Using Your Personal Credit Card for Business Is a Terrible Idea | Dentistry Today

credit cardsMany of us have a preferred credit card in our wallet—the one we reach for first to swipe at checkout or shop online. We use it to pay for just about everything to accumulate points, earn rewards, and build our credit scores.

This is fine for personal purchases. But I hope you’re not also using your favorite card to cover your dental practice expenses, not only for the sake of your credit score, but for simplifying taxes and accounting as well.

For big-ticket expenses like equipment, technology, staff salaries, or expansion, you likely tap into a business line of credit or working capital loan to cover the costs. The lines may get a little blurry when it comes to covering smaller or daily expenses like driving to or between offices, buying employee meals at a tradeshow, or paying lab bills. It may be convenient simply to pay with that favorite credit card, but it’s not the best approach.

You would be surprised by how many professionals do this—dentists and other small business owners alike. But this practice can cause issues and annoyances for both your business finances and personal finances. 

It Can Negatively Impact Your Personal Credit Profile 

To some, using a personal card more often may feel like a favorable way to build credit, but this is not always the case.

It doesn’t matter if you have a perfect credit history. Charging a business expense to your personal credit card will only draw you closer to your borrowing limit, leaving you with little room for personal expenses or emergencies.

Continually using a personal card for business charges will also have you maintaining a higher credit balance and further reducing your available credit ratio, a primary factor in determining your credit score.

You Won’t Be Building Business Credit

Like an individual, your practice has its own credit profile and score. Oftentimes, this business credit score is just as important as a personal one when seeking financing for your practice.

Putting any business expenses on your personal card will hinder your ability to build business credit for your practice (because you’re not doing it by using a personal card), making it more difficult to attain a loan for your practice in the future.

To build business credit for your practice, consider a business credit card. 

It’s An Accounting Nightmare. 

Using a personal credit card to cover both personal and business expenses can set your accounting team up for a potential, yet avoidable, headache.

When tax season comes around, you’ll need to deduct your business expenses. By charging both business and personal payments to your personal credit card, it’s going to be more difficult and time-consuming to go through and separate what may and may not be deductible.

And vice versa. When using a business credit card, don’t make personal charges. By keeping these two accounts separate, it will simplify the lives of both you and whoever is in charge of your practice’s bookkeeping, allowing for a clear perspective of your spending on the business side.

You May Be Missing Out on Perks that Benefit Your Business 

Your personal credit card probably rewards you for consumer purchases, incentivizing things like paying at the grocery store or eating out at a restaurant. But many business cards offer rewards and perks that align with your business spending. Think about your everyday operational purchases and the targeted rewards you may be missing. 

The road to financial discipline is paved by both practice and persistence. So next time if it may seem more convenient to cover a business cost with your personal card, pause. Being proactive and keeping these two cards separate can set you and your practice up for continued financial success.

Mr. Gruebele is senior vice president at Bankers Healthcare Group, the leading provider of financial solutions for healthcare professionals. Contact him directly at or visit the BHG website at

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Read more via Using Your Personal Credit Card for Business Is a Terrible Idea | Dentistry Today

Seven Keys to Preventing More Patients from Dying from Dental Sedation

kid at dentistThe number of patients—and, particularly, children—who have been injured or killed by dental sedation indicates that there are gaps in the standard of medical care being used during these procedures. Here are just some of the cases that we know about:

  • 6-year-old Caleb Sears stopped breathing after receiving several different kinds of intravenous anesthetics during a tooth extraction.
  • 5-year-old Amber Athwal suffered brain damage after receiving general anesthesia to extract some of her teeth.
  • 17-year-old Sydney Gallegher died nearly a week after she suffered cardiac arrest after having her wisdom teeth pulled.

An investigation by the local ABC affiliate in Austin, Texas, identified at least 85 patients in Texas who died shortly following dental procedures from 2010 to 2015.

We offer seven keys to preventing more patients—especially children—from dying from dental sedation.

The Dentist Should Not Be the Anesthesia Provider and Monitor

In many of the fatalities following sedation for dental procedures, the same person was performing the dental procedure and monitoring the patient. As the American Academy of Pediatric Dentistry (AAPD) “Guideline for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures” states:

“The use of moderate sedation shall include the provision of a person, in addition to the practitioner, whose responsibility is to monitor appropriate physiologic parameters and to assist in any supportive or resuscitation measures, if required.”

Clinicians Should Be Trained to Recognize Respiratory Compromise and Be Able to Intervene Appropriately

The AAPD guideline, which applies not just to dental procedures but to sedation for all procedures, notes that children under the age of 6 years (and especially those under the age of 6 months) are particularly likely to suffer adverse events during sedation. It emphasizes that there is a very narrow margin in children between the intended level of sedation and much deeper sedation or anesthesia.

Therefore, the practitioner must be trained in moderate sedation and have the skills to rescue patients from such deeper levels. This would include the skills needed to:

  • Rescue a child with apnea, laryngospasm, and/or airway obstruction
  • Open the airway
  • Suction secretions
  • Provide continuous positive airway pressure
  • Perform successful bag-valve-mask ventilation
  • Insert an oral airway, a nasopharyngeal airway, or a laryngeal mask airway (LMA)
  • Perform tracheal intubation

The guideline notes that these skills are likely best maintained with frequent simulation and team training for the management of rare events. Without appropriate and trained personnel attending to the sedated dental patient—­and, particularly, children, as noted in the AAPD guideline—the safety of the patient is at risk.

Patients Should Be Monitored for Adequacy of Ventilation with Capnography

The updated AAPD guideline emphasizes the role of capnography in appropriate physiologic monitoring:

“A competent individual shall observe the patient continuously. Monitoring shall include all parameters described for moderate sedation. Vital signs, including heart rate, respiratory rate, blood pressure, oxygen saturation, and expired carbon dioxide, must be documented at least every 5 minutes in a time-based record. Capnography should be used for almost all deeply sedated children because of the increased risk of airway/ventilation compromise. Capnography may not be feasible if the patient is agitated or uncooperative during the initial phases of sedation or during certain procedures, such as bronchoscopy or repair of facial lacerations, and this circumstance should be documented. For uncooperative children, the capnography monitor may be placed once the child becomes sedated. Note that if supplemental oxygen is administered, the capnograph may underestimate the true expired carbon dioxide value; of more importance than the numeric reading of exhaled carbon dioxide is the assurance of continuous respiratory gas exchange (ie, continuous waveform). Capnography is particularly useful for patients who are difficult to observe (eg, during MRI or in a darkened room).”

Do Not Delay in Calling 911

In analyzing 78 cases of mishandled sedation or anesthesia, the Blue Ribbon Panel on Dental Sedation/Anesthesia of the Texas State Board of Dental Examiners found that, of the factors contributing to dental sedation incidents, the most common was that “the provider was slow to activate EMS [emergency medical services].”

Sure, the practitioner may be embarrassed over having allowed an adverse event to occur. However, any embarrassment is preferable to the death of the patient. We cannot stress this point enough. Do not delay in calling 911.

Practice, Practice, Practice

We must emphasize that every person in the dental practice, including clerical and front office staff, has a responsibility in an emergency. The only way to prepare all for such emergencies is to practice or perform drills. Since many dental practices employ part-time employees, that means drills must be performed on multiple occasions so all employees are familiar with their roles in emergencies.

In discussing factors that might have helped avoid the death of Joan Rivers, Kenneth P. Rothfield, MD, MBA, chairman of the Department of Anesthesiology at Saint Agnes Hospital in Baltimore and a member of the board of advisors of the Physician-Patient Alliance for Health and Safety, probably said it best when he told the Washington Post, “Unless you have drilled for it, and trained for it, it can be hard to pull off.”

Be Prepared

Being prepared is a key to managing adverse events and taking steps to avoid patient deaths. We recommend two related tools to be prepared: pre-procedure huddles (briefings) and post-procedure debriefings. These meetings offer the opportunity to both plan for contingencies ahead of time and to analyze things that might have been done better after a procedure.

We also encourage the use of checklists as a reminder of the key steps to be followed. The American Dental Society of Anesthesiology provides a Safety Checklist for Office-Based Procedural Sedation/Anesthesia (see the figure). This checklist has broken down key considerations along the continuum of care: procedure room setup, pre-operative encounter, post-operative recovery, and records.

Restraints Should Only Be Used With Extreme Caution

Dentists sometimes use a papoose board when treating pediatric patients. Papoose boards restrain the patient from interfering with the dental procedure and may have contributed to the adverse outcomes in several cases. The AAPD guideline provides the following cautions to using papoose boards or other restraining devices:

“Immobilization devices, such as papoose boards, must be applied in such a way as to avoid airway obstruction or chest restriction. The child’s head position and respiratory excursions should be checked frequently to ensure airway patency. If an immobilization device is used, a hand or foot should be kept exposed, and the child should never be left unattended. If sedating medications are administered in conjunction with an immobilization device, monitoring must be used at a level consistent with the level of sedation achieved.”


Although we cannot say for certain whether these seven keys would have saved the lives of Caleb, Amber, and Sydney, we do know that the application of a higher standard of care, in accordance with AAPD recommendations, might indeed save the life of another patient.

Dr. Truax of the Truax Group is board-certified in neurology and internal medicine. A clinician and educator with more than 20 years of experience in medical administration, he has been involved in patient safety for more than 25 years. He was trained at Johns Hopkins Hospital and Massachusetts General Hospital. And, he was a clinical association professor of neurology at the SUNY Buffalo School of Medicine. He can be reached at

Mr. Wong is the founder and executive director of the Physician-Patient Alliance for Health & Safety. A graduate of Johns Hopkins University and a former practicing attorney, he is a recognized healthcare and patient safety expert. Also, he is a founding member of the American Board of Patient Safety and a member of the editorial board of the Journal for Patient Compliance. He can be reached at

Related Articles

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Read more via Seven Keys to Preventing More Patients from Dying from Dental Sedation | Dentistry Today



Exclusive-Five Banks Open Up Trillion Dollar Gold Club – The New York Times

100281353-gold_bars_piles_gettyP.530x298LONDON — The five banks that settle every transaction in London’s $6.8 trillion (4.9 trillion pounds) a year gold market are changing the rules of their clearing house to make it easier for newcomers to join.

The reform is part of a broad overhaul of institutions that underpin the world’s largest bullion trading centre to make them more transparent after accusations of price manipulation by banks and traders and pressure from regulators.

As that pressure increased, the number of banks clearing gold transactions through a company they own called the London Precious Metals Clearing Limited (LPMCL) has dwindled from seven to five. They are HSBC, JPMorgan, Scotiabank, UBS, and ICBC Standard.

Several banks have attempted to join the group in recent years. ICBC Standard joined in 2016 after months of wrangling over conditions and an application from at least one other, Goldman Sachs, was declined, sources in LPMCL member banks said.

Spokespeople for HSBC, JPMorgan, Scotiabank, UBS and ICBC Standard declined to comment. A spokesman for Goldman Sachs declined to comment on whether its application had been turned down.

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Protect Your Patients and Practice from Prions, Viruses, and Systemic Disease | Dentistry Today

Viruses are an extremely important component of periodontal disease, both in its initiation and in the ongoing promotion of the attack process. Viruses that initially stem from the mouth also may have much wider systemic impacts.

Several years ago, Jorgen Slots, DDS, PhD, a professor of dentistry at the University of Southern California, reported that herpesviruses [both Epstein-Barr virus type 1 (EBV-1) and human cytomegalovirus (HCMV)] are some of the unrecognized major viruses implicated1 in periodontal attack. Unfortunately, when one transitions from the study of bacteria to consideration of viruses, most dentists cringe, since the profession has the least training in comprehending that submicroscopic world.

Herpesviruses are a leading cause of human viral diseases. There are 9 herpesvirus types known to infect humans: herpes simplex viruses (HSV-1 and HSV-2), varicella-zoster virus (chicken pox and shingles), Epstein-Barr virus (EBV or HHV-4), human cytomegalovirus (HCMV or HHV-5), human herpesvirus (HHV-6A, HHV-6B, and HHV-7), and Kaposi’s sarcoma-associated herpesvirus (KSHV)2.

Ruth F. Itzhaki, PhD, MSc, MA3, demonstrated that the herpes simplex virus type 1 (HSV1), the same virus that causes cold sores in the mouth, is present in the elderly human brain. Once HSV1 infects the epithelial cells of the mucous membranes of the face, it secondarily infects sensory nerve terminals. After it enters the neuron, HSV1 moves to the neuronal cell body in the trigeminal ganglion, located at the base of the skull adjacent to the brain stem.

HSV1 remains in the ganglion in a latent form until reactivation, when the newly synthesized virus is retrograde transported more peripherally4, eventually leading to visible outbreaks such as on the lip. In older subjects, this highly prevalent virus reactivates and enters the brain by way of the peripheral nervous system or the olfactory route5. Though it becomes latent in the brain, it periodically reactivates in association with stressors such as systemic infection and immunosuppression.

Spirochetes, HSV1, Beta Amyloid, and Systemic Diseases

Pathogen-induced inflammation and central nervous system accumulation of beta amyloid (Aβ) (Figure 1) damages the blood-brain barrier, which contributes to the pathophysiology of Alzheimer’s disease (AD)6. Data for both Chlamydophila pneumoniae and spirochetes7,8 shows a high prevalence of these pathogens in AD brains only, suggesting that secondary C pneumoniae and/or spirochete infection of the brain may occur after preliminary HSV1 and other co-factors have already initiated AD pathogenesis9.

Figure 2. Amyloid plaques are the hallmark of Alzheimer’s disease. Figure 3. The icosahedral capsid in the herpes simplex virus resembles the bacteriophage capsid.

Since spirochetes can invade all tissues of the body via circulatory pathways10, they may be the instigators of the inflammation that damages the lining of blood vessels and possibly deteriorates the blood brain barrier11. Spirochetes also can take the trigeminal nerve pathway to the brain. Thus, the activation of the already present latent HSV1 by spirochetes in the brain could represent the final step in a series of infections leading to full blown Alzheimer’s disease.

Amyloid plaques, the hallmark of AD, contain fibrillar Aβ (Figure 2). HSV1 has been implicated as a risk factor for AD and found to co-localize within Aβ plaques. Aβ peptides represent anti-infective peptides that protect against neurotropic virus infections such as HSV1 (Figure 3). The Aβ peptide may protect against latent herpes viruses and other infections. This antimicrobial property may explain why Aβ plaque formation plays a pathogenic role in the progression of the sporadic form of AD because it is reacting to an infection12,13.

Very recent research has shown that Aβ plaque in AD is an active biofilm of viable Borrelia spirochetes in Alzheimer’s disease patients. Alan MacDonald, MD, presented compelling evidence from brain tissue harvested from deceased Alzheimer’s patients. In his 37-minute video14Borrelia Chronic Brain Infections and Development of Alzheimer’s Disease, MacDonald used specific DNA marker probes to ascertain the presence of Borrelia burgdorferi spirochetes (implicated in Lyme disease).

Figure 4. There are key differences between a normal prion and the variant folded-over pathogenic form. Figure 5. The icosahedral capsid in the bacteriophage resembles the herpes virus capsid.

According to MacDonald, 100% of the samples tested demonstrated that active biofilms of various forms of Borrelia were enveloped within Aβ. For the first time, MacDonald demonstrated the spore-like role of granular forms of borrelia as viable, virulent pathogens, distinct from the easily recognized spiral corkscrew shaped forms. He identified round body forms of spirochetes in the evolution of AD. All these forms live within active biofilm communities previously characterized as undefined, dead, brown-appearing lesions called Aβ plaques.

Alzheimer’s, Diabetes, and CJD

Growing evidence is showing that diabetes and AD are concurrent entities. Plaques containing fibrillar Aβ deposits associated with dying cells and inflammatory processes are hallmark pathological features in AD and diabetes15,16. The accumulation of Aβ within islet β-cells is a major pathological feature of the pancreas in patients with chronic diabetes.

Figure 6. Bacteriophages inject virus particles into spirochetes.

Viruses also may be involved Creutzfeldt–Jakob disease (CJD) despite its earlier connection with prion accumulation. CJD is more commonly known as the human form of “mad cow disease” [bovine spongiform encephalopathy (BSE)]. This devastating degenerative neurological disorder is untreatable and inevitably fatal.

CJD is characterized by the presence of a deformed protein called a prion. There is controversy as to how the disease progresses. The explanation most commonly accepted is that a defective prion replicates by converting its properly folded counterparts in the host to the same misfolded structure it possesses, or “prion only theory”17.

However, Laura Manuelidis, MD,18 proposed that virus particles cause CJD.19 Manuelidis claimed that although much work remains to be done, there is a reasonable explanation that viral particles cause the transformation of the prion that is the hallmark of CJD.

It is likely that all the various versions of an abnormal prion are the result of infection by an exogenous and stable viral particle and are a consequence of the neurodegenerative disease process rather than its cause. Abnormal prions are present in extremely small amounts in accessible tissues or body fluids such as blood, urine, saliva, and cerebrospinal fluid20,21.

CJD causes tissue to degenerate rapidly. As the disease destroys the brain, holes in the neural structures develop that resemble a sponge in appearance. Viruses incorporating their DNA elements into the host DNA can reprogram the prion protein synthesis mechanism to produce “mutant” prions.

Prion disease epidemics, which have demonstrated unpredictable recurrence, are of significant concern for animal and human health. Furthermore, chronic wasting disease (CWD) is a relatively new and burgeoning prion epidemic in deer, elk, and moose (members of the cervid family) and may be related to the human prion versions22,23.

This perspective on possible links between CJD and viral pathogens causes us to question if other neurologic diseases causing similar brain damage also may by caused by viruses. AD, multiple sclerosis, autism, Parkinson’s disease, amyotrophic lateral sclerosis, and other neurological entities display similar brain damage.

AD24 is the most common of many neurodegenerative disorders primarily affecting aging humans. Frank Dohler and his colleagues25 reported an investigation that showed an amyloid’s abnormal ability to attract and bind to prions, the same type of molecules that become erratic in BSE and CJD. A normal amyloid is a stacking of normal prions26 (Figure 4).

The main problem in AD is that Aβ formation becomes so prevalent that this material interferes with normal electrical connections in the brain11. Aβ are peptides of 36 to 43 amino acids that are fatefully involved in AD as the main component of the Aβ plaques11.

These peptides result from an amyloid precursor protein (APP) that is altered by certain enzymes to yield Aβ. These molecules can accumulate to form flexible, soluble Aβ fibrils. Abnormal Aβ is a variant binding of a deformed amyloid with folded-over prions, the same malformed, problematic process that exists in BSE and CJD.

It is now believed that certain misfolded abnormal oligomers known as seeds can induce other amyloid molecules to also take on an aberrant, misfolded oligomeric form, leading to a chain reaction akin to an abnormal prion infection.27 The seeds, or the resulting Aβ plaques, interfere with function and are toxic to nerve cells. The other protein implicated in AD, tau protein, also forms prion-like misfolded oligomers, and there is some evidence that misfolded Aβ can induce tau to misfold 32, 28.

In BSE and CJD, as discussed earlier, there is a growing consensus that a virus is encoding prions that are misfolded. If this hypothesis proves to be true, then what is the possibility that the final step of the AD process is also caused by the same virus?

Spirochetes and Viruses

Spirochetes are associated with bacterial viruses called bacteriophages (Figure 5), which are normally lethal to bacteria. Eukaryotic dsDNA viruses (those viruses that replicate only inside the living cells) evolved from bacteriophages. The herpesviruses discussed earlier also evolved from a bacteriophage, but from a different evolutionary root.

Papillomaviruses evolved from single-stranded DNA viruses and ultimately from plastids29. When phages attach to and inject their DNA contents into spirochetes, the cells react differently from other bacteria and are not lysed by the bacteriophage30.

Instead, researchers realized that they could use these bacteria viruses as research tools31 to alter spirochetal DNA. Bacteriophages were used to inject virus DNA into spirochetes to increase their virulence, such as antibiotic resistance. The Borrelia burgdorferi spirochete is an alleged example of this potentially weaponizing alteration32. Bacteriophages have also been isolated in dental plaque33.

Spirochetes contain plastids, which are small linear or circular extra-chromosomal DNA. These packages can be transferred between other species’ spirochetes and to other bacteria as well in a process called transduction. Since bacteriophages and plastids are intimately associated with spirochetes (Figure 6), it would not be much of a stretch to speculate that the herpesviruses are also associated with spirochetes since all three are so closely related to each other in their evolutionary tree.

Spirochetes can transport these viruses by disseminating them to distant organs, further substantiating their potential importance in oral and linked systemic disease. Thus, it is possible that spirochetes serve as a rich source of transferable genetic material to remote locations of the body. Since many spirochetal diseases produce neurological symptoms34, such as syphilis and Lyme disease, further research is needed to evaluate whether herpesviruses or viral particles carried by spirochetes to the brain are associated with alteration of prions and Aβ.

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Different Smiles Provoke Different Physical Responses | Dentistry Today

smilesDifferent kinds of smiles provoke different kinds of biological responses in the people who see them, according the University of Wisconsin-Madison. For example, friendly smiles intended as a reward to reinforce behavior appear to physically buffer recipients against stress. However, smiles meant to convey dominance lead to a spike in stress hormones.

“Facial expressions really do regulate the world. We have that intuition, but there hasn’t been a lot of science behind it,” said Jared Martin, a psychology graduate student and leader of the study. “Our results show that subtle differences in the way you make facial expressions while someone is talking to you can fundamentally change their experience, their body, and the way they feel like you’re evaluating them.”

Previous research by the study’s coauthor, psychology professor Paula Niedenthal, PhD, found three major types of smiles: dominance (meant to convey status), affiliation (communicating a bond showing you’re not a threat), and reward (a toothy smile showing people that they are making your happy).

In the recent study, the researchers stressed out 90 male college students by giving them a series of short, impromptu speaking assignments judged over a webcam by a fellow student who actually was in on the study. Throughout their speeches, the subjects saw brief video clips they believed were their judge’s reactions.

In fact, each video was a prerecorded version of a single type of smile: reward, affiliation, or dominance. Meanwhile, the researchers were monitoring the speakers’ heart rates and periodically taking saliva samples to measure cortisol, a hormone associated with stress.

“If they received dominance smiles, which they would interpret as negative and critical, they felt more stress, and their cortisol went up and stayed up longer after their speech,” said Niedenthal. “If they received reward smiles, they reacted to that as approval, and it kept them from feeling as much stress and producing as much cortisol.”

The effect of affiliative smiles was closer to that of reward smiles: interesting, but hard to interpret, Niedenthal said, because the affiliative message in the judging context was probably hard for the speakers to understand. Also, other research has shown that people with greater variation in the rate at which their hearts beat are better able to understand social cues such as facial expressions.

“People vary in how tolerant or capable they are at sitting with and understanding or engaging with social information,” said Niedenthal. “The thing about your body that permits you to take in the information and process it fully, or make sense of it, is the functioning of your parasympathetic nervous system, which manages your breathing and heart rate and allows you to be calm in the face of social information.”

Subjects with high heart-rate variability showed stronger physiological reactions to the different smiles. But, Martin said, heart-rate variable is not innate and unalterable. Many disorders such as obesity, cardiovascular disease, autism, anxiety, and depression can drag down heart-rate variability. That in turn make people worse at recognizing and reacting to social signals such as dominance and reward smiles.

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Newmont Mining Poised for Growth in Gold Sector – The New York Times

TORONTO — Newmont Mining Corp laid out plans on Thursday for new projects to grow gold production and cut costs, while reporting market-beating profits and output forecasts that position it to take the title of wgold nugorld’s largest bullion producer in 2018.

Newmont, whose 2017 production slightly lagged industry leader Barrick Gold, boosted its 2018 capital budget by $300 million, to $1.2-$1.3 billion, after approving a power project at an Australian mine and expansion of a joint venture mine in Nevada.

Chief Executive Gary Goldberg said Newmont’s efforts to attract a broader investor base, by sweetening its dividend and focusing on shareholder returns, is drawing increased interest from generalist investors.

“We need to make ourselves more attractive, which I think we’ve done by upping our dividend yield,” he said in an interview with Reuters.

And as the gold industry studies blockchain technology as a way to confirm ethical and sustainable production, Newmont is interested in trialing it this year, he said.

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Dentists Advised to Stay the Course in Antibiotics Debate | Dentistry Today

pillsTo combat antimicrobial resistance, physicians typically tell patients to complete their full courses of antibiotic treatment. Yet a team of researchers in the United Kingdom not only says that there is no evidence that this approach is helpful, but that it may even make things worse and that patients should stop taking these medications once they feel better.

As physicians and medical organizations such as the Royal College of General Practitioners continue to debate if full or abbreviated treatment is better for preventing resistance, the Faculty of General Dental Practice in the UK (FGDP(UK)) says that nothing should change for dentists, who often prescribe short courses of antibiotics anyway.

“This will be nothing new for dentists. Our advice since publishing the first edition of our guidance in 2001, and in line with the British National Formulary and scientific evidence, has always been that courses of antibiotics should not be unduly prolonged because they encourage resistance and may lead to side effects,” said Nikolaus Palmer, BDS, PhD, editor of the FGDP(UK)’s Antimicrobial Prescribing for General Dental Practitioners.

“Where antibiotics are indicated in the management of dental infections as an adjunct to definitive treatment such as drainage, the evidence is clear that complete resolution occurs within 3 days in most cases. We recommend that antibiotics should be prescribed where indicated for up to 5 days, with patients being reviewed at 2 to 3 days and discontinuing antibiotic use where there is resolution of temperature and swelling,” Palmer said.

The FGDP(UK) further advises patients to return any unused medication they may have to their local pharmacy for safe disposal. Also, the FGDP(UK) has other resources for dentists, including the Antimicrobial Prescribing Self-Audit ToolAntibiotics Don’t Cure Toothache poster, and a patient information leaflet. More information about antimicrobial resistance is available on the group’s antibiotic stewardship page as well.

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Minnesota Has the Best Dental Health; Mississippi Has the Worst | Dentistry Today

visit-dentist-twice-year-846x564Even as more people recognize the importance that oral healthcare plays in overall health, the quality of that oral healthcare varies significantly across the country, according to 2018’s States with the Best & Worst Dental Health from WalletHub.

The states with the best dental health are:

  1. Minnesota
  2. Wisconsin
  3. Connecticut
  4. Illinois
  5. North Dakota
  6. District of Columbia
  7. Michigan
  8. Massachusetts
  9. South Dakota
  10. Idaho

The states with the worst dental health are:

  1. Texas
  2. South Carolina
  3. Florida
  4. California
  5. Louisiana
  6. Montana
  7. West Virginia
  8. Alabama
  9. Arkansas
  10. Mississippi

Rhode Island has the lowest share of the population who couldn’t afford more dental visits due to costs at 37%, which is half of the rate of Georgia, which is the highest in the nation at 74%. Massachusetts has the most dentists per 100,000 residents at 48. That’s three times more than Tennessee, which has the fewest at 16.

Solutions that focus on reducing costs such as evidence-based treatment and silver diamine fluoride and on increasing the scope of care among other dental professionals could have a significant impact on improving oral health in states that face these challenges, according to experts polled by WalletHub. Expansion of dental coverage and school-based treatment would have a significant impact as well, the experts noted.

“Dental healthcare, in my opinion, can be made more affordable when dental hygienists are allowed to practice more independently and in different settings without the direct supervision of dentists. The expansion of dental hygiene mid-level providers (dental therapists) could potentially fill the gap in access to care and reduce costs,” said Elmer E. Gonzalez, MS, RDH, program director and assistant professor of dental hygiene at New Mexico State University.

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Metals: Gold Closes Higher With Dollar Falling

Gold prices closed higher Thursday, supported again by a weaker dollar.

Gold for February delivery swung between small gains and losses and closed up 0.5%, at $1,362.40 a troy ounce, on the Comex division of the New York Mercantile Exchange. Prices have risen to their highest level since August 2016 recently, with the dollar hitting fresh multiyear lows amid international trade concerns. A weaker dollar makes gold and other commodities denominated in the U.S. currency cheaper for overseas buyers.

The WSJ Dollar Index, which tracks the dollar against a basket of 16 other currencies, shed 0.5% before later paring those losses.

Read more via Metals: Gold Closes Higher With Dollar Falling – WSJ

US News & World Report Names Dentistry the Best Healthcare Profession | Dentistry Today

female-associate-dentistIt looks like it’s a good time to be a dentist. US News & World Report has named dentistry the top healthcare profession in the country and number two overall behind software development. Plus, orthodontists came in fifth on the full list, oral and maxillofacial surgeons got the eighth place nod, prosthodontists landed in the sixteenth slot, and dental hygienists were right behind at 17. Dental assistants cracked the chart as well at number 98.

US News & World Report identified professions by analyzing data on the jobs that had the largest projected number of openings through 2026, according to the US Bureau of Labor Statistics (BLS). The news agency then ranked these choices based on a variety of criteria, including median salary, employment rate, 10-year growth, future job prospects, stress level, and work-life balance.

“Dentistry is a fulfilling and wonderful profession for many reasons. It encompasses science, technology, artistry, and the highest level of research,” said Eli Eliav, DMD, PhD, vice dean of oral health at the University of Rochester School of Medicine and Dentistry. “The ability to help patients and improve the quality of their lives is very gratifying. The profession provides ample room to be challenged and grow as general dentists and specialists.”

“I think the agreeable work-life balance says more about individuals placing this important part of their and their families’ well-being high on a priority list—something I find personally very satisfying,” said Ronnie Myers, DDS, MS, dean of the Touro College of Dental Medicine. “This is also inherently seen in applications and acceptances to dental schools, where 50% are women who have often said that the life balances afforded by the profession are very appealing.”

Read more via US News & World Report Names Dentistry the Best Healthcare Profession | Dentistry Today

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