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

Dentist Appointments: No-Shows Must Pay Anyway

Dentist missed appointment feesMissed dentist appointment fees have recently made headlines, with one Canadian man complaining loudly about a $400 cancellation charge.

Many dentists charge patients missed appointment fees. Typically, these fees tend to be about $25-50 per appointment. But there’s a lot more variation than you might expect!

A recent survey we conducted showed that an average of 1 in 10 patients is a no-show. That’s a 10% reduction in dental practice profitability, and a serious dental management issue.

The $400 missed appointment fee

Roland Ikporo’s son got a toothache last month, but their family dentist was closed. So he took his son instead to Calgary’s Expressions Dental clinic.

The dentist there conducted an exam and took x-rays at a cost of $150. He told Ikporo that his son needed 4 teeth removed right away. So Ikporo made another appointment for two days later.

But within an hour, Ikporo cancelled the appointment, realizing that his general dentist would be cheaper. (While Expressions Dental would charge $1,700 to remove the four teeth, the dental work was only $800 from their regular dentist.)

Though called the dentist office to cancel the appointment less than an hour after he made it, his Visa was billed an additional $400 missed dentist appointment fee.

Ikporo had in fact signed a consent form that explained the clinic’s cancellation policy: give 72 hours notice or be charged $200 per hour of missed appointment time. So by booking an appointment less than 3 days in the future, Ikporo had no ability to cancel.

Angry, Ikporo has registered a complaint with the Alberta Dental Association and College. They are now investigating.

Just an observation: Even if he pays the $400 fee, Ikporo will still have saved money by having his family dentist perform the extractions… The general dentist‘s $800 fee plus the $400 cancellation charge is still significantly less than the $1,700 quoted by the dental clinic.

What’s your policy?

Many dentists find that a $20 cancellation charge just doesn’t get the job done. How does your practice handle no-shows?

Read more: Father angry over $400 dentist cancellation charge

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

Is Dentist Practice Production on the Rebound in 2011?

dental production for 2011Dentist practice production hasn’t declined for all dentists, with 46% reporting increases to their production in the first quarter of 2011, according to our recent survey.

24% of practices have seen an increase of up to 10%, and another 16% are seeing increases in the 10 – 20% range. Only 6% have seen production increase by 20% or more.

The slight minority (38%) have seen their dental practice production decrease this quarter. Only 16% have not noticed a change.

Here are some dentist comments:

  • “The recovery has not trickled down to the worker level yet. Now we are feeling the pinch of higher gas prices and also the increase in consumer goods.” (Texas dentist)
  • “During these economic times, being lazy is not an asset. It is a time to dig in, work hard, market hard and effectively and make sure that you have the capacity to handle the demands your marketing (internal and external) will place on your practice.” (Michigan dentist)
  • “The measuring rod is not the practice’s production, it’s the practice’s collections! I am actually producing more but my collections rate has decreased. The insurance companies are making me take more write-offs if I am a “preferred” provider for them and the insurance companies, in general, are paying less for the same procedures than they have in past years. I guess they are trying to build up their coffers before health care reform takes full effect!” (Alabama dentist)
  • “Our production has increased significantly the past 6 months, especially the past 3 months. This may not necessarily be due to a slightly better economy but likely due to more people feeling like they can no longer continue to delay treatment, improved office marketing (including increased Internet dental marketing) and an emphasis on internal marketing. We have actually decreased our advertising costs compared to last year and have become smarter with our marketing.” (Ohio dentist)
  • “The economy has not picked up from what I see, only significant stress, clenching, fractures. I will note that I have not seen any slowing in Botox, and dermal fillers treatment, whether for TMD or cosmetic.” (Minnesota dentist)
  • “Production seems to be up due to pent-up demand. Patients who had been delaying treatment were continuing their treatment.” (Tennessee dentist)
  • “I took Jim Du Molin’s signage advice and new patient flow has increased noticeably. Thank you so much!” (Nevada dentist)

Dental Practice Production for Dentists in 2011

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?

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