Topics of the day:
1. Non-integrated implants
Dear Dr. Paul Thomas:
Last year "specifically" at June 2 2004, I had an opinion about non- integrated implants in this forum. Now and after a year, I should confess that you have been utterly right. The sardonic part, is that I have now a lecture about the advantages of non- integrated implants to represent. Again thank you.
> From: Orthos68@aol.com
For prevention, the use of Colgate 5000 (a 5ppm flouride) toothpaste used several times per week is one part of my choices. I do not suggest mouthrinses as my good patients will not need them and my bad patients will not use another step in their oral hygiene regime. I try to keep things very simple and simply emphasise the use of toothpaste and instruct them to spit out ... not rinse out.
Another factors is hydration levels, any dehydration reduces the salivary rate and the saliva cannot then increase remineralisation, provide antigens, provide a buffer to raise the pH etc. Have patients drink more water.
Along with this is to reduce dehydration, main culprits are caffine and alcohol. If you see significant wear, consider dehyration as differential diagnosis. Simple things like asking someone to do exactly what they normally do plus have a glass of water when they wake and one for lunch can make a large difference. Often, mouthbreathing is also present so improving nasal function can help.
Another alternative is to fluoride rinses is to alter the mouth's pH by having the person use bicarb soda mouthrinses. This is 1 teaspoon of bicarb in a glass of water. The patient uses this mix and swishes it around 5 times a day. It raises the pH and makes acidophillic bacteria unhappy and introduces bicarbonate ions which can act as a buffer against the pH falling too much. A fresh batch is made daily. Some will not like the taste, with persistence, it can change the oral flora to a less acidic one.
Finally, using remineralisation products such as GC tooth mouse (I have no financial interest in Colgate or GC) or caesin phosphate can remineralise decalcification. A less expensive way to engage milk products is to have the person use the milk as a mouthwash, just not before bed when salivary rates decrease.
Again, the patients that need this most often have selective deafness and I find the best approach is to identify these people before starting treatment and me choosing not to treat.
Some of the comments on GIC have been interesting. I remember using GIC as an undergrad student 28 years ago and it has been in common use in Australia for at least that time. I know this is restorative and not orthoodntic, but in the most recent Australian dental Journal there wasa review article by Tyas and it reported that flouride did not confer protections against secondary caries. I hope some of the above is pertinent.
I made the conversion the week before the AAO. Data was converted before that and went extremely well. A lot has to do with how clean you get your data before converting. They will tell you what will and won't convert. All I can tell you is that the benefits have been so immediate and terrific in spite of all the hardware and software mini glitches that will occur. They will stay focused in support of you during the first up and running period. They should do even better from the feedback we gave for helping doctors convert especially if they and their staffs are computer savvy to start. I had been waiting for something like Dolphin to emerge that was large enough to do it and young enough to move rapidly and dynamically with innovations. I like it. The staff likes it. The patients like it. (no financial interest - just my experience and hopefully yours)
My assistants tell me that Panadent, the company I understand was started by Ron Roth, has stopped selling their compound bite tabs (I have not heard whether or not their sales of articulators is also affected). I suppose we could go back to heating up compound and placing it on the bite fork when taking a face bow record, but thought that I would ask in this forum if there are some other options.
Can anyone help?
(Home of the 2008 Canadian Association of Orthodontist Meeting!)
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