Dentists Say Lead Is Dentistry’s Biggest Health Threat

Other Dental Health Concerns Include Mercury and Bisphenol-A

In this survey, we asked dentists how concerned they are about various potential public health threats linked to dentistry. Dentists’ concerns, in order, are:

General dentists versus specialists

  1. Lead in dental lab work
  2. Mercury in amalgam
  3. Bisphenol-A in composite, and
  4. Fluoride in water supplies.

General dentists had higher levels of concern on all issues than specialists. However, specialists and generalists agreed on the relative dangers of the chemicals covered in this survey.

Dentists’ thoughts

  • “I’d like to be doing all gold restorations.” (New Jersey dentist)
  • “All four of these need to be totally nailed down as to their safety, or lack thereof.” (Arkansas dentist)
  • “Two things that will bite dentistry in the butt are fluoride and amalgam if we don’t stop forcing them on the public.” (Idaho dentist)

Mercury

  • “150 years have not proved Amalgam to be dangerous.” (Arkansas dentist)
  • “Amalgams have saved billions of teeth!” (Washington dentist)
  • “A known toxin, no safe levels, should be banned.” (Louisiana dentist)

Lead

  • “Lead in dental casting alloy? Outrageous!” (Colorado dentist)
  • “Recent articles have debunked the worry over the amount of lead in ‘farmed-out’ crowns. Still, we need to monitor that work.” (California dentist)

Bisphenol-A (BPA)

  • “This stuff is everywhere. Composites without BPA just don’t hold up well.” (Wisconsin dentist)
  • “It’s probably not too dangerous, but don’t cast stones, Mr. Composite: you live in a glass house!” (New Jersey dentist)
  • “It’s ironic that many patients are removing long tested amalgam and replacing them with bisphenol composites of unproven safety.” (California dentist)

Fluoride

  • “It’s been shown to be effective, but we shouldn’t be medicating the whole population.” (Colorado dentist)
  • “The best public health measure ever instituted in this country for caries prevention.” (Texas dentist)
  • “Known to be toxic.” (California dentist)

Post your thoughts or read the complete dental public health threats survey results

Invisalign Cost: Invisalign Braces Fee Analysis

According to the Invisalign website, the national average cost for Invisalign treatment ranges from $3,500 to $8,000, with the national average at about $5,000.

The Wealthy Dentist conducted a survey to determine what dentists and orthodontists are charging for Invisalign.

The results from the survey revealed that Invisalign treatment costs an average of $4,622 when provided by a dentist and $6.945 when treated by a specialist.

“We adjust our cost according to how long treatment takes. Times can range from 5 – 18 months (rarely more). We are willing to “deal” on Invisalign because the actual Dr. time is so minimal,” reported a Minnesota dentist.

The cost of Invisalign treatment is on average $500 higher than the cost for regular braces treatment. The dentists who responded to this survey noted that the higher cost reflects the lab fee that they pay for the Invisalign trays.

Here’s a sample of what dentists had to say about the cost of Invisalign treatment:

“I take into consideration material cost of impressions for both initial and refinement, the lab cost and shipping. We charge $5,000 for a full treatment.” (Georgia dentist)

“I have wrestled with the most appropriate fee levels for Invisalign for a long time. We have historically kept the cost of a ‘full’ treatment a bit higher than traditional orthodontia. Although the ‘full’ treatment cost is $5800 — I charge $3200 for express.” (Washington orthodontist)

“Specialists usually get ‘tougher’ cases, so they charge more. We have three fee structures for simple, medium, and complex.” (California dentist)

“My Invisalign rep suggests that I should lower my fees or offer financing that takes a bite out of my profit due to the economy, but I don’t see them lowering their lab fees to me!” (Illinois dentist)

“I hate how high the lab fee is!” (General dentist)

“Invisalign pre-treatment of prosthetic cases greatly reduces the complexity and cost of many restorative challenges. Talk about a revenue enhancer! Invisalign is the best thing this GP has added to the bag of tricks in the last 4 years!” (Florida dentist)

“I am thinking of lowering my fees to compete with the general dentists in the area …” (Oregon orthodontist)

“Clear Choice is much lower in cost to the dentist (and the cost savings can be passed along to the patient). Clear Choice appears to be just as good, if not better than Invisalign. I’m so fed up with Invisalign and our local rep is not very helpful either.” (Ohio prosthodontist)

“Our cost includes whitening and first set of retainers, which we make in house.” (Connecticut dentist)

“There is no free lunch!” (Ohio dentist)

For more on this survey see: Fees for Invisalign Treatment Average $4,622 – $6.945

FDA Finally Takes a Stand on Mercury… Sort Of

Agency Promises to Make a Decision Next Year

The Food and Drug Administration (FDA) has long avoided taking a public stand on the safety or danger of mercury in silver dental fillings. However, with a recent settlement in a lawsuit brought by the organization Moms Against Mercury, the governmental health agency has finally agreed to take a stand on the issue. Eventually.

The agreement calls for the FDA to complete its reclassification of dental amalgam by July of 2009. (The agency began that process in 2002.)

Some news articles have heralded this as a major change in the FDA’s attitude toward amalgam, with headlines making grand proclamations about a new post-amalgam era.

Can you guess which of the following is not a genuine headline?

These are attention-grabbing headlines, to be sure! The problem is, they’re not necessarily true per se. (And okay, I made the last one up.)

In the ADA’s response to news of the decision, the dental organization disputes these suggestions. “As far as the ADA is aware, the FDA has in no way changed its approach to, or position on, dental amalgam,” reads the statement.

As part of the agreement, the FDA has updated the consumer information provided by its website on the subject of mercury and dental amalgam.

“Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses. When amalgam fillings are placed in teeth or removed from teeth, they release mercury vapor. Mercury vapor is also released during chewing. FDA’s rulemaking will examine evidence concerning whether release of mercury vapor can cause health problems, including neurological disorders, in children and fetuses.”
Questions and Answers on Dental Amalgam (FDA Consumer Information)

What do you think? Is this a new era, or just more of the same?

Dentists Worry About Long Term Use of NTI Splint (video)

NTI splint surveyThe NTI-splint is a dental mouthguard used to treat headaches, migraines and teeth grinding. But there are dentists who worry about its long-term use.

“I think the NTI-splint does more damage than good. It is only for immediate pain relief, not as a long-term appliance,” said a California prosthodontist.

“NTI causes open bite issues and long-term damage to the TMJ’s,” reported a Texas dentist.

Some dentists worry that improper use of the NTI can cause orthodontic problems or jaw pain.

“The NTI caused a patient increased TMJ pain,” said a Georgia dentist. “The NTI creates anterior open bites if used for the long term,” declared a Hawaii dentist.

To hear more of what dentists had to say about NTI-splints, please click play and watch the following survey video –

In general, it’s great for dentists have more treatment options in their bag of tricks, but the NTI is like almost any other treatment modality: if you don’t know what you’re doing, you can do more harm than good.

What has been your experience with the NTI-splint at your dental practice?

Dentists Say Specialists Usually Refer Patients Back

Prosthodontists and Periodontists Suck; Oral Surgeons and Orthodontists Rule

Dental Survey ResultsThis survey asked dentists how frequently their patients are referred back after being sent out for treatment by specialists. The clear majority said they always or almost always got their patients back.

Dentists reported that prosthodontists were the worst offenders when it comes to not referring patients back. There were also complaints about pediatric dentists and periodontists. Dentists were happiest with oral surgeons, orthodontists, and endodontists.

Here are some comments from dentists about specialist referrals…

  • “Periodontists only have incoming phone lines. They never refer back.” (Arizona dentist)
  • “Building a good relationship with your specialists is critical. Specialist referrals are our second greatest source of new patients, after existing patient referrals.” (Pennsylvania cosmetic dentist)
  • “Endodontists love to do it all, endo and restorations. They’re too greedy.” (Arizona dentist)
  • “The endodontists to whom I send patients are tremendous.” (Illinois dentist)
  • “Oral surgeons and orthodontists are a great source of new patients, especially in a growing area.” (North Carolina dentist)
  • “Orthodontists will not share or help with easy cases, and refer existing patients to oral surgeons, not back to us.” (Arizona dentist)
  • “I enjoy the relationship with my periodontist. He does the perio and I do the restorative. I’m not afraid that when I refer the patient that they will get lost.” (California dentist)
  • “Periodontists attempt to take over patients’ care and regular hygiene visits.” (North Carolina dentist)
  • “Pedodontists never, ever refer back! They are by far the worst of all specialists.” (Arkansas dentist)

about specialist referrals or read the complete results

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