Monday, December 5, 2016

Never *Ever* Download an App Outside of Google or Apple's Store

Probably the best reason for only downloading from the Google Play Store or the Apple App Store is that the apps located therein have been carefully screened by Google and Apple.  That means that the odds of getting any type of malware hidden in your app is pretty slim.
However, there are those of us out there that are cheap enough to download and install apps from places other than “the stores” and often times those apps come with a little something extra… malware.  What do expect for free?  I mean, let’s face it, nothing in life is free.  So hackers are creating very pretty looking and enticing apps that just beg you to install them.  Once installed the malware packet is also installed and begins to do all kinds of nefarious things such as steal your data, etc.
The most recent example of this is Gooligan and it has recently been estimated that at least 1.3 million Android users are infected.  Not only that, but it continues to infect 13,000 new devices every day.  Once Gooligan is installed on your Android device, it steals authentication tokens that can be used to access data from Google Play, Gmail, Google Photos, Google Docs, G Suite, Google Drive, and more.  Nice, huh?
You’ve read here before about Check Point Software Technologies, a company of which I have become a really big fan.  They have done a lot of work on Gooligan and have also been working with Google on the problem.  Here is what Check Point has to say:

“The infection begins when a user downloads and installs a Gooligan-infected app on a vulnerable Android device.”

“Our research team has found infected apps on third-party app stores, but they could also be downloaded by Android users directly by tapping malicious links in phishing attack messages.”

So how does Gooligan work?  Here is a graphic that does a great job of explaining it:
Gooligan Map.jpg

Thursday, December 1, 2016

OCR warns providers to be on the lookout for a fake email

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This was available in the ADA morning huddle newsletter.  The scammers just keep getting better & better…

Washington — The U.S. Office for Civil Rights issued an alert Nov. 28, warning health care providers of a phishing email disguised as an official OCR audit communication.

"It has come to our attention that a phishing email is being circulated on mock Health and Human Services Departmental letterhead under the signature of OCR's director, Jocelyn Samuels," said OCR in the alert. "This email appears to be an official government communication, and targets employees of HIPAA-covered entities and their business associates. 
"The email prompts recipients to click a link regarding possible inclusion in the Health Insurance Portability and Accountability Act Privacy, Security, and Breach Rules Audit Program," the alert continued. "The link directs individuals to a non-governmental website marketing a firm's cybersecurity services. In no way is this firm associated with the U.S. Department of Health and Human Services or the Office for Civil Rights."

OCR urged organizations or individuals with questions about official agency communications regarding HIPAA audits to contact the office via email at

For more information about phishing scams, the Federal Trade Commission website has a resources page here and also has a page with tips for consumers.

The ADA Center for Professional Success also has tips to help ADA member dentists safeguard their practice from hackers.

Wednesday, November 30, 2016

The New Giro MIPS Helmet to Protect Your Skull from Concussions & Other Damage

When I was younger, I used to love to snow ski.  Back in the good old days before age set in, I would fly down the slopes with little concern for personal safety.  Maybe that’s why I got a couple of concussions along the way…

Of course, back then all I had on my head was a hat which wasn’t too good at providing protection when I fell.  The last time I hit the slopes, a couple of years ago, everyone was in helmets, myself included.

Protecting yourself is important, but think about the risk that is taken by professional Olympic skiers.

 They are skiing at ridiculous speeds and when they fall, it’s just like a motorcycle crash on hard packed snow.  Needless to say, the art of protection needs to evolve to protect all of us, and now it has.

The Giro folks have created a fascinating helmet that isn’t just a padded lining in a very hard shell.

 Take a look at the video above.

Then if you want more info on Giro gear, head to the website.

Tuesday, November 29, 2016

Archaeologists Find Earliest Dental Prosthesis In Medieval Tomb

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It looks like a team of archeologists from University of Pisa in Italy have found what might be the earliest RPD (removable partial denture) in history.  It consists of a lower left canine and 4 mandibular incisors all attached to a band of metal.  The fascinating and yet terrifying part of the story is that the teeth are not the teeth of the body that was discovered.  You read that right.  These 5 teeth were somehow acquired from another human and then placed in the mouth of a separate human.


Ancient', 'green', or 'borrowed from other people' aren't descriptors many of us would want used to describe our pearly whites.


But all three are apt for a set of dentures unearthed from a chapel in Italy, which could date back to the time of Leonardo Da Vinci.


Archaeologists believe the prosthesis, which is made from a string of human teeth and a strip of metal, could date back as far as the 14th century - making them one of the only sets from the Renaissance period to be found.

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According to English language Italian news website, The Local, the dentures were uncovered during a dig in Lucca in Italy, in the bottom layers of a tomb.

A team from the University of Pisa unearthed the Renaissance false teeth while excavating a family tomb in 2010 where hundreds of skeletons are buried in the chapel of San Francesco.

The site was the tomb for the Guinigi family, an aristocratic group of powerful bankers and traders who governed the city, with generations of Guinigi's buried atop one another.

Dental implants have been recorded as far back as the ancient Egyptians, with Romans and Etruscans also showing signs of having dental work done to fill the gaps.

The first porcelain dentures didn't arrive until the late 18th century, so animal teeth, human teeth, bone, ivory and other tough surfaces were trialled.

Monday, November 28, 2016

How to Simplify Endodontics with Technology

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Back when I was learning to do endo (of course this is when dinosaurs ruled the Earth and dirt had just started to form) there were not a lot of choices for any part of the procedure. Back then it was basically:

  1. Access
  2. Get working length via radiograph
  3. Hand file
  4. Step back
  5. Check fit/length of gutta percha master cone(s)
  6.  Fill with gutta percha

The process was time consuming, inefficient and difficult to perform. In fact, it was so difficult that most general clinicians preferred not to be involved with it. Instead, the majority of root canals were referred out to specialists. Anteriors, and sometimes premolars, were treated in house, but many of those, and especially molars, were referred.

While this did spare the general dentist the frustration of doing the procedure, the entire process of the referral introduced a whole new type of inefficiency into the system. Because so few root canals were performed in general dentistry settings, endodontists were sometimes overwhelmed with the volume of patients. This meant that patients frequently waited longer than they preferred for treatment and consequently the comprehensive dentistry being done in the general dentist’s office also took longer to complete.

Fortunately, many bright minds saw the advantage of improving the entire clinical process of endodontics and over the time since my initial training, we’ve seen amazing and dramatic improvements in the process. We have now reached a point where the procedure is much easier, much more predictable, and many are being performed by general dentists. In fact, according to the American Association of Endodontists, 72 percent of root canals are performed by general dentists.

Related reading: 6 ways to improve tech in your dental practice for the second half of 2016

Endo is one of the procedures in dentistry that can be greatly improved both in decreasing stress to the practitioner and better clinical result to the patient, through the use of technology. Over the years many systems have been created which use a series of proprietary instruments to cleanse, shape, and finish canal preparation.

While often times learning and depending on one system can be all that is needed to complete the majority of cases, there will always be cases that require a little something extra or “outside the box” as the situation may be.

For that reason, over the years I have developed a hybrid technique that incorporates several different systems. This has allowed me to adapt my treatment to a myriad of clinical situations for those times when it’s necessary to step outside the box. For this installment of Technology Evangelist, I’m going to discuss some of the products I keep in my “endo utility belt.” Keep in mind that since I’m using a hybrid technique, my endodontic cases are fluid situations and I do not use all of these products on every case. Also, this is not a “how to” article; there are many more steps and products used than what I am discussing here.

Apex locator

In my humble opinion, an apex locator is an absolute necessity to do quality endo. Today’s devices are small, lightweight and incredibly accurate. Today we are battling what I call “countertop real estate” and any device that takes up significant counter space begins to limit the number of counter-based devices you can have. With apex locators being such small devices, they can become a routine part of your endo setup.

Some of my current favorite devices in this category are the Sybron Endo Elements Diagnostic Unit (an apex locator and electric pulp tester in one unit), the Sybron Endo Apex ID, and the Ultradent Endo-Eze FIND.

Apex locators are now so accurate that I believe their readings much more than I believe the position of a file on a radiograph.

More from the author: The top overlooked technologies your dental practice should be thinking about


Over the years there have been more endodontic files created and marketed than I can even remember. Some have withstood the test of time while others streaked across the dental landscape like a near-miss comet and were gone. Both manufacturers and clinicians are looking for the magic bullet of one design that can do everything. Unfortunately, that design doesn’t exist—at least not yet. Hence my preference for a hybrid technique.

Since I’ve yet to find the magic bullet file, here are some files I keep in the toolbox to help make some cases easier.

Ultradent Endo-Eze Genius files are used with the Genius motor. These files can be used in either reciprocating or rotary motion depending on the clinical situation and the comfort/skill of the operator. Any file that can be used in a reciprocating motion is harder to break.

Coltene Hyflex EDM files are incredibly flexible. This makes them a very nice option when instrumenting curved canals. The other advantage is that while they are nickel titanium, they also possess a property called CM (controlled memory effect) which means they can be pre-curved for instrumentation of highly curved canals. I’ve found this to be a great advantage in curved cases. The other interesting property delivered by CM is that when autoclaved, these files go back to their original straight shape. Personally I advocate a one use file inventory of single use and toss, but if you like to reuse files, these are an excellent choice.

Trending article: The state of technology in dentistry

Sybron Endo Twisted Files are created by twisting nickel titanium wire instead of grinding the cutting flutes into it. This makes the files less susceptible to fracture as they tend to unwind (or untwist) before they fracture. I’ve found these files to be durable and difficult (though not impossible) to break. My philosophy with rotary files is to use as few as possible per case which statistically reduces the incidence of breakage. I have found that when using TF files I can frequently complete a case with two rotary twisted files. The first TF is .06 taper and the second is .08 taper.

Endodontic motors

A company can have the best files on the market, but if there is no way to properly use them in the canal system, they do nobody any good. Most instrument companies also have motors in their inventory. I cannot remember ever test driving a motor that didn’t perform, however there have been a couple I have really liked.

The first motor is the Coltene CanalPro CL. From an ease of use and countertop real estate perspective, the CanalPro CL is a dream come true. It is a cordless device that is about the size of a Sonicare toothbrush. Ergonomically it is very easy to hold and is nicely balanced. Since it is cordless, it takes up very little counter space because it does not have a controller unit that it is attached to via a cord. It is fully programmable for up to five different files so you can use it with any rotary file on the market. Just put in the file parameters and you are ready to instrument. The battery will last for 80 minutes of usage and will recharge in just 90 minutes. I have been using this handpiece for about 18 months and it has been a great piece of equipment.

The second motor is the Ultradent Endo-Eze Genius. This motor is corded and has a control unit. It is also fully programmable and works in rotary or reciprocating mode. The reciprocating mode is even programmable to degrees of reciprocation which is a great feature. It has a much smaller footprint than most countertop based motors and comes preprogrammed with the settings needed for the Genius file system. It is included as part of the complete Genius Endo system and is one of the best endo motors I have had the privilege to use.

Trending article: 4 practice-changing technologies

Wrapping up

These are a few of the products that I reach for when performing endo in my practice. They are most assuredly products/devices that have been vetted “in the trenches” over the last couple of years.

Our profession requires that we are planners. If you aren’t good at planning when you enter the profession, it certainly doesn’t take long for the profession to make a planner out of you. Along those lines, we all approach any clinical situation with a plan in mind. Usually we go so far in our planning to even plan what to do if our current treatment scenario doesn’t give us the long term results we were expecting.

If you are a clinician who performs endo, you know what it’s like when cases throw you a curveball. On those occasions when something goes sideways, it’s nice to have a few extra options at your fingertips.

Even if it is something as simple as just having a few different boxes of files in the armamentarium, those little nuances can go a long way to helping work around an unexpected clinical complication. Many of these complications are ones that couldn’t be predicted preoperatively and not the fault of the treating clinician. Frequently these situations are simply something that could not be avoided.

Being prepared and using technology to the best of your, and its, ability can frequently create a favorable outcome simply by being prepared to step outside the box.

Wednesday, November 23, 2016

Teething Tips and Tricks



Parents are always looking for ways to help their babies get through the discomfort of teething.  Frequently the remedies are passed along from family to family with little science to back them up.  Well, the smart people at Texas A&M (go Aggies, for all my A&M friends) have come up with some suggestions and recommendations.  I’ve posted their article below…

After reading, if you are interested in providing some really cool teething toys for your patients check out this page at Ultradent for the Baby Banana and Shark Brushes.  I love them!


Newswise — Your baby is growing up so fast. It seems like just yesterday you were welcoming them home, listening to their first coos and, unfortunately, getting used to some sleepless nights. Now, you’ve entered a new phase: teething. While those new pearly whites sure are adorable, teething is a new experience for baby and one that could come with some challenges. William Wathen, DMD, associate professor at the Texas A&M University College of Dentistry, offers some tips and tricks to get your family through the pains of teething.

When do babies start teething?

Most babies get their first tooth around six months of age, although some can start as early as three months and some as late as eight or nine months. Your child will first sprout their bottom biters, which can cause mild discomfort and curiosity. Typically, their front teeth will appear first, followed by the first molars and then the canines or eyeteeth.

“Your baby may begin chewing on anything they can get their hands on when they’re teething,” Wathen said. “They may be fussy during this time or you may notice that their gums are a little swollen or red.”

What signs of teething should I look for?

Many parents will attribute fever, diarrhea and constipation to teething, however many experts believe these symptoms are not related to teething itself. Instead, teething presents with swollen and tender gums, drooling, irritability, difficulty sleeping and loss of appetite.

Children may put their hands or other objects in their mouths during this time to ease the pain, so it’s not uncommon for them to simultaneously contract a virus or bacteria. Parents should be sure to keep the baby’s common areas clean to help prevent the spread of germs. If your child has a fever higher than 101 degrees, that warrants a trip to your health care provider.

Tips to cope with the pain

It’s tough to see your baby struggling with discomfort, but luckily there are a few things you can do to help ease this tough time for your teething child.

If your baby is fussy, it’s best to give them a plain, solid teething ring. This allows your child to apply pressure to ease the pain on their own. Some parents may opt to chill their teething ring which may help, however, don’t give them a completely frozen ring as contact with extreme temperatures can be harmful instead of soothing.

“Your child’s gums can be sensitive during this time, and your child will know how much pressure they should apply to try and relieve the pain,” Wathen said. “They’re their best teacher and, in this instance, know what they need.”

Another common soothing method is to massage their gums with a clean finger or a cooled washcloth. While this may ease the pain, it will take a lot of give-and-take with your baby. Also, if you’ve began introducing solid food to your baby, cold applesauce or yogurt could offer them some edible relief.

“It’s important to respond to your baby when it comes to coping with the pain,” Wathen said. “Your baby may want more pressure or less pressure, so it’ll take a lot of experimenting to see what works and which areas of the gums are most sensitive.”

One common habit that parents may fall into is giving their child pain relievers, however, it is usually unnecessary. “I do not suggest giving them pain relievers,” Wathen said. “Just remember that teething is a normal event, and if baby has discomfort, it is mild and temporary.”

Another common product that parents may give children is a teething gel, however this can be problematic as well. “Many teething gels contain benzocaine,” Wathen said. “This ingredient can be harmful to babies if they swallow it, which is very likely if it’s on their gums.”

Teething tablets have also been an item of controversy when it comes to relief. The Food & Drug Administration recently publicly warned against the use of homeopathic teething tablets or gels because they pose a major health risk in children.

Your child’s dental health

When your baby starts getting their teeth, it can be very exciting time for them. It’s best to keep the child relaxed and be prepared to clean up a lot of drool.

“A baby will naturally drool a lot during this time,” Wathen said. “It’s a natural response to help cool off inflamed gums.”

By the time your child gets their full set of 20 teeth, at about age 3, it’s very important to have already started caring for their teeth.

“Many parents may ignore the health of deciduous teeth because they aren’t their child’s permanent teeth,” Wathen said. “This is a very bad mistake and can lead to cavities, premature tooth loss and future problems that may need to be corrected by an orthodontist.”

Wathen recommends using a soft pediatric tooth brush with water on a child’s new teeth in between the child’s teeth and gum-line and between the teeth to remove dental plaque, which is made up of cavity-causing germs.

“It’s very important to take good care of your child’s baby teeth,” Wathen said. “They are placeholders for permanent teeth and play a major role in helping permanent teeth erupt into correct place and alignment.”


Tuesday, November 22, 2016

E-cigarettes and flavorings induce inflammatory and pro-senescence responses in oral epithelial cells and periodontal fibroblasts

Here is an interesting study I came across dealing with e-cigs and the oral tissues.  This study appeared in Oncotarget which is a journal that focuses on cancer related issues.  For the full study, here is the link.  The Abstract is below…


Electronic-cigarettes (e-cigs) represent a significant and increasing proportion of tobacco product consumption, which may pose an oral health concern. Oxidative/carbonyl stress via protein carbonylation is an important factor in causing inflammation and DNA damage. This results in stress-induced premature senescence (a state of irreversible growth arrest which re-enforces chronic inflammation) in gingival epithelium, which may contribute to the pathogenesis of oral diseases. We show that e-cigs with flavorings cause increased oxidative/carbonyl stress and inflammatory cytokine release in human periodontal ligament fibroblasts, Human Gingival Epithelium Progenitors pooled (HGEPp), and epigingival 3D epithelium. We further show increased levels of prostaglandin-E2 and cycloxygenase-2 are associated with upregulation of the receptor for advanced glycation end products (RAGE) by e-cig exposure-mediated carbonyl stress in gingival epithelium/tissue. Further, e-cigs cause increased oxidative/carbonyl and inflammatory responses, and DNA damage along with histone deacetylase 2 (HDAC2) reduction via RAGE-dependent mechanisms in gingival epithelium. A greater response is elicited by flavored e-cigs. Increased oxidative stress, pro-inflammatory and pro-senescence responses (DNA damage and HDAC2 reduction) can result in dysregulated repair due to proinflammatory and pro-senescence responses in periodontal cells. These data highlight the pathologic role of e-cig aerosol and its flavoring to cells and tissues of the oral cavity in compromised oral health.