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27 January
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What do dentists and credit counselors have in common?

Hope you’ve been brushing your teeth because Denver might see an influx of dentists.

A US News and World Report study released Wednesday showed that dentist ranks as the best job overall in the nation. Diving even deeper, Denver is one of the best-paying cities for dentists with a meansalary of $269,530 compared to a national mean of $172,350.

The city is also one of the best paying for community health workers ($53,140), credit counselors ($78,220), geographers ($77,860) and petroleum engineers ($170,170), according tothe report.

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The best jobs rankings are based on salary, the number of expected openings, advancement opportunities and career fulfillment.

Job seekers are entering a solid market with a national unemployment rate below 5 percent, recently reaching the lowest point since 2007, according to the Bureau of Labor Statistics. Additionally, 10 million jobs are expected to be added between 2014 and 2024.

The unemployment rate in metro Denver fell to 2.6 percent in November, down from 3.5 percent in November 2015, according to the Colorado Department of Labor and Employment.

24 January
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Australian Dentists Clinic’s New Website Helps People Looking for a Dentist

MELBOURNE, AUSTRALIA / ACCESSWIRE / January 20, 2017 / The Australian Dentists Clinic has recently launched a new website that is designed to offer essential information to people in Australia about the modern dental services and treatments. The Australian Dentists Clinic, which has branches all over Australia, provides a number of dental procedures, and the new site keeps patients informed with listings of various treatment choices.

The Australian Dentists Clinic provides general dentistry as well as cosmetic and emergency services, which include root canal treatments, Invisalign braces, dental crowns and implants, wisdom teeth extraction, and dental veneers.

Meanwhile, in line with their goal of helping people in terms of dental costs and also in compliance with the Department of Healths Child Dental Benefits Schedule (CDBS), the clinic offers free dental care to children aged between 2 – 17 years old. The CDBS, which started on January 1, 2014, offers access to children who belong to eligible families. Families can contact the Department of Human Services to check if their children are eligible.

Our dental team always stresses to our patients that it is crucial to keep up with dental care, and prevention is always better than a cure, says Nick McMahon from the Australian Dentists Clinic. We want you to enjoy healthy teeth and gums, and part of that is visiting your dentist on a regular basis.

The clinics website offers in-depth information on Invisalign treatment and other procedures, including dental fillings, teeth whitening, splints for teeth grinding, dentures, oral health, and periodontal disease. Other vital information provided on the website includes how a general dentist will check the dental health of a patient, when dental crowns are needed, when a root canal is required, the use of dental bridges, and various trends in cosmetic dentistry.

Our goal is to help people save money and time when it comes to dental care, says McMahon. We want you to be completely informed of your options, whether thats for implants or braces, and we want our patients to know that they can rely on us for those emergency dental situations that may happen from time to time, hence why many of our dental clinics are open 7 days a week.

Mr. McMahon says that the websites goal is to provide information to patients so that they can make informed decisions on their dental care. He states that too many patients rely on advice from friends and family, as opposed to visiting a dentist to have certain issues resolved, and says that the site covers dental conditions and treatment options, as well as what patients can expect from specific procedures.

Those interested can visit the website of Australian Dentists Clinic and check out the services offered and the various specials for new patients, such as the free Invisalign consultation at our Melbourne CBD dental clinic.

Contact Australian Dentists Clinic:

Nick McMahon
(03) 9088 0257
adcmelbournedentist@gmail.com
MELBOURNE CBD Level 3 – 620 Bourke Street, Melbourne, Victoria, 3000

SOURCE: Australian Dentists Clinic

14 September
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14 June
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Handful of dentists care for Jefferson County’s poor

Dr. Liza Mathias and Dr. Steve Scharf of Uptown Dental in Port Townsend take some low-income clients who have Medicaid insurance, mostly children. They are two of three dentists in Jefferson County to provide care to more than 7,000 people on the states Apple Health program. Dr. Edward P. Savidge of Port Townsend also takes children on Apple Health. All three welcome the idea of a nonprofit clinic to help care for adults. Photo by Nicholas Johnson

13 June
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Denver’s Top Dentists 2016

Check out our complete list of Colorado’s Top Dentists–including professionals in cities like Aspen, Fruita, and Durango.

The Process

How we come up with the Top Dentists list.

This list is pulled from the 2016 top Dentists database, which is created using peer evaluations and includes listings for more than 800 dentists and specialists in Colorado alone. To create its list, topDentists asked dentists and specialists a personal question: “If you had a patient in need of a dentist, which dentist would you refer him or her to?” The nomination pool consisted of all active dentists listed online with the American Dental Association as well as with dental academies and societies. (Dentists could also nominate others who may not be on those lists.) Respondents were asked to consider experience, continuing education, manner with patients, use of new techniques and technologies, and physical results. After responses were compiled, dentists were checked against state dental boards for disciplinary actions to make sure they have active licenses and are in good standing. We realize there are many fine dentists who are not on this list; a dentist’s inclusion is based on the subjective judgments of fellow dentists. For more information, visit usatopdentists.com.

Specialties

Endodontist: Treats issues related to nerves and the inner portions of the tooth, such as root canal therapy

General Dentist: Performs preventive dental care and basic upkeep, including cleanings and X-rays

Oral and Maxillofacial Surgeon: Removes impacted teeth (such as wisdom teeth) and performs reconstructive surgeries, like rebuilding broken jaws

Oral Pathologist: Studies, identifies, and treats oral diseases ranging from potentially cancerous leukoplakia to canker sores

Orthodontist: Modifies your bite or coaxes teeth into alignment using braces and other devices

Pediatric Dentist: Provides therapeutic and preventive dental care for kids

Periodontist: Specializes in the periodontium, or supporting tooth structure, and treats gum disease and receding gums

Prosthodontist: Deals with dentures, implants, and bridges, as well as complex crown work

The Four Commandments of Backcountry Brushing

A veteran guide at backpacking outfitter Noah’s Ark in Buena Vista, Jordan Wrinkle doles out teeth-cleaning rules that will keep the forest fresh–no mint gel required.

1. Thou shalt not swish with stream water. Purify water from creeks or lakes with iodine tablets, or use a water filtration pump. Even if you don’t swallow unclean water, giardia and other parasites can leech onto your toothbrush, making you susceptible to infections the next time you brush and, uh, GI symptoms that’ll catch up to you a week or two after your return to civilization.

2. Thou shalt not leave dental hygiene products inside the tent. When you’re finished brushing, place your sweet-smelling toothbrush, toothpaste, and floss in a bear-proof bag with the rest of your food. Then fasten it at least 12 feet up a tree and no fewer than 100 feet away from your campsite.

3. Thou shalt not spit near the river. Discarded toothpaste (the stuff you spit out) releases triclosan, a toxin that has been found to kill healthy bacteria in aquatic ecosystems. Hike at least 100 feet away from creeks or lakes before spitting to avoid contaminating water sources. And even when you’re far away from any babbling brooks, use an environmentally friendly paste like Earthpaste, which has only five simple ingredients.

4. Thou shalt not spit in a single blob. Leaving toothpaste remnants in one location not only attracts wild animals, but it can also sicken them. If possible, dilute the paste in your mouth with enough water to employ a spray technique, therefore distributing the watered-down solution over a larger area.

Leave No Trace (of Paste) 

When you’re in the mountains without a shower or bar of soap in sight, maintaining a spotless smile is the closest you’ll get to feeling clean. That’s why we consulted local dentists to come up with a manual for backcountry dental care.

Packing List

Dental hygiene essentials in the wild are just offshoots of what you use at home. 

»Toothbrush: Any travel-size brush with a plastic cap that protects the bristles from dirt–such as Liberty Mountain’s compact toothbrush ($2.50 at REI)–will do. Be sure to replace your toothbrush after each camping season, unless you want it to grow something unsavory. 

»Toothpaste: Lakewood-based Archtek’s Toothpaste Tablets weigh less than a dime each. Just pop one of the mint-flavored, bleach-free discs into your mouth, chew, brush (no water required), and spit. 

»NonFlavored Floss: The unusually strong string is the most under-appreciated camping sidekick this side of a pocketknife. In a bind, it can tie down a tent flap, repair a shoe lace, and cinch a bear bag. 

»Saline Solution: If your tooth gets knocked out, place it–unwashed–into a container filled with saline solution. Then get yourself to the dentist, where the tooth can often be put back into the socket if it’s still hydrated and whole. 

Neglect In Nature

Let’s face it: When we hit the trail, we like to travel light and leave the creature comforts at home. But Dr. James Fischer, a Westminster dentist, explains in icky detail what happens when you “forget” to pack in your toothbrush and paste.

After Just One Day: Teeth feeling a little furry after 24 hours of no brushing? That woolly sensation is plaque–bacteria that feed on sugar and other food leftovers–beginning to stick to your teeth. The filmy, sticky, colorless deposits won’t make a long-term home if you resume your regular hygiene routine tomorrow. In short, this is your free pass. Enjoy.

After Three To Six Days: Plaque continues to gorge on the remnants of last night’s s’mores, leading to the beginnings of stains on your teeth. Plaque can also harden into tartar, mineral buildup that won’t budge even when you start brushing again. If that doesn’t make you break out the brush, consider the tent-clearing rotten breath you’ll have.

After A Week: After seven days without a good scrubbing, your mouth becomes a petri dish of horrors. Bacteria begin eating into tooth enamel (read: cavities!) and gingivitis–mild gum disease caused by too much plaque–could begin to set in. And if your kid is sporting metal, the accumulation of plaque around her braces will permanently weaken her teeth.

After A Month: Let’s say you’re hiking the 485-mile Colorado Trail and have decided a toothbrush is an extravagance. Huge mistake. Massive plaque buildup leads to decalcification, a scenario in which little white spots on your teeth indicate that your choppers are losing nutrients like calcium and phosphate and becoming susceptible to decay. Plus, advanced gingivitis might result in periodontal disease, which is the breakdown of gum tissue and underlying bone.

13 June
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Dentists: Too few to care for poor

All of those numbers add up to a critical shortage of dentists in Jefferson County not just for the poor, but for those on Medicare and others without insurance, said Kees Kolff, a Jefferson Healthcare commissioner who wants to improve access to dental care.

Even before a public meeting attended by more than 70 people in April, Kolff had reached out to Sea Mar Community Health Centers, a nonprofit organization that runs 50 health clinics in 12 counties in the state.

“The vast majority of Sea Mar clinics have dental care, and Im currently in the process of discussions with Sea Mar to see what, when and how we can do it here,” said Kolff.

Kolff said that Mary Bartolo, executive vice president of Sea Mar, has advised him that chances are good that Sea Mar would open a clinic in Jefferson County. He also said Sea Mar may need to offer general health care and mental health in order to qualify for federal funding.

Kolff noted that he is not pursuing the invitation to Sea Mar as a hospital district commissioner, but as a member of the community concerned about health care issues. As such, he hasnt asked fellow health care commissioners for an endorsement of the idea, but does advise them of what he was doing.

HISTORY WITH SEA MAR

Kolff is no newcomer to Sea Mar clinics. He was the medical director of Sea Mar’s first clinic, which opened in the South Park neighborhood of Seattle in 1978. It had seven employees.

Today, Sea Mar has more than 2,200 employees and 50 medical, dental and behavioral clinics and centers in the state, according to its website. Its programs are located in Clallam, Clark, Cowlitz, Franklin, Grays Harbor, Island, King, Pierce, Skagit, Snohomish, Thurston and Whatcom counties.

Initially, Sea Mar focused on providing health care services in areas where people spoke both English and Spanish. The intent was to provide services from Seattle to Marysville.

Today, there is still a need for health care providers statewide – especially dentists, mental health and general medical health providers in rural areas of the state.

MEDICAID MONEY

Access to dental care is an issue for people who are on Medicaid, known in Washington state as Apple Health, Kolff said.

“The difficulty here is that when people who have Medicaid call, they cant get in to see a local dentist because [the dentists] dont take adults with Apple Health,” he said.

Of all 39 counties, Jefferson County has the lowest utilization rates of dental services in the state for those with Medicaid, according to statistics shared in April by Jefferson County Public Health.

In 2015, for example, 21 percent of those eligible for Medicaid in Jefferson County used that benefit to access dental health, according to a PowerPoint presentation by Dr. Tom Locke, health officer for Jefferson and Clallam counties.

Kolff says many of those people likely go to the nearest Sea Mar clinic, which is in Port Angeles.

Kolff doesnt blame dentists for refusing to accept Apple Health.

“The reimbursement for care is 28 cents to 29 cents on the dollar,” he said of understanding why dentists dont accept Apple Health.

That means for every $1 of care that a dentist might provide, he or she would be paid only 28 cents to 29 cents, not enough to keep the doors open, dentists contend.

Kolff said the key to improved access is getting a clinic that is designated as a federally qualified health center (FQHC). Not only do those nonprofit clinics accept those Medicaid dollars, they also get federal dollars to help provide free care to the poor. Those organizations also can provide care on a sliding-scale fee basis to other paying patients, including those on Medicare, patients in a federal health insurance program for seniors, and the disabled.

FQHC clinics do not turn away anyone, regardless of their ability to pay, Kolff said.

13 June
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200 dentists offer free care at annual clinic in Downtown Pittsburgh

Vicki Lowmiller mumbled her gratitude through two pieces of heavy gauze Saturday for the free tooth extractions she received at the David L. Lawrence Convention Center, Downtown.

“It was a really great experience,” said Lowmiller, 47, of Turtle Creek. “Everybody was really nice.”

She was one of hundreds who received free dental care ranging from cleanings to root canals and denture fittings Friday and Saturday.

Nearly 1,000 people, including about 200 dentists, volunteered at Pennsylvanias version of the national Mission of Mercy program, known here as MOM-n-PA.

Lowmiller, a bus driver, said she cannot afford dental insurance on her part-time salary. After about two weeks of pain in one of her lower teeth, she found out about the clinic on Facebook. During an examination a dentist found a tooth she didnt know she had in her upper gum, where she wears a denture.

The dentist removed both in procedures that Gary Davis, MOM-n-PAs chairman, estimated would have normally cost her about $500.

The Pittsburgh event was the organizations fourth annual clinic. Dentists in the state saw a need among lower-income people for better dental care, but many cannot afford to provide lots of free care in their offices, Davis said.

Organizing the clinics has only strengthened their sense of the need that exists, particularly among the working poor who cannot afford dental insurance and report difficulty in getting time off for appointments.

Among patients in the last three years, 39 percent showed up in pain, Davis said.

“We thought that was kind of alarming,” he said. “We see it as an emergency situation. For that many people to be in pain, I think theres something wrong with our system.”

Low reimbursement rates for dental care in Pennsylvanias Medicaid program make it difficult for doctors to treat many low-income adults with the health plan, he said.

Some people with private insurance report that dental care is too expensive, he said. As a result, many adults forgo care — he said that more than half of clinic participants report not having visited a dentist in five years.

“Dental health is key to overall health because poor health in one area makes your health poorer in other areas,” said Bill Spruill, a MOM-n-PA board member.

Gum infections can make diabetes harder to control, for example, and periodontal disease increases the risk of premature delivery in pregnant mothers, Spruill said.

The clinic prepared for as many as 1,000 patients per day. Past events in Philadelphia, Harrisburg and Allentown drew about that number, but on Friday fewer than 400 attended the Pittsburgh event, Davis said.

He didnt know why fewer attended in Pittsburgh on Friday, speculating that the event might have attracted more of the people who need care if it had been held closer to where they live. A steadier stream of participants was coming through the doors midday Saturday.

The event, which organizers said cost about $200,000, was funded through donations.

Next years clinic is planned for Erie.

Wes Venteicher is a Tribune-Review staff writer. Reach him at 412-380-5676 or wventeicher@tribweb.com.

11 June
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Augusta University launches Pediatric Dental Rx, helps dentists with pediatric dosing

Over the past year weve seen a number of dental apps hitting the App Store. Smiles for Life is a great dental app for primary care physicians focused on oral health hygiene. Knocked out is a free dental emergencies app made by a dental society. The University of Augusta recently added another dental app to the App Store called Pediatric Dental Rx.  The dental app is aimed at helping dentists with medication dosing for commonly prescribed drugs for the pediatric patient population.  Prescribing medications to the pediatric population is more challenging than adults due to the nature of weight based dosing. Pediatric Dental Rx was created to help dentists with this.

When you download the dental app, the first thing you notice is its simplicity and ease of use. The colors dont clash, and the font is easy on the eyes. The homepage consists of categories that, when clicked on, will direct you to a page where you choose the medication and the patients weight. The dental app will then calculate the right amount of medication according to the patients weight.

4 Categories:

SBE Prophylaxis. The prescriptions in this square are Amoxicillin and Clindamycin and the patients weight is needed.

Avulsion. PenVK and Doxycycline are in this square and the patients age and patients weight are required.

Antifungal. The Antifungal category caters to infants and children 5+ years and depending on which one you choose, the Oral Candidiasis and Angular Cheiltis are different.

Ulcers/Chapped Lips. Those with ulcers choose between Magic Mouthwash and Kenalog in Orabase, while those with chapped lips have Triamcinolone 1% ointment treatment.

This isnt the first dental app the University of Augusta created with the purpose of helping out dental students and medical students. The Dentistry Consultant App provides a quick and easy way for dental students to review procedures, while the smarTooth App helps automate tooth proportion metrics and space analysis calculations.

11 June
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Dentists must address dental pain first

The Patient Files- Part 6

This series of articles deals with real patients who came to my office for a second opinion. Not all dentists see things the same way, and there are almost always multiple options for every patient. There is not always one “best” treatment plan for a patient, but there is usually a right one.

I recently treated a patient who came to me with a complaint of severe facial pain and swelling in her cheek. She had a very complex medical and dental history that made treating her successfully very difficult. About 15 years ago, she had orthognathic surgery to align her jaws with the goal of improving her function and appearance. The surgery is aggressive and involves physically sectioning the jaw from the skull and using plates and other methods to position the jaw in the proper position for healing. Unfortunately, my patient had a very bad experience with the surgery including multiple infections that required further surgeries and bone grafts that occurred over the following years. To complicate the situation, she was also diagnosed with breast cancer shortly after her jaw surgery and her chemotherapy schedule was adversely affected by the complications arising from that problematic jaw surgery.

She continued to have problems with facial pain for years and had extensive routine dental treatment performed three years ago.When I saw her she was in extreme pain in her upper and lower jaw and had noticeable swelling in her right cheek. She had seen 3 oral surgeons, 2 general dentists and an endodontist (root canal specialist) and none saw any infection in her teeth. The only recommendation was from one oral surgeon who advised TMJ (jaw-joint) surgery.

When I examined the patient, I noticed that all of her fillings were very deep and close to the nerve, and that one of her teeth had a root that was more that half resorbed (dissolved). The first and most important goal was to get her out of pain, and that initially involved the removal of one lower tooth that had a retreated root canal that could not be saved and three root canals on her upper right jaw. I also let her know that my treatment would not likely remove all of her facial pain, but should improve the situation. Residual facial pain from her previous surgery and some discomfort in the TMJ area would remain unchanged.

After the extraction and the root canals, much of her pain and swelling slowly resolved. The procedure did not go completely smoothly, however, and some adjustments and antibiotics were also required as she healed. When I think about the other dentists who saw her and told her she did not have any dental infections, I believe it was the complexity of the patients medical and dental history that influenced them into not taking the definitive action that was required. Not all dental treatment is predictable and routine, but as a dentist we have an obligation to try to treat every patient to the best of our ability. If we cannot treat the patient ourselves, then we need to refer her or him to another dentist who can. Clearly, relieving a patients pain is of the highest priority.

Dr. Jerry Gordon can be reached at (215) 639-0571. Comments, questions, and second opinions are available at The Dental Comfort Zone, 2734 Street Rd. Bensalem, PA 19020 (across from the Giant supermarket). To learn more: www.dentalcomfortzone.com E-mail:drjdmd@comcast.net

11 June
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Why dentists write too many scripts

He said he wanted me to scare the hell out of them, said Aquino, who also worked for the Drug Enforcement Administration and now advises pharmacies on DEA compliance issues.

Every fall, Aquino spends a couple of hours with Hershs pharmacology class, explaining what can happen to patients who overuse opioids and to dentists who illegally prescribe them. Hersh devotes 12 hours to this subject in an 88-hour course.

They are part of a nationwide push to get dental schools to help fight opioid addiction.

In April, US Surgeon General Vivek Murthy announced a campaign that included a special plea to dentists and other medical professionals.

A Harvard research team reported recently in the Journal of the American Medical Association (JAMA) that dentists are among the leading prescribers of opioid analgesics, particularly for surgical tooth extractions.

Hersh points out that some dentists are prescribing opioid combinations that are both unnecessary and less effective than other painkilling drugs. There are some cases where the pain is so bad you need an opioid, he says, but it shouldnt be the first thing you prescribe. Opioids have their place but only in special situations.

Hersh said he has found that Advil is usually at least as effective as Vicodin for dental pain. He and his frequent research collaborator Paul Moore of the University of Pittsburgh are hoping to conduct a larger study to confirm this and similar findings.

Back in 2011, they wrote in the Journal of the American Dental Association, dentists were prescribing 12 percent of immediate-release opioids in the United States.

In another study published in JAMA in 2011, data from 2009 showed that dentists were the largest source of opioid prescriptions for patients age 10 to 19. Hersh says this is the age when wisdom teeth are likely to be removed surgically.

The downside of opioids is well-known: They are potentially addictive, can lead to the use of street drugs such as heroin, and can have side effects such as nausea, vomiting, constipation and dizziness. Drugs prescribed for adults can find their way into the hands of children.

Why, then, do dentists frequently prescribe them?

In some cases, Hersh says, nonsteroidal anti-inflammatory medicines have side effects that some patients cant tolerate. Naproxen and Aleve, for example, can cause stomach issues. Acetaminophen should not be prescribed for anyone with liver disease.

But except for these cases, Hersh blames habit: Some practitioners have been writing opioid prescriptions for years and havent kept up with the effectiveness of alternate drugs.

In other cases, they are anticipating a pain level that might occur in only a small minority of patients. For this he cites patient expectation as a major cause of overprescribing.

They want a strong pain reliever and they have a perception that something with an opioid is better. And the dentists and physicians cave in.

Patient demand is a bigger factor in recent years with the spread of clinician-rating sites on the internet: An unhappy patient delivers a bad rating that can damage a dental or medical practice.

And then there are the patients seeking opioids to feed a drug habit – which in many cases started with a painkiller prescription.

George Downs, dean emeritus at the University of the Sciences, says that in about 85 percent of cases, a well-trained physician, dentist or pharmacist should be able to spot addiction.

Hersh says that warning flags include patients who come a long way to see a dentist for no discernible reason, who want to pay only in cash, or who claim to have a list of ailments that preclude about every over-the-counter pain management drug.

Some of them know their pharmacology better than the physician or the dentist, he says.

Aquino said that in his law enforcement career he saw cases in which patients were so desperate to get drugs from a dentist that they sliced their gums so they would get infected.

Improvements in electronic record-keeping are making doctor-shopping more difficult, Hersh says, but there is still room for error.

State health guidelines adopted last year and endorsed by the Pennsylvania Dental Association call on dentists to refer patients with chronic pain to pain management specialists.

Aquino says he warns dental students to stick with what they know.

Your field is dentistry, not pain management, he tells them. But if you get involved in pain management, youd better do a lot of education on it.

pjablow@comcast.net