Tuesday, July 23, 2019

DMG Introduces Revolutionary LuxaCrown Chairside Way to Long-Lasting Crowns

 


 DMG today announced that it is now accepting pre-orders for its LuxaCrown️ semi-permanent crown and bridge material. The revolutionary new product will start shipping to customers in September.

LuxaCrown creates long-lasting crowns directly chairside, which saves time and money for both the patient and the practice. The easy-to-make semi-permanent composite crown is highly esthetic and shows remarkable longevity of up to 5 years.
LuxaCrown is ideal for crown and bridge work and implant procedures where phasing of treatment over several weeks or months is recommended, for geriatric and pediatric patients, and for patients who need an immediate same-day crown. LuxaCrown offers patients the confidence, natural esthetics and economy while delivering the high strength, efficiency and reliability dental professionals have come to expect from DMG.

In-vitro studies have demonstrated LuxaCrown’s outstanding mechanical strength as well as its ability to preserve healthy dentition. It is reliably hard and resistant, with an exceptional fracture toughness (> 2 MPa*m0,5) that ensures stable restorations. By giving the remaining tooth long-term protection, LuxaCrown is able to restore the anatomical form and masticatory function and deliver esthetic corrections. It is well suited for the long-term monitoring of treatment success while bridging the gap during healing stages and in difficult restorations.

According to Jack Ringer, DDS, FAACD, FIADFE, “LuxaCrown is an innovative chairside material that can be utilized for a long-term durable and esthetic provisional or semi-permanent restoration in a highly efficient and cost-effective manner.”

For more information about DMG and its category-defining products, please visit https://www.dmg-america.com/.

About DMG 
 DMG manufactures and distributes market-leading restorative materials and preventive products that are internationally recognized for their quality and innovation. Known for breakthrough material technology, including flagship products Luxatemp, LuxaCore Z Dual, and the revolutionary Icon resin infiltrant, DMG is committed to helping the dental profession meet its materials needs through innovation, collaboration and dedication. For more information about DMG products, or to find a sales representative, please visit online at www.dmg-america.com, or call (800) 662-6383.

Monday, July 22, 2019

Ultradent Announces Support ofOut of Darkness Suicide Prevention Walk

 


Ultradent Products Inc. is honored to announce its participation and support of the upcoming Out of the Darkness Suicide Prevention Walk Saturday, September 14, at Liberty Park (600 E. 900 S.) in Salt Lake City. Opening ceremonies begin at 11am, and the 5k Out of the Darkness Walk begins at 11:30am. Any employee, family member, or friend of Ultradent employees are invited to join in on the walk, or to donate. Ultradent hopes to rank as the number one team this year in fundraising, and encourages all employees to register to walk and/or to donate and/or encourage friends and family to support the cause.

There are currently four ways employees can participate and/or donate to the Out of the Darkness Suicide Prevention Walk. These include inviting friends and co-workers to join the Ultradent team (extra black Ultradent tee-shirts will be available at the park); inviting those who cannot attend to donate to the Ultradent team; sharing the Ultradent team’s donation page via social media; and emailing the link to Ultradent’s team donation page to friends.

Ultradent invites everyone to participate in any way they can. To register for the walk or to donate, please visitwww.afsp.org/slc, join “Team Ultradent,” and donate the desired amount as an Ultradent team member. Remember, even non-employees of Ultradent can join the Ultradent team, so let’s raise some incredible awareness and support for this worthy cause.

Thursday, July 18, 2019

DryShield Evaluation Starting Soon

 


I’m excited to let you know that in the not too distant future (as in the next week) the team and I will start an evaluation of the DryShield isolation system.

I’m excited to be able to do this and to provide to all os you my evaluation of DryShield… especially since ewe’ve been doing a pretty vigorous test and evaluation of the Isolite system.  The 2 products are pretty much direct competitors and it will be nice to be able to report back to all of you on the advantages and disadvantages of each.

Anyone who practices knows what it’s like to battle and to attain proper isolation of the field.  Today’s materials, especially bonded ones, require a very organized field that allows the operator to directly control how much moisture is present and how much water/moisture is used.  The long term success of a restoration can be directly affected by moisture.  Water, saliva, blood, and crevicular fluid can ALL create havoc for an operator.  These things *must* be controlled.

I’m also a big fan of competition in any given field.  Competition drives innovation which can create incredible advances on products.  Here is what DryShield has to say about their product, direct from the company website:

PRODUCT DESCRIPTION
DryShield performs all of the tasks of a high-suction evacuator, bite block, tongue shield and oral pathway protector in one easy-to-use device. It’s an intelligent breakthrough in isolation that brings unmatched levels of ease and comfort to doctors and patients alike.
Installing DryShield is quick and easy, transporting your dental office into the future in seconds.
DryShield Pediatric Starter Kit boasts the ground-breaking, U.S. and worldwide patent-pending, autoclavable mouthpiece. DryShield mouthpieces are engineered to be fully autoclavable.
Turn your practice into a 100% DryShield Pediatric practice. Feel the freedom to use DryShield on ALL pediatric patients and procedures. Maximize the full potential of DryShield.
Includes:
• DryShield Isolation System
• Portable Operatory Kit
• Y Connector Kit
• Cleaning Brush
• Autoclavable Mouthpiece X-Pedo (4-pack)
• Autoclavable Mouthpiece Pedo (4-pack)
• Autoclavable Mouthpiece Small (4-pack)
• Autoclavable Mouthpiece Medium (4-pack)


The kit is on its way to my office and should be arriving in the next day or 2.  Once it arrives, my assistant Nicky will be doing the install (I love it when I can turn her loose on a project and *know* it will be done right) and then we’ll get right down to putting DryShield through its clinical paces.

We’ll be using it in a variety of situations and for a variety of procedures.  If you’re interested to find out how it’s going before I post my final evaluation, you can get info on my Twitter feed (@jflucke) or though my Facebook feed or from my Instagram page.  I’ll be updating the social media feeds on Dryshield as I go through my evaluation.  Of course, I’ll also be updating those feeds on any personal or technology ramblings on a regular basis.  Be sure to stay tuned!

Wednesday, July 17, 2019

RESEARCHERS PRESENT KEY FINDINGS ON DETECTION OF WHITE SPOT LESIONS USING THE CANARY SYSTEM

 


Caries detection has become *much* more than just evaluating how “sticky” a pit or fissure feels with a dental explorer.  In fact, the explorer itself is a pretty poor tool for detecting carious lesions in teeth that are not exhibiting obvious cavitated lesions.  Because of that I have pretty much done away with sharp explorer diagnosis when doing clinical exams.  The most predictable and reliable diagnostic devices currently available use some type of digital imaging with light waves that penetrate the intact structure and reveal lesions that are hidden under what appears to be healthy enamel.

Of those devices, The Canary System provides very accurate and reproducible results.  Here is some news about the device that is pretty much  “hot off the digital press”:

The Canary System is sufficiently sensitive to detect early white spot lesions according to a study presented at
the International Association for Dental Research in Vancouver, Canada by Dr. Clif Carey, University of Colorado
Anschutz Medical Campus, School of Dental Medicine. By detecting early white spot lesions, The Canary System
gives an early warning of caries or tooth decay activity allowing for early intervention to preserve the integrity of
the tooth.

Caries or tooth decay will typically start as a white spot. These white spots may appear on various tooth
surfaces and are an indication that destruction of the crystal structure of the tooth has started below the tooth
surface. As the decay process advances, the white spot may not
change in appearance but the underlying tooth structure is being
slowly disrupted and/or destroyed. Waiting for a cavity to
develop is not really the appropriate approach to treatment.
The study also concluded that “The larger Canary Number scale
allows for greater sensitivity in the detection and classification of
the severity of the white spot lesion and is better than a visual
evaluation”.

“The Canary System provides dentists with the ability to detect
and monitor tooth decay on all tooth surfaces, beneath the edges
of fillings, crowns and bridges and underneath sealants. X‐Rays
can only aid clinicians to diagnose decay on the sides or
interproximal areas of teeth once the decay is well advance into
the tooth”, said Dr. Stephen Abrams, co‐founder of Quantum
Dental Technologies. “Visual detection provides very little information on what is occurring beneath the tooth surface. Early detection of tooth decay, before it is seen visually or on an x‐ray means that dentists can treat problems before the decay has destroyed large amounts of vital tooth structure.”
The Canary System, with its unique crystal structure diagnostics, can quantify, image, monitor and record
changes in the structure of enamel, dentin and cementum. It can detect caries beneath opaque sealants, around
the margins of restorations, around orthodontic brackets and beneath interproximal, occlusal and smooth
surfaces. The Canary Cloud enables dentists to view and manage this data and track Canary usage in the office.
The Canary Patient report provides the patient with information on the examination and engages them in their
oral health care.

Tuesday, July 16, 2019

Homeland Security Issues Warning of GE Medical Device Flaw

 


One of my very worst fears is the hacking of healthcare devices.  It’s not just because I happen to be IN healthcare mind you; it’s that lives potentially hang in the balance.  A couple of years ago, back in 2017 there was a virus or worm that was unleashed on Ukraine called NotPetya.  This malicious piece of software suddenly began replicating and spread across Europe.  It caused massive destruction including wreaking havoc on the British healthcare system.  I’ve never seen any evidence, but there could very well have been some deaths due to the effects of this thing in hospitals in the UK.

However, even before the nightmare of NotPetya I have had concerns about nefarious parties hacking into medical devices and either turning them off or changing critical parameters.  Now comes word from the Department of Homeland Security that a vulnerability exists in the following GE Aestiva and Aespire Anesthesia Machines:
  • GE Aestiva  and Aespire Versions 7100
  • GE Aestiva  and Aespire Versions 7900

Here is part of the notice from DHS:

A vulnerability exists where serial devices are connected via an added unsecured terminal server to a TCP/IP network configuration, which could allow an attacker to remotely modify device configuration and silence alarms.
GE Healthcare recommends organizations use secure terminal servers when connecting GE Healthcare anesthesia device serial ports to TCP/IP networks. Secure terminal servers provide robust security features, including strong encryption, VPN, authentication of users, network controls, logging, audit capability, and secure device configuration and management options.
GE Healthcare recommends that organizations utilize best practices for terminal servers that include governance, management, and secure deployment measures such as network segmentation, VLANs, and device isolation to enhance existing security measures.
GE Healthcare plans to provide updates and additional security information about this vulnerability for affected users at the following location:
http://www3.gehealthcare.com/en/support/security
NCCIC recommends users take defensive measures to minimize the risk of exploitation of this vulnerability. Specifically, users should:
Minimize network exposure for all medical devices and/or systems.
Locate medical devices behind firewalls and isolate them where possible.
Restrict system access to authorized personnel only and follow a least privilege approach.
Apply defense-in-depth strategies.
Disable any unnecessary accounts, protocols and services.
Where additional information is needed, refer to existing cybersecurity in medical device guidance issued by the FDA at the following location:
https://www.fda.gov/MedicalDevices/DigitalHealth/ucm373213.htm
NCCIC reminds organizations to perform proper impact analysis and risk assessment prior to deploying defensive measures.
NCCIC also provides a section for control systems security recommended practices on the ICS-CERT web page. Several recommended practices are available for reading and download, including Improving Industrial Control Systems Cybersecurity with Defense-in-Depth Strategies.
Additional mitigation guidance and recommended practices are publicly available on the ICS-CERT website in the Technical Information Paper, ICS-TIP-12-146-01B--Targeted Cyber Intrusion Detection and Mitigation Strategies.
Organizations observing any suspected malicious activity should follow their established internal procedures and report their findings to NCCIC for tracking and correlation against other incidents.
No known public exploits specifically target this vulnerability.

The good news is the last line above.  No known public exploits have yet been discovered.  However, I’m afraid this is a situation we’ll be seeing more of in the future.  For the full rundown on this exploit, follow this link.

Monday, July 15, 2019

ADA Files Complaint about SmileDirectClub withFederal Trade Commission’s Bureau of Consumer Protection

 


For those of you who didn’t hear or see the announcement, on Thursday July 11th the American Dental Association announced that they have filed a complaint with the Federal Trade Commission’s Bureau of Consumer Protection regarding the business pratices of Smile Direct Club.  The press release does a better job of describing the situation than I can so I’ll let you read it direct from the ADA.

The ADA is a strong advocate for the public and the profession. We are also strong advocates on the issue of direct to consumer orthodontic aligners.  For that reason, the ADA has filed a complaint with the Federal Trade Commission (FTC) against SmileDirectClub, L.L.C. (SDC).
In compiling its citizen petition with the Food and Drug Administration, the ADA identified a number of advertising and marketing claims of SmileDirectClub. The ADA believes these are false and misleading, and constitute substantive deceptive acts under Section 5 of the Federal Trade Commission Act.”
Therefore, on June 27, the American Dental Association (ADA) sent a complaint letter to the FTC’s Bureau of Consumer Protection citing the following practices of SmileDirectClub that the ADA believes to be deceptive:Informing customers they have recourse against SDC via arbitration when, in the same document, SDC hides a “small print” provision obligating the customer to waive any and all rights the customer “or any third party” may have against SDC;
Encouraging consumers to become customers by telling them individually and directly that SDC aligners will correct their overbite, underbite, and crossbite conditions or their “extreme” malocclusion, and then, when customers complain, SDC invokes other SDC documents that state its aligners cannot treat bite conditions at all and can only treat mild to moderate teeth misalignment, not “extreme” misalignment; and,
Claiming that SDC customers receive the same level of dental/orthodontic care as actual dental patients when actually SDC and its “affiliated dentists” provide virtually no care and, contrary to its prominent and repeated claims, SDC does not use teledentistry.
The ADA considers it our duty on behalf of the public to make the regulatory agencies aware of concerns with direct to consumer orthodontics.
We will continue to keep you apprised of developments.
Sincerely,


Jeffrey M. Cole, D.D.S., M.B.A.
President
American Dental Association

Thursday, July 11, 2019

Isolite 3 Evaluation Complete

 


For over a month now we’ve been using and evaluating the Isolite 3 from Zyris and I have to admit that I have come away very impressed.

For those of you who may not be completely knowledgable about the system, the Isolite 3 is a retraction, vacuum, and illumination device.  It provides a bite block, tongue, and cheek retraction in a disposable mouthpiece.  The system is connected to the office vacuum pump.  The mouthpiece has several holes that provide incredible removal of water and saliva leaving a dry well isolated field in which to work.  The non-disposable part of the system has 2 high intensity LEDs.  One of the LEDs is bright white from illumination of the field while the other is orange and works as illumination while performing procedures with light sensitive materials such as composites.  It allows the field to be brightly defined without worry of premature photo polymerization.

We have used it in a variety of clinical situations.  It makes things remarkably easy.  Whether it’s for operative or fixed prosthetics, the device makes treatment *much* easier to perform.  By retracting all tissues, lighting the field, and keeping the field dry the Isolite has been a welcome addition to the armamentarium.  One of the really great things about the parent company Zyris is their commitment to educating offices on proper usage.  The staff went thought a very detailed live online training utilizing 2 way video that allowed the trainer to show us the proper way to place the device and then she watched the staff place it on each other and offered suggestions.  when the training was complete we all walked away with a high degree of confidence.

In clinical usage I can assure you that the training paid off.  Without training, the Isolite learning curve would have been much greater.  Instead, it was placed and we were off to work.  The device made me more efficient and helped free up the assistant as well.

After each procedure where it was used I took time to talk to the patient and get their honest evaluation.  In all of the procedures, only 1 person said they would prefer to have treatment without it.  All the others stated it was comfortable and they loved being able to close on the bite block.  Many also commented on the fact that the vacuum system also worked extremely well and that they preferred it over the standard way.

If you are looking for a way to increase you efficiency while also making patients more comfortable I feel you should check out the Isolite 3 by Zyris.  This product is highly recommended.

Wednesday, July 10, 2019

Beware of Scammers Impersonating the Drug Enforcement Agency

 


This post is a warning for fellow practitioners.  As everyone knows, prescribing and laws that govern it have been undergoing a lot of scrutiny lately.  This is especially true in regards to prescribing of any type of pain control medication.  Due to the over prescribing of some renegade pill mills, there is a much greater focus on those of us authorized to prescribe these medications.

The last thing a law abiding doctor wants is to receive contact from a government agency… especially one that has the potential to remove prescribing privileges or begin felony prosecution.

However, the bad guys are also well aware of this.  They are fully aware that contact from the DEA is bound to strike fear into the hearts of prescribers.  Because of that, nefarious parties are  now contacting practices and they are impersonating the DEA and threatening aggressive legal action unless a large fine is paid immediately over the phone.  Do not fall for this scam!

Here is the lowdown on this scam direct from the DEA:

The Drug Enforcement Administration urges its DEA-registered practitioners and members of the public to be cautious of telephone calls from criminals posing as DEA or other law enforcement personnel threatening arrest and prosecution for supposed violations of federal drug laws or involvement in drug-trafficking activities.

DEA continues to receive reports from practitioners and the general public, alike, indicating that they have received calls threatening legal action if an exorbitant fine is not paid immediately over the phone. The callers typically identify themselves as DEA personnel and instruct their victims to pay the "fine" via wire transfer to avoid arrest, prosecution, and imprisonment.

The reported scam tactics are continually changing, but often share many of the following characteristics:
Callers use fake names and badge numbers or, alternatively, names of well-known DEA senior officials.
The tone of calls is urgent and aggressive; callers refuse to speak or leave a message with anyone other than the person for whom they are calling.
Callers threaten arrest, prosecution, and imprisonment, and in the case of medical practitioners, revocation of their DEA numbers.
Callers demand thousands of dollars via wire transfer or, in some instances, in the form of untraceable gift cards taken over the phone.
Callers falsify the number on caller ID to appear as a legitimate DEA phone number.
Callers will often ask for personal information, such as social security number or date of birth.
When calling a medical practitioner, callers often reference National Provider Identifier numbers and/or state license numbers. They also might claim that patients are making accusations against the practitioner.

It’s important to underscore that DEA personnel will never contact practitioners or members of the public by telephone to demand money or any other form of payment. DEA will not request any personal or sensitive information over the phone. Notification of a legitimate investigation or legal action is made via official letter or in person.

Impersonating a federal agent is a violation of federal law.

Anyone receiving a telephone call from a person purporting to be a DEA special agent or other law enforcement official seeking money should refuse the demand and report the threat using the online form or by calling 877-792-2873. Reporting scam calls will greatly assist DEA in investigating and stopping this criminal activity. Any urgent concerns or questions, including inquiring about legitimate investigations, should be directed to the local DEA field division.

To report scam activity online, visit the DEA Diversion on line reporting page.

For contact information for DEA field divisions, visit the domestic division page on DEA.gov.  

Tuesday, July 9, 2019

Malware and Ransomware Now Being Spread by "Affiliate Programs"

 


As if the entire problem with data theft and Ransomware isn’t bad enough, now comes word that the creators of these programs are working to create networks of individuals who can help spread the codes and to help infect more unwary users and businesses.. for profit.

The information comes from one of my favorite places to read and learn about cyber security, Krebs On Security.  Brian Krebs is a journalist and a relentless researcher of anything having to do with computer security.  He is at the forefront of reporting in this space and even has the respect of the hackers he researches and tries to warn the world about. 

Recently I was reading a story that Brian had posted about the GandCrab Ransomware.  He has discovered that the individuals who created the program began to distribute it as “ransomware as service”.  In a nutshell this means the hackers delivered the code to others who then designed SPAM operations to generate installs of GandCrab.  For doing this, the spammers received a commission on every ransom that was paid.  This allowed the program’s designers to concentrate on creating better and more toxic versions of the malware while leaving the expansion and spamming to other parties.

Utilizing this method allowed GandCrab to proliferate at an amazing rate.  So much so that “In one year, people who worked with us have earned over US $2 billion,” says a statement by the Internet voice of the Gandcrab creators.  This quote was part of a much larger statement by the GandCrab creators who spoke out to announce their retirement from the ransomware industry.

Another part of the statement reads:

“We ourselves have earned over US $150 million in one year. This money has been successfully cashed out and invested in various legal projects, both online and offline ones. It has been a pleasure to work with you. But, like we said, all things come to an end. We are getting a well-deserved retirement. We are a living proof that you can do evil and get off scot-free. We have proved that one can make a lifetime of money in one year. We have proved that you can become number one by general admission, not in your own conceit.”

The frightening part of this to me is that successful business practices are quickly copied and implemented by competitors.  Rest assured that other creators of malware are reading this and adjusting accordingly.  The fight against “malware as service” is going to get a lot more difficult.

Monday, July 8, 2019

Charcoal Toothpaste: Even Tech Websites Say the Risks Outweigh the Potential Benefits

 


I’ve been reporting and commenting on this subject for a while now… even as recently as May of this year.  The straight up truth is that charcoal toothpastes are a fad.  There is very little science to back up the claims being made.

It seems that every year or so some new “miracle” product comes along that touts the possibility of amazing things.  Weight loss, better complexion, growing hair, you name it.  The last 1 or 2 years, one of these “miracle products” has been toothpaste with activated charcoal.  My article from May emphasizes that these do NOT whiten teeth.

Recently I came across an article on Cnet.com that discusses this subject in some pretty good depth.  Personally I love Cnet .com because they have really great tech writers and they cover almost the entire tech spectrum.  If you have a passion for technology like I do, it’s a great place to bookmark and browse.  So while I was perusing articles the other day, I came across a great article that discusses claims and facts about charcoal toothpastes.

The author, Amanda Capritto, even goes so far as to call it “Internet elixir” which I think fits rather well with this topic.  Here are a few other things she has to say:

Because of its super absorbent properties, activated charcoal is thought to detoxify your mouth and super-clean your teeth by latching onto bacteria, tartar, food residue and stains, and stripping them all from your mouth.
The supposed result? A cleaner mouth and brighter, whiter teeth.
Keep in mind that the evidence on charcoal toothpaste itself is limited -- even called insufficient by some scientists-- so no one can yet definitely claim that charcoal toothpaste whitens or cleans your teeth better than any other toothpaste. In fact, one study compared activated charcoal toothpaste to other toothpastes and found that the charcoal brand performed no better than the others.
There's plenty of anecdotal claims that charcoal toothpaste prevents cavities or otherwise promotes better oral health, but again, there's no sound scientific evidence to support those claims. 

This is a really well done article by someone with no ax to grind and no financial incentive to agree or disagree with this entire subject.  If you would like to read the entire article (which I recommend),https://www.cnet.com/news/charcoal-toothpaste-why-the-risks-outweigh-the-benefits/ head on over to Cnet and check it out.

Thursday, July 4, 2019

Happy Independence Day!

 


As an American I cannot be more grateful to live in the United States of America.  While I realize there are a lot of nice places on Earth with freedoms similar to ours, I’m grateful to be living where I am.

Today, I’d like to make a special post to those who give of themselves to keep us safe.  I recently finished a book titled The Eleventh Day: The Full Story of 9/11 and Osama bin Laden by Anthony Summers.  It is a terrific read if you have any interest in the history of that tragic event.  It’s well written and covers the story from multiple angles.  It is *highly recommended* if you like this sort of thing.

One of my big takeaways from the book is the incredible and almost incomprehensible bravery of those who ran into the buildings while anyone with a shred of self preservation was running out of the buildings.  We often salute those who are serving or have served in the military and rightfully so.  Often folks will talk about veterans and first responders and I have to admit that while I appreciated the efforts of all of those covered by the description of “first responders” I didn’t really think that much about it.  After reading this book, I’ve got a whole new appreciation for what they do.

Lots of first responders died on 9-11 and many many more passed of injuries sustained, including breathing all of the dust and pollutants.  Many of them realized that they were breathing poison… and went into the fray anyway.  Some died in the collapse.  Some even died by being hit by victims who jumped from the burning towers.

This post is totally inadequate to indicate just how grateful I am and how humbled I am by the incredible sacrifices of ALL the people who put their lives on the line every day.  God Bless all of you and the most heartfelt “thank you” I can muster.  You are all truly heroes.  Thank you for your service.

Wednesday, July 3, 2019

Over Half of Medical Devices Operate Utilizing Systems that will Soon be Insecure

 


Healthcare systems are incredibly technology dependent.  Now, as we are moving more and more into IoT (Internet of Things) with tons of connected devices,  that dependency is growing exponentially.

However, a problem lurks in all of this tech in the healthcare sphere and that problem is security.  A recent evaluation from Forescout shows how vulnerable the current state of healthcare truly is.  Forescout uses Device Cloud "a repository of host and network information for more than 8 million devices. For this study, researchers limited Device Cloud analysis to 75 healthcare deployments with over 1.5 million devices”.  This has allowed the company to get a pretty good overall feel of what is happening in the industry.

What they found is that the healthcare sector is utilizing a huge number of devices that either operate on old, insecure legacy software or do not have adequate security to protect from unwanted attacks.

For the medical networks examined, they determined
The most common devices on medical networks are still traditional computing devices (53 percent) followed by IoT devices (39 percent), including VoIP phones, network printers, tablets and smart TVs. OT systems, including medical devices, critical care systems, building automation systems, facilities, utilities and physical security, comprise eight percent of the devices on medical networks.
Within the OT device category, the three most common connected medical devices found were patient tracking and identification systems (38 percent), infusion pumps (32 percent) and patient monitors (12 percent). Considering the growing number of vulnerabilities in OT environments, we can see an increase in the attack surface in healthcare environments.

The potential security issues arise when you consider that 71% of the Windows devices are currently using some version that Microsoft is planning to no longer support as of January 14, 2020.  When they are no longer supported, those systems will no longer be receiving security updates to patch them from vulnerabilities.  Obviously it would be impossible to update all of those systems to a current operating system.  Many healthcare systems would cease to function properly if their OS were updated.

That leaves a bit of a security mess.  With attacks in the healthcare sector increasing at an almost exponential rate, keeping systems secure is critical.  For all the info on the Forescout analysis, click here.

Tuesday, July 2, 2019

ZOLL Creates AutoPulse Resuscitation System




Here is an incredible device that is definitely going to save lives.  About 15 years ago, the AED (automated external defibrillator) hit the market.  Those incredible devices, when attached correctly to the patient, can monitor the heart rhythm and apply a needed electric shock to bring a heart in V-fib back into a normal sinus rhythm.

Now comes another device which I think will quickly become just as common place as the AED.  The device is the ZOLL AutoPulse Resuscitation System.  Here is what the website has to say:

High-quality CPR Without Interruption
The AutoPulse® Resuscitation System provides high-quality automated CPR to victims of sudden cardiac arrest. Easy to use and battery operated, AutoPulse squeezes the patient’s entire chest to improve blood flow to the heart and brain.1,2,3 The only device of its kind, AutoPulse automatically sizes to the patient, and has shown improved outcomes in numerous clinical trials.4,5
Designed for Patient Movement and Transport
When the AutoPulse Resuscitation System’s stabilizing board is placed on a soft stretcher, rescuers can continue providing high-quality CPR down steep stairwells, around sharp corners, or even in a cramped elevator. Compared with manual CPR, AutoPulse has been shown to reduce interruptions in compressions during transport by more than 85%.6 The AutoPulse Resuscitation System is made for Resuscitation on the Move™.

The idea is that this system will perform CPR properly for a much longer time than a human rescuer can provide.  CPR training, since its inception, has relied on the skill and the memory of the provider.  Unfortunately many who end up performing CPR are individuals with minimal medical training and in the confusion and panic of the moment often don’t provide CPR correctly.  The AutoPulse can hopefully help eliminate that problem from the treatment loop.

I can imagine that it won’t be too terribly long before these devcies begin appearing in public places right next to the AED.

Monday, July 1, 2019

Transillumination from Different Angles

 


Transillumination is a pretty cool and handy thing in dentistry.   In its most basic explanation, transillumination is passing photons through a substance (in this case tooth structure) and being able to examine the tooth from the other side.  The idea being that the light is reflected and refracted by variations in the structure.  For instance, shining a light from the buccal surface and observing from the lingual surface can reveal dark areas indicative of decay between the teeth.  

It can also show cracks, fractures, decay in pits and fissures, as well as other pathologies of teeth.  Personally I find the use of transillumination to be very helpful.  While it is NOT a replacement for routine radiographs (x-rays) it can aid in diagnosis for cases where radiographic images are not completely definitive or in situations such as a pregnant patient.  It can also be extremely helpful in situations of pain from cracked teeth or from injuries sustained from some type of traumatic impact.


There are a lot of transillumination devices that are readily available to purchase in dentistry.  All of them work well.  Probably the best known currently is the Kavo CariVu (called the DiagnoCam outside the US… no idea why).  The CariVu uses transillumination via near infrared energy and combines the transillumination with a camera lens that takes a picture of the tooth, allowing you to record what you see.  You can rotate the device around the tooth in "live" mode to get views from multiple angles and then freeze the image if you want to save it.  The near infrared energy is invisible to the human eye, but captured by the CCD in the device.  This wavelength of light is easily disrupted by changes in tooth structure (more so than visible light) which helps improve the accuracy.

However, what if you are working on a very tight budget?  Is there a way to utilize the advantages of this technology without having to make a major capital investment?  In some ways, yes it’s possible.  There are some curing lights on the market that have small “snap on” type attachments for the curing head that focus and create a small aperture for the light to shine through.  Usually these attachments are designed for “spot cure” situations such as bonding on veneers or other indirect restorative prosthetics.  A spot cure lens allows the user to cure just a small amount of the luting material, which holds the restoration firmly in place, while leaving the remaining material soft and easily removed from the margins.  Once the margins have been addressed, the spot cure lens is removed and the entire restoration is polymerized into place.

However, these spot cure attachments can also be used to focus a small amount of the curing light into the interproximal areas of teeth to transilluminate the area.  The only drawback to this method is that most curing lights are very intense, emitting photons in the range of 1000mw/cm2.  Lights of this intensity and in the 400-500 nm range can cause eye damage over the span of a career in dentistry.  To prevent that, the observer should wear orange eye protective glasses.


There is a company that offers a nice alternative to this.  The DentLight company has created the Fusion 5 curing light.  One of the genius parts of its design is the ability to swap the LED head.  There is a head for composite curing (blue), a head for oral cancer detection (violet), and a head for transillumination (white).  All the head sizes are the same, meaning that the spot cure attachment for the curing head will also snap onto the transillumination head.  Since the transillumination head is white LEDs there is no danger to the users eyes and the spot cure attachment focuses the light in a small spot size directly into the area needing evaluation.

The nice thing about this particular device is that it is multifaceted.  Rather than needing to purchase multiple devices for different uses/procedures, you can purchase one device with multiple uses.  This means less cash outlay and, perhaps even more importantly, fewer devices to keep track of, maintain, etc.  Swapping the different LED heads is simple and easy.  The curing light portion is also incredibly bright providing for good depth of cure, but that is a post for another day.


Finally I wanted to tell you about a little known device that can also help with transillumination.  As a tech nerd, I love American Science & Surplus.  The company has all kinds of interesting and affordable products and devices.  I love to browse the site just to see what wild and unusual things they have for sale.  It’s like a giant garage sale for gear heads at this site & most of the products are really easy on the wallet.

The other day I was browsing the site and lo and behold what did I find?  A device called a “Fiber Optic LED Bore Light”.  Basically the device is a small bright LED flashlight with an attachment that fits over the end which focuses the light into a small, clear acrylic fiber optic tip.  The device is sold as a way to look into hard to reach areas, but to me it looked like a nice little transilluminator.  Considering the price is $4.95 US I thought getting one was a no-brainer.  If it doesn’t work?  I’m out $5.

It turns out the little device works pretty darn well.  You can wrap it in a sheath used for your curing light so that there is no worry about cross contamination.  So if you are looking for a way to do transillumination and you are on a tight budget, this might be for you.  The best part is that for the price you can afford to have one in every treatment area too.  If you happen to get one, leave a comment below.  I’d love to hear what you think about it.  Actually I’d love to hear your thoughts on anything that I discuss here, so feel free to leave a comment.

Now also remember, all you can do with this is light up teeth.  There is no curing, no cancer screening, no ability take pictures, etc.  However for $4.95 it's not a bad little gadget.