Steven M. Lugar, CFP

Beaird Harris Wealth Management, Inc.

26 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com

The Role of

Salivary Diagnostics in Today’s Practice

alivary diagnostics is moving today’s dental practices toward a practice model of evidence-based dentistry, creating a balance between the scientific and technically-based practice. Salivary diagnostics presents a new scientific tool that affords dental practices the opportunity to provide lab-based data in educating patients and dental professionals alike.

the introduction of salivary diagnostics there has not been a way of quantifying the oral biofilm in the mouth in a simple and concise way. Dental professionals based a diagnosis on the effects of the damage caused by the oral biofilm. We now have a way of preventing the damage from the uncontrolled biofilm versus fixing the damage after the damage has occurred.

There are numerous studies and articles authored on the oralsystemic links and how the body is affected by the oral biofilm. Salivary diagnostics provides the tool for acquiring more information on the oral biofilm in the mouth at practice level.

When we speak of the oral biofilm what does this really mean? This is the saliva in the mouth, but when we look deeper at the DNA of the biofilm, it is made up of over 500 strains of bacteria; the majority of the 500 are harmless. Salivary diagnostics reveals the 13 strains of bacteria that are known to be tissue and bone destructive in the mouth and through research we know these same 13 are directly linked to systemic issues in the body. Knowing the 13 infective types of bacteria and whether or not it is of consequence on the body opens the window in truly controlling the oral biofilm. With a quantifiable report, treatment regimens become truly personalized based on a patient’s oral biofilm’s bacteria types, bacteria concentrations and the patient’s genetic predisposition to inflammation.

When we perform salivary diagnostics we are testing the oral biofilm, the bacteria present in the mouth. It is tested, typed and quantified. We also have the ability to test the patients’ genetic predisposition for inflammation. A patient is either positive or negative for the inflammation marker. The inflammatory marker is linked to all critical diseases facing the population today. These include, but are not limited to, heart disease, stroke and diabetes. Performing these two tests answers pieces of the puzzle in diagnosing the mouth that dentists and hygienists have been unable to answer before. Controlling the oral biofilm is the common denominator in dentistry today. Clinically, when a practitioner is performing endodontics, periodontics, decay removal or placing an implant, controlling or eradicating the oral biofilm is one of the key steps in successful treatment. Prior to

Quantifiable reports before and after treatment are of unquestionable benefit. In medicine, it is standard of care to test a patient starting on a cholesterol reducing drug, performing ongoing monitoring of how the therapy is working with follow-up lab reports. Lab reports can answer questions that at times would have been unanswerable in dentistry. We have all had a mouth that looked CONTINUED ON PAGE 30 4 www.northtexasdentistry.com

NORTH TEXAS DENTISTRY

Photo courtesy of Dr. Songtao Shi

Science vs. the Tooth Fairy New Promise in Baby Teeth By Tina Cauller Songtao Shi, DDS, PhD, Associate Professor, Herman Ostrow School of Dentistry of USC (University of Southern California, Los Angeles, CA) in the laboratory.

How much is a baby tooth worth — fifty cents? A dollar? Ten dollars? Some researchers think a single baby tooth could be priceless, providing you plan ahead instead of giving it away to the tooth fairy. When intellect, inspiration and serendipity converge, interesting things can happen. Dr. Songtao Shi certainly has the first element of the equation. He earned a D.D.S. and M.S. degree from Peking University and a Ph.D. from USC. After serving on the faculty at Beijing Medical University, Shi opened a private pediatric dentistry practice in Los Angeles. He was eventually lured to the laboratories of the NIH, where he quickly earned accolades in the scientific world for his brilliant work in the area of stem cells taken from bone marrow. Then in 2003, along came serendipity. Shi’s little girl showed her dentist-scientist daddy a wiggly front tooth and asked him for help. She needed to get it to the tooth fairy. He obliged, and while cleaning the tooth off, he noticed a tiny bit of tissue inside the tooth. That got Shi thinking. In 2000, he and another NIH researcher had found mesenchymal stem cells (MSCs) in the dental pulp of adult teeth. A few days later, when his daughter lost her other front tooth at bedtime, Shi zipped off to his lab. Sure enough, his inspiration had led him to an exciting discovery – there were young stem cells in the tooth pulp left behind in the baby tooth! 28 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com

A singularly special cell Stem cells have a unique job. They are the only cells in our body that can regenerate. A specific type of stem cell can differentiate into a variety of specialized tissue types in order to regenerate organs, tissues, and bones. Because stem cells are the building blocks of organ tissue, the immune system and blood, scientists have pondered their healing potential for decades. Stem cells from bone marrow were first used to save the lives of cancer patients who need help regenerating blood and immune cells after chemotherapy. Then, in the ‘80s, scientists began looking at stem cells taken from umbilical cord blood, which offer a number of advantages over bone marrow stem cells. Youth, as it turns out, is particularly significant when it comes to a stem cell. In fact, we age partly because the ravages of time outpace our adult stem cells’ weakened ability to regenerate cells. Stem cells taken from cord blood and teeth are vital and powerful, with only minimal degradation from age. Cryopreserving stem cells protects them from damage from aging, environmental factors, and viruses that occurs naturally in our bodies as we grow older. Cryopreserved stem cells are available right away as opposed to waiting for cells from bone marrow, and collection is safe and painless. They are very young but not taken from embryos, so they are not associated with the same ethical controversy as embryonic stem cells. Because

the cells are autologous – taken from the patient’s own body – there is less risk of complication and no need for immunosuppressive medications to prevent rejection. After the discovery of stem cells in his daughter’s tooth, Songtao Shi began collecting newly-lost baby teeth from her friends and any other cooperative 7- and 8-year olds he could enlist. He named the cells SHED (stem cells from human exfoliated deciduous teeth). He found that they proliferated rapidly into clusters, much faster than stem cells isolated from bone marrow or adult teeth. Shi hypothesized that SHED are responsible for giving the order to make bone around the permanent tooth as it comes in, and with the proper cues, might be able to induce bone formation. He was right. When he implanted SHED under the skin of mice, they triggered the formation of bone. This was exciting – an earlier trial using stem cells from adult wisdom teeth had been unsuccessful. Shi knew that the stem cells in teeth share a common origin with neural tissue. With careful direction, he managed to coax the SHED to form neural cells in the brain and fat cells. Stem cells from adult teeth are much less potent generators of neural cells and incapable of inducing fat cell formation. Researchers believe that SHED may be able to restore cells damaged by diseases like Parkinson’s or restore the cells that make dopamine so nerve cells can function properly.

Tooth or fiction? When it comes to therapies using stem cells, the future is here. It isn’t science fiction and its promise, while still continuing to unfold, has arrived. Whole bladders grown in the laboratory from a patient’s own stem cells have been successfully implanted. Doctors have grown patches to cover a hole or weakening in a blood vessel, as well as knee cartilage and tendons. Stem cells are being used to grow cardiac tissue, bone, insulin-producing pancreatic beta cells and other tissues. In some cases, a biological or synthetic scaffold is required to direct the growth of the cells into the desired form. Doctors recently replaced a British teenager’s trachea with one grown from her own stem cells over a donor scaffold. Dr. Jeremy Mao of Columbia University Medical Center recently developed a growth factor-infused scaffold with the potential to regenerate an anatomically correct tooth in just nine weeks from implantation. Once the stem cells have colonized the scaffold, a tooth can grow in the socket and then merge with the surrounding tissue.

Shi. “A whole human tooth is no less complex an organ than a human heart.” For now, Shi and his team at USC are working on growing a “bio root” – a living tooth root – and he predicts that this milestone could be just a year or two away. They have already grown a living root and supporting periodontal ligaments in a pig sufficient to support a crown restoration and hope to go to clinical trials in the near future. “We are using the background information and experience from dental implants and looking for ways to replace the artificial root substitute with a functional bioimplant,” Shi notes. When asked about research goals that are closer to realization, Shi shares his excitement about the team’s proximity to success in treating periodontal disease. “At present, we can treat periodontitis, but we lack an effective method to reverse the damage done by disease. We are very close to being able to use cell regeneration to grow new tissue to firmly support a tooth affected by disease. This is a very promising development.”

Saving for the future While NIH is prohibited by conflict of interest considerations from operating a stem cell bank, private companies are springing up to meet the demand for this promising new area of medical technology. One company at the forefront of this new technology is StemSave, an FDAregistered company based In New York. StemSave works with dentists to recover teeth at the optimal time, before they become very loose, to assure the highest probability of stem cell viability. (The pulp chamber of the deciduous tooth may be obliterated by the erupting tooth by the time the tooth actually becomes loose.) To participate, patients enroll at www.StemSave.com or by calling 877-STEMSAVE. Prior to the planned procedure, the patient’s dentist receives a patented kit that contains a vial with a special solution to nourish and protect the cells during transport. When the tooth is extracted, the dentist simply places the extracted tooth into the kit. The kit is then sealed and sent to StemSave laboratories where the specimen is processed. Once the presence and viability of the cells is confirmed, the cells are cryopreserved. If the patient has a need for their stem cells in the future, they contact StemSave directly to arrange

Further research has proven that the tooth bud of the mandibular third molar is an especially rich source of multipotent stem cells, which can form enamel, dentin, blood vessels, dental pulp, neural tissues, muscle, bone, organs, insulin-producing pancreatic cells, skin, cartilage, and hepatocytes. Researchers are currently developing stem cell therapies to treat a host of ailments including Type I diabetes, Parkinson’s, Alzheimer’s, arthritis, cardiac disease, multiple sclerosis, spinal cord injury and numerous others. Even some genetic conditions may be treated using stem cells from a healthy sibling. For dentistry, stem cell therapy could mean the ability to regrow natural teeth. How far off is this? A whole tooth is complicated structure. Most experts think that growing a whole tooth in a human mouth is a decade or more in the offing. “We have a long way to go,” says Dr. Songtao www.northtexasdentistry.com

NORTH TEXAS DENTISTRY

transport from storage. The StemSave process was carefully designed to take less than a minute of a dentist’s time. The company maintains the contractual relationship with the patient for cryopreservation so there is no paperwork or payments for the dentist’s office to manage.

CONTINUED FROM PAGE 274

For parents who missed out on the chance to bank cord blood, harvesting and preserving a child’s stem cells from baby teeth could be a golden opportunity. Parents of older children may be relieved to know that the opportunity to bank immature tooth-derived stem cells does not end at the kindergarten door. Adolescents can bank dental stem cells when bicuspid teeth are extracted in preparation for orthodontic treatment, when a tooth is fractured, or after the extraction of wisdom teeth. It is best to recover these teeth during the developmental stage, between age 16 and 20, since this is when the stem cells are most active in formation of the root. However, even third molars or permanent teeth with healthy pulp that are extracted later in life can be a source of viable stem cells.

Dentistry is revolutionized when biofilm pathogens are known and quantified. Judicious care can be prescribed in treating and eradicating the pathogens doing the damage when we use this powerful tool in every day practice. A patient’s genetic risk assessment and biofilm test all become part of the diagnostics equation along with x-rays and clinical examination. Enabling practitioners to assess and know what a patient’s inflammatory response and bacterial infection is as an adjunct to prescribed therapy. By embracing the knowledge that saliva’s DNA provides, dentists can prevent the oral cavity from being of any negative consequence on the overall health of the body.

Tooth wisdom The value of tooth-derived stem cell banking is questioned by some who argue that the future potential of the cells to provide useful therapy is uncertain and speculative. Others argue that the companies are preying on parents’ natural concerns for their child’s health, nudging them toward excessive anxiety. There are concerns about what will happen to the saved cells if the company goes under. Skeptics are critical of the initial and annual costs of cryopreservation. Banking companies have responded with assurances that their fees are fair and worthwhile and that they have a plan in place for the continuity of their services should the company fail. Still, the NIH and HHS (Department of Health and Human Services) are waving off these reservations. Both are putting a lot of eggs into the basket of regenerative medicine, and these organizations are not known to commit funds without good reason. Experts at both agencies are banking on regenerative medicine to improve our quality of life and reduce health care costs and have committed significant resources to the field. The U.S. military’s Armed Forces Institute of Regenerative Medicine is channeling hundreds of millions of dollars into efforts to develop stem cell therapies to treat wounded soldiers. While the practical payoff may be years away, research is advancing our knowledge by leaps and bounds every day. Many informed and thoughtful people who can afford to pay the fees for cryopreserving cells from teeth are deciding that the potential benefit far outweighs the cost. After all, how do you put a price on even the slightest possibility that your child might someday be helped by investing in a simple, painless procedure? Dentists are finding that the service is simple and convenient. More important, they are finding that it is being enthusiastically received by patients who appreciate that their dentist is looking out for them by offering an option that might someday save the life of their child. Of course, no one is looking to send the tooth fairy into quaint obsolescence. Just hoping that she might become a lifesaving fairy godmother for someone should the need arise. n 30 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com

textbook perfect with slight inflammation and bleeding only to have the patient return in six months with bleeding and probe depths that were progressing and a noticeable odor in the mouth.

Today, patients are better educated in the care of their teeth and gums, and have a better understanding of how this relates to their body’s overall health. Patients are more ready than ever to embrace and accept partnering with their doctors in their overall care, and fully expect to keep their teeth for their lifetime. The integration of salivary diagnostics into dentistry today will fuel the growth of the next century of dentistry. Creating a shift in the nature of today’s dental practice requires an approach from many different angles. Currently, dentists are afforded the opportunity to be at the forefront of integrating salivary diagnostics into their practices and learn how this will grow and change the way dentistry is practiced. Clinical research continues to give us the empirical data needed as evidence grows on the oral-systemic links. Indicators show there is a visionary shift in dentistry moving dental practices toward evidence-based dentistry utilizing salivary diagnostics. Salivary diagnostics presents an adjunct for educating, motivating and changing the way dentistry is practiced both today and in the future. Salivary diagnostics, as with any new technique, product or service, demands due diligence and proper training to employ the new tool and interpret the results in order to utilize the product to its full potential and benefit the patient and practices of today. Financially, this creates a revenue stream much like the boost dental practices received from intraoral cameras. “A picture is worth a thousand words.” In the case of salivary diagnostics, the picture is the lab report. Go to www.mydentalgenetics.com for more information on salivary diagnostics. n

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