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Entries in Dentist (15)

Sunday
Mar312013

Oklahoma Dentist's Patients Struggle to Cope with HIV, Hepatitis Scare

iStockphoto/Thinkstock(TULSA, Oka.) -- Among the 7,000 patients who may have been exposed to HIV and Hepatitis in an Oklahoma dentist's office are children, as their nervous parents wait to get them tested and grapple with how to explain the public health nightmare.

Deann Zavala took her four children to Dr. Wayne Scott Harrington, an oral surgeon who practices in Tulsa and Owasso. She said her youngest daughter had a tooth extracted.

"How do you look at her and be like, 'You could have AIDS?'" she told ABC News Radio.

The state dental board is offering free testing to Harrington's patients after a 17-count complaint revealed his allegedly poor sterilization practices could have put them at risk for contracting HIV, hepatitis C, and hepatitis B.

Patients received a letter from the Tulsa Health Department on Friday informing them of an inquiry into Harrington's practice and advising them to get screened.

Zavala, who said she trusted Harrington to care for her four children, was left shaken.

"If you can't trust a doctor and a dentist and ... the people that are supposed to do right by you ... who can you trust?" she said.

The dentist's alleged practices came to light after a patient who had no known risk factors other than receiving dental treatment in Harrington's office, tested positive for both HIV and hepatitis C.

After hearing about the infected patient on March 15, the Oklahoma Board of Dentistry conducted a surprise investigation of the dentist's practice on March 18, allegedly finding numerous sterilization and cross-contamination issues.

Harrington, who has been practicing for more than 30 years, may face criminal charges. The dentist voluntarily surrendered his state dental license and other permits, and a formal hearing before the dentistry board is scheduled for April 19.

Copyright 2013 ABC News Radio

Thursday
Dec272012

Florida Dentist Office Doubles as a Beauty Spa

iStockphoto/Thinkstock(FT. LAUDERDALE, Fla.) -- Scary lights, intrusive equipment and high-pitched sounds that make you squirm are what normally come to mind when one thinks of a visit to the dentist’s office.

Not so for the patients of Dr. Patty’s Dental Boutique in Ft. Lauderdale, Fla., a dentist office that doubles as a beauty spa.

“There are about 30 to 40 million Americans who suffer from dental anxiety,” Dr. Patty, whose real name is April Patterson, told ABC News’ Bianna Golodryga.  “I wanted to do everything I can to make those clients feel like they are not at the dentist.”

To do that, Patterson created an office that is definitely not your father’s dentist’s office.  Her version features treatments you’d get at your everyday spa -- from facials to massages to eyelash extensions and a brow bar -- along with the typical dental work.

“I offer high-end, quality dental services along with a full menu of spa services,” Patterson said.

“I can give you a great example of how all the services kind of work together,” she said.  “A client is coming in to have their dental veneers done.  They come in an hour early [and] they can have a facial or a massage while their valium takes effect.  They come in to start their dental procedure and they’re nice and relaxed.”

Patterson said her combination dental office and spa is about more than just cosmetics.

“This is not just about teeth,” she said.  “This is also about building confidence and changing lives.”

Copyright 2012 ABC News Radio

Friday
Nov022012

John Lennon's Molar to Help Fight Oral Cancer

Ivan Keeman/Redferns(NEW YORK) -- Imagine there's no oral cancer. It isn't hard to do. You may say I'm a dreamer. But I'm not the only one.

Those rewritten John Lennon lyrics may be Tony Gedge's new motto.

Gedge has made it his life's work to reduce the rates of oral cancer in his native Britain. And now, Gedge has enlisted the former Beatle to help inspire Brits to walk into the dentist and receive a simple, 10-minute-long test for oral cancer.

Specifically, Gedge has turned to one of John Lennon's molars.

Encased in a smart silver pendant, Lennon's tooth is going on tour. Walk into your dentist's office, try on the necklace with the tooth, and get a free cancer screening.

"The biggest group at risk for oral cancer are males, 55-59," Gedge told ABC News. "They were around when the Beatles were doing their thing. So to appeal to the 55-plus boomer market, to get them into the practice with something they know – the Beatles – was far easier than getting them in by spouting a bunch of statistics."

In 2010 in Britain, nearly 2,000 people died from oral cancer. In the U.S., that number was 7,850, with more than 40,000 new cases. If the cancer is caught early, most people will survive. (Click here for the National Cancer Institute's guide to preventing Oral Cancer.)

For Gedge, those statistics are personal. Gedge lost his father to mouth cancer, and his mother now feeds through a tube because she too had oral cancer.

"Since that happened, I've been working with dentists to help them promote dentistry to make it more interesting to the general public," he says.

In the mid 1960s, Lennon gave his tooth to his housekeeper, Dot Jarlett, while she worked at his home southwest of London. Her family kept it until last year, when Canadian dentist Michael Zuk bought it in an auction for more than $31,000.

Zuk then created three necklaces containing fragments of tooth and sent one to Gedge, who runs a charity called Dental Mavericks.

In the next few weeks the necklace will visit 16 dental practices. Dentists will check anyone who comes in to see the tooth for oral cancer – an easy and painless detection that can be done with the help of a special light.

Castlepark Dental Centre in Hull in northeast England, one of the first practices taking part, has already screened about 100 people, Gillian Fisher, the practice manager, told ABC News.

"Fifty years ago this week the Beatles were playing at the local cinema," Fisher said. "The patients were coming in and talking about what they were wearing, what they were playing. It was a total trip down memory lane for them. Through the curiosity we're hoping to raise awareness of mouth cancer."

Copyright 2012 ABC News Radio

Tuesday
Jul172012

Colorado Dental Patients Advised to Get HIV, Hepatitis Testing

A screen grab from Dr. Stephen Stein's former dental practice website. (www.drstephenstein.com)(DENVER) -- Patients of a former Colorado oral surgeon have been advised to get tested for HIV and hepatitis infections after a state health department investigation accused him of reusing syringes and needles on patients receiving intravenous medications for nearly 12 years.

Any patient who received an IV injection, including sedation, from licensed dentist Dr. Stephen Stein between September 1999 and June 2011 might have been exposed to HIV, hepatitis B and hepatitis C, the Colorado Department of Public Health and Environment said in a statement July 12.

Denver police are also involved in the case.

"Right now [Stein's] case is an active ongoing investigation for prescription fraud," police spokeswoman Raquel Lopez said. "We received the information on April 3 of this year."

Stein sold his practice in September 2012 to Dr. Jeremey Miner, an oral surgeon, according to a woman who answered the phone at his former practice. They had not worked together previously.

Meanwhile, the state health department issued about 8,000 letters to some of Stein's former patients at both his Highlands Ranch and Denver, Colo., offices, urging them to get tested, department spokesman Mark Salley said.

Records were only available for Stein's patients from 2005 to 2011, so they will be the only ones receiving the notifications, Salley said. The patients he treated before then will not receive a notice to seek testing.

Without the records, Salley added, there's no way to know how many patients were at risk in the earlier years.

Salley said the state health department began its investigation in April after receiving a report of alleged unsafe injection practices from the Colorado Department of Regulatory Agencies, which licenses dentists statewide.

The investigation determined that the "syringes and needles used to inject medications through patient's IV lines were saved and used again to inject medications through other patients' IV lines."

"This practice has been shown to transmit infections," according to the health department's statement.

But by the time the Department of Public Health was notified of Stein's allegedly unsafe practices, the dentist had already entered into an interim agreement with the Colorado Board of Dental Examiners to stop practicing in June 2011, Salley said.

Salley declined to provide details and Stein's lawyer, Victoria Lovato, has not returned telephone messages requesting comment.

Salley said that even if Stein's former patients test positive for any of the diseases, it does not mean they contracted it through Stein's injection practices.

The health department has asked health providers who test Stein's former patients to report any positive tests for HIV, hepatitis B and hepatitis C to their county or state health departments, according to the statement.

"We don't have any results back and we're not likely to for a couple of weeks," Salley said. "It might be that there are no positive tests to come back."

The risk to Stein's former patients' health is likely to be low and a negative result should not require additional follow up, said Dr. Joseph Perz, a health care epidemiologist at the Centers for Disease Control and Prevention in Atlanta.

"My understanding is that for the majority of patients affected, the exposure would have taken place a considerable while ago and so the issues around incubation shouldn't be a factor for the vast majority of patients," he said.

But Perz said special treatment must be given to blood- borne viruses because there is potential for chronic infection.

Perz said that while the CDC takes a firm stance that safe injection practices are every health provider's responsibility, there have been multiple incidents of doctors reusing syringes for significant time periods that led to mass patient notification.

"This is sort of the latest in a string of these events that really do leave us scratching our heads," he said.

Salley said individuals at risk who have health insurance should contact their health care providers for testing. Those who don't, he said, should contact the state health department's hotline for a list of information by county.

Copyright 2012 ABC News Radio

Tuesday
Jul172012

Study: BPA-Based Fillings May Change Kids' Behavior

iStockphoto/Thinkstock(NEW YORK) -- As if a visit to the dentist for some kids isn't traumatic enough, a new study finds that many who received fillings made from a widely-used, but controversial plastics chemical may suffer minimal yet long-term emotional problems.

The study, published in the journal Pediatrics, followed more than 500 children and found that children who got composite fillings made with the chemical bisphenol-A, or BPA, tended to experience behavioral differences over a five-year period.  The more BPA-based fillings a child had, the more likely he or she was to show these changes.

Children with other types of fillings, however, did not experience any differences.

Researchers are not sure if it's the BPA or something in the resin causing the problems and say further investigation is warranted.

Copyright 2012 ABC News Radio

Monday
Apr092012

Are Dental X-Rays Causing Brain Tumors?

Stockbyte/Thinkstock(NEW YORK) -- “It’s time for your annual X-rays.”  This is what millions of Americans are told when they visit the dentist.  But new research out of Yale finds dental X-rays may be linked to increased rates of brain tumors.

Meningioma is the most common type of brain tumors that originate in the brain and spinal cord, making up one third of these.  People who were diagnosed with meningioma were compared with healthy individuals.  They were asked how often they had the most common type of dental X-ray, called a bitewing, which involves placing an X-ray film between the teeth and shooting the film from outside of your cheek.  In those who reported having this type of X-ray once a year or more the risk for meningioma was 1.4-1.9 times increased depending on their age.

Another type of dental X-ray, called the Panorex, that rotates around your head taking a picture of all of your teeth from outside your mouth was associated with an almost five-fold increase in rates of meningioma when the X-ray was performed before age 10.  For those older than 10 there was a 2.7 to 3 fold increased risk when this X-ray was performed once a year or more.

Current recommendations by the American Dental Association do admit that there is little use for dental X-rays in healthy people without any symptoms, but still recommends X-rays of healthy children be taken every 1-2 years and every 2-3 years for healthy adults.  The authors think these guidelines may need to be reevaluated in the wake of their findings.

Reactions to the study have been mixed. For critics, the design of the study has some serious flaws. The main weakness is the failure of the researchers to obtain any of the patient’s dental records to verify that the number of X-rays they reported having was true, says Dr. Richard Besser, ABC News' chief health and medical editor.

“People with cancer are more likely to remember having dental X-rays,” explains Besser. “They are searching for some cause of their cancer and may incorrectly attribute it to any number of factors.”  Dr. Besser also points out that the study failed to find any connection between having braces and risk for meningioma.  “When you have braces you remember that clearly, and people who have braces on average undergo more x-rays than people without braces,” says Besser.

Dr. Alan G. Lurie, a Ph.D. radiation biologist who specializes in cancer induction and is president of the American Academy of Oral and Maxillofacial Radiology, agrees with Dr. Besser that the study has a serious flaw.

“They’re asking people to remember (in some cases) a couple of radiographs they had 30 years earlier when they were kids. They’re not going to be able to tell you what kind of X-ray machine was used…what kind of film, were there any retakes?" Lurie says.

Other doctors see this as a strong study and think that it raises valid concerns.  “The current study is well-done and confirms that even in the ‘modern era’ radiation exposure from repeated dental X-rays conveys an increased risk of these tumors,” says Dr. David Schiff of the Neuro-Oncology Center at the University of Virginia.

Overall, doctors are not surprised that dental X-rays could cause this type of tumor because the type of radiation that X-rays give off is known to be associated with brain tumors. “Ionizing radiation is the only well-accepted environmental risk factor for development of meningiomas," says Dr. Schiff.

However they warn that this study cannot prove that dental X-rays cause brain tumors.  It can only reveal a possible association between dental X-rays and tumors.

Still, there are some important things people can do to minimize their exposure to dental X-rays.  For example, patients can ask their doctors whether X-rays are completely necessary, or how much radiation will be delivered by the various options available.

“All health professionals should be thinking that for our patients, each exposure must be beneficial and we should be of a mindset to do the fewest exposures possible to obtain needed diagnostic information," explains Paul Casamassimo DDS, professor and chair of pediatric dentistry at the Ohio State University College of Dentistry and chief of dentistry at Nationwide Children's.

Overall, experts hope that as a result of this study the public gains new awareness of a potential risk and will take their concerns to their dentist.  

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Copyright 2012 ABC News Radio

Friday
Feb172012

Woman Dies After Contracting Legionnaires' Disease at Dentist's Office

iStockphoto/Thinkstock(ROME) -- An 82-year-old Italian woman died after she contracted Legionnaires' disease, a severe, pneumonia-like illness, from the water in her dentist's office, according to a case report published in the journal The Lancet.

Scientists who determined the source of the woman's illness, which occurred in February 2011, said during the disease's incubation period the woman only left her home twice to visit her dentist.

When they tested the water in both places, they discovered the bacteria that causes Legionnaires' in the dentist's water line.  Water lines carry water from the main water supply to certain devices used during patient care.

While the authors wrote the most common sources of infection are air conditioning systems, hot water systems, spas and fountains, a recent study found dental water lines to be another major source of contamination with Legionella bacteria.  Legionella pneumophila is the bacterial strain that causes Legionnaires' disease.

"However, as far as we are aware, no case of Legionnaires' disease has been associated with this source of infection," added the authors, led by Maria Luisa Ricci of the Italian National Health Service.

While it was not clear what kind of water line standards were in place in Italy, in the U.S., the American Dental Association (ADA) said infection control standards are very stringent in order to prevent cases like the one in Italy from happening.

"Since the ADA convened a special task force in the mid-1990s focusing on infection prevention, there have been a number of recommendations made to treat the water and keep the number of bacteria down," said John Molinari, the ADA's spokesman on infection control, infectious diseases and allergic reactions.

The ADA recommends that dental water lines contain no more than 500 colony-forming units of bacteria per milliliter of water, the same limit recommended by the U.S. Centers for Disease Control and Prevention.

The ADA also recommends that dentists monitor water quality and maintain a water reservoir that is separate from the municipal water supply, as well as use filters that will keep microorganisms out of the water.

Copyright 2012 ABC News Radio

Wednesday
Jan182012

Calif. Clinic Brings Free Dental Care to Developmentally Disabled

Comstock/Thinkstock(MORENO VALLEY, Calif.) -- For most adults, a cavity calls for a quick prick of novocaine and a 20-minute filling. But for 40-year-old Tina Lumbley of Moreno Valley, Calif., the routine procedure was a day-long ordeal.

Lumbley has autism, a developmental disorder that makes the sounds, smells, tastes and bright lights of the dentist's office overwhelming.

"She would get so anxious and have meltdowns," Lumbley's mom, Marjorie, told ABC News. "When she was a child, we had a great pediatric dentist and she was fine. But as she got older, it just wasn't working."

Most dentists refused to take Lumbley after she turned 18. And the few who were willing would only treat her under general anesthetic, which raises the risk and price of the procedure.

Lumbley is not alone. Across the country, adults with intellectual disabilities suffer from a lack of access to dental care.

"It's the biggest health care problem in the country today," said Dr. Steven Perlman, professor of pediatric dentistry at Boston University School of Dental Medicine. "People with intellectual disabilities are the most medically underserved population we have, and dental care is by far the most unmet need."

Adults with disabilities are usually covered by Medicaid. But the reimbursement rate is so "pathetically low that no dentist wants to participate in the program," Perlman said. And they don't have to. Dental schools are not even required to teach students how to treat disabled patients.

"These kids are coming out of school with huge loans," said Perlman. "What are they going to do when they get out? I'll tell you who they're not going to treat: people who are poor or disabled."

In 2009, California dropped dental coverage for all adults on Medicaid. That prompted Marianne and Russell Benson to open We Care, a nonprofit that brings free dental care to people with disabilities.

Now Lumbley, with her parents, makes the hourlong trip to the Rancho Mirage-based dental clinic where she gets cleanings and fillings like any other patients, without general anesthetic. The clinic has four dentists and student volunteers from nearby Western University of Health Sciences College of Dental Medicine.

"They treat her with dignity and respect and expect her to come out with a beautiful smile," said Marjorie Lumbley. Other dentists, she recalled, suggested pulling her daughter's teeth. "Yes, Tina has a lot of challenges but she has a right to have decent teeth."

Having healthy teeth and gums not only looks good; it also guards against disease. And for people with disabilities who are unable to communicate, a minor toothache can quickly evolve into a major emergency.

Marjorie Lumbley said she's grateful for We Care but worries about the future, as her daughter's dental and medical needs will surely grow.

"They have all the same things that go along with people getting older, but they still have these needs that can't be met any other way," she said. "I think people forget what happens to them after they grow up. They're not cute anymore. She's 40 years old and she deserves good care."

Copyright 2012 ABC News Radio

Friday
Dec022011

When Dentists Drill Too Much

Comstock/Thinkstock(NEW YORK) -- By the time a dentist finds a cavity, that tooth has been through several stages of a chronic infectious disease called dental caries, where acids dissolve tooth enamel, letting bacteria inside. Unchecked, the tooth can die.

Dentistry today focuses on early intervention to prevent bacterial invasion of the dentin, a layer just inside the enamel, and the vital pulp. Laser scanning, fiber optics and fluorescent technologies have allowed dentists to better visualize weakened, decayed enamel before it becomes visible on an X-ray or to the naked eye. Some dentists say high-tech tools enable them to perform minimally invasive dentistry, which preserves more of the tooth, often by treating "incipient carious lesions," also called microcavities. These abnormalities begin as white spots, which can progress to dark, stained pits and fissures.

Dentistry has evolved from "drill and fill" mechanics to a disease model focused on averting decay, supported by a 2001 National Institutes of Health consensus statement that identified a shift toward improving the diagnosis of early lesions and stopping their progression.

However, this early treatment may -- but need not -- involve the good old dental drill.

Some dentists want to fill all these little pits and flaws, sometimes warning of cavities to come, perhaps leading to a dreaded root canal, or losing the tooth. "Some dentists may honestly believe they're doing a patient a favor by treating early," said Dr. James C. Hamilton, now retired from the University of Michigan dental school. "Some dentists would convince patients caries is like cancer. 'Do you want me to leave a little cancer in your mouth? No.'"

Hamilton led a five-year study that found early treatment of microcavities using an air drill (less painful than a traditional drill) and a composite filling failed to conserve more of the tooth than watchful waiting until caries were diagnosed.

"We found no benefit at any time for early treatment," Hamilton said in an interview Thursday. He worries that expensive equipment pushes some dentists toward more aggressive treatment to get a "return on their investment."

"When you buy this new technology to treat incipient carious lesions, you have increased your overhead. You now have to make this piece of equipment pay for itself," Hamilton said. With the cost of a filling ranging from about $100 to $250, dentists might be "using this to find and treat those lesions when in fact they ought to be just watching them," he said.

Patients may balk at what they perceive as overzealous dentists proposing unnecessary and costly filling of microcavities before they've eaten into the dentin. That's why they should ask for a second opinion as they would for a medical issue, said Dr. Irwin Mindell. His mid-town Manhattan dental practice is very conservative and often proposes "watchful waiting" for microcavities.

"We have a very aggressive recall system. It's not that if you don't do it now, chances are you aren't going to come back to the dentist for another three years and at that time, we have another major problem," Mindell said. "I know I'm going to see the patient six months hence."

Mindell, who has been in practice since the 1950s, said that if damage hasn't reached the dentin, "you don't treat, because it may take years and years and years to become something. A lot of stuff never goes any further." For patients who aren't prone to cavities, removing the compromised enamel could lead to "greater loss of tooth than what the decay process will do."

But there's also a third way, said Dr. Peter Arsenault, a clinical professor at the Tufts University dental school in Boston. "Does treating mean drilling? Not in my eyes. That's what carpenters do," he said.

For the appropriate patient, Arsenault proposes a treatment plan that requires "a lot of dedication and a lot of education." It relies on neutralizing acidity in the mouth with frequent use of pH-boosting sprays and drops; killing mouth bacteria with xylitol--a sugar alcohol derived from birch trees, and using re-mineralizing toothpastes that stabilize and shore up weakened enamel.

Arsenault teaches dental students and dental colleagues the Caries Management by Risk Assessment (CAMBRA) approach, which uses a patient's history of cavities and dental work, oral hygiene habits and consumption of acid-promoting sugary foods, among other factors, to categorize them as low-risk, moderate-risk or high-risk for developing cavities.

"For each level of risk, there's a bit of an art, and a bit of science to it," Arsenault said Thursday. He described a low-risk, highly motivated patient who came to him a year ago with four small spots in her dental enamel and conscientiously adhered to the recommended treatments. When he examined her teeth earlier this week, the spots had shrunk. "She's thrilled I didn't have to drill this tooth," he said.

Arsenault first learned about CAMBRA at an NYU conference four years ago, where he said that at first, "it sounded like hogwash." But he was quickly won over and brought CAMBRA to Tufts. "We're showing with low-risk patients we can slow down, freeze and reverse" the caries process, he said. With extreme-risk patients, they can fill decayed teeth with materials that release fluoride to safeguard the other teeth.

CAMBRA is now being taught at dental schools. Although the American Dental Association supports a risk assessment approach to dentistry, it hasn't yet taken a position on treating microcavities. "Evidence-based things are slow-moving," Arsenault said. "It's a momentum thing. It's on its way. We're getting closer."

Copyright 2011 ABC News Radio

Thursday
Dec012011

Dentist Threatens to Sue Patient for Negative Review

Jupiterimages/Thinkstock(NEW YORK) -- Robert Lee went into Dr. Stacy Makhnevich’s New York dentist office for a sore tooth, but the year that followed turned into what one Public Citizen senior lawyer called an “unconscionable practice.”

The controversy began in 2010, when Lee went into Makhnevich’s office for a scheduled dentist’s appointment. Bleary from pain, Lee claimed he was told he had to sign several papers, including a “Mutual Agreement to Maintain Privacy,” before being treated. The form required Lee to agree not to publish any commentary or write anything disparaging about his experience with Makhnevich.

While Lee said he was hesitant to sign such a form, he claimed he was in severe pain and, therefore, gave in to the requirements.

Lee received a bill for $4,766 for the dental work, according to Public Citizen, a nonprofit consumer advocacy organization. Lee reportedly asked the dentist to send the necessary paperwork to his insurance company, but she sent it to the wrong company. When he asked for the forms to submit them himself, Makhnevich’s office apparently refused to hand them over and referred him to a third party that required five percent of the total bill for its services.

Fed up, Lee wrote negative reviews about Makhnevich and her practice on Yelp and DoctorBase.

Lee then received a letter from the dentist demanding that he delete the post, warning him that he violated the agreement and threatening to sue for breach of contract. Makhnevich also reached out to both websites, asking for Lee’s comments to be removed, according to Public Citizen.

The sites refused to take down the negative reviews, but Makhneich reportedly claimed that a copyright clause gave her ownership of the harsh words. She then sent Lee an invoice for $100 for each day the criticism remained online.

Makhnevich did not immediately return requests for comment.

“We are now seeking a declaratory judgment from the judge to show that my client was not doing anything wrong,” said Paul Levy, Lee’s lawyer, a senior attorney at Public Citizen. “Doctors and dentists are expected to behave in an ethical manner, and to impose this sort of requirement on people who are having emergencies is unethical.”

The suit argues that the forms that Lee signed should be deemed null and void.

“Facing criticism comes with the turf of these jobs,” Levy said. “If they defame you, then that’s something else. A doctor can sue for that.”

Copyright 2011 ABC News Radio







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