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Vitamin K2

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Can anyone share their thoughts about Vitamin K2? A patient asked for my thoughts about Vitamin K2 and its dental benefits. I could only found that Vitamin K2 is naturally produced by gut flora; plays a central role in calcium metabolism and it is "speculated" that Vitamin K2 "stimulates growth of new dentin". However, there are no human studies. Thanks in advance for your input
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Advocacy: It’s not just a word anymore Changes in dentistry are occurring and your participation in the political process, or advocacy, is needed now more than ever. Insurance carrier reimbursement limitations and recent changes associated with the IRS, DEP and OSHA are pinching and penalizing dentists more than any other time in history. Political communication and support is essential to combat and facilitate these hot issues. Please consider helping your profession by donating time or financial support for dental advocacy. Current items of concern are: HB2263 – Representative Karen Boback, Ph.D., from the 117 th legislative district in Northeastern ...
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Kids’ Healthy Mouths PSA Campaign Continues to Encourage Parents to Make Sure Their Kids Brush 2 Minutes, Twice a Day In an effort to educate parents and children about the importance of good oral health habits, the Partnership for Healthy Mouths, Healthy Lives —which includes the Academy of General Dentistry—and the Ad Council, recently launched new Public Service Ads (PSAs) for the Kids’ Healthy Mouths campaign. These new PSAs, aimed at parents, portray humorous depictions of life lessons, making the point that while parenting can be tricky at times, in comparison, getting kids to brush for 2 minutes, twice a day can be simple. The ...
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Has anyone looked closely at the Cigna notification emailed on 05/20/2014? Piled deep under the BS regarding a "preview" of the "new and improved Cigna," it looks like they are going to rate a participating office's "cost effectiveness" based on their submitted fee schedule!!! NEVER MIND.... PARTICIPANTS WITH CIGNA ALREADY HAVE TO ABIDE BY THEIR CONTRACTED FEE SCHEDULE!!! NOW ... CIGNA IS ATTEMPTING TO INFLUENCE THOSE FEES AND THE FEES NOT COVERED BY THEIR FEE SCHEDULES BY RATING DOCTORS ON HOW HIGH THEIR "FEE FOR SERVICE" FEES ARE!!! I don't know about other participating dental practices but my fee schedules are not public and to my knowledge I have ...
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Now what??

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Returned from a great weekend of PAGD CE in Hershey. Fred J. filled us with tons of information, L. Guth and Ben Tuinei was good as well. I am wondering how the membership will chose to apply the data presented to deal with the realities of Corporate Dentistry, United Concordia, Delta Dental, Recent graduates working for Dental corporations and what the future holds for those of us who have lived and worked by a more traditional model of business and practice? Or if some are not affected at all, how do they feel they are not affected?
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Busy private practice

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It is possible that we will come to a two tier system. I am very qualified to make the following observations. Cases labeled TMD or TMJ are not covered by the majority of ins. companies. I do not believe that the government will cover them either. I do not know statistically how much time is missed from work due to these conditions but I believe it to be substantial. I do know that when people are hurting and tired of pain meds, they seek treatment and are willing to "foot the bill". Many of you simply do not see the potential in offering this treatment. Most of you have not been interested enough to learn the "How to's". If I were to return to active ...
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What is PEAK?

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What is PEAK? PEAK is a continuing education program of the PAGD designed but not limited to allow members to attain Mastership in the AGD in a convenient way. PAGD has two PEAK programs, PEAK Track 1 and PEAK Track 2. Both PEAK tracks are open to new members. The PEAK programs both meet twice a year, in the spring and fall. Each session provides 20 hours of lecture credit, but attendees can attain 48 hours of PARTICIPATION credits for the session provided that they present a powerpoint relevant to that meeting at the following meeting. PEAK programs are designed to cover all the sections of the Mastership participation requirements in a 4 ...
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I spent the last week of my life in the hospital with a small bowel obstruction. If none of you have experienced this, please keep it off the bucket list.....sickest I have ever been. I am posting to see and hear feedback from the Dr. Cooper presentation on Corporate Dentistry and the changing business models and reimbursement models. Any and all ideas and feedback are appreciated. I did not see him talk. But I do have first hand experience dealing with Aspen, All Care and now ReFresh Dental. Thanks Bill
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Examining the occlusion Tooth wear patterns, can indicate both functional and non functional interferences. This a really good indication of muscle hyperfunction. As in the case of the bruxer. When you see evidence of hyperfuntion do not be quick to reshape enamel. Better to quiet the muscles first, in all cases. You can accomplish this by separating the teeth with a pencil, credit card, anterior jig.. anything that will keep the teeth from touching. Excursive interferences are best evaluated by using occlusal marking ribbon and dental floss or tape. The ribbon I prefer is made of mylar. Be careful using mylar. The wax can be rubbed off on the ...
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Show me a female with a class II, Div II skeletal relationship and I will show you a woman who gets headaches. If she says she does not, she is lying for some reason. These cases are easy to treat and be a hero at the same time. You can help them by changing the relationship between the upper and lower incisors. A sagittal adjusted properly and with an anterior bite plane worn full time will eliminate the headaches almost immediately. This provides motivation to continue treatment. Move the maxillary anterior forward about 1mm and change the inclination of the max incisors. Depending on age, they will need long term retention. My oldest case was 65 yr old woman ...
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This may seem like a trivial thing but I can tell you, it is not. Deep bites are responsible for many TMJ inflammations due to anterior misguidance via anterior prematurities that distalize the mandible. When you observe deep bites developing, tell the parents about prevention and how you intend to intervene in this developmental disturbance as well as the benefits to the child. There are different techniques to do this. You need an understanding of FJO and growth and development. Simple Hawley with anterior bite plane will work. Remember that a child can be uncomfortable or even hurting but not understand why. Because the parent "cannot see anything wrong" ...
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In school we were taught to treat impacted first permanent molars by extracting the first primary molars and fabricating a distal shoe appliance and cementing this to the second primary molar. I did this on one or two occasions. In my experience this was a rare occurrence. In the middle 1980s I had more experience and knowledge. Studying Functional Jaw Orthopedics (FJO) had given me a better understanding of how to treat this problem. The technique employing a, distal shoe, was inferior compared to my "new appliance". The distal shoe technique did nothing to improve the position and orientation of the first permanent molar, required minor surgery and resulted ...
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TMD - More

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I learn from extreme cases. So I am going to relate some of the most extreme in hopes that you learn the same way. Most heartbreaking: I was treating this woman's daughter for a class i crowded condition with a deep bite. This is not the case. Her mother, early thirties school teacher scheduled an appointment for exam and prophy. This family of two were new to my practice. My only prior contact was during evaluation of her daughter's orth problem. One of my first questions to young females is "Do you get headaches"? Her response was completely unexpected. She sat up and asked "Why did you ask me that"? "you are here for an exam, right"? was my response. "Yes, ...
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TMD and Malocclusion

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Malocclusion is the misalignment of teeth between the upper and lower. Two teeth or more. The contact between these teeth causes the maximum intercuspal position to bring about the displacement of the mandible to a position that is muscle guided (learned? in some cases, habitual). In order to be able to achieve this acquired position on swallowing, the muscles must work "overtime" 24/7. This leads to hypertonicity and at times hypertonicity results in spasm with resultant pain that we term TMD. At times this pain is reflected in the TMJ. This is the result of a latero-posterior displacement of one or both condyles. TMD/TMJ is, in my opinion, the most troublesome ...
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Hypothetical: What if you select one or more of each, male/female, identical in age, size and fitness, provide same nutrition and exercise for a specified period, and at the end of this period you had a contest of strength and endurance. Which one/group will win the contest. I would bet on the males. I think that there was a U.S. Army study done on this some time before 1990, at a time when there were concerns about women serving in combat roles. I believe that men will develop a stronger musculo-skeletal system under the circumstances described above. The gnathostomatic system is no different than any other system of the body in that it is only as strong ...
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malocclusion and Perio

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Even as a dental student I was troubled by the lack of my understanding of directional forces on the teeth and their relationship to periodontal disease. I began looking at this relationship with this analogy. This is the way I explain it to patients, even today: "If you had a gate post in your yard and everyday on the way in and out, you shook that post side to side, it would eventually get loose because you would be expanding the ground which is holding it. Now, add water every time you shake the post. I ask them "do you think the post will loosen more quickly?" The answer is yes. It makes sense because you soften the dirt. Now think of the tooth/teeth. If ...
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I believe that if you have been reading this blog/posts, you are getting the idea of the importance of muscle tonicity relative to restorative dentistry. There is more. Endodontic considerations in malocclusion. My philosophy regarding pulpal inflammation and death. Pulps deteriorate to a state of necrosis. At times extremely slowly and then again very rapidly. The rate depends on the manner of the insult. The stages of "death" are subject to interpretation of reaction to temperature changes and pressure. If the pain goes away within seconds of the removal of the noxious stimulus, the pulp is healthy. I then look for cervical erosion, exposed cementum, and/or ...
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Examining the occlusion

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Evaluation of Gnathic system with attention given to occlusion and Muscle tone. a. Tooth wear patterns, b. Jaw opening, how wide? measure. lateral movement during open/close c. Freedom to move laterally, how far? measure. d. occlusal plane - steep curve? interupted? missing and/or tipped teeth, uneven marginal ridges. e. Midline deviation f. Ortho Class - I, I with *variation, II,II2, III, pseudo III, and note variations g. Tongue habits retraction during opening** using tongue to brace the mandible during swallowing***, during speech, resting the mandible.(tongue placement for comfort) ...
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I have been a continuous student, as most/all of you. I read an article in the ADA Journal sometime in the very early 1970s. It was written by a midwest dentist. He and an engineer hypothesized that enamel and quartz would behave similarly when placed under pressure, ie galvanic activity. Of course that is true now as it ever was. They took that one step farther. They deduced that this activity would attract bacteria. In this "unscientific study" they connected electrodes to a tooth that would be subjected to pressures equal to that of chewing, and set the ends of the wires into a growth medium. A sample of oral bacteria was introduced to the growth medium and ...
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Lancaster Mistake

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For those of you in the Harrisburg - Lancaster area, thought you might like this funny PennDot road sign spelling error!! http://screen.yahoo.com/spelling-error-catching-driver-eyes-234954363.html
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