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Great post - thanks tom!
Why do all the ol' timers tell me to specialize?
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Good use of illustrations Tom!!! 
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Tom,
Wouldn't repeated exposure to Doxycycline cause a deep and nearly permanent staining of the teeth?
In our society where a beautiful smile is so important, this is a no-no.
Wouldn't repeated exposure to Doxycycline cause a deep and nearly permanent staining of the teeth?
In our society where a beautiful smile is so important, this is a no-no.
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UBTom,
In the spirit of everyone else's response, great post! I now see that not every kid wants to hide in the washroom and pulling his shirt to conceal his malocclusion!
In the spirit of everyone else's response, great post! I now see that not every kid wants to hide in the washroom and pulling his shirt to conceal his malocclusion!
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to Gavin:
If tetracycline is taken during childhood when tooth organs are still laying down enamel for unerupted permanent teeth, yes there will be intrinsic tetracycline staining (the tetracycline has high affinity for growing hard tissue), which as you mentioned is virtually impossible to get rid of.
Fortunately for us, periodontitis usually happens later in life, after the teenage years (when all the teeth have already erupted) when there is no more amelogenesis taking place. So doxycycline can be used without fear of staining teeth.
One of the other periodontal adjuncts do stain teeth-- Chlorhexidine rinses. These are extrinsic stains though and can be easily removed.
So basically, we just need to be a bit careful when prescribing tetracycline-- Just don't Rx them for kids younger than 15 and we should be OK.
HTH!
If tetracycline is taken during childhood when tooth organs are still laying down enamel for unerupted permanent teeth, yes there will be intrinsic tetracycline staining (the tetracycline has high affinity for growing hard tissue), which as you mentioned is virtually impossible to get rid of.
Fortunately for us, periodontitis usually happens later in life, after the teenage years (when all the teeth have already erupted) when there is no more amelogenesis taking place. So doxycycline can be used without fear of staining teeth.
One of the other periodontal adjuncts do stain teeth-- Chlorhexidine rinses. These are extrinsic stains though and can be easily removed.
So basically, we just need to be a bit careful when prescribing tetracycline-- Just don't Rx them for kids younger than 15 and we should be OK.
HTH!
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Here are some facts:
The population of the US is rising faster than at any time in history.
The number of dentists is projected to fall in the next ten years, both in absolute numbers and especially against the population in general. By 2020 the dentist/population ratio will be the lowest since World War I.
There are still many multiple county areas in the US with no dentists at all serving them.
With state budgets what they are, it is getting harder to open a new dental school and attract faculty necessary to open one. As demand outpaces supply, salaries rise and academia becomes less attractive. This has the vicious cycle of further lowering entrants to dentistry.
The population is aging rapidly and much of the population over 50 in America had no access to flouride or other preventions for many years. They are more likely to require care but less likely to be edentulous. This bulge should last at least 30 more years, at current life expectancies.
The diet and consumption habits of younger Americans are abysmal. Soda in schools everywhere and the like are rotting a lot of teeth. This has undone a lot of the good that preventions were doing.
A GP can learn virtually anything. My GP does some ortho, endo, and prostho as well as general work. He is obviously very successful because he can keep a ton of profitable work for himself. New technologies make it easier for GPs to keep work "in-house".
Yes, a vaccine may make a nice sized long-term dent in the profession, but it would most widely reach those who don't need it. The kids who got the monthly appts for the vaccine would be the same ones who dutifully came in for perfect 15 minute checkups every six months. The kids who were most likely to be at risk would still not get it.
The biggest risk the profession faces is a takeover by managed care, leading to massive cuts in pay and quality of care. This could also allow the scourge of wild government sponsored immigration to take hold, as DMOs complain about being held hostage by dentists. The DMOs would seek tens of thousands of foreign dentists to come in and depress wages to the point of bankrupting the existing practices through a huge oversupply. Government lobbying is a powerful thing, just look at IT and the fake shortages they made up to depress wages.
The population of the US is rising faster than at any time in history.
The number of dentists is projected to fall in the next ten years, both in absolute numbers and especially against the population in general. By 2020 the dentist/population ratio will be the lowest since World War I.
There are still many multiple county areas in the US with no dentists at all serving them.
With state budgets what they are, it is getting harder to open a new dental school and attract faculty necessary to open one. As demand outpaces supply, salaries rise and academia becomes less attractive. This has the vicious cycle of further lowering entrants to dentistry.
The population is aging rapidly and much of the population over 50 in America had no access to flouride or other preventions for many years. They are more likely to require care but less likely to be edentulous. This bulge should last at least 30 more years, at current life expectancies.
The diet and consumption habits of younger Americans are abysmal. Soda in schools everywhere and the like are rotting a lot of teeth. This has undone a lot of the good that preventions were doing.
A GP can learn virtually anything. My GP does some ortho, endo, and prostho as well as general work. He is obviously very successful because he can keep a ton of profitable work for himself. New technologies make it easier for GPs to keep work "in-house".
Yes, a vaccine may make a nice sized long-term dent in the profession, but it would most widely reach those who don't need it. The kids who got the monthly appts for the vaccine would be the same ones who dutifully came in for perfect 15 minute checkups every six months. The kids who were most likely to be at risk would still not get it.
The biggest risk the profession faces is a takeover by managed care, leading to massive cuts in pay and quality of care. This could also allow the scourge of wild government sponsored immigration to take hold, as DMOs complain about being held hostage by dentists. The DMOs would seek tens of thousands of foreign dentists to come in and depress wages to the point of bankrupting the existing practices through a huge oversupply. Government lobbying is a powerful thing, just look at IT and the fake shortages they made up to depress wages.
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Hi, I'm on vacation but heard about this
particular product:
http://www.oragenics.com/replacement.htm
It claims to be a one-time permanent
replacement of oral s.mutans, effectively
preventing caries. The webpage says
the product will only take 7 years of clinical
trials before it is released to the public.
Any thoughts?
particular product:
http://www.oragenics.com/replacement.htm
It claims to be a one-time permanent
replacement of oral s.mutans, effectively
preventing caries. The webpage says
the product will only take 7 years of clinical
trials before it is released to the public.
Any thoughts?
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As a future DDS/DMD GP advances in bio-tech are your best friend. I would say that most folks who fail to procure cradle to grave regular dental checkups for themselves and dependents do so because they have a fear of the unknown economic/medical consequences of such a choice. When we arrive at the point that technology has equipped GPs to deliver an inexpensive lifetime dental maintenance program for everyone, people will seek out that service in droves. It will become automatic with them just like shopping at the grocery store for food.
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