Sleep Apnea Increases Blood Pressure and More | Dentistry Today

Man-sleeping-and-snoring-overhead-viewSleep apnea can increase blood sugar and fat levels, stress hormones, and blood pressure, even if it’s left untreated for just a few days, according to the Johns Hopkins University School of Medicine. The study also produced additional support for the use of continuous positive airway pressure (CPAP) to keep the airway open in treating obstructive sleep apnea (OSA), which affects 20% to 30% of adults.

“This is one of the first studies to show real-time effects of sleep apnea on metabolism during the night,” said Johnathan Jun, MD, assistant professor of medicine at the school and senior author of the study.

OSA has been associated with risks for diabetes and heart disease, yet there has been no consensus on whether it causes these disorders or if it is just a marker of obesity, which predisposes patients to diabetes and heart disease. Also, previous metabolic studies of patients with OSA usually collected data while participants were awake, obtaining a snapshot of its aftermath, not the actual sleep period when OSA occurs.

To better understand how OSA affects metabolism, the researchers measured free fatty acids in the blood, glucose, insulin, and the stress hormone cortisol while participants slept in a sleep laboratory at the Johns Hopkins Bayview Medical Center. The participants’ brainwaves, blood oxygen levels, heart rates, and breathing, along with eye and leg movements, were recorded each night of the study.

Read more via Sleep Apnea Increases Blood Pressure and More | Dentistry Today


Investors Big and Small Ramp Up Gold Bets – MoneyBeat – WSJ

Gold Coins Images wide

Photo courtesy of this wallpaper

By Chris Dieterich
Aug 29, 2017 8:54 am ET
Another missile launch by North Korea has investors reaching for gold. The fact that retail and professional investors are now in sync with their bullish bets is sign that the precious metal can continue higher. Gold for August delivery on Monday shot up 1.3% to $1309.70 an ounce on the Comex division of the New York Mercantile […]

Read more via Investors Big and Small Ramp Up Gold Bets – MoneyBeat – WSJ

Palladium Prices Are on a Tear

Palladium barPrices for the precious metal are up 37% this year

Aug. 25, 2017 8:14 p.m. ET

Platinum bulls are hearing footsteps—from the precious metal’s close relative palladium.

Palladium has been a standout even amid the recent boom in industrial metals like copper, surging to its highest levels since 2001 amid a yearslong supply deficit. For the year, prices are up 37%, and some analysts and investors think palladium could soon cost more than platinum—a shift that would reverse a longstanding relationship and, in the…

Read the full article via Palladium Prices Are on a Tear – WSJ

Questions to Ask Prior to Root Canal Treatment | Dentistry Today

When one discusses clinical endodontic techniques, it often tends to involve a drill, an endodontic file, or an obturator. But a noninvasive procedure that must not be overlooked, and that which precedes the aforementioned, is that of diagnosing and treatment planning the case at hand.

In this article, the author will review diagnostic techniques in the form of very important fundamental questions that should be asked, along with clinical criteria to consider, prior to every potential endodontic case.

What Is the Origin of the Pain?

While a patient may have oral pain and point to the teeth, the clinician needs to determine if the pain is of an endodontic origin. Perhaps the pain is due to nonendodontic sources such as dentin hypersensitivity, occlusal trauma such as clenching/grinding, or is sinus-related. So, even if the patient points to his or her teeth, the clinician must always keep an open mind when diagnosing the symptoms. One cannot assume it is always endo-related.

Criteria to Consider
Pardon the obvious statement, but endo should be performed only if the clinician is certain that the pain is of an endodontic origin. Such pain should meet the fundamental criteria for pain of pulpal, or apical, origin. This, at least in part, includes symptoms such as lingering pain to hot or cold, no response to pulp tests (with exceptions), and cases with apical pathology (Figure A in the Table). One of the simplest but most important techniques to should use in order to diagnose the pulpal state is a cold test with Endo-Ice (Hygenic) (Figures 1 and 2). To determine common signs of pain of neuromuscular or parafunction origin, one should perform and evaluate the following: palpate for tender or tense masticatory muscles (Figure 3) and look for occlusal wear facets (Figure B in the Table) or nonlocalized pain that either wakes the patient up at night or is present upon waking up in the morning.

Read more via Questions to Ask Prior to Root Canal Treatment | Dentistry Today

Desktop Device Diagnoses What Causes Bad Breath | Dentistry Today


Photo courtesy of Dentistry Today

Halitosis is no laughing matter. Bad breath can be the result of a range of problems, from the need for a good cleaning to systemic illnesses like acid reflux or diabetes. Nissha USA’s OralChroma is designed to help dentists identify those causes so effective treatment can begin, restoring fresh breath as well as good health.

“The OralChroma is a gas chromatograph. The only one of its kind currently available in the marketplace,” said Val Di Giovanni, P.Eng., who has been in the gas sensor industry for more than 25 years and is now the technical consultant of Nissha USA. “It will take a breath sample and analyze it and tell you what levels of the 3 major components of halitosis exist in that breath sample.”

Patients simply blow into a small, disposable syringe. The dental professional then inserts the syringe into the OralChroma, which analyzes the air sample. Within 4 minutes, the OralChroma measures the levels of those halitosis components in the sample. It then sends its findings to a computer that runs the associated data management software and presents the results.

The first component, hydrogen sulfide, is directly related to oral hygiene. Patients who haven’t been brushing or flossing, or those who haven’t had a recent cleaning or scaling, may see a buildup of organic debris on the dorsum of the tongue, producing the bad breath.

Methyl mercaptan, the second component, is associated with the bacteria that cause periodontitis, gingivitis, pockets, and cavities. The third component, dimethyl sulfide, is blood borne and comes from elsewhere in the system, possibly resulting from digestive issues, liver or kidney disease, or even cancer.

“Once you know the levels of these gases, then the professional involved—whether it’s a hygienist, a dentist, or even a medical doctor with the dimethyl sulfide—uses their experience to treat it,” said Di Giovanni.

A high level of hydrogen sulfide, for example, would prompt the hygienist to initiate a verbal examination of the patient’s diet, followed by an inspection of the mouth to see if cleaning is necessary. After a large methyl mercaptan reading, the dentist would perform an exam to find the infection causing the odor. High levels of dimethyl sulfide may require a referral to the patient’s primary care physician.

Once the source of the odor has been determined, the dental personnel would devise and execute a treatment plan. The OralChroma’s software then monitors the ongoing treatment, maintaining records of the readings from each dental visit and then charting them over time.

Read more via Desktop Device Diagnoses What Causes Bad Breath | Dentistry Today

8 Ways to Reduce Expenses in a Dental Practice

lightCutting out unnecessary expenses in a dental practice is a critical component of becoming more profitable. Fortunately, practice owners can take 8 easy steps to improve their bottom line.

  1. Add motion detectors in examination and storage rooms. Using motion detectors to operate lights and certain types of equipment in examination or storage rooms can greatly reduce energy costs for the practice.
  2. Invest in a waterless vacuum system. Consider investing in a dry or waterless vacuum system, as it can help decrease daily water usage by 300 to 500 gallons. When it comes to cutting costs, a lower monthly water bill can have a tremendous impact on the overall expenses for a practice.
  3. Replace any halogen light bulbs with LED light bulbs. Replacing halogen light bulbs in the practice with LED bulbs can reduce energy usage by up to 75%. LED bulbs also have a longer lifespan than halogen bulbs, making them a more valuable investment for any practice.
  4. Purchase a washer and dryer for the practice. Many dental offices still send their scrubs to the dry cleaner to be cleaned. Installing a washer and dryer directly in your practice can help save time and reduce both cleaning and uniform costs in the long run.
  5. Invest in management software. Consider implementing dental management software such as DAISYfrom Dentists Management to help reduce administrative costs and increase the overall efficiency of the practice. DAISY, for example, is able to organize and manage electronic billing, prescriptions, claims, patient recall, and more.
  6. Look for a cheaper supplier. It is important for dental practices to frequently evaluate the current value of their supplier contracts. By doing so, practices could discover an alternate supplier that provides items such as impression trays and hygiene instruments of similar quality at lower prices. They could even use this information as leverage to negotiate a better contract with their current supplier.
  7. Use reusable patient barriers. Consider using reusable sterilization pouches and patient barriers rather than the disposable alternative. Eco-friendly choices don’t sacrifice on sterilization standards and can lower costs.
  8. Perform collection claim risk-benefit analysis. Sometimes a malpractice claim arises when dentists pursue collection claims, so try to perform a risk-benefit analysis before each collection attempt. If a patient files a malpractice claim, it can sometimes cost the practice more than the original collection would have been.

Read more via 8 Ways to Reduce Expenses in a Dental Practice | Dentistry Today

Sugar Consumption Costs the World $172 Billion in Dental Care | Dentistry Today


photo courtesy of Allen Carr

Global sugar consumption costs the world approximately $172 billion in dental treatment, according to Martin Luther University Halle-Wittenberg (MLU) and the Biotechnology Research and Information Network AG (BRAIN AG). In Germany alone, sugar consumption cost about $23 billion in dental treatment.

The researchers evaluated representative data on the prevalence of caries, inflammation of the gums, and tooth loss, corresponding costs of treatment and the disease burden, and sugar consumption in 168 countries for 2010. Next, they calculated the share of total costs attributable to sugar, including white household sugar and the “hidden” sugar in processed foods such as soft drinks, ketchup, ice cream, frozen foods, breads, cakes, and pastries.

“The data shows a clear correlation between the consumption of sugar and the incidence of caries, periodontitis, and, as a result, tooth loss,” said Dr. Toni Meier of the MLU and lead author of the study. “For every additional 25 grams of sugar consumed per person and day, which amounts to roughly 8 sugar cubes or a glass of sweetened lemonade, the costs of dental treatment in high-income countries increase on average by $100 per person and year.”

Read more via Sugar Consumption Costs the World $172 Billion in Dental Care | Dentistry Today

PRECIOUS-Gold buoyed by global tensions, U.S. inflation data

north korea gold
By Marcy Nicholson and Zandi Shabalala

* U.S. July consumer prices rise less than expected
* Platinum hits five-month high
* Silver on track for biggest weekly gain since Gold prices
climbed to two-month highs on Friday, rising for the fourth
straight day as investors sought refuge amid escalating tensions
between North Korea and the United States, while bullion also
received support from weak U.S. inflation data.
U.S. President Donald Trump issued a new threat to North
Korea on Friday, saying the U.S. military was “locked and
loaded” as Pyongyang accused him of driving the Korean Peninsula
to the brink of nuclear war and world powers expressed alarm.

Spot gold was up 0.2 percent at $1,287.91 an ounce by
2:03 p.m. EDT (1803 GMT), and set for its biggest weekly gain
since mid-April. It earlier hit $1,291.86, its highest level
since June 7.
U.S. gold futures settled up 0.3 percent at $1,294.
“There is a continuation of flight to the safe havens after
remarks on Thursday evening from Trump about North Korea,” said
Quantitative Commodity Research consultant Peter Fertig. “It’s
not very likely that these tensions will ease in the near future
so the outlook seems supportive for gold.”
Geopolitical risks can boost demand for assets considered
safe-haven investments, such as gold.
“There remains huge uncertainty as to how the current
geopolitical crisis will play out and this may support gold
prices over the coming weeks,” said Capital Economics in a
research note.
“On the other hand, if Trump’s threats prove to be nothing
more than inflammatory rhetoric – as on previous occasions – we
would not be surprised to see the gold price retreat as the
focus of investors returns to Fed tightening.”
Data on Friday showed U.S. consumer prices rose less than
expected in July, which was also supportive to gold.

read more via PRECIOUS-Gold buoyed by global tensions, U.S. inflation data

Flossing vs. Water Pick: Which is better?


photo courtesy of threesixty gh

Answers from Alan Carr, D.M.D.

Standard dental floss is generally considered the most effective tool for cleaning the tight spaces between the teeth. You can also use dental floss to scrape up and down the sides of each tooth.

A water pick (oral irrigator) is a device that aims a stream of water at your teeth. A water pick can help remove food particles from your teeth and might help reduce bleeding and gum disease — but it isn’t generally considered a substitute for brushing and flossing.

If plain dental floss gets stuck in your teeth, use the waxed variety. If you have a hard time handling dental floss, try a floss holder. Other options might include special brushes, picks or sticks designed to clean between the teeth.

via Dental floss vs. water pick: Which is better? – Mayo Clinic

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

To 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.

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