It’s a busy time of year with the holidays, so you may have missed a few of these articles that your colleagues are focusing on this month. Topics range from lead shielding to zirconia crowns, a new breakthrough in periodontitis and oral cancer treatment … and more. Here are some quick takes from leading articles in DentistryIQ, Dental Economics, RDH, and Perio-Implant Advisory.
DentistryIQ
Lead shielding in dental x-rays
Are they a thing of the past or a staple in your office?
In late 2023 and early 2024, the dental profession saw a change that had quietly been in the works for some time—major professional organizations were coming out to recommend against the routine use of lead shielding such as aprons during dental x-rays.
For both patients and providers who saw the lead apron as a symbol of safety and care, this change was difficult to process. More than that, many states, such as California, actually still require the use of lead shielding for x-rays.
Since about a year has gone by, we wanted to check in with the dental profession and ask if you were still routinely using lead shielding. Let us know, and we'll share the results with you soon.
UnitedHealthcare CEO’s murder
The targeted killing of Brian Thompson shows how violence in health care isn't limited to clinicians. Here's what it means for dentistry.
By now you’ve likely heard of the killing of UnitedHealthcare CEO Brian Thompson in broad daylight on a Manhattan sidewalk as he was headed into a shareholder meeting. The online vitriol that’s followed has been disturbing, if not surprising, with versions of “he had it coming to him” ranging from casually unfeeling to some outright celebrating his death.
Health-care workers are five times more likely to be victims of workplace violence and threats—and dental professionals have not been immune from this trend. Read the full article.
Dental Economics
Successful cementing of zirconia crowns
The frustrating challenge of zirconia crowns coming off continues to be a significant problem in dentistry. Dr. Gordon Christensen suggests several methods to reduce or eliminate the problem.
Q: I have cemented many zirconia crowns, but some are still coming off during service. I have done what some of the companies have recommended for this problem, and the crowns are still coming off. This challenge almost never happened with some of the older generations of cement. What can be done about this significant problem?
A: You and tens of thousands of other dentists are having the same problem. Your statement is not new information. This problem has been observed for about 11 years, since zirconia crowns were first introduced to the profession, and it continues to be reported routinely by dental practitioners.
Zirconia crowns are the most popular crown type in the US. What can cause the disagreeable situation of crowns coming off? Here are the most important reasons … Read the full article.
Local anesthesia: Our savior and our nemesis
Local anesthesia is, unfortunately, a necessary part of dentistry, and it’s a focal point in almost every appointment. Dr. Neville Hatfield shares tips on how he virtually eliminates the discomfort associated with local anesthesia and reaps the dividends.
As we all know, patient experience is the single most important factor in driving new-patient growth. You could have the best marketing strategy in the world, but you will fall short of your growth goals without word-of-mouth referrals or positive online reviews. One of the most effective ways I’ve improved patient experience is by updating my anesthetic delivery technique.
I used to rely on humor to diffuse patient tension and anxiety, and while I still do to some extent, I realized that anxiety often stems from the fear of injections or the noise of dental handpieces. While we can reduce handpiece noise by using electric handpieces or offering headphones and earplugs—and even invest in expensive dental lasers for cavity preparation without anesthesia—we often need to find more accessible methods to alleviate the anxiety associated with local anesthesia. Read the full article.
RDH
Is rapamycin the next big breakthrough?
Originally developed as an immunosuppressant, rapamycin is now being studied for its wide-ranging potential in oral health—particularly in treating periodontitis, oral dysbiosis, and oral cancer.
Rapamycin, also known as sirolimus, is a fascinating drug with a history as intriguing as its potential applications. Initially discovered in the soil of Easter Island, or Rapa Nui, rapamycin was originally prized for its antifungal properties. However, its influence extends far beyond that, impacting everything from organ transplantation to the latest antiaging research. Recent studies have begun exploring its potential benefits for oral health, which could open new avenues for dental medicine.
What sets rapamycin apart from other compounds is its ability to inhibit a specific protein known as mTOR (mammalian target of rapamycin or mechanistic target of rapamycin). The mTOR signaling is crucial in regulating cell growth, proliferation, metabolism, and autophagy—the body’s process of cleaning out damaged cells and regenerating new, healthier ones. Rapamycin’s ability to inhibit mTOR made it a valuable immunosuppressant, especially in organ transplantation, preventing the body from rejecting new organs. Read the full article.
Bananas versus dental radiographs
What has more radiation, bananas or dental x-rays? Here's an interesting way to explain how much radiation patients are exposed to during dental x-rays.
The most frequent pushback dental hygienists get from patients is about dental x-rays. Many people are concerned about the radiation emitted from the checkup bite-wing x-rays, panoramics, or full series. Now we have a straightforward way to help patients understand and relate to just how much radiation there is in dental x-rays compared to their everyday encounters with radiation.
People are exposed to radiation every day and they don’t even think about it—from the sun, flying in an airplane, talking on our cellphones, and even in some of the foods we eat. Amazingly, bananas are a naturally occurring radioactive food due to their elevated levels of potassium. A fraction of potassium is radioactive, and radiation is measured in millisieverts. One banana is equivalent to 0.001 millisieverts of radiation.
One would still have to ingest an exceptionally high number of bananas (more than 100) to receive the same amount of radiation encountered in the environment daily.Today, when receiving a set of four bite-wing x-rays taken once a year to check for cavities between the posterior teeth, the total amount of radiation is 0.005 millisieverts. Read the full article.
Perio-Implant Advisory
Cold sore treatment: 4 methods to improve healing
Cold sore treatment typically involves antiviral drugs that slow or inhibit viral replication but do not eliminate the virus or its recurrence. Dr. Scott Froum looks at several alternative treatments proposed to reduce both onset and duration of the lesions.
Cold sores, or herpes labialis, are also known as “sun blisters”—a common viral infection of the lips or mouth area caused by the herpes simplex virus (HSV). The sores typically appear as one or more small, painful blisters or lesions on or around the lips. Symptoms may include ulcerations, itching, burning, tingling around the mouth, and swollen lymph nodes.
Cold sores do not have a cure, and treatment usually involves antiviral drugs such as acyclovir, penciclovir, and valacyclovir in cream or tablet form. These treatments work to slow or inhibit viral replication via the herpesvirus DNA polymerase, but do not completely eliminate the virus or its recurrence. Side effects of these antiviral drugs taken orally include lethargy, fatigue, loss of appetite, joint pain, muscle pain, sinus congestion, and cramps. Currently, four different kinds of alternative treatments that can be used as stand-alone or adjunctive treatment to conventional medications have been proposed to reduce both onset and duration of the cold sore lesions. Read the full article.
Tooth pain after root canal therapy
The origin of pain following root canal treatment can be multifactorial. Drs. Scott Froum and Omar Ikram look at early identification and treatment of tooth pain to ensure positive therapeutic outcomes.
Patients often expect to have immediate pain relief following endodontic therapy. Depending upon the size of the periapical lesion, necrotic state of the pulp, and the medical history of the patient, complete healing postendodontic treatment can vary. The literature reports that 3%–6% of patients can experience severe pain after root canal therapy, but this typically subsides within a week following treatment.
Frustration can ensue, however, when pain persists (lasting longer than a week), and a common question from patients is, “I had a root canal, so why am I still in pain?” One meta-analysis reports that 5% of patients may experience pain that can last six months or longer after root canal therapy.
To prevent patients from experiencing long-lasting pain, it is important to recognize and diagnose the potential etiology of pain following root canal treatment, especially since the origin can be multifactorial and nonodontogenic. The literature suggests that early identification and treatment of pain can lead to more effective therapeutic outcomes.
There are five reasons why tooth pain may exist after root canal therapy … Read the full article.
Share these articles with your peers if they haven’t seen them and stay tuned for more content to help you in your career.
