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?

Dentist & Dental Insurance: No Love Lost (video)

Dentists not accepting dental insuranceHalf of dentists have mostly or completely stopped accepting dental insurances, according to this survey.

"If all dentists dropped all insurances, then ALL dentists could collect their fees in full from everyone," declared one dentist. "They could also have more leeway to give courtesy discounts to whomever they choose instead of patients who belong to certain plans."

"I'd be cutting ties to 85% of my patient base!" objected an endodontist.

"We converted to [not accepting dental insurance] six years ago," explained one dentist. "We ask for payment at time of service, then send in the claim form for the patient to have insurance company pay them. People have to want to stay with you because this policy can rub many the wrong way. I have lost many a patient over this, but still gain many new patients every month who are fine with it. I have built a strong reputation in my community for personal service, quality, and outstanding cosmetic dentistry. Hopefully that is what keeps them coming back."

"So-called 'insurance' companies must be making a fortune on 'dental insurance,'" fumed another dentist. "When these programs began in the 1960's, the dental coverage limits generally were $500-750 per calendar year. A dental crown cost $100 then. Now, 50 years later, porcelain crowns cost $1000, but the yearly limits are $750-1500. The dental insurance plan premiums have surely kept up with 50 years of inflation, but the dental plan benefits haven't. Do the math… somebody is making a hell of a lot of money on these plans, and it is not the dentist!"

Read more about this dental management survey: Most Dentists Are Dropping Dental Insurances

Dentists: Heed the Incredible Power of the Checklist

Checklists for airline pilots, surgeons, and dentistsWhether you’re a dentist, surgeon, or airline pilot, checklists can dramatically improve performance. In fact, Russell Taichman, professor of dentistry at the University of Michigan, has co-authored a study with two pilots about how airline crew resource management (CRM) checklists can be applied to dental care.

This study of CRM and dentistry proposes breaking the dental visit into five distinct stages, each with its own explicit checklist.

It was some 30 years ago that airlines realized that CRM could reduce human error, the cause of most accidents. Within that industry, studies have consistently found significant – even dramatic – reductions in accidents when airline checklists are used.

Since then, other industries have taken notice. Once a revolutionary concept, the use of medical checklists has rapidly become the new standard.

Dr. Atul Gawande, an associate professor at the Harvard School of Public Health, pioneered the field of medical checklists. He was named a MacArthur fellow in 2006, and his surgical safety checklist has been credited with reducing hospital death rates by as much as 50%.

The results of using a pre-surgical checklist have spoken for themselves. There are fewer deaths and fewer complications (about one-third less, according to some research) – and hospitals are even saving money by not having to treat those complications.

While hospitals have been eager to adopt the checklist, doctors and staff have been somewhat more reluctant. In a real-world setting, many surgical teams do not actually consult an itemized checklist.

But it seems to me patients would love to know their surgeon or dentist was using a checklist before each and every procedure. You could even mention it in your dental marketing as a patient benefit!

Read more: Should Dentists Take Safety Advice from Pilots?

What Makes a Dentist go Bad?

when dentists go badIn recent news, dentist Davinder Singh Jamus failed to effectively sedate a patient as he filed down her teeth at the Kensington Dental Spa clinic in West London, causing her to scream out in agony.

His response was to tell her that, “Nobody screams in my surgery,” while botching her veneer job.

On March 21, the UK General Dental Council listened to story upon story from angry former patients of Dr. Jamus.

When one of the former patients complained about the quality of her dental care, he allegedly told her she had been “very ambitious and naughty.” Apparently he tried to intimidate her into silence by advising that if she tried to take it further he “could guarantee she would lose.”

Jamus is also accused of allegedly fitting one patient with dental crowns to two teeth, instead of providing veneers as agreed, and failing to give another patient enough time to consider treatment before asking for consent while not admitting he had perforated her root canal.

Is this a bad misuse of his position as a medical professional, or an example of a poorly trained dentist?

NHS in the UK saw a 4.4% rise in annual complaints about GP services and dentistry to in 2009 -2010. There are twice as many claims on British dentists as there are on British doctors for poorly done treatment, fraud or excessive fees.

Other complaints are for badly done root canals or broken crowns and bridges.

Some believe the rise in complaints in the UK is due to the rise in the costs of procedures during rough economic times. Davinder Singh Jamus seems to be the exception — not the rule — when it comes to quality dental care.

What are your thoughts on bad dentistry?

For more on the Jamus dental story, see: The Daily Mail.

Do You Have The Best Dental Sign? See Who Thinks Theirs is Better!

the wealthy dentist dental signage contest

In this article, we are featuring a few of the top contenders in our contest for the best dental practice office sign, display window or office front.

Do you think you have the best dental sign?

Does your dental office front kick butt?

Well, what are you waiting for?

Take a picture and enter The Wealthy Dentist Dental Practice Office Sign, Display Window or Front Picture Contest!

Hurry! We are still accepting submissions through June 30th.

Here are the most notable entries to date:

1. Jayhawk Dental

Window –

Signage –

Jayhawk Dental Sign

2.  Biderman Dentistry

Signage –

Biderman dental sign contest

3.  Boger Dental

Window dressing and signage –

Boger Dental Sign

4.  Marina – Pacific Dental

Window dressing,  signage and front office –

Marina Pacific Heights Dental

So come on!

Enter your dental office sign or office front for a chance to win a Cisco Flip. Just submit a photo of your dental sign or office front by emailing chughes(at)drs1.com before midnight on June 30th.


Dental Signage tutorialDesigning The $1,000,000 Dental Sign

Everything you need to know to design and position your sign – even tips on how to pick the best location for a new dental facility.

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