Tongue Piercing Can Lead to Crooked Teeth, Warn Dentists

Tongue piercings can damage teethIt turns out that tongue piercings can be bad for one’s teeth. While this is hardly a surprise to any dentist, it’s been confirmed by a recent study from New York’s University of Buffalo.

Researchers had previously found that teens with pierced tongues tend to “play” with the barbell-shaped piercing, often pushing the end of the stud against their front teeth — a habit that might leave them needing braces to fix the damage.

In this particular case study, a young woman who had had her tongue pieced for seven years developed a gap between her front teeth from pushing the barbell into the space between the teeth.

It’s already known that a tongue piercing can increase the risks of chipping or cracking teeth, wearing down tooth enamel, receding gums and more — now it’s time to add orthodontic damage to the list.

Read more: Tongue piercings could be a dental nightmare

Best Braces Dentist: A Family Dentist or an Orthodontist?

Should GPs do ortho? 74% of general dentists think so, but only 4% of orthodontists agreeIs the best braces dentist a GP or a specialist? It all depends on who you ask.

Three out of four general dentists think it’s appropriate for GPs to do orthodontics, but a mere 4% of orthodontists surveyed agree. In fact, 41% of orthodontists say they’re the ones who should be doing virtually all ortho work.

“The training is often minimal and results often are not retained,” said one dentist. “I just think it is better to leave the specialties to the specialists.”Should general dentists do ortho?

Here are some dentist comments on general dentists and orthodontics.

  • “Case selection is critical and should be based upon the knowledge and skill of the GP.” (Florida dentist)
  • “Some orthodontists resent GPs doing their own ortho. Why is that? I have never met a single oral surgeon, endodontist, or prosthodontist that had a problem with my practice desires. It could be a matter of greed or pride. You make the call.” (Georgia dentist)
  • “Those who are doing it hopefully have a good lawyer on their side.” (Kentucky dental implant dentist)
  • Invisalign is becoming the latest malpractice issue. Too many GPs are doing it and getting into trouble!” (Florida dentist)
  • “General dentists don’t have the proper knowledge to perform orthodontics. ‘Little knowledge is dangerous.'” (New York dentist)
  • “Would you send your wife to a family physician for her brain surgery?” (Orthodontist)
  • “As long as they stay within their level of training and they refer when appropriate.” (Texas pediatric dentist)
  • “The quality of GP ortho is directly related to the quality and quantity of the dental CE. Most GP ortho CE courses are cursory and superficial. Only one or two are a true continuum that mimics an ortho residency.” (Alaska dentist)
  • “Diagnosis is the most difficult part. Once you have the background, the rest is easy.” (New York dentist)
  • “With proper training, any GP should be able to perform any procedure, whether it is endo, ortho, dental implants, etc.” (Prosthodontist)
  • “Every orthodontist is being asked to help or bail out GP cases as they often underestimate the complexity of cases and or are tackling more complex cases than they should due to economic pressures.” (California orthodontist)
  • “GPs see relapse on a regular basis after ‘specialist’ treatment.” (Maryland dentist)
  • “No different than a GP doing endodontics, prosthodontics, pedodontics, oral surgery or perio.” (Florida pediatric dentist)
  • “Bad ortho can ruin a patient’s dentition.” (Georgia periodontist)
  • “It’s not rocket science.” (Australia dentist)

Read more about dental braces: General Dentists Do Orthodontics, But Orthodontists Aren’t Sure They Should

Invisalign Creates Greater Profits for Orthodontists

Invisalign Creates Greater Profits for OrthodontistsIs Invisalign a smarter braces treatment for an orthodontist’s bottom line?

A new study suggests some truth to this by revealing that, while Invisalign clear orthodontic aligners cost more in materials than conventional edgewise braces, they require fewer patient visits and a shorter duration of treatment for dentists.

Researchers reported this finding at the recent American Association for Dental Research annual meeting, according to Medscape News.

Researchers evaluated the records of 150 dental patients with mild to moderate class I malocclusion. The types of orthodontic procedures were matched for the amount of initial malocclusion and the number of rotated teeth.

According to Medscape News, here’s what they found:

Conventional braces required a median of 13.6 minutes for a routine visit, whereas Invisalign required 9.9 minutes. Emergency, initial, and final appointments were all longer than regular visits.

Conventional braces required about 2.6 more visits than Invisalign, treatment for 2.4 months longer, 1.1 more emergency visits, 9.7 minutes more in chair time, 1.2 minutes more emergency doctor time, and 86.2 minutes more in total chair time.

However, Invisalign cost $500 to $1441 more in materials and required 5.9 minutes more doctor time than conventional braces.

Measuring profitability as fees minus the cost of materials, Invisalign was more profitable than conventional braces, the researchers found, especially for Invisalign providers who are charged $899 in lab costs, a discount that the appliance maker, Align, offers to orthodontists who do more cases.

For these doctors, Invisalign provided about $1000 of profit per hour of chair time with the first $2750 in fees to the patient, rising to $3250 with $6000 in fees. Doctors who are charged $1549 in lab costs by Align had a profit of about $500 with the first $2750 in fees, rising to $3000 with $6000 in fees.

Braces were less profitable overall, starting at $750 per hour of chair time with the first $2750 in fees, but reaching only $2000 with $6000 in fees.

Invisalign is clearly the profit-maker when it comes to adding value to an orthodontist’s practice.

For more on this story see: Study Shows Invisalign More Profitable Than Braces

Dental Marketing Dilemma: Orthodontist in Local Newspaper

Dental marketing dilemma: bad press in newspaperWhen it comes to dental marketing, not all press is good press. Just ask the orthodontist who was recently featured in the Chicago Tribune’s “What’s Your Problem?” section.

The newspaper has recently covered a mother’s plight to have her son’s braces removed.

According to the woman, the orthodontist refused to remove the teen’s braces until the family settled a mysterious $300 bill for missed visits. Her two daughters had seen the same doctor, and the family had paid the orthodontic practice a total of about $12,000 over the years.

The dispute occurred in January, and involved the office filing a police report against the mother (for charges she denies). She contacted the newspaper in July. Now that it’s been featured in the paper, the boy’s dental braces are off.

The orthodontist expressed bewilderment over the whole thing. According to the practice, there is no $300 balance due, and the boy would have been welcome in at any time.

It’s not clear what really happened – but it is clear that the orthodontist doesn’t come out looking so good in the local paper!

Read more: Mom not smiling over dental dispute

Private Equity Dental Management Companies Come Under Fire

Private Equity Dental Management Companies Come Under FirePrivate Equity dental management companies are at the center of a U.S. Senate inquiry, audits, investigations and civil actions in six states over allegations of unnecessary procedures, low-quality treatment and the unlicensed practice of dentistry, according to a report released by Bloomberg News.

Federal lawmakers and state regulators are trying to determine whether a popular dental practice model funded by Wall Street is having a destructive influence on dentistry in the U.S.

The private equity dental companies only account for about 12,000, or 8%, of U.S. dental practices, according to Thomas A. Climo, a Las Vegas dental consultant.

In 2010, The Wealthy Dentist reported that All Smiles Dental Center Inc., a management company owned by Chicago-based Valor Equity Partners, filed for bankruptcy protection after a Texas Medicaid action cut off reimbursement payments because of their exorbitant amounts of orthodontic care at the expense of Texas taxpayers.

All Smiles was part of a state audit that discovered 90% of the Medicaid claims for orthodontic braces weren’t medically needed.

After years of criticism that the poor were being deprived of dental care under Medicaid, class-action lawsuits and public pressure forced Medicaid to change their health care reimbursements. As reported by The Wealthy Dentist in our story, Taxpayers Footing the Bill for Braces in Texas, some Texas’ dental practices went on to bill Medicaid $184 million for Medicaid orthodontics — more than the rest of the United States combined.

M. Alec Parker, executive director of the North Carolina Dental Society told Bloomberg News that the private equity industry stepped up its investments in dental management over the last 5 years partly because health care was one of the few areas that grew through the recession.

According to the Bloomberg report, Christine Ellis, a Dallas orthodontist, who testified before Congress in April of this year reported that the “flagrancy of the fraud” she found in audits she performed for Texas Medicaid “is truly unbelievable,” with only 10% of the paid claims she reviewed actually qualifying for Medicaid coverage.

Ellis told the U.S. House Committee on Oversight and Government Reform that Texas “has gained a lot of fraudulent orthodontic providers, including many private equity owned dental clinics engaged in the illegal practice of dentistry.”

Medicaid's Dental Boom - Bloomberg News

This May North Carolina is considering legislation that would subject agreements between dentists and the companies to state approval over concerns brought about by the the practices of private equity dental practices.

The Wealthy Dentist twice reported on the North Carolina Senate Bill 655 that would require the North Carolina Board of Dental Examiners to examine all business contracts entered into by dental practices in their state.

Our first article, Dentists Beware: The Government May Want To Tell You How To Manage Your Practice detailed information concerning inclusive authority over how dentists manage their business.

The second The Wealthy Dentist article, Dental Practice Management: North Carolina Senate Bill Wants Dentists To Do It Themselves discussed dentist responses to the impact this bill could have on their dental practices.

The measure has already passed the state Senate and has moved on to the House, where leaders have appointed a special interim committee to study the bill and its potential repercussions to dentists.

Reports have surfaced that the legislative proposal likely to be heard this month. The basics of the bill is intended to restrict contracts dentists can build with dental service organizations and give the Dental Board control of how dentists in North Carolina run their practices.

The North Carolina Dental Society supports the bill, stating that dental management companies often bill dental patients for unneeded care and opponents insist that passage of the bill will only drive up dental care costs.

What are your thoughts on private equity dental management practices?

For more on this story see: Dental Abuse Seen Driven by Private Equity Investments

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