The Future of Dentistry

North Texas

Dentistrya business and lifestyle magazine for north texas dentists

special issue

SPOTLIGHTThe Future of Mission Dentistry

Shaping Smiles

Science vs. the Tooth Fairy

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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 heart-

warming 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

[email protected]

(214) 629-7110

from the publisher

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 respon-

sible 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 DentistryFor more information on advertising in North Texas

Dentistry, call LuLu Stavinoha at (214) 629-7110 or

email: [email protected]. Send press

releases and all other information related to this

publication to:

North Texas Dentistry

P.O. Box 12623

Dallas, Texas 75225

North Texas

Dentistry

www.northtexasdentistry.com | NORTH TEXAS DENTISTRY 3

NORTH TEXAS DENTISTRY | www.northtexasdentistry.com4

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SEDATION RESOURCEKeeping Sedation Simple

DR. DENNIS M. ABBOTTDental Oncology Specialists of North Texas

STEVE BILTCEO, Smile Brands, Inc.

STEVEN LUGERBeaird Harris Wealth Management, Inc.

BLAKE EATONFounder, 3i Outsourcing Solutions, Inc.

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PROFILES

DR. STEPHEN BASS & DR. ELLEN HALLDental Implant &Periodontal Partners

DR. DOUGLASDINGWERTH & DR. MAXWELL FINN Oral Surgery Associates of North Texas

DR. EDUARDO TANUR & DR. RUBEN OVADIAPeriodontal Associates

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

DR. HAROON ISMAILIPark Forest Oral & Maxillofacial

Surgery

The Future of Dentistry

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SHAPING SMILES

Making dentistry digital

with CAD/CAM


special issue

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FEATURES

North Texas

Dentistry

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EMERGING TECHNOLOGIES in DENTISTRY ENHANCE PATIENT CARE

A look at new technologies and techniques to improve the practice of dentistry

THE FUTURE of MISSION DENTISTRYin UNDERSERVED COMMUNITIESExamining portable equipment options and volunteer opportunities at home and around the world

THE FUTURE of DENTAL MARKETINGA properly implemented online marketing campaign is the most effective way to reach potential new patients

THE ROLE of SALIVARY DIAGNOSTICSin TODAY’S PRACTICE

Salivary diagnostics presents a new scientific tools that affords dental practices the opportunity to provide lab-baseddata in educating patients and dental professionals

SCIENCE vs THE TOOTH FAIRYExciting new promise in baby teeth

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 function-

ality. 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. Lead-

ing a national effort by dental schools to prepare their graduates for the

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 de-

signed 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 nurs-

ing 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.

EMERGING

TECHNOLOGIES

IN DENTISTRY

ENHANCE

PATIENT CARE


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 in-

fections. Diabetes, for one, increases the

risks of gingival and periodontal inflam-

mation 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 cal-

cium, 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 re-

ceived more than 96,000 patient visits, and more than 170,000 people

were served through our community-based care, screening and educa-

tion programs. With more resources, we could have served tens of thou-

sands 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 under-

served as practicing dentists.

Improved Preventative Therapies

Although not a new technique, fluoride varnish

has improved as a caries (cavity) prevention ther-

apy. 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 bet-

ter flavor, an added bonus for the patient. The use

of glass ionomers — a composite-type filling ma-

terial that continually releases fluoride — is

another method of strengthening patients’ teeth. Patients using fluoride-

based toothpaste continue to receive the benefits of this composite fill-

ing 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 rec-

ognized 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 com-

munities throughout Texas.


What do you think is the mostsurprising development on thehorizon 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.

Dr. Dennis M. Abbott CURRENT ROLEFounder and CEO, Dental Oncology Professionals of North Texas

www.dopnt.com

Private Practice

www.abbottdds.com

EDUCATION AND TRAININGBA, 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 AFFILIATIONSMember, American Dental Association

Member, Texas Dental Association

Member, Dallas County Dental Society

Member, American Academy of Oral Medicine

Member (pending), Oral Cancer Foundation

Dental Oncology Professionals of North Texas(972) 226-6947

www.dopnt.com

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What is the first thing that needs tohappen to improve dental care inAmerica?

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 dentistryexcites you the most for it's potentialeffect 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 thebiggest change in dentistry in thenext 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 aboutdentistry?

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 thatyou live by?

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

What or who inspired you to pursuea career in dentistry?

Dr. Abbott: Three classes I took at Rice as an under-

graduate 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 themost people?

Dr. Abbott: Hands down...local anesthetics!

In general, do you think patientstoday 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 infor-

mation 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 doyou most wish to communicate toyour 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.

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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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 envi-

ronment 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 salesman-

ship, 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 situ-

ation, 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

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.”

In 2003, the inception of Sedation Resource

came from the frustration of doctors not know-

ing 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 Stetho-

scope. 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 tradi-

tional 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, stu-

dents 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, co-

course director with Dr. Stanley Malamed (www.learnivsedation.com), to

sum up Sedation Resource, “They simply have the supplies and equip-

ment that dentists doing sedation need. The prices are fair and service

is outstanding.”


Photo Courtesy of Solis Surgery Arts Center www.advancedanesthesia.org

Sedation Resource

Sedation ResourceIs Keeping Sedation Simple

How is Sedation Resourcecontributing 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 stetho-

scope 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 Stetho-

scope, you can obtain the mobility you want with the continuous

monitoring you need.

How is the Sedation Stethoscopedifferent than a traditionalprecordial/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 Stethoscopeadvancing 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 Resourceprovide 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.

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.

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Sedation StethoscopeModern Technology for Sedation Dentistry


What new develop-ment in Periodonticsexcites you the most

for its potential effect onpatient care and why?

Dr. Bass: Though lasers in dentistry have

been available for many years, a relatively new

FDA approved technology for treatment of peri-

odontal disease is showing impressive results.

We recently incorporated the Millennium Dental

Technologies PerioLase® MVP-7 laser to per-

form the patented Laser Assisted New

Attachment Procedure (LANAP™). This tech-

nique utilizes a specific laser wavelength and

proprietary laser settings to provide the neces-

sary 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 sur-

gery, 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 periodon-

tal 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 patientshave gingival reces-

sion and dentin hypersensiti-vity. Can the periodontistaddress this problem?

Dr. Hall: Gingival grafting can cover exposed

root surfaces and increase the zone of kera-

tinized 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 enhancementsare 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 com-

puter. 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 com-

puter 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 achievePerio-Restorative harmony?

Dr. Hall: It is important for clinicians to con-

sider 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 perio-

restorative harmony.

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Dr. Stephen Bass & Dr. Ellen HallDental Implant & Periodontal Partners, LLP

Dr. Stephen Bass CREDENTIALSDiplomate of the American Board of Periodontology

Fellow of the Institute for Advanced Laser Dentistry

EDUCATIONBS, Biology - Southwestern University, Georgetown, 1985

DDS - UTHSC, San Antonio, 1990

MS / Periodontal Certificate - UTHSC, San Antonio, 1993

PROFESSIONAL AFFILIATIONSDallas 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 HallCREDENTIALSDiplomate of the American Board of Periodontology

EDUCATIONBS, Zoology - Texas A&M University, College Station, 1991

DDS - UTHSC, San Antonio, 1995

MS / Periodontal Certificate - UTHSC, San Antonio, 1998

PROFESSIONAL AFFILIATIONSDallas County Dental Society



Texas Society of Periodontists

Southwest Society of Periodontists

American Academy of Periodontists

Dental Implant & Periodontal Partners, LLP

(972) 612-2040

www.implantperioteam.com

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When 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 individu-

als and organizations around the world that continue to reach out to un-

derserved 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 pop-

ulation 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 “Give a man a fish and feed him for a day, teach a

man to fish and feed him for a lifetime”.

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 un-

developed and underdeveloped communities suffer the greatest losses.

Many organizations that I have worked alongside globally are passion-

ately 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 individ-

uals 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 cor-

rectly 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 lit-

erally 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 de-

void of electricity still require the basic elements and instruments to per-

form exodontias of hopeless or infected teeth, basic oral hygiene care

THE FUTURE OF

Mission DentistryIN UNDERSERVED COMMUNITIES

by Sloan Hildebrand, DDS

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


and fluoride treatment. Areas where a clinic

has previously been established or there is

some semblance of rudimentary clinical sup-

plies are more equipped to serve patients with

restorative, cosmetic, surgical or a basic den-

tal prophylaxis.

These remote areas of the earth require

portable dental equipment, which is available

from over twenty manufacturers and distribu-

tors. 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 in-

stances. 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, de-

velops, and manufactures precision dental

equipment based on electric motor technol-

ogy. It was founded on a heritage of product

development and program management in the

aerospace, medical, and dental industries.

These products listed below are used exclu-

sively 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 Oper-

atory 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 specif-

ically 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 approxi-

mately $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 ex-

pect from your office. The TravelBELL™ goes

anywhere, anytime in a rugged, compact brief-

Ethiopian children living in remote mountains need basicdental care.

Local Maasai village where our team resides while serving

the children's dental needs daily.

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


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 TravelBELL™ is an ultra-lightweight, full

featured battery powered field dental system

that is engineered for high-performance den-

tistry anywhere you can go. The E-type motor

will accept any standard E-type nose cone

providing a broad range of capability and flex-

ibility, 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 radi-

ography, including the new “Nomad” x-ray unit

from Aribex, volunteers now have the oppor-

tunity to bring more precise and diagnostic

dental services to isolated areas. The com-

pact design of these units and low weight, 5.5

pounds, allows a team to check them as reg-

ular luggage for international travel. Most com-

plete 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 ben-

efits of their donations.

For those interested in donating

their dental skills, many organiza-

tions are available to partner along-

side providing a wide variety of

experiences. Given that caries is still

the most pervasive dental problem,

volunteers can provide care in multi-

ple 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 ware-

houses. World Dental Relief sup-

plies 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 volun-

teer 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 recon-

structions, 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 geo-

graphically isolated. Whether he is serving in

the high Himalayas of Nepal, the jungles of

Cambodia, the plains of Africa, the under-

served communities of Dallas or a remote

island in the south Pacific, he feels the need is

global and the need is now. n

Maasai women wait to be seen at the clinic in

the African plains with Dr. Hildebrand.

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!


When you position yourself well on the

major search engines like Google, Yahoo and

Bing, they can deliver highly targeted con-

sumers directly to your website.

While most dentists understand the impor-

tance 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 con-

sumers (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.

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 investi-

gation 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 mar-

keting 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 understand-

ing 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 vis-

iting www.OnlineDentalMarketing.com.

Remember 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.

According to Google, the average

number of monthly searches conducted

over a 12-month period for some select

keyword phrases are:

The

Futureof Dental Marketing by Marc Fowler

Dentist Dallas..........14,800

Dentist Flower Mound.....3,600

Dentist McKinney.........4,400

Dentist Rockwall.........1,300

Dentist DFW..............8,100


What new develop-ment do you findexciting for its

potential to impact patienthealth ?

Dr. Finn: We hear a lot about stem cells and

their amazing potential for use in medical ther-

apies 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 pancre-

atic cells that may be useful in treating Type I

diabetes. Now, with a new, affordable process

called StemSave™, the oral surgeon can pre-

serve valuable stem cells from a child, teen,

or adult when there is a wisdom tooth,

baby tooth, orthodontic or other tooth extrac-

tion planned.

Are there any newoptions foredentulous 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.

Are there newoptions for patientswho want dental

implants but haveinadequate bone?

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 maxillo-

facial 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 associ-

ated 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 newtechnology changedorthodontictreatment 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.

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Dr. Douglas Dingwerth & Dr. Maxwell FinnOral Surgery Associates of North Texas

Douglas J. Dingwerth, DMD MDCREDENTIALS

Diplomate, American Board of Oral & Maxillofacial Surgery

EDUCATIONDMD - Southern Illinois University (1995)

MD -Texas Tech University (1998)

Internship in General Surgery/Oral & Maxillofacial Surgery

Residency - Baylor University Medical Center, Dallas, TX

PROFESSIONAL AFFILIATIONSAmerican 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 MDCREDENTIALSDiplomate, American Board of Oral and Maxillofacial Surgery

EDUCATIONDDS - 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 AFFILIATIONSAmerican 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

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Back in the days before CAD/CAM

technology, most all manmade prod-

ucts began with ink and paper. The initial

concept flowed through the hand of a skilled

draftsman who painstakingly rendered succes-

sive iterations until ultimately arriving at a final

design, which was given in blueprint form to the man-

ufacturer. 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.

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 paral-

leled 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.

The computer scientists who breathed life into those early applications

probably didn’t have time to imagine that their work would revolutionize

manufacturing so completely that it would affect everything from aero-

space to zippers, including the way dentists restore a patient’s smile.

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.

To address the need

for optimum precision,

CAD/CAM technology

was first introduced in

restorative dentistry by Fran-

cois Duret in 1971. Since the first

CAD/CAM restoration was created

in the 1980s, dentists and laboratory

technicians have found that it helps them reli-

ably and efficiently fabricate all-ceramic crowns and

bridges with great precision.

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 prepa-

ration. Newer systems are clinically and economically superior to

first-generation systems, so more dentists are now choosing to com-

pletely 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.

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.

In about 20 minutes, the milling machine fabricates a ceramic restora-

tion, which conforms to the defect within 50 microns, from a solid block

of ceramic material that matches the surrounding teeth. When the

SHAPING

SMILESMaking Dentistry

Digital with

CAD/CAM

By Tina Cauller


restoration is complete, it is sectioned from the unmilled ceramic block

and tried in place in the patient’s mouth. Depending on the material cho-

sen, 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.

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 frame-

works 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 computer-

controlled milling equipment to

create completely customized

implant abutments and gain precise

control over the margin design,

emergence profile, angulation and

retention. Customized implant abut-

ments provide a better fit and can

offer greater durability since materials

such as titanium, alumina and zirco-

nium 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, den-

tists 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 sur-

gery, 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

embrace CAD/CAM technology. There is a learning curve required to

use CAD/CAM properly, and dentists make a significant capital invest-

ment 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



What new develop-ment in dentistryexcites you the most

for its potential effect onpatient 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 andseverely compromised

teeth that will need to beextracted, is there analternative to wearingremovable 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.

When patientscomplain that adenture is unstable,

uncomfortable andawkward, is there analternative that provides a permanent solution?

Dr. Tanur: For the denture wearer, implants

can mean a life without pain or embarrass-

ment, 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.

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Dr. Eduardo Tanur & Dr. Ruben Ovadia Periodontal Associates

Periodontal Associates8722 Greenville Ave. Suite #100

Dallas, TX, 75243

www.dallasimplant.com

Eduardo Tanur DDS MS

(214) 503-1000

Ruben Ovadia DDS MS

(214) 503-1000

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Photo by Ray Bryant, Bryant Studios


What are dentalimplants?

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 apatient a good

candidate for dentalimplants?

Dr. Tanur: A thorough review of the person’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 implantsare required tostabilize 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 theadvantages with All-On-4?

Dr. Tanur: Since fewer implants are needed,

the All-On-4 is the most cost-effective perma-

nent 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 docu-

mented option.

What level of comfortcan a patient expectwith an implant-

supported 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 istreatment withdental 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 natural-

looking, fully functional smiles they deserve.

How long doimplants last?

Dr. Ovadia: With adequate hygiene and

regular maintenance, implants normally can be

expected to last a lifetime.

Do implants helpprevent further boneloss?

Dr. Tanur: Implants stimulate bone like natu-

ral 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.

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Dr. Eduardo TanurCREDENTIALSDiplomate of the American Board of Periodontology

Former Faculty Member, Baylor College of Dentistry

EDUCATIONDDS - University Technological of Mexico, Mexico City

Certificate and MS in Periodontics and Implant Dentistry,

Baylor College of Dentistry, Dallas TX

PROFESSIONAL AFFILIATIONSAmerican Academy of Periodontology

American Academy of Osseointegration

Southwest Society of Periodontics


Dallas County Dental Association


Alpha Omega Dental Fraternity

Hispanic Dental Association

Dr. Ruben OvadiaCREDENTIALSDiplomate of the American Board of Periodontology

EDUCATIONDDS - 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 AFFILIATIONSAmerican Dental Association

American Academy of Periodontology

Hispanic Dental Association


North Texas Hispanic Dental Association

Dallas County Dental Society

Alpha Omega Dental Fraternity

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As the head of the largest dentalsupport services company in the U.S.,what do you think is the biggestchallenge 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.

Underutilization can also mean people are not getting adequate peri-

odontal care and therefore suffer bone loss then ultimately tooth loss.

Or perhaps they are suffering from other illnesses, such as cardiovas-

cular 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 peopleseeking dental care and what doSmile Brands affiliated offices offerpatients to increase utilization ofdental 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 deliv-

ering 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.

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Steve BiltPresident & CEO

Smile Brands Inc.

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What makes the Smile Brandsbusiness 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 mostsignificant 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 innova-

tions that are on the way. But there are many people far more qualified

than I am to opine on those changes.

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.

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 thenext 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 inno vations 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 under-

standing 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.

Q:

Q:

Q:


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.

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 interna-

tional 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 experimen-

tation, 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!


Dr. J. Hadley Hall Co-Developer of SockIt!

CREDENTIALSDiplomate 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 TRAININGDDS - Baylor College of Dentistry (1973)

Residency in Oral and Maxillofacial Surgery,

Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

PROFESSIONAL AFFILIATIONSAmerican Association of Oral and Maxillofacial Surgeons



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 HallCo-Developer of SockIt!

Dr. Haroon Ismaili

Park Forest Oral and Maxillofacial Surgery(817) 466-8080

www.pfoms.com

CREDENTIALSDiplomate 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 TRAININGDDS - New York University

Residency in Oral and Maxillofacial Surgery, Washington Hospital

Center, Washington DC

PROFESSIONAL AFFILIATIONSAmerican Association of Oral & Maxillofacial Surgeons

American College of Oral and Maxillofacial Surgeons

Southwest Society of Oral and Maxillofacial Surgeons


International Society of Oral and Maxillofacial Surgeons

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 func-

tions. 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 compli-

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

Dr. Haroon IsmailiPark Forest Oral and Maxillofacial Surgery


Steven M. Lugar, CFP®

Beaird Harris Wealth Management, Inc.

12221 Merit Drive, Suite 750, Dallas, TX 75251

(972) 503-1040

[email protected]

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.

What’s thedifference 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 addi-

tional 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.

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 thou-

sands, 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 reper-

cussions 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 fee-

only financial advisor.

What experience doyou have workingwith 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 mul-

tiple owners. We provide expertise and objec-

tive advice in the myriad of subjects that dental

school did not equip them to deal with. This in-

cludes 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 yourclients in a fiduciarycapacity?

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 in-

centive prize for selling you a particular “suitable”

investment. The line is blurred between function-

ing as a fiduciary and almost functioning in a fidu-

ciary 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.

Q:

Q: Q:

Q: Q:

Steven M. Lugar, CFP®

Beaird Harris Wealth Management, Inc.

&AQ


The Role of

SalivaryDiagnosticsin Today’s Practice

Salivary 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.

There are numerous studies and articles authored on the oral-

systemic 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 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 inflam-

mation. 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, peri-

odontics, decay removal or placing an implant, controlling or eradicating

the oral biofilm is one of the key steps in successful treatment. Prior to

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.

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.

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


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!

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

Science vs. theTooth 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.

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the cells are autologous – taken from the patient’s own body – there is

less risk of complication and no need for immunosuppressive medica-

tions 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.

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

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 oper-

ating 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 FDA-

registered 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 oblit-

erated 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


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.

For parents who missed out on the chance to bank cord blood, harvest-

ing 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 treat-

ment, 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.

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 enthusias-

tically 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

CONTINUED FROM PAGE 274 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.

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.

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 prac-

tices 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 intra-

oral 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

ADVERTISER’S INDEX

Destiny Dental Laboratory ......................................................................page 7

Med+Tech Construction....................................................................back cover

Straumann..............................................................................inside front cover


The Future of Dentistry

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Transcript of The Future of Dentistry